Scott --

When my husband Barry was treated at John Hopkins (where I hope they know what they are doing!) his medical oncologist did not want to give him cisplatin because he (Barry) already had high-end hearing loss from childhood ear infections, and further loss would compromise his ornithological work. The MO first considered the carbo/taxol combination but Barry had concerns about peripheral neuropathy from the Taxol (a fairly common but not universal side effect). His MO, who is expert on chemoradiation and organ preservation, frankly said that there was little good data showing significant benefit from the taxol addition and as far as she was concerned, he didn't need to take it. So he didn't. He had 7 weekly carboplatin treatments, each low dose. He was getting 33x radiation at same time (tomo-Therapy IMRT), plus amifostine. No surgery other than pre-treatment tonsillectomy (his primary tumor).

The chemotheray was, in Barry's words, a "non-event" -- he was given Anzemet by IV beforehand and took a Zofran the next day and had no probems. The amifostine was much more difficult to handle!

Although Hopkins does, I believe, prefer to give the carbo/taxol combo (and still uses cisplatin for some patients) we were told by our onc nurse that more patients are getting just carbo as they are having such good results with this in combo with radiation. Some are also getting Eribitux -- you should ask the doctor about this. It was not available when Barry started treatment.

Barry finished treatment at end of September and recovered very quickly, and now -- except for need to regain some more weight -- he is pretty much back to normal. All tests (including two PET/CT scans) have shown no sign of cancer, so he is considered to have had a complete clinical response. Of course he will need to be monitored for years but so far it looks good.

This is just to say that carboplatin (with or without Taxol) is a good alternative and can result in a successful treatment with fewer lingering side effects.

Gail