Review Systemic therapy in the curative treatment of head and neck squamous cell cancer: a systematic review
Chemotherapy with cisplatin (≥40 mg/m²/week) combined with radiation is a standard curative approach for locally advanced head and neck squamous cell carcinoma.
The review appraises evidence for systemic drug use combined with radiation and/or surgery in locally advanced non‑metastatic squamous cell carcinoma of the head and neck (LASCCHN). Meta‑analyses of chemotherapy (MACH‑NC) confirm improved overall survival with concurrent chemoradiotherapy, especially using high‑dose cisplatin. No targeted agent or radiosensitizer has shown superiority to standard concurrent cisplatin‑RT; cetuximab‑RT is only recommended for patients unable to receive CRT. Induction triplet taxane‑based chemotherapy (TPF) improves tumour response and larynx preservation but not overall survival. 5‑FU + platinum may be an alternative to cisplatin for unsuitable patients.
This finding reinforces the evidence‑based standard of concurrent cisplatin‑RT, guiding clinicians to adopt this regimen for most patients while reserving alternative agents for those who cannot tolerate cisplatin.
Bizonyítékszint: Feltételezés / hírjelzés. Nincs önálló tudományos bizonyíték.
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