This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
[{'content': 'In carcinoma cheek what is the best drug for single drug chemotherapy - \nSelect and explain. \nA. Vincristine, B. Cyclosphosphamide, C. Cisplatin, D. Daunorubicin', 'role': 'user'}, {'content': 'Answer: C \nExplanation: 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 -\n\n\nCisplatin \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0 \xa0\nMethotrexate\xa0\n5 Fu\xa0\xa0\xa0\nPaclitaxel\nDocetaxel\n\n\nSometimes combinations of these drugs are used.\nRemember these basic points about the t/t of head and neck cancers and one can apply them to all tumors of head and neck.\n\na)\xa0\xa0 Treatment of localized head and neck cancers  -\n\nThese tumors are treated with curative intent either with surgery or radiotherapy.\nThe 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.\n\nb) Locally or advanced regional disease -\n\nCombined modality therapy including surgery, radiation therapy, and chemotherapy is used. Concomitant chemotherapy and radiotherapy appear to be most effective.\n\nc) Recurrent or metastatic disease -\n\nchemotherapy is used.\n\nManagement of neck lymph nodes\n\nThe 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.\nThe decision to perform neck dissection or irradiate the neck is related to the treatment of the primary lesion.\nIf the primary tumor is being treated with radiation and the neck is N0 or N1, the nodes are usually treated with irradiation.\nFor 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.\nFor N2 or N3 neck disease, neck dissection with planned postoperative radiation therapy is performed.', 'role': 'assistant'}]