Accelerated hyperfractionated irradiation for head and neck cancer with concomitant use of daily low-dose carboplatin (CBDCA)

From May 1994 to March 1995, 18 patients with head and neck cancer were treated with accelerated hyperfractionated irradiation and concomitant use of daily low-dose carboplatin. Tumors were located in the maxillary sinus, the hypopharynx in five patients, respectively, the tongue in four, the larynx in two and the tonsil, the buccal mucosa in one, respectively. The median age was 60.5 years (range, 38-70). All patients had biopsy-proven squamous cell carcinoma. According to TNM stage (UICC 1987), T3N0 in 5 patients, T4N0 in 7, T3N1 in one, T3N2 in two, T4N2 in one and T4N3 in two, respectively. All patients were treated with 1.6 Gy, twice daily, 10 times a week, with minimum interval of 6 hours between fractions and the total tumor dose to 70.4 Gy. Carboplatin was administered intravenously 15-30 minutes before irradiation at a dose of 30 mg/body/day. The median follow-up period was 6.7 months with a range of 2-12 months. Complete response was observed in 9 patients (50%), partial response was observed in 8 patients (45%). Only one patient with maxillary sinus carcinoma showed no response. Major toxicities, graded according to RTOG criteria were stomatitis and bone marrow suppression. Grade 2-3 stomatitis were observed in 17 patients and Grade 4 was observed in just one patient. Grade 3-4 thrombocytopenia were observed in 22% of all patients, but none of the all was critical. (author)