[Simultaneous cisplatin and radiotherapy of locally advanced squamous cell carcinomas of the head and neck region. A clinical pilot study].

Cisplatin (20 mg/m2 on five successive days, together with hydration and osmotic diuresis) was administered in two treatment cycles to 32 patients with locally advanced tumours (T2-4, N1-3, M0) of the head and neck region. Cisplatin-free interval was at least four weeks. At the same time there was radiotherapy with photons or electrons, daily fractions of 2 Gy four to five times weekly to a final volume dose of 60-70 Gy. Tumour resection was undertaken if there was no tumour involution of at least 50% after 40 Gy and one cisplatin cycle. Total remission rate (complete and partial) was 91%. Complete remission occurred in 22 patients (69%). Biopsies in 14 patients after 40 Gy and one cisplatin cycle indicated that in seven there was no histological evidence of tumour. There was no clinically serious rise in local toxicity. However, erythema and oedema in the radiation fields were more frequent and earlier than with radiotherapy alone. The results indicate that combined cisplatin administration and radiotherapy give the same or even better results than aggressive chemotherapy followed by radiotherapy.