Hypopharyngeal cancer medical therapy: Difference between revisions

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Revision as of 20:04, 8 October 2015

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Faizan Sheraz, M.D. [2]

Overview

Medical Therapy

Treatment Options by Stage:^[1]===Treatment according to Stages===


Stage	Treatment

Stage 1	Laryngopharyngectomy and neck dissection with or without high-dose radiation therapy to the lymph nodes of the neck Partial laryngopharyngectomy with or without high-dose radiation therapy to the lymph nodes on both sides of the neck
Stage 2	Laryngopharyngectomy and neck dissection High-dose radiationtherapy to the lymph nodes of the neck may be given before or after surgery Chemotherapy given during or after radiation therapy or after surgery
Stage 3	Radiation therapy before or after surgery Chemotherapy given during or after radiation therapy or after surgery Radiation therapy followed by surgery to remove cancer containing lymph nodes in the neck that remain or come back after radiation therapy If all or part of the hypopharynx is removed, the patient may need reconstructive surgery
Stage 4	Chemotherapy given with radiation therapy Radiation therapy Radiation therapy followed by surgery to remove cancer containing lymph nodes in the neck that remain or come back after radiation therapy Chemotherapy for cancer that has metastasized (spread) to other parts of the body Treatment of stage IV hypopharyngeal cancer that cannot be treated with surgery may include: Chemotherapy given at the same time as radiation therapy The goal of treatment is to completely remove the cancer and prevent it from metastasizing to other parts of the body When the tumor is larger or has spread to lymph nodes in the neck, a combination of radiation and chemotherapy is often used to preserve the larynx

Supportive Treatment

Many patients also need swallowing therapy after treatment to help them adjust to the changes in the structure of the throat.

Radiation Therapy

As a single-modality treatment in early lesions. This was traditionally the case with small tumours of the true vocal fold. The disadvantage is a 5-week course of therapy. *Laser surgery is tending to replace radiotherapy for these lesions as the outcomes are similar and the treatment involves only a 1 or 2 days hospital stay.
In certain advanced hypopharyngeal and laryngeal cancer, where combined radiotherapy and chemotherapy offers organ preservation and good locoregional control without surgery.
For palliation for recurrent disease or advanced disease not suitable for surgery or organ preservation through chemoradiotherapy.
Radiation is delivered by external beam in dedicated radiotherapy units.
Radiation affects both normal tissue and cancer tissue, and the salivary glands and oral mucosa are particularly affected.
Dryness is a common post-radiotherapy complaint.
The mandible is commonly devascularised following radiotherapy and very prone to osteomyelitis and necrosis, secondary to dental sepsis.

References

↑ Treatment of hypopharyngeal cancer according to stages. http://www.cancer.gov/types/head-and-neck/patient/hypopharyngeal-treatment-pdq#section/_72

Template:WH Template:WS

[aaa-1] Treatment of hypopharyngeal cancer according to stages. http://www.cancer.gov/types/head-and-neck/patient/hypopharyngeal-treatment-pdq#section/_72

[1]

