The two ends meet together, wonderful: head and neck tumor big curry a total of 2020 CSCO head and neck tumor guide release!

The 2020 CSCO guidelines for head and neck cancer and Summit Forum on precision / immunotherapy of head and neck cancer were held in Shanghai on July 12, 2020.this meeting is sponsored by the Oriental clinical cancer research center (Ecco) and co organized by CSCO head and neck cancer special committee.the meeting was successfully held by the combination of online and offline, aiming to broaden horizons, update knowledge, and enhance guidelines and academic exchanges.in his speech, Professor Guo Ye pointed out: "in the past half a year, most of the meetings in the field of oncology have been changed into online form, including the release conference of CSCO guidelines for various types of tumors, CSCO head and neck cancer guidelines release conference and head and neck cancer precise / immunotherapy Summit Forum. The combination of online and offline methods is adopted to hold the conference The second is to increase the opportunities and friendship of face-to-face learning and communication. After many discussions and two online finalization meetings, the 2020 CSCO head and neck cancer guidelines have been officially published this month. In addition to the contents of the guidelines, this conference also carefully prepared the contents of precision treatment and immunotherapy, which will surely make everyone gain a lot. I wish the conference a complete success.Professor Zhang Chaoping and Professor Hu Chaoping presided over the press conference.Professor Tao Lei gave a detailed interpretation of the updated guidelines for early and locally advanced head and neck squamous cell carcinoma. Professor Tao pointed out: "nasopharyngeal carcinoma is the most common head and neck squamous cell carcinoma in China, and the 5-year survival rate is the lowest among all head and neck squamous cell carcinoma; MDT treatment mode helps to shorten the waiting time for treatment and improve the prognosis; the depth of invasion of primary tumor and nerve invasive lymph nodes are newly added in case diagnosis HPV was recommended by grade II experts for oropharyngeal carcinoma DNA or RNA detection; AJCC 8th edition of the most significant content of head and neck tumor staging updated HPV related oropharyngeal cancer staging; for locally advanced head and neck squamous cell carcinoma, multidisciplinary treatment is needed, and different parts are different; for laryngeal cancer / hypopharyngeal cancer, chemotherapy has a certain role in some patients who need organ preservation, and T4 patients do not recommend laryngeal preservation, and surgery is recommended Resection."Professor Zhang Chen Ping commented: CSCO guidelines on head and neck cancer have been revised many times, the frequency is close to NCCN guidelines, and close to clinical practice.the latest guidelines put forward the prospect of robotic surgery in the future. In terms of the use of robots, it is believed that many hospitals and centers will unite to form a new treatment mode and expert consensus.Professor Han Fei gave a detailed interpretation of the updated guidelines for nasopharyngeal carcinoma.Professor Han pointed out: "the incidence of nasopharyngeal carcinoma in southern China is high in the world, and most of them are related to EBV infection, so it is recommended to detect EBV by in situ hybridization; for early treatment, stage I nasopharyngeal carcinoma should be treated with radiotherapy alone, and stage II nasopharyngeal carcinoma should be treated with concurrent chemoradiotherapy, induction chemotherapy and concurrent radiochemotherapy Treatment is one of the treatment modes, which is usually used for patients with stage IV or rapid tumor progression, and concurrent chemoradiotherapy plus adjuvant chemotherapy is also one of the optional modes. For the first-line treatment scheme of recurrent / metastatic nasopharyngeal carcinoma, grade I experts recommend cisplatin combined with gemcitabine, grade II experts recommend single drugs that have not been used before, including gemcitabine, docetaxel, capecitabine, and grade III experts recommend PD- 1 MAb (pablizumab, navulizumab, carrilezumab, trepril mAb). Professor Hu chaosu pointed out: different from foreign guidelines, radiotherapy alone is recommended for some patients with stage II nasopharyngeal carcinoma, while radiotherapy and chemotherapy are recommended in foreign guidelines.personally, for some patients with locally recurrent nasopharyngeal carcinoma, experienced hospitals can still carry out surgical treatment.in addition, there are currently four drugs available for immunotherapy of metastatic nasopharyngeal carcinoma.Professor Fang Meiyu explained in detail the updated guidelines for recurrent / metastatic head and neck squamous cell carcinoma.Professor Fang summarized the updated guidelines: "local radical treatment (salvage surgery or radiotherapy) is recommended for local or cervical squamous cell carcinoma (non nasopharyngeal carcinoma) with local or cervical recurrence, and in-process radiotherapy is only recommended in experienced centers; for the first-line treatment of recurrent / metastatic head and neck squamous cell carcinoma (non nasopharyngeal carcinoma), cetuximab combined with platinum and / or / or For paclitaxel based chemotherapy, paclitaxel (CPS ≥ 1) or pabolizumab combined with platinum and fluorouracil is recommended for grade II; cetuximab combined with single drug chemotherapy is recommended for patients who cannot tolerate dual drug chemotherapy; for second-line treatment, navulizumab is recommended for grade I, and pabolizumab or cetuximab or single drug chemotherapy is recommended for grade II Afatinib was recommended as grade III.At present, robot surgery has developed to the fourth generation and two major hospitals in Shanghai are preparing to install them. Professor Guo ye, based on a very important study at the ASCO conference this year (patients with HPV positive oropharyngeal cancer underwent robotic surgery first, and then received appropriate radiotherapy according to the situation, and achieved good survival results) He expressed his own opinion.Professor Tao pointed out: for some patients with advanced local stage, robotic surgery has certain limitations, especially in the treatment of large blood vessels and some important organs, robots may be unprepared, and these patients may also need open surgery.in a word, the first operation of oropharyngeal patients should be strictly screened, and should not be rash, but should be explored step