Inclusion Criteria:

- Histological confirmation of squamous cell carcinoma

- Primary tumor site in the head and neck area

- Stage III or IV disease

- Measurable locoregional disease and no distant metastasis

- No prior cancer treatment

- 20-70 years old

- KPS ≧ 70

- Adequate bone marrow, liver, and renal function

- Fed with gastric tubes but without intestinal malabsorption or obstruction

- Not pregnancy and use a reliable contraceptive method during the study

- Signed informed consent

- Willing and able to complete quality of life questionnaires

Exclusion Criteria:

- Decompensated liver function

- Serious concomitant illness that might be aggravated by chemotherapy

- Active cardiac disease preceding the entry into the study

- Severe uncontrolled hypertension

- Uncontrolled infection

- History of other malignancy

- Pregnant or breast feeding

- Receiving other concomitant chemotherapy, radiotherapy or any other anticancer
treatment

- Mental status not suitable for clinical trials

- Intestinal obstruction or malabsorption.