RESUMEN
Currently curative treatment for esophageal squamous cell cancer (ESCC) is possible only in patients with early-stage, usually asymptomatic disease. In Western countries, where the incidence of ESCC is relatively low, a screening of asymptomatic, average-risk population is untenable. In order to detect early-stage ESCC or its precursor lesions it is important to identify high-risk patients and consider endoscopic surveillance in these groups. These high-risk groups include patients after curative treatment for head and neck cancer, previous endoscopic resection of ESCC, caustic injury, and patients with tylosis or achalasia. This paper discuss the evidence and proposed method of endoscopy surveillance of these high-risk patients.
Asunto(s)
Carcinoma de Células Escamosas/diagnóstico , Neoplasias Esofágicas/diagnóstico , Esofagoscopía , Carcinoma de Células Escamosas/epidemiología , Neoplasias Esofágicas/epidemiología , Carcinoma de Células Escamosas de Esófago , Humanos , Vigilancia de la Población , Factores de RiesgoRESUMEN
In the Head and Neck Cancer Department of Cancer in Warsaw between August 1997 and September 1998 twenty patients with primary unresectable oral cavity cancer were referred for combined modality treatment with cisplatin based chemotherapy followed by wide resection (in the case of tumor regression) with immediate reconstruction and adjuvant radiotherapy. Tumor regression after chemotherapy was obtained in 15 patients and all of them were referred to surgery; wide resection and reconstruction using pectoralis major (PM) flap. 14 patients completed all treatment protocol, also with adjuvant radiotherapy. Tolerance of treatment was excellent and there was no influence of chemo- and radiotherapy for adaptation of PM flaps. During observation local recurrence was observed in two cases. Twelve patients are alive without evidence of disease. Study is continued.
Asunto(s)
Neoplasias de la Boca , Adulto , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Terapia Combinada , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias de la Boca/tratamiento farmacológico , Neoplasias de la Boca/radioterapia , Neoplasias de la Boca/cirugía , Estadificación de Neoplasias , Músculos Pectorales/trasplante , Colgajos QuirúrgicosRESUMEN
Combination of radio- and chemotherapy is one of the methods which may improve results of treatment in patients with locally advanced head and neck cancer. Currently, the most promising sequence of radio- and chemotherapy is concomitant. In Head and Neck Cancer Department of Cancer Center in Warsaw since 1995 is continued study estimated tolerance and effectiveness of the concomitant radiochemotherapy for patients with locally advanced oro- and hypopharyngeal cancer. Chemotherapy consist of cisplatinum and 5-fluorouracil in continuous infusion during first week of irradiation followed by 24-hours infusion of 5-fluorouracil one weekly until radiotherapy is finished. Radiotherapy is used with conventional fractionation 2 Gy per fraction, 5 fractions weekly to total dose 66 Gy. Between October 1995 and September 1998 fifty seven patients with oropharyngeal cancer were entered to study. Tolerance of treatment was acceptable. Complete regression of the tumor was obtained in 41/57 patients (72%). Five other patients after radiotherapy were referred for successful radical neck dissection. Including this group, local control was obtained in 81%. At this moment, 60% of patients are alive without evidence of disease. In 12 patients with hypopharyngeal cancer tolerance of treatment and early results were poor, so the study was stopped in this group.