Table 1 Current chemotherapeutic models in head and neck cancer

Platinum agents

(Cisplatin/Carboplatin)

Formation of DNA adducts, induction of apoptosis and senescence

Cisplatin/Carboplatin single-agent Cisplatin/Carboplatin in combination with 5-Flurouracil

Nephrotoxicity (acute renal

failure, chronic renal insufficiency)

Ototoxicity (high-frequency hearing loss)

Neurotoxicity (peripheral neuropathy)

Hematologic (myelosupression)

Gastrointestinal (nausea, vomiting)

Electrolyte disturbances

(hypomagnesiumia/hypokalemia/

hypocalcemia)

[8–12]

5-Flurouracil

Anti-metabolite (pyrimidine analog, inhibits thymidylate synthase)

5-Flurouracil in combination with Cisplatin/Carboplatin, and with or without Paclitaxel

Cardiac toxicity (angina, myocardial ischemia), Gastrointestinal (nausea, omiting, ulcers), Hematologic (myelosupression), Thrombophlebitis, Dermatologic (rash)

[8–10]

Taxanes

(Paclitaxel/Docetaxel)

Anti-microtubular agent

(inhibitor of mitosis)

Paclitaxel in combination with Carboplatin/Cisplatin, and with or without 5-Fluoruracil

Cardiovascular (hypotension, EKG changes) Gastrointestinal (mucositis, nausea, vomiting) Hematologic (neutropenia, leukopenia, thrombocytopenia), Neuromuscular (peripheral neuropathy, myalgias), Hepatic (elevated liver enzymes)

[9, 10]

Cetuximab

Anti-EGFR monoclonal antibody

Cetuximab plus radiation therapy Single-agent cetuximab in platinum refractory HNSCC Phase I/II trial of cetuximab plus 5-FU and platinum agents (on going)

Infusion reaction Dermatologic (acneform rash, pruritis)

Gastrointestinal (abdominal pain, constipation,

diarrhea, nausea, vomiting), Respiratory

(dyspnea, cough), Neuromuscular weakness

[14–17, 202]