Head and Neck

Carboplatin for chemoradiation for head and neck cancer – pro

Organ sparing approaches are now standard for laryngeal cancer. These center on combined chemotherapy and radiation approaches; more recently induction multi-drug regimens are used to precede chemoradiation. Although NCCN lists only Taxol and cisplatin among tis platin containing regimens on p. 73 of its recommendations for laryngeal cancer, use of carboplatin instead of cisplatin is widespread and there are a number of phase II studies that support

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Tarceva for head and neck cancer – pro

Tarceva is currently FDA approved for pancreatic cancer in combination with gemcitabine and for non-small cell lung cancer for second line. Head and neck cancers display high levels of EGFR activity and another EGFR inhibitor, cetuximib, is active and FDA approved for head and neck cancer. Similar to cetuximab, there are indications that erlotinib may be synergistic with radiation. Erlotinib has been evaluated in combination with Radiation Therapy

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PET surveillance for head and neck cancer – pro

Routine surveillance is not indicated and not recommended by any guidelines. As such, it is not supported by credible scientific evidence published in peer-reviewed medical literature generally and recognized by the relevant medical community, such as guidelines cited in the Reference section. It is not clinically appropriate in terms of type, frequency, extent, site and duration and considered effective for the condition in question; AND◦not primarily

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TPF induction chemotherapy or head and neck cancer – pro

A growing body of data from randomized clinical trials has demonstrated that induction chemotherapy -- in combination with chemoradiotherapy -- may play an important role in the treatment localized head and neck cancers. The standard neoadjuvant chemotherapy regimen has consisted of a platinum agent and 5-fluorouracil (5-FU), a regimen known as PF. More recently, the addition of a taxane such as docetaxel (or, less commonly, paclitaxel) to the PF

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Chemotherapy for sinonasal carcinoma – pro

Sinonasal undifferentiated carcinoma (SNUC) is a rare and highly aggressive neoplasm of the paranasal sinuses, which has recently been characterized as a distinct pathologic entity. The prognosis for patients with SNUC is poor. There is only case report level information on the usefullness of chemotherapy for this condition and most of these indicate that it is not very effective. Etoposide is supported by a few reports, mostly in combination but

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Taxotere Avastin for salivary gland – pro

Salivary galnd tumors are not common in stage IV and not much is known about how to optimally treat metastatic salivary galnd cancer.  Their cancer may be responsive to aggressive combinations of chemotherapy and radiation. Patients with any metastatic lesions could be considered for clinical trials. Chemotherapy using doxorubicin, cisplatin, cyclophosphamide, and fluorouracil as single agents or in various combinations is associated with modest

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Taxol, carboplatin, Erbitux for stage IV head and neck cancer – pro

For the treatment of recurrent and/or metastatic head and neck cancer, therapeutic options include re-irradiation and salvage surgery and chemotherapy, with best supportive care for patients unable or unwilling to undergo treatment. Palliative chemotherapy has demonstrated survival advantages over best supportive care, and the most commonly used agents are cisplatin and carboplatin, generally in combination regimens with infusional fluorouracyl or

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Chemosensitivity and chemoresistance assays – pro

Chemosensitivity assays are controversial but most experts believe that they do not reliably assist in selecting chemotherapy. There is more evidence for chemoresistance assays but this also remains disputed. Chemoresistance assays are a modification that tests resistance to chemo rather than sensitivity. They work on the assumption that if celss show reesistance to very high concentrations of a drug in vitro, they will also be resistant in vivo

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Combining platin and Erbitux with radiation for head and neck cancer – pro

Lay Summary: Erbitux or platin with radiation or induction chemotehrapy followed by one of these two options with radiation is the standard of care. One study described the combination of the two. The best quality data in head and neck cancer for locally advanced disease are available for cetuximab since the 2006 publication of a randomized clinical trial comparing radiation treatment plus cetuximab versus radiation treatment alone. This study found

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Xeloda for nasopharyngeal cancer – pro

Nasopharyngeal carcinoma is endemic in Southeast Asia and China with increased incidences in the Mediterranean countries. It is relatively rare in the United States and Continental Europe. It differs markedly from other head and neck cancers based on its distinct histology, its association with EBV, its marked responsiveness to chemotherapy, and its rapid growth with early dissemination. Presentation is commonly a locally advanced stage with nodal

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