Recent Advances in Head and Neck Cancer

English Version

More than half a million patients receive the diagnosis of squamous cell carcinoma of the head and neck worldwide each year. In this disease, which primarily affects the oropharynx, oral cavity, hypopharynx, and larynx, smoking and alcohol abuse are major risk factors. Symptomsvary, depending on the site of origin, and can include a sore throat, dysphagia, odynophagia, and hoarseness. On examination, patients of ten have an identifiable primary site and a palpable neck mass. A multidisciplinary approach is important in treating these patients, given the complexity of the treatment and the acute and longterm complications that result from chemotherapy, radiation therapy, and surgery. Appropriate clinical and radiographic staging is crucial for accurate treatment planning and delivery.

Since this topic was last reviewed in the Journal, new findings have emerged, leading to a better understanding of the biologic features of these tumors and, in particular,indicating that human papillomavirus (HPV) is a risk factor for cancer of the oropharynx. More treatment options are available because of the development of new therapeutic agents directed against multiple molecular targets, including the epidermal growth factor receptor (EGFR). In addition, the roles of chemotherapy have expanded so that such therapy is used as a neoadjuvant for larynx preservation6 and for postoperative care. Irradiation techniques have also improved with the widespread use of intensity modulated radiation therapy. New imaging techniques, such as positron emission tomography, may be helpful in staging, restaging after therapy, and potentially planning radiation therapy. As more patients are cured of their cancers, survivors need help in coping with the longterm complications of therapy.

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