[Neo-adjuvant chemotherapy in patients with head and neck cancer]

Standard treatment for head and neck carcinomas consists of surgery, and/or radiotherapy. However, standard treatment alone is less successful for advanced head and neck carcinomas. With the development of cisplatin (CDDP), the efficacy of chemotherapy including CDDP has markedly increased in head and neck carcinomas. Accordingly, neo-adjuvant chemotherapy has been applied for advanced carcinomas. The purpose of neo-adjuvant chemotherapy for head and neck carcinomas is to improve the curability by means of this chemotherapy strategy followed by standard treatment, to eradicate micro-metastatic lesions, and, more recently, organ preservation without compromising overall survival. The previous studies have demonstrated that this chemotherapy is efficacious for patients with complete response (CR), especially pathological CR, after chemotherapy in terms of preserving primary organ and overall survival. Therefore, the development of intensive chemotherapy regimen showing a high CR rate is necessary. Furthermore, the control of the secondary malignancies frequently occurring in patients with head and neck cancer, and the management of complications caused by aging and/or heavy drinking, are also indispensable to improve survival in advanced head and neck cancer patients.