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CT may, or may not, be associated with surgery and/or RT.The choice of HNC therapy depends on the tumor staging and the approaches for organ preservation.
The head and neck are anatomically complex regions where a wide variety of cancers with different phenotypes, histologies and invasiveness may occur.However, the choice of therapy depends on the tumor staging and approaches, which are aimed at organ preservation.Because of systemic RT and CT genotoxicity, one of the important side effects is a secondary cancer that can result from the activity of radiation and antineoplastic drugs on healthy cells.Regarding CT, cisplatin is still the standard protocol for the treatment of squamous cell carcinoma, the most common cancer located in the oral cavity.However, simultaneous treatment with cisplatin, bleomycin and 5-fluorouracil or treatment with paclitaxel and cisplatin are also used.These drugs can interact with the DNA, causing DNA crosslinks, double and single-strand breaks and changes in gene expression.
Currently, the late effects of therapy have become a recurring problem, mainly due to the increased survival of HNC patients.
High rates of morbidity and mortality are observed, mainly because of the advanced clinical stage at the time of diagnosis.
However, the use of concurrent chemotherapy (CT) and radiation demonstrates that survival has substantially improved over the past decades for patients with most of the forms of HNC.
See: contributions: Minicucci EM and da Silva GN collected the literature and drafted the first version of the manuscript; Salvadori DMF did a critical reading of the manuscript and included additional literature.
Correspondence to: Daisy Maria Fávero Salvadori, Ph D, Departamento de Patologia, Faculdade de Medicina de Botucatu, Univ.
Head and neck cancer (HNC) is the sixth most common human malignancy worldwide.