Advances in radiotherapy of head and neck cancers

作者：Tao Yungan; Daly Schveitzer Nicolas; Lusinchi Antoine; Bourhis Jean^*

来源：Current Opinion in Oncology, 2010, 22(3): 194-199.

DOI：10.1097/CCO.0b013e3283388906

• cancer
• chemotherapy
• head and neck
• radiotherapy
• targeted therapy

Purpose of review
Radiation therapy plays a key role in the management of head and neck cancers (HNCs). We reviewed the recent advances in radiotherapy of HNCs and the role of imaging in treatment planning.
Recent findings
As shown in a recent update of meta-analysis of chemotherapy in head and neck cancer (MACH-NC), concurrent chemoradiotherapy was confirmed to be a standard of care in the management of locally advanced HNCs. Two recent large-scale randomized trials [Groupe d'Oncologie Radiotherapie Tete et Cou (GORTEC) and Radiation Therapy Oncology Group (RTOG)] failed to show additional benefit when combining accelerated radiotherapy with concurrent chemoradiotherapy. Updated 5-year results of a phase III pivotal trial confirmed the benefit of targeting epidermal growth factor receptor with cetuximab when combined with radiotherapy. Taxane-platinum-fluorouracil-based induction chemotherapy has been established as a reference induction regimen and has been explored as a possible part of the treatment of locally advanced HNCs, which was particularly successful in larynx preservation. The superiority of intensity-modulated radiation therapy compared with conventional radiotherapy for parotid protection has been shown in a prospective phase III trial. PET-based treatment planning is still to be validated in HNCs.
Summary
Concurrent chemoradiotherapy could still be considered as a standard of care; several new treatment combinations and new radiation technologies have been recently successfully evaluated in clinical trials.

• 出版日期2010-5