title: Pharmacotherapy of head and neck cancer.
abstract: BACKGROUND
  There are over 55,000 new cases of head and neck cancer diagnosed annually in the United States. Historically surgical resection was the standard of care, but due to vital structures in the head and neck region this led to severe morbidity. The integration of pharmacotherapy has rapidly expanded over the years into a multimodality treatment paradigm for locally advanced head and neck cancer, allowing organ-sparing treatment approaches. Here we discuss the various approaches and settings in which chemotherapy can be incorporated into the management of head and neck squamous cell carcinoma (HNSCC).
  
  
  METHODS
  Chemotherapy in HNSCC can be administered in several different treatment circumstances: in the metastatic setting for palliation of symptoms and prolongation of survival, before definitive local treatment (induction), as part of definitive treatment simultaneously with radiation (concurrent) or after definitive local therapy (adjuvant).
  
  
  CONCLUSIONS
  The incorporation of chemotherapy into the management of patients with head and neck cancer has allowed organ preservation approaches and improved survival. Because of the toxicities of chemotherapy, it is imperative that chemotherapy is only administered to the appropriate patient population who are more likely to benefit. Cisplatin 100 mg/m(2) given in combination with radiation in the non-metastatic setting is the most widely tested regimen and remains the reference regimen. Cetuximab is also an alternative, but there is no data to support the use of cetuximab in a laryngeal preservation approach or in the postoperative setting.
authors.affiliation: a Taussig Cancer Institute, Cleveland Clinic, Department of Hematology and Medical Oncology , Desk R35, 9500 Euclid Avenue, Cleveland, OH 44195, USA +1 216 445 0320 ; +1 216 444 9464 ; nwizut@ccf.org.
authors.forename: Tobenna
authors.initials: T
authors.lastname: Nwizu
authors.affiliation: a Taussig Cancer Institute, Cleveland Clinic, Department of Hematology and Medical Oncology , Desk R35, 9500 Euclid Avenue, Cleveland, OH 44195, USA +1 216 445 0320 ; +1 216 444 9464 ; nwizut@ccf.org.
authors.forename: David
authors.initials: D
authors.lastname: Adelstein
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000532:radiotherapy; D059248:Chemoradiotherapy; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000627:therapeutic use; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy; D006801:Humans; D059351:Organ Sparing Treatments; D010166:Palliative Care
chemical_list: D000970:Antineoplastic Agents; D002945:Cisplatin
keywords: adjuvant therapy; chemoradiotherapy; chemotherapy; cisplatin; head and neck cancer; induction chemotherapy; radiation