Background. Patients with advanced, inoperable head and neck cancers have cure rates of approximately 10-15%. In these patients, concomitant chemoradiotherapy seems to improve local control and survival. 5-Fluorouracil(5-FU) administered by continuous infusion and cisplatin plus concomitant conventional radiation therapy may be promising in treating advanced, inoperable head and neck cancers.
Methods. Forty-five evaluable patients with primary nonmetastatic, inoperable head and neck cancers were treated. From January 1987 to April 1988, the patients were treated with cisplatin plus radiation therapy (Group 1) and from May 1988 to November 1990, they were treated with the same combination plus 5-FU, given in continuous infusion (Group 2). Clinical and pathologic responses were assessed after radiation therapy was completed. Patients who relapsed underwent salvage sur- gery, if possible. The disease free and overall survival rates of the patients were evaluated.
Results. The overall response rate (complete and partial response) was 93%, 60°/0 of which comprised complete remissions. Despite the high response rates obtained in the two groups, the time to progression for complete responses and the median survival time were unsatisfactory (13 [Group 11 and 10 months [Group 21 and 17 [Group 11 and 16 months [Group 21, respectively). The toxicity rate from the two treatments was not relevant. A Grade I1 mucositis, according to the World Health Organization,