10.

Treatment of recurrent or metastatic squamous cell carcinoma of head and neck

Staging	Treatment selection	Level I expert recommendation	Level II expert recommendation
5-FU, 5-fluorourcacil.
Recurrence or Metastasis	First-line therapy	Cisplatin + 5-FU (1) (category 1A) Carboplatin + 5-FU (1) (category 1A) Cisplatin + paclitaxel (2) (category 1A) Cisplatin + docetaxel (3) (category 2A)	Cisplatin + 5-FU + cetuximab (4) (category 1A) Carboplatin + 5-FU + cetuximab (4) (category 1A) Cisplatin + docetaxel + cetuximab (3) (category 2A) Cisplatin + cetuximab (5,6) (category 2A) Paclitaxel + cetuximab (7) (category 2A)
	Salvage therapy	Methotrexate (8) (category 2A) Docetaxel (9) (category 2A) Paclitaxel (10) (category 2A)	Cetuximab (11) (category 2A) Clinical trials (category 2A)