Thermochemotherapy in inoperable head and neck cancer R. KIM DAVIS, MD. FREDERIC A. GIBBS. MD. MICHAEL D. SAPOZINK, MD. MAX FARVER. MD. and GRAYDON HARKER. MD. Salt Lake City. Utah

A combined hyperthermia and chemotherapy approach was used to treat five patients with locally advanced or recurrent squamous cell carcinoma of the head and neck whose tumors had failed to respond to chemotherapy. In two patients, tumor had recurred after initial combined modality therapy (surgery/radiation) and had failed to respond to one course of cisplatln/S-fluorouracll (clsplatin/S-FU) chemotherapy. The three remaining patients were enrolled onto a phase II evaluation of Induction chemotherapy with cisplatinlfluorouracll for advanced head and neck carcinomas and had failed to achieve a partial remission after one treatment cycle. Palpable cervical tumors were heated to 40° to 42° C for 30 to 40 minutes, during which time cisplatln (100 mg/m 2 ) was infused Intravenously. A S-day infusion of S-f1uorouracil (1000 mg/m2/d) followed. Despite less than a partial response to previous cisplatin/f1uorouracll chemotherapy alone. two patients had complete clinical resolution of the heated tumor volume with two cycles of the combined thermochemotherapy approach. One patient achieved a partial remission with this approach. The remaining two patients died shortly after the Initial thermochemotherapy treatment. as a result of progressive tumor growth. The two complete responders were subsequently treated with radiation (1 patient) and radical neck dissection (1 patient) and remained without evidence of disease 2 and 26 months after the completion of therapy. respectively. The toxicity of this combined modality approach was acceptable and appeared to be no greater than had been experienced during earlier treatment with chemotherapy alone. Further studies using a combination of these treatment modalities for locally advanced head and neck carcinomas are warranted. (OTOlARYNGOL HEAD NECK SURG 1990;103:897.)

The management of patients with inoperable squamous cell carcinoma of the head and neck region or who have recurrence of inoperable tumor despite aggressive initial therapy presents one of the greatest challenges to head and neck oncologists. The patient who at presentation is inoperable is at high risk of both local and distal tumor recurrence despite intensive chemotherapy, radiation therapy, or combined modality approaches. I-I>

From the Departments of Otolaryngology-Head and Neck Surgery (Dr. Davis). Radiation Oncology

Thermochemotherapy in inoperable head and neck cancer.

A combined hyperthermia and chemotherapy approach was used to treat five patients with locally advanced or recurrent squamous cell carcinoma of the he...
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