Radioquimioterapia simultánea en el tratamiento de los tumores: Cabeza y cuello

The treatment of patients with squamous cell carcinoma of the head and neck has changed during the past decade. On locally advanced disease, the addition of chemotherapy to conventional radiotherapy has been shown to be superior to radiotherapy alone, improving locoregional control and overall survival. On postoperative setting, recent randomized trials demonstrated the improvement of concurrent treatment for patient with high risk of recurrence. Induction chemotherapy to concurrent chemoradiotherapy has been showing promising results for organ preservation. Concurrent treatment with Cisplatin-based regimens has been identified as the most active treatment. Altered radiation fractionation regimens that incorporate acceleration and hyperfraction can improve loco-regional control but also increases acute toxicities. Intensity modulated radiotherapy (IMRT) has emerged as a promising method for delivery of increased dose to tumour tissues while limiting dose to normal structures. Novel targeted agents, such as antagonists of the epidermal growth factor receptor are showing promise in the treatment of patients with both locally advanced and metastasis head and neck cancer.