MESSAGES FROM COMPLETED RANDOMIZED TRIALS IN HEAD AND NECK-CANCER

During the last three decades numerous randomized trials have been con ducted in head and neck squamous cell carcinoma, The issue of pre-vs p ost-operative radiotherapy in advanced cancers was settled in the late 70s in favour of the latter approach and new fractionation schemes ar e currently being investigated, with no definite answers as yet, There is no uniform policy regarding the problem of elective neck dissectio n in early stage anterior oral cavity carcinoma, Often some chemothera peutic regimen is involved in clinical trials in an attempt to improve on the standard of surgery and radiotherapy, Neoadjuvant chemotherapy has never been proven to benefit patients with advanced squamous cell carcinoma of the head and neck despite being able to decrease the rat e of distant metastases, Chemotherapy given prior to or simultaneously with definite radiotherapy seems to offer the best chances for preser ving vital organs, such as the larynx, Methotrexate is still the least toxic and most potent drug in recurrent or metastastic disease, The c hemoprotective effect of low-dose isotretinoin on multiple primaries i n the head and neck has yet to be evaluated.