***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND Single-modality radiotherapy is still considered st and ard treatment for patients with locally advanced unresectable cancer of the head and neck . As treatment outcome is poor , attempts to integrate chemotherapy into the overall management of these patients are ongoing . PATIENTS AND METHODS A r and omized study was undertaken to compare a sequential with a simultaneous chemoradiotherapy program . Between February 1986 and February 1991 , 93 eligible patients with locally advanced unresectable cancer of the head and neck were stratified by WHO PS , T and N class and primary site and then r and omized to receive either three courses of neoadjuvant chemotherapy with cisplatin ( 100 mg/m2 i.v . d 1 ) and 5-fluorouracil 1000 mg/m2/days 1 - 5 by continuous i.v . infusion every 3 weeks prior to definitive conventional radiotherapy of 65 - 70 Gy ( sequential treatment ) , or cisplatin 100 mg/m2 on days 1 , 22 , 43 given simultaneously for the duration of the same conventional radiotherapy ( simultaneous treatment ) . RESULTS At the end of the entire treatment 18 complete responses ( 47 % ) in the sequential-treatment arm and 18 ( 41 % ) in the simultaneous treatment arm were obtained . No statistically significant differences in the 5-yr progression-free survival , in the median time to loco-regional and distant progression and in the 5-yr overall survival were observed . Leukopenia was more frequent in the simultaneous than in the sequential arm ( p = 0.03 ) , whereas alopecia ( p = 0.008 ) and phlebitis ( p < 0.0001 ) were more frequent in the sequential-treatment arm . A better compliance was associated with the concomitant treatment , with 87 % of the patients completing the entire radiotherapy program versus 63 % of those in the sequential arm ( p = 0.01 ) . CONCLUSIONS In the present study , the two treatment arms showed similar activity ( complete response , progression-free and overall survival rates ) . Compliance to treatment was better in the concomitant arm . These data suggest that concomitant chemo-radiation therapy might be considered an option in unresectable locally advanced cancer of the head and neck . Phase III studies are needed in order to establish the superiority of this combination of cisplatin and radiotherapy versus radiotherapy alone BACKGROUND AND PURPOSE This phase II study evaluated the efficacy and toxicity of weekly cisplatin along with concomitant boost accelerated radiation regimen in patients with locally advanced unresectable head and neck carcinoma . MATERIAL AND METHODS A total of 94 patients ( median age , 58 years ) with UICC stage III ( n = 19 ) and IV ( n = 75 ) cancer of the oropharynx , larynx , hypopharynx and oral cavity were included . Patients received radiotherapy with a concomitant boost scheme ( 1.8 Gy on days 1 - 40 and 1.5 Gy boost on days 25 - 40 with a total dose of 72 Gy ) and concurrent cisplatin , 40 mg/m(2 ) weekly , for the first 4 weeks . RESULTS Most patients ( 95 % ) received both radiation and chemotherapy according to protocol . Toxicity was manageable with grade III mucositis and pharyngeal-oesophageal toxicity in 85 and 50 % of patients , respectively . Haematological toxicity was mild . Four patients ( 4 % ) died due to complications . With a median follow of 41 months , median overall survival and time to progression were 27 and 25 months , respectively . The estimated overall survival at 4 years was 41 % . CONCLUSIONS Concomitant boost accelerated radiation plus concurrent weekly cisplatin is a feasible schedule in patients with locally advanced unresectable head and neck carcinoma , with acceptable toxicity and survival data BACKGROUND Our goal was to evaluate long-term efficacy outcomes of patients with squamous cell carcinoma of the head and neck ( SCCHN ) treated with carboplatin , paclitaxel ( Taxol ) and radiotherapy . PATIENTS AND METHODS We conducted a phase II trial in inoperable patients with locally advanced SCCHN .  Carboplatin 100 mg/m(2 ) and paclitaxel 40 mg/m(2 ) were administered i.v . once a week during external beam radiation therapy ( 180 cGy per fraction ) for 6 - 7 weeks . Interstitial brachytherapy was used as a boost in selected patients with primary malignancies of the oral cavity and the oropharynx . RESULTS Fifty-five patients were enrolled . Fifty-two patients ( 95 % ) had stage IV and 51 ( 93 % ) had technically unresectable disease ; 62 % had an oropharyngeal primary site . Twenty-one patients underwent brachytherapy boost .  Grade 3 or 4 mucositis occurred in 30 % of patients . One death occurred during treatment that was related to complications of gastrostomy tube placement . Forty of 50 assessable patients ( 80 % ) had an objective response , with a complete response rate of 52 % . With a median follow-up of 69 months for surviving patients , the 5-year progression-free survival was 36 % and the 5-year overall survival was 35 % . Two of the 18 long-term survivors of > 50 months were gastrostomy tube feeding dependent . Patients undergoing brachytherapy boost ( n = 21 ) had similar outcomes compared with the rest of the patients . In multivariate analysis , baseline hemoglobin levels and N stage were predictive of survival . CONCLUSION Treatment with concurrent carboplatin , paclitaxel and radiation is safe and offers curative potential for poor prognosis patients with locally advanced SCCHN We compared concurrent chemoradiotherapy ( CCRT ) with docetaxel , cisplatin ( CDDP ) , and 5-fluorouracil ( 5-FU ) ( TPF ) with CCRT with CDDP , 5-FU , methotrexate and leucovorin ( PFML ) in patients with locally advanced squamous cell carcinoma of the head and neck ( SCCHN ) in terms of safety and efficacy on survival . A total of 100 patients were enrolled . The TPF group received CCRT with the TPF regimen [ docetaxel ( 50 mg/m2 : day 1 ) , CDDP ( 60 mg/m2 : day 4 ) , and continuous 5-FU infusion ( 600 mg/m2/day : days 1–5 ) ] . In the PFML group , patients received CCRT with the PFML regimen [ CDDP ( 60 mg/m2 : day 4 ) ] , continuous 5-FU infusion ( 600 mg/m2/day : days 1–5 ) , methotrexate ( 30 mg/m2 : day 1 ) and leucovorin ( 20 mg/m2/day : days 1–5 ) ] . Both groups received 2 cycles of chemotherapy during definitive radiotherapy . The total radiation dose was between 66.6 and 70.2 Gray . The overall response rates after CCRT were 98 with 90 % of a pathologically complete response ( pCR ) in the TPF group and 94 with 77 % in the PFML group . For grade 3/4 adverse events , mucositis was more frequent in the PMFL group , and the TPF group showed a higher incidence of hematological toxicity . CCRT with TPF or PMFL for advanced SCCHN was tolerable and produced excellent survival rates PURPOSE To select one of two chemoradiotherapy regimens for locally advanced squamous cell carcinoma ( SCC ) of the head and neck as the experimental arm for the next Trans-Tasman Radiation Oncology Group phase III trial . PATIENTS AND METHODS One hundred twenty-two previously untreated patients with stage III/IV SCC of the head and neck were r and omized to receive definitive radiotherapy ( 70 Gy in 7 weeks ) concurrently with either cisplatin ( 75 mg/m(2 ) ) plus tirapazamine ( 290 mg/m(2)/d ) on day 2 of weeks 1 , 4 , and 7 , and tirapazamine alone ( 160 mg/m(2)/d ) on days 1 , 3 , and 5 of weeks 2 and 3 ( TPZ/CIS ) , or cisplatin ( 50 mg/m(2 ) ) on day 1 and infusional fluorouracil ( 360 mg/m(2)/d ) on days 1 through 5 of weeks 6 and 7 ( chemoboost ) . RESULTS Three-year failure-free survival rates were 55 % with TPZ/CIS ( 95 % CI , 39 % to 70 % ) and 44 % with chemoboost ( 95 % CI , 30 % to 60 % ; log-rank P = .16 ) . Three-year locoregional failure-free rates were 84 % in the TPZ/CIS arm ( 95 % CI , 71 % to 92 % ) and 66 % in the chemoboost arm ( 95 % CI , 51 % to 79 % ; P = .069 ) . More febrile neutropenia and grade 3 or 4 late mucous membrane toxicity were observed with