Abstract
Head and neck cancer is the seventh most common cancer in Australia and globally. Despite the current improved treatment modalities, there is still up to 50–60% local regional recurrence and or distant metastasis. High-resolution medical imaging technologies such as PET/CT and MRI do not currently detect the early spread of tumour cells, thus limiting the potential for effective minimal residual detection and early diagnosis. Circulating tumour cells (CTCs) are a rare subset of cells that escape from the primary tumour and enter into the bloodstream to form metastatic deposits or even re-establish themselves in the primary site of the cancer. These cells are more aggressive and accumulate gene alterations by somatic mutations that are the same or even greater than the primary tumour because of additional features acquired in the circulation. The potential application of CTC in clinical use is to acquire a liquid biopsy, by taking a reliable minimally invasive venous blood sample, for cell genotyping during radiotherapy treatment to monitor the decline in CTC detectability, and mutational changes in response to radiation resistance and radiation sensitivity. Currently, very little has been published on radiation therapy, CTC, and circulating cancer stem cells (CCSCs). The prognostic value of CTC in cancer management and personalised medicine for head and neck cancer radiotherapy patients requires a deeper understanding at the cellular level, along with other advanced technologies. With this goal, this review summarises the current research of head and neck cancer CTC, CCSC and the molecular targets for personalised radiotherapy response.
Highlights
The worldwide incidence of head and neck cancer is more than 600,000 cases with 350,000 deaths each year [1]
Morris et al identified hepatocellular Circulating tumour cells (CTCs) in 19 out of 19 (100%) patients by ISET methodology and 14 out of 50 (28%) patients by Cell Search system suggesting the accuracy in sensitivity and specificity [35]
Tracking CTC counts during radiotherapy treatment will measure the outcome and disease resistance leading to recurrence especially in loco regionally advanced disease with a significant potential for clinical application
Summary
The worldwide incidence of head and neck cancer is more than 600,000 cases with 350,000 deaths each year [1]. Cancers 2019, 11, 367 of head and neck cancer: laryngeal and hypo pharyngeal (voice box), nasal cavity and paranasal sinus (behind the nose), nasopharyngeal in the upper part of the throat (behind the nose), oral and oropharyngeal (mouth, tongue and salivary glands) [4,5,6,7,8,9,10]. These tumours predominantly originate from the squamous cells lining the surfaces of mouth, nose and the throat. Globally the diagnosis and prognosis of HNSCC remains a challenge [12]
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