Recurrent/Metastatic Squamous Cell Carcinoma of the Head and Neck: A Big and Intriguing Challenge Which May Be Resolved by Integrated Treatments Combining Locoregional and Systemic Therapies

doi:10.3390/cancers13102371

Review

. 2021 May 14;13(10):2371.

doi: 10.3390/cancers13102371.

Recurrent/Metastatic Squamous Cell Carcinoma of the Head and Neck: A Big and Intriguing Challenge Which May Be Resolved by Integrated Treatments Combining Locoregional and Systemic Therapies

Affiliations

¹ Otolaryngology Unit, INT IRCCS Foundation G. Pascale, Naples. Via M. Semmola, 80131 Naples, Italy.
² Medical Oncology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia, ASST-Spedali Civili, 25123 Brescia, Italy.
³ U.O.C. Odontostomatologia, A.O.R.N. Cardarelli, 80131 Naples, Italy.
⁴ Radiation Therapy Unit, INT IRCCS Foundation G Pascale, Via M. Semmola, 80131 Naples, Italy.
⁵ Department of Abdominal Oncology, SSD-Innovative Therapies for Abdominal Cancers, Istituto Nazionale Tumori di Napoli, IRCCS "G. Pascale" Via M. Semmola, 80131 Naples, Italy.
⁶ Medical Oncology Unit, Azienda Ospedaliera S. Anna e S. Sebastiano, 81100 Caserta, Italy.
⁷ Otolaryngology and Maxillo-Facial Surgery Unit, Ospedale Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy.
⁸ Sarcoma and Rare Tumors Medical Oncology Unit, Istituto Nazionale Tumori di Napoli, IRCCS "G. Pascale" Via M. Semmola, 80131 Naples, Italy.
⁹ Medical Oncology Unit Sir Apicella Hospital, ASL Na3 Sud, Pollena Trocchia, 80040 Naples, Italy.
¹⁰ Medical and Experimental Head and Neck Oncology Unit, INT IRCCS Foundation G Pascale, Via M. Semmola, 80131 Naples, Italy.

PMID: 34069092
PMCID: PMC8155962
DOI: 10.3390/cancers13102371

Review

Recurrent/Metastatic Squamous Cell Carcinoma of the Head and Neck: A Big and Intriguing Challenge Which May Be Resolved by Integrated Treatments Combining Locoregional and Systemic Therapies

Franco Ionna et al. Cancers (Basel). 2021.

. 2021 May 14;13(10):2371.

doi: 10.3390/cancers13102371.

Affiliations

¹ Otolaryngology Unit, INT IRCCS Foundation G. Pascale, Naples. Via M. Semmola, 80131 Naples, Italy.
² Medical Oncology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia, ASST-Spedali Civili, 25123 Brescia, Italy.
³ U.O.C. Odontostomatologia, A.O.R.N. Cardarelli, 80131 Naples, Italy.
⁴ Radiation Therapy Unit, INT IRCCS Foundation G Pascale, Via M. Semmola, 80131 Naples, Italy.
⁵ Department of Abdominal Oncology, SSD-Innovative Therapies for Abdominal Cancers, Istituto Nazionale Tumori di Napoli, IRCCS "G. Pascale" Via M. Semmola, 80131 Naples, Italy.
⁶ Medical Oncology Unit, Azienda Ospedaliera S. Anna e S. Sebastiano, 81100 Caserta, Italy.
⁷ Otolaryngology and Maxillo-Facial Surgery Unit, Ospedale Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy.
⁸ Sarcoma and Rare Tumors Medical Oncology Unit, Istituto Nazionale Tumori di Napoli, IRCCS "G. Pascale" Via M. Semmola, 80131 Naples, Italy.
⁹ Medical Oncology Unit Sir Apicella Hospital, ASL Na3 Sud, Pollena Trocchia, 80040 Naples, Italy.
¹⁰ Medical and Experimental Head and Neck Oncology Unit, INT IRCCS Foundation G Pascale, Via M. Semmola, 80131 Naples, Italy.

