Chemotherapy and Radiation Therapy Following Surgery in Treating Patients With Head and Neck Cancer

You may be eligible if

• DISEASE CHARACTERISTICS:
• Histologically proven stage III or IV squamous cell carcinoma of the oral cavity, oropharynx, larynx, or hypopharynx
• * Gross total resection completed or planned
• * No less than gross total resection
• * No disease requiring staging surgery
• Prior gross total resection completed with one or more of the following risk factors:
• * Histologically proven multiple lymph node metastases
• * At least 1 lymph node with extracapsular extension of tumor
• * Positive margin(s) of resection, including mucosal margins and/or soft tissue or deep margins of resection OR
• Gross total resection planned within 14 days of study enrollment with anticipated need for postoperative radiotherapy for one of the following:
• * Multiple clinically/radiologically evident lymph nodes of at least 1.5 cm
• * Single clinically/radiologically evident lymph node of at least 3 cm
• * Histologically proven lymph node metastases
• No T3, N0 glottic cancer
• No nasopharyngeal or paranasal sinus carcinoma
• No distant metastases
• PATIENT CHARACTERISTICS:
• Age:
• 21 and over
• Performance status:
• Zubrod 0-1
• Life expectancy:
• Not specified
• Hematopoietic:
• White blood cell (WBC) at least 3,000/mm\^3
• Platelet count at least 100,000/mm\^3
• Hepatic:
• Bilirubin no greater than 1.5 times upper limit of normal (ULN)
• Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) no greater than 1.5 times ULN
• Renal:
• Creatinine no greater than 1.5 ULN
• Cardiovascular:
• No unstable angina
• No myocardial infarction within the past 6 months unless successfully treated with coronary artery bypass graft or percutaneous transluminal coronary angioplasty
• No uncontrolled arrhythmia
• No second or third degree heart block or other clinically significant conduction system abnormality unless pacemaker is in place
• Pulmonary:
• No severe chronic obstructive pulmonary disease requiring 3 or more hospitalizations within the past year
• Other:
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception
• No pre-existing grade 2 or greater peripheral neurotoxicity
• No other prior malignancy within the past 3 years except low-risk nonmelanomatous skin cancer; carcinoma in situ (e.g., breast, cervix, or bladder); or stage T1-2, low to moderate grade prostate cancer
• No significant wound infection
• No fistula
• No major wound dehiscence
• Nutritional status adequate
• PRIOR CONCURRENT THERAPY:
• Biologic therapy:
• Concurrent colony-stimulating factors for neutropenic fever during study chemoradiotherapy allowed
• Chemotherapy:
• No prior chemotherapy
• Endocrine therapy:
• Not specified
• Radiotherapy:
• See Disease Characteristics
• No prior radiotherapy to head and neck
• Surgery:
• See Disease Characteristics