A Review on the Efficacy of Chemotherapy in Locally Advanced Head and Neck Cancers

Abstract

Background and Aims: Chemotherapy is utilized as a part of combined-modality programs to achieve organ preservation and improve survival in patients with locally advanced head and neck cancer. Combinedmodality protocols can be used in three forms: a) neoadjuvant induction chemotherapy before definitive surgery or radiotherapy; b) concomitant chemoradiotherapy; and c) sequential therapy consisting of induction chemotherapy and chemoradiation. The aim of this article was to study the role of these methods in treatment of locoregionally advanced head and neck cancers. Methods: An extensive search was performed on PubMed using five key phrases of head and neck, carcinoma, neoadjuvant chemotherapy, induction chemotherapy, and adjuvant chemotherapy. The search results were limited to randomized trials and meta-analysis. Results: Despite an improvement in organ preservation, induction treatment has no impact on survival. Chemoradiation provides higher survival and increased rate of organ preservation compared to radiation alone. Ongoing phase III comparisons of sequential therapy with chemoradiotherapy may help identify the superior approach. Conclusion: Although further studies in this field are required, taxane-based sequential therapy can be currently used as a reasonable alternative to chemoradiotherapy in patients with locally advanced head and neck cancers.