Camil Ciprian Mirestean1,2, Roxana Irina Iancu3,4, Dragos Teodor Petru Iancu5,6
1Oncology and Radiotherapy Department, University of Medicine and Pharmacy Craiova, Craiova, Romania.
2Railways Clinical Hospital, Surgical Department, Iasi, Romania.
3Oral Pathology Department, “Gr.T.Popa” University of Medicine and Pharmacy, Iasi, Romania.
4Clinical Laboratory, “St.Spiridon” Emergency Hospital, Iasi, Romania.
5Oncology and Radiotherapy Department, “Gr. T. Popa” University of Medicine and Pharmacy, Iasi, Romania.
6Radiation Oncology Department, Regional Institute of Oncology, Iasi, Romania.
Summary
Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide, with more than 650,000 new cases diagnosed each year. The current management of this pathology has evolved from surgery or radiotherapy as the sole treatment to a combination of methods with a modern approach based on multidisciplinary loco-regional and systemic treatments. Cisplatin-based chemotherapy administered concurrently with radiotherapy is accepted as a therapeutic standard in locally advanced cases of HNSCC (T3, T4 or N+), which account for 60% of newly diagnosed patients. The use of induction chemotherapy (IC) has been practiced for over 30 years, with controversial results. Currently, the combination of taxanes with platinum-fluorouracil-based regimens has shown benefits in numerous studies. Gemcitabine has also demonstrated radiosensitizing potential when administered alone or in combination with platinum salts. The addition of new molecular targeted agents or immunotherapy to the therapeutic arsenal, as well as the development of irradiation techniques with reduced toxicities, offer new possibilities for the sequential administration of IC followed by radiotherapy either as a single modality or as concurrent chemoradiation (CCRT).
Keywords: induction chemotherapy, head and neck cancers, radiotherapy, immunotherapy, surgery, toxicity, oncology.
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