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Radiochemotherapy in locally advanced squamous cell carcinomas of the head and neck
Clinical Oncology, 06/26/09

Matzinger O et al. - In a review of radiochemotherapy in locally advanced squamous cell carcinomas of the head and neck (SCCHN), this overview reviews the most relevant published studies on the multidisciplinary management of SCCHN and discusses future strategies to reduce locoregional failures.

• SCCHN is a common disease that develops in the upper aerodigestive epithelium.
• Most important risk factors are tobacco and alcohol consumption.
• There is increasing evidence that human papillomavirus plays an important role in the cause of SCCHN.
• The complex anatomy, the vital functions of the upper aerodigestive tract, and close proximity to vital structures, explain that the goal of treatment is not only to improve survival outcomes, but also to preserve organ function.

• Radiotherapy and surgery are standard modalities of treatment, reflecting the locoregional predominance of SCCHN.
• Chemotherapy plays an important role in treatment of pts with locoregionally advanced disease, in conjunction with radiotherapy and surgery.
• Standard therapy for resectable locoregionally advanced (stage III or IV) SCCHN cancers consists either of surgery and adjuvant chemoradiotherapy or definitive concomitant chemoradiotherapy, depending upon disease site, stage and resectability of the tumour, or institutional experience.
• Concomitant chemoradiotherapy has been shown in several randomised trials to improve disease-free (DFS) and overall survival (OS) in the postoperative setting for resected disease with poor prognostic factors.
• Multiple randomised studies and meta-analyses have shown that definitive chemoradiotherapy, as well anti-epidermal growth factor receptor treatment in 1 randomised study, improved DFS and OS when compared with radiotherapy alone.

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