Reirradiation in squamous cell head and neck cancer: recent developments and future directions

Langendijk, Johannes A.; Bourhis, Jean

doi:10.1097/cco.0b013e3280f00ff8

Cited by 42 publications

(38 citation statements)

References 44 publications

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“…However, the situation is different for rnpc. Experience in treating recurrent head-and-neck cancer demonstrates that recurrent tumours might be more radioresistant than the primary tumours 21 . Radiation can induce tissue fibrosis and microvasculature damage, and alter the tumour microenvironment.…”

Section: Patho-clinical Characteristicsmentioning

confidence: 99%

Recurrent Nasopharyngeal Carcinoma: A Clinical Dilemma and Challenge

et al. 2013

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Recurrent nasopharyngeal carcinoma, which represents a small proportion of head-and-neck cancers, has a unique set of patho-clinical characteristics. The management of recurrent nasopharyngeal carcinoma remains a challenging clinical problem. Traditional treatments offer limited local control and survival benefits; more seriously, they frequently induce severe late complications. Recently, novel treatment techniques and strategies—including precision radiotherapy, endoscopic surgery or transoral robotic resection, third-generation chemotherapy regimens, and targeted therapies and immunotherapy—have provided new hope for patients with recurrent nasopharyngeal carcinoma. Some of these patients can potentially be cured with modern treatments. However, a lack of adequate evidence makes it difficult for clinicians to apply these powerful techniques and strategies. Individualized management guidelines, full evaluation of quality of life in these patients, and a further understanding of the mechanisms underlying recurrence are future directions for research into recurrent nasopharyngeal carcinoma.

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Section: Patho-clinical Characteristicsmentioning

confidence: 99%

Recurrent Nasopharyngeal Carcinoma: A Clinical Dilemma and Challenge

et al. 2013

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“…En enfermedad irresecable, la quimioterapia exclusiva solo ofrece paliación, sin larga supervivencia 8,9 , siendo fundamental seleccionar los casos por su elevada toxicidad 10 . Reirradiación con o sin quimioterapia obtiene supervivencias a largo plazo en pacientes seleccionados: no candidatos a cirugía; adyuvante a cirugía de rescate (cuando existen características de alto riesgo, como nuestro caso); como paliación cuando no es posible resección curativa.…”

Section: Discussionunclassified

Braquiterapia intersticial de alta tasa de rescate en cáncer cabeza cuello previamente radiado

Gutiérrez-Bayard

Salas-Buzón

Angulo-Pain

et al. 2011

Rev Esp Cirug Oral y Maxilofac

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“…Lowering the complications can perhaps be strived for by using newer radiation techniques, e.g., IMRT, enabling us to limit the volume of normal tissue irradiated, while limiting the CTV to the high risk area or GTV with some margin [22]. The use of cytoprotective agents such as amifostine should also be investigated in future trials [22].…”

Section: Discussionmentioning

confidence: 99%

“…However, due to tumor location and extent, surgery is often irradical with close or positive margins. Moreover, only 20% of patients will be able to undergo salvage surgery because of the extent of the disease, medical contraindications, or patient refusal [20,22,49]. Obviously, the risk of morbidity is also higher as a result of radiation-induced tissue changes which complicate healing.…”

Section: Introductionmentioning

confidence: 99%