Improving The Therapeutic Ratio In Head And Neck Cancer

Improving the Therapeutic Ratio in Head and Neck Cancer provides a complete review of current approaches to modulating therapeutic sensitivity in head and neck cancer. It presents a broad background of current approaches and by highlighting the potential for clinical translational, introduces a roadmap for how to move promising preclinical findings into the clinic. The book discusses topics such as immunotherapy and molecularly targeted therapies in head and neck cancer, PI3k/mTOR pathway, autophagy inhibition to sensitize HNC to radiation and chemotherapy, TAM and Eph/Ephrin family proteins and metabolic reprogramming to modulate therapeutic sensitivity. Additionally, it details approaches to improve the response to immunotherapy, and Chk1/2 inhibition in radiation and cetuximab resistance. This book is a valuable source to head and neck cancer researchers and advanced students, and to those studying specific approaches in other model systems and disease sites. Provides key scientific background for clinicians when developing novel clinical trials and important examples for basic scientists of the types of work required to move a concept from the lab to the clinic Presents consistent pathway diagrams in each chapter, thus making it easier to understand complicated pathways Includes chapter summaries of the critical next steps needed to move studies from their current state into practice changing clinical data

Current cancer therapies are focused on three general strategies: modifying intrinsic radiosensitivity via molecular targeting, manipulating microenvironmental factors to enhance tumor susceptibility to radiation, and improving delivery of radiation to critical tumor locations while sparing normal tissues. The goal of this volume is to describe a number of promising approaches corresponding to each strategy. In general, research in radiation oncology tends to be siloed into fundamental biology, physics or treatment delivery. The strategies for improving therapeutic ratio encompassed in this book will involve each of these components of radiation oncology. Thus, they will illustrate the variety of disparate approaches available for potentially improving the efficacy of radiotherapy, which may then stimulate discussion across disciplines and foster further translational investigations. Although a goal of each chapter will be to highlight advances within an approach, of equal importance will be the delineation of barriers to successful clinical application and how to overcome or minimize such impediments. Along these lines, because therapeutic ratio incorporates both tumor and normal tissue radio response, a point of emphasis will be the mechanistic rationale for selectively modifying tumor (sensitization) or normal cells (protection). Finally, whereas the literature is replete with studies describing potential targets/strategies for increasing the therapeutic ratio for radiotherapy, this book will focus on those supported by in vivo data consistent with impending translational application along with those that are already being evaluated in the clinic.

This issue of Radiation Medicine Rounds examines the latest advances in the use of radiation medicine in treatment of head and neck cancer. Head and neck cancer treatment has undergone major change over the course of the past few years and Head and Neck Cancer addresses current best practices in the light of the most recent evidence. Head and Neck Cancer addresses a wide range of topics under the broad heading of head and neck oncology. In the initial section, the authors address therapeutic approaches with chapters on current and future treatments. Coverage is extensive and includes articles on IMRT, combined modality treatments, the use of targeted agents in conjunction with chemotherapy, the use of transoral robotic surgery followed by postoperative radiation therapy, and the use of particle therapy. The second section addresses issues of health services and covers palliative care, how to assess toxicity in patients, and issues of interpreting and integrating classic study data into treatment decisions. The third section examines the factors influencing clinical decisions ranging including biomarkers and image guidance. . Radiation Medicine Rounds features : In-depth, up-to-date expert reviews and analysis of major new developments in all areas of Radiation Medicine Each issue edited by an authority in that subject area Each issue focused on a single major topic in Radiation Medicine, providing coverage of advances in radiation science, radiation medicine technology, radiation medicine practice, and assessment of recent quality and outcome studies Series Description: Radiation Medicine Rounds is a review series providing a thorough analysis of new scientific, technologic, and clinical advances in all areas of radiation medicine. There will be an emphasis throughout on multidisciplinary approaches to the specialty, as well as an emphasis on quality and outcomes analysis. The goal is to provide authoritative, thorough assessment of a wide range of "hot topics" and emerging new data for the entire specialty of radiation medicine.

Cancers of the head and neck are among the most morbid of cancers. Convention al surgery and/or radiation therapy have a high cure rate for patients with early stage disease. However, despite optimal treatment with surgery and radiotherapy, patients with nodal spread or extensive local disease have a low cure rate. Even if a cancer is cured, a patient is often left with long-term debilities from the treatment and/or cancer. The major causes for decreased survival in patients with advanced head and neck cancer include local recurrence, distant metastases, and second primaries. All of these need to be addressed if one is to improve upon the curability of advanced disease. There are several new techniques, surgical and radiotherapeutic, designed to improve local control. Brachytherapy, or interstitial implantation, delivers a high dose of localized radiation with minimal normal tissue injury. This technique as discussed by Goffinet, may be even more efficacious when combined with hyperthermia. New, creative methods of radiation therapy delivery, such as the use of multiple fractions per day, as discussed by Parsons and Million, are also contributing to long-term local control. Laser therapy, discussed by Ossoff and Nemeroff, provides another tool for treatment of local disease.

This volume will describe recent progress and future directions in radiation oncology and biology research, focusing on strategies designed to improve disease control and reduce the risk of long-term adverse effects on patients. As more and more patients are becoming long-term survivors, this strategy will become increasingly important--in radiation oncology and throughout the field of oncology.

The emphasis on cancer management in the past was based primarily on control rates from multidisciplinary input in management. There has always been a recognition that one would like to achieve the best result with the least complication, but never has there been any major emphasis on evidence-based outcome studies, nor on functional preservation and quality of life. The authors of this book have dealt very effectively with the various tumor types in head and neck cancer with the experts in the ? eld of management. The contents range from epidemiology and treatment outcome, treatment techniques with the potential impact on the quality of life such as dysphagia, to the various options relative to high technology radiation therapy programs for mana- ment. The potential for improving form and function through surgical care as an integrated part of the program is dealt with very effectively as well as the potentials for chemotherapy and the use of targeted agents have on quality of life issues. The volume also addresses toxicity, quality of life, and techniques for prevention of adverse effects, as well as the potentials for rehabilitation and supportive care. The authors have clearly done an extraordinarily good job in addressing the mul- plicity of problems that impact upon the functional preservation and quality of life in head and neck radiation therapy. Philadelphia Luther W.