PMID: 34069092
PMCID: PMC8155962
DOI: 10.3390/cancers13102371

Abstract

Squamous cell carcinoma of the head and neck (SCCHN) is a complex group of malignancies, posing several challenges to treating physicians. Most patients are diagnosed with a locally advanced disease and treated with strategies integrating surgery, chemotherapy, and radiotherapy. About 50% of these patients will experience a recurrence of disease. Recurrent/metastatic SCCHN have poor prognosis with a median survival of about 12 months despite treatments. In the last years, the strategy to manage recurrent/metastatic SCCHN has profoundly evolved. Salvage treatments (surgery or re-irradiation) are commonly employed in patients suffering from locoregional recurrences and their role has gained more and more importance in the last years. Re-irradiation, using some particularly fractionating schedules, has the dual task of reducing the tumor mass and eliciting an immune response against cancer (abscopal effect). In this review, we will analyze the main systemic and/or locoregional strategies aimed at facing the recurrent/metastatic disease, underlining the enormous importance of the multidisciplinary approach in these types of patients.

Keywords: abscopal effect; immunotherapy; multidisciplinary team management; recurrent/metastatic; squamous cell carcinoma of the head and neck.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
A flow-chart illustrating the therapeutic options in recurrent/metastatic SCCHN.

See this image and copyright information in PMC

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References

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[1] Stenson K.M. Epidemiology and Risk Factors for Head and Neck Cancer. [(accessed on 21 March 2021)];2019 Available online: https://www.uptodate.com/contents/epidemiology-andrisk-factors-for-head-....

[2] Stenson K.M. Epidemiology and Risk Factors for Head and Neck Cancer. [(accessed on 21 March 2021)];2019 Available online: https://www.uptodate.com/contents/epidemiology-andrisk-factors-for-head-....

[3] Gillison M.L., Chaturvedi A.K., Anderson W.F., Fakhry C. Epidemiology of Human Papillomavirus–Positive Head and Neck Squamous Cell Carcinoma. J. Clin. Oncol. 2015;33:3235–3242. doi: 10.1200/JCO.2015.61.6995. - DOI - PMC - PubMed

[4] Gillison M.L., Chaturvedi A.K., Anderson W.F., Fakhry C. Epidemiology of Human Papillomavirus–Positive Head and Neck Squamous Cell Carcinoma. J. Clin. Oncol. 2015;33:3235–3242. doi: 10.1200/JCO.2015.61.6995. - DOI - PMC - PubMed

[5] NCCN Guidelines Version 1. Head and Neck Cancer. [(accessed on 21 March 2021)];2021 Available online: https://www.nccn.org/professionals/physician_gls/pdf/head-and-neck.pdf.

[6] NCCN Guidelines Version 1. Head and Neck Cancer. [(accessed on 21 March 2021)];2021 Available online: https://www.nccn.org/professionals/physician_gls/pdf/head-and-neck.pdf.

[7] Pignon J.-P., le Maître A., Maillard E., Bourhis J. Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): An update on 93 randomised trials and 17,346 patients. Radiother. Oncol. 2009;92:4–14. doi: 10.1016/j.radonc.2009.04.014. - DOI - PubMed

[8] Pignon J.-P., le Maître A., Maillard E., Bourhis J. Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): An update on 93 randomised trials and 17,346 patients. Radiother. Oncol. 2009;92:4–14. doi: 10.1016/j.radonc.2009.04.014. - DOI - PubMed

[9] Muzaffar J., Bari S., Kirtane K., Chung C. Recent Advances and Future Directions in Clinical Management of Head and Neck Squamous Cell Carcinoma. Cancers. 2021;13:338. doi: 10.3390/cancers13020338. - DOI - PMC - PubMed

[10] Muzaffar J., Bari S., Kirtane K., Chung C. Recent Advances and Future Directions in Clinical Management of Head and Neck Squamous Cell Carcinoma. Cancers. 2021;13:338. doi: 10.3390/cancers13020338. - DOI - PMC - PubMed

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Recurrent/Metastatic Squamous Cell Carcinoma of the Head and Neck: A Big and Intriguing Challenge Which May Be Resolved by Integrated Treatments Combining Locoregional and Systemic Therapies

Affiliations

Recurrent/Metastatic Squamous Cell Carcinoma of the Head and Neck: A Big and Intriguing Challenge Which May Be Resolved by Integrated Treatments Combining Locoregional and Systemic Therapies

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