Treatment of Locally Advanced Head and Neck Cancer: Historical and Critical Review

BACKGROUND: Advanced squamous cell cancers of the head and neck have traditionally been associated with high rates of morbidity and mortality. Advances in management have improved outcomes for most of these patients. METHODS: The author reviews the historical progress in management of these difficult tumors and adds his own wide experience to describe and evaluate newer approaches to management. RESULTS: Over the last 10 years, overall survival rates for patients with head and neck cancers have improved as has quality of life. New standards of care have been defined for patients with nasopharyngeal cancer and for those with advanced unresectable disease. Organ preservation is more commonly achieved. CONCLUSIONS: Newer targeted therapies are likely to add to the progress that has already been achieved in the multimodality management of patients with head and neck cancers.