Abstract
The treatment of HNSCC in Taiwan is still very challenging and might be related to betel-nuts use. Betel nut chewing might contribute to strong angiogenesis/invasion and treatment refractoriness. In western countries where HPV+ oropharynheal cancer prevalence is high, induction TPF (TAX323/324) response rate in locally advanced HNSCC is around 70%; cetuximab and TP (Argiris et al. J Clin Oncol 2008) induction response is 86%. In the analysis from KGMH in Taiwan, induction chemotherapy response for locally advanced HNSCC was 55% in betel nut chewers compared with 75% in non-users (p=0.038; Su in World J Surgical Oncol 2016).
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