Changing Patterns of Failure of Head and Neck Cancer

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Abstract
HEAD AND NECK squamous cell carcinomas (HNSCCs) are a diverse group of cancers and are frequently aggressive in their biological behavior. They account for 2% to 3% of all cancers in the United States and for 1% to 2% of all cancer deaths. Most patients with this malignancy have advanced disease at presentation, with regional disease in 43% and distant metastases in 10%.1 Initial therapy for these cancers has traditionally involved surgery, radiotherapy, or a combination of both. However, the use of radical surgery or radiotherapy has been associated with significant long-term morbidity, such as dysphagia and loss or alteration of voice. In addition, recurrent disease develops in 27% to 50% of these patients. The use of multimodality therapy has gained favor in recent years in an attempt to increase organ preservation, improve local control, and decrease the incidence of second primary tumors.

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