Competing Morbidities In Advanced Head And Neck Squamous Cell Carcinoma Concurrent Chemoradiotherapy: A Strong Implication Of A Multidisciplinary Team Approach
Grazia Lazzari,1 Maria Assunta De Cillis,2 Giovanni Buccoliero,3 Giovanni Silvano1 1Radiation Oncology Unit, S. Giuseppe Moscati Hospital, Taranto 74100, Italy; 2Otorynolaringoiatry Unit, S. Giuseppe Moscati Hospital, Taranto 74100, Italy; 3Infection Diseases Unit, S. Giuseppe Moscati Hospital, Tara...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2019-11-01
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| Series: | Cancer Management and Research |
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| Online Access: | https://www.dovepress.com/competing-morbidities-in-advanced-head-and-neck-squamous-cell-carcinom-peer-reviewed-article-CMAR |
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| author | Lazzari G De Cillis MA Buccoliero G Silvano G |
| author_facet | Lazzari G De Cillis MA Buccoliero G Silvano G |
| author_sort | Lazzari G |
| collection | DOAJ |
| description | Grazia Lazzari,1 Maria Assunta De Cillis,2 Giovanni Buccoliero,3 Giovanni Silvano1 1Radiation Oncology Unit, S. Giuseppe Moscati Hospital, Taranto 74100, Italy; 2Otorynolaringoiatry Unit, S. Giuseppe Moscati Hospital, Taranto 74100, Italy; 3Infection Diseases Unit, S. Giuseppe Moscati Hospital, Taranto 74100, ItalyCorrespondence: Grazia LazzariRadiation Oncology Unit, S. Giuseppe Moscati Hospital, Str. Per Martina Franca, Taranto 74100, ItalyTel +039-099 4585721Email lazzarigrazia@gmail.comAbstract: Concurrent chemoradiotherapy (CCRT) is the standard approach for the treatment of locally advanced head and neck squamous cell carcinoma. Despite its undisputed advantages, CCRT is associated with acute and late toxicities, leading to unfavorable implications (eg, unplanned interruptions and noncancer-related mortality). The former prolongs the overall treatment time leading to a detrimental effect on tumor control. The latter consists of several noncancer morbidities arising from treatment-related toxicities, identifying a new pathway in cancer fate. This pathway has been termed noncancer mortality or competing mortality and consists of a series of treatment-competing morbidities, which nullify all therapeutic efforts aimed at curing these patients. The management of patients with head and neck squamous cell carcinoma who experience treatment-related toxicities is complex and requires expertise in oncological treatment as well as supportive care. The optimal management of these patients should start with knowledge regarding the most important competing morbidities developing during all phases of the disease (ie, from diagnosis to follow-up) to minimize treatment interruptions, ensure appropriate psychological support, and achieve the best oncological result. The purpose of the present review is to analyze the most important competing morbidities due to patient’s condition at baseline and CCRT, which could result in noncancer mortality. A multidisciplinary team approach is strongly required in the management of this disease.Keywords: competing mortality, head and neck squamous cell carcinoma, concurrent chemoradiotherapy, multidisciplinary team
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| first_indexed | 2024-12-12T10:34:10Z |
| format | Article |
| id | doaj.art-ee0c2ea2a1374d4d9a00f9fa6390e911 |
| institution | Directory Open Access Journal |
| issn | 1179-1322 |
| language | English |
| last_indexed | 2024-12-12T10:34:10Z |
| publishDate | 2019-11-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Cancer Management and Research |
| spelling | doaj.art-ee0c2ea2a1374d4d9a00f9fa6390e9112022-12-22T00:27:17ZengDove Medical PressCancer Management and Research1179-13222019-11-01Volume 119771978249851Competing Morbidities In Advanced Head And Neck Squamous Cell Carcinoma Concurrent Chemoradiotherapy: A Strong Implication Of A Multidisciplinary Team ApproachLazzari GDe Cillis MABuccoliero GSilvano GGrazia Lazzari,1 Maria Assunta De Cillis,2 Giovanni Buccoliero,3 Giovanni Silvano1 1Radiation Oncology Unit, S. Giuseppe Moscati Hospital, Taranto 74100, Italy; 2Otorynolaringoiatry Unit, S. Giuseppe Moscati Hospital, Taranto 74100, Italy; 3Infection Diseases Unit, S. Giuseppe Moscati Hospital, Taranto 74100, ItalyCorrespondence: Grazia LazzariRadiation Oncology Unit, S. Giuseppe Moscati Hospital, Str. Per Martina Franca, Taranto 74100, ItalyTel +039-099 4585721Email lazzarigrazia@gmail.comAbstract: Concurrent chemoradiotherapy (CCRT) is the standard approach for the treatment of locally advanced head and neck squamous cell carcinoma. Despite its undisputed advantages, CCRT is associated with acute and late toxicities, leading to unfavorable implications (eg, unplanned interruptions and noncancer-related mortality). The former prolongs the overall treatment time leading to a detrimental effect on tumor control. The latter consists of several noncancer morbidities arising from treatment-related toxicities, identifying a new pathway in cancer fate. This pathway has been termed noncancer mortality or competing mortality and consists of a series of treatment-competing morbidities, which nullify all therapeutic efforts aimed at curing these patients. The management of patients with head and neck squamous cell carcinoma who experience treatment-related toxicities is complex and requires expertise in oncological treatment as well as supportive care. The optimal management of these patients should start with knowledge regarding the most important competing morbidities developing during all phases of the disease (ie, from diagnosis to follow-up) to minimize treatment interruptions, ensure appropriate psychological support, and achieve the best oncological result. The purpose of the present review is to analyze the most important competing morbidities due to patient’s condition at baseline and CCRT, which could result in noncancer mortality. A multidisciplinary team approach is strongly required in the management of this disease.Keywords: competing mortality, head and neck squamous cell carcinoma, concurrent chemoradiotherapy, multidisciplinary team https://www.dovepress.com/competing-morbidities-in-advanced-head-and-neck-squamous-cell-carcinom-peer-reviewed-article-CMARcompeting mortalityhead and neck squamous cell carcinomaconcurrent chemoradiotherapymultidisciplinary team |
| spellingShingle | Lazzari G De Cillis MA Buccoliero G Silvano G Competing Morbidities In Advanced Head And Neck Squamous Cell Carcinoma Concurrent Chemoradiotherapy: A Strong Implication Of A Multidisciplinary Team Approach Cancer Management and Research competing mortality head and neck squamous cell carcinoma concurrent chemoradiotherapy multidisciplinary team |
| title | Competing Morbidities In Advanced Head And Neck Squamous Cell Carcinoma Concurrent Chemoradiotherapy: A Strong Implication Of A Multidisciplinary Team Approach |
| title_full | Competing Morbidities In Advanced Head And Neck Squamous Cell Carcinoma Concurrent Chemoradiotherapy: A Strong Implication Of A Multidisciplinary Team Approach |
| title_fullStr | Competing Morbidities In Advanced Head And Neck Squamous Cell Carcinoma Concurrent Chemoradiotherapy: A Strong Implication Of A Multidisciplinary Team Approach |
| title_full_unstemmed | Competing Morbidities In Advanced Head And Neck Squamous Cell Carcinoma Concurrent Chemoradiotherapy: A Strong Implication Of A Multidisciplinary Team Approach |
| title_short | Competing Morbidities In Advanced Head And Neck Squamous Cell Carcinoma Concurrent Chemoradiotherapy: A Strong Implication Of A Multidisciplinary Team Approach |
| title_sort | competing morbidities in advanced head and neck squamous cell carcinoma concurrent chemoradiotherapy a strong implication of a multidisciplinary team approach |
| topic | competing mortality head and neck squamous cell carcinoma concurrent chemoradiotherapy multidisciplinary team |
| url | https://www.dovepress.com/competing-morbidities-in-advanced-head-and-neck-squamous-cell-carcinom-peer-reviewed-article-CMAR |
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