Hypopharyngeal cancer medical therapy: Difference between revisions

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{{Hypopharyngeal cancer}}
{{Hypopharyngeal cancer}}
{{CMG}} {{AE}}{{Faizan}}
{{CMG}}; {{AE}} {{G.D.}}, {{Faizan}}
 
==Overview==
==Overview==
The optimal therapy for hypopharyngeal cancer depends on the stage at the time of diagnosis.
The [[medical]] [[therapy]] with the combination of the [[radiotherapy]] has been used compared to [[Surgery|surgical]] [[therapy]] for the treatment of hypopharyngeal cancer.The optimal [[therapy]] for hypopharyngeal cancer depends on the stage at the time of the [[diagnosis]]. The combined treatment helps with [[Organ (anatomy)|organ]] preservation. [[Swallowing]], [[speech]] and [[laryngeal]] preservation are important to consider during the treatment.
 
==Medical Therapy==
==Medical Therapy==
The optimal therapy for hypopharyngeal cancer depends on the stage at the time of diagnosis.
* The [[medical]] [[therapy]] with [[radiotherapy]] has been used compared to surgical [[therapy]] for the treatment of hypopharyngeal cancer due to [[Organ (anatomy)|organ]] preservation.<ref name="pmid19306746">{{cite journal |vauthors=Lefebvre JL, Ang KK |title=Larynx preservation clinical trial design: key issues and recommendations-a consensus panel summary |journal=Int. J. Radiat. Oncol. Biol. Phys. |volume=73 |issue=5 |pages=1293–303 |date=April 2009 |pmid=19306746 |doi=10.1016/j.ijrobp.2008.10.047 |url=}}</ref><ref name="pmid8656441">{{cite journal |vauthors=Lefebvre JL, Chevalier D, Luboinski B, Kirkpatrick A, Collette L, Sahmoud T |title=Larynx preservation in pyriform sinus cancer: preliminary results of a European Organization for Research and Treatment of Cancer phase III trial. EORTC Head and Neck Cancer Cooperative Group |journal=J. Natl. Cancer Inst. |volume=88 |issue=13 |pages=890–9 |date=July 1996 |pmid=8656441 |doi= |url=}}</ref>
Treatment according to Stages:<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>
* The optimal [[therapy]] for hypopharyngeal cancer depends on the stage at the time of [[diagnosis]]. The following factors are important to consider:
{| style="border: 0px; font-size: 90%; margin: 3px; width: 600px" align=center
**[[Swallowing]]
|valign=top|
**[[Speech]]
|+
**[[Larynx]]
! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|Stage}}
! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Treatment}}
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
Stage 1
| style="padding: 5px 5px; background: #F5F5F5;" |
*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
|-
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" |
Stage 2
| style="padding: 5px 5px; background: #F5F5F5;" |
*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
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
Stage 3
| style="padding: 5px 5px; background: #F5F5F5;" |
*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
|-
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" |
Stage 4
| style="padding: 5px 5px; background: #F5F5F5;" |
*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.


==Chemotherapy==
*[[Chemotherapy]] followed by [[radiation therapy]] may help in [[Organ (anatomy)|organ]] preservation.<ref name="urlHypopharyngeal Cancer Treatment (PDQ®)—Health Professional Version - National Cancer Institute">{{cite web |url=https://www.cancer.gov/types/head-and-neck/hp/adult/hypopharyngeal-treatment-pdq#section/_74 |title=Hypopharyngeal Cancer Treatment (PDQ®)—Health Professional Version - National Cancer Institute |format= |work= |accessdate=}}</ref>
*[[Cisplatin]] plus [[Fluorouracil|Fluorouraci]]<nowiki/>l followed by [[radiation therapy]] are used for advanced stage.
==Radiation Therapy==
==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.  
*[[Radiation therapy]] may be used as a single modality treatment in early lesions.<ref name="Wei2002">{{cite journal|last1=Wei|first1=William I.|title=The Dilemma of Treating Hypopharyngeal Carcinoma: More or Less|journal=Archives of Otolaryngology–Head & Neck Surgery|volume=128|issue=3|year=2002|pages=229|issn=0886-4470|doi=10.1001/archotol.128.3.229}}</ref>
*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.
*[[Laser surgery]] is gradually replacing [[radiotherapy]] for early lesions as the outcome of both are similar while the [[laser therapy]].
*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==
==References==
{{reflist|2}}
{{reflist|2}}


{{WH}}
[[Category:Up-To-Date]]
{{WS}}
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[[Category:Medicine]]
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[[Category:Otolaryngology]]
[[Category:Surgery]]

Latest revision as of 17:18, 1 February 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Gertrude Djouka, M.D.[2], Faizan Sheraz, M.D. [3]

Overview

The medical therapy with the combination of the radiotherapy has been used compared to surgical therapy for the treatment of hypopharyngeal cancer.The optimal therapy for hypopharyngeal cancer depends on the stage at the time of the diagnosis. The combined treatment helps with organ preservation. Swallowing, speech and laryngeal preservation are important to consider during the treatment.

Medical Therapy

Chemotherapy

Radiation Therapy

References

  1. Lefebvre JL, Ang KK (April 2009). "Larynx preservation clinical trial design: key issues and recommendations-a consensus panel summary". Int. J. Radiat. Oncol. Biol. Phys. 73 (5): 1293–303. doi:10.1016/j.ijrobp.2008.10.047. PMID 19306746.
  2. Lefebvre JL, Chevalier D, Luboinski B, Kirkpatrick A, Collette L, Sahmoud T (July 1996). "Larynx preservation in pyriform sinus cancer: preliminary results of a European Organization for Research and Treatment of Cancer phase III trial. EORTC Head and Neck Cancer Cooperative Group". J. Natl. Cancer Inst. 88 (13): 890–9. PMID 8656441.
  3. "Hypopharyngeal Cancer Treatment (PDQ®)—Health Professional Version - National Cancer Institute".
  4. Wei, William I. (2002). "The Dilemma of Treating Hypopharyngeal Carcinoma: More or Less". Archives of Otolaryngology–Head & Neck Surgery. 128 (3): 229. doi:10.1001/archotol.128.3.229. ISSN 0886-4470.