Comparison of Radiation Therapy and Combined Chemotherapy and Radiation Therapy for Locally Advanced Head and Neck Cancer

Lee, Gyu Taeg; Byun, Jae Ho; Hwangbo, Kwon; Mok, Ji Oh; Kim, Eun Seuk; Won, Jong Ho; Baick, Seung Ho; Choi, Doo Ho; Hong, Dae Sik; Park, Hee Sook

Abstract

PURPOSE: In locally advanced head and neck cancer, radiation therapy is currently unsatisfactory because the end result is often limited regional disease control and survival. A clinical study was carried out to compare the effectiveness between the radiation therapy and the combined chemotherapy and radiation therapy. MATERIALS AND METHOD: Thirty-six patients with previously untreated, locally advanced squamous cell carcinoma of the head and neck were treated with radiotherapy alone and combined chemo-radiotherapy. Induction chemotherapy was administered 2~3 cycles, consisting of intravenous cisplatin (100 mg/m2 on day 1) and 5-fluorouracil (1000 mg/m2/day for 5 days as a continuous infusion) every 4 weeks followed by 7~8 weeks of radiation therapy for a total dose of 60~75 Gy.
RESULTS
1) Among 36 locally advanced head and neck cancer, 17 patients received radiation therapy alone and 19 patients received combined chemo-radiotherapy, respectively. 2) Response rate was 47% (complete response 29%, and partial response 18%) in radiation therapy group and 79% (complete response 37%, and partial response 42%) in combined chemo-radiotherapy group (p<0.05). 3) In median survival, radiation therapy group was 13 months and combined chemo- radiotherapy group was 15 months. Both groups were not significantly different (p>0.05). 4) Treatment related mortality was not noted, but the toxic effects were seen on the half cases of the both groups. Grade II toxicities were similar between the two arms.
CONCLUSION
Combined chemotherapy and radiation therapy was more effective in local control but not superior in survival than radiation therapy alone. Continuous evaluation and identification of proper sequence for the therapeutic modality is supposed to prolong the survival of patients.