[Chemotherapy of advanced head and neck tumors. A prospective randomized study comparing the effectiveness of chemotherapy alone to a chemo-radiotherapy procedure]

Abstract

One of the most difficult problems of cancer treatment is the management of advanced squamous cell carcinomas of the upper respiratory tract. For several reasons the surgical resection of the primary lesion and the observed neck node metastases are limited to earlier tumour stages. Advanced and not resectable tumours of T3-4-N2-3-stages have very poor cure rates. Their treatment is based traditionally on radiotherapy and in recent years on combination chemotherapy programmes. 75 patients were entered into this prospective randomised study. 33 of these were treated with two cycles of chemotherapy followed by radiotherapy and 42 patients received three cycles of chemotherapy alone. Both therapy modalities induced tumour response rates of up to 75% but have done little to improve survival. The role of combined radiotherapy and chemotherapy in advanced squamous tumours is not yet well defined. In our group only patients who showed tumour response after chemotherapy actually benefited from radiotherapy.