Review article
Induction chemotherapy in squamous cell carcinoma of the head and neck
Valentina Krstevska
; Institute of Radiotherapy and Oncology, Clinical Center, Skopje, R. Macedonia
Maja Popova
; Institute of Radiotherapy and Oncology, Clinical Center, Skopje, R. Macedonia
Abstract
Chemotherapy represents an important component of multimodality treatment approach for locally and/or locoregionally advanced squamous cell carcinoma of the head and neck. There is now clear evidence that concurrent chemoradiotherapy provides statistically significant improvement in survival and locoregional control in patients with advanced head and neck cancer. Induction chemotherapy has been shown to permit organ preservation in operable patients and to reduce the risk of distant metastases. The renewed interest of re-integration of induction chemotherapy in the treatment of head and neck cancer is based upon the recognition that the development of distant metastatic disease has become more frequent pattern of failure when concurrent chemotherapy is utilized as standard of care for this patient category. Induction chemotherapy, being directed to decrease the incidence of distant metastases, is expected to improve overall treatment outcome. Recently documented improvement of response rates and survival outcome by the addition of a taxane to standard platinum plus 5-fluorouracil regimen has also indicated the possibility of a new role for induction chemotherapy. There are encouraging results of phase II trials investigating the sequential treatment approach of induction chemotherapy with threedrug regimens incorporating taxane followed by concurrent chemoradiotherapy. Phase III trials comparing taxane containing induction chemotherapy followed by chemoradiotherapy with chemoradiotherapy alone are currently underway. However, induction chemotherapy still remains an investigational treatment strategy in the management of advanced head and neck cancer.
Keywords
head and neck cancer; chemotherapy; concurrent chemoradiotherapy; induction chemotherapy
Hrčak ID:
280774
URI
Publication date:
22.11.2007.
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