Laryngeal and hypopharyngeal cancers
|
|
- Abigail Lamb
- 5 years ago
- Views:
Transcription
1 Laryngeal and hypopharyngeal cancers Induction Chemotherapy in combined modality approaches Atenas Ana Ferreira Castro, MD Medical Oncology Centro Hospitalar do Porto Instituto de Ciências Biomédicas de Abel Salazar Chair of Portuguese Head and Neck Study Group
2 Principles of Systemic Therapy for LA HNSCC Primary systemic therapy concurrent RT Patients appropriate for Systemic Therapy High Dose Cisplatin (preferred) (Category 1) Cetuximab (Category 1) oropharynx, hypopharynx, larynx) Carboplatin/ Infusional 5FU (Category 1) Weekly Cisplatin 40 mg/m2 (Category 2B) Carboplatin/Paclitaxel (Category 2B) Other (Category 2A): 5FU/hydroxyurea; Cisplatin/paclitaxel; Carboplatin/5FU Induction/sequential chemotherapy Docetaxel/cisplatin/5FU (Category 1) Paclitaxel/cisplatin/infusional 5FU Following induction, agent to be used: Cetuximab or weekly Carboplatin Cisplatin-based induction chemotherapy followed High-dose cisplatin CRT is not recommended due to toxicity concerns. National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: Head and Neck Cancer, V Available at:
3 Rationale for Induction Chemotherapy in Locally Advanced HNSCC HNSCC is highly responsive to chemotherapy In locally advanced HNSCC, high response rates (about 80%), including many complete responses, are observed 1 Chemotherapy predicts complete response to subsequent radiotherapy 2 that allows for patient selection for laryngeal-sparring approaches Induction chemotherapy may improve local disease control and eradicate micrometastatic disease 1. Argiris A et al. Oncology (Williston Park). 2005;19(6): Ensley JF, et al. Cancer. 1984;54(5):
4 Which Patient Population Could Benefit From Induction Chemotherapy? Organ preservation? Unresectable patients? Larynx preservation? Reduction of distant metastases? Risk of increased toxicity Potential benefits Potential risks
5 Induction Chemotherapy for HNSCC: Taxane/Cisplatin/5-FU vs Cisplatin/5-FU Study Population Regimen RT Outcome P value GORTEC 1 Larynx and hypopharynx, organ preservation T: 75 mg/m 2 P: 75 mg/m 2 F: 750 mg/m 2 CI x 5 days 3 cycles Standard RT Better organ preservation for TPF.03 Hitt et al. 2 Resectable and unresectable Taxol: 175 mg/m 2 P: 100 mg/m 2 F: 500 mg/m 2 CI x 5 days 3 cycles RT/cisplatin Improved survival in patients with unresectable HNC for TPF.05 T: 75 mg/m 2 Vermorken et al. EORTC 3 Unresectable P: 75 mg/m 2 F: 750 mg/m 2 CI x 5 days 4 cycles Standard RT Improved survival for TPF.02 Posner et al. TAX324 4 Unresectable, resectable with poor outcome T: 75 mg/m 2 ; P: 100 mg/m 2 ; F: 1000 mg/m 2 CI x 4 days 3 cycles RT/carboplatin Improved survival for TPF Janoray G, et al. J Clin Oncol. 2015;33(suppl): Abstract Hitt R et al. J Clin Oncol. 2005;23(34): Vermorken JB et al. N Engl J Med. 2007;357(17): Posner MR et al. N Engl J Med. 2007;357(17):
6 ICT is an emerging treatment paradigm with the potential to improve OS: Organ preservation Study Treatment 1º endpoint VALCSG 1 TREMPLIN 2 PF RT vs surgery + RT TPF (CRT vs cetuximab + RT) 2-year OS TTCC TPF cetuximab + RT 3-year LEDFS RTOG (PF RT) vs CRT vs RT Potential for organ preservation with ICT? Ongoing trials are evaluating cetuximab-containing sequential regimens as a potential approach to increase efficacy and decrease toxicity 5 8 LP LFS LEDFS, laryngo-esophageal dysfunction free survival; LFS, laryngectomy-free survival; LP, larynx preservation; PF, platinum-based CT + 5-FU 1. Department of Veterans Affairs Laryngeal Cancer Study Group. N Engl J Med 1991;324: ; 2. Lefebvre J-L, et al. J Clin Oncol 2013;31: ; 3. Mesia R, et al. ASCO 2015 (Abstract No. 6037); 4. Forastiere AA, et al. J Clin Oncol 2013;31: ; 5. clinicaltrials.gov/ct2/show/nct ; 6. clinicaltrials.gov/ct2/show/nct ; 7. clinicaltrials.gov/ct2/show/nct ; 8. clinicaltrials.gov/ct2/show/nct
7 Phase III Randomized Trials of Induction Chemotherapy Followed by CRT vs CRT Alone Study Regimens HR for OS P value TTCC (Spain) 1 N = 439 TPF x 3 CRT (cisplatin) PF x 3 CRT (cisplatin) CRT (cisplatin) for TPF 1.1 ( ).49 for PF 0.97 ( ).87 Paradigm (USA) 2 N = 145 (/300) TPF x 3 CRT (carbo or docetaxel) CRT (cisplatin) 1.09 ( ).77 DeCIDE (USA) 3 N=285 (/400) H&N07 (Italy) 4,5 N = 421 TPF x 2 CRT (THFX) CRT (THFX) TPF CRT (cisplatin + 5FU) or BRT (cetuximab) CRT (cisplatin+ 5FU) or BRT (cetuximab) 0.91 ( ) ( ) Hitt R, et al. Ann Oncol. 2014;25(1): Haddad R, et al. Lancet Oncol. 2013;14(3): Cohen EE, et al. J Clin Oncol. 2014;32(25): Ghi MG, et al. Bonner JA, et al. Presented at: 5 th ICHNO International Conference; February 12-14, 2015: Nice, France. Abstract: OC Ghi MG, et al. J Clin Oncol. 2014;32(suppl): Abstract 6004.
