V posledních 10 letech se objevila možnost využít k odstranění vhodně lokalizovaných T1 a T2 spinocelulárních karcinomů orofaryngu, zejména kořene jazyka, tonzily a supraglotis, miniinvazivní robotický přístup skrze ústní dutinu - TORS (TransOralRoboticSurgery). Lokalizací a tvarem jsou pro TORS nejlépe vhodné povrchově uložené a ohraničené spinocelulární karcinomy, dostupné pro robotické nástroje. Rozhodující úlohu při indikaci k TORS hraje zobrazení karcinomů hlavy a krku pomocí magnetické rezonance.
In the last 10 years, it became possible to be used by appropriately localized T1 and T2 squamous cell carcinomas of oropharynx and supraglottis robotic minimally invasive approach trough oral cavity – TORS (TransOralRoboticSurgery). Localization and shape best suited tumors for TORS are surface stored and bounded squamous cell carcinomas available for robotic tools. Decisive role in indication for removal of cancers by the TORS plays magnetic resonance imaging and computer tomography of the head and neck.
- MeSH
- Humans MeSH
- Magnetic Resonance Imaging utilization MeSH
- Minimally Invasive Surgical Procedures MeSH
- Laryngeal Neoplasms * diagnostic imaging surgery MeSH
- Oropharyngeal Neoplasms * diagnostic imaging surgery MeSH
- Tomography, X-Ray Computed utilization MeSH
- Robotic Surgical Procedures methods MeSH
- Tonsillar Neoplasms diagnostic imaging surgery MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
BACKGROUND: In recurrent head and neck squamous cell carcinoma ineligible for resection or irradiation, treatment aims primarily at symptom control and quality of life enhancement with an expected outcome of 6-12 months. METHODS: In 2005, a male patient, born in 1944, with a second local recurrence of human papillomavirus negative tonsil cancer was enrolled in the EXTREME trial, and randomized to platinum/5-fluorouracil/cetuximab arm resulting in partial remission with progression-free survival of 12 months. The second-line systemic therapy comprised 5 cycles of 3-weekly docetaxel/cisplatin/5-fluorouracil regimen plus weekly cetuximab. RESULTS: As confirmed on imaging and repeated biopsies, complete response was achieved with disease-free survival of 8 years and follow-up period of 12 years. Severe acute toxicities during the taxane-based chemotherapy plus cetuximab included grade 4 anorexia and grade 3 febrile neutropenia. CONCLUSIONS: Poor tumor differentiation, no weight loss, oropharyngeal location, white race, and particularly the induced complete response were most likely the key favorable prognostic factors in the reported patient. The possibility of a synergistic interaction between taxanes and cetuximab should be further explored.
- MeSH
- Time Factors MeSH
- Cetuximab administration & dosage MeSH
- Cisplatin administration & dosage MeSH
- Fluorouracil administration & dosage MeSH
- Remission Induction MeSH
- Quality of Life MeSH
- Middle Aged MeSH
- Humans MeSH
- Neoplasm Recurrence, Local diagnostic imaging drug therapy MeSH
- Head and Neck Neoplasms diagnostic imaging drug therapy MeSH
- Positron Emission Tomography Computed Tomography MeSH
- Disease-Free Survival MeSH
- Antineoplastic Combined Chemotherapy Protocols adverse effects therapeutic use MeSH
- Carcinoma, Squamous Cell diagnostic imaging drug therapy MeSH
- Taxoids administration & dosage MeSH
- Tonsillar Neoplasms diagnostic imaging drug therapy MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Publication type
- Journal Article MeSH
- Case Reports MeSH
