Current and Emerging Role of Chemotherapy in Oral Cancer

The role of chemotherapy in oral cancer has been evolving [1]. In addition to palliation, it also has an established role in curative management [2]. It can be offered as a single modality treatment for palliation, in combination with concomitant radiation therapy (chemoradiation) as either adjuvant therapy following surgical resection or primary definitive treatment for locally advanced disease, or as induction therapy prior to definitive treatment. Unlike surgery, chemotherapy usually exerts its cytotoxic activity systemically; therefore it is often associated with side effects caused by toxicities to the normal tissues. The toxicities and cellular resistance to chemotherapy are two major obstacles to the clinical efficacy of chemotherapy [3]. Recent advances in understanding molecular biology of HNSCC have opened many new research directions. In addition to traditional cytotoxic chemotherapy, novel targeted therapy has demonstrated its efficacy in palliation [4]. Although most of the studies of chemotherapy in HNSCC were not site specific, many of the findings may be applicable to oral cancers.