Cargando…

The Role of Adjuvant Treatment in Craniofacial Malignancy: A Critical Review

Background: Tumors originating from the craniofacial region usually present in a locally advanced stage with frequent involvement of adjacent sites and have a strong tendency for local recurrence in the absence of adjuvant therapy, even when the original surgical resection was presumed to be radical...

Descripción completa

Detalles Bibliográficos
Autores principales: König, Marton, Osnes, Terje, Bruland, Øyvind, Sundby Hall, Kirsten, Bratland, Åse, Meling, Torstein R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7426725/
https://www.ncbi.nlm.nih.gov/pubmed/32850452
http://dx.doi.org/10.3389/fonc.2020.01402
_version_ 1783570741296365568
author König, Marton
Osnes, Terje
Bruland, Øyvind
Sundby Hall, Kirsten
Bratland, Åse
Meling, Torstein R.
author_facet König, Marton
Osnes, Terje
Bruland, Øyvind
Sundby Hall, Kirsten
Bratland, Åse
Meling, Torstein R.
author_sort König, Marton
collection PubMed
description Background: Tumors originating from the craniofacial region usually present in a locally advanced stage with frequent involvement of adjacent sites and have a strong tendency for local recurrence in the absence of adjuvant therapy, even when the original surgical resection was presumed to be radical. In the past decades, several advances in the radiological diagnosis and treatment of craniofacial malignancies have been introduced. There are, however, no randomized trials that define the optimal multimodal treatment of these tumors because of their rarity as well as heterogeneity in both histology and site of origin. The aim of this study was to conduct a critical review of the role of adjuvant therapy in the treatment of craniofacial malignancy. Method: We conducted a critical review of the past and contemporary literature available, focusing on adjuvant oncological treatments of the most common craniofacial malignancies. Results: Preoperative radiotherapy can have a documented role in the treatment of olfactory neuroblastoma and soft tissue sarcoma, while preoperative chemotherapy can be advocated in the treatment of sinonasal undifferentiated carcinoma, neuroendocrine carcinoma, olfactory neuroblastoma, and craniofacial sarcoma (both soft-tissue and high-grade osteosarcoma). Postoperative radiotherapy has a well-established role in the treatment of most craniofacial malignancies. The role of postoperative chemotherapy is unclear in most histologies, but is commonly used during the treatment of well-selected cases of paranasal sinus carcinoma, olfactory neuroblastoma, mucosal melanoma, soft tissue sarcoma and high-grade craniofacial osteosarcoma. Discussion: Alongside developments in surgery, there have also been improvements in diagnostics, radiotherapy, and chemotherapy. Implementation of novel radiation techniques allows delivery of higher radiation doses while minimizing irradiation-related morbidity. Better understanding of tumor biology allows the construction of more complex treatment strategies, incorporating adjuvant chemotherapy either pre- or postoperatively. In the era of personalized targeted therapy, rapid strides are being made to identify specific tumor-targets for use of novel biologic agents, with the potential to change current management paradigms.
format Online
Article
Text
id pubmed-7426725
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-74267252020-08-25 The Role of Adjuvant Treatment in Craniofacial Malignancy: A Critical Review König, Marton Osnes, Terje Bruland, Øyvind Sundby Hall, Kirsten Bratland, Åse Meling, Torstein R. Front Oncol Oncology Background: Tumors originating from the craniofacial region usually present in a locally advanced stage with frequent involvement of adjacent sites and have a strong tendency for local recurrence in the absence of adjuvant therapy, even when the original surgical resection was presumed to be radical. In the past decades, several advances in the radiological diagnosis and treatment of craniofacial malignancies have been introduced. There are, however, no randomized trials that define the optimal multimodal treatment of these tumors because of their rarity as well as heterogeneity in both histology and site of origin. The aim of this study was to conduct a critical review of the role of adjuvant therapy in the treatment of craniofacial malignancy. Method: We conducted a critical review of the past and contemporary literature available, focusing on adjuvant oncological treatments of the most common craniofacial malignancies. Results: Preoperative radiotherapy can have a documented role in the treatment of olfactory neuroblastoma and soft tissue sarcoma, while preoperative chemotherapy can be advocated in the treatment of sinonasal undifferentiated carcinoma, neuroendocrine carcinoma, olfactory neuroblastoma, and craniofacial sarcoma (both soft-tissue and high-grade osteosarcoma). Postoperative radiotherapy has a well-established role in the treatment of most craniofacial malignancies. The role of postoperative chemotherapy is unclear in most histologies, but is commonly used during the treatment of well-selected cases of paranasal sinus carcinoma, olfactory neuroblastoma, mucosal melanoma, soft tissue sarcoma and high-grade craniofacial osteosarcoma. Discussion: Alongside developments in surgery, there have also been improvements in diagnostics, radiotherapy, and chemotherapy. Implementation of novel radiation techniques allows delivery of higher radiation doses while minimizing irradiation-related morbidity. Better understanding of tumor biology allows the construction of more complex treatment strategies, incorporating adjuvant chemotherapy either pre- or postoperatively. In the era of personalized targeted therapy, rapid strides are being made to identify specific tumor-targets for use of novel biologic agents, with the potential to change current management paradigms. Frontiers Media S.A. 2020-08-07 /pmc/articles/PMC7426725/ /pubmed/32850452 http://dx.doi.org/10.3389/fonc.2020.01402 Text en Copyright © 2020 König, Osnes, Bruland, Sundby Hall, Bratland and Meling. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
König, Marton
Osnes, Terje
Bruland, Øyvind
Sundby Hall, Kirsten
Bratland, Åse
Meling, Torstein R.
The Role of Adjuvant Treatment in Craniofacial Malignancy: A Critical Review
title The Role of Adjuvant Treatment in Craniofacial Malignancy: A Critical Review
title_full The Role of Adjuvant Treatment in Craniofacial Malignancy: A Critical Review
title_fullStr The Role of Adjuvant Treatment in Craniofacial Malignancy: A Critical Review
title_full_unstemmed The Role of Adjuvant Treatment in Craniofacial Malignancy: A Critical Review
title_short The Role of Adjuvant Treatment in Craniofacial Malignancy: A Critical Review
title_sort role of adjuvant treatment in craniofacial malignancy: a critical review
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7426725/
https://www.ncbi.nlm.nih.gov/pubmed/32850452
http://dx.doi.org/10.3389/fonc.2020.01402
work_keys_str_mv AT konigmarton theroleofadjuvanttreatmentincraniofacialmalignancyacriticalreview
AT osnesterje theroleofadjuvanttreatmentincraniofacialmalignancyacriticalreview
AT brulandøyvind theroleofadjuvanttreatmentincraniofacialmalignancyacriticalreview
AT sundbyhallkirsten theroleofadjuvanttreatmentincraniofacialmalignancyacriticalreview
AT bratlandase theroleofadjuvanttreatmentincraniofacialmalignancyacriticalreview
AT melingtorsteinr theroleofadjuvanttreatmentincraniofacialmalignancyacriticalreview
AT konigmarton roleofadjuvanttreatmentincraniofacialmalignancyacriticalreview
AT osnesterje roleofadjuvanttreatmentincraniofacialmalignancyacriticalreview
AT brulandøyvind roleofadjuvanttreatmentincraniofacialmalignancyacriticalreview
AT sundbyhallkirsten roleofadjuvanttreatmentincraniofacialmalignancyacriticalreview
AT bratlandase roleofadjuvanttreatmentincraniofacialmalignancyacriticalreview
AT melingtorsteinr roleofadjuvanttreatmentincraniofacialmalignancyacriticalreview