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A Journal on Otorhinolaryngology, Head and Neck Surgery,
Plastic Reconstructive Surgery, Otoneurosurgery
Indexed/Abstracted in: EMBASE, Scopus
REVIEWS HOT TOPICS IN OTOLARYNGOLOGY
Otorinolaringologia 2010 June;60(2):65-80
Update on the management of advanced head and neck cancer
Wichmann G., Boehm A., Brus J., Horn I.-S., Gessner K., Kruber P., Mozet C., Lyutenski S., Dietz A.
Ear, Nose and Throat and Plastic Surgery Department, University Hospital of Leipzig, Leipzig, Germany
Contrary to most other malignant neoplasias, two thirds of patients having head and neck cancer die on complications of the primus or local recurrences without distant metastasis. Therefore local treatment, i.e., surgery and irradiation, are predominantly used to treat the cancer. Hence, the view of head and neck surgeons is mainly adjusted to the balance act between targeted, minimal ablative surgery and the evidence-based demand of oncologic accurate surgery with clear margins. Additionally, as accepted to be necessarily needed in the treatment of advanced head and neck squamous cell carcinoma (HNSCC), adjuvant irradiation or (in the case of inoperability) alternatively applied primary chemoradiation regimens have to be considered. However, there is an increasing pressure to include multimodal therapy concepts into the routinely applied treatment options also for operable advanced HNSCC. In this context, an interdisciplinary tumor board should be established to have a comprehensive discourse and agreement in regard choosing the potentially best treatment option for the individual patient having an advanced HNSCC. This is especially important in the context of a variety of new substances, and in particular substances allowing for targeted therapies. This update discusses the scientific background that should guide the necessary evidence-based decision-making process, and an integrated approach to manage and treat advanced HNSCC. Also, some diagnostic aspects are outlined within this review.