Latest News on Neck Cancer : Dec 2020

Latest News on Neck Cancer : Dec 2020

Head and neck cancer

Most head and neck cancers are squamous cell carcinomas that develop in the upper aerodigestive epithelium after exposure to carcinogens such as tobacco and alcohol. Human papillomavirus has also been strongly implicated as a causative agent in a subset of these cancers. The complex anatomy and vital physiological role of the tumour-involved structures dictate that the goals of treatment are not only to improve survival outcomes but also to preserve organ function. Major improvements have been accomplished in surgical techniques and radiotherapy delivery. Moreover, systemic therapy including chemotherapy and molecularly targeted agents—namely, the epidermal growth factor receptor inhibitors—has been successfully integrated into potentially curative treatment of locally advanced squamous-cell carcinoma of the head and neck. In deciding which treatment strategy would be suitable for an individual patient, important considerations include expected functional outcomes, ability to tolerate treatment, and comorbid illnesses. The collaboration of many specialties is the key for optimum assessment and decision making. We review the epidemiology, molecular pathogenesis, diagnosis and staging, and the latest multimodal management of squamous cell carcinoma of the head and neck. [1]

The molecular biology of head and neck cancer

Head and neck squamous cell carcinomas (HNSCCs) are caused by tobacco and alcohol consumption and by infection with high-risk types of human papillomavirus (HPV). Tumours often develop within preneoplastic fields of genetically altered cells. The persistence of these fields after treatment presents a major challenge, because it might lead to local recurrences and second primary tumours that are responsible for a large proportion of deaths. Aberrant signalling pathways have been identified in HNSCCs and inhibition of epidermal growth factor receptor (EGFR) has proved a successful therapeutic strategy. In this Review, we discuss the recent literature on tumour heterogeneity, field cancerization, molecular pathogenesis and the underlying causative cancer genes that can be exploited for novel and personalized treatments of patients with HNSCC. [2]

Head and Neck Cancer: Changing Epidemiology, Diagnosis, and Treatment

Head and neck cancers account for less than 5% of all cancers and for less than 3% of all cancer deaths in the United States. The populations at risk for head and neck cancers are those who have a long-standing history of smoking and alcohol use. More recently, the incidence of oropharyngeal cancer in younger populations has been increasing and is associated with exposure to the human papillomavirus. This subset of patients appears to have a better overall prognosis and to respond better to treatment. This review is limited to head and neck cancers of squamous cell histology, which constitute more than 90% of head and neck cancers. Because treatment of head and neck cancers is complex and involves multiple modalities, a multidisciplinary approach is needed. This review focuses on the goal of organ preservation and postoperative treatment of high-risk patients with the concurrent use of chemotherapy and radiation therapy. This review also highlights recent advances in treatment using molecularly targeted therapies, specifically the role of inhibitors of the epidermal growth factor receptor in locally advanced and recurrent/metastatic squamous cell cancer of the head and neck. Studies in the English language were identified by searching the MEDLINE, EMBASE database (1980-2007) using the search terms head and neck, squamous cell, carcinoma, chemotherapy, radiation, human papillomavirus, epidermal growth factor receptor, and targeted therapy. [3]

The Relationship between Single Nucleotide Polymorphisms of Gene XRCC1 and Toxicity Induced Radiation in Patients with Head and Neck Cancer

Aims: The head and neck cancer is one of the most common types and their treatment brings complications such as dermatitis, mucositis and dysphagia. Studies of genetic variations of patients are those that enable the identification of prognostic factors for treatment, generally based on greater risk of injury to healthy tissue.

Study Design: This study examined the association between single nucleotide polymorphisms (SNPs) of XRCC1 gene in patients with head and neck cancer with adverse reactions presented in normal tissues as result of radiotherapy.

Place and Duration of Study: The study was conduct at Pontifícia Universidade Católica de Goiás, and the patients were recruited at Hospital Araújo Jorge, Associação de Combate ao Câncer em Goiás, Radiotherapy Service.