8 ICT is an emerging treatment paradigm with the potential to improve OS: Unresectable SCCHN H&N07 study 1 Unresectable LA SCCHN: CRT or cetuximab + RT vs TPF CRT or cetuximab + RT All SCCHN TPF induction (n=181) No induction (n=191) Adjusted HR (95% CI) p value Median OS, months ( ) Median PFS, months ( ) Complete response, n (%) 77 (42.5) 53 (28) Prior studies in unresectable LA SCCHN 2 4 Study Treatment 1º endpoint DeCIDE 2 * (TPF CRT) vs CRT 3-year OS PARADIGM 3 * (TPF CRT) vs CRT 3-year OS TTCC 4 (TPF CRT) vs (PF CRT) vs CRT PFS, TTTF Benefit with ICT? *Small sample size with limited statistical power; Spanish Head And Neck Cancer Cooperative Group; No statistically significant difference in outcome OS, overall survival; PFS, progression-free survival; TPF, docetaxel, carboplatin, and 5-FU; TTTF, time to treatment failure 1. Ghi MG, et al. ICHNO 2015 (Abstract No. OC-006); 2. Cohen EE, et al. J Clin Oncol 2014;32: ; 3. Haddad RI, et al. Lancet Oncol 2013;14: ; 4. Hitt R, et al. Ann Oncol 2014;25:
9 Induction CT Study 1 Treatment Endpoint Outcome p-value TAX 323 (PF vs TPF) RT PFS TPF > PF TAX 324 (PF vs TPF) CRT OS TPF > PF Pointreau 2009 (PF vs TPF) CRT 3-year larynx preservation rate TPF > PF 0.03 DeCIDE (TPF CRT) vs CRT 3-year OS ICT = CT + RT 0.70 PARADIGM (TPF CRT) vs CRT 3-year OS ICT = CT + RT 0.77 H&N07 2 TPF CRT vs TPF cetuximab + RT vs CRT vs cetuximab + RT 3-year OS ICT > no ICT 0.03 TREMPLIN TPF (CRT vs cetuximab + RT) Larynx preservation rate, OS CT + RT = cetuximab + RT NS More acute and late toxicity with CRT Adiction of Taxanes to ICT improved outcomes vs PF 1 Next generation regimens, including Cetuximab, are under evaluation, as a better combination with less toxicity and with more efficacy 2,3 ICT, induction CT; NS, not significant; PF, platinum based CT + 5-FU; PFS, progression-free survival 1. Argiris A. Crit Rev Oncol Hematol 2013;88: Lefebvre J-L, et al. J Clin Oncol 2013;31: Ghi MG, et al. Presented at ASCO 2014 (Abstract No. 6004)
10 Cumulative cisplatin exposure is becoming increasingly relevant for management decisions Cisplatin accumulation in the tissues 1 can reach a level above which toxicity becomes unacceptable and further exposure becomes unwise 2,3 ICT might result in cisplatin build-up that places a patient into the gray zone for further cisplatin therapy 1,2,4 Phase 3 DeCIDE study in patients with LA SCCHN: 3 Grade 3 toxicity Reduction in white blood cell count (% patients) Reduction in absolute neutrophil count (% patients) ICT* + CRT (n=124) CRT alone (n=133) p value *ICT consisted of TPF or PF 1. Arany I, Safirstein RL. Semin Nephrol 2003;23: ; 2. Gamelin E et al. Cancer Chemother Pharmacol 1995;37:97 102; 3. Cohen EE, et al. J Clin Oncol 2014;32: ; 4. Bourhis J et al. Eur J Cancer 2010;46:
11 Meta-analysisof ICT
12 Meta-analysisof ICT
13 Meta-analysisof ICT
14 TREMPLIN ICT Chemotherapy Fase II en pcts candidatos a laringectomía total Main Objective: Larynx preservation at 3 months of treatment Secundary Objectives: Larynx preservation and OS at 18 months of treatment Lefebvre J et al. J Clin Oncol 2009;27(Suppl. 15):Abstract 6010; J Clin Oncol Jan 22. [Epub ahead of print]
15 TREMPLIN - results Endpoint* Cetuximab + RT (n = 56) CRT (n = 60) Larynx preservation at 3 months (LP) 93% 95% Larynx function preservation 18 months (LFP) 82% 87% Overall Survival (OS) 18 months 89% 92% OS 36 months 73% 75% OS (ITT pts with respnse to ICT) *Todas las comparaciones son estadísticamente no-significativas (p>0.05)
16 TREMPLIN toxicity J Clin Oncol Jan 22. [Epubaheadof print]
17 TREMPLIN treatment compliance More patients complied with planed treatment with Cetuximab+RT vs CT+RT Patients who finished RT after ICT (%) Lefebvre J et al. J Clin Oncol 2009;27(Suppl. 15):Abstract 6010; J Clin Oncol Jan 22. [Epub ahead of print]
18 TREMPLIN salvage surgery J Clin Oncol Jan 22. [Epub ahead of print]
19
20 The choice of treatment for an individual with LA SCCHN depends on a variety of factors LA SCCHN 1 YES Resectable? NO Is surgery the best treatment option? NO RT-based treatment YES Organ preservation? Surgery Follow-up Follow-up Adjuvant therapy (RT/CRT) ICT CRT or cetuximab + RT YES Sequential therapy? NO CRT or cetuximab + RT or RT alone Characteristics may vary between patients from Europe, the US, and the rest of the world 2,3 CRT, chemoradiotherapy; ICT, induction chemotherapy; LA, locally advanced; RT, radiotherapy 1. NCCN Clinical Practice Guidelines in Oncology: Head and Neck Cancers V1.2015; 2. Ang KK, et al. N Engl J Med 2010;363:24 35; 3. Granata R, et al. Ann Oncol 2012;23:
21 Status of Induction Chemotherapy Induction chemotherapy is a treatment option in LA HNSCC Induction chemotherapy does not improve survival Induction chemotherapy is an evidence-based option for laryngeal preservation Selected patients may benefit TPF is a standard regimen but associated with considerable toxicities; mortality risk of about 5% Novel regimens with targeted agents should be explored in the induction setting
