Chemotherapy for Salivary Gland Tumours

Eligibility Details: DISEASE CHARACTERISTICS: - Pathologically proven diagnosis of a malignant major salivary gland tumor or malignant minor salivary gland tumor of the head and neck of the following histologic subtypes: - Intermediate-grade adenocarcinoma or intermediate-grade mucoepidermoid carcinoma - High-grade acinic cell carcinoma or high-grade (>30% solid component) adenoid cystic carcinoma - Surgical resection with curative intent within 8 weeks prior to registration - All patients must have a Medical Oncology evaluation within 4 weeks prior to registration - Pathologic stage T3-4 or N1-3 or T1-2, N0 with a close (≤ 1mm) or microscopically positive surgical margin; patients must be free of distant metastases based upon the following minimum diagnostic workup: - History/physical examination within 8 weeks prior to registration - Radiologic confirmation of the absence of hematogenous metastasis within 12 weeks prior to registration; at a minimum, contrast CT imaging of the chest is required (PET/CT is acceptable) - No patients with residual macroscopic disease after surgery - No prior systemic chemotherapy or radiation therapy for salivary gland malignancy PATIENT CHARACTERISTICS: - Zubrod performance status 0-1 - Absolute neutrophil count (ANC) ≥ 1,800 cells/mm^3 - Platelets ≥ 100,000 cells/mm^3 - Hemoglobin ≥ 8.0 g/dL (the use of transfusion or other intervention to achieve hemoglobin ≥ 8.0 g/dL is acceptable) - Serum creatinine < 2.0 mg/dL - Total bilirubin < 2 x the institutional upper limit of normal (ULN) - Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) < 3 x the institutional ULN - Negative serum pregnancy test within 2 weeks prior to registration for women of childbearing potential - Women of childbearing potential and male participants who are sexually active must practice adequate contraception during treatment and for 6 weeks following treatment - Not pregnant or nursing - Patients must be deemed able to comply with the treatment plan and follow-up schedule - Patients must provide study specific informed consent prior to study entry, including consent for mandatory tissue submission for central review - No prior invasive malignancy (except non-melanomatous skin cancer) unless disease free for a minimum of 3 years (for example, carcinoma in situ of the breast, oral cavity, or cervix are all permissible) - No severe, active co-morbidity, defined as follows: - Unstable angina and/or congestive heart failure requiring hospitalization within the last 6 months - Transmural myocardial infarction within the last 6 months - Acute bacterial or fungal infection requiring intravenous antibiotics at the time of registration - Chronic Obstructive Pulmonary Disease exacerbation or other respiratory illness requiring hospitalization or precluding study therapy at the time of registration - Hepatic insufficiency resulting in clinical jaundice and/or coagulation defects (coagulation parameters are not required for entry into this protocol) - Acquired immune deficiency syndrome (AIDS) based upon current Centers for Disease Control (CDC) definition (HIV testing is not required for entry into this protocol) - Protocol-specific requirements may also exclude immunocompromised patients - Pre-existing ≥ grade 2 neuropathy - No significant pre-existing hearing loss, as defined by the patient or treating physician PRIOR CONCURRENT THERAPY: - See Disease Characteristics - No prior systemic chemotherapy or radiation therapy for salivary gland malignancy (prior chemotherapy for a different cancer is allowable) - No prior radiotherapy to the region of the study cancer that would result in overlap of radiation therapy fields - No prior organ transplant - No concurrent hematopoietic growth factors (e.g., G-CSF or pegfilgrastim) during radiotherapy - No concurrent erythropoiesis-stimulating agents