A total of 450 patients aged 35 years to 76 years ( World Health Organization performance status ( WHO PS ) 2 ) with untreated , resectable advanced squamous cell carcinoma of the larynx ( tumor classification of T3-T4 ) or hypopharynx ( tumor classification of T2-T3-T4 ) with regional lymph nodes in the neck classified as N0 to N2 with no metastases were randomized in this prospective phase 3 trial into either the sequential arm ( control ) or the alternating arm ( experimental ) .