by step. Professor Han pointed out that the progress of robotic surgery is a good news for patients. In this study, low-risk patients were observed after surgery, and the moderate risk patients were divided into 50 Gy and 60 Gy groups. The high-risk patients were given chemotherapy and radiotherapy after surgery. This study just confirmed our experience in China, and 50 Gy was given in general. postoperative pathology is particularly important for the selection of treatment options. For undifferentiated and poorly differentiated cancer, radiotherapy can be used for radical treatment. For moderately and highly differentiated squamous cell carcinoma, surgery is still the main choice. Professor Yang Ankui pointed out that robotic surgery has brought hope to these patients, but it is still a relatively new field and needs further exploration. Professor Zhou Liang said: at present, imported robotic surgery has certain risks, because there are important structures such as large vessels and nerves in oropharynx. If the technology is not enough, it is easy to cause postoperative complications, and more experience and technology are needed. surgical robot is the direction of the future and still needs to be explored. the follow-up experts also had a wonderful discussion and exchange on the new adjuvant treatment scheme, the first induction therapy for advanced patients with positive lymph nodes (large n) or lymph node dissection. the precision treatment session was presided over by Professor Yang Ankui and Professor Zhu Guopei. Professor Guo Ye gave a wonderful explanation on the precise diagnosis and individualized treatment of head and neck tumors. Professor Guo ye made a brilliant explanation on the accurate diagnosis and individualized treatment of head and neck tumors. Professor Guo Ye has made a series of achievements in the field of cancer treatment from the aspects of case interpretation, change of anti-tumor treatment mode, tumor markers, common targets and related signal pathways, and related targets He was discovered, as well as the problems existing in relevant early clinical research and current clinical research, and so on, the accurate diagnosis and treatment were interpreted in a multi angle and multi-level way, which provided a lot of new ideas and Enlightenment for the precise treatment direction of head and neck squamous cell carcinoma. Professor Guo summarized that: with the development of detection methods and drug development, the treatment of head and neck cancer will enter the era of precision treatment. For head and neck squamous cell carcinoma, accurate diagnosis will be conducive to reasonable selection of immune and targeted therapy drugs. For head and neck tumors with rare driving genes, precise targeted therapy will greatly improve the therapeutic effect, and ngs will be applied in the head and neck The diagnosis and treatment of tumors play an increasingly important role. Professor Yang Ankui commented that Professor Guo Ye's 30 minute interpretation has brought us a lot of information, as well as inspiration and Thinking on points, lines and surfaces. Precision therapy may be on the road in the future. Dean Lu Jiade, the most famous returnee scholar in the field of radiotherapy, gave a wonderful interpretation of precise radiotherapy for head and neck tumors. finally, Professor Lu summarized the overall efficacy of related particle radiotherapy in the treatment of head and neck cancer from 2015 to now. He pointed out that particle radiotherapy also had toxic and side effects, but the overall toxicity of treatment-related was lower than that of conventional radiotherapy. the relevant research data within 5 years have been accepted or published. I hope these data can provide reference. in addition, Shanghai proton and heavy ion hospital jointly published the world's first clinical guidelines for proton heavy ion radiotherapy last month. Professor Lu pointed out that another guideline will be published next year. I hope the guidelines can be recognized and receive valuable comments from colleagues. Professor Zhu Guopei commented that Professor Lu has brought us amazing research results in the field of head and neck cancer. It is worth noting that all the results of this technology have been included in the prospective clinical research, which is very scientific and rigorous. we look forward to better research results of Professor Lu's team in the future. Professor Wang Wei gave a wonderful explanation on the anti EGFR treatment of head and neck squamous cell carcinoma. Professor Wang pointed out that the goal of treatment and treatment for patients with recurrent / metastatic head and neck squamous cell carcinoma is to control disease symptoms and prolong survival, and achieve tumor regression. anti EGFR monoclonal antibody is an important treatment for recurrent / metastatic head and neck squamous cell carcinoma. Clinical studies at home and abroad have confirmed that cetuximab combined with chemotherapy as the first-line treatment for recurrent / metastatic head and neck squamous cell carcinoma is a clear and reliable treatment scheme, and it is the first-line treatment recommended by many guidelines at home and abroad. new joint exploration based on cetuximab / immune checkpoint inhibitors in the future is worth looking forward to. immunotherapy session is hosted by Professor Chen Xiaozhong and Professor Yuan Rongtao. Professor Cao Guochun explained in detail the first-line immunotherapy for recurrent / metastatic head and neck squamous cell carcinoma. Professor Cao pointed out that: "head and neck squamous cell carcinoma is the most common head and neck tumor. The 5-year survival rate of advanced patients is low, and there is a significant unmet treatment demand. Immunotherapy has become an important treatment method for recurrent / metastatic head and neck squamous cell carcinoma, Pabolizumab or combination chemotherapy can significantly improve the prognosis of patients with advanced head and neck squamous cell carcinoma, and become a new standard of first-line treatment. the exploration of combined immunotherapy will further guide the optimal treatment mode of advanced head and neck squamous cell carcinoma. "Professor Chen Xiaozhong pointed out: thanks to Professor Cao for showing us the latest clinical research results, especially for the detailed interpretation of the keynote-048 study. Professor Cao also introduced the latest exploratory research results, hoping that the new research will bring information in the near future. Professor Yang Kunyu explained the recurrence / metastasis in detail