Current management of locally advanced head and neck cancer: the combination of chemotherapy with locoregional treatments.

Abstract

This review will discuss the evolution of the role of chemotherapy in the treatment of locally advanced head and neck cancer (HNC), over the last few decades. Studies were identified by searching PubMed electronic databases. Surgery followed by radiotherapy (RT) or definitive RT are potentially curative approaches for locally advanced HNC. While chemotherapy itself is not curative, it can improve cure rates when given as an adjunct to RT. The benefit of combining chemotherapy with RT is related to the timing of the chemotherapy. Several prospective randomized trials have demonstrated that concurrent delivery of chemotherapy and RT (CRT) is the most promising approach, given that locoregional recurrence is the leading pattern of failure for patients with locally advanced HNC. Induction chemotherapy before CRT has not been shown to be superior to CRT alone and the added toxicity may negatively impact the compliance with CRT. Sequential chemotherapy administration, in the form of induction chemotherapy followed by RT or CRT, has been successful as a strategy for organ preservation in patients with potentially resectable laryngeal and hypopharyngeal cancer. Systemic chemotherapy delivered concurrently with RT is used as a standard treatment for locally advanced HNC.

• Authors: Voichita Bar-Ad, Joshua Palmer, Hushan Yang, David Cognetti, Joseph Curry, Adam Luginbuhl, Madalina Tuluc, Barbara Campling, Rita Axelrod
• Journal: Seminars in oncology (Semin Oncol) Vol. 41 Issue 6 Pg. 798-806 (Dec 2014) ISSN: 1532-8708 [Electronic] United States
• PMID: 25499638 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2014 Elsevier Inc. All rights reserved.

Topics

• Chemoradiotherapy
• Disease Management
• Head and Neck Neoplasms (therapy)
• Humans