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80th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

20.05. - 24.05.2009, Rostock

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Therapy-strategies for patients with recurrent squamous cell carcinoma of the head and neck (SCCHN)

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  • corresponding author Eva-Tessina Becker - ENT-Department, Greifswald, Germany
  • Werner Hosemann - ENT-Department, Greifswald, Germany
  • Georg Wallner - ENT-Department, Greifswald, Germany
  • Michael Herzog - ENT-Department, Greifswald, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 80th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Rostock, 20.-24.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. Doc09hno055

doi: 10.3205/09hno055, urn:nbn:de:0183-09hno0552

Published: July 22, 2009

© 2009 Becker et al.
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Outline

Text

Therapeutic strategies for patients with recurrent squamous cell carcinoma of the head and neck, including salvage surgery, reirradiation, chemotherapy, immunotherapy or combinations are of insecure value at high personal costs to the patient. Decisions regarding the therapeutic management are made very individually mainly on clinical grounds.

The aim of this study was to assess the value of therapeutic procedures in the treatment of local and regional recurrence and to find a concept, which standardises the therapeutic management as far as possible.

We analysed retrospectively clinical records of 596 patients with SCCHN treated between 1997 and 2007 in our clinic. Documented were age and sex of the patients, localisation, stage and therapy of their primary tumours as well as time of diagnosis, localisation and therapy of the recurrence and overall survival.

21% of the patients developed recurrence. 80% were local relapses, 20% occurred locoregionally. Local recurrence emerged at an average of 16 months, locoregional recurrence at an average of 10 months after primary therapy. The overall median survival after diagnosis of recurrence was 35 months with local recurrence and 40 months with locoregional recurrence.

Recurrence should be resected as long as possible, even manifold. With inoperable tumours refractory to radiation and platinum based chemotherapy, reirradiation with 40 Gy and Cetuximab are a reasonable alternative. Distant metastases can be treated with chemotherapy (Taxanes) or LITT.

Outline

References

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León X, Hitt R, Constenla M, Rocca A, Stupp R, Kovács AF, Amellal N, Bessa EH, Bourhis J. A retrospective analysis of the outcome of patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck refractory to a platinum-based chemotherapy. Clin Oncol (R Coll Radiol). 2005.
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Harrison LB, Sessions RB, Ki Hong W. Head and neck cancer: a multidisciplinary approach. 3rd ed. Lippincott Williams & Wilkins; 2009.