This book is a multidisciplinary guide to head and neck cancer.Head and neck cancer remains one of the most technically complex cancer subsites to manage. This field involves highly specialized, multidisciplinary management and collaboration amongst surgeons, radiation oncologists, medical oncologists, radiologists, pathologists, and other health disciplines. The clinical and research landscape for head and neck oncology continues to evolve at a rapid pace.
This multidisciplinary book provides the latest updates in the contemporary understanding and management of these tumors. The text incorporates updates in surgical techniques (minimally invasive and robotic techniques, reconstructive approaches), radiation medicine (new data on dose and fields, oligometastatic/oligoprogressive disease, retreatment), medical oncology (targeted, immunotherapy and molecular agents), in addition to other overarching topics such as side effects, biomarkers/nanotechnology, and epidemiology. Written by experts in their respective fields, chapters include the most up to date scientific and clinical information with perspectives from each relevant subspeciality. These sections are concise and accessible, yet comprehensive. Palliative medicine, pathologic and imaging principles, and health systems/economics considerations are also described.This book is an ideal resource for clinicians, trainees, and researchers dealing with, and interested in, this challenging malignancy.
Author(s): Ravi A. Chandra, Ryan J. Li
Publisher: Springer
Year: 2022
Language: English
Pages: 246
City: Cham
Foreword
Foreword
Preface
Contents
Contributors
1: De-intensification Strategies for Head and Neck Cancer
Introduction
Prognosis
Traditional Treatment Paradigm
Rationale for De-escalation
Mechanisms of Improved Prognosis
Overview of De-intensification Strategies
Surgery Alone or with Risk-Based Adjuvant Therapy
Transoral Surgery for Work-Up of Unknown Primary
Definitive Radiotherapy/Chemoradiotherapy De-intensification
Response-Based De-escalation of Definitive Chemoradiotherapy
Limitations of De-intensification
Conclusion
References
2: Novel Multidisciplinary Paradigms: Surgery/Radiation, Immunotherapy, Organ Preservation
Background
Advances in Surgery and Radiation
Oropharynx Cancer
Radiotherapy Options for Oligometastatic Disease
Immunotherapy
Multidisciplinary Regimens Including Epidermal Growth Factor Receptor Blockers
Multidisciplinary Regimens Including Immune Checkpoint Blockers
Organ Preservation
Neoadjuvant Chemotherapy and Radiation for Advanced Oral Cavity Squamous Cell Carcinoma (OSCC)
Induction Chemotherapy
Conclusion
References
3: Advances in Surgery and Reconstruction: TORS, TLM
Introduction
Epidemiology
Technique
Management of the Neck
Adjuvant Therapy
Outcomes
Prospective Trials
Conclusions
References
4: Advances in Radiation: Ion Therapy and Advanced Techniques
Charged Particle Therapy
Proton Beam Therapy
Background
Rationale
Clinical Evidence
Oropharyngeal Cancer
Nasopharyngeal Cancer
Sinonasal Malignancies
Salivary Gland Tumors
Ongoing Clinical Trials
Carbon Ion Radiation Therapy
Background
Rationale
Patient Selection
Clinical Evidence
Unresolved Questions
Stereotactic Body Radiation Therapy
Background and Rationale
Clinical Evidence
Personalized Radiotherapy
Tumor Hypoxia
Immune Microenvironment
Radiosensitivity Index
Conclusion
References
5: Systemic Therapy Advances in Head and Neck Cancer
Introduction
Systemic Therapy for Recurrent/Metastatic Head and Neck Cancer
Immunotherapy for Recurrent/Metastatic Head and Neck Cancer
Targeted Agents for Recurrent/Metastatic Head and Neck Cancer
Palliative Metronomic Chemotherapy
Locally Advanced Squamous Cell Carcinoma of the Head and Neck
Organ Preservation in Locally Advanced Squamous Cell Carcinoma of the Larynx
Definitive Chemoradiation Therapy in Unresectable Locally Advanced SCCHN
De-escalation of Therapy in HPV-Positive Oropharyngeal Carcinoma
Neoadjuvant Chemotherapy Followed by Definitive Chemoradiation Therapy
Alternative Anti-EGFR Agents in Concurrent Chemoradiation Therapy
Immunotherapy in Locally Advanced SCCHN
Advances in Postoperative Chemoradiation Therapy
Future Directions
References
6: Advances in Molecular, Functional, and Anatomical Head and Neck Imaging
Introduction
Ultrasound
Computed Tomography and Magnetic Resonance Imaging
CT
Dual Energy CT
MRI
Functional Imaging
DW-MRI
DCE-MRI
