Ambulantná terapia 3-4/2007

CHEMOTHERAPY OF THE HEAD AND NECK TUMOR´S

Head and neck carcinomas (HNC) are frequently occurring tumors, with more than 650 000 new cases each year worldwide. The majority of patients presents with advanced (stage III and IV) disease. Multidisciplinary approach is very important, especially for those patients with inoperable disease or those designated to organ preservation. Optimal chirurgical resection and full dose radiotherapy are the cornestone of treament. Standard treatment for patients with unresectable disease is platinum-based chemoradiotherapy. The results of recent studies that evaluated sequential induction chemotherapy including taxanes and chemoradiation have shown encouraging improvement of response rate, survival and time to progression. Now, the role and optimal integration of molecular-targeted agents into standard treatment modalities is an area of intensive investigation. Whether carboplatin may substitute for cisplatin in platinum – based chemoradiotherapy and whether platinum-based chemoradiotherapy will be substituted by a new and more effective treatment involving molecularly targeted agents, are very important questions now. The answers will only be given by new randomized phase III trials, some of them are ongoing.

Keywords: head and neck carcinomas, chemotherapy, chemoradiotherapy, targeted agents