Platinum based combined modality approach for locally advanced head and neck carcinoma

Radiation therapy delivered soon after cisplatin administration is used for the treatment of advanced head and neck cancer. A radiation dose of 4800 cGy is given in standard fractions, followed by clinical evaluation and either surgical resection or an additional radiation dose of 2000 cGy. The histopathology of the surgical specimens from 21 patients undergoing resection in this protocol is compared with the corresponding clinical evaluation of tumor response. A significant number of both false negative and false positive clinical assessments are revealed by this comparison. In addition, it appears that local control of bulky head and neck cancer is approached by 4800 cGy combined soon after cisplatin. Discussion of the likely bases for this apparently favorable clinical interaction between cisplatin and radiation is presented.