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Summary
For recurrent or metastatic head and neck cancer, methotrexate is the standard chemotherapy, offering transient responses in 25% of patients. Its use in primary treatment requires further clinical trial validation.
Area of Science:
- Oncology
- Head and Neck Cancer Treatment
Background:
- Chemotherapy plays a role in managing head and neck cancers.
- Evaluating the efficacy of chemotherapy for recurrent or metastatic disease is crucial.
Purpose of the Study:
- To review the role of chemotherapy in head and neck cancer.
- To assess the effectiveness of chemotherapy for recurrent or metastatic squamous cell carcinoma.
Main Methods:
- Review of literature and clinical trials from The Princess Margaret Hospital.
- Critical analysis of chemotherapy response rates and survival data.
Main Results:
- Methotrexate is the superior agent for recurrent/metastatic squamous cell carcinoma, with ~25% transient response rates.
- Reported higher response rates often lack correlation with survival and may be inflated by variable criteria.
- Long-term benefits of chemotherapy in combined modality treatment are not yet demonstrated.
Conclusions:
- Chemotherapy is not standard for recurrent/metastatic head and neck cancer.
- Use in primary treatment should be confined to well-designed clinical trials.