Chemoradiotherapy of head and neck stage IV squamous cell carcinoma with concomitant chemotherapy delivered each day of radiotherapy

An external beam therapy with two fractions a day giving 48 Gy with 16 fractions and 45 days, initialy palliative, has been shown to be well adapted for a simultaneous radiosensitizing chemotherapy employment. Associated to a cisplatin, fluorouracyl, etoposide and hydrea based chemotherapy, it has been applyed to 46 patients with inoperable stages IV ORL tumors including 91% T4, 9% T3, 48% N2N3, 72% performans status equal or less than 2. With a 30 months observation median delay a clinical complete response at 4 months is observed in 93%, with further locoregional relapses in 38%. One year survival is 58%, 2 years 40%, 3 years 35%. These results are equal or better than those obtained with hyperfractionnated, accelerated, hyperfractionnated and accelerated, and classical radiotherapy.