Adjuvant therapy in head and neck cancer

Abstract

Many challenges remain, but considerable progress has been made in this field since 1983, when we published in this journal an article titled "Adjuvant Radiation Therapy in Locally Advanced Head and Neck Cancer." Several clinical and pathologic features have been identified that can stratify patients according to the risk of relapse (whether at the primary site, in the neck, or at distant sites) or the risk of second cancers, so that additional adjuvant treatment might be administered only to patients who are the most likely to benefit from it. Hope exists that in the near future our capabilities will be bolstered by the availability of powerful new biologic and molecular genetic tools. The greatest advance, perhaps, has been the recognition that adjuvant therapy for head and neck cancer should not be an afterthought but part of a thoughtfully crafted interdisciplinary strategy aimed at maximizing tumor control with the least morbidity.