Integrated Therapeutic Approaches in Head and Neck Cancer: The Importance of Multidisciplinary Team Management

ISSN: 1875-5992 (Online)
ISSN: 1871-5206 (Print)


Volume 16, 12 Issues, 2016


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Anti-Cancer Agents in Medicinal Chemistry

Formerly: Current Medicinal Chemistry - Anti-Cancer Agents

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Michelle Prudhomme
Universite Blaise Pascal - C.N.R.S
Aubiere Cedex
France


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Integrated Therapeutic Approaches in Head and Neck Cancer: The Importance of Multidisciplinary Team Management



Anti-Cancer Agents in Medicinal Chemistry, 13(6): 834-843.

Author(s): Francesco Perri, Paolo Muto, Corrado Aversa, Antonio Daponte, Giuseppina Della Vittoria, Stefano Pepe and Francesco Caponigro.

Affiliation: National Tumor Institute of Naples- Head and Neck Medical Oncology Unit, Via Mariano Semmola- 80131-Naples.

Abstract

Multidisciplinary team (MDT) is of paramount importance in the approach to patients with head and neck cancer. Its aim is to provide the best diagnostic work-up, tumor staging, and treatment. Furthermore, the prognosis of patients who are managed by MDT is usually better. MDT has a great value in all presentation settings. The role of the pathologist in the team is of utmost importance, in particular with regards to information provided on Human Papilloma Virus (HPV) status, which has a well acknowledged independent prognostic value mainly in oropharyngeal carcinoma.

In early stage disease, namely in T1-2 N0 M0 patients, the meetings within the MDT mainly involve surgeons and radiation therapists. Surgery represents the mainstay of treatment, while radiation therapy is a suitable alternative, in particular in patients with advanced age, poor performance status and comorbidities.

In locally advanced disease, surgeons, medical oncologists and radiotherapists are the key people, since different approaches have been carried out. In operable patients, adjuvant chemoradiation is indicated when resection margins are involved or close, or in presence of extracapsular nodal spread. Concurrent chemoradiotherapy, preceeded or not by induction chemotherapy, is the favourite approach in this setting when surgery is strictly not indicated.

In recurrent/metastatic disease chemotherapy and best supportive care are the main options, although local treatments, such as reirradiation and salvage surgery, are also worth considering. The standard chemotherapy treatment has finally evolved after about 30 years, and strong efforts are being pursued to further improve the outcome, mainly with the addition of new drugs.


Keywords:

Early stage, Head and neck cancer, Locally advanced disease, Multidisciplinary team, Pathologist, Recurrent/metastatic disease.



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Article Details

Volume: 13
Issue Number: 6
First Page: 834
Last Page: 843
Page Count: 10
DOI: 10.2174/18715206113139990110
Price: $58
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