Inclusion Criteria

DISEASE CHARACTERISTICS: Histologically proven squamous cell carcinoma of the head and
neck, including lymphoepithelioma and anaplastic carcinoma Biopsy from the primary or
regional nodes acceptable No adenocarcinomas The following stages and sites are eligible:
Stage III/IV oral cavity, including: Anterior 2/3 of the tongue Buccal mucosa Floor of
mouth Hard palate Gingiva Retromolar trigone Stage III/IV oropharynx, including: Tonsil
and pillars Faucial arch and soft palate Posterolateral pharyngeal walls Stage II/III/IV
base of the tongue and hypopharynx Stage III/IV supraglottic larynx, including:
Ventricular band Arytenoid Supra- and infrahyoid epiglottis Aryepiglottic fold (tumors at
glottic and subglottic sites excluded) Nonpalpable nodes detected only on CT or MRI must
be at least 1.0 cm in diameter or contain necrosis to prove N+ disease No metastasis below
the clavicle clinically or radiologically

PATIENT CHARACTERISTICS: Age: At least 18 Performance status: Karnofsky 60-100%
Hematopoietic: Not specified Hepatic: Not specified Renal: Not specified Other: Medically
able to withstand radiotherapy No second malignancy within 5 years except nonmelanomatous
skin cancer Follow-up by participating radiotherapist required

PRIOR CONCURRENT THERAPY: Biologic therapy: Not specified Chemotherapy: No prior
chemotherapy Endocrine therapy: Not specified Radiotherapy: No prior radiotherapy to head
and neck No planned combined external beam and interstitial boost irradiation Surgery: No
prior surgery (other than biopsy) No planned combined pre- or postoperative programs
Radical neck dissections allowed if lymph nodes are greater than 3 cm prior to
radiotherapy or involvement persists after treatment Resection of persistent disease at
the primary site may be performed 6 weeks after completion of radiotherapy