Sequential and Concurrent Chemoradiation: State of the Art

Hematol Oncol Clin North Am. 2015 Dec;29(6):1061-74. doi: 10.1016/j.hoc.2015.07.005. Epub 2015 Oct 21.

Abstract

Most patients diagnosed with head and neck cancer have locally advanced disease. Sequential and concurrent chemoradiation are standard, nonsurgical, curative-intent treatment options. Controversy remains regarding the superiority of one approach to another. Definitive management strategies are evolving with increasing efforts to pursue deintensification of therapy for low-risk patients, and to pursue therapeutic intensification for high-risk patients. Both sequential therapy and concurrent chemoradiation play important roles in shaping treatment paradigms because both approaches may be used to investigate deintensification or intensification strategies. This article examines the latest evidence and state-of-the-art approaches, highlighting ongoing controversies and future directions.

Keywords: Chemoradiation; Head and neck cancer; Induction chemotherapy; Sequential therapy; Treatment.

Publication types

  • Review

MeSH terms

  • Chemoradiotherapy* / methods
  • Clinical Trials, Phase III as Topic
  • Combined Modality Therapy / methods
  • Disease Progression
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / therapy*
  • Humans
  • Neoplasm Staging
  • Organ Sparing Treatments / methods
  • Patient Selection
  • Randomized Controlled Trials as Topic
  • Treatment Outcome