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World J Clin Oncol. Dec 10, 2014; 5(5): 966-972
Published online Dec 10, 2014. doi: 10.5306/wjco.v5.i5.966
Chemotherapy advances in locally advanced head and neck cancer
Peter Georges, Kumar Rajagopalan, Chady Leon, Priya Singh, Nadir Ahmad, Kamyar Nader, Gregory J Kubicek
Peter Georges, Kumar Rajagopalan, Chady Leon, Priya Singh, Kamyar Nader, Department of Medical Oncology, Cooper University Hospital, Camden, NJ 08103, United States
Nadir Ahmad, Department of Otolaryngology, Cooper University Hospital, Camden, NJ 08103, United States
Gregory J Kubicek, Department of Radiation Oncology, Cooper University Hospital, Camden, NJ 08103, United States
Author contributions: Georges P and Kubicek GJ wrote the paper; Rajagopalan K, Leon C, Singh P, Ahmad N and Kubicek GJ edited the article; all the authors contributed to this paper.
Correspondence to: Gregory J Kubicek, MD, Department of Radiation Oncology, Cooper University Hospital, One Cooper Plaza, Camden, NJ 08103, United States. greg.kubicek@gmail.com
Telephone: +1-856-3422300 Fax: +1-856-3658504
Received: December 30, 2013
Revised: July 17, 2014
Accepted: July 27, 2014
Published online: December 10, 2014
Processing time: 345 Days and 16.9 Hours
Abstract

The management of locally advanced unresectable head and neck squamous cell cancer (HNSCC) continues to improve. One of the major advances in the treatment of HNSCC was the addition of chemotherapy to radiation in the treatment of non-surgical patients. The majority of the data regarding chemotherapy in HNSCC involve cisplatin chemotherapy with concurrent radiation. However, several new approaches have included targeted therapy against epidermal growth factor receptor and several recent studies have explored the role of induction chemotherapy in the treatment of HNSCC. The purpose of this article is to provide an overview of the role of chemotherapy in the treatment of locally advanced HNSCC.

Keywords: Head and neck cancer; Chemotherapy; Induction

Core tip: For select patient subsets the addition of chemotherapy to radiation in head and neck squamous cell cancer improves outcome. Most data is for concurrent cisplatin although other agents are also being explored. There has recently been interest in induction chemotherapy, the induction studies although heterogeneous have failed to show an improvement in overall survival. In this article we discuss the data regarding concurrent chemotherapy and also the data regarding induction therapy and which patient subsets we feel are best suited for induction chemotherapy (patients with N3 disease and those expected to have a delay in starting concurrent concurrent chemoradiotherapy).