Chemotherapy Plus Radiation Therapy in Treating Patients With Head and Neck Cancer

Esophageal Cancer, Head and Neck Cancer

stage II esophageal cancer, stage III esophageal cancer, stage II nasopharyngeal cancer, stage III nasopharyngeal cancer, stage II lip and oral cavity cancer, stage III lip and oral cavity cancer, stage II hypopharyngeal cancer, stage III hypopharyngeal cancer, stage II laryngeal cancer, stage III laryngeal cancer, stage II paranasal sinus and nasal cavity cancer, stage III paranasal sinus and nasal cavity cancer, stage II oropharyngeal cancer, stage III oropharyngeal cancer

RATIONALE: Drugs used in chemotherapy use different ways to stop tumor cells from dividing so they stop growing or die. Radiation therapy uses high-energy x-rays to damage tumor cells. Combining radiation therapy with chemotherapy may kill more tumor cells. PURPOSE: Phase II trial to study the effectiveness of chemotherapy plus radiation therapy in treating patients with head and neck cancer.

OBJECTIVES: * Determine the locoregional control rates, time to failure, need for salvage surgery and overall survival of patients with intermediate stage cancer of the oral cavity, pharynx, larynx, paranasal sinuses, and cervical esophagus. * Measure the impact of concomitant Hyper-FHX radiotherapy on organ preservation, organ function and quality of life parameters. * Identify possible prognostic factors for toxic effects and response by performing pharmacologic monitoring. OUTLINE: Patients receive concomitant chemoradiotherapy with curative intent. Patients who have microscopic or macroscopic residual disease 6 weeks after completion of chemoradiotherapy will receive a surgical salvage procedure. The first cycle of chemotherapy will begin with PO doses of hydroxyurea every 12 hours on days 0-5. Fluorouracil is given IV on days 0-4. Radiation therapy BID is given on days 1-6. Cycles repeat every 14 days for a total of 5 cycles. The disease will be reevaluated 4-6 weeks after completion of all treatment, every 3 months for 1 year, then yearly. PROJECTED ACCRUAL: Approximately 40 patients will be accrued for this study.

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United States