Update in cancer chemotherapy: head and neck cancer, Part 1

Squamous cell tumors of the head and neck are sensitive to a variety of chemotherapeutic agents, of which the most consistently active are methotrexate, bleomycin, and cisplatin. In recurrent disease, active single agents or combination chemotherapy can provide important yet temporary palliation of the disease in from 30 to 60 percent of patients with a duration of months. In previously untreated disease, however, a variety of effective combinations of drugs, mostly platinum-based combinations, are providing high response rates ranging from 60 to 90+ percent and are often associated with complete remissions.When induction chemotherapy is followed by definitive surgery and/or radiation therapy, there are beginning to appear evidences of increased disease-free survival and improved survival rates in some uncontrolled trials. Further appropriate randomized studies are necessary to establish whether polychemotherapy combined with surgery and/or radiation therapy will bring cancer of the head and neck further upon the horizon of cure.Part 1 of this study will review single-agent chemotherapeutic agents; Part 2, to be published in the November issue of the Journal, will evaluate polychemotherapy combined with surgery and/or radiation therapy.