Treatment of Advanced Head and Neck Cancer: Past, Present, and Future

Surgery and/or radiation were historically standard of care in locally advanced head and neck malignancies. During the 1980s, various radiation schedules were studied. Chemotherapy was eventually added to radiotherapy, first sequentially, as induction chemotherapy, then concurrently, recognizing the primary need of improved locoregional control over that of distant disease control. Simultaneously, the optimization of radiation as single-modality therapy was pursued. The authors review multiple randomized trials and meta-analyses evaluating altered fractionation radiation schedules and conclude that altered fractionation improves local and local regional control compared to conventional fractionated radiation.[1-12]