Effective chemoradiotherapy without additive toxicity in locoregionally advanced head and neck cancer

A previous preclinical study revealed that the maximum additive effect between chemotherapy (CT) and irradiation (RT) occurred at a low level of CT. Therapy was therefore designed with an oral drug daily given in combination with RT in order to determine the efficacy and toxicity. Locoregionally advanced head and neck tumor patients were treated with simultaneous RT and CT. RT was administered 5 times per week at 2 Gy per fraction to a total dose of 70 Gy. Throughout the treatment 30 mg/kg Tegafur was given daily orally. In the period between 2000 and 2002, 50 patients were enrolled. In 60%, complete remission was attained with an overall response rate of 94%. Acute mucositis of grade 2 or 3 was observed in 56% (28 patients), while gastrointestinal and hematological toxicity of grade 2 or 3 occured in 8% (4 patients). Because of side-effects, the duration of treatment was at most 2 weeks long. Toxicity was eliminated quickly by careful supportive therapy. In conclusion, it is considered that oral low-dose CT in combination with RT is an efficient and simple mode of treatment for locally advanced head and neck tumor patients with a poor prognosis.