Management of head and neck squamous cell carcinoma in the primary and relapsed setting requires the coordinated efforts of head and neck surgeons, radiation oncology, and medical oncology in order to maximize clinical care. Multidisciplinary efforts must be strengthened and new research performed to improve the otherwise poor prognosis for patients with locally recurrent HNSCC.
Two-year results from the largest randomized trial of IMRT in head and neck cancer confirm that it dramatically reduces the risk of dysphagia and xerostomia. The study was too small to establish a survival advantage, although the results are encouraging.
Induction chemotherapy has led to improved survival and organ preservation. Combining induction therapy with other treatment modalities is critical for treating this complex disease and attaining optimal outcomes.
Removing an oropharyngeal tumor through the open mouth using robotic instruments now has FDA approval, and its safety is well documented. Comparative evidence of its effectiveness is beginning to trickle in.
In the following sections, we will first review the radiotherapy techniques that have been investigated. We will then review the progressive advances achieved with the addition of chemotherapeutic strategies to RT in an attempt to achieve better outcomes.
Genzyme Corp. recently announced that the US Food and Drug Administration (FDA) has approved a supplemental indication for thyrotropin alfa for injection (Thyrogen) to be used in combination with radioiodine to ablate, or destroy, the remaining thyroid tissue in patients who have had their cancerous thyroids removed.
A 51-year-old man presented to the Dermatology Section at the University of Chicago Medical Center in August 2007 with a pruritic, papulopustular eruption on the face. He had been started 4 weeks ago on induction chemotherapy with paclitaxel, carboplatin, and cetuximab (Erbitux) for hypopharyngeal squamous cell carcinoma (T2N3M0). He denied any prior history of acne or rosacea.