Cancer of the head and neck

Description:

Heterogeneous group of the malignant tumors proceeding from an oral cavity, a throat, upper respiratory tracts and a thyroid gland.
The majority of malignant diseases of the head and neck are presented by planocellular cancer, undifferentiated cancer and lymphoepitheliomas of a nasopharyngeal zone.
Malignancies of the head and neck make about 3-5% of all cancer educations. High prevalence is noted among men 50 years are more senior.

Reasons of cancer of the head and neck:

RGSh is studied insufficiently.
As the contributing factors of development of RGSh are considered:

smoking
alcohol abuse
the ionizing radiation
the burdened family anamnesis
Mongoloid race
long contact with asbestos

Classification:

Histologic classification:

1. Planocellular cancer (90%)

2. Lymphoma

3. Tumors of sialadens:

a. adenocarcinoma

b. adenokistozny cancer

c. mucoepidermoid cancer

4. Sarcomas
Melanoma


Tumors of the head and neck preferential ectodermal - planocellular carcinomas of various degree дифференцировкн. Low degree of a differentiation epidermal carcinomas, lymphoepitheliomas and carcinomas of transitional cells usually are located in a zone of a nasopharynx, almonds, the lower part of a throat and a mobile part of language.
Not epidermoid tumors make 10% of cases of cancer of the head and a neck and arise from sites of ferruterous fabric. In sialadens there can be enclavomas and columnar-celled carcinomas (adenoidokistozny), slizistoepidermondny and atsinarnokletochny carcinomas. Adenocarcinomas can arise in a nose, a Highmore's bosom or a nasopharynx. Lymphoma meet in a nasopharynx, the nasal courses and on almonds. Sarcomas arise in Highmore's bosoms and a mandible.
Cancer of the head and neck is classified by the sizes and localization of primary tumor, by number and size of metastasises in cervical lymph nodes, by existence or lack of the remote metastasises. Stadirovaniye is carried out by RGSh according to the TNM system (AJCC and UICC).

Symptoms of cancer of the head and neck:

Symptoms  of cancer of the head and neck depend on localization of tumoral process. At localization in oral cavities and throats long quinsy, unilateral increase in an almond (at adults), a canker mucous, a jaw new growth, a dysphagy, disturbance of speech/phonation (a dysarthtia at language cancer, change of a voice at throat cancer or nasopharynxes), etc. can be symptoms. At localization in a nasal cavity difficulty of nasal breath, hemorrhagic and purulent discharges from the nasal courses (unilateral are more often), persistent unilateral sinusitis, headaches is possible. At defeat of sialadens the palpated tumor in the field of gland projection, a lack of coordination of work of muscles of the person and neck is defined during the involving of cherpny nerves,  pains and paresthesias, etc. Rasprostaneny tumoral process it can be shown in the form of unilateral deafness, it is frequent against the background of serous otitis.
The specified symptomatology often is followed by the phenomena of a paraneoplastic syndrome.

Cancer therapy of the head and neck:

The combined method including radiation therapy and an operative measure remains by a traditional method of treatment of patients with cancer of the head and neck.  

The induction chemotherapy (before operation or radiation therapy) at locally-spread tumors allows to achieve remission more than in 80% of cases, reduces risk of the remote metastasises, but does not influence risk of a local recurrence and survival. At moderate distribution himioluchevy therapy allows to destroy a tumor and to keep a throat.

The adjuvant chemotherapy has the greatest effect – at throat cancer and nasopharynxes. Cisplatinum is most effective. Besides are used карбоплатин, ftoruratsit, Bleomycinum, митомицин, the methotrexate, топотекан, винорелбин, gemcitabine, капецитабин, dotsetakset or paklitakset in the mode of monotherapy cause remission in 15-30% of patients, but do not increase bezretsidivny and general survival.

Adjuvant himioluchevy therapy reduces risk of a local and regional recurrence, increases survival at locally-spread cancer mucous a mouth, a throat and a throat.

Polikhimioterpiya isporlzutsya at the metastasizing tumors. Increases remission frequency, than monotherapy, but does not increase survival. Two schemes are traditionally used: PF (Cisplatinum also ftoruratsit) and PEL (Cisplatinum, ftoruratsit, фолинат calcium).

Considering development of serious side effects of a combination therapy, carrying out treatment, directed to correction of the arising disturbances is recommended. High performance modern antiemetic drug – гранисетрон has

To patients with a long or febrile neutropenia in the anamnesis it is appointed filgrasty.