Presentation Onkologi

8/10/2019 Presentation Onkologi

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Margarita Mega Pertiwi (UPN)Willy Tenjaya (UKRIDA)


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What is head and neck cancer?

Head and Neck

Cancer is a

group ofcancers that

includes tumors

in several areasabove the

collar bone.


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1.Oral Cancer2.Laryngeal Cancer3.Nasopharyngeal Cancer

Head and Neck Cancer has three

major subdivisions:


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Squamous cell carcinoma of the

head and neck (SCCHN) occurs in50,000 new cases annually in the

US, resulting in over 13,000 deaths

each year

Head and Neck Cancer


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Possible Occupational Risks

for Head and Neck Cancer

*Wood working

*Leather manufacturing*Nickel refining

*Textile industry

*Radium dial painting


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Not all cancers present with

symptoms at early stages!

Serous otitis media

Neck mass

Non-healing ulcer

Dysphagia

Submucosal mass

Hoarseness

Erythroplasia

Referred otalgia

Persistent sore throat

Epistaxis

Nasal obstruction

Warning Signs of Head and Neck

Cancer

Hoarseness

Erythroplasia

Referred otalgia

Persistent sore throat

Epistaxis

Nasal obstruction


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Factors Delaying the Diagnosis of

Head and Neck Cancers

Patient procrastination in seeking

medical attentionPhysician delay in diagnosis

Patient remains asymptomatic for a

prolonged period


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0

10

20

30

40

50

60

70

Localized Regional Distant

Caucasian

African-American

Stage at Diagnosis


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Research in Head and Neck Cancer

Biomarkers at UPCI

Concentrations of 60 cytokines, growth

factors, and tumor antigens were measured

in the sera of 116 SCCHN patients prior totreatment (active disease group), 103

patients who were successfully treated (no

evidence of disease, NED, group), and 117smoker controls without evidence of

cancer.


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*Find it, usually late

-over 80% of tumors are late stage

*Surgery (cut it out)

*Radiation (burn it)

*Chemotherapy (selective poisoning)

*Combine the above


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Stop all smoking (causes more cancer

deaths than any other factor)Ignore cancers due to:

Low level exposures

Multifactorial genetic predispositionStochastic phenomena

The Key to Curing Cancer


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*Preventiondefinition of more subtle genetic and environmental risk

factors

*Targeted Therapy

- Molecular and otherwise

*Screening

Molecular Screening for early disease

Genetic screening for inherited cancersusceptibility

Conventional screening for non-genetic risk factors

oPap smear, colonoscopy, etc


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The purpose of this study is to present the

experience treating patients with squamous cell

carcinoma (SCC) from an unknown head andneck primary site and to determine whether a

policy change eliminating the larynx and

hypopharynx from the radiotherapy (RT) portals

has impacted outcome.


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*Mucosal control at 5 years was 92%. Themucosal control rate in patients with RT

limited to the nasopharynx and oropharynx

was 100%.

*The 5-year neck-control rates were as follows:

*N1,94%;

*N2a, 98%;

*N2b, 86%;

*N2c, 86%;

*N3, 57%; and overall, 81%.


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The 5-year cause-specific survival rates

were as follows:

*N1, 94%;

*N2a, 88%;

*N2b, 82%;

*N2c, 71%;



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The 5-year overall survival rates were asfollows:

*N1, 50%;

*N2a, 70%;*N2b, 59%;

*N2c, 45%;



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Eleven patients (7%) developed

severe complications


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RT alone or combined with neck dissection

results in a high probability of cure with a

low risk of severe complications.

Eliminating the larynx and hypopharynx

from the RT portals did not compromise

outcome and likely reduces treatment

toxicity.


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