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The Contribution of Chemotherapy

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Functional Preservation and Quality of Life in Head and Neck Radiotherapy

Part of the book series: Medical Radiology ((Med Radiol Radiat Oncol))

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Squamous cell carcinomas of the head and neck (SCCHN) are a heterogeneous group of malignancies that originate in the epithelium of the nasal cavity, sinuses, pharynx, oral cavity, and larynx. They are frequently diagnosed at advanced stages with extension of the primary tumor to adjacent structures and/or regional spread to neck lymph nodes. Since SCCHN and its treatment can affect organs and systems critical for important functions, such as speaking, breathing, and swallowing, patients with SCCHN may develop a variety of symptoms and impairments, including mouth or neck pain, diffi culties in chewing and swallowing resulting in malnutrition and aspiration, hoarseness or loss of natural voice, problems in breathing, head and neck deformities, and others. Given the risk for potential functional defi cits from potentially curative treatment, not only cure but organ preservation, functional outcomes, and quality of life (QOL) are of foremost importance in the management of patients with SCCHN.

Therapeutic options for the treatment of locally advanced SCCHN have evolved over the past two decades as a result of developments in the area of combined modality strategies. Historically, standard therapy for locally advanced SCCHN involved surgical resection with or without postoperative radiotherapy for resectable disease or radiation therapy alone for unresectable tumors. In an effort to increase the probability of organ preservation and survival, chemotherapy was evaluated as a component of combined modality approaches. The contribution of induction, concomitant, and/or adjuvant chemotherapy was studied in a large number of phase III randomized clinical trials. On the basis of this cumulative experience, concomitant chemoradiotherapy (CRT) emerged as a standard treatment for improving survival and/or achieving organ preservation in locally advanced SCCHN. However, with treatment intensifi cation, mostly related to the addition of chemotherapy to radiotherapy in a concurrent fashion, complications of treatment are seen in increased frequency. This chapter aims to concisely review the effi cacy and toxicity of current combined modality approaches with a focus on functional outcomes and the potential impact on QOL.

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Authors and Affiliations

  1. Division of Hematology-Oncology, University of Pittsburgh School of Medicine, UPMC Cancer Pavilion, 5th Floor 5150 Centre Avenue, Pittsburgh, PA, 15232, USA

    Michalis V. Karamouzis MD, Michael K. Gibson MD & Athanassios Argiris MD

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  1. Michalis V. Karamouzis MD
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  2. Michael K. Gibson MD
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  3. Athanassios Argiris MD
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Editors and Affiliations

  1. Department of Human Oncology, University of Wisconsin School of Medicine, 600 Highland Avenue, K4/332, Madison, WI, 53792, USA

    P. M. Harari MD

  2. Division of Otolaryngology-Head and Neck Surgery, University of Wisconsin Medical School, 600 Highland Avenue K4/711, Madison, WI, 53792-7375, USA

    N. P. Connor PhD

  3. Department of Oncology, Aarhus University Hospital, 44 Nøerrebrogade, Building 5, Aarhus C, DK-8000, Denmark

    C. Grau MD

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Karamouzis, M.V., Gibson, M.K., Argiris, A. (2009). The Contribution of Chemotherapy. In: Harari, P.M., Connor, N.P., Grau, C. (eds) Functional Preservation and Quality of Life in Head and Neck Radiotherapy. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-73232-7_18

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