Combined chemotherapy and radiation therapy for advanced squamous-cell cancer of the head and neck

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The combination of chemotherapy and radiation has found a place among treatments for advanced head and neck cancer. It is most useful in the treatment of unresectable cancer and cancer for which the surgical morbidity would be prohibitive. In addition, combinations of chemotherapy and radiation have proven useful in the treatment of nasopharyngeal cancer and unresectable cancers that recur after irradiation. The most promising approaches use concomitant multiagent chemotherapy and radiation; in these approaches, chemotherapy seems to act largely as a radiation sensitizer. These approaches are replacing the traditional neoadjuvant or induction approaches. New radiation fractionation schemes are also being introduced and seem to yield better results. Further study is needed to find new chemotherapeutic agents and new, less toxic therapeutic combinations, to determine the best way to combine treatments, and to define the population of patients most likely to benefit from these newer approaches.

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