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Changing paradigms in the treatment of residual/recurrent head and neck cancer: implications for dysphagia management.

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ICR Author
Harrington, Kevin
Author
Brady, GC
Hardman, JC
Paleri, V
Harrington, KJ
Roe, JWG
Type
Journal Article
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Abstract
Purpose of review Despite advances in head and neck cancer treatment provision, recurrence rates remain high with the added risk of successfully treated patients developing a second primary. We report on the management of dysphagia in the context of residual/recurrent or new disease in a preirradiated field and make suggestions for future research.Recent findings There have been numerous developments in treatment options for people with residual/recurrent head and neck cancer. This is because of improved surgical interventions including microvascular reconstruction techniques and transoral robotic surgery. In the era of highly conformal radiotherapy techniques, such as intensity-modulated radiotherapy (IMRT), there may be opportunities for re-irradiation. These advancements are now increasingly employed in the context of locoregionally recurrent disease. With results being reported from an increasing number of clinical trials, systemic therapies, including treatment with immunotherapy, offer the potential for increased survival with less treatment-related toxicity.Summary Dysphagia is recognized as a significant toxicity following radical surgical and radiation-based approaches, particularly when multimodal treatment is required. Increasingly, late radiation-associated dysphagia is gaining greater attention in the literature. Many patients presenting with residual and recurrent disease do so against a background of comorbidities as well as persistent and late treatment-related toxicity.
URI
https://repository.icr.ac.uk/handle/internal/4439
DOI
https://doi.org/10.1097/moo.0000000000000620
Collections
  • Cancer Biology
  • Radiotherapy and Imaging
Subject
Humans
Head and Neck Neoplasms
Neoplasm Recurrence, Local
Neoplasm, Residual
Deglutition Disorders
Radiation Injuries
Research team
Targeted Therapy
Targeted Therapy
Language
eng
Date accepted
2020-06-01
Citation
Current opinion in otolaryngology & head and neck surgery, 2020, 28 (3), pp. 165 - 171

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