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Head and neck sarcomas in adulthood: current trends and evolving management concepts
1University College Hospital London, 250 Euston Road, London NW1 2PG, United Kingdom.
The British Journal of Oral & Maxillofacial Surgery
|July 9, 2020
Summary
Head and neck sarcomas require multimodal treatment for improved survival. Management strategies evolve, integrating advanced imaging, chemotherapy, surgery, and radiotherapy, with proton beam therapy showing promise.
Area of Science:
- Oncology
- Surgical Oncology
- Radiotherapy
Background:
- Sarcomas are rare mesenchymal malignancies affecting bone and soft tissues.
- Head and neck sarcomas present diagnostic challenges due to non-specific symptoms.
Purpose of the Study:
- To review evolving management concepts and treatment trends for adult head and neck sarcomas.
- To emphasize the importance of specialized sarcoma centers for multimodal treatment.
Main Methods:
- Diagnosis and staging utilize imaging (US, MRI, CT, PET-CT) and biopsy.
- Treatment strategies involve neoadjuvant chemotherapy, surgery, and radiotherapy.
- Response to neoadjuvant chemotherapy is assessed by PET-CT and MRI.
Main Results:
- Multimodal treatment at a reference center is crucial for disease clearance and preventing metastasis.
- Bone sarcomas often treated with neoadjuvant chemotherapy followed by resection.
- Soft tissue sarcoma treatment varies by grade, with surgery for low-grade and neoadjuvant chemotherapy/surgery/radiotherapy for high-grade.
Conclusions:
- Multimodal therapy is imperative for head and neck sarcomas.
- Proton beam therapy is emerging for unresectable cases, especially in children.
- Radiotherapy is generally reserved for high-grade, advanced soft tissue sarcomas and palliative care for bone sarcomas.
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