Methodology: We evaluated 54 patients, through a retrospective study, based on data contained in records and teletherapy records of patients with this cancer who underwent radiotherapy for at least 5 years.

Results: The mean age of patients was 58.43±13.79 years and the mean dose was applied 64,02Gy. Regarding the acute and late toxicities, patients analyzed showed a higher frequency of low-grade morbidities when compared to high grade. For acute toxicity, patients presenting polymorphism rs1799782 had an increased risk for developing mucositis, but the other polymorphisms were not statistically significant for the development of these changes (dermatitis, xerostomia and mucositis) acute. Patients who have studied polymorphisms have no increased risk of developing chronic changes of the larynx and esophagus (P>.05). In relation to the suspension of radiotherapy, patients with polymorphism rs25487 had reduced risk to have treatment discontinued, while patients with polymorphism rs25489 have an increased risk. Conclusion: Studies of genetic variants XRCC1 gene family should continue, to develop mechanisms to determine the degree of radiosensitivity in risk organs in patients with head and neck tumor. Thus, the personalized treatment with ionizing radiation can be prescribed for patients decreasing complications and improving the effectiveness of treatment and quality of life of patients. [4]

Epidemiology of Head and Neck Cancers in Maiduguri-Northeastern Nigeria

Head and neck cancers is one of the common health problems in our environment affecting relatively the youth. The paucity of literature on community based studies in Nigeria to determine the incidence of the disease obscure its burden, pattern and magnitude. This study presents epidemiological characteristics of head and neck cancers in Maiduguri as seen during the period of insurgency.

A 5 year retrospective review of patients seen from January, 2010 to December, 2014 with histologically diagnosed head and neck cancers. Data extracted from the records of histopathology department of University of Maiduguri Teaching Hospital was analyzed using SPSS version 16.0.

Of the 7655 patients, 1312 (17.14%) were cancers and 217 (16.54%) of this was head and neck malignancies. Average age was 35.5years with SD±20.07. About 69% of cases were epithelial in origin and 60.83% of patients were less than 41 years of age. The age group worse affected by carcinoma is older than those with sarcoma and lymphoma.

Head and neck is not uncommon in Maiduguri even in the face of insurgency, it is also among one of the common health problems of the relatively young. This therefore call for in-depth research on aetiological factors. Relevant authorities shall also establish oncology centers which will promote education, screening programmes, early detection, prevention and control of head and neck cancers. [5]

Reference

[1] Argiris, A., Karamouzis, M.V., Raben, D. and Ferris, R.L., 2008. Head and neck cancer. The Lancet, 371(9625), pp.1695-1709.

[2] Leemans, C.R., Braakhuis, B.J. and Brakenhoff, R.H., 2011. The molecular biology of head and neck cancer. Nature reviews cancer, 11(1), pp.9-22.

[3] Marur, S. and Forastiere, A.A., 2008, April. Head and neck cancer: changing epidemiology, diagnosis, and treatment. In Mayo Clinic Proceedings (Vol. 83, No. 4, pp. 489-501). Elsevier.

[4] Augusto de Oliveira Neto, O., Lázaro de Carvalho Vasconcelos, G., de Abreu Mendonça, Y., Castro Dourado Pinezi, J. and de Bastos Ascenço Soares, R. (2016) “The Relationship between Single Nucleotide Polymorphisms of Gene XRCC1 and Toxicity Induced Radiation in Patients with Head and Neck Cancer”, Journal of Cancer and Tumor International, 4(1), pp. 1-17. doi: 10.9734/JCTI/2016/27419.

[5] Kodiya, A. M., Adamu, A. I., Nggada, H. A., Garandawa, H. I., Ngamdu, Y. B., Sandabe, M. B. and Isa, A. (2015) “Epidemiology of Head and Neck Cancers in Maiduguri-Northeastern Nigeria”, Journal of Advances in Medicine and Medical Research, 11(5), pp. 1-7. doi: 10.9734/BJMMR/2016/20344.

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