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Chapter-058 Combining Chemotherapy with Radiotherapy in Advanced Squamous Cell Carcinoma

BOOK TITLE: Head & Neck Surgery (2 Volumes)

Author
1. Adelstein David J
ISBN
9788184486797
DOI
10.5005/jp/books/10351_58
Edition
1/e
Publishing Year
2009
Pages
13
Author Affiliations
1. Cleveland Clinic Lerner College of Medicine of Case; Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio, USA, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Staff Physician Cleveland Clinic, Cleveland, Ohio, USA, Cleveland Clinic Foundation Cleveland, Ohio, USA
Chapter keywords
chemotherapy, radiotherapy, squamous cell carcinoma, radiotherapeutic treatment, locoregional tumor, lymphoproliferative disorders, germ cell neoplasms, meta-analyses, neck cancer, head cancer

Abstract

This chapter discusses combining chemotherapy with radiotherapy in advanced squamous cell carcinoma, where sophisticated surgical techniques and aggressive radiotherapeutic treatment plans have been developed in an effort to address the problem of locoregional tumor. Systemic combination chemotherapy although highly active as a palliative tool, did not appear to possess curative potential for this disease, as had been observed in other cancers such as the lymphoproliferative disorders, or the germ cell neoplasms. Four separate meta-analyses performed to assess the value of chemotherapy in patients with head and neck cancer have failed to demonstrate a survival advantage for the neoadjuvant approach. Complete response rate, progression-free survival and overall survival were again significantly improved by the interdigitation of chemotherapy into the radiation therapy schedule. Histopathologic and molecular markers of this sensitivity are actively being investigated.

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