A Pilot Study of Induction Chemotherapy Followed by Surgery for Locally Advanced Resectable Head and Neck Cancer

Inclusion Criteria:

1. Ability to understand and the willingness to sign a written informed consent document.
2. Histologically confirmed Stage III-IV (T1, T2, T3) (N0-N2) squamous cell carcinoma of the oropharynx staged according to AJCC guidelines.
3. The subject must be considered surgically resectable via a transoral approach at the time of presentation.
4. Age \>18 years
5. Life expectancy \>/= 5 years
6. ECOG performance status \<2
7. Subject must have measurable disease, at least one lesion accurately measured in at least one dimension as \>10 mm with CT scan.
8. Hematologic Absolute neutrophil count \> 1,000/mm3, Hemoglobin \> 8.0 g/dl Platelet count \> 100,000/mm3 Leukocytes \>3,000/mcL
9. Hepatic Total Bilirubin ≤ ULN; AST and ALT and Alkaline Phosphatase within the eligible range
10. Renal - creatinine within normal institutional limits or \>60 mL/min/1.73 m2 creatinine \> institutional normal
11. Women of childbearing potential with negative pregnancy test.
12. Men and women of childbearing age willing to use effective contraception

Exclusion Criteria:

1. N3 nodal disease according to AJCC guidelines
2. Retropharyngeal nodal involvement
3. Trismus
4. Second primary head and neck tumor unless it is/was a basal or squamous cell skin cancer
5. Prior surgery, chemotherapy, biologic or radiotherapy for a head or neck malignancy
6. Concurrent investigational agent or intervention (within 90 days of screening visit)
7. History of allergic reactions attributed to compounds of similar chemical or biologic composition to docetaxol, cisplatin, 5- fluorouracil, or carboplatin.
8. History of severe hypersensitivity reaction to drugs formulated with polysorbate 80
9. Breastfeeding women
10. Pre-existing peripheral neuropathy grade \> 3
11. Evidence of distant metastatic disease
12. Unknown primary site
13. Prior or concurrent malignancies (excluding adequately treated basal or squamous cell skin cancer, in situ cervical cancer, stage I or II cancer from which the subject has been in complete remission for at least 12 months (excluding head and neck), any cancer from which the subject has been cancer free for 5 years)
14. History of allergies to any of the pre-medications.
15. Investigator consideration based upon screening interview and/or procedures
16. Evidence of bone invasion/destruction
17. Uncontrolled intercurrent illness including ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
18. Pregnant women
19. History of HIV, hepatitis B, hepatitis C, or delta antigen
20. Known allergy to India Ink or methylene blue