Concomitant chemoradiotherapy is the most promising primary chemotherapy approach to prolonging the survival of patients with locally advanced resectable and unresectable disease. It is the only systemic approach consistently shown…

Adjuvant chemotherapy to eradicate micrometastases following local therapy has not been studied extensively in HNSCC. The principal objectives of adjuvant trials have been to control subclinical persistent disease after surgery…

Neoadjuvant (induction) therapy prior to surgery is sometimes referred to as sequential chemoradiotherapy when chemotherapy is followed by definitive radiotherapy. This latter approach specifically excludes or limits the extent…

Although chemo-therapy has not improved the short-term survival of patients with recurrent or metastatic HNSCC, promising results are emerging from the intense study of chemotherapy as an adjunct to…

Radiotherapy is often given as an adjuvant to surgery for moderately advanced but resectable tumors. For most head and neck sites, giving adjuvant radiotherapy improves local…

Clinical testing of new cytotoxic agents traditionally has been conducted first in patients with recurrent disease, followed by testing in combined modality treatments in patients with potentially…

HNSCC responds to radiation injury through a loss of reproductive capability, resulting in a clonogenic rather than an interphase death. Within the context of a given fractionation…

There are two basic intents to the addition of chemotherapy to the treatment regimen for head and neck cancer: (1) there is potentially a synergistic effect…

Accelerated and Hyperfractionated Radiotherapy - treatment of head and neck cancer
An area of current interest in the treatment of head and neck cancer is…

Radiotherapy plays an integral role in the treatment of most head and neck cancers. Used as the sole modality for the treatment of select early-stage disease (T1 and T2), it gives…

Advances in radiotherapy have been tied to advances in technology. In the early days, low-energy orthovoltage devices and radium 226 sources were used to treat HNSCC. Then came…

Anatomy
Salivary gland tissue is ubiquitous in the submucosa of the upper gastrointestinal tract and is grouped into three major salivary glands: the parotid, the submaxillary (or submandibular), and the sublingual glands. The…

As mentioned previously, the nose and the paranasal sinuses pose a unique set of problems that deserve separate consideration from SCC of the UADT. For instance, while SCC is still the most…

Although the skin of the head and neck accounts for less than 10% of the body’s surface area, 70% to 80% of cutaneous malignancies occur in this region. As a result of greater…

A special issue relates to the treatment of carcinoma in situ of the vocal cords. This disease often can be managed with vocal cord stripping, but if enough serial sections are examined, foci of…

The treatment of glottic cancer is greatly influenced by the secondary goal of voice preservation. Mobility of the vocal cords is a critical factor in selecting treatment. For small cancers (T1, T2)…

Cancer of the base of the tongue poses a more difficult therapeutic problem than do tonsillar carcinomas. The 5-year survival rates are lower, metastases are more common, early diagnosis is less common, and treatment…

Cancers of the soft palate and pharyngeal wall are less common than other oropharyngeal neoplasms. Most soft-palate cancers occur on the anterior surface of the palate and tend to be…

Because of the prominent role the larynx plays in communication, swallowing, respiration, protection of the lower airway, and therefore, quality of life, the treatment of cancer of the larynx presents…

The hypopharynx represents one of the most lethal sites for SCC. Lymph node metastases are clinically evident at time of diagnosis in 70% to 80% of patients and are indicative of…

Important factors in selecting therapy for supraglottic cancers are tumor location and preepiglottic extension. Tumors limited to the suprahyoid epiglottis are amenable to radiation with fields that encompass neck regions…