Clinical Aspects of Head and Neck Cancer

On considering a function-preserving treatment for laryngeal and hypopharyngeal cancer, swallowing is a capital issue. For most of the patients, achieving an effective and safe deglutition will mark the difference between a functional and a dysfunctional outcome. We present an overview of the management of dysphagia in head and neck cancer patients. A brief review on the normal physiology of swallowing is mandatory to analyze next the impact of head and neck cancer and its treatment on the anatomic and functional foundations of deglutition. The approach proposed underlines two leading principles: a transversal one, that is, the multidisciplinary approach, as clinical aspects to be managed in the oncologic patient with oropharyngeal dysphagia are diverse, and a longitudinal one; that is, the concern for preserving a functional swallow permeates the whole process of the diagnosis and treatment, with interventions required at multiple levels. We further discuss the clinical reports of two patients who underwent a supracricoid laryngectomy, a function-preserving surgical technique that particularly disturbs the laryngeal mechanics, and in which swallowing rehabilitation dramatically conditions the functional results.

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Clinical aspects of IMRT for head-and-neck cancer

Medical Dosimetry ◽

10.1016/s0958-3947(02)00091-2 ◽

2002 ◽

Vol 27 (2) ◽

pp. 99-104 ◽

Cited By ~ 34

Author(s):

Avraham Eisbruch

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Clinical Aspects

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MR-Guided Radiotherapy for Head and Neck Cancer: Current Developments, Perspectives, and Challenges

Frontiers in Oncology ◽

10.3389/fonc.2021.616156 ◽

2021 ◽

Vol 11 ◽

Author(s):

Simon Boeke ◽

David Mönnich ◽

Janita E. van Timmeren ◽

Panagiotis Balermpas

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Clinical Aspects ◽

Future Perspectives ◽

Image Guided Radiotherapy ◽

Adaptive Treatment ◽

Image Guided ◽

Novel Technology ◽

Recent Developments

Based on the development of new hybrid machines consisting of an MRI and a linear accelerator, magnetic resonance image guided radiotherapy (MRgRT) has revolutionized the field of adaptive treatment in recent years. Although an increasing number of studies have been published, investigating technical and clinical aspects of this technique for various indications, utilizations of MRgRT for adaptive treatment of head and neck cancer (HNC) remains in its infancy. Yet, the possible benefits of this novel technology for HNC patients, allowing for better soft-tissue delineation, intra- and interfractional treatment monitoring and more frequent plan adaptations appear more than obvious. At the same time, new technical, clinical, and logistic challenges emerge. The purpose of this article is to summarize and discuss the rationale, recent developments, and future perspectives of this promising radiotherapy modality for treating HNC.

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Relation Between Age and Head and Neck Cancer Recurrence after Surgery: A Multivariate Analysis

Otolaryngology ◽

10.1016/s0194-5998(95)70106-0 ◽

1995 ◽

Vol 113 (3) ◽

pp. 197-203 ◽

Cited By ~ 14

Author(s):

Peter G. Von Doersten ◽

Raul M. Cruz ◽

Barry M. Rasgon ◽

Charles P. Quesenberry ◽

Raymond L. Mlsinger

Keyword(s):

Multivariate Analysis ◽

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Young Patients ◽

Biomedical Literature ◽

Future Research ◽

Clinical Aspects ◽

Upper Aerodigestive Tract ◽

Old Patients

Recent reports have described an increase in squamous cell carcinoma of the upper aerodigestive tract in young adults. As the preponderance of epidemiologic data exists for the population between 50 and 70 years of age, controversy has developed regarding the clinical course of head and neck cancer in youth. Some authors advocate more aggressive management, calling attention to the lack of “classic” predisposing factors and suggesting genetic disorders or Immunodeficiency. Basic science researchers have reported greater DNA fragility, sensitivity to carcinogens, and altered immune responses in young patients with carcinoma. To further elucidate the clinical aspects of this controversy, we performed a retrospective review using multivariate analysis to determine factors that affect recurrence. After screening 820 charts, 155 patients were found who met strict entrance criteria to the study. The patients were separated into five age groups, and 16 clinical variables were collected on each patient. Cox proportional hazards modeling revealed no significantly higher likelihood of recurrence in the 15- to 39-year-old age group. The model did find that metastatic adenopathy was predictive of recurrence ( p = 0.034). The overall model further suggested a trend toward higher relative risk of recurrence in the middle-aged groups ( p = 0.0541). In our review of the English biomedical literature, this is the first study to directly compare the outcome of young head and neck cancer patients with that of old patients using multivariate analysis. Future research is indicated in developing precise outcome predictions according to TNM staging, aneuploidy status, and DNA fragility In young patients. Efforts at limiting carcinogen exposure Should continue.

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