Cancer of the head and neck: general principles of radiobiology, radiotherapy and chemotherapy. Radiation damage.
The overall incidence of tumours of the head and neck area versus tumours of other areas is 10%; in other words, 1 neoplastic lesion out of 10 affecting the human body is in this area. The relative frequency places malignant tumours of the larynx in 1(st) place with 25-30%. This data relates only to the areas of competence of the dentist and ENT specialist, and thus indicates that it is now becoming increasingly frequent for the dentist to be faced with treating a cancer patient. At the same time, it is not possible to consider as "dental cancer patients" only those patients whose disease involves an anatomic structure of the oral cavity as such. Pa-tients with tumours involving any of the anatomic structures of the head and neck area (pharynx, larynx, lip, oral cavity, pa-ranasal sinuses, nasal fossae, salivary glands) must also be included. This article provides information on the epidemiology of tumours of the head and neck, the theoretical foundations of radiobiology, radiotherapy and chemotherapy, and possibilities for integration among the different possible treatment methods, i.e. radiotherapy, surgery, and chemotherapy. It looks at the most recent developments in these methods for patients with cancer of the head and neck, including the diagnostic protocol (clinical and instrumental). Lastly, irradiation damage to this anatomical area is analysed in terms of acute and delayed manifestations.
Branchi
R
R
Service of Dental Prosthesis, Department of Dentistry and Stomatology, University of Florence, Careggi Hospital, Florence, Italy. r.branchi@odonto.unifi.it
Fancelli
V
V
De Salvador
A
A
Giovannoni
A
A
D003131:Combined Modality Therapy; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D011832:Radiation Injuries / Q000209:etiology; D011853:Radiobiology