The standard treatment for locally advanced squamous cell carcinoma of the head and neck region (SCCHN) has been complete surgical resection followed by radiotherapy. But the outcome of this strategy is unsatisfactory, and the complete surgical resection leads to a poor cosmetic outcome and organ dysfunction. To improve the treatment outcome, the administration of chemotherapy has been investigated. Recent investigations have demonstrated that radiation therapy with concurrent chemotherapy might lead to synergistic effects against SCCHN. Concurrent chemoradiation leads to acute adverse effects, which when severe may prolong the treatment time. Because the prolongation of total treatment time adversely affects the treatment outcome for SCCHN, supportive care including nutrition and pain control should be considered to avoid the interruption of treatment. The appropriate combination of anti-cancer drugs and radiation regimen, that has acceptable toxicity without significant interruptions, should be established.

The purpose of this article is to explore the use of definitive chemoradiation for locally advanced SCCHN, and to demonstrate the future direction.