Document Detail


Challenges of integrating chemotherapy and targeted therapy with radiation in locally advanced head and neck squamous cell cancer.
MedLine Citation:
PMID:  20216313     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: The curative treatment of locally advanced head and neck squamous cell cancer has advanced greatly in recent years, with the establishment of standard of care indications for chemoradiation (CRT). At the same time, there have been advances in each modality, including intensity-modulated radiation therapy, sequential chemotherapy and more tailored combination therapies. However, with new therapies come new challenges. This review will discuss some of the novel approaches to treating head and neck squamous cell cancer, particularly the introduction of biological agents into treatment paradigms, and some of the challenges arising as the field advances. RECENT FINDINGS: A number of recent clinical trials have focused on reducing the disadvantages of concurrent CRT, specifically acute toxicity, lack of compliance and potential for late effects affecting quality of life and function. In particular, the use of biological agents as radiosensitizers has led to the investigation of new combination therapies, such as epidermal growth factor receptor inhibitors administered concurrently with CRT. These new therapies have potential for improving overall survival and lowering locoregional recurrence rates. SUMMARY: Combination therapies hold promise for improving outcomes of patients with head and neck squamous cell cancer, both human papilloma virus-associated and human papilloma virus-negative tumors. The introduction of intensity modulated radiation therapy and biological agents into CRT treatment approaches may reduce some of the disadvantages of more traditional radiation and CRT treatments. Although many challenges remain, the possibility of improving survival with reduced toxicity through treatment selection based on risk stratification and prognostic biomarkers is incrementally evolving.
Authors:
Shanthi Marur; Arlene A Forastiere
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in oncology     Volume:  22     ISSN:  1531-703X     ISO Abbreviation:  Curr Opin Oncol     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-15     Completed Date:  2010-07-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9007265     Medline TA:  Curr Opin Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  206-11     Citation Subset:  IM    
Affiliation:
Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland 21231-1000, USA. smarur1@jhmi.edu
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MeSH Terms
Descriptor/Qualifier:
Antineoplastic Agents / administration & dosage*
Carcinoma, Squamous Cell / therapy*
Clinical Trials as Topic
Combined Modality Therapy
Drug Delivery Systems / methods*
Head and Neck Neoplasms / therapy*
Humans
Radiotherapy
Chemical
Reg. No./Substance:
0/Antineoplastic Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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