Update in cancer chemotherapy: head and neck cancer, Part 2.

Until further controlled trials demonstrate a clear advantage for combination chemotherapy, single-agent chemotherapy will be considered the standard palliative therapy for recurrent squamous cell tumors of the head and neck. The most consistently active of the single agents include methotrexate, bleomycin, and cisplatin, which have produced important, but temporary, responses in 30 to 60 percent of patients. Part 1 describing single-agent chemotherapy was published in the October issue of the Journal.There are suggestions in some trials that disease-free intervals as well as increases in survival time are achieved when combination chemotherapy is administered as a first-line therapy before standard surgery and/or radiation therapy. Further randomized studies are needed to establish the final role of chemotherapy in the multimodal treatment of cancer of the head and neck.