Controversies surrounding the use of neoadjuvant chemotherapy in locally advanced head and neck cancer

Abstract

What guidelines can be given on the treatment of locally advanced HNSCC today? The choice of treatment has often been dictated by the primary site, patient preferences (e.g., organ preservation) and the experience of the treatment team. CT-RT may be considered the gold standard treatment for patients with resectable locally advanced disease. For unresectable disease, CT-RT as well as induction TPF followed by CT-RT may be appropriate. Cetuximab/RT is a good option for patients who cannot receive chemotherapy. We must redouble our efforts to find appropriate predictive and prognos- tic features that could be used to improve treatment selection pathways, minimize toxicity and maximize efficacy. In that sense multidisciplinary work is the base of future research. © 2008 Expert Reviews Ltd.