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How I treat squamous ENT cancer

The definition of ‘head and neck cancer’ (HNC) identifies squamous cell carcinoma arising from the pharynx, the larynx and the oral cavity. Most of them are induced by smoking and alcohol abuse, but tumours arising in the nasopharynx and in the oropharynx may be virus induced, Epstein-Barr virus and...

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Autores principales: Merlano, Marco Carlo, Denaro, Nerina, Galizia, Danilo, Garrone, Ornella
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6735671/
https://www.ncbi.nlm.nih.gov/pubmed/31555490
http://dx.doi.org/10.1136/esmoopen-2019-000542
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author Merlano, Marco Carlo
Denaro, Nerina
Galizia, Danilo
Garrone, Ornella
author_facet Merlano, Marco Carlo
Denaro, Nerina
Galizia, Danilo
Garrone, Ornella
author_sort Merlano, Marco Carlo
collection PubMed
description The definition of ‘head and neck cancer’ (HNC) identifies squamous cell carcinoma arising from the pharynx, the larynx and the oral cavity. Most of them are induced by smoking and alcohol abuse, but tumours arising in the nasopharynx and in the oropharynx may be virus induced, Epstein-Barr virus and human papillomavirus, respectively. Medical oncologists are involved in HNC in locally advanced disease and in relapsed/metastatic disease not suitable for salvage radiotherapy or surgery. A close cooperation with surgeons and in particular with radiation oncologists is required in the first situation. The second situation is almost completely responsibility of medical oncologists while surgeons and radiation oncologists are involved in specific situations requiring palliative treatments. Interventions in locally advanced diseases change according to the goal of treatment. Indeed, the target may be the cure of patients unresectable disease or that have refused surgery, the adjuvant treatment of resected diseases at high risk of relapse, or organ preservation, which means sparing demolitive surgery requiring severe functional impairment, such as definitive laryngectomy. In all these situations, a close cooperation between the medical oncologist and the radiation oncologist is mandatory. Treatment of relapsed/metastatic disease is rapidly changing due to the development of immunotherapy. Although the results of immune checkpoint inhibitors in HNC are less impressive than in other tumours such as melanoma or lung cancer, these drugs are effective and allow for long-term survivors that were not expected with chemotherapy and target therapy. In particular, first-line treatment will change soon. Indeed, due to the result of a large randomised trial, immunotherapy will replace the combination of cisplatin, fluorouracil and cetuximab at least in a large proportion of patients.
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spelling pubmed-67356712019-09-25 How I treat squamous ENT cancer Merlano, Marco Carlo Denaro, Nerina Galizia, Danilo Garrone, Ornella ESMO Open Review The definition of ‘head and neck cancer’ (HNC) identifies squamous cell carcinoma arising from the pharynx, the larynx and the oral cavity. Most of them are induced by smoking and alcohol abuse, but tumours arising in the nasopharynx and in the oropharynx may be virus induced, Epstein-Barr virus and human papillomavirus, respectively. Medical oncologists are involved in HNC in locally advanced disease and in relapsed/metastatic disease not suitable for salvage radiotherapy or surgery. A close cooperation with surgeons and in particular with radiation oncologists is required in the first situation. The second situation is almost completely responsibility of medical oncologists while surgeons and radiation oncologists are involved in specific situations requiring palliative treatments. Interventions in locally advanced diseases change according to the goal of treatment. Indeed, the target may be the cure of patients unresectable disease or that have refused surgery, the adjuvant treatment of resected diseases at high risk of relapse, or organ preservation, which means sparing demolitive surgery requiring severe functional impairment, such as definitive laryngectomy. In all these situations, a close cooperation between the medical oncologist and the radiation oncologist is mandatory. Treatment of relapsed/metastatic disease is rapidly changing due to the development of immunotherapy. Although the results of immune checkpoint inhibitors in HNC are less impressive than in other tumours such as melanoma or lung cancer, these drugs are effective and allow for long-term survivors that were not expected with chemotherapy and target therapy. In particular, first-line treatment will change soon. Indeed, due to the result of a large randomised trial, immunotherapy will replace the combination of cisplatin, fluorouracil and cetuximab at least in a large proportion of patients. BMJ Publishing Group 2019-07-16 /pmc/articles/PMC6735671/ /pubmed/31555490 http://dx.doi.org/10.1136/esmoopen-2019-000542 Text en © Author (s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ on behalf of the European Society for Medical Oncology. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, any changes made are indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Review
Merlano, Marco Carlo
Denaro, Nerina
Galizia, Danilo
Garrone, Ornella
How I treat squamous ENT cancer
title How I treat squamous ENT cancer
title_full How I treat squamous ENT cancer
title_fullStr How I treat squamous ENT cancer
title_full_unstemmed How I treat squamous ENT cancer
title_short How I treat squamous ENT cancer
title_sort how i treat squamous ent cancer
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6735671/
https://www.ncbi.nlm.nih.gov/pubmed/31555490
http://dx.doi.org/10.1136/esmoopen-2019-000542
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