title: [Radioresistance parameters in head and neck cancers and methods to radiosensitize].
abstract: Head and neck cancers have been widely studied concerning their sensitivity to radiation therapy. Several parameters affect tumour response to radiation therapy. Some parameters are linked to the tumour. Large or invasive tumours, localization, such as oral cavity or adenopathy, are factors of radioresistance. Others parameters are linked to the patients themselves. Tobacco intoxication during radiotherapy and a low hemoglobin level contribute to radioresistance. More recently, a positive human papilloma virus (HPV) status has been reported to positively affect radiosensitivity. Finally, other parameters are related to tumour biology. Hypoxia, intrinsic radiosensitivity of tumour cells, tumour differentiation and repopulation (provided by Ki-67 index or EGFR level) are components of radiosensitivity. Currently, concurrent chemoradiotherapy is one of the gold standard treatments to overcome clinical outcome of locally advanced head and neck cancer. This combination increases locoregional control and survival. Taxane-based induction chemotherapy can also be an alternative. Another validated approach is the association of radiotherapy with cetuximab (EGFR targeting) but only one randomized study has been published. Fractionation modifications, especially hyperfractionation, have given positive results on both tumour control and survival. Strategies targeting hypoxia improve locoregional control but have less clinical impact.
authors.affiliation: Département de radiothérapie, centre Jean-Perrin, 58, rue Montalembert, BP 5026, 63011 Clermont-Ferrand cedex 1, France; EA7283 Cancer Resistance Exploring and Targeting (CREAT), Clermont université, université d'Auvergne, 49, boulevard François-Mitterrand, CS 60032, 63001 Clermont-Ferrand cedex 1, France; Équipe recombinaison, réparation et cancer, UMR 3347, CNRS, centre universitaire, 91405 Orsay cedex, France; Inserm U1021, centre universitaire, 91405 Orsay cedex, France; Institut Curie, 26, rue d'Ulm, 75005 Paris, France. Electronic address: julian.biau@cjp.fr.
authors.forename: J
authors.initials: J
authors.lastname: Biau
authors.affiliation: Département de radiothérapie, centre Jean-Perrin, 58, rue Montalembert, BP 5026, 63011 Clermont-Ferrand cedex 1, France; EA7283 Cancer Resistance Exploring and Targeting (CREAT), Clermont université, université d'Auvergne, 49, boulevard François-Mitterrand, CS 60032, 63001 Clermont-Ferrand cedex 1, France.
authors.forename: E
authors.initials: E
authors.lastname: Chautard
authors.affiliation: Département de radiothérapie, centre Jean-Perrin, 58, rue Montalembert, BP 5026, 63011 Clermont-Ferrand cedex 1, France.
authors.forename: J
authors.initials: J
authors.lastname: Miroir
authors.affiliation: Département de radiothérapie, centre Jean-Perrin, 58, rue Montalembert, BP 5026, 63011 Clermont-Ferrand cedex 1, France.
authors.forename: M
authors.initials: M
authors.lastname: Lapeyre
mesh_terms: D000740:Anemia / Q000628:therapy; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001803:Blood Transfusion; D015687:Cell Hypoxia; D003952:Diagnostic Imaging; D019583:Dose Fractionation, Radiation; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006397:Hematinics / Q000627:therapeutic use; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D006931:Hyperbaric Oxygenation; D006979:Hyperthermia, Induced; D009154:Mutation; D014411:Neoplastic Stem Cells; D030361:Papillomavirus Infections / Q000150:complications; D011836:Radiation Tolerance; D011837:Radiation-Protective Agents / Q000627:therapeutic use; D011838:Radiation-Sensitizing Agents / Q000627:therapeutic use; D012907:Smoking / Q000009:adverse effects; D016159:Tumor Suppressor Protein p53 / Q000235:genetics
chemical_list: D000970:Antineoplastic Agents; D006397:Hematinics; D006454:Hemoglobins; D011837:Radiation-Protective Agents; D011838:Radiation-Sensitizing Agents; D016159:Tumor Suppressor Protein p53; D066246:ErbB Receptors
keywords: Cancers voies aérodigestives supérieures; Head and neck cancers; Radioresistance; Radiorésistance; Radiosensibilisation; Radiosensitization