Department of Diagnostic Radiology, Tan Tock Seng Hospital, Basement 1, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.
Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
Curr Oncol Rep. 2021 Mar 22;23(5):52. doi: 10.1007/s11912-021-01045-7.
In this review, we will outline the role of percutaneous interventional radiological management of recurrent head and neck (H&N) cancer in the context of a multidisciplinary setting which consists of surgery, radiation therapy, as well as established and evolving systemic therapies that may impact current practice.
Management of recurrent H&N cancer is complex, with attention to the preservation of function and minimal treatment-related morbidity. The favored treatment modalities in local recurrence previously treated with radiotherapy are surgical resection, and if unresectable, for chemotherapy as definitive treatment, or as a prelude to resection if there is good tumor response. Unfortunately, some of these patients are too frail for major surgery or to withstand the toxicity of chemotherapy. There is a gap for effective local therapy without the morbidity of surgery, toxicity of re-irradiation, and systemic side effects of chemotherapy. Percutaneous interventions have the potential to bridge that gap as well as provide palliative symptomatic treatment for patients that have exhausted all treatment options. In the multidisciplinary setting involving the treatment of complex recurrent H&N cancer, percutaneous management now plays a viable and effective role with a foothold in this team-based approach.
在本次综述中,我们将概述多学科环境下经皮介入放射学管理复发性头颈部(H&N)癌症的作用,该多学科环境包括手术、放射治疗以及既定和不断发展的系统治疗,这些可能会影响当前的治疗实践。
复发性 H&N 癌症的管理非常复杂,需要注意功能的保留和最小的治疗相关发病率。对于先前接受过放射治疗的局部复发性肿瘤,首选的治疗方式是手术切除,如果无法切除,则作为确定性治疗选择化疗,或者如果肿瘤反应良好,则作为切除的前奏。不幸的是,其中一些患者身体太虚弱,无法接受大手术或无法承受化疗的毒性。因此,需要一种有效的局部治疗方法,而无需手术的发病率、再放疗的毒性和化疗的全身副作用。介入治疗有可能填补这一空白,并为已用尽所有治疗选择的患者提供姑息性对症治疗。在涉及治疗复杂复发性 H&N 癌症的多学科环境中,经皮管理现在发挥了可行且有效的作用,在这种基于团队的方法中占据了一席之地。