Squamous cell carcinoma of the head and neck counts for 3 % of all cancers in men and half of this number less in women with a 5-year survival of 61 %. While the number of laryngeal carcinoma is decreasing, carcinoma of the oral cavity related to an infection by the human papilloma virus (HPV), high-risk subtypes is increasing, especially in younger patients. HPV related squamous cell carcinomas show better survival data, especially in regard to recurrence free rates or secondary carcinoma of adjacent locations. Squamous cell carcinomas related to the presence of HPV DNA material is almost exclusively found in carcinoma of the oral cavity and oropharyngeal mucosa. Much less frequently HPV is present in hypopharyngeal carcinomas and even less number of cases of squamous cell carcinoma with proof for HPV in the nasopharynx and larynx. In case of evidence for HPV DNA; most cases are positively tested for subtype 16, followed by subtype 18. As a surrogate immunhistochemical marker, p16 INK4A is stained positive, cytoplasmic and nuclear. In a small study by ourselves, we found a positive correlation in 100 % of p16 INK4A positivity and positive HPV testing. Oral squamous cell carcinoma is more frequently related to HPV in patients below 50 years of age with a prevalence of ca. 20 %. Whilst HPV high-risk positive carcinomas show very few mutations in single signalling molecules of the downstream receptor tyrosin kinase pathways, HPV negative carcinomas show in many cases a chaotic DNA mutation type with typical mutations in tumor suppressor genes, as p53 and CDKN2A. This pattern is often seen in carcinoma types develop from a summation of accidental mutations often caused by toxins (e.g. inhaled cigarette smoke). However, it is discussed and under investigation whether a subset of head and neck squamous cell carcinomasdevelop from so called driver mutations, as are called mutations in critical members of signalling pathways and receptor tyrosin kinases, e. g. FGF receptors, PTEN, PIK3CA. In a similar group of squamous cell carcinomas, those of the lower airways, trachea, bronchi and lung parenchyma, also massively caused by inhaled toxins, a subset of 20 % show these driver mutations. Tumors with driver mutations, especially related to tyrosin kinases and depending pathways are eligible for small molecule therapeutics, inhibitors of tyrosin kinases and signalling kinases, e. g. Erlotinib in EGF receptor or Vemurafininb for B-RAF. There is much need for further stratification of head and neck squamous cell carcinoma to introduce the wide field of inhibitors at least to a subset of these patients.

Resistance of well-differentiated distant metastases to radioactive iodine treatment severely deteriorate survival prognosis of patients. Chemotherapy (doxorubicin and combinations) and retinoid acid analoques (isotretinоin, roaccutan) implimentation did not allow to recommend them as a therapy of choice. Effectiveness of several multikinase inhibitors (vandetanib, sorafenib, sunitinib) was confirmed in phase II clinical trials. In result of phase III clinical trial of sorafenib (reported on ASCO’2013, Chicago, USA) its therapeutic efficacy in patient with iodine-refractory well-differentiated thyroid cancer was affirmed.

The treatment of aggressive benign and malignant head and neck tumors requires partial (segmental) or half mandibular resection on frequent occasions. Mandibular defects of even a small extent lead to significant cosmetic deformity and are accompanied by impairment of important functions, such as chewing, swallowing, and correct speech production. Mandibuloplasty using a revascularized peroneal graft is the method of choice after extensive resections for disseminated benign and malignant tumors.

The literature review analyzes current trends in the treatment of oral mucosal cancer. Surgery performed at the first stage of complex or combination treatment, followed by radiation or platinum drug-based competitive chemotherapy, is the standard treatment. To choose treatment policy depends on the extent of a tumor process and the presence of unfavorable prognostic factors that determine the high risk of disease recurrence and progression. The basic principles of combination and complex therapy are to strictly comply with the time and sequence of therapy. The treatment of recurrent tumors to be surgically untreated is based on chemotherapy using platinum and target drugs.

This article analyzes the current trends in radiation therapy of primary and recurrent, localized and locally advanced head and neck tumors. Address the use of radiation therapy as a stand-alone options, or in combination with surgery. Describe the characteristics and evaluate the use of the most modern methods.

Cerebral metastases cancer of the larynx are rare and poorly understood pathology, many questions of diagnostics and treatment of this pathology remain open. In the work presents clinical cases сerebral metastases cancer of the larynx. Special attention is paid to surgical treatment in complex with chemotherapy.

The paper presents the possibilities of surgical treatment of tongue tumours spreading to neighbouring organs: the throat, larynx, alveolar edge of lower jaw. Application of ресtoralis mayor musculocutaneous flap allows you to perform a single reconstruction of post-operative defect with acceptable functional and cosmetic result.