@@ Line 4: / Line 4: @@
 ==Overview==
 ==Medical Therapy==
-Treatment Options by Stage:<ref>http://www.cancer.gov/types/head-and-neck/patient/hypopharyngeal-treatment-pdq#section/_72</ref>
+Treatment Options by Stage:<ref name=aaa>Treatment of hypopharyngeal cancer according to stages. http://www.cancer.gov/types/head-and-neck/patient/hypopharyngeal-treatment-pdq#section/_72</ref>===Treatment according to Stages===
-===Stage I Hypopharyngeal Cancer===
+{| style="border: 0px; font-size: 90%; margin: 3px; width: 600px" align=center
-*Treatment of stage I hypopharyngeal cance
+|valign=top|
+|+
-Laryngopharyngectomy and neck dissection with or without high-dose radiation therapy to the lymph nodes of the neck.
+! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Stage}}
-Partial laryngopharyngectomy with or without high-dose radiation therapy to the lymph nodes on both sides of the neck.
+! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Treatment}}
+|-
-Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage I hypopharyngeal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website.
+| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
+Stage 1
-===Stage II Hypopharyngeal Cancer===
+| style="padding: 5px 5px; background: #F5F5F5;" |
+*Laryngopharyngectomy and neck dissection with or without high-dose radiation therapy to the lymph nodes of the neck
-*Treatment of stage II hypopharyngeal cancer may include the following:
+*Partial laryngopharyngectomy with or without high-dose radiation therapy to the lymph nodes on both sides of the neck
+|-
-Laryngopharyngectomy and neck dissection. High-dose radiationtherapy to the lymph nodes of the neck may be given before or after surgery.
+| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
-Partial laryngopharyngectomy. High-dose radiation therapy to the lymph nodes of the neck may be given before or after surgery.
+Stage 2
-Chemotherapy given during or after radiation therapy or after surgery.
+| style="padding: 5px 5px; background: #F5F5F5;" |
-A clinical trial of chemotherapy followed by radiation therapy or surgery.
+*Laryngopharyngectomy and neck dissection
+*High-dose radiationtherapy to the lymph nodes of the neck may be given before or after surgery
-Check the list of NCI-supported cancer clinical trials that are now accepting patients withstage II hypopharyngeal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website.
+*Chemotherapy given during or after radiation therapy or after surgery
+|-
-===Stage III Hypopharyngeal Cancer===
+| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
+Stage 3
-*Treatment of stage III hypopharyngeal cancer may include the following:
+| style="padding: 5px 5px; background: #F5F5F5;" |
+*Radiation therapy before or after surgery
-Radiation therapy before or after surgery.
+*Chemotherapy given during or after radiation therapy or after surgery
-Chemotherapy given during or after radiation therapy or after surgery.
+*Radiation therapy followed by surgery to remove cancer containing lymph nodes in the neck that remain or come back after radiation therapy
-A clinical trial of chemotherapy followed by surgery and/or radiation therapy.
+If all or part of the hypopharynx is removed, the patient may need reconstructive surgery
-A clinical trial of chemotherapy given at the same time as radiation therapy.
+|-
-A clinical trial of surgery followed by chemotherapy given at the same time as radiation therapy.
+| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
+Stage 4
-Treatment and follow-up of stage III hypopharyngeal cancer is complex and is ideally overseen by a team of specialists with experience and expertise in treating this type ofcancer. If all or part of the hypopharynx is removed, the patient may need plastic surgeryand other special help with breathing, eating, and talking.
+| style="padding: 5px 5px; background: #F5F5F5;" |
+*Chemotherapy given with radiation therapy
-Check the list of NCI-supported cancer clinical trials that are now accepting patients withstage III hypopharyngeal cancer. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. Talk with your doctor about clinical trials that may be right for you. General information about clinical trials is available from the NCI website.
+*Radiation therapy
+*Radiation therapy followed by [[surgery]] to remove cancer containing lymph nodes in the neck that remain or come back after radiation therapy
-===Stage IV Hypopharyngeal Cancer===
+*Chemotherapy for cancer that has metastasized (spread) to other parts of the body
+*Treatment of stage IV hypopharyngeal cancer that cannot be treated with surgery may include:
-*Treatment of stage IV hypopharyngeal cancer that can be treated with surgery may include the following:
+:*Chemotherapy given at the same time as radiation therapy
+:*The goal of treatment is to completely remove the cancer and prevent it from metastasizing to other parts of the body
-Radiation therapy before or after surgery.
+:*When the [[tumor]] is larger or has spread to lymph nodes in the neck, a combination of radiation and chemotherapy is often used to preserve the larynx
-A clinical trial of chemotherapy followed by surgery and/or radiation therapy.
+|-
-A clinical trial of surgery followed by chemotherapy given at the same time as radiation therapy.
+|}
-Surgical treatment and follow-up of stage IV hypopharyngeal cancer is complex and is ideally overseen by a team of specialists with experience and expertise in treating this type of cancer. If all or part of the hypopharynx is removed, the patient may need plastic surgery and other special help with breathing, eating, and talking.
-Treatment of stage IV hypopharyngeal cancer that cannot be treated with surgery may include the following:
-==Radiation therapy==
-Chemotherapy given at the same time as radiation therapy.
-A clinical trial of radiation therapy with chemotherapy.
-* The goal of treatment is to completely remove the cancer and prevent it from spreading to other parts of the body.
-* When the [[tumor]] is larger or has spread to lymph nodes in the neck, a combination of radiation and chemotherapy is often used to preserve the voice box.
 ==Supportive Treatment==
 Many patients also need swallowing therapy after treatment to help them adjust to the changes in the structure of the throat.
 ==Radiation Therapy==
+*As a single-modality treatment in early lesions. This was traditionally the case with small tumours of the true vocal fold. The disadvantage is a 5-week course of therapy. *Laser surgery is tending to replace radiotherapy for these lesions as the outcomes are similar and the treatment involves only a 1 or 2 days hospital stay.
-As a single-modality treatment in early lesions. This was traditionally the case with small tumours of the true vocal fold. Cure rates are excellent, as are functional outcomes. The disadvantage is a 5-week course of therapy. Consequently, laser surgery is tending to replace radiotherapy for these lesions as the outcomes are similar and the treatment involves only a 1- or 2-day stay in hospital.
+*In certain advanced hypopharyngeal and laryngeal cancer, where combined radiotherapy and chemotherapy offers organ preservation and good locoregional control without surgery.
-In certain advanced hypopharyngeal and laryngeal cancer, where combined radiotherapy and chemotherapy offers organ preservation and good locoregional control without surgery.
+*For palliation for recurrent disease or advanced disease not suitable for surgery or organ preservation through chemoradiotherapy.
-For palliation for recurrent disease or advanced disease not suitable for surgery or organ preservation through chemoradiotherapy.
+*Radiation is delivered by external beam in dedicated radiotherapy units.
-Post-operatively and, less commonly, pre-operatively, in disease where it is felt prudent to use multimodality therapy. Whether radiation is used preoperatively or post-operatively is often determined by the accepted practices in individual cancer treatment units.
+*Radiation affects both normal tissue and cancer tissue, and the salivary glands and oral mucosa are particularly affected.
+*Dryness is a common post-radiotherapy complaint.
-Radiation is delivered by external beam in dedicated radiotherapy units. Radiation affects both normal tissue and cancer tissue, and the salivary glands and oral mucosa are particularly affected. Dryness is a common post-radiotherapy complaint. The mandible is commonly devascularised following radiotherapy and very prone to osteomyelitis and necrosis, secondary to dental sepsis. Dental consultation and management of the teeth are therefore essential if the jaw is to be involved in the radiotherapy field.
+*The mandible is commonly devascularised following radiotherapy and very prone to osteomyelitis and necrosis, secondary to dental sepsis.
 ==References==