Combined treatment of advanced head and neck cancer

Abstract Between 1991 and 1993, 64 patients with inoperable head and neck cancer were randomized to receive either radiation therapy alone (group A) or radiotherapy with simultaneous application of Mitomycin C and Bleomycin (group B). Disease-free survival (DFS) was in group B 37%, and in group A 8% ( p =0.01). DFS for patients with oropharyngeal carcinoma only was in group B 48% and in group A 10% ( p =0.001). Since 1993, 95 consecutive patients with advanced inoperable oropharyngeal carcinoma were routinely treated with above scheme. DFS (55%) was comparable to that of the randomized group B patients. Based on previous favorable experience, the same combination was tested as postoperative treatment in patients operated for advanced head and neck carcinoma. Over 4 years, in patients from radiochemotherapy group, locoregional control (86%) was better than in radiotherapy group (57%) ( p =0.037), as was the overall survival 71% and 43%, respectively ( p =0.036). Patients who benefited by chemotherapy were those with high risk factors.