Detection of Distant Metastases in Head and Neck Cancer: Changing Landscape
Por:
de Bree, R, Senft, A, Coca-Pelaz, A, Kowalski, L, Lopez, F, Mendenhall, W, Quer, M, Rinaldo, A, Shaha, AR, Strojan, P, Takes, RP, Silver, CE, Leemans, CR, Ferlito, A
Publicada:
1 feb 2018
Resumen:
As head and neck squamous cell carcinoma (HNSCC) patients with distant metastases (DM) were generally treated only palliatively, the value of screening for DM was usually limited to attempts to avoid extensive locoregional treatment when DM were present pretreatment. Recently, the concept of treating oligometastases, e.g., by metastatectomy or stereotactic body radiotherapy, has been reintroduced for HNSCC and may cause a change in the treatment paradigm. Although whole body F-18-fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET) combined with computed tomography (CT; WB-FDG-PET/CT) is still the mainstay diagnostic technique, there is a growing body of evidence supporting implementation of whole body magnetic resonance imaging (WB-MRI) as an important diagnostic technique for screening for DM. Also, FDG-PET/MRI may become a valuable technique for the detection of DM in HNSCC patients. Because the yield of examinations for detection of DM is too low to warrant routine screening of all HNSCC patients, only patients with high risk factors should be selected for intense screening for DM. Clinical and histopathological risk factors are mainly related to the extent of lymph node metastases. Risk for development of DM may also be assessed by molecular characterization of the primary tumor using genomic and proteomic technologies and radiomics. More research is needed to develop a new protocol for screening for DM after introduction of the concept of treating oligometastases in HNSCC.
Filiaciones:
de Bree, R:
Univ Med Ctr Utrecht, Dept Head & Neck Surg Oncol, UMC Utrecht Canc Ctr, Utrecht, Netherlands
Vrije Univ Amsterdam, Dept Otolaryngol Head & Neck Surg, Med Ctr, Amsterdam, Netherlands
Senft, A:
Vrije Univ Amsterdam, Dept Otolaryngol Head & Neck Surg, Med Ctr, Amsterdam, Netherlands
Coca-Pelaz, A:
Hosp Univ Cent Asturias, Dept Otolaryngol, Oviedo, Spain
Kowalski, L:
Hosp Canc AC Camargo, Ctr Tratamento & Pesquisa, Dept Otorhinolaryngol Head & Neck Surg, Sao Paulo, Brazil
Lopez, F:
Hosp Univ Cent Asturias, Dept Otolaryngol, Oviedo, Spain
Univ Oviedo, Inst Invest Sanitaria Principado Asturias, Inst Univ Oncol Principado Asturias, Oviedo, Spain
Univ Oviedo, ISCIII, CIBERONC, Oviedo, Spain
Mendenhall, W:
Univ Florida, Dept Radiat Oncol, Gainesville, FL USA
Quer, M:
Hosp Santa Creu & Sant Pau, Dept Otolaryngol, Barcelona, Spain
Rinaldo, A:
Univ Udine, Sch Med, Udine, Italy
Shaha, AR:
Mem Sloan Kettering Canc Ctr, Head & Neck Serv, 1275 York Ave, New York, NY 10021 USA
Strojan, P:
Inst Oncol, Dept Radiat Oncol, Ljubljana, Slovenia
Takes, RP:
Radboud Univ Nijmegen, Dept Otolaryngol Head & Neck Surg, Med Ctr, Nijmegen, Netherlands
Silver, CE:
Univ Arizona, Coll Med, Dept Surg, Phoenix, AZ USA
Leemans, CR:
Vrije Univ Amsterdam, Dept Otolaryngol Head & Neck Surg, Med Ctr, Amsterdam, Netherlands
Ferlito, A:
Int Head & Neck Sci Grp, Padua, Italy
|