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  1. Nutrition management for head and neck cancer patients improves clinical outcome and survival.

    Science.gov (United States)

    Müller-Richter, Urs; Betz, C; Hartmann, S; Brands, R C

    2017-12-01

    Up to 80% of patients with head and neck cancers are malnourished because of their lifestyle and the risk factors associated with this disease. Unfortunately, nutrition management systems are not implemented in most head and neck cancer clinics. Even worse, many head and neck surgeons as well as hospital management authorities disregard the importance of nutrition management in head and neck cancer patients. In addition, the often extensive resection and reconstruction required for tumors in the upper aerodigestive tract pose special challenges for swallowing and sufficient food intake, placing special demands on nutrition management. This article presents the basics of perioperative metabolism and nutrition management of head and neck cancer patients and makes recommendations for clinical practice. Implementing a nutrition management system in head and neck cancer clinics will improve the clinical outcome and the survival of the patients. Copyright © 2017 Elsevier Inc. All rights reserved.

  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. Head and Neck Cancer Treatment

    Science.gov (United States)

    ... Professions Site Index A-Z Head and Neck Cancer Treatment Head and neck cancer overview What are my ... and neck cancer. For updated information on new cancer treatments that are available, you should discuss these issues ...

  4. 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

  5. Head, Neck, and Oral Cancer

    Medline Plus

    Full Text Available ... and Neck Pathology Close to 49,750 Americans will be diagnosed with oral or pharyngeal cancer this ... and Neck Pathology Close to 49,750 Americans will be diagnosed with oral or pharyngeal cancer this ...

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

    NARCIS (Netherlands)

    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

  7. 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.

  8. 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

  9. 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.

  10. The role of dentistry other than oral care in patients undergoing radiotherapy for head and neck cancer

    Directory of Open Access Journals (Sweden)

    Hidenobu Matsuzaki

    2017-05-01

    Full Text Available The usefulness of dental approaches, such as oral management, has gained recognition among patients treated for head and neck cancer. In particular, oral management plays a very important role before, during, and after treatment in patients undergoing radiotherapy, chemotherapy, or a combination of both. However, specialized dentistry knowledge and techniques that are useful for patients undergoing radiotherapy for head and neck cancer have yet to be reported. Therefore, in this review article, our aim is to introduce dental approaches in radiotherapy for patients with head and neck cancer that have been developed and are currently being used at our institute.

  11. End-stage head and neck cancer coping mechanisms

    Directory of Open Access Journals (Sweden)

    Bogdan Popescu

    2017-10-01

    Full Text Available Coping mechanisms are patients’ means of adapting to stressful situations and involve psychological and physical changes in behavior. Patients adapt to head and neck cancer in a variety of ways. Head and neck cancers are extremely debilitating, especially in advanced stages of the disease or in end-of-life situations. While an oncology team needs to address the needs of all oncology patients, the advanced terminal patients require special attention. Most of these patients do not cope well with their situation and have a tendency to cease social interactions. Pain is the most frequentlyexperienced medical disability in patients having an end-stage illness experience, and thus an important medical endeavor is to afford dignity to the dying patient facingan incurable disease. In such cases, the medical community should never refuse therapy or to assist a dying patient.In some instances, the patient and family may derive benefit from their religious beliefs.

  12. Pocket Proteins Suppress Head and Neck Cancer

    Science.gov (United States)

    Shin, Myeong-Kyun; Pitot, Henry C.; Lambert, Paul F.

    2012-01-01

    Head and neck squamous cell carcinomas (HNSCC) is a common cancer in humans long known to be caused by tobacco and alcohol use, but now an increasing percentage of HNSCC is recognized to be caused by the same human papillomaviruses (HPVs) that cause cervical and other anogenital cancers. HPV-positive HNSCCs differ remarkably from HPV-negative HNSCCs in their clinical response and molecular properties. From studies in mice, we know that E7 is the dominant HPV oncoprotein in head and neck cancer. E7 is best known for its ability to inactivate pRb, the product of the retinoblastoma tumor susceptibility gene. However loss of pRb function does not fully account for E7’s potency in causing head and neck cancer. In this study, we characterized the cancer susceptibility of mice deficient in the expression of pRb and either of two related “pocket” proteins, p107 and p130, that are also inactivated by E7. pRb/p107 deficient mice developed head and neck cancer as frequently as do HPV16 E7 transgenic mice. The head and neck epithelia of the pRb/p107 deficient mice also displayed the same acute phenotypes and biomarker readouts as observed in the epithelia of E7 transgenic mice. Mice deficient for pRb and p130 in their head and neck epithelia showed intermediate acute and tumor phenotypes. We conclude that pRb and p107 act together to efficiently suppress head and neck cancer, and are therefore highly relevant targets of HPV16 E7 in its contribution to HPV-positive HNSCC. PMID:22237625

  13. 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

  14. 50 Facts about Oral, Head and Neck Cancer

    Science.gov (United States)

    ... Marketplace Find an ENT Doctor Near You 50 Facts about Oral, Head and Neck Cancer 50 Facts about Oral, Head and Neck Cancer Patient Health ... cancer has increased in all races and both sexes. Thyroid cancers account for ... who work in environments with dust, glues, formaldehyde, mustard gas, ...

  15. 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 ...

  16. 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

  17. 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)

  18. 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.

  19. Head and Neck Cancers in Developing Countries

    Directory of Open Access Journals (Sweden)

    Poonam Joshi

    2014-04-01

    Full Text Available Head and neck cancers are the most common cancers in developing countries, especially in Southeast Asia. Head and neck cancers are more common in males compared to females. This is mainly attributed to tobacco, areca nut, alcohol, etc. Oral cancers are most common amongst all head and neck squamous cell cancers (HNSCC. HNSCC in the developing world differ from those in the Western world in terms of age, site of disease, etiology, and molecular biology. Poverty, illiteracy, advanced stage at presentation, lack of access to health care, and poor treatment infrastructure pose a major challenge in management of these cancers. The annual GDP (gross domestic product spent on health care is very low in developing countries compared to the developed countries. Cancer treatment leads to a significant financial burden on the cancer patients and their families. Several health programs have been implemented to curb this rising burden of disease. The main aims of these health programs are to increase awareness among people regarding tobacco and to improve access to health care facilities, early diagnosis, treatment, and palliative care.

  20. 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.

  1. Dietetic assessment of ambulatory cancer patients: with special attention to problems of patients suffering from head-neck cancers undergoing radiation thrapy

    International Nuclear Information System (INIS)

    Dwyer, J.T.

    1979-01-01

    The prime objective of nutritional surveillance of cancer patients is to set up screening criteria for those who are likely to be at risk of nutrition problems and to further assess those so identified. Interventions to improve nutritional status or comfort are called for. The single most useful item with respect to screening is careful weight measurement at every visit. Subjective reports of appetite and food intake, 24-hour recalls of dietary intake, and therapy being undergone by the patient are also useful. Assessment involves obtaining the 24-hour recall data and in some cases keeping food records, and determining the patients' food likes and dislikes. Taken together, dietary, biochemical, clinical, anthropometric, and patient history data permit us to achieve greater certainty as to the problem. Usually energy intakes are problematic, but other nutrition difficlties may also be present. Intervention with respect to diet may involve therapeutic diets, special nutrition advice, or general advice. Food assistance, help with food managemnt, and general health education may also be necessary. Constant surveillance consisