<prompt> Which of the following is the most beneficial technique of using chemotherapy with a course of radiotherapy in head and neck malignancies ?Neo adjuvant chemotherapyAdjuvant chemotherapyConcurrent chemotherapyAlternating chemotherapy and radiotherapy  <response>: Ans. is c i.e., Concurrent chemotherapy Chemotherapy is only used in the tt of advanced cancer, of head or neck Not in localized disease In advanced cancers locally or regional the treatment includes all the three modalities i.e., Surgery Chemotherapy Radiotherapy Earlier it was thought that neoadjuvant chemotherapy was best form of therapy, but now it is confirmed that concomitant chemotherapy is the most effective. TT of head and neck Tumors A Localized disease These includes cancers without detectable lymphnode involvement or distant metastasis i.e., Stage I and H - These patients are treated with curative intent They are treated either by surgery or radiotherapy. - The choice of modality depends upon the anatomical location and institutional expeice Laryngeal cancers -- Usually radiotherapy is done Oral cancers -- Usually surgery is required B Advanced disease Local or regional - an be treated with curative intent - Combined modality tt including Surgery, chemotherapy and radiation is the best Also know Drugs commonly useful in the tt of head and neck cancers a 5 Fluorouracil b Cisplatin oplasia Terminology Neoadjuvant chemotherapy -- when chemotherapy is done before surgery or radiotherapy Concomitant chemotherapy -- when chemotherapy is done at the time of surgery or radiotherapy Adjuvant chemotherapy --- When chemotherapy is done after surgery or radiotherapy. 