22 CONCLUSIONS Multidisciplinary approach is crucial for head and neck patients CRT and CET+RT has the same efficacy and Cetuximab+RT less systemic toxicity and can be used after ICT Compliance after ICT with Cetuximab+RT is higher and the late toxicity is lower Patients selection should be made according clinical data
23 Thank You
The International Federation of Head and Neck Oncologic Societies. Current Concepts in Head and Neck Surgery and Oncology
The International Federation of Head and Neck Oncologic Societies Current Concepts in Head and Neck Surgery and Oncology www.ifhnos.net The International Federation of Head and Neck Oncologic Societies
More informationNeoplasie del laringe Diagnosi e trattamento
Neoplasie del laringe Diagnosi e trattamento Venerdì 22 maggio 2015 Alessandria Trattamenti non chirurgici: Preservazione d organo, malattia localmente avanzata Marco C Merlano A.O. S.Croce e Carle, Ospedale
More informationHead and NeckCancer: multi-modal therapeuticintegration
Head and NeckCancer: multi-modal therapeuticintegration P. Ponticelli, L. Lastrucci, R. De Majo, A. Rampini U.O.C. Radioterapia Ospedale S. Donato ASL 8 -AREZZO Summary Biological considerations Clinical
More informationOrgan-Preservation Strategies in head and neck cancer. Teresa Bonfill Abella Oncologia Mèdica Parc Taulí Sabadell. Hospital Universitari
Organ-Preservation Strategies in head and neck cancer Teresa Bonfill Abella Oncologia Mèdica Parc Taulí Sabadell. Hospital Universitari Larynx Hypopharynx The goal of treatment is to achieve larynx preservation
More informationHead and Neck cancer
Head and Neck cancer Medical Oncologist s Role in Multidisciplinary Teams - Focus on Adjuvant & Neo-adjuvant Therapy - Hye Ryun Kim, M.D. Yonsei Cancer Center, Medical Oncology Contents I. Introduction
More informationSequencing Chemo with Radiation therapy Locally Advanced Head and Neck Cancer. Dr P Vijay Anand Reddy Director Apollo Cancer Hospital
Sequencing Chemo with Radiation therapy Locally Advanced Head and Neck Cancer Dr P Vijay Anand Reddy Director Apollo Cancer Hospital H&N Ca - Disease Burden 15-20% of all cancers in India, 8% worldwide
More informationNeoadjuvant Chemotherapy in Locally Advanced Squamous Cell Cancer of Head and Neck. Mei Tang, MD
Neoadjuvant Chemotherapy in Locally Advanced Squamous Cell Cancer of Head and Neck Mei Tang, MD Head and Neck Cancer Worldwide New cases : 644,000 Cancer deaths: 350,000 About 5% of all cancers Local Recurrence:
More informationThe PARADIGM Study: A Phase III Study Comparing Sequential Therapy (ST) to Concurrent Chemoradiotherapy (CRT) in Locally Advanced Head and Neck Cancer
The PARADIGM Study: A Phase III Study Comparing Sequential Therapy (ST) to Concurrent Chemoradiotherapy (CRT) in Locally Advanced Head and Neck Cancer Robert I. Haddad, Guilherme Rabinowits, Roy B. Tishler,
More informationLocally advanced head and neck cancer
Locally advanced head and neck cancer Radiation Oncology Perspective Petek Erpolat, MD Gazi University, Turkey Definition and Management of LAHNC Stage III or IV cancers generally include larger primary
More informationLarynx Hypopharynx. Therapy algorithms. Why larynx preservation at all? State of the art Jean Louis Lefebvre,Lille Jan Klozar,Prague
Larynx Hypopharynx Moderation Rainald Knecht,Hamburg State of the art Jean Louis Lefebvre,Lille Debate pro CRT Jan Klozar,Prague contra CRT Marshall Posner,Boston Clinical cases all Therapy algorithms
More informationGuillaume Janoray, Yoann Pointreau, Pascal Garaud, Sophie Chapet, Marc Alfonsi, Christian Sire, Eric Jadaud, Gilles Calais
JNCI J Natl Cancer Inst (016) 108(4): djv368 doi:10.1093/jnci/djv368 First published online December 16, 015 Article Long-Term Results of a Multicenter Randomized Phase III Trial of Induction Chemotherapy
More informationState of the Art: Management of Squamous Cell Carcinoma of the Head and Neck. Raul Giglio
State of the Art: Management of Squamous Cell Carcinoma of the Head and Neck Raul Giglio Disclosures Nothing to disclose SCCHN Outline 1. General considerations: MTD 2. Epidemiology 3. Locoregional disease
More informationPractice teaching course on head and neck cancer management
28-29 October 2016 - Saint-Priest en Jarez, France Practice teaching course on head and neck cancer management IMPROVING THE PATIENT S LIFE THROUGH MEDICAL EDUCATION www.excemed.org Nicolas Magné France
More informationLaryngeal Preservation Using Radiation Therapy. Chemotherapy and Organ Preservation
1 Laryngeal Preservation Using Radiation Therapy 1903: Schepegrell was the first to perform radiation therapy for the treatment of laryngeal cancer Conventional external beam radiation produced disappointing
More informationEmerging Role of Immunotherapy in Head and Neck Cancer
Emerging Role of Immunotherapy in Head and Neck Cancer Jared Weiss, MD Associate Professor of Medicine and Section Chief of Thoracic and Head/Neck Oncology UNC Lineberger Comprehensive Cancer Center Copyright
More informationPresent and Future of Head and Neck Cancer Therapy (Focus at systemic therapy)
Present and Future of Head and Neck Cancer Therapy (Focus at systemic therapy) Jan B; Vermorken, MD, PhD Department of Medical Oncology Antwerp University Hospital Edegem, Belgium 1st Hellenic Conference
More informationNon-surgical treatment for locally advanced head and neck squamous cell carcinoma: beyond the upper limit
Editorial Non-surgical treatment for locally advanced head and neck squamous cell carcinoma: beyond the upper limit Hiroto Ishiki, Satoru Iwase Department of Palliative Medicine, The Institute of Medical
More informationNon-small Cell Lung Cancer: Multidisciplinary Role: Role of Medical Oncologist
Non-small Cell Lung Cancer: Multidisciplinary Role: Role of Medical Oncologist Vichien Srimuninnimit, MD. Medical Oncology Division Faculty of Medicine, Siriraj Hospital Outline Resectable NSCLC stage
More informationMultimodular treatment in Head and Neck Squamous Cell Carcinoma (HNSCC)
Multimodular treatment in Head and Neck Squamous Cell Carcinoma (HNSCC) Amanda Psyrri, MD,FACP Attikon University Hospital Athens, Greece Learning objectives After reading and reviewing this material,
More informationRecent Advances & Ongoing Challenges in Head & Neck Cancers
Recent Advances & Ongoing Challenges in Head & Neck Cancers Robert Haddad, MD Disease Center Leader Head and Neck Oncology Program Dana Farber Cancer Institute Harvard Medical School Boston, MA Disclosures
More informationHead and Neck Cancer:
Head and Neck Cancer: Robert Haddad M.D. Clinical Director Head and Neck Oncology Program Dana Farber Cancer Institute Boston, MA Predictive Biomarkers: HPV Abstract 6003: Survival Outcomes By HPV Status
More informationCurrent patient journey in SCCHN
Contents Current patient journey in SCCHN 1 st line options for R/M SCCHN 2 nd line treatmens options for R/M SCCHC The evolving continuum of care in R/M SCCHH Current patient journey in SCCHN 1. Mabanta
More information17th ESO-ESMO Masterclass Clinical Oncology
Chemoradiotherapy and Systemic Therapy in Squamous Cell Carcinoma of the Head and Neck (SCCHN) Jan B. Vermorken, MD, PhD Department of Medical Oncology Antwerp University Hospital Edegem, Belgium 17 th
More informationLocoregionally advanced squamous cell carcinoma of the head and neck: chemoradiation or bioradiation
Editorial Locoregionally advanced squamous cell carcinoma of the head and neck: chemoradiation or bioradiation Pol Specenier 1,2, Jan B. Vermorken 1,2 1 Department of Medical Oncology, Antwerp University
More informationSAMO MASTERCLASS HEAD & NECK CANCER. Nicolas Mach, PD Geneva University Hospital
SAMO MASTERCLASS HEAD & NECK CANCER Nicolas Mach, PD Geneva University Hospital Epidemiology Prevention Best treatment for localized disease Best treatment for relapsed or metastatic disease Introduction
More informationConcurrent Chemo- and Radiotherapy for Ororpharynx Cancer
Concurrent Chemo- and Radiotherapy for Ororpharynx Cancer Faye Johnson MD, PhD Associate Professor Thoracic/Head and Neck Medical Oncology August 2017 Objectives Review data that support concurrent chemo-
More informationState of the art for radiotherapy of SCCHN
State of the art for radiotherapy of SCCHN Less side effects Cured More organ & function preservation Head & neck cancer = 42 000 new cases / year in Europe Not cured Local failure Distant failure More
More informationTratamiento Multidisciplinar de Estadios Localmente Avanzados en Cáncer de Pulmón
Tratamiento Multidisciplinar de Estadios Localmente Avanzados en Cáncer de Pulmón Santiago Ponce Aix Servicio Oncología Médica Hospital Universitario 12 de Octubre Madrid Stage III: heterogenous disease
More informationThe effect of induction chemotherapy followed by chemoradiotherapy in advanced head and neck cancer: a prospective study
International Journal of Research in Medical Sciences Nikam BM et al. Int J Res Med Sci. 2014 May;2(2):476-480 www.msjonline.org pissn 2320-6071 eissn 2320-6012 Research Article DOI: 10.5455/2320-6012.ijrms20140519
More informationHPV INDUCED OROPHARYNGEAL CARCINOMA radiation-oncologist point of view. Prof. dr. Sandra Nuyts Dep. Radiation-Oncology UH Leuven Belgium
HPV INDUCED OROPHARYNGEAL CARCINOMA radiation-oncologist point of view Prof. dr. Sandra Nuyts Dep. Radiation-Oncology UH Leuven Belgium DISCLOSURE OF INTEREST Nothing to declare HEAD AND NECK CANCER -HPV
More informationRAMY R. GHALI, M.D.*; EMAN EL-SHARAWY, M.D.*; AZZA M. ADEL, M.D.* and SAMER A. IBRAHIM, M.D.**
Med. J. Cairo Univ., Vol. 79, No. 2, June: 13-18, 2011 www.medicaljournalofcairouniversity.com Induction Docetaxel, Cisplatin and 5 Fluorouracil (TPF) Followed by Concomitant Chemoradiotherapy Versus Concomitant
More informationCetuximab/cisplatin and radiotherapy in HNSCC: is there a favorite choice?
Cent. Eur. J. Med. 9(2) 2014 279-284 DOI: 10.2478/s11536-013-0154-9 Central European Journal of Medicine Cetuximab/cisplatin and radiotherapy in HNSCC: is there a favorite choice? Jacopo Giuliani* 1, Marina
More informationHEAD AND NECK CANCER TREATMENT REGIMENS (Part 1 of 5)
HEAD AND NECK CANCER TREATMENT S (Part 1 of 5) Clinical Trials: The National Comprehensive Cancer Network (NCCN) recommends cancer patient participation in clinical trials as the gold standard for treatment.
