الفهرس 
الملخص العربي
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Abstract
Head and neck cancer is one of the most common malignant cancers and represent 17% in Egypt, it includes malignant tumors of the upper aero digestive tract, Para nasal sinuses, salivary glands and ears.
The treatment of head and neck cancer is complex and difficult, both technically and physically. Treatment of head and neck cancer differ according to tumor site, extension, patient preference and his nutrition.
Radiotherapy may be used alone, instead of surgery. It can also be used after an operation, to destroy small areas of cancer that could not be removed by the surgery, and radiotherapy may given by external beam radiotherapy or internal radiotherapy.
For patients with unrespectable disease, the use of chemo radiotherapy has improved the overall survival and show higher survival rates, near 60 to 70 percent.
But chemoradiation not tolerated by some patients especially old persons and many patients have a poor performance sta¬tus and comorbid illnesses that make the management of its side effects more difficult. So, the use of target therapy is preferable in such cases
Many head and neck cancer cells over express a protein called the epidermal growth factor receptor (EGFR), which may help cancer cells to grow more aggressively. Cetuximab is a potentially less toxic targeted therapy - a monoclonal antibody that specifically attaches to and blocks EGFRs.
A multinational randomized trial showed that the ad¬dition of cetuximab (Erbitux) to ra¬diotherapy improved disease control, progression-free sur¬vival, and overall survival in patients with squamous cell carcinoma of the head and neck without increasing the risk of mucositis or other common side effects of radiotherapy.
And side effects of cetuximab are tolerable and not exceed 5% so we use it with radiotherapy.