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Accelerated and Hyperfractionated Radiotherapy - treatment of head and neck cancer
An area of current interest in the treatment of head and neck cancer is…

Radiotherapy plays an integral role in the treatment of most head and neck cancers. Used as the sole modality for the treatment of select early-stage disease (T1 and T2), it gives…

Advances in radiotherapy have been tied to advances in technology. In the early days, low-energy orthovoltage devices and radium 226 sources were used to treat HNSCC. Then came…

Anatomy
Salivary gland tissue is ubiquitous in the submucosa of the upper gastrointestinal tract and is grouped into three major salivary glands: the parotid, the submaxillary (or submandibular), and the sublingual glands. The…

As mentioned previously, the nose and the paranasal sinuses pose a unique set of problems that deserve separate consideration from SCC of the UADT. For instance, while SCC is still the most…

Although the skin of the head and neck accounts for less than 10% of the body’s surface area, 70% to 80% of cutaneous malignancies occur in this region. As a result of greater…

A special issue relates to the treatment of carcinoma in situ of the vocal cords. This disease often can be managed with vocal cord stripping, but if enough serial sections are examined, foci of…

The treatment of glottic cancer is greatly influenced by the secondary goal of voice preservation. Mobility of the vocal cords is a critical factor in selecting treatment. For small cancers (T1, T2)…

Cancer of the base of the tongue poses a more difficult therapeutic problem than do tonsillar carcinomas. The 5-year survival rates are lower, metastases are more common, early diagnosis is less common, and treatment…

Cancers of the soft palate and pharyngeal wall are less common than other oropharyngeal neoplasms. Most soft-palate cancers occur on the anterior surface of the palate and tend to be…

Because of the prominent role the larynx plays in communication, swallowing, respiration, protection of the lower airway, and therefore, quality of life, the treatment of cancer of the larynx presents…

The hypopharynx represents one of the most lethal sites for SCC. Lymph node metastases are clinically evident at time of diagnosis in 70% to 80% of patients and are indicative of…

Important factors in selecting therapy for supraglottic cancers are tumor location and preepiglottic extension. Tumors limited to the suprahyoid epiglottis are amenable to radiation with fields that encompass neck regions…

Gingival cancers occur most commonly (80%) in the lower gingiva posterior to the bicuspids. For both sites, trismus is an ominous sign indicating extension to masseter or pterygoid muscles. Clinical staging…

Cancers arising in the retromolar trigone (the narrow band of mucosa that lies behind the mandibular molars and covers the ascending ramus) are rarely confined to that gingiva, but involve adjacent buccal mucosa,…

Floor of mouth cancers occur with a frequency similar to that for tongue cancer. Early spread to adjacent areas (gingiva and periosteum of the mandible) is common. The periosteum is a natural…

Cancers of the tonsil tend to be superficial, better differentiated, and of an earlier stage than other oropharyngeal tumors. The treatment of early tonsillar neoplasms (stages I and II) is usually radiation…

General Principals

After a histologic diagnosis has been established and tumor extent determined, the selection of appropriate treatment for a specific cancer depends on a complex array of variables, including tumor site,…

The identification and appropriate management of premalignant mucosal lesions in the head and neck are important aspects of patient management that have major impact on overall survival rates. Since stage…

Tongue cancers account for over 25% of oral cavity SCCs and most commonly arise in the oral portion or anterior two-thirds of the tongue on the lateral edge or ventral surface. Infiltration of the…

Introduction
The term “cancer of the head and neck” describes a diverse collection of cancers of varying histologies arising from a variety of anatomic sites that make up the UADT. This…