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

Inclusion Criteria

• •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