Radiation Therapy With or Without Epoetin Alfa in Treating Anemic Patients With Head and Neck Cancer

DISEASE CHARACTERISTICS:

* Histologically confirmed invasive squamous cell carcinoma of the head and neck, including carcinoma arising from the oral cavity, oropharynx, larynx, and hypopharynx

  * Stage I-IV disease
  * No distant metastases
  * No carcinoma of the nasopharynx, nasal cavity/paranasal sinuses, or salivary glands
  * No carcinoma in situ without an identifiable invasive component
* Plan for radiotherapy in continuous course
* Prior surgical exploration with gross residual disease remaining allowed
* Prior neck dissection with or without biopsy of primary tumor, but no radical surgery for primary tumor, allowed
* Anemia, defined as hemoglobin no greater than 13.5 g/dL for males and no greater than 12.5 g/dL for females (transfusion prior to study allowed)

  * No severe anemia (i.e., hemoglobin less than 9.0 g/dL)
  * No anemia confirmed to be due to causes other than chronic disease (e.g., iron deficiency anemia)
* Not entered on other RTOG head and neck protocols

PATIENT CHARACTERISTICS:

Age:

* 18 and over

Performance status:

* Zubrod 0-2

Life expectancy:

* Not specified

Hematopoietic:

* See Disease Characteristics
* Stage III/IV patients receiving concurrent cisplatin:

  * Absolute neutrophil count at least 2,000/mm\^3
  * Platelet count at least 100,000/mm\^3

Hepatic:

* Not specified

Renal:

* Stage III/IV patients receiving concurrent cisplatin:

  * Creatinine no greater than 1.5 mg/dL
  * Creatinine clearance at least 50 mL/min

Cardiovascular:

* No malignant or poorly controlled hypertension (e.g., symptomatic hypertension or diastolic blood pressure of 100 mm Hg or greater despite antihypertensive medication)
* No unstable angina or other poorly controlled cardiac disease

Other:

* Not pregnant or nursing
* Negative pregnancy test
* Fertile patients must use effective contraception
* If stage III or IV disease is present, willing to come for twice daily radiotherapy for the last 2.5 weeks of therapy
* No active infection requiring IV antibiotics
* No unexplained fever
* No AIDS or other history of congenital or acquired immunodeficiency
* No other malignancies within the past 3 years except carcinoma in situ or nonmelanomatous skin cancer
* No known hypersensitivity to mammalian cell-derived products or to human albumin
* No acute/subacute illness that would make the need for transfusion likely

PRIOR CONCURRENT THERAPY:

Biologic therapy:

* At least 4 weeks since other prior cytokine therapy (e.g., filgrastim \[G-CSF\], interleukins, or interferons)
* No prior epoetin alfa
* No other concurrent cytokine therapy

Chemotherapy:

* No prior chemotherapy
* Concurrent cisplatin, paclitaxel/cisplatin, or paclitaxel/carboplatin for patients with stage III/IV disease is allowed

Endocrine therapy:

* Not specified

Radiotherapy:

* See Disease Characteristics
* No prior radiotherapy to the head and neck

Surgery:

* See Disease Characteristics

Other:

* No concurrent amifostine
* No concurrent transfusion