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Sample records for neck cancer 2-year

  1. Head and Neck Cancer

    Science.gov (United States)

    Head and neck cancer includes cancers of the mouth, nose, sinuses, salivary glands, throat, and lymph nodes ... swallowing A change or hoarseness in the voice Head and neck cancers are twice as common in ...

  2. Head and neck cancer

    International Nuclear Information System (INIS)

    Vogl, S.E.

    1988-01-01

    This book contains 10 chapters. Some of the titles are: Combined Surgical Resection and Irradiation for Head and Neck Cancers; Analysis of Radiation Therapy Oncology Group Head and Neck Database: Identification of Prognostic Factors and the Re-evaluation of American Joint Committee Stages; Combined Modality Approach to Head and Neck Cancer; Induction Combination Chemotherapy of Regionally Advanced Head and Neck Cancer; and Outcome after Complete Remission to Induction Chemotherapy in Head and Neck Cancer

  3. Influence of intravenous amifostine on xerostomia, tumor control, and survival after radiotherapy for head-and- neck cancer: 2-year follow-up of a prospective, randomized, phase III trial

    International Nuclear Information System (INIS)

    Wasserman, Todd H.; Brizel, David M.; Henke, Michael; Monnier, Alain; Eschwege, Francois; Sauer, Rolf; Strnad, Vratislav

    2005-01-01

    Purpose: To evaluate chronic xerostomia and tumor control 18 and 24 months after initial treatment with amifostine in a randomized controlled trial of patients with head-and-neck cancer; at 12 months after radiotherapy (RT), amifostine had been shown to reduce xerostomia without changing tumor control. Methods and Materials: Adults with head-and-neck cancer who underwent once-daily RT for 5-7 weeks (total dose, 50-70 Gy) received either open-label amifostine (200 mg/m 2 i.v.) 15-30 min before each fraction of radiation (n = 150) or RT alone (control; n = 153). Results: Amifostine administration was associated with a reduced incidence of Grade ≥2 xerostomia over 2 years of follow-up (p = 0.002), an increase in the proportion of patients with meaningful (>0.1 g) unstimulated saliva production at 24 months (p = 0.011), and reduced mouth dryness scores on a patient benefit questionnaire at 24 months (p < 0.001). Locoregional control rate, progression-free survival, and overall survival were not significantly different between the amifostine group and the control group. Conclusions: Amifostine administration during head-and-neck RT reduces the severity and duration of xerostomia 2 years after treatment and does not seem to compromise locoregional control rates, progression-free survival, or overall survival

  4. Head and Neck Cancer Treatment

    Science.gov (United States)

    ... News Physician Resources Professions Site Index A-Z Head and Neck Cancer Treatment Head and neck cancer ... there any new developments in treating my disease? Head and neck cancer overview The way a particular ...

  5. Head and Neck Cancer

    International Nuclear Information System (INIS)

    Tomita, Toshiki; Imanishi, Yorihisa

    2008-01-01

    The limitation of concurrent chemo-radiotherapy (CCRT) in head and neck cancer (HNC) as the primary treatment is described based on recent findings. Limits in the application/indication involve factors of age, performance status (PS) and renal function. The first is that, as deaths in >71 years old patients are derived from other causes (41%) than HNC, CCRT is only useful for younger population; the second, patients with PS 0-1 or Karnofsky performance score >60-70 can be indicated; and third, contraindicated are those with creatinine clearance (CCr) <60 mL/min as the key drug cisplatin in CCRT has a high renal toxicity. It should be recognized that completion rates of chemotherapy and RT are as low as 66-85% and 84-92%, respectively, in CCRT. CCRT has such limiting adverse events as mucitis, dry mouth, dysohagia, weight loss, neutropenia, sepsis, etc., which are most important in CCRT application. CCRT is recommended for the primary cancers of larynx and hypopharynx because they are significantly better conserved than middle pharyngeal, oral and upper jaw cancers. Evidence of CCRT is poor for cancers in paranasal sinuses. Planned neck dissection (PND) is for the cervical metastatic lymph nodes and conducted 6-12 weeks after CCRT regardless to its outcome. In fluorodeoxyglucose-positron emission tomography (FDG-PET) negative cases, PND can be omitted. Necessity of PND is possibly inversely proportional to CCRT intensity performed. For control of remote metastasis, CCRT has obvious limits and inductive chemotherapy before it is currently considered. Salvage surgery post CCRT does not always yield a relief because of complication. Patients with advanced laryngeal cancer can be selected either to surgery or CCRT depending on results of the inductive chemotherapy. To predict the sensitivity to CCRT, some biomarkers like HPV, EGFR and VEGF have been suggested to be useful by retrospective studies. Understanding the limitation is as important as knowing the usefulness in

  6. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... teeth or become infected. It can also invite bacteria that lead to gum disease. Click here to find out ... and surgically treating cancer of the head, neck and mouth. The Oral Cancer Foundation estimates that close to ...

  7. Morbidity of the neck after head and neck cancer therapy

    NARCIS (Netherlands)

    van Wilgen, C.P.; Dijkstra, P.U.; van der Laan, B.F.; Plukker, J.T.; Roodenburg, J.L.

    Background. Studies on morbidity of the neck after head and neck cancer therapy are scarcely described. Methods. Patients who underwent surgery, including neck dissection, with and without radiation therapy at least 1 year before the study were asked to participate. We assessed neck pain, loss of

  8. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... the head, neck and mouth. The Oral Cancer Foundation estimates that close to 42,000 Americans will ... cheek out to see its inside surface as well as the back of the gums Pull out ...

  9. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... cancer of the head, neck and mouth. The Oral Cancer Foundation estimates that close to 42,000 Americans ... diagnosed with oral or pharyngeal cancer this year. Oral cancer’s mortality is particularly high, not because it is ...

  10. Cupping for chronic nonspecific neck pain: a 2-year follow-up.

    Science.gov (United States)

    Lauche, Romy; Cramer, Holger; Langhorst, Jost; Dobos, Gustav

    2013-01-01

    Several trials have shown that cupping might be an effective treatment for chronic nonspecific neck pain, but little is known about the long-term effectiveness. This study aimed to investigate long-term effects of a short series of cupping; therefore additional follow-up measurements were conducted 2 years after completion of 3 studies. Participants from 3 randomized waitlist controlled trials on cupping for chronic nonspecific neck pain were followed 2 years after treatment. Outcome measures included neck pain intensity (100 mm Visual Analog Scale; VAS), functional disability (Neck Disability Index, NDI), and health-related quality of life (Short Form 36 Health Survey Questionnaire; SF-36). 133 of 150 patients had received cupping treatment and were contacted; 82 of them (61.7%) returned the follow-up questionnaires. No effect was found for neck pain intensity, but for physical function (∆ NDI: -3.15; 95% CI: -5.89; -0.41; p = 0.025) and quality of life (∆ physical component summary: 2.97; 95% CI: 0.97; 4.97; p = 0.004; ∆ bodily pain: 14.53; 95 % CI: 9.67; 19.39; p cupping effect was 8.9 ± 8.7 months with 16 patients reporting that neck pain had not yet reached the level before cupping. The majority of the patients did not continue cupping therapy, mostly due to lack of providers, costs or loss of interest. A series of cupping treatments did not influence neck pain intensity on the longer term, however significant increases were found for physical function and quality of life in patients with chronic nonspecific neck pain. Due to the considerable drop-out rate conclusions are limited. There is evidence suggesting that cupping treatment might have sustainable effects in some patients. Further randomized controlled trials with long-term follow-up are urgently needed for conclusive judgment of long-term effectiveness. © 2013 S. Karger GmbH, Freiburg.

  11. Head and Neck Cancers

    Science.gov (United States)

    ... Abstract] Gandini S, Botteri E, Iodice S, et al. Tobacco smoking and cancer: a meta-analysis. International Journal of Cancer 2008; 122(1):155–164. [PubMed ... Alcohol drinking in never users of tobacco, cigarette smoking in never drinkers, ... Consortium. Journal of the National Cancer Institute 2007; 99(10): ...

  12. Drugs Approved for Head and Neck Cancer

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for head and neck cancer. The list includes generic names and brand names. The drug names link to NCI’s Cancer Drug Information summaries.

  13. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... out more. Oral, Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans ... out more. Oral, Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans ...

  14. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed ... Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed ...

  15. Public knowledge of head and neck cancer.

    LENUS (Irish Health Repository)

    O'Connor, T E

    2010-04-01

    Studies show 60% of patients with newly diagnosed Head & Neck Squamous Cell Cancer in Ireland, present with advanced disease. A poor level of knowledge and awareness among the public of Head & Neck Cancer, is an important consideration in the often delayed presentation for medical attention in many of these cases. Our study surveyed 200 members of the public to assess their knowledge and awareness of Head & Neck Cancer. One hundred and forty (70%) of respondents had never encountered the term "Head & Neck Cancer". One hundred and forty six (73%) failed to identify excessive alcohol consumption as a risk factor. Less than 100 (50%) would have concern about persisting hoarseness or a prolonged oral ulcer. An urgent need exists to raise awareness of Head & Neck Cancer among the public in Ireland.

  16. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed with oral or ... Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed with oral or ...

  17. Treatment of Childhood Head and Neck Cancer - Patient Version

    Science.gov (United States)

    Find diagnosis, staging, and treatment information for these head and neck cancers: hypopharynx, larynx, lip and oral cavity, neck cancer with occult primary, nasopharynx, oropharynx, paranasal sinus and nasal cavity, and salivary gland cancer.

  18. Treatment of Head and Neck Cancer in Adults - Patient Version

    Science.gov (United States)

    Find diagnosis, staging, and treatment information for these head and neck cancers: hypopharynx, larynx, lip and oral cavity, neck cancer with occult primary, nasopharynx, oropharynx, paranasal sinus and nasal cavity, and salivary gland cancer.

  19. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... Oral Surgeries Facial Cosmetic Surgery Facial Injury / Trauma Surgery Obstructive Sleep Apnea (OSA) Oral, Head and Neck Pathology TMJ and Facial Pain Wisdom Teeth Management Procedures Anesthesia Anesthesia Oral and maxillofacial surgeons are ...

  20. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... Other Oral Surgeries Facial Cosmetic Surgery Facial Injury / Trauma Surgery Obstructive Sleep Apnea (OSA) Oral, Head and Neck Pathology TMJ and Facial Pain Wisdom Teeth Management Procedures Anesthesia Anesthesia Oral and maxillofacial surgeons ...

  1. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... can also invite bacteria that lead to gum disease. Click here to find out more. Who We ... Injury / Trauma Surgery Obstructive Sleep Apnea (OSA) Oral, Head and Neck Pathology TMJ ...

  2. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... Neck Pathology Download Download the ebook for further information Your oral and maxillofacial surgeon (OMS) is the ... well be the key to complete recovery. The information provided here is not intended as a substitute ...

  3. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... disorders are not uncommon. Individuals with a TMJ disorder may experience a variety of symptoms, such as earaches, ... Obstructive Sleep Apnea (OSA) Oral, Head and Neck Pathology TMJ ...

  4. [Photodynamic therapy for head and neck cancer

    DEFF Research Database (Denmark)

    Lajer, C.B.; Specht, Lena; Kirkegaard, J.

    2006-01-01

    Photodynamic therapy (PDT) is a new treatment for head and neck cancer. The principle of the treatment is a photochemical reaction initiated by light activation of a photosensitizer, which causes the death of the exposed tissue. This article presents the modes of action of PDT and the techniques...... as well as the clinical procedure. A critical review of the literature is also presented, regarding treatment results of the different techniques and indications for treatments. The possibilities for PDT for head and neck cancer in Denmark are mentioned Udgivelsesdato: 2006/6/5...

  5. Primary head and neck cancers in north eastern Nigeria | Otoh ...

    African Journals Online (AJOL)

    Primary head and neck cancers in north eastern Nigeria. EC Otoh, NW Johnson, IS Danfillo, OA Adeleke, HA Olasoji. Abstract. Background:To document the pattern of primary head and neck cancers in North Eastern Nigeria. Study DesignA record-based study of primary head and neck cancers histologically diagnosed at ...

  6. [Photodynamic therapy for head and neck cancer

    DEFF Research Database (Denmark)

    Lajer, C.B.; Specht, Lena; Kirkegaard, J.

    2006-01-01

    Photodynamic therapy (PDT) is a new treatment for head and neck cancer. The principle of the treatment is a photochemical reaction initiated by light activation of a photosensitizer, which causes the death of the exposed tissue. This article presents the modes of action of PDT and the techniques...

  7. The Danish Head and Neck Cancer database

    Directory of Open Access Journals (Sweden)

    Overgaard J

    2016-10-01

    Full Text Available Jens Overgaard,1 Aleksandar Jovanovic,1 Christian Godballe,2,3 Jesper Grau Eriksen3 1Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, 2Department of ORL – Head and Neck Surgery, 3Department of Oncology, Odense University Hospital, Odense, Denmark Aim of the database: The Danish Head and Neck Cancer database is a nationwide clinical quality database that contains prospective data collected since the early 1960s. The overall aim of this study was to describe the outcome of the national strategy for multidisciplinary treatment of head and neck cancer in Denmark and to create a basis for clinical trials. Study population: The study population consisted of all Danish patients referred for treatment of squamous cell carcinoma of the larynx, pharynx, oral cavity, or neck nodes from unknown primary or any histopathological type (except lymphoma of cancer in the nasal sinuses, salivary glands, or thyroid gland (corresponding to the International Classification of Diseases, tenth revision, classifications C.01–C.11, C.30–C.32, C.73, and C.80. Main variables: The main variables used in the study were symptoms and the duration of the symptoms; etiological factors; pretreatment and diagnostic evaluation, including tumor–node–metastasis classification, imaging, histopathology, and laboratory tests; primary treatment with semidetailed information of radiotherapy, surgery, and medical treatment; follow-up registration of tumor status and side effects; registration of relapse and treatment thereof; and registration of death and cause of death. Main results: Data from >33,000 patients have been recorded during a period of >45 years. In this period, the outcome of treatment improved substantially, partly due to better treatment as a result of a series of continuous clinical trials and subsequent implementation in national guidelines. The database has furthermore been used to describe the effect of reduced waiting time

  8. The Danish Head and Neck Cancer database

    DEFF Research Database (Denmark)

    Overgaard, Jens; Jovanovic, Aleksandar; Godballe, Christian

    2016-01-01

    cancer in Denmark and to create a basis for clinical trials. STUDY POPULATION: The study population consisted of all Danish patients referred for treatment of squamous cell carcinoma of the larynx, pharynx, oral cavity, or neck nodes from unknown primary or any histopathological type (except lymphoma...... of continuous clinical trials and subsequent implementation in national guidelines. The database has furthermore been used to describe the effect of reduced waiting time, changed epidemiology, and influence of comorbidity and socioeconomic parameters. CONCLUSION: Half a century of registration of head and neck...

  9. ''Watch-and-see'' policy for the clinically positive neck in head and neck cancer treated with chemoradiotherapy

    International Nuclear Information System (INIS)

    Homma, Akihiro; Furuta, Yasushi; Oridate, Nobuhiko

    2006-01-01

    Chemoradiotherapy (CRT) is becoming more widely used for head and neck cancer. However, there are conflicting theories regarding the best management options for patients with advanced nodal disease. From 1990 to 1999, we treated 96 patients with N1-N2 neck disease by concomitant CRT for organ preservation, using weekly carboplatin or a low daily dose of cisplatin, followed by a ''watch-and-see'' policy for the neck. In the present study, we retrospectively analyzed the treatment outcome in 63 of these patients who received definitive CRT for primary and neck diseases and were monitored for neck disease for more than 2 years. In 12 of the 22 (55%) N1 patients, CRT successfully controlled the neck disease. CRT was successful in 18 of the 41(44%) patients with N2 disease. In 6 (60%) of 10 patients with residual or recurrent N1 disease, salvage surgery was successful. Of the 23 patients with residual or recurrent N2 disease, salvage surgery was successful in 8 patients (35%). The group of patients who showed a clinical complete response (CCR) to CRT had an overall survival rate of 62.4% (33 patients), whereas for those with a less than complete response (< CCR), the figure was 13.3% (30 patients; P<0.001). Among the < CCR-neck group, patients who underwent neck dissection (ND) as well (n=20) did not have a significantly better overall survival than those who did not undergo ND (n=10; P=0.069). We propose a treatment plan for neck disease that involves observing the neck closely following CRT. ND should be planned only when there is evidence that neck disease exists. (author)

  10. Head and neck cancer imaging. 2. ed.

    Energy Technology Data Exchange (ETDEWEB)

    Hermans, Robert (ed.) [University Hospital, Leuven (Belgium). Dept. of Radiology

    2012-07-01

    Imaging is crucial in the multidisciplinary approach to head and neck cancer management. The rapid technological development of recent years makes it necessary for all members of the multidisciplinary team to understand the potential applications, limitations, and advantages of existing and evolving imaging technologies. It is equally important that the radiologist has sufficient clinical background knowledge to understand the clinical significance of imaging findings. This book provides an overview of the findings obtained using different imaging techniques during the evaluation of head and neck neoplasms, both before and after therapy. All anatomic areas in the head and neck are covered, and the impact of imaging on patient management is discussed in detail. The authors are recognized experts in the field, and numerous high-quality images are included. This second edition provides information on the latest imaging developments in this area, including the application of PET-CT and diffusion-weighted magnetic resonance imaging.

  11. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... will be diagnosed with oral or pharyngeal cancer this year. Here’s what you need to know. Click here ... will be diagnosed with oral or pharyngeal cancer this year. Here’s what you need to know. Click here ...

  12. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... Americans will be diagnosed with oral or pharyngeal cancer this year. Here’s what you need to know. ... Americans will be diagnosed with oral or pharyngeal cancer this year. Here’s what you need to know. ...

  13. Oncologic safety of cervical nerve preservation in neck dissection for head and neck cancer.

    Science.gov (United States)

    Honda, Keigo; Asato, Ryo; Tsuji, Jun; Miyazaki, Masakazu; Kada, Shinpei; Tsujimura, Takashi; Kataoka, Michiko

    2017-09-01

    Although the functional merits of preserving cervical nerves in neck dissection for head and neck cancer have been reported, the oncologic safety has not yet been determined. Therefore, the purpose of this study was to evaluate the safety of cervical nerve preservation. A retrospective chart review was performed on patients with head and neck cancer who had been treated by neck dissection between 2009 and 2014 at Kyoto Medical Center. Management of cervical nerves and clinical results were analyzed. A total of 335 sides of neck dissection had been performed in 222 patients. Cervical nerves were preserved in 175 neck sides and resected in 160 sides. The 5-year overall survival (OS) rate calculated by the Kaplan-Meier method was 71%. The 5-year neck control rate was 95% in cervical nerve preserved sides and 89% in cervical nerve resected sides. Preserving cervical nerves in neck dissection is oncologically safe in selected cases. © 2017 Wiley Periodicals, Inc.

  14. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... at risk for oral cancer? Learn the facts. White patches of the oral tissues — leukoplakia Red patches — erythroplakia Red and white patches — erythroleukoplakia A sore that fails to heal ...

  15. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... cancer? Learn the facts. White patches of the oral tissues — leukoplakia Red patches — erythroplakia Red and white patches — erythroleukoplakia A sore that fails to heal and bleeds easily An abnormal lump or thickening of the tissues of the mouth Chronic sore throat or hoarseness Difficulty in chewing ...

  16. 50 Facts about Oral, Head and Neck Cancer

    Science.gov (United States)

    ... cells, in any of these different types of glands, salivary cancer is not just one disease. There are many different types of salivary gland cancer. Oral head and neck cancer awareness week (OHANCAW) ...

  17. Neck control after definitive radiochemotherapy without planned neck dissection in node-positive head and neck cancers

    International Nuclear Information System (INIS)

    Jang, Na Young; Lee, Keun-Wook; Ahn, Soon-Hyun; Kim, Jae-Sung; Ah Kim, In

    2012-01-01

    The purpose of this study was to evaluate neck control outcomes after definitive radiochemotherapy without planned neck dissection in node-positive head and neck cancer. We retrospectively reviewed medical records of fifty patients with node-positive head and neck cancer who received definitive radiochemotherapy. Twelve patients subsequently underwent neck dissection for suspicious recurrent or persistent disease. A median dose of 70 Gy (range 60-70.6) was delivered to involved nodes. Response evaluation was performed at a median of 5 weeks after completion of radiotherapy. Neck failure was observed in 11 patients and the 3-year regional control (RC) rate was 77.1%. Neck dissection was performed in 10 of the 11 patients; seven of these cases were successfully salvaged, and the ultimate rate of neck control was 92%. The remaining two patients who received neck dissection had negative pathologic results. On univariate analysis, initial nodal size > 2 cm, a less-than-complete response at the primary site, post-radiotherapy nodal size > 1.5 cm, and post-radiotherapy nodal necrosis were associated with RC. On multivariate analysis, less-than-complete primary site response and post-radiotherapy nodal necrosis were identified as independent prognostic factors for RC. The neck failure rate after definitive radiochemotherapy without planned neck dissection was 22%. Two-thirds of these were successfully salvaged with neck dissection and the ultimate neck control rate was 92%. Our results suggest that planned neck dissection might not be necessary in patients with complete response of primary site, no evidence of residual lesion > 1.5 cm, or no necrotic lymph nodes at the 1-2 months follow-up evaluation after radiotherapy

  18. Treatment of Pediatric Head and Neck Cancer - Health Professional Version

    Science.gov (United States)

    Find information about prognosis, staging, and treatment for the following head and neck cancer sites in children: esthesioneuroblastoma, larynx and papillomatosis, nasopharynx, oral cavity, and salivary gland.

  19. Salvage Re-Irradiation for Recurrent Head and Neck Cancer

    International Nuclear Information System (INIS)

    Lee, Nancy; Chan, Kelvin; Bekelman, Justin E.; Zhung, Joanne; Mechalakos, James; Narayana, Ashwatha; Wolden, Suzanne; Venkatraman, Ennapadam S.; Pfister, David; Kraus, Dennis; Shah, Jatin; Zelefsky, Michael J.

    2007-01-01

    Purpose: To present a retrospective review of treatment outcomes for recurrent head and neck (HN) cancer patients treated with re-irradiation (re-RT) at a single medical center. Methods and Materials: From July 1996-September 2005, 105 patients with recurrent HN cancer underwent re-RT at our institution. Sites included were: the neck (n = 21), nasopharynx (n 21), paranasal sinus (n = 18), oropharynx (n = 16), oral cavity (n = 9), larynx (n = 10), parotid (n = 6), and hypopharynx (n = 4). The median prior RT dose was 62 Gy. Seventy-five patients received chemotherapy with their re-RT (platinum-based in the majority of cases). The median re-RT dose was 59.4 Gy. In 74 (70%), re-RT utilized intensity-modulated radiation therapy (IMRT). Results: With a median follow-up of 35 months, 18 patients were alive with no evidence of disease. The 2-year loco-regional progression-free survival (LRPFS) and overall survival rates were 42% and 37%, respectively. Patients who underwent IMRT, compared to those who did not, had a better 2-year LRPF (52% vs. 20%, p < 0.001). On multivariate analysis, non-nasopharynx and non-IMRT were associated with an increased risk of loco-regional (LR) failure. Patients with LR progression-free disease had better 2-year overall survival vs. those with LR failure (56% vs. 21%, p < 0.001). Acute and late Grade 3-4 toxicities were reported in 23% and 15% of patients. Severe Grade 3-4 late complications were observed in 12 patients, with a median time to development of 6 months after re-RT. Conclusions: Based on our data, achieving LR control is crucial for improved overall survival in this patient population. The use of IMRT predicted better LR tumor control. Future aggressive efforts in maximizing tumor control in the recurrent setting, including dose escalation with IMRT and improved chemotherapy, are warranted

  20. Genome Study Yields Clues to Head and Neck Cancers

    Science.gov (United States)

    Researchers have surveyed the genetic changes in nearly 300 head and neck cancers, revealing some previously unknown alterations that may play a role in the disease, including in patients whose cancer is associated with the human papillomavirus (HPV).

  1. Exercise therapy for trismus in head and neck cancer

    NARCIS (Netherlands)

    Dijkstra, P.U.; Sterken, M.W.; Spijkervet, F.K.L.; Roodenburg, J.L.N.; Pater, R.

    The aim of this study was to analyze retrospectively effects of exercise therapy on trismus related to head and neck cancer or as a consequence of its treatment, and to compare these effects with trismus not related to head and neck cancer. Medical records of patients referred to the department of

  2. Photodynamic therapy in head and neck cancer

    Directory of Open Access Journals (Sweden)

    Kamil H Nelke

    2014-02-01

    Full Text Available Photodynamic therapy (PDT is a special type of treatment involving the use of a photosensitizer or a photosensitizing agent along with a special type of light, which, combined together, induces production of a form of oxygen that is used to kill surrounding cells in different areas of the human body. Specification of the head and neck region requires different approaches due to the surrounding of vital structures. PDT can also be used to treat cells invaded with infections such as fungi, bacteria and viruses. The light beam placed in tumor sites activates locally applied drugs and kills the cancer cells. Many studies are taking place in order to invent better photosensitizers, working on a larger scale and to treat deeply placed and larger tumors. It seems that PDT could be used as an alternative surgical treatment in some tumor types; however, all clinicians should be aware that the surgical approach is still the treatment of choice. PDT is a very accurate and effective therapy, especially in early stages of head and neck squamous cell carcinomas (HNSCC, and can greatly affect surgical outcomes in cancerous patients. We present a detailed review about photosensitizers, their use, and therapeutic advantages and disadvantages.

  3. Increase in head and neck cancer in younger patients due to human papillomavirus (HPV).

    Science.gov (United States)

    Young, David; Xiao, Christopher C; Murphy, Benjamin; Moore, Michael; Fakhry, Carole; Day, Terry A

    2015-08-01

    The face of head and neck cancer has changed dramatically over the past 30 years. There has been a steady decline in the number of tobacco and alcohol related squamous cell carcinomas over the past 30 years, but and increasing incidence of human papillomavirus (HPV) related cancers. Some estimates suggest that 70-90% of new oropharyngeal cancers have evidence of HPV. These patients have different demographic patterns, in that they are more likely to be younger, white adults in their 40s and 50s who are never smokers or have reduced tobacco exposure. Studies have shown that a higher number of lifetime oral sex partners (>5) and a higher number of lifetime vaginal sex partners (>25) have been associated with increased risk of HPV positive head and neck cancer. People can also reduce their risk of HPV linked head and neck cancer by receiving the HPV vaccine series prior to becoming sexually active. Recent evidence suggests HPV related head and neck cancers present with different symptoms than those caused by tobacco. The most popular test for HPV status is the p16 immunohistochemical stain because it is cheap, simple, and studies have shown it to have comparable sensitivity and specificity to the previous standards. It is widely recommended that all cancers of the oropharynx be tested for the presence of HPV, and some recommend it for all head and neck cancers. Overall 2-year and 5-year survival for HPV positive head and neck cancer is significantly greater than for HPV negative cancers, likely due to HPV positive cancers being more responsive to treatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Outcome after re-irradiation of head and neck cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Platteaux, Nele; Dirix, Piet; Vanstraelen, Bianca; Nuyts, Sandra [University Hospitals Leuven, Campus Gasthuisberg (Belgium). Dept. of Radiation Oncology

    2011-01-15

    Purpose: To retrospectively report the outcome of head and neck cancer patients following re-irradiation. Patients and Methods: A total of 51 patients with recurrent or second primary head and neck cancer received re-irradiation at Leuven University Hospital. Survival and locoregional control were calculated. Doses to organs at risk were retrieved from dose-volume histograms. Radiation-related toxicities were reported. Results: The 2-year actuarial overall survival rate was 30%. On univariate analysis, surgery before re-irradiation and high radiation dose were associated with superior survival. Grade 3 acute and grade 3 or more late toxicity occurred in respectively 29.4% and 35.3% of the patients. Conclusion: Re-irradiation in head and neck cancer patients is feasible with acceptable late toxicity, although the survival remains poor. (orig.)

  5. Role of Met Axis in Head and Neck Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Yiru, E-mail: xuyiru@umich.edu; Fisher, Gary J., E-mail: xuyiru@umich.edu [Department of Dermatology, University of Michigan, Ann Arbor, MI 48109 (United States)

    2013-11-26

    Head and neck cancer is the sixth most common type of cancer worldwide. Despite advances in aggressive multidisciplinary treatments, the 5-year survival rate for this dreadful disease is only 50%, mostly due to high rate of recurrence and early involvement of regional lymph nodes and subsequent metastasis. Understanding the molecular mechanisms responsible for invasion and metastasis is one of the most pressing goals in the field of head and neck cancer. Met, also known as hepatocyte growth factor receptor (HGFR), is a member of the receptor protein tyrosine kinase (RPTK) family. There is compelling evidence that Met axis is dysregulated and plays important roles in tumorigenesis, progression, metastasis, angiogenesis, and drug resistance in head and neck cancer. We describe in this review current understanding of Met axis in head and neck cancer biology and development of therapeutic inhibitors targeting Met axis.

  6. Radiotherapy for head and neck cancer in elderly patients

    International Nuclear Information System (INIS)

    Schofield, Clare P.; Sykes, Andrew J.; Slevin, Nicholas J.; Rashid, Noor Z.Z.

    2003-01-01

    Background and purpose: Elderly patients with head and neck cancer may not be treated aggressively with radiotherapy, due to concerns regarding tolerance of treatment and toxicity. A retrospective study was undertaken of patients aged 80 years and over, treated by definitive radiotherapy for head and neck cancer. Material and methods: 98 patients aged 80-92 received radiotherapy for carcinoma of the head and neck between 1991 and 1995. All patients received beam directed radiotherapy with radical intent using an immobilisation shell. Results: Cancer specific survival was 59% and overall local control was 70% at 5 years. Both were significantly affected by T stage and site of disease. Cancer specific survival was comparable to that of patients aged below 80 years. Seven patients died within 6 months of the treatment. Three patients developed severe late toxicity. Metastatic disease occurred in eight patients. Conclusions: Radiotherapy is a beneficial and well tolerated treatment in elderly patients with carcinoma of the head and neck

  7. Cancer stem cells in head and neck cancer

    Directory of Open Access Journals (Sweden)

    Trapasso S

    2012-11-01

    Full Text Available Eugenia Allegra, Serena TrapassoOtolaryngology – Head and Neck Surgery, University Magna Graecia of Catanzaro, Catanzaro, ItalyAbstract: Cancer stem cells (CSCs, also called "cells that start the tumor," represent in themselves one of the most topical and controversial issues in the field of cancer research. Tumor stem cells are able to self-propagate in vitro (self-renewal, giving rise both to other tumor stem cells and most advanced cells in the line of differentiation (asymmetric division. A final characteristic is tumorigenicity, a fundamental property, which outlines the tumor stem cell as the only cell able to initiate the formation of a tumor when implanted in immune-deficient mice. The hypothesis of a hierarchical organization of tumor cells dates back more than 40 years, but only in 1997, thanks to the work of John Dick and Dominique Bonnet, was there the formal proof of such an organization in acute myeloid leukemia. Following this, many other research groups were able to isolate CSCs, by appropriate selection markers, in various malignancies, such as breast, brain, colon, pancreas, and liver cancers and in melanoma. To date, however, it is not possible to isolate stem cells from all types of neoplasia, particularly in solid tumors. From a therapeutic point of view, the concept of tumor stem cells implies a complete revision of conventional antineoplastic treatment. Conventional cytotoxic agents are designed to target actively proliferating cells. In the majority of cases, this is not sufficient to eliminate the CSCs, which thanks to their reduced proliferative activity and/or the presence of proteins capable of extruding chemotherapeutics from the cell are not targeted. Therefore, the theory of cancer stem cells can pose new paradigms in terms of cancer treatment. Potential approaches, even in the very early experimental stages, relate to the selective inhibition of pathways connected with self-renewal, or more specifically based on

  8. Clinical problems of multiple primary cancers including head and neck cancers. From the viewpoint of radiotherapy

    International Nuclear Information System (INIS)

    Nishio, Masamichi; Myojin, Miyako; Nishiyama, Noriaki; Taguchi, Hiroshi; Takagi, Masaru; Tanaka, Katsuhiko

    2003-01-01

    A total of 2144 head and neck cancers were treated by radiotherapy at the National Sapporo Hospital between 1974 and 2001. Of these, 313 (14.6%) were found to have other primary cancers besides head and neck cancer, in which double cancers were 79% and triple or more cancers were 21%. Frequency according to primary site of the first head and neck cancer was oral cavity: 107/603 (17.7%), epipharynx cancer: 7/117 (6.0%), oropharyngeal cancer: 63/257 (24.5%), hypopharyngeal cancer: 65/200 (32.5%), laryngeal cancer: 114/558 (20.4%), and nose/paranasal sinus: 4.9% respectively. Esophageal cancer, head and neck cancer, lung cancer and gastric cancer were very frequent as other primary sites combined with the head and neck. The first onset region was the head and neck in 233 out of 313 cases with multiple primary cancers. The five-year survival rate from the onset of head and neck cancers is 52%, 10-year: 30%, and 5-year cause-specific survival rate 82%, and 10-year: 78%, respectively. The treatment possibilities in multiple primary cancers tend to be limited because the treatment areas are sometimes overlapped. New approaches to the treatment of multiple primary cancers should be considered in the future. (author)

  9. Neck mass: An unusual presentation of prostate cancer metastasis ...

    African Journals Online (AJOL)

    Globally, prostate cancer is a disease of public health importance and it is most common among men between 60 to 70 years of age. Distant primaries involving supraclavicular nodes secondary to prostate cancer is very rare. This report is a case of an unusual presentation of prostate cancer manifesting as a huge neck ...

  10. Dose-response relationship for elective neck irradiation of head and neck cancer - facts and controversies

    International Nuclear Information System (INIS)

    Suwinski, R.; Maciejewski, B.; Withers, H.R.

    1998-01-01

    The aim of this study is to assign dose-response relationship for subclinical neck metastases of squamous cell head and neck cancer based on extensive survey of 24 data sets collected from the literature. Neck relapse rates (NRR) without and after elective (ENI) or preoperative irradiation were estimated for each site and stage of primary tumor and the reduction in neck relapse rate was calculated. An average NRR without ENI was 22% (12-35% ) and only 2.5% (0-1 0%) after the ENI with total dose of 46- 50 Gy which gives high reduction rate in the risk of neck recurrences being on the average 89% and 42% (0-46%) after preoperative irradiation using 22-30 Gy. Dose response curve for elective and preoperative irradiation have shown that 50 Gy in 2 Gy fraction reduces the incidence of neck relapses in the NO patients by more than 90% and only by less than 50% after total doses lower than 30 Gy. No correlation between the risk of neck metastases without ENI and the reduction in neck relapses after ENI was found. (authors)

  11. Concomitant weekly cisplatin and radiotherapy for head and neck cancer

    International Nuclear Information System (INIS)

    Homma, Akihiro; Inamura, Naoya; Oridate, Nobuhiko

    2011-01-01

    The most common chemoradiotherapy regimen is high-dose (100 mg/m 2 ) three-weekly cisplatin with concomitant radiotherapy; however, this protocol is associated with acute and late toxicities. Here, we reviewed the dose intensity and toxicity for concomitant weekly cisplatin and radiotherapy in patients with head and neck cancer. Fifty-three patients with untreated head and neck cancer were enrolled and evaluated at our institution from April 2006 to April 2010. Weekly cisplatin (40 mg/m 2 ) was given on weeks 1, 2, 3, 5, 6 and 7 with radiotherapy, which comprised a standard dose of 70 Gy delivered in 35 daily fractions over 7 weeks. Fifty-one patients (96.2%) received the full dose of radiotherapy, while the course was disrupted by adverse events in two. Over the course of the chemotherapy, 31 patients (58.5%) received more than 200 mg/m 2 cisplatin. The toxicity was manageable in all except one patient, who died of sepsis after completing treatment. The 2-year overall survival rate and local progression-free rate for all patients were 93.7% and 88.0%, respectively. The primary site showed a complete response in 52 patients (98.1%) and a partial response in 1 patient (1.9%). The primary disease was well controlled by chemoradiotherapy in 47 patients (88.7%). Weekly cisplatin could be easier to manage than three-weekly cisplatin, because patients can be monitored more regularly for toxicity allowing the schedule to be altered if required. This regimen appears to be a suitable alternative to three-weekly high-dose cisplatin with concomitant radiotherapy. (author)

  12. Treatment of Head and Neck Cancer in Adults - Health Professional Version

    Science.gov (United States)

    Find information about prognosis, staging, and treatment for adult head and neck cancer sites: hypopharynx, larynx, lip and oral cavity, neck cancer with occult primary, nasopharynx, oropharynx, paranasal sinus and nasal cavity, and salivary gland cancer.

  13. Planned neck dissection for oropharyngeal and hypopharyngeal cancers

    International Nuclear Information System (INIS)

    Hanai, Nobuhiro; Hasegawa, Yasuhisa; Terada, Akihiro; Ozawa, Taijiro; Hirakawa, Hitoshi; Kawakita, Daisuke; Maruo, Takashi; Mikami, Shinnji

    2010-01-01

    Recently, the use of chemoradiotherapy for preserving organs in the treatment of head and neck cancer is increasing. However, there is controversy about advanced neck node management in post-chemoradiation cases. We retrospectively analyzed our 119 cases of chemoradiotherapy for oropharyngeal and hypopharyngeal cancer to examine the effectiveness and indications of planned neck dissection. Regional control rate and survival rate were superior in the neck dissection group. If the cases did not achieve complete response (CR) in imaging, planned neck dissection improved the regional control rate significantly. We should perform planned neck dissection immediately rather than 'wait and see' for this persistent disease. However, in the cases achieving radiological CR, it is possible to omit planned neck dissection because of the high salvage rate of neck disease. However, in these cases, careful observation is essential. We clarified that the presence of pathologically positive lymph node is a prognostic factor. For evaluating persistent disease of cervical lymph nodes, positron emission tomography (PET)-CT was the most accurate method of imaging. (author)

  14. Hypothyroidism after Radiotherapy of Locally Advanced Head and Neck Cancer

    International Nuclear Information System (INIS)

    Lee, Jeong Eun; Eun; Kim, Jae Chul; Park, In Kyu; Yea, Ji Woon

    2010-01-01

    The aim of the present study was to retrospectively evaluate the incidence of hypothyroidism in locally advanced head and neck cancer patients who received radiotherapy (RT) either with or without neck dissection. From January 2000 to December 2005, 115 patients with locally advanced head and neck cancer and who received definitive RT or postoperative RT including standard anterior low-neck field were recruited to be part of this study. Nineteen patients had undergone ipsilateral neck dissection, whereas, 18 patients underwent bilateral neck dissection, and 78 patients were received RT alone. Patients' ages ranged from 28 to 85 years (median, 59 years) and there were a total of 73 male and 42 female patients. The primary tumor sites were the oral cavity, oropharynx, hypopharynx, larynx, and other sites in 18, 40, 28, 22 and 7 patients, respectively. Radiation dose to the thyroid gland ranged from 44 Gy to 66 Gy with a median dose of 50 Gy. Follow-up time ranged from 2 to 91 months, with a median of 29 months. The 1- and 3- year incidence of hypothyroidism was 28.7% (33 patients) and 33.0% (38 patients), respectively. The median time to detection of hypothyroidism was 8.5 months (range, 0 to 36 months). A univariate analysis revealed that neck node dissection was a risk factor for hypothyroidism (p=0.037). However, no factor was statistically significant from the results of a multivariate analysis. Patients treated for advanced head and neck cancer with radiotherapy with or without neck dissection will develop hypothyroidism. It is important to check the thyroid function periodically in these patients especially with the risk factor of neck node dissection.

  15. Hypothyroidism after Radiotherapy of Locally Advanced Head and Neck Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Eun; Eun; Kim, Jae Chul; Park, In Kyu [Kyungpook National Yonsei University School of Medicine, Daegu (Korea, Republic of); Yea, Ji Woon [Dongguk University Gyeongju Hospital, Gyeongju (Korea, Republic of)

    2010-11-15

    The aim of the present study was to retrospectively evaluate the incidence of hypothyroidism in locally advanced head and neck cancer patients who received radiotherapy (RT) either with or without neck dissection. From January 2000 to December 2005, 115 patients with locally advanced head and neck cancer and who received definitive RT or postoperative RT including standard anterior low-neck field were recruited to be part of this study. Nineteen patients had undergone ipsilateral neck dissection, whereas, 18 patients underwent bilateral neck dissection, and 78 patients were received RT alone. Patients' ages ranged from 28 to 85 years (median, 59 years) and there were a total of 73 male and 42 female patients. The primary tumor sites were the oral cavity, oropharynx, hypopharynx, larynx, and other sites in 18, 40, 28, 22 and 7 patients, respectively. Radiation dose to the thyroid gland ranged from 44 Gy to 66 Gy with a median dose of 50 Gy. Follow-up time ranged from 2 to 91 months, with a median of 29 months. The 1- and 3- year incidence of hypothyroidism was 28.7% (33 patients) and 33.0% (38 patients), respectively. The median time to detection of hypothyroidism was 8.5 months (range, 0 to 36 months). A univariate analysis revealed that neck node dissection was a risk factor for hypothyroidism (p=0.037). However, no factor was statistically significant from the results of a multivariate analysis. Patients treated for advanced head and neck cancer with radiotherapy with or without neck dissection will develop hypothyroidism. It is important to check the thyroid function periodically in these patients especially with the risk factor of neck node dissection.

  16. [Genetic basis of head and neck cancers and gene therapy].

    Science.gov (United States)

    Özel, Halil Erdem; Özkırış, Mahmut; Gencer, Zeliha Kapusuz; Saydam, Levent

    2013-01-01

    Surgery and combinations of traditional treatments are not successful enough particularly for advanced stage head and neck cancer. The major disadvantages of chemotherapy and radiation therapy are the lack of specificity for the target tissue and toxicity to the patient. As a result, gene therapy may offer a more specific approach. The aim of gene therapy is to present therapeutic genes into cancer cells which selectively eliminate malignant cells with no systemic toxicity to the patient. This article reviews the genetic basis of head and neck cancers and important concepts in cancer gene therapy: (i) inhibition of oncogenes; (ii) tumor suppressor gene replacement; (iii) regulation of immune response against malignant cells; (iv) genetic prodrug activation; and (v) antiangiogenic gene therapy. Currently, gene therapy is not sufficient to replace the traditional treatments of head and neck cancers, however there is no doubt that it will have an important role in the near future.

  17. 2 years versus 1 year of adjuvant trastuzumab for HER2-positive breast cancer (HERA)

    DEFF Research Database (Denmark)

    Goldhirsch, Aron; Gelber, Richard D; Piccart-Gebhart, Martine J

    2013-01-01

    Trastuzumab has established efficacy against breast cancer with overexpression or amplification of the HER2 oncogene. The standard of care is 1 year of adjuvant trastuzumab, but the optimum duration of treatment is unknown. We compared 2 years of treatment with trastuzumab with 1 year of treatment......, and updated the comparison of 1 year of trastuzumab versus observation at a median follow-up of 8 years, for patients enrolled in the HERceptin Adjuvant (HERA) trial....

  18. Orofacial pain onset predicts transition to head and neck cancer

    Science.gov (United States)

    LAM, D.K.; SCHMIDT, B.L.

    2011-01-01

    Contrary to a clinical aphorism that early head and neck cancer is painless, we show that patients who develop head and neck cancer experience significant pain at the time of initial diagnosis. We compared orofacial pain sensitivity in groups of patients with normal oral mucosa, oral precancer and newly diagnosed oral cancer. The UCSF Oral Cancer Pain Questionnaire was administered to these patients at their initial visit, before being prescribed analgesics for pain and before any treatment. In contrast to those with biopsy-proven normal oral mucosa and oral precancer, only oral cancer patients reported significant levels of spontaneous pain and functional restriction from pain. Moreover, oral cancer patients experienced significantly higher function-related, rather than spontaneous pain qualities. These findings suggest an important predictor for the transition from oral precancer to cancer may be the onset of orofacial pain that is exacerbated during function. Screening patients who have new-onset orofacial pain may lead to a diagnosis of early, resectable head and neck cancer and may improve quality of life and survival for head and neck cancer patients. PMID:21388740

  19. Head and Neck Cancer: Symptoms and Signs

    Science.gov (United States)

    ... to Content ASCO.org Conquer Cancer Foundation ASCO Journals Donate eNews Signup f Cancer.net on Facebook t Cancer.net on Twitter q Cancer.net on YouTube g Cancer.net on Google Menu Home Types of Cancer Navigating Cancer Care Coping With Cancer Research and Advocacy Survivorship Blog About ...

  20. Carotid Artery Sacrifice and Reconstruction in the Setting of Advanced Head and Neck Cancer.

    Science.gov (United States)

    Mourad, Moustafa; Saman, Masoud; Stroman, David; Lee, Thomas; Ducic, Yadranko

    2015-08-01

    To determine oncological and neuromorbidity outcomes in patients with advanced head and neck cancer (stage IVB) requiring sacrifice and reconstruction of the carotid artery. Case series with chart review. Tertiary care referral center. Overall, 51 patients underwent carotid artery sacrifice during surgical treatment of the neck, in both the primary and salvage setting. All patients underwent autogenous in-line carotid artery bypass grafting with either saphenous vein or the deep femoral vein in conjunction with vascular surgery. In all, the study included 39 males and 12 female subjects, with age ranging from 39 to 82 (mean, 62.7). Two patients (3.9%) had a cerebral vascular accident in the immediate postoperative period. The remaining 49 patients (96%) had no neurologic sequela. Serial ultrasonic evaluation revealed 4 patients with intra-luminal thrombus within the site of reconstruction. Perioperative mortality occurred in a single patient. Disease-related mortality occurred in 9.8% (5) of patients, with an overall 2-year survival of 82%. We presently report the largest series of surgical treatment for advanced head and neck cancer with carotid artery involvement. We document an overall 2-year survival of 82% in the setting of low perioperative neuromorbidity and mortality rates. We therefore consider carotid artery sacrifice and autogenous vein graft reconstruction in the absence of distant metastatic disease as a viable treatment option for what was once thought to be a palliative procedure. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  1. Medullary Thyroid Cancer: It is a pain in the neck?

    Directory of Open Access Journals (Sweden)

    Marlon A. Guerrero, Sheila Lindsay, Insoo Suh, Menno R. Vriens, Elham Khanafshar, Wen T. Shen, Jessica Gosnell, Electron Kebebew, Quan-Yang Duh, Orlo H. Clark

    2011-01-01

    Full Text Available Background: Medullary thyroid cancer (MTC commonly presents with lymph node (LN metastases, and has a worse prognosis than papillary thyroid cancer (PTC. Tumor size and LN involvement have been shown to affect stage of disease; however, to our knowledge, ours is the first study that attempts to correlate anterior neck pain on presentation with the extent of disease.Methods: We performed a retrospective review of patients with MTC who underwent an operation from February 1998 through December 2008. We compared the symptom of anterior neck pain with the pathologic extent of disease. Our control group comprised patients who underwent an operation for PTC. Analysis was performed using the Fisher's exact test and the Mann-Whitney test.Results: Of the 109 patients with MTC, 50 (46% met our inclusion criteria. Of the 50 patients with MTC, 11 presented with neck pain, compared to 3 of the 50 patients with PTC (p = 0.041. Of those 11 patients, 9 (82% had LN involvement on final pathology, as compared with 14 (36% of the 39 without neck pain (p = 0.014. Of patients with neck pain, 18% were diagnosed at stage I to II and 82% at stage III to IV, compared to 64% at stage I to II and 36% at stage III to IV (p = 0.014.Conclusions: Our study demonstrates that more patients with MTC present with anterior neck pain than do patients with PTC and that patients with MTC and neck pain have an increased risk of LN metastases. The results of this study suggest that MTC patients, who present with concomitant neck pain, should undergo a total thyroidectomy, prophylactic bilateral central neck dissection, and ipsilateral lateral neck dissection.

  2. Medullary Thyroid Cancer: It is a pain in the neck?

    Science.gov (United States)

    Guerrero, Marlon A; Lindsay, Sheila; Suh, Insoo; Vriens, Menno R; Khanafshar, Elham; Shen, Wen T; Gosnell, Jessica; Kebebew, Electron; Duh, Quan-Yang; Clark, Orlo H

    2011-04-08

    Medullary thyroid cancer (MTC) commonly presents with lymph node (LN) metastases, and has a worse prognosis than papillary thyroid cancer (PTC). Tumor size and LN involvement have been shown to affect stage of disease; however, to our knowledge, ours is the first study that attempts to correlate anterior neck pain on presentation with the extent of disease. We performed a retrospective review of patients with MTC who underwent an operation from February 1998 through December 2008. We compared the symptom of anterior neck pain with the pathologic extent of disease. Our control group comprised patients who underwent an operation for PTC. Analysis was performed using the Fisher's exact test and the Mann-Whitney test. Of the 109 patients with MTC, 50 (46%) met our inclusion criteria. Of the 50 patients with MTC, 11 presented with neck pain, compared to 3 of the 50 patients with PTC (p = 0.041). Of those 11 patients, 9 (82%) had LN involvement on final pathology, as compared with 14 (36%) of the 39 without neck pain (p = 0.014). Of patients with neck pain, 18% were diagnosed at stage I to II and 82% at stage III to IV, compared to 64% at stage I to II and 36% at stage III to IV (p = 0.014). Our study demonstrates that more patients with MTC present with anterior neck pain than do patients with PTC and that patients with MTC and neck pain have an increased risk of LN metastases. The results of this study suggest that MTC patients, who present with concomitant neck pain, should undergo a total thyroidectomy, prophylactic bilateral central neck dissection, and ipsilateral lateral neck dissection.

  3. Medullary Thyroid Cancer: It is a pain in the neck?

    Science.gov (United States)

    Guerrero, Marlon A.; Lindsay, Sheila; Suh, Insoo; Vriens, Menno R.; Khanafshar, Elham; Shen, Wen T.; Gosnell, Jessica; Kebebew, Electron; Duh, Quan-Yang; Clark, Orlo H.

    2011-01-01

    Background: Medullary thyroid cancer (MTC) commonly presents with lymph node (LN) metastases, and has a worse prognosis than papillary thyroid cancer (PTC). Tumor size and LN involvement have been shown to affect stage of disease; however, to our knowledge, ours is the first study that attempts to correlate anterior neck pain on presentation with the extent of disease. Methods: We performed a retrospective review of patients with MTC who underwent an operation from February 1998 through December 2008. We compared the symptom of anterior neck pain with the pathologic extent of disease. Our control group comprised patients who underwent an operation for PTC. Analysis was performed using the Fisher's exact test and the Mann-Whitney test. Results: Of the 109 patients with MTC, 50 (46%) met our inclusion criteria. Of the 50 patients with MTC, 11 presented with neck pain, compared to 3 of the 50 patients with PTC (p = 0.041). Of those 11 patients, 9 (82%) had LN involvement on final pathology, as compared with 14 (36%) of the 39 without neck pain (p = 0.014). Of patients with neck pain, 18% were diagnosed at stage I to II and 82% at stage III to IV, compared to 64% at stage I to II and 36% at stage III to IV (p = 0.014). Conclusions: Our study demonstrates that more patients with MTC present with anterior neck pain than do patients with PTC and that patients with MTC and neck pain have an increased risk of LN metastases. The results of this study suggest that MTC patients, who present with concomitant neck pain, should undergo a total thyroidectomy, prophylactic bilateral central neck dissection, and ipsilateral lateral neck dissection. PMID:21509150

  4. Is open surgery for head and neck cancers truly declining?

    NARCIS (Netherlands)

    Hartl, D.M.; Brasnu, D.F.; Shah, J.P.; Hinni, M.L.; Takes, R.P.; Olsen, K.D.; Kowalski, L.P.; Rodrigo, J.P.; Strojan, P.; Wolf, G.T.; Rinaldo, A.; Suarez, C.; Mendenhall, W.M.; Paleri, V.; Forastiere, A.A.; Werner, J.A.; Ferlito, A.

    2013-01-01

    In the past two decades, major modifications in the way we treat head and neck cancers, due to advances in technology and medical oncology, have led to a decline in the use of open surgery as first-line treatment of cancers arising from several primary tumor sites. The incidence of tobacco- and

  5. The predictive value of 2-year posttreatment biopsy after prostate cancer radiotherapy for eventual biochemical outcome

    International Nuclear Information System (INIS)

    Vance, Waseet; Tucker, Susan L.; Crevoisier, Renaud de; Kuban, Deborah A.; Cheung, M. Rex

    2007-01-01

    Purpose: To determine the value of a 2-year post-radiotherapy (RT) prostate biopsy for predicting eventual biochemical failure in patients who were treated for localized prostate cancer. Methods and Materials: This study comprised 164 patients who underwent a planned 2-year post-RT prostate biopsy. The independent prognostic value of the biopsy results for forecasting eventual biochemical outcome and overall survival was tested with other factors (the Gleason score, 1992 American Joint Committee on Cancer tumor stage, pretreatment prostate-specific antigen level, risk group, and RT dose) in a multivariate analysis. The current nadir + 2 (CN + 2) definition of biochemical failure was used. Patients with rising prostate-specific antigen (PSA) or suspicious digital rectal examination before the biopsy were excluded. Results: The biopsy results were normal in 78 patients, scant atypical and malignant cells in 30, carcinoma with treatment effect in 43, and carcinoma without treatment effect in 13. Using the CN + 2 definition, we found a significant association between biopsy results and eventual biochemical failure. We also found that the biopsy status provides predictive information independent of the PSA status at the time of biopsy. Conclusion: A 2-year post-RT prostate biopsy may be useful for forecasting CN + 2 biochemical failure. Posttreatment prostate biopsy may be useful for identifying patients for aggressive salvage therapy

  6. Importance of comorbidity in head and neck cancer.

    Science.gov (United States)

    Piccirillo, J F

    2000-04-01

    Patients with head and neck cancer are staged according to the morphology of the tumor with little or no attention given to the importance of the other diseases, illnesses, or conditions. These other conditions are generally referred to as comorbidities. Although not a feature of the cancer itself, comorbidity is an important attribute of the patient with cancer. Comorbidity has direct impact on the care of patients, selection of initial treatment, and evaluation of treatment effectiveness. The objective of this thesis is to demonstrate the importance of comorbidity in head and neck cancer. Specifically, the aims are 1) to demonstrate the burden of comorbidity among head and neck cancer patients by comparing the incidence of none, mild, moderate, and severe comorbidity among patients with head and neck cancer to patients with cancers of the colorectum, lung, breast, gynecological sites, or prostate, 2) to demonstrate the independent impact of comorbidity on overall survival, and 3) to demonstrate the importance of comorbidity in the assessment of initial treatment effectiveness. This was a prospective cohort study of the impact of comorbidity on head and neck cancer patients presenting for treatment between January 1995 and December 1996. In 1994, the author trained cancer registrars at an academic teaching hospital to code comorbidity from the medical record of new patients using a standard comorbidity index. Standard statistical techniques, including multivariable analysis, were used to compare and contrast the burden of comorbidity for patients with different cancers. Life survival techniques and multivariable logistic regression analysis were used to assess the independent prognostic impact of comorbidity. Further, the technique of conjunctive consolidation was used to augment the TNM system with comorbidity information, to more completely assess the impact of different initial treatments for patients with head and neck cancers. The cohort consisted of 3

  7. Complete Response to Bicalutamide Withdrawal Prolonged for Almost 2 Years in Patients With Metastatic Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Hiroshi Hongo

    2014-09-01

    Full Text Available This is the first case report describing a complete response to bicalutamide withdrawal that lasted for almost 2 years in a patient with metastatic prostate cancer. An 80-year-old man who had prostate-specific antigen (PSA level elevation (168.1 ng/mL visited our hospital in February 2010. Bone scintigraphy showed pelvic metastases. We started hormonal therapy with leuprorelin and bicalutamide. The PSA concentration decreased to <0.1 ng/mL but started increasing again and reached 1.64 ng/mL in October 2012, at which time bicalutamide administration was discontinued. The PSA concentration decreased again and has remained below the limit of sensitivity for almost 2 years.

  8. Postoperative radiation for advanced head and neck cancers

    International Nuclear Information System (INIS)

    Ang, K. Kian; Garden, Adam S.

    1995-01-01

    Purpose: To discuss both general and specific indications for radiation following surgery for patients with cancers of the head and neck. Patients with advanced cancers of the head and neck are often not suitable candidates for treatment with definitive radiation, and are treated with surgery. Frequently these patients fail by recurring in either the primary sites or in the necks. Adjuvant radiation is therefore often a critical component in the management of these patients. While radiation can be done either prior to or after surgery, most centers prefer the postoperative setting. This refresher course will review general concepts of postoperative irradiation for the patient with head and neck cancer and apply these concepts to specific situations. The course will begin with a broad review of the indications for postoperative irradiation as not all patients undergoing surgery for cancers of the head and neck require additional treatment. We will also review the concept of using postoperative radiation to allow for more conservative surgery with preservation of function. The second portion of the course will focus on general techniques of postoperative irradiation. We will review concepts of patient setup and treatment portal design and describe how specific techniques are practiced at MDACC. Controversial topics, including field matching, total dose and fractionation, and the timing of postoperative radiation will be discussed. The final section of the course will review the results of postoperative irradiation as applied to the head and neck in general as well as to specific subsites. In addition to results for the common scenarios of squamous cell carcinomas of the oral cavity, pharynx and larynx, we will review results of postoperative irradiation for skin cancers of the head and neck, paranasal sinuses, and salivary glands

  9. Neck muscle atrophy and soft-tissue fibrosis after neck dissection and postoperative radiotherapy for oral cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jinu; Shin, Eun Seow; Kim, Jeong Eon; Yoon, Sang Pil [Jeju National University School of Medicine, Jeju (Korea, Republic of); Kim, Young Suk [Dept. of Radiation Oncology, Jeju National University Hospital, Jeju National University School of Medicine, Jeju (Korea, Republic of)

    2015-12-15

    Late complications of head and neck cancer survivors include neck muscle atrophy and soft-tissue fibrosis. We present an autopsy case of neck muscle atrophy and soft-tissue fibrosis (sternocleidomastoid, omohyoid, digastric, sternohyoid, sternothyroid, and platysma muscles) within the radiation field after modified radical neck dissection type I and postoperative radiotherapy for floor of mouth cancer. A 70-year-old man underwent primary tumor resection of the left floor of mouth, left marginal mandibulectomy, left modified radical neck dissection type I, and reconstruction with a radial forearm free flap. The patient received adjuvant radiotherapy. The dose to the primary tumor bed and involved neck nodes was 63 Gy in 35 fractions over 7 weeks. Areas of subclinical disease (left lower neck) received 50 Gy in 25 fractions over 5 weeks. Adjuvant chemotherapy was not administered.

  10. Performance assessment of diffuse optical spectroscopic imaging instruments in a 2-year multicenter breast cancer trial

    Science.gov (United States)

    Leproux, Anaïs; O'Sullivan, Thomas D.; Cerussi, Albert; Durkin, Amanda; Hill, Brian; Hylton, Nola; Yodh, Arjun G.; Carp, Stefan A.; Boas, David; Jiang, Shudong; Paulsen, Keith D.; Pogue, Brian; Roblyer, Darren; Yang, Wei; Tromberg, Bruce J.

    2017-12-01

    We present a framework for characterizing the performance of an experimental imaging technology, diffuse optical spectroscopic imaging (DOSI), in a 2-year multicenter American College of Radiology Imaging Network (ACRIN) breast cancer study (ACRIN-6691). DOSI instruments combine broadband frequency-domain photon migration with time-independent near-infrared (650 to 1000 nm) spectroscopy to measure tissue absorption and reduced scattering spectra and tissue hemoglobin, water, and lipid composition. The goal of ACRIN-6691 was to test the effectiveness of optically derived imaging endpoints in predicting the final pathologic response of neoadjuvant chemotherapy (NAC). Sixty patients were enrolled over a 2-year period at participating sites and received multiple DOSI scans prior to and during 3- to 6-month NAC. The impact of three sources of error on accuracy and precision, including different operators, instruments, and calibration standards, was evaluated using a broadband reflectance standard and two different solid tissue-simulating optical phantoms. Instruments showed <0.0010 mm-1 (10.3%) and 0.06 mm-1 (4.7%) deviation in broadband absorption and reduced scattering, respectively, over the 2-year duration of ACRIN-6691. These variations establish a useful performance criterion for assessing instrument stability. The proposed procedures and tests are not limited to DOSI; rather, they are intended to provide methods to characterize performance of any instrument used in translational optical imaging.

  11. A review of scientific papers about head and neck cancers

    International Nuclear Information System (INIS)

    Paoli, Severo de; Fonseca, Adenilson de Souza da; Paoli, Flavia de; Geller, Mauro; Presta, Giuseppe Antonio; Santos-Filho, Sebastiao David; Bernardo-Filho, Mario

    2008-01-01

    Head and neck cancer is one of the 10 most frequent cancers worldwide, with an estimated 500000 new cases diagnosed annually. Treatment of head and neck cancers require a multidisciplinary approach due their complexity and the functional and esthetic alterations that cancer can cause. The interest of the scientific community in a specific subject can be evaluated by analyzing of the number and the quality of published papers on the topic. The information obtained from PubMed (www.ncbi.nlm.nih.gov/sites/entrez) has been used as a tool in various publications to aid the evaluation of the scientific interest in specific research areas The aim of this work is to evaluate, using PubMed, the scientific interest in studies of head and neck cancer treatments such as radiotherapy, chemotherapy and surgery. The searches were performed on PubMed for publications from the period of 1949 to 2008 using the search terms 'head and neck cancer' and 'surgery' or 'radiotherapy' or 'chemotherapy'. The number of publications per year was determined in each search. The percentage of publications was also calculated for each subject in each year. An interest factor in a subject (IFS) was also determined. The number of publications was higher for surgery than chemotherapy or radiotherapy. The calculated 1964 IFS for surgery was 14.79, 12.74 for radiotherapy, and 19.58 for chemotherapy. The 1995 IFS for surgery was 1.99, 2.09 for radiotherapy, and 2.08 for chemotherapy. The relation obtained for 1995 was maintained in the subsequent years. There are more publications related to surgical treatment for head and neck cancer when compared with radiotherapy and chemotherapy. Moreover, in the recent years there has an increased interest in treatments utilizing chemotherapy, or this associated to radiotherapy. (author)

  12. Carcinoembryonic antigen and head and neck cancer

    NARCIS (Netherlands)

    Laarman, D. A.; van Kamp, G. J.; Balm, A. J.; Braakhuis, B. J.; Snow, G. B.

    1991-01-01

    Carcinoembryonic antigen (CEA) concentrations were determined in the sera of 45 patients with a head and neck squamous cell carcinoma and of 13 controls. In 13 patients serial CEA measurements were made during the follow-up period. In 38% of the patients the serum CEA level was slightly elevated

  13. The role of human papillomavirus in head and neck cancer

    DEFF Research Database (Denmark)

    Lajer, Christel Braemer; Buchwald, Christian von

    2010-01-01

    Over the last 20 years, there has been increasing awareness of a subset of squamous cell carcinomas of the head and neck (HNSCC), i.e. HPV-positive HNSCC. These cancers seem to differ somewhat from HPV-negative HNSCC. Patients with HPV-positive HNSCC tend to be younger and have a lower intake...

  14. Prophylactic Swallowing Exercises in Head and Neck Cancer Radiotherapy

    DEFF Research Database (Denmark)

    Mortensen, H R; Jensen, Kenneth; Aksglæde, K

    2015-01-01

    Many head and neck cancer (HNC) survivors experience reduced quality of life due to radiotherapy (RT)-related dysphagia. The aim of this prospective randomized trial was to evaluate the impact of prophylactic swallowing exercises on swallowing-related outcomes in HNC patients treated with curative...

  15. Morbidity And Quality Of Life Among Head And Neck Cancer ...

    African Journals Online (AJOL)

    Objectives: To determine the relative frequency of acute radiation morbidity and their perceived effect on quality of life among head and neck cancer patients treated with radical radiotherapy. Design: A cross-sectional study. Setting: Kenyatta National Hospital, Nairobi. Subjects: Thirty eight patients comprising 28 males and ...

  16. Clinicopathological correlates of pediatric head and neck cancer

    Directory of Open Access Journals (Sweden)

    Sengupta Subhabrata

    2009-01-01

    Full Text Available Background : The spectrum of head and neck tumors in children continues to be the cause of diverse, diagnostically challenging issues. Aims : To demonstrate and compare the unique clinicopathological features in our study population and their correlations with the final histopathological diagnosis. Methods : Fifty-three children with head and neck cancer were examined thoroughly at the Otorhinolaryngology department in a tertiary care teaching hospital followed by histopathological studies. Results : Lymphomas were the most common malignant lesions seen followed by rhabdomyosarcomas, nasopharyngeal carcinomas, and others like thyroid carcinomas and eosinophilic granulomas. In the neck, the commonest cause of primary malignant disease was lymphoma; however, the most frequent lesion was reactive lymphadenitis. In the sinonasal region, the commonest malignancy was rhabdomyosarcoma, which often had extension to the orbit and the face. Recurrent epistaxis was found universally in the malignant cases of this region. In the facial region, disfiguring swelling with proptosis was mainly caused by rhabdomyosarcoma. The only case of tonsillar malignancy was due to non-Hodgkin lymphoma. The duration of disease was less than 1 year. Conclusion : The most common manifestation of the malignant lesions in the pediatric age group was with a history of an enlarging, painless neck swelling. Still, an insignificant lump in the neck or recurrent bleeding from nose may be the manifestation of an underlying cancer.

  17. Metastatic colorectal cancer responsive to regorafenib for 2 years: a case report.

    Science.gov (United States)

    Yoshino, Kenji; Manaka, Dai; Kudo, Ryo; Kanai, Shunpei; Mitsuoka, Eisei; Kanto, Satoshi; Hamasu, Shinya; Konishi, Sayuri; Nishitai, Ryuta

    2017-08-18

    Regorafenib is an oral multikinase inhibitor that has been demonstrated as clinically effective in patients with metastatic colorectal cancer in phase III studies. Although disease control was achieved in 40% of the pretreated patients with metastatic colorectal cancer in the pivotal studies, radiological response has rarely been reported. Severe adverse events associated with regorafenib are known to occur during the first and second courses of treatment. We present a case of a 62-year-old Japanese patient whose metastatic colorectal cancer has been responding to treatment with regorafenib for 2 years. A 54-year-old Japanese man visited our institute exhibiting general malaise, and he was diagnosed with ascending colon cancer in April 2006. He underwent right hemicolectomy, and the final staging was T3N0M0, stage II. After 19 months, pulmonary metastasis and anastomotic recurrences were detected, and a series of operations were performed to resect both metastatic lesions. After that, liver metastasis, a duodenal metastasis with right renal invasion, right adrenal metastasis, and para-aortic lymph node metastases were observed during follow-up, and chemotherapy and resection were performed. The patient had metastatic para-aortic lymph nodes after the fifth tumor resection and underwent multiple lines of chemotherapy in April 2014. Regorafenib monotherapy was started at 80 mg/day. Then, regorafenib was increased to 120 mg/day in the second cycle. Regorafenib monotherapy led to 60% tumor shrinkage within the initial 2 months, and the tumor further decreased in size over 4 months until it became unrecognizable on imaging studies. The clinical effects of regorafenib monotherapy have shown a partial response according to Response Evaluation Criteria in Solid Tumors criteria. No severe adverse events were observed, except for mild fatigue and hand-foot syndrome. The patient has received 24 courses of regorafenib over 2 years without exhibiting tumor progression. To the

  18. Intensity-Modulated Radiotherapy for Head and Neck Cancer of Unknown Primary: Toxicity and Preliminary Efficacy

    International Nuclear Information System (INIS)

    Klem, Michelle L.; Mechalakos, James G.; Wolden, Suzanne L.; Zelefsky, Michael J.; Singh, Bhuvanesh; Kraus, Dennis; Shaha, Ashok; Shah, Jatin; Pfister, David G.; Lee, Nancy Y.

    2008-01-01

    Purpose: Unknown primary head and neck cancers often require comprehensive mucosal and bilateral neck irradiation. With conventional techniques, significant toxicity can develop. Intensity-modulated radiotherapy (IMRT) has the potential to minimize the toxicity. Methods and Materials: Between 2000 and 2005, 21 patients underwent IMRT for unknown primary head and neck cancer at our center. Of the 21 patients, 5 received IMRT with definitive intent and 16 as postoperative therapy; 14 received concurrent chemotherapy and 7 IMRT alone. The target volumes included the bilateral neck and mucosal surface. The median dose was 66 Gy. Acute and chronic toxicities, esophageal strictures, and percutaneous endoscopic gastrostomy tube dependence were evaluated. Progression-free survival, regional progression-free survival, distant metastasis-free survival, and overall survival were estimated with Kaplan-Meier curves. Results: With a median follow-up of 24 months, the 2-year regional progression-free survival, distant metastasis-free survival, and overall survival rate was 90%, 90%, and 85%, respectively. Acute grade 1 and 2 xerostomia was seen in 57% and 43% of patients, respectively. Salivary function improved with time. Percutaneous endoscopic gastrostomy tube placement was required in 72% with combined modality treatment and 43% with IMRT alone. Only 1 patient required percutaneous endoscopic gastrostomy support at the last follow-up visit. Two patients treated with combined modality and one treated with IMRT alone developed esophageal strictures, but all had improvement or resolution with dilation. Conclusion: The preliminary analysis of IMRT for unknown primary head and neck cancer has shown acceptable toxicity and encouraging efficacy. The analysis of the dosimetric variables showed excellent tumor coverage and acceptable doses to critical normal structures. Esophageal strictures developed but were effectively treated with dilation. Techniques to limit the esophageal dose

  19. Morbidity after neck dissection in head and neck cancer patients : a study describing shoulder and neck complaints, and quality of life

    NARCIS (Netherlands)

    Wilgen, Cornelis Paul van

    2004-01-01

    In this thesis we are aiming at more insight in morbidity after head and neck cancer treatment (resection of the primary tumour, neck dissection and pre-or post-operative radiation therapy). We will study shoulder complaints and the role of the spinal accessory nerve, pain and the underlying pain

  20. Palliative radiotherapy in head and neck cancers: Evidence based review

    Directory of Open Access Journals (Sweden)

    Talapatra Kaustav

    2006-01-01

    Full Text Available Squamous cell carcinoma of head and neck (SCCHN is one of the commonest cancers seen in India, constituting up to 25% of their overall cancer burden. Advanced SCCHN is a bad disease with a poor prognosis and patients usually die of uncontrolled loco-regional disease. Curative intent management of loco-regionally advanced SCCHN has become more evidence-based with active clinical research in the form of large prospective randomized controlled trials and meta-analyses. However, little has been written about palliative radiotherapy (PRT in head and neck cancers. It is widely recognized that PRT provides effective palliation and improved quality-of-life in advanced incurable malignancies. It is in this context that this study proposes to review the existing literature on palliative radiotherapy in advanced incurable SCCHN to help formulate consensus guidelines and recommendations.

  1. Intraoperative radiation therapy for recurrent head-and-neck cancer: The UCSF experience

    International Nuclear Information System (INIS)

    Chen, Allen M.; Bucci, M. Kara; Singer, Mark I.; Garcia, Joaquin; Kaplan, Michael J.; Chan, Albert S.; Phillips, Theodore L.

    2007-01-01

    Purpose: To review a single-institutional experience with the use of intraoperative radiation therapy (IORT) for recurrent head-and-neck cancer. Methods and Materials: Between 1991 and 2004, 137 patients were treated with gross total resection and IORT for recurrence or persistence of locoregional cancer of the head and neck. One hundred and thirteen patients (83%) had previously received external beam radiation as a component of definitive therapy. Ninety-four patients (69%) had squamous cell histology. Final surgical margins were microscopically positive in 56 patients (41%). IORT was delivered using either a modified linear accelerator or a mobile electron unit and was administered as a single fraction to a median dose of 15 Gy (range, 10-18 Gy). Median follow-up among surviving patients was 41 months (range, 3-122 months). Results: The 1-year, 2-year, and 3-year estimates of in-field control after salvage surgery and IORT were 70%, 64%, and 61%, respectively. Positive margins at the time of IORT predicted for in-field failure (p = 0.001). The 3-year rates of locoregional control, distant metastasis-free survival, and overall survival were 51%, 46%, and 36%, respectively. There were no perioperative fatalities. Complications included wound infection (4 patients), orocutaneous fistula (2 patients), flap necrosis (1 patient), trismus (1 patient), and neuropathy (1 patient). Conclusions: Intraoperative RT results in effective disease control with acceptable toxicity and should be considered for selected patients with recurrent or persistent cancers of the head and neck

  2. Spectrum of head and neck cancer in children

    Directory of Open Access Journals (Sweden)

    Sengupta Subhabrata

    2009-01-01

    Full Text Available Aim: To assess the incidence of different head and neck cancers in pediatric age group in a referral hospital. Methods: In this prospective study, children below the age of 12 years underwent a thorough clinical, ENT examination and the diagnosis was conformed histologically in all the cases. Results: Fifty-three were diagnosed to be suffering from different head and neck neoplasms among 21,216 children (0.25%. Male-to-female sex distribution was 1.78:1. The lymphomas were the most common (43.39% followed by the rhabdomyosarcoma (20.75% and the nasopharyngeal carcinoma (15.09%. Of the lymphomas, the non-Hodgkin′s lymphoma was predominant (26.41%. Other lesions were thyroid carcinomas and mucoepidermoid carcinoma of parotid. Conclusions: Malignancy should always be considered in the differential diagnosis of masses in the head and neck region in children.

  3. Countermeasure against postoperative fistulas of head and neck cancer

    International Nuclear Information System (INIS)

    Hori, Yasutaka; Nishikawa, Kunio; Utida, Hiroshi; Fujisawa, Takurou; Eguchi, Motoharu

    2004-01-01

    It is very difficult to treat postoperative fistulas of head and neck cancer by irradiation and other preoperative therapy. We reviewed 179 patients with oral cancer, mesopharyngeal and hypopharyngeal cancer underwent reconstruction between 1994 and 2003. Our analysis reveals that the incidence of fistula is 18.4% and exposure dose is predisposing factor for fistula formation. We observed many fistulas in posterior of oral floor and pedicle flap more than free flap. There are 14 patients of surgical repair, we detected pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA) in them. (author)

  4. Neck sweat gland cancer hemorrhage. Case study.

    Science.gov (United States)

    Ciesielski, Przemysław; Górnicka, Barbara; Górnicki, Krzysztof; Kołodziejczak, Małgorzata; Siekierski, Paweł

    2013-01-01

    This paper reports a case of an 87-year-old female patient who was admitted for an emergency operation due to massive hemorrhage of an ulceration localized on a huge neck tumor. Post-interventional diagnosis indicated hidradenocarcinoma. Hidradenocarcinoma is a rare skin neoplasm. It can coincide with adenoma, may develop through its malignant transformation or develop as a malignant tumor from the beginning. It may be found in all dermal localizations. It may develop metastases or appear in the diffuse form. Surgical excision of the tumor was performed obtaining a surgical margin, completed with excision of local lymph nodes and multiple layer suturing. Due to lack of the patient's consent, she has not been qualified for adjuvant therapy. Control examination 6 and 12 months later showed no signs of local recurrence or lymph node metastasis. Surgical excision of apocrine hidradenocarcinoma with a surgical margin could present a good therapeutic effect in spite of lack of adjuvant therapy.

  5. Combined radiochemotherapy of head and neck cancer

    International Nuclear Information System (INIS)

    Schlappack, O.; Springer, B.; Hainz, A.

    1994-01-01

    Advanced tumors of the head and neck are often treated with combined radiochemotherapy. The chemotherapeutic agents used should be active in this tumor type and its adverse effects should not overlap with those of the radiation treatment. Published studies were reviewed and discussed on the basis of these principles. Initially, single agents such as 5-fluorouracil (5-FU) and methotrexate were used in combination with radiotherapy. These combinations caused an improved local tumor control but also an increased mucosal reaction. For mitomycin C it has been shown in a randomized trial that local tumor control was improved without concomitant increased normal tissue toxicity. Also cisplatin and carboplatin were studied in combination with radiotherapy. Unfortunately, there are no results of randomized studies available but these agents do not seem to increase mucosal toxicity. The standard chemotherapy of squamous cell carcinomas of the head and neck is cisplatin and 5-FU. Many studies have been conducted with this chemotherapy in combination with radiotherapy. To this day it has not been shown that the results of an effective radiation treatment or an effective chemotherapy can be improved by these experiments. The explanation for that is that either the chemotherapy or the radiotherapy cannot be given at full dose because the regimen would become too toxic. 5-FU containing polychemotherapy regimens should not be combined with radiation any more because it is known that 5-FU increases the mucosal reaction. Agents that could be studied in the future either alone or in combination with cisplatin or carboplatin are etoposide and taxol. (orig.) [de

  6. Human Papillomavirus in Head and Neck Cancer

    Directory of Open Access Journals (Sweden)

    Anna Rosa Garbuglia

    2014-08-01

    Full Text Available Human papillomavirus (HPV is currently considered to be a major etiologic factor, in addition to tobacco and alcohol, for oropharyngeal cancer (OPC development. HPV positive OPCs are epidemiologically distinct from HPV negative ones, and are characterized by younger age at onset, male predominance, and strong association with sexual behaviors. HPV16 is the most prevalent types in oral cavity cancer (OCC, moreover the prevalence of beta, and gamma HPV types is higher than that of alpha HPV in oral cavity.

  7. IMRT for head and neck cancer: reducing xerostomia and dysphagia

    OpenAIRE

    Wang, XiaoShen; Eisbruch, Avraham

    2016-01-01

    Dysphagia and xerostomia are the main sequellae of chemoradiotherapy for head and neck cancer, and the main factors in reducing long-term patient quality of life. IMRT uses advanced technology to focus the high radiation doses on the targets and avoid irradiation of non-involved tissues. The decisions about sparing organs and tissues whose damage causes xerostomia and dysphagia depends on the evidence for dose?response relationships for the organs causing these sequellae. This paper discusses...

  8. Preradiation dental decisions in patients with head and neck cancer

    OpenAIRE

    Bruins, H.H. (Hubert Herman)

    2001-01-01

    This thesis presents a series of studies that investigated preradiation dental decision making in patients with head and neck cancer. In Chapter 1, it is ascertained that in view of the risk for oral sequelae resulting from high-dose radiotherapy, special attention to preradiation dental planning appears critical. Each case must be managed individually on the basis of the patient's needs, the status of the tumor, and the risks for dental health in irradiated tissues; a single-formula approach...

  9. Head and neck cancer: genetic polymorphisms and folate metabolism.

    Science.gov (United States)

    Galbiatti, Ana Lívia Silva; Ruiz, Mariangela Torreglosa; Maniglia, José Victor; Raposo, Luis Sérgio; Pavarino-Bertelli, Erika Cristina; Goloni-Bertollo, Eny Maria

    2012-02-01

    Epidemiological evidence suggests that genetic variants encoding enzymes involved in folate metabolism may modulate HNSCC risk by altering DNA methylation synthesis and genomic estability. A review of the literature on genetic polymorphisms involved in folate metabolism and risk of head and neck cancer was carried out. An electronic search was made on the Medline database to select papers on head and neck cancer and polymorphisms involved in folate metabolism. The association between MTHFR C677T polymorphism and the risk of this tumor type was evaluated in nine studies; there was an association with this disease in three papers. The MTR A2756G and MTRR A66G and RFC1 A80G polymorphisms were also associated with increased risk for HNSCC. MTHFD1 G1958A polymorphism was not associated with increased risk of this disease; the evaluation results of the MTHFR A1298C polymorphism in this neoplasm were contradictory. Other polymorphisms involved in folate metabolism were not studied for this neoplasm. We conclude that polymorphisms involved in folate metabolism may modulate the risk of head and neck cancer, however, these results need to be demonstrated in different populations.

  10. Delayed damage after radiation therapy for head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Matsumoto, Yoshiyuki [Osaka Dental Univ., Hirakata (Japan)

    2000-03-01

    I investigated radiation damage, including osteoradionecrosis, arising from tooth extraction in fields that had received radiation therapy for head and neck cancer, and evaluated the effectiveness of pilocarpine for xerostomia. Between January 1990 and April 1996, I examined 30 patients for bone changes after tooth extraction in fields irradiated at the Department of Oral Radiology, Osaka Dental University Hospital. Nineteen of the patients had been treated for nasopharyngeal cancer and 11 for oropharyngeal cancer. Between January and April 1996, 4 additional patients were given pilocarpine hydrochloride (3-mg, 6-mg and 9-mg of KSS-694 orally three times a day) for 12 weeks and evaluated every 4 weeks as a base line. One had been treated for nasopharyngeal carcinoma, two for cancer of the cheek and one for an unknown carcinoma. Eighteen of the patients (11 with nasopharyngeal carcinoma and 7 with oropharyngeal carcinoma) had extractions. Use of preoperative and postoperative radiographs indicated that damage to the bone following tooth extraction after radiation exposure was related to whether antibiotics were administered the day before the extraction, whether forceps or elevators were used, and whether the tooth was in the field of radiation. Xerostomia improved in all 4 of the patients who received 6-mg or 9-mg of pilocarpine. It improved saliva production and relieved the symptoms of xerostomia after radiation therapy for head and neck cancer, although there were minor side effects such as fever. This information can be used to improve the oral environment of patients who have received radiation therapy for head and neck cancer, and to better understand their oral environment. (author)

  11. Delayed damage after radiation therapy for head and neck cancer

    International Nuclear Information System (INIS)

    Matsumoto, Yoshiyuki

    2000-01-01

    I investigated radiation damage, including osteoradionecrosis, arising from tooth extraction in fields that had received radiation therapy for head and neck cancer, and evaluated the effectiveness of pilocarpine for xerostomia. Between January 1990 and April 1996, I examined 30 patients for bone changes after tooth extraction in fields irradiated at the Department of Oral Radiology, Osaka Dental University Hospital. Nineteen of the patients had been treated for nasopharyngeal cancer and 11 for oropharyngeal cancer. Between January and April 1996, 4 additional patients were given pilocarpine hydrochloride (3-mg, 6-mg and 9-mg of KSS-694 orally three times a day) for 12 weeks and evaluated every 4 weeks as a base line. One had been treated for nasopharyngeal carcinoma, two for cancer of the cheek and one for an unknown carcinoma. Eighteen of the patients (11 with nasopharyngeal carcinoma and 7 with oropharyngeal carcinoma) had extractions. Use of preoperative and postoperative radiographs indicated that damage to the bone following tooth extraction after radiation exposure was related to whether antibiotics were administered the day before the extraction, whether forceps or elevators were used, and whether the tooth was in the field of radiation. Xerostomia improved in all 4 of the patients who received 6-mg or 9-mg of pilocarpine. It improved saliva production and relieved the symptoms of xerostomia after radiation therapy for head and neck cancer, although there were minor side effects such as fever. This information can be used to improve the oral environment of patients who have received radiation therapy for head and neck cancer, and to better understand their oral environment. (author)

  12. The role of FDG PET in management of neck metastasis from head-and-neck cancer after definitive radiation treatment

    International Nuclear Information System (INIS)

    Yao Min; Smith, Russell B.; Graham, Michael M.; Hoffman, Henry T.; Tan Huaming; Funk, Gerry F.; Graham, Scott M.; Chang, Kristi; Dornfeld, Kenneth J.; Menda, Yusuf; Buatti, John M.

    2005-01-01

    Purpose: The role of neck dissection after definitive radiation for head-and-neck cancer is controversial. We select patients for neck dissection based on postradiation therapy (post-RT), computed tomography (CT), and [ 18 F] fluorodeoxyglucose positron emission tomography (FDG PET). We summarize the clinical outcomes of patients treated with this policy to further elucidate the role of FDG PET in decision making for neck dissection after primary radiotherapy. Methods and Materials: Between December 1999 and February 2004, 53 eligible patients were identified. These patients had stage N2A or higher head-and-neck squamous cell carcinoma and had complete response of the primary tumor after definitive radiation with or without chemotherapy. PET or computed tomography (CT) scans were performed within 6 months after treatment. Neck dissection was performed in patients with residual lymphadenopathy (identified by clinical examination or CT) and a positive PET scan. Those without residual lymph nodes and a negative PET were observed without neck dissection. For patients with residual lymphadenopathy, but a negative PET scan, neck dissection was performed at the discretion of the attending surgeon and decision of the patient. There was a total of 70 heminecks available for analysis (17 patients had bilateral neck disease). Results: There were 21 heminecks with residual lymphadenopathy identified on CT imaging or clinical examination and negative PET. Of these, 4 had neck dissection and were pathologically negative. The remaining 17 were observed without neck dissection. There was a total of 42 heminecks without residual lymph nodes on post-RT CT imaging or clinical examination with a negative PET. They were also observed without neck dissection. Seven heminecks had a positive PET scan and residual lymphadenopathy. Six of them had neck dissection and 1 had fine-needle aspiration of a residual node; 3 contained residual viable cancer and 4 were pathologically negative. At

  13. Molecular genetic study of head and neck cancer

    International Nuclear Information System (INIS)

    Lee, Yong Sik; Shim, Youn Sang; Lee, Je Ho

    1993-01-01

    We analyzed 15 cases of head and neck cancer (13 out of 15 were squqmous cell cancer.) by Southern blotting to identify the possible tumor suppressor gene. Firstly we searched the chromosome 17p with pYNZ22, pMCT35.1 and p144D6. 5 out of 7 informative cases showed loss of heterozygosity implying the loss of tumor suppressor gene near those loci. Afterwards analysis of these 5 cases is needed to identify the presence of tumor suppressor genes and the oncogenetic mechanism. (Author)

  14. The role of human papillomavirus in head and neck cancer

    DEFF Research Database (Denmark)

    Lajer, Christel Braemer; Buchwald, Christian von

    2010-01-01

    Over the last 20 years, there has been increasing awareness of a subset of squamous cell carcinomas of the head and neck (HNSCC), i.e. HPV-positive HNSCC. These cancers seem to differ somewhat from HPV-negative HNSCC. Patients with HPV-positive HNSCC tend to be younger and have a lower intake of ......-negative HNSCC, and this seems to be related to the immune system. Whether the new vaccines for HPV will protect not only against cervical cancer but also against HPV-positive HNSCC remains unknown....

  15. Radiation therapy for head and neck cancers

    International Nuclear Information System (INIS)

    Gillette, S.M.; Gillette, E.L.

    1995-01-01

    Radiation therapy may be indicated for larger invasive tumors of the head and neck that may be difficult to surgically excise or for which surgery would be significantly disfiguring. Previous studies of oral squamous cell carcinomas indicate that it should be possible to control approximately 80% of all but the most advanced local or locoregional tumors. Aggressive radiation therapy to total doses of 56 Gy or greater may be required. That can be done by using smaller doses per fraction and gradually reducing the size of the field so that the highest dose is given only to the tumor with a relatively tight margin. Malignant melanomas can be controlled locally apparently with a few large fractions. Metastatic disease limits survival; therefore, some type of systemic therapy seems to be needed to improve survival of those patients. Canine oral fibrosarcomas require a very high dose for a reasonable probability of control. It seems that a dose of 56 Gy given in 3.3 Gy fractions might provide local control of 50% of the tumors. It is likely that a combination of surgery and radiation would significantly improve the probability for control. Oral squamous cell carcinomas of cats must also be treated very aggressively to improve local control. Tumors of the nasal cavity are usually very large and invasive at the time of diagnosis. Radiation therapy has been shown to be effective in some instances. It is possible that with better definition of the tumor through computerized tomography imaging and improved treatment planning, control of these difficult to manage nasal tumors can be improved

  16. Delayed airway stenosis after radiotherapy for head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Yuta, Atsushi; Tatematsu, Masanori; Ishinaga, Hajime; Harada, Teruhiko; Majima, Yuichi [Mie Univ., Tsu (Japan). School of Medicine

    2002-03-01

    Seven cases of delayed airway stenosis after radiotherapy for early staged head and neck cancers during 1989 and 1999 were evaluated (aged 54-77 yrs, 6 male and a female). The cases included five glottic laryngeal cancers (T1a, T1b, and three T2), a subglottic laryngeal cancer, and an unknown origin, but strongly suspected laryngeal cancer, with neck metastasis. Radio injury was found from 3 months to 47 months after radiotherapy. {sup 60}Co for radiotherapy was used in all seven cases, although {sup 60}Co radionuclide was changed to Liniac in 1997. The total dose was 60 Gy for 3 cases, and 70 Gy for 4 cases. Tracheostomy was performed in 3 cases due to bilateral vocal cord impairment. Background, treatment, and response to radiotherapy were compared to those of 90 patients of a control group with early staged laryngeal cancer who did not fail radiation injury during the same period. As a result, radionuclide ({sup 60}Co), total dose, cervical surgery, antiinflammatory drugs, laryngeal edema during radiotherapy were risk factors. The intensity and the period of mucositis by radiotherapy was important for indicating delayed airway stenosis. (author)

  17. Delayed airway stenosis after radiotherapy for head and neck cancer

    International Nuclear Information System (INIS)

    Yuta, Atsushi; Tatematsu, Masanori; Ishinaga, Hajime; Harada, Teruhiko; Majima, Yuichi

    2002-01-01

    Seven cases of delayed airway stenosis after radiotherapy for early staged head and neck cancers during 1989 and 1999 were evaluated (aged 54-77 yrs, 6 male and a female). The cases included five glottic laryngeal cancers (T1a, T1b, and three T2), a subglottic laryngeal cancer, and an unknown origin, but strongly suspected laryngeal cancer, with neck metastasis. Radio injury was found from 3 months to 47 months after radiotherapy. 60 Co for radiotherapy was used in all seven cases, although 60 Co radionuclide was changed to Liniac in 1997. The total dose was 60 Gy for 3 cases, and 70 Gy for 4 cases. Tracheostomy was performed in 3 cases due to bilateral vocal cord impairment. Background, treatment, and response to radiotherapy were compared to those of 90 patients of a control group with early staged laryngeal cancer who did not fail radiation injury during the same period. As a result, radionuclide ( 60 Co), total dose, cervical surgery, antiinflammatory drugs, laryngeal edema during radiotherapy were risk factors. The intensity and the period of mucositis by radiotherapy was important for indicating delayed airway stenosis. (author)

  18. Pulmonary complication associated with head and neck cancer surgery

    International Nuclear Information System (INIS)

    Manzoor, T.; Ahmed, Z.; Sheikh, N.A.; Khan, M.M.

    2007-01-01

    To evaluate the frequency of short-term pulmonary complications in the patients undergoing various head and neck cancer surgeries in our setup and to assess possible risk factors responsible for these complications. Seventy patients of age group 20 to 80 years, regardless of gender, treated surgically for head and neck cancers were enrolled. Main outcome measures included development of pulmonary complications following 15 days of oncological surgery. The complications studied were pneumothorax, bronchopneumonia, atelectasis, pulmonary embolism and cardiopulmonary arrest. A total of 24.28% patients suffered from postoperative pulmonary complications; 17.14% developed bronchopneumonia, 5.71% pulmonary embolism, and 1.42% went into cardiopulmonary arrest, none developed pneumothorax or pulmonary atelectasis. A significant correlation of postoperative bronchopneumonia was seen with heavy smoking and assisted ventilation. Pulmonary embolism was associated with extended assisted ventilation and prolonged surgery. Cardiopulmonary arrest was associated with comorbidity and assisted ventilation after surgery. The frequency of bronchopneumonia supersedes all of the postoperative pulmonary complications in head and neck oncological surgery. Patients at risk of developing postoperative complications are heavy smokers, diabetics, those undergoing prolonged surgery, tracheostomy, and extended assisted ventilation. (author)

  19. Trismus following treatment of head and neck cancer.

    Science.gov (United States)

    Jeremic, Goran; Venkatesan, Varagur; Hallock, Abhirami; Scott, Danielle; Hammond, Alexander; Read, Nancy; Franklin, Jason; Yoo, John; Fung, Kevin

    2011-08-01

    The aim of this preliminary study was to determine the prevalence of trismus in head and neck cancer patients treated with radiotherapy with or without concomitant chemotherapy and surgery. Patients with malignant lesions in the head and neck treated with curative intent were comprehensively evaluated for trismus using subjective and objective measures. A large proportion of the 70 patients recruited demonstrated moderate to severe subjective trismus (45.7%). Similarly, the vast majority of patients showed slight to severe trismus (91.4%) according to objective secondary outcome measures. Of these patients, 21 (65.6%) were also treated with concurrent chemoradiotherapy. When the radiation field involved the pterygoid muscles, 30 (93.8%) patients reported subjective trismus. Similarly, bilateral pterygoid muscle inclusion resulted in 28 (87.5%) patients with trismus. Trismus is a significantly prevalent consequence of treatment for head and neck cancer. Predictive factors include treatment with concurrent chemoradiotherapy and bilateral inclusion of the structures of mastication in the high-dose radiotherapy volume.

  20. Examining clinicians' perceptions of head and neck cancer (HNC) information.

    Science.gov (United States)

    Jabbour, Joe; Wykes, James; Milross, Chris; Sundaresan, Puma; Ebrahimi, Ardalan; Shepherd, Heather L; Dhillon, Haryana M; Clark, Jonathan R

    2018-03-02

    Providing appropriate educational resources to patients with head and neck cancer (HNC) is important but challenging. The aim of this study was to determine Australian clinicians' perceptions of currently used HNC information resources. A purpose-designed questionnaire was disseminated electronically to clinician members of the Australian and New Zealand Head and Neck Cancer Society (ANZHNCS) and The Australian Society of Otolaryngology Head and Neck Surgery (ASOHNS). Of the 648 clinicians invited, 112 responded to the survey (17.3% response rate). Overall, 85% utilized written information as their primary mode of patient education and 49% received information on treatment details. Areas for improvement include information provision, pain management, emerging risk factors, survivorship and side effects. The majority (66%) of clinicians had a preference for internet patient education materials. Clinicians predominantly utilized written HNC information rather than multimedia or interactive resources. However, they expressed the desire to be able to deliver HNC information resources via an internet-based platform covering the psychosocial effects of treatment. © 2018 John Wiley & Sons Australia, Ltd.

  1. Knowledge and screening of head and neck cancer among American Indians in South Dakota.

    Science.gov (United States)

    Dwojak, Sunshine; Deschler, Daniel; Sargent, Michele; Emerick, Kevin; Guadagnolo, B Ashleigh; Petereit, Daniel

    2015-06-01

    We established the level of awareness of risk factors and early symptoms of head and neck cancer among American Indians in South Dakota and determined whether head and neck cancer screening detected clinical findings in this population. We used the European About Face survey. We added questions about human papillomavirus, a risk factor for head and neck cancer, and demographics. Surveys were administered at 2 public events in 2011. Participants could partake in a head and neck cancer screening at the time of survey administration. Of the 205 American Indians who completed the survey, 114 participated in the screening. Mean head and neck cancer knowledge scores were 26 out of 44. Level of education was the only factor that predicted higher head and neck cancer knowledge (b = 0.90; P = .01). Nine (8%) people had positive head and neck cancer screening examination results. All abnormal clinical findings were in current or past smokers (P = .06). There are gaps in American Indian knowledge of head and neck cancer risk factors and symptoms. Community-based head and neck cancer screening in this population is feasible and may be a way to identify early abnormal clinical findings in smokers.

  2. Evaluation of comorbidity in 9388 head and neck cancer patients

    DEFF Research Database (Denmark)

    Bøje, Charlotte Rotbøl; Dalton, Susanne O; Primdahl, Hanne

    2014-01-01

    affected overall survival (OS) and cancer specific death (CSD). In total, 36% of patients had comorbidity. Six comorbid conditions within the CCI significantly reduced five-year OS probability: congestive heart failure, cerebrovascular disease, chronic pulmonary disease, peptic ulcer disease, liver disease......BACKGROUND: Comorbidity is common in head and neck squamous cell carcinoma (HNSCC) patients due to the etiology of the disease being primarily smoking. The aim of this study was to investigate the impact of comorbidity on survival in a national population-based cohort study on 9388 HNSCC......-patients treated with radiotherapy (RT), to re-evaluate the prognostic impact of individual diseases within the Charlson Comorbidity Index (CCI), and to develop a revised head and neck comorbidity index (HN-CCI). MATERIAL AND METHODS: A national cohort of 9388 HNSCC-patients treated with curative intended RT...

  3. The potential for tumor suppressor gene therapy in head and neck cancer.

    Science.gov (United States)

    Birkeland, Andrew C; Ludwig, Megan L; Spector, Matthew E; Brenner, J Chad

    2016-01-01

    Head and neck squamous cell carcinoma remains a highly morbid and fatal disease. Importantly, genomic sequencing of head and neck cancers has identified frequent mutations in tumor suppressor genes. While targeted therapeutics increasingly are being investigated in head and neck cancer, the majority of these agents are against overactive/overexpressed oncogenes. Therapy to restore lost tumor suppressor gene function remains a key and under-addressed niche in trials for head and neck cancer. Recent advances in gene editing have captured the interest of both the scientific community and the public. As our technology for gene editing and gene expression modulation improves, addressing lost tumor suppressor gene function in head and neck cancers is becoming a reality. This review will summarize new techniques, challenges to implementation, future directions, and ethical ramifications of gene therapy in head and neck cancer.

  4. Adjuvant Intraoperative Photodynamic Therapy in Head and Neck Cancer

    Science.gov (United States)

    Rigual, Nestor R.; Shafirstein, Gal; Frustino, Jennifer; Seshadri, Mukund; Cooper, Michele; Wilding, Gregory; Sullivan, Maureen A.; Henderson, Barbara

    2015-01-01

    IMPORTANCE There is an immediate need to develop local intraoperative adjuvant treatment strategies to improve outcomes in patients with cancer who undergo head and neck surgery. OBJECTIVES To determine the safety of photodynamic therapy with 2-(1-hexyloxyethyl)-2-devinyl pyropheophorbide-a (HPPH) in combination with surgery in patients with head and neck squamous cell carcinoma. DESIGN, SETTING, AND PARTICIPANTS Nonrandomized, single-arm, single-site, phase 1 study at a comprehensive cancer center among 16 adult patients (median age, 65 years) with biopsy-proved primary or recurrent resectable head and neck squamous cell carcinoma. INTERVENTIONS Intravenous injection of HPPH (4.0 mg/m2), followed by activation with 665-nm laser light in the surgical bed immediately after tumor resection. MAIN OUTCOMES AND MEASURES Adverse events and highest laser light dose. RESULTS Fifteen patients received the full course of treatment, and 1 patient received HPPH without intraoperative laser light because of an unrelated myocardial infarction. Disease sites included larynx (7 patients), oral cavity (6 patients), skin (1 patient), ear canal (1 patient), and oropharynx (1 patient, who received HPPH only). The most frequent adverse events related to photodynamic therapy were mild to moderate edema (9 patients) and pain (3 patients). One patient developed a grade 3 fistula after salvage laryngectomy, and another patient developed a grade 3 wound infection and mandibular fracture. Phototoxicity reactions included 1 moderate photophobia and 2 mild to moderate skin burns (2 due to operating room spotlights and 1 due to the pulse oximeter). The highest laser light dose was 75 J/cm2. CONCLUSIONS AND RELEVANCE The adjuvant use of HPPH-photodynamic therapy and surgery for head and neck squamous cell carcinoma seems safe and deserves further study. PMID:23868427

  5. Human Papillomavirus Genome Integration and Head and Neck Cancer.

    Science.gov (United States)

    Pinatti, L M; Walline, H M; Carey, T E

    2017-12-01

    We conducted a critical review of human papillomavirus (HPV) integration into the host genome in oral/oropharyngeal cancer, reviewed the literature for HPV-induced cancers, and obtained current data for HPV-related oral and oropharyngeal cancers. In addition, we performed studies to identify HPV integration sites and the relationship of integration to viral-host fusion transcripts and whether integration is required for HPV-associated oncogenesis. Viral integration of HPV into the host genome is not required for the viral life cycle and might not be necessary for cellular transformation, yet HPV integration is frequently reported in cervical and head and neck cancer specimens. Studies of large numbers of early cervical lesions revealed frequent viral integration into gene-poor regions of the host genome with comparatively rare integration into cellular genes, suggesting that integration is a stochastic event and that site of integration may be largely a function of chance. However, more recent studies of head and neck squamous cell carcinomas (HNSCCs) suggest that integration may represent an additional oncogenic mechanism through direct effects on cancer-related gene expression and generation of hybrid viral-host fusion transcripts. In HNSCC cell lines as well as primary tumors, integration into cancer-related genes leading to gene disruption has been reported. The studies have shown that integration-induced altered gene expression may be associated with tumor recurrence. Evidence from several studies indicates that viral integration into genic regions is accompanied by local amplification, increased expression in some cases, interruption of gene expression, and likely additional oncogenic effects. Similarly, reported examples of viral integration near microRNAs suggest that altered expression of these regulatory molecules may also contribute to oncogenesis. Future work is indicated to identify the mechanisms of these events on cancer cell behavior.

  6. Occurance of head and neck cancers at the Nairobi Cancer Registry ...

    African Journals Online (AJOL)

    Occurance of head and neck cancers at the Nairobi Cancer Registry in Kenya 2000-2002. AK Limo, A Rugutt-Korir, JO Gichana, EA Dimba, ML Chindia, GZ Mutuma. Abstract. No Abstract. African Journal of Oral Health Sciences Vol. 5 (1) 2007: pp. 2-4. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL ...

  7. Current assessment and treatment strategies of dysphagia in head and neck cancer patients: a systematic review of the 2012/13 literature

    NARCIS (Netherlands)

    Kraaijenga, S. A. C.; van der Molen, L.; van den Brekel, M. W. M.; Hilgers, F. J. M.

    2014-01-01

    Dysphagia, or swallowing impairment, is a serious sequel of head and neck cancer (HNC) and its treatment. This review focuses on the rapidly growing literature published during the past 2 years about the current assessment and treatment strategies of dysphagia in HNC patients. Functional swallowing

  8. Validity and QOL of neck dissection preceding radiation therapy for hypopharyngeal cancer

    International Nuclear Information System (INIS)

    Uemura, Hirokazu; Yoshino, Kunitoshi; Fujii, Takashi; Suzuki, Motoyuki

    2009-01-01

    Thirty-one cases of hypopharyngeal cancer with neck dissection preceding radiation and 16 cases of hypopharyngeal cancer with neck dissection for locoregional recurrences after radiation were reviewed in order to make comparative evaluations of difficulty in surgical operation, postoperative complications, laryngeal preservation rate, and cause specific 5-year survival rate retrospectively. And quality of life (QOL) after neck dissection was additionally evaluated through the questionnaire. Since neck dissection preceding radiation for hypopharyngeal cancer may be superior to neck dissection for radiation failure, with easy surgical approach an non-lymphoid tissue preservation, that modality can be a reasonable choice of treatment for patients with nodal lesions, which are probably difficult to treat with radiation alone. Even though further investigation on QOL questionnaire is necessary, this modality can make a contribution to the neck and shoulder condition after neck dissection. (author)

  9. Best practice guidelines in the psychosocial management of HPV-related head and neck cancer: recommendations from the European Head and Neck Cancer Society's Make Sense Campaign.

    Science.gov (United States)

    Reich, M; Licitra, L; Vermorken, J B; Bernier, J; Parmar, S; Golusinski, W; Castellsagué, X; Leemans, C R

    2016-10-01

    Over the past three decades, oral human papillomavirus (HPV) has been associated with an increase in the incidence of oropharyngeal squamous cell carcinoma (OPSCC) in several countries. Specialist oncologists in head and neck cancer are observing a wider range of demographics, sexual behaviours, and survival outcomes with their patients. Additionally, there are fewer smokers, consumers of alcohol, or people of lower socioeconomic status than in previous decades. In order to support patients, the European Head and Neck Society's Make Sense Campaign aims to promote best practice in the management of head and neck cancer through the delivery of counselling, psychological assessment, support with the patient experience following HPV-related cancer diagnosis, sexual impact (in terms of communication, behaviour and prevention), facilitating access to educational resources about HPV in head and neck squamous cell carcinoma and OPSCC, and early referral if necessary. New concerns about psychosocial distress and unmet psychosocial needs following diagnosis, therefore, exist throughout the disease and treatment periods. Oncologists treating patients with HPV-related head and neck cancer must integrate new parameters focused on infection risk transmission and sexual topics. The development and dissemination of best practice guidelines through The European Head and Neck Cancer Society Make Sense Campaign will help healthcare professionals to be more confident and resourceful in supporting patients with HPV-related head and neck cancer. © The Author 2016. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  10. Job tenure and self-reported workplace discrimination for cancer survivors 2 years after diagnosis: does employment legislation matter?

    Science.gov (United States)

    Paraponaris, Alain; Teyssier, Luis Sagaon; Ventelou, Bruno

    2010-12-01

    To assess the risk of leaving employment for cancer survivors 2 years after diagnosis and the role of workplace discrimination in this risk. A representative sample of 4270 French individuals older than 17 and younger than 58 years when diagnosed with cancer in 2002 were interviewed 2 years later. Their occupational status was analyzed with the help of Probit and IV-Probit models. Overall, 66% of the cancer survivors who were working at the time of diagnosis were still employed 2 years later. Age, education level, income at diagnosis, work contract, professional status, affective support, relative prognosis at diagnosis, tumor site and treatment have contrasting impacts upon the probability of job loss across gender. Even after having controlled for these variables, self-reported workplace discrimination increases the probability of job loss by 15%. Despite protective labor law and favorable health insurance arrangements, French cancer survivors continue to experience problems to stay in or to return to the labor force. Measures targeting only the employment protection of cancer survivors do not seem to be sufficient to end prior social inequalities in job attainment. Intervention for specific populations particularly exposed to job-loss risks would also be needed. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  11. Radiotherapy and hyperbaric oxygen in head and neck cancer

    International Nuclear Information System (INIS)

    Henk, J.M.; Smith, C.W.

    1977-01-01

    A controlled clinical trial is in progress to assess the value of hyperbaric oxygen and radiotherapy in the management of head and neck cancer. An established dose-fractionation schedule in hyperbaric oxygen is being compared with a widely used conventional schedule in air. Survival and local recurrence-free rates are significantly higher in the oxygen group, and the effects on normal tissues are similar in both groups. These findings suggest a genuine therapeutic advantage. There was a distinct improvement in the results of treating advanced laryngeal carcinoma, where there was a high survival rate, without resort to laryngectomy. (author)

  12. Longitudinal Perioperative Pain Assessment in Head and Neck Cancer Surgery.

    Science.gov (United States)

    Buchakjian, Marisa R; Davis, Andrew B; Sciegienka, Sebastian J; Pagedar, Nitin A; Sperry, Steven M

    2017-09-01

    To evaluate perioperative pain in patients undergoing major head and neck cancer surgery and identify associations between preoperative and postoperative pain characteristics. Patients undergoing head and neck surgery with regional/free tissue transfer were enrolled. Preoperative pain and validated screens for symptoms (neuropathic pain, anxiety, depression, fibromyalgia) were assessed. Postoperatively, patients completed a pain diary for 4 weeks. Twenty-seven patients were enrolled. Seventy-eight percent had pain prior to surgery, and for 38%, the pain had neuropathic characteristics. Thirteen patients (48%) completed at least 2 weeks of the postoperative pain diary. Patients with moderate/severe preoperative pain report significantly greater pain scores postoperatively, though daily pain decreased at a similar linear rate for all patients. Patients with more severe preoperative pain consumed greater amounts of opioids postoperatively, and this correlated with daily postoperative pain scores. Patients who screened positive for neuropathic pain also reported worse postoperative pain. Longitudinal perioperative pain assessment in head and neck patients undergoing surgery suggests that patients with worse preoperative pain continue to endorse worse pain postoperatively and require more narcotics. Patients with preoperative neuropathic pain also report poor pain control postoperatively, suggesting an opportunity to identify these patients and intervene with empiric neuropathic pain treatment.

  13. Head and Neck Sarcomas: A Comprehensive Cancer Center Experience

    Science.gov (United States)

    Tejani, Mohamedtaki A.; Galloway, Thomas J.; Lango, Miriam; Ridge, John A.; von Mehren, Margaret

    2013-01-01

    Head/neck sarcomas are rare, accounting for about 1% of head/neck malignancies and 5% of sarcomas. Outcomes have historically been worse in this group, due to anatomic constraints leading to difficulty in completely excising tumors, with high rates of local recurrence. We retrospectively analyzed cases of head/neck soft tissue sarcomas (STS) and osteogenic sarcomas managed in a multi-disciplinary setting at Fox Chase Cancer Center from 1999–2009 to describe clinicopathologic characteristics, treatment, outcomes, and prognostic factors for disease control and survival. Thirty patients with STS and seven patients with osteogenic sarcoma were identified. Most STS were high grade (23) and almost all were localized at presentation (28). Common histologies were synovial cell (6), rhabdomyosarcoma (5), angiosarcoma (4), liposarcoma (4) and leiomyosarcoma (3). The type of primary therapy and disease outcomes were analyzed. Cox proportional hazards regression analysis was performed to identify predictors of disease-free survival (DFS) and overall survival (OS). The HR and 95% CI for Cox model and median DFS/OS analyzed by Kaplan-Meier curves were calculated. PMID:24202325

  14. Preliminary results of SIB-IMRT in head and neck cancers: Report from a regional cancer center in northern India

    Directory of Open Access Journals (Sweden)

    Chakraborty Santam

    2009-01-01

    Full Text Available Background : Intensity-modulated radiotherapy using simultaneous integrated boost (SIB-IMRT is an attractive method for the treatment of head and neck cancers with sparing of the salivary function. Aims : To assess the feasibility, toxicity, and tumor control using SIB-IMRT in locally advanced head and neck cancers in the Indian setting. Settings and Design : The study was conducted in a regional cancer center in northern India. A review of the treatment result of the first 20 patients is presented. Methods and Materials : SIB-IMRT was planned for 20 patients-14 patients were treated with the SIB-72 schedule delivering a dose of 72 Gy, 66 Gy, and 57 Gy to the PTV GTV , PTV CTV1 , and PTV CTV2 in 33 fractions. Six patients were treated with the SIB-66 schedule delivering 66 Gy, 60 Gy, and 54 Gy to the above-mentioned volumes in 30 fractions. Patients were monitored for toxicity using the CTCAE v 3.0 criteria. Descriptive analysis of toxicity and actuarial estimates of the loco-regional control and survival are presented. Results : Grade III mucositis was seen in 65% patients. None of the patients had Grade III dermatitis. The projected 2-year overall survival was 95%. Conclusion : SIB-IMRT schedules evaluated were found to be safe and effective and are being subjected to further prospective studies.

  15. Dose-volumetric parameters for predicting hypothyroidism after radiotherapy for head and neck cancer

    International Nuclear Information System (INIS)

    Kim, Mi Young; Yu, Tosol; Wu, Hong-Gyun

    2014-01-01

    To investigate predictors affecting the development of hypothyroidism after radiotherapy for head and neck cancer, focusing on radiation dose-volumetric parameters, and to determine the appropriate radiation dose-volumetric threshold of radiation-induced hypothyroidism. A total of 114 patients with head and neck cancer whose radiotherapy fields included the thyroid gland were analysed. The purpose of the radiotherapy was either definitive (n=81) or post-operative (n=33). Thyroid function was monitored before starting radiotherapy and after completion of radiotherapy at 1 month, 6 months, 1 year and 2 years. A diagnosis of hypothyroidism was based on a thyroid stimulating hormone value greater than the maximum value of laboratory range, regardless of symptoms. In all patients, dose volumetric parameters were analysed. Median follow-up duration was 25 months (range; 6-38). Forty-six percent of the patients were diagnosed as hypothyroidism after a median time of 8 months (range; 1-24). There were no significant differences in the distribution of age, gender, surgery, radiotherapy technique and chemotherapy between the euthyroid group and the hypothyroid group. In univariate analysis, the mean dose and V35-V50 results were significantly associated with hypothyroidism. The V45 is the only variable that independently contributes to the prediction of hypothyroidism in multivariate analysis and V45 of 50% was a threshold value. If V45 was <50%, the cumulative incidence of hypothyroidism at 1 year was 22.8%, whereas the incidence was 56.1% if V45 was ≥50%. (P=0.034). The V45 may predict risk of developing hypothyroidism after radiotherapy for head and neck cancer, and a V45 of 50% can be a useful dose-volumetric threshold of radiation-induced hypothyroidism. (author)

  16. The role of oral hygiene in head and neck cancer: results from International Head and Neck Cancer Epidemiology (INHANCE) consortium.

    Science.gov (United States)

    Hashim, D; Sartori, S; Brennan, P; Curado, M P; Wünsch-Filho, V; Divaris, K; Olshan, A F; Zevallos, J P; Winn, D M; Franceschi, S; Castellsagué, X; Lissowska, J; Rudnai, P; Matsuo, K; Morgenstern, H; Chen, C; Vaughan, T L; Hofmann, J N; D'Souza, G; Haddad, R I; Wu, H; Lee, Y-C; Hashibe, M; Vecchia, C La; Boffetta, P

    2016-08-01

    Poor oral hygiene has been proposed to contribute to head and neck cancer (HNC) risk, although causality and independency of some indicators are uncertain. This study investigates the relationship of five oral hygiene indicators with incident HNCs. In a pooled analysis of 8925 HNC cases and 12 527 controls from 13 studies participating in the International Head and Neck Cancer Epidemiology Consortium, comparable data on good oral hygiene indicators were harmonized. These included: no denture wear, no gum disease (or bleeding), oral hygiene indicator and cumulative score on HNC risk, adjusting for tobacco smoking and alcohol consumption. Inverse associations with any HNC, in the hypothesized direction, were observed for oral hygiene indicators was 8.9% (95% CI 3.3%, 14%) for oral cavity cancer. Good oral hygiene, as characterized by few missing teeth, annual dentist visits, and daily tooth brushing, may modestly reduce the risk of HNC. © The Author 2016. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  17. Metastatic Squamous Neck Cancer with Occult Primary Treatment (PDQ®)—Health Professional Version

    Science.gov (United States)

    Metastatic squamous neck cancer with occult primary in adults occurs when squamous cell cancer spreads to lymph nodes in the neck from an undetectable primary tumor. Treatment includes surgery and radiation therapy. Learn about the diagnosis, survival, staging, and treatment of these tumors.

  18. PO-62 - Remote ischemic preconditioning in head and neck cancer reconstruction - a randomized controlled trial

    DEFF Research Database (Denmark)

    Krag, A E; Kiil, B J; Hvas, Christine Lodberg

    2016-01-01

    subjected to ischemia-reperfusion injury. RIPC has also been shown to impact the coagulation system. AIM: The aim of the trial is to investigate, if RIPC attenuates platelet aggregation during reconstructive head and neck cancer surgery. MATERIALS AND METHODS: Sixty patients with head and neck cancer...

  19. The need for patients' endocrine function vigilance following treatment of head and neck cancer

    NARCIS (Netherlands)

    de Bree, R.; Lips, P.T.A.M.; Leemans, C.R.

    2008-01-01

    PURPOSE OF REVIEW: The aim of this article is to examine the need for screening of endocrine dysfunction following treatment of head and neck cancer. RECENT FINDINGS: The incidence of occult hypothyroidism following treatment of head and neck cancer is high. Patients who develop hypothyroidism after

  20. Voice and speech outcomes of chemoradiation for advanced head and neck cancer: a systematic review

    NARCIS (Netherlands)

    Jacobi, Irene; van der Molen, Lisette; Huiskens, Hermelinde; van Rossum, Maya A.; Hilgers, Frans J. M.

    2010-01-01

    Purpose of this review is to systematically assess the effects on voice and speech of advanced head and neck cancer and its treatment by means of chemoradiotherapy (CRT). The databases Medline, Embase and Cochrane were searched (1991-2009) for terms head and neck cancer, chemoradiation, voice and

  1. Screening for thyroid cancer in survivors of childhood and young adult cancer treated with neck radiation.

    Science.gov (United States)

    Tonorezos, Emily S; Barnea, Dana; Moskowitz, Chaya S; Chou, Joanne F; Sklar, Charles A; Elkin, Elena B; Wong, Richard J; Li, Duan; Tuttle, R Michael; Korenstein, Deborah; Wolden, Suzanne L; Oeffinger, Kevin C

    2017-06-01

    The optimal method of screening for thyroid cancer in survivors of childhood and young adult cancer exposed to neck radiation remains controversial. Outcome data for a physical exam-based screening approach are lacking. We conducted a retrospective review of adult survivors of childhood and young adult cancer with a history of neck radiation followed in the Adult Long-Term Follow-Up Clinic at Memorial Sloan Kettering between November 2005 and August 2014. Eligible patients underwent a physical exam of the thyroid and were followed for at least 1 year afterwards. Ineligible patients were those with prior diagnosis of benign or malignant thyroid nodules. During a median follow-up of 3.1 years (range 0-9.4 years), 106 ultrasounds and 2277 physical exams were performed among 585 patients. Forty survivors had an abnormal thyroid physical exam median of 21 years from radiotherapy; 50% of those with an abnormal exam were survivors of Hodgkin lymphoma, 60% had radiation at ages 10-19, and 53% were female. Ultimately, 24 underwent fine needle aspiration (FNA). Surgery revealed papillary carcinoma in seven survivors; six are currently free of disease and one with active disease is undergoing watchful waiting. Among those with one or more annual visits, representing 1732 person-years of follow-up, no cases of thyroid cancer were diagnosed within a year of normal physical exam. These findings support the application of annual physical exam without routine ultrasound for thyroid cancer screening among survivors with a history of neck radiation. Survivors with a history of neck radiation may not require routine thyroid ultrasound for thyroid cancer screening. Among adult survivors of childhood and young adult cancer with a history of radiation therapy to the neck, annual physical exam is an acceptable thyroid cancer screening strategy.

  2. Exercise program design considerations for head and neck cancer survivors.

    Science.gov (United States)

    Midgley, Adrian W; Lowe, Derek; Levy, Andrew R; Mepani, Vishal; Rogers, Simon N

    2018-01-01

    The present study aimed to establish exercise preferences, barriers, and perceived benefits among head and neck cancer survivors, as well as their level of interest in participating in an exercise program. Patients treated for primary squamous cell carcinoma of the head and neck between 2010 and 2014 were identified from the hospital database and sent a postal questionnaire pack to establish exercise preferences, barriers, perceived benefits, current physical activity levels, and quality of life. A postal reminder was sent to non-responders 4 weeks later. The survey comprised 1021 eligible patients of which 437 (43%) responded [74% male, median (interquartile range) age, 66 (60-73) years]. Of the respondents, 30% said 'Yes' they would be interested in participating in an exercise program and 34% said 'Maybe'. The most common exercise preferences were a frequency of three times per week, moderate-intensity, and 15-29 min per bout. The most popular exercise types were walking (68%), flexibility exercises (35%), water activites/swimming (33%), cycling (31%), and weight machines (19%). Home (55%), outdoors (46%) and health club/gym (33%) were the most common preferred choices for where to regularly exercise. Percieved exercise benefits relating to improved physical attributes were commonly cited, whereas potential social and work-related benefits were less well-acknowledged. The most commonly cited exercise barriers were dry mouth or throat (40%), fatigue (37%), shortness of breath (30%), muscle weakness (28%) difficulty swallowing (25%), and shoulder weakness and pain (24%). The present findings inform the design of exercise programs for head and neck cancer survivors.

  3. Does Resilience Mediate Carer Distress After Head and Neck Cancer?

    Science.gov (United States)

    Simpson, Grahame K; Dall'Armi, Luci; Roydhouse, Jessica K; Forstner, Dion; Daher, Maysaa; Simpson, Teresa; White, Kathryn J

    2015-01-01

    Caring for patients with head and neck cancer (HNC) can have significant negative psychological and practical impact; however, some carers seem able to cope effectively. Little research has investigated this resilience among carers. The objective of this study was to investigate the resilience levels among carers of patients with HNC. Carers (n = 51) from 2 cancer services in New South Wales completed the Resilience Scale (RS), the Head and Neck Information Needs Questionnaire, and the Hospital Anxiety and Depression Scale. Hospital Anxiety and Depression Scale cutoff scores (>8) were used to classify carers with clinically significant levels of anxiety or depression. The majority of carers (67% [34/51]) reported moderately high to high resilience. Rates of anxiety and depression among carers were 27.4% and 9.8%, respectively. Higher resilience scores were significantly correlated with lower anxiety and depression scores, as well as increasing age. Resilience Scale scores were independent of the severity of the HNC. There were no significant correlations between RS scores and Head and Neck Information Needs Questionnaire scores. Finally, increasing RS scores were associated with a decreasing probability of possible anxiety or depression. These results indicate that higher resilience in carers of HNC patients was associated with lower levels of psychological distress. Further investigation into the relationship between resilience and carer psychological wellbeing is warranted. If further evidence supports the findings of this study, then investigating ways to build resilience will be an important clinical option for reducing carer morbidity associated with anxiety and depression. The RS could be used to assess resilience levels among carers of HNC patients.

  4. Viable tumor in salvage neck dissections in head and neck cancer : Relation with initial treatment, change of lymph node size and human papillomavirus

    NARCIS (Netherlands)

    van den Bovenkamp, Karlijn; Dorgelo, Bart; Noordhuis, Maartje G; van der Laan, Bernard F A M; van der Vegt, Bert; Bijl, Hendrik P; Roodenburg, Jan L; van Dijk, Boukje A C; Oosting, Sjoukje F; Schuuring, Ed M D; Langendijk, Johannes A; Halmos, Gyorgy B; Plaat, Boudewijn E C

    Objectives: To identify predictive factors for the presence of viable tumor and outcome in head and neck cancer patients who undergo therapeutic salvage neck dissections. Materials and Methods: Retrospective analysis of 76 salvage neck dissections after radiotherapy alone (n = 22), radiotherapy in

  5. Hyperfractionation radiation therapy in advanced head and neck cancer

    International Nuclear Information System (INIS)

    Kim, Jin Hee; Ye, Ji Won

    2003-01-01

    The effects of hyperfractionation radiation therapy, such as the failure pattern and survival, on the treatment results in advanced stage head and neck cancer were studied. Between September 1990 and October 1998, 24 patients with advanced stage (III, IV) head and neck cancers, were treated using hyperfractionation radiation therapy in the Department at Radiation Oncology at the Keimyung University Dongsan Medical Center. The male to female ratio was 7 ; 1, and the age range from 38 to 71 years with the median of 56 years. With regard to the TNM stage, 11 patients were stage III and 13 were stage IV. The sites of primary cancer were the nasopharynx in six, the hypopharynx in 6, the larynx in five, the oropharynx in three, the maxillary sinus in three, and the oral cavity in one patient. The radiotherapy was delivered by 6 MV X-ray, with a fraction size of 1.2 Gy at two fractions a day, with at least 6 hours inter-fractional interval. The mean total radiation doses was 72 Gy, (ranging from 64.4 to 76.8 Gy). Fallow-up periods ranged between 3 and 136 months, with the median of 52 months. The overall survival rates at 3 and 5 years in all patients were 66.7% and 52.4%. The disease-free survival rates at 3 and 5 years (3YDFS, 5YDFS) in all patients Were 66.7% and 47.6%. The 3YDFS and 5YDFS in stage III patients were 81.8% and 63.6%, and those in stage IV patients were 53.8% and 32.3%. Ten patients were alive with no local nor distant failures at the time of analyses. Six patients (25%) died due to distant metastasis and 12.5% died due to local failure. Distant metastasis was the major cause of failure, but 2 patients died due to unknown failures and 3 of other diseases. The distant metastasis sites were the lung (3 patients), the bone (1 patient), and the liver (2 patients). One patient died of second esophageal cancer. There were no severe late complications, with the exception of 1 osteoradionecrosis of the mandible 58 months after treatment. Although this study was

  6. In a bad place: Carers of patients with head and neck cancer experiences of travelling for cancer treatment.

    Science.gov (United States)

    Balfe, Myles; Keohane, Kieran; O' Brien, Katie; Gooberman-Hill, Rachael; Maguire, Rebecca; Hanly, Paul; O' Sullivan, Eleanor; Sharp, Linda

    2017-10-01

    To explore the effect that treatment-related commuting has on carers of patients with head and neck cancer. Semi-structured interviews, thematically analysed, with 31 carers. Treatment-related commuting had a considerable impact on carers of patients with head and neck cancer, both in practical terms (economic costs, disruption) and also in psychological terms. Many carers of patients with head and neck cancer described becoming distressed by their commute. Some carers from large urban cities appeared to have hidden commuting burdens. Some carers respond to commuting stress by 'zoning out' or becoming 'like zombies'. Treatment-related travel for head and neck cancer can have significant practical and psychological impacts. Health professionals should be aware of the impacts that commuting can have on head and neck caregivers. Health services may be able to take practical steps, such as providing subsidized parking, to address head and neck carergivers' difficulties. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Opioid responsiveness in patients with advanced head and neck cancer.

    Science.gov (United States)

    Mercadante, S

    1998-09-01

    The degree of opioid responsiveness in patients with different pain syndromes associated with advanced head and neck cancer was studied with the aid of various indices that have proved to be easy to compare and capable of eliciting individual profiles of opioid responsiveness in cancer patients with pain. Thirty-seven patients requiring opioid therapy for more than 6 weeks were reviewed. The opioid escalation index (OEI) was lower in aged patients, albeit not significantly. Significant differences in OEI were found among patients belonging to the different categories of responses proposed. Although higher doses were needed than reported in the general population, pain was considered acceptable and most patients were classified as partially responsive. Neuropathic pain was associated with higher OEIs. The indices applied will be useful in clinical research to demonstrate individual profiles of opioid responsiveness, from cases of easy and immediate pain control to unresponsiveness to opioid treatment, which can be difficult to evaluate in the clinical setting.

  8. Management of head and neck cancer in older patients.

    Science.gov (United States)

    Magnano, Mauro; Bertone, Fabio; Andreis, Marco; Boffano, Paolo; Machetta, Giacomo

    2018-04-01

    A progressive increase in the number of older patients with head and neck cancer has been observed in the last few years. The aim of this study was to assess our experience in the management of older patients with head and neck cancer (HNC) in comparison with younger patients. A retrospective review was conducted for all patients admitted and treated for newly diagnosed HNC between January 2008 and December 2012. The clinical characteristics, management approaches, and outcome data were recorded. In total, 316 patients with HNC (232 males, 84 females) were enrolled: 203 (64%) were in the young group, whereas 113 patients (36%) were in the older group. Comorbidities (P < .000005) and stage IV tumors (P < .0005) were more frequently observed in the older group. Treatment options were uniformly distributed within the 2 groups; only radiotherapy alone was more frequently administered in older patients (P < .0005). Chronologic age should not be a reason to deny appropriate treatments that could prevent death in older patients. A careful pretreatment assessment should always be performed. Copyright © 2018 Elsevier Inc. All rights reserved.

  9. Scoring irradiation mucositis in head and neck cancer patients

    Energy Technology Data Exchange (ETDEWEB)

    Spijkervet, F.K.L.; Panders, A.K. (Departments of Oral and Maxillofacial Surgery, University Hospital Groningen (Netherlands)); Saene, H.K.F. van (Medical Microbiology, University of Liverpool (UK)); Vermey, A. (Department of Surgery Oncology Division, University Hospital Groningen (Netherlands)); Mehta, D.M. (Department of Radiotherapy, University Hospital Groningen (Netherlands))

    1989-01-01

    Irradiation mucositis is defined as an inflammatory-like process of the oropharyngeal mucosa following therapeutic irradiation of patients who have head and neck cancer. Clinically, it is a serious side effect because severe mucositis can cause generalized problems (weight loss, nasogastic tube feedings) and interferes with the well-being of the patient seriously. Grading mucositis is important for the evaluation of preventive and therapeutic measures. The object of this study was to develop a scoring method based on local mucositis signs only. Four clinical local signs of mucositis were used in this score: white discoloration, erythema, pseudomembranes and ulceration. Mucositis of the oral cavity was calcualted during conventional irradiation protocol for 8 distinguishable areas using the 4 signs and their extent. A prospective evaluation of this method in 15 irradiated head and neck cancer patients displayed an S-curve reflecting a symptomless first irradiation week, followed by a rapid and steady increase of white discoloration, erythema and pseudomembranes during the second and third week. Oral candidiasis, generalized symptoms such as weight loss and the highest mucositis scores were seen after 3 weeks irradiation. The novel mucositis scoring method may be of value in studying the effect of hygiene programs, topical application of disinfectans or antibiotics on oral mucositis. (author).

  10. Scoring irradiation mucositis in head and neck cancer patients

    International Nuclear Information System (INIS)

    Spijkervet, F.K.L.; Panders, A.K.; Saene, H.K.F. van; Vermey, A.; Mehta, D.M.

    1989-01-01

    Irradiation mucositis is defined as an inflammatory-like process of the oropharyngeal mucosa following therapeutic irradiation of patients who have head and neck cancer. Clinically, it is a serious side effect because severe mucositis can cause generalized problems (weight loss, nasogastic tube feedings) and interferes with the well-being of the patient seriously. Grading mucositis is important for the evaluation of preventive and therapeutic measures. The object of this study was to develop a scoring method based on local mucositis signs only. Four clinical local signs of mucositis were used in this score: white discoloration, erythema, pseudomembranes and ulceration. Mucositis of the oral cavity was calcualted during conventional irradiation protocol for 8 distinguishable areas using the 4 signs and their extent. A prospective evaluation of this method in 15 irradiated head and neck cancer patients displayed an S-curve reflecting a symptomless first irradiation week, followed by a rapid and steady increase of white discoloration, erythema and pseudomembranes during the second and third week. Oral candidiasis, generalized symptoms such as weight loss and the highest mucositis scores were seen after 3 weeks irradiation. The novel mucositis scoring method may be of value in studying the effect of hygiene programs, topical application of disinfectans or antibiotics on oral mucositis. (author)

  11. Impact of oral hygiene on head and neck cancer risk in a Chinese population.

    Science.gov (United States)

    Kawakita, Daisuke; Lee, Yuan-Chin Amy; Li, Qian; Chen, Yuji; Chen, Chien-Jen; Hsu, Wan-Lun; Lou, Pei-Jen; Zhu, Cairong; Pan, Jian; Shen, Hongbing; Ma, Hongxia; Cai, Lin; He, Baochang; Wang, Yu; Zhou, Xiaoyan; Ji, Qinghai; Zhou, Baosen; Wu, Wei; Ma, Jie; Boffetta, Paolo; Zhang, Zuo-Feng; Dai, Min; Hashibe, Mia

    2017-12-01

    Although the impact of oral hygiene on head and neck cancer risk has been investigated, few studies have been conducted among the Asian population. We conducted a multicenter case-control study to investigate this potential association. We performed unconditional multiple logistic regression models adjusted by potential confounders. We observed an inverse association of frequency of dental visits with head and neck cancer risk, with an adjusted odds ratio (OR) of 3.70 (95% CI 2.51-5.45) for never dental visits compared with ≥1 time/year (P trend oral hygiene indicators, poor oral hygiene scores increased head and neck cancer risk. Poor oral hygiene may increase head and neck cancer risk in the Chinese population. Therefore, improving oral hygiene may contribute to reducing the head and neck cancer risk in the Chinese population. © 2017 Wiley Periodicals, Inc.

  12. Analysis of free flaps in head and neck cancer reconstruction

    International Nuclear Information System (INIS)

    Hirokawa, Eiko; Yokogawa, Hideki; Nakatsuka, Takashi; Tsuchiya, Sunao; Sato, Tomoya; Momosawa, Akira

    2011-01-01

    Approximately 107 patients have received free tissue transfer in head and neck reconstruction since our center opened in April, 2007 (until March, 2010). We examined the relationship between the postoperative complication rate and past history (high blood pressure, diabetes, cerebro-vascular disease, radiation exposure to the head cervix. chemotherapy career and head cervix operation career). The mean patient age was 62.2 years old (range 15 to 90), and there were 77 males (72.0%) and 30 females (28.0%). Among the patients who developed postoperative complications, total necroses occurred in 3 cases (2.8%). In addition to these cases of total necrosis, 8 patients needed a re-operation, 5 of whom received preoperative radiotherapy. Preoperative radiotherapy was related to the development of complications when we performed multiplex logistics analysis. (author)

  13. Daily amifostine given concomitantly to chemoradiation in head and neck cancer. A pilot study

    International Nuclear Information System (INIS)

    Trog, D.; Bank, P.; Wendt, T.G.; Koscielny, S.; Beleites, E.

    1999-01-01

    Background: In patients with loco-regionally advanced head and neck cancer conventionally fractionated radiotherapy alone results in poor loco-regional control and survival rates. Treatment intensification by simultaneous administration of cytotoxic drugs produces higher acute morbidity. Therefore chemical radioprotection of normal tissues may be of clinical benefit. Patients and Methods: In a pilot study patients with advanced nonresectable head neck cancer treated with conventionally fractionated radical radiotherapy (60 to 66 Gy total doses) and concomitantly given 5-fluorouracil as protracted venous infusion, 250 mg/sqm/24 h over the entire treatment period were given amifostine 300 mg absolutely before each fraction. Acute treatment related mobidity was scored according to CTC classification and loco-regional control and survival rates were estimated. Comparison was made with a historical control group of identical chemoradiation but without amifostine application. Results: Chemoradiation induced oral mucositis was delayed and showed significant lower degrees at all 10 Gy increments (p 0.05). No significant toxicity was recorded with respect to blood pressure, serum calcium, potassium, hematologic parameters, emesis, nausea or body weight loss. Progression free survival and overall survival probability at 2 years were not statistically different in both cohorts. Conclusion: Amifostine given before each fraction of radiotherapy over 6 weeks has no cumulative toxicity, was well tolerated and may reduce treatment induced oral mucositis. No tumor protective effect was observed. (orig.) [de

  14. Freedom From Local and Regional Failure of Contralateral Neck With Ipsilateral Neck Radiotherapy for Node-Positive Tonsil Cancer: Results of a Prospective Management Approach

    International Nuclear Information System (INIS)

    Rusthoven, Kyle E.; Raben, David; Schneider, Charles; Witt, Robert; Sammons, Sarah; Raben, Adam

    2009-01-01

    Purpose: To review the outcomes of a prospective management approach using ipsilateral neck radiotherapy in the treatment of node-positive squamous cell carcinoma of the tonsil with a well-lateralized primary lesion. Methods and Materials: Between August 2003 and June 2007, 20 patients who presented with squamous cell carcinoma of the tonsil, without involvement of the base of the tongue or midline soft palate, and with Stage N1-N2b disease were prospectively treated with radiotherapy to the primary site and ipsilateral neck. In addition, 18 patients received concurrent chemotherapy. The actuarial freedom from contralateral nodal and in-field progression was determined. Acute and late toxicity were prospectively evaluated using the National Cancer Institute Common Terminology Criteria for Adverse Events, version 3, and Radiation Therapy Oncology Group criteria. Results: The nodal disease was Stage N1 in 4 patients, N2a in 3 patients, and N2b in 13 patients. At a median follow-up 19 months (range, 12-40), no in-field or contralateral nodal recurrences had been observed. The 2-year freedom from distant metastasis rate was 87.4%. The actuarial 2-year disease-free and overall survival rates were both 79.5%. Late Radiation Therapy Oncology Group grade 2 xerostomia occurred in 1 patient (5%). No late Grade 3 or greater toxicity was observed. No patient was feeding tube dependent at their last follow-up visit. Conclusion: In carefully selected patients with node-positive, lateralized tonsillar cancer, treatment of the ipsilateral neck and primary site does not appear to increase the risk of contralateral nodal failure and reduces late morbidity compared with historical controls. Although the outcomes with ipsilateral radiotherapy in the present series were promising, these findings require longer follow-up and validation in a larger patient cohort.

  15. Treatment results of the neck by concurrent chemoradiotherapy for advanced head and neck cancer

    International Nuclear Information System (INIS)

    Tokumaru, Yutaka; Fujii, Masato; Habu, Noboru; Yajima, Yoko; Yorozu, Atsunori

    2009-01-01

    Concurrent chemoradiotherapy (CCRT) is one of the recent emerging modalities for advanced squamous cell carcinoma of the head and neck (HNSCC). However some of the patients treated by CCRT have residual or recurrent cervical lymph nodes. In these cases, neck dissection is considered to be useful in the point of locolegional control and disease free survival. This study aims to analyze neck control rate by CCRT and usefulness of the neck dissection after CCRT for HNSCC. The medical records of 69 consecutive patients (stage III: 4%, stage IV: 96%) treated with CCRT for SCCHN (hypopharynx: 40, oropharynx: 25, larynx: 4) from 2003 through 2007 were reviewed. Clinical complete response (CR) rates of N1, N2a, N2b, N2c and N3 were 75%, 100%, 71%, 74% and 43% respectively. Among the patients with complete neck response, only 2 patients (5%) had an isolated neck recurrence. Eleven patients underwent surgical neck procedures including 7 planned neck dissections and 4 salvage neck dissections. All the 11 patients with neck dissections had good regional control except 1 case. There were a few minor complications such as wound infection and laryngeal edema. Patients who have a complete clinical regional response to CCRT have a low probability of an isolated recurrence in the neck. Planned and salvage neck dissections can be safely performed and considered to be useful in the point of regional control after intensive CCRT. (author)

  16. Orbital apex syndrome affecting head and neck cancer patients: A case series.

    Science.gov (United States)

    Prado-Ribeiro, A-C; Luiz, A-C; Montezuma, M-A; Mak, M-P; Santos-Silva, A-R; Brandão, T-B

    2017-05-01

    Orbital apex syndrome (OAS) is a complex and uncommon disorder that typically damages multiple cranial nerves in association with optic nerve dysfunction. OAS is associated with several different pathologies, however; only a few cases have been reported in association with head and neck cancer (HNC) so far. A case series of HNC patients diagnosed with OAS is described including clinicopathological data, image findings, and disease outcome. Ptosis and diplopia were diagnosed in four male patients with mean age of 61.2 years who were undergoing treatment for late-stage carcinomas of the tongue, larynx, and nasopharynx, eventually leading to the diagnosis of OAS. The mean overall survival rate after the diagnosis of OAS was 9.5 months. The current study reinforces evidence that OAS indicates poor prognosis and highlights the importance of early diagnosis.

  17. Quality of life and psychological adaptation in siblings of paediatric cancer patients, 2 years after diagnosis

    NARCIS (Netherlands)

    Houtzager, B. A.; Grootenhuis, M. A.; Caron, H. N.; Last, B. F.

    2004-01-01

    Several studies have been conducted on sibling psychosocial adaptation to cancer in a brother or sister, but little is known on how the long-term adaptation of siblings to the illness develops. The concept quality of life has primarily been applied in research on the effects of chronic illness on

  18. Genome Stability Pathways in Head and Neck Cancers

    Directory of Open Access Journals (Sweden)

    Glenn Jenkins

    2013-01-01

    Full Text Available Genomic instability underlies the transformation of host cells toward malignancy, promotes development of invasion and metastasis and shapes the response of established cancer to treatment. In this review, we discuss recent advances in our understanding of genomic stability in squamous cell carcinoma of the head and neck (HNSCC, with an emphasis on DNA repair pathways. HNSCC is characterized by distinct profiles in genome stability between similarly staged cancers that are reflected in risk, treatment response and outcomes. Defective DNA repair generates chromosomal derangement that can cause subsequent alterations in gene expression, and is a hallmark of progression toward carcinoma. Variable functionality of an increasing spectrum of repair gene polymorphisms is associated with increased cancer risk, while aetiological factors such as human papillomavirus, tobacco and alcohol induce significantly different behaviour in induced malignancy, underpinned by differences in genomic stability. Targeted inhibition of signalling receptors has proven to be a clinically-validated therapy, and protein expression of other DNA repair and signalling molecules associated with cancer behaviour could potentially provide a more refined clinical model for prognosis and treatment prediction. Development and expansion of current genomic stability models is furthering our understanding of HNSCC pathophysiology and uncovering new, promising treatment strategies.

  19. Intensity-modulated radiation therapy for head and neck cancers with bilateral irradiation of the neck: preliminary results

    International Nuclear Information System (INIS)

    Lapeyre, M.; Mege, A.; Mege, P.; Racadot, S.; Marchal, C.; Marchesi, V.; Aletti, P.; Noel, A.; Marchesi, V.; Aletti, P.; Noel, A.; Marchal, C.

    2004-01-01

    Purpose. - To report preliminary results of a prospective study of intensity-modulated radiotherapy (IMRT) for head and neck squamous cell carcinoma (HNC) with bilateral irradiation of the neck. Patients and methods. - At the Alexis Vautrin Cancer Center, 23 patients have been treated with IMRT for HNC since January 2002-August 2003. The first 10 patients with a minimum follow-up of 3 months were analyzed. All tumors were oropharyngeal. There were four females and six males, with a mean age of 50 years (range 39-66). Stages were I-II in eight and III-IV in two. CTV1 was microscopic disease and N0 neck (prescribed dose: 50 Gy) and CTV2 was macroscopic disease and the volume at risk (prescribed dose: 66-70 Gy). PTV were CTV + 5 mm. Patient's immobilization consisted of a five-point head neck shoulder thermoplastic mask. Set-up verifications were done by semi-automatically matching portal images and digitized reconstructed radiographs. IMRT used dynamic multi-leaf collimation. Five patients (group A) received 50 Gy IMRT (two post-operative and three with a brachytherapy boost with a mean dose: 27.5 Gy), and five patients (group B) received 66-70 Gy IMRT (four post-operative). Acute and late normal tissue effects were graded according to the RTOG-EORTC radiation morbidity scoring criteria. Results. - With a median follow-up of 7.4 months (range 3-18.5), no patient died or had loco-regional relapse. The displacements were <4 mm in 98% cases. CTV1 and 2 received 95% of the prescribed dose in 100% of the volume. On average the mean dose to the contralateral parotid was 25.5 Gy for group A vs. 31 Gy for group B (P = 0.09). Mean doses <26 Gy were obtained in three of five patients in group A vs. zero of five patients in group B (P = 0.04). Acute skin toxicities were grade 1 in five patients, grade 2 in four and grade 3 in one. Acute mucositis cases were grade 1 in three patients, grade 2 in five and localized grade 3 in two. At 3 months, 50% of the patients had a grade 0

  20. Oxygenation measurements in head and neck cancers during hyperbaric oxygenation

    International Nuclear Information System (INIS)

    Becker, A.; Kuhnt, T.; Dunst, J.; Liedtke, H.; Krivokuca, A.; Bloching, M.

    2002-01-01

    Background: Tumor hypoxia has proven prognostic impact in head and neck cancers and is associated with poor response to radiotherapy. Hyperbaric oxygenation (HBO) offers an approach to overcome hypoxia. We have performed pO 2 measurements in selected patients with head and neck cancers under HBO to determine in how far changes in the oxygenation occur and whether a possible improvement of oxygenation parameters is maintained after HBO. Patients and Methods: Seven patients (five male, two female, age 51-63 years) with squamous cell cancers of the head and neck were investigated (six primaries, one local recurrence). The median pO 2 prior to HBO was determined with the Eppendorf histograph. Sites of measurement were enlarged cervical lymph nodes (n = 5), the primary tumor (n = 1) and local recurrence (n = 1). Patients then underwent HBO (100% O 2 at 240 kPa for 30 minutes) and the continuous changes in the oxygenation during HBO were determined with a Licox probe. Patients had HBO for 30 minutes (n = 6) to 40 minutes (n = 1). HBO was continued because the pO 2 had not reached a steady state after 30 minutes. After decompression, patients ventilated pure oxygen under normobaric conditions and the course of the pO 2 was further measured over about 15 minutes. Results: Prior to HBO, the median tumor pO 2 in the Eppendorf histography was 8.6 ± 5.4 mm Hg (range 3-19 mm Hg) and the pO 2 measured with the Licox probe was 17.3 ± 25.5 mm Hg (range 0-73 mm Hg). The pO 2 increased significantly during HBO to 550 ± 333 mm Hg (range 85-984 mm Hg, p = 0.018). All patients showed a marked increase irrespective of the oxygenation prior to HBO. The maximum pO 2 in the tumor was reached after 10-33 minutes (mean 17 minutes). After leaving the hyperbaric chamber, the pO 2 was 282 ± 196 mm Hg. All patients maintained an elevated pO 2 for further 5-25 minutes (138 ± 128 mm Hg, range 42-334 mm Hg, p = 0.028 vs the pO 2 prior to HBO). Conclusions: Hyperbaric oxygenation resulted in a

  1. Relationship between ABO blood groups and head and neck cancer among Greek patients.

    Science.gov (United States)

    Kakava, Kassiani; Karelas, Ioannis; Koutrafouris, Ioannis; Damianidis, Savvas; Stampouloglou, Paulos; Papadakis, Georgios; Xenos, Antonios; Krania, Foteini; Sarof, Paulos; Tasopoulos, Georgios; Petridis, Nikolaos

    2016-01-01

    We examined the association of ABO blood groups with the different types of head and neck cancers. 195 diagnosed cases and 801 controls were selected from a Greek tertiary cancer center. Information regarding type of head and neck cancer and ABO blood group was collected and registered. The O blood group was found to be most prevalent followed by A, B and AB among the controls, whereas blood group A followed by O, B and AB was most prevalent among cancer patients. The difference among the distribution between the cases and controls was statistically significant in blood group A (pblood group A had 1.52-fold higher risk of developing head and neck cancer compared to people of other blood groups. Blood group A was found to be a potential risk factor for the development of head and neck cancers.

  2. Engineering Vaccines to Reprogram Immunity against Head and Neck Cancer.

    Science.gov (United States)

    Tan, Y S; Sansanaphongpricha, K; Prince, M E P; Sun, D; Wolf, G T; Lei, Y L

    2018-03-01

    The recent Food and Drug Administration's approval of monoclonal antibodies targeting immune checkpoint receptors (ICRs) for recurrent or metastatic head and neck squamous cell carcinoma (HNSCC) offers exciting promise to improve patient outcome and reduce morbidities. A favorable response to ICR blockade relies on an extensive collection of preexisting tumor-specific T cells in the tumor microenvironment (TME). ICR blockade reinvigorates exhausted CD8 + T cells and enhances immune killing. However, resistance to ICR blockade is observed in about 85% of patients with HNSCC, therefore highlighting the importance of characterizing the mechanisms underlying HNSCC immune escape and exploring combinatorial strategies to sensitize hypoimmunogenic cold HNSCC to ICR inhibition. Cancer vaccines are designed to bypass the cold TME and directly deliver cancer antigens to antigen-presenting cells (APCs); these vaccines epitomize a priming strategy to synergize with ICR inhibitors. Cancer cells are ineffective antigen presenters, and poor APC infiltration as well as the M2-like polarization in the TME further dampens antigen uptake and processing, both of which render ineffective innate and adaptive immune detection. Cancer vaccines directly activate APC and expand the tumor-specific T-cell repertoire. In addition, cancer vaccines often contain an adjuvant, which further improves APC function, promotes epitope spreading, and augments host intrinsic antitumor immunity. Thus, the vaccine-induced immune priming generates a pool of effectors whose function can be enhanced by ICR inhibitors. In this review, we summarize the major HNSCC immune evasion strategies, the ongoing effort toward improving HNSCC vaccines, and the current challenges limiting the efficacy of cancer vaccines.

  3. Accelerated fractionation in advanced head and neck cancer

    International Nuclear Information System (INIS)

    Olmi, P.; Cellai, E.; Chiavacci, A.; Fablai, C.

    1990-01-01

    From 1975 to 1985, 161 patients affected by head and neck cancer (58 oropharynx, 67 oral cavity, 36 paranasal sinuses) were treated with radiotherapy using an accelerated fractionation (AF) schedule at the University and Hospital Radiotherapy Departments of Florence. Five-year actuarial local control and survival was 38% for the oropharynx, 18% and 20% for the oral cavity, and 38% and 31% for the paranasal sinuses. Results were analysed according to T and N stage as well. Severe late sequelae were evaluated in 53 patients without local disease and with a minimum follow-up of one year: 8 patients developed osteonecrosis; there were 3 cases of trismus, 2 cases of laryngeal oedema, one case of blindness and one case of opththalmitis. (author). 19 refs.; 2 figs.; 9 tabs

  4. Accelerated fractionation in advanced head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Olmi, P.; Cellai, E. (Florence University (Italy). Department of Radiotherapy); Chiavacci, A.; Fablai, C. (Florence Hospital (Italy). Department of Radiotherapy)

    1990-03-01

    From 1975 to 1985, 161 patients affected by head and neck cancer (58 oropharynx, 67 oral cavity, 36 paranasal sinuses) were treated with radiotherapy using an accelerated fractionation (AF) schedule at the University and Hospital Radiotherapy Departments of Florence. Five-year actuarial local control and survival was 38% for the oropharynx, 18% and 20% for the oral cavity, and 38% and 31% for the paranasal sinuses. Results were analysed according to T and N stage as well. Severe late sequelae were evaluated in 53 patients without local disease and with a minimum follow-up of one year: 8 patients developed osteonecrosis; there were 3 cases of trismus, 2 cases of laryngeal oedema, one case of blindness and one case of opththalmitis. (author). 19 refs.; 2 figs.; 9 tabs.

  5. IMRT for head and neck cancer: reducing xerostomia and dysphagia

    International Nuclear Information System (INIS)

    Wang, XiaoShen; Eisbruch, Avraham

    2016-01-01

    Dysphagia and xerostomia are the main sequellae of chemoradiotherapy for head and neck cancer, and the main factors in reducing long-term patient quality of life. IMRT uses advanced technology to focus the high radiation doses on the targets and avoid irradiation of non-involved tissues. The decisions about sparing organs and tissues whose damage causes xerostomia and dysphagia depends on the evidence for dose–response relationships for the organs causing these sequellae. This paper discusses the evidence for the contribution of radiotherapy to xerostomia via damage of the major salivary glands (parotid and submandibular) and minor salivary glands within the oral cavity, and the contribution of radiotherapy-related effect on important swallowing structures causing dysphagia. Recommendations for dose limits to these organs, based on measurements of xerostomia and dysphagia following radiotherapy, are provided here

  6. Dysphagia in head and neck cancer patients treated with chemoradiotherapy.

    Science.gov (United States)

    Platteaux, Nele; Dirix, Piet; Dejaeger, Eddy; Nuyts, Sandra

    2010-06-01

    Dysphagia is a very common complaint of head and neck cancer patients and can exist before, during, and after chemoradiotherapy. It leads to nutritional deficiency, weight loss, and prolonged unnatural feeding and also has a major potential risk for aspiration. This has a significant negative impact on the patient's entire quality of life. Because treatment of dysphagia in this setting is rarely effective, prevention is paramount. Several strategies have been developed to reduce dysphagia. These include swallowing exercises, treatment modification techniques such as intensity-modulated radiotherapy, selective delineation of elective nodes, reducing xerostomia by parotid-sparing radiotherapy, and adding of radioprotectors. However, more research is needed to further decrease the incidence of dysphagia and improve quality of life.

  7. Coping strategies of African American head and neck cancer survivors.

    Science.gov (United States)

    Agarwal, Mansi; Hamilton, Jill B; Crandell, Jamie L; Moore, Charles E

    2010-01-01

    A cross-sectional study was conducted with 50 African American head and neck cancer survivors. Common coping strategies were identified and examined in relation with quality of life and relationship well-being. Coping through support from God, seeking emotional support from family and friends, and helping others were the most commonly used strategies. Having emotional support, being strong and self-reliant, and engaging in distracting activities with family and friends had strongest associations with quality of life. Coping through emotional support, help from God, assistance from one's church family to maintain religious practices, helping others, and engaging in distracting activities with others was more strongly associated with relationship well-being. Future intervention studies should consider these strategies and their possible impact on the physical, psychological, and relationship well-being of this population.

  8. Negative cancer stereotypes and disease-specific self-concept in head and neck cancer.

    Science.gov (United States)

    Wong, Janice C; Payne, Ada Y M; Mah, Kenneth; Lebel, Sophie; Lee, Ruth N F; Irish, Jonathan; Rodin, Gary; Devins, Gerald M

    2013-05-01

    Life-threatening diseases, such as head and neck cancer (HNCa), can stimulate the emergence of a new disease-specific self-concept. We hypothesized that (i) negative cancer-stereotypes invoke distancing, which inhibits the adoption of a disease-specific self-concept and (ii) patient characteristics, disease and treatment factors, and cancer-related stressors moderate the phenomenon. Head and neck cancer outpatients (N = 522) completed a semantic-differential measure of disease-specific self-concept (perceived similarity to the 'cancer patient') and other self-report measures in structured interviews. Negative cancer-stereotypes were represented by the number of semantic-differential dimensions (0-3) along which respondents evaluated the stereotypic 'cancer patient' negatively (i.e., negative valence). We tested the two-way interactions between negative valence and hypothesized moderator variables. We observed significant negative valence × moderator interactions for the following: (i) patient characteristics (education, employment, social networks); (ii) disease and treatment factors (cancer-symptom burden); and (iii) cancer-related stressors (uncertainty, lack of information, and existential threats). Negative cancer stereotypes were consistently associated with distancing of self from the stereotypic 'cancer patient,' but the effect varied across moderator variables. All significant moderators (except employment and social networks) were associated with increasing perceived similarity to the 'cancer patient' when respondents maintained negative stereotypes; perceived similarity decreased when people were employed or had extensive social networks. Moderator effects were less pronounced when respondents did not endorse negative cancer stereotypes. When they hold negative stereotypes, people with HNCa distance themselves from a 'cancer patient' identity to preserve self-esteem or social status, but exposure to cancer-related stressors and adaptive demands may

  9. Poor oral health affects survival in head and neck cancer.

    Science.gov (United States)

    Farquhar, Douglas R; Divaris, Kimon; Mazul, Angela L; Weissler, Mark C; Zevallos, Jose P; Olshan, Andrew F

    2017-10-01

    Poor oral health has emerged as a risk factor for squamous cell carcinoma of the head and neck (HNSCC) but its impact on survival has not been examined. We sought to estimate the impact of oral health indicators on survival in a population-based HNSCC cohort. Cases (n=1381) and age-, sex- and race-matched controls (n=1396) were participants in the Carolina Head and Neck Cancer Epidemiologic Study (CHANCE). Vital status was determined via linkage with the National Death Index. Survival was considered at 5years post-diagnosis or study-enrollment for controls. Oral health was assessed using self-reported indicators including frequency of routine dental exams and tooth brushing. We used Kaplan-Meyer analyses and Cox regression to estimate adjusted hazard ratios (HR) and 95% confidence intervals (CI). Routine dental visits during the preceding 10years were associated with decreased mortality risk (>10 visits: HR=0.6, 95% CI=0.4-0.8) after adjusting for confounders. This effect was most pronounced for oral cavity cancer-(e.g., >10 visits: HR=0.4, 95% CI=0.2-0.9). Dental visits were also positively associated with survival among controls. No other routine health screening (e.g., eye exams) was associated with survival. We found significant associations between markers of oral health and survival among both HNSCC cases and controls. This association was most pronounced for sites closer to the dentition. Oral health may have a direct effect on tumor biology due to the associated immune or inflammatory response. It may also represent a proxy for wellness or unmeasured social determinants of health. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. Treatment results of neck dissection with the preservation of cervical nerves for hypopharyngeal cancer

    International Nuclear Information System (INIS)

    Hasegawa, Toshifumi; Iwae, Shigemichi; Tanaka, Hironori; Yonezawa, Kouichiro; Inoue, Kenzo

    2007-01-01

    Treatment results of neck dissection with the preservation of cervical nerves for hypopharyngeal cancer were analyzed retrospectively by comparing neck dissection with the preservation of cervical nerves and that with the resection of cervical nerves. Pharyngolaryngectomy or pharyngolaryngoesophagectomy with bilateral neck dissection was performed in 76 hypopharyngeal cancer cases between January 1992 and November 2001. Neck dissection with the resection of cervical nerves was performed on 42 sides of the neck in 21 cases (the cervical nerve-resected group). In 55 cases we attempted to employ neck dissection with the preservation of cervical nerves, but in 9 cases the cervical nerves were resected because of their nodal adhesion or involvement Neck dissection with the preservation of cervical nerves was performed on 92 sides of the neck in 46 cases (the cervical nerve-preserved group). There were significant differences between background factors of two groups about age, sex, induction chemotherapy, preservation of accessory nerve, and pN classification. The 5-year cumulative control rates of cervical lymph nodes were 81.3% for the cervical nerve-resected group and 79.7% for the cervical nerve-preserved group. There was no significant difference between the two groups. It was suggested that neck dissection with the preservation of cervical nerves for cases whose cervical nerves were able to be preserved from metastatic lymph nodes under induction chemotherapy and post-operative irradiation was as effective to control cervical lymph nodes as neck dissection with the resection of cervical nerves. (author)

  11. Oncogenic impact of human papilloma virus in head and neck cancer.

    LENUS (Irish Health Repository)

    Heffernan, C B

    2012-02-01

    There is considerable debate within the literature about the significance of human papilloma virus in head and neck squamous cell carcinoma, and its potential influence on the prevention, diagnosis, grading, treatment and prognosis of these cancers. Cigarette smoking and alcohol consumption have traditionally been cited as the main risk factors for head and neck cancers. However, human papilloma virus, normally associated with cervical and other genital carcinomas, has emerged as a possible key aetiological factor in head and neck squamous cell carcinoma, especially oropharyngeal cancers. These cancers pose a significant financial burden on health resources and are increasing in incidence. The recent introduction of vaccines targeted against human papilloma virus types 16 and 18, to prevent cervical cancer, has highlighted the need for ongoing research into the importance of human papilloma virus in head and neck squamous cell carcinoma.

  12. Chromosomal radiosensitivity in head and neck cancer patients: evidence for genetic predisposition?

    Science.gov (United States)

    De Ruyck, K; de Gelder, V; Van Eijkeren, M; Boterberg, T; De Neve, W; Vral, A; Thierens, H

    2008-01-01

    The association between chromosomal radiosensitivity and genetic predisposition to head and neck cancer was investigated in this study. In all, 101 head and neck cancer patients and 75 healthy control individuals were included in the study. The G2 assay was used to measure chromosomal radiosensitivity. The results demonstrated that head and neck cancer patients had a statistically higher number of radiation-induced chromatid breaks than controls, with mean values of 1.23 and 1.10 breaks per cell, respectively (Pgenetic predisposition to head and neck cancer, and the genetic contribution is highest for oral cavity and pharynx cancer patients and for early onset and non- and light smoking patients. PMID:18414410

  13. PET-CT–Guided Surveillance of Head and Neck Cancers

    Science.gov (United States)

    Patients with advanced squamous cell carcinoma of the head and neck who underwent PET-CT–guided surveillance had fewer operations but similar overall survival rates to those of patients who underwent planned neck dissection.

  14. Treatment-induced hearing loss after (chemo)radiotherapy in patients with head and neck cancer

    NARCIS (Netherlands)

    Theunissen, E.A.R.

    2015-01-01

    Ototoxicity is a common adverse event after cisplatin treatment and radiotherapy to the head and neck area. Counseling patients about this adverse event is important. The thesis main objective is to improve our knowledge ototoxicity in patients with head and neck cancer. A systematic review showed

  15. Shoulder and neck morbidity in quality of life after surgery for head and neck cancer

    NARCIS (Netherlands)

    van Wilgen, C.P.; Dijkstra, P.U.; van der Laan, B.F.; Plukker, J.T.; Roodenburg, J.L.

    2004-01-01

    Background. Quality of life has become a major issue in determining the outcome of treatment in head and neck surgery with curative intent. The aim of our study was to determine which factors in the postoperative care, especially shoulder and neck morbidity, are related to quality of life and how

  16. Allergies and risk of head and neck cancer.

    Science.gov (United States)

    Michaud, Dominique S; Langevin, Scott M; Eliot, Melissa; Nelson, Heather H; McClean, Michael D; Christensen, Brock C; Marsit, Carmen J; Kelsey, Karl T

    2012-08-01

    Individuals with allergies have a heightened Th2 (T helper 2) immunity, which may provide advantages in controlling tumor growth. Inverse associations have been reported among individuals with allergies and risk of brain and pancreatic cancers. We examined the relationship between allergies and risk of head and neck squamous cell carcinoma (HNSCC) in a population-based case-control study with 1,014 cases and 1,193 frequency-matched controls. Logistic regression models were used to estimate odds ratios (OR) and 95 % confidence intervals (95 % CI) controlling for age, sex, race, smoking history, alcohol consumption, and education. In addition, in a subset of the population, models were adjusted for HPV16 status. Individuals with allergies had a 19 % lower risk of HNSCC (OR = 0.81, 95 % CI = 0.67-0.98). Associations with allergies were stronger for laryngeal (OR = 0.66, 95 % CI = 0.45-0.97) and oropharyngeal (OR = 0.73, 95 % CI = 0.57-0.92) cancers, while no association was observed for oral cavity cancers (OR = 0.98, 95 % CI = 0.76-1.26). History of asthma was not associated with overall HNSCC, but the association was statistically significant for oropharyngeal cancer (OR = 0.67, 95 % CI = 0.44-0.99). HPV16 status did not confound or modify the associations with allergies. Elevated Th2 immunity in individuals with history of allergies and asthma may reduce the risk of HNSCC. Additional research into related mechanisms may provide new insights into how to treat HNSCC. These findings may provide new insight into biological pathways that could lead to a better understanding of the etiology of this disease.

  17. Human Papillomavirus Induced Transformation in Cervical and Head and Neck Cancers

    Energy Technology Data Exchange (ETDEWEB)

    Adams, Allie K. [Cancer and Blood Diseases Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229 (United States); Wise-Draper, Trisha M. [Division of Hematology/Oncology, University of Cincinnati Medical Center, University of Cincinnati, Cincinnati, OH 45229 (United States); Wells, Susanne I., E-mail: Susanne.Wells@cchmc.org [Cancer and Blood Diseases Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229 (United States)

    2014-09-15

    Human papillomavirus (HPV) is one of the most widely publicized and researched pathogenic DNA viruses. For decades, HPV research has focused on transforming viral activities in cervical cancer. During the past 15 years, however, HPV has also emerged as a major etiological agent in cancers of the head and neck, in particular squamous cell carcinoma. Even with significant strides achieved towards the screening and treatment of cervical cancer, and preventive vaccines, cervical cancer remains the leading cause of cancer-associated deaths for women in developing countries. Furthermore, routine screens are not available for those at risk of head and neck cancer. The current expectation is that HPV vaccination will prevent not only cervical, but also head and neck cancers. In order to determine if previous cervical cancer models for HPV infection and transformation are directly applicable to head and neck cancer, clinical and molecular disease aspects must be carefully compared. In this review, we briefly discuss the cervical and head and neck cancer literature to highlight clinical and genomic commonalities. Differences in prognosis, staging and treatment, as well as comparisons of mutational profiles, viral integration patterns, and alterations in gene expression will be addressed.

  18. Human Papillomavirus Induced Transformation in Cervical and Head and Neck Cancers

    International Nuclear Information System (INIS)

    Adams, Allie K.; Wise-Draper, Trisha M.; Wells, Susanne I.

    2014-01-01

    Human papillomavirus (HPV) is one of the most widely publicized and researched pathogenic DNA viruses. For decades, HPV research has focused on transforming viral activities in cervical cancer. During the past 15 years, however, HPV has also emerged as a major etiological agent in cancers of the head and neck, in particular squamous cell carcinoma. Even with significant strides achieved towards the screening and treatment of cervical cancer, and preventive vaccines, cervical cancer remains the leading cause of cancer-associated deaths for women in developing countries. Furthermore, routine screens are not available for those at risk of head and neck cancer. The current expectation is that HPV vaccination will prevent not only cervical, but also head and neck cancers. In order to determine if previous cervical cancer models for HPV infection and transformation are directly applicable to head and neck cancer, clinical and molecular disease aspects must be carefully compared. In this review, we briefly discuss the cervical and head and neck cancer literature to highlight clinical and genomic commonalities. Differences in prognosis, staging and treatment, as well as comparisons of mutational profiles, viral integration patterns, and alterations in gene expression will be addressed

  19. Low-density lipoprotein cholesterol and radiotherapy-induced carotid atherosclerosis in subjects with head and neck cancer

    International Nuclear Information System (INIS)

    Pereira, Eduardo B; Gemignani, Tiago; Sposito, Andrei C; Matos-Souza, José R; Nadruz Jr, Wilson

    2014-01-01

    Radiotherapy (RT) is a risk factor for accelerated carotid artery atherosclerotic disease in subjects with head and neck cancer. However, the risk factors of RT-induced carotid artery remodeling are not established. This study aimed to investigate the effects of RT on carotid and popliteal arteries in subjects with head and neck cancer and to evaluate the relationship between baseline clinical and laboratory features and the progression of RT-induced atherosclerosis. Eleven men (age = 57.9 ± 6.2years) with head and neck cancer who underwent cervical bilateral irradiation were prospectively examined by clinical and laboratory analysis and by carotid and popliteal ultrasound before and after treatment (mean interval between the end of RT and the post-RT assessment = 181 ± 47 days). No studied subject used hypocholesterolemic medications. Significant increases in carotid intima-media thickness (IMT) (0.95 ± 0.08 vs. 0.87 ± 0.05 mm; p < 0.0001) and carotid IMT/diameter ratio (0.138 ± 0.013 vs. 0.129 ± 0.014; p = 0.001) were observed after RT, while no changes in popliteal structural features were detected. In addition, baseline low-density lipoprotein cholesterol levels showed a direct correlation with RT-induced carotid IMT change (r = 0.66; p = 0.027), while no other studied variable exhibited a significant relationship with carotid IMT change. These results indicate that RT-induced atherosclerosis is limited to the irradiated area and also suggest that it may be predicted by low-density lipoprotein cholesterol levels in subjects with head and neck cancer

  20. Tea consumption and risk of head and neck cancer.

    Directory of Open Access Journals (Sweden)

    Cheng-Chih Huang

    Full Text Available BACKGROUND: The current study evaluated the association between tea consumption and head and neck cancer (HNC in Taiwan, where tea is a major agricultural product and a popular beverage. METHODS: Interviews regarding tea consumption (frequency, duration, and types were conducted with 396 HNC cases and 413 controls. Unconditional logistic regression was performed to estimate the odds ratio (OR and 95% confidence interval (CI of HNC risk associated with tea drinking, adjusted for sex, age, education, cigarette smoking, betel quid chewing, and alcohol drinking. RESULTS: A reduced HNC risk associated with tea drinking (OR for every cup per day = 0.96, 95% CI: 0.93-0.99; OR for ≧5 cups per day = 0.60, 95% CI: 0.39-0.94 was observed. The association was especially significant for pharyngeal cancer (OR for every cup per day = 0.93, 95% CI: 0.88-0.98; OR for ≧5 cups per day = 0.32, 95% CI: 0.16-0.66. A significant inverse association between HNC and tea consumption was observed particularly for green tea. CONCLUSIONS: This study suggests that tea drinking may reduce the risk of HNC. The anticancer property of tea, if proven, may offer a natural chemopreventive measure to reduce the occurrence of HNC.

  1. Nutritional consequences of the radiotherapy of head and neck cancer

    International Nuclear Information System (INIS)

    Chencharick, J.D.; Mossman, K.L.

    1983-01-01

    Nutrition-related complications of radiotherapy were evaluated in 74 head and neck cancer patients. Subjective changes of mouth dryness, taste, dysphagia, appetite, and food preferences were determined by questionnaire before and at weekly intervals during curative radiotherapy. Changes in body weight during therapy were also recorded. In addition, 24-hour dietary histories were taken from eight patients at the beginning and end of treatment. Results of the study indicate that patients were subjectively aware of nutritional problems prior to therapy and that therapy exacerbated these problems. As many as 25% of the patients experienced oral complications such as taste loss and/or dry mouth prior to initiation of radiotherapy. By the end of radiotherapy, over 80% of the patients were aware of oral and nutritional problems. Patients had an average weight loss of 5 kg prior to therapy; this loss of weight did not change during therapy. Diet histories of eight patients indicate significant caloric deficiencies early and late in radiotherapy. The oral and nutritional problems experienced by patients, even prior to therapy, support the idea that nutritional evaluation and maintenance are important not only during therapy, but prior to radiotherapy as well. Nutritional evaluation should be made a routine, integral part of therapy for every cancer patient

  2. [Management of mucositis following radiotherapy for head and neck cancers].

    Science.gov (United States)

    Lapeyre, M; Charra-Brunaud, C; Kaminsky, M C; Geoffrois, L; Dolivet, G; Toussaint, B; Maire, F; Pourel, N; Simon, M; Marchal, C; Bey, P

    2001-11-01

    Acute mucositis is common after radiotherapy for head and neck cancers. During the past 3 decades, there was a gradual evolution in the treatment modalities for locally advanced carcinomas (concomitant radio-chemotherapy, accelerated radiotherapy). These new strategies are accompanied by an increase in early mucosal reactions. At the present time, there is no widely accepted prophylaxis or effective treatment. Many traditional remedies or new agents seem ineffective (Sucralfate, Chlorhexidine, GM-CSF, Silver nitrate, Prostaglandin, anti-oxidants, Benzydamine hydrochloride), while others seem promising (Povidone-iodine, nonabsorbable antibiotic lozenges and antifungals, local GM-CSF, Glutamide, Low-energy laser, corticosteroïds). Radioprotectors are controversial and should be only used in experimental protocols and not in routine practice. However, some recommendations can be proposed: general prevention and global care before cancer therapy should be systematic (oral hygiene, dental and periodontal treatment, advice to avoid the use of tobacco and alcohol); frequent oral rinsing with a bland mouthwash (Povidone-iodine or others) should be used at the start of treatment because there are significant modifications of the oral microflora increased by a disturbed salivary flow; these mouthwashes could be associated with nonabsorbable antibiotic lozenges or antifungal topicals (bicarbonates, Amphotéricine B); Systematic percutaneous fluoroscopic gastrostomy should be decided before any aggressive treatments (concomitant radio-chemotherapy, accelerated radiotherapy); pain should be controlled; finally, the radiation technique should be optimized (mucosal-sparing block, conformal radiotherapy and intensity-modulated radiation therapy).

  3. Periodontal disease, atherosclerosis, adverse pregnancy outcomes, and head-and-neck cancer

    NARCIS (Netherlands)

    Han, Y.W.; Houcken, W.; Loos, B.G.; Schenkein, H.A.; Tezal, M.

    2014-01-01

    Interrelationships between periodontal infection and systemic conditions such as cardiovascular disease, adverse pregnancy outcomes, and head-and-neck cancer have become increasingly appreciated in recent years. Periodontitis is associated with cardiovascular disease (CVD) and, experimentally, with

  4. A new complementary procedure for patients affected by head and neck cancer: Chemo-predictive assay

    Directory of Open Access Journals (Sweden)

    Antonio Cortese

    2016-01-01

    Conclusions: This procedure may be useful in helping physicians choose an effective chemotherapy regimen for head and neck cancer patients and lower treatment costs by eliminating ineffective chemotherapies and unnecessary toxicity particularly in elderly patients.

  5. Accuracy of self-reported tobacco assessments in a head and neck cancer treatment population

    International Nuclear Information System (INIS)

    Warren, Graham W.; Arnold, Susanne M.; Valentino, Joseph P.; Gal, Thomas J.; Hyland, Andrew J.; Singh, Anurag K.; Rangnekar, Vivek M.; Cummings, K. Michael; Marshall, James R.; Kudrimoti, Mahesh R.

    2012-01-01

    Prospective analysis was performed of self-reported and biochemically confirmed tobacco use in 50 head and neck cancer patients during treatment. With 93.5% compliance to complete weekly self-report and biochemical confirmatory tests, 29.4% of smokers required biochemical assessment for identification. Accuracy increased by 14.9% with weekly vs. baseline self-reported assessments. Data confirm that head and neck cancer patients misrepresent true tobacco use during treatment.

  6. Managing complications of radiation therapy in head and neck cancer patients: Part I. Management of xerostomia

    OpenAIRE

    Ngeow, Dr. W.C.; Chai, W. L.; Rahman, R. A.; Ramli, R.

    2006-01-01

    Head and neck cancer is becoming a more recognizable pathology to the general population and dentists. The modes of treatment include surgery and/or radiation therapy. Where possible, pretreatment dental assessment shall be provided for these patients before they receive radiation therapy. There are occasions, however, whereby head and neck cancer patients are not prepared optimally for radiation therapy. Because of this, they succumb to complicated oral adverse effects after radiation therap...

  7. Planned neck dissection after weekly docetaxel and concurrent radiotherapy for advanced oropharyngeal cancer

    International Nuclear Information System (INIS)

    Tomita, Toshiki; Ozawa, Hiroyuki; Sakamoto, Koji; Fujii, Ryoichi; Ogawa, Kaoru; Fujii, Masato; Yamashita, Taku; Shinden, Seiichi

    2007-01-01

    Small oropharyngeal carcinomas with advanced neck metastases (stage N2 or greater) are common. Patients with small T with large N oropharyngeal carcinoma have high rates of local control but lower rates of regional control when treated with chemoradiotherapy. Clinical assessment after chemoradiotherapy cannot ensure the absence of neck disease. In the last 5 years, we have treated patients with T1-2 with N2-3 oropharyngeal carcinoma with weekly docetaxel radiotherapy followed by planned neck dissection (PND). Our objectives were to clarify the pathologically complete response (CR) rate of neck metastasis after weekly docetaxel radiotherapy, to identify the clinical predictor of residual neck disease, and to determine the mobidity of planned neck dissection. After chemoradiotherapy, all 12 patients had a complete response at the primary site. We conducted 15 neck dissections. Of these, 6 (40%) had positive nodes. The pathological CR rate of neck metastasis was 58.3%, whereas overall 2-year neck control rate was 91.7%. These findings lend support to the role of PND after chemoradiotherapy in N2-3 neck disease. After chemoradiotherapy, clinical parameters including TN status, feasibility of chemoradiotherapy, largest lymph node size or size reduction in MRI, did not identify patients with residual neck disease. We conducted selective neck dissection (SND) in 80% of patients. SND as PND appears to be appropriate in this group of patients because of the low incidence of complications. A further cohort study including the comparison of PND nonenforcement group is necessary to clarify the validity of the addition of PND in weekly docetaxel radiotherapy. (author)

  8. Superselective arterial infusion and concomitant radiotherapy for advanced head and neck cancer

    International Nuclear Information System (INIS)

    Homma, Akihiro; Furuta, Yasushi; Ushikoshi, Satoshi

    2003-01-01

    Superselective arterial infusion for patients with advanced head and neck cancer has increasingly been applied in Japan. We analyzed our experiences and evaluated the efficacy and safety of this treatment. Forty-four patients, who were considered contraindicated for surgery or rejected radical surgery, received superselective intra-arterial infusion therapy of cisplatin (100-120 mg/m 2 /week) with simultaneous intravenous infusion of thiosulfate to neutralize cisplatin toxicity, and conventional concomitant extrabeam radiotherapy (65 Gy/26 f/6.5 weeks). During the median follow-up period of 17 months, 2-year progression-free survival rate of primary lesion was 66.9%, and that of patients with T4b diseases 57%. The 2-year overall survival rate was 52.4%. Although acute toxic effects were considered acceptable, severe toxic events occurred in some cases, namely, cranial nerve palsy, Methicillin-resistant Staphylococcus aureus (MRSA) pneumonia, sepsis, and osteoradionecrosis. We confirmed the high effectiveness of superselective arterial infusion and concomitant radiotherapy, which can concentrate the attack of decadose cisplatin on locoregional disease. Moreover, even patients with unresectable disease can be cured. We must clarify the treatment results and late side effects, and establish the indications for this treatment. (author)

  9. Simultaneous radiochemotherapy versus concomitant boost radiation for advanced inoperable head and neck cancer

    International Nuclear Information System (INIS)

    Schaefer, U.; Schueller, P.; Micke, O.; Willich, N.

    2000-01-01

    In this prospective, non-randomized study we compare the results of simultaneous radiochemotherapy (RCT) with those of concomitant boost treatment (CBT) in advanced head and neck cancer. From January 1993 to March 1999, 77 patients were treated with cisplatin, 5-FU, and 70.2 Gy (accelerated split-course); from January 1995 to March 1999, a further 33 patients received CBT to a total dose of 72 Gy. Toxicities were prospectively recorded according to RTOG/EORTC criteria. Acute and subacute reactions did not differ significantly. Severe late effects (III/IV) remained anecdotal (one fistula). Therapy-associated mortalities were 3%(RCT) vs. 0% (CBT), most tumors responding well to therapy (CR + PR: RCT: 72%, CBT: 63%). The 2-year probabilities for freedom from locoregional progression amounted to 42% (RCT) and 31% (CBT); p > 0.05. Tumor-specific 2-year survival amounted to 40% (RCT) and 34% (CBT); p > 0.05. Both of the treatment concepts yield high remission rates with moderate toxicities. Nevertheless, median time to recurrence is still fairly short. We could not find any differences for local control and survival. For patients who are not able to complete the full three courses of radiochemotherapy, the concomitant boost schedule presents a good alternative

  10. Is Planned Neck Dissection Necessary for Head and Neck Cancer After Intensity-Modulated Radiotherapy?

    International Nuclear Information System (INIS)

    Yao Min; Hoffman, Henry T.; Chang, Kristi; Funk, Gerry F.; Smith, Russell B.; Tan Huaming; Clamon, Gerald H.; Dornfeld, Ken; Buatti, John M.

    2007-01-01

    Purpose: The objective of this study was to determine regional control of local regional advanced head and neck squamous cell carcinoma (HNSCC) treated with intensity-modulated radiotherapy (IMRT), along with the role and selection criteria for neck dissection after IMRT. Methods and Materials: A total of 90 patients with stage N2A or greater HNSCC were treated with definitive IMRT from December 1999 to July 2005. Three clinical target volumes were defined and were treated to 70 to 74 Gy, 60 Gy, and 54 Gy, respectively. Neck dissection was performed for selected patients after IMRT. Selection criteria evolved during this period with emphasis on post-IMRT [ 18 F] fluorodeoxyglucose positron emission tomography in recent years. Results: Median follow-up for all patients was 29 months (range, 0.2-74 months). All living patients were followed at least 9 months after completing treatment. Thirteen patients underwent neck dissection after IMRT because of residual lymphadenopathy. Of these, 6 contained residual viable tumor. Three patients with persistent adenopathy did not undergo neck dissection: 2 refused and 1 had lung metastasis. Among the remaining 74 patients who were observed without neck dissection, there was only 1 case of regional failure. Among all 90 patients in this study, the 3-year local and regional control was 96.3% and 95.4%, respectively. Conclusions: Appropriately delivered IMRT has excellent dose coverage for cervical lymph nodes. A high radiation dose can be safely delivered to the abnormal lymph nodes. There is a high complete response rate. Routine planned neck dissection for patients with N2A and higher stage after IMRT is not necessary. Post-IMRT [ 18 F] fluorodeoxyglucose positron emission tomography is a useful tool in selecting patients appropriate for neck dissection

  11. Split-course accelerated therapy in head and neck cancer: an analysis of toxicity

    International Nuclear Information System (INIS)

    Delaney, Geoffrey P.; Fisher, Richard J.; Smee, Robert I.; Hook, Carolyn; Barton, Michael B.

    1995-01-01

    Purpose: To retrospectively assess a protocol of split-course accelerated radiation therapy (SCAT) for selected head and neck cancers. Methods and Materials: SCAT consisted of 1.8 Gy per fraction administered twice daily with a minimum gap between fractions of 6 h. The treatment protocol prescribed an initial 16 fractions followed by a planned 5 to 12 day break, and then a further 20 to 22 fractions for a total dose ranging from 64.8 to 72 Gy delivered in 5 to 6 weeks. Results: Twenty-eight patients received SCAT for histologically confirmed head and neck cancer between January 1987 and August 1991. All patients were followed up until December 1, 1993. The mean potential follow-up time was 4.2 years (range: 2.9-6.2 years). All patients completed the treatment protocol. Thirteen tumors were laryngeal in origin, eight hypopharyngeal, four paranasal sinus, and three oropharyngeal. There were no Stage I, three Stage II, nine Stage III, and 12 Stage IV tumors. Four tumors were not staged (two paranasal sinus cancers and two surgical recurrences). Early and late toxicities were moderate to severe. Confluent mucositis was experienced by 27 of the 28 patients (96%). One patient required a prolonged midtreatment break of 24 days. Nine patients (32%) required narcotic analgesia for pain relief. Eleven patients (39%) required hospitalization for nasogastric feeding or pain control. The median length of hospital stay was 14 days (range 7-98 days). The actuarial rate of severe late toxicity at 3 years was 47% (standard error (SE) = 13%). A complete tumor response was achieved in 86% of patients. The actuarial local control rate at 3 years was 43% (SE = 11%) and the actuarial survival rate at 3 years was 25% (SE = 8%). Conclusion: Given the encouraging complete response rate and local control for such advanced tumors, SCAT for locoregionally advanced tumors merits further investigation. However, because of the significant late toxicity observed, the total dose, interfraction

  12. How the neck affects the back: changes in regional cervical sagittal alignment correlate to HRQOL improvement in adult thoracolumbar deformity patients at 2-year follow-up.

    Science.gov (United States)

    Protopsaltis, Themistocles S; Scheer, Justin K; Terran, Jamie S; Smith, Justin S; Hamilton, D Kojo; Kim, Han Jo; Mundis, Greg M; Hart, Robert A; McCarthy, Ian M; Klineberg, Eric; Lafage, Virginie; Bess, Shay; Schwab, Frank; Shaffrey, Christopher I; Ames, Christopher P

    2015-08-01

    OBJECT Regional cervical sagittal alignment (C2-7 sagittal vertical axis [SVA]) has been shown to correlate with health-related quality of life (HRQOL). The study objective was to examine the relationship between cervical and thoracolumbar alignment parameters with HRQOL among patients with operative and nonoperative adult thoracolumbar deformity. METHODS This is a multicenter prospective data collection of consecutive patients with adult thoracolumbar spinal deformity. Clinical measures of disability included the Oswestry Disability Index (ODI), Scoliosis Research Society-22 Patient Questionnaire (SRS-22), and 36-Item Short-Form Health Survey (SF-36). Cervical radiographic parameters were correlated with global sagittal parameters within the nonoperative and operative cohorts. A partial correlation analysis was performed controlling for C-7 SVA. The operative group was subanalyzed by the magnitude of global deformity (C-7 SVA ≥ 5 cm vs Physical Component Summary (PCS), SRS Activity domain, and SRS Appearance domain. Baseline C2-7 SVA also correlated with SRS Pain and SRS Total. For the operative patients with baseline C-7 SVA ≥ 5 cm, the 2-year C2-7 SVA significantly correlated with 2-year Mental Component Summary, SRS Mental, SRS Satisfaction, and decreases in ODI. Decreases in C2-7 SVA at 2 years significantly correlated with lower ODI at 2 years. Using partial correlations while controlling for C-7 SVA, the C2-7 SVA correlated significantly with baseline ODI (r = 0.211, p = 0.002), PCS (r = -0.178, p = 0.009), and SRS Activity (r = -0.145, p = 0.034) for the entire cohort. In the subset of operative patients with larger thoracolumbar deformities, the change in C2-7 SVA correlated with change in ODI (r = -0.311, p = 0.03). CONCLUSIONS Changes in cervical lordosis correlate to HRQOL improvements in thoracolumbar deformity patients at 2-year follow-up. Regional cervical sagittal parameters such as CL and C2-7 SVA are correlated with clinical measures of

  13. Relative Risk of Various Head and Neck Cancers among Different Blood Groups: An Analytical Study.

    Science.gov (United States)

    Singh, Khushboo; Kote, Sunder; Patthi, Basavaraj; Singla, Ashish; Singh, Shilpi; Kundu, Hansa; Jain, Swati

    2014-04-01

    Cancer is a unique disease characterized by abnormal growth of cells which have the ability to invade the adjacent tissues and sometimes even distant organs. The limited and contrasting evidence regarding the association of ABO blood groups with the different types of head and neck cancers in the Indian population warrants the need for the present study. To assess the relative risk of various Head & Neck cancers among different blood groups. Three hundred sixty two diagnosed cases of different type of head and neck cancers and 400 controls were selected from four hospitals of New Delhi, India. The information regarding the type of head and neck cancer was obtained from the case sheets of the patients regarding their socio demographic profile, dietary history using a structured performa. The information regarding type of cancer (cases only), ABO blood group was collected. Statistical Tests: The data was analysed using the SPSS 19 version. Chi square test and odd ratios were calculated. The level of significance was fixed at 5%. The O blood group was found to be most prevalent followed by B, A and AB among the cases as well as the controls. Oral cancer patients showed maximum number in blood group O followed by B, A and AB. Significant pattern of distribution was seen among the patients of esophageal cancer, laryngeal cancer and salivary gland cancer as well (p= 0.003, p=0.000 p=0.112 respectively. The present study reveals that there is an inherited element in the susceptibility or protection against different types of head and neck cancers. Blood group A was found to be a potential risk factor for the development of oral cancers, esophageal cancers and salivary gland cancers while blood group B was found to be a potential risk factor for laryngeal cancers.

  14. Head and neck cancer in HIV patients and their parents: a Danish cohort study

    DEFF Research Database (Denmark)

    Engsig, Frederik N; Gerstoft, Jan; Kronborg, Gitte

    2011-01-01

    The mechanism for the increased risk of head and neck cancer (HNC) observed in HIV patients is controversial. We hypothesized that family-related risk factors increase the risk of HNC why we estimated the risk of this type of cancer in both HIV patients and their parents.......The mechanism for the increased risk of head and neck cancer (HNC) observed in HIV patients is controversial. We hypothesized that family-related risk factors increase the risk of HNC why we estimated the risk of this type of cancer in both HIV patients and their parents....

  15. Xerostomia and its predictors following parotid-sparing irradiation of head-and-neck cancer

    International Nuclear Information System (INIS)

    Eisbruch, Avraham; Kim, Hyungjin M.; Terrell, Jeffrey E.; Marsh, Lon H.C.; Dawson, Laura A.; Ship, Jonathan A.

    2001-01-01

    Purpose: To assess long-term xerostomia in patients receiving parotid-sparing radiation therapy (RT) for head-and-neck cancer, and to find the patient and therapy-related factors that affect its severity. Patients and Methods: From March 1994 through January 2000, 84 patients received comprehensive bilateral neck RT using conformal and multisegmental intensity-modulated RT (IMRT) aiming to spare the major salivary glands. Before RT and periodically through 2 years after the completion of RT, salivary flow rates from each of the major salivary glands were selectively measured. At the same time intervals, each patient completed an 8-item self-reported xerostomia-specific questionnaire (XQ). To gain a relative measure of the effect of RT on the minor salivary glands, whose output could not be measured, the surfaces of the oral cavity (extending to include the surface of the base of tongue) were outlined in the planning CT scans. The mean doses to the new organ ('oral cavity') were recorded. Forty-eight patients receiving unilateral neck RT were similarly studied and served as a benchmark for comparison. Factors predicting the XQ scores were analyzed using a random-effects model. Results: The XQ was found to be reliable and valid in measuring patient-reported xerostomia. The spared salivary glands which had received moderate doses in the bilateral RT group recovered to their baseline salivary flow rates during the second year after RT, and the spared glands in the unilateral RT group, which had received very low doses, demonstrated increased salivary production beyond their pre-RT levels. The increase in the salivary flow rates during the second year after RT paralleled an improvement in xerostomia in both patient groups. The improvement in xerostomia was faster in the unilateral compared with the bilateral RT group, but the difference narrowed at 2 years. The major salivary gland flow rates had only a weak correlation with the xerostomia scores. Factors found to be

  16. Serum immunoglobulins in head and neck cancer: effect of radiotherapy

    International Nuclear Information System (INIS)

    Kohli, G.S.; Yadav, S.P.S.; Chowdhry, D.; Mehta, H.C.

    1987-01-01

    Twenty-five patients with head and neck cancer and 25 age-matched normal controls were investigated for serum, immunoglobulin levels (IgA, IgG and IgM). The levels of all the three immunoglobulins in the patients were significantly higher than controls, the rise in IgA being more than that of IgG or IgM. The ratios of IgA/IgG and IgA/IgM were also higher than normal. The immunoglobulin levels showed a progressive rise with the advance in stage of the tumour. A fall in the immunoglobulin levels, as well as in the ratios of IgA/IgG and IgA/IgM, was noted following radiotherapy though the levels were still higher than controls. The range of increase in immunoglobulins appears to be a satisfactory prognostic tool, and a fall after radiotherapy appears to be related to the effectiveness of treatment. (author). 3 tables, 11 refs

  17. Serum, plasma and saliva biomarkers for head and neck cancer.

    Science.gov (United States)

    Arantes, Lidia Maria Rebolho Batista; De Carvalho, Ana Carolina; Melendez, Matias Eliseo; Lopes Carvalho, André

    2018-01-01

    Head and neck squamous cell carcinoma (HNSCC) encompasses tumors arising from several locations (oral and nasal cavities, paranasal sinuses, salivary glands, pharynx, and larynx) and currently stands as the sixth most common cancer worldwide. The most important risk factors identified so far are tobacco and alcohol consumption, and, for a subgroup of HNSCCs, infection with high-risk types of human papillomavirus (HPV). Despite several improvements in the treatment of these tumors in the last decades, overall survival rates have only improved marginally, mainly due to the advanced clinical stage at diagnosis and the high rates of treatment failure associated with this late diagnosis. Areas covered: This review will focus on the feasibility of evaluating molecular-based biomarkers (mRNA, microRNA, lncRNA, DNA methylation and protein expression) in body fluids (serum, plasma, and saliva) as markers for diagnosis, prognosis, and surveillance. Expert commentary: The potential use of those markers in the clinical setting would allow for early diagnosis, prediction of treatment response, improvement in treatment selection and provide disease monitoring for early detection of tumor recurrence. It can ultimately be translated into better survival rates and improved quality of life for HNSCC patients.

  18. Accelerated fractionation radiotherapy for advanced haed and neck cancer

    International Nuclear Information System (INIS)

    Lamb, D.S.; Spry, N.A.; Gray, A.J.; Johnson, A.D.; Alexander, S.R.; Dally, M.J.

    1990-01-01

    Between 1981 and 1986, 89 patients with advanced head and neck squamous cancer were treated with a continuous accelerated fractionation radiotherapy (AFRT) regimen. Three fractions of 1.80 Gy, 4 h apart, were given on three treatment days per week, and the tumour dose was taken to 59.40 Gy in 33 fractions in 24-25 days. Acute mucosal reactions were generally quite severe, but a split was avoided by providing the patient with intensive support, often as an in-patient, until the reactions settled. Late radiation effects have been comparable to those obtained with conventional fractionation. The probability of local-regional control was 47% at 3 years for 69 previously untreated patients, whereas it was only 12% at one year for 20 patients treated for recurrence after radical surgery. Fifty-eight previously untreated patients with tumours arising in the upper aero-digestive tract were analysed in greated detail. The probability of local-regional control at 3 years was 78% for 17 Stage III patients and 15% for 31 Stage IV patients. This schedule of continuous AFRT is feasible and merits further investigation. (author). 31 refs.; 4 figs.; 6 tabs

  19. The future of personalised radiotherapy for head and neck cancer.

    Science.gov (United States)

    Caudell, Jimmy J; Torres-Roca, Javier F; Gillies, Robert J; Enderling, Heiko; Kim, Sungjune; Rishi, Anupam; Moros, Eduardo G; Harrison, Louis B

    2017-05-01

    Radiotherapy has long been the mainstay of treatment for patients with head and neck cancer and has traditionally involved a stage-dependent strategy whereby all patients with the same TNM stage receive the same therapy. We believe there is a substantial opportunity to improve radiotherapy delivery beyond just technological and anatomical precision. In this Series paper, we explore several new ideas that could improve understanding of the phenotypic and genotypic differences that exist between patients and their tumours. We discuss how exploiting these differences and taking advantage of precision medicine tools-such as genomics, radiomics, and mathematical modelling-could open new doors to personalised radiotherapy adaptation and treatment. We propose a new treatment shift that moves away from an era of empirical dosing and fractionation to an era focused on the development of evidence to guide personalisation and biological adaptation of radiotherapy. We believe these approaches offer the potential to improve outcomes and reduce toxicity. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Immunotherapy of Head and Neck Cancer: Current and Future Considerations

    Directory of Open Access Journals (Sweden)

    Alexander D. Rapidis

    2009-01-01

    Full Text Available Patients with head and neck squamous cell carcinoma (HNSCC are at considerable risk for death, with 5-year relative survival rates of approximately 60%. The profound multifaceted deficiencies in cell-mediated immunity that persist in most patients after treatment may be related to the high rates of treatment failure and second primary malignancies. Radiotherapy and chemoradiotherapy commonly have severe acute and long-term side effects on immune responses. The development of immunotherapies reflects growing awareness that certain immune system deficiencies specific to HNSCC and some other cancers may contribute to the poor long-term outcomes. Systemic cell-mediated immunotherapy is intended to activate the entire immune system and mount a systemic and/or locoregional antitumor response. The delivery of cytokines, either by single cytokines, for example, interleukin-2, interleukin-12, interferon-, interferon-, or by a biologic mix of multiple cytokines, such as IRX-2, may result in tumor rejection and durable immune responses. Targeted immunotherapy makes use of monoclonal antibodies or vaccines. All immunotherapies for HNSCC except cetuximab remain investigational, but a number of agents whose efficacy and tolerability are promising have entered phase 2 or phase 3 development.

  1. The current status of oncolytic viral therapy for head and neck cancer

    Directory of Open Access Journals (Sweden)

    Matthew O. Old

    2016-06-01

    Full Text Available Objective: Cancer affects the head and neck region frequently and leads to significant morbidity and mortality. Oncolytic viral therapy has the potential to make a big impact in cancers that affect the head and neck. We intend to review the current state of oncolytic viruses in the treatment of cancers that affect the head and neck region. Method: Data sources are from National clinical trials database, literature, and current research. Results: There are many past and active trials for oncolytic viruses that show promise for treating cancers of the head and neck. The first oncolytic virus was approved by the FDA October 2015 (T-VEC, Amgen for the treatment of melanoma. Active translational research continues for this and many other oncolytic viruses. Conclusion: The evolving field of oncolytic viruses is impacting the treatment of head and neck cancer and further trials and agents are moving forward in the coming years. Keywords: Head and neck squamous cell carcinoma, Oncolytic viruses, Clinical trials, Novel therapeutics

  2. Head and Neck Cancers in North-East Iran: A 25 year Survey

    Directory of Open Access Journals (Sweden)

    Maryam Emadzadeh

    2017-05-01

    Full Text Available Introduction Cancers are among the worst noncommunicable diseases around the world. Head and neck cancers are ranked as the fifth most common cancers worldwide. As there are different distributions of risk factors around the world, the incidence of these cancers varies from one place to another. Materials and Methods: We conducted a descriptive analytic cross-sectional study, based on census-based records from the private oncology clinic in Mashhad, Iran. Data from 1,075 patients with head and neck cancers were analyzed from 1986 to 2010. We categorized the duration of study into five periods: 1986–1990, 1991–1995, 1996–2000, 2001–2005, and 2006–2010. Head and neck cancers refers to cancers originating from seven sites in the head and neck including the nasal cavity, oral cavity, pharynx, larynx, salivary glands, paranasal sinuses, and thyroid. Results: Data of 1,075 patients were analyzed. 66.2% were male. Mean ± standard deviation (SD age at the time of diagnosis was 55.37±15.55 years. The most frequent type of head and neck cancer was larynx cancer (36%, followed by pharynx (28.5%, oral (17.5%, thyroid (6.8%, sinus (6.4%, salivary gland (4.10%, and nasal cancer (0.70%. although larynx cancer was the most frequent cancer over the whole study duration, there was a significant (P=0.04 difference in the relative frequency of these cancers across the five time periods. There was a significant difference in mean age between cancer categories (P

  3. Survey of return to work of head and neck cancer survivors: A report from a tertiary cancer center in India.

    Science.gov (United States)

    Agarwal, Jaiprakash; Krishnatry, Rahul; Chaturvedi, Pankaj; Ghosh-Laskar, Sarbani; Gupta, Tejpal; Budrukkar, Ashwani; Murthy, Vedang; Deodhar, Joyita; Nair, Deepa; Nair, Sudhir; Dikshit, Rajesh; D'Cruz, Anil K

    2017-05-01

    The rates and factors associated with the return to work of head and neck cancer survivors from low- and middle-income countries, such as India, are largely unknown. We conducted a preliminary cross-sectional survey of 250 consecutive eligible head and neck cancer survivors (age work rates and sociodemographic, clinical, and quality of life (QOL; European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30-questions [EORTC-QLQ-C30] and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 Head and Neck 35-questions [EORTC-QLQ-H&N35]) correlates. In our cohort, 92.4% of the patients were employed pretreatment, 65.6% and 81.2% returned to work at 6 months posttreatment and by the time of the survey (median follow-up 19 months), respectively. Family structure (work. Head and neck cancer survivors who returned to work had better global quality of life (QOL; p = .014) and less coughing (p = .001) but more problems related to sticky saliva (p = .004). Further studies are needed to address the large unmet needs regarding identification and amelioration of barriers to return to work for head and neck cancer survivors in low- and middle-income countries, such as India. © 2017 Wiley Periodicals, Inc. Head Neck 39: 893-899, 2017. © 2017 Wiley Periodicals, Inc.

  4. Brachytherapy for head and neck cancer. Treatment results and future prospect

    International Nuclear Information System (INIS)

    Shibuya, Hitoshi; Yoshimura, Ro-ichi; Miura, Masahiko; Ayukawa, Fumio; Watanabe, Hiroshi

    2005-01-01

    Following the increasing desire of many patients to keep the form and function of speech and swallowing, interstitial brachytherapy has become the main treatment for head and neck cancer. In addition, aged and physically handicapped patients who are refused general anesthesia have come to be referred to our clinic to receive less invasive and curative treatment. In the field of brachytherapy for head and neck cancers, less complicated and more superior treatment results have been achieved following the introduction of spacers, computer dosimetry and so on. As a result of these efforts, treatment results have come to fulfill the desire of patients and their families. During the past 43 years from 1962 to 2005, we have treated over 2, 100 patients of head and neck cancer including 850 with stage I·II oral tongue carcinoma by brachytherapy and acquired a lot of important and precious data including the treatment results, multiple primary cancers as well as radiation-induced cancers. (author)

  5. Randomized Controlled Trial of Forward-Planned Intensity Modulated Radiotherapy for Early Breast Cancer: Interim Results at 2 Years

    International Nuclear Information System (INIS)

    Barnett, Gillian C.; Wilkinson, Jennifer S.; Moody, Anne M.; Wilson, Charles B.; Twyman, Nicola; Wishart, Gordon C.; Burnet, Neil G.; Coles, Charlotte E.

    2012-01-01

    Purpose: This single-center randomized trial was designed to investigate whether intensity-modulated radiotherapy (IMRT) reduces late toxicity in patients with early-stage breast cancer. Methods and Materials: The standard tangential plans of 1,145 nonselected patients were analyzed. The patients with inhomogeneous plans were randomized to a simple method of forward-planned IMRT or standard radiotherapy (RT). The primary endpoint was serial photographic assessment of breast shrinkage. Results: At 2 years, no significant difference was found in the development of any photographically assessed breast shrinkage between the patients randomized to the interventional or control group (odds ratio, 1.51; 95% confidence interval, 0.83–1.58; p = .41). The patients in the control group were more likely to develop telangiectasia than those in the IMRT group (odds ratio, 1.68; 95% confidence interval 1.13–2.40; p = .009). Poor baseline surgical cosmesis resulted in poor overall cosmesis at 2 years after RT. In patients who had good surgical cosmesis, those randomized to IMRT were less likely to deteriorate to a moderate or poor overall cosmesis than those in the control group (odds ratio, 0.63; 95% confidence interval, 0.39–1.03, p = .061). Conclusions: IMRT can lead to a significant reduction in telangiectasia at comparatively early follow-up of only 2 years after RT completion. An important component of breast induration and shrinkage will actually result from the surgery and not from the RT. Surgical cosmesis is an important determinant of overall cosmesis and could partially mask the longer term benefits of IMRT at this early stage.

  6. Longitudinal changes over 2 years in parotid glands of patients treated with preoperative 30-Gy irradiation for oral cancer

    International Nuclear Information System (INIS)

    Tomitaka, Etsushi; Murakami, Ryuji; Teshima, Keiko

    2011-01-01

    The objective of this study was to evaluate longitudinal changes in parotid volumes and saliva production over 2 years after 30 Gy irradiation. We retrospectively evaluated 15 assessable patients treated for advanced oral cancer. Eligibility criteria were a pathologic diagnosis of squamous cell carcinoma, preoperative radiation therapy with a total dose of 30 Gy delivered in 15 fractions, and the availability of longitudinal data of morphological assessments by computed tomography and functional assessments with the Saxon test spanning 2 years after radiation therapy. In the Saxon test, saliva production was measured by weighing a folded sterile gauze pad before and after chewing; the low-normal value is 2 g/2 min. Repeated-measures analysis of variance with Bonferroni adjustment for multiple comparisons was used to determine the longitudinal changes. The normalized ipsilateral parotid volumes 2 weeks and 6-, 12- and 24 months after radiation therapy were found to be 72.5, 63.7, 66.9 and 78.1%, respectively; the normalized contralateral volumes were 69.8, 64.6, 72.2 and 82.0%, respectively. The bilateral parotid volumes were significantly decreased after radiation therapy (P<0.01). The nadir appeared at 6 months post-radiation therapy and the volumes substantially recuperated 24 months after radiation therapy (P<0.01). Mean saliva production before radiation therapy was 3.7 g; the longitudinal changes after radiation therapy were 31.3, 38.0, 43.3 and 69.6%, respectively. Substantial recuperation of saliva production was observed 24 months after radiation therapy (P=0.01). Although parotid volumes and saliva production were decreased after 30 Gy irradiation, we observed the recuperation of morphological and functional changes in the parotid glands 2 years after radiation therapy. (author)

  7. Intensity-Modulated Radiotherapy is Associated With Improved Global Quality of Life Among Long-term Survivors of Head-and-Neck Cancer

    International Nuclear Information System (INIS)

    Chen, Allen M.; Farwell, D. Gregory; Luu, Quang; Vazquez, Esther G.; Lau, Derick H.; Purdy, James A.

    2012-01-01

    Purpose: To compare the long-term quality of life among patients treated with and without intensity-modulated radiotherapy (IMRT) for head-and-neck cancer. Methods and Materials: University of Washington Quality of Life instrument scores were reviewed for 155 patients previously treated with radiation therapy for locally advanced head-and-neck cancer. All patients were disease free and had at least 2 years of follow-up. Eighty-four patients (54%) were treated with IMRT. The remaining 71 patients (46%) were treated with three-dimensional conformal radiotherapy (3D CRT) by use of initial opposed lateral fields matched to a low anterior neck field. Results: The mean global quality of life scores were 67.5 and 80.1 for the IMRT patients at 1 and 2 years, respectively, compared with 55.4 and 57.0 for the 3D CRT patients, respectively (p < 0.001). At 1 year after the completion of radiation therapy, the proportion of patients who rated their global quality of life as “very good” or “outstanding” was 51% and 41% among patients treated by IMRT and 3DCRT, respectively (p = 0.11). At 2 years, the corresponding percentages increased to 73% and 49%, respectively (p < 0.001). On multivariate analysis accounting for sex, age, radiation intent (definitive vs. postoperative), radiation dose, T stage, primary site, use of concurrent chemotherapy, and neck dissection, the use of IMRT was the only variable independently associated with improved quality of life (p = 0.01). Conclusion: The early quality of life improvements associated with IMRT not only are maintained but apparently become more magnified over time. These data provide powerful evidence attesting to the long-term benefits of IMRT for head-and-neck cancer.

  8. Age-specific incidence and treatment patterns of head and neck cancer in the Netherlands : A cohort study

    NARCIS (Netherlands)

    Halmos, G. B.; Bras, L.; Siesling, S.; van der Laan, B.F.A.M.; Langendijk, Johannes A.; van Dijk, Boukje A.C.

    Objectives: To explore the incidence and treatment pattern of head and neck cancer in different age groups. Design: Cohort study. Setting: Netherlands Cancer Registry. Participants: All new primary head and neck cancer cases diagnosed between 2010 and 2014 were included and categorised into

  9. Age-specific incidence and treatment patterns of head and neck cancer in the Netherlands : A cohort study

    NARCIS (Netherlands)

    Halmos, G. B.; Bras, L.; Siesling, S.; van der Laan, B.F.A.M.; Langendijk, Johannes A.; van Dijk, Boukje A.C.

    2017-01-01

    Objectives: To explore the incidence and treatment pattern of head and neck cancer in different age groups. Design: Cohort study. Setting: Netherlands Cancer Registry. Participants: All new primary head and neck cancer cases diagnosed between 2010 and 2014 were included and categorised into

  10. Lenalidomide and Cetuximab in Treating Patients With Advanced Colorectal Cancer or Head and Neck Cancer

    Science.gov (United States)

    2018-03-02

    Recurrent Colon Carcinoma; Recurrent Hypopharyngeal Squamous Cell Carcinoma; Recurrent Laryngeal Squamous Cell Carcinoma; Recurrent Laryngeal Verrucous Carcinoma; Recurrent Lip and Oral Cavity Squamous Cell Carcinoma; Recurrent Metastatic Squamous Cell Carcinoma in the Neck With Occult Primary; Recurrent Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma; Recurrent Nasopharyngeal Keratinizing Squamous Cell Carcinoma; Recurrent Oral Cavity Verrucous Carcinoma; Recurrent Oropharyngeal Squamous Cell Carcinoma; Recurrent Rectal Carcinoma; Recurrent Salivary Gland Carcinoma; Salivary Gland Squamous Cell Carcinoma; Squamous Cell Carcinoma Metastatic in the Neck With Occult Primary; Stage IV Hypopharyngeal Squamous Cell Carcinoma AJCC v7; Stage IV Nasopharyngeal Keratinizing Squamous Cell Carcinoma AJCC v7; Stage IVA Colon Cancer AJCC v7; Stage IVA Laryngeal Squamous Cell Carcinoma AJCC v7; Stage IVA Laryngeal Verrucous Carcinoma AJCC v7; Stage IVA Lip and Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage IVA Major Salivary Gland Cancer AJCC v7; Stage IVA Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma AJCC v7; Stage IVA Oral Cavity Cancer AJCC v6 and v7; Stage IVA Oropharyngeal Squamous Cell Carcinoma AJCC v7; Stage IVA Rectal Cancer AJCC v7; Stage IVB Colon Cancer AJCC v7; Stage IVB Laryngeal Squamous Cell Carcinoma AJCC v7; Stage IVB Laryngeal Verrucous Carcinoma AJCC v7; Stage IVB Lip and Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage IVB Major Salivary Gland Cancer AJCC v7; Stage IVB Nasal Cavity and Paranasal Sinus Squamous Cell Carcinoma AJCC v7; Stage IVB Oral Cavity Cancer AJCC v6 and v7; Stage IVB Oropharyngeal Squamous Cell Carcinoma AJCC v7; Stage IVB Rectal Cancer AJCC v7; Stage IVC Laryngeal Squamous Cell Carcinoma AJCC v7; Stage IVC Laryngeal Verrucous Carcinoma AJCC v7; Stage IVC Lip and Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7; Stage IVC Major Salivary Gland Cancer AJCC v7; Stage IVC Nasal Cavity and Paranasal

  11. Impact of cabazitaxel on 2-year survival and palliation of tumour-related pain in men with metastatic castration-resistant prostate cancer treated in the TROPIC trial

    DEFF Research Database (Denmark)

    Bahl, A; Oudard, S; Tombal, B

    2013-01-01

    Cabazitaxel significantly improves overall survival (OS) versus mitoxantrone in patients with metastatic castration-resistant prostate cancer after docetaxel failure. We examined patient survival at 2 years and tumour-related pain with cabazitaxel versus mitoxantrone....

  12. Pattern of the head and the neck cancer in two geographically and socioeconomically different countries

    Directory of Open Access Journals (Sweden)

    Somayyeh Azimi

    2017-01-01

    Full Text Available Context: The differences in frequency of cancer among the less developed and the more developed regions continue to remain as an important problem for service planning and international action against cancers of the head and the neck. Aim: This study compares distribution of cancers of the head and the neck between two similar-sized populations from the west of Iran and Western Australia. Setting and Design: In this retrospective study, de-identified data were collected for a 10-year period from patients diagnosed with head and the neck cancers. Materials and Methods: Data were obtained from the Western Australia Cancer Registries and from major hospitals in the west of Iran. Age at diagnosis, sex, and site code were included in the data sheet. Descriptive analysis was used to describe the basic features, means (±standard deviation were reported, and tests of significance were used as appropriate. Results: In Iran, cancer of the lip, followed by cancer of the major salivary gland, and cancer of the tongue were the three most frequent types of cancers, whereas in Australia, the most frequent types of cancer were cancer of the lip followed by cancers of the tongue and the tonsil. Distribution of malignancy by site among the patients belonging to different ages indicated that cancer of the lip was the most frequent cancer in both Iran and Australia, except among the patients belonging to the age group of 60–74 years in Iran, where cancer of the major salivary gland had the highest frequency. Both men and women were susceptible for cancers of the head and the neck in the age range of 60–74 years in Iran, whereas in Australia, it was more frequent among men belonging to the age range of 45–59 years and in women above the age of 75 years. Conclusion: This preliminary study defined differences in orofacial malignancy between Iran and Australia. Further studies in countries with different socioeconomic status are recommended.

  13. The "new" head and neck cancer patient-young, nonsmoker, nondrinker, and HPV positive: evaluation.

    Science.gov (United States)

    Deschler, Daniel G; Richmon, Jeremy D; Khariwala, Samir S; Ferris, Robert L; Wang, Marilene B

    2014-09-01

    The near epidemic rise of the incidence of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinomas (OPSCC) presents the practitioner with a "new" head and neck cancer patient, vastly different from those with the traditional risk factors who formed the basis of most practitioners' training experience. Accordingly, a thorough and disease-specific evaluation process is necessitated. This article will review the evaluation of the HPV-related cancer patient, including a review of the HPV-positive oropharyngeal cancer epidemic from the surgeon's perspective, evaluation of the primary lesion, evaluation of the neck mass, and role of imaging, to provide a framework for addressing the challenging questions patients may ask. Available peer-reviewed literature and practice guidelines. Assessment of selected specific topics by authors solicited from the Head and Neck Surgery and Oncology Committee of the American Academy of Otolaryngology-Head and Neck Surgery Foundation and the American Head and Neck Society. The dramatic rise in OPSSC related to HPV is characterized by a "new" cancer patient who is younger and lacks traditional risk factors. Today's caregiver must be prepared to appropriately evaluate, counsel, and treat these patients with HPV-positive disease with the expectation that traditional treatment algorithms will evolve to maintain or improve current excellent cure rates while lessening treatment related side effects. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

  14. Randomized clinical trial of post-operative radiotherapy versus concomitant carboplatin and radiotherapy for head and neck cancers with lymph node involvement

    International Nuclear Information System (INIS)

    Racadot, Severine; Mercier, Mariette; Dussart, Sophie; Dessard-Diana, Bernadette; Bensadoun, Rene-Jean; Martin, Michel; Malaurie, Emmanuelle; Favrel, Veronique; Housset, Martin; Durdux, Catherine; Journel, Catherine; Calais, Gilles; Huet, Jocelyne; Pillet, Gerard; Hennequin, Christophe; Haddad, Elias; Diana, Christian; Blaska-Jaulerry, Brigitte; Henry-Amar, Michel; Gehanno, Pierre

    2008-01-01

    Background and purpose: Post-operative radiotherapy is indicated for the treatment of head and neck cancers. In vitro, chemotherapy potentiates the cytotoxic effects of radiation. We report the results of a randomized trial testing post-operative radiotherapy alone versus concomitant carboplatin and radiotherapy for head and neck cancers with lymph node involvement. Materials and methods: The study involved patients undergoing curative-intent surgery for head and neck cancers with histological evidence of lymph node involvement. Patients were randomly assigned to receive radiotherapy alone (54-72 Gy, 30-40 fractions, 6-8 weeks) or identical treatment plus concomitant Carboplatin (50 mg/m 2 administered by IV infusion twice weekly). Results: Between February 1994 and June 2002, 144 patients were included. With a median follow-up of 106 months (95% confidence interval (CI) [92-119]), the 2-year rate of loco-regional control was 73% (95% CI: 0.61-0.84) in the combined treatment group and 68% (95% CI: 0.57-0.80) in the radiotherapy group (p = 0.26). Overall survival did not differ significantly between groups (hazard ratio for death, 1.05; 95% CI: 0.69-1.60; p = 0.81). Conclusions: Twice-weekly administration of carboplatin concomitant to post-operative radiotherapy did not improve local control or overall survival rates in this population of patients with node-positive head and neck cancers

  15. Cryotherapy and radiotherapy combination in extensive and recurrent types of head and neck skin cancer treatment

    International Nuclear Information System (INIS)

    Pustynskij, I.N.; Paches, A.I.; Tkachev, S.I.; Tabolinovskaya, T.D.; Alieva, S.B.; Yagubov, A.S.; Slanina, S.V.; Bazhutova, G.A.

    2007-01-01

    The method of infiltrative skin cancer treatment based on different variants of radiotherapy and cryotherapy combination is described. During the period of 1988-2006 the Department of head and neck neoplasms of N. N. Blohin Russian Cancer Research Center provided radiation and cryogenic treatment of 94 patients with locally advanced head and neck epidermoid and basal cell cancer. For this purpose before every radiotherapy session the tumor was exposed to cryo cooling till freezing temperature (-5 degrees C). The total involution of tumors was observed at 91 patients. Residual tumors were removed surgically. The follow-up showed good functional and aesthetic results, retention of local tissues.

  16. Hyperfractionated stereotactic reirradiation for recurrent head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Cvek, Jakub; Knybel, Lukas; Skacelikova, Eva; Otahal, Bretislav; Molenda, Lukas; Feltl, David [University Hospital Ostrava, Department of Oncology, Ostrava (Czech Republic); Stransky, Jiri; Res, Oldrich [University Hospital Ostrava, Department of Maxilofacial Surgery, Ostrava (Czech Republic); Matousek, Petr; Zelenik, Karol [University Hospital Ostrava, Department of Otolaryngology, Ostrava (Czech Republic)

    2016-01-15

    The goal of this work was to evaluate the efficacy and toxicity of hyperfractionated stereotactic reirradiation (re-RT) as a treatment for inoperable, recurrent, or second primary head and neck squamous cell cancer (HNSCC) that is not suitable for systemic treatment. Forty patients with recurrent or second primary HNSCC were included in this study. The patients had a median gross tumor volume of 76 ml (range 14-193 ml) and a previous radiotherapy dose greater than 60 Gy. Treatment was designed to cover 95 % of the planning target volume (PTV, defined as gross tumor volume [GTV] + 3 mm to account for microscopic spreading, with no additional set-up margin) with the prescribed dose (48 Gy in 16 fractions b.i.d.). Treatment was administered twice daily with a minimum 6 h gap. Uninvolved lymph nodes were not irradiated. Treatment was completed as planned for all patients (with median duration of 11 days, range 9-14 days). Acute toxicity was evaluated using the RTOG/EORTC scale. A 37 % incidence of grade 3 mucositis was observed, with recovery time of ≤ 4 weeks for all of these patients. Acute skin toxicity was never observed to be higher than grade 2. Late toxicity was also evaluated according to the RTOG/EORTC scale. Mandible radionecrosis was seen in 4 cases (10 %); however, neither carotid blowout syndrome nor other grade 4 late toxicity occurred. One-year overall survival (OS) and local progression-free survival (L-PFS) were found to be 33 and 44 %, respectively. Performance status and GTV proved to be significant prognostic factors regarding local control and survival. Hyperfractionated stereotactic re-RT is a reasonable treatment option for patients with recurrent/second primary HNSCC who were previously exposed to high-dose irradiation and who are not candidates for systemic treatment or hypofractionation. (orig.) [German] Ziel der Studie war es, die Effektivitaet und Toxizitaet der hyperfraktionierten akzelerierten stereotaktischen Wiederbestrahlung (re

  17. GST genotypes in head and neck cancer patients and its clinical ...

    African Journals Online (AJOL)

    STORAGESEVER

    2008-11-05

    Nov 5, 2008 ... GST genotypes in head and neck cancer patients and its clinical implications. K. Sabitha1, M. V. V. Reddy2 and Kaiser Jamil3*. 1Mahavir Medical Research Center, Hyderabad, A.P. India. 2Osmania Medical College, Hyderabad, India. 3Indo American Cancer Institute and Research Centre, Road No 14, ...

  18. Automatic Patient Modeling for Hyperthermia Treatment Planning of Head and Neck Cancer

    NARCIS (Netherlands)

    V. Fortunati (Valerio)

    2015-01-01

    markdownabstractHead and neck (H&N) cancer is the term used to describe a wide range of malig- nant tumors originating in the upper airways and swallowing tracts. In 2012, this disease accounted for approximately 5% of all cancers worldwide, with 680,000 new cases diagnosed and 370,000 recorded

  19. Risk of head-and-neck cancer following a diagnosis of severe cervical intraepithelial neoplasia

    DEFF Research Database (Denmark)

    Svahn, Malene F; Munk, C; Jensen, S M

    2016-01-01

    OBJECTIVE: Women with a history of cervical intraepithelial neoplasia grade 3 including adenocarcinoma in situ (CIN3/AIS) may be more prone to develop cancers of the ano-genital region and head-and-neck cancers. The current literature is, however, limited. METHODS: We established a nationwide...

  20. Advice about Work-Related Issues to Peers and Employers from Head and Neck Cancer Survivors

    NARCIS (Netherlands)

    Dewa, Carolyn S.; Trojanowski, Lucy; Tamminga, Sietske J.; Ringash, Jolie; McQuestion, Maurene; Hoch, Jeffrey S.

    2016-01-01

    The purpose of this exploratory and descriptive study is to contribute to the sparse return-to-work literature on head and neck cancer (HNC) survivors. Interview participants were asked to reflect upon their work-related experience with cancer by answering two specific questions: (1) What advice

  1. High prevalence of cachexia in newly diagnosed head and neck cancer patients : An exploratory study

    NARCIS (Netherlands)

    Jager-Wittenaar, Harriet; Dijkstra, Pieter U.; Dijkstra, Gerard; Bijzet, Johan; Langendijk, Johannes A.; van der Laan, Bernard F. A. M.; Roodenburg, Jan L. N.

    Objective: In patients with cancer, weight loss can be related to simple starvation, disturbedmetabolism, or both. In patients with head and neck cancer (HNC), weight loss often is attributed to simple starvation because the obvious oral symptoms are known to hinder dietary intake. In this

  2. Hyperfractionated stereotactic reirradiation for recurrent head and neck cancer

    International Nuclear Information System (INIS)

    Cvek, Jakub; Knybel, Lukas; Skacelikova, Eva; Otahal, Bretislav; Molenda, Lukas; Feltl, David; Stransky, Jiri; Res, Oldrich; Matousek, Petr; Zelenik, Karol

    2016-01-01

    The goal of this work was to evaluate the efficacy and toxicity of hyperfractionated stereotactic reirradiation (re-RT) as a treatment for inoperable, recurrent, or second primary head and neck squamous cell cancer (HNSCC) that is not suitable for systemic treatment. Forty patients with recurrent or second primary HNSCC were included in this study. The patients had a median gross tumor volume of 76 ml (range 14-193 ml) and a previous radiotherapy dose greater than 60 Gy. Treatment was designed to cover 95 % of the planning target volume (PTV, defined as gross tumor volume [GTV] + 3 mm to account for microscopic spreading, with no additional set-up margin) with the prescribed dose (48 Gy in 16 fractions b.i.d.). Treatment was administered twice daily with a minimum 6 h gap. Uninvolved lymph nodes were not irradiated. Treatment was completed as planned for all patients (with median duration of 11 days, range 9-14 days). Acute toxicity was evaluated using the RTOG/EORTC scale. A 37 % incidence of grade 3 mucositis was observed, with recovery time of ≤ 4 weeks for all of these patients. Acute skin toxicity was never observed to be higher than grade 2. Late toxicity was also evaluated according to the RTOG/EORTC scale. Mandible radionecrosis was seen in 4 cases (10 %); however, neither carotid blowout syndrome nor other grade 4 late toxicity occurred. One-year overall survival (OS) and local progression-free survival (L-PFS) were found to be 33 and 44 %, respectively. Performance status and GTV proved to be significant prognostic factors regarding local control and survival. Hyperfractionated stereotactic re-RT is a reasonable treatment option for patients with recurrent/second primary HNSCC who were previously exposed to high-dose irradiation and who are not candidates for systemic treatment or hypofractionation. (orig.) [de

  3. Association Between Preoperative Nutritional Status and Postoperative Outcome in Head and Neck Cancer Patients.

    Science.gov (United States)

    Leung, John S L; Seto, Alfred; Li, George K H

    2017-04-01

    Head and neck cancer patients treated with surgery often experience significant postoperative morbidities. Administering preoperative nutritional intervention may improve surgical outcomes, but there is currently a paucity of data reviewing the association between preoperative nutritional status and postoperative outcome. It is therefore of importance to investigate this association among head and neck cancer patients. To assess the association between preoperative nutritional status and postoperative outcome in head and neck cancer patients treated with surgery, a retrospective study of 70 head and neck cancer patients who were surgically treated between 2013 and 2014 in a tertiary referral head and neck surgery center in Hong Kong was conducted. Clinical data regarding preoperative nutritional status and postoperative outcome were retrieved from a computer record system. Logistic and linear regressions were used to analyze the appropriate parameters. A higher preoperative albumin level was associated with lower rates of postoperative complications and better wound healing (P cancer patients, preoperative intervention strategies that boost albumin levels could be considered for improving surgical outcome.

  4. Assessment of nutritional status and quality of life in patients treated for head and neck cancer.

    Science.gov (United States)

    Prevost, V; Joubert, C; Heutte, N; Babin, E

    2014-04-01

    The purpose of this study was to identify tools for the assessment of nutritional status in head and neck cancer patients, to evaluate the impact of malnutrition on therapeutic management and quality of life and to propose a simple screening approach adapted to routine clinical practice. The authors conducted a review of the literature to identify tools for the assessment of nutritional status in head and neck cancer patients published in French and English. Articles were obtained from the PubMed database and from the references of these articles and selected journals, using the keywords: "nutritional assessment", and "head and neck" and "cancer". Anthropometric indices, laboratory parameters, dietary intake assessment, clinical scores and nutritional risk scores used in patients with head and neck cancers are presented. The relevance of these tools in clinical practice and in research is discussed, together with the links between nutritional status and quality of life. This article is designed to help teams involved in the management of patients with head and neck cancer to choose the most appropriate tools for assessment of nutritional status according to their resources and their objectives. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  5. Liposomal treatment of xerostomia, odor, and taste abnormalities in patients with head and neck cancer.

    Science.gov (United States)

    Heiser, Clemens; Hofauer, Benedikt; Scherer, Elias; Schukraft, Johannes; Knopf, Andreas

    2016-04-01

    Smell and taste disorders, sicca symptoms, can be detected in patients with head and neck cancer. The purpose of this study was to assess the utility of local liposomal application in the treatment of patients with head and neck cancers. Ninety-eight patients with head and neck cancer were included in this study. The groups were defined as: group 1 = only surgery; group 2 = surgery + adjuvant radiochemotherapy; and group 3 = primarily radiochemotherapy. All patients had finished cancer treatment and received liposomal sprays for the nose and mouth for 2 months (LipoNasal, LipoSaliva; Optima Pharmaceutical GmbH, Germany) and suffered from taste and smell disorders. We performed tests with "Sniffin' Sticks," "Taste Strips," and a xerostomia questionnaire before and after treatment. After application of liposomes, patients demonstrated a statistically significant increase in smell and taste, and reduced xerostomia. Our results demonstrate that using nonpharmaceutical liposomal sprays improve smell, taste, and symptoms of xerostomia in patients with head and neck cancer. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1232-E1237, 2016. © 2015 Wiley Periodicals, Inc.

  6. Conformal re-irradiation of recurrent and new primary head-and-neck cancer

    International Nuclear Information System (INIS)

    Dawson, Laura A.; Myers, Larry L.; Bradford, Carol R.; Chepeha, Doug B.; Hogikyan, Norman D.; Teknos, Theodore N.; Terrell, Jeffrey E.; Wolf, Gregory T.; Eisbruch, Avraham

    2001-01-01

    Purpose: To review the outcome of head-and-neck cancer patients re-irradiated using conformal radiation. Patients and Methods: From 1983 to 1999, 60 patients with recurrent or new primary head-and-neck cancer received re-irradiation at the University of Michigan. Twenty patients were excluded due to the planned cumulative radiation dose being less than 100 Gy (18) and absence of prior radiation details (2), leaving 40 patients. Thirty-five patients were re-irradiated for unresectable disease, while 4 patients received adjuvant re-irradiation for high-risk disease. Thirty-eight patients had recurrences from previously treated cancer (19 regional, 14 local, 5 regional and local), and 2 patients had new primary tumors. The median time from the first course of radiation to re-irradiation was 21 months. Thirty-one patients (78%) were re-irradiated with curative intent, whereas 9 were treated with palliative intent. Re-irradiation was delivered using conformal techniques in the majority of patients and with concurrent chemotherapy in 14 patients. The median re-irradiation dose was 60 Gy. The median cumulative dose received was 121 Gy. Five patients (13%) did not complete their prescribed course of re-irradiation. Results: The median survival following completion of re-irradiation was 12.5 months. The 1- and 2-year actuarial survival rates were 51.1% and 32.6%, respectively. On multivariate analysis, palliative intent of treatment, tumor bulk, and tumor site other than nasopharynx or larynx were associated with worse survival. The patients treated for unresectable disease did no worse than those treated adjuvantly. The median times to relapse-free survival, local-regional recurrence (LRR)-free survival, and ultimate LRR-free survival (allowing for surgical salvage) were 3.9 months, 7.8 months, and 8.7 months, respectively. Seven patients (18%) are presently alive with no evidence of disease, with a median follow-up of 49.9 months (range 3.3-78.9). Severe radiation

  7. Head and neck cancer in India--review of practices for prevention policy.

    Science.gov (United States)

    Mishra, A

    2009-10-01

    India, with a population of over a billion is likely to increase global concern on cancer, particularly that of head and neck. The increasing immigration of Indians is likely to influence other parts of the world and an analysis of cancer-related practices could serve as a model for defining cancer-prevention strategies across the globe. The objective of this study was to review the anti- and pro-carcinogenic practices in India pertaining to head and neck cancer. The published literature on practices, compounds/chemicals/crude reparations related to the head and neck cancer in India was retrieved for analysis, while unauthentic or local information was discarded. The anti-carcinogenic practices prevalent in India consisted of classically varied diet being predominantly vegetarian, along with spices, condiments, beverages etc. The pro-carcinogenic practices predominantly include all shades of alcoholism and tobacco intake. Moreover, the diverse culture of the country reflects unique regional practices. The enormous diversity in practices related to head and neck cancer in India is very unique and interesting. Cancer prevention strategies need to focus on these trends to define a better global prevention.

  8. Predictors of health-related quality of life in patients treated with neck dissection for head and neck cancer.

    Science.gov (United States)

    Gane, Elise M; McPhail, Steven M; Hatton, Anna L; Panizza, Benedict J; O'Leary, Shaun P

    2017-12-01

    Patients with head and neck cancer can report reduced health-related quality of life several years after treatment. The aim of this study was to identify risk factors for reduced quality of life in patients up to 5 years following neck dissection. This cross-sectional study was conducted at two hospitals in Brisbane, Australia. Patients completed two measures of quality of life: the Neck Dissection Impairment Index (NDII), a region- and disease-specific tool, and the Assessment of Quality of Life-4 Domains, a general tool. Generalised linear modelling was used to determine which demographic and clinical variables were associated with quality of life. The cohort included n = 129 patients (71% male, median age 61, median 3 years since surgery). Positive nodal disease was associated with better quality of life on the NDII [e.g. N2 vs N0 coeff (95% CI) = 22.84 (7.33, 38.37)]. Worse quality of life was associated with adjuvant treatment [e.g. Independent Living domain model: surgery with chemoradiation vs surgery only coeff (95% CI) = -0.11 (-0.22, -0.01)]. Positive nodal disease was associated with better quality of life, which may be a reflection of response shift. Multimodality treatment leads to worse quality of life compared with surgery only.

  9. Patterns of Care in Elderly Head-and-Neck Cancer Radiation Oncology Patients: A Single-Center Cohort Study

    International Nuclear Information System (INIS)

    Huang Shaohui; O'Sullivan, Brian; Waldron, John; Lockwood, Gina; Bayley, Andrew; Kim, John; Cummings, Bernard; Dawson, Laura A.; Hope, Andrew; Cho, John; Witterick, Ian; Chen, Eric X.; Ringash, Jolie

    2011-01-01

    Purpose: To compare the patterns of care for elderly head-and-neck cancer patients with those of younger patients. Methods and Materials: A retrospective review was conducted of all new mucosal head-and-neck cancer referrals to radiation oncology between July 1, 2003 and December 31, 2007 at our institution. The clinical characteristics, treatment pattern, tolerance, and outcomes were compared between the elderly (aged ≥75 years) and younger (aged <75 years) cohorts. Results: A total of 2,312 patients, including 452 (20%) elderly and 1,860 (80%) younger patients, were studied. The elderly patients were more likely to be women (36% vs. 27%, p <.01) and to have other malignancies (23% vs. 13%, p <.01), Stage I or II disease (38% vs. 32%, p <.01), and N0 status (56% vs. 42%, p <.01). Treatment was less often curative in intent (79% vs. 93%, p <.01). For the 1,487 patients who received definitive radiotherapy (RT), no differences were found between the elderly (n = 238) and younger (n = 1,249) patients in treatment interruption, completion, or treatment-related death. Within the subset of 760 patients who received intensified treatment (concurrent chemoradiotherapy or hyperfractionated accelerated RT), no difference was seen between the elderly (n = 46) and younger (n = 714) patients in treatment interruption, completion, or treatment-related death. After a median follow-up of 2.5 years, the 2-year cause-specific survival rate after definitive RT was 72% (range, 65-78%) for the elderly vs. 86% (range, 84-88%) for the younger patients (p <.01). Conclusion: Elderly head-and-neck cancer patients exhibited different clinical characteristics and experienced different patterns of care from younger patients. Although age itself was an adverse predictor of cause-specific survival, its effect was modest. Elderly patients selected for definitive RT or intensified RT showed no evidence of impaired treatment tolerance.

  10. Indications of elective neck dissection and postoperative radiotherapy for parotid cancers

    International Nuclear Information System (INIS)

    Shibata, Tomohisa; Yonezawa, Kouichiro; Morimoto, Koichi; Yamashita, Daisuke; Otsuki, Naoki; Nishimura, Hideki; Sasaki, Ryohei; Nibu, Ken-ichi

    2011-01-01

    Regional lymph node metastases significantly influence the prognosis of patients with parotid cancer. To assess our indications of elective neck dissection and postoperative radiotherapy for parotid cancer, a retrospective chart review was performed. Between 2001 and 2009, 35 patients with parotid cancer were initially treated at our department. The median follow-up was 30 months (range, 10-90 months). Out of all patients, 31 (89%) patients were preoperatively diagnosed as malignant, while 4 (11%) patients were initially diagnosed as benign. Mucoepidermoid carcinoma was the most common histological type (10 patients). Twenty-two tumors (63%) were pathologically diagnosed as high-grade. The numbers of patients with Stages I, II, III, and IVA were 3, 10, 7, and 15, respectively. Ipsilateral neck dissection (Level II-V) was performed in seven patients with clinically positive neck metastasis (cN+), and in ten patients without lymph node metastasis who had T4 disease, high-grade malignancy, or positive neck (Level II) metastasis during intraoperative evaluation. Postoperative radiotherapy was performed in 24 patients with pathological T4, high-grade malignancy, positive surgical margin, multiple neck metastasis and/or extranodal extension (ENI). Seven of 28 (25%) patients with clinically N0 had pathologically positive neck metastasis (pN+). Regional recurrence developed in one patient with high-grade malignancy and ENI (T4N2b). Disease-specific survival rates for Stages I, II, III, and IVA at 3 years were 100%, 73%, 100%, and 37%, respectively. Loco-regional control rates for pN0 (21 patients) and pN+ (14 patients) at 3 years were 90% and 95%, respectively. Our present favorable loco-regional control supported our current indications of elective neck dissection and postoperative radiotherapy. We also recommend intraoperative biopsy of level IIB nodes to study the need for elective neck dissection. (author)

  11. Value of PET/CT in the approach to head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Curioni, Otavio Alberto; Amar, Ali; Viana, Debora [Hospital Heliopolis, Sao Paulo, SP (Brazil). Service of Head and Neck Surgery and Otorhynolaryngology; Souza, Ricardo Pires de [Hospital Heliopolis, Sao Paulo, SP (Brazil). Service of Radiology; Rapoport, Abrao [Hospital Heliopolis, Sao Paulo, SP (Brazil); Dedivitis, Rogerio Aparecido [Universidade de Sao Paulo (HC-FMUSP), SP (Brazil). Hospital das Clinicas. Group of Larynx and Hypopharynx; Cernea, Claudio Roberto; Brandao, Lenine Garcia [Universidade de Sao Paulo (FMUSP), SP (Brazil). Fac. de Medicina. Dept. of Head and Neck Surgery

    2012-11-15

    Objective: To evaluate the role of PET/CT in the approach to patients with head and neck cancer. Materials and Methods: Retrospective study of medical records and PET/CT images of 63 patients with head and neck cancer. Results: Alterations were observed in 76% of the cases. Out of these cases, 7 (11%) were considered as false-positive, with SUV < 5.0. PET/CT demonstrated negative results in 15 cases (24%). Among the 14 cases where the method was utilized for staging, 3 (22%) had their stages changed. Conclusion: PET/CT has shown to be of potential value in the routine evaluation of patients with head and neck cancer, but further studies of a higher number of cases are required to define a protocol for utilization of the method. (author)

  12. Improving Therapeutic Ratio in Head and Neck Cancer with Adjuvant and Cisplatin-Based Treatments

    Directory of Open Access Journals (Sweden)

    Loredana G. Marcu

    2013-01-01

    Full Text Available Advanced head and neck cancers are difficult to manage despite the large treatment arsenal currently available. The multidisciplinary effort to increase disease-free survival and diminish normal tissue toxicity was rewarded with better locoregional control and sometimes fewer side effects. Nevertheless, locoregional recurrence is still one of the main reasons for treatment failure. Today, the standard of care in head and neck cancer management is represented by altered fractionation radiotherapy combined with platinum-based chemotherapy. Targeted therapies as well as chronotherapy were trialled with more or less success. The aim of the current work is to review the available techniques, which could contribute towards a higher therapeutic ratio in the treatment of advanced head and neck cancer patients.

  13. Pre- and postirradiation care of the mouth in head and neck cancer patients

    International Nuclear Information System (INIS)

    Cohen, M.A.; Lownie, J.F.

    1982-01-01

    Radiotherapy plays an important role in the treatment of head and neck cancer. The effects of radiotherapy on the oral hard and soft tissues may range from a mild mucositis to severe caries and osteoradionecrosis. It is the responsibility of the dentist to treat and prevent the severe sequelae which may arise. This paper outlines the effects of radiotherapy on the oral structures and discusses the dental treatment of the patient during radiotherapy. Emphasis is placed on the prevention of complications. The head and neck cancer patient must be thoroughly examined by the dentist and treatment planning may then be divided into pre-irradiaton treatment, treatment during irradiation and post-irradiation treatment. The dentist thus forms an essential member of the team treating patients with head and neck cancer [af

  14. Human papilloma virus: a new risk factor in a subset of head and neck cancers.

    Science.gov (United States)

    Bisht, Manisha; Bist, Sampan Singh

    2011-01-01

    Head and neck cancer is the sixth most common malignancy worldwide. Tobacco smoking and alcohol consumption are two well known behavioral risk factors associated with head and neck cancer. Recently, evidence is mounting that infection with human papilloma virus, most commonly human papilloma virus-16 is responsible for a subset of head and neck squamous cell carcinoma especially tumors of tonsillar origin. The molecular pathway used by human papilloma virus to trigger malignant transformation of tissue is different from that of other well known risk factors, i.e. smoking and alcohol, associated with squamous cell carcinoma. Apparently, these subsets of patients with human papilloma virus positive tumor are more likely to have a better prognosis than human papilloma virus negative tumor. Considering this fact, the human papilloma virus infection should be determined in all oropharyngeal cancers since it can have a major impact on the decision making process of the treatment.

  15. Head and neck cancer due to heavy metal exposure via tobacco smoking and professional exposure: A review

    International Nuclear Information System (INIS)

    Khlifi, Rim; Hamza-Chaffai, Amel

    2010-01-01

    Chronic exposures to heavy metals via tobacco smoking and professional exposure may increase the risk of head and neck cancer, although the epidemiologic evidence is limited by problems of low study power and inadequate adjustment for tobacco and professional exposure use. Numerous scientific reviews have examined the association of various heavy metals exposure with respiratory cancer as well as other cancer types, but few have been published on head and neck cancer. The purpose of this paper, therefore, is to review the head and neck tract cancer-related data on exposure to heavy metals via smoking and working exposure and to study the major mechanisms underlying some toxic metals carcinogenesis.

  16. Late term tolerance in head neck cancer patients irradiated in the IMRT era

    International Nuclear Information System (INIS)

    Studer, Gabriela; Studer, Stephan; Zwahlen, Roger; Rordorf, Tamara; Glanzmann, Christoph; Linsenmeier, Claudia; Riesterer, Oliver; Najafi, Yousef; Brown, Michelle; Yousefi, Bita; Bredell, Marius; Huber, Gerhard; Schmid, Stephan

    2013-01-01

    The aim was to quantify severe transient and persisting late term effects in our single institution head neck cancer (HNC) cohort treated with curatively intended intensity modulated radiation therapy (IMRT). Hypothesis was if a 2-year follow up (FU) is sufficient to estimate the long term tolerance in HNC irradiated in the IMRT era. Between 01/2002-8/2012, 707/1211 (58%) consecutively treated IMRT patients met the inclusion criteria of a FU time >12 months and loco-regional disease control (LRC). 45% presented with loco-regionally advanced disease; 55% were referred for curative definitive IMRT (66 Gy-72 Gy in 30–35 fractions), 45% underwent postoperative IMRT (60-66 Gy in 30–33 fractions). Systemic concomitant therapy was administered in 85%. Highly consistent treatment procedures were performed with respect to contouring processes, dose constraints, radiation schedules, and the use of systemic therapy. Grade 3/4 late term effects were prospectively assessed and analyzed with respect to subgroups at particular risk for specific late effects. Mean/median FU of the cohort was 41/35 months (15–124). 13% of the patients (92/707) experienced any grade 3/4 late effects (101 events in 92/707 patients), 81% in the first 12 months after radiation. 4% of all developed persisting late grade 3/4 effects (25 events in 25/707 patients). IMRT led to a high late term tolerance in loco-regionally disease free HNC patients. The onset of any G3/4 effects showed a plateau at 2 years. The question of the cervical vessel tolerance in disease free long time survivors is still open and currently under evaluation at our institution

  17. Characterization of HPV and host genome interactions in primary head and neck cancers

    Science.gov (United States)

    Parfenov, Michael; Pedamallu, Chandra Sekhar; Gehlenborg, Nils; Freeman, Samuel S.; Danilova, Ludmila; Bristow, Christopher A.; Lee, Semin; Hadjipanayis, Angela G.; Ivanova, Elena V.; Wilkerson, Matthew D.; Protopopov, Alexei; Yang, Lixing; Seth, Sahil; Song, Xingzhi; Tang, Jiabin; Ren, Xiaojia; Zhang, Jianhua; Pantazi, Angeliki; Santoso, Netty; Xu, Andrew W.; Mahadeshwar, Harshad; Wheeler, David A.; Haddad, Robert I.; Jung, Joonil; Ojesina, Akinyemi I.; Issaeva, Natalia; Yarbrough, Wendell G.; Hayes, D. Neil; Grandis, Jennifer R.; El-Naggar, Adel K.; Meyerson, Matthew; Park, Peter J.; Chin, Lynda; Seidman, J. G.; Hammerman, Peter S.; Kucherlapati, Raju; Ally, Adrian; Balasundaram, Miruna; Birol, Inanc; Bowlby, Reanne; Butterfield, Yaron S.N.; Carlsen, Rebecca; Cheng, Dean; Chu, Andy; Dhalla, Noreen; Guin, Ranabir; Holt, Robert A.; Jones, Steven J.M.; Lee, Darlene; Li, Haiyan I.; Marra, Marco A.; Mayo, Michael; Moore, Richard A.; Mungall, Andrew J.; Robertson, A. Gordon; Schein, Jacqueline E.; Sipahimalani, Payal; Tam, Angela; Thiessen, Nina; Wong, Tina; Protopopov, Alexei; Santoso, Netty; Lee, Semin; Parfenov, Michael; Zhang, Jianhua; Mahadeshwar, Harshad S.; Tang, Jiabin; Ren, Xiaojia; Seth, Sahil; Haseley, Psalm; Zeng, Dong; Yang, Lixing; Xu, Andrew W.; Song, Xingzhi; Pantazi, Angeliki; Bristow, Christopher; Hadjipanayis, Angela; Seidman, Jonathan; Chin, Lynda; Park, Peter J.; Kucherlapati, Raju; Akbani, Rehan; Casasent, Tod; Liu, Wenbin; Lu, Yiling; Mills, Gordon; Motter, Thomas; Weinstein, John; Diao, Lixia; Wang, Jing; Fan, You Hong; Liu, Jinze; Wang, Kai; Auman, J. Todd; Balu, Saianand; Bodenheimer, Tom; Buda, Elizabeth; Hayes, D. Neil; Hoadley, Katherine A.; Hoyle, Alan P.; Jefferys, Stuart R.; Jones, Corbin D.; Kimes, Patrick K.; Marron, J.S.; Meng, Shaowu; Mieczkowski, Piotr A.; Mose, Lisle E.; Parker, Joel S.; Perou, Charles M.; Prins, Jan F.; Roach, Jeffrey; Shi, Yan; Simons, Janae V.; Singh, Darshan; Soloway, Mathew G.; Tan, Donghui; Veluvolu, Umadevi; Walter, Vonn; Waring, Scot; Wilkerson, Matthew D.; Wu, Junyuan; Zhao, Ni; Cherniack, Andrew D.; Hammerman, Peter S.; Tward, Aaron D.; Pedamallu, Chandra Sekhar; Saksena, Gordon; Jung, Joonil; Ojesina, Akinyemi I.; Carter, Scott L.; Zack, Travis I.; Schumacher, Steven E.; Beroukhim, Rameen; Freeman, Samuel S.; Meyerson, Matthew; Cho, Juok; Chin, Lynda; Getz, Gad; Noble, Michael S.; DiCara, Daniel; Zhang, Hailei; Heiman, David I.; Gehlenborg, Nils; Voet, Doug; Lin, Pei; Frazer, Scott; Stojanov, Petar; Liu, Yingchun; Zou, Lihua; Kim, Jaegil; Lawrence, Michael S.; Sougnez, Carrie; Lichtenstein, Lee; Cibulskis, Kristian; Lander, Eric; Gabriel, Stacey B.; Muzny, Donna; Doddapaneni, HarshaVardhan; Kovar, Christie; Reid, Jeff; Morton, Donna; Han, Yi; Hale, Walker; Chao, Hsu; Chang, Kyle; Drummond, Jennifer A.; Gibbs, Richard A.; Kakkar, Nipun; Wheeler, David; Xi, Liu; Ciriello, Giovanni; Ladanyi, Marc; Lee, William; Ramirez, Ricardo; Sander, Chris; Shen, Ronglai; Sinha, Rileen; Weinhold, Nils; Taylor, Barry S.; Aksoy, B. Arman; Dresdner, Gideon; Gao, Jianjiong; Gross, Benjamin; Jacobsen, Anders; Reva, Boris; Schultz, Nikolaus; Sumer, S. Onur; Sun, Yichao; Chan, Timothy; Morris, Luc; Stuart, Joshua; Benz, Stephen; Ng, Sam; Benz, Christopher; Yau, Christina; Baylin, Stephen B.; Cope, Leslie; Danilova, Ludmila; Herman, James G.; Bootwalla, Moiz; Maglinte, Dennis T.; Laird, Peter W.; Triche, Timothy; Weisenberger, Daniel J.; Van Den Berg, David J.; Agrawal, Nishant; Bishop, Justin; Boutros, Paul C.; Bruce, Jeff P; Byers, Lauren Averett; Califano, Joseph; Carey, Thomas E.; Chen, Zhong; Cheng, Hui; Chiosea, Simion I.; Cohen, Ezra; Diergaarde, Brenda; Egloff, Ann Marie; El-Naggar, Adel K.; Ferris, Robert L.; Frederick, Mitchell J.; Grandis, Jennifer R.; Guo, Yan; Haddad, Robert I.; Hammerman, Peter S.; Harris, Thomas; Hayes, D. Neil; Hui, Angela BY; Lee, J. Jack; Lippman, Scott M.; Liu, Fei-Fei; McHugh, Jonathan B.; Myers, Jeff; Ng, Patrick Kwok Shing; Perez-Ordonez, Bayardo; Pickering, Curtis R.; Prystowsky, Michael; Romkes, Marjorie; Saleh, Anthony D.; Sartor, Maureen A.; Seethala, Raja; Seiwert, Tanguy Y.; Si, Han; Tward, Aaron D.; Van Waes, Carter; Waggott, Daryl M.; Wiznerowicz, Maciej; Yarbrough, Wendell; Zhang, Jiexin; Zuo, Zhixiang; Burnett, Ken; Crain, Daniel; Gardner, Johanna; Lau, Kevin; Mallery, David; Morris, Scott; Paulauskis, Joseph; Penny, Robert; Shelton, Candance; Shelton, Troy; Sherman, Mark; Yena, Peggy; Black, Aaron D.; Bowen, Jay; Frick, Jessica; Gastier-Foster, Julie M.; Harper, Hollie A.; Lichtenberg, Tara M.; Ramirez, Nilsa C.; Wise, Lisa; Zmuda, Erik; Baboud, Julien; Jensen, Mark A.; Kahn, Ari B.; Pihl, Todd D.; Pot, David A.; Srinivasan, Deepak; Walton, Jessica S.; Wan, Yunhu; Burton, Robert; Davidsen, Tanja; Demchok, John A.; Eley, Greg; Ferguson, Martin L.; Shaw, Kenna R. Mills; Ozenberger, Bradley A.; Sheth, Margi; Sofia, Heidi J.; Tarnuzzer, Roy; Wang, Zhining; Yang, Liming; Zenklusen, Jean Claude; Saller, Charles; Tarvin, Katherine; Chen, Chu; Bollag, Roni; Weinberger, Paul; Golusiński, Wojciech; Golusiński, Paweł; Ibbs, Matthiew; Korski, Konstanty; Mackiewicz, Andrzej; Suchorska, Wiktoria; Szybiak, Bartosz; Wiznerowicz, Maciej; Burnett, Ken; Curley, Erin; Gardner, Johanna; Mallery, David; Penny, Robert; Shelton, Troy; Yena, Peggy; Beard, Christina; Mitchell, Colleen; Sandusky, George; Agrawal, Nishant; Ahn, Julie; Bishop, Justin; Califano, Joseph; Khan, Zubair; Bruce, Jeff P; Hui, Angela BY; Irish, Jonathan; Liu, Fei-Fei; Perez-Ordonez, Bayardo; Waldron, John; Boutros, Paul C.; Waggott, Daryl M.; Myers, Jeff; Lippman, Scott M.; Egea, Sophie; Gomez-Fernandez, Carmen; Herbert, Lynn; Bradford, Carol R.; Carey, Thomas E.; Chepeha, Douglas B.; Haddad, Andrea S.; Jones, Tamara R.; Komarck, Christine M.; Malakh, Mayya; McHugh, Jonathan B.; Moyer, Jeffrey S.; Nguyen, Ariane; Peterson, Lisa A.; Prince, Mark E.; Rozek, Laura S.; Sartor, Maureen A.; Taylor, Evan G.; Walline, Heather M.; Wolf, Gregory T.; Boice, Lori; Chera, Bhishamjit S.; Funkhouser, William K.; Gulley, Margaret L.; Hackman, Trevor G.; Hayes, D. Neil; Hayward, Michele C.; Huang, Mei; Rathmell, W. Kimryn; Salazar, Ashley H.; Shockley, William W.; Shores, Carol G.; Thorne, Leigh; Weissler, Mark C.; Wrenn, Sylvia; Zanation, Adam M.; Chiosea, Simion I.; Diergaarde, Brenda; Egloff, Ann Marie; Ferris, Robert L.; Romkes, Marjorie; Seethala, Raja; Brown, Brandee T.; Guo, Yan; Pham, Michelle; Yarbrough, Wendell G.

    2014-01-01

    Previous studies have established that a subset of head and neck tumors contains human papillomavirus (HPV) sequences and that HPV-driven head and neck cancers display distinct biological and clinical features. HPV is known to drive cancer by the actions of the E6 and E7 oncoproteins, but the molecular architecture of HPV infection and its interaction with the host genome in head and neck cancers have not been comprehensively described. We profiled a cohort of 279 head and neck cancers with next generation RNA and DNA sequencing and show that 35 (12.5%) tumors displayed evidence of high-risk HPV types 16, 33, or 35. Twenty-five cases had integration of the viral genome into one or more locations in the human genome with statistical enrichment for genic regions. Integrations had a marked impact on the human genome and were associated with alterations in DNA copy number, mRNA transcript abundance and splicing, and both inter- and intrachromosomal rearrangements. Many of these events involved genes with documented roles in cancer. Cancers with integrated vs. nonintegrated HPV displayed different patterns of DNA methylation and both human and viral gene expressions. Together, these data provide insight into the mechanisms by which HPV interacts with the human genome beyond expression of viral oncoproteins and suggest that specific integration events are an integral component of viral oncogenesis. PMID:25313082

  18. Dietary fiber intake and head and neck cancer risk: A pooled analysis in the International Head and Neck Cancer Epidemiology consortium.

    Science.gov (United States)

    Kawakita, Daisuke; Lee, Yuan-Chin Amy; Turati, Federica; Parpinel, Maria; Decarli, Adriano; Serraino, Diego; Matsuo, Keitaro; Olshan, Andrew F; Zevallos, Jose P; Winn, Deborah M; Moysich, Kirsten; Zhang, Zuo-Feng; Morgenstern, Hal; Levi, Fabio; Kelsey, Karl; McClean, Michael; Bosetti, Cristina; Garavello, Werner; Schantz, Stimson; Yu, Guo-Pei; Boffetta, Paolo; Chuang, Shu-Chun; Hashibe, Mia; Ferraroni, Monica; La Vecchia, Carlo; Edefonti, Valeria

    2017-11-01

    The possible role of dietary fiber in the etiology of head neck cancers (HNCs) is unclear. We used individual-level pooled data from ten case-control studies (5959 cases and 12,248 controls) participating in the International Head and Neck Cancer Epidemiology (INHANCE) consortium, to examine the association between fiber intake and cancer of the oral cavity/pharynx and larynx. Odds Ratios (ORs) and their 95% Confidence Intervals (CIs) were estimated using unconditional multiple logistic regression applied to quintile categories of non-alcohol energy-adjusted fiber intake and adjusted for tobacco and alcohol use and other known or putative confounders. Fiber intake was inversely associated with oral and pharyngeal cancer combined (OR for 5th vs. 1st quintile category = 0.49, 95% CI: 0.40-0.59; p for trend effect across studies for oral and pharyngeal cancer combined. Nonetheless, inverse associations were consistently observed for the subsites of oral and pharyngeal cancers and within most strata of the considered covariates, for both cancer sites. Our findings from a multicenter large-scale pooled analysis suggest that, although in the presence of between-study heterogeneity, a greater intake of fiber may lower HNC risk. © 2017 UICC.

  19. The role of physical activity and nutritional intake on nutritional status in patients with head and neck cancer

    NARCIS (Netherlands)

    Martine Sealy

    2015-01-01

    Malnutrition is a frequent problem in patients with head and neck cancer. Prevention or timely treatment of malnutrition is of great importance because deteriorated nutritional status can have a negative effect on clinical outcome in head and neck cancer patients. Malnutrition can be viewed as a

  20. ICF Core Set for Head and Neck Cancer: Do the Categories Discriminate Among Clinically Relevant Subgroups of Patients?

    Science.gov (United States)

    Tschiesner, Uta; Oberhauser, Cornelia; Cieza, Alarcos

    2011-01-01

    The multidisciplinary assessment of functioning in patients with head and neck cancer (HNC) according to the "ICF Core Set for Head and Neck Cancer" (ICF-HNC) was developed in an international and multi-disciplinary approach. The ICF-HNC is an application of the ICF that was adopted by the World Health Organization. The objective of this study was…

  1. Critical weight loss in head and neck cancer - prevalence and risk factors at diagnosis : an explorative study

    NARCIS (Netherlands)

    Jager-Wittenaar, H.; Dijkstra, P.U.; Vissink, A.; van der Laan, B.F.A.M.; van Oort, R.P.; Roodenburg, J.L.N.

    Goals of work Critical weight loss (>= 5% in 1 month or >= 10% in 6 months) is a common phenomenon in head and neck cancer patients. It is unknown which complaints are most strongly related to critical weight loss in head and neck cancer patients at the time of diagnosis. The aim of this explorative

  2. Hypothyroidism following surgery and radiation therapy for head and neck cancer

    International Nuclear Information System (INIS)

    Park, I. K.; Kim, J. C.

    1997-01-01

    Radiation therapy in combination with surgery has an important role in the therapy of the head and neck cancer. We conducted a prospective study for patients with head and neck cancer treated with surgery and radiation to evaluate the effect of therapies on the thyroid gland, and to identify the factors that might influence the development of hypothyroidism. From September 1986 through December 1994, 71 patients with head and cancer treated with surgery and radiation were included in this prospective study. Patients' age ranged from 32 to 73 years with a median age of 58 years. There were 12 women and 59 men. Total laryngectomy with neck dissection was carried out in 45 patients and neck dissection alone in 26 patients. All patients were serially monitored for thyroid function before and after radiation therapy. Radiation dose to the thyroid gland ranged from 40.6Gy to 60Gy with a median dose of 50Gy. The follow-up duration was 3 to 80 months. The overall incidence of hypothyroidism was 56.3% (40/71); 7 out of 71 patients (9.9%) developed clinical hypothyroidism and 33 patients (46.4%) developed subclinical hypothyroidism. No thyroid nodules, thyroid cancers, or hyperthyroidism was detected. The risk factor that significantly influenced the incidence of hypothyroidism was a combination of surgery (total laryngectomy with neck dissection) and radiation therapy (P=0.0000). Four of 26 patients (15.4%) with neck dissection alone developed hypothyroidism while 36 of 45 patients (80%) with laryngectomy and neck dissection developed hypothyroidism. The hypothyroidism following surgery and radiation therapy was a relatively common complication. The factor that significantly influenced the incidence of hypothyroidism was combination of surgery and radiation therapy. Evaluation of thyroid function before and after radiation therapy with periodic thyroid function tests is recommended for an early detection of hypothyroidism and thyroid hormone replacement therapy is

  3. FDG uptake after intraarterial chemotherapy in head and neck cancer

    International Nuclear Information System (INIS)

    Doebert, N.; Kovacs, A.F.

    2006-01-01

    Aim: the intraarterial chemotherapy (i.a.CHT) using high dose cisplatin combined with systemic neutralization in patients with head and neck cancer (HNSCC) is used to reduce the tumor volume preoperatively. Aim of the study is the evaluation of the influence of i.a.CHT on the metabolism of fluor-18-deoxyglucose (FDG) in the primary and lymph nodes (LN). The value of FDG positron emission tomography (PET) preoperative and as follow-up method otter i.a.CHT is examined. Patients, methods: altogether 16 patients with HNSCC underwent two preoperative FDG PET examinations: the baseline examination one week before and the follow-up three weeks after i.a.CHT. The SUVmax values of the primary and the IN and LN metastases were evaluated and compared with each other and the histopathology. Results: the SUVmax value of the primary decreased after i.a.CHT significantly from a median (25 th percentile/ 75 th percentile) of 6.4 (4.1/ 7.8) to 3.6 (2.4/ 6.7) (p = 0.01). In 11 out of 16 patients cervical LN metastases were detected. The cervical LN metastases showed a decrease of the SUVmax value from 3.6 (2.3/ 4.8) in the pretreatment examination to 2.3 (1.7/ 3.6) after i.a.CHT (p = 0,008). Only in one patient with LN metastases the SUVmax of the nodes increased. The histopathologically measured size of the LN metastases ranged from 2 to 30 mm. Non malignant LN did not reveal a significant SUVmax decrease after i.a.CHT (p = 0.13). Conclusions: as expected, primaries of HNSCC showed a significant reduction of SUV after i.a.CHT. Compared to the primary the SUVmax decrease in LN metastases was less, but also significant. Since cytotoxic levels of cisplatin do not occur systemic, postinflammatory reactions of the LN or a lymphatic drainage of the chemotherapeutic drug into the LN could be an explanation. PET for staging of HNSCC must thus be performed prior to i.a.CHT. (orig.)

  4. Magnetic Nanoparticle-Based Hyperthermia for Head & Neck Cancer in Mouse Models

    Science.gov (United States)

    Zhao, Qun; Wang, Luning; Cheng, Rui; Mao, Leidong; Arnold, Robert D.; Howerth, Elizabeth W.; Chen, Zhuo G.; Platt, Simon

    2012-01-01

    In this study, magnetic iron oxide nanoparticle induced hyperthermia is applied for treatment of head and neck cancer using a mouse xenograft model of human head and neck cancer (Tu212 cell line). A hyperthermia system for heating iron oxide nanoparticles was developed by using alternating magnetic fields. Both theoretical simulation and experimental studies were performed to verify the thermotherapy effect. Experimental results showed that the temperature of the tumor center has dramatically elevated from around the room temperature to about 40oC within the first 5-10 minutes. Pathological studies demonstrate epithelial tumor cell destruction associated with the hyperthermia treatment. PMID:22287991

  5. Managing complications of radiation therapy in head and neck cancer patients: Part I. Management of xerostomia.

    Science.gov (United States)

    Ngeow, Wei Cheong; Chai, Wen Lin; Rahman, Roslan Abdul; Ramli, Roszalina

    2006-12-01

    Head and neck cancer is becoming a more recognizable pathology to the general population and dentists. The modes of treatment include surgery and/or radiation therapy. Where possible, pretreatment dental assessment shall be provided for these patients before they receive radiation therapy. There are occasions, however, whereby head and neck cancer patients are not prepared optimally for radiation therapy. Because of this, they succumb to complicated oral adverse effects after radiation therapy. Part I of this series reviews the management of xerostomia. The management of the effect of xerostomia to the dentition/oral cavity is discussed in Part II.

  6. Effect of cepharanthin to prevent radiation induced xerostomia in head and neck cancer

    International Nuclear Information System (INIS)

    Imada, Hajime; Nomoto, Satoshi; Ohguri, Takayuki; Yahara, Katsuya; Kato, Fumio; Morioka, Tomoaki; Korogi Yukunori

    2004-01-01

    We retrospectively examined the effect of Cepharanthin to prevent radiation xerostomia in 37 cases of head and neck cancer. In the Cepharanthin group, the degree of xerostomia was milder than in the non-Cepharanthin group in spite of higher normal tissue complication probability (NTCP) and mean dose (MD) of parotid glands. In the non-Cepharanthin group, the degree of xerostomia was significantly correlated with NTCP and MD of parotid glands. MD of parotid glands and use of Cepharanthin were significantly related to more severe xerostomia by multivariate analysis with logistic regression. Cepharanthin may prevent radiation xerostomia after radiotherapy for head and neck cancer. (author)

  7. Lugol's dye spray chromoendoscopy establishes early diagnosis of esophageal cancer in patients with primary head and neck cancer.

    Science.gov (United States)

    Hashimoto, Claudio L; Iriya, Kiyoshi; Baba, Elisa R; Navarro-Rodriguez, Tomas; Zerbini, Maria C; Eisig, Jaime N; Barbuti, Ricardo; Chinzon, Decio; Moraes-Filho, Joaquim Prado P

    2005-02-01

    Patients with primary head and neck cancer show a predisposition to develop esophageal cancer. The aim of this study was to investigate in these patients: the prevalence of esophageal cancer comparing the value of chromoendoscopy using Lugol's solution examination to standard endoscopy, in the early diagnosis of esophageal cancer. Prospective observational study at a state general university hospital in Sao Paulo, Brazil. 326 consecutive adult patients with primary head and neck cancer were evaluated. A standard endoscopy was performed, followed by a 2% Lugol's dye spray chromoendoscopy and histopathologic study. The prevalence of esophageal cancer was defined. The results of the two endoscopic methods were compared. Twenty-four patients with esophageal cancer and high-grade intraepithelial neoplasia were detected and had a prevalence of 7.36%. Chromoendoscopy and standard endoscopy were equivalent to the diagnosis of advanced and invasive esophageal cancer. However, standard endoscopy diagnosed 55% of high-grade intraepithelial neoplasia, in comparison to chromoendoscopy that detected 100%. Patients with primary head and neck cancer should be considered as high risks for the presence of esophageal cancer. Lugol's dye chromoendoscopy diagnosed high-grade intraepithelial neoplasia, which went unnoticed with standard endoscopy. It permits a more exact detection of lesion boundaries and facilitates a more precise targeting of biopsy fragments.

  8. Highly preserved consensus gene modules in human papilloma virus 16 positive cervical cancer and head and neck cancers.

    Science.gov (United States)

    Zhang, Xianglan; Cha, In-Ho; Kim, Ki-Yeol

    2017-12-26

    In this study, we investigated the consensus gene modules in head and neck cancer (HNC) and cervical cancer (CC). We used a publicly available gene expression dataset, GSE6791, which included 42 HNC, 14 normal head and neck, 20 CC and 8 normal cervical tissue samples. To exclude bias because of different human papilloma virus (HPV) types, we analyzed HPV16-positive samples only. We identified 3824 genes common to HNC and CC samples. Among these, 977 genes showed high connectivity and were used to construct consensus modules. We demonstrated eight consensus gene modules for HNC and CC using the dissimilarity measure and average linkage hierarchical clustering methods. These consensus modules included genes with significant biological functions, including ATP binding and extracellular exosome. Eigengen network analysis revealed the consensus modules were highly preserved with high connectivity. These findings demonstrate that HPV16-positive head and neck and cervical cancers share highly preserved consensus gene modules with common potentially therapeutic targets.

  9. The effect of radiotherapy on NKT cells in patients with advanced head and neck cancer.

    Science.gov (United States)

    Kobayashi, Kouichi; Tanaka, Yuriko; Horiguchi, Shigetoshi; Yamamoto, Shouji; Toshinori, Nakayama; Sugimoto, Akira; Okamoto, Yoshitaka

    2010-10-01

    Cancer immunotherapy with NKT cells is a potential new treatment strategy for advanced head and neck cancer. NKT cell therapy is promising due to its unique anti-tumor activity and higher degree of safety compared to current therapies. Radiotherapy is indispensable as a standard treatment for advanced head and neck cancer. To elucidate the possibility of using NKT cells as an adjuvant immunotherapy with radiotherapy, we examined the effect of radiotherapy on NKT cells in patients with head and neck cancer. The number, IFN-gamma production and proliferation capacity of NKT cells were analyzed before and after 50 Gy radiation therapy in 12 patients with stage IV head and neck squamous cell carcinoma. The cytotoxic activity of NKT cells was examined in vitro. The number of NKT cells in the blood varied widely between patients. After radiation therapy, the population of CD3 T cells decreased significantly, while the NKT cell population remained stable. The number of NKT cells was the same after radiation therapy as before. IFN-gamma production from NKT cells collected just after radiotherapy was impaired after stimulation with exogenous ligand, but the proliferative responses of these NKT cells was enhanced in comparison to those collected before radiation therapy. Furthermore, the proliferated NKT cells displayed a significant level of anti-tumor activity. NKT cells are relatively resistant to radiation and might therefore be suitable for adjuvant immunotherapy to eradicate remnant cancer cells in patients who have undergone radiation therapy.

  10. Complementary medicine use in patients with head and neck cancer in Ireland.

    LENUS (Irish Health Repository)

    Amin, Mohamed

    2010-08-01

    The objectives of the study were: first, to determine the prevalence of traditional medicine (TM) and complementary and alternative medicine (CAM) use in head and neck cancer patients in Ireland; second, to educate ourselves on the plethora of CAM\\/TM options available to patients outside the dominion of conventional medicine. The study design consisted of a cross-sectional survey carried out in three head and neck cancer centres. Self-administered questionnaires were distributed to 110 head and neck cancer patients attending the three cancer centres and data were collected for statistical analysis. A total of 106 patients completed the questionnaire; 21.7% of the participants used CAM\\/TM since their diagnosis with head and neck cancer. CAM\\/TM usage was higher in female (34.3%) than in male patients (16.2%). CAM\\/TM use was more common in the 41-50-year age group, in patients with higher educational levels and those holding strong religious beliefs, and also in married than single patients. The most common types of CAM\\/TM used were spiritual and laying on of hands. The most common reasons reported for using CAM\\/TM were to counteract the ill effects of treatment and increase the body\\'s ability to fight cancer. Sources of information on CAM\\/TM were friends (65%), family (48%) and media (21%). This survey reveals a high prevalence of CAM\\/TM use in head and neck cancer patients, hence emphasising the need for otolaryngologists to educate themselves on the various therapies available to be able to provide informative advice. There is an urgent need for evidence-based investigation of various CAM\\/TM therapies currently offered to patients.

  11. Community Awareness - A Key to the Early Detection of Head and Neck Cancer

    Directory of Open Access Journals (Sweden)

    Ajay Manickam

    2016-04-01

    Full Text Available INTRODUCTION Mortality and morbidity associated with head and neck cancers have decreased to a great extent in many developed countries of the world due to early diagnosis and treatment with advances in surgical techniques and better availability of radiotherapist and oncologists. But the situation in developing countries like India is quite different. AIMS AND OBJECTIVES This study was conducted amongst the patients attending the Otolaryngology department of a teaching hospital in Kolkata to find the incidence of various types and sites of head and neck cancer, to assess time delay from the date of onset of symptom to the final disease confirmation in relation to patients’ demographic profile, to assess time delay in histopathological diagnosis after reaching a tertiary care setup and also to correlate tobacco consumption and alcohol intake as risk factors for head and neck cancer and to note the reasons for late presentation, as described by the patient. MATERIALS AND METHODS The descriptive study was conducted at a tertiary level teaching hospital, in the Department of Otorhinolaryngology for a period from August 2013 to August 2015 with a study population of 133.  OBSERVATIONS  An average time lag from the onset of symptom to final diagnosis as malignancy was found to be 6 months to one year in nearly 72% of cases. Most of the patients were uneducated males of more than 50 years of age, hailing from rural areas. Cancer larynx was found to be the commonest of all head and neck cancers (31.6%. More than 65% of the patients were addicted to tobacco chewing or smoking or consumption of alcohol.  DISCUSSION  Poverty, lack of education, poor communication, lack of health care infrastructure in rural areas, community awareness about various risk factors, lack of effective health policy to achieve early diagnosis of head neck cancer were common factors related to delay in diagnosis.  CONCLUSION  Tobacco use and alcohol intake are the

  12. Sentinel node biopsy in head and neck cancer

    DEFF Research Database (Denmark)

    Ross, Gary L; Soutar, David S; Gordon MacDonald, D

    2004-01-01

    BACKGROUND: The aim was to determine the reliability and reproducibility of sentinel node biopsy (SNB) as a staging tool in head and neck squamous cell carcinoma (HNSCC) for T1/2 clinically N0 patients by means of a standardized technique. METHODS: Between June 1998 and June 2002, 227 SNB...

  13. Recombinant Interleukin-15 in Treating Patients With Advanced Melanoma, Kidney Cancer, Non-small Cell Lung Cancer, or Squamous Cell Head and Neck Cancer

    Science.gov (United States)

    2017-09-14

    Head and Neck Squamous Cell Carcinoma; Recurrent Head and Neck Carcinoma; Recurrent Non-Small Cell Lung Carcinoma; Recurrent Renal Cell Carcinoma; Recurrent Skin Carcinoma; Stage III Renal Cell Cancer; Stage IIIA Cutaneous Melanoma AJCC v7; Stage IIIA Non-Small Cell Lung Cancer AJCC v7; Stage IIIB Cutaneous Melanoma AJCC v7; Stage IIIB Non-Small Cell Lung Cancer AJCC v7; Stage IIIC Cutaneous Melanoma AJCC v7; Stage IV Cutaneous Melanoma AJCC v6 and v7; Stage IV Non-Small Cell Lung Cancer AJCC v7; Stage IV Renal Cell Cancer

  14. Sequential response patterns to chemotherapy and radiotherapy in head and neck cancer

    International Nuclear Information System (INIS)

    Hong, W.K.; O'Donoghue, G.M.; Sheetz, S.

    1985-01-01

    Surgery and/or radiotherapy have been the standard therapies for locally advanced squamous cell carcinoma of the head and neck region. Despite major improvement in these therapeutic techniques, the control rate in cases of advanced cancer remains poor. More recently, induction chemotherapy as initial treatment has been used in previously untreated squamous cell carcinoma of the head and neck. For the last 6 years at the Boston Veterans Administration (V.A.) Medical Center, initial induction chemotherapy followed by surgery and/or radiotherapy has been employed in the treatment of advanced head and neck cancer. The use of chemotherapy and radiotherapy has allowed the authors to monitor and correlate sequential response patterns produced by each modality of treatment. The authors have observed that responders to chemotherapy can be predicted to have further response to subsequent radiotherapy

  15. Cephalic vein: Saviour in the microsurgical reconstruction of breast and head and neck cancers

    Directory of Open Access Journals (Sweden)

    Vinay K Shankhdhar

    2012-01-01

    Full Text Available Background: Reconstruction with microvascular free flaps is considered the reconstructive option of choice in cancer of the head and neck regions and breast. Rarely, there is paucity of vessels, especially the veins, at the recipient site. The cephalic vein with its good caliber and constant anatomy is a reliable recipient vein available in such situations. Materials and Methods: It is a retrospective study from January 2010 to July 2012 and includes 26 patients in whom cephalic vein was used for free-flap reconstruction in head and neck (3 cases and breast cancers (23 cases. Results: All flaps in which cephalic vein was used survived completely. Conclusion: Cephalic vein can be considered as a reliable source of venous drainage when there is a non-availability/unusable of veins during free-flap reconstruction in the head and neck region and breast and also when additional source of venous drainage is required in these cases.

  16. Improved Dosimetric and Clinical Outcomes With Intensity-Modulated Radiotherapy for Head-and-Neck Cancer of Unknown Primary Origin

    International Nuclear Information System (INIS)

    Chen, Allen M.; Li Baoqing; Farwell, D. Gregory; Marsano, Joseph; Vijayakumar, Srinivasan; Purdy, James A.

    2011-01-01

    Purpose: To compare differences in dosimetric, clinical, and quality-of-life endpoints among a cohort of patients treated by intensity-modulated radiotherapy (IMRT) and conventional radiotherapy (CRT) for head-and-neck cancer of unknown primary origin. Methods and Materials: The medical records of 51 patients treated by radiation therapy for squamous cell carcinoma of the head and neck presenting as cervical lymph node metastasis of occult primary origin were reviewed. Twenty-four patients (47%) were treated using CRT, and 27 (53%) were treated using IMRT. The proportions of patients receiving concurrent chemotherapy were 54% and 63%, respectively. Results: The 2-year estimates of overall survival, local-regional control, and disease-specific survival for the entire patient population were 86%, 89%, and84%, respectively. There were no significant differences in any of these endpoints with respect to radiation therapy technique (p > 0.05 for all). Dosimetric analysis revealed that the use of IMRT resulted in significant improvements with respect to mean dose and V30 to the contralateral (spared) parotid gland. In addition, mean doses to the ipsilateral inner and middle ear structures were significantly reduced with IMRT (p < 0.05 for all). The incidence of severe xerostomia in the late setting was 58% and 11% among patients treated by CRT and IMRT, respectively (p < 0.001). The percentages of patients who were G-tube dependent at 6 months after treatment were 42% and 11%, respectively (p < 0.001). Conclusions: IMRT results in significant improvements in the therapeutic ratio among patients treated by radiation therapy for head-and-neck cancer of unknown primary origin.

  17. Oral and neck examination for early detection of oral cancer--a practical guide.

    LENUS (Irish Health Repository)

    MacCarthy, Denise

    2011-08-01

    Cancer of the head and neck region presents a challenge since, unlike other areas of the body, the boundaries are not always easy to delineate. The functional morbidity associated with head and neck cancer and its treatment are considerable. Head and neck cancer is described as cancer of the lip, mouth, tongue, tonsil, pharynx (unspecified), salivary gland, hypopharynx, larynx and other. Oral cancer refers to cancers of the lip, tongue, gingivae, floor of the mouth, palate (hard and soft), maxilla, vestibule and retromolar area up to the anterior pillar of the fauces (tonsil). When patients present with oral cancer, over 60% of them have regional (lymph node) and sometimes distant (metastatic) spread. The overall five-year survival rates for oral cancer average at between 50 and 80%, depending on the stage of the disease, varying from 86% for stage I to 12-16% for stage IV. The incidence of \\'field cancerisation\\'\\/unstable oral epithelium is high (17%), and even after successful treatment our patients need to be monitored for dental care and further disease. Unlike other areas in the body, the oral epithelium is readily accessible for examination and even self-examination. Dentists and dental hygienists are effective clinicians in the examination of the oral cavity for mouth cancer. An oral and neck examination must be part of every dental examination. An examination protocol is suggested here, which is similar to, but more detailed than, the standardised oral examination method recommended by the World Health Organisation, and consistent with those protocols followed by the Centres for Disease Control and Prevention and the National Institutes of Health.

  18. A Planned Neck Dissection Is Not Necessary in All Patients With N2-3 Head-and-Neck Cancer After Sequential Chemoradiotherapy

    International Nuclear Information System (INIS)

    Soltys, Scott G.; Choi, Clara Y.H.; Fee, Willard E.; Pinto, Harlan A.; Le, Quynh-Thu

    2012-01-01

    Purpose: To assess the role of a planned neck dissection (PND) after sequential chemoradiotherapy for patients with head-and-neck cancer with N2–N3 nodal disease. Methods and Materials: We reviewed 90 patients with N2–N3 head-and-neck squamous cell carcinoma treated between 1991 and 2001 on two sequential chemoradiotherapy protocols. All patients received induction and concurrent chemotherapy with cisplatin and 5-fluorocuracil, with or without tirapazamine. Patients with less than a clinical complete response (cCR) in the neck proceeded to a PND after chemoradiation. The primary endpoint was nodal response. Clinical outcomes and patterns of failure were analyzed. Results: The median follow-up durations for living and all patients were 8.3 years (range, 1.5–16.3 year) and 5.4 years (range, 0.6–16.3 years), respectively. Of the 48 patients with nodal cCR whose necks were observed, 5 patients had neck failures as a component of their recurrence [neck and primary (n = 2); neck, primary, and distant (n = 1); neck only (n = 1); neck and distant (n = 1)]. Therefore, PND may have benefited only 2 patients (4%) [neck only failure (n = 1); neck and distant failure (n = 1)]. The pathologic complete response (pCR) rate for those with a clinical partial response (cPR) undergoing PND (n = 30) was 53%. The 5-year neck control rates after cCR, cPR→pCR, and cPR→pPR were 90%, 93%, and 78%, respectively (p = 0.36). The 5-year disease-free survival rates for the cCR, cPR→pCR, and cPR→pPR groups were 53%, 75%, and 42%, respectively (p = 0.04). Conclusion: In our series, patients with N2–N3 neck disease achieving a cCR in the neck, PND would have benefited only 4% and, therefore, is not recommended. Patients with a cPR should be treated with PND. Residual tumor in the PND specimens was associated with poor outcomes; therefore, aggressive therapy is recommended. Studies using novel imaging modalities are needed to better assess treatment response.

  19. Targeted therapies and radiation for the treatment of head and neck cancer

    International Nuclear Information System (INIS)

    Kim, Gwi Eon

    2004-01-01

    The purpose of this review is to provide an update on novel radiation treatments for head and neck cancer. Despite the remarkable advances in chemotherapy and radiotherapy techniques, the management of advanced head and neck cancer remains challenging. Epidermal growth factor receptor (EGFR) is an appealing target for novel therapies in head and neck cancer because not only EGFR activation stimulates many important signaling pathways associated with cancer development and progression, and importantly, resistance to radiation. Furthermore, EGFR overexpression is known to be portended for a worse outcome in patients with advanced head and neck cancer. Two categories of compounds designed to abrogate EGFR signaling, such as monoclonal antibodies (Cetuximab) and tyrosine kinase inhibitors (ZD1839 and OSI-774) have been assessed and have been most extensively studied in preclinical models and clinical trials. Additional TKIs in clinical trials include a reversible agent, Cl-1033, which blocks activation of all erbB receptors. Encouraging preclinical data for head and neck cancers resulted in rapid translation into the clinic. Results from initial clinical trials show rather surprisingly that only minority of patients benefited from EGFR inhibition as monotherapy or in combination with chemotherapy. In this review, we begin with a brief summary of erbB-mediated signal transduction. Subsequently, we present data on prognostic-predictive value of erbB receptor expression in HNC followed by preclinical and clinical data on the role of EGFR antagonists alone or in combination with radiation in the treatment of HNC. Finally, we discuss the emerging thoughts on resistance to EGFR blockade and efforts in the development of multiple-targeted therapy for combination with chemotherapy or radiation. Current challenges for investigators are to determine (1) who will benefit from targeted agents and which agents are most appropriate to combine with radiation and/or chemotherapy, (2

  20. Phase Ib Study of BKM120 With Cisplatin and XRT in High Risk Locally Advanced Squamous Cell Cancer of Head and Neck

    Science.gov (United States)

    2017-05-19

    Carcinoma, Squamous Cell of Head and Neck; HPV Positive Oropharyngeal Squamous Cell Carcinoma; Hypopharyngeal Cancer; Early Invasive Cervical Squamous Cell Carcinoma; Carcinoma of Larynx; Cancer of Nasopharynx

  1. Oral and head and neck cancer. Special listing

    International Nuclear Information System (INIS)

    1981-09-01

    This Special Listing of Current Cancer Research Projects is a publication of the International Cancer Research Data Bank (ICRDB) Program of the National Cancer Institute. Each Listing contains descriptions of ongoing projects in one selected cancer research area. The research areas include: Human cancer etiology and epidemiology; Experimental carcinogenesis and pathology; Preclinical diagnosis and therapy; Clinical diagnosis and prognosis; Clinical therapy; Rehabilitation and psychological aspects of treatment; Training programs for dental professionals; Broad clinical programs

  2. Socioeconomic position and stage at diagnosis of head and neck cancer - a nationwide study from DAHANCA

    DEFF Research Database (Denmark)

    Olsen, Maja Halgren; Bøje, Charlotte Rotbøl; Kjær, Trille Kristina

    2015-01-01

    for hypopharynx cancer patients living in rural areas or provincial cities. Having one or more comorbid conditions was associated with an increased OR for advanced stage oral cancer but with a decreased OR for oropharynx cancer. CONCLUSION: In this nationwide population-based study, socioeconomic differences......BACKGROUND: Socioeconomic differences in survival after head and neck squamous cell carcinoma (HNSCC) are among the greatest for any malignancy. To improve our understanding of the mechanisms by which socioeconomic position influences HNSCC survival, we investigated the association between...... socioeconomic position and advanced stage HNSCC at diagnosis. MATERIAL AND METHODS: Men and women with HNSCC diagnosed between 1992 and 2008 were identified in the Danish Head and Neck Cancer Group (DAHANCA) database, which contains detailed information on all cases of HNSCC treated in Denmark. Individual...

  3. Targeted genetic and viral therapy for advanced head and neck cancers.

    Science.gov (United States)

    Huang, Pin-I; Chang, Ju-Fang; Kirn, David H; Liu, Ta-Chiang

    2009-06-01

    Head and neck cancers usually present with advanced disease and novel therapies are urgently needed. Genetic therapy aims at restoring malfunctioned tumor suppressor gene(s) or introducing proapoptotic genes. Oncolytic virotherapeutics induce multiple cycles of cancer-specific virus replication, followed by oncolysis, virus spreading and infection of adjacent cancer cells. Oncolytic viruses can also be armed to express therapeutic transgene(s). Recent advances in preclinical and clinical studies are revealing the potential of both therapeutic classes for advanced head and neck cancers, including the approval of two products (Gendicine and H101) by a governmental agency. This review summarizes the available clinical data to date and discusses the challenges and future directions.

  4. Case Report: Down-staging locally advanced head and neck cancer ...

    African Journals Online (AJOL)

    Case Report: Down-staging locally advanced head and neck cancer in an HIV infected patient in a limited resource setting. L Masamba, D Nkosi, D Kumiponjera. Abstract. No Abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals ...

  5. TheraBite exercises to treat trismus secondary to head and neck cancer

    NARCIS (Netherlands)

    Kamstra, Jolanda I.; Roodenburg, Jan L. N.; Beurskens, Carien H. G.; Reintsema, Harry; Dijkstra, Pieter U.

    The aim of this study was to evaluate the effect of TheraBite exercises on mouth opening and to analyze factors influencing this effect in a patient record evaluation. Effect of exercises with a TheraBite to treat trismus was evaluated in 69 head and neck cancer patients of two university medical

  6. Dose to the masseter muscle and risk of trismus after chemoradiation for advanced head & neck cancer

    NARCIS (Netherlands)

    S Verheijen; Emmy Lamers

    2015-01-01

    Purpose / objective: Head and neck cancer patients treated with chemoradiation are at risk for developing trismus (reduced mouth opening). Trismus is often a persisting side-effect and difficult to manage. It impairs eating, speech and oral hygiene, affecting quality of life. Although several

  7. Dynasplint Trismus System exercises for trismus secondary to head and neck cancer : a prospective explorative study

    NARCIS (Netherlands)

    Kamstra, Jolanda I.; Reintsema, Harry; Roodenburg, Jan L. N.; Dijkstra, Pieter U.

    The Dynasplint Trismus System (DTS) can be used to treat trismus secondary to head and neck cancer. We conducted a prospective study with the following aims: (1) to determine the effects of DTS exercises on changes in mouth opening, pain, mandibular function, quality of life (QoL), and

  8. Swallowing therapy and progressive resistance training in head and neck cancer patients undergoing radiotherapy treatment

    DEFF Research Database (Denmark)

    Hajdú, Sara F; Wessel, Irene; Johansen, Christoffer

    2017-01-01

    BACKGROUND: Head and neck cancer (HNC) patients are often challenged by treatment induced dysphagia and trismus. Traditionally, rehabilitation is initiated when loss of function has already occurred. There is increasing evidence that it is of benefit to patients to initiate an early rehabilitation...

  9. Exercise therapy for trismus secondary to head and neck cancer : A systematic review

    NARCIS (Netherlands)

    Kamstra, Jolanda I.; van Leeuwen, M.; Roodenburg, Jan L. N.; Dijkstra, Pieter U.

    2017-01-01

    BACKGROUND: Effects of exercise therapy for trismus secondary to head and neck cancer have not been reviewed systematically since 2004. METHODS: Four databases were searched. The quality of observational studies and randomized controlled trials was assessed. RESULTS: Two hundred eleven articles were

  10. Trismus in patients with head and neck cancer : etiopathogenesis, diagnosis and management

    NARCIS (Netherlands)

    Rapidis, A. D.; Dijkstra, P. U.; Roodenburg, J. L. N.; Rodrigo, J. P.; Rinaldo, A.; Strojan, P.; Takes, R. P.; Ferlito, A.

    2015-01-01

    Background: Trismus indicates severely restricted mouth opening of any aetiology. A mouth opening of 35 mm or less should be regarded as trismus. Aim of this study was to review the etiopathogenesis, incidence, treatment and prevention of trismus in patients with head and neck cancer. Objective of

  11. Prevalence of obstructive sleep apnoea following head and neck cancer treatment : A cross-sectional study

    NARCIS (Netherlands)

    Nesse, W; Hoekema, A; Stegenga, B; van der Hoeven, JH; de Bont, LGM; Roodenburg, JLN

    The obstructive sleep apnoea-hypopnoea syndrome (OSAHS) is a sleep-related breathing disorder characterised by repetitive pharyngeal collapse. OSAHS is associated with a reduced quality of life. A high OSAHS prevalence has been reported in patients treated for head and neck cancer (HNC). The aim of

  12. GST genotypes in head and neck cancer patients and its clinical ...

    African Journals Online (AJOL)

    Polymorphisms of carcinogen-metabolizing enzymes, known to be involved in metabolism of carcinogens found in tobacco smoke, are relatively common in most populations. Cigarette and bidi smoking has been demonstrated to increase the risk of head and neck cancers in our study group. This study evaluated the risk of ...

  13. Parotid gland sparing IMRT for head and neck cancer improves xerostomia related quality of life

    NARCIS (Netherlands)

    van Rij, C. M.; Oughlane-Heemsbergen, W. D.; Ackerstaff, A. H.; Lamers, E. A.; Balm, A. J. M.; Rasch, C. R. N.

    2008-01-01

    ABSTRACT: Background and purpose: To assess the impact of intensity modulated radiotherapy (IMRT) versus conventional radiation on late xerostomia and Quality of Life aspects in head and neck cancer patients. Patients and methods: Questionnaires on xerostomia in rest and during meals were sent to

  14. Parotid gland sparing IMRT for head and neck cancer improves xerostomia related quality of life

    NARCIS (Netherlands)

    C.M. van Rij (Caroline); W.D. Oughlane-Heemsbergen; A.H. Ackerstaff; E.A. Lamers; A.J.M. Balm (Alfons); C.R.N. Rasch (Coen)

    2008-01-01

    textabstractBackground and purpose: To assess the impact of intensity modulated radiotherapy (IMRT) versus conventional radiation on late xerostomia and Quality of Life aspects in head and neck cancer patients. Patients and nethods: Questionnaires on xerostomia in rest and during meals were sent to

  15. Treatment in elderly patients with head and neck cancer : A challenging dilemma

    NARCIS (Netherlands)

    Teymoortash, A; Ferlito, A; Halmos, G B

    Despite the increasing number of elderly patients requiring treatment for head and neck cancer, there is insufficient available evidence about the oncological results of treatment and its tolerability in such patients. Owing to comorbidities, elderly patients often need complex evaluation and

  16. Resting energy expenditure in head and neck cancer patients before and during radiotherapy

    NARCIS (Netherlands)

    Langius, Jacqueline A. E.; Kruizenga, Hinke M.; Uitdehaag, Bernard M. J.; Langendijk, Johannes A.; Doornaert, Patricia; Leemans, C. Rene; Weijs, Peter J. M.

    Background & aims: Weight loss is a frequently observed problem in patients with head and neck cancer (HNC) during radiotherapy. It is still to be assessed whether hypermetabolism is contributing to this problem. The aim of this study was to investigate hypermetabolism before radiotherapy, and

  17. Treatment of late sequelae after radiotherapy for head and neck cancer

    NARCIS (Netherlands)

    Strojan, Primož; Hutcheson, Katherine A; Eisbruch, Avraham; Beitler, Jonathan J; Langendijk, Johannes A; Lee, Anne W M; Corry, June; Mendenhall, William M; Smee, Robert; Rinaldo, Alessandra; Ferlito, Alfio

    Radiotherapy (RT) is used to treat approximately 80% of patients with cancer of the head and neck. Despite enormous advances in RT planning and delivery, a significant number of patients will experience radiation-associated toxicities, especially those treated with concurrent systemic agents. Many

  18. Magnetic resonance imaging guided reirradiation of recurrent and second primary head and neck cancer

    Directory of Open Access Journals (Sweden)

    Allen M. Chen, MD

    2017-04-01

    Conclusions: Our preliminary findings show that reirradiation with MRI guided radiation therapy results in effective disease control with relatively low morbidity for patients with recurrent and second primary cancers of the head and neck. The superior soft tissue resolution of the MRI scans that were used for planning and delivery has the potential to improve the therapeutic ratio.

  19. Hyperthermia with radiation in the treatment of advanced head and neck cancers

    International Nuclear Information System (INIS)

    Huilgol, Nagraj G.; Chatterjee, N.; Agarwal, J.P.; Shrivastava, Shyam; Sarin, Rajiv; Laskar, S.; Dinshaw, K.A.

    2004-01-01

    Hypoxic cells are deterrent to cure with radiotherapy. Hyperthermia (HT) which has the potential to be cytocidal can be complementary to radiation therapy. HT can be complementary to radiation as the targets of cellular lethality are different and hypoxic cells are more sensitive. The present study involves radiation of locally advanced Head and neck cancer with weekly HT as an adjuvant

  20. Incidence and risk factors of refeeding syndrome in head and neck cancer patients

    DEFF Research Database (Denmark)

    Rasmussen, Stine Ostenfeldt; Kristensen, Marianne Boll; Wessel, Irene

    2016-01-01

    -four head and neck cancer patients referred for surgery were included. Forty-six potential risk factors were registered at the baseline, and p-phosphate was measured at Days 2, 4, and 7. Eleven patients (20%) developed RFS, and twenty-eight (52%) developed refeeding phenomena. At baseline, these patients...

  1. Radiation dose, driving performance, and cognitive function in patients with head and neck cancer

    International Nuclear Information System (INIS)

    Yuen, Hon K.; Sharma, Anand K.; Logan, William C.; Gillespie, M. Boyd; Day, Terry A.; Brooks, Johnell O.

    2008-01-01

    Seven head and neck cancer patients participated in a driving evaluation in a driving simulator. Radiation dose on the temporal lobes was moderately associated with time to complete a cognitive test and with driving performance. Results indicated that incidental irradiation may contribute to a decrease in cognition and in unsafe driving performance, which seems to be time-dependent

  2. The radiotherapy effect on the quality of life of patients with head and neck cancer

    International Nuclear Information System (INIS)

    Sawada, Namie Okino; Dias, Adriana Marques; Zago, Marcia Maria Fontao

    2006-01-01

    In cases of head and neck cancer, surgical advances in combination with radiotherapy (RT) have brought an increase in patients' probability of cure. RT is widely used and aims to destroy cancer cells in order to reduce or eliminate a malignant tumor. However, RT also causes major changes in patients' quality of life during and after treatment. The current study aims to evaluate the side effects of RT in patients with head and neck cancer and its influence on quality of life. The study population included head and neck cancer patients submitted to RT at the University of Sao Paulo Hospital in Ribeirao Preto, Brazil. Data were collected with the FACT H and N instrument and McMaster University's Questionnaire for head and neck RT and submitted to quantitative statistical analysis using SPSS (Statistical Package for the Social Sciences). The main side effects of RT that affected physical quality of life were related to salivation and nutritional problems, while the predominant emotional problems were depression and anxiety. (author)

  3. p53 oncogene mutations in head and neck cancer based on the ...

    African Journals Online (AJOL)

    Yomi

    2012-01-26

    Jan 26, 2012 ... In order to study the p53 mutations in head and neck cancer, we explored the relationship between the different positions of the bases and the amino acids' physical and chemical properties. In this paper, the Euclidean distance (d) was defined. Furthermore, by using improved variation coefficient method,.

  4. Clinical utility and prospective comparison of ultrasonography and computed tomography imaging in staging of neck metastases in head and neck squamous cell cancer in an Indian setup

    International Nuclear Information System (INIS)

    Ashraf, M.; Biswas, J.; Jha, J.; Nayak, S.; Singh, V.; Majumdar, S.; Bhowmick, A.; Dam, A.

    2011-01-01

    Preoperative lymph node screening of all neck compartments is favored by clinicians for the management of the neck. The presence of a metastatic node on one side of the neck reduces the 5-year survival rate to 50%, and the presence of a metastatic node on both sides of the neck reduces the 5-year survival rate to 25%. This study compared the evaluation of lymph node metastases by ultrasonography (USG) and computed tomography (CT) in patients with squamous cell cancer of the head and neck region. Five hundred and eighty-four patients with squamous cell cancer of the head and neck were prospectively evaluated for the presence of cervical lymph node metastases. All patients underwent clinical examination (palpation), USG and CT imaging. Neck dissection was performed in all the patients, and the results of the preoperative evaluation were correlated with the surgical and histopathological findings. Metastases in neck nodes were identified in 148 patients by histopathological examination. Doppler USG correctly identified 136 node-positive patients (n=148; sensitivity 91.8%, specificity 97%). CT imaging correctly identified 122 patients with metastatic lymph nodes (n=148; sensitivity 83%, specificity 93%). Positive predictive values of USG and CT imaging were 95.6% and 91.3%, respectively, whereas the negative predictive values of these two imaging studies were 95.4% and 89.6%, respectively. The accuracy and sensitivity of USG in detection of cervical lymph node metastases make it a potentially promising and cheap preoperative tool for staging neck node metastases and optimizing the treatment plan for surgeons, especially in countries such as India. (author)

  5. Metastatic papillary thyroid cancer with lateral neck disease: pattern of spread by level.

    Science.gov (United States)

    Merdad, Mazin; Eskander, Antoine; Kroeker, Teresa; Freeman, Jeremy L

    2013-10-01

    Currently, there is no clear consensus on the extent of this lateral neck dissection required in papillary thyroid cancer (PTC) with lateral neck metastasis. The purpose of this study was to review our experience with metastatic PTC, and identify the pattern of lymphatic spread to the lateral neck. A retrospective medical chart review of PTC patients treated with lateral neck dissection (levels II-Vb) at our institution between January 2004 and 2011. A total of 185 patients underwent 248 selective lateral neck dissections. Levels II, III, IV, and Vb were respectively involved in 49.3%, 76.6%, 61.6%, and 29.2% of cases. We advocate for a routine excision of levels II, III, IV, and Vb in PTC with metastasize to any lateral neck level. Although we have routinely dissected level IIb, it may be appropriate to omit its dissection, as well as level Va, when there are no clinical, radiologic, or intraoperative evidence of disease involving these sublevels. Copyright © 2013 Wiley Periodicals, Inc.

  6. The role of precautionary radiotherapy of the neck in NO laryngeal cancers

    International Nuclear Information System (INIS)

    Baroncelli, G.; Bonetti, B.; La Face, B.; Moretti, R.

    1988-01-01

    The role of precautionary radiotherapy of the neck in laryngeal cancers (exept T1-T2 glottic and some T1 supraglottic cancers) NO at the clinical staging was investigated. Two-hundred and fifty-three patients were examined: 143 were irradiated only on T, and 110 also on the neck. Radiotherapy of the neck in the latter group was performed either by means of two large opposed fields of photon beams including T and N, or by means of fields of photon beams on T and electron beams (8x12 cm 2 average) on the neck, to quite exclude any risks for the spinal cord. The dose was 45-50 Gy (2 Gy/fraction/day; 5 fraction/week) in 4-5 weeks. A comparison of the results obtained in the two groups, in terms of survival-rate and relapse-free time, indicates that radiotherapy reduces the change of relapses on N (6.1% vs. 14.62% at 3 years; p=0.04) and improves the patient's survival chances (82.5% vs. 68.4% at 3 years; and 80.8% vs. 63.4% at 5 years). Our data were then compared with literature data on the importance of N field size in radiation treatment. As a rule, some authors enlarge the field to be treated to a total nodal neck irradiation, but their results are not significally different from those we obtained with 8x12 cm 2 field size

  7. The impact of dose on parotid salivary recovery in head and neck cancer patients treated with radiation therapy

    International Nuclear Information System (INIS)

    Li Yun; Taylor, Jeremy; Haken, Randall K. ten; Eisbruch, Avraham

    2007-01-01

    Purpose: A common side effect experienced by head and neck cancer patients after radiation therapy (RT) is impairment of the parotid glands' ability to produce saliva. Our purpose is to investigate the relationship between radiation dose and saliva changes in the 2 years after treatment. Methods and Materials: The study population includes 142 patients treated with conformal or intensity-modulated radiotherapy. Saliva flow rates from 266 parotid glands are measured before and 1, 3, 6, 12, 18, and 24 months after treatment. Measurements are collected separately from each gland under both stimulated and unstimulated conditions. Bayesian nonlinear hierarchical models were developed and fit to the data. Results: Parotids receiving higher radiation produce less saliva. The largest reduction is at 1-3 months after RT followed by gradual recovery. When mean doses are lower (e.g., 30 Gy), the stimulated saliva does not return to original levels after 2 years. Without stimulation, at 24 months, the predicted saliva is 86% of pretreatment levels for 25 Gy and 40 Gy. We do not find evidence to support that the overproduction of stimulated saliva at 18 and 24 months after low dose in 1 parotid gland is the result of low saliva production from the other parotid gland. Conclusions: Saliva production is affected significantly by radiation, but with doses <25-30 Gy, recovery is substantial and returns to pretreatment levels 2 years after RT

  8. Sex differences in the return-to-work process of cancer survivors 2 years after diagnosis: results from a large French population-based sample.

    Science.gov (United States)

    Marino, Patricia; Teyssier, Luis Sagaon; Malavolti, Laetitia; Le Corroller-Soriano, Anne-Gaelle

    2013-04-01

    To investigate the effects of clinical, sociodemographic, and occupational factors on time to return to work (RTW) during the 2 years after cancer diagnosis and to analyze whether sex differences exist. This study was based on a French national cross-sectional survey involving 4,270 cancer survivors. Time to RTW was estimated through the duration of sick leave of 801 cancer survivors younger than 58 years who were employed during the 2-year survey. Multivariate analysis of the RTW after sick leave was performed using a Weibull accelerated failure time model. We found some sex differences in the RTW process. Older men returned to work more slowly than older women (P = .013), whereas married men returned to work much faster than married women (P = .019). Duration dependence was also sex-specific. In men, the time spent on sick leave was independent of the probability of returning to work, whereas in women, this duration dependence was positive (P factors including chemotherapy, adverse effects, and cancer severity were found to delay RTW (P = .035, P = .001, and P investing most strongly in their personal lives also delayed their RTW (P = .006), as did those with a permanent work contract (P = .042). The factor found to accelerate RTW was a higher educational level (P = .014). The RTW process 2 years after cancer diagnosis differed between men and women. A better knowledge of this process should help the national implementation of more cost-effective strategies for managing the RTW of cancer survivors.

  9. Aspiration in Head and Neck Cancer Patients: A Single Centre Experience of Clinical Profile, Bacterial Isolates and Antibiotic Sensitivity Pattern

    OpenAIRE

    Lakshmaiah, K. C.; Sirsath, Nagesh T.; Subramanyam, Jayshree R.; Govind, Babu K.; Lokanatha, D.; Shenoy, Ashok M.

    2013-01-01

    Most patients with head and neck cancer have dysphagia and are at increased risk of having aspiration and subsequent pneumonia. It can cause prolonged hospitalization, treatment delay and/or interruption and mortality in cancer patients. The treatment of these infections often relies on empirical antibiotics based on local microbiology and antibiotic sensitivity patterns. The aim of present study is to analyse respiratory tract pathogens isolated by sputum culture in head and neck cancer pati...

  10. Biology and immunology of cancer stem(-like) cells in head and neck cancer.

    Science.gov (United States)

    Qian, Xu; Ma, Chenming; Nie, Xiaobo; Lu, Jianxin; Lenarz, Minoo; Kaufmann, Andreas M; Albers, Andreas E

    2015-09-01

    Immunological approaches against tumors including head and neck squamous cell carcinoma (HNSCC) have been investigated for about 50 years. Such immunotherapeutic treatments are still not sufficiently effective for therapy of HNSCC. Despite the existence of immunosurveillance tumor cells may escape from the host immune system by a variety of mechanisms. Recent findings have indicated that cancer stem(-like) cells (CSCs) in HNSCC have the ability to reconstitute the heterogeneity of the bulk tumor and contribute to immunosuppression and resistance to current therapies. With regard to the CSC model, future immunotherapy possibly in combination with other modes of treatment should target this subpopulation specifically to reduce local recurrence and metastasis. In this review, we will summarize recent research findings on immunological features of CSCs and the potential of immune targeting of CSCs. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  11. Hypofractionated palliative radiotherapy in locally advanced inoperable head and neck cancer: CMC vellore experience

    Directory of Open Access Journals (Sweden)

    Saikat Das

    2013-01-01

    Full Text Available Background: A novel, short duration, palliative radiotherapy schedule for inoperable head and neck cancer was evaluated in terms of palliation of cancer-related symptoms and acute toxicities. Materials and Methods: Thirty-six patients with inoperable head and neck cancer were included in the study (2010-2012. All patients received 40 Gy in 10 fractions (equivalent dose: 49.8 Gy in conventional fractionation with 2 fractions per week. Treatment-related toxicity was assessed using Radiation Therapy Oncology Group criteria. Functional Assessment of Cancer Therapy (Head and Neck, FACT H and N quality of life (QOL tool was administered before starting and at the completion of radiotherapy. Mean value before and after treatment was compared (paired t-test, P = 0.05, two-tailed for significance. Results: Thirty-three patients (male: 29, female: 4, mean age: 57.8 ± 9.7 years were included in the analysis (three patients discontinued treatment due to socioeconomic reasons. All patients had advanced inoperable head and neck cancers (27% IVA, 61% IVB, 9% IVC, TNM stage and 3% recurrent disease. Distressing pain at primary site (42%, dysphagia (18%, neck swelling (30%, and hoarseness (10% were common presentations. Incidence of grade III mucositis and dermatitis and pain was 18%, 3%, and 24%, respectively. Planned radiotherapy without any interruptions was completed by 73% patients. QOL assessment showed improvement in social well-being (17.4 vs. 20.01, P = 0.03, but no significant change was observed in head and neck specific score (25.1 vs. 25.0, P = NS after treatment. Reduction of pain was observed in 88% patients and 60% patients had improvement of performance status. Median overall survival of the cohort was 7 months. Conclusions: The study shows that this short duration palliative radiotherapy schedule is a clinically viable option for advanced inoperable head and neck cancer to achieve significant palliation of the main presenting symptoms like

  12. Pattern of head and neck cancers among patients attending ...

    African Journals Online (AJOL)

    nasopharyngeal and laryngeal cancer, respectively. Sinonasal cancer showed the most histology diversity than any other HNCA. Table 2. Distribution of head and cancer by anatomical location and histological diagnosis. Site. Number and percent (%) of Histological diagnosis. ADNCY SCC. SCM. MUCO ONBSM ADENO ...

  13. Parotid gland sparing IMRT for head and neck cancer improves xerostomia related quality of life

    International Nuclear Information System (INIS)

    Rij, CM van; Oughlane-Heemsbergen, WD; Ackerstaff, AH; Lamers, EA; Balm, AJM; Rasch, CRN

    2008-01-01

    To assess the impact of intensity modulated radiotherapy (IMRT) versus conventional radiation on late xerostomia and Quality of Life aspects in head and neck cancer patients. Questionnaires on xerostomia in rest and during meals were sent to all patients treated between January 1999 and December 2003 with a T1-4, N0-2 M0 head and neck cancer, with parotid gland sparing IMRT or conventional bilateral neck irradiation to a dose of at least 60 Gy, who were progression free and had no disseminated disease (n = 192). Overall response was 85% (n = 163); 97% in the IMRT group (n = 75) and 77% in the control group (n = 88) the median follow-up was 2.6 years. The prevalence of complaints was compared between the two groups, correcting for all relevant factors at multivariate ordinal regression analysis. Patients treated with IMRT reported significantly less difficulty transporting and swallowing their food and needed less water for a dry mouth during day, night and meals. They also experienced fewer problems with speech and eating in public. Laryngeal cancer patients in general had fewer complaints than oropharynx cancer patients but both groups benefited from IMRT. Within the IMRT group the xerostomia scores were better for those patients with a mean parotid dose to the 'spared' parotid below 26 Gy. Parotid gland sparing IMRT for head and neck cancer patients improves xerostomia related quality of life compared to conventional radiation both in rest and during meals. Laryngeal cancer patients had fewer complaints but benefited equally compared to oropharyngeal cancer patients from IMRT

  14. Parotid gland sparing IMRT for head and neck cancer improves xerostomia related quality of life

    Science.gov (United States)

    van Rij, CM; Oughlane-Heemsbergen, WD; Ackerstaff, AH; Lamers, EA; Balm, AJM; Rasch, CRN

    2008-01-01

    Background and purpose To assess the impact of intensity modulated radiotherapy (IMRT) versus conventional radiation on late xerostomia and Quality of Life aspects in head and neck cancer patients. Patients and nethods Questionnaires on xerostomia in rest and during meals were sent to all patients treated between January 1999 and December 2003 with a T1-4, N0-2 M0 head and neck cancer, with parotid gland sparing IMRT or conventional bilateral neck irradiation to a dose of at least 60 Gy, who were progression free and had no disseminated disease (n = 192). Overall response was 85% (n = 163); 97% in the IMRT group (n = 75) and 77% in the control group (n = 88) the median follow-up was 2.6 years. The prevalence of complaints was compared between the two groups, correcting for all relevant factors at multivariate ordinal regression analysis. Results Patients treated with IMRT reported significantly less difficulty transporting and swallowing their food and needed less water for a dry mouth during day, night and meals. They also experienced fewer problems with speech and eating in public. Laryngeal cancer patients in general had fewer complaints than oropharynx cancer patients but both groups benefited from IMRT. Within the IMRT group the xerostomia scores were better for those patients with a mean parotid dose to the "spared" parotid below 26 Gy. Conclusion Parotid gland sparing IMRT for head and neck cancer patients improves xerostomia related quality of life compared to conventional radiation both in rest and during meals. Laryngeal cancer patients had fewer complaints but benefited equally compared to oropharyngeal cancer patients from IMRT. PMID:19068126

  15. Parotid gland sparing IMRT for head and neck cancer improves xerostomia related quality of life

    Directory of Open Access Journals (Sweden)

    Balm AJM

    2008-12-01

    Full Text Available Abstract Background and purpose To assess the impact of intensity modulated radiotherapy (IMRT versus conventional radiation on late xerostomia and Quality of Life aspects in head and neck cancer patients. Patients and nethods Questionnaires on xerostomia in rest and during meals were sent to all patients treated between January 1999 and December 2003 with a T1-4, N0-2 M0 head and neck cancer, with parotid gland sparing IMRT or conventional bilateral neck irradiation to a dose of at least 60 Gy, who were progression free and had no disseminated disease (n = 192. Overall response was 85% (n = 163; 97% in the IMRT group (n = 75 and 77% in the control group (n = 88 the median follow-up was 2.6 years. The prevalence of complaints was compared between the two groups, correcting for all relevant factors at multivariate ordinal regression analysis. Results Patients treated with IMRT reported significantly less difficulty transporting and swallowing their food and needed less water for a dry mouth during day, night and meals. They also experienced fewer problems with speech and eating in public. Laryngeal cancer patients in general had fewer complaints than oropharynx cancer patients but both groups benefited from IMRT. Within the IMRT group the xerostomia scores were better for those patients with a mean parotid dose to the "spared" parotid below 26 Gy. Conclusion Parotid gland sparing IMRT for head and neck cancer patients improves xerostomia related quality of life compared to conventional radiation both in rest and during meals. Laryngeal cancer patients had fewer complaints but benefited equally compared to oropharyngeal cancer patients from IMRT.

  16. Contemporary radiotherapy in head and neck cancer: balancing chance for cure with risk for complication.

    Science.gov (United States)

    Cabrera, Alvin R; Yoo, David S; Brizel, David M

    2013-07-01

    Radiotherapy plays an integral role in the management of most patients with cancers of the head and neck. Better understanding of radiobiology and radiation physics has allowed radiation oncologists to enhance the tumoricidal effects of radiation and reduce the severity of normal tissue toxicities. This article reviews the biologic foundation of head and neck radiotherapy, the physical principles and technological innovations that enable delivery of highly conformal radiation, the acute and late complications of radiation-based treatments, and the clinical evidence supporting contemporary practice. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Acupuncture in Treating Dry Mouth Caused By Radiation Therapy in Patients With Head and Neck Cancer | Division of Cancer Prevention

    Science.gov (United States)

    RATIONALE: Acupuncture may help relieve dry mouth caused by radiation therapy. PURPOSE: This randomized phase III trial is studying to see how well one set of acupuncture points work in comparison to a different set of acupuncture points or standard therapy in treating dry mouth caused by radiation therapy in patients with head and neck cancer. |

  18. Stereotactic body radiotherapy for recurrent head and neck cancer: A critical review.

    Science.gov (United States)

    Baliga, Sujith; Kabarriti, Rafi; Ohri, Nitin; Haynes-Lewis, Hilda; Yaparpalvi, Ravindra; Kalnicki, Shalom; Garg, Madhur K

    2017-03-01

    The management of patients with recurrent head and neck cancers remains a challenging clinical dilemma. Concerns over toxicity with re-irradiation have limited its use in the clinical setting. Stereotactic Body Radiation Therapy (SBRT) has emerged as a highly conformal and precise type of radiotherapy and has the advantage of sparing normal tissue. Although SBRT is an attractive treatment modality, its use in the clinic is limited, given the technically challenging nature of the procedure. In this review, we attempt to provide a comprehensive overview of the role of re-irradiation in patients with recurrent head and neck cancers, with particular attention to the advent of SBRT and its use with systemic therapies such as cetuximab. In the second portion of this review, we present our systematic review of published experiences with SBRT in recurrent head and neck cancers in an attempt to provide data on response rates (RR), overall survival and toxicity. © 2016 Wiley Periodicals, Inc. Head Neck 39: 595-601, 2017. © 2016 Wiley Periodicals, Inc.

  19. Effect of Pretreatment Anemia on Treatment Outcome of Concurrent Radiochemotherapy in Patients With Head and Neck Cancer

    International Nuclear Information System (INIS)

    Fortin, Andre; Wang Changshu; Vigneault, Eric

    2008-01-01

    Purpose: To investigate the effect of anemia on outcome of treatment with radiochemotherapy in patients with head-and-neck cancer. Methods and Materials: The data of 196 patients with Stage II-IV head-and-neck cancer treated with concomitant cisplatin-based radiochemotherapy were retrospectively reviewed. Anemia was defined according to World Health Organization criteria as hemoglobin 140 g/L. Conclusions: Anemia was strongly associated with local control and survival in this cohort of patients with head-and-neck cancer receiving radiochemotherapy

  20. Walking with purpose after an HPV-related head and neck cancer diagnosis | Center for Cancer Research

    Science.gov (United States)

    In November 2015, Michael Becker was diagnosed with Stage IV head and neck cancer caused by a strain of the human papillomavirus, or HPV. He now advocates for education and awareness of the HPV vaccine as cancer prevention for both boys and girls. “I want to make people aware that you can avoid my situation by getting the shot.” Read more…

  1. Profile of Head and Neck Cancer Patients at Department of Otorhinolaringology-Head and Neck Surgery Dr. Hasan Sadikin General Hospital Bandung

    Directory of Open Access Journals (Sweden)

    Inez Aulia Rakhmawulan

    2015-12-01

    Full Text Available Background: Head and neck cancer is a health problem with a high mortality rate. Head and neck cancer are increasing and effect many individuals from diverse backgrounds. Usually patients come with advanced stages, therefore these conditions could lead to decrease their quality of life. Aim of this study was to describe the profile of head and neck cancer patients at the Otorhinolaringology-Head and Neck Surgery Department, Dr. Hasan Sadikin General Hospital Bandung. Methods: A descriptive cross-sectional method was used from medical records of head neck cancer patients at Department of Otorhinolaringology-Head and Neck Surgery, Dr. Hasan Sadikin General Hospital Bandung from 2008 to 2012 that used the total sampling method. Results: There were 665 patients included in this study, which men who participated were 388 and women were 277. Most of them were elementary educated (44.96%, housewives (32.03%, and those aged 46–55 years old (28.33%. There were nasopharyngeal (38.20%, sinonasal (17.29%, larnyx (13.08%, oropharnyx (6.32%, thyroid gland (6.17%, oral cavity (3.91%, hypopharynx (2.41%, and parotid gland (2.26% cancer. The major histopathological findings were undifferentiated carcinoma (45.41% and squamous cell carcinoma (22.26%, those were presented with stage I (7.4%, II (13.5%, III (24.4%, and IV (54.7%. Conclusions: Nasopharyngeal carcinoma was the most predominant cases which majority were presented in advanced stage and major histopathology features was undifferentiated carcinoma, while demografic characteristic mostly were in middle aged and older, men with low education background.

  2. Twice-a-day fractionated radiotherapy for head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Kita, Midori [Tokyo Metropolitan Hospital of Fuchu (Japan)

    1996-12-01

    To improve the local control rate in radiotherapy for hand and neck cancer, several prospected twice-a-day fractionated radiotherapy (TDRF) were conducted in Tokyo Women`s Medical College. T2 glottic cancer was irradiated with 1.5 Gy/fraction, 2 fraction/day to a total dose of 72 Gy. Five cumulative local control rate was 88.2%. Locally advanced head and neck cancer was treated with TDFR and systemic chemotherapy. Response rate was 100%. Palliative radiotherapy with TDFR was done to relive from the pain and other symptoms for advanced and recurrent cases. Nine cases of 11 were relieved from the symptoms. These results was suggested the TDFR was useful to improve the local control rate. (author)

  3. Twice-a-day fractionated radiotherapy for head and neck cancer

    International Nuclear Information System (INIS)

    Kita, Midori

    1996-01-01

    To improve the local control rate in radiotherapy for hand and neck cancer, several prospected twice-a-day fractionated radiotherapy (TDRF) were conducted in Tokyo Women's Medical College. T2 glottic cancer was irradiated with 1.5 Gy/fraction, 2 fraction/day to a total dose of 72 Gy. Five cumulative local control rate was 88.2%. Locally advanced head and neck cancer was treated with TDFR and systemic chemotherapy. Response rate was 100%. Palliative radiotherapy with TDFR was done to relive from the pain and other symptoms for advanced and recurrent cases. Nine cases of 11 were relieved from the symptoms. These results was suggested the TDFR was useful to improve the local control rate. (author)

  4. Effects of radiation therapy on T-lymphocyte subpopulations in patients with head and neck cancer

    International Nuclear Information System (INIS)

    Gray, W.C.; Chretien, P.B.; Suter, C.M.; Revie, D.R.; Tomazic, V.T.; Blanchard, C.L.; Aygun, C.; Amornmarn, R.; Ordonez, J.V.

    1985-01-01

    Cellular immunity was assessed in 85 patients with head and neck cancer with monoclonal antibodies to lymphocyte surface antigens that identify total T cells, helper cells, and suppressor cells. The control group consisted of 22 healthy volunteers. Nine patients who had surgical procedures for benign diseases were also studied. Compared with the controls, the patients with cancer who received radiation therapy had a significant decrease in total lymphocytes, T cells, helper cells, suppressor cells, and decreased helper/suppressor cell ratio. Significant decreases in lymphocyte subpopulations were not detected in patients tested before treatment or in patients treated with surgery alone. The immune deficits observed were prolonged in duration, with some present in the patients studied up to 11 years after radiation therapy. This long-lasting immune depression may have relevance to tumor recurrences and second primaries in patients with head and neck cancer treated by radiation therapy and to attempts at increasing cure rates with adjuvant agents that improve immune reactivity

  5. Molecular biology and immunology of head and neck cancer.

    Science.gov (United States)

    Guo, Theresa; Califano, Joseph A

    2015-07-01

    In recent years, our knowledge and understanding of head and neck squamous cell carcinoma (HNSCC) has expanded dramatically. New high-throughput sequencing technologies have accelerated these discoveries since the first reports of whole-exome sequencing of HNSCC tumors in 2011. In addition, the discovery of human papillomavirus in relationship with oropharyngeal squamous cell carcinoma has shifted our molecular understanding of the disease. New investigation into the role of immune evasion in HNSCC has also led to potential novel therapies based on immune-specific systemic therapies. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Disruption of NSD1 in head and neck cancer promotes favorable chemotherapeutic responses linked to hypomethylation.

    Science.gov (United States)

    Bui, Nam; Huang, Justin K; Bojorquez-Gomez, Ana; Licon, Katherine; Sanchez, Kyle S; Tang, Sean N; Beckett, Alex N; Wang, Tina; Zhang, Wei; Shen, John Paul; Kreisberg, Jason F; Ideker, Trey

    2018-04-10

    Human papillomavirus (HPV) negative head and neck squamous cell carcinoma (HNSCC) represents a distinct classification of cancer with poor expected outcomes. Of the 11 genes recurrently mutated in HNSCC, we identify a singular and substantial survival advantage for mutations in the gene encoding Nuclear Set Domain Containing Protein 1 (NSD1), a histone methyltransferase altered in approximately 10% of patients. This effect, a 55% decrease in risk of death in NSD1-mutated versus non-mutated patients, can be validated in an independent cohort. NSD1 alterations are strongly associated with widespread genome hypomethylation in the same tumors, to a degree not observed for any other mutated gene. To address whether NSD1 plays a causal role in these associations, we use CRISPR-Cas9 to disrupt NSD1 in HNSCC cell lines and find that this leads to substantial CpG hypomethylation and sensitivity to cisplatin, a standard chemotherapy in head and neck cancer, with a 40 - 50% decrease in IC50. Such results are reinforced by a survey of 1,001 cancer cell lines, in which loss-of-function NSD1 mutations have an average 23% decrease in cisplatin IC50 compared to cell lines with wild type NSD1. This study identifies a favorable subtype of head and neck cancer linked to NSD1 mutation, hypomethylation and cisplatin sensitivity. Copyright ©2018, American Association for Cancer Research.

  7. Thyroid cancer causing obstruction of the great veins in the neck

    Directory of Open Access Journals (Sweden)

    Haq Masud

    2008-04-01

    Full Text Available Abstract Background and aims To report our experience and review the literature of thyroid cancer obstructing the great veins in the neck, highlighting clinical aspects and response to treatment. Methods Clinical data were collected from the thyroid cancer register and from follow-up clinic visits of patients referred to the Thyroid Unit at the Royal Marsden Hospital. A Medline literature search was conducted between 1980 and 2007. Results Of 1448 patients with thyroid cancer on our cancer register and treated in our unit over the last 60 years, we identified five patients, four women and one man, aged 43 – 81 years with a median follow up of 28 (24–78 months in whom tumour had occluded the great veins in the neck. All patients underwent total thyroidectomy and all subsequently received ablative 131I with the exception of patient 3 whose post-operative isotope scan shown no significant 131I uptake. External beam radiotherapy to the neck and upper mediastinum was used for residual disease control in the 5 patients. The median survival was 28 months and the disease-free survival was 24 months. One patient remains asymptomatic but with disease 53 months after initial presentation. Survival in this small series is significantly better than that previously reported for this condition. Conclusion A multimodality therapeutic approach comprising surgery, radioiodine and external beam radiotherapy may give the best results for patients in whom thyroid cancer is occluding the great veins.

  8. Emotions and coping of patients with head and neck cancers after diagnosis: A qualitative content analysis.

    Science.gov (United States)

    Jagannathan, A; Juvva, S

    2016-01-01

    Patients suffering with head and neck cancers are observed to have a relatively high risk of developing emotional disturbances after diagnosis and treatment. These emotional concerns can be best understood and explored through the method of content analysis or qualitative data. Though a number of qualitative studies have been conducted in the last few years in the field of psychosocial oncology, none have looked at the emotions experienced and the coping by head and neck cancer patients. Seventy-five new cases of postsurgery patients of head and neck cancers were qualitatively interviewed regarding the emotions experienced and coping strategies after diagnosis. Qualitative content analysis of the in-depth interviews brought out that patients experienced varied emotions on realizing that they were suffering from cancer, the cause of which could be mainly attributed to three themes: 1) knowledge of their illness; 2) duration of untreated illness; and 3) object of blame. They coped with their emotions by either: 1) inculcating a positive attitude and faith in the doctor/treatment, 2) ventilating their emotions with family and friends, or 3) indulging in activities to divert attention. The results brought out a conceptual framework, which showed that an in-depth understanding of the emotions - Their root cause, coping strategies, and spiritual and cultural orientations of the cancer survivor - Is essential to develop any effective intervention program in India.

  9. Role of prophylactic central neck dissection in cN0 papillary thyroid cancer

    Science.gov (United States)

    Costa, S; Giugliano, G; Santoro, L; Ywata De Carvalho, A; Massaro, MA; Gibelli, B; De Fiori, E; Grosso, E; Ansarin, M; Calabrese, L

    2009-01-01

    Summary Prophylactic central neck dissection in papillary thyroid cancer is controversial. In this retrospective cohort study, the aim was to assess possible advantages of prophylactic central neck dissection with total thyroidectomy in cN0 papillary thyroid cancer. A total of 244 consecutive patients with papillary thyroid cancer, without clinical and ultrasound nodal metastases (cN0), were evaluated out of 1373 patients operated for a thyroid disease at the Istituto Europeo di Oncologia, Milan, Italy from 1994 to 2006. Of these 244 patients, 126 (Group A) underwent thyroidectomy with central neck dissection, while 118 (Group B) underwent thyroidectomy alone. Demographic, clinical and pathological features were analysed. Overall recurrence rate was 6.3% (8/126) in Group A and 7.7% (9/118) in Group B, with a mean follow-up of 47 (Group A) and 64 (Group B) months. In Group A patients, 47% were pN1a and all patients with recurrence had nodal involvement (p = 0.002). Survival rate did not differ in the two groups. Nine patients were lost to follow-up. Group A patients were older and their tumours were larger in size; according to the pT distribution, a higher extra-capsular invasion rate was observed. The two groups were equivalent as far as concerns histological high risk variants and multifocality. Nodal metastases correlated with stage: pT1-2 vs. pT3-T4a, p = 0.0036. A lower risk of nodal metastases was related to thyroiditis (p = 0.0034). In conclusion, central neck metastases were predictive of recurrence without influencing prognosis. From data obtained, possible greatest efficacy of central neck dissection in pT3-4 papillary thyroid cancer without thyroiditis is suggested. PMID:20111614

  10. Initial results of CyberKnife treatment for recurrent previously irradiated head and neck cancer

    International Nuclear Information System (INIS)

    Himei, Kengo; Katsui, Kuniaki; Yoshida, Atsushi

    2003-01-01

    The purpose of this study was to evaluate the efficacy of CyberKnife for recurrent previously irradiated head and neck cancer. Thirty-one patients with recurrent previously irradiated head and neck cancer were treated with a CyberKnife from July 1999 to March 2002 at Okayama Kyokuto Hospital were retrospectively studied. The accumulated dose was 28-80 Gy (median 60 Gy). The interval between CyberKnife treatment and previous radiotherapy was 0.4-429.5 months (median 16.3 months). Primary lesions were nasopharynx: 7, maxillary sinus: 6, tongue: 5, ethmoid sinus: 3, and others: 1. The pathology was squamous cell carcinoma: 25, adenoid cystic carcinoma: 4, and others: 2. Symptoms were pain: 8, and nasal bleeding: 2. The prescribed dose was 15.0-40.3 Gy (median 32.3 Gy) as for the marginal dose. The response rate (complete response (CR)+partial response (PR)) and local control rate (CR+PR+no change (NC)) was 74% and 94% respectively. Pain disappeared for 4 cases, relief was obtained for 4 cases and no change for 2 cases and nasal bleeding disappeared for 2 cases for an improvement of symptoms. An adverse effects were observed as mucositis in 5 cases and neck swelling in one case. Prognosis of recurrent previously irradiated head and neck cancer was estimated as poor. Our early experience shows that CyberKnife is expected to be feasible treatment for recurrent previously irradiated head and neck cancer, and for the reduction adverse effects and maintenance of useful quality of life (QOL) for patients. (author)

  11. Sleep quality in long-term survivors of head and neck cancer: preliminary findings.

    Science.gov (United States)

    Li, Na; Otomaru, Takafumi; Taniguchi, Hisashi

    2017-12-01

    This preliminary study evaluated sleep quality in long-term head and neck cancer survivors, using demographic data and clinical features of the cancers as assessment criteria. In addition, a possible correlation was examined between scores on self-rated questionnaires of sleep quality and assessments of quality of life and oral health status. Subjects were 77 head and neck cancer survivors. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale. Oral and general health status was assessed using The Oral Health Impact Profile (OHIP-14) and the Short-Form Health Survey (SF-36), respectively, and correlated with clinical parameters. Spearman's correlation coefficients were calculated to examine relationships between variables. Logistic regression analysis was performed to identify independent variables associated with poor sleep quality. Eighty-three percent of patients had poor sleep quality (global scores ≥5) and 40% had a global Pittsburgh Sleep Quality Index score ≥8, indicating significantly poor sleep quality. Nocturnal enuresis, daytime sleepiness, and early morning awakening were the most common complaints. Extensive neck dissection, a lower SF-36 mental component score, and a higher OHIP-14 psychological disability score were independently associated with poor sleep quality. OHIP-14 global score was linked independently with daytime sleepiness. This is the first study to demonstrate a high prevalence of poor sleep quality in long-term head and neck cancer survivors. Extensive neck dissection, poor mental health, and psychological disability may contribute to poor sleep quality. Maintaining good oral health-related quality of life could promote better sleep in these patients.

  12. Evaluation of Human Papillomavirus Antibodies and Risk of Subsequent Head and Neck Cancer

    Science.gov (United States)

    Kreimer, Aimée R.; Johansson, Mattias; Waterboer, Tim; Kaaks, Rudolf; Chang-Claude, Jenny; Drogen, Dagmar; Tjønneland, Anne; Overvad, Kim; Quirós, J. Ramón; González, Carlos A.; Sánchez, Maria José; Larrañaga, Nerea; Navarro, Carmen; Barricarte, Aurelio; Travis, Ruth C.; Khaw, Kay-Tee; Wareham, Nick; Trichopoulou, Antonia; Lagiou, Pagona; Trichopoulos, Dimitrios; Peeters, Petra H.M.; Panico, Salvatore; Masala, Giovanna; Grioni, Sara; Tumino, Rosario; Vineis, Paolo; Bueno-de-Mesquita, H. Bas; Laurell, Göran; Hallmans, Göran; Manjer, Jonas; Ekström, Johanna; Skeie, Guri; Lund, Eiliv; Weiderpass, Elisabete; Ferrari, Pietro; Byrnes, Graham; Romieu, Isabelle; Riboli, Elio; Hildesheim, Allan; Boeing, Heiner; Pawlita, Michael; Brennan, Paul

    2013-01-01

    Purpose Human papillomavirus type 16 (HPV16) infection is causing an increasing number of oropharyngeal cancers in the United States and Europe. The aim of our study was to investigate whether HPV antibodies are associated with head and neck cancer risk when measured in prediagnostic sera. Methods We identified 638 participants with incident head and neck cancers (patients; 180 oral cancers, 135 oropharynx cancers, and 247 hypopharynx/larynx cancers) and 300 patients with esophageal cancers as well as 1,599 comparable controls from within the European Prospective Investigation Into Cancer and Nutrition cohort. Prediagnostic plasma samples from patients (collected, on average, 6 years before diagnosis) and control participants were analyzed for antibodies against multiple proteins of HPV16 as well as HPV6, HPV11, HPV18, HPV31, HPV33, HPV45, and HPV52. Odds ratios (ORs) of cancer and 95% CIs were calculated, adjusting for potential confounders. All-cause mortality was evaluated among patients using Cox proportional hazards regression. Results HPV16 E6 seropositivity was present in prediagnostic samples for 34.8% of patients with oropharyngeal cancer and 0.6% of controls (OR, 274; 95% CI, 110 to 681) but was not associated with other cancer sites. The increased risk of oropharyngeal cancer among HPV16 E6 seropositive participants was independent of time between blood collection and diagnosis and was observed more than 10 years before diagnosis. The all-cause mortality ratio among patients with oropharyngeal cancer was 0.30 (95% CI, 0.13 to 0.67), for patients who were HPV16 E6 seropositive compared with seronegative. Conclusion HPV16 E6 seropositivity was present more than 10 years before diagnosis of oropharyngeal cancers. PMID:23775966

  13. Image-guided radiotherapy for locally advanced head and neck cancer

    Directory of Open Access Journals (Sweden)

    Nam Phong Nguyen

    2013-07-01

    Full Text Available Treatment of locally advanced head and neck cancer remains a challenge because of the head and neck complex anatomy and the tumor invasion to the adjacent organs and/or metastases to the cervical nodes. Postoperative irradiation or concurrent chemoradiation may lead to damage of radiosensitive structures such as the salivary glands, mandible, cochlea, larynx, and pharyngeal muscles. Xerostomia, osteoradionecrosis, deafness, hoarseness of the voice, dysphagia, and aspiration remain serious complications of head and neck irradiation and impair patient quality of life. Intensity-modulated and image-guided radiotherapy by virtue of steep dose gradient and daily imaging may allow for decreased radiation of the organs at risk for complication while preserving loco-regional control.

  14. Profiling Invasiveness in Head and Neck Cancer: Recent Contributions of Genomic and Transcriptomic Approaches

    Energy Technology Data Exchange (ETDEWEB)

    Nisa, Lluís, E-mail: lluis.nisa@dkf.unibe.ch [Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Bern 3010 (Switzerland); Department of Clinical Research, Inselspital, Bern University Hospital, and University of Bern, MEM-E807, Murtenstrasse 35, Bern 3010 (Switzerland); Department of Otorhinolaryngology-Head and Neck Surgery, Inselspital, Bern University Hospital, and University of Bern, Bern 3010 (Switzerland); Aebersold, Daniel Matthias [Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Bern 3010 (Switzerland); Department of Clinical Research, Inselspital, Bern University Hospital, and University of Bern, MEM-E807, Murtenstrasse 35, Bern 3010 (Switzerland); Giger, Roland; Caversaccio, Marco Domenico; Borner, Urs [Department of Otorhinolaryngology-Head and Neck Surgery, Inselspital, Bern University Hospital, and University of Bern, Bern 3010 (Switzerland); Medová, Michaela; Zimmer, Yitzhak, E-mail: lluis.nisa@dkf.unibe.ch [Department of Radiation Oncology, Inselspital, Bern University Hospital, and University of Bern, Bern 3010 (Switzerland); Department of Clinical Research, Inselspital, Bern University Hospital, and University of Bern, MEM-E807, Murtenstrasse 35, Bern 3010 (Switzerland)

    2015-03-31

    High-throughput molecular profiling approaches have emerged as precious research tools in the field of head and neck translational oncology. Such approaches have identified and/or confirmed the role of several genes or pathways in the acquisition/maintenance of an invasive phenotype and the execution of cellular programs related to cell invasion. Recently published new-generation sequencing studies in head and neck squamous cell carcinoma (HNSCC) have unveiled prominent roles in carcinogenesis and cell invasion of mutations involving NOTCH1 and PI3K-patwhay components. Gene-expression profiling studies combined with systems biology approaches have allowed identifying and gaining further mechanistic understanding into pathways commonly enriched in invasive HNSCC. These pathways include antigen-presenting and leucocyte adhesion molecules, as well as genes involved in cell-extracellular matrix interactions. Here we review the major insights into invasiveness in head and neck cancer provided by high-throughput molecular profiling approaches.

  15. Can FDG-PET assist in radiotherapy target volume definition of metastatic lymph nodes in head-and-neck cancer?

    NARCIS (Netherlands)

    Schinagl, D.A.X.; Hoffmann, A.L.; Vogel, W.V.; Dalen, J.A. van; Verstappen, S.M.M.; Oyen, W.J.G.; Kaanders, J.H.A.M.

    2009-01-01

    BACKGROUND AND PURPOSE: The role of FDG-PET in radiotherapy target volume definition of the neck was evaluated by comparing eight methods of FDG-PET segmentation to the current CT-based practice of lymph node assessment in head-and-neck cancer patients. MATERIALS AND METHODS: Seventy-eight

  16. Efficacy of a novel swallowing exercise program for chronic dysphagia in long-term head and neck cancer survivors

    NARCIS (Netherlands)

    Kraaijenga, S.A.C.; van der Molen, L.; Stuiver, M.M.; Takes, R.P.; Al-Mamgani, A.; van den Brekel, M.W.M.; Hilgers, F.J.M.

    2017-01-01

    Background: The efficacy of rehabilitative exercises for chronic dysphagia treatment in head and neck cancer survivors has not been studied extensively and is ambiguous. Methods: A prospective clinical phase II study using an intensive strength training program was carried out in 17 head and neck

  17. Intimacy processes and psychological distress among couples coping with head and neck or lung cancers.

    Science.gov (United States)

    Manne, Sharon; Badr, Hoda

    2010-09-01

    Couples coping with head and neck and lung cancers are at increased risk for psychological and relationship distress given patients' poor prognosis and aggressive and sometimes disfiguring treatments. The relationship intimacy model of couples' psychosocial adaptation proposes that relationship intimacy mediates associations between couples' cancer-related support communication and psychological distress. Because the components of this model have not yet been evaluated in the same study, we examined associations between three types of cancer-related support communication (self-disclosure, perceived partner disclosure, and protective buffering), intimacy (global and cancer-specific), and global distress among patients coping with either head and neck or lung cancer and their partners. One hundred and nine patients undergoing active treatment and their partners whose average time since diagnosis was 15 months completed cross-sectional surveys. For both patients and their partners, multilevel analyses using the actor-partner interdependence model showed that global and cancer-specific intimacy fully mediated associations between self- and perceived partner disclosure and distress; global intimacy partially mediated the association between protective buffering and distress. Evidence for moderated mediation was found; specifically, lower levels of distress were reported as a function of global and cancer-specific intimacy, but these associations were stronger for partners than for patients. Enhancing relationship intimacy by disclosing cancer-related concerns may facilitate both partners' adjustment to these illnesses. (c) 2010 John Wiley & Sons, Ltd.

  18. FDG uptake in cervical lymph nodes in children without head and neck cancer.

    Science.gov (United States)

    Vali, Reza; Bakari, Alaa A; Marie, Eman; Kousha, Mahnaz; Charron, Martin; Shammas, Amer

    2017-06-01

    Reactive cervical lymphadenopathy is common in children and may demonstrate increased 18 F-fluoro-deoxyglucose ( 18 F-FDG) uptake on positron emission tomography/computed tomography (PET/CT). We sought to evaluate the frequency and significance of 18 F-FDG uptake by neck lymph nodes in children with no history of head and neck cancer. The charts of 244 patients (114 female, mean age: 10.4 years) with a variety of tumors such as lymphoma and post-transplant lymphoproliferative diseases (PTLD), but no head and neck cancers, who had undergone 18 F-FDG PET/CT were reviewed retrospectively. Using the maximum standardized uptake value (SUVmax), increased 18 F-FDG uptake by neck lymph nodes was recorded and compared with the final diagnosis based on follow-up studies or biopsy results. Neck lymph node uptake was identified in 70/244 (28.6%) of the patients. In 38 patients, the lymph nodes were benign. In eight patients, the lymph nodes were malignant (seven PTLD and one lymphoma). In 24 patients, we were not able to confirm the final diagnosis. Seven out of the eight malignant lymph nodes were positive for PTLD. The mean SUVmax was significantly higher in malignant lesions (4.2) compared with benign lesions (2.1) (P = 0.00049). 18 F-FDG uptake in neck lymph nodes is common in children and is frequently due to reactive lymph nodes, especially when the SUVmax is cervical lymph nodes is higher in PTLD patients compared with other groups.

  19. EVIDENCE OF EPSTEIN-BARR VIRUS ASSOCIATION WITH HEAD AND NECK CANCERS: A REVIEW.

    Science.gov (United States)

    Prabhu, Soorebettu R; Wilson, David F

    2016-01-01

    Epstein-Barr virus (EBV) is ubiquitous: over 90% of the adult population is infected with this virus. EBV is capable of infecting both B lymphocytes and epithelial cells throughout the body including the head and neck region. Transmission occurs mainly by exchange of saliva. The infection is asymptomatic or mild in children but, in adolescents and young adults, it causes infectious mononucleosis, a self-limiting disease characterized by lethargy, sore throat, fever and lymphadenopathy. Once established, the virus often remains latent and people become lifelong carriers without experiencing disease. However, in some people, the latent virus is capable of causing malignant tumours, such as nasopharyngeal carcinoma and various B- and T-cell lymphomas, at sites including the head, neck and oropharyngeal region. As lymphoma is the second-most common malignant disease of the head, neck and oral region after squamous cell carcinoma, oral health care workers including dentists and specialists have a responsibility to carry out a thorough clinical examination of this anatomical region with a view to identifying and diagnosing lesions that may represent lymphomas. Early detection allows early treatment resulting in better prognosis. The focus of this review is on the morphology, transmission and carcinogenic properties of EBV and clinical and diagnostic aspects of a range of EBV-associated malignancies occurring in the head, neck and oral region. As carcinogenic agents, viruses contribute to a significant proportion of the global cancer burden: approximately 15% of all human cancers, worldwide, are attributable to viruses.1,2 Serologic and epidemiologic studies are providing mounting evidence of an etiologic association between viruses and head and neck malignancies.3 To update oral and maxillofacial surgeons and oral medicine specialists and raise awareness of this association, we recently reviewed the evidence of the etiologic role of human papillomavirus in oral disease.4

  20. FDG uptake in cervical lymph nodes in children without head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Vali, Reza; Bakari, Alaa A.; Marie, Eman; Kousha, Mahnaz; Shammas, Amer [University of Toronto, Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON (Canada); Charron, Martin [Brampton Nuclear Services, Toronto, ON (Canada)

    2017-06-15

    Reactive cervical lymphadenopathy is common in children and may demonstrate increased {sup 18}F-fluoro-deoxyglucose ({sup 18}F-FDG) uptake on positron emission tomography/computed tomography (PET/CT). We sought to evaluate the frequency and significance of {sup 18}F-FDG uptake by neck lymph nodes in children with no history of head and neck cancer. The charts of 244 patients (114 female, mean age: 10.4 years) with a variety of tumors such as lymphoma and post-transplant lymphoproliferative diseases (PTLD), but no head and neck cancers, who had undergone {sup 18}F-FDG PET/CT were reviewed retrospectively. Using the maximum standardized uptake value (SUVmax), increased {sup 18}F-FDG uptake by neck lymph nodes was recorded and compared with the final diagnosis based on follow-up studies or biopsy results. Neck lymph node uptake was identified in 70/244 (28.6%) of the patients. In 38 patients, the lymph nodes were benign. In eight patients, the lymph nodes were malignant (seven PTLD and one lymphoma). In 24 patients, we were not able to confirm the final diagnosis. Seven out of the eight malignant lymph nodes were positive for PTLD. The mean SUVmax was significantly higher in malignant lesions (4.2) compared with benign lesions (2.1) (P = 0.00049). {sup 18}F-FDG uptake in neck lymph nodes is common in children and is frequently due to reactive lymph nodes, especially when the SUVmax is <3.2. The frequency of malignant cervical lymph nodes is higher in PTLD patients compared with other groups. (orig.)

  1. Image cytometric nuclear texture features in inoperable head and neck cancer: a pilot study

    International Nuclear Information System (INIS)

    Strojan-Flezar, Margareta; Lavrencak, Jaka; Zganec, Mario; Strojan, Primoz

    2011-01-01

    Image cytometry can measure numerous nuclear features which could be considered a surrogate end-point marker of molecular genetic changes in a nucleus. The aim of the study was to analyze image cytometric nuclear features in paired samples of primary tumor and neck metastasis in patients with inoperable carcinoma of the head and neck. Image cytometric analysis of cell suspensions prepared from primary tumor tissue and fine needle aspiration biopsy cell samples of neck metastases from 21 patients treated with concomitant radiochemotherapy was performed. Nuclear features were correlated with clinical characteristics and response to therapy. Manifestation of distant metastases and new primaries was associated (p<0.05) with several chromatin characteristics from primary tumor cells, whereas the origin of index cancer and disease response in the neck was related to those in the cells from metastases. Many nuclear features of primary tumors and metastases correlated with the TNM stage. A specific pattern of correlation between well-established prognostic indicators and nuclear features of samples from primary tumors and those from neck metastases was observed. Image cytometric nuclear features represent a promising candidate marker for recognition of biologically different tumor subgroups

  2. [Epidemiology, diagnosis and treatment of head and neck cancers].

    Science.gov (United States)

    Dubray-Vautrin, Antoine; Ballivet de Régloix, Stanislas; Girod, Angélique; Jouffroy, Thomas; Rodriguez, Joseph

    2015-09-01

    Cancers of the upper aerodigestive tracts are the fourth most common cancer in France. The main risk factors are smoking and alcohol. They do not necessarily present specific signs, making their early diagnosis difficult. A change in the patient's general condition is a late sign leading to a poor prognosis of the disease. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  3. National evaluation of multidisciplinary quality metrics for head and neck cancer.

    Science.gov (United States)

    Cramer, John D; Speedy, Sedona E; Ferris, Robert L; Rademaker, Alfred W; Patel, Urjeet A; Samant, Sandeep

    2017-11-15

    The National Quality Forum has endorsed quality-improvement measures for multiple cancer types that are being developed into actionable tools to improve cancer care. No nationally endorsed quality metrics currently exist for head and neck cancer. The authors identified patients with surgically treated, invasive, head and neck squamous cell carcinoma in the National Cancer Data Base from 2004 to 2014 and compared the rate of adherence to 5 different quality metrics and whether compliance with these quality metrics impacted overall survival. The metrics examined included negative surgical margins, neck dissection lymph node (LN) yield ≥ 18, appropriate adjuvant radiation, appropriate adjuvant chemoradiation, adjuvant therapy within 6 weeks, as well as overall quality. In total, 76,853 eligible patients were identified. There was substantial variability in patient-level adherence, which was 80% for negative surgical margins, 73.1% for neck dissection LN yield, 69% for adjuvant radiation, 42.6% for adjuvant chemoradiation, and 44.5% for adjuvant therapy within 6 weeks. Risk-adjusted Cox proportional-hazard models indicated that all metrics were associated with a reduced risk of death: negative margins (hazard ratio [HR] 0.73; 95% confidence interval [CI], 0.71-0.76), LN yield ≥ 18 (HR, 0.93; 95% CI, 0.89-0.96), adjuvant radiation (HR, 0.67; 95% CI, 0.64-0.70), adjuvant chemoradiation (HR, 0.84; 95% CI, 0.79-0.88), and adjuvant therapy ≤6 weeks (HR, 0.92; 95% CI, 0.89-0.96). Patients who received high-quality care had a 19% reduced adjusted hazard of mortality (HR, 0.81; 95% CI, 0.79-0.83). Five head and neck cancer quality metrics were identified that have substantial variability in adherence and meaningfully impact overall survival. These metrics are appropriate candidates for national adoption. Cancer 2017;123:4372-81. © 2017 American Cancer Society. © 2017 American Cancer Society.

  4. Compliance of post-radiation therapy head and neck cancer patients with caries preventive protocols.

    Science.gov (United States)

    Frydrych, A M; Slack-Smith, L M; Parsons, R

    2017-06-01

    Caries prevention is paramount in safeguarding the life quality of head and neck cancer patients and is dependent on patient compliance with caries preventive protocols. The purpose of this study was to examine this compliance. All records of patients referred to one public oral medicine clinic servicing a head and neck oncology unit of one major Western Australian hospital, between January 2005 and December 2011, were examined. Data extracted included patient and cancer characteristics and compliance with dietary advice, dental care, oral hygiene instruction and fluoride use over a follow-up period of at least 12 months. Compliance was assessed against various oral health outcomes and patient characteristics. Of the 116 participants, 75.9% complied with all caries preventive measures over a mean follow-up period of 45 months. Non-compliance with regular dental attendance (P = 0.004), oral hygiene instruction (P = 0.009), dietary advice (P = 0.034) and daily fluoride use (P = 0.018) were associated with the development of dental caries post-treatment. The presence of dental caries at the time of cancer diagnosis was predictive of poorer compliance. High compliance with caries preventive measures is attainable in the head and neck cancer patient group. Factors other than fluoride use seem important in caries prevention. © 2016 Australian Dental Association.

  5. Dysphagia after sequential chemoradiation therapy for advanced head and neck cancer.

    Science.gov (United States)

    Goguen, Laura A; Posner, Marshall R; Norris, Charles M; Tishler, Roy B; Wirth, Lori J; Annino, Donald J; Gagne, Adele; Sullivan, Christopher A; Sammartino, Daniel E; Haddad, Robert I

    2006-06-01

    Assess impact of sequential chemoradiation therapy (SCRT) for advanced head and neck cancer (HNCA) on swallowing, nutrition, and quality of life. Prospective cohort study of 59 patients undergoing SCRT for advanced head and neck cancer. Follow-up median was 47.5 months. Regional Cancer Center. Median time to gastrostomy tube removal was 21 weeks. Eighteen of 23 patients who underwent modified barium swallow demonstrated aspiration; none developed pneumonia. Six of 7 with pharyngoesophageal stricture underwent successful dilatation. Functional Assessment of Cancer Therapy-Head and Neck Scale questionnaires at median 6 months after treatment revealed "somewhat" satisfaction with swallowing. At the time of analysis, 97% have the gastronomy tube removed and take soft/regular diet. Early after treatment dysphagia adversely affected weight, modified barium swallow results, and quality of life. Diligent swallow therapy, and dilation as needed, allowed nearly all patients to have their gastronomy tubes removed and return to a soft/regular diet. Dysphagia is significant after SCRT but generally slowly recovers 6 to 12 months after SCRT. C-4.

  6. MicroRNAs as new biomarkers for human papilloma virus related head and neck cancers.

    Science.gov (United States)

    Wang, Yuhan; Wang, Jie; Huang, Yuanshuai

    2015-01-01

    Head and neck cancers are the sixth most common cancer in the world and the predominant type of which consist of squamous cell carcinomas (head and neck squamous cell carcinoma, HNSCC). Besides tobacco smoking and alcohol consumption, human papilloma virus (HPV) infection is the third leading cause of the occurrence of HNSCC. The presence of HPV is a distinct group of head and neck cancers exhibiting epidemiological, histopathological, clinical and prognostic differences opposed to the typical HNSCC. HPV positive HNSCC normally have a favorable prognosis compared with HPV negative HNSCC, so biomarkers suitable for the early detection of HPV positive HNSCC should be developed urgently to improve patient outcomes. HPV DNA screening is sensitive, but probably not useful because of the high prevalence of oral HPV and low risk of HNSCC. MicroRNAs (miRNAs) constitute a class of small non-coding RNAs that act as post-transcriptional regulators of gene expression. Since miRNAs have a role in the cancer development and HPV status may affect the miRNAs expression pattern in HNSCC, the specific of miRNAs' expression in HPV positive HNSCC may expound the role of HPV in HNSCC and be new biomarkers for the early detection of HNSCC. More excitingly, saliva as proximal biofluid in the context of HNSCC contains a good deal of miRNAs. These miRNAs are stabile and may be suitable for noninvasive biomarkers of HNSCC.

  7. Dysphagia severity following chemoradiation and postoperative radiation for head and neck cancer

    International Nuclear Information System (INIS)

    Nguyen, Nam P.; Moltz, Candace C.; Frank, Cheryl; Karlsson, Ulf; Nguyen, Phuc D.; Vos, Paul; Smith, Herbert J.; Dutta, Suresh; Nguyen, Ly M.; Lemanski, Claire; Chan, Wayne; Sallah, Sabah

    2006-01-01

    Objective: The purpose of the study is to evaluate dysphagia severity following chemoradiation and postoperative radiation for head and neck cancer, and particularly the aspiration risk because of its potential life-threatening consequence. Materials and methods: We reviewed retrospectively the modified barium swallow (MBS) results in 110 patients who complained of dysphagia following chemoradiation (57) and postoperative radiation (53) of their head and neck cancer. Patients were selected if they were cancer free at the time of the swallowing study. Dysphagia severity was graded on a scale of 1-7. Patients were grouped according to the dysphagia severity: mild (grades 2-3), moderate (grades 4-5), and severe (grades 6-7). Results: Mean and median dysphagia grades were 4.84/5 and 4.12/4 for chemoradiation and postoperative radiation respectively. The mean difference between the two groups is statistically significant (p = 0.02). Mild dysphagia occurred in 13 patients (22%) of the chemoradiation group and 17 (32%) of the postoperative group. Corresponding number for the moderate group was 25 (43%) and 25 (48%), respectively. Severe dysphagia was significant in the chemoradiation group (34%) compared to the postoperative group (19%). However, the difference was not statistically significant (p = 0.29). There was a higher proportion of patients with large tumor (T3-T4) in the chemoradiation group who developed severe dysphagia. Conclusion: Dysphagia remained a significant morbidity of chemoradiation and postoperative radiation for head and neck cancer. Dysphagia may be more severe in the chemoradiation group because of the higher proportion of patients with large tumor, the high radiation dose, and a high number of oropharyngeal tumors. Aspiration occurred in both groups. Diagnostic studies such as MBS should be part of future head and neck cancer prospective studies to assess the prevalence of aspiration, as it may be silent

  8. Radial displacement of clinical target volume in node negative head and neck cancer

    International Nuclear Information System (INIS)

    Jeon, Wan; Wu, Hong Gyun; Song, Sang Hyuk; Kim, Jung In

    2012-01-01

    To evaluate the radial displacement of clinical target volume in the patients with node negative head and neck (H and N) cancer and to quantify the relative positional changes compared to that of normal healthy volunteers. Three node-negative H and N cancer patients and fi ve healthy volunteers were enrolled in this study. For setup accuracy, neck thermoplastic masks and laser alignment were used in each of the acquired computed tomography (CT) images. Both groups had total three sequential CT images in every two weeks. The lymph node (LN) level of the neck was delineated based on the Radiation Therapy Oncology Group (RTOG) consensus guideline by one physician. We use the second cervical vertebra body as a reference point to match each CT image set. Each of the sequential CT images and delineated neck LN levels were fused with the primary image, then maximal radial displacement was measured at 1.5 cm intervals from skull base (SB) to caudal margin of LN level V, and the volume differences at each node level were quantified. The mean radial displacements were 2.26 (±1.03) mm in the control group and 3.05 (±1.97) in the H and N cancer patients. There was a statistically significant difference between the groups in terms of the mean radial displacement (p = 0.03). In addition, the mean radial displacement increased with the distance from SB. As for the mean volume differences, there was no statistical significance between the two groups. This study suggests that a more generous radial margin should be applied to the lower part of the neck LN for better clinical target coverage and dose delivery.

  9. Differences of symptoms in head and neck cancer patients with and without lymphedema.

    Science.gov (United States)

    Deng, Jie; Murphy, Barbara A; Dietrich, Mary S; Sinard, Robert J; Mannion, Kyle; Ridner, Sheila H

    2016-03-01

    Head and neck cancer (HNC) patients are at risk for developing external and internal lymphedema. Currently, no documentation of symptom differences between individuals with and without head and neck lymphedema is available. The purpose of this analysis was to examine symptom differences among HNC patients with and without lymphedema. Data were drawn from three cross-sectional studies of HNC patients >3 months post-cancer treatment (total N = 163; 128 patients with lymphedema, 35 without lymphedema). External lymphedema was evaluated via physical examination; internal lymphedema was identified through endoscopic examination. Participant's head and neck lymphedema status was categorized into two groups: no indication of external or internal lymphedema and at least some indication of external or internal lymphedema. Lymphedema Symptom Intensity and Distress Survey-Head and Neck (LSIDS-H&N) was used to assess symptom burden. Descriptive statistics, McNemar, chi-squared, Wilcoxon signed-ranks, and Mann-Whitney tests were used. Twenty-three pairs of patients were identified and matched on the age, primary tumor site, tumor stage, and time since end of cancer treatment. Relative to patients without lymphedema, matched patients with lymphedema reported either increased symptom prevalence or severity or distress level for the following symptoms (prevalence differences of at least 15 % between the matched groups and p < 0.05): (1) numbness; (2) tightness; (3) heaviness; (4) warmth; (5) pain without head/neck movement; (6) problems swallowing mashed or pureed foods; (7) trouble breathing; (8) blurred vision; (9) feel worse when flying in an airplane; and (10) swelling. Findings suggest that HNC-related lymphedema may be associated with substantial symptom burden. Studies with larger sample sizes are needed to replicate the findings.

  10. Radial displacement of clinical target volume in node negative head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Wan; Wu, Hong Gyun; Song, Sang Hyuk; Kim, Jung In [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2012-03-15

    To evaluate the radial displacement of clinical target volume in the patients with node negative head and neck (H and N) cancer and to quantify the relative positional changes compared to that of normal healthy volunteers. Three node-negative H and N cancer patients and fi ve healthy volunteers were enrolled in this study. For setup accuracy, neck thermoplastic masks and laser alignment were used in each of the acquired computed tomography (CT) images. Both groups had total three sequential CT images in every two weeks. The lymph node (LN) level of the neck was delineated based on the Radiation Therapy Oncology Group (RTOG) consensus guideline by one physician. We use the second cervical vertebra body as a reference point to match each CT image set. Each of the sequential CT images and delineated neck LN levels were fused with the primary image, then maximal radial displacement was measured at 1.5 cm intervals from skull base (SB) to caudal margin of LN level V, and the volume differences at each node level were quantified. The mean radial displacements were 2.26 ({+-}1.03) mm in the control group and 3.05 ({+-}1.97) in the H and N cancer patients. There was a statistically significant difference between the groups in terms of the mean radial displacement (p = 0.03). In addition, the mean radial displacement increased with the distance from SB. As for the mean volume differences, there was no statistical significance between the two groups. This study suggests that a more generous radial margin should be applied to the lower part of the neck LN for better clinical target coverage and dose delivery.

  11. Advances in Supportive Care for Late Effects of Head and Neck Cancer.

    Science.gov (United States)

    Murphy, Barbara A; Deng, Jie

    2015-10-10

    As the population of head and neck cancer survivors increases, it has become increasingly important for health care providers to understand and manage late complications of therapy. Functional deficits can be categorized as general health deficits resulting in frailty or debility, head and neck-specific functional deficits such as swallowing and speech, and musculoskeletal impairment as a result of tumor and treatment. Of critical importance is the growing data indicating that swallow therapy and physical therapy may prevent or ameliorate long-term functional deficits. Oral health complications of head and neck therapy may manifest months or years after the completion of treatment. Patients with hyposalivation are at high risk for dental caries and thus require aggressive oral hygiene regimens and routine dental surveillance. Swallowing abnormalities, xerostomia, and poor dentition may result in dietary adaptations that may cause nutritional deficiencies. Identification and management of maladaptive dietary strategies are important for long-term health. Follow-up with primary care physicians for management of comorbidities such as diabetes and hyperlipidemia may help to limit late vascular complications caused by radiation therapy. Herein, we review late effects of head and neck cancer therapy, highlighting recent advances. © 2015 by American Society of Clinical Oncology.

  12. Effects of radiation on the temporal bone in patients with head and neck cancer.

    Science.gov (United States)

    Lambert, Elton M; Gunn, G Brandon; Gidley, Paul W

    2016-09-01

    Radiotherapy is a key component in the treatment of many head and neck cancers, and its potential to cause long-term adverse effects has become increasingly recognized. In this review, we describe the short-term and long-term sequelae of radiation-associated changes in and injury to the temporal bone and its related structures. The pathophysiology of radiation-induced injury and its clinical entities, including sensorineural hearing loss, chronic otitis media, osteoradionecrosis, and radiation-associated malignancies, are described. We also discuss radiation dose to the head and neck as it relates to these conditions. An improved understanding of radiation's effects on the temporal bone will enable physicians and researchers to continue efforts to reduce radiotherapy-related sequelae and guide clinicians in diagnosing and treating the various otologic conditions that can arise in patients with head and neck cancer who have received radiotherapy. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1428-1435, 2016. © 2016 Wiley Periodicals, Inc.

  13. The Prevalence of Xerostomia Occurrence after Doing Radiation Therapy in Patients with Head and Neck Cancer

    Directory of Open Access Journals (Sweden)

    Barunawaty Yunus

    2017-04-01

    Full Text Available Xerostomia is one side effect of radiation therapy that most commonly affects head and neck. This situation is a symptom and not a disease which is generally associated with reduced saliva. For patients this situation is not pleasant and for dentist, this symptom is considered as a challenging case. This research intended to know the prevalence of xerostomia after radiation therapy in cancer patients with head and neck area. The subjects of this study were patients with head and neck area cancer who underwent radiotherapy treatment at Hasanuddin University teaching hospital, subjects were then taken saliva before and after given a total dose of 20 Gy and a total dose of 40 Gy. The analysis of the data processed by the computer program and the Wilcoxon test significance level is accepted when p<0.05. The mean bulk saliva before radiotherapy was higher than average rainfall saliva after radiotherapy total dose of 20 Gy and 40 Gy. Radiotherapy of the head and neck area total dose of 20 Gy and 40 Gy may affect rainfall saliva so that patients feel the symptoms of xerostomia.

  14. Role of radiotherapy fractionation in head and neck cancers (MARCH)

    DEFF Research Database (Denmark)

    Lacas, Benjamin; Bourhis, Jean; Overgaard, Jens

    2017-01-01

    BACKGROUND: The Meta-Analysis of Radiotherapy in squamous cell Carcinomas of Head and neck (MARCH) showed that altered fractionation radiotherapy is associated with improved overall and progression-free survival compared with conventional radiotherapy, with hyperfractionated radiotherapy showing...... the greatest benefit. This update aims to confirm and explain the superiority of hyperfractionated radiotherapy over other altered fractionation radiotherapy regimens and to assess the benefit of altered fractionation within the context of concomitant chemotherapy with the inclusion of new trials. METHODS......: For this updated meta-analysis, we searched bibliography databases, trials registries, and meeting proceedings for published or unpublished randomised trials done between Jan 1, 2009, and July 15, 2015, comparing primary or postoperative conventional fractionation radiotherapy versus altered fractionation...

  15. Dysphagia in head and neck cancer patients treated with radiotherapy and systemic therapies : Literature review and consensus

    NARCIS (Netherlands)

    Schindler, Antonio; Denaro, Nerina; Russi, Elvio G.; Pizzorni, Nicole; Bossi, Paolo; Merlotti, Anna; Bissetti, Massimo Spadola; Numico, Gianmauro; Gava, Alessandro; Orlandi, Ester; Caspiani, Orietta; Buglione, Michela; Alterio, Daniela; Bacigalupo, Almalina; De Sanctis, Vitaliana; Pavanato, Giovanni; Ripamonti, Carla; Merlano, Marco C.; Licitra, Lisa; Sanguineti, Giuseppe; Langendijk, Johannes A.; Murphy, Barbara

    2015-01-01

    Background: Head and neck cancer (HNC) and its therapy are associated with acute and late swallowing dysfunction. Consensus guidelines regarding evaluation and management are lacking. To address this gap, a multidisciplinary team of experts (oncologists, practitioners, deglutologists, etc.) met in

  16. Automatic Speech Recognition Systems for the Evaluation of Voice and Speech Disorders in Head and Neck Cancer

    OpenAIRE

    Andreas Maier; Tino Haderlein; Florian Stelzle; Elmar Nöth; Emeka Nkenke; Frank Rosanowski; Anne Schützenberger; Maria Schuster

    2010-01-01

    In patients suffering from head and neck cancer, speech intelligibility is often restricted. For assessment and outcome measurements, automatic speech recognition systems have previously been shown to be appropriate for objective and quick evaluation of intelligibility. In this study we investigate the applicability of the method to speech disorders caused by head and neck cancer. Intelligibility was quantified by speech recognition on recordings of a standard text read by 41 German laryngect...

  17. Quality of Life of Head and Neck Cancer Patients Receiving Cancer Specific Treatments

    Directory of Open Access Journals (Sweden)

    James Gonsalves

    2013-01-01

    Full Text Available Background: Head and neck cancer (HNC remains a considerable challenge to both patient and health care provider as the disease can have profound effect on Quality of life (QOL. Aims and Objectives: To assess the QOL and performance status of HNC patients, to find relation between domains of QOL and to find association between QOL and demographic and disease variables. Settings and Design: The study was conducted at Manipal group of hospitals, Manipal and Mangalore, using descriptive survey design. Material and Methods: The study comprised of 89 samples with all stages of HNC. Patients primarily diagnosed with HNC and undergoing disease specific treatment were included in the study. Tool on demographic, disease variables and quality of life were developed and content validity was established. Reliability of the tool was established. Karnofsky Performance Status (KPS scale was used to assess performance status. Corelational analysis was done to find relation between the domains of QOL. Association was found between the quality of life and demographic and disease variables. Results: Majority (83% of the participants were males, 39% had cancer arising from oral cavity, and 35% each were in cancer stage III and IV. Quality of life was poor among 30% of the subjects and 65% had KPS scores<80 %. There was moderate positive relation between the domains of QOL and a positive correlation between the QOL and performance status. No statistically significant association was found between QOL and disease and demographic variables. Conclusion: Physical, psychological, social and spiritual domains of QOL and functional status are affected in patients with HNC. The impact on one domain area of well being, significantly affects the other domain of QOL and there is relationship between the performance status and QOL

  18. Evaluation, prevention and management of radiotherapy-induced xerostomia in head and neck cancer patients.

    Science.gov (United States)

    de Castro, Gilberto; Federico, Miriam Hatsue Honda

    2006-05-01

    As part of the multidisciplinary approach to head and neck cancer patients, radiation therapy plays an essential role, improving locoregional control. Radiation therapy-induced xerostomia is a late side-effect that increases the risk for developing dental caries and compromises oral mucosal integrity, resulting in oral pain, loss of taste, difficulties with swallowing and chewing, sleep disorders and worse quality of life. This review focuses on evaluation, prevention and management of radiation therapy-induced xerostomia. In terms of xerostomia prevention, some clinical trials evaluating amifostine and intensity-modulated radiation therapy have shown positive results. Pilocarpine is a useful agent as a treatment of radiation-induced xerostomia in head and neck cancer patients. Despite some advances in radiation therapy-induced xerostomia prevention, its treatment is an area in which advances are urgently needed.

  19. Pain management in head and neck cancer patients undergoing chemo-radiotherapy: Clinical practical recommendations.

    Science.gov (United States)

    Mirabile, A; Airoldi, M; Ripamonti, C; Bolner, A; Murphy, B; Russi, E; Numico, G; Licitra, L; Bossi, P

    2016-03-01

    Pain in head and neck cancer represents a major issue, before, during and after the oncological treatments. The most frequent cause of pain is chemo/radiation related oral mucositis, which involves 80% of the patients and worsens their quality of life inhibiting speaking, eating, drinking or swallowing and sometimes reducing the treatment compliance, the maximum dose intensity and thus the potential efficacy of treatment. Nevertheless pain is still often under estimated and undertreated. An Italian multidisciplinary group of head and neck cancer specialists met with the aim of reaching a consensus on pain management in this setting. The Delphi Appropriateness method was used for the consensus. External expert reviewers evaluated the final statements. The paper contains 30 consensus-reached statements about pain management in HNC patients and offers a review of recent literature in these topics. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. Cigarette smoking prior to first cancer and risk of second smoking-associated cancers among survivors of bladder, kidney, head and neck, and stage I lung cancers.

    Science.gov (United States)

    Shiels, Meredith S; Gibson, Todd; Sampson, Joshua; Albanes, Demetrius; Andreotti, Gabriella; Beane Freeman, Laura; Berrington de Gonzalez, Amy; Caporaso, Neil; Curtis, Rochelle E; Elena, Joanne; Freedman, Neal D; Robien, Kim; Black, Amanda; Morton, Lindsay M

    2014-12-10

    Data on smoking and second cancer risk among cancer survivors are limited. We assessed associations between smoking before first cancer diagnosis and risk of second primary smoking-associated cancers among survivors of lung (stage I), bladder, kidney, and head/neck cancers. Data were pooled from 2,552 patients with stage I lung cancer, 6,386 with bladder cancer, 3,179 with kidney cancer, and 2,967 with head/neck cancer from five cohort studies. We assessed the association between prediagnostic smoking and second smoking-associated cancer risk with proportional hazards regression, and compared these estimates to those for first smoking-associated cancers in all cohort participants. Compared with never smoking, current smoking of ≥ 20 cigarettes per day was associated with increased second smoking-associated cancer risk among survivors of stage I lung (hazard ratio [HR] = 3.26; 95% CI, 0.92 to 11.6), bladder (HR = 3.67; 95% CI, 2.25 to 5.99), head/neck (HR = 4.45; 95% CI, 2.56 to 7.73), and kidney cancers (HR = 5.33; 95% CI, 2.55 to 11.1). These estimates were similar to those for first smoking-associated cancer among all cohort participants (HR = 5.41; 95% CI, 5.23 to 5.61). The 5-year cumulative incidence of second smoking-associated cancers ranged from 3% to 8% in this group of cancer survivors. Understanding risk factors for second cancers among cancer survivors is crucial. Our data indicate that cigarette smoking before first cancer diagnosis increases second cancer risk among cancer survivors, and elevated cancer risk in these survivors is likely due to increased smoking prevalence. The high 5-year cumulative risks of smoking-associated cancers among current smoking survivors of stage I lung, bladder, kidney, and head/neck cancers highlight the importance of smoking cessation in patients with cancer. © 2014 by American Society of Clinical Oncology.

  1. Health-Related Quality of Life 2 Years After Treatment With Radical Prostatectomy, Prostate Brachytherapy, or External Beam Radiotherapy in Patients With Clinically Localized Prostate Cancer

    International Nuclear Information System (INIS)

    Ferrer, Montserrat; Suarez, Jose Francisco; Guedea, Ferran; Fernandez, Pablo; Macias, Victor; Marino, Alfonso; Hervas, Asuncion; Herruzo, Ismael; Ortiz, Maria Jose; Villavicencio, Humberto; Craven-Bratle, Jordi; Garin, Olatz; Aguilo, Ferran

    2008-01-01

    Purpose: To compare treatment impact on health-related quality of life (HRQL) in patients with localized prostate cancer, from before treatment to 2 years after the intervention. Methods and Materials: This was a longitudinal, prospective study of 614 patients with localized prostate cancer treated with radical prostatectomy (134), three-dimensional external conformal radiotherapy (205), and brachytherapy (275). The HRQL questionnaires administered before and after treatment (months 1, 3, 6, 12, and 24) were the Medical Outcomes Study 36-Item Short Form, the Functional Assessment of Cancer Therapy (General and Prostate Specific), the Expanded Prostate Cancer Index Composite (EPIC), and the American Urological Association Symptom Index. Differences between groups were tested by analysis of variance and within-group changes by univariate repeated-measures analysis of variance. Generalized estimating equations (GEE) models were constructed to assess between-group differences in HRQL at 2 years of follow-up after adjusting for clinical variables. Results: In each treatment group, HRQL initially deteriorated after treatment with subsequent partial recovery. However, some dimension scores were still significantly lower after 2 years of treatment. The GEE models showed that, compared with the brachytherapy group, radical prostatectomy patients had worse EPIC sexual summary and urinary incontinence scores (-20.4 and -14.1; p < 0.001), and external radiotherapy patients had worse EPIC bowel, sexual, and hormonal summary scores (-3.55, -5.24, and -1.94; p < 0.05). Prostatectomy patients had significantly better EPIC urinary irritation scores than brachytherapy patients (+4.16; p < 0.001). Conclusions: Relevant differences between treatment groups persisted after 2 years of follow-up. Radical prostatectomy had a considerable negative effect on sexual functioning and urinary continence. Three-dimensional conformal radiotherapy had a moderate negative impact on bowel

  2. Variables associated with feeding tube placement in head and neck cancer.

    Science.gov (United States)

    Cheng, Sara S; Terrell, Jeffrey E; Bradford, Carol R; Ronis, David L; Fowler, Karen E; Prince, Mark E; Teknos, Theodoros N; Wolf, Gregory T; Duffy, Sonia A

    2006-06-01

    To identify clinical factors associated with enteral feeding tube placement in a head and neck cancer population. A self-administered survey was given to patients being treated for head and neck cancer while they were waiting to be seen in 1 of 4 otolaryngology clinics. The post hoc analysis presented here combines survey and chart review data to determine clinical and demographic variables associated with feeding tube placement. Four otolaryngology clinics. Otolaryngology clinic patients being treated for head and neck cancer. Enteral feeding tube placement. Of the 724 patients eligible for this study, 14% (n = 98) required enteral feeding tube placement. Multivariate analysis found the following variables to be independently associated with feeding tube placement: oropharynx/hypopharynx tumor site (odds ratio [OR], 2.4; P = .01), tumor stage III/IV (OR, 2.1; P = .03), flap reconstruction (OR, 2.2; P = .004), current tracheotomy (OR, 8.0; P<.001), chemotherapy (OR, 2.6; P<.001), and increased age (OR, 1.3; P = .02). In addition, there was a curvilinear relationship between time since treatment and feeding tube placement, with about 30% having a feeding tube at 1 month posttreatment, tapering down during the first 3 years to about 8% and leveling off thereafter. Identification of factors associated with an increased risk of feeding tube placement may allow physicians to better counsel patients regarding the possibility of feeding tube placement during treatment. Since feeding tube placement has been linked to decreased quality of life in head and neck cancer, such counseling is an integral part of the clinical management of these patients.

  3. Transaminase Activity Predicts Survival in Patients with Head and Neck Cancer

    OpenAIRE

    Takenaka, Yukinori; Takemoto, Norihiko; Yasui, Toshimichi; Yamamoto, Yoshifumi; Uno, Atsuhiko; Miyabe, Haruka; Ashida, Naoki; Shimizu, Kotaro; Nakahara, Susumu; Hanamoto, Atshushi; Fukusumi, Takahito; Michiba, Takahiro; Cho, Hironori; Yamamoto, Masashi; Inohara, Hidenori

    2016-01-01

    Various serum biomarkers have been developed for predicting head and neck squamous cell carcinoma (HNSCC) prognosis. However, none of them have been proven to be clinically significant. A recent study reported that the ratio of aspartate aminotransaminase (AST) to alanine aminotransaminase (ALT) had a prognostic effect on non-metastatic cancers. This study aimed to examine the effect of the AST/ALT ratio on the survival of patients with HNSCC. Clinical data of 356 patients with locoregionally...

  4. Affiliation to the work market after curative treatment of head-and-neck cancer

    DEFF Research Database (Denmark)

    Kjær, Trille; Bøje, Charlotte Rotbøl; Olsen, Maja Halgren

    2013-01-01

    Survivors of squamous cell carcinoma of the head and neck (HNSCC) are more severely affected in regard to affiliation to the work market than other cancer survivors. Few studies have investigated associations between socioeconomic and disease-related factors and work market affiliation after...... curative treatment of HNSCC. We investigated the factors for early retirement pension due to disability and unemployment in patients who had been available for work one year before diagnosis....

  5. Residue influences quality of life independently of penetration and aspiration in head and neck cancer survivors.

    Science.gov (United States)

    Meyer, Tanya K; Pisegna, Jessica M; Krisciunas, Gintas P; Pauloski, Barbara R; Langmore, Susan E

    2017-07-01

    Dysphagia is one of the most significant side effects of the treatment of head and neck cancer. Residue and aspiration are two indicators of dysphagia, but aspiration is historically the only indicator of interest, because it may impact health outcomes. Clinicians have anecdotally used residue as another marker of swallowing dysfunction, but it is understudied. This project investigated the impact of aspiration versus residue on function and quality of life (QoL) in these patients. Observational study. A total of 168 head and neck cancer survivors with moderate to severe dysphagia were enrolled in a randomized clinical trial comparing two swallow therapy interventions. Data at time of entry were used for the current study. A modified barium swallow study was done to compute Penetration-Aspiration Scale (PAS) scores, percentage oral residue, and percentage pharyngeal residue with three bolus consistencies (5 mL thin, nectar, and pudding). The Performance Status Scale (PSS) and the Head Neck Cancer Inventory (HNCI) questionnaires were administered. Data were analyzed to determine associations between aspiration and residue estimates with function and QoL scores. Worsening aspiration and residue estimates were all correlated with decreased scores on the PSS functional scales (r = -0.190 to -0.324, P ≤ .031). However, only increasing residue estimates were significantly related to decreased patient-perceived QoL on the HNCI (r = -.178 to -.194, P < .046). This effect was more pronounced with oral versus pharyngeal residue. In this group of head and neck cancer survivors, penetration/aspiration and residue show independent effects. PAS affects functional status only, but residue affects both functional status and QoL. This study supports that residue should be considered a primary measurement of swallowing function and be a target for identification, treatment, and evaluation of swallowing. 2c. Laryngoscope, 127:1615-1621, 2017. © 2016 The American Laryngological

  6. Effects of irradiation on nasal mucociliary clearance in head and neck cancer patients

    OpenAIRE

    Gupta, S. C.; Chandra, S.; Singh, M.

    2006-01-01

    A prospective longitudinal study was conducted on fifty patients of histopathologically confirmed head and neck cancer with the main aim to assess the nasal mucociliary clearance, pre-and post-irradiation; and to compare the findings with the healthy non-irradiated age and sex-matched controls. All the patients underwent saccharin particle test for nasal mucociliary clearance before commencement of radiation therapy and again within 6 months of completion of radiation therapy. The difference ...

  7. Early-onset dropped head syndrome after radiotherapy for head and neck cancer: dose constraints for neck extensor muscles

    International Nuclear Information System (INIS)

    Inaba, Koji; Nakamura, Satoshi; Okamoto, Hiroyuki; Kashihara, Tairo; Kobayashi, Kazuma; Harada, Ken; Kitaguchi, Mayuka; Sekii, Shuhei; Takahashi, Kana; Murakami, Naoya; Ito, Yoshinori; Igaki, Hiroshi; Uno, Takashi; Itami, Jun

    2016-01-01

    Dropped head syndrome (DHS) is a famous but unusual late complication of multimodality treatment for head and neck carcinoma. We reported this early-onset complication and analyzed the dose to the neck extensor muscles. We examined the records of three patients with DHS after radiotherapy. The doses to the neck extensor muscles were compared between three patients with DHS and nine patients without DHS. The mean dose to the neck extensor muscles of the three patients with DHS were 58.5 Gy, 42.3 Gy and 60.9 Gy, while the dose was <50 Gy in all nine patients in the control group. The onset of this syndrome was 5 months, 6 months and 15 months. The early-onset DHS may have something to do with dose to the neck extensor muscles. The proposed dose to the neck extensor muscles might be <46 Gy (or at least <50 Gy)

  8. Daily amifostine given concomitantly to chemoradiation in head and neck cancer. A pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Trog, D.; Bank, P.; Wendt, T.G. [Friedrich-Schiller Univ., Jena (Germany). Dept. of Radiation Oncology; Koscielny, S.; Beleites, E. [Friedrich-Schiller Univ., Jena (Germany). Dept. of Ear Nose Throat Diseases

    1999-09-01

    Background: In patients with loco-regionally advanced head and neck cancer conventionally fractionated radiotherapy alone results in poor loco-regional control and survival rates. Treatment intensification by simultaneous administration of cytotoxic drugs produces higher acute morbidity. Therefore chemical radioprotection of normal tissues may be of clinical benefit. Patients and Methods: In a pilot study patients with advanced nonresectable head neck cancer treated with conventionally fractionated radical radiotherapy (60 to 66 Gy total doses) and concomitantly given 5-fluorouracil as protracted venous infusion, 250 mg/sqm/24 h over the entire treatment period were given amifostine 300 mg absolutely before each fraction. Acute treatment related mobidity was scored according to CTC classification and loco-regional control and survival rates were estimated. Comparison was made with a historical control group of identical chemoradiation but without amifostine application. Results: Chemoradiation induced oral mucositis was delayed and showed significant lower degrees at all 10 Gy increments (p<0.05) except 60 Gy and over (p>0.05). No significant toxicity was recorded with respect to blood pressure, serum calcium, potassium, hematologic parameters, emesis, nausea or body weight loss. Progression free survival and overall survival probability at 2 years were not statistically different in both cohorts. Conclusion: Amifostine given before each fraction of radiotherapy over 6 weeks has no cumulative toxicity, was well tolerated and may reduce treatment induced oral mucositis. No tumor protective effect was observed. (orig.) [German] Hintergrund: Bei Patienten mit lokoregionaer fortgeschrittenen Karzinomen im Kopf-Hals-Bereich fuehrt die alleinige konventionell fraktionierte Radiotherapie zu unuenstigen lokoregionaeren Tumorkontrollraten und Ueberlebensraten. Die Therapieintensivierung durch simultane Radiochemotherapie fuehrt zu gesteigerter Akutmorbiditaet. Die chemische

  9. Limited mouth opening after primary therapy of head and neck cancer.

    Science.gov (United States)

    Weber, Clemens; Dommerich, Steffen; Pau, Hans Wilhelm; Kramp, Burkhard

    2010-09-01

    Patients after surgery and radiation/chemoradiation for treatment of head and neck cancer often suffer from oral complications. These problems may be caused by surgery and radiation. Patients complain, for example, of swallowing problems and limited mouth opening (trismus). The maximal interincisal mouth opening (MIO) was measured in patients treated with surgery and radiation/chemoradiation for head and neck cancer at the Department of Otorhinolaryngology at the University of Rostock. These patients also completed a 20-item questionnaire concerning nutritional, sensual, and speech disorders and pain. One hundred one patients (16 female and 85 male) returned the questionnaire and were included in the study. About 50% of the patients had a limited mouth opening (problems with opening the mouth (73%), eating (65%), drinking (73%), xerostomia (92%), speech disorders (68%), and voice (62%). Patients with laryngeal cancer only reported about problems with xerostomia (62%), speech (83%), and voice (90%), similar to patients with pharyngeal cancer. About half of the patients who underwent primary treatment for oral and oropharyngeal cancer developed trismus and reported about problems with opening the mouth, eating, drinking, dry mouth, voice, and speech. Trismus has a negative impact on quality of life and should be a focus in the postoperative management of patients with oral and oropharyngeal cancer, and, if diagnosed, special treatment should be initialized.

  10. Cold Atmospheric Plasma: A Promising Complementary Therapy for Squamous Head and Neck Cancer.

    Directory of Open Access Journals (Sweden)

    Christian Welz

    Full Text Available Head and neck squamous cell cancer (HNSCC is the 7th most common cancer worldwide. Despite the development of new therapeutic agents such as monoclonal antibodies, prognosis did not change for the last decades. Cold atmospheric plasma (CAP presents the most promising new technology in cancer treatment. In this study the efficacy of a surface micro discharging (SMD plasma device against two head and neck cancer cell lines was proved. Effects on the cell viability, DNA fragmentation and apoptosis induction were evaluated with the MTT assay, alkaline microgel electrophoresis (comet assay and Annexin-V/PI staining. MTT assay revealed that the CAP treatment markedly decreases the cell viability for all tested treatment times (30, 60, 90, 120 and 180 s. IC 50 was reached within maximal 120 seconds of CAP treatment. Comet assay analysis showed a dose dependent high DNA fragmentation being one of the key players in anti-cancer activity of CAP. Annexin-V/PI staining revealed induction of apoptosis in CAP treated HNSCC cell lines but no significant dose dependency was seen. Thus, we confirmed that SMD Plasma technology is definitely a promising new approach on cancer treatment.

  11. Postradiation trismus and its impact on quality of life in patients with head and neck cancer.

    Science.gov (United States)

    Lee, Li-Yun; Chen, Shu-Ching; Chen, Wen-Cheng; Huang, Bing-Shen; Lin, Chien-Yu

    2015-02-01

    The aims of this study were to investigate the following in patients with head and neck cancer (HNC): (1) factors related to trismus that predict the development of trismus, (2) factors affecting quality of life and measurements of these factors, and (3) comparison of these findings in patients with and without trismus to evaluate the effects of trismus on quality of life. This cross-sectional study included the questionnaires: the Hospital Anxiety and Depression Scale (HADS) - Depression Subscale, the Chewing Function Questionnaire (CFQ), and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Head and Neck Cancer Module (EORTC QLQ-HN35). A scaled ruler was used to measure maximal intercisal opening (MIO). Of the 104 patients in the study, 8.7% had clinical depression. The average MIO was 35.81 mm, and 47.1% of patients had trismus. Moderate levels of chewing dysfunction with regard to different types of food were noted. Lower body mass index, chemoradiotherapy treatment, longer time since treatment completion, and higher radiation dose were significantly associated with trismus. Such patients had significantly lower head and neck-specific quality of life in terms of social contact, sexuality, teeth, mouth opening, dry mouth, feeling ill, nutritional supplement, and weight loss. Patients with trismus should be provided mouth opening exercises after treatment and programs to improve trismus and quality of life. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Study of the relationship virus of the human papilloma (VHP) and cancer of uterine neck

    International Nuclear Information System (INIS)

    Bravo, Maria Mercedes

    1999-01-01

    Today in day the narrow relationship is known among the viral infection by VHP and the cancer of uterine neck; in this pathology they also appear the proteins E6 and E7 that are target of oncogenes and important part in the course of cancer of uterine neck. It intends as hypothesis that when to a patient with neck cancer, it is administered radiotherapy, there is lysis tumoral that liberates viral components that then E7 acts on the proteins being given an immunologic answer of cellular type, activating clones. When the immunologic answer is positive, the results to the treatment are but favorable and vice versa. The objective was to determine if the virus is detected after the treatment with the radiotherapy and if the titles of antibodies had increased or diminished. An analysis of the age was made, of the size of the tumor, of the state and one of the virus of the papilloma was looked for before and after the treatment, quantifying the variation (increase or decrease) of its quantity, finally it was observed if the presage after the treatment was related with the patient's survival

  13. Radiobiological modeling of interplay between accelerated repopulation and altered fractionation schedules in head and neck cancer

    Directory of Open Access Journals (Sweden)

    Marcu Loredana

    2009-01-01

    Full Text Available Head and neck cancer represents a challenge for radiation oncologists due to accelerated repopulation of cancer cells during treatment. This study aims to simulate, using Monte Carlo methods, the response of a virtual head and neck tumor to both conventional and altered fractionation schedules in radiotherapy when accelerated repopulation is considered. Although clinical trials are indispensable for evaluation of novel therapeutic techniques, they are time-consuming processes which involve many complex and variable factors for success. Models can overcome some of the limitations encountered by trials as they are able to simulate in less complex environment tumor cell kinetics and dynamics, interaction processes between cells and ionizing radiation and their outcome. Conventional, hyperfractionated and accelerated treatment schedules have been implemented in a previously developed tumor growth model which also incorporates tumor repopulation during treatment. This study focuses on the influence of three main treatment-related parameters, dose per fraction, inter fraction interval and length of treatment gap and gap timing based on RTOG trial data on head and neck cancer, on tumor control. The model has shown that conventionally fractionated radiotherapy is not able to eradicate the stem population of the tumor. Therefore, new techniques such as hyperfractionated/ accelerated radiotherapy schedules should be employed. Furthermore, the correct selection of schedule-related parameters (dose per fraction, time between fractions, treatment gap scheduling is crucial in overcoming accelerated repopulation. Modeling of treatment regimens and their input parameters can offer better understanding of the radiobiological interactions and also treatment outcome.

  14. Head and neck cancer information on the internet: type, accuracy and content.

    LENUS (Irish Health Repository)

    Ni Riordain, Richeal

    2009-08-01

    This study aimed to determine the type, accuracy and content of information available on the internet regarding head and neck cancer. The search engine Google was used to generate a list of the top 100 websites about head and neck cancer. The websites were evaluated using the DISCERN instrument and the JAMA benchmarks and whether the site displayed the Health on the Net seal was also recorded. The search yielded 1,650,000 sites on the Google website. Of the top 100 sites, a total of 33 sites were suitable for analysis due to duplicate links, non-functioning links and irrelevant website. 45% achieved all four JAMA benchmarks and 18% achieved only 1 benchmark. No website receiving the maximum mark on the overall score and four websites received the lowest overall score regarding the DISCERN instrument. The question with the poorest response score was \\'Does it describe how the treatment choices affect overall quality of life?\\' 39% of the websites displayed the Health on the Net (HON) seal. A wide variety of types of information are available on the internet regarding head and neck cancer with variable accuracy levels based on both Journal of the American Medical Association (JAMA) benchmarks and DISCERN. The onus lies with the practitioner to guide the patient regarding scientific reliability of information and to direct the patient in filtering the information sourced. The inclusion of quality of life related information is currently lacking and should be addressed to ensure a more comprehensive understanding for patients of treatment options.

  15. Primary Radiation Therapy for Head-and-Neck Cancer in the Setting of Human Immunodeficiency Virus

    International Nuclear Information System (INIS)

    Klein, Emily A.; Guiou, Michael; Farwell, D. Gregory; Luu, Quang; Lau, Derick H.; Stuart, Kerri; Vaughan, Andrew; Vijayakumar, Srinivasan; Chen, Allen M.

    2011-01-01

    Purpose: To analyze outcomes after radiation therapy for head-and-neck cancer among a cohort of patients with human immunodeficiency virus (HIV). Methods and Materials: The medical records of 12 patients with serologic evidence of HIV who subsequently underwent radiation therapy to a median dose of 68 Gy (range, 64-72 Gy) for newly diagnosed squamous cell carcinoma of the head and neck were reviewed. Six patients (50%) received concurrent chemotherapy. Intensity-modulated radiotherapy was used in 6 cases (50%). All patients had a Karnofsky performance status of 80 or 90. Nine patients (75%) were receiving antiretroviral therapies at the time of treatment, and the median CD4 count was 460 (range, 266-800). Toxicity was graded according to the Radiation Therapy Oncology Group / European Organization for the Treatment of Cancer toxicity criteria. Results: The 3-year estimates of overall survival and local-regional control were 78% and 92%, respectively. Acute Grade 3+ toxicity occurred in 7 patients (58%), the most common being confluent mucositis (5 patients) and moist skin desquamation (4 patients). Two patients experienced greater than 10% weight loss, and none experienced more than 15% weight loss from baseline. Five patients (42%) experienced treatment breaks in excess of 10 cumulative days, although none required hospitalization. There were no treatment-related fatalities. Conclusions: Radiation therapy for head-and-neck cancer seems to be relatively well tolerated among appropriately selected patients with HIV. The observed rates of toxicity were comparable to historical controls without HIV.

  16. Freedom from local and regional failure of contralateral neck with ipsilateral neck radiotherapy for node-positive tonsil cancer: updated results of an institutional clinical management approach.

    Science.gov (United States)

    Dan, Tu D; Raben, David; Schneider, Charles J; Hockstein, Neil G; Witt, Robert L; Dzeda, Michael; Cormier, Jennifer F; Raben, Adam

    2015-06-01

    To update the outcomes of an institutional clinical management approach using ipsilateral neck radiotherapy in the treatment of node-positive squamous cell carcinoma of the tonsil with a well-lateralized primary lesion. Between August 2003 and April 2014, 61 consecutive patients with ipsilateral node-positive squamous cell carcinoma of the tonsil without involvement of the base of the tongue or midline soft palate were treated at a community hospital-based cancer center with radiotherapy to the primary site and ipsilateral neck. Overall survival, disease-free survival and freedom from contralateral failure were calculated. Median follow up was 37.2months (range 4-121months). Freedom from contralateral nodal failure at 5years was 98% with one contralateral nodal failure noted. The patient underwent a salvage neck dissection and was treated with post-operative radiotherapy with no evidence of disease to date. 5-year overall survival (OS) was 92.4% and 5year disease-free survival (DFS) was 86.7%. This represents the single largest series reported from a community hospital-based cancer center in which lateralized tonsil cancers with N+ disease were treated with ipsilateral neck radiotherapy. In this carefully selected cohort of patients with well-lateralized tonsil cancers, the risk of contralateral nodal failure appears to be <5%, suggesting that prophylactic radiation of the contralateral neck may not be necessary. Future planned studies will focus on prospectively selecting subgroups of patients eligible for treatment de-intensification as survivorship issues in excellent prognosis HPV positive patients are increasingly becoming relevant. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. General Information about Metastatic Squamous Neck Cancer with Occult Primary

    Science.gov (United States)

    ... causes the tissue to light up under a microscope. This type of test may be used to tell the difference between different types of cancer. Light and electron ... and high-powered microscopes to look for certain changes in the cells. ...

  18. Paediatric head and neck cancers in Nigeria: Implications for ...

    African Journals Online (AJOL)

    In resource limited settings where diagnoses depend majorly on clinical intuition, an awareness of predictors of a disease can shorten the time spent on arriving at a working diagnosis and guide the immediate choice of investigations and treatment. Keywords: Cancer, children, lymphoma, Nigeria Nigerian Medical Journal ...

  19. Immune Regulatory Activity of Vitamin D3 in Head and Neck Cancer

    Directory of Open Access Journals (Sweden)

    M. Rita I. Young

    2013-08-01

    Full Text Available While vitamin D exhibits a multitude of cellular effects that can impact on cancer development and progression, this review focuses on its immune modulatory effects. These immune modulatory effects can be both direct and indirect. Compared to other cancer types, head and neck squamous cell carcinomas (HNSCC have received less attention, but are a fascination immunologically because of the profound extent to which they inhibit immune defenses. This review describes the mechanisms of some of these immune inhibitory processes and how vitamin D can help overcome aspects of this immune suppression.

  20. Liposuction for Submental Lymphedema Improves Appearance and Self-Perception in the Head and Neck Cancer Patient.

    Science.gov (United States)

    Brake, Maria K; Jain, Lauren; Hart, Robert D; Trites, Jonathan R B; Rigby, Matthew; Taylor, S Mark

    2014-08-01

    Patients who have undergone treatment for head and neck cancer are at risk for neck lymphedema, which can severely affect quality of life. Liposuction has been used successfully for cancer patients who suffer from posttreatment limb lymphedema. The purpose of our study was to review the outcomes of head and neck cancer patients at our center who have undergone submental liposuction for posttreatment lymphedema. Prospective cohort study. Oncology center in tertiary hospital setting. Head and neck cancer patients who underwent submental liposuction for posttreatment lymphedema were included. Nine patients met the study criteria. Patients completed 2 surveys (Modified Blepharoplasty Outcome Evaluation and the validated Derriford Appearance Scale) pre- and postoperatively to assess satisfaction. Patients' pre- and postoperative photos were graded by independent observers to assess outcomes objectively. Our study demonstrated a statistically significant improvement in patients' self-perception of appearance and statistically significant objective scoring of appearance following submental liposuction. Submental liposuction improves the appearance and quality of life for head and neck cancer patients suffering from posttreatment lymphedema by way of improving their self-perception and self-confidence. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

  1. Socioeconomic and Other Demographic Disparities Predicting Survival among Head and Neck Cancer Patients.

    Science.gov (United States)

    Choi, Seung Hee; Terrell, Jeffrey E; Fowler, Karen E; McLean, Scott A; Ghanem, Tamer; Wolf, Gregory T; Bradford, Carol R; Taylor, Jeremy; Duffy, Sonia A

    2016-01-01

    The Institute of Medicine (IOM) report, "Unequal Treatment," which defines disparities as racially based, indicates that disparities in cancer diagnosis and treatment are less clear. While a number of studies have acknowledged cancer disparities, they have limitations of retrospective nature, small sample sizes, inability to control for covariates, and measurement errors. The purpose of this study was to examine disparities as predictors of survival among newly diagnosed head and neck cancer patients recruited from 3 hospitals in Michigan, USA, while controlling for a number of covariates (health behaviors, medical comorbidities, and treatment modality). Longitudinal data were collected from newly diagnosed head and neck cancer patients (N = 634). The independent variables were median household income, education, race, age, sex, and marital status. The outcome variables were overall, cancer-specific, and disease-free survival censored at 5 years. Kaplan-Meier curves and univariate and multivariate Cox proportional hazards models were performed to examine demographic disparities in relation to survival. Five-year overall, cancer-specific, and disease-free survival were 65.4% (407/622), 76.4% (487/622), and 67.0% (427/622), respectively. Lower income (HR, 1.5; 95% CI, 1.1-2.0 for overall survival; HR, 1.4; 95% CI, 1.0-1.9 for cancer-specific survival), high school education or less (HR, 1.4; 95% CI, 1.1-1.9 for overall survival; HR, 1.4; 95% CI, 1.1-1.9 for cancer-specific survival), and older age in decades (HR, 1.4; 95% CI, 1.2-1.7 for overall survival; HR, 1.2; 95% CI, 1.1-1.4 for cancer-specific survival) decreased both overall and disease-free survival rates. A high school education or less (HR, 1.4; 95% CI, 1.0-2.1) and advanced age (HR, 1.3; 95% CI, 1.1-1.6) were significant independent predictors of poor cancer-specific survival. Low income, low education, and advanced age predicted poor survival while controlling for a number of covariates (health behaviors

  2. Economic and quality-of-life outcomes in head and neck cancer

    International Nuclear Information System (INIS)

    Harrison, Louis B.

    1996-01-01

    Head and neck cancer offers a special and unique challenge to physicians and patients. Treatment of cancers in this part of the body, especially surgical resection, can cause profound changes in quality-of-life. The patient's ability to work, earn a living, articulate speech, communicate, have social interaction, and live a normal life, can be affected in a major way. Therefore, physicians and patients must look beyond the obvious oncologic outcomes of locoregional control, distant metastasis free survival, and overall survival. These outcomes must be assessed along with detailed, quality-of-life and economic outcomes, in order to properly manage patients. It is also mandatory that patients have a clear understanding of all their treatment options, and the implications of these options on cancer control and quality-of-life. This panel will focus on the available methods to assess quality-of-life and economic outcomes in head and neck cancer management. It will also highlight areas where new oncologic strategies are utilized which emphasize organ and function preservation. This latter area is an important aspect of modern clinical research and practice. In particular, management of cancers of the tongue, larynx, and hypopharynx offer special opportunities. Resection of these organs can produce debilitating functional outcomes. New multidisciplinary approaches to treat patients while avoiding primary resection have been developed. The oncologic and quality-of-life/economic outcomes will be assessed for these organ preserving strategies

  3. A comprehensive review of head and neck cancer rehabilitation: Physical therapy perspectives

    Directory of Open Access Journals (Sweden)

    Karthikeyan Guru

    2012-01-01

    Full Text Available Rehabilitation in relation to cancer can be preventative, restorative, supportive, and palliative. It is recognized that patients may have rehabilitation needs throughout their care pathway. The role of physiotherapy in the cancer rehabilitation is less understood and particularly in the head and neck cancer (HNC patients. This results in various residual deformities and dysfunctions for the patients with HNC. The objective of this review is to provide detailed information regarding the problems faced after the cancer treatments and rehabilitation of patients who suffered with HNC. The fact that cancer patients are facing several months of chemotherapy and/or radiotherapy and usually major surgery, as well as the direct effect of immobility due to pain, means that muscle wasting, joint stiffness, as well as de-conditioning and fatigue are inevitable. The absence of physiotherapy intervention would be detrimental to patient care and the ability of the patient/family to cope with the effects of the disease or its treatment on their functional capacity and quality of life. Following any treatment for HNC, physical therapy may play an essential role in preventing various complications and helping patients to mitigate impairments, and restoring function of the shoulder joint, neck, and face.

  4. Robotic-assisted neck dissection in submandibular gland cancer: preliminary report.

    Science.gov (United States)

    Kim, Chul-Ho; Koh, Yoon Woo; Kim, Dae; Chang, Jae Won; Choi, Eun Chang; Shin, Yoo Seob

    2013-08-01

    Robot-assisted neck dissection (ND) in patients with head and neck cancer has been developed as a plausible substitute for conventional surgery and it provides an excellent cosmetic outcome. The authors hypothesized that surgery for submandibular gland (SMG) cancer could be achieved with a gasless retroauricular (RA) approach using the robotic system. This study evaluated the feasibility of robot-assisted ND using an RA approach for SMG cancer. Primary tumor resection with robot-assisted ND using an RA incision was performed in 6 patients with SMG cancer. All cases of robot-assisted ND combined with primary tumor resection were conducted successfully without any significant intraoperative complication, need for an additional incision, or conversion to open conventional ND. The amount and duration of drainage, length of hospital stay, number of retrieved lymph nodes, and complications were generally acceptable. The postoperative scar was completely hidden by the auricle and hair. Robot-assisted ND with primary tumor excision using an RA approach is a feasible and useful method, with excellent cosmetic results, for surgical treatment of selected cases of SMG cancer. Copyright © 2013 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  5. Role of CT/PET in predicting nodal disease in head and neck cancers

    International Nuclear Information System (INIS)

    Singham, S.; Iyer, G.; Clark, J.

    2009-01-01

    Full text:Introduction: Pre-treatment evaluation of the presence of cervical nodal metastases is important in head and neck cancers and has major prognostic implications. In this study, we aim to determine the accuracy of CT/PET as a tool for identifying such metastases. Methods: All patients from Royal Prince Alfred and Liverpool Hospitals, who underwent CT/PET for any cancer arising from the head and neck, and who underwent subsequent surgery (which included a neck dissection) within 8 weeks of the CT/PET were included. Nodal staging was undertaken by utilising imaging-based nodal classification, and comparison with pathologic data from the surgical specimen was made. PET was considered positive if the SUV was greater than 2. Results: We identified 111 patients from the above criteria. 80 of such patients were treated for squamous cell carcinoma (SCC). CT/PET identified unsuspected metastatic disease in 6 patients. Correlation of CT/PET findings and the presence of disease at the primary site: sensitivity: 98%, specificity: 93%, positive predictive value (PPV): 98% and negative predictive value (NPV): 93%. Correlating CT/PET findings with the presence of nodal disease at any level: sensitivity: 95%, specificity: 88%, PPV: 95% and NPV: 88%. CT/PET was anatomically accurate in predicting the site of metastases in 62/74 (84%). Conclusion: PET is accurate in predicting both presence of nodal metastases and the level of involvement. CT/PET should be undertaken as a pre-operative tool to assist in planning the extent of surgery required in head and neck cancers.

  6. Issues of intimacy and sexual dysfunction following major head and neck cancer treatment.

    Science.gov (United States)

    Low, C; Fullarton, M; Parkinson, E; O'Brien, K; Jackson, S R; Lowe, D; Rogers, S N

    2009-10-01

    Problems with sexuality and intimacy in head and neck cancer are under reported. This study set out to describe patients self-reporting of intimacy and sexual dysfunction following treatment and to explore associations with patient characteristics. Patients treated for primary head and neck squamous cell carcinoma, alive and disease free, were identified from the University Hospital Aintree Head and Neck Cancer database, January 2000 to December 2006. A postal survey with two questions from the European Organisation for Research and Treatment of Cancer Quality of Life questionnaire-Head and Neck 35 (EORTC H&N35) regarding sexuality, a self-designed question about intimacy and the University of Washington quality of life questionnaire Version 4 (UW-QOL v4) was sent to patients in March 2007. There was a 68% response (350/518). One-third of those answering the intimacy and sexuality questions reported substantial problems with sexual interest and enjoyment, and one-quarter reported problems with intimacy. Intimacy problems declined with age from 36% if aged under 55 years to 6% for those 75 years and older. Intimacy and sexuality issues were largely unrelated to site, stage of disease, treatment modality and time since surgery. Gender and having a spouse or partner were related to answering the questions but not to having problems. With one-quarter of responders reporting intimacy problems it is surprising how little information and support regarding intimacy and sexual dysfunction is offered to patients and their carers. There is a need to explore these issues more extensively with further research.

  7. Honey and Radiation-Induced Stomatitis in Patients With Head and Neck Cancer.

    Science.gov (United States)

    Bahramnezhad, Fatemeh; Dehghan Nayeri, Nahid; Bassampour, Shiva Sadat; Khajeh, Mahboobeh; Asgari, Parvaneh

    2015-10-01

    Stomatitis is a common oral complication which affects 100% of patients undergoing head and neck radiotherapy. Acute stomatitis might cause failure and delay radiotherapy. Attention to mouth hygiene, particularly using mouthwash, has a fundamental importance for these patients. The current study came to addresses the effects of pure natural honey on radiation-induced stomatitis in patients with a variety of head and neck cancers. The present single-blinded nonrandomized controlled trial was conducted on 105 patients undergoing radiotherapy due to head and neck cancer at the radiation unit of Shafa hospital in Kerman, Iran, from October 2012 to March 2012. The research groups were selected by writing the names of the protocols (the mouthwashes of chamomile, honey and the common caring protocol at ward which uses water) on three cubes. The first extracted cube was related to the chamomile mouthwash (Matrica), the second to the honey mouthwash and the last cube to the water mouthwash. The first experimental group (n = 35) gurgled a solution containing 20 mL diluted honey, the second group gurgled a solution containing German chamomile, and the 35 patients in the control group were advised to gurgle 20 mL water (the ward routine). The results showed that severe stomatitis in groups of honey, chamomile and control was 0, 5.7%, and 17.6%, respectively. On the 14th day, it was 0, 0, and 17.6%, respectively. There were significant differences between the three groups regarding the severity of stomatitis in the 14th day (P < 0.001). The application of natural honey is effective in managing and preventing radiation-induced stomatitis in patients with head and neck cancers.

  8. Management and outcome of clinically evident neck recurrence in patients with papillary thyroid cancer.

    Science.gov (United States)

    Wang, Laura Y; Migliacci, Jocelyn C; Tuttle, R Michael; Shaha, Ashok R; Shah, Jatin P; Patel, Snehal G; Ganly, Ian

    2017-11-01

    The aim of this study was to report our incidence of clinically evident neck recurrence, salvage neck management and subsequent outcomes in patients with papillary thyroid cancer. This is important to know so that patients with thyroid cancer can be properly counselled about the implications of recurrent disease and subsequent outcome. An institutional database of 3664 patients with thyroid cancer operated between 1986 and 2010 was reviewed. Patients with nonpapillary histology and gross residual disease and those with distant metastases at presentation or distant metastases prior to nodal recurrence were excluded from the study. Of these, 99 (3.0%) patients developed clinically evident nodal recurrence. Details of recurrence and subsequent therapy were recorded for each patient. Subsequent disease-specific survival (sDSS), distant recurrence-free survival (sDRFS) and nodal recurrence-free survival (sNRFS) were determined from the date of first nodal recurrence using the Kaplan-Meier method. Of the 99 patients, 59% were female and 41% male. The median age was 41 years (range 5-91). The majority of patients had pT3/4 primary tumours (63%) and were pN+ (78%) at initial presentation. The median time to clinically evident nodal recurrence was 28 months (range: 3-264). Nodal recurrence occurred in the central neck in 15 (15%) patients, lateral neck in 74 (75%) patients and both in 10 (10%) patients. After salvage treatment, the 5-year sDSS was 97.4% from time of nodal recurrence. The 5-year sDRFS and sNRFS were 89.2% and 93.7%, respectively. In our series, isolated clinically evident nodal recurrence occurred in 3.0% of patients. Such patients are successfully salvaged with surgery and adjuvant therapy with sDSS of 97.4% at 5 years. © 2017 John Wiley & Sons Ltd.

  9. Management of the clinically negative neck in early-stage head and neck cancers after transoral resection

    NARCIS (Netherlands)

    Rodrigo, J.P.; Shah, J.P.; Silver, C.E.; Medina, J.E.; Takes, R.P.; Robbins, K.T.; Rinaldo, A.; Werner, J.A.; Ferlito, A.

    2011-01-01

    The decision regarding treatment of the clinically negative neck has been debated extensively. This is particularly true with early-stage tumors for which surgery is the treatment of choice, and the tumor has been resected transorally without a cervical incision. Elective neck dissection in this

  10. Reduction of xerostomia in head and neck cancer patients. A critical review of the literature

    International Nuclear Information System (INIS)

    Hanley, O.; Leech, M.

    2016-01-01

    Background: Radical radiotherapy given with or without concurrent chemotherapy is the main treatment modality in non-surgical patients for the management of squamous cell carcinoma in the head and neck. Xerostomia, which results from reduced salivary production is a debilitating side-effect of radiation therapy to these patients. Xerostomia may greatly impact on quality of life for head and neck cancer patients for up to 24 months post-radiation therapy. Such effects include difficulties in fundamental daily activities such as speech, mastication and swallowing. It is believed that modulated techniques provide better sparing to surrounding salivary glands. The aim of this critical review of the literature is to investigate what advantage intensity modulated radiotherapy (IMRT) can provide over 3 dimensional conformal radiation therapy (3DCRT) in reducing xerostomia in this subset of patients. Search methodology: An extensive literature search was undertaken to compare the incidence of grade 2 or worse xerostomia in HNSCC patients treated with IMRT or 3DCRT (±chemotherapy). Results: Studies reported a lower incidence of grade 2 or worse xerostomia with IMRT over patients treated with 3DCRT. The highest incidence of xerostomia was reported at 6 months following the completion of radiotherapy treatment. The incidence of xerostomia in patients declined with time, in both patients treated with IMRT and those of the 3DCRT cohort. The incidence of xerostomia was greater in the acute setting than in the late. Conclusion: An IMRT technique can consistently reduce grade 2 or worse xerostomia in head and neck cancer patients over conformal techniques. This will not compromise dose homogeneity or dose coverage. IMRT should remain the standard of care for head and neck patients. - Highlights: • IMRT technique can consistently reduce grade 2 or worse xerostomia in head and neck cancer patients over 3DCRT. • IMRT does not compromise the treatment's dose homogeneity or

  11. Advice about Work-Related Issues to Peers and Employers from Head and Neck Cancer Survivors.

    Science.gov (United States)

    Dewa, Carolyn S; Trojanowski, Lucy; Tamminga, Sietske J; Ringash, Jolie; McQuestion, Maurene; Hoch, Jeffrey S

    2016-01-01

    The purpose of this exploratory and descriptive study is to contribute to the sparse return-to-work literature on head and neck cancer (HNC) survivors. Interview participants were asked to reflect upon their work-related experience with cancer by answering two specific questions: (1) What advice would you give someone who has been newly diagnosed with head and neck cancer? (2) What advice would you give to employers of these people? Data were gathered through 10 individual semi-structured in-depth interviews with HNC clinic patients at a regional cancer center's head and neck clinic in Ontario, Canada. A constant comparative method of theme development was used. Codes identified in and derived from the data were discussed by research team members until consensus was reached. Codes with similar characteristics were grouped together and used to develop overarching themes. Work-related advice for peers focused on personal self-care and interactions within workplaces. Work-related advice to employers focused on demonstrating basic human values as well as the importance of communication. The study results suggest HNC clinic patients should be proactive with employers and help to set reasonable expectations and provide a realistic plan for work to be successfully completed. HNC clinic patients should develop communication skills to effectively disclose their cancer and treatment to employers. In this exploratory study, HNC clinic patients' advice was solution-focused underscoring the importance of self-care and pro-active communication and planning with employers. Employers were advised to demonstrate core human values throughout all phases of the work disability episode beginning at diagnosis.

  12. Antiproliferative study of B. javanica extracts against head and neck cancer cells

    International Nuclear Information System (INIS)

    Mohd Noor Hidayat Adenan; Zainah Adam; Shafii Khamis; Fazliana Mohd Saaya

    2014-01-01

    Brucea javanica or locally known as Meladapahit, are being used in Malaysia as traditional medicine mainly for the treatment of diabetes mellitus and hypertension. In order to study the potential use of this plant for cancer treatment, we have prepared crude extracts of the leaves and fruits, and assessed them for antiproliferative activities against head and neck cancer cell line which is HTB-43. The dried and ground leaves and fruits of the plant were successively extracted using hexane, chloroform, methanol and water, respectively. Inhibition of growth of the cultured cancer cells line was measured using a standard Micro culture Tetrazolium Technique (MTT) assay. The crude extracts were also subjected to toxicity test using brine shrimp lethality assay. Most of the tested crude extracts exhibited significant antiproliferative activities against the HTB-43 cell with IC 50 ranging from 8.46 μg/ml to 47.25 μg/ml. The chloroform extract from the leaves gave the highest antiproliferative activity (IC 50 , 8.46 μg/ml). Hexane extract from the fruits, aqueous and hexane extracts from B. javanica leaves showed low antiproliferative activities to the HTB-43 cell line with an IC 50 values >100 μg/ml. The chloroform extracts from fruits and leaves and methanol extract from fruits induced toxicity against brine shrimps with LC 50 values of 118.7 μg/ml, 512.44 μg/ml and 75.27 μg/ml respectively. It indicated that bioactive components presence in the crude extracts for its pharmacologic effects against head and neck cancer cells. Methanolic extract of Brucea javanica fruit was selected as the most effective extract to inhibit the growth of head and neck cancer cells (HTB-43) by the two different assays used. (author)

  13. Prepare to Care, A Supported Self-Management Intervention for Head and Neck Cancer CaregiversHead and Neck Cancer

    Science.gov (United States)

    2017-05-16

    Caregiver; Malignant Head and Neck Neoplasm; Paranasal Sinus Squamous Cell Carcinoma; Salivary Gland Squamous Cell Carcinoma; Stage I Hypopharyngeal Squamous Cell Carcinoma; Stage I Laryngeal Squamous Cell Carcinoma; Stage I Lip and Oral Cavity Squamous Cell Carcinoma; Stage I Oropharyngeal Squamous Cell Carcinoma; Stage II Hypopharyngeal Squamous Cell Carcinoma; Stage II Laryngeal Squamous Cell Carcinoma; Stage II Lip and Oral Cavity Squamous Cell Carcinoma; Stage II Oropharyngeal Squamous Cell Carcinoma; Stage III Hypopharyngeal Squamous Cell Carcinoma; Stage III Laryngeal Squamous Cell Carcinoma; Stage III Lip and Oral Cavity Squamous Cell Carcinoma; Stage III Oropharyngeal Squamous Cell Carcinoma; Stage IV Hypopharyngeal Squamous Cell Carcinoma; Stage IV Laryngeal Squamous Cell Carcinoma; Stage IV Lip and Oral Cavity Squamous Cell Carcinoma; Stage IV Oropharyngeal Squamous Cell Carcinoma; Stage IVA Hypopharyngeal Squamous Cell Carcinoma; Stage IVA Laryngeal Squamous Cell Carcinoma; Stage IVA Lip and Oral Cavity Squamous Cell Carcinoma; Stage IVA Oropharyngeal Squamous Cell Carcinoma; Stage IVB Hypopharyngeal Squamous Cell Carcinoma; Stage IVB Laryngeal Squamous Cell Carcinoma; Stage IVB Lip and Oral Cavity Squamous Cell Carcinoma; Stage IVB Oropharyngeal Squamous Cell Carcinoma; Stage IVC Hypopharyngeal Squamous Cell Carcinoma; Stage IVC Laryngeal Squamous Cell Carcinoma; Stage IVC Lip and Oral Cavity Squamous Cell Carcinoma; Stage IVC Oropharyngeal Squamous Cell Carcinoma

  14. Studies of skin cancer and thyroid tumors after irradiation of the head and neck

    International Nuclear Information System (INIS)

    Shore, R.E.; Moseson, M.; Hildreth, N.

    1992-01-01

    Two longitudinal studies of children given medical X-irradiation to the head and neck are described, one of 2,650 infants who received x-ray treatment for enlarged thymus glands and the other of 2,200 children who received x-ray treatment for tinea capitis (ringworm of the scalp). The thymus study showed a dose-related excess of thyroid cancer and a long period of excess risk. The tinea study also showed an excess of thyroid tumors even though the thyroid dose was only about 0.06 Gy. An excess of non-melanotic skin cancers has also occurred in the tinea study, but no evidence for excess malignant melanomas. The skin cancer excess is not evident among blacks in the study, and, among Caucasians, it is more prominent among those with a light complexion. This suggests that host-susceptibility to ultraviolet effects is an important modifier of skin cancer risk from ionizing irradiation. (author)

  15. The Role of HPV in Head and Neck Cancer Stem Cell Formation and Tumorigenesis

    Directory of Open Access Journals (Sweden)

    Mark S. Swanson

    2016-02-01

    Full Text Available The cancer stem cell (CSC theory proposes that a minority of tumor cells are capable of self-replication and tumorigenesis. It is these minority of cells that are responsible for cancer metastasis and recurrence in head and neck squamous cell cancers (HNSCC. Human papilloma virus (HPV-related cancer of the oropharynx is becoming more prevalent, which makes understanding of the relationship between HPV and CSCs more important than ever. This relationship is critical because CSC behavior can be predicted based on cell surface markers, which makes them a suitable candidate for targeted therapy. New therapies are an exciting opportunity to advance past the stalled outcomes in HNSCC that have plagued patients and clinicians for several decades.

  16. The impact of virus in N3 node dissection for head and neck cancer.

    Science.gov (United States)

    Armas, Gian Luca; Su, Chih-Ying; Huang, Chao-Cheng; Fang, Fu-Min; Chen, Ching-Mei; Chien, Chih-Yen

    2008-11-01

    This study is to determine the impact of virus in surgical outcomes among patients of head and neck cancer with N3 lymph node metastasis. A retrospective analysis was conducted for 32 patients with operable N3 neck metastasis undergoing surgical treatment between January 1987 and October 2006. The nuclei of the tumor cells were investigated for the presence of human papillomavirus (HPV) and Epstein-Barr virus (EBV) DNAs and were taken into account as the variable for survival analysis. The primary sites were oropharynx in 11 patients, tongue in 3, buccal mucosa in 1, hypopharynx in 8 and unknown primary in 9. The five-year cumulative overall survival rate was 40.7% and 5-year cumulative regional control rate was 55.8%. The 5-year cumulative overall survival rate of patients with unknown primary site (72.9%) and HPV or EBV positive in the tumor (77.8%) were significantly higher than those patients with known primary site (31.3%) and HPV or EBV negative in the tumor (27.4%), respectively (P = 0.0335 and P = 0.0348, log rank test). In conclusion, surgery with adjuvant therapy offers reasonable outcomes for operable N3 node in head and neck cancer in our cohort. In addition, patients with HPV or EBV positive in the tumor have a better survival.

  17. Multidisciplinary Service Utilization Pattern by Advanced Head and Neck Cancer Patients: A Single Institution Study

    Directory of Open Access Journals (Sweden)

    Jacqueline C. Junn

    2012-01-01

    Full Text Available Purpose. To analyze the patterns and associations of adjunctive service visits by head and neck cancer patients receiving primary, concurrent chemoradiation therapy. Methods. Retrospective chart review of patients receiving adjunctive support during a uniform chemoradiation regimen for stages III-IV head and neck squamous cell carcinoma. Univariate and multivariate models for each outcome were obtained from simple and multivariate linear regression analyses. Results. Fifty-two consecutive patients were assessed. Female gender, single marital status, and nonprivate insurance were factors associated with an increased number of social work visits. In a multivariate analysis, female gender and marital status were related to increased social work services. Female gender and stage IV disease were significant for increased nursing visits. In a multivariate analysis for nursing visits, living greater than 20 miles between home and hospital was a negative predictive factor. Conclusion. Treatment of advanced stage head and neck cancer with concurrent chemoradiation warrants a multidisciplinary approach. Female gender, single marital status, and stage IV disease were correlated with increased utilization of social work and nursing services. Distance over 20 miles from the center was a negative factor. This information may help guide the treatment team to allocate resources for the comprehensive care of patients.

  18. FDG PET/MR for lymph node staging in head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Platzek, Ivan, E-mail: ivan.platzek@uniklinikum-dresden.de [Dresden University Hospital, Department of Radiology, Fetscherstr. 74, 01307 Dresden (Germany); Beuthien-Baumann, Bettina, E-mail: bettina.beuthien-baumann3@uniklinikum-dresden.de [Dresden University Hospital, Department of Nuclear Medicine, Fetscherstr. 74, 01307 Dresden (Germany); Schneider, Matthias, E-mail: m.schneider@mkgdresden.de [Dresden University Hospital, Department of Oral and Maxillofacial Surgery, Fetscherstr. 74, 01307 Dresden (Germany); Gudziol, Volker, E-mail: volker.gudziol@uniklinikum-dresden.de [Dresden University Hospital, Department of Otolaryngology, Fetscherstr. 74, 01307 Dresden (Germany); Kitzler, Hagen H., E-mail: hagen.kitzler@uniklinikum-dresden.de [Dresden University Hospital, Department of Neuroradiology, Fetscherstr. 74, 01307 Dresden (Germany); Maus, Jens, E-mail: j.maus@hzdr.de [Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Bautzner Landstr. 400, 01328 Dresden (Germany); Schramm, Georg, E-mail: g.schramm@hzdr.de [Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Bautzner Landstr. 400, 01328 Dresden (Germany); Popp, Manuel, E-mail: manuel.popp@praxisklinik-dresden.de [Dresden University Hospital, Department of Nuclear Medicine, Fetscherstr. 74, 01307 Dresden (Germany); Laniado, Michael, E-mail: michael.laniado@uniklinikum-dresden.de [Dresden University Hospital, Department of Radiology, Fetscherstr. 74, 01307 Dresden (Germany); Kotzerke, Jörg, E-mail: Joerg.Kotzerke@uniklinikum-dresden.de [Dresden University Hospital, Department of Nuclear Medicine, Fetscherstr. 74, 01307 Dresden (Germany); Hoff, Jörg van den, E-mail: j.van_den_hoff@hzdr.de [Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Bautzner Landstr. 400, 01328 Dresden (Germany)

    2014-07-15

    Objective: To assess the diagnostic value of PET/MR (positron emission tomography/magnetic resonance imaging) with FDG (18F-fluorodeoxyglucose) for lymph node staging in head and neck cancer. Materials and methods: This prospective study was approved by the local ethics committee; all patients signed informed consent. Thirty-eight patients with squamous cell carcinoma of the head and neck region underwent a PET scan on a conventional scanner and a subsequent PET/MR on a whole-body hybrid system after a single intravenous injection of FDG. The accuracy of PET, MR and PET/MR for lymph node metastases were compared using receiver operating characteristic (ROC) analysis. Histology served as the reference standard. Results: Metastatic disease was confirmed in 16 (42.1%) of 38 patients and 38 (9.7%) of 391 dissected lymph node levels. There were no significant differences between PET/MR, MR and PET and MR (p > 0.05) regarding accuracy for cervical metastatic disease. Based on lymph node levels, sensitivity and specificity for metastatic involvement were 65.8% and 97.2% for MR, 86.8% and 97.0% for PET and 89.5% and 95.2% for PET/MR. Conclusions: In head and neck cancer, FDG PET/MR does not significantly improve accuracy for cervical lymph node metastases in comparison to MR or PET.

  19. Treatment of late sequelae after radiotherapy for head and neck cancer.

    Science.gov (United States)

    Strojan, Primož; Hutcheson, Katherine A; Eisbruch, Avraham; Beitler, Jonathan J; Langendijk, Johannes A; Lee, Anne W M; Corry, June; Mendenhall, William M; Smee, Robert; Rinaldo, Alessandra; Ferlito, Alfio

    2017-09-01

    Radiotherapy (RT) is used to treat approximately 80% of patients with cancer of the head and neck. Despite enormous advances in RT planning and delivery, a significant number of patients will experience radiation-associated toxicities, especially those treated with concurrent systemic agents. Many effective management options are available for acute RT-associated toxicities, but treatment options are much more limited and of variable benefit among patients who develop late sequelae after RT. The adverse impact of developing late tissue damage in irradiated patients may range from bothersome symptoms that negatively affect their quality of life to severe life-threatening complications. In the region of the head and neck, among the most problematic late effects are impaired function of the salivary glands and swallowing apparatus. Other tissues and structures in the region may be at risk, depending mainly on the location of the irradiated tumor relative to the mandible and hearing apparatus. Here, we review the available evidence on the use of different therapeutic strategies to alleviate common late sequelae of RT in head and neck cancer patients, with a focus on the critical assessment of the treatment options for xerostomia, dysphagia, mandibular osteoradionecrosis, trismus, and hearing loss. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. Bilateral synchronous parathyroids cancer and femoral neck fracture as the complications of tertiary hyperparathyroidism

    Directory of Open Access Journals (Sweden)

    A F Romanchishen

    2013-12-01

    Full Text Available In the paper has presented the first in Russia observation of bilateral synchronous parathyroids cancer in patient with urolithiasis complicated by chronic pyelonephritis, renal insufficiency with tertiary hyperparathyroidism and femoral neck fracture. During observation of the patient in our hospital were found hyperparathyroid osteodystrophy, medial right femoral neck fracture, very high level of parathormone (1969,0 pg/ml, tumorous of right (16,0 × 17,0 mm and left (23,0 × 17,0 mm parathyroid glands located behind of inferior thyroid poles during ultrasound research. Surgical exploration has found bilateral whitish parathyroid tumorous with invasion to right recurrent laryngeal nerve. Were performed right hemithyroidectomy, left thyroid lobe resection and central neck dissections. Parathormone level has decreased to 3.5 times (up to 582 pg/ml. 20 minutes later after bilateral inferior parathyroidectomies. The regular hemodialysis was restore and six months later was successfully undertaken the hip prosthetics. Two year later after the surgery signs of parathyroid cancer relapses were no found.

  1. Postradiotherapy quality of life for head-and-neck cancer patients is independent of xerostomia

    International Nuclear Information System (INIS)

    Ringash, Jolie; Warde, Padraig; Lockwood, Gina; O'Sullivan, Brian; Waldron, John; Cummings, Bernard

    2005-01-01

    Purpose: To determine the relationship between quality of life (QOL) and xerostomia over time for patients undergoing radiotherapy (RT) for head-and-neck cancer in a prospective clinical trial. Methods and materials: Patients with head-and-neck cancer were randomized to pilocarpine (n = 65) vs. placebo (n = 65) during RT. QOL was measured using the McMaster Head and Neck Radiotherapy Questionnaire (HNRQ). Xerostomia was measured on a linear analog scale. No statistically significant differences were observed between arms; all 130 patients were analyzed together. Results: Baseline QOL data were obtained for 98.5% of participants. The baseline HNRQ score of 5.7 declined significantly to 4.0 (p <0.0001) by RT Week 6 and returned to baseline (5.8) by 6 months after treatment. This represents a large, clinically important change of 1.7 of 7 (24%; effect size 1.34). The decline in HNRQ score during RT paralleled the onset of xerostomia on the linear analog scale (r = 0.36 at 1 month). After treatment, the QOL scores recovered without improvement in xerostomia. The trajectory of the linear analog scale score resembled that of the HNRQ's single xerostomia question (r = 0.75 at 1 month). Conclusion: Quality of life recovers to baseline after RT, despite persistent xerostomia. Either a response shift occurs or xerostomia in the absence of acute mucositis has a relatively small influence on overall QOL

  2. Radiosensitization of head and neck cancer cells by the phytochemical agent sulforaphane

    Energy Technology Data Exchange (ETDEWEB)

    Kotowski, Ulana; Heiduschka, Gregor; Brunner, Markus; Fahim, Tammer; Thurnher, Dietmar [Medical University of Vienna (Austria). Dept. of Otorhinolaryngology, Head and Neck Surgery; Czembirek, Cornelia; Eder-Czembirek, Christina [Medical University of Vienna (Austria). Dept. of Cranio-, Maxillofacial and Oral Surgery; Schmidt, Rainer [Medical University of Vienna (Austria). Dept. of Radiotherapy and -biology

    2011-09-15

    Sulforaphane is a naturally occurring compound found in broccoli and other cruciferous vegetables. Recently it gained attention because of its antiproliferative properties in many cancer cell lines. The aim of this study was to investigate whether sulforaphane could act as a radiosensitizer in head and neck squamous cell carcinoma cell lines. Four head and neck squamous cell carcinoma cell lines (i.e., (HNSCC) SCC9, SCC25, CAL27, and FADU) were treated with sulforaphane and subsequently irradiated. Then proliferation and clonogenic assays were performed. Apoptosis was detected by flow cytometry. Possible regulation of Akt and Mcl-1 was investigated by western blotting. Sulforaphane and radiation in combination leads to stronger inhibition of cell proliferation and of clonogenic survival than each treatment method alone. Western blot analysis of Akt and Mcl-1 showed no changed expression. Sulforaphane is a promising agent in the treatment of head and neck cancer due to its antiproliferative and radio-sensitizing properties. A combination of sulforaphane and radiation decreases clonogenic survival. Apoptosis is not regulated through Akt or the Mcl-1 protein. (orig.)

  3. A case of radiation-induced skin cancer of the neck

    International Nuclear Information System (INIS)

    Matsushita, Tetsuya; Susuki, Takeo; Kikui, Tomoko; Masada, Yoshiko; Tahara, Shinya.

    1994-01-01

    The authors discuss the case of radiation-induced skin cancer of the neck in a 76-year-old woman who had undergone irradiation of tubercular lymphadenitis of the cervix while in her low teens. Some fifty years later, a squamous cell carcinoma developed in the irradiated region and in due course deeply invaded the sternocleidomastoidous muscle. Thus, a radical neck dissection was performed and the tumor and the lymph tissue removed en bloc, after which reconstruction was accomplished by using a latissimus dorsi musculocutaneous flap. With regard to the lessons learned from treating this case, three points are considered important and are listed below. When treating radiation-induced skin cancer patients, the head and neck regions should be examined in detail for the presence of other tumors. The excision of the skin surrounding the tumor should be as wide as possible, so as to remove skin that may have been also over-subjected to irradiation. The remaining skin surrounding the defect left by the excision is atrophic and thin. (author)

  4. Computer-assisted planning and dosimetry for radiation treatment of head and neck cancer in Cameroon

    International Nuclear Information System (INIS)

    Yomi, J.; Ngniah, A.; Kingue, S.; Muna, W.F.T.; Durosinmi-Etti, F.A.

    1995-01-01

    This evaluation was part of a multicenter, multinational study sponsored by the International Agency for Atomic Energy (Vienna) to investigate a simple, reliable computer-assisted planning and dosimetry system for radiation treatment of head and neck cancers in developing countries. Over a 13-month period (April 1992-April 1993), 120 patients with histologically-proven head or neck cancer were included in the evaluation. In each patient, planning and dosimetry were done both manually and using the computer-assisted system. The manual and computerized systems were compared on the basis of accuracy of determination of the outer contour, target volume, and critical organs; volume inequality resolution; structure heterogeneity correction; selection of the number, angle, and size of beams; treatment time calculation; availability of dosimetry predictions; and duration and cost of the procedure. Results demonstrated that the computer-assisted procedure was superior over the manual procedure, despite less than optimal software. The accuracy provided by the completely computerized procedure is indispensable for Level II radiation therapy, which is particularly useful in tumors of the sensitive, complex structures in the head and neck. (authors). 7 refs., 3 tabs

  5. Dual-Lumen Chest Port Infection Rates in Patients with Head and Neck Cancer

    International Nuclear Information System (INIS)

    Bos, Aaron; Ahmed, Osman; Jilani, Danial; Giger, Maryellen; Funaki, Brian S.; Zangan, Steven M.

    2015-01-01

    PurposeThe aim of this study was to investigate dual-lumen chest port infection rates in patients with head and neck cancer (HNC) compared to those with other malignancies (non-HNC).Materials and MethodsAn IRB-approved retrospective study was performed on 1,094 consecutive chest ports placed over a 2-year period. Patients with poor follow-up (n = 53), no oncologic history (n = 13), or single-lumen ports (n = 183) were excluded yielding a study population of 845 patients. The electronic medical records were queried for demographic information, data regarding ports and infections, and imaging review.ResultsHNC patients experienced more infections (42 vs. 30), an increased infection rate per 1,000 catheter days (0.68 vs. 0.21), and more early infections within 30 days compared to non-HNC patients (10 vs. 6) (p < 0.001, p < 0.001, p = 0.02, respectively). An existing tracheostomy at the time of port placement was associated with infection in the HNC group (p = 0.02) but was not an independent risk factor for infection in the study population overall (p = 0.06). There was a significant difference in age, male gender, and right-sided ports between the HNC and non-HNC groups (p < 0.01, p < 0.001, and p = 0.01), although these were not found to be independent risk factors for infection (p = 0.32, p = 0.76, p = 0.16).ConclusionHNC patients are at increased risk for infection of dual-lumen chest ports placed via a jugular approach compared to patients with other malignancies. Tracheostomy is associated with infection in HNC patients but is not an independent risk factor for infection in the oncologic population as a whole

  6. Dual-Lumen Chest Port Infection Rates in Patients with Head and Neck Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Bos, Aaron, E-mail: abos1210@gmail.com; Ahmed, Osman [University of Chicago Medical Center (United States); Jilani, Danial [Wright State University Boonshoft School of Medicine (United States); Giger, Maryellen; Funaki, Brian S.; Zangan, Steven M. [University of Chicago Medical Center (United States)

    2015-06-15

    PurposeThe aim of this study was to investigate dual-lumen chest port infection rates in patients with head and neck cancer (HNC) compared to those with other malignancies (non-HNC).Materials and MethodsAn IRB-approved retrospective study was performed on 1,094 consecutive chest ports placed over a 2-year period. Patients with poor follow-up (n = 53), no oncologic history (n = 13), or single-lumen ports (n = 183) were excluded yielding a study population of 845 patients. The electronic medical records were queried for demographic information, data regarding ports and infections, and imaging review.ResultsHNC patients experienced more infections (42 vs. 30), an increased infection rate per 1,000 catheter days (0.68 vs. 0.21), and more early infections within 30 days compared to non-HNC patients (10 vs. 6) (p < 0.001, p < 0.001, p = 0.02, respectively). An existing tracheostomy at the time of port placement was associated with infection in the HNC group (p = 0.02) but was not an independent risk factor for infection in the study population overall (p = 0.06). There was a significant difference in age, male gender, and right-sided ports between the HNC and non-HNC groups (p < 0.01, p < 0.001, and p = 0.01), although these were not found to be independent risk factors for infection (p = 0.32, p = 0.76, p = 0.16).ConclusionHNC patients are at increased risk for infection of dual-lumen chest ports placed via a jugular approach compared to patients with other malignancies. Tracheostomy is associated with infection in HNC patients but is not an independent risk factor for infection in the oncologic population as a whole.

  7. Prophylactic treatment of mycotic mucositis in radiotherapy of patients with head and neck cancers

    International Nuclear Information System (INIS)

    Koc, M.; Aktas, E.

    2003-01-01

    Patients undergoing radiotherapy for head and neck cancer are at increased risk of developing oral candidiasis. The objective of this study was to investigate the clinical Candida mucositis and interruptions in radiotherapy in patients suffering from head and neck cancer, receiving fluconazole in comparison with a control group without specific prophylaxis. Eighty consecutive patients were randomized in a prospective double-blind trial of prophylactic oral fluconazole or treatment with the same drug when mycotic infections appeared. Adult head and neck cancer patients who were undergoing treatment with radiotherapy and/or chemotherapy, radiotherapeutic coverage of the entire oropharynx and oral cavity at least 3 cm anterior to the retromolar trigone and receiving a total dose of more than 6000 cGy and Karnofsky Performance Status (KPS) >70 were included in the study. Group A received radiation therapy plus fluconazole (Fluzole 100 mg/day) starting from the sixth irradiation session throughout the treatment; 40 patients in group B received the same baseline treatment, but were given fluconazole only when mycotic infections appeared. We evaluated 37 patients in group A and the first 37 patients were evaluated in group B. Three of the patients in group A (8.1%) and 14 of the patients in group B (37.8%) demonstrated clinical candidasis. Radiotherapy was interrupted in all of these patients. The differences between the two groups were statistically significant with respect to clinical candidiasis (P=0.005). The median discontinuation time was 5 days (range, 3-7 days) in group A and 7 days (range, 4-10 days) in group B. The median dose resulting in clinical candidiasis was 3200 cGy (range, 2200-5800 cGy) in all groups. In the fluconazole group it was 4200 cGy and in the control group 2800 cGy. These results suggest that patients undergoing head and neck radiation therapy are at risk of developing candidiasis and that fluconazole may be used to reduce the frequency of

  8. Prophylactic treatment of mycotic mucositis in radiotherapy of patients with head and neck cancers

    Energy Technology Data Exchange (ETDEWEB)

    Koc, M.; Aktas, E. [Ataturk Univ., Erzurum (Turkey). Medical School

    2003-02-01

    Patients undergoing radiotherapy for head and neck cancer are at increased risk of developing oral candidiasis. The objective of this study was to investigate the clinical Candida mucositis and interruptions in radiotherapy in patients suffering from head and neck cancer, receiving fluconazole in comparison with a control group without specific prophylaxis. Eighty consecutive patients were randomized in a prospective double-blind trial of prophylactic oral fluconazole or treatment with the same drug when mycotic infections appeared. Adult head and neck cancer patients who were undergoing treatment with radiotherapy and/or chemotherapy, radiotherapeutic coverage of the entire oropharynx and oral cavity at least 3 cm anterior to the retromolar trigone and receiving a total dose of more than 6000 cGy and Karnofsky Performance Status (KPS) >70 were included in the study. Group A received radiation therapy plus fluconazole (Fluzole 100 mg/day) starting from the sixth irradiation session throughout the treatment; 40 patients in group B received the same baseline treatment, but were given fluconazole only when mycotic infections appeared. We evaluated 37 patients in group A and the first 37 patients were evaluated in group B. Three of the patients in group A (8.1%) and 14 of the patients in group B (37.8%) demonstrated clinical candidasis. Radiotherapy was interrupted in all of these patients. The differences between the two groups were statistically significant with respect to clinical candidiasis (P=0.005). The median discontinuation time was 5 days (range, 3-7 days) in group A and 7 days (range, 4-10 days) in group B. The median dose resulting in clinical candidiasis was 3200 cGy (range, 2200-5800 cGy) in all groups. In the fluconazole group it was 4200 cGy and in the control group 2800 cGy. These results suggest that patients undergoing head and neck radiation therapy are at risk of developing candidiasis and that fluconazole may be used to reduce the frequency of

  9. Head and neck cancer patient perspectives regarding pain, cosmesis, swallow function, voice quality and overall quality of life

    International Nuclear Information System (INIS)

    Bhatia, Vinona; Harari, Paul M.; Thompson, Sandra P.; Ford, Charles N.; Hartig, Gregory K.

    1996-01-01

    Purpose/Objective: Head and neck (H and N) cancer patients can experience unique and sometimes severe tumor-induced and treatment-precipitated alterations in physical appearance and function. This study was carried out to assist in defining H and N cancer patient perceptions regarding overall quality of life with particular attention to issues of pain, cosmesis, swallow function and voice quality. Materials and Methods: A series of 119 H and N cancer patients were studied over a 12-month period using a combination of personal interview and provision of selected questionnaires. The interview included administration of 2 assessment tools with each patient during the personal interview: the Performance Status Scale for H and N Cancer and the Karnofsky Performance Scale (KPS). Each patient then received a packet containing 4 additional tools with general instructions to complete and return the questionnaires via mail or at their next follow-up check. These tools included the Functional Assessment of Cancer Therapy for H and N Cancer (FACT-H and N), the Memorial Symptom Assessment Scale (MSAS), a Tumor Outcome Assessment Survey and a Visual Analog Scale (VAS) regarding life quality. All patients were interviewed twice (identical procedure) by the data manager at 3-5 month intervals. Seventy-six males and 43 females with a mean age of 63 years were studied. Forty-one patients had received treatment with radiation alone, 35 with surgery alone and 43 with combined surgery and postoperative radiation. Twenty-four percent of the patient cohort had Stage I/II tumors, whereas 76% had Stage III/IV tumors. Results: A primary categorization of patients was identified based upon cancer treatment date. New patients were considered those within 3 months of their cancer diagnosis (23 patients), intermediate patients were those between 3 months and 2 years from diagnosis (72 patients) and long-term patients were those greater than 2 years from cancer diagnosis (24 patients). The

  10. Does initial haemoglobin level modify the efficacy of radiosensitizers. An analysis of the MRC misonidazole studies in head and neck cancer and cervix cancer

    International Nuclear Information System (INIS)

    Freedman, L.S.; Honess, D.J.; Bleehen, N.M.; Adams, G.E.; Henk, J.M.

    1987-01-01

    The authors report a new analysis of the data from two Medical Research Council (MRC) studies of misonidazole in the treatment of head and neck cancer (MRC Working Party 1984a) and cancer of the cervix (MRC Working Party 1984 b). There were no clear differences in local failure or survival rates between the groups of patients receiving misonidazole and placebo in either head and neck or cervix study. (author)

  11. Ways of understanding the encounter with head and neck cancer patients in the hospital dental team--a phenomenographic study.

    Science.gov (United States)

    Röing, Marta; Hirsch, J-M; Holmström, Inger

    2006-10-01

    Head and neck cancer is the sixth most common malignancy in the world. Fifty percent of the patients can be cured by surgery, radiotherapy or a combination approach. Head and neck cancer is life-threatening, and treatment may leave the patient with visible facial disfigurements and impairment of functions such as speech and eating. This affects not only the patient, but may arouse difficult feelings in the treatment staff. Dental personnel are involved in all facets of treatment, yet they have no specific training in cancer care. The aim of this study was to describe the variation in ways dental personnel understand and experience the encounter with head and neck cancer patients, as the way of understanding a certain phenomenon is judged to be fundamental to the way we act and form our beliefs. Twenty members of hospital dental teams were interviewed. The interviews focused on experiences of the encounter with head and neck cancer patients. A qualitative research approach, phenomenography, was used in analysing the interviews. The encounter was perceived in three qualitatively different ways: as an act of caring, as a serious and responsible task and as an overwhelming emotional situation. The results indicate that hospital dental personnel are not able to lean on education and professional training in finding ways of dealing with situations with strong emotional impact. This has implications for the treatment of patients with head and neck cancer, as well as education of dental personnel.

  12. Conservative neck dissection in oral cancer patients: A 5 years retrospective study

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    Wan Mahadzir Wan Mustafa

    2016-06-01

    Full Text Available The impact of ablative oral cancer surgery was studied, with reference to recurrence and nodal metastasis,  survival probability and prognostic indicators and to determine if ethnicity influences the survival of patients. Patients who underwent major ablative surgery of the head and neck region with neck dissection were identified and assessed. Those with stage I-IV oral and oropharyngeal malignancies necessitating resection with or without radiotherapy from 2004 to 2009 were included in this study. All individuals had a pre-operative assessment and post operative assessment. Survival distributions were analyzed using Kaplan-Meier curves. Eighty seven patients (males: 38%; females: 62% were included in this study, with an age range of 21-85 years. Some 78% underwent neck dissections while 63% had surgery and radiotherapy. Nodal and primary site recurrence was 5.7% and 20.5%. The median survival time was 57 months. One year Overall Survival (OS rate was 72.7% and three year overall survival rate 61.5%. The log-rank test showed a significant difference of survival between Malay and Chinese patients (Bonferroni correction p=0.033. Recurrence-Free Survival (RFS analysis revealed that 25% of the patients have reached the event of recurrence at 46 months. The three year survival rate was 76.1%. In the RFS analysis, the log-rank test showed a significant difference in the event of recurrence and nodal metastasis (p<0.001. Conservative neck effectively controls neck metastases. Ethnicity influence  survival.

  13. Metachronous Second Primary Malignancies after Head and Neck Cancer in a Korean Cohort (1993-2010.

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    Yuh-S Jung

    Full Text Available Second primary malignancy (SPM is the major long-term cause of patient mortality with head and neck squamous cell carcinoma (HNSCC. As the incidence of high-risk human papillomavirus (HPV-related HNSCC is increasing globally, we analyzed the patterns of SPM occurrence, the effect of the index tumor site along with attributes to HPV, and the effect of SPM on survival in South Korean patients with head and neck cancer (HNC. Data were retrieved from the Korea Central Cancer Registry, a nationwide population-based cancer registry, from 1993 to 2010. Standardized incidence ratios were analyzed and compared between index tumor sites, particularly oropharyngeal vs. non-oropharyngeal sites. After adjustment for competing risks, 3- and 5-year SPM rates were calculated using the cumulative incidence function. The effects of SPM occurrence on overall survival (OS were then analyzed. SPM rates were significantly lower for HPV-attributable oropharyngeal sites than for non-oropharyngeal sites, such as the larynx and hypopharynx (p<0.001. SPM rates were also lower for oral cavity first primary sites than for non-oropharyngeal first primary sites (p<0.001. SPMs typically occurred in the esophagus, lungs and the head and neck. Uterine cervical cancers occurred significantly more frequently after index oropharyngeal cancer in women. The 5-year and 10-year OS rates were 57.8 and 45.7% in all HNC patients, respectively. The OS after SPM occurrence was poor (5-year, 31.8%; 10-year, 20.8% compared to after index HNC occurrence (5-year, 68.4%; 10-year, 41.2%. SPM occurrence in the esophagus and lung/bronchus showed a worse OS than SPM localized to the head and neck. South Korean HNC patient, the first primary cancer site affected SPM risk and distribution. The 5- and 10-year OS rates deteriorated after SPM occurrence, particularly in the esophagus and lungs. Further optimization of follow-up strategies for effective surveillance of SPM, particularly in the esophagus

  14. Management of bladder neck stenosis and urethral stricture and stenosis following treatment for prostate cancer

    Science.gov (United States)

    Nicholson, Helen L.; Al-Hakeem, Yasser; Maldonado, Javier J.

    2017-01-01

    The aim of this review is to examine all urethral strictures and stenoses subsequent to treatment for prostate cancer, including radical prostatectomy (RP), radiotherapy, high intensity focused ultrasound (HIFU) and cryotherapy. The overall majority respond to endoscopic treatment, including dilatation, direct visual internal urethrotomy (DVIU) or bladder neck incision (BNI). There are adjunct treatments to endoscopic management, including injections of corticosteroids and mitomycin C (MMC) and urethral stents, which remain controversial and are not currently mainstay of treatment. Recalcitrant strictures are most commonly managed with urethroplasty, while recalcitrant stenosis is relatively rare yet almost always associated with bothersome urinary incontinence, requiring bladder neck reconstruction and subsequent artificial urinary sphincter (AUS) implantation, or urinary diversion for the devastated outlet. PMID:28791228

  15. Dental and nutritional management of the head and neck cancer patient

    International Nuclear Information System (INIS)

    Lee, W. Robert; Sandow, Pamela L.; Moore, Giselle J.

    1996-01-01

    This course will examine the expected acute and late normal tissue toxicities associated with the delivery of high dose radiation therapy to the head and neck region. The purpose of this course will be to identify strategies to reduce radiotherapy-related toxicity without compromising adequate tumor treatment. A multidisciplinary approach will be emphasized and the following topics will be addressed: 1) Appropriate dental evaluation prior to the institution of treatment, oral care during radiation therapy and management of dental complications following completion of treatment. 2) Treatment techniques that accurately localize the target tissue, displace normal tissues from high dose volume and reduce the volume of normal tissue included in the radiation portals. 3) The investigative use of radioprotective agents. 4) The nutritional management of head and neck cancer patients including enteral and parenteral nutrition. 5) The use of medications to reduce the severity of acute symptomatology before, during and after radiation therapy

  16. Dental and nutritional management of the head and neck cancer patient

    International Nuclear Information System (INIS)

    Lee, W. Robert; Sandow, Pamela L.; Moore, Giselle J.

    1997-01-01

    This course will examine the expected acute and late normal tissue toxicities associated with the delivery of high dose radiation therapy to the head and neck region. The purpose of this course will be to identify strategies to reduce radiotherapy-related toxicity without compromising adequate tumor treatment. A multidisciplinary approach will be emphasized and the following topics will be addressed: 1) Appropriate dental evaluation prior to the institution of treatment, oral care during radiation therapy and management of dental complications following completion of treatment. 2) Treatment techniques that accurately localize the target tissue, displace normal tissues from high dose volume and reduce the volume of normal tissue included in the radiation portals. 3) The investigative use of radioprotective agents. 4) The nutritional management of head and neck cancer patients including enteral and parenteral nutrition. 5) The use of medications to reduce the severity of acute symptomatology before, during and after radiation therapy

  17. Impact of HPV infection on the development of head and neck cancer

    Science.gov (United States)

    Betiol, J.; Villa, L.L.; Sichero, L.

    2013-01-01

    Human papillomavirus (HPV)-related head and neck squamous cell carcinoma (HNSCC) is considered to be a distinct clinical entity with better prognosis than the classical tobacco- and alcohol-associated tumors. The increasing incidence of this neoplasia during the last decades highlights the need to better understand the role of HPV in the development of these cancers. Although the proportion of HNSCC attributed to HPV varies considerably according to anatomical site, overall approximately 25% of all HNSCC are HPV-DNA positive, and HPV-16 is by far the most prevalent type. In this review we discuss the existing evidence for a causal association between HPV infection and HNSCC at diverse anatomical head and neck subsites. PMID:23532264

  18. In vivo dosimetry using thermoluminescent detector in cancer therapy of head and neck

    International Nuclear Information System (INIS)

    Viegas, Claudio C.B.; Batista, D.V.; Campos, A.M.; Lopes, R.T.

    2002-01-01

    The viability and implementation of a routine in vivo dosimetry, using thermoluminescent dosemeters (TLD), at the radiotherapy section of the National Institute of Cancer in Brazil, in the case of head and neck treatment is shown. In order to reach that aim, the characteristics of the response of the LiF:Mg;Ti (TLD-100) thermoluminescent detectors in powder form were determined. The performed of this detector for in vivo dosimetry was testes using an RANDO Alderson anthropomorphic phantom and, once their adequability proved for the kind of measurements proposed , it was used for dose assessment in the case of tumour treatments in the head and neck regions, for Cobalt-60 irradiations. (author)

  19. Oral adverse events to radiotherapy in geriatric patients with head and neck cancer. INOR. 2008

    International Nuclear Information System (INIS)

    Garcia Heredia, Gilda L.; Miranda Tarrago, Josefa; Lence Anta, Juan; Chong Chu, Ivon

    2009-01-01

    For every million people newly diagnosed with cancer, up to 400,000 may have oral complications. The trend toward increasing age of the population and the need to keep patients in good oral health requires prior dental care in patients with cancer who are subjected to various treatments onco specific. We tried to show adverse reactions early and late treatment related radiation the existing oral health status in patients with head and neck cancer. We performed a prospective study of patients diagnosed with head and neck cancer treated with radiation in the period from January to December 2008, at the National Institute of Oncology and Radiobiology. 100 patients were examined. Adverse events were collected and their intensity, classified according to CTC version 3.1. 70 patients were initially evaluated as being deficient in the oral health status. Xerostomia and mucositis immediate adverse events were more frequent and intense, while the caries postradiation and consequential events were delayed with greater frequency. We found an association between oral health status and the occurrence of adverse events, which resulted in treatment interruptions. The persistent oral conditions determine the duration and intensity of adverse events mouth of Radiotherapy, which leads to treatment interruptions, with implications for therapeutic results. (Author)

  20. Evaluation of Reirradiation in Locally Advanced Head and Neck Cancers: Toxicity and Early Clinical Outcomes

    Directory of Open Access Journals (Sweden)

    Amit Bahl

    2018-01-01

    Full Text Available Objectives. Locoregional recurrence is the predominant pattern of treatment failure in advanced head and neck cancers. Reirradiation is a useful modality to treat inoperable head and neck cancer patients with recurrent disease. The aim of the present study was to analyze the treatment toxicity and early clinical outcomes in patients undergoing reirradiation. Methods. Twenty patients of head and neck cancers with recurrences or second cancers were evaluated. Reirradiation was done using simultaneous integrated boost volumetric modulated arc therapy (SIB VMAT, intensity modulated radiotherapy (IMRT, or conventional radiotherapy using 6MV photons. Dose prescription ranged from 30 to 60 Gy in conventional fractionation. Results. Seventeen males and three females were evaluated in this analysis. The median age of patients under study was 56.5 years. At time of analysis 8 patients (40% had a complete response, 7 patients (35% had progressive disease, and 25% had partial response or stable disease. Grade III-IV mucositis, dermatitis, xerostomia, dysphagia, and trismus were seen in 20%, 20%, 50%, 35%, and 45% patients, respectively, during retreatment. Patients receiving a radiotherapy dose less than 45 Gy showed a higher incidence of progressive disease (p=0.01. The median disease-free survival for patients receiving reirradiation dose of ≥46 Gy was 19±3.3 months (median ± S Error compared to 8±2.61 months for those with a dose prescription less than 45 Gy (p=0.03. At 18-month follow-up 26% of patients undergoing reirradiation were disease-free. Conclusions. Our results show improved tumor control using a prescription of doses ≥46 Gy in retreatment setting.

  1. Internet use among head and neck cancer survivors in the North West of England.

    Science.gov (United States)

    Rogers, Simon N; Rozek, Aleksandra; Aleyaasin, Narges; Promod, Prakash; Lowe, Derek

    2012-04-01

    In general, use of the internet by patients in their healthcare is increasing. However, its use specifically among those with head and neck cancer in the UK has not been reported. The aims of this study were to report access to the internet by survivors of head and neck cancer, to indicate where it fits within their information sources, how they have used it, and how they might use it in future. A question on its use has been included in annual surveys of patients since 2006. Patient-reported access to the internet increased from 32% in 2006 to 54% in 2010. There were considerable differences in access by age; currently (2010) 83% of those under 55 years, and 40% of those aged 65-84 years. Binary logistic regression modelling involving age at survey (peducation (psex (p=0.01), gave all three as independent predictors of access. In the 2010 survey 49% (234/473) never used the internet, 10% (49/473) used it rarely, 15% (70/473) used it occasionally, and 25% (120/473) used it often. The main reasons for its use for head and neck cancer were to find information, learn about treatment, side effects, and medication, and obtain advice from members of multidisciplinary teams. The findings of this study show that the internet has an important role for patients in providing information and support about their cancer, although other sources are still very important. Data from the study will help inform those promoting e-health about the type of resource that is wanted by patients. Copyright © 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  2. P53 overexpression and outcome of radiation therapy in head and neck cancers

    International Nuclear Information System (INIS)

    Kim, In Ah; Choi, Ihl Bhong; Kang, Ki Mun; Jang, Ji Young; Kim, Kyung Mi; Park, Kyung Shin; Kim, Young Shin; Kang, Chang Suk; Cho, Seung Ho; Kim, Hyung Tae

    1999-01-01

    Experimental studies have implicated the wild type p53 in cellular response to radiation. Whether altered p53 function can lead to changes in clinical radiocurability remains an area of ongoing study. This study was performed to investigate whether any correlation between change of p53 and outcome of curative radiation therapy in patients with head and neck cancers. Immunohistochemical analysis with a mouse monoclonal antibody (D0-7) specific for human p53 was used to detect to overexpression of protein in formalin fixed, paraffin-embedded tumor sample from 55 head and neck cancer patients treated with curative radiation therapy (median dose of 7020 cGy) from February 1988 to March 1996 at St. Mary's Hospital. Overexpression of p53 was correlated with locoregional control and survival using Kaplan-Meier method. A Cox regression multivariate analysis was performed that included all clinical variables and status of p53 expression. Thirty-seven (67.2%) patients showed overexpression of p53 by immunohistochemical staining in their tumor. One hundred percent of oral cavity, 76% of laryngeal, 66.7% of oropharyngeal, 66.7% of hypopharyngeal cancer showed p53 overexpression (p=0.05). The status of p53 had significant relationship with stage of disease (p=0.03) and history of smoking (p=0.001). The overexpression of p53 was not predictive of response rate to radiation therapy. The locoregional control was not significantly affected by p53 status. Overexpression of p53 didn't have any prognostic implication for disease free survival and overall survival. Primary site and stage of disease were significant prognostic factors for survival. The p53 overexpression as detected by immunohistochemical staining had significant correlation with stage, primary site of disease and smoking habit of patients. The p53 overexpression didn't have any predictive value for outcome of curative radiation therapy in a group of head and neck cancers

  3. Radiomic Machine Learning Classifiers for Prognostic Biomarkers of Head & Neck Cancer

    Directory of Open Access Journals (Sweden)

    Chintan eParmar

    2015-12-01

    Full Text Available Introduction: Radiomics extracts and mines large number of medical imaging features in a non-invasive and cost-effective way. The underlying assumption of radiomics is that these imaging features quantify phenotypic characteristics of entire tumor. In order to enhance applicability of radiomics in clinical oncology, highly accurate and reliable machine learning approaches are required. In this radiomic study, thirteen feature selection methods and eleven machine learning classification methods were evaluated in terms of their performance and stability for predicting overall survival in head and neck cancer patients. Methods: Two independent head and neck cancer cohorts were investigated. Training cohort HN1 consisted 101 HNSCC patients. Cohort HN2 (n=95 was used for validation. A total of 440 radiomic features were extracted from the segmented tumor regions in CT images. Feature selection and classification methods were compared using an unbiased evaluation framework. Results: We observed that the three feature selection methods MRMR (AUC = 0.69, Stability = 0.66, MIFS (AUC = 0.66, Stability = 0.69, and CIFE (AUC = 0.68, Stability = 0.7 had high prognostic performance and stability. The three classifiers BY (AUC = 0.67, RSD = 11.28, RF (AUC = 0.61, RSD = 7.36, and NN (AUC = 0.62, RSD = 10.52 also showed high prognostic performance and stability. Analysis investigating performance variability indicated that the choice of classification method is the major factor driving the performance variation (29.02% of total variance. Conclusions: Our study identified prognostic and reliable machine learning methods for the prediction of overall survival of head and neck cancer patients. Identification of optimal machine-learning methods for radiomics based prognostic analyses could broaden the scope of radiomics in precision oncology and cancer care.

  4. Radiotherapy on the neck nodes predicts severe weight loss in patients with early stage laryngeal cancer

    International Nuclear Information System (INIS)

    Langius, Jacqueline A.E.; Doornaert, Patricia; Spreeuwenberg, Marieke D.; Langendijk, Johannes A.; Leemans, C. Rene; Schueren, Marian A.E. van Bokhorst-de van der

    2010-01-01

    Background and purpose: Although patients with early stage (T1/T2) laryngeal cancer (LC) are thought to have a low incidence of malnutrition, severe weight loss is observed in a subgroup of these patients during radiotherapy (RT). The objective of this study was to evaluate weight loss and nutrition-related symptoms in patients with T1/T2 LC during RT and to select predictive factors for early identification of malnourished patients. Methods: Of all patients with T1/T2 LC, who received primary RT between 1999 and 2007, the following characteristics were recorded: sex, age, TNM classification, tumour location, radiation schedule, performance status, quality of life, weight loss, and nutrition-related symptoms. The association between baseline characteristics and malnutrition (>5% weight loss during RT) was investigated by Cox regression analysis. Results: The study population consisted of 238 patients. During RT, 44% of patients developed malnutrition. Tumour location, TNM classification, RT on the neck nodes, RT dose, nausea/vomiting, pain, swallowing, senses problems, trouble with social eating, dry mouth and the use of painkillers were all significantly associated with malnutrition. In the multivariate analysis, RTs on both the neck nodes (HR 4.16, 95% CI 2.62-6.60) and dry mouth (HR 1.72, 95% CI 1.14-2.60) remained predictive. Nevertheless, RT on the neck nodes alone resulted in the best predictive model for malnutrition scores. Conclusions: Patients with early stage laryngeal cancer are at risk of malnutrition during radiotherapy. Radiotherapy on the neck nodes is the best predictor of malnutrition during radiotherapy. Therefore, we suggest to offer nutritional counselling to all the patients who receive nodal irradiation.

  5. Nonrigid Image Registration for Head and Neck Cancer Radiotherapy Treatment Planning With PET/CT

    International Nuclear Information System (INIS)

    Ireland, Rob H.; Dyker, Karen E.; Barber, David C.; Wood, Steven M.; Hanney, Michael B.; Tindale, Wendy B.; Woodhouse, Neil; Hoggard, Nigel; Conway, John; Robinson, Martin H.

    2007-01-01

    Purpose: Head and neck radiotherapy planning with positron emission tomography/computed tomography (PET/CT) requires the images to be reliably registered with treatment planning CT. Acquiring PET/CT in treatment position is problematic, and in practice for some patients it may be beneficial to use diagnostic PET/CT for radiotherapy planning. Therefore, the aim of this study was first to quantify the image registration accuracy of PET/CT to radiotherapy CT and, second, to assess whether PET/CT acquired in diagnostic position can be registered to planning CT. Methods and Materials: Positron emission tomography/CT acquired in diagnostic and treatment position for five patients with head and neck cancer was registered to radiotherapy planning CT using both rigid and nonrigid image registration. The root mean squared error for each method was calculated from a set of anatomic landmarks marked by four independent observers. Results: Nonrigid and rigid registration errors for treatment position PET/CT to planning CT were 2.77 ± 0.80 mm and 4.96 ± 2.38 mm, respectively, p = 0.001. Applying the nonrigid registration to diagnostic position PET/CT produced a more accurate match to the planning CT than rigid registration of treatment position PET/CT (3.20 ± 1.22 mm and 4.96 ± 2.38 mm, respectively, p = 0.012). Conclusions: Nonrigid registration provides a more accurate registration of head and neck PET/CT to treatment planning CT than rigid registration. In addition, nonrigid registration of PET/CT acquired with patients in a standardized, diagnostic position can provide images registered to planning CT with greater accuracy than a rigid registration of PET/CT images acquired in treatment position. This may allow greater flexibility in the timing of PET/CT for head and neck cancer patients due to undergo radiotherapy

  6. Germline mutation in RNASEL predicts increased risk of head and neck, uterine cervix and breast cancer.

    Directory of Open Access Journals (Sweden)

    Bo Eskerod Madsen

    Full Text Available UNLABELLED: THE BACKGROUND: Ribonuclease L (RNASEL, encoding the 2'-5'-oligoadenylate (2-5A-dependent RNase L, is a key enzyme in the interferon induced antiviral and anti-proliferate pathway. Mutations in RNASEL segregate with the disease in prostate cancer families and specific genotypes are associated with an increased risk of prostate cancer. Infection by human papillomavirus (HPV is the major risk factor for uterine cervix cancer and for a subset of head and neck squamous cell carcinomas (HNSCC. HPV, Epstein Barr virus (EBV and sequences from mouse mammary tumor virus (MMTV have been detected in breast tumors, and the presence of integrated SV40 T/t antigen in breast carcinomas correlates with an aggressive phenotype and poor prognosis. A genetic predisposition could explain why some viral infections persist and induce cancer, while others disappear spontaneously. This points at RNASEL as a strong susceptibility gene. METHODOLOGY/PRINCIPAL FINDINGS: To evaluate the implication of an abnormal activity of RNase L in the onset and development of viral induced cancers, the study was initiated by searching for germline mutations in patients diagnosed with uterine cervix cancer. The rationale behind is that close to 100% of the cervix cancer patients have a persistent HPV infection, and if a defective RNase L were responsible for the lack of ability to clear the HPV infection, we would expect to find a wide spectrum of mutations in these patients, leading to a decreased RNase L activity. The HPV genotype was established in tumor DNA from 42 patients diagnosed with carcinoma of the uterine cervix and somatic tissue from these patients was analyzed for mutations by direct sequencing of all coding and regulatory regions of RNASEL. Fifteen mutations, including still uncharacterized, were identified. The genotype frequencies of selected single nucleotide polymorphisms (SNPs established in the cervix cancer patients were compared between 382 patients

  7. Role of EGF inhibitors in the treatment of recurrent or metastatic squamous cell head and neck cancer

    Directory of Open Access Journals (Sweden)

    Jochen H Lorch

    2009-11-01

    Full Text Available Jochen H LorchDana Farber Cancer institute, Boston, MA, USAAbstract: Squamous cell cancer of the head and neck (SCCHN is a major contributor to morbidity and mortality worldwide. In recent years, inhibition of the epidermal growth factor receptor has become an established treatment strategy in SCCHN both in the up-front treatment and in the recurrent and metastatic setting. This review summarizes the most important developments of the recent past and provides an overview of newer developments. Keywords: squamous cell cancer, head, neck, epidermal growth factor receptor

  8. Photodynamic Therapy for Head and Neck Dysplasia and Cancer

    Science.gov (United States)

    Rigual, Nestor R.; Thankappan, Krishnakumar; Cooper, Michele; Sullivan, Maureen A.; Dougherty, Thomas; Popat, Saurin R.; Loree, Thom R.; Biel, Merrill A.; Henderson, Barbara

    2009-01-01

    Objective To determine the response of dysplasia, carcinoma in situ (CIS), and T1 carcinoma of the oral cavity and larynx to photodynamic therapy with porfimer sodium. Design Prospective trial. Setting A National Cancer Institute–designated cancer institute. Patients Patients with primary or recurrent moderate to severe oral or laryngeal dysplasia, CIS, or T1N0 carcinoma. Intervention Porfimer sodium, 2 mg/kg of body weight, was injected intravenously 48 hours before treatment. Light at 630 nm for photosensitizer activation was delivered from an argon laser or diode laser using lens or cylindrical diffuser fibers. The light dose was 50 J/cm2 for dysplasia and CIS and 75 J/cm2 for carcinoma. Main Outcome Measures Response was evaluated at 1 week and at 1 month and then at 3-month intervals thereafter. Response options were complete (CR), partial (PR), and no (NR) response. Posttreatment biopsies were performed in all patients with persistent and recurrent visible lesions. Results Thirty patients were enrolled, and 26 were evaluable. Mean follow-up was 15 months (range, 7–52 months). Twenty-four patients had a CR, 1 had a PR, and 1 had NR. Three patients with oral dysplasia with an initial CR experienced recurrence in the treatment field. All the patients with NR, a PR, or recurrence after an initial CR underwent salvage treatment. Temporary morbidities included edema, pain, hoarseness, and skin phototoxicity. Conclusion Photodynamic therapy with porfimer sodium is an effective treatment alternative, with no permanent sequelae, for oral and laryngeal dysplasia and early carcinoma. PMID:19687399

  9. Feasibility of Primary Tumor Culture Models and Preclinical Prediction Assays for Head and Neck Cancer: A Narrative Review

    NARCIS (Netherlands)

    Dohmen, Amy J. C.; Swartz, Justin E.; van den Brekel, Michiel W. M.; Willems, Stefan M.; Spijker, René; Neefjes, Jacques; Zuur, Charlotte L.

    2015-01-01

    Primary human tumor culture models allow for individualized drug sensitivity testing and are therefore a promising technique to achieve personalized treatment for cancer patients. This would especially be of interest for patients with advanced stage head and neck cancer. They are extensively treated

  10. Effect of a 2-year home-based endurance training intervention on physiological function and PSA doubling time in prostate cancer patients

    DEFF Research Database (Denmark)

    Hvid, Thine; Lindegaard, Birgitte; Winding, Kamilla

    2016-01-01

    AIM: Physical activity after prostate cancer diagnosis has been shown to reduce the risk of disease progression. Here, we aimed to evaluate the effect of a 2-year home-based endurance training intervention on body composition, biomarkers levels, and prostate-specific antigen (PSA) doubling time...... as a surrogate end-point for progressing disease. METHODS: Out-clinic patients with either biochemical recurrence following radical prostatectomy or patients managed on active surveillance were randomized to either 24 months (3 times/week) of home-based endurance training or usual care. Aerobic fitness, body...... to 76 months (p body composition were not associated with the increased PSADT. The training group showed...

  11. Image-guided adaptive radiotherapy for prostate and head-and-neck cancers

    Science.gov (United States)

    O'Daniel, Jennifer C.

    In the current practice of radiation therapy, daily patient alignments have been based on external skin marks or on bone. However, internal organ variation (both motion and volumetric changes) between treatment fractions can displace the treatment target, causing target underdosage and normal tissue overdosage. In order to deliver the radiation treatment as planned, more accurate knowledge of the daily internal anatomy was needed. Additionally, treatments needed to adapt to these variations by either shifting the patient to account for the daily target position or by altering the treatment plan. In this dissertation, the question of whether inter-fractional variations in internal patient anatomy combined with external set-up uncertainties produced measurable differences between planned and delivered doses for prostate and head-and-neck cancer patients was investigated. Image-guided adaptive treatment strategies to improve tumor coverage and/or reduce normal tissue dose were examined. Treatment deliveries utilizing various alignment procedures for ten prostate cancer patients and eleven head-and-neck cancer patients, each of whom received multiple CT scans over the course of treatment, were simulated. The largest prostate dose losses between planning and delivery were correlated with anterior/posterior and superior/inferior prostate displacement. Daily bone alignment sufficiently maintained target coverage for 70% of patients, ultrasound for 90%, and CT for 100%. A no-action-level correction protocol, which corrected the daily bone alignment for the systematic internal displacement of the prostate based on a pre-determined number of CT image sets, successfully improved the prostate and seminal vesicle dosimetric coverage. Three CT image sets were sufficient to accurately correct the bone alignment scheme for the prostate internal systematic shifts. For head-and-neck cancer patient treatment, setup uncertainties and internal organ variations did not greatly affect

  12. Radiofrequency ablation of sphenopalatine ganglion for head and neck cancer pain management

    Directory of Open Access Journals (Sweden)

    Priti R Sanghavi

    2017-01-01

    Full Text Available Introduction: Pain in advanced head and neck cancer is intractable and many a times difficult to manage with pharmacological agents. Sphenopalatine ganglion (SPG block provides excellent pain relief in patients who are suffering from various types of orofacial pain. Role of radiofrequency ablation (RFA of SPG is described for orofacial cancer pain. Aim: The aim of the study was to observe efficacy and duration of pain relief by RFA of SPG in advanced head and neck cancer patients. Materials and Methods: Thirty-three patients suffering from advanced head and neck cancer were enrolled in this study between September 2013 and February 2016. All patients underwent RFA of SPG, under fluoroscopy guidance following a successful diagnostic block of SPG with local anesthetic. Pain was assessed before the procedure, immediately after the procedure, and during each follow-up visit. Follow-up visits were weekly for 4 weeks and then monthly till the end of life. Patients were continued on oral morphine, but the dose was reduced to one-third of total dose and was adjusted according to patients' requirement during each follow-up. Duration of analgesia, morphine requirements, and incidence of complications were noted. Results: There were 32 males and one female. Mean age of patients was 43.24 ± 13.52 (mean ± standard deviation [SD], ranging from 19 to 58 years. Three patients did not undergo RFA due to cheek hematoma formation during the procedure. Visual analog score was reduced from 8.43 ± 1.10 (preprocedure to 1.36 ± 1.61 (postprocedure (mean ± SD. Mean duration of analgesia was 17.55 ± 26.12 (mean ± SD weeks. Mean reduction in the dose of morphine was from 124.65 ± 46.78 to 40.00 ± 18.05 mg (mean ± SD immediately after the procedure. One patient was followed up for 30 months. Sixteen patients died within 3 months and had good pain relief. None of the patients had any serious complications. Conclusion: RFA of SPG is a good adjuvant method of pain

  13. Lugol's iodine dye-enhanced endoscopy in patients with cancer of the oesophagus and head and neck.

    Science.gov (United States)

    Chisholm, E M; Williams, S R; Leung, J W; Chung, S C; Van Hasselt, C A; Li, A K

    1992-12-01

    Lugol's iodine dye indicates the presence of unsuspected early oesophageal cancers during endoscopy at which such cancers fail to show the characteristic black colour change. We evaluated Lugol's iodine dye-enhanced endoscopy in 17 patients with oesophageal cancer. In a further 37 patients with head and neck cancer we examined the use of Lugol's iodine since these patients have a 29% risk of synchronous oesophageal cancer. The oesophagus was sprayed with Lugol's iodine (1.5%) during endoscopy. Any areas not turning black were biopsied. In 13 patients with oesophageal cancer discrete areas beyond the macroscopically obvious primary tumour showed no change in colour. Biopsy revealed cancer in all cases. Six synchronous cancers were found in the head and neck group, one of which was identified only by the use of Lugol's iodine. Lugol's iodine augmented the information gained about the oesophageal mucosa during endoscopy. It revealed unsuspected cancer which altered the management of patients with primary oesophageal cancer as well as those with head and neck cancer. We recommend the routine use of Lugol's iodine-enhanced endoscopy for surveillance of all 'at risk' oesophageal cases.

  14. Recent advances in head and neck cancer reconstruction

    Directory of Open Access Journals (Sweden)

    Prabha Yadav

    2014-01-01

    Full Text Available Treatment of cancer is race against time! Following radical excision, breathing, speech, mastication and swallowing are hampered. Face is invariably involved. Beside functional normalcy, excellent cosmetic restoration is necessary for patient′s life quality. Primary wound healing, quick resumption of adequate oral intake, prompt initiation of chemo-radiotherapy has direct bearing on cure. Primary reconstruction with pedicle or free flap is the choice of treatment in most protocols. Composite defects are requiring bone, muscle and skin restrict choice of donor site and may have shortfalls in aesthetic and functional requirements. To improve further newer, and newer modalities are being developed and used to give best aesthetic and functions. Navigation, use of three-dimensional imaging, stereo lithic model and custom made implant for reconstruction are recommended as they promise improvement in aesthetics. Robotic surgeries allow access for resection of tumours and reconstruction with free flap in deep oropharynx obviating need of doing mandibulotomy. Researchers in stem cell and tissue engineering are looking forward to regenerating tissues and avoid the need of autologous tissue flaps. Desired tissue combination across counter may be available in the future. Excellent immunosuppressant drugs have made it possible to reconstruct composite facial anatomical units with allotransplant in a single surgery, along sensory and motor recovery! Mythological heterogenic head transplant like clone Ganesha, will be a reality in the near future!!

  15. Assessment of percutaneous endoscopic gastrostomy (PEG) in head and neck cancer patients

    International Nuclear Information System (INIS)

    Kakuta, Risako; Matsuura, Kazuto; Noguchi, Tetsuya; Katagiri, Katsunori; Imai, Takayuki; Ishida, Eichi; Saijyo, Shigeru; Kato, Kengo

    2011-01-01

    As nutrition support for head and neck cancer patients who receive chemoradiotherapy (CRT) and whose oral cavity or pharynx is exposed to radiation, we perform percutaneous endoscopic gastrostomy (PEG) tube placement. We examined 235 patients who underwent PEG in our division between January 2003 and December 2009. For 64% of them, the purpose of performing PEG was nutrition support for CRT, of whom 74% actually used the tube. However, the situation varied according to the primary sites of patients. Forty-four percent of laryngeal cancer patients who underwent PEG actually used the tube, which was a significantly lower rate than others. Also, 81% of them removed the PEG tube within one year. These findings suggest that PEG-tube placement for nutrition support is not indispensable for all CRT cases. Therefore, we recommend performing PEG for oral, oropharyngeal, and hypopharyngeal cancer patients. (author)

  16. Human Papilloma Virus as a Biomarker for Personalized Head and Neck Cancer Radiotherapy.

    Science.gov (United States)

    Eriksen, Jesper Grau; Lassen, Pernille

    A dramatic increase in the incidence of HPV-related oropharyngeal cancer has been reported in some parts of the western world over the past 30 years. They constitute a clinically distinct subgroup of cancers in terms of molecular biology, patient characteristics, and treatment outcome. This chapter describes the molecular characteristics, epidemiology, and demographics of the HPV-related head and neck cancers and discuss available methods to detect HPV-related tumours. The impact of HPV-related biomarkers in clinical studies on radiotherapy only, altered fractionation, modulation of hypoxia, and concurrent chemo- or bio-radiotherapy are reviewed as well as the perspectives of de-escalation and immune-modulation are discussed.

  17. Arsenic, cadmium, chromium and nickel in cancerous and healthy tissues from patients with head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Khlifi, Rim, E-mail: rimkhlifi@yahoo.fr [Marine Ecotoxicology, UR 09-03, Sfax University, IPEIS, BP 805, 3018 Sfax (Tunisia); Bioinformatics Unit, Centre of Biotechnology of Sfax, BP 1177, 3018 Sfax (Tunisia); Olmedo, Pablo; Gil, Fernando [Department of Legal Medicine and Toxicology, University of Granada (Spain); Hammami, Bouthaina; Chakroun, Amine [Department of Otorhinolaryngology, HUC Habib Borguiba Hospital, Sfax (Tunisia); Rebai, Ahmed [Bioinformatics Unit, Centre of Biotechnology of Sfax, BP 1177, 3018 Sfax (Tunisia); Hamza-Chaffai, Amel [Marine Ecotoxicology, UR 09-03, Sfax University, IPEIS, BP 805, 3018 Sfax (Tunisia)

    2013-05-01

    Chronic exposure to heavy metals has long been recognized as being capable to increase head and neck cancer incidence among exposed human populations. Head and neck cancer is a significant public health issue in Tunisia. The aim of the present study was to evaluate the concentrations of As, Cd, Cr and Ni in healthy and tumor tissues of head and neck cancer patients. Metal concentrations were determined in tumor and healthy tissues of 101 head and neck cancer patients, using Atomic Absorption Spectrometry. The As, Cd, Cr, and Ni levels in tumor tissues were 3.4, 2.5, 1.3 and 1.5 times higher than those of healthy tissues (p < 0.05), respectively. Tumor tissue metal levels were higher in men than in women. As and Cd levels in tumor and healthy tissue samples of patients smokers are significantly higher than those of non-smokers (p < 0.05). A strong effect of cumulative smoking as expressed in the number of pack per year, and tumor tissue Cd levels were positively associated with three groups of age (< 40, 51–60 and > 60 years) in both never-smokers and ever-smokers (< 20 and ≥ 20 pack per year). Healthy tissue Cd levels were negatively associated with age in those three groups of smokers. The highest Cd and Cr concentrations among both workers and non-workers were observed in tumor tissues. The Cd and Cr in tissues of farmers, bricklayers and painters were all significantly higher among the workers as compared with the non-workers group. Tissue metal levels have increased due to smoking and occupational exposure. Heavy metal exposure via tobacco smoking and occupational exposures may increase the risk of head and neck in the Tunisian population. - Highlights: ► Heavy metal levels in tumor tissues were higher than those in healthy tissues. ► Tumor tissue Cd levels were positively associated with age in smokers. ► Tumor tissue metal levels were higher in men than in women. ► The highest Cd and Cr concentrations among workers were observed in tumor tissues

  18. Prediction of post-treatment trismus in head and neck cancer patients.

    Science.gov (United States)

    Lee, R; Slevin, N; Musgrove, B; Swindell, R; Molassiotis, A

    2012-06-01

    Our aim was to establish the incidence of trismus over time, together with risk factors (including quality of life (QoL)) for the prediction of trismus after treatment in patients with cancer of the head and neck. It was a longitudinal study of 152 patients accepted for primary operation who attended the head and neck cancer clinic of a tertiary referral cancer centre in the United Kingdom. A total of 87 patients was studied prospectively. Our results showed that 41/87 (47%) of patients presented with trismus, 57/80 (71%) had postoperative trismus, and 41/52 (79%) had trismus 6 months after operation or radiotherapy (trismus defined as a maximum mouth opening of ≤ 35 mm). Men and those who drank a lot of alcohol were less likely to have trismus after treatment. QoL variables showed that pain, eating, chewing, taste, saliva, social functioning, social contact, and dry mouth were significantly more impaired in the trismus group than among those without trismus. Postoperative differences in QoL between the two groups highlighted problems with social function and role-playing, fatigue, activity, recreation, and overall reduction in QoL. Women, and those who do not drink alcohol, are at particularly high risk of developing trismus, and, to prevent it and treat it, patients may benefit from multidisciplinary management at an early stage during treatment. Copyright © 2011 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  19. A TRACER 3D Co-Culture tumour model for head and neck cancer.

    Science.gov (United States)

    Young, Miki; Rodenhizer, Darren; Dean, Teresa; D'Arcangelo, Elisa; Xu, Bin; Ailles, Laurie; McGuigan, Alison P

    2018-05-01

    Cancer-associated fibroblasts (CAFs) are a key component of the tumour microenvironment and have been shown to play an important role in the progression of cancer. To probe these tumour-stroma interactions, we incorporated CAFs derived from head and neck cancer patients and squamous carcinoma cells of the hypopharynx (FaDu) into the Tissue Roll for the Analysis of Cellular Environment and Response (TRACER) platform to establish a co-culture platform that simulates the CAF-tumour microenvironmental interactions in head and neck tumours. TRACER culture involves infiltrating cells into a thin fibrous scaffold and then rolling the resulting biocomposite around a mandrel to generate a 3D and layered structure. Patterning the fibrous scaffold biocomposite during fabrication enables control over the specific location of different cell populations in the rolled configuration. Here, we optimized the seeding densities and configurations of the CAF and FaDu cell tissue sections to enable a robust 3D co-culture system under normoxic conditions. Co-culture of CAFs with FaDu cells produced negligible effects on radiation resistance, but did produce increases in proliferation rate and invasive cell migration at 24 and 48 h of culture. Our study provides the basis for use of our in vitro co-culture TRACER model to investigate the tumour-stroma interactions, and to bridge the translational gap between preclinical and clinical studies. Copyright © 2018 Elsevier Ltd. All rights reserved.

  20. Nutritional Interventions in Head and Neck Cancer Patients Undergoing Chemoradiotherapy: A Narrative Review

    Directory of Open Access Journals (Sweden)

    Maurizio Bossola

    2015-01-01

    Full Text Available The present review aimed to define the role of nutritional interventions in the prevention and treatment of malnutrition in HNC patients undergoing CRT as well as their impact on CRT-related toxicity and survival. Head and neck cancer patients are frequently malnourished at the time of diagnosis and prior to the beginning of treatment. In addition, chemo-radiotherapy (CRT causes or exacerbates symptoms, such as alteration or loss of taste, mucositis, xerostomia, fatigue, nausea and vomiting, with consequent worsening of malnutrition. Nutritional counseling (NC and oral nutritional supplements (ONS should be used to increase dietary intake and to prevent therapy-associated weight loss and interruption of radiation therapy. If obstructing cancer and/or mucositis interfere with swallowing, enteral nutrition should be delivered by tube. However, it seems that there is not sufficient evidence to determine the optimal method of enteral feeding. Prophylactic feeding through nasogastric tube or percutaneous gastrostomy to prevent weight loss, reduce dehydration and hospitalizations, and avoid treatment breaks has become relatively common. Compared to reactive feeding (patients are supported with oral nutritional supplements and when it is impossible to maintain nutritional requirements enteral feeding via a NGT or PEG is started, prophylactic feeding does not offer advantages in terms of nutritional outcomes, interruptions of radiotherapy and survival. Overall, it seems that further adequate prospective, randomized studies are needed to define the better nutritional intervention in head and neck cancer patients undergoing chemoradiotherapy.

  1. Emerging Phytochemicals for the Prevention and Treatment of Head and Neck Cancer

    Directory of Open Access Journals (Sweden)

    Santosh K. Katiyar

    2016-11-01

    Full Text Available Despite the development of more advanced medical therapies, cancer management remains a problem. Head and neck squamous cell carcinoma (HNSCC is a particularly challenging malignancy and requires more effective treatment strategies and a reduction in the debilitating morbidities associated with the therapies. Phytochemicals have long been used in ancient systems of medicine, and non-toxic phytochemicals are being considered as new options for the effective management of cancer. Here, we discuss the growth inhibitory and anti-cell migratory actions of proanthocyanidins from grape seeds (GSPs, polyphenols in green tea and honokiol, derived from the Magnolia species. Studies of these phytochemicals using human HNSCC cell lines from different sub-sites have demonstrated significant protective effects against HNSCC in both in vitro and in vivo models. Treatment of human HNSCC cell lines with GSPs, (−-epigallocatechin-3-gallate (EGCG, a polyphenolic component of green tea or honokiol reduced cell viability and induced apoptosis. These effects have been associated with inhibitory effects of the phytochemicals on the epidermal growth factor receptor (EGFR, and cell cycle regulatory proteins, as well as other major tumor-associated pathways. Similarly, the cell migration capacity of HNSCC cell lines was inhibited. Thus, GSPs, honokiol and EGCG appear to be promising bioactive phytochemicals for the management of head and neck cancer.

  2. Anxiety and depression in patients after surgery for head and neck cancer in Japan.

    Science.gov (United States)

    Suzuki, Miho; Deno, Minako; Myers, Mie; Asakage, Takahiro; Takahashi, Koji; Saito, Kenichi; Mori, Yoshiyuki; Saito, Hiroto; Ichikawa, Yuji; Yamamoto-Mitani, Noriko; Miyashita, Mitsunori

    2016-06-01

    The present study sought to examine the impact of physical symptoms, facial disfigurement, adequacy of preoperative information, and social support on anxiety and depression in Japanese patients with head and neck cancer (HNC) who had undergone surgery. A cross-sectional study with 194 patients was conducted using a self-administered questionnaire. This instruments included the Hospital Anxiety and Depression Scale (HADS), the European Organization for Research and Treatment of Cancer (EORTC) Head and Neck cancer module (QLQ-H&N35), and a Social Support Scale developed by Okabayashi et al. (1997). The majority (56.7%) had surgery two or more years before completing the questionnaire. More than 25% of respondents showed anxiety or depression. Higher levels of perceived social support were associated with lower rates of anxiety and depression (p anxiety, and reduced sexuality was associated with depression (p anxiety or depression. Survivors of HNC experience anxiety and depression for an extended period of time. Social support may alleviate the severity of these disorders. More research is needed to confirm the impact of facial disfigurement and that of the preoperative information provided by surgeons on psychological distress in HNC patients.

  3. Productivity Losses Associated with Head and Neck Cancer Using the Human Capital and Friction Cost Approaches.

    Science.gov (United States)

    Pearce, Alison M; Hanly, Paul; Timmons, Aileen; Walsh, Paul M; O'Neill, Ciaran; O'Sullivan, Eleanor; Gooberman-Hill, Rachael; Thomas, Audrey Alforque; Gallagher, Pamela; Sharp, Linda

    2015-08-01

    Previous studies suggest that productivity losses associated with head and neck cancer (HNC) are higher than in other cancers. These studies have only assessed a single aspect of productivity loss, such as temporary absenteeism or premature mortality, and have only used the Human Capital Approach (HCA). The Friction Cost Approach (FCA) is increasingly recommended, although has not previously been used to assess lost production from HNC. The aim of this study was to estimate the lost productivity associated with HNC due to different types of absenteeism and premature mortality, using both the HCA and FCA. Survey data on employment status were collected from 251 HNC survivors in Ireland and combined with population-level survival estimates and national wage data. The cost of temporary and permanent time off work, reduced working hours and premature mortality using both the HCA and FCA were calculated. Estimated total productivity losses per employed person of working age were EUR253,800 using HCA and EUR6800 using FCA. The main driver of HCA costs was premature mortality (38% of total) while for FCA it was temporary time off (73% of total). The productivity losses associated with head and neck cancer are substantial, and return to work assistance could form an important part of rehabilitation. Use of both the HCA and FCA approaches allowed different drivers of productivity losses to be identified, due to the different assumptions of the two methods. For future estimates of productivity losses, the use of both approaches may be pragmatic.

  4. Nutritional Interventions in Head and Neck Cancer Patients Undergoing Chemoradiotherapy: A Narrative Review

    Science.gov (United States)

    Bossola, Maurizio

    2015-01-01

    The present review aimed to define the role of nutritional interventions in the prevention and treatment of malnutrition in HNC patients undergoing CRT as well as their impact on CRT-related toxicity and survival. Head and neck cancer patients are frequently malnourished at the time of diagnosis and prior to the beginning of treatment. In addition, chemo-radiotherapy (CRT) causes or exacerbates symptoms, such as alteration or loss of taste, mucositis, xerostomia, fatigue, nausea and vomiting, with consequent worsening of malnutrition. Nutritional counseling (NC) and oral nutritional supplements (ONS) should be used to increase dietary intake and to prevent therapy-associated weight loss and interruption of radiation therapy. If obstructing cancer and/or mucositis interfere with swallowing, enteral nutrition should be delivered by tube. However, it seems that there is not sufficient evidence to determine the optimal method of enteral feeding. Prophylactic feeding through nasogastric tube or percutaneous gastrostomy to prevent weight loss, reduce dehydration and hospitalizations, and avoid treatment breaks has become relatively common. Compared to reactive feeding (patients are supported with oral nutritional supplements and when it is impossible to maintain nutritional requirements enteral feeding via a NGT or PEG is started), prophylactic feeding does not offer advantages in terms of nutritional outcomes, interruptions of radiotherapy and survival. Overall, it seems that further adequate prospective, randomized studies are needed to define the better nutritional intervention in head and neck cancer patients undergoing chemoradiotherapy. PMID:25569622

  5. Relation of allium vegetables intake with head and neck cancers: evidence from the INHANCE consortium.

    Science.gov (United States)

    Galeone, Carlotta; Turati, Federica; Zhang, Zuo-Feng; Guercio, Valentina; Tavani, Alessandra; Serraino, Diego; Brennan, Paul; Fabianova, Eleonora; Lissowska, Jola; Mates, Dana; Rudnai, Peter; Shangina, Oxana; Szeszenia-Dabrowska, Neonila; Vaughan, Thomas L; Kelsey, Karl; McClean, Michael; Levi, Fabio; Hayes, Richard B; Purdue, Mark P; Bosetti, Cristina; Brenner, Hermann; Pelucchi, Claudio; Lee, Yuan-Chin Amy; Hashibe, Mia; Boffetta, Paolo; La Vecchia, Carlo

    2015-09-01

    Only a few studies analyzed the role of allium vegetables with reference to head and neck cancers (HNC), with mixed results. We investigated the potential favorable role of garlic and onion within the International Head and Neck Cancer Epidemiology (INHANCE) Consortium. We analyzed pooled individual-level data from eight case-control studies, including 4590 cases and 7082 controls. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) for associations between garlic and onion intakes and HNC risk. Compared with no or low garlic use, the ORs of HNC were 0.95 (95% CI 0.71-1.27) for intermediate and 0.74 (95% CI 0.55-0.99) for high garlic use (p for trend = 0.02). The ORs of HNC for increasing categories of onion intake were 0.91 (95% CI 0.68-1.21) for >1 to ≤3 portions per week, and 0.83 (95% CI 0.60-1.13) for >3 portions per week (p for trend = 0.02), as compared to <1 portion per week. We found an inverse association between high onion intake and laryngeal cancer risk (OR = 0.69; 95% CI 0.54-0.88), but no significant association for other subsites. The results of this pooled-analysis support a possible moderate inverse association between garlic and onion intake and HNC risk. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  6. Parotid gland sparing with helical tomotherapy in head-and-neck cancer.

    Science.gov (United States)

    Voordeckers, Mia; Farrag, Ashraf; Everaert, Hendrik; Tournel, Koen; Storme, Guy; Verellen, Dirk; De Ridder, Mark

    2012-10-01

    This study evaluated the ability of helical tomotherapy to spare the function of the parotid glands in patients with head-and-neck cancer by analyzing dose-volume histograms, salivary gland scintigraphy, and quality of life assessment. Data from 76 consecutive patients treated with helical tomotherapy (Hi-Art Tomotherapy) at the University Hospital Brussel were analyzed. During planning, priority was given to planning target volume (PTV) coverage: ≥ 95% of the dose must be delivered to ≥ 95% of the PTV. Elective nodal regions received 54 Gy (1.8 Gy/fraction). A dose of 70.5 Gy (2.35 Gy/fraction) was prescribed to the primary tumor and pathologic lymph nodes (simultaneous integrated boost scheme). Objective scoring of salivary excretion was performed by salivary gland scintigraphy. Subjective scoring of salivary gland function was evaluated by the European Organization for Research and Treatment of Cancer quality of life questionnaires Quality of Life Questionnaire-C30 (QLQ-C30) and Quality of Life Questionnaire-Head and Neck 35 (H&N35). Analysis of dose-volume histograms (DVHs) showed excellent coverage of the PTV. The volume of PTV receiving 95% of the prescribed dose (V95%) was 99.4 (range, 96.3-99.9). DVH analysis of parotid gland showed a median value of the mean parotid dose of 32.1 Gy (range, 17.5-70.3 Gy). The median parotid volume receiving a dose parotid function, and quality of life assessment of our patient group showed that helical tomotherapy makes it possible to preserve parotid gland function without compromising disease control. We recommend mean parotid doses of parotid volume as planning goals. Intensity-modulated radiotherapy should be considered as standard treatment in patients with head-and-neck cancer. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. Prospective Study of Psychosocial Distress Among Patients Undergoing Radiotherapy for Head and Neck Cancer

    International Nuclear Information System (INIS)

    Chen, Allen M.; Jennelle, Richard; Grady, Victoria; Tovar, Adrienne; Bowen, Kris; Simonin, Patty; Tracy, Janice; McCrudden, Dale; Stella, Jonathan R.; Vijayakumar, Srinivasan

    2009-01-01

    Purpose: To determine the prevalence of psychosocial distress among patients undergoing radiotherapy (RT) for head and neck cancer and to examine the association between depression and anxiety and demographic and medical variables. Methods and Materials: A total of 40 patients (25 men and 15 women) with nonmetastatic head and neck cancer were enrolled in this prospective study and underwent RT administered with definitive (24 patients) or postoperative (16 patients) intent. Twenty patients (50%) received concurrent chemotherapy. All patients completed the Hospital Anxiety and Depression Scale and Beck Depression Inventory-II instrument before RT, on the last day of RT, and at the first follow-up visit. The effect of patient-, tumor-, and treatment-related factors on psychosocial distress was analyzed. Results: The prevalence of mild to severe pre-RT depression was 58% and 45% using the Hospital Anxiety and Depression Scale-D and Beck Depression Inventory-II scale, respectively. The prevalence of severe pre-RT anxiety was 7%. The depression levels, as determined by the Hospital Anxiety and Depression Scale and Beck Depression Inventory-II instrument increased significantly during RT and remained elevated at the first follow-up visit (p < 0.001 for both). The variables that were significantly associated with post-RT depression included a greater pre-RT depression level, employment status (working at enrollment), younger age (<55 years), single marital status, and living alone (p < 0.05, for all). Conclusion: The results of our study have shown that an alarming number of patients undergoing RT for head and neck cancer have symptoms suggestive of psychosocial distress even before beginning treatment. This proportion increases significantly during RT. Studies investigating the role of antidepressants and/or psychiatric counseling might be warranted in the future

  8. Tobacco Smoking During Radiation Therapy for Head-and-Neck Cancer Is Associated With Unfavorable Outcome

    International Nuclear Information System (INIS)

    Chen, Allen M.; Chen, Leon M.; Vaughan, Andrew; Sreeraman, Radhika; Farwell, D. Gregory; Luu, Quang; Lau, Derick H.; Stuart, Kerri; Purdy, James A.; Vijayakumar, Srinivasan

    2011-01-01

    Purpose: To evaluate the effect of continued cigarette smoking among patients undergoing radiation therapy for head-and-neck cancer by comparing the clinical outcomes among active smokers and quitters. Methods and Materials: A review of medical records identified 101 patients with newly diagnosed squamous cell carcinoma of the head and neck who continued to smoke during radiation therapy. Each active smoker was matched to a control patient who had quit smoking before initiation of radiation therapy. Matching was based on tobacco history (pack-years), primary site, age, sex, Karnofsky Performance Status, disease stage, radiation dose, chemotherapy use, year of treatment, and whether surgical resection was performed. Outcomes were compared by use of Kaplan-Meier analysis. Normal tissue effects were graded according to the Radiation Therapy Oncology Group/European Organization for the Treatment of Cancer toxicity criteria. Results: With a median follow-up of 49 months, active smokers had significantly inferior 5-year overall survival (23% vs. 55%), locoregional control (58% vs. 69%), and disease-free survival (42% vs. 65%) compared with the former smokers who had quit before radiation therapy (p < 0.05 for all). These differences remained statistically significant when patients treated by postoperative or definitive radiation therapy were analyzed separately. The incidence of Grade 3 or greater late complications was also significantly increased among active smokers compared with former smokers (49% vs. 31%, p = 0.01). Conclusions: Tobacco smoking during radiation therapy for head-and-neck cancer is associated with unfavorable outcomes. Further studies analyzing the biologic and molecular reasons underlying these differences are planned.

  9. Inhibition of Hsp27 Radiosensitizes Head-and-Neck Cancer by Modulating Deoxyribonucleic Acid Repair

    Energy Technology Data Exchange (ETDEWEB)

    Guttmann, David M.; Hart, Lori [Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (United States); Du, Kevin [Department of Radiation Oncology, New York University School of Medicine, New York, New York (United States); Seletsky, Andrew [Department of Biology, Drexel University, Philadelphia, Pennsylvania (United States); Koumenis, Constantinos, E-mail: koumenis@xrt.upenn.edu [Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (United States)

    2013-09-01

    Purpose: To present a novel method of tumor radiosensitization through Hsp27 knockdown using locked nucleic acid (LNA) and to investigate the role of Hsp27 in DNA double strand break (DSB) repair. Methods and Materials: Clonogenic survival assays, immunoblotting, the proximity ligation assay, and γH2AX foci analysis were conducted in SQ20B and FaDu human head-and-neck cancer cell lines treated with Hsp27 LNA and Hsp27 short hairpin RNA (shRNA). Additionally, nude mice with FaDu flank tumors were treated with fractionated radiation therapy after pretreatment with Hsp27 LNA and monitored for tumor growth. Results: Hsp27 LNA and Hsp27 shRNA radiosensitized head-and-neck cancer cell lines in an Hsp27-dependent manner. Ataxia-Telangectasia Mutated-mediated DNA repair signaling was impaired in irradiated cells with Hsp27 knockdown. ATM kinase inhibition abrogated the radiosensitizing effect of Hsp27. Furthermore, Hsp27 LNA and shRNA both attenuated DNA repair kinetics after radiation, and Hsp27 was found to colocalize with ATM in both untreated and irradiated cells. Last, combined radiation and Hsp27 LNA treatment in tumor xenografts in nude mice suppressed tumor growth compared with either treatment alone. Conclusions: These results support a radiosensitizing property of Hsp27 LNA in vitro and in vivo, implicate Hsp27 in double strand break repair, and suggest that Hsp27 LNA might eventually serve as an effective clinical agent in the radiotherapy of head-and-neck cancer.

  10. Comparison of acute toxicities of two chemotherapy schedules for head and neck cancers

    Directory of Open Access Journals (Sweden)

    Geeta S

    2006-01-01

    Full Text Available Background: Chemo-radiotherapy has become the standard of care for loco-regionally advanced head and neck cancers. Platinum based regimens are the most effective. Although benefits are proven with chemo-radiation, acute toxicities are markedly increased. The dose and delivery schedules of Cisplatin have ranged from intermittent higher dose [100 mg/m2] every 3 weeks to low dose [6 mg/m2] daily administration. At present there is no data indicating which regimen is superior. Purpose: To compare acute toxicities of two chemotherapy schedules for head and neck cancers. Materials and Methods: A total of 83 head and neck cancer patients treated with two schedules of concurrent chemo RT were analyzed, retrospectively, for treatment toxicity. In group A [51 patients], chemotherapy [CT] was administered on week 1, 4 and 7 [cisplatin 100 mg/m2] over a period of 2-3 days. In group B [32 patients], CT was delivered weekly [cisplatin 40 mg/m2]. Radiotherapy dose was 7000 cGy in 35 fractions for definitive concurrent chemo-radiation and 6600 cGy in 33 fractions for adjuvant treatment. Results: Group B patients had increased grade III skin and hematological toxicity, where as patients in group A had more pharyngeal toxicity. Treatment interruptions and percentage of weight loss were higher in group B. Weekly CT schedule had higher rate of severe mucositis, which was statistically significant on both univariate [ P =0.005] and multivariate [ P =0.007] analysis. Conclusions: Three weekly CT is less toxic than weekly. Weekly CT can be made more acceptable by reducing the dose and using feeding tubes for nutrition.

  11. Dynamic intensity-modulated non-coplanar arc radiotherapy (INCA) for head and neck cancer

    International Nuclear Information System (INIS)

    Krayenbuehl, Jerome; Davis, J. Bernard; Ciernik, I. Frank

    2006-01-01

    Background and purpose: To define the potential advantages of intensity-modulated radiotherapy (IMRT) applied using a non-coplanar dynamic arc technique for the treatment of head and neck cancer. Materials and methods: External beam radiotherapy (EBRT) was planned in ten patients with head and neck cancer using coplanar IMRT and non-coplanar arc techniques, termed intensity modulated non-coplanar arc EBRT (INCA). Planning target volumes (PTV1) of first order covered the gross tumor volume and surrounding clinical target volume treated with 68-70 Gy, whereas PTV2 covered the elective lymph nodes with 54-55 Gy using a simultaneous internal boost. Treatment plan comparison between IMRT and INCA was carried out using dose-volume histogram and 'equivalent uniform dose' (EUD). Results: INCA resulted in better dose coverage and homogeneity of the PTV1, PTV2, and reduced dose delivered to most of the organs at risk (OAR). For the parotid glands, a reduction of the mean dose of 2.9 (±2.0) Gy was observed (p 0.002), the mean dose to the larynx was reduced by 6.9 (±2.9) Gy (p 0.003), the oral mucosa by 2.4 (±1.1) Gy (p < 0.001), and the maximal dose to the spinal cord by 3.2 (±1.7) Gy (p = 0.004). The mean dose to the brain was increased by 3.0 (±1.4) Gy (p = 0.002) and the mean lung dose increased by 0.2 (±0.4) Gy (p = 0.87). The EUD suggested better avoidance of the OAR, except for the lung, and better coverage and dose uniformity were achieved with INCA compared to IMRT. Conclusion: Dose delivery accuracy with IMRT using a non-coplanar dynamic arc beam geometry potentially improves treatment of head and neck cancer

  12. Effect of irradiation upon the bacterial flora in patients with head and neck cancer

    International Nuclear Information System (INIS)

    Rice, D.H.; Gill, G.

    1979-01-01

    Twenty-two consecutive patients with cancer of the head and neck, who were to receive a full tumoricidal dose of irradiation to a field that included the oral cavity and pharynx, were studied to determine the effect of the irradiation on their local bacterial flora. Aerobic cultures were taken prior to, at the completion of, and one month after the completion of their irradiation. The percentage of patients with potentially pathogenic organisms increased dramatically as the effect of the irradiation increased. This change in the local flora has obvious implications concerning the increased incidence of postoperative wound infections in patients who have received prior irradiation

  13. Failure pattern and salvage treatment after radical treatment of head and neck cancer

    DEFF Research Database (Denmark)

    Pagh, Anja; Grau, Cai; Overgaard, Jens

    2016-01-01

    Purpose The aim of the study was to test the hypothesis that head and neck cancer (HNC) patients benefit from specialized follow-up (FU), as this strategy ensures timely detection of relapses for successful salvage treatment. This was done by evaluation of the pattern of failure, the temporal...... recordings of recurrent disease in 567 patients with primary tumors of the larynx, pharynx, oral cavity, nasal cavity, paranasal sinuses and salivary glands. A review of medical records was performed in order to update and supplement the database. Results Failures of the 567 patients were primarily in T...

  14. Pathophysiology of Radiation-Induced Dysphagia in Head and Neck Cancer.

    Science.gov (United States)

    King, Suzanne N; Dunlap, Neal E; Tennant, Paul A; Pitts, Teresa

    2016-06-01

    Oncologic treatments, such as curative radiotherapy and chemoradiation, for head and neck cancer can cause long-term swallowing impairments (dysphagia) that negatively impact quality of life. Radiation-induced dysphagia comprised a broad spectrum of structural, mechanical, and neurologic deficits. An understanding of the biomolecular effects of radiation on the time course of wound healing and underlying morphological tissue responses that precede radiation damage will improve options available for dysphagia treatment. The goal of this review is to discuss the pathophysiology of radiation-induced injury and elucidate areas that need further exploration.

  15. Changes in the Submandibular Gland in Patients with Head and Neck Cancer After Radiation Therapy

    DEFF Research Database (Denmark)

    Uchiyama, Y.; Kreiborg, Sven; Murakami, Shumei

    2017-01-01

    Aim: The purpose of this study was to assess the impairment of the submandibular gland, in terms of changes in volume by computed tomography (CT) and CT value, which was the mean pixel value at a region of interest, in a group of patients with head and neck cancer treated with radiation therapy (RT......). Patients and Methods: Eleven patients treated with RT, where the effective radiation dose to the submandibular gland was known, were included in the study. CT scanning was performed both before and after RT. The average follow-up period after RT was 555 days (range=107-1231 days). Results: The mean volume...

  16. [Radiologic analysis of known-interval cancers after 2 years of organized mass screening for breast cancer in Ille-et-Vilaine].

    Science.gov (United States)

    de Korvin, B; Courtel, M L; Bohec, C; Durand, G; Piette, C; Le Frêche, J N; Duvauferrier, R; Ramée, A

    1998-11-01

    The first thirty-two known interval breast cancers (appearing within the first or second year after a negative screen) occurring during a two-year breast screening round were reviewed and the radiograms analyzed. Five classes were established: true interval cancers (13/32 cases), radiologically occult cancers (2/32), cancers with no specific sign (7/32), false negative cancers (5/32) and unclassifiable cancers (5/32). In more than 50% of the cases, there was no abnormality on the initial radiographic test, although the literature reports that the rate of false-negatives in interval cancers is less than 20%. Standard classification (by at least 3 readers) is very important to provide a possible explanation of cancer development. Action should be initiated to reduce their number.

  17. CT and MRI matching for radiotherapy planning in head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Rasch, C.; Keus, R.; Touw, A.; Lebesque, J.; Van Herk, M. [Nederlands Kanker Inst. `Antoni van Leeuwenhoekhuis`, Amsterdam (Netherlands)

    1995-12-01

    The objective of this study was to evaluate the impact of matched CT and MRI information on target delineation in radiotherapy planning for head and neck tumors. MRI images of eight patients with head and neck cancer in supine position, not necessarily obtained in radiotherapy treatment position were matched to the CT scans made in radiotherapy position using automatic three-dimensional chamfer-matching of bony structures. Four independent observers delineated the Gross Tumor Volume (GTV) in CT scans and axial and sagittal MR scans. The GTV`s were compared, overlapping volumes and non-overlapping volumes between the different datasets and observers were determined. In all patients a good match of CT and MRI information was accomplished in the head region. The combined information provided a better visualisation of the GTV, oedema and normal tissues compared with CT or MRI alone. Determination of overlapping and non-overlapping volumes proved to be a valuable tool to measure uncertainties in the determination of the GTV. CT-MRI matching in patients with head and neck tumors is feasible and makes a more accurate irradiation with higher tumor doses and less normal tissue complications possible. Remaining uncertainties in the determination of the GTV can be quantified using the combined information of MRI and CT.

  18. Critical appraisal of a conformal head and neck cancer irradiation avoiding electron beams and field matching

    International Nuclear Information System (INIS)

    Fogliata, Antonella; Cozzi, Luca; Bieri, Sabine; Bernier, Jacques

    1999-01-01

    Purpose: In head and neck cancer patients, spinal chains are usually irradiated by a combination of photon and electron beams, requiring high precision in field matching. This study compares a conventional treatment approach where two lateral photon beams are combined to direct electron fields, to a conformal radiotherapy based on five photon fields, covering the whole neck. Methods and Materials: A comparative analysis of dose distributions and dose-volume histograms was carried out in patients with locally advanced head and neck tumors, for which planning target volumes (PTV) were outlined from the base of the skull down to the supraclavicular region. The prescribed dose to PTV (excluding booster irradiation) was 54 Gy, with spinal dose constraint not exceeding 75% of the total dose, whatever the technique. Results: For the new five-field technique, minimum and maximum point doses showed mean deviations, on five patients entered in the study, of 84% and 113% from the ICRU prescription point. In the conventional treatment, the corresponding figures were 73% and 112%, respectively. A positioning error analysis (isocenter displacement of 2 mm, in all directions) did not elicit any systematic difference in five-field treatment plans while hot spots were found with electron fields. Conclusions: The five-field technique appears routinely feasible and compares favorably with the conventional mixed photon- and electron-therapy approach, especially in regard to its better compliance with dose homogeneity requirements and a reduced risk in dose inhomogeneity related to field matching and patient positioning

  19. Quantitative interpretation method for detection of head and neck cancer with Tc-99m MIBI SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Seok, Ju Won; Kim, In Ju; Kim, Yong Ki; Wang, Soo Geun [College of Medicine, Pusan National Univ., Pusan (Korea, Republic of)

    2001-07-01

    The aim of this study was to present a method for diagnosis of head and neck cancer with Tc-99m MIBI SPECT by creating regions of interest (ROIs). Tc-99m MIBI SPECT was performed at 10 minutes after injection of 750 MBq of Tc-99m MIBI on 42 patients (36 males, 6 females. mean age=59.1yr) with the clinical suspicion for head and neck tumors. All lesions were histopathologically proven and data was analysed by creating ROIs over lesions and various backgrounds; submandibular gland (L/S), parotid gland (L/P). nuchal muscle (L/N), scalp muscle (L/Se). Each lesion to background ratios were calculated for each patients. Malignant disease were 37 patients and benign lesions were 5 patients, there was no statistically significant correlation between the histopathologic results and L/S ratio (p>0.05). L/P, L/N. L/Sc ratios of malignant disease and benign lesion revealed statistical difference (p<0.05). When ROC curve analysis was used, Area under the ROC curve of L/Sc ratio was largest. Sensitivity and specificity of MIBI SPECT using L/Sc ratio were 100% and 100%, respectively. It is more helpful and objective method appling L/Sc ratio to differentiating malignant from benign lesions in head and neck.

  20. Qualitative interpretation of PET scans using a Likert scale to assess neck node response to radiotherapy in head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Sjoevall, Johanna; Wahlberg, Peter [Lund University, Department of Otorhinolaryngology (ORL)-Head and Neck Surgery, Skane University Hospital, Lund (Sweden); Bitzen, Ulrika [Lund University, Department of Clinical Physiology and Nuclear Medicine, Skane University Hospital, Lund (Sweden); Kjellen, Elisabeth; Nilsson, Per; Brun, Eva [Lund University, Department of Oncology and Radiation Physics, Skane University Hospital, Lund (Sweden)

    2016-04-15

    The aim of this study was to determine whether PET scans after radiotherapy (RT), visually interpreted as equivocal regarding metabolic neck node response can be used to accurately categorize patients as responders or nonresponders using a Likert scale and/or maximum standardized uptake value (SUVmax). Other aims were to determine the performance of different methods for assessing post-RT PET scans (visual inspection, a Likert scale and SUVmax) and to establish whether any method is superior in predicting regional control (RC) and overall survival (OS). In 105 patients with neck node-positive head and neck cancer, the neck node response was evaluated by FDG PET/CT 6 weeks after RT. The scans were clinically assessed by visual inspection and, for the purposes of this analysis, re-evaluated using the Deauville criteria, a five-point Likert scale previously used in lymphoma studies. In addition, SUVmax was determined. All assessment methods were able to significantly predict RC but not OS. The methods were also able to significantly predict remission of tumour after completion of RT. Of the 105 PET scans, 19 were judged as equivocal on visual inspection. The Likert scale was preferable to SUVmax for grouping patients as responders or nonresponders. All methods (visual inspection, SUVmax and the Likert scale) identified responders and nonresponders and predicted RC. A Likert scale is a promising tool to reduce to a minimum the problem of PET scans judged as equivocal. Consensus regarding qualitative assessment would facilitate PET reporting in clinical practice. (orig.)

  1. Partners’ Long-term Appraisal of Their Caregiving Experience, Marital Satisfaction, Sexual Satisfaction, and Quality of Life 2 Years After Prostate Cancer Treatment

    Science.gov (United States)

    Harden, Janet K.; Sanda, Martin G.; Wei, John T.; Yarandi, Hossein; Hembroff, Larry; Hardy, Jill; Northouse, Laurel L.

    2013-01-01

    Background Partners of men treated for prostate cancer report more emotional distress associated with a diagnosis of prostate cancer than the men report; the duration of distress for partners is seldom examined. Objectives The purpose of this study was to determine the long-term effects of prostate cancer treatment on partners’ appraisal of their caregiving experience, marital satisfaction, sexual satisfaction, and quality of life (QOL) and factors related to these variables. Methods This exploratory study evaluated QOL among spouses of prostate cancer survivors at 24 months after treatment. Partners completed a battery of self-report questionnaires in a computer-assisted telephone interview. Results The sample consisted of 121 partners with average age of 60 years. There was a significant relationship between partners’ perceptions of bother about the man’s treatment outcomes and negative appraisal of their caregiving experience and poorer QOL. Younger partners who had a more negative appraisal of caregiving also had significantly worse QOL. Conclusions Men’s treatment outcomes continued to bother the partner and resulted in more negative appraisal and lower QOL 2 years after initial prostate cancer treatment. Younger partners may be at greater risk of poorer QOL outcomes especially if they have a more negative view of their caregiving experience. Implications for Practice Findings support prior research indicating that prostate cancer affects not only the person diagnosed with the disease but also his partner. Partners may benefit from tailored interventions designed to decrease negative appraisal and improve symptom management and QOL during the survivorship period. PMID:22728952

  2. Significance of p16 expression in head and neck cancer patients treated with radiotherapy and cetuximab

    Energy Technology Data Exchange (ETDEWEB)

    Heiduschka, Gregor; Thurnher, Dietmar [Medical University of Vienna, Department of Otorhinolaryngology - Head and Neck Surgery, Vienna (Austria); Grah, Anja; Kranz, Alexander; Selzer, Edgar [Medical University of Vienna, Department of Radiotherapy, Vienna (Austria); Oberndorfer, Felicitas; Wrba, Fritz [Medical University of Vienna, Department of Clinical Pathology, Vienna (Austria); Seemann, Rudolf [Medical University of Vienna, Department of Maxillofacial Surgery, Vienna (Austria); Kornek, Gabriela [Medical University of Vienna, Department of Medicine I - Division of Clinical Oncology, Vienna (Austria)

    2014-09-15

    HPV-infection, p16 positivity, and EGFR expression have been correlated with favorable responses of head and neck cancer patients treated with radiotherapy (RT) with or without chemotherapy. However, a possible correlation of HPV/p16 and EGFR status on the effect of RT in combination with cetuximab has not been sufficiently investigated. We analyzed tumor samples for p16 and EGFR expression and correlated these variables with treatment outcome. Cox-proportional-hazard regression models were applied to compare the risk of death among patients stratified according to risk factors. Survival was estimated by the Kaplan-Meier method. Results were compared with an institutional historical control group treated without cetuximab and with published data. Expression of p16 was predominantly found in oropharyngeal squamous cell cancer patients (OPSCC; 36.6 % positivity; 92 % of all cases), while EGFR was expressed at high levels in all tumor subsites (82 %). p16 expression was associated with improved overall survival in irradiated OPSCC patients (2-year overall survival of 80 % in p16-positive vs. 33 % overall survival in p16-negative patients). In a multivariable analysis covering all tumor sites, nodal stage (> N2a vs. ≤ N2a) and tumor site (OPSSC vs. non-OPSCC) had an impact on overall survival. Our results show that p16 positivity is associated with a favorable outcome in OPSCC patients treated with RT and cetuximab. (orig.) [German] HPV-Infektion, p16-Positivitaet und EGFR-Expression wurden bei Kopf-Hals-Tumorpatienten, die mit einer Strahlentherapie (RT) mit oder ohne Chemotherapie behandelt wurden, mit einem besseren Ergebnis in Verbindung gebracht. Bis jetzt wurde eine solche Korrelation bei Patienten, die mit einer RT in Kombination mit Cetuximab therapiert wurden, nicht untersucht. Es wurden die p16- und die EGFR-Expression in Tumormaterial untersucht und die Daten mit dem Behandlungsergebnissen korreliert. Um die Sterberisiken zu vergleichen, wurden Cox

  3. Reirradiation of Head and Neck Cancers With Intensity Modulated Radiation Therapy: Outcomes and Analyses

    Energy Technology Data Exchange (ETDEWEB)

    Takiar, Vinita [Department of Radiation Oncology, University of Cincinnati, Cincinnati, Ohio (United States); Garden, Adam S.; Ma, Dominic; Morrison, William H.; Edson, Mark [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Zafereo, Mark E. [Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Gunn, Gary B.; Fuller, Clifton D.; Beadle, Beth; Frank, Steven J. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); William, William N.; Kies, Merrill [Department of Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); El-Naggar, Adel K. [Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Weber, Randal [Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Rosenthal, David I. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Phan, Jack, E-mail: jphan@mdanderson.org [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States)

    2016-07-15

    Purpose: To review our 15-year institutional experience using intensity modulated radiation therapy (IMRT) to reirradiate patients with head and neck squamous cell carcinomas (HNSCC) and identify predictors of outcomes and toxicity. Methods and Materials: We retrospectively reviewed the records of 227 patients who received head and neck reirradiation using IMRT from 1999 to 2014. Patients treated with noncurative intent were excluded. Radiation-related acute and late toxicities were recorded. Prognostic variables included performance status, disease site, disease-free interval, chemotherapy, and RT dose and volume. Correlative analyses were performed separately for surgery and nonsurgery patients. Results: Two hundred six patients (91%) were retreated with curative intent, and 173 had HNSCC histology; 104 (50%) underwent salvage resection, and 135 (66%) received chemotherapy. Median follow-up after reirradiation was 24.7 months. Clinical outcomes were worse for HNSCC patients, with 5-year locoregional control, progression-free survival, and overall survival rates of 53%, 22%, and 32%, respectively, compared with 74%, 59%, and 79%, respectively, for non-HNSCC patients. On multivariate analysis, concurrent chemotherapy and retreatment site were associated with tumor control, whereas performance status was associated with survival. Favorable prognostic factors specific to surgery patients were neck retreatment and lack of extracapsular extension, whereas for nonsurgery patients, these were a nasopharynx subsite and complete response to induction chemotherapy. Actuarial rates of grade ≥3 toxicity were 32% at 2 years and 48% at 5 years, with dysphagia or odynophagia being most common. Increased grade ≥3 toxicity was associated with retreatment volume >50 cm{sup 3} and concurrent chemotherapy. Conclusions: Reirradiation with IMRT either definitively or after salvage surgery can produce promising local control and survival in selected patients with head and neck

  4. Impact of submandibular gland excision on salivary gland function in head and neck cancer patients.

    Science.gov (United States)

    Jaguar, G C; Lima, E N P; Kowalski, L P; Pellizon, A C; Carvalho, A L; Alves, F A

    2010-05-01

    Head and neck cancer surgery is often associated with neck dissection and usually includes the submandibular glands. Literature data related to remaining salivary gland function after surgery is scarce and controversial. A reduction in salivary output and increase in complaints of xerostomia have been suggested. However, a compensatory salivary mechanism has also been reported. The aim of this prospective study was to evaluate the effect of neck dissection (with submandibular excision) on salivary gland function measured by salivary flow rate and salivary gland scintigraphy. A total of 80 patients with head and neck tumors were evaluated. The surgery group was composed of 37 patients, who underwent submandibular gland resection, and the non-surgery group of 43 patients evaluated prior to radiation and/or chemotherapy treatment. Whole unstimulated and stimulated saliva collection and salivary gland scintigraphy were performed in all patients. Twenty-one percent of patients in the surgery group reported xerostomia, whereas 7% in the non-surgery group. The mean unstimulated salivary flow was 0.60 and 0.94 m/min for the surgery and non-surgery groups, respectively (p=0.008). Nevertheless, no statistical difference in the stimulated salivary flow was observed between the groups (p=0.26). In addition, the mean uptake and excretion rates for parotid and remaining submandibular glands also showed no statistical difference. The data of the present study support the contention that submandibular gland resection causes a decrease in unstimulated salivary volume. However, the residual submandibular glands in the surgery group showed similar function to that of submandibular glands in the non-surgery group. Consequently, the compensatory salivary mechanism seems not to be a possibility. Copyright (c) 2010 Elsevier Ltd. All rights reserved.

  5. Usefulness of fat suppression MR imagings for head and neck cancers

    International Nuclear Information System (INIS)

    Kitagawa, Yoshimasa; Ishii, Yasuo; Morihiro, Hironori; Ogasawara, Toshiyuki

    1996-01-01

    Large amounts of fat and complex anatomy make the head and neck region one of the more challenging areas for MR imagings. The high signal intensity of fat on T1 weighted images (T1W1) has limited the utility of Gd-DTPA in imaging of head and neck lesions. The contrast enhanced lesions may have T1W1 signal intensity similar to fat, which results in diagnostic difficulty. A fat suppression technique used in conjunction with Gd-DTPA ensures that enhancing lesions will not be obscured by high signal from the surrounding fat or by chemical shift artifact. We evaluated the role or chemical shift imagings for fat suppression in the depiction of 15 patients with head and neck cancers. Gd-DTPA-enhanced fat suppression T1W1 were compared with conventional pre and postcontrast T1- and T2W1 using a four-point grading system (Grade 0-3) in detecting and defining the extent of primary lesions and lymphnodes. Gd-DTPA-enhanced fat suppression T1W1 (average score 2.93) which had a score of 3 in 14 patients, were superior to conventional T1W1 (0.73), postcontrast T1W1 (1.80) and T2W1 (1.67). Gd-DTPA enhanced fat suppression T1W1 were particularly beneficial in the detection of central necrosis or extracapsular invasion of neck lymphnodes as well as in defining the extent of tumor invasion to fat-containing areas such as bone marrow or cheek. Our data suggested that fat suppression technique was extremely useful to delineate the primary tumors and regional lymphnodes without increasing scan time or image postprocessing. (author)

  6. Interactions between E-Cadherin and MicroRNA Deregulation in Head and Neck Cancers: The Potential Interplay

    Directory of Open Access Journals (Sweden)

    Thian-Sze Wong

    2014-01-01

    Full Text Available E-cadherin expression in the head and neck epithelium is essential for the morphogenesis and homeostasis of epithelial tissues. The cadherin-mediated cell-cell contacts are required for the anchorage-dependent growth of epithelial cells. Further, survival and proliferation require physical tethering created by proper cell-cell adhesion. Otherwise, the squamous epithelial cells will undergo programmed cell death. Head and neck cancers can escape from anoikis and enter into the epithelial-mesenchymal transition stages via the modulation of E-cadherin expression with epigenetic mechanisms. At epigenetic level, gene expression control is not dependent on the DNA sequence. In the context of E-cadherin regulation in head and neck cancers, 2 major mechanisms including de novo promoter hypermethylation and microRNA dysregulation are most extensively studied. Both of them control E-cadherin expression at transcription level and subsequently hinder the overall E-cadherin protein level in the head and neck cancer cells. Increasing evidence suggested that microRNA mediated E-cadherin expression in the head and neck cancers by directly/indirectly targeting the transcription suppressors of E-cadherin, ZEB1 and ZEB2.

  7. Risk factors for postoperative delirium in patients undergoing major head and neck cancer surgery: a meta-analysis.

    Science.gov (United States)

    Zhu, Yun; Wang, Gangpu; Liu, Shengwen; Zhou, Shanghui; Lian, Ying; Zhang, Chenping; Yang, Wenjun

    2017-06-01

    Postoperative delirium is common after extensive surgery. This study aimed to collate and synthesize published literature on risk factors for delirium in patients with head and neck cancer surgery. Three databases were searched (MEDLINE, Embase, and Cochrane Library) between January 1987 and July 2016. The Newcastle Ottawa Scale (NOS) was adopted to evaluate the study quality. Pooled odds ratios or mean differences for individual risk factors were estimated using the Mantel-Haenszel and inverse-variance methods. They provided a total of 1940 patients (286 with delirium and 1654 without), and predominantly included patients undergoing head and neck cancer surgery. The incidence of postoperative delirium ranged from 11.50% to 36.11%. Ten statistically significant risk factors were identified in pooled analysis. Old age, age >70 years, male sex, duration of surgery, history of hypertension, blood transfusions, tracheotomy, American Society of Anesthesiologists physical status grade at least III, flap reconstruction and neck dissection were more likely to sustain delirium after head and neck cancer surgery. Delirium is common in patients undergoing major head neck cancer surgery. Several risk factors were consistently associated with postoperative delirium. These factors help to highlight patients at risk of developing delirium and are suitable for preventive action. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  8. Potential prevention: Aloe vera mouthwash may reduce radiation-induced oral mucositis in head and neck cancer patients.

    Science.gov (United States)

    Ahmadi, Amirhossein

    2012-08-01

    In recent years, more head and neck cancer patients have been treated with radiotherapy. Radiation-induced mucositis is a common and dose limiting toxicity of radiotherapy among patients with head and neck cancers. Patients undergoing radiation therapy for head and neck cancer are also at increased risk of developing oral candidiasis. A number of new agents applied locally or systemically to prevent or treat radiation-induced mucositis have been investigated, but there is no widely accepted prophylactic or effective treatment for mucositis. Topical Aloe vera is widely used for mild sunburn, frostbites, and scalding burns. Studies have reported the beneficial effects of Aloe gel for wound healing, mucous membrane protection, and treatment of oral ulcers, in addition to antiinflammatory, immunomudulation, antifungal, scavenging free radicals, increasing collagen formation and inhibiting collagenase. Herein the author postulates that oral Aloe vera mouthwash may not only prevent radiation-induced mucositis by its wound healing and antiinflammatory mechanism, but also may reduce oral candidiasis of patients undergoing head and neck radiotherapy due to its antifungal and immunomodulatory properties. Hence, Aloe vera mouthwash may provide an alternative agent for treating radiation-induced oral mucositis and candidiasis in patients with head and neck cancers.

  9. Cancer Stem Cells Accountability in Progression of Head and Neck Squamous Cell Carcinoma: The Most Recent Trends!

    Directory of Open Access Journals (Sweden)

    Samapika Routray

    2014-01-01

    Full Text Available Cancer stem cells (CSCs play a major role in local recurrence and metastatic spread in head and neck squamous cell carcinomas (HNSCC. Evidence suggests that cancer stem cells are resistant to conventional therapy. So the emerging concepts of the role of cancer stem cells in the pathobiology of HNSCC should be understood carefully to be able to create new paradigms in treatment plans.

  10. AKT and MET signalling mediates antiapoptotic radioresistance in head neck cancer cell lines.

    Science.gov (United States)

    Ettl, Tobias; Viale-Bouroncle, Sandra; Hautmann, Matthias G; Gosau, Martin; Kölbl, Oliver; Reichert, Torsten E; Morsczeck, Christian

    2015-02-01

    Induction of apoptosis is a major mechanism of radiosensitivity in different types of cancer. In contrast, EGFR/PI3K/AKT signalling and recently the presence of so-called cancer stem cells are discussed as reasons for radioresistance. The study investigates mechanisms of apoptosis, key oncogenes of the PI3K/AKT pathway and the presence of cancer cells with stem cell properties during irradiation in two cell lines (PCI-9A, and PCI-15) of head and neck squamous cell carcinoma. WST-1-tests, qRT-PCR, western blots and FACS analysis were performed for analysis. The two cell lines presented different degrees of cell death upon irradiation. The radiosensitive cell line PCI-9A showed increased apoptosis after irradiation measured by expressed cleaved caspases 3 and 7 while the radioresistant cell line PCI-15 upregulated antiapoptotic Survivin and BCL2A1 mRNA. Besides, increased PI3K/AKT- and ERK1/2-signalling was associated with radioresistance accompanied by loss of PTEN function through phosphorylation on S380. Blockade of pAKT increased radiation-induced cell death, and moreover, led to an upregulation of pMET in the radioresistant cell line. The percentage of ALDH-positive tumour cells was markedly decreased after irradiation in the radiosensitive cell line. Functional apoptosis is mandatory for sensitivity to irradiation in head neck cancer cells. Upregulation of the AKT-pathway seems to be one reason for poor radioresponse. Activated MET may also predict radioresistance, possibly through ERK1/2 signalling. Moreover MET may indicate the presence of cancer stem cells facilitating radioresistance as shown by increased ALDH expression. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Tumor cells with low proteasome subunit expression predict overall survival in head and neck cancer patients

    International Nuclear Information System (INIS)

    Lagadec, Chann; Vlashi, Erina; Bhuta, Sunita; Lai, Chi; Mischel, Paul; Werner, Martin; Henke, Michael; Pajonk, Frank

    2014-01-01

    Experimental and clinical data suggest that solid cancers contain treatment-resistant cancer stem cells that will impair treatment efficacy. The objective of this study was to investigate if head and neck squamous cell carcinoma (HNSCC) also contain cancer stem cells that can be identified by low 26S proteasome activity and if their presence correlates to clinical outcome. Human HNSCC cells, engineered to report lack of proteasome activity based on accumulation of a fluorescent fusion protein, were separated based on high (ZsGreen-cODC neg ) or low (ZsGreen-cODC pos ) proteasome activity. Self-renewal capacity, tumorigenicity and radioresistance were assessed. Proteasome subunit expression was analyzed in tissue microarrays and correlated to survival and locoregional cancer control of 174 patients with HNSCC. HNSCC cells with low proteasome activity showed a significantly higher self-renewal capacity and increased tumorigenicity. Irradiation enriched for ZsGreen-cODC pos cells. The survival probability of 82 patients treated with definitive radio- or chemo-radiotherapy exhibiting weak, intermediate, or strong proteasome subunit expression were 21.2, 28.8 and 43.8 months (p = 0.05), respectively. Locoregional cancer control was comparably affected. Subpopulations of HNSCC display stem cell features that affect patients’ tumor control and survival. Evaluating cancer tissue for expression of the proteasome subunit PSMD1 may help identify patients at risk for relapse

  12. Therapeutic benefits and tolerance of chemoradiotherapy for advanced and recurrent head and neck cancers

    International Nuclear Information System (INIS)

    Nishio, Masamichi; Myoujin, Miyako; Kawashima, Kazuyuki; Mizoguchi, Fumiki; Onimaru, Rikiya; Tanaka, Katsuhiko; Asano, Katsushi; Somekawa, Yukihiro

    1999-01-01

    Results of chemoradiation therapy for head and neck cancers that were locally advanced or recurrent or both were investigated retrospectively. From 1983 thorough 1995, 136 patients were treated with radiotherapy and with multiagent chemotherapy including cisplatin. Forty-two patients were treated first with chemoradiation, then with high-dose cisplatin every 4 to 6 weeks. Sixty-seven patients with recurrent cancers were treated with high-dose cisplatin. Twenty-seven patients with previously untreated cancers received chemoradiation and four medium doses of cisplatin a week every 4 weeks. Primary response rates were 88% in patients with previously untreated cancers who received high-dose cisplatin, 34% in patients with recurrent cancers who received high-dose cisplatin, and 100% in patients with previously untreated cancers who received medium-dose cisplatin. Treatment with high-dose cisplatin was more often of longer duration or was not completed than was treatment with medium-dose cisplatin because of more severe side effects. Chemoradiotherapy with a fractionated, medium dose of cisplatin was well tolerated and achieved good results. (author)

  13. Ex-vivo holographic microscopy and spectroscopic analysis of head and neck cancer

    Science.gov (United States)

    Holler, Stephen; Wurtz, Robert; Auyeung, Kelsey; Auyeung, Kris; Paspaley-Grbavac, Milan; Mulroe, Brigid; Sobrero, Maximiliano; Miles, Brett

    2015-03-01

    Optical probes to identify tumor margins in vivo would greatly reduce the time, effort and complexity in the surgical removal of malignant tissue in head and neck cancers. Current approaches involve visual microscopy of stained tissue samples to determine cancer margins, which results in the excision of excess of tissue to assure complete removal of the cancer. Such surgical procedures and follow-on chemotherapy can adversely affect the patient's recovery and subsequent quality of life. In order to reduce the complexity of the process and minimize adverse effects on the patient, we investigate ex vivo tissue samples (stained and unstained) using digital holographic microscopy in conjunction with spectroscopic analyses (reflectance and transmission spectroscopy) in order to determine label-free, optically identifiable characteristic features that may ultimately be used for in vivo processing of cancerous tissues. The tissue samples studied were squamous cell carcinomas and associated controls from patients of varying age, gender and race. Holographic microscopic imaging scans across both cancerous and non-cancerous tissue samples yielded amplitude and phase reconstructions that were correlated with spectral signatures. Though the holographic reconstructions and measured spectra indicate variations even among the same class of tissue, preliminary results indicate the existence of some discriminating features. Further analyses are presently underway to further this work and extract additional information from the imaging and spectral data that may prove useful for in vivo surgical identification.

  14. Evidence on Effectiveness of Upper Neck Irradiation Versus Whole Neck Irradiation as Elective Neck Irradiation in Node-Negative Nasopharyngeal Cancer: A Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Jayson L. Co

    2016-11-01

    Full Text Available Purpose: Nasopharyngeal carcinoma (NPC is a central tumor with a rich lymphatic network and a propensity for bilateral cervical lymph node metastasis. There is an orderly pattern of lymph node involvement in NPC. There is no current standard for prophylactic neck irradiation in node-negative or limited retropharyngeal (RP node–positive NPC. This study aims to synthesize the current evidence on upper neck irradiation (UNI versus whole neck irradiation (WNI as prophylactic neck irradiation in node-negative or limited RP node–positive NPC. Materials and Methods: A search of relevant articles was done from 2000 to October 2015. Critical appraisal and meta-analysis of the eligible studies were undertaken to assess the effectiveness of UNI versus WNI as prophylactic neck irradiation in node-negative or limited involved RP node NPC. Results: Only one randomized controlled trial investigated the use of prophylactic UNI versus WNI and showed no confirmed nodal relapse in both arms. Pooled analysis of four retrospective studies showed no significant difference in nodal recurrence, whether in-field or out-of-field recurrence. There was also no significant difference in terms of 5-year distant metastasis–free and overall survival. Conclusion: In node-negative or limited RP node–positive NPC, the current evidence shows the possibility of treating only the upper neck (levels II, III, and VA without compromising nodal control, distant metastasis, and overall survival. As a result of the scarcity of data, more randomized clinical trials are warranted in this subset of patients.

  15. Preliminary experience with thallous chloride T1 201-labeled single-photon emission computed tomography scanning in head and neck cancer

    NARCIS (Netherlands)

    Gregor, R. T.; Valdés-Olmos, R.; Koops, W.; Balm, A. J.; Hilgers, F. J.; Hoefnagel, C. A.

    1996-01-01

    To test the feasibility of single-photon emission computed tomography (SPECT) scanning with the use of thallous chloride T1 201 in patients with head and neck cancer and to decide its possible applications to improve the diagnosis and staging of head and neck cancer. Findings from SPECT with the use

  16. Determining optimal clinical target volume margins in head-and-neck cancer based on microscopic extracapsular extension of metastatic neck nodes

    International Nuclear Information System (INIS)

    Apisarnthanarax, Smith; Elliott, Danielle D.; El-Naggar, Adel K.; Asper, Joshua A. P.A.; Blanco, Angel; Ang, K. Kian; Garden, Adam S.; Morrison, William H.; Rosenthal, David; Weber, Randal S.; Chao, K.S. Clifford

    2006-01-01

    Purpose: To determine the optimal clinical target volume margins around the gross nodal tumor volume in head-and-neck cancer by assessing microscopic tumor extension beyond cervical lymph node capsules. Methods and Materials: Histologic sections of 96 dissected cervical lymph nodes with extracapsular extension (ECE) from 48 patients with head-and-neck squamous cell carcinoma were examined. The maximum linear distance from the external capsule border to the farthest extent of the tumor or tumoral reaction was measured. The trends of ECE as a function of the distance from the capsule and lymph node size were analyzed. Results: The median diameter of all lymph nodes was 11.0 mm (range: 3.0-30.0 mm). The mean and median ECE extent was 2.2 mm and 1.6 mm, respectively (range: 0.4-9.0 mm). The ECE was <5 mm from the capsule in 96% of the nodes. As the distance from the capsule increased, the probability of tumor extension declined. No significant difference between the extent of ECE and lymph node size was observed. Conclusion: For N1 nodes that are at high risk for ECE but not grossly infiltrating musculature, 1 cm clinical target volume margins around the nodal gross tumor volume are recommended to cover microscopic nodal extension in head-and-neck cancer

  17. Management of somatic pain induced by treatment of head and neck cancer: Postoperative pain. Guidelines of the French Oto-Rhino-Laryngology--Head and Neck Surgery Society (SFORL).

    Science.gov (United States)

    Espitalier, F; Testelin, S; Blanchard, D; Binczak, M; Bollet, M; Calmels, P; Couturaud, C; Dreyer, C; Navez, M; Perrichon, C; Morinière, S; Albert, S

    2014-09-01

    To present the guidelines of the French Oto-Rhino-Laryngology--Head and Neck Surgery Society (SFORL) concerning the management of somatic pain induced by the treatment of head and neck cancer, and in particular the management of early and late post-surgical pain. A multidisciplinary work group conducted a review of the scientific literature on the study topic. An editorial group subsequently read the resulting guidelines before validation. It is recommended to prevent onset of pain caused by malpositioning on the operating table, as well as pain related to postoperative care. During surgery, it is recommended to spare nerve and muscle structures as far as possible to limit painful sequelae. Management of early postoperative pain upon tumor resection and flap harvesting sites requires patient-controlled analgesia by morphine pump. Physical therapy is recommended after flap harvesting to minimize painful sequelae. Preventive and curative measures should be undertaken for appropriate management of post-surgical pain in the treatment of head and neck cancers. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  18. Aspiration in head and neck cancer patients: a single centre experience of clinical profile, bacterial isolates and antibiotic sensitivity pattern.

    Science.gov (United States)

    Lakshmaiah, K C; Sirsath, Nagesh T; Subramanyam, Jayshree R; Govind, Babu K; Lokanatha, D; Shenoy, Ashok M

    2013-07-01

    Most patients with head and neck cancer have dysphagia and are at increased risk of having aspiration and subsequent pneumonia. It can cause prolonged hospitalization, treatment delay and/or interruption and mortality in cancer patients. The treatment of these infections often relies on empirical antibiotics based on local microbiology and antibiotic sensitivity patterns. The aim of present study is to analyse respiratory tract pathogens isolated by sputum culture in head and neck cancer patients undergoing treatment at a tertiary cancer centre in South India who presented with features of aspiration. The study is carried out to establish empirical antibiotic policy for head and neck cancer patients who present with features of aspiration. This was a retrospective study. The study included sputum samples sent for culture and sensitivity from January 2011 to December 2012. Analysis of microbiologic species isolated in sputum specimen and the antibiotic sensitivity pattern of the bacterial isolates was performed. A detailed study of case files of all patients was done to find out which is the most common site prone for producing aspiration. There were 47 (31.54 %) gram positive isolates and 102 (68.45 %) gram negative isolates. The most common bacterial isolates were Klebsiella pneumoniae (25.50 %), Pseudomonas aeruginosa (16.77 %) and Haemophilus influenzae (15.43 %). Levofloxacin was the most effective antibiotic with excellent activity against both gram positive and gram negative isolates. Most patients with aspiration had laryngeal cancer (34.89 %). Aspiration pneumonia was present in 14 (9.39 %) patients. Gram negative bacteria are common etiologic agents in head and neck cancer patients presenting with features of aspiration. Levofloxacin should be started as empirical antibiotic in these patients while awaiting sputum culture sensitivity report. As aspiration in head and neck cancer is an underreported event such institutional antibiotic sensitivity

  19. Hypotensive endovascular test occlusion of the carotid artery in head and neck cancer.

    Science.gov (United States)

    Dare, Amos O; Gibbons, Kevin J; Gillihan, Matthew D; Guterman, Lee R; Loree, Thom R; Hicks, Wesley L

    2003-03-15

    To evaluate the reliability of balloon test occlusion with hypotensive challenge (BTO and HC) as a predictor of neurological complications before internal carotid artery (ICA) sacrifice in patients with advanced head and neck cancer, the authors retrospectively reviewed the medical records of patients presenting to their institutions between 1992 and 1997 in whom this preoperative assessment was performed. Eleven patents who were candidates for extended comprehensive neck dissection (ECND) and potential ICA sacrifice were included in the study. Eight patients tolerated the test and underwent endovascular occlusion or surgical ligation of the ICA before ECND (four patients), preservation of the ICA at the time of surgery (three patients), or palliative therapy (one patient). Of three patients in whom BTO and HC failed, one patient received palliative treatment only; the other two underwent ECND with preservation of the ICA. In the group of patients who passed the test and underwent ICA occlusion or ligation before ECND, fatal thromboembolic stroke occurred within 24 hours of permanent balloon occlusion in one patient, resulting in a combined neurological morbidity/mortality rate of 25% in this subset of patients and an overall complication rate of 9% in this series. The authors found that BTO and HC offers a simple and reliable method of preoperative risk assessment when ICA resection is planned for regional control of disease in advanced head and neck cancer. This management option, however, is associated with a potential for neurological complication that must be weighed against the natural course of the disease and the risks and benefits of other treatment modalities.

  20. Oral candidiasis in patients receiving radiation therapy for head and neck cancer.

    Science.gov (United States)

    Deng, Zeyi; Kiyuna, Asanori; Hasegawa, Masahiro; Nakasone, Isamu; Hosokawa, Atsushi; Suzuki, Mikio

    2010-08-01

    To investigate oral candidiasis in patients with head and neck cancer before, during, and after radiation therapy, and to explore its association with clinical oropharyngeal symptoms. A cohort study. University hospital. Subjects who received radiation therapy (RT) for the treatment of head and neck cancer were divided into two groups: an oral cavity irradiated group (OIRR group, n = 29) and an oral cavity nonirradiated group (ONIRR group, n = 17). A control group consisted of 18 healthy subjects. Patients were examined for signs of oral candidiasis before, during, immediately after, and one month after RT. Mouth and throat soreness (MTS), dysphagia, and xerostomia were evaluated by self-reported questionnaires, and associations between oral candidiasis and these symptoms were analyzed. The incidence of oral candidiasis during RT was significantly higher in the OIRR group (55.2%) than in the ONIRR group (11.8%). Similarly, the occurrence of xerostomia during RT was significantly higher in the OIRR group (86.2%) than in the ONIRR group (52.9%). In the OIRR group, the mean MTS score at the 20th fraction of RT was significantly higher in patients with candidiasis (mean +/- SD, 5.8 +/- 2.1) than in those with RT-induced mucositis without candidiasis (3.7 +/- 2.0). In the OIRR group, 65.2 percent of patients who experienced dysphagia developed oral candidiasis, compared with only 10 percent in the ONIRR group. Oral candidiasis concurrent with oral mucositis due to RT may increase oropharyngeal discomfort during RT. Copyright (c) 2010 American Academy of Otolaryngology-Head and Neck Surgery Foundation. Published by Mosby, Inc. All rights reserved.

  1. Impact of dysphagia on quality of life after treatment of head-and-neck cancer

    International Nuclear Information System (INIS)

    Nguyen, Nam P.; Frank, Cheryl; Moltz, Candace C.; Vos, Paul; Smith, Herbert J.; Karlsson, Ulf; Dutta, Suresh; Midyett, Allan; Barloon, Jessica; Sallah, Sabah

    2005-01-01

    Purpose: To evaluate the quality of life (QOL) associated with dysphagia after head-and-neck cancer treatment. Methods and materials: Of a total population of 104, a retrospective analysis of 73 patients who complained of dysphagia after primary radiotherapy (RT), chemoradiotherapy, and postoperative RT for head-and-neck malignancies were evaluated. All patients underwent a modified barium swallow examination to assess the severity of dysphagia, graded on a scale of 1-7. QOL was evaluated by the University of Washington (UW) and Hospital Anxiety and Depression questionnaires. The QOL scores obtained were compared with those from the 31 patients who were free of dysphagia after treatment. The QOL scores were also graded according to the dysphagia severity. Results: The UW and Hospital Anxiety and Depression scores were reduced and elevated, respectively, in the dysphagia group compared with the no dysphagia group (p = 0.0005). The UW scores were also substantially lower among patients with moderate-to-severe (Grade 4-7) compared with no or mild (Grade 2-3) dysphagia (p = 0.0005). The corresponding Hospital Anxiety (p = 0.005) and Depression (p = 0.0001) scores were also greater for the moderate-to-severe group. The UW QOL subscale scores showed a statistically significant decrease for swallowing (p = 0.00005), speech (p = 0.0005), recreation/entertainment (p = 0.0005), disfigurement (p = 0.0006), activity (p = 0.005), eating (p = 0.002), shoulder disability (p = 0.006), and pain (p = 0.004). Conclusion: Dysphagia is a significant morbidity of head-and-neck cancer treatment, and the severity of dysphagia correlated with a compromised QOL, anxiety, and depression. Patients with moderate-to-severe dysphagia require a team approach involving nutritional support, physical therapy, speech rehabilitation, pain management, and psychological counseling

  2. European Research on Electrochemotherapy in Head and Neck Cancer (EURECA) project

    DEFF Research Database (Denmark)

    Bertino, Giulia; Sersa, Gregor; De Terlizzi, Francesca

    2016-01-01

    affected by primary or recurrent skin cancer of the HN area were enrolled; of these, 99 were eligible for evaluation of tumour response. By far, the majority (82%) were treated only once, and 18% of patients had a second treatment. The objective response was highest for basal cell carcinoma (97...... report results of a European multi-institutional prospective study of the effectiveness of electrochemotherapy in the treatment of skin cancer of the head and neck (HN) area, where standard treatments had either failed or were not deemed suitable or declined by the patient. A total of 105 patients......%) and for other histologies was 74%. Small, primary, and treatment-naive carcinomas responded significantly better (p

  3. Primary and secondary prevention of acute complications of radiotherapy of head and neck cancers

    International Nuclear Information System (INIS)

    Lambrexhe, M.; Frederick, B.; Burie, D.; Cavuto, C.; Rob, L.; Rasquin, I.; Coiffier, N.; Untereiner, M.

    2009-01-01

    Purpose: the standard treatment of head and neck cancers associates a 70 Gy irradiation and weekly concomitant chemotherapy by 5-fluoro-uracils and cisplatin or targeted therapy by Erbitux. A retrospective study realised at the Francois Baclesse center in 2004-2005 for 84 patients suffering of ear-nose-throat cancers whom treatment was a concomitant chemoradiotherapy, showed the noxious effects of the treatment on the patients nutritional situation: weight loss for 90% of patients; temporary interruption or definitive stop of radiotherapy for 28% of patients. based on this observation, a preventive approach of the nutritional risk was implemented. The objective was to reduce the malnutrition risk linked to radiotherapy associated to chemotherapy or to the targeted therapy. (N.C.)

  4. Diet and the risk of head and neck cancer: a pooled analysis in the INHANCE consortium.

    LENUS (Irish Health Repository)

    Chuang, Shu-Chun

    2012-01-01

    We investigated the association between diet and head and neck cancer (HNC) risk using data from the International Head and Neck Cancer Epidemiology (INHANCE) consortium. The INHANCE pooled data included 22 case-control studies with 14,520 cases and 22,737 controls. Center-specific quartiles among the controls were used for food groups, and frequencies per week were used for single food items. A dietary pattern score combining high fruit and vegetable intake and low red meat intake was created. Odds ratios (OR) and 95% confidence intervals (CI) for the dietary items on the risk of HNC were estimated with a two-stage random-effects logistic regression model. An inverse association was observed for higher-frequency intake of fruit (4th vs. 1st quartile OR = 0.52, 95% CI = 0.43-0.62, p (trend) < 0.01) and vegetables (OR = 0.66, 95% CI = 0.49-0.90, p (trend) = 0.01). Intake of red meat (OR = 1.40, 95% CI = 1.13-1.74, p (trend) = 0.13) and processed meat (OR = 1.37, 95% CI = 1.14-1.65, p (trend) < 0.01) was positively associated with HNC risk. Higher dietary pattern scores, reflecting high fruit\\/vegetable and low red meat intake, were associated with reduced HNC risk (per score increment OR = 0.90, 95% CI = 0.84-0.97).

  5. Fatal carotid blowout syndrome after BNCT for head and neck cancers

    International Nuclear Information System (INIS)

    Aihara, T.; Hiratsuka, J.; Ishikawa, H.; Kumada, H.; Ohnishi, K.; Kamitani, N.; Suzuki, M.; Sakurai, H.; Harada, T.

    2015-01-01

    Boron neutron capture therapy (BNCT) is high linear energy transfer (LET) radiation and tumor-selective radiation that does not cause serious damage to the surrounding normal tissues. BNCT might be effective and safe in patients with inoperable, locally advanced head and neck cancers, even those that recur at previously irradiated sites. However, carotid blowout syndrome (CBS) is a lethal complication resulting from malignant invasion of the carotid artery (CA); thus, the risk of CBS should be carefully assessed in patients with risk factors for CBS after BNCT. Thirty-three patients in our institution who underwent BNCT were analyzed. Two patients developed CBS and experienced widespread skin invasion and recurrence close to the carotid artery after irradiation. Careful attention should be paid to the occurrence of CBS if the tumor is located adjacent to the carotid artery. The presence of skin invasion from recurrent lesions after irradiation is an ominous sign of CBS onset and lethal consequences. - Highlights: • This study is fatal carotid blowout syndrome after BNCT for head and neck cancers. • Thirty-three patients in our institution who underwent BNCT were analyzed. • Two patients (2/33) developed CBS. • The presence of skin invasion from recurrent lesions after irradiation is an ominous sign of CBS. • We must be aware of these signs to perform BNCT safely.

  6. Trismus following different treatment modalities for head and neck cancer: a systematic review of subjective measures.

    Science.gov (United States)

    Loh, Sook Y; Mcleod, Robert W J; Elhassan, Hassan A

    2017-07-01

    The aim of this review was to compare systematically the subjective measure of trismus between different interventions to treat head and neck cancer, particularly those of the oropharynx. Using The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) Guidelines, Six databases were searched for the text using various terms which include "oropharyngeal/head and neck cancer", "trismus/mouth opening" and the various treatment modalities. Included in the review were clinical studies (> or =10 patients). Three observers independently assessed the papers identified. Among the six studies reviewed, five showed a significantly worst outcome with regard to the quality-of-life questionnaire scores for a radiotherapy or surgery and radiotherapy (RT) ± chemotherapy or chemoradiotherapy when compared to surgery alone. Only one study showed no significant difference between surgery alone and other treatment modalities. Subjective quality-of-life measures are a concurrent part of modern surgical practice. Although subjective measures were utilised to measure post operative trismus successfully, there was no consensus as to which treatment modality had overall better outcomes, with conflicting studies in keeping with the current debate in this field. Larger and higher quality studies are needed to compare all three treatment modalities.

  7. Acupuncture for the prevention of radiation-induced xerostomia in patients with head and neck cancer

    Directory of Open Access Journals (Sweden)

    Fabio do Prado Florence Braga

    2011-04-01

    Full Text Available The aim of this study was to evaluate the effectiveness of acupuncture in minimizing the severity of radiation-induced xerostomia in patients with head and neck cancer. A total of 24 consecutive patients receiving > 5000 cGy radiotherapy (RT involving the major salivary glands bilaterally were assigned to either the preventive acupuncture group (PA, n = 12, treated with acupuncture before and during RT, or the control group (CT, n = 12, treated with RT and not receiving acupuncture. After RT completion, clinical response was assessed in all patients by syalometry, measuring the resting (RSFR and stimulated (SSFR salivary flow rates, and by the visual analogue scale (VAS regarding dry mouth-related symptoms. Statistical analyses were performed with repeated-measures using a mixed-effect modeling procedure and analysis of variance. An alpha level of 0.05 was accepted for statistical significance. Although all patients exhibited some degree of impairment in salivary gland functioning after RT, significant differences were found between the groups. Patients in the PA group showed improved salivary flow rates (RSFR, SSFR; p < 0.001 and decreased xerostomia-related symptoms (VAS, p < 0.05 compared with patients in the CT group. Although PA treatment did not prevent the oral sequelae of RT completely, it significantly minimized the severity of radiation-induced xerostomia. The results suggest that acupuncture focused in a preventive approach can be a useful therapy in the management of patients with head and neck cancer undergoing RT.

  8. Function of the parotid gland following radiation therapy for head and neck cancer

    International Nuclear Information System (INIS)

    Cheng, V.S.T.; Downs, J.; Herbert, D.; Aramany, M.

    1981-01-01

    The parotid gland was selected for study of its salivary output before and after radiation therapy for head and neck cancer. Before radiation therapy, a sialogram of the parotid gland was performed with the patient's head positioned for radiation therapy; a lateral radiographic view of the parotid gland was used to compare with the radiation treatment portal to determine the portion of the parotid gland to be irradiated. Samples of stimulated saliva were collected from the parotid gland before and at 1 and 6 months post-radiation. Eighteen patients with head and neck cancer who received radiation therapy were studied. The data showed that in the irradiation of nasopharyngeal, advanced oropharyngeal and Waldeyer's ring lesions, 100% of the parotid gland was irradiated; for the early oropharyngeal and hypopharyngeal lesions, from 30 to 90% of the parotid gland was irradiated and for the supraglottic and oral cavity lesions, 25 to 30% of the parotid gland was irradiated. When 100% of the parotid gland was irradiated, no saliva was produced at 1 month post-radiation; this remained the same when re-tested at 4 to 8 months, however, when any portion of the parotid gland was not irradiated, there was residual salivary function

  9. Role of Honey in Prevention of Radiation induced Mucositis in Head and Neck Cancer

    International Nuclear Information System (INIS)

    Alvi, Z. A.; Mahmood, A.; Rasul, S.; Ali, U.; Arif, S.; Ishtiaq, S.; Maqsood, T.

    2013-01-01

    Objective: To determine the efficacy of honey in preventing radiation induced mucositis (RIM) in patients with head and neck cancers. Design: Randomized controlled trial. Setting: Oncology Department of Combined Military Hospital Rawalpindi, from July 2011 to September 2012. Patients and Methods: Sixty patients diagnosed with head and neck cancer requiring radiotherapy to the oropharyngeal mucosa were randomized into two groups to receive either radiation alone or radiation and natural honey. Patients were treated using 6-MV X-ray beams from linear accelerator at a dose rate of 2 Gy per day five times a week up to a dose of 66 Gy. In the treatment group, patients were advised to take 20 ml of pure honey 15 minutes before, 15 minutes after and 6 hours after radiotherapy. Patients were evaluated every week for the development of RIM using the WHO oral mucositis grading system. Results: In treatment group, out of 30 patients, 4(13%) developed grade 3 RIM and none developed grade 4 RIM. In control group, out of 30 patients, 12 (40%) developed grade 3 or 4 RIM (p=0.039). Four patients (13%) in treatment group lost more than 5 Kg weight during the course of radiotherapy compared to 16 patients (53%) in control group (p=0.002). Conclusion: The results of our study have shown that honey is a simple and cost effective treatment to prevent RIM. Large scale randomized trials are needed to confirm the results of our study. (author)

  10. Acupuncture for the prevention of radiation-induced xerostomia in patients with head and neck cancer.

    Science.gov (United States)

    Braga, Fabio do Prado Florence; Lemos Junior, Celso Augusto; Alves, Fabio Abreu; Migliari, Dante Antonio

    2011-01-01

    The aim of this study was to evaluate the effectiveness of acupuncture in minimizing the severity of radiation-induced xerostomia in patients with head and neck cancer. A total of 24 consecutive patients receiving > 5000 cGy radiotherapy (RT) involving the major salivary glands bilaterally were assigned to either the preventive acupuncture group (PA, n = 12), treated with acupuncture before and during RT, or the control group (CT, n = 12), treated with RT and not receiving acupuncture. After RT completion, clinical response was assessed in all patients by syalometry, measuring the resting (RSFR) and stimulated (SSFR) salivary flow rates, and by the visual analogue scale (VAS) regarding dry mouth-related symptoms. Statistical analyses were performed with repeated-measures using a mixed-effect modeling procedure and analysis of variance. An alpha level of 0.05 was accepted for statistical significance. Although all patients exhibited some degree of impairment in salivary gland functioning after RT, significant differences were found between the groups. Patients in the PA group showed improved salivary flow rates (RSFR, SSFR; p xerostomia-related symptoms (VAS, p xerostomia. The results suggest that acupuncture focused in a preventive approach can be a useful therapy in the management of patients with head and neck cancer undergoing RT.

  11. Expression of Ku correlates with radiation sensitivities in the head and neck cancer cell lines

    International Nuclear Information System (INIS)

    Lee, Sang Wook; Yu, Eun Sil; Yi, So Lyoung; Son, Se Hee; Kim, Jong Hoon; Ahn, Seung Do; Shin, Seong Soo; Choi, Eun Kyung

    2004-01-01

    DNA-dependent protein kinase (DNA-PK) is a serine/threonine kinase consisting of a 470 kDa catalytic subunit (DNA-PKcs) and a heterodimeric regulatory complex, called Ku, which is composed of 70 kDa (Ku 70) and 86 kDa (Ku 80) proteins. The DNA-PK has been shown to play a pivotal role in rejoining DNA double-strand-breaks (dsb) in mammalian cells. The purpose of this study is to examine the relationship between the level of Ku expression and radiation sensitivity. Nine head and neck, cancer cell lines showed various intrinsic radiation sensitivities. Among the nine, AMC-HN-3 cell was the most sensitive for X-ray irradiation and AMC-HN-9 cell was the most resistance. The most sensitive and resistant cell lines were selected and the test sensitivity of radiation and expression of Ku were measured. Radiation sensitivity was obtained by colony forming assay and Ku protein expression using Western blot analysis. Ku80 increased expression by radiation, wheras Ku70 did not. Overexpression of Ku80 protein increased radiation resistance in AMC-HN9 cell line. There was a correlation between Ku80 expression and radiation resistance. Ku80 was shown to play an important role in radiation damage response. Induction of Ku80 expression had an important role in DNA damage repair by radiation. Ku80 expression may be an effective predictive assay of radiosensitivity on head and neck cancer

  12. Epigenetic Modifications and Head and Neck Cancer: Implications for Tumor Progression and Resistance to Therapy

    Directory of Open Access Journals (Sweden)

    Rogerio M. Castilho

    2017-07-01

    Full Text Available Head and neck squamous carcinoma (HNSCC is the sixth most prevalent cancer and one of the most aggressive malignancies worldwide. Despite continuous efforts to identify molecular markers for early detection, and to develop efficient treatments, the overall survival and prognosis of HNSCC patients remain poor. Accumulated scientific evidences suggest that epigenetic alterations, including DNA methylation, histone covalent modifications, chromatin remodeling and non-coding RNAs, are frequently involved in oral carcinogenesis, tumor progression, and resistance to therapy. Epigenetic alterations occur in an unsystematic manner or as part of the aberrant transcriptional machinery, which promotes selective advantage to the tumor cells. Epigenetic modifications also contribute to cellular plasticity during tumor progression and to the formation of cancer stem cells (CSCs, a small subset of tumor cells with self-renewal ability. CSCs are involved in the development of intrinsic or acquired therapy resistance, and tumor recurrences or relapse. Therefore, the understanding and characterization of epigenetic modifications associated with head and neck carcinogenesis, and the prospective identification of epigenetic markers associated with CSCs, hold the promise for novel therapeutic strategies to fight tumors. In this review, we focus on the current knowledge on epigenetic modifications observed in HNSCC and emerging Epi-drugs capable of sensitizing HNSCC to therapy.

  13. Audiometric patterns in ototoxicity after radiotherapy and chemotherapy in patients of head and neck cancers

    Directory of Open Access Journals (Sweden)

    Monika Shamrao Malgonde

    2015-01-01

    Full Text Available Introduction: Inspite of various strategies adopted to protect the sensitive structures during organ preservation strategies, radiation damage can occur from the pharyngotympanic tube to the brain stem auditory pathway causing hearing loss. The purpose of this study is to evaluate the audiometric abnormalities and characterize them among the patients of head and neck cancers who have undergone radiotherapy (RT and chemoradiation therapy (CT+RT. Materials and Methods: Sixty-six histopathologically proven head and neck cancer patients receiving RT and 34 patients receiving concomitant CT + RT underwent evaluation for audiometric abnormalities from 1 st September 2010 to 31 st August 2012. Results: Hearing losses were predominately of sensorineural type and mild. Patients who received concomitant CT+RT experienced greater sensorineural hearing loss compared with patients treated with RT alone. A paired sample t-test was conducted to compare the hearing losses before therapy and 6 and 12 months after therapy and was found to be significant ( P < 0.05. It was found that hearing loss was persistent. Significant difference was found in the proportion of hearing loss after RT and RT+CT ( P < 0.05 after 1 month. In addition, mixed hearing loss occurred due to damage to the middle ear contents and can be improved if intervened appropriately.

  14. In vivo dosimetry with semiconductor and thermoluminescent detectors applied to head and neck cancer treatment

    International Nuclear Information System (INIS)

    Viegas, Claudio Castelo Branco

    2003-03-01

    In vivo dosimetry in radiotherapy, i. e, the assessment of the doses received by patients during their treatments, permits a verification of the therapy quality. A routine of in vivo dosimetry is, undoubtedly, a direct benefit for the patient. Unfortunately, in Brazil and in Latin America this procedure is still a privilege for only a few patients. This routine is of common application only in developed countries. The aim of this work is to show the viability and implementation of a routine in vivo dosimetry, using diodes semiconductors and thermoluminescent dosimeters (TLD), at the radiotherapy section of the National Institute of Cancer in Brazil, in the case of head and neck cancer treatment. In order to reach that aim, the characteristics of the response of diodes ISORAD-p and LiF:Mg;Ti (TLD-100) thermoluminescent detectors in powder form were determined. The performance of those detectors for in vivo dosimetry was tested using an RANDO Alderson anthropomorfic phantom and, once their adequacy proved for the kind of measurements proposed, they were used for dose assessment in the case of tumour treatments in the head and neck regions, for Cobalt-60 irradiations. (author)

  15. Survival of patients with head and neck cancer. Impact of physical status and comorbidities

    International Nuclear Information System (INIS)

    Sadat, F.; Wienke, A.; Dunst, J.; Kuhnt, T.

    2012-01-01

    Prognostic factors (e.g., gender, tumor stage, and hypoxia) have an impact on survival in patients with head and neck cancer. Thus, the impact of physical status and comorbidities on treatment decision and survival were evaluated. Patients and methods A total of 169 primary, inoperable patients with squamous cell cancer of the head and neck were retrospectively investigated. Patients were treated with hyperfractionated accelerated radio(chemo)therapy (HARcT) or hypofractionated radio(chemo)therapy (HypoRcT). Depending on the individual patient's situation (Karnofsky Performance Index, KPI), treatment for patients with a KPI of 80-100% was generally radiochemotherapy and for patients with a KPI ≤ 70% treatment was radiotherapy alone. In addition, all comorbidities were evaluated. Uni- and multivariate proportional hazards model were used, and overall survival (OS) was estimated by the Kaplan-Meier method. Results Treatment consisted of HARcT for 76 patients (45%), HART for 28 patients (17%), HypoRcT for 14 patients(8%), and HypoRT for 51 patients (30%). Of the patients, 107 patients (63%) presented with a KPI of 80-100%. OS (20%) was significantly better for patients with a KPI of 80-100%, while the OS for patients with a KPI ≤ 70% was 8% (p 70 Gy), and chemotherapy were significant prognostic factors for better OS. Conclusion Our retrospective analysis shows that performance status with dependency on comorbidities was an independent risk factor for OS. (orig.)

  16. Radioprotective effect of Punica granatum extract in head and neck cancer patients

    International Nuclear Information System (INIS)

    Amulya, T.M.; Bhandary, Satheesh Kumar

    2016-01-01

    To study protective role of pomegranate extract on radiation induced dermatitis and mucositis in head and neck cancer patients, a prospective, clinical, double blind case control study was carried out. 60 patients (30 active and controls) undergoing radiotherapy for head and neck cancer were studied for 12 months. Patients in study group were given whole fruit pomegranate extract. Each capsule contained 300 mg of whole fruit extract, each capsule contains 40% polyphenols and 27% punicalagin. Each patient was given 2 capsules every day for a period of 6 to 7 weeks. The skin and mucosal changes was graded according to the Acute Radiation Morbidity Scoring criteria (RTOG) for skin and mucous membrane. Among the 30 patients who received the pomegranate extract, 27 had grade 1, 2 had grade 2 and 1 had grade 3 dermatitis. Whereas those who did not receive the extract, 20 had grade 2 dermatitis, 7 had grade 3 dermatitis and 3 had grade 4 dermatitis. Among the 30 patients who received the pomegranate extract, 10 had grade 0, 17 had grade 1 and 3 had grade 2 mucositis. Whereas of those who did not receive the extract, 21 had grade 2 mucositis, 9 had grade 3 mucositis. The results were statistically significant. Our study is one of the first study in humans to demonstrate the effectiveness of pomegranate extract in preventing radiation dermatitis and mucositis. (author)

  17. Cachexia at diagnosis is associated with poor survival in head and neck cancer patients.

    Science.gov (United States)

    Orell-Kotikangas, Helena; Österlund, Pia; Mäkitie, Outi; Saarilahti, Kauko; Ravasco, Paula; Schwab, Ursula; Mäkitie, Antti A

    2017-07-01

    One third of the patients had cachexia with an association of significantly shorter survival. These results suggest that combining HGS and MAMA seems to be a practical method to screen cachexia in patients with head and neck cancer and may also be used when assessing their prognosis. The aim of this study was to analyze the hypothesis that cachexia defined as both low mid-arm muscle area (MAMA) and handgrip strength (HGS) is associated with decreased survival in patients with head and neck squamous cell carcinoma (HNSCC). Sixty-five consecutive patients with primary HNSCC were enrolled prior to cancer therapy. Cachexia was defined as low handgrip strength (HGS) and low mid-arm muscle area (MAMA). Nutritional status was assessed by patient-generated subjective global assessment (PG-SGA) and sarcopenia by low MAMA. Biochemical parameters reflecting nutritional status and S-25-OHD were measured. Cachexia was seen in 31% and sarcopenia in 46% of patients. Altogether, 34% of patients were malnourished. Disease-free survival was 13 months (3-62) in cachectic patients, compared with 66 months (31-78) in non-cachectic patients (p = 0.009). S-25-OHD was 28 nmol/l in cachectic patients, compared with 46 nmol/l in non-cachectic patients (p = 0.009) and prealbumin 187 mg/l and 269 mg/l, respectively (p < 0.001).

  18. Clinical study of S-1 nedaplatin/concurrent chemoradiotherapy for head and neck cancer

    International Nuclear Information System (INIS)

    Fujii, Naokazu; Shimane, Toshikazu; Ikeda, Kenichiro

    2013-01-01

    Concurrent chemotherapy may cause various adverse events and complications, which can greatly influence oral health care or the preoperative detection of complications, whole-body control during treatment, and the subsequent completion rate or response to treatment. We clinically examined the therapeutic effects as well as the disease-specific survival rate, completion rate, adverse events, complications, recurrence rate, and poor performance status in 100 patients who received S-1 plus nedaplatin with concurrent radiotherapy (SN therapy) as primary treatment for head and neck squamous cell cancer in our department between January 2005 and August 2011. The 3-year disease-specific survival rate was 93.0%, complete response rate was 88.0%, partial response rate was 12.0%, rate of effect was 100%, and completion rate was 85.0%. As for adverse events, grade 3 or greater hematologic toxicity and no hematologic toxicity were observed in 66.0% and 45.0% of the patients, respectively. Major complications after treatment initiation were observed in 9.0% of the patients; the most common complication was delirium in 5.0% of the patients. The recurrence rate was 13.0%, and 4.0% of the patients had poor performance status. Therefore, SN therapy was considered effective for head and neck squamous cell cancer. (author)

  19. Morbidity and quality of life among head and neck cancer patients treated with radical radiotherapy.

    Science.gov (United States)

    Solomon, M M; Onyango, J F; Nyabola, L O; Opiyo, A; Chindia, M L

    2009-04-01

    To determine the relative frequency of acute radiation morbidity and their perceived effect on quality of life among head and neck cancer patients treated with radical radiotherapy. A cross-sectional study. Kenyatta National Hospital, Nairobi. Thirty eight patients comprising 28 males and 10 females with ages ranging between 21 and 69 years were evaluated. Most of the tumours occurred in the nasopharynx (38.6%). The rest of the tumours were equally divided between the oral cavity and larynx (31.6%). All tumours except two were carcinomas. The two exceptions were a glomus tumour and a malignant melanoma. The patients had received doses of radiotherapy ranging between 58.5 Grey and 75.5 Grey. Of the 38 patients, 22 (53%) completed their treatment in the prescribed time while 16 (47%) had treatment interruption on account of radiation morbidity. The cumulative radiation done at the time of interruption ranged between 20 and 46 Grey. The most frequent symptom was dryness of the mouth while the most troublesome symptom was difficulty in tasting foods. The quality of life (QOL) did not vary by age, gender or tumour site. Patients who had treatment interruption had a better QOL than those who did not. This study provides information that should aid in communicating with the head and neck cancer patients scheduled for radiotherapy and in the design of preventive and interventional strategies aimed at enhancing patient support and rehabilitation.

  20. Mexican Cervical Cancer Screening Study II: 6-month and 2-year follow-up of HR-HPV women treated with cryotherapy in a low-resource setting.

    Science.gov (United States)

    Starks, David; Arriba, Lucybeth Nieves; Enerson, Christine L; Brainard, Jennifer; Nagore, Norma; Chiesa-Vottero, Andres; Uribe, Jesús Villagran; Belinson, Jerome

    2014-10-01

    To determine the efficacy and tolerance of cryotherapy in a visual inspection with acetic acid (VIA) triage protocol after primary human papillomavirus (HPV) screening in a low-resource setting. This continuous series conducted over 2 years enrolled nonpregnant, high-risk HPV (HR-HPV)-positive women between the ages of 30 and 50 years, who resided in the state of Michoacán, Mexico, and had a history of no Pap smear screening or knowledge of Pap smear results within the last 3 years. These women were initially enrolled in the Mexican Cervical Cancer Screening Study II (MECCS II) trial and were treated with cryotherapy after VIA triage. They subsequently followed up at 6 months and 2 years for repeat VIA, colposcopy, and biopsy. A total of 291 women were treated with cryotherapy, of whom 226 (78%) followed up at 6 months. Of these 226 women, 153 (68%) were HR-HPV-negative; there were no findings of cervical intraepithelial neoplasia grade 2 (CIN2) or worse. The remaining 73 women (32%) were HR-HPV-positive; of these women, 2 had CIN2 and 3 had CIN3. Only 137 women followed up at 2 years. Of these 137 women, 116 were HR-HPV-negative and 21 were HR-HPV-positive. Of the 21 women positive for HR-HPV, 9 had negative biopsy results, 11 had CIN1, and 1 had no biopsy. The clearance rate of HR-HPV was 83% (95% confidence interval: 0.78-0.87). There were no biopsy findings of CIN2 or worse at 2 years. Before cryotherapy, of the 226 women, 15 (6.6%) were positive for endocervical curettage (ECC) and 5 (2.2%) were referred for surgical management. Of these 15 ECC-positive women, 10 (67%) followed up at 6 months and it was shown that no patient was ECC positive at that time point. Moreover, of the 15 ECC-positive women, 11 (73%) followed up at 2 years and it was shown that no patient was ECC positive at that time point. In our study, VIA had a false-positive rate of 5%. Cryotherapy was an effective, acceptable, and well-tolerated means of treating cervical dysplasia in a low

  1. Patient Concerns Inventory for head and neck cancer: Brazilian cultural adaptation.

    Science.gov (United States)

    Jungerman, Ivy; Toyota, Julia; Montoni, Neyller Patriota; Azevedo, Elma Heitmann Mares; Guedes, Renata Ligia Vieira; Damascena, Aline; Lowe, Derek; Vartanian, José Guilherme; Rogers, Simon N; Kowalski, Luiz Paulo

    2017-04-01

    The purpose of this study was to translate, culturally validate and evaluate the Patients Concerns Inventory - Head and Neck (PCI-H&N) in a consecutive series of Brazilian patients. This study included adult patients treated for upper aerodigestive tract (UADT) cancer. The translation and cultural adaptation of the PCI-H&N followed internationally accepted guidelines and included a pretest sample of patients that completed the first Brazilian Portuguese version of the PCI. Use, feasibility and acceptability of the PCI were tested subsequently in a consecutive series of UADT cancer patients that completed the final Brazilian Portuguese version of the PCI and a Brazilian Portuguese version of the University of Washington Quality of Life Questionnaire (UW-QOL). Associations between physical and socio-emotional composite scores from the UW-QOL and the PCI were analyzed. Twenty (20) patients participated in the pretest survey (translation and cultural adaptation process), and 84 patients were analyzed in the cultural validation study. Issues most selected were: fear of cancer returning, dry mouth, chewing/eating, speech/voice/being understood, swallowing, dental health/teeth, anxiety, fatigue/tiredness, taste, and fear of adverse events. The three specialists most selected by the patients for further consultation were speech therapist, dentist and psychologist. Statistically significant relationships between PCI and UW-QOL were found. The translation and cultural adaptation of the PCI into Brazilian Portuguese language was successful, and the results demonstrate its feasibility and usefulness, making this a valuable tool for use among the Brazilian head and neck cancer population.

  2. Multimedia information intervention and its benefits in partners of the head and neck cancer patients.

    Science.gov (United States)

    D'Souza, V; Blouin, E; Zeitouni, A; Muller, K; Allison, P J

    2017-07-01

    We aimed to investigate the levels of anxiety, depression, satisfaction with information provision and cancer-related knowledge in partners of head and neck cancer (HNC) patients receiving a Multimode Comprehensive Tailored Information Package (MCTIP). A non-randomised, controlled trial was conducted with partners of HNC patients recruited at two academic hospitals in Montreal. The Test participants received the MCTIP, while the Control participants received information in an ad hoc manner. All participants were evaluated using the Hospital Anxiety and Depression Scale (HADS), Satisfaction with Cancer Information Profile and a cancer knowledge questionnaire at baseline, and 3 and 6 months later. Data were analysed using descriptive statistics, t-test and chi-square test, and mixed model analysis to test the impact of the intervention. A total of 31 partners of HNC patients participated in this study and completed all the evaluations. The partners in the Test group experienced significantly lower levels of anxiety (P = 0.001) and depression (P = 0.003) symptoms and were more satisfied (P = 0.002) with cancer information provided than partners in the Control group. Providing tailored information seems to have positive outcomes regarding anxiety, depression, and satisfaction in partners of HNC patients. Larger randomised studies are warranted to validate these effects. © 2016 John Wiley & Sons Ltd.

  3. Curcumin and Other Polyphenolic Compounds in Head and Neck Cancer Chemoprevention

    Directory of Open Access Journals (Sweden)

    Philipp Baumeister

    2012-01-01

    Full Text Available Despite clear results of observational studies linking a diet rich in fruits and vegetables to a decreased cancer risk, large interventional trials evaluating the impact of dietary micronutrient supplementation, mostly vitamins, could not show any beneficial effects. Today it has become clear that a single micronutrient, given in supernutritional doses, cannot match cancer preventive effects of whole fruits and vegetables. In this regard polyphenols came into focus, not only because of their antioxidant potential but also because of their ability to interact with molecular targets within the cells. Because polyphenols occur in many foods and beverages in high concentration and evidence for their anticancer activity is best for tissues they can come into direct contact with, field cancerization predestines upper aerodigestive tract epithelium for cancer chemoprevention by polyphenols. In this paper, we summarize cancer chemopreventive attempts with emphasis on head and neck carcinogenesis and discuss some methodological issues. We present data regarding antimutagenic effects of curcumin and epigallocatechin-3-gallate in human oropharyngeal mucosa cultures exposed to cigarette smoke condensate.

  4. Metabolic autofluorescence imaging of head and neck cancer organoids quantifies cellular heterogeneity and treatment response (Conference Presentation)

    Science.gov (United States)

    Shah, Amy T.; Heaster, Tiffany M.; Skala, Melissa C.

    2017-02-01

    Treatment options for head and neck cancer are limited, and can cause an impaired ability to eat, talk, and breathe. Therefore, optimized and personalized therapies could reduce unnecessary toxicities from ineffective treatments. Organoids are generated from primary tumor tissue and provide a physiologically-relevant in vitro model to measure drug response. Additionally, multiphoton fluorescence lifetime imaging (FLIM) of the metabolic cofactors NAD(P)H and FAD can resolve dynamic cellular response to anti-cancer treatment. This study applies FLIM of NAD(P)H and FAD to head and neck cancer organoids. Head and neck cancer tissue was digested and grown in culture as three-dimensional organoids. Gold standard measures of therapeutic response in vivo indicate stable disease after treatment with cetuximab (antibody therapy) or cisplatin (chemotherapy), and treatment response after combination treatment. In parallel, organoids were treated with cetuximab, cisplatin, or combination therapy for 24 hours. Treated organoids exhibit decreased NAD(P)H lifetime (pmetabolic fluorescence imaging could provide a high-throughput platform for drug discovery. Organoids grown from patient tissue could enable individualized treatment planning. These achievements could optimize quality of life and treatment outcomes for head and neck cancer patients.

  5. Feasibility of image-guided radiotherapy based on helical tomotherapy to reduce contralateral parotid dose in head and neck cancer

    International Nuclear Information System (INIS)

    Nguyen, Nam P; Krafft, Shane P; Jang, Siyoung; Hamilton, Russ; Karlsson, Ulf; Abraham, Dave; Vos, Paul; Vinh-Hung, Vincent; Ceizyk, Misty; Smith-Raymond, Lexie; Stevie, Michelle; Slane, Benjamin; Chi, Alexander; Desai, Anand

    2012-01-01

    To evaluate the feasibility of image-guided radiotherapy based on helical Tomotherapy to spare the contralateral parotid gland in head and neck cancer patients with unilateral or no neck node metastases. A retrospective review of 52 patients undergoing radiotherapy for head and neck cancers with image guidance based on daily megavoltage CT imaging with helical tomotherapy was performed. Mean contralateral parotid dose and the volume of the contralateral parotid receiving 40 Gy or more were compared between radiotherapy plans with significant constraint (SC) of less than 20 Gy on parotid dose (23 patients) and the conventional constraint (CC) of 26 Gy (29 patients). All patients had PTV coverage of at least 95% to the contralateral elective neck nodes. Mean contralateral parotid dose was, respectively, 14.1 Gy and 24.7 Gy for the SC and CC plans (p < 0.0001). The volume of contralateral parotid receiving 40 Gy or more was respectively 5.3% and 18.2% (p < 0.0001) Tomotherapy for head and neck cancer minimized radiotherapy dose to the contralateral parotid gland in patients undergoing elective node irradiation without sacrificing target coverage

  6. Myofascial pain syndrome after head and neck cancer treatment: Prevalence, risk factors, and influence on quality of life.

    Science.gov (United States)

    Cardoso, Leticia Rodrigues; Rizzo, Cláudia Carvalho; de Oliveira, Cleyton Zanardo; dos Santos, Carlos Roberto; Carvalho, André Lopes

    2015-12-01

    Patients undergoing treatment for head and neck cancer may develop myofascial pain syndrome as sequelae. The purpose of this study was to determine the prevalence, risk factors, and quality of life (QOL) related to myofascial pain syndrome. This was a prospective study including patients with head and neck cancer with at least a 1-year disease-free interval. One hundred sixty-seven patients were analyzed, and myofascial pain syndrome was diagnosed in 20 (11.9%). In the multivariate analysis, hypopharyngeal tumors (odds ratio [OR] = 6.35; 95% confidence interval [CI] = 1.58-25.56) and neck dissection (OR = 3.43; 95% CI = 1.16-10.17) were independent factors for myofascial pain syndrome. The pain (p < .001) and shoulder domain (p < .001) as well as overall University of Washington Quality of Life (UW-QOL) score (p = .006) were significantly lower in the patients with myofascial pain syndrome. Myofascial pain syndrome was observed in 1 of 9 patients after head and neck cancer treatment and a worse QOL was observed among them. Tumor site and neck dissection were found to be risk factors for myofascial pain syndrome. © 2014 Wiley Periodicals, Inc.

  7. Simultaneous PET/MR head–neck cancer imaging: Preliminary clinical experience and multiparametric evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Covello, M., E-mail: echoplanare@gmail.com [IRCCS SDN, Via E. Gianturco, 111-113 – 80143, Naples (Italy); Cavaliere, C.; Aiello, M.; Cianelli, M.S. [IRCCS SDN, Via E. Gianturco, 111-113 – 80143, Naples (Italy); Mesolella, M.; Iorio, B. [Department of Otorhinolaryngoiatry, Federico II University, Naples (Italy); Rossi, A.; Nicolai, E. [IRCCS SDN, Via E. Gianturco, 111-113 – 80143, Naples (Italy)

    2015-07-15

    Highlights: • Simultaneous PET/MRI is a suitable tool for head/neck T-staging. • No significant differences have been found for PET measures get by both PET/CT and PET/MRI. • SUV 2D and 3D measures in HN lesion offer comparable estimations. • Multiparametric evaluation allows a complete characterization of HN lesions. - Abstract: Purpose: To evaluate the role of simultaneous hybrid PET/MR imaging and to correlate metabolic PET data with morpho-functional parameters derived by MRI in patients with head–neck cancer. Methods: Forty-four patients, with histologically confirmed head and neck malignancy (22 primary tumors and 22 follow-up) were studied. Patients initially received a clinical exam and endoscopy with direct biopsy. Next patients underwent whole body PET/CT followed by PET/MR of the head/neck region. PET and MRI studies were separately evaluated by two blinded groups (both included one radiologist and one nuclear physician) in order to define the presence or absence of lesions/recurrences. Regions of interest (ROIs) analysis was conducted on the primary lesion at the level of maximum size on metabolic (SUV and MTV), diffusion (ADC) and perfusion (K{sup trans}, V{sub e}, k{sub ep} and iAUC) parameters. Results: PET/MR examinations were successfully performed on all 44 patients. Agreement between the two blinded groups was found in anatomic allocation of lesions by PET/MR (Primary tumors: Cohen's kappa 0.93; Follow-up: Cohen's kappa 0.89). There was a significant correlation between CT-SUV measures and MR (e.g., CT-SUV VOI vs. MR-SUV VOI: ρ = 0.97, p < 0.001 for the entire sample). There was also significant positive correlations between the ROI area, SUV measures, and the metabolic parameters (SUV and MTV) obtained during both PET/CT and PET/MR. A significant negative correlation was observed between ADC and K{sup trans} values in the primary tumors. In addition, a significant negative correlation existed between MR SUV and ADC in

  8. Patterns of local-regional recurrence following parotid-sparing conformal and segmental intensity-modulated radiotherapy for head and neck cancer

    International Nuclear Information System (INIS)

    Dawson, Laura A.; Anzai, Yoshimi; Marsh, Lon; Martel, Mary K.; Paulino, Augusto; Ship, Jonathan A.; Eisbruch, Avraham

    2000-01-01

    (including one noninvasive recurrence) and 1 stomal recurrence were seen in 12 patients, for a 2-year actuarial local-regional control rate of 79% (95% confidence interval 68-90%). Ten patients (80%) relapsed in-field (in areas of previous gross tumor in nine patients), and two patients developed marginal recurrences in the side of the neck at highest risk (one in the high retropharyngeal nodes/base of skull and one in the submandibular nodes). Four regional recurrences extended superior to the jugulodigastric node, in the high jugular and retropharyngeal nodes near the base of skull of the side of the neck at highest risk. Three of these were in-field, in areas that had received the dose intended for subclinical disease. No recurrences were seen in the nodes superior to the jugulodigastric nodes in the side of the neck at less risk, where RT was partially spared. Conclusions: The majority of local-regional recurrences after conformal and segmental IMRT were 'in-field', in areas judged to be at high risk at the time of RT planning, including the GTV, the operative bed, and the first echelon nodes. These findings motivate studies of dose escalation to the highest risk regions

  9. Trismus in head and neck cancer patients treated by telecobalt and effect of early rehabilitation measures.

    Science.gov (United States)

    Nagaraja, Sindhu; Kadam, S Amrut; Selvaraj, Karthikeyan; Ahmed, Iqbal; Javarappa, Rajesh

    2016-01-01

    Trismus is one of the common late side effects of radiotherapy (RT) of head and neck cancers. It occurs in about 30% of patients treated by telecobalt. It, in turn, leads to significant morbidity, including malnutrition, difficulty in speaking, and compromised oral hygiene with severe psychosocial, and economic impacts. To determine the prevalence of trismus and its progression in patients who have received radical concurrent chemoradiation for head and neck cancer by telecobalt at our institution. To note the effect of early rehabilitative measures on the severity of trismus and to assess its impact on the quality of life (QOL). A total of 47 evaluable patients of head and neck cancer patients treated by telecobalt with radical intent between January 2012 and December 2013 were analyzed and baseline maximal inter-incisal opening (MIO) and MIO at the completion of RT, after 3 months, 6 months, and 1 year, after completion of RT were noted. Grading of trismus was done using Modified Common Toxicity Criteria (CTCAE Version 3.0). QOL assessment was done using European Organization for Research and Treatment of Cancer QLQ-HN35. The time when the rehabilitative measures were started were also noted. Chi-square test with Fisher exact probability test and Students t-test. Radiation-induced trismus (RIT) was seen in 31.9%, 34.04%, and 38.39% of cases at 3, 6, and 12 months after completion of RT. Grade II and III trismus accounted for 17.02% and 6.38% at the end of 1 year. Patients who started regular rehabilitative exercises soon, after completion of RT had a better mean MIO as compared to those who were not compliant (32 mm vs. 24 mm at 1 year), and there was a trend toward delayed progression in them. Trismus was also seen to adversely affect QOL of the patients. RIT is a major cause for late morbidity in patients treated with conventional RT leading to poor QOL. Early rehabilitative measures are useful in preventing progression of trismus.

  10. The Impact of Radiation Treatment Time on Survival in Patients With Head and Neck Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Shaikh, Talha [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Handorf, Elizabeth A. [Department of Biostatistics, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Murphy, Colin T. [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Mehra, Ranee [Department of Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Ridge, John A. [Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States); Galloway, Thomas J., E-mail: Thomas.Galloway@fccc.edu [Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania (United States)

    2016-12-01

    Purpose: To assess the impact of radiation treatment time (RTT) in head and neck cancers on overall survival (OS) in the era of chemoradiation. Methods and Materials: Patients with diagnoses of tongue, hypopharynx, larynx, oropharynx, or tonsil cancer were identified by use of the National Cancer Database. RTT was defined as date of first radiation treatment to date of last radiation treatment. In the definitive setting, prolonged RTT was defined as >56 days, accelerated RTT was defined as <47 days, and standard RTT was defined as 47 to 56 days. In the postoperative setting, prolonged RTT was defined as >49 days, accelerated RTT was defined as <40 days, and standard RTT was defined as 40 to 49 days. We used χ{sup 2} tests to identify predictors of RTT. The Kaplan-Meier method was used to compare OS among groups. Cox proportional hazards model was used for OS analysis in patients with known comorbidity status. Results: 19,531 patients were included; 12,987 (67%) had a standard RTT, 4,369 (34%) had an accelerated RTT, and 2,165 (11%) had a prolonged RTT. On multivariable analysis, accelerated RTT (hazard ratio [HR] 0.84; 95% confidence interval [CI] 0.73-0.97) was associated with an improved OS, and prolonged RTT (HR 1.25; 95% CI 1.14-1.37) was associated with a worse OS relative to standard RTT. When the 9,200 (47%) patients receiving definitive concurrent chemoradiation were examined, prolonged RTT (HR 1.29; 95% CI 1.11-1.50) was associated with a worse OS relative to standard RTT, whereas there was no significant association between accelerated RTT and OS (HR 0.76; 95% CI 0.57-1.01). Conclusion: Prolonged RTT is associated with worse OS in patients receiving radiation therapy for head and neck cancer, even in the setting of chemoradiation. Expeditious completion of radiation should continue to be a quality metric for the management of head and neck malignancies.

  11. Waiting times for diagnosis and treatment of head and neck cancer in Denmark in 2010 compared to 1992 and 2002

    DEFF Research Database (Denmark)

    Lyhne, N M; Christensen, A; Alanin, M C

    2013-01-01

    BACKGROUND AND AIM: Significant tumour progression was observed during waiting time for treatment of head and neck cancer. To reduce waiting times, a Danish national policy of fast track accelerated clinical pathways was introduced in 2007. This study describes changes in waiting time and the pot......BACKGROUND AND AIM: Significant tumour progression was observed during waiting time for treatment of head and neck cancer. To reduce waiting times, a Danish national policy of fast track accelerated clinical pathways was introduced in 2007. This study describes changes in waiting time...... and the potential influence of fast track by comparing waiting times in 2010 to 2002 and 1992. METHODS: Charts of all new patients diagnosed with squamous cell carcinoma of the oral cavity, pharynx and larynx at the five Danish head and neck oncology centres from January to April 2010 (n=253) were reviewed...

  12. A "package solution" fast track program can reduce the diagnostic waiting time in head and neck cancer

    DEFF Research Database (Denmark)

    Sørensen, Jesper Roed; Johansen, Jørgen; Gano, Lars

    2014-01-01

    In 2007, a fast track program for patients with suspicion of head and neck cancer (HNC) was introduced in Denmark to reduce unnecessary waiting time. The program was based on so called "package solutions" including pre-booked slots for outpatient evaluation, imaging, and diagnostic surgical...... procedures. The purpose of this study is to present a model for fast track handling of patients suspicious of cancer in the head and neck region and to evaluate the effect of implementation on the diagnostic work up time. Patients with suspicion of HNC referred to the same university department of ENT Head...... and Neck Surgery during three comparable time intervals 2006-2007, 2007-2008, and 2011-2012 (groups 1-3) were investigated. We recorded the time from patient referral, to first consultation and final diagnosis. The first interval was before initiation of the "package solution", the second just after...

  13. Prospective randomized trial to compare accelerated (six fractions a week radiotherapy against concurrent chemoradiotherapy (using conventional fractionation in locally advanced head and neck cancers

    Directory of Open Access Journals (Sweden)

    Manoj Gupta

    2015-01-01

    Full Text Available Background: Concurrent chemoradiation (CCRT is currently considered to be the standard of care in locally advanced head and neck cancer. The optimum radiotherapy schedule for best local control and acceptable toxicity is not yet clear. We aimed at shortening of treatment time by using accelerated radiation, thereby comparing the disease response, loco-regional tumor control and tolerability of accelerated radiation (six fractions per week against CCRT in locally advanced head and neck cancer. Materials and Methods: We conducted the prospective randomized study for a period of 2 years from June 2011 to May 2013 in 133 untreated patients of histologically confirmed squamous cell carcinoma of head and neck. Study group (66 patients received accelerated radiotherapy with 6 fractions per week (66Gy/33#/5½ weeks. Control group (67 patients received CCRT with 5 fractions per week radiation (66 Gy/33#/6½ weeks along with intravenous cisplatin 30 mg/m 2 weekly. Tumor control, survival, acute and late toxicities were assessed. Results: Median overall treatment time was 38 days and 45 days in the accelerated radiotherapy and concurrent chemoradiation arm, respectively. At a median follow up of 12 months, 41 patients (62.1% in the accelerated radiotherapy arm and 47 patients (70.1% in the CCRT arm were disease free (P = 0.402. Local disease control was comparable in both the arms. Acute toxicities were significantly higher in the CCRT arm as compared with accelerated radiotherapy arm. There was no difference in late toxicities between the two arms. Conclusion: We can achieve, same or near to the same local control, with lower toxicities with accelerated six fractions per week radiation compared with CCRT especially for Indian population.

  14. Impact of Node Negative Target Volume Delineation on Contralateral Parotid Gland Dose Sparing Using IMRT in Head and Neck Cancer.

    Science.gov (United States)

    Magnuson, William J; Urban, Erich; Bayliss, R Adam; Harari, Paul M

    2015-06-01

    There is considerable practice variation in treatment of the node negative (N0) contralateral neck in patients with head and neck cancer. In this study, we examined the impact of N0 neck target delineation volume on radiation dose to the contralateral parotid gland. Following institutional review board approval, 12 patients with head and neck cancer were studied. All had indications for treatment of the N0 neck, such as midline base of tongue or soft palate extension or advanced ipsilateral nodal disease. The N0 neck volumes were created using the Radiation Therapy Oncology Group head and neck contouring atlas. The physician-drawn N0 neck clinical target volume (CTV) was expanded by 25% to 200% to generate volume variation, followed by a 3-mm planning target volume (PTV) expansion. Surrounding organs at risk were contoured and complete intensity-modulated radiation therapy plans were generated for each N0 volume expansion. The median N0 target volume drawn by the radiation oncologist measured 93 cm(3) (range 71-145). Volumetric expansion of the N0 CTV by 25% to 200% increased the resultant mean dose to the contralateral parotid gland by 1.4 to 8.5 Gray (Gy). For example, a 4.1-mm increase in the N0 neck CTV translated to a 2.0-Gy dose increase to the parotid, 7.4 mm to a 4.5 Gy dose increase, and 12.5 mm to an 8.5 Gy dose increase, respectively. The treatment volume designated for the N0 neck has profound impact on resultant dose to the contralateral parotid gland. Variations of up to 15 mm are routine across physicians in target contouring, reflecting individual preference and training expertise. Depending on the availability of immobilization and image guidance techniques, experts commonly recommend 3 to 10 mm margin expansions to generate the PTV. Careful attention to the original volume of the N0 neck CTV, as well as expansion margins, is important in achieving effective contralateral gland sparing to reduce the resultant xerostomia and dysguesia that may ensue

  15. [Physiological metals in the serum, hair and nails of patients with head and neck cancer].

    Science.gov (United States)

    Woźniak, Anna; Kujawa, Anita; Seńczuk-Przybyłowska, Monika; Kulza, Maksymilian; Gawecki, Wojciech; Szybiak, Bartosz; Herman, Małgorzata; Czarnywojtek, Agata; Kurhańska-Flisykowska, Anna; Chesy, Paulina; Szyfter, Witold; Walas, Stanisław; Golusiński, Wojciech; Szyfter, Krzysztof; Krejpcio, Zbigniew; Piekoszewski, Wojciech; Parczewski, Andrzej; Florek, Ewa

    2012-01-01

    Cigarette smoking and excessive alcohol drinking result in the rise of numbers of patients suffering from the head and neck cancer. Addiction to any of these stimulants carry a risk of developing a cancerogenesis process. Using them simultaniously lead not to a summary of each of those risks but multiplies them. Scientific research also indicates the important difference in the incidence of cancer in people who have never smoked cigarettes or drunk alcohol in comparison to those, whose exposure to these stimulatns was longterm - in such case, the former group had a lower percentage of developing the disease. Human body burdened with the ongoing cancer shows disturbances on various levels of the system. One of such disturbances is change of the concetration levels of physiological metals, such as calcium, magnesium, iron, copper, zinc or mangenese. They play key roles in maintaing the hormonal and ionic stability, they act as cofactors in many enzymes in metabolic processes. Diagnostic research of any deviations in levels of those essential elements enables a full estimation of a patient condition. The aim of this study was physiological metal levels evaluation in different kinds of biological material in patients with tumors of larynx, salivary glands and oral cavity and tongue. Hair and nail samples were used as examples of alternative material, beside the serum samples, which is a standard material and often used. Subjects were patients of Otolaryngology and Laryngological Oncology Clinic of Poznan University of Medical Sciences (Samodzielny Publiczny Szpital Kliniczny nr 2 im. Heliodora Swiecickiego Uniwersytetu Medycznego im. Karola Marcinkowskiego w Poznaniu) and The Head and Neck Surgery Ward of The Greater Poland Cancer Centre in Poznan. Subjects were 41 men and 18 women with tumors of larynx, salivary glands and oral cavity and tongue. The control group consisted of patients from the Otolaryngology and Laryngological Oncology Clinic of Poznan University of

  16. Distancing, self-esteem, and subjective well-being in head and neck cancer.

    Science.gov (United States)

    Devins, Gerald M; Wong, Janice C; Payne, Ada Y M; Lebel, Sophie; Lee, Ruth N F; Mah, Kenneth; Irish, Jonathan; Rodin, Gary

    2015-11-01

    Distancing (i.e. construing oneself as dissimilar to a negatively-stereotyped group) preserves self-esteem and may benefit other domains of subjective well-being. Head and neck cancer (HNC) is stigmatized because major risk factors include avoidable lifestyle variables (smoking, alcohol consumption, and human papilloma virus). Because the benefits of coping efforts, such as distancing, are most evident when people are under stress, we hypothesize that the psychosocial benefits of distancing will be most pronounced when cancer and its treatment interfere substantially with participation in valued activities and interests (i.e. high illness intrusiveness). To test whether distancing preserves self-esteem and other domains of subjective well-being (SWB) in HNC, especially when illness intrusiveness is high. Five hundred and twenty-two HNC outpatients completed a semantic-differential measure of perceived similarity to the 'cancer patient' and measures of illness intrusiveness, self-esteem, depressive symptoms, and psychological well-being in structured interviews. Evaluations of the 'cancer patient' reflected cancer stereotypes. A statistically significant interaction supported the central hypothesis: When people held negative stereotypes, those who construed themselves as similar to the 'cancer patient' reported lower self-esteem than those who construed themselves as dissimilar. Distancing did not benefit other SWB variables. Some results were counter-intuitive: e.g. Emotional distress increased with increasing illness intrusiveness when people did not hold negative cancer stereot