الفهرس 
Acknowledgment
EpidemiologyOnly 14 pages are availabe for public view
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Abstract
Therapy for head and neck cancers has evolved over the past decade, but few detailed analyses of recent developments in survival on the population level have been published.Aim of work : The purpose of our study was to evaluate the treatment outcomes in patients with metastatic / recurrent head and neck cancer. Patients & Methods: We performed a retrospective analysis on 73 patients treated between 2009 and 2011 at the NCI & NICC. The treatment outcome was evaluated according to patient and disease criteria in the form of relapse rate (of initial treatment), Clinical response, PFS and OS.Results: Although statistically insignificant a small difference was found in DFS between patients who had surgical intervention and those who received only chemo-radiotherapy.The most affected and significant measures of treatment outcome found were relapse rate occurred in 47 patients (65.7%) and median OS of 36 months (the OS was measured from the initial treatment for all the patients). when related to patient and disease criteria the relapse rate was high in female gender, younger age (60 years or younger), When considering the tumor-related factors, hypopharyngeal tumor site, Grade II, T3 tumor size and LN positivity were associated with the highest rate of relapse. OS was affected by gender (Males lived significantly longer than females), tumor size (T1 tumors had the longest survival), N stage significantly affected OS (p=0.0001) (N0 tumors had the longest surviva). Anatomical Subsite strongly affected OS (p=0.001) (Laryngeal tumors had the best median OS, 44 months, Hypopharyngeal and nasopharyngeal tumors had the shortest OS, 30months).Conclusions: We can conclude that Patients who require organ preservation can undergo concomitant chemoradiotherapy only as a non-inferior effective option. On the other hand the treatment protocol for salvage chemotherapy didn’t have a significant effect as adding Taxens on the outcome. Patients were treated through a multi-disciplinary team, to individualize the plan of management case-by-case. This concludes that each patient should be treated on individual bases as each patient has his own different criteria.