Optimized Intensity Modulated Irradiation for Head and Neck Cancer

Inclusion Criteria:

• All patients must have histologically confirmed invasive cancer of the head and neck.
• Irradiation to both neck sides is required.
• Standard radiation techniques would irradiate most of both parotid glands to a high dose (>50 Gy). Patients with oropharyngeal, oral, nasopharyngeal, hypopharyngeal and advanced laryngeal cancer are expected to fulfill this requirement.
• Patients with resectable disease that is either measurable, evaluable or non-measurable disease (post-operative) will be eligible.
• Karnofsky performance status >60
• Patients receiving or not receiving chemotherapy are eligible.
• All patients must sign an informed consent.

• Pre-treatment laboratory criteria:

  • WBC (White Blood Cell) > 3500/ul, granulocyte > 1500/ul.
  • Platelet count > 100,000/ul.
  • Creatinine clearance > 60 cc/min. to receive cisplatin; creatinine clearance 30-59 cc/min to receive carboplatin.
  • Bilirubin < 1.5 mg% with no evidence of obstructive liver disease.
  • AST (Aspartate Aminotransferase) and ALT (Alanine Aminotransferase) equal to or less than 2.5 x upper limit of normal.

Exclusion Criteria:

• Patients who received past irradiation to the head and neck are not eligible.
• Prior head and neck malignancy or history of other prior non-head and neck malignancy within the past 3 years.
• Prior head and neck radiation or prior chemotherapy.
• Documented evidence of distant metastases.
• Active infection.
• Pregnancy or lactation; patients must use effective contraception during the course of the clinical trial.
• Any medical or psychiatric illness which in the opinion of the principal investigator would compromise the patients ability to tolerate this treatment.
• Patients residing in prison.
• Age < 18 years.