Head and Neck Cancer

379 Pages·2003·12.002 MB·English

by  Gregory Masters M.D., Bruce Brockstein M.D. (auth.), Brockstein Bruce M.D., Masters Gregory M.D. (eds.)

HEAD AND NECK CANCER
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Brockstein, B., Masters, G. (eds): Head and Neck Cancer. 2002. ISBN 1-4020-7336-4.
HEAD AND NECK CANCER
edited by
Bruce Brockstein, M.D.
Evanston Northwestern Healthcare, Evanston, IL
Robert H. Lurie Cancer Center of Northwestern University,
Feinberg School of Medicine, Chicago IL
Gregory Masters, M.D.
Evanston Northwestern Healthcare, Evanston, IL
Robert H. Lurie Cancer Center of Northwestern University,
Feinberg School of Medicine, Chicago IL
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Print ISBN: 1-4020-7336-4
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TABLE OF CONTENTS
Preface vii
List of Contributors ix
Chapter 1 Overview of Head and Neck Cancer
Gregory Masters, M.D.,
Bruce Brockstein, M.D. 1
Chapter 2 Epidemiology, Staging, and Screening of Head and Neck
Cancer
Athanassios Argiris,M.D. and
Cathy Eng, M.D. 15
Chapter 3 Oral Preneoplasia and Chemoprevention of Squamous
Cell Carcinoma of the Head and Neck
Omer Kucuk, M.D., FACN 61
Chapter 4 Early Stage Head and Neck Cancer – Surgery
Steven J. Charous, M.D. 85
Chapter 5 Radiation Therapy in the Management of Early-Stage
Head and Neck Cancer
Russell W. Hinerman, M.D.,
William M. Mendenhall, M.D. and
Robert J. Amdur, M.D. 115
Chapter 6 Advanced Head and Neck Cancer-Surgery and
Reconstruction
Brandon G. Bentz, M.D. and
Dennis H. Kraus, M.D. 145
Chapter 7 Modified Fractionated Radiotherapy in Head and Neck
Squamous Cell Carcinoma (HNSCC) & Re-irradiation in
Recurrent Head and Neck Carcinomas
R. De Crevoisier, M.D. and
J. Bourhis M.D., PhD and
F. Eschwège, M.D. 199
Chapter 8 Organ preservation-Induction Chemotherapy
A. Dimitrios Colevas, M.D. 213
vi Table of Contents
Chapter 9 Organ Preservation forAdvanced Head and Neck
Cancer, Concomitant Chemoradiation
Bruce Brockstein, M.D. 235
Chapter 10 Unresectable, Locoregionally Advanced Head and Neck
Cancer
Fred Rosen, M.D. 249
Chapter 11 Nasopharyngeal Cancer
Anthony TC Chan, M.D.,
Peter ML Teo, M.D. and
Philip J. Johnson, M.D. 275
Chapter 12 Treatment of Metastatic Head and Neck Cancer:
Chemotherapy and Novel Agents
Edward S. Kim, M.D. and
Bonnie S. Glisson, M.D. 295
Chapter 13 New Therapies for Locoregionally Advanced and
Locoregionally Recurrent Head and Neck Cancer
Barry L. Wenig, M.D., M.P.H. 315
Chapter 14 Quality of Life and Late Toxicities in Head and Neck
Cancer
Marcy A. List, PhD and
JohnStracks,BA. 331
Chapter 15 Oral, Dental, and Supportive Care in the Cancer Patient
Harry Staffileno, Jr. DDS, MS and
Leslie Reeder, DDS 353
Index 371
PREFACE
Bruce Brockstein, M.D., Gregory Masters, M.D.
Evanston Northwestern Healthcare, Evanston IL and Robert Lurie Cancer Center of
Northwestern University, Feinberg School of Medicine, Chicago IL.
Squamous cell carcinoma of the head and neck affects more than
40,000 people each year in the U.S., and at least 13,000 people each year die
of this disease. In many countries, oral cancers are one of the leading causes
of cancer incidence, and a major cause of morbidity and mortality. Sadly,
these statistics have not improved despite clear delineation of tobacco and
alcohol as contributory or etiologic in at least 80% of cases.
Excitingadvances are occurring in the understanding of the molecular
pathogenesis of squamous head and neck cancers. This progress may allow
for earlier detection using molecular markers in blood, saliva, or tissue.
Molecular diagnostic tools to distinguish between second primary upper
aerodigestive tract tumors and metastases may be routinely used clinically in
the near future. Understanding the significance of molecular markers such as
p53 mutations improves our ability to use these as both prognostic markers of
outcome, and predictive markers of response to our therapies.
For early stage head and neck cancer, surgery and radiotherapy
remain standard therapies, with cure achieved in 60-90% of such patients.
Although there is still room for improvement in these numbers, a significant
need for these patients is effective chemoprevention of second primary
malignancies. These occur in the head and neck, lung, and esophagus at the
rate of 5% per year in those who continue to smoke, and slightly less in those
who have quit. Eagerly awaited data from large randomized trials of
chemoprevention agents will emerge in the next few years, and preclinical
and early clinical work promisefurther advances in the nearfuture.
Locoregionally advanced head and neck cancer, the most common
presentation, and metastatic head and neck cancer are both considered stage
IV disease. This reflects the unique biology of HNC in which the majority of
patients die of locoregional, not metastatic, disease. Traditional treatment
with surgery and postoperative radiotherapy has led to cure in 30-35% of
patients, and less in unresectable patients treated with radiotherapy alone. In
the last decade, a clear role for chemotherapy has emerged in the
viii Preface
multimodality treatment of head and neck cancer. This has led to improved
