Kulak Burun Boğazda Medikal Onkoloji ve Radyoterapi
Özet
Baş boyun kanserlerinde tıbbi onkoloji ve radyoterapi yaklaşımlarını inceleyen bu çalışmada, tedavi edici ve palyatif yöntemlerin önemi, tümör evresi ve yerleşimine göre değişen sağ kalım oranları eşliğinde ele alınmaktadır. İleri evre baş boyun yassı hücreli kanserlerinde, kemoterapinin radyasyon öncesi (indüksiyon) veya eş zamanlı uygulanmasının tümör kitlesini küçültmede, organ korumada ve uzak metastazları önlemede cerrahiye göre kritik avantajlar sağladığı belirtilmektedir. Nazofarinks, larinks ve hipofarinks gibi farklı anatomik bölgelerdeki tümörlerin biyolojik davranışları ve tedavi protokolleri detaylandırılırken, erken evre glottik tümörlerde radyoterapinin cerrahiyle benzer başarı oranlarına sahip olduğu ve ses kalitesini koruduğu vurgulanmaktadır. Cerrahi rezeksiyonun ana tedavi olduğu oral kavite, tükrük bezi ve nazal sinüs tümörlerinde ise pozitif sınır veya lenf nodu tutulumu varlığında adjuvan kemoradyoterapinin lokal kontrolü iyileştirdiği gösterilmektedir. Son olarak, antineoplastik bir ajan olan Mitomisin-C'nin subglottik stenoz ve dakriyositorinostomi ameliyatlarındaki başarıyı artırıcı rolüne değinilmektedir.
This study evaluates medical oncology and radiotherapy approaches in head and neck cancers, emphasizing therapeutic and palliative strategies alongside survival rates that vary based on tumor stage and localization. In locally advanced head and neck squamous cell carcinomas, administering chemotherapy prior to (induction) or concurrently with radiation offers critical advantages over surgery alone by shrinking tumor mass, preserving organs, and preventing distant metastases. While the biological behaviors and treatment protocols for various anatomical sites—such as nasopharyngeal, laryngeal, and hypopharyngeal tumors—are detailed, it is highlighted that radiotherapy achieves similar success rates to surgery in early-stage glottic tumors while preserving voice quality. In oral cavity, salivary gland, and nasal sinus tumors where surgical resection remains the primary modality, adjuvant chemoradiotherapy is shown to improve local control in the presence of positive margins or lymph node involvement. Finally, the role of Mitomycin-C, an antineoplastic agent, in enhancing success rates and minimizing fibrosis in subglottic stenosis and dacryocystorhinostomy surgeries is addressed.
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