Head and Neck Cancer Recurrence: Evidence-based, Multidisciplinary Management PDF
Preview Head and Neck Cancer Recurrence: Evidence-based, Multidisciplinary Management
Head and Neck Cancer Recurrence Evidence-based, Multidisciplinary Management Hisham M. Mehanna, PhD, BMedSc (Hons), MBChB (Hons), FRCS, FRCS (ORL-HNS) Director, Institute of Head and Neck Studies and Education Consultant Head–Neck and Thyroid Surgeon Chair, Head and Neck Surgery at the School of Cancer Sciences The University of Birmingham Birmingham UK K. Kian Ang, MD, PhD, FACR, FASTRO Professor and holder of the Gilbert H. Fletcher Memorial Distinguished Chair Department of Radiation Oncology The University of Texas MD Anderson Cancer Center Houston, Texas USA With contributions by Oludolapo O. Adesanya, K. Kian Ang, R. J. Baatenburg de Jong, Alfonsus J. M. Balm, Beth M. Beadle, Jan Paul de Boer, Maarten F. de Boer, Lenine Garcia Brandão, Augusto Caraceni, Claudio R. Cernea, Kevin S. Choe, Ezra E. W. Cohen, Marc A. Cohen, Ralph Gilbert, David P. Goldstein, Patrick Gullane, Kevin J. Harrington, Jarrod Homer, Julie Howle, N. Gopalakrishna Iyer, Charles G. Kelly, Lai Wan Dora Kwong, Lisa Licitra, Julia Maclean, Hisham M. Mehanna, Gary Morgan, Dan Munday, Ramez Nassif, Christopher M. Nutting, Marinella P. J. Offerman, Vinidh Paleri, Alison Perry, Jean F. A. Pruyn, Alexander D. Rapidis, Coen R. N. Rasch, Joseph Kamel Salama, M. P. van der Schroeff, Cherith J. Semple, Ashok R. Shaha, Priyamal Silva, Nick Slevin, Pol Specenier, Miroslav Tedla, R. Michael Tuttle, Michael Veness, Jan B. Vermorken, Randal S. Weber, Eduardo Weltman, William I. Wei, Mark E. Zafereo 358 illustrations Thieme Stuttgart • New York IV Library of Congress Cataloging-in-Publication Data is available from Important note: Medicine is an ever-changing science undergo- the publisher. ing continual development. Research and clinical experience are continually expanding our knowledge, in particular our knowl- edge of proper treatment and drug therapy. 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Cover design: Thieme Publishing Group This book, including all parts thereof, is legally protected by copy- Typesetting by le-tex publishing services GmbH, Leipzig, Germany right. Any use, exploitation, or commercialization outside the nar- Printed in China by Asia Pacific Offset, Hong Kong row limits set by copyright legislation, without the publisher’s consent, is illegal and liable to prosecution. This applies in particu- ISBN 978-3-13-147391-2 lar to photostat reproduction, copying, mimeographing, prepara- eISBN 978-3-13-164571-5 tion of microfilms, and electronic data processing and storage. V Contributors Oludolapo O. Adesanya, PG Dip (Nucl Med), MRCP, FRCR Lenine Garcia Brandão, MD, PhD Consultant Radiologist Professor Department of Radiology Head and Neck Surgeon University Hospital Coventry and Warwickshire (UHCW) Brazilian Institute for Cancer Control (IBCC) Coventry Sao Paulo UK Brazil K. Kian Ang, MD, PhD, FACR, FASTRO Augusto Caraceni, MD Professor Palliative Care, Pain Therapy and Rehabilitation Unit and holder of the Gilbert H. Fletcher Fondazione IRCCS Istituto Nazionale Tumori Memorial Distinguished Chair Milan Department of Radiation Oncology Italy The University of Texas MD Anderson Cancer Center Houston, Texas Claudio R. Cernea, MD Professor of Surgery USA Department of Head and Neck Surgery R. J. Baatenburg de Jong, MD University of Sao Paulo Medical School KNO-Heelkunde Sao Paulo Erasmus MC Brazil Rotterdam Netherlands Kevin S. Choe, MD Assistant Professor Alfonsus J. M. Balm, MD Department of Radiation Oncology Professor University of Texas The Netherlands Cancer Institute Southwestern Dallas, Texas Antoni van Leeuwenhoek Hospital USA Amsterdam Netherlands Ezra E. W. Cohen, MD University of Chicago Medical Center Beth M. Beadle, MD Chicago, Illinois Assistant Professor USA University of Texas M. D. Anderson Cancer Center Marc A. Cohen, MD Houston, Texas Department of Otolaryngology Princess Margaret Hospital USA Toronto, Ontario Jan Paul de Boer, MD Canada Department of Medical Oncology The Netherlands Cancer Institute Ralph Gilbert, MD Antoni van Leeuwenhoek Hospital Professor of Otolaryngology—Head and Neck Surgery Amsterdam Princess Margaret Hospital Netherlands University of Toronto Toronto, Ontario Maarten F. de Boer, MD Canada KNO-Heelkunde Erasmus MC David