Abstract
Adjuvant systemic therapy in head and neck cancer has not been actively studied because regional recurrences have focused attention on the need for improved regional therapy and because additive toxicity with radiation therapy has discouraged use of effective regimens of chemotherapy. Randomized multi-institution studies have shown no differences in disease-free survival after 2 years [15, 28]. However, improved disease-free survival for the first 8–12 months was observed in a few studies [14, 21]. Such a duration of effect from methotrexate in the treatment of gross residual disease would be unusual and suggested that a more aggressive approach to adjuvant treatment might yield more long-lasting beneficial results. With improved local control from more effective surgery and radiation therapy, systemic metastases have caused an increased percentage of treatment failures accentuating the need to re-examine systemic adjuvant therapy [13]. Response rates to chemotherapy have also improved with the use of methotrexate and leucovorin in a weekly schedule [20] and use of combination drug therapy [3] although duration of response remains short. These developments are background to our current approach to adjuvant therapy trials.
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Taylor, S.G., Sisson, G.A., Bytell, D.E. (1979). Adjuvant Chemoimmunotherapy of Head and Neck Cancer. In: Bonadonna, G., Mathé, G., Salmon, S.E. (eds) Adjuvant Therapies and Markers of Post-Surgical Minimal Residual Disease II. Recent Results in Cancer Research, vol 68. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-81332-0_46
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