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.

Carcinoma, Squamous Cell↗

PubMed1983

[Reconstruction of atrophic mandibular ridge with sandwich osteoplasty].

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Alveolar Ridge Augmentation↗

PubMed1983

Present interdisciplinary treatment regimen for advanced head and neck tumours at the West German Tumour Centre, Essen.

Apart from the classic combination of surgery and irradiation, four other treatment modalities are presently being evaluated in advanced head and neck tumours. These are: 1) antineoplastic chemotherapy 2) radiosensitizing agents 3) high LET radiotherapy 4)local hyperthermia Preoperative chemotherapy, followed by surgery and irradiation, has improved the local control as well as survival rates in phase II trials. Cis-platinum may yield some additional benefit due to its radiosensitizing properties. Radiosensitizing drugs such as nitro-imidazoles have so far failed to show any advantage in randomized trials, since neurotoxicity prevented maximum effective concentrations. The same is true for high LET radiotherapy with neutrons as compared to conventional irradiation. Local hyperthermia is considered as a palliation at the present time, when all other treatment modalities have been exhausted. In our centre, the preliminary results of radiotherapy and sensitization with cis-platinum in combination with surgery are encouraging. Some methods are discussed which permit the prediction of prognostic criteria for tumors under treatment. This may contribute to the optimization of individual treatment regimes in the future.

Antineoplastic Agents↗

PubMed1982