The Therapeutic Landscape of Head and Neck Cancer

Dear Colleagues,

Head and neck cancer (HNC) was reported to be the seventh most common cancer worldwide, accounting for approximately 8,900,000 new cases and 450,000 deaths in 2018. However, the incidence of HNC has been slowly declining globally due to the decrease in smokers, while cases of HPV-related oropharyngeal cancer induced by HPV type16 and 18 are increasing.

For the treatment of HNC, we have been utilizing “the triad of cancer treatment” (i.e., surgery, radiotherapy, and chemotherapy), or combinations of this triad. Preoperative evaluation for establishing a treatment strategy is very important in the choice of the piece of the triad for HNC, since treatment differs according to the stage of disease, anatomical site, and surgical accessibility. Both better survival outcome and structural/functional preservation should be carefully considered before treatment in accordance with the patient’s request as influenced by their daily life.

There have been several innovations in each area of the triad of HNC cancer treatments. In the area of surgery, the use of transoral resection robotic surgery (TORS) using the da Vinci surgical robot for the resection of oropharynx tumor is becoming a general procedure worldwide. This minimally invasive procedure is reported to decrease surgical morbidity and reduce the hospitalization period, with an almost identical survival outcome to traditional open surgery. Advances in radiation therapy have also been noted in the area of HNC. The use of intensity-modulated radiation therapy (IMRT) is the major innovation in this area over the last two decades, and it has been becoming a primary therapeutic strategy in treating HNC. Other innovations, such as proton therapy, carbon beam therapy, and boron neutron capture therapy, are also promising, but we are still awaiting the results of long-term morbidity and survival outcome. Finally, the area of medical oncology had a great progress with the emergence of immune-checkpoint inhibitors (ICIs). ICIs have been drastically changing the strategy for the treatment of recurrent/metastatic HNC, while we are acutely aware of the importance of multispecialty teams comprising surgeons, radiation oncologists, and medical oncologists. At present, precision medicine based on genomic profiling is becoming more common, and is a method used to investigate the genetic information related to individual patients or specific cancer cells and the way their genes interact with each other and with the environment. This method may provide more effective treatment strategies that are tailored to the genetic profile of each patient.

This Special Issue of Medicina entitled “The Therapeutic Landscape of Head and Neck Cancer” welcomes submissions of clinical original articles, as well as systematic reviews, meta-analyses, and overviews, related to head and neck cancer treatment, advances in surgery, radiologic oncology treating HNC, or treatment outcome of chemotherapy/chemoradiotherapy, as well as treatment outcomes of regimens including ICI. This Issue also invites new experimental results of basic science in the field of HNC.

Dr. Shogo Shinohara
Guest Editor

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• sinonasal cancer
• oral cancer
• nasopharyngeal cancer
• oropharyngeal cancer
• hypopharyngeal cancer
• laryngeal cancer
• minimally invasive surgery
• chemoradiotherapy
• immune checkpoint inhibitor
• precision medicine