Mitomycin and fluorouracil with concomitant radiotherapy in head and neck cancer

Forty-two previously untreated patients with predominantly stage IV (35) head and neck squamous cell carcinoma were treated preoperatively with mitomycin and fluorouracil and concomitant radiotherapy with 5,000 to 6,000 rad using a split-course technique. Toxic reactions were acceptable. Five patients developed severe mucositis. The white blood cell count fell to 1,500/cu mm in two patients; the platelet count fell to 100,000/cu mm in three. Other complications occurred in three patients. Eighty-six percent of patients completed advised treatment. Complete response, assessed clinically and with histologic correlation, was 79% at primary sites and 69% at nodal sites. Twenty-seven patients had a complete response (64%). Follow-up currently is between ten and 24 months. Though analysis of disease-free intervals and survival data is premature, the high complete response rates in this study are encouraging.