Combination Chemotherapy With or Without Radiation Therapy in Treating Patients With Recurrent Head and Neck Cancer That Cannot Be Removed By Surgery

You may be eligible if

• DISEASE CHARACTERISTICS:
• Histologically\* or cytologically\* confirmed squamous cell carcinoma (SCC) of the oral cavity, oropharynx, hypopharynx, or larynx, including any of the following histologic variants:
• * Spindle cell carcinoma
• * Poorly differentiated keratin-positive carcinoma
• * Lymphoepithelioma NOTE: \*Biopsy or primary tumor and/or fine needle aspiration of the metastatic lymph node required
• Original or second primary tumor
• * Recurrent neck metastases with unknown primary allowed
• Locally recurrent disease
• Measurable disease
• Unresectable disease
• * Attempted surgical resection allowed provided surgery was performed ≥ 3 months ago, wound is completely healed, and there is no sign of carotid exposure
• Must have had prior radiotherapy for SCC of the head and neck with \> 75% of the present tumor volume in areas irradiated at doses ≥ 45 Gy but ≤ 75 Gy
• * Able to successfully re-irradiate the area of the gross tumor volume without exceeding lifetime spinal cord dose of 54 Gy as determined by physical examination and CT scan and/or MRI performed within the past 8 weeks
• * First recurrence occurred \> 6 months after completion of radiotherapy
• * More than 1 recurrence allowed provided the above criteria for first recurrence has been met
• No primary tumor of the nasopharynx or salivary gland
• No distant metastases by history or physical examination, chest CT scan, and CT scan or MRI of the tumor site
• * Patients with equivocal pulmonary nodules are eligible provided the nodules are \< 1 cm, can be safely biopsied, or are negative by positron emission tomography imaging
• * No circumferential tumor involvement of the carotid sheath by imaging unless prophylactic carotid stent is placed
• PATIENT CHARACTERISTICS:
• Age
• 18 and over
• Performance status
• Zubrod 0-1
• Life expectancy
• Not specified
• Hematopoietic
• Absolute neutrophil count ≥ 1,800/mm³
• Platelet count ≥ 100,000/mm³
• Hemoglobin ≥ 8.0 g/dL (transfusion or other intervention allowed)
• Hepatic
• AST or ALT \< 2 times upper limit of normal (ULN)
• Bilirubin \< 1.5 mg/dL
• No hepatic insufficiency resulting in clinical jaundice and/or coagulation defects
• Renal
• Creatinine clearance \> 50 mL/min
• Calcium \< 11.5 mg/dL
• Cardiovascular
• No New York Heart Association class III or IV heart disease
• No other symptomatic or uncontrolled cardiac disease
• Pulmonary
• No chronic obstructive pulmonary disease exacerbation
• No other respiratory illness requiring hospitalization within the past 6 months or that would preclude study therapy
• Immunologic
• No AIDS
• No prior allergic reaction to E. coli-derived products
• No acute bacterial or fungal infection requiring IV antibiotics
• Other
• Not pregnant or nursing
• Negative pregnancy test
• Fertile patients must use effective contraception during and for 30 days after completion of study treatment
• No other invasive malignancy within the past 3 years except nonmelanoma skin cancer, carcinoma in situ of the breast, oral cavity, or cervix
• No pre-existing peripheral sensory neuropathy \> grade 2
• No other severe active co-morbidity
• PRIOR CONCURRENT THERAPY:
• Biologic therapy
• Not specified
• Chemotherapy
• At least 6 months since prior chemotherapy
• No prior systemic chemotherapy for recurrent SCC of the head and neck
• * Prior neoadjuvant, adjuvant, and/or concurrent chemotherapy and radiotherapy for initial SCC of the head and neck allowed
• Endocrine therapy
• Not specified
• Radiotherapy
• See Disease Characteristics
• See Chemotherapy
• At least 6 months since prior radiotherapy
• Surgery
• See Disease Characteristics
• Other
• Prior cyclooxygenase-2 inhibitor or retinoids for chemoprevention allowed
• At least 6 months since prior epidermal growth factor receptor (EGFR) inhibitors or other targeted agents
• No prior EGFR inhibitors or other targeted agents for recurrent SCC of the head and neck
• No concurrent cimetidine or allopurinol (for patients on arm II, regimen 1)