Chemotherapy advances in locally advanced head and neck cancer

Abstract

The management of locally advanced unresectable head and neck squamous cell cancer (HNSCC) continues to improve. One of the major advances in the treatment of HNSCC was the addition of chemotherapy to radiation in the treatment of non-surgical patients. The majority of the data regarding chemotherapy in HNSCC involve cisplatin chemotherapy with concurrent radiation. However, several new approaches have included targeted therapy against epidermal growth factor receptor and several recent studies have explored the role of induction chemotherapy in the treatment of HNSCC. The purpose of this article is to provide an overview of the role of chemotherapy in the treatment of locally advanced HNSCC.

Keywords: Head and neck cancer, Chemotherapy, Induction

Core tip: For select patient subsets the addition of chemotherapy to radiation in head and neck squamous cell cancer improves outcome. Most data is for concurrent cisplatin although other agents are also being explored. There has recently been interest in induction chemotherapy, the induction studies although heterogeneous have failed to show an improvement in overall survival. In this article we discuss the data regarding concurrent chemotherapy and also the data regarding induction therapy and which patient subsets we feel are best suited for induction chemotherapy (patients with N3 disease and those expected to have a delay in starting concurrent concurrent chemoradiotherapy).