outcome in virtually all categories for which it has been used. Larynx
preservation is demonstrated to be feasible for two-thirds or more of larynx
and hypopharyx cancer patients treated with induction chemotherapy and
radiation. Even higher rates of larynx preservation are possible with
concomitant chemotherapy and radiation. Concomitant chemoradiation has
clearly improved survival in unresectabele HNC when compared to RT alone,
and this modality continues to be studied in resectable HNC. In the
postoperative setting chemoradiation shows promise for improving survival
versus radiation alone. This approach can allow organ preservation while
preserving or improving cure rates when used as a substitute for surgery.
Advances in reconstruction for patients requiring extensive surgeries have
allowed for improved cosmesis and function.
Despite our best efforts, any treatment for HNC has the potential to
lead to anatomic, functional or cosmetic sequelae, and altered quality of life.
Many efforts are currently underway to describe, quantify and compare these
adverse outcomes in the various treatments used for HNC. Understanding
and improving these outcomes is a fertilearena for ongoing investigation.
Notwithstanding all of the advances in the multidisciplinary treatment
of head and neck cancer, we continue to hope that throughprimary prevention
we can eliminate more head and neck cancer cases and deaths than we can
with all of the diagnostic and therapeutic measures discussed in this book.
LIST OF CONTRIBUTORS
Robert J. Amdur, M.D. Department of Radiation Oncology, University of
Florida College of Medicine, Gainesville, Florida
Athanassios Argiris, M.D. Assistant Professor of Medicine, Division of
Hematology/Oncology, Department of Medicine, Northwestern University,
Feinberg School of Medicine and the Robert H. Lurie Comprehensive Cancer
Center Chicago, Illinois
Brandon G. Bentz, M.D. Division of Head & Neck Surgery, Department of
Surgery, Memorial Sloan-Kettering Cancer Center
J. Bourhis, M.D. PhD. Institut Gustave-Roussy, 39 rue Camille Desmoulins
94805 Villejuif Cédex, France
Bruce Brockstein, M.D. Evanston Northwestern Healthcare, Evanston, IL
and Robert H. Lurie Cancer Center of Northwestern University, Feinberg
School of Medicine, Chicago IL
Anthony TC Chan, M.D. Chinese University of Hong Kong, HKSAR,
China
Steven J. Charous, M.D. Assistant Professor, Rush-Presbyterian-St. Luke’s
Medical Center & Evanston Northwestern Healthcare Hospitals
A. Dimitrios Colevas, M.D. Senior Investigator, Investigational Drug
Branch,NCI/CTEP, 6130 Executive Blvd. EPN 7130, Rockville MD 20852
R. De Crevoisier, M.D. Institut Gustave-Roussy, 39 rue Camille Desmoulins
94805 Villejuif Cédex, France
Cathy Eng, M.D. Fellow, Division of Hematology/Oncology, The
University of Chicago, Chicago, Illinois
F. Eschwège, M.D. Institut Gustave-Roussy - 39 Rue Camille Desmoulins -
94805 VILLEJUIF Cedex, France
Bonnie S. Glisson, M.D. Professor of Medicine, Chief, Section of Head and
Neck Medical Oncology, Department of Thoracic/Head and Neck Medical
Oncology, University of Texas M. D. AndersonCancer Center, 1515
Holcombe Blvd. Box 432, Houston, TX 77030
Russell W. Hinerman, M.D. Department of Radiation Oncology, University
of Florida College of Medicine, Gainesville, Florida
Philip J Johnson, M.D. Chinese University of Hong Kong, HKSAR, China
x Contributors
Barbara Ann Karmanos Cancer Institute, Wayne State University, Detroit,
Michigan
EdwardS. Kim, M.D. Assistant Professor of Medicine, Department of
Thoracic/Head and Neck Medical Oncology, University of Texas M. D.
AndersonCancer Center, 1515 Holcombe Blvd. Box 432, Houston, TX 77030
Dennis H. Kraus, M.D., Division of Head & Neck Surgery, Department of
Surgery, Memorial Sloan-Kettering Cancer Center
Omer Kucuk, M.D.,FACN Professor of Medicine, Oncology and Nutrition
(adjunct), Leader, PreventionProgram, Barbara Ann Karmanos Cancer
Institute, Wayne State University, 3990 John R, 5 Hudson, Detroit, MI 48201
Marcy A. List, Ph.D. University of Chicago Cancer Research Center,
Chicago, IL 60637
Gregory Masters, M.D. Evanston Northwestern Healthcare, Evanston, IL
and Robert H. Lurie Cancer Center of Northwestern University, Feinberg
School of Medicine, Chicago IL
William M. Mendenhall, M.D. Department of Radiation Oncology,
University of Florida College of Medicine, Gainesville, Florida
Leslie Reeder, DDS , Northwestern University, Feinberg School of
Medicine, Chicago,IL 60611, Evanston Northwestern Healthcare, Evanston,
IL 60201
Fred Rosen, M.D. University of Illinois at Chicago, Department of
Medicine, Section of Hematology/Oncology, Chicago, Illinois 60612
Harry Staffileno, Jr. DDS, MS , Northwestern University, Feinberg School
of Medicine, Chicago,IL 60611, Evanston Northwestern Healthcare,
Evanston, IL 60201
John Stracks, B.A. University of Chicago Cancer Research Center, Chicago,
IL 60637
Peter ML Teo, M.D. Chinese University of Hong Kong, HKSAR, China
Barry L. Wenig, M.D., M.P.H. Professor of Otolaryngology – Head and
Neck Surgery, Feinberg School of Medicine, Northwestern University,
Director, Division of Otolaryngology - Head and Neck Surgery, Evanston
Northwestern Healthcare