Oligometastatic Head and Neck Cancer: Challenges and Perspectives.
Simple Summary: Oligometastasis represents a disease state and an opportunity for cure when metastases emerge. Emerging evidence supports that most head and neck cancer patients with oligometastatic disease are likely to benefit from curative intent local ablative therapy if appropriate selection cr...
| Publicado en: | Cancers Vol. 14; no. 16; pp. 3894 - 3908 |
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| Autores principales: | , , |
| Formato: | pictorial review tables/charts Journal Article |
| Publicado: |
MDPI
Aug2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=158750462&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 158750462 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 20726694 B74B jtl: Cancers issn: 20726694 maglogo: N pubinfo: dt: Aug2022 vid: 14 iid: 16 pid: 97109 pub: MDPI artinfo: ui: 158750462 158750462 158750462 10.3390/cancers14163894 158750462 ppf: 3894 ppct: 14 formats: tig: atl: Oligometastatic Head and Neck Cancer: Challenges and Perspectives. aug: au: Bahig, Houda Huang, Shao Hui O'Sullivan, Brian affil: Department of Radiation Oncology, University of Montreal, Montreal, QC H2X 3E4, Canada sug: subj: Neoplasm Metastasis Head and Neck Neoplasms Neoplasm Metastasis Symptoms Head and Neck Neoplasms Symptoms Neoplasm Metastasis Drug Therapy Head and Neck Neoplasms Drug Therapy Neoplasm Metastasis Prognosis Head and Neck Neoplasms Prognosis Health Services Accessibility Needs Assessment Attitude to Illness ab: Simple Summary: Oligometastasis represents a disease state and an opportunity for cure when metastases emerge. Emerging evidence supports that most head and neck cancer patients with oligometastatic disease are likely to benefit from curative intent local ablative therapy if appropriate selection criteria are applied. Biomarkers to predict development of oligometastasis, as well as to identify which patients could benefit from a radical intent approach, are under investigation. This review summarizes recent knowledge about the characteristics, investigational efforts, and evidence for local ablation regarding oligometastasis in head and neck cancer. We also describe the challenges and opportunities in patient selection and discuss the role of radiotherapy and immunotherapy combinations to enhance anti-tumor immunity. A minority of patients with metastatic head and neck squamous cell carcinoma (HNSCC) present with oligometastatic disease. Oligometastasis not only reflects a disease state, but might also present an opportunity for cure in the metastatic setting. Radical ablation of all oligometastatic sites may confer prolonged survival and possibly achieve cure in some patients. However, substantial debate remains about whether patients with oligometastatic disease could benefit from curative intent therapy or whether aggressive treatments expose some patients to futile toxicity. Optimal selection of patients, carefully balancing the currently known prognostic factors against the risks of toxicity is critical. Emerging evidence suggests that patients with a limited burden of disease, viral-related pharyngeal cancer, metachronous metastasis and lung-only metastasis may benefit most from this approach. Efforts are underway to identify biomarkers that can detect oligometastasis and better select patients who would derive the maximum benefit from an aggressive radical approach. The combination of radiotherapy and immunotherapy promises to enhance the anti-tumoral immune response and help overcome resistance. However, optimization of management algorithms, including patient selection, radiation dose and sequencing, will be critical in upcoming clinical trials. This review summarizes recent knowledge about the characteristics and investigational efforts regarding oligometastasis in HNSCC. pubtype: Academic Journal doctype: pictorial review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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