Radiation Therapy With or Without Chemotherapy in Treating Patients With Advanced Cancer of the Larynx

DISEASE CHARACTERISTICS: Biopsy-proven, previously untreated, squamous cell carcinoma of
the glottic and supraglottic larynx that would normally require total laryngectomy Stage
III/IV disease (excluding T1 and M1) Endoscopic tumor staging required within 4 weeks of
entry Tumors must be considered resectable and potentially curable with conventional
surgery and radiotherapy T4 disease limited to: Up to 1 cm invasion of the base of tongue
Questionable cartilage invasion on CT (clinically T3) Measurable disease required No
synchronous primary tumors No subglottic tumors

PATIENT CHARACTERISTICS: Age: 18 and over Performance status: Karnofsky 60%-100%
Hematopoietic: (obtained within 3 weeks of entry) WBC at least 3,500 Platelets at least
100,000 Hepatic: Not specified Renal: (obtained within 2 weeks of entry) Creatinine
clearance at least 50 mL/min (measured or calculated) Serum calcium normal
Cardiovascular: Status adequate to tolerate all protocol therapy Pulmonary: Status
adequate to tolerate all protocol therapy Other: Nutritional status adequate to tolerate
all protocol therapy Mental status adequate to follow instructions and keep appointments
No second malignancy except nonmelanomatous skin cancer (Patients who have been
disease-free for at least 3 years following treatment for a prior cancer may be eligible
at the discretion of the protocol chairman) Negative pregnancy test required of fertile
women Effective contraception required of fertile women

PRIOR CONCURRENT THERAPY: Biologic therapy: No prior therapy Chemotherapy: No prior
therapy Endocrine therapy: No prior therapy Radiotherapy: No prior radiotherapy to the
head and neck Surgery: No prior therapy