In addition to the currently available conventional therapeutic modalities i.e. chemotherapy, radiotherapy and surgery, there is a desperate need for more effective and less toxic therapies for head and neck malignancies. Chemotherapy alone shows high toxicity and a low survival rate. In some cases, malignant cells develop resistance to a particular drug and to combat this, a variety of approaches like intra-arterial therapy, induction chemotherapy, immunotherapy, photodynamic therapy as well as targeted molecular therapy have recently been employed. Techniques like intra-arterial and induction chemotherapy have showed some improvement in survival rate. Immununotherapy is in the experimental stages while photodynamic therapy is being clinically applied, but because of its side effects it is not very popular. Utilizing specific molecular targets with their inhibitors (like inhibitors of EGFR and VEGF); either alone or in combination with conventional therapy, may improve the survival rate of these patients. Blocking the signaling pathway (P13k/Akt/mTOR), with or without chemotherapy, may also overcome the problem of drug resistance. These modalities hold the promise of being more selective - harming fewer normal cells, reducing side effects and improving the quality of life. The various options and novel strategies currently available to the treating physician are critically examined in this review.
Keywords: Head immunotherapy, malignancy, molecular, neck, photodynamic, chemotherapy, Activated protein kinase, Cysteine-aspartic protease-9, Human papilloma virus, Kinesin spindle protein, Photodynamic therapy, Vascular Endothelial Growth Factor, Monoclonal antibodies
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