Head and neck squamous cell carcinoma (HNSCC) is usually diagnosed in III/IV stages, locally advanced and/or unresectable with curative intent. These patients are treated with concurrent chemoradiation, which presents better outcomes in comparison with radiation alone. However, chemoradiation is associated with high rates of severe toxicity, and those candidates must present good performance status (PS) and no organ disfunctions in order to tolerate this therapy, not usually found in the majority of HNSCC patients. Induction/neoadjuvant chemotherapy allows the patients to begin radiation therapy with lower tumor burden, less symptomatic, with better PS. In addition, micrometastatic disease is treated earlier. Randomized studies have shown that in patients presenting with metastatic HNSCC, both 5-fluorouracil/cisplatin and paclitaxel/cisplatin (TP) offer equivalent outcomes, and then TP was selected as neoadjuvant regimen for locally advanced HNSCC at Instituto do Câncer do Estado de São Paulo (ICESP), followed by (chemo-)radiation. Here we aim to evaluate efficacy and safety of paclitaxel/cisplatin as neoadjuvant chemotherapy in locally advanced HNSCC treated at ICESP.
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