Which of the following is the most beneficial technique of using chemotherapy with a course of radiotherapy in head and neck malignancies ?
Ans. is 'c' i.e., Concurrent chemotherapy Chemotherapy is only used in the t/t of advanced cancer, of head or neck (Not in localized disease) In advanced cancers (locally or regional) the treatment includes all the three modalities i.e., Surgery + Chemotherapy + Radiotherapy Earlier it was thought that neoadjuvant chemotherapy was best form of therapy, but now it is confirmed that concomitant chemotherapy is the most effective. T/T of head and neck Tumors A) Localized disease These includes cancers without detectable lymphnode involvement or distant metastasis i.e., (Stage I and H) - These patients are treated with curative intent They are treated either by surgery or radiotherapy. - The choice of modality depends upon the anatomical location and institutional expeice Laryngeal cancers --> Usually radiotherapy is done Oral cancers --> Usually surgery is required B) Advanced disease (Local or regional) - an be treated with curative intent - Combined modality t/t including Surgery, chemotherapy and radiation is the best Also know Drugs commonly useful in the t/t of head and neck cancers a) 5 Fluorouracil b) Cisplatin oplasia Terminology Neoadjuvant chemotherapy --> when chemotherapy is done before surgery or radiotherapy Concomitant chemotherapy --> when chemotherapy is done at the time of surgery or radiotherapy Adjuvant chemotherapy ---> When chemotherapy is done after surgery or radiotherapy.
Neo adjuvant chemotherapy
Adjuvant chemotherapy
Concurrent chemotherapy
Alternating chemotherapy and radiotherapy