Systemic Therapy in the Curative Treatment of Head and Neck Squamous Cell Cancer

Guideline Objective

The objective of this guideline is to make recommendations, based on data from randomized controlled trials (RCTs), regarding treatment strategies for cure and/or organ preservation in patients with locally advanced nonmetastatic (Stage III to IVB) squamous cell carcinoma of the head and neck (LASCCHN). The treatment strategies assessed are those that utilize systemically administered drugs in combination or in sequence with radiation and/or surgery.

Patient Population

Patients with LASCCHN being considered for curative intent treatment

Intended Guideline Users

Clinicians and other healthcare professionals involved in the management of LASCCHN

Research Question(s)

1. In patients with unresected squamous cell carcinoma of the head and neck, what are the chemotherapy regimens that, administered concurrently with conventional or intensified radiotherapy, are superior or equivalent to other regimens on important outcomes such as tumour response rate, survival rate, and organ preservation with fewer toxicity/adverse events?
2. In postoperative patients with squamous cell carcinoma of the head and neck, what is the optimal chemotherapy regimen that can be administered concurrently with conventional radiotherapy?
3. Compared to chemoradiotherapy, can targeted agents or radiosensitizers improve or maintain outcomes, with reduced adverse events/toxicity, when used alone or in addition to primary radiotherapy in the treatment of patients with squamous cell carcinoma of the head and neck?
4. In patients with squamous cell carcinoma of the head and neck, what are the induction chemotherapy regimens that are superior or equivalent to others on important outcomes such as tumour response rate, survival rate, and organ preservation with fewer toxicity/adverse events?
5. What are the subgroups of patients with squamous cell carcinoma of the head and neck that would benefit more than others from postoperative systemic therapy?