Cis-platinum induction chemotherapy in the multi-modality initial treatment of advanced stage IV carcinoma of the head and neck

S. D. Schaefer, R. Middleton, J. Reisch, E. P. Frenkel

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29 Scopus citations

Abstract

Twenty-eight previously untreated patients with unresectable and radical radiotherapy incurable advanced stage IV squamous cell carcinoma of the head and neck underwent cis-diamminedichloroplatinum (DDP) induction chemotherapy followed by radiation with 6500 rad to the primary and 5000 rad to the supraclavicular area given over six weeks. Of the 26 patients completing this regimen, none had a complete remission after DDP alone. Following radiation therapy, 39% of the patients had a total regression of all disease. This modality converted 16 patients to operable candidates. After surgery, 68% of the patients were in complete remission. Survival was significantly correlated (P ≤ 0.001) with complete disappearance of disease, and surgical intervention was additive to chemotherapy and radiation. Histopathologic staging demonstrated that clinical assessment of residual disease in the neck determined after chemotherapy and radiation of the neck was unreliable. Therefore, radical neck dissection appears indicated in lesions initially staged as N2 and N3 irrespective of the postradiation clinical status of the neck region. Finally, a serious limitation of improved survival duration was the occurrence of disseminated disease in patients whose primary and regional lesions were well controlled.

Original languageEnglish (US)
Pages (from-to)2168-2174
Number of pages7
JournalCancer
Volume51
Issue number12
Publication statusPublished - 1983

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ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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