In what scenario would you recommend induction chemotherapy prior to chemo-radiation in head and neck cancers and what would be the preferred regimen?

The use of a sequential approach to treating locally advanced SCC of the head and neck is not generally recommended since three studies from Spain, the Dana Farber Cancer Institute, and the University of Chicago failed to demonstrate a survival benefit from three cycles of TPF (platinum, paclitaxel/...

Agree. For non nasopharynx settings: Terrible tumors or clinical trials are the indications for induction chemo. This has been the case for over 20 years with multiple studies to support. Induction chemo consumes patient tolerance and precludes safe/adequate delivery of the proven option of concurre...

I find 2- 3 cycles useful for the reduction of level III and IV nodal disease that abuts the brachial plexus or primary tumor that abuts the optic nerve.

Patients who are very symptomatic would benefit from rapid tumor regression and likely tolerate chemoradiation better.

TPF