Studies on concurrent radiotherapy and chemotherapy to point to preservation of the prgan and function for head and neck cancer

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The trial of concurrent carboplatin (CBDCA) and radiotherapy for head and neck was initiated in 1990. As a result a better survival was achieved in cancers of the larynx, the oral cavity and the paranasal sinuses. Interestingly the overall survival with larynx preservation was better in the concurrent CBDCA and radio-therapy group than in radiation alone group. So the randomized controlled study has been conducted between CBDCA + Rad and CDDP + Rad group since 1995. The 96 patients were randomized into two groups : CBDCA group 50 cases vs CDDP group 46 cases. The 78 cases were completed ; CBDCA group : 41/50 and CDDP group : 37/46. The 3-year survivals of the complete cases were 87.8% in CBDCA group and 61.5% in CDDP group respectively. If we look at 3-year survival by primary site, CBDCA group : 100% and CDDP group : 64.3% in the oropharynx, CBDCA group : 60% and CDDP group : 83.3% in the hypopharynx, and CBDCA group : 94.1% and CDDP group : 63.2%, respectively. But there was no statistically significant difference between CBDCA group and CDDP group. Furthermore looking at the 3-year survival with larynx preservation, the results were as follows ; glottic : CBDCA : 86.7% vs CDDP : 55.6% (n.s.), supraglottic : CBDCA : 85.7% vs CDDP : 13.9% (p=0.0241). As for T2 cases, there was a significantly difference between the two groups ; CBDGA : 90% vs CDDP 42.1% (p=0.0097). In terms of toxicity, lower incidence and grade of mucositis, and severer bone marrow suppression were observed in CBDCA group, meanwhile higher incidence and grade of mucositis, and lower bone marrow suppression appeared in CDDP group.