Integration of chemotherapy in the curative treatment of locally advanced head and neck cancer.

The role of chemotherapy for locoregionally advanced head and neck cancer continues to evolve. Chemotherapy can be given as induction therapy, concomitant with radiation or occasionally in an adjuvant form following definitive local therapy. Timing and sequence of chemotherapy varies between institutions. The recent advances in the treatment of head and neck cancer will be reviewed, with focus on the recent application of sequential chemoradiotherapy regimens, which combines high-dose induction chemotherapy with concomitant chemoradiation. Surgery is reserved for advanced nodal-stage disease and for salvage at the primary site. This novel approach has resulted in a higher rate of organ preservation and is ultimately expected to improve survival in this patient population.