Radiotherapy with concomitant chemotherapy for head and neck cancer

Concomitant chemoradiotherapy has already resulted in statistically significantly improved disease-free and overall survival for patients with head and neck cancer. Although the differences observed so far have been small, it is of note that the improved outcome was achieved even though only single-agent chemotherapy was used. More recent, chemoradiotherapy schedules have employed more aggressive chemotherapy regimens, frequently with split-course radiotherapy. Several of these schedules have resulted in encouraging response and survival figures in phase II trials. At the same time, toxicities, usually in the form of mucositis, have also been increased. The role of these schedules in the management of patients with advanced head and neck cancer will need further evaluation, eventually using a randomized format comparing such a regimen with standard radiotherapy alone. Their use outside of clinical trials cannot be recommended yet.