[Advances in the treatment of head and neck tumors. I. Chemotherapy].
OBJECTIVE
Cancer of the head and neck is commonly diagnosed in an advanced stage with a poor prognosis. New active agents and combinations have recently been identified. By adding chemotherapy to a multimodality approach with surgery and radiation therapy the outcome may be altered.


METHODS
We reviewed the more recently published literature on induction and adjuvant chemotherapy.


RESULTS
Four conclusive randomized trials of induction chemotherapy have failed to show an improved survival. No survival advantage has been shown for adjuvant chemotherapy. Organ preservation can be achieved with induction chemotherapy followed by limited surgery and radiation in approximately two thirds of the patients with laryngeal carcinoma. Patients achieving a complete response after induction chemotherapy have a better prognosis. Chemotherapy has consistently shown to reduce the frequency of distant metastases.


CONCLUSIONS
Chemotherapy is indicated only in recurrent or metastatic disease. Induction chemotherapy is limited to laryngeal carcinoma with organ preservation as intent. Local recurrences and intercurrent morbidity are the main reasons for treatment failures.
Stupp
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University of Chicago Medical Center, Section of Hematology/Oncology, Ill.
Vokes
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EE
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D007822:Laryngeal Neoplasms / Q000188:drug therapy; D015337:Multicenter Studies as Topic; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic
D000970:Antineoplastic Agents
Fortschritte in der Therapie von Kopf- und Halstumoren. 1. Teil: Chemotherapie.