Mouth cancer for clinicians part 12: cancer treatment (chemotherapy and targeted therapy)

Chemotherapy alone cannot cure mouth cancer and thus traditionally has rarely been used in mouth cancer therapy except for palliation or in combination with radiotherapy, or occasionally to treat lip cancer. Some regard chemotherapy as the optimal treatment for recurrent/metastatic head and neck cancer. Chemotherapy given concurrently with radiotherapy may improve local control and has now become the standard of care in advanced disease and appears to have a survival benefit compared to radiotherapy alone but also gives greater adverse effects (toxicities) which limit its application. Systemic chemotherapy, as part of primary treatment, can be administered with radiotherapy (chemo-radiotherapy, CRT) either:

There is increasing evidence proving the benefits of chemotherapy in all these settings, but at the cost of higher treatment-related toxicity. Therefore, if the cancer is advanced (advanced stage III or stage IV), radiation treatment schedules sometimes include a chemotherapy (or a biological regimen), most commonly using cisplatin and cetuximab, respectively. Occasionally, other drugs used in chemotherapy may include fluorouracil (5-FU), carboplatin and paclitaxel.