Induction chemotherapy followed by hyperfractionated radiotherapy with concurrent chemotherapy for locally advanced head and neck cancer.

Background: The aim of this study was to improve tumor control, the survival rate and organ preservation for locally advanced head and neck cancer by using induction chemotherapy followed by hyperfractionated radiotherapy and concurrent chemotherapy. Materials and Methods: Thirty-five patients with stage III-IVB head and neck cancer were treated with this protocol. Induction chemotherapy consisted of cisplatin and fluorouracil and concurrent chemotherapy consisted of carboplatin and doxifluridin. Radiotherapy was administered twice a day until a dose of 72 Gy was reached. Results: Twenty-two (63%) and 13 patients (37%) achieved complete responses and partial responses, respectively. In terms of nonhematological toxicities, grade 3 mucositis was observed in 49 % of the patients. The overall 5-year survival was 53.5 % and the progression-free survival was 40.6 %. Conclusion: Response to induction chemotherapy was useful as a predictive factor for ultimate outcome and organ conservation. More intensive regimen or other combination chemotherapy is needed to improve treatment outcome with hyperfractionated radiotherapy.