TAILIEUCHUNG - Chapter 084. Head and Neck Cancer (Part 5)

Head and Neck Cancer: Treatment Patients with head and neck cancer can be categorized into three clinical groups: those with localized disease, those with locally or regionally advanced disease, and those with recurrent and/or metastatic disease. Comorbidities associated with tobacco and alcohol abuse can affect treatment outcome and define long-term risks for patients who are cured of their disease. Localized Disease Nearly one-third of patients have localized disease; that is, T1 or T2 (stage I or stage II) lesions without detectable lymph node involvement or distant metastases. These lesions are treated with curative intent by surgery or radiation therapy. The choice. | Chapter 084. Head and Neck Cancer Part 5 Head and Neck Cancer Treatment Patients with head and neck cancer can be categorized into three clinical groups those with localized disease those with locally or regionally advanced disease and those with recurrent and or metastatic disease. Comorbidities associated with tobacco and alcohol abuse can affect treatment outcome and define long-term risks for patients who are cured of their disease. Localized Disease Nearly one-third of patients have localized disease that is T1 or T2 stage I or stage II lesions without detectable lymph node involvement or distant metastases. These lesions are treated with curative intent by surgery or radiation therapy. The choice of modality differs according to anatomic location and institutional expertise. Radiation therapy is often preferred for laryngeal cancer to preserve voice function and surgery is preferred for small lesions in the oral cavity to avoid the long-term complications of radiation such as xerostomia and dental decay. Overall 5-year survival is 60â 90 . Most recurrences occur within the first 2 years following diagnosis and are usually local. Locally or Regionally Advanced Disease Locally or regionally advanced diseasea disease with a large primary tumor and or lymph node metastasesa is the stage of presentation for 50 of patients. Such patients can also be treated with curative intent but not with surgery or radiation therapy alone. Combined modality therapy including surgery radiation therapy and chemotherapy is most successful. Concomitant chemotherapy and radiation therapy appears to be the most effective approach. It can be administered either as a primary treatment for patients with unresectable disease to pursue an organ preserving approach or in the postoperative setting for intermediate-stage resectable tumors. Induction Chemotherapy In this strategy patients receive chemotherapy usually cisplatin and fluorouracil 5-FU before surgery and radiation therapy. Most .

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