Head and Neck Cancer Basic and Clinical Aspects

9780792330158

0792330153

Throughout the world, head and neck cancer is a major threat to public health and a significant challenge to both clinicians and basic scientists. Despite extensive efforts in primary prevention, screening, early detection, and therapy, long-term survival rates have not improved substantially in the last three decades. This book covers a wide range of exciting new findings in both clinical and basic sciences as they are relevant to head and neck cancer. These findings have recently enhanced our understanding of head and neck carcinogenesis at the genetic and molecular levels, offering the promise of improved preventive and therapeutic strategies. The book also presents information on the important clinical advances that have been made in chemoprevention, organ preservation, and the simultaneous use of chemotherapy and radiotherapy. The first section provides an overview of the etiology and biology of head and neck cancer, including an examination of human papillomaviruses in both benign and malignant lesions. This section also discusses the carcinogenic process at the genetic and molecular levels, as well as aberrant squamous differentiation; increased understanding of these areas has great potential to translate into new strategies for cancer prevention. The second section describes recent advances in developing a risk model for head and neck cancer, as well as the application of genetic susceptibility data in chemoprevention. This section also includes overviews of the status of chemoprevention trials and of the process of invasion and metastasis in head and neck cancer. The third section covers molecular studies of radioresistance, early detection of head and neck cancer, and the implications of photodynamic therapy, while the fourth section of the book includes studies of the timing and sequencing of chemoradiotherapy. New strategies in this area have made a significantly increased feasibility of laryngeal preservation in the treatment of advanced laryngeal cancer. The fifth and last section discusses the management of clinically negative neck disease, the role of adjuvant therapy in preventing distant metastasis, and new strategies for the treatment of recurrent tumors. Finally, we close with some intriguing predictions for the future of head and neck cancer therapy.