Systemic therapy in head and neck cancer: changing paradigm (original) (raw)
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Treatment of locally advanced head and neck cancer: historical and critical review
Cancer control, 2002
Background: Advanced squamous cell cancers of the head and neck have traditionally been associated with high rates of morbidity and mortality. Advances in management have improved outcomes for most of these patients. Methods: The author reviews the historical progress in management of these difficult tumors and adds his own wide experience to describe and evaluate newer approaches to management. Results: Over the last 10 years, overall survival rates for patients with head and neck cancers have improved as has quality of life. New standards of care have been defined for patients with nasopharyngeal cancer and for those with advanced unresectable disease. Organ preservation is more commonly achieved. Conclusions: Newer targeted therapies are likely to add to the progress that has already been achieved in the multimodality management of patients with head and neck cancers.
European journal of clinical & medical oncology
The management of head and neck cancer is complex and requires a multidisciplinary approach to optimize the balance between the goals of organ preservation and long-term cure. The role of chemotherapy in head and neck cancers has recently expanded as a result of increasing evidence in the induction and postoperative setting. Several evidence-based clinical practice guidelines have been published by reputable cancer organizations to facilitate the translation of evidence from clinical trials to patient care. There is a high concordance in the recommendations for chemotherapy between the various clinical practice guidelines in head and neck cancers. The quality of evidence for recommendations for induction, concurrent and postoperative chemotherapy is high, but remains poor in the palliative setting. The main limitations of current guideline recommendations are the lack of guidance in addressing the impact of performance status and comorbidities in their recommendations for chemotherapy. Population-based studies suggest that the compliance with guideline recommendations for chemotherapy may be lagging behind newer evidence, and that opportunities for improvement in care exist.
Contemporary management of head and neck cancers
The Israel Medical Association journal : IMAJ, 2009
Head and neck cancer is the sixth most common cancer worldwide. HNCs can originate in the skin or soft tissue, in the upper aerodigestive tracts (oral cavity, oropharynx, hypopharynx, larynx, nasopharynx, paranasal sinuses, salivary glands), or in the thyroid. In each of these sites, tumors vary not only by the primary site but also by pathophysiology, biological behavior, and sensitivity to radiotherapy or chemotherapy. Management should be planned according to the tumor's characteristics, patient factors and expertise of the medical team. The main goals of therapy are ablation of the cancer while minimizing morbidity and preserving function and cosmesis. A multidisciplinary team is needed to achieve these goals. Early-stage HNC (stage I and II) should be managed with a single modality, and advanced tumors (stage III and IV) with multimodality therapy. Treatment should be directed to the primary tumor and the area of its lymphatic drainage--the neck lymph nodes. Evidence of met...
Chemotherapy in head and neck cancer- A review
2020
Chemotherapy is progressively being utilized for the radical treatment of propelled head and neck malignant growths. Chemotherapy offers unassuming advantages in the metastatic. Platinum containing operators are the most dynamic medications and structure the pillar of most chemotherapy plans. Lately, taxanes have indicated action in head and neck malignant growths and are joined into neo-adjuvant and concomitant chemotherapy regimens. Directed operators and epidermal development factor receptor inhibitors, like cetuximab, specifically, have demonstrated an advantage in the metastatic and the concomitant setting. In this article, we will show the ways of treating with this method. Keywords: Chemotherapy, Epidermal Development Growth Factor (Egfr), Radiotherapy, Platinum.
Current Insights and Progress in the Clinical Management of Head and Neck Cancer
Cancers
Head and neck cancer (HNC), also known as the cancer that can affect the structures between the dura mater and the pleura, is the 6th most common type of cancer. This heterogeneous group of malignancies is usually treated with a combination of surgery and radio- and chemotherapy, depending on if the disease is localized or at an advanced stage. However, most HNC patients are diagnosed at an advanced stage, resulting in the death of half of these patients. Thus, the prognosis of advanced or recurrent/metastatic HNC, especially HNC squamous cell carcinoma (HNSCC), is notably poorer than the prognosis of patients diagnosed with localized HNC. This review explores the epidemiology and etiologic factors of HNC, the histopathology of this heterogeneous cancer, and the diagnosis methods and treatment approaches currently available. Moreover, special interest is given to the novel therapies used to treat HNC subtypes with worse prognosis, exploring immunotherapies and targeted/multi-targete...
Chemotherapy advances in locally advanced head and neck cancer
World journal of clinical oncology, 2014
The management of locally advanced unresectable head and neck squamous cell cancer (HNSCC) continues to improve. One of the major advances in the treatment of HNSCC was the addition of chemotherapy to radiation in the treatment of non-surgical patients. The majority of the data regarding chemotherapy in HNSCC involve cisplatin chemotherapy with concurrent radiation. However, several new approaches have included targeted therapy against epidermal growth factor receptor and several recent studies have explored the role of induction chemotherapy in the treatment of HNSCC. The purpose of this article is to provide an overview of the role of chemotherapy in the treatment of locally advanced HNSCC.
Update in the management of head and neck cancer
Update on Cancer Therapeutics, 2006
Patients with head and neck cancer present numerous challenges to treating physicians. The optimum management requires a coordinated , multispeciality team, comprising experienced head and neck surgeons, medical and radiation oncologists, pathologists, diagnostic radiologists and nuclear medicine physicians. The improved survival observed with CRT using high-dose cisplatin over RT alone warrants its use as standard care for fit patients with high risk SCCHN following surgery or as definitive therapy for patients with unresectable disease. Patients with unresectable disease also have better survival with induction CT and RT compared to RT alone. However, when the goal of therapy is preservation of the larynx, CRT is superior to both induction CT followed by RT, and RT alone. Drugs that inhibit the EGFR pathway, alone or in combination with radiation, appear promising in the treatment of patients with unresectable disease and with recurrent or metastatic disease. Local control rates may improve with wider utilization of altered fractionation schedules in CRT regimens. Intensity modulation and PET-CT fusion are improved means to target and accurately deliver radiation therapy to the head and neck. Endoscopic laser surgery and supracricoid partial laryngectomy can improve organ preservation in suitable patients.
Head and Neck Cancers, Version 2.2020, NCCN Clinical Practice Guidelines in Oncology
Journal of the National Comprehensive Cancer Network
Treatment is complex for patients with head and neck (H&N) cancers with specific site of disease, stage, and pathologic findings guiding treatment decision-making. Treatment planning for H&N cancers involves a multidisciplinary team of experts. This article describes supportive care recommendations in the NCCN Guidelines for Head and Neck Cancers, as well as the rationale supporting a new section on imaging recommendations for patients with H&N cancers. This article also describes updates to treatment recommendations for patients with very advanced H&N cancers and salivary gland tumors, specifically systemic therapy recommendations.