PERSPECTIVESPanelists Ardeshir Ghavamzadeh Tehran Barbara Wollenberg Lübeck Frank Riedel Mannheim Barbara Burtness Philadelphia Thomas J. Vogl Frankfurt Jan Olofsson Bergen Frankfurt 2008

PERSPECTIVES RadiotherapySurgery Neoadjuvant Chemotherapy Chemoradiotherapy Molecular Therapy-Targeted therapy: Tyrosine kinase inhibitors EGFR inhibitors VEGF inhibitors Cox-2 inhibitors Genetically steared therapy HPV-vaccination Individualized tailor-made therapy? How to select the therapy? Function, QOL, and Cost of treatment Frankfurt 2008

PERSPECTIVES Certain restrictions in medical research and the ethical debate concerning use of human tissue and biobank laws may be obstacles to overcome in coming years especially for international multicenter studies. Frankfurt 2008

Perspectives Head and neck cancer treatment is and will be a team therapy where insight in tumour biology, pharmacodynamics, molecular genetics and modern technology in imaging as CT – PET, radiotherapy, surgery and chemotherapy may be have to be taken into account. Frankfurt 2008

Perspectives A non-smoking, HPV-vaccinated world may hopefully change the incidence of certain cancers and may definitely change focus in head and neck cancer therapy. Frankfurt 2008

Advanced training in head and neck oncology/surgery in Europe Frankfurt 2008

Advanced training in head and neck oncology/surgery in Europe Most head and neck surgeons come from ORL. Some head and neck surgeons come from Maxillofacial Surgery as in GB, Spain, Slovakia. Some head and neck surgeons come from General Surgery as in Belgium, Slovakia. Frankfurt 2008

Advanced training in head and neck oncology/surgery in Europe In most countries there are not any organised advanced training – fellowships - as in Poland, Germany, Italy, Nordic countries (except for Finland where it is starting up). In most countries there are not any organised advanced training – fellowships - as in Poland, Germany, Italy, Nordic countries (except for Finland where it is starting up). Frankfurt 2008

Advanced training in head and neck oncology/surgery in Europe Hungary has a national oncological institute in Budapest and regular courses in head and neck oncology. Belgium - some half-time fellowships. Spain - two fellowships per year, H. Sant Pau in Barcelona and H. Central de Asturias. Frankfurt 2008

Advanced training in head and neck oncology/surgery in Europe Finland (UEMS): Newly suggested ”fellowship” programme. Accepted by the University clinics. Two years training programme. Training master. Licenced ORL – specialist. At least 18 months ORL – HNS. Frankfurt 2008

Advanced training in head and neck oncology/surgery in Europe Six months may be performed in maxillofacial surgery, oral surgery, plastic surgery or oncology. Final examination. Not a separate legally valid licence. Frankfurt 2008

Advanced training in head and neck oncology/surgery in Europe Aims: Good knowledge in: - Prevention and Early Diagnosis - Diagnostic methods for diagnosing and treatment planning planning - Experience treatment and rehabilitation planning and be able to act as chairman for a multi- and be able to act as chairman for a multi- disciplinary head & neck oncology group disciplinary head & neck oncology group - Surgical treatment of head & neck tumours - Participation in planning of new treatment modalities modalities - Evaluation of treatment results using scientific methods Frankfurt 2008

Advanced training in head and neck oncology/surgery in Europe Theoretical training - Interdisciplinary weekly planning meetings meetings - Educational sessions of the University Hospital Hospital - Working group meetings - 60 hours theoretical courses including meetings as SSHNO, AHNS, EHNS meetings as SSHNO, AHNS, EHNS Frankfurt 2008

Advanced training in head and neck oncology/surgery in Europe United Kingdom: Interface training set up by RCS London Two year programme Five centres identified Applications, site visit, interviews Planned for ENT, Oral, Max.Fac. Surgeons and Plastic Surgeons Frankfurt 2008

Advanced training in head and neck oncology/surgery in Europe Up to now ENT and Max.Fac. Surgery only A few candidates have come out of this system Most time spent in parent speciality, but some time in other specialities References: Graham John Cox: Training in Head and Neck Surgery. ENT News, vol. 12, no. 4, 51, Graham John Cox: Training in Head and Neck Surgery. ENT News, vol. 12, no. 4, 51, John Watkinson: Comments on the Interface Head & Neck Oncological Training Fellowships in the United Kingdom. ENT News, vol. 14, no. 4, 42-46, John Watkinson: Comments on the Interface Head & Neck Oncological Training Fellowships in the United Kingdom. ENT News, vol. 14, no. 4, 42-46, Frankfurt 2008

Advanced training in head and neck oncology/surgery in Europe The Netherlands: Advanced training in H & N Oncology and Surgery Aims: Guarantee high quality care for H & N Cancer patients H & N Cancer patients Frankfurt 2008

Advanced training in head and neck oncology/surgery in Europe Training approved by the General Assembly ORL-Soc. which determines the number of training institutions Two years continous training Specialist in ORL Member Dutch Society ORL-HNS Frankfurt 2008

Advanced training in head and neck oncology/surgery in Europe Training: - Diagnosis, treatment, rehabilitation in H&N tumour patients as well as H&N tumour patients as well as premalignant lesions premalignant lesions - Six weeks at the Dept of Radiotherapy - Six weeks at the Dept of Medical Oncology Oncology Frankfurt 2008

Advanced training in head and neck oncology/surgery in Europe Certification as Head & Neck Surgeon/ Oncologist Certification valid for five years Re-registration after this period Frankfurt 2008

Advanced training in head and neck oncology/surgery in Europe Summation: Few countries with organised advanced training in Europe EHNS must have such organised training as one of its primary aims Multidisciplinary approach Stimulate recruitment by - good planning - scientific possibilities - regular meetings in Europe - international collaboration in and outside Europe - international fellowships - international fellowships Frankfurt 2008