 Approximately 40,000 new cases of head and neck cancer are diagnosed annually in the United States 1. Squamous cell carcinomas account for more than 90 of head and neck cancer cases. Patients with squamous cell carcinoma of the head and neck HNSCC usually present with locoregionally advanced disease. Initial presentation with distant metastasis may occur in about 10 of all patients. However, recurrence of disease either in local or distant sites after potentially curative treatment with surgery, radiation, andor chemotherapy occurs in more than 50 of patients. Therefore, the majority of patients with HNSCC develop recurrent or metastatic disease during the course of their illness. These patients have a dismal prognosis with a median survival of 6-9 months 2-4. 