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Locally advanced diseases accounting for most HNSCC have a poor prognosis. The main reason for this is that corresponding symptoms of HNSCC are not always obvious or ignored by patients at early stage, which is mostly reflected by the fact that more than 2/3 HNSCC patients present with stage III/IV disease (AL-Sarraf, 1987; Argiris, 2008). Patients characterized with advanced HNSCC are subjected to worse prognosis than those with confined disease, exhibiting 5-year survival of 10-40%, cure rate of 30% and median survival time of 6-10 months (Argiris, 2008; Vokes et al, 1993; Cohen et al, 2004). Our recent study in a large series (X. Li et al, 2009) demonstrated that overall survival rates of patients with distant metastases in clinic were 56.8% at 1 year, 9.1% at 3 years, and 6.8% at 5 years, respectively. In addition, traditional treatment related morbidities could negatively influence quality life of patients, which involves loss of speech, permamant tracheostomy or gastrostomy dependence, dysphagia and other systematic side effects. Therefore, it is necessary to seek novel strategies to cure advanced HNSCC aiming at organ preservation, prevention of metastases as well as second malignancies and improvement in quality of life.

intech ebooks

Molecular Mechanisms Involving Therapeutic Resistance in Head and Neck Squamous Cell Carcinoma (HNSCC) – Roles of Hypoxic Microenvironment and Cancer Stem Cell