The role of chemotherapy for advanced oro and hypopharyngeal cancer.

Although important progress continuous to be made in the treatment of oro and hypopharyngeal cancer, the 5-year survival rate for all this disease has remained at less than 30% for the past 30 years. In the early 1980s, chemotherapy was introduced with high expectation of reducing in the incidence of distant metastases and increasing the possibility of local control. This article explores the use of chemotherapy in the treatment of advanced pharyngeal cancer. Thus, the efficacy of chemotherapy are reviewed and treatment options for advanced pharyngeal cancer are made. When advanced carcinoma is still localized, function-preserving surgery is performed. In these cases, the possibility of instituting adjuvant chemotherapy with an active treatment regimen may be taken into account depending on the condition of the patient and the tumor. Patients with surgically resectable tumors are given 1-2 cycles of induction chemotherapy. Cases who respond to the induction chemotherapy are subsequently given concurrent chemoradiotherapy. Residual lymph nodes in the neck are removed surgically. The cases who do not respond to the induction chemotherapy are treated with radical surgery. Patients with unresectable carcinoma are given concurrent chemoradiotherapy because local treatment should be performed in such patients as early as possible. In principle, concurrent regimens should be supplemented with adjuvant chemotherapy in all cases. This is particularly required for those with advanced N-stage patients.