J Med Assoc Thai 1997; 80 (4):207

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Squamous Cell Carcinoma of Head and Neck
Voravud N Mail, Charuruks N , Mutirangura A

Head and neck cancers are a major heath problem and common malignancies in Thailand.
Up to 80 per cent of cases are caused by smoking and alcohol consumption. Epithelial mucosa
of the aerodigestive tract exposed to carcinogens results in cellular mutations at different areas by
a process called field cancerization and causes multistep carcinogenesis. Over 90 per cent of cases
are squamous cell carcinoma. Prognostic factors depend on the patients, diseases and treatment.
Currently, several molecular pathogenesis have been discovered such as abnormalities of c-myc,
e-ras·, c-erbB-l, bel, int-2, hstl oncogenes, p53 and pl6 tumor suppressor genes. Common chromosomal
abnormalities are 3p, 9p, llq, l3q, l7p. Diagnosis requires symptoms and signs, radioimaging,
and pathology. Stage I and II can be treated by surgery or radiotherapy. However, stage
II requires and combination of surgery and radiotherapy, and studies of chemotherapy and local
treatment to increase therapeutic efficacy by several approaches such as combination chemotherapy,
new drugs, and biologic therapy.

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