It was not too many years ago that the role of chemotherapy for
head and neck cancer consisted of single-agent methotrexate for
selected patients with recurrent disease. In the past decade,
multiple new agents, high-dose chemotherapy, combinations, and
intra-arterial approaches have been used for the patient with
recurrent disease. Wheeler critically assesses the current status
of these approaches. When oncologists began testing chemotherapy in
the combined modality approach, trials consisted of induction
chemotherapy and use of single agents as radiosensitizers. Although
a great deal has been learned from these trials, benefit in terms
of survival has been marginal. Even more promising may be the
concomitant use of combination chemo therapy and radiation. Taylor
describes the encouraging results as well as the potential.
Induction chemotherapy may have a second important goal in addition
to improving curability-it could be used for organ preservation.
Dimery et al., present the background for this approach in the
patient with laryngeal cancer as well as a description of their
randomized trial for voice preservation. Head and neck squamous
cancers are a heterogeneous group of diseases, and surgeons have
long sought parameters that will help predict outcome."
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