The use of concurrent chemotherapy and radiotherapy for locoregionally advanced head and neck cancer.

The long-term prognosis of patients with advanced head and neck cancer has been poor. Combined modality approaches, such as induction chemotherapy, adjuvant chemotherapy, and concomitant chemoradiotherapy, have been studied in an effort to control local tumor and reduce systemic tumor dissemination. Randomized clinical trials and meta-analyses have both demonstrated a survival benefit with concomitant chemoradiotherapy, despite the omission of surgery. Because of both direct and indirect toxicities of concomitant chemoradiotherapy, less-toxic and equally effective strategies are being investigated. Concurrent chemoradiotherapy should be considered a possible standard therapy option for head and neck cancer patients and should be administered at treatment centers with experienced health care providers who have access to clinical trials.