Molecular Spectroscopy
Tumor Characterization with Quantitative DWI and DCE-MRI
Tumor Staging
Therapy Response Assessment
Posttreatment Change
Metabolic Imaging
Unknown Primary
Staging and Response Assessment
PET/MR
Conclusion
References
7: Radiotherapy and Immunotherapy for Head and Neck Cancer
Introduction
Immune Effects of Radiotherapy
Immune Landscape of HNSCC
Preclinical Evidence for Radioimmunotherapy in HNSCC Models
Augmenting Antitumor Cellular Immunity
Decreasing an Immunosuppressive Microenvironment
Radiation Dose and Fractionation Effects
Clinical Evidence for Radioimmunotherapy in HNSCC
Recurrent/Metastatic Setting
Locally Advanced/Definitive Setting
Conclusions/Future Directions
References
8: Epidemiology and Genomics of Head and Neck Squamous Cell Carcinoma
Epidemiology of Head and Neck Cancer
Overview
Risk Factors
Human Papillomavirus
Evolving Changes in Management of HNSCC
Genomic Landscape of Head and Neck Cancer
Genomic Characteristics: Overview
Genomic Landscape of HPV-Negative HNSCC
Genomic Landscape of HPV-Positive HNSCC
Molecular Profiling and Therapeutic Implications
Receptor Tyrosine Kinases
HRAS
TP53
PIK3CA
STAT
Immunologic Characteristics of HNSCC
Conclusion
References
9: Biomarkers in Head and Neck Cancer
Introduction
P53
DNA Damage Response and Apoptosis
HPV
EGFR
PI3K/PIK3CA
EBV
Immune Checkpoint Inhibitors
Hypoxia
Biomarkers in Non-squamous Histologies
Conclusion
References
10: Reirradiation for Head and Neck Cancer
Introduction
Prognostic Factors and Patient Selection
Post-operative Reirradiation
Definitive Reirradiation
Conventional Radiation
Dose and Fractionation
Treatment Volume and Patterns of Failure
Systemic Therapy
Organs at Risk (OAR)
Conventional Radiation Conclusion
Stereotactic Ablative Radiation Therapy (SABR)
Dose and Fractionation
Systemic Therapy
SABR Versus IMRT
Post-operative SABR
Organs at Risk (OARs)
SABR Conclusion
Charged Particle Radiation
Proton
Carbon
Brachytherapy
Summary
References
11: Medical Dentistry
Introduction
Multidisciplinary Management of Head and Neck Cancer
Oral Optimization: Coordinated Timely Care
HNC Referral for Oral Management and Optimization: Standard Workflow [38]
HNC Referral for Oral Management and Optimization: Urgent Workflow [38]
Head and Neck Cancer: Phases of Oral Care Management
Pre-HNC Therapy—Oral Care and Optimization
Intra-HNC Therapy: Oral Care Maintenance
Post-HNC Therapy: Oral Care—Risks, Impact, and Complications of HNC
Overcoming Barriers to Multidisciplinary Management of Head and Neck Cancer: Oral Care
Conclusion
References
12: Supportive Care, Comorbid Conditions, and Survivorship
Supportive Care in Head and Neck Cancer
Comorbidity Assessment in Head and Neck Cancer
Pre-treatment Supportive Care
Acute Symptom Control During Cancer Treatment
Mucositis and Odynophagia
Dermatitis
Salivary Dysfunction
Cancer Surveillance
Health Promotion in Survivorship
Survivorship and Management of Late Effects
Lymphedema
Dysphagia
Dysgeusia
Ototoxicity
Dysphonia
Musculoskeletal Impairment
Oral and Dental Complications
Body Image
Chronic Systemic Symptoms
Fatigue
Chronic Pain
Sleep and Neurocognitive Disturbance
Mood Disorders
Metabolic Alterations
References
13: Rare Head and Neck Cancers
Exemplar Case
Introduction
Epithelial Tissue
Esthesioneuroblastoma
Mucosal Melanomas
Neuroendocrine Carcinomas
Connective and Muscle Tissue
Chondrosarcoma
Osteogenic Sarcoma
Synovial Cell Sarcoma
Rhabdomyosarcoma
Ewing Sarcoma
Leiomyosarcoma
Angiosarcoma
Liposarcoma
Kaposi Sarcoma
Teratocarcinosarcoma
Nervous Tissue
Malignant Nerve Sheath Tumors
Paraganglioma
Conclusions
References
14: Speech, Voice, and Swallowing Rehabilitation for Patients with Head and Neck Cancers
Introduction
Value of Baseline Assessment
Preoperative Assessment and Counseling
Determine the Status of Related Factors: Health Literacy, Support, Resources
Considerations for Specific Surgical Procedures
Glossectomy
Floor of Mouth and Composite Resections
Mandibulectomy
Maxillectomy
Oropharyngeal Resections
Thyroidectomy
Laryngectomy
Postsurgical Management
Outpatient Rehabilitation
Lymphedema
Transitioning from Surgery to Adjuvant Therapy
Nonoperative Treatment of Head and Neck Cancer
Functional Changes Associated with Nonoperative Treatment
Importance of Education and Pre-habilitation
Management During Treatment
First-Year Posttreatment
Long-Term Management
Conclusions
References
Index
