Malignant lymphoma of the head and neck – therapeutic approaches

Malignant lymphoma is one of the problems of modern medicine. Among head and neck malignancies, lymphoma is the second most common cause. Most of the extranodal lymphomas are represented by non-Hodgkin lymphomas. Aero-digestive upper tract non-Hodgkin lymphomas are classified into different categories, depending on the respective frequency of these types in: oral cavity lymphomas, pharynx and Waldeyer ring lymphoma and nasal sinuses, throat, pharynx and trachea lymphomas. Main therapeutic approaches of malignant lymphoma are: conventional chemotherapy, radiotherapy, surgery, “salvage” therapy such as interpheron therapy, monoclonal antibody therapy, bone marrow transplant, treatment with peptides. Cytotoxic chemotherapy is the main treatment for medium and high grade malignant lymphomas. However, studies have shown increased toxicity without a significant benefit compared to the use of CHOP cure (cyclophosphamide, doxorubicin, vincristine and prednisone), both in terms of survival at 3 years and time until therapeutic success. The use of third generation therapeutic protocols allows to achieve complete remission in approximately 50% of non-Hodgkin’s lymphoma cases. Doctors endeavor to diagnose correctly and adopt the appropriate therapy for head and neck malignant lymphomas. It is a complex approach, integrating clinical, morphological and cytogenetic elements, interdisciplinary collaboration between the pathologist, haematologist, oncologist, radiotherapist, nutritionist, psychologist, this process leading to the adoption of the most appropriate treatment for a patient with malignant lymphoma.