Therapy for locoregionally advanced head and neck cancer

Abstract

Studies evaluating the integration of chemotherapy into the treatment of locoregionally advanced head and neck cancer were initiated because traditional therapy with surgery and postoperative radiation frequently failed to eradicate locoregional disease and because morbidity with traditional therapy was substantial. Sequential multimodality treatment approaches have included adjuvant and induction chemotherapy plus surgery and postoperative radiation. Published evidence suggests that induction chemotherapy should not be routinely recommended; however, induction chemotherapy with cisplatin and 5-fluorouracil increases the likelihood of larynx preservation in patients with laryngeal or hypopharyngeal cancer and should be offered as a treatment option in this setting. Positive results of several randomized studies and recent metaanalyses of relevant clinical data show that concomitant use of chemotherapy and radiotherapy in unresectable head and neck cancer is beneficial and should be considered a treatment option. Cisplatin administered with concomitant radiation also has proved to be beneficial in patients with nasopharyngeal cancer. The possible role of novel chemotherapeutic agents and treatment approaches is being investigated.