Annals of Oncology 13:995-1006, 2002
© 2002 European Society for Medical Oncology
Review Article |
End points for new agents in induction chemotherapy for locally advanced head and neck cancers
Departments of 1 Medicine, 2 Head and Neck Surgery and 3 Radiotherapy, Institut Gustave-Roussy, Villejuif, France
Received 24 July 2001; revised 7 December 2001; accepted 9 January 2002
Abstract
More than 60% of patients diagnosed with squamous cell carcinoma of the head and neck present at a locally advanced stage. Although multimodality therapy has improved locoregional control, the 5-year survival rate of this population rarely exceeds 30%. In this review, we analyzed the impact of chemotherapy in the management of locally advanced head and neck cancer and we underline the potential benefit of induction chemotherapy. The Meta-Analysis of Chemotherapy in Head and Neck Cancer collaborative group has suggested a survival advantage of 5% at 5 years for platin–5-fluorouracil induction chemotherapy. We have analyzed cofactors that may affect the survival of head and neck patients and propose new end points for assessment of the efficacy of induction chemotherapy. The detrimental effect of second primary tumors on long-term results is stressed and we have suggested the use of overall 2-year survival as a surrogate end point for induction chemotherapy efficacy. Finally, we have examined the impact of new cytotoxic agents and present the promising results of new taxane-based combinations.
Key words: head and neck cancer, neoadjuvant chemotherapy, new drugs, new methodology, taxanes
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