For
head and neck cancer, a recent meta-analysis of published randomized trial results showed that
concurrent chemoradiotherapy,
adjuvant chemotherapy and
neoadjuvant chemotherapy may increase absolute survival by 12.1%, 6.5%, and 3.7%, respectively. Initial response rates to first line
chemotherapy are high, but this responsiveness does not appear to translate into a survival benefit. Thus,
chemotherapy can be indicated as the standard
therapy for a very limited range of advanced head and
neck cancers. With the aim of prolonging survival, N stage advanced
nasopharyngeal cancer is a good candidate for
neoadjuvant chemotherapy. Among a large number of randomized trials of
neoadjuvant chemotherapy, organ function preservation studies showed the possibility of laryngeal preservation for locally resectable T2 and T3 laryngeal and
hypopharyngeal cancer.
Concurrent chemoradiotherapy may be indicated for advanced T stage head and
neck cancers, especially those with locally unresectable lesions. For N stage advanced
pharyngeal cancer patients,
adjuvant chemotherapy with applied after the standard
therapy has a role in the treatment. With
palliative treatment in advanced and/or recurrent disease, there is less benefit from
chemotherapy and indications for
chemotherapy should be selected for individual patients.