RESUMO
PURPOSE OF REVIEW: This is a review about recent clinical developments in rare cancers of the head and neck. RECENT FINDINGS: Progress in molecular biology techniques has allowed the identification of new prognostic factors, and potential molecular-targeted therapies. This is of importance since chemotherapy continues to play a role but is still limited in this group of malignancies. New techniques of irradiation such as intensity-modulated radiotherapy and three-dimensional conformal radiotherapy appear to improve the locoregional control of these tumors. Surgery continues to be the cornerstone of treatment, with a growing interest in the technique of sentinel lymph node biopsy. SUMMARY: As salivary gland carcinomas, paranasal sinus cancers and melanoma of the head and neck are rare malignancies, these tumors must be treated in specialized anticancer centers with access to the latest surgical and irradiation techniques. Moreover, clinical studies with translational research are needed to identify strong prognostic and predictive factors, and effective molecular-targeted therapies.
Assuntos
Carcinoma/terapia , Neoplasias de Cabeça e Pescoço/terapia , Melanoma/terapia , Neoplasias dos Seios Paranasais/terapia , Neoplasias das Glândulas Salivares/terapia , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Cegueira/etiologia , Carcinoma/genética , Ensaios Clínicos como Assunto , Terapia Combinada , Sistemas de Liberação de Medicamentos , Drogas em Investigação/uso terapêutico , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Metástase Linfática , Melanoma/diagnóstico , Melanoma/patologia , Melanoma/secundário , Estudos Multicêntricos como Assunto , Terapia Neoadjuvante , Cuidados Paliativos , Neoplasias dos Seios Paranasais/genética , Lesões por Radiação/etiologia , Radioterapia/efeitos adversos , Radioterapia/métodos , Radioterapia Adjuvante , Neoplasias das Glândulas Salivares/genética , Biópsia de Linfonodo SentinelaRESUMO
BACKGROUND: The aim of this article is to review recent developments in the biological understanding of head and neck squamous cell carcinomas. METHODS AND RESULTS: We describe the markers according to their function and their prognostic or predictive roles. Some associations can be found between molecular markers and invasiveness, aggressiveness, degree of differentiation, and tumor stage, but only a few clinical studies have shown an impact on prognosis. In addition, despite an increasing number of articles relating to this topic, the small number of patients included in the studies reported reduces the clinical implications of these results. Few studies applied a more comprehensive molecular analysis approach, such as DNA microarrays or differential expression profiling by polymerase chain reaction, to identify a combination of markers that could be more informative than a single molecular marker. CONCLUSION: Some progress has been made with respect to molecular markers and head and neck cancers. Translational and prospective, hypothesis-driven research must proceed with sufficient rigor to facilitate the clinical applicability of such results.
