presentation onkologi
TRANSCRIPT
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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%;
*N3, 48%; and overall, 73%.
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The 5-year overall survival rates were asfollows:
*N1, 50%;
*N2a, 70%;*N2b, 59%;
*N2c, 45%;
*N3, 34%; and overall, 52%.
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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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