Chemotherapy-free innovations in locally advanced head and neck cancer: a comprehensive review

Chemotherapy-free innovations in locally advanced head and neck cancer: a comprehensive review

The treatment of locally advanced head and neck squamous cell carcinoma (LA-HNSCC) has traditionally relied on a multimodal approach, combining surgery, radiation therapy (RT), and chemotherapy. While chemotherapy plays a critical role in improving cure rates and functional outcomes, its substantial...

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Main Authors: Shatha Abu Taha, Taher Abu Hejleh, Mostafa ElHaddad, Akram Al-Ibraheem, Ahmed Abbasi, Abdulrahman Sumaida, Ahmad Bushehri, Ahmad Mostafa, Bassem Youssef, Ibrahim Alotain, Ibrahim Abu-Gheida, Mohammed Aldehaim, Majed Alghamdi, Mohamed Shelan, Mohammed Al Dohan, Maysa Al-Hussaini, Nadeem Pervez, Shoukri Temraz, Saad Alrashidi, Wael El-Sheshtawy, Zahid Al-Mandhari, Hamza Ghatasheh, Ali Hosni, Issa Mohamad
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Oncology
Subjects:
head and neck cancer
concurrent chemoradiation
altered fractionation
immunotherapy
targeted therapy
hyperthermia
Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1552337/full
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Summary:The treatment of locally advanced head and neck squamous cell carcinoma (LA-HNSCC) has traditionally relied on a multimodal approach, combining surgery, radiation therapy (RT), and chemotherapy. While chemotherapy plays a critical role in improving cure rates and functional outcomes, its substantial toxicity remains a major concern, particularly in older patients. These challenges are especially relevant for those who are unfit for chemotherapy or decline conventional concurrent chemoradiotherapy (CCRT), highlighting the need for alternative therapeutic options. Many patients are at high risk for severe side effects, often preventing them from completing the full chemotherapy regimen. This review explores alternative strategies to definitive CCRT of carcinomas of the larynx, hypopharynx and oropharynx, aiming to optimize treatment outcomes while minimizing toxicity. We discuss altered fractionation strategies as a promising alternative to conventional RT, offering a balance between treatment efficacy and quality of life. Additionally, we examine emerging approaches, including the combining of targeted therapies, immunotherapy, hyperthermia, photodynamic therapy and nanoparticle-based treatments with RT, which provide alternative or complementary options to traditional therapies in the management of LA-HNSCC.
ISSN:2234-943X

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