A randomized study of adjuvant chemotherapy for cancer of the upper aerodigestive tract

Larry E. Kun, Robert J. Toohill, Paul Y. Holoye, James A. Duncavage, Roger W. Byhardt, Paul S. Ritch, Thomas W. Grossman, Raymond G. Hoffmann, James D. Cox, Tom Malin

Research output: Contribution to journalArticlepeer-review

72 Scopus citations


A prospective, randomized trial of induction chemotherapy in advanced squamous cell carcinomas of the upper aerodigestive tract (UAD) was conducted between July 1979 and September 1982. Eighty-three patients with locally advanced Stage III-IV tumors received standard treatment (STD RX; defined as preoperative irradiation and radical excision or irradiation alone), or induction chemotherapy (CTX) followed by STD RX. Chemotherapy consisted of two cycles of bleomycin (30 units/day by continuous infusions Days 1-4), cyclophosphamide (200 mg/m2 IV Days 1-5), methotrexate (30 mg/m2 Days 1 + 5), and 5-fluorouracil (400 mg/m2 IV Days 1-5). Response to CTX was complete in 2 and partial (>50% reduction) in 27; the overall response rate was 68%. Tumor clearance was documented in 30 40 STD RX patients at completion of irradiation and/or surgery and in 24 43 CTX patients ( 17 29 responders, 7 14 non-responders). Freedom from local-regional disease was noted at 2 years in 53% STD RX and 35% CTX patients (p < .06). CTX patients had a higher proportion of local-regional persistence and recurrence. The difference was apparent only in the subset of patients treated with primary irradiation; local-regional control following irradiation and surgery was equal in STD RX and CTX groups. Survival at 2 years was 43% STD RX and 31% CTX. Disease-free survival in those with clearance was 64% STD RX and 59% CTX. Induction chemotherapy did not improve tumor clearance or survival in this series. Caution regarding local-regional control with CTX and primary irradiation is noted.

Original languageEnglish (US)
Pages (from-to)173-178
Number of pages6
JournalInternational journal of radiation oncology, biology, physics
Issue number2
StatePublished - Feb 1986


  • Head and neck cancer
  • Induction chemotherapy

ASJC Scopus subject areas

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research


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