Current chemotherapy of head and neck cancer

This article reviews the results of over 50 published trials testing the use of chemotherapy in patients with squamous cell carcinoma of the head and neck. Among the trials using chemotherapy before standard surgery and/or radiotherapy in stage III and IV disease, none has shown an improvement in survival compared with surgery and/or radiotherapy alone. In these studies, the survival at 3 to 5 years has been generally 40% to 50%. Several trials using chemotherapy after standard therapy, however, have reported survival benefits of 10% to 20%, suggested that further evaluation of classic adjuvant chemotherapy in this disease is warranted. Among studies in recurrent head and neck cancer, the most effective chemotherapy regimens appear to be variations of the program consisting of cisplatin followed by a 5-day infusion of 5-fluorouracil. Nevertheless, median survivals in recurrent disease remain short, generally 5 to 10 months.