Radiotherapy in combination with low-dose chemotherapy in locally advanced head and neck cancer

A previous preclinical study revealed that the maximal additive effect between chemotherapy (CT) and irradiation (RT) occurred at a low level of CT. Therapy was therefore designed with an oral drug daily given in combination with RT in order to determine the efficacy and toxicity. Locoregionally advanced head and neck tumor patients were treated with simultaneous RT and CT. RT was administered 5 times per week at 2 Gy per fraction in a total dose of 70 Gy. Throughout the treatment 30 mg/kg Tegafur was given daily orally. In the period between 2000 and 2002, 50 patients were enrolled. Complete remission was attained in 60%, with an overall response rate of 94%. Acute mucositis of grade 2 or 3 was observed in 56% (28 patients), and gastrointestinal and hematologic toxicity of grade 2 or 3 occurred in 8% (4 patients). Because of side-effects, the duration of treatment was at most 2 weeks longer. Toxicity was eliminated quickly by careful supportive therapy. In conclusion, it is considered that oral low-dose CT in combination with RT is an efficient and simple mode of treatment for locally advanced head and neck tumor patients with a poor prognosis.