Search

We studied the effect of cytoreductive chemotherapy in head and neck cancer and analyzed it in terms of efficacy, remission rates, and duration, as well effect on survival. Single-agent chemotherapy, which formerly was used as a palliative therapy in recurrent and metastatic disease, had little affect on survival. More recently, multi-agent chemotherapy trials have shown significantly higher response rates, but this success has not translated into an added survival benefit. These findings led to the introduction of multi-agent chemotherapy into the induction (neoadjuvant) clinical setting. In these clinical circumstances, better objective response rates were found, particularly in the previously untreated patient. Although this therapy has resulted in better control of local disease, the impact on survival is not yet clear. Adjuvant chemotherapy is most useful in patients who have a high risk of relapse. Therapy appears to decrease its incidence, particularly at distant sites. Finally, chemoradiation trials have shown that this treatment provides a survival advantage, but at the cost of a significant increase in toxicity.

Round pneumonia is well known in the pediatric population; however, it is relatively uncommon in adults. The appearance of round pneumonia may be difficult to distinguish from lung carcinoma on anatomic images. This case illustrates a round pneumonia mimicking a pulmonary malignancy on PET/CT. In patients found to have rapid development of a round pulmonary lesion and clinical manifestations of pneumonia, it may be prudent to treat with empiric antibiotics before invasive diagnostic procedures for malignancy.