The prognosis of patients with recurrent or metastatic head and neck squamous cell cancer is generally poor. The median survival in most series is six to nine months depending upon patient and disease-related factors.
Systemic therapy is indicated in conjunction with best supportive care for most patients with metastatic or advanced recurrent head and neck cancer. The choice of a systemic regimen is influenced by whether patients have received prior treatment as part of a combined modality approach to functional organ preservation as part of their initial management or whether they had been previously received systemic therapy for metastatic or incurable locoregional disease.
Treatment options include single agent therapy and combination regimens using either conventional cytotoxic chemotherapy and/or molecularly targeted agents, combined with best supportive care. The approach to patients requiring palliative systemic therapy is reviewed here, along with the management of oligometastatic disease.
The use of chemotherapy as a component of initial definitive therapy is discussed separately, as is the use of systemic chemotherapy in other malignancies of the head and neck region:
●(See "Locally advanced squamous cell carcinoma of the head and neck: Approaches combining chemotherapy and radiation therapy".)