Pretreatment staging, involving laryngoscopy, measurement of the tumor, and high-resolution computed tomographic (CT) scanning of the pri- mary tumor and the neck, was performed within four weeks before entry into the study. To rule out synchronous primary cancers, either CT imaging of the chest and barium esophagography or pan- endoscopy (i.e., esophagoscopy and bronchoscopy) was performed. Imaging was performed as clinical- ly indicated to rule out metastatic disease.