Head and neck cancer in Hong Kong

Abstract

Head and neck cancer is a major cause of morbidity and mortality in Hong Kong. HNC is well-known for its heterogeneity in epidemiology, clinical behavior, clinic-pathological features and patient characteristics. Treatment strategies for this heterogeneous disease vary greatly in different parts of the world, depending on availability of resources, local expertise and experience. Extensive research in head and neck cancer, particularly nasopharyngeal carcinoma, has been conducted in Hong Kong in the past few decades. In this article, we will review the available local evidence and summarize common practice in management of head and neck cancer in Hong Kong.

Pretreatment Prediction of Adaptive Radiation Therapy Eligibility Using MRI-Based Radiomics for Advanced Nasopharyngeal Carcinoma Patients

“…Due to the high proximity of the primary NPC tumor to the surrounding critical organs (spinal cord, brainstem, parotid glands) and metastatic neck lymph nodes, NPC is rarely treated surgically; radiation therapy (RT) remains the mainstay of NPC treatment (1). Intensity-modulated radiation therapy (IMRT) with/without induction chemotherapy (IC) or adjuvant chemotherapy (AC) is currently the standard of care for NPC patients (1).…”

“…Due to the high proximity of the primary NPC tumor to the surrounding critical organs (spinal cord, brainstem, parotid glands) and metastatic neck lymph nodes, NPC is rarely treated surgically; radiation therapy (RT) remains the mainstay of NPC treatment (1). Intensity-modulated radiation therapy (IMRT) with/without induction chemotherapy (IC) or adjuvant chemotherapy (AC) is currently the standard of care for NPC patients (1). In clinical practice, RT treatment plans are tailor-made based on anatomic information of individual patients from their pre-treatment planning computed tomography (CT) images to maximize the radiation dose to tumor while protecting nearby critical structures and maintaining sufficiently high dose coverage to surrounding nodal targets.…”

Management of locally recurrent nasopharyngeal carcinoma

“…A two-stage operation has been described: an extra-to-intracranial vascular bypass using the autologous radial artery or long saphenous vein is performed during the first-stage. After ascertaining the patency of the bypass by CT angiogram, the tumor including the involved bone and ICA will be removed en-bloc in the second operation [35].…”

Dysphagia after chemo‐radiation for nasopharyngeal cancer: A scoping review

“…2 It is unique in its highly specific regional distribution in the world, with the incidence of NPC the highest in the southern parts of China, followed by South East Asia and some artic areas in which Eskimos reside. 3,4 The histology of the main subtype of NPC is nonkeratinizing carcinomas. Compared with squamous cell carcinoma in other HNCs, they are more radiosensitive and respond better to radiation therapy (RT).…”

“…While dysphagia post NPC is a recognized consequence of treatment, and there is emerging evidence that both cranial nerve function and fibrosis may be contributing factors, there is still much work needed to fully understand the prevalence and nature of dysphagia post NPC management. Variability in methodologies, and a limited numbers of papers specifically examining the issue of dysphagia in this population means that the evidence for core questions such as: (1) how prevalent dysphagia and related complications are among NPC patients; (2) whether dysphagia in this population has characteristic deficits across the phases of swallowing; (3) whether there is any collective evidence to effectively prevent and manage dysphagia in this population; (4) what are the effects on the dysphagia-related quality of life e are only just emerging. For this reason, the purpose of the current study was to conduct a scoping review to map the research done in this area, and to identify any issues and existing gaps in the knowledge base in order to inform an agenda for future research into dysphagia and its consequences post NPC treatment.…”