Treatment of advanced squamous-cell carcinoma of the head and neck with alternating chemotherapy and radiotherapy

Marco Merlano, Vito Vitale, Riccardo Rosso, Marco Benasso, Renzo Corvò, Monica Cavallari, Giuseppe Sanguineti, Almalina Bacigalupo, Fausto Badellino, Giovanni Margarino, Fulvio Brema, Gisella Pastorino, Corrado Marziano, Andrea Grimaldi, Felice Scasso, Giuseppe Sperati, Eugenio Pallestrini, Giacomo Garaventa, Emilio Accomando, Giovanni CordoneGiuseppe Comella, Antonio Daponte, Alessandra Rubagotti, Paolo Bruzzi, Leonardo Santi

Research output: Contribution to journalArticlepeer-review

Abstract

Background. For patients with advanced, unresectable squamous-cell carcinoma of the head and neck, radiotherapy is the standard treatment but has poor results. We therefore designed a randomized trial to determine whether alternating chemotherapy with radiotherapy would improve the survival of such patients. Methods. Patients in the trial had biopsy-confirmed unresectable, previously untreated Stage III or IV, squamous-cell carcinoma of the oral cavity, pharynx, or larynx. They were randomly assigned to chemotherapy consisting of four cycles of intravenous cisplatin (20 mg per square meter of body-surface area per day for five consecutive days) and fluorouracil (200 mg per square meter per day for five consecutive days) alternating with radiotherapy in three two-week courses (20 Gy per course; 2 Gy per day, five days per week), or to radiotherapy alone (up to 70 Gy; 2 Gy per day, five days per week). Results. The 80 patients given chemotherapy alternating with radiotherapy and the 77 given radiotherapy alone were comparable in terms of age, sex, performance status, disease stage, and site of the primary tumor. Complete responses were obtained in 42 percent of the patients in the combined-therapy group and 22 percent of those in the radiotherapy group (P = 0.037). The median survival was 16.5 months in the combined-therapy group and 11.7 months in the radiotherapy group (P

Original languageEnglish
Pages (from-to)1115-1121
Number of pages7
JournalNew England Journal of Medicine
Volume327
Issue number16
Publication statusPublished - Oct 15 1992

ASJC Scopus subject areas

  • Medicine(all)

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