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WHAT IS NEW IN HEAD AND NECK CANCERS PowerPoint Presentation

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Description : Check out this medical presentation on Pathology, which is titled "WHAT IS NEW IN HEAD AND NECK CANCERS?", to know about the new developments in head and neck cancers.

Tags : Pathology, developments, head, neck cancers

Published on : Aug 06, 2021 | Views : 2897 | Downloads : 1

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Slide 1-

Oral Cancer Professor Ravi Kant MS, DNB, FRCS (Edin.) ,FRCS( Glasg.), FACS , FICS, MNAMS,
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WHAT IS NEW IN HEAD AND NECK CANCERS? Dr. K.A.Pathak, MS, Dip NB, FRCS, FRCSEd. Associate Professor in Head & Neck Oncology Tata Memorial Hospital, Mumbai
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New Molecular Model Califano et al , Cancer Research 1996
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What is New in Imaging? Ultrasonography and Guided FNAC Real time Inexpensive Quicker but operator dependent Doppler can show flow characteristics CT Scan with 3 D views Virtual Laryngoscopy
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CT Scan with 3 D views
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Virtual Laryngoscopy
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MRI and MR Angiography
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Residual / recurrent locoregional disease Detection of occult primaries in MUO Occult metastatic disease in the neck Synchronous primaries or metastasis 18FDG-PET
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What is New in Staging ? T4 lesions have been divided into T4a (resectable) and T4b (unresectable) Stage IVA T4a N0 M0 T4a N1 M0 T1-4a N2 M0 Stage IVB T4b Any N M0 Any T N3 M0 Stage IVC Any T Any N M1 (AJCC 6th Ed, 2000)
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What is New in Surgery? Oral cavity: Pattern of Mandibular invasion Mandible Preservation Larynx: Endoscopic Laser Excision Conservative laryngectomy Primary voice rehabilitation PNS Tumors: Endoscopic Sinus Surgery Cranio-facial Excision
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What is New in Chemotherapy ? Category Hazard ratio CT effect Abs. benefit (p) 2yrs 5yrs Adjuvant 0.98 0.74 1% 1% Neo-adjuvant 0.95 0.10 2% 2% Concomitant 0.81 <0.0001 7% 8% Total 0.90 <0.0001 4% 4% MACH-NC, LANCET 2000
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Laryngeal Preservation VALCSG 1991 Larynx preserved in 64% patients No change in overall survival EORTC 1996 42% functioning larynx-3 yrs, 35% -5 yrs RTOG 2003 88% functioning larynx at 2 years 22% loco- regional failures
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What is New in Radiotherapy ? Techniques Alt. Fractionation- Accelerated & Hyperfr. 3D Conformal Radiotherapy & IMRT Stereotactic/ Fr. Stereotactic Radiothearpy Neutron Beam/Charged Particle RT Intraoperative Radiotherapy Radiation Induced Xerostomia Pharmacological Agents- Amifostin, GMCSF Submandibular Gland Transfer (Seikaly et al)
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Newer Targets of Therapy Photodynamic Therapy: Palliation Curative intent- Small primary tumor Second primary/ Recurrent tumor Premalignant lesions Antibody based Therapy Monoclonal Ab against EGFr-C225 Inhibitors of EGFr-ZD1839, Erlotinib HCl Gene Therapy
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Gene Therapy- Approaches Augmentation therapy Immunotherapy: Cytokine gene transfer- IL-2,IL-12, IFN- g Vaccination Tumor specific antigen Co-stimulator molecule Foreign antigen Chemotherapy: HSV TK Drug sensitization / Drug resistance Gene replacement Replace tumor suppressor gene- p53 Inhibit an oncogene- Antisense c DNA Adjuvant Therapy- Post CT / RT/ Surgery
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Chemoprevention Possible Roles Reversal of oral pre-cancerous lesions Chemoprevention of SPT Primary chemoprevention in high-risk Phamacological Agents Beta Carotene Retinoids- 13cRA,Vitamin A Retinamides a-tocopherol
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Thank You!
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Overview Molecular Basis of Carcinogenesis Imaging- 3-D CT , MR Angio, FDG-PET Staging- Changes in TNM (6th Ed. AJCC) Concurrent Chemo- RT- MACH- NC, RTOG Advances in Radiotherapy Techniques Improved Quality of Life- Post Surgery/RT Newer Targets for therapy Advances in Chemoprevention