Squamous cell carcinoma of head and neck organs: contemporary management and perspectives
Journal Title: Postępy Nauk Medycznych - Year 2011, Vol 24, Issue 2
Abstract
Some 5600 head and neck malignancies are diagnosed each year in Poland. Among them squamous cell carcinoma constitutes over 90%, and 40% are carcinomas of larynx. Risk factors are well-defined and contribute to relatively high incidence (0.015-0.05/year) of second independent malignancies in these patients.Pathological assessment should include malignancy grading (G1-G3) where G1 is well-differentiated and G3 non-differentiated tumor. It is one of strong prognostic factors along with regional lymph node status (N0-N3).Management of a vast majority of patients who present with an advanced head and neck squamous cell carcinoma should be carried out by a multidisciplinary team. Principles of management are relatively complex due to multiplicity of organs and localizations in head and neck region. More than half of patients present with an advanced disease. Decision has to be made whether management with curative intent, palliative antineoplastic treatment or symptomatic/supportive management is indicated.Recent advances in management of head and neck squamous cell carcinoma include improved reconstruction of post-resection defects with free microsurgical tissue transfer, improved precision of irradiation with intensity modulated radiation therapy, application of radiochemotherapy with cisplating and other chemotherapuetics, implementation of therapy acting through molecular targets. EGFR inhibitor cetuximab added to radiotherapy improved overall survival by 9%.These improvements brought an incremental improvement but early diagnosis still remains the best and the safest way to improve outcomes in patients with squamous cell carcinomas of head and neck.
Authors and Affiliations
Andrzej Kawecki, Romuald Krajewski
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