Although important progress continuous to be made in the treatment of oro and
hypopharyngeal cancer, the 5-year survival rate for all this disease has remained at less than 30% for the past 30 years. In the early 1980s,
chemotherapy was introduced with high expectation of reducing in the incidence of distant
metastases and increasing the possibility of local control. This article explores the use of
chemotherapy in the treatment of advanced
pharyngeal cancer. Thus, the efficacy of
chemotherapy are reviewed and treatment options for advanced
pharyngeal cancer are made. When advanced
carcinoma is still localized, function-preserving surgery is performed. In these cases, the possibility of instituting
adjuvant chemotherapy with an active treatment regimen may be taken into account depending on the condition of the patient and the
tumor. Patients with surgically resectable
tumors are given 1-2 cycles of
induction chemotherapy. Cases who respond to the
induction chemotherapy are subsequently given
concurrent chemoradiotherapy. Residual lymph nodes in the neck are removed surgically. The cases who do not respond to the
induction chemotherapy are treated with radical surgery. Patients with unresectable
carcinoma are given
concurrent chemoradiotherapy because local treatment should be performed in such patients as early as possible. In principle, concurrent regimens should be supplemented with
adjuvant chemotherapy in all cases. This is particularly required for those with advanced N-stage patients.