Eligibility criteria
Active infection, Psychiatric disorder, cancers, myocardial infarction, Tumor, head and neck cancers, head and neck surgeon, valvular disease, intramucosal tumors, human immunodeficiency virus antibody test., Fever, squamous cell carcinoma, tumors, head or neck lesions
CANCERS, UNCONTROLLED HYPERTENSION, MYOCARDIAL INFARCTION, LYMPH NODE METASTASES, TUMOR, DILATED CARDIOMYOPATHY, POSITIVE, UNSTABLE ANGINA, HYPERTROPHIC CARDIOMYOPATHY, OROPHARYNGEAL CANCER, HEAD AND NECK CANCER, ONCOLOGY, SQUAMOUS CELL CARCINOMA, TUMORS, POORLY CONTROLLED DIABETES MELLITUS
The inclusion criteria are as follows:
Primary lesions are located in the oropharynx, hypopharynx, or larynx.Histologically proven squamous cell carcinoma on biopsy specimens of the primary lesion. Immunohistochemistry reveals p16 negativity in patients with oropharyngeal cancer.Clinical stage of III, IVA, or IVB (excluding N3a) based on the 8th UICC-TNM classification.Age of ≥ 20 years.Eastern Cooperative Oncology Group performance status of 0 or 1.Measurable lesions are not required.No prior chemotherapy for any cancers and no prior RT for brain, head or neck lesions. No prior surgery for head and neck cancers, except for a biopsy of neck lymph nodes for a diagnosis.Any of the following conditions:
Both the primary lesion and regional lymph node metastases are technically or functionally unresectable. Tumor resectability will be determined through a review by a head and neck surgeon.Although the tumors are resectable, patients do not wish to undergo surgical resection.
Adequate organ function.
Neutrophil ≥ 1,000/mmHemoglobin ≥ 9.0 g/dL.Platelet ≥ 100,000/mmTotal bilirubin ≤ 2.0 mg/dL.Aspartate aminotransferase ≤ 100 U/L.Alanine aminotransferase ≤ 100 U/L.CCr ≥ 60 mL/min.
Written informed consent for participation.Exclusion criteria.
Synchronous or metachronous (within 5 years) double cancers, except for intramucosal tumors curatively resected with local therapy.Active infection requiring systemic therapy.Fever over 38.0 °C.Female during pregnancy, within 28 days of postparturition, or during lactation. Male who wants partner’s pregnancy.Psychiatric disorder difficult to participate in this clinical study.Requirement of systemic steroid medication or immunosuppressant treatment.Poorly controlled diabetes mellitus.Poorly controlled hypertension.Unstable angina within 3 weeks or with a history of myocardial infarction within 6 months before trial enrollment.Poorly controlled valvular disease, dilated cardiomyopathy, or hypertrophic cardiomyopathy.Positive hepatitis B surface antigen test.Positive human immunodeficiency virus antibody test.Inability to quit smoking and drinking.