title: Neoadjuvant chemotherapy or chemoradiotherapy in head and neck cancer.
abstract: The multidisciplinary approach to treating squamous cell carcinoma of the head and neck is complex and evolving. Chemotherapy is increasingly being incorporated into the treatment of squamous cell carcinoma of the head and neck. Previously, radiotherapy following surgery was the standard approach to the treatment of loco regionally advanced resectable disease. Data from randomized trials have confirmed the benefits of concurrent chemo radiotherapy in the adjuvant setting. Chemo radiotherapy is also the recommended approach for unresectable disease. Advanced loco regional disease is the most frequent clinical situation in Head and Neck cancer. The standard of care for most clinicians is a multidisciplinary treatment with concomitant chemotherapy plus radiotherapy (CRT). However, retrospective studies have shown that in patients treated with CRT there was a relative increase in systemic relapse due to a lack of systemic control. For this reason a renewed interest has appeared for the incorporation of induction chemotherapy in the treatment of locally advanced Head and Neck Cancer. Furthermore new combination regimens with taxanes have shown to be more active than the classical cisplatin and 5-fluorouracil induction regimen. Novel targeted agents, such as epidermal growth factor receptor antagonists, are showing promise in the treatment of patients with both loco regionally advanced and recurrent/metastatic squamous cell carcinoma of the head and neck.
authors.affiliation: Department of Medical Oncology, Tata Memorial Hospital, Dr. E. Borges Road, Parel, Mumbai - 400 012, India. drpreetesh@yahoo.co.in
authors.forename: Preetesh
authors.initials: P
authors.lastname: Jain
authors.forename: Prabhash
authors.initials: P
authors.lastname: Kumar
authors.forename: Vasanth Raghuvir
authors.initials: VR
authors.lastname: Pai
authors.forename: Purvish Mahendra
authors.initials: PM
authors.lastname: Parikh
mesh_terms: D017024:Chemotherapy, Adjuvant; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000628:therapy*; D006801:Humans; D020360:Neoadjuvant Therapy; D018714:Radiotherapy, Adjuvant