P. Goldstein, MD, MSC, FRCSC Rotterdam Assistant Professor Netherlands Department of Otolaryngology—Head and Neck Surgery Princess Margaret Hospital University of Toronto Toronto, Ontario Canada VI Contributors Patrick Gullane, CM, MB, FRCSC, FACS, Hon FRACS, Hon FRCS Hisham M. Mehanna, PhD, BMedSc (Hons), MBChB (Hons), FRCS, Professor and Chair FRCS (ORL-HNS) Department of Otolaryngology—Head and Neck Surgery Director, Institute of Head and Neck Studies and Education University Health Network Consultant Head–Neck and Thyroid Surgeon Toronto General Hospital Chair, Head and Neck Surgery at the School of Cancer Sciences University of Toronto The University of Birmingham Toronto, Ontario Birmingham Canada UK Kevin J. Harrington, MD Gary Morgan Institute of Cancer Research Head and Neck Cancer Service Chester Beatty Laboratories Westmead Hospital London Westmead UK Sydney Australia Jarrod Homer, MD, FRCS ENT / Head and Neck Surgeon Dan Munday, MD Manchester Royal Infirmary Associate Clinical Professor Manchester Honorary Consultant in Palliative Medicine UK Health Sciences Research Institute University of Warwick/Myton Hospice Julie Howle, MB, BS, FRACS Coventry Staff Specialist UK Surgical Oncology Unit Westmead Cancer Care Centre Ramez Nassif, MD Wentworthville, New South Wales ENT Department Australia Norfolk and Norwich University Hospital Norwich N. Gopalakrishna Iyer, MD UK Department of Surgical Oncology National Cancer Centre Christopher M. Nutting, MD Singapore Director Head and Neck Unit Royal Marsden Hospital Charles G. Kelly, MD London Consultant Clinical Oncologist UK Degree Program Director and Honorary Clinical Senior Lecturer Newcastle University Marinella P. J. Offerman, MSc Northern Centre for Cancer Care KNO-Heelkunde Freeman Hospital Erasmus MC Newcastle-upon-Tyne Rotterdam UK Netherlands Lai Wan Dora Kwong Vinidh Paleri Professor Consultant Head Neck Surgeons Department of Clinical Oncology ENT Department Queen Mary Hospital Freeman Hospital University of Hong Kong Newcastle-upon-Tyne Hong Kong UK China Alison Perry Lisa Licitra, MD Professor Department of Otolaryngology Head of Department of Clinical Therapies National Cancer Institute Faculty of Education and Health Sciences Milan University of Limerick Italy Limerick Ireland Julia Maclean Cancer Care Centre St. George Hospital Kogarah, New South Wales Australia Contributors VII Jean F. A. Pruyn, PhD Pol Specenier Professor Department of Oncology Department of Pulmonary Medicine and Tuberculosis Antwerp University Hospital Erasmus MC Edegem Rotterdam Belgium Netherlands Miroslav Tedla, MD Alexander D. Rapidis Post CCT Fellow in Head and Neck Surgery Professor and Chairman Coventry Department of Head and Neck / Maxillofacial Surgery UK Greek Anticancer Institute St. Savvas Hospital R. Michael Tuttle Athens Professor of Medicine Greece Endocrinology Service Memorial Sloan-Kettering Cancer Center Coen R. N. Rasch, MD, PhD New York Department of Radiation Oncology USA The Netherlands Cancer Institute Antoni van Leeuwenhoek Hospital Michael Veness, MD (UNSW), MB, BS, MMed FRANZCR Amsterdam Clinical Associate Professor Netherlands Senior Staff Specialist Department of Radiation Oncology Joseph Kamel Salama, MD Westmead Hospital Department of Radiation and Cellular Oncology University of Sydney University of Chicago Hospitals Wentworthville, New South Wales Chicago, Illinois Sydney USA Australia M. P. van der Schroeff Jan B. Vermorken, MD KNO-Heelkunde Department of Medical Oncology Erasmus MC Antwerp University Hospital Rotterdam Edegem Netherlands Belgium Cherith J. Semple, MD Randal S. Weber, MD Cancer Services University of Texas Ulster Hospital M. D. Anderson Cancer Center Belfast, Northern Ireland Houston, Texas UK USA Ashok R. Shaha Eduardo Weltman, PhD Professor of Surgery Department of Radiation Oncology Chair of Head and Neck Surgery Department Hospital Israelita Albert Einstein Memorial Sloan-Kettering Cancer Center Morumbi, Sao Paolo New York Brazil USA William I. Wei Priyamal Silva, MD Professor Department of Head and Neck Surgery Queen Mary Hospital John Radcliffe Infirmary Oxford Hong Kong Wallingford, Oxfordshire China UK Mark E. Zafereo, MD Nick Slevin, MD T. Boone Pickens Academy Director of Clinical Oncology Houston, Texas The Christie NHS Foundation Trust USA Withington, Manchester UK VIII Preface The head and neck region contains numerous delicate, intricately The first few chapters of the book discuss the general principles organized organs essential for basic physiological functions and and techniques underpinning the investigation and management critical for appearance, expression, and social interactions. Al- of recurrence in head and neck cancer. These cover the molecular though representing less than 5% of cancers, a variety of neo- biology, radiological investigations, re-irradiation, chemotherapy, plasms with diverging natural histories arise in this relatively surgical reconstruction, and patient selection in the setting of head small region of the body. Many advances have been made during and neck recurrence. The rest of the chapters provide detailed the past few decades in the understanding of the biology, natural evidence-based, multidisciplinary guides to the management of history, and treatment of head and neck cancer through thorough recurrence at each site within the head and neck. Each chapter is basic, translational, and clinical investigations. Although improve- written by at least one surgeon and one clinical oncologist. Empha- ment in overall survival has been modest, substantial progress has sis has been given to providing the evidence in a structured and been made in terms of organ preservation and toxicity reduction systematic manner. Each chapter outlines the epidemiology of the by incorporating new treatment technologies, such as intensity- disease, the risk factors, and the outcomes of treatment. It then dis- modulated radiotherapy (IMRT) and transoral laser and robotic cusses the recommended investigations followed by the principles surgery, and establishing new multimodality therapy regimens. of the management of recurrence following previous treatment Early-stage head and neck cancer can now be successfully with surgery and/or chemoradiotherapy. The authors then discuss cured with modern therapy modalities. Unfortunately, a substan- any specific practical techniques, pitfalls, and potential complica- tial proportion of patients with locally advanced head and neck tions relevant to management of recurrence in that particular area. cancer still develop local recurrence despite aggressive multimo- Real case histories illustrate important and/or practical aspects of dality therapy. These patients die of the distressing consequences management. Each chapter has a summary of the important points, of uncontrolled local tumor growth. An increasing body of data as well as recommendations for further reading, further research, reveals that some of the patients with local relapse can be suc- and indications of the most important reference articles on the cessfully salvaged with surgery or combined therapy including topic. The final chapters give detailed practical reviews of rehabili- re-irradiation, when selected and managed properly, albeit at the tation and palliative care for head and neck recurrence. cost of some severe morbidity. In addition, well-organized sup- We have selected the contributors for their world-renowned portive and symptomatic care can reduce suffering of those with expertise and extensive experience in their fields. We are indebted progressive disease. to all of them for their efforts in putting together a comprehensive Many textbooks focus on the biology, diagnosis and work-up, review and providing practical guidelines in these rather difficult and frontline management of various head and neck cancers. So and challenging topics. far, little published work has specifically addressed assessment We sincerely hope that you will find this book of practical use and management of patients with recurrent disease. That need in your day-to-day clinical practice. prompted us to edit this textbook, which is intended to serve as an evidence-based reference book for oncologists in day-to-day Hisham M. Mehanna practice and also for trainees interested in the field. K. Kian Ang IX Acknowledgments We thank all the contributors who have very generously given their time and effort to put this book together. Their contributions have been invaluable and are much appreciated. We would also like to thank all the staff at Thieme Publishers who have worked on the book, especially Stephan Konnry, editor, and Dr. Sibylle Toenjes, freelance editor, who have been very helpful and patient throughout. We would also like to thank our PAs, Gemma Jones and Cathy Ramirez for their help with the manuscripts. Finally, last but not least, we would like to thank our families who have had to endure the time we spent away from them while putting the book together. X Contents 1 Introduction 5 Systemic Therapy in the Treatment of Recurrent K. Kian Ang, Hisham M. Mehanna and Metastatic Head and Neck Carcinoma Clinical Assessment and Imaging Evaluation of Lisa Licitra, Jan B. Vermorken, Pol Specenier, Recurrence .............................................. 1 Augusto Caraceni Principles of the Assessment of Potential Recurrence ... 1 Patient’s Clinical Profile and Assessment .............. 81 History and Examination ................................ 1 Clinical Decision Making .............................. 82 Previous Treatment Records ............................. 2 Medical Treatment .................................... 83 Imaging ................................................. 2 Special Issues in End-of-Life Supportive Care ......... 89 Examination under Anesthetic .......................... 4 Needle or Open Biopsy .................................. 4 6 Principles and Concepts of Reconstruction in the Recurrent Setting 2 Molecular Biology of Recurrence Ralph Gilbert Kevin J. Harrington Introduction .......................................... 95 Introduction ............................................ 7 Issues in Surgical Approach—Impact of Previous The Biology of Treatment Resistance .................... 7 Treatment ............................................. 95 Activation of Alternative Signaling Pathways ......... 12 Management of the Vessel-depleted Neck ............ 96 Biological Processes Involved in Metastasis ........... 12 Site-specific Defect Considerations .................... 96 Conclusions ........................................... 14 Conclusion ............................................ 99 3 Imaging Modalities for Head 7 Patient Selection for Treatment and Neck Cancer Recurrence Vinidh Paleri, Charles G. Kelly Oludolapo O. Adesanya Introduction ......................................... 101 Therapy-related Changes in the Head and Neck Region 17 Assessment of the Recurrent Cancer ................. 101 Imaging Modalities for Detection of Recurrence ...... 38 Factors Involved in Treatment Selection ............. 102 Imaging for Recurrence at Specific Sites ............... 47 Involving the Patient in the Decision-making Process 105 Treatment Options ................................... 107 4 Concurrent Chemotherapy and Re-irradiation for Recurrent Head and Neck Cancer 8 Recurrent Laryngeal Cancer Kevin S. Choe, Joseph Kamel Salama, Ezra E.W. Cohen Marc A. Cohen, Ramez Nassif, David P. Goldstein, Introduction .......................................... 67 Ralph Gilbert, Patrick Gullane Reasons for Tumor Recurrence Following Definitive Introduction ......................................... 113 Therapy ............................................... 67 Epidemiology ........................................ 113 Regimens for Concurrent Chemotherapy with Diagnosis of Recurrent Laryngeal Cancer ............ 114 Re-irradiation ......................................... 68 Staging of Recurrent Laryngeal Cancer ............... 114 Evidence for Concurrent Chemotherapy with Principles of Management ........................... 115 Re-irradiation ......................................... 68 Surgical Management of Recurrent Disease .......... 116 Brachytherapy for Recurrent Head and Neck Cancer .. 70 Patient Selection and Prognostic Factors .............. 70 9 Management of Recurrent Simulation and Planning for Re-irradiation ........... 72 Hypopharyngeal Cancer Treatment Volume Definition ......................... 72 Jarrod Homer, Nick Slevin, Priyamal Silva Beam Arrangement ................................... 73 Incidence and Patterns of Recurrence in Advances in Delivery of Radiation ..................... 73 Hypopharyngeal Cancer .............................. 127 New Approaches to CRRT ............................. 74 Detection of Recurrent Disease ...................... 127 Conclusion ............................................ 75 Principles of Management ........................... 128 Surgical Techniques of Salvage Pharyngolaryngectomy .............................. 129 Re-irradiation for Recurrent Hypopharyngeal Cancer 131
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