More informationTwo Cycles of Chemoradiation: 2 Cycles is Enough. Concurrent Chemotherapy / RT Regimens
1 Two Cycles of Chemoradiation: 2 Cycles is Enough Heather Wakelee, M.D. Assistant Professor of Medicine, Oncology Stanford University Concurrent Chemotherapy / RT Regimens Cisplatin 50 mg/m 2 on days
More informationPrognostic significance of thyroid or cricoid cartilage invasion in laryngeal or hypopharyngeal cancer treated with organ preserving strategies
Wagner et al. Radiation Oncology 2012, 7:219 RESEARCH Open Access Prognostic significance of thyroid or cricoid cartilage invasion in laryngeal or hypopharyngeal cancer treated with organ preserving strategies
More informationRT +/- Surgery. Concurrent ChemoRT +/- Surgery
Molecular targeted approaches to head and neck cancer Lillian L. Siu Department of Medical Oncology & Hematology Princess Margaret Hospital, University of Toronto Locally Advanced HNSCC Locally Advanced
More informationImmunotherapy for the Treatment of Head and Neck Cancers. Barbara Burtness, MD Yale University
Immunotherapy for the Treatment of Head and Neck Cancers Barbara Burtness, MD Yale University Disclosures AstraZeneca Pharmaceuticals LP, Boehringer Ingelheim, Bristol-Myers Squibb, Merck & Co., Inc.,
More informationHEAD AND NECK CANCER TREATMENT REGIMENS (Part 1 of 5)
HEAD AND NECK CANCER TREATMENT S (Part 1 of 5) Clinical Trials: The National Comprehensive Cancer Network (NCCN) recommends cancer patient participation in clinical trials as the gold standard for treatment.
More informationUpdate on Neoadjuvant Chemotherapy (NACT) in Cervical Cancer
Update on Neoadjuvant Chemotherapy (NACT) in Cervical Cancer Nicoletta Colombo, MD University of Milan-Bicocca European Institute of Oncology Milan, Italy NACT in Cervical Cancer NACT Stage -IB2 -IIA>4cm
More informationWe are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors
We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 3,900 116,000 120M Open access books available International authors and editors Downloads Our
More informationRecent Advances in Oral Oncology
Recent Advances in Oral Oncology Alexander D Rapidis 1 and Crispian Scully 2 1. Chairman, Department of Head and Neck/Maxillofacial Surgery, Greek Anticancer Institute, Saint Savvas Hospital, Athens, and
More informationNEWER DRUGS IN HEAD AND NECK CANCER. Prof. Anup Majumdar. HOD, Radiotherapy, IPGMER Kolkata
NEWER DRUGS IN HEAD AND NECK CANCER Prof. Anup Majumdar HOD, Radiotherapy, IPGMER Kolkata 1 Included Oral cavity Nasal cavity Pharynx Larynx Lymph node in upper part of neck Excluded Brain Eye Cancer arising
More informationHead&Neck, and Thyroid Cancers: Incorporating New Therapies into Current Treatment Algorithms
Head&Neck, and Thyroid Cancers: Incorporating New Therapies into Current Treatment Algorithms Robert Haddad, MD Disease Center Leader Head and Neck Oncology Program Dana Farber Cancer Institute Harvard
More informationMANAGEMENT OF CA HYPOPHARYNX
MANAGEMENT OF CA HYPOPHARYNX GENERAL TREATMENT RECOMMENDATIONS BASED ON HYPOPHARYNX TUMOR STAGE For patients presenting with early-stage definitive radiotherapy alone or voice-preserving surgery are viable
More informationRADIATION THERAPY AND CHEMOTHERAPY IN LOCALLY ADVANCED CANCER OF THE HEAD AND NECK Carlos A. Perez, M.D. Former Chairman/Professor Emeritus
RADIATION THERAPY AND CHEMOTHERAPY IN LOCALLY ADVANCED CANCER OF THE HEAD AND NECK Carlos A. Perez, M.D. Former Chairman/Professor Emeritus Department of Radiation Oncology Mallinckrodt Institute of Radiology/
More informationParadigm Shift in the Treatment of Head and Neck Cancer: The Role of Neoadjuvant Chemotherapy
This material is protected by U.S. Copyright law. Unauthorized reproduction is prohibited. For reprints contact: Reprints@AlphaMedPress.com Paradigm Shift in the Treatment of Head and Neck Cancer: The
More informationSelf-Assessment Module 2016 Annual Refresher Course
LS16031305 The Management of s With r. Lin Learning Objectives: 1. To understand the changing demographics of oropharynx cancer, and the impact of human papillomavirus on overall survival and the patterns
More informationPre- Versus Post-operative Radiotherapy
Postoperative Radiation and Chemoradiation: Indications and Optimization of Practice Dislosures Clinical trial support from Genentech Inc. Sue S. Yom, MD, PhD Associate Professor UCSF Radiation Oncology
More informationMedicinae Doctoris. One university. Many futures.
Medicinae Doctoris The Before and The After: Can chemotherapy revise the trajectory of gastric and esophageal cancers? Dr. David Dawe MD, FRCPC Medical Oncologist Assistant Professor Disclosures None All
More informationSanguineti s (2)Comment: When it was initially published in 2003 with a median follow-up of 3.8 years (4), the RTOG study led to a change in
Commento di due Soci AIRO pubblicati su due prestigiose riviste internazionali al Trial della forastiere et al. Long term results of RTOG:91-11 (a cura di Dr. Russi e Dr. Testolin )! Forastiere)et)al.)Long/Term)Results)of)RTOG)91/11:)A)Comparison)of)
More informationThe following slides are provided as presented by the author during the live educa7onal ac7vity and are intended for reference purposes only.
