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. 2016 Apr;126(4):870-9.
doi: 10.1002/lary.25726. Epub 2015 Oct 20.

Natural history and management of Fanconi anemia patients with head and neck cancer: A 10-year follow-up

David I Kutler  1 , Krupa R Patel  2 , Arleen D Auerbach  3 , Jennifer Kennedy  4 , Francis P Lach  4 , Erica Sanborn  4 , Marc A Cohen  1 , William I Kuhel  1 , Agata Smogorzewska  4
Affiliations

Natural history and management of Fanconi anemia patients with head and neck cancer: A 10-year follow-up

David I Kutler et al. Laryngoscope. 2016 Apr.

Abstract

Objectives/hypothesis: To describe the management and outcomes of Fanconi anemia (FA) patients with head and neck squamous cell carcinoma.

Study design: Cohort study.

Methods: Demographic information, prognostic factors, therapeutic management, and survival outcomes for FA patients enrolled in the International Fanconi Anemia Registry who developed head and neck squamous cell carcinoma (HNSCC) were analyzed.

Results: Thirty-five FA patients were diagnosed with HNSCC at a mean age of 32 years. The most common site of primary cancer was the oral cavity (26 of 35, 74%). Thirty patients underwent surgical resection of the cancer. Sixteen patients received radiation therapy with an average radiation dose of 5,050 cGy. The most common toxicities were high-grade mucositis (9 of 16, 56%), hematologic abnormalities (8 of 16, 50%), and dysphagia (8 of 16, 50%). Three patients received conventional chemotherapy and had significant complications, whereas three patients who received targeted chemotherapy with cetuximab had fewer toxicities. The 5-year overall survival rate was 39%, with a cause-specific survival rate of 47%.

Conclusions: Fanconi anemia patients have a high risk of developing aggressive HNSCC at an early age. Fanconi anemia patients can tolerate complex ablative and reconstructive surgeries, but careful postoperative care is required to reduce morbidity. The treatment of FA-associated HNSCC is difficult secondary to the poor tolerance of radiation and chemotherapy. However, radiation should be used for high-risk cancers due to the poor survival in these patients.

Level of evidence: 4.

Keywords: Fanconi anemia; head and neck; squamous cell carcinoma.

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Conflict of interest statement

This manuscript is a Triological Society thesis paper.

Conflicts of Interest: None to report.

Figures

Figure 1
Figure 1
Kaplan-Meier survival curves for Disease-Free Survival (A) and Overall Survival (B) for FA patients with HNSCC
Figure 1
Figure 1
Kaplan-Meier survival curves for Disease-Free Survival (A) and Overall Survival (B) for FA patients with HNSCC
See this image and copyright information in PMC

Comment in

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