Head and neck cancer: improving outcomes with a multidisciplinary approach

Abstract

For early-stage head and neck cancer (HNC), surgery (S) or radiotherapy (RT) is a standard treatment. The multidisciplinary approach, which includes multimodality treatment with S followed by RT, with or without chemotherapy (CT) or concurrent chemoradiotherapy (CRT), is required for locally advanced head and neck cancer (LAHNC). CRT improves prognosis, locoregional control (LRC), and organ function in LAHNC, compared to RT alone. Prognosis in recurrent/metastatic HNC (R/M HNC) is dismal. Platinum-based CT, combined with the anti-Epidermal Growth Factor Receptor (EGFR) antibody (Ab) cetuximab, is used in first-line setting, while no further validated options are available at progression. The complexity of disease is, in part, due to the heterogeneity of organs and functions involved and the need for a multimodality approach. In addition, the patient population (often elderly and/or patients with smoking and alcohol habits) argues for an individually tailored treatment plan. Furthermore, treatment goals – which include cure, organ, and function preservation, quality of life and palliation – must also be considered. Thus, optimal management of patients with HNC should involve a range of healthcare professionals with relevant expertise. The purpose of the present review is to 1) highlight the importance and necessity of the multidisciplinary approach in the treatment of HNC; 2) update the knowledge regarding modern surgical techniques, new medical and RT treatment approaches, and their combination; 3) identify the treatment scenario for LAHNC and R/M HNC; and 4) discuss the current role of immunotherapy in HNC.

Morphology, Volume, and Density Characteristics of the Parotid Glands before and after Chemoradiation Therapy in Patients with Head and Neck Tumors

“…Head and neck squamous cell carcinoma (HNSCC) is a heterogeneous disease encompassing lesions that originate in the oral cavity, lips, oropharynx, hypopharynx, nasopharynx, or larynx. Worldwide, HNSCC represents the sixth most common neoplasia and constitutes more than 90% of HNC cases [1].…”

How patients adjust psychologically to the experience of head and neck cancer: A grounded theory

“…In 2016, there were an estimated 930,000 cases worldwide, making it the sixth most common cancer type (Global Burden and of Disease Cancer Collaboration, Fitzmaurice, & Allen, ). A diagnosis is often quickly followed by aggressive and intrusive treatment, which may include surgery, radiotherapy, chemotherapy or a combination thereof (Argiris, Karamouzis, Raben, & Ferris, ; Nigro, Denaro, Merlotti, & Merlano, ). Treatment effects are wide ranging and create considerable difficulties with many fundamental functions, such as breathing, eating, speaking and swallowing, in addition to facial disfigurement, residual pain, loss of taste and smell, swelling and excessive dry mouth (Ganzer et al, ; List & Bilir, ; Macmillan, 2015), making it potentially the most “traumatic” cancer (Björklund, Sarvimäki, & Berg, ).…”

E pluribus unum: Combining Molecular Strategies to Defeat Head and Neck Cancer

“…Better treatment for this miserable disease remains an unmet need, but the cancer is largely resistant to newer immunotherapeutic approaches with antibodies and immune cells. 1 In this issue of Molecular Therapy, using mouse xenograft models of the human tumor, Shaw and colleagues 2 first demonstrated partial efficacy of several molecular and immunotherapeutics in controlling tumor growth. They then combined these diverse approaches into a single successful treatment strategy that promises to represent a major improvement in the management of this lethal cancer.…”

“…Alberico Luigi Catapano, 1,2 Angela Pirillo, 2,3 and Giuseppe Danilo Norata 1,3,4 https://doi.org/10.1016/j.ymthe.2017.10.008…”

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