TPZ/CIS , while acute skin radiation reaction was more severe and prolonged with chemoboost . Compliance with protocol treatment was satisfactory on both arms . CONCLUSION Both regimens are feasible and are associated with significant but acceptable toxicity profiles in the cooperative group setting . Based on the promising efficacy seen in this trial , TPZ/CIS is being evaluated in a large phase III trial BACKGROUND A r and omized phase 3 trial of the treatment of squamous-cell carcinoma of the head and neck compared induction chemotherapy with docetaxel plus cisplatin and fluorouracil ( TPF ) with cisplatin and fluorouracil ( PF ) , followed by chemoradiotherapy . METHODS We r and omly assigned 501 patients ( all of whom had stage III or IV disease with no distant metastases and tumors considered to be unresectable or were c and i date s for organ preservation ) to receive either TPF or PF induction chemotherapy  , followed  by chemoradiotherapy with weekly carboplatin therapy and radiotherapy for 5 days per week . The primary end point was overall survival . RESULTS With a minimum of 2 years of follow-up ( > or =3 years for 69 % of patients ) , significantly more patients survived in the TPF group than in the PF group ( hazard ratio for death , 0.70 ; P=0.006 ) . Estimates of overall survival at 3 years were 62 % in the TPF group and 48 % in the PF group ; the median overall survival was 71 months and 30 months , respectively ( P=0.006 ) . There was better locoregional control in the TPF group than in the PF group ( P=0.04 ) , but the incidence of distant metastases in the two groups did not differ significantly ( P=0.14 ) . Rates of neutropenia and febrile neutropenia were higher in the TPF group ; chemotherapy was more frequently delayed because of hematologic adverse events in the PF group . CONCLUSIONS Patients with squamous-cell carcinoma of the head and neck who received docetaxel plus cisplatin and fluorouracil induction chemotherapy plus chemoradiotherapy had a significantly longer survival than did patients who received cisplatin and fluorouracil induction chemotherapy plus chemoradiotherapy . ( Clinical Trials.gov number , NCT00273546 [ Clinical Trials.gov ] . ) A r and omized phase 2 study was performed to investigate the efficacy/toxicity of combining concomitant boost radiation and weekly carboplatin/paclitaxel with or without amifostine in patients with locally advanced squamous cell carcinoma of the head and neck ( SCCHN ) BACKGROUND A phase II study was conducted using concurrent paclitaxel , carboplatin , and external beam radiotherapy ( RT ) in patients with advanced head and neck cancer . METHODS Forty-three patients ( stage III , n = 12 ; stage IV , n = 31 ) were treated with 8 cycles of weekly paclitaxel ( 60 mg/m(2 ) ) , carboplatin ( area under the curve [ AUC ] = 1 ) , and RT ( 1.8 Gy daily ; total dose , 66 - 72 Gy ) . Patients with initially palpable lymph nodes underwent neck dissection . RESULTS The overall clinical response rate was 91 % ( 65 % complete , 26 % partial ) . Severe mucositis occurred in 37 ( 90 % ) patients , necessitating hospitalization in 13 ( 31 % ) patients . With a median follow-up of 49 months , the locoregional and distant failure rates were 26 % and 21 % , respectively . CONCLUSIONS Concurrent paclitaxel , carboplatin , and RT for advanced head and neck cancer results in high complete response rates . Long-term follow-up has revealed the curative potential of this regimen , though the doses used result ed in unacceptable toxicity BACKGROUND . Simultaneous radiochemotherapy result ed in a significant benefit improving both local control and overall survival in advanced head and neck cancer . In this phase II study the efficacy and tox 
    Output:
    
The improved overall survival observed supports the choice of taxane-based regimens in the concurrent setting but may also reflect the predominance of single arm multi-agent phase II trials in the taxane arm .