Respiratory oncology

respiratory oncology

Tumors of the upper respiratory tract are called ENT cancer (cancer in the head and neck). 

Cancer of the otolaryngal ENT region and neck develops in the upper digestive tract. It includes a number of tumors that are located either in the nasopharynx or in the oropharynx (behind the oral cavity, at the base of the tongue and tonsils), or in the larynx. It is most often squamous cell carcinoma. Patients older than 50 years are most exposed to these types of cancers. Risk factors are smoking, excessive alcohol drinking or their combined use (synergistic effect).

 

For oropharynx cancer for younger patients, around 40 years old, one of the risk factors is human papillomavirus (HPV type 16 and 18), you can get infected during coitus. These tumors have lymphatic drainage in the neck, cervical region and can cause swollen lymph nodes. Some tumors are diagnosed by palpating the mass (of the lymph node) on the neck.

 

A full diagnostic assessment is performed to eliminate synchronous ENT, esophagus or lung cancer, where the cervicothoracic scanner allows you to visualize the tumor, its local, local-regional (lymph nodes) or metastatic (at the pulmonary level) expansion. 

A dental examination is also performed before starting the treatment. Two treatments are discussed at a multidisciplinary consultation meeting, as well as surgery need to remove the tumor with dissection of the lymph node if the tumor is operable.

This surgery may be accompanied by a postsurgery radiotherapy, sometimes in-hand with chemotherapy in accordance with the pathological criteria of the tumor and lymph nodes. After resection, the general area is irradiated to prevent relapse. An oncologist examines whether the lymph nodes are with capsular disorders, is there an invasion of the vessels or nerves (perinervic membrane)? If the surgery is not recommended, a tumor and node radiotherapy is performed, together with chemotherapy of Cisplatin type 100 mg / m2 (in the absence of contraindications, renal failure or hearing impairment). Radiation therapy is usually carried out from 33 to 35 sessions, and a total dose of 70 Gy is delivered to the tumor and nodes that are clearly visible on the scanner. This combination of radiochemotherapeutic treatment is often performed for oropharyngeal cancer (cancer of the base of the tongue or tonsil) or cancer of the laryngopharynx or cancer of the nasopharynx. Some patients may also be offered radiotherapy for cancer of the vocal cords in order to preserve them and, thus, preserve the voice system. In the case of metastatic cancer of the ENT organs, chemotherapy, targeted therapy (an EGF R inhibitor) and immune therapy (PD 1 inhibitors: a monoclonal antibody that binds and blocks the programmed cell death receptor 1 (PD1) are discussed at the consultation), interdisciplinary consultation which are offered to the patients of our center.

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