The following slides are provided as presented by the author during the live educa7onal ac7vity and are intended for reference purposes only. If you have any ques7ons, please contact Imedex via email at:
More informationAdjuvant Therapy in Locally Advanced Head and Neck Cancer. Ezra EW Cohen University of Chicago. Financial Support
Adjuvant Therapy in Locally Advanced Head and Neck Cancer Ezra EW Cohen University of Chicago Financial Support This program is made possible by an educational grant from Eli Lilly Oncology, who had no
More informationASCO Highlights Head and Neck Cancer
ASCO Highlights Head and Neck Cancer Anne S. Tsao, M.D. Director, Mesothelioma Program Assistant Professor July 11, 2009 The University of Texas MD ANDERSON CANCER CENTER Department of Thoracic/Head &
More informationQuality of life in patients treated for advanced hypopharyngeal or laryngeal cancer
European Annals of Otorhinolaryngology, Head and Neck diseases (2011) 128, 218 223 ORIGINAL ARTICLE Quality of life in patients treated for advanced hypopharyngeal or laryngeal cancer M. Guibert a, B.
More informationDe-Escalate Trial for the Head and neck NSSG. Dr Eleanor Aynsley Consultant Clinical Oncologist
De-Escalate Trial for the Head and neck NSSG Dr Eleanor Aynsley Consultant Clinical Oncologist 3 HPV+ H&N A distinct disease entity Leemans et al., Nature Reviews, 2011 4 Good news Improved response to
More informationINAS I. ABDELHALIM, M.D.; NAWAL M. ELSAID, M.D.; ELSAID M. ALI, M.D. and BASHEER S. ATA, M.Sc.
Med. J. Cairo Univ., Vol. 81, No. 1, December: 887-893, 2013 www.medicaljournalofcairouniversity.net Neoadjuvant Docetaxel (Taxotere) Plus Cisplatin and 5-Flurouracil Followed by Concomitent Chemoradiotherapy
More informationAdjuvant Chemotherapy
State-of-the-art: standard of care for resectable NSCLC Adjuvant Chemotherapy JY DOUILLARD MD PhD Professor of Medical Oncology Integrated Centers of Oncology R Gauducheau University of Nantes France Adjuvant
More informationAccepted 20 April 2009 Published online 25 June 2009 in Wiley InterScience (www.interscience.wiley.com). DOI: /hed.21179
ORIGINAL ARTICLE DOCETAXEL, CISPLATIN, AND FLUOROURACIL INDUCTION CHEMOTHERAPY FOLLOWED BY ACCELERATED FRACTIONATION/CONCOMITANT BOOST RADIATION AND CONCURRENT CISPLATIN IN PATIENTS WITH ADVANCED SQUAMOUS
More informationHead & Neck Cancer: When to Irradiate
Head & Neck Cancer: When to Irradiate ESO-ESMO Latin-America 2018 Talented students colleagues 1 > 15 different diseases for RT strategies NC NP OC OP H L 2 HPV Prognostic Marker >2010 Trial Cases Marker
More informationHypofractionated palliative radiotherapy for advanced head and neck cancer: The IHF2SQ regimen
ORIGINAL ARTICLE Hypofractionated palliative radiotherapy for advanced head and neck cancer: The IHF2SQ regimen Laurie Monnier, MD, 1 * Emmanuel Touboul, MD, PhD, 1 Catherine Durdux, MD, 2 Philippe Lang,
More informationThe Role of Docetaxel in the Treatment of Head and Neck Cancer
GBMC Head and Neck Conference The Role of Docetaxel in the Treatment of Head and Neck Cancer Simon Best December 7, 2007 Needs assessment: Providers who participate in the care of head and neck cancer
More informationImmunotherapy for the Treatment of Head and Neck Cancers. Robert F. Taylor, MD Aurora Health Care
Immunotherapy for the Treatment of Head and Neck Cancers Robert F. Taylor, MD Aurora Health Care Disclosures No relevant financial relationships to disclose I will be discussing non-fda approved indications
More informationExiste-t-il un sous groupe à risque qui pourrait bénéficier d une modification de la durée de traitement par trastuzumab? X. Pivot CHRU De Besançon
Existe-t-il un sous groupe à risque qui pourrait bénéficier d une modification de la durée de traitement par trastuzumab? X. Pivot CHRU De Besançon In 25 results of 4 Adjuvant Herceptin trials have definitively
More informationHighlights in head and neck cancer
Special Edition Highlights in head and neck cancer P. Specenier, MD, PhD (Belg J Med Oncol 201;9:168-72) Management of locoregional lymph nodes The optimal management of the regional lymph nodes was studied
More informationThe International Federation of Head and Neck Oncologic Societies. Current Concepts in Head and Neck Surgery and Oncology
The International Federation of Head and Neck Oncologic Societies Current Concepts in Head and Neck Surgery and Oncology 2018 www.ifhnos.net The International Federation of Head and Neck Oncologic Societies
More information5/20/ ) Haffty GB: Concurrent chemoradiation in the treatment of head and neck cancer. Hematol. Oncol. Clin: North Am.
Prague, 24-25 25 April 29 ALTERNATING CHEMORADIATION: FOR WHOM? M. Merlano MD Holy Cross Gen. Hospital Cuneo - Italy ALTERNATING CHEMORADIATION: FOR WHOM? Definition of alternating chemoradiation Targets
More informationNew Paradigms for Treatment of. Erminia Massarelli, MD, PHD, MS Clinical Associate Professor
New Paradigms for Treatment of Head and Neck cancers Erminia Massarelli, MD, PHD, MS Clinical Associate Professor City of Hope Disclosure Statement Grant/Research Support frommerck Bristol Grant/Research
More informationCALGB Thoracic Radiotherapy for Limited Stage Small Cell Lung Cancer
CALGB 30610 Thoracic Radiotherapy for Limited Stage Small Cell Lung Cancer Jeffrey A. Bogart Department of Radiation Oncology Upstate Medical University Syracuse, NY Small Cell Lung Cancer Estimated 33,000
More informationMoving EGFR Targeted Therapy into the Induction Phase of the Management of Squamous Cell Carcinoma of the Head and Neck
14 Journal of Cancer Research Updates, 2012, 1, 14-21 Moving EGFR Targeted Therapy into the Induction Phase of the Management of Squamous Cell Carcinoma of the Head and Neck Belisario A. Arango 1, Bertha
More informationThe Role of Concurrent Chemo-radiotherapy in Patients with Head and Neck Cancers: A Review
The Role of Concurrent Chemo-radiotherapy in Patients with Head and Neck Cancers: A Review M.D. Al-Sarraf 1 1 Williams Beaumont Hospital, Royal Oak, Michigan, USA Introduction In the past, radiotherapy
More informationCombined Modality Therapy State of the Art. Everett E. Vokes The University of Chicago
Combined Modality Therapy State of the Art Everett E. Vokes The University of Chicago What we Know Some patients are cured (20%) Induction and concurrent chemoradiotherapy are each superior to radiotherapy
More informationCombined modality treatment for N2 disease
Combined modality treatment for N2 disease Dr Clara Chan Consultant in Clinical Oncology 3 rd March 2017 Overview Background The evidence base Systemic treatment Radiotherapy Future directions/clinical
More informationTreatment of Locally Recurrent and Metastatic Squamous Cell Carcinoma of Head and Neck
Review Article imedpub Journals http://www.imedpub.com/ Head and Neck Cancer Research ISSN 2572-2107 Treatment of Locally Recurrent and Metastatic Squamous Cell Carcinoma of Head and Neck Chukwuemeka V
More informationHead and Neck Reirradiation: Perils and Practice
Head and Neck Reirradiation: Perils and Practice David J. Sher, MD, MPH Department of Radiation Oncology Dana-Farber Cancer Institute/ Brigham and Women s Hospital Conflicts of Interest No conflicts of
More informationCURRENT STANDARD OF CARE IN NASOPHARYNGEAL CANCER
CURRENT STANDARD OF CARE IN NASOPHARYNGEAL CANCER Jean-Pascal Machiels Department of medical oncology Institut I Roi Albert II Cliniques universitaires Saint-Luc Université catholique de Louvain, Brussels,
More informationORIGINAL ARTICLE. Examining the Need for Neck Dissection in the Era of Chemoradiation Therapy for Advanced Head and Neck Cancer
ORIGINAL ARTICLE Examining the Need for Neck Dissection in the Era of Chemoradiation Therapy for Advanced Head and Neck Cancer Laura A. Goguen, MD; Marshall R. Posner, MD; Roy B. Tishler, MD, PhD; Lori
More informationThoracic and head/neck oncology new developments
Thoracic and head/neck oncology new developments Goh Boon Cher Department of Hematology-Oncology National University Cancer Institute of Singapore Research Clinical Care Education Scope Lung cancer Screening
More informationHead and Neck Cancer: 2016 It s Not What You Think!
Head and Neck Cancer: 2016 It s Not What You Think! New Treatments, Improved Outcomes, and A Sexually Transmitted Disease? John R. Clark, MD Clinical Director, Center for Head and Neck Oncology Massachusetts
More informationClinical Discussion. Dr Pankaj Chaturvedi. Professor and Surgeon Tata Memorial Hospital
Clinical Discussion Dr Pankaj Chaturvedi Professor and Surgeon Tata Memorial Hospital chaturvedi.pankaj@gmail.com 47/M/smoker Hopkins : Transglottic lesion No cartilage infiltration but sclerosis Left
More informationRadiotherapy of head and neck cancer
ФГБУ «НИИ онкологии им. Н.Н. Петрова» Минздрава России Radiotherapy of head and neck cancer S.N. Novikov ФГБУ «НИИ онкологии им. Н.Н. Петрова» Минздрава России Postoperative radiotherapy Radiotherapy
More informationUpdate on Head and Neck Cancer Outline. Presenter Disclosure Information. Head and Neck Cancer Primary Disease Sites. Epidemiology
Welcome to Master Class for Oncologists Miami, FL December 19, 2009 Session 5: 4:30 PM - 5:15 PM Head and Neck Cancer: Update on Comprehensive Management Speaker: David G. Pfister, MD Chief, Head & Neck
More informationSTUDY FINDINGS PRESENTED ON TAXOTERE REGIMENS IN HEAD AND NECK, LUNG AND BREAST CANCER
Contact: Anne Bancillon + 33 (0)6 70 93 75 28 STUDY FINDINGS PRESENTED ON TAXOTERE REGIMENS IN HEAD AND NECK, LUNG AND BREAST CANCER Key results of 42 nd annual meeting of the American Society of Clinical
More informationSystemic Management of Malignant Pleural Mesothelioma
ESO-ESMO EASTERN EUROPE AND BALKAN REGION MASTERCLASS IN MEDICAL ONCOLOGY 15.June-19.June 2018 Belgrade, Serbia Systemic Management of Malignant Pleural Mesothelioma Dragana Jovanovic University Hospital
More informationKey words: Head-and-neck cancer, Chemoradiation, Concomitant Boost Radiation, Docetaxel. Materials and Methods
Weekly Cisplatin and Docetaxel plus Concomitant Boost Concurrently with Radiation Therapy in the Treatment of Locally Advanced Head And Neck Cancer: Phase II Trial Abd El Halim Abu-Hamar, MD 1, Naser Abd
More informationMaintenance Therapy for Advanced NSCLC: When, What, Why & What s Left After Post-Maintenance Relapse?
Maintenance Therapy for Advanced NSCLC: When, What, Why & What s Left After Post-Maintenance Relapse? Mark A. Socinski, MD Professor of Medicine Multidisciplinary Thoracic Oncology Program Lineberger Comprehensive
More informationHead, Neck, and Thyroid Cancers: Evidence-Based Approaches to Multimodal Management
Head, Neck, and Thyroid Cancers: Evidence-Based Approaches to Multimodal Management Robert Haddad, MD Disease Center Leader Head and Neck Oncology Program Dana Farber Cancer Institute Harvard Medical School
More informationRadiotherapy for rectal cancer. Karin Haustermans Department of Radiation Oncology
Radiotherapy for rectal cancer Karin Haustermans Department of Radiation Oncology O U T L I N E RT with TME surgery? Neoadjuvant or adjuvant RT? 5 x 5 Gy or long-course CRT? RT with new drugs? Selection
More informationRadio(chemo)therapy for head and neck cancer HNSCC: indications and modalities Prof. dr. Sandra Nuyts Radiotherapy-Oncology
Radio(chemo)therapy for head and neck cancer HNSCC: indications and modalities Prof. dr. Sandra Nuyts Radiotherapy-Oncology March 2018 > Half million new cases HNC/year in world 50-60% cured not cured
More informationThomas Gernon, MD Otolaryngology THE EVOLVING TREATMENT OF SCCA OF THE OROPHARYNX
Thomas Gernon, MD Otolaryngology THE EVOLVING TREATMENT OF SCCA OF THE OROPHARYNX Disclosures I have nothing to disclose. 3 Changing Role of Surgery N=42,688 Chen Ay et al. Larygoscope. 2007; 117:16-21
More informationDisclosures. Immunotherapyin Head & NeckCancer. Actual landscape of systemic treatment in HNSCC. Head andneckcanceris an immunogeneic tumor
Immunotherapyin Head & NeckCancer Disclosures Astra-Zeneca/medimmune: clinical trial BMS: advisory board, clinical trial Merck: advisory board, clinical trial, research funding Carla van Herpen Medical
More informationStage III Non-Small Cell Lung Cancer, Is There Any Progress? HARMESH R NAIK, MD. KARMANOS CANCER INSTITUTE 2/24/99
Stage III Non-Small Cell Lung Cancer, Is There Any Progress? HARMESH R NAIK, MD. KARMANOS CANCER INSTITUTE 2/24/99 Introduction 1/3 of the total lung cancer cases few patients are cured with single modality
More informationPERIOPERATIVE TREATMENT OF NON SMALL CELL LUNG CANCER. Virginie Westeel Chest Disease Department University Hospital Besançon, France
PERIOPERATIVE TREATMENT OF NON SMALL CELL LUNG CANCER Virginie Westeel Chest Disease Department University Hospital Besançon, France LEARNING OBJECTIVES 1. To understand the potential of perioperative
More informationIs the Neo-adjuvant Approach Better than Adjuvant Approach? Comparative Levels of Evidence: Randomized Trials
Is the Neo-adjuvant Approach Better than Approach? Virginie Westeel University Hospital Besançon, France Perspectives in Lung Cancer Amsterdam, 5-6 March 2010 Comparative Levels of Evidence: Randomized
More informationTristate Lung Meeting 2014 Pro-Con Debate: Surgery has no role in the management of certain subsets of N2 disease
Tristate Lung Meeting 2014 Pro-Con Debate: Surgery has no role in the management of certain subsets of N2 disease Jennifer E. Tseng, MD UFHealth Cancer Center-Orlando Health Sep 12, 2014 Background Approximately
More informationImmunotherapy in head and neck cancer and MSI in solid tumors
Immunotherapy in head and neck cancer and MSI in solid tumors Brian Hunis, MD, MBA Associate Medical Director, Memorial Cancer Institute. Hollywood, FL »No disclosures Objectives»Discuss the role of immunology
More informationLung Cancer Non-small Cell Local, Regional, Small Cell, Other Thoracic Cancers: The Question Isn t Can We, but Should We
Lung Cancer Non-small Cell Local, Regional, Small Cell, Other Thoracic Cancers: The Question Isn t Can We, but Should We Edward Garon, MD, MS Associate Professor Director- Thoracic Oncology Program David
More informationRob Glynne-Jones Mount Vernon Cancer Centre
ESMO Preceptorship Programme Colorectal Cancer Prague July 2016 State of the art: Standard of care for anal squamous cancer Rob Glynne-Jones Mount Vernon Cancer Centre Aim to discuss Background The trials
More informationENFERMEDAD LOCALMENTE AVANZADA: Estado del Arte y Eventual Papel de las Nuevas Terapias. Dolores Isla H. Clínico Universitario Lozano Blesa ZARAGOZA
ENFERMEDAD LOCALMENTE AVANZADA: Estado del Arte y Eventual Papel de las Nuevas Terapias Dolores Isla H. Clínico Universitario Lozano Blesa ZARAGOZA Formigal, 28 de Junio de 2018 CÓMO DEFINÍAMOS EL ESTADIO
More informationAccepted 28 April 2005 Published online 13 September 2005 in Wiley InterScience ( DOI: /hed.
DEFINING RISK LEVELS IN LOCALLY ADVANCED HEAD AND NECK CANCERS: A COMPARATIVE ANALYSIS OF CONCURRENT POSTOPERATIVE RADIATION PLUS CHEMOTHERAPY TRIALS OF THE EORTC (#22931) AND RTOG (#9501) Jacques Bernier,
More informationExpanding Role of the Medical Oncologist in the Management of Head and Neck Cancer Nicholas Choong and Everett Vokes DOI: /CA.2007.
Expanding Role of the Medical Oncologist in the Management of Head and Neck Cancer Nicholas Choong and Everett Vokes CA Cancer J Clin 2008;58;32-53; originally published online Dec 20, 2007; DOI: 10.3322/CA.2007.0004
More information