[Recurrence of upper aerodigestive tract tumors].
Identifieur interne : 000292 ( France/Analysis ); précédent : 000291; suivant : 000293[Recurrence of upper aerodigestive tract tumors].
Auteurs : Laurent Martin [France] ; Mustapha Zoubir [France] ; Christophe Le Tourneau [France]Source :
- Bulletin du cancer [ 1769-6917 ] ; 2014.
English descriptors
- KwdEn :
- Antineoplastic Agents (therapeutic use), Carcinoma, Squamous Cell (secondary), Carcinoma, Squamous Cell (therapy), Chemoradiotherapy (methods), Head and Neck Neoplasms (pathology), Head and Neck Neoplasms (therapy), Humans, Hypopharyngeal Neoplasms (therapy), Laryngeal Neoplasms (therapy), Lymph Nodes (pathology), Mouth Neoplasms (therapy), Neoplasm Recurrence, Local (therapy), Oropharyngeal Neoplasms (therapy), Prognosis, Radiotherapy (methods).
- MESH :
- chemical , therapeutic use : Antineoplastic Agents.
- methods : Chemoradiotherapy, Radiotherapy.
- pathology : Head and Neck Neoplasms, Lymph Nodes.
- secondary : Carcinoma, Squamous Cell.
- therapy : Carcinoma, Squamous Cell, Head and Neck Neoplasms, Hypopharyngeal Neoplasms, Laryngeal Neoplasms, Mouth Neoplasms, Neoplasm Recurrence, Local, Oropharyngeal Neoplasms.
- Humans, Prognosis.
Abstract
Recurrences of tumours of the upper aerodigestive tract are frequent despite the improvement of the primary treatment and they limit the rate of survival long-term. They occur in patients with multiple co-morbidities, often associated with sequelae or side effects of earlier treatments. The salvage treatment will add a cumulative toxicity and therapeutic options are limited. The choice will go from curator to palliative treatment. The report benefit-risk must be assessed in each case depending on the terrain and prognostic factors that have been identified, such as performance status, the time between initial disease and the recurrence, the site and the stratification of the recurrence. In operable non-metastatic recurrence surgery remains the treatment of choice. Multimodal treatment involving surgery, radiation therapy and chemotherapy in this context is being evaluated. Non-operable tumors have long been considered only in a palliative context. The evaluation of detailed irradiation as bifractionnated radiotherapy combined with chemotherapy helped establish protocols allowing long-term survivals and consider these treatments as potentially curators. However, the toxicity of these treatments is important. That is why the technical innovations of the radiation and the development of new chemotherapeutic agents today offer opportunities remaining to assess. The use of irradiation targeted by intensity-modulated radiation therapy (IMRT), and stereotactic radiotherapy by decreasing the irradiated volume should decrease the toxicity. Generally better tolerated than conventional chemotherapy agents, targeted therapies also took their places associated with radiotherapy in the treatment of these patients already treated. Cetuximab was the first agent obtaining an indication. Other agents are being evaluated in metastatic recurrent tumors, including exploring the possibilities of radiopotentialisation nanoparticles and the inhibitors of apoptosis proteins.
DOI: 10.1684/bdc.2014.1970
PubMed: 24886903
Affiliations:
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pubmed:24886903Le document en format XML
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<sourceDesc><biblStruct><analytic><title xml:lang="en">[Recurrence of upper aerodigestive tract tumors].</title>
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<term>Chemoradiotherapy (methods)</term>
<term>Head and Neck Neoplasms (pathology)</term>
<term>Head and Neck Neoplasms (therapy)</term>
<term>Humans</term>
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<term>Mouth Neoplasms (therapy)</term>
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<term>Prognosis</term>
<term>Radiotherapy (methods)</term>
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<term>Radiotherapy</term>
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<term>Laryngeal Neoplasms</term>
<term>Mouth Neoplasms</term>
<term>Neoplasm Recurrence, Local</term>
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<front><div type="abstract" xml:lang="en">Recurrences of tumours of the upper aerodigestive tract are frequent despite the improvement of the primary treatment and they limit the rate of survival long-term. They occur in patients with multiple co-morbidities, often associated with sequelae or side effects of earlier treatments. The salvage treatment will add a cumulative toxicity and therapeutic options are limited. The choice will go from curator to palliative treatment. The report benefit-risk must be assessed in each case depending on the terrain and prognostic factors that have been identified, such as performance status, the time between initial disease and the recurrence, the site and the stratification of the recurrence. In operable non-metastatic recurrence surgery remains the treatment of choice. Multimodal treatment involving surgery, radiation therapy and chemotherapy in this context is being evaluated. Non-operable tumors have long been considered only in a palliative context. The evaluation of detailed irradiation as bifractionnated radiotherapy combined with chemotherapy helped establish protocols allowing long-term survivals and consider these treatments as potentially curators. However, the toxicity of these treatments is important. That is why the technical innovations of the radiation and the development of new chemotherapeutic agents today offer opportunities remaining to assess. The use of irradiation targeted by intensity-modulated radiation therapy (IMRT), and stereotactic radiotherapy by decreasing the irradiated volume should decrease the toxicity. Generally better tolerated than conventional chemotherapy agents, targeted therapies also took their places associated with radiotherapy in the treatment of these patients already treated. Cetuximab was the first agent obtaining an indication. Other agents are being evaluated in metastatic recurrent tumors, including exploring the possibilities of radiopotentialisation nanoparticles and the inhibitors of apoptosis proteins.</div>
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