PURPOSE: Results are reported from an aggressive chemoradiotherapy protocol for @entity135 . @entity1 AND METHODS: @entity1 with @entity135 were treated with hyperfractionated radiation therapy (72 Gy at 1.2 Gy twice per day) and two courses of concurrent chemotherapy with @entity1487 (1,000 mg/m(2)/d) and @entity900 (20 mg/m(2)/d), both given as 96-hour continuous intravenous infusions during weeks 1 and 4 of radiation therapy. Primary-site resection was reserved for residual or recurrent primary-site disease after chemoradiotherapy. Neck dissection was considered for N2 or greater disease, irrespective of clinical response, and for residual or recurrent @entity135 after nonoperative treatment. RESULTS: Forty-one @entity1 with stage IV disease were treated. @entity137 was significant, with grade 3 to 4 @entity33 in 98%, @entity1282 in 88%, and skin reaction in 85%. @entity221 requiring hospitalization occurred in 51%. Despite feeding tube placement in 35 @entity1 (85%), the mean weight loss during chemoradiotherapy was 13.3% of initial body weight. One @entity1 died during treatment as a result of a @entity358 . At a median follow-up period of 30 months, the 3-year Kaplan-Meier projected overall survival was 59%, disease-specific survival 69%, likelihood of local control without surgical resection 91%, and local control with surgical resection 97%. The likelihood of distant disease control at 3 years was 74%, and distant @entity3 were present in eight of 13 @entity1 who died. CONCLUSION: This chemoradiotherapy schedule produces considerable but manageable @entity137 . Survival and organ preservation are excellent for this poor-prognosis @entity1 cohort. Distant @entity3 are the most common cause of treatment failure.

Maximizing local control and organ preservation in stage IV squamous cell XXXX With hyperfractionated radiation and concurrent chemotherapy.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient', 'PATIENTS'] @entity135 :: ('MESH:D006258', 'Disease') :: ['advanced squamous cell head and neck cancer', 'neck disease'] @entity137 :: ('MESH:D064420', 'Disease') :: ['toxicity', 'Toxicity'] @entity900 :: ('MESH:D002945', 'Chemical') :: ['cisplatin'] @entity33 :: ('MESH:D052016', 'Disease') :: ['mucositis'] @entity358 :: ('MESH:D008171', 'Disease') :: ['pulmonary embolus'] @entity1282 :: ('MESH:D003680', 'Disease') :: ['dysphagia'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastases'] @entity221 :: ('MESH:D005334', 'Disease') :: ['Neutropenic fever'] @entity1487 :: ('MESH:D005472', 'Chemical') :: ['fluorouracil']
@entity135 :: (MESH:D006258,Disease) :: ['head and neck cancer']
