Cancers of the Head and Neck

Cancers of the head and neck are among the most morbid of cancers. Convention al surgery and/or radiation therapy have a high cure rate for patients with early stage disease. However, despite optimal treatment with surgery and radiotherapy, patients with nodal spread or extensive local disease have a low cure rate. Even if a cancer is cured, a patient is often left with long-term debilities from the treatment and/or cancer. The major causes for decreased survival in patients with advanced head and neck cancer include local recurrence, distant metastases, and second primaries. All of these need to be addressed if one is to improve upon the curability of advanced disease. There are several new techniques, surgical and radiotherapeutic, designed to improve local control. Brachytherapy, or interstitial implantation, delivers a high dose of localized radiation with minimal normal tissue injury. This technique as discussed by Goffinet, may be even more efficacious when combined with hyperthermia. New, creative methods of radiation therapy delivery, such as the use of multiple fractions per day, as discussed by Parsons and Million, are also contributing to long-term local control. Laser therapy, discussed by Ossoff and Nemeroff, provides another tool for treatment of local disease.

Résumé
` this is a worthwhile addition to the collection of oncologists of all disiplines, as well as for the otolaryngologist and head and neck surgeon. '
Radiology'

Contenu
I Advances in surgical therapy.- 1. Mandibular reconstruction in the surgical management of head and neck tumors.- 2. Extracapsular spread of squamous carcinoma in cervical metastasis.- 3. The role of a modified neck dissection.- 4. Extended partial laryngeal surgery.- 5. Laser surgery for head and neck cancer.- II Advances in radiation therapy/radiology.- 6. Radiation therapy with multiple fractions per day in the treatment of head and neck cancer.- 7. Brachytherapy head and neck cancer.- 8. Magnetic resonance imaging of head and neck tumors.- III Advances in chemotherapy/biologic modifiers.- 9. Timing of chemotherapy as part of multi-modality treatment in patients with advanced head and neck cancer.- 10. Immunology of the lymph node.- 11. Nasopharyngeal carcinoma: relationship to Epstein-Barr virus and treatment with interferon.- 12. The use of retinoids in head and neck cancer.- IV Other management problems.- 13. Avoiding biostatistical pitfalls in the design and analysis of head and neck cancer clinical trials.- 14. Management of orbital rhabdomyosarcoma.- 15. Current management of cutaneous melanomas of the head and neck.- 16. Lymphomas of extranodal head and neck sites.