The Treatment of Distant Metastases in Head and Neck Cancer – Present and Future

Abstract

At the present time the occurrence of distant metastases in patients with head and neck squamous cell carcinoma means that lifespan is measured in months. In most instances treatment is purely palliative. Isolated lung metastasis can be successfully removed with long-term disease control in selected patients. Radiotherapy can be useful for palliation of bone metastases and occasionally lung or brain metastases. Chemotherapy does not have a major impact at the present time except for the treatment of metastases from nasopharyngeal cancer. Palliative symptomatic care, along with appropriate pain control, is essential since pain management is very important in these patients. A significant change in the survival of patients with head and neck cancer is only likely to occur by the development of new approaches to treatment. Blocking tumor angiogenesis and treatment based on genetic abnormalities or cell surface receptors offer the two strategies that are most likely to be successful.

Zoledronic acid combined with chemotherapy bring survival benefits to patients with bone metastases from nasopharyngeal carcinoma

“…More than half of the patients with NPC eventually failed treatment due to distant metastases (Liu et al 2003). Current management of metastatic disease from NPC is based essentially on palliative chemotherapy (Buckley et al 2001;Ma and Chan 2005). The frequently adopted regimen includes (i) cisplatin and infusional 5-FU, with a 66-76% response rate (Au and Ang 1994); (ii) paclitaxel and carboplatin, with a 75% response rate and a median survival of 12 months (Tan et al 1999); (iii) gemcitabine and cisplatin, with a response rate of 73%, and the mean duration of the response being only 5.3 months (Ngan et al 2002).…”

The Role of Human Papillomavirus 16 E6 in Anchorage-Independent and Invasive Growth of Mouse Tonsil Epithelium

“…1 Despite advances in surgical and combined chemotherapy and radiation therapy, the overall survival of patients with HNSCCA has not improved during the last 30 years. 2 Staging of HNSCCA is based on local invasion and nodal or distant spread. Current treatment of early-stage (stage 1 and 2) HNSCCA produces good 5-year diseasespecific survival rates (81%), whereas latestage tumors have poor survival rates (50%).…”

Fatores de risco para metástases à distância no câncer de cabeça e pescoço

“…A quimioterapia não tem maior impacto atualmente, com exceção dos casos cujo tumor primário é de rinofaringe. Os cuidados sintomáticos paliativos, com controle adequado da dor, são essenciais 17 . Os fatores de risco para o surgimento de MD em pacientes tratados cirurgicamente por carcinoma espinocelular das vias aerodigestivas superiores foram: invasão extracapsular microscópica (risco relativo de 17,471) e macroscópica (RR de 14,429), presença de linfonodo positivo à avaliação histopatológica (RR de 4,409) e tumor primário avançado, ou seja T3 e T4 (RR de 2,929).…”