Hyperthermia Combined with Radiation Therapy and Chemotherapy for Locally Advanced Head and Neck Cancer
Abstract
From July 1993 to October 1996, 18 patients with locally advanced head and neck cancers were treated with hyperthermia, radiation therapy, and chemotherapy. Primary tumors were located in nasopharynx (10), base of tongue (4), pyriform sinus (2), and larynx (2). All patients were in stage III or IV(5T1, 3T2, 5T3, 5T4/2N2, 16N3). Microwave hyperthermia, administering twice weekly, was given to enlarged neck nodes and aimed at 42.5-43"C for 60 minutes during each session. Radical dose of irradiation was delivered to primary tumor and regional neck nodes.Concomitant chemotherapy (cisplatin/5FU; carboplatin/UFT) of 2 courses was given during radiation therapy with additional 2-4 courses as an adjuvant treatment. At one month after completion of treatment, 6 patients (33%) achieved CR and 12 patients (67%) had PR. Subsequently, 6 patients had surgical salvage of their neck nodes. Thus, at 3 months follow up, 13 patients (72%) demonstrated local regional control. (One patient who initially had PR turned into CR without surgical interven-tion). Relapse rate of 30% (4 out of 13) was noted. Significant toxicity included mucositis (28% gr. 3), neutropenia (6% gr. 3) and anemia (6% gr. 3). The 12 and 18-month actuarial survival were 93% and 81% respectively. In conclusion, the trimodality approach of hyper-thermia, radiation therapy and chemotherapy proved feasible, effective and safe. Further studies to maximize the effects of this multidisciplinary approach are necessary, preferably in a rospective randomized trial.
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