Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-848d4c4894-nmvwc Total loading time: 0 Render date: 2024-06-28T23:07:08.328Z Has data issue: false hasContentIssue false

8 - Head and neck

Published online by Cambridge University Press:  23 December 2009

By
Laura Moss  and
Chris Gaffney
Edited by
Louise Hanna ,
Tom Crosby  and
Fergus Macbeth
Laura Moss
Affiliation:
Consultant, Clinical Oncologist, Velindre Cancer Centre, Velindre Hospital, Whitchurch, Cardiff, UK
Chris Gaffney
Affiliation:
Consultant, Clinical Oncologist, Velindre Cancer Centre, Velindre Hospital, Whitchurch, Cardiff, UK
Louise Hanna
Affiliation:
Velindre Hospital, Cardiff
Tom Crosby
Affiliation:
Velindre Hospital, Cardiff
Fergus Macbeth
Affiliation:
Velindre Hospital, Cardiff
Get access

Summary

Introduction

It is not possible in a book with this format to discuss the treatment details for each tumour type, stage and subsite. This chapter highlights treatment principles and controversies.

This chapter covers the anatomical sites of the lip, oral cavity, pharynx, larynx, nose, paranasal sinuses, salivary glands, middle ear and squamous carcinoma of unknown primary. The first section considers general features of head and neck cancer. Subsequent sections focus on specific tumour sites.

General features of head and neck tumours

Types of head and neck tumour

The majority of head and neck cancers are squamous carcinomas, which account for 90% of all cases. The range of tumours is shown in Table 8.1.

Incidence and epidemiology of head and neck tumours

  • Approximately 8000 new cases occur per year in England and Wales (CRUK, 2004).

  • Approximately 3000 deaths occur per year in England and Wales (CRUK, 2004).

  • The UK annual incidence is approximately 14/100,000 cases per year (CRUK, 2004).

  • Regional variation in the UK is 8 per 100,000 in the Thames region compared to 13 to 15 per 100,000 in Wales and northwest England (NICE, 2004).

  • Head and neck tumours are more common in males than females (male-to-female ratio of 2:1), except for salivary gland tumours.

  • Incidence increases from middle age, with peak incidence occurring in the 60- to 75-age group.

Risk factors and aetiology for head and neck tumours

Prolonged exposure to environmental factors plays a key role.

Type
Chapter
Information
Practical Clinical Oncology , pp. 93 - 120
Publisher: Cambridge University Press
Print publication year: 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Joint Committee on Cancer. (2002). American Joint Committee on Cancer Cancer Staging Manual, ed. Greene, F.et al., 6th edn. New York: Springer.Google Scholar
Al-Sarraf, M., LeBlanc, M., Giri, P.et al. (1998). Chemoradiotherapy versus radiotherapy in patients with advanced nasopharyngeal cancer: phase III randomized intergroup study 0099. J. Clin. Oncol., 16, 1310–17.CrossRefGoogle ScholarPubMed
Bernier, J., Domenge, C., Ozsahin, M.et al. (2004). Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. (European Organisation for Research and Treatment of Cancer Trial 22931). N. Engl. J. Med., 350, 1945–52.CrossRefGoogle Scholar
Bonner, J. A., Giralt, J., Harari, P. M.et al. (2004). Cetuximab prolongs survival in patients with locoregionally advanced squamous cell carcinoma of head and neck: a phase III study of high dose radiation therapy with or without cetuximab. J. Clin. Oncol., American Society of Clinical Oncology Annual Meeting Proceedings (Post-Meeting Edition). Vol. 22 (14 Suppl.), 5507.CrossRefGoogle Scholar
Bourhis, J., Syz, N., Overgaard, J.et al. (2002). Conventional vs modified fractionated radiotherapy. Meta-analysis of radiotherapy in head and neck sqamous carcinoma: a meta-analysis based on individual patient data. Int. J. Radiat. Oncol. Biol. Phys., 54 (Suppl.), 71–2.CrossRefGoogle Scholar
British Association of Otorhinolaryngologists – Head and Neck Surgeons. (2002). Effective Head and Neck Cancer Management: Third Consensus Document. London: Royal College of Surgeons.
Cooper, J., Pajak, T., Forastiere, A.et al. (2004). Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. N. Engl. J. Med., 350, 1937–44.CrossRefGoogle ScholarPubMed
Cancer Research United Kingdom. (2004) CancerStats Monograph 2004: Cancer Incidence, Survival and Mortality in the United Kingdom and European Union, ed. Toms, J. R.. London: Cancer Research United Kingdom.Google Scholar
Dische, S., Saunders, M., Barrett, A.et al. (1997). A randomised multicentre trial of continuous hyperfractionated accelerated radiotherapy versus conventional radiotherapy in head and neck cancer. Radiother. Oncol., 44, 123–36.CrossRefGoogle ScholarPubMed
Horiot, J. C., Le, Fur R., N'Guyen, T.et al. (1992). Hyperfractionation versus conventional fractionation in oropharyngeal carcinoma: final analysis of a randomized trial of the European Organisation for Research and Treatment of Cancer cooperative group of radiotherapy. Radiother. Oncol., 25, 231–41.CrossRefGoogle Scholar
Intercollegiate Standing Committee on Nuclear Medicine. (2003). Positron Emission Tomography: A Strategy for Provision in the United Kingdom. London: Royal College of Physicians.
Monnerat, C., Faivre, S., Temam, S.et al. (2002). End points for new agents in induction chemotherapy for locally advanced head and neck cancers. Ann. Oncol., 13, 995–1006.CrossRefGoogle ScholarPubMed
National Institute for Health and Clinical Excellence. (2004). Improving Outcomes in Head and Neck Cancers. London: National Institute for Health and Clinical Excellence.
Overgaard, J., Hansen, H., Specht, L.et al. (2003). Five compared with six fractions per week of conventional radiotherapy of squamous-cell carcinoma of head and neck: Danish Head and Neck Cancer 6 and 7 randomised controlled trial. Lancet, 362, 933–40.CrossRefGoogle Scholar
Pignon, J., Bourhis, J., Domenge, C.et al. (2000). Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data. MACH-NC Collaborative Group MetaAnalysis of chemotherapy on head and neck cancer. Lancet, 355, 949–55.CrossRefGoogle Scholar
Royal College of Radiologists. (2001). The Role and Development of Brachytherapy Services in the United Kingdom. London: Royal College Radiologists.
Shanmugaratnam, K. and Sobin, L. H. (1978). International Histological Classification of Tumours, No 19: Histological Typing of Upper Respiratory Tract Tumors. Geneva: World Health Organization, p. 32.Google Scholar
International Union Against Cancer. (2002). tumour nodes metastases Classification of Malignant Tumours, ed. Sobin, L. H. and Ch., Wittekind, 6th edn. New York: Wiley-Liss.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

  • Head and neck
    • By Laura Moss, Consultant, Clinical Oncologist, Velindre Cancer Centre, Velindre Hospital, Whitchurch, Cardiff, UK, Chris Gaffney, Consultant, Clinical Oncologist, Velindre Cancer Centre, Velindre Hospital, Whitchurch, Cardiff, UK
  • Edited by Louise Hanna, Tom Crosby, Fergus Macbeth
  • Book: Practical Clinical Oncology
  • Online publication: 23 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545375.009
Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

  • Head and neck
    • By Laura Moss, Consultant, Clinical Oncologist, Velindre Cancer Centre, Velindre Hospital, Whitchurch, Cardiff, UK, Chris Gaffney, Consultant, Clinical Oncologist, Velindre Cancer Centre, Velindre Hospital, Whitchurch, Cardiff, UK
  • Edited by Louise Hanna, Tom Crosby, Fergus Macbeth
  • Book: Practical Clinical Oncology
  • Online publication: 23 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545375.009
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Head and neck
    • By Laura Moss, Consultant, Clinical Oncologist, Velindre Cancer Centre, Velindre Hospital, Whitchurch, Cardiff, UK, Chris Gaffney, Consultant, Clinical Oncologist, Velindre Cancer Centre, Velindre Hospital, Whitchurch, Cardiff, UK
  • Edited by Louise Hanna, Tom Crosby, Fergus Macbeth
  • Book: Practical Clinical Oncology
  • Online publication: 23 December 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511545375.009
Available formats
×