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Multidisciplinary Management of Hypopharyngeal Carcinoma

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Head and Neck Cancer

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Abstract

Despite advances in treatment modalities, the management of hypopharyngeal squamous cell carcinoma (SCC) remains difficult. Most patients have advanced locoregional disease at the time of diagnosis.

Treatment selection favors laryngeal preservation approaches either surgically or nonsurgically to improve the quality of life without compromising locoregional control and survival. For patients with early disease, conservation surgery and primary radiotherapy are equally effective therapeutic options. For patient with advanced locoregional disease, a conservative treatment combining chemotherapy and radiotherapy should be favored. Total laryngopharyngectomy (TLP) remains indicated in tumors not suitable for conservative nonsurgical approaches and for salvage. Despite a good locoregional control rate, most patients succumb to distant metastases, intercurrent diseases, or second primaries.

Future developments should be connected with treatments with a better toxicity profile than chemotherapy aimed to decrease the rate of late distant recurrences and the occurrence of second primaries. Targeted agents could be nicely incorporated into the standard regimen to either improve efficacy and/or decrease treatment toxicity. Ongoing studies investigating the combination of targeted agent administration during or after induction chemotherapy or with concomitant chemoradiation regimens will help to better define the respective role of chemotherapy and targeted agents in the multimodal treatment of this disease. In addition, efforts to identify predictive biomarkers that could help to better select the patients who will benefit of a specific treatment modality are of crucial importance.

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Authors and Affiliations

  1. Department of Head and Neck Surgery, St Luc University Hospital and King Albert II Cancer Institute; Université Catholique de Louvain, Avenue Hippocrate, 10, Brussels, 1200, Belgium

    Marc Hamoir MD & Sandra Schmitz MD, PhD

  2. Department of Medical Oncology, St Luc University Hospital and King Albert II Cancer Institute, Université Catholique de Louvain, Brussels, Belgium

    Jean-Pascal Machiels MD, PhD

  3. Department of Radiation Oncology, St Luc University Hospital and King Albert II Cancer Institute, Université Catholique de Louvain, Brussels, Belgium

    Vincent Grégoire MD, PhD, Hon, FRCR

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  2. Jean-Pascal Machiels MD, PhD
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  4. Vincent Grégoire MD, PhD, Hon, FRCR
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  1. Department of Radio-Oncology, Genolier Swiss Medical Network, Genolier, Switzerland

    Jacques Bernier

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Hamoir, M., Machiels, JP., Schmitz, S., Grégoire, V. (2016). Multidisciplinary Management of Hypopharyngeal Carcinoma. In: Bernier, J. (eds) Head and Neck Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-27601-4_28

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