In carcinoma cheek what is the best drug for single drug chemotherapy -

Single-agent chemotherapy is used as palliative therapy in head and neck cancers with the recurrent or metastatic form of cancer. The drugs which are used are - Cisplatin                                                                             Methotrexate  5 Fu    Paclitaxel Docetaxel Sometimes combinations of these drugs are used. Remember these basic points about the t/t of head and neck cancers and one can apply them to all tumors of head and neck. a)   Treatment of localized head and neck cancers - These tumors are treated with curative intent either with surgery or radiotherapy. The choice of modality differs according to anatomic location and institutional expertise. In early laryngeal cancer generally, radiotherapy is done to preserve voice while in early oral cavity cancers, surgery is preferred to avoid the long-term complication of radiation such as xerostomia and dental decay. b) Locally or advanced regional disease - Combined modality therapy including surgery, radiation therapy, and chemotherapy is used. Concomitant chemotherapy and radiotherapy appear to be most effective. c) Recurrent or metastatic disease - chemotherapy is used. Management of neck lymph nodes The neck lymph nodes should be treated when there are clinically positive nodes or the risk for occult disease is high based on the location and stage of the primary lesion. The decision to perform neck dissection or irradiate the neck is related to the treatment of the primary lesion. If the primary tumor is being treated with radiation and the neck is N0 or N1, the nodes are usually treated with irradiation. For surgically treated primary lesions, N0 or N1 neck disease may be treated surgically as well (Radical neck dissection/Modified neck dissection/Selective neck dissection). Negative prognostic factors such as extracapsular spread of tumor, perineural invasion, vascular invasion, fixation to surrounding structures, and multiple positive nodes are indicators for postoperative adjuvant radiation therapy. For N2 or N3 neck disease, neck dissection with planned postoperative radiation therapy is performed.