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Locally advanced squamous cell carcinoma of the head and neck: Approaches combining chemotherapy and radiation therapy

Authors
Bruce E Brockstein, MD
Everett E Vokes, MD
Avraham Eisbruch, MD
Section Editors
Marshall R Posner, MD
David M Brizel, MD
Marvin P Fried, MD, FACS
Deputy Editor
Michael E Ross, MD

INTRODUCTION

Definitive local therapy (surgery and/or radiation therapy [RT]) is the key component of the initial treatment of locally advanced squamous cell head and neck cancer but is associated with high rates of locoregional and distant recurrence. In addition, treatment can cause considerable morbidity, including loss of swallowing and larynx function.

In an effort to improve cure rates and functional outcomes, chemotherapy has been integrated into various multimodality approaches. These approaches have been applied for both patients with unresectable cancers and those with resectable disease who prefer a non-surgical organ preservation technique.

Combined modality functional organ preservation approaches that have been studied in patients with locoregionally advanced head and neck cancer in addition to definitive RT alone include:

Induction (neoadjuvant) chemotherapy (chemotherapy prior to surgery and/or RT)

Concurrent chemoradiotherapy, in which chemotherapy is administered at the same time as RT. This approach has included various schedules in which cycles of induction chemotherapy are alternated with RT [1]. Newer targeted therapies can also be combined with concurrent radiation.

                                 

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Literature review current through: Nov 2016. | This topic last updated: Tue Nov 22 00:00:00 GMT 2016.
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