title: Squamous cell carcinomas of the head and neck in Fanconi anemia: risk, prevention, therapy, and the need for guidelines.
abstract: Fanconi anemia (FA) is a rare recessive DNA repair disorder that is clinically characterized by congenital malformations, progressive bone marrow failure, and increased incidence of malignancies, especially acute myeloid leukemia and squamous cell carcinomas of the head and neck (HNSCCs) and the anogenital regions. On a cellular level, typical features of the disorder are a high degree of genomic instability and an increased sensitivity to bi-functionally alkylating agents. So far, germ-line defects in 15 different FA genes have been identified. Some of these FA genes are also established as tumor susceptibility genes for familiar cancers.In recent years, the prevention and therapy of HNSCCs in FA patients has become more important as the percentage of patients surviving into adulthood is rising. HNSCCs appear in very young FA patients without common risk factors. Since cisplatin-based chemotherapy in combination with radiotherapy, essential parts of the standard treatment approach for sporadic HNSCCs, cannot be used in FA patients due to therapy-associated toxicities and mortalities even with reduced dosing, surgery is the most important treatment option for HNSCCs, in FA patients and requires an early and efficient detection of malignant lesions. So far, no uniform treatment protocol for the management of HNSCCs in FA patients exists. Therefore, we propose that the information on affected FA patients should be collected worldwide, practical therapeutic guidelines developed and national treatment centers established.
authors.affiliation: Department of Otorhinolaryngology/Head and Neck Surgery, Heinrich Heine University, Düsseldorf, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Scheckenbach
authors.forename: M
authors.initials: M
authors.lastname: Wagenmann
authors.forename: M
authors.initials: M
authors.lastname: Freund
authors.forename: J
authors.initials: J
authors.lastname: Schipper
authors.forename: H
authors.initials: H
authors.lastname: Hanenberg
mesh_terms: D000465:Algorithms; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics / Q000628:therapy; D059248:Chemoradiotherapy; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D042241:Early Diagnosis; D005199:Fanconi Anemia / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics; D020022:Genetic Predisposition to Disease / Q000235:genetics; D018095:Germ-Line Mutation; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics / Q000628:therapy; D006801:Humans; D015994:Incidence; D008403:Mass Screening; D010039:Otorhinolaryngologic Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics / Q000517:prevention & control; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics / Q000628:therapy; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D000077195:Squamous Cell Carcinoma of Head and Neck; D016896:Treatment Outcome
chemical_list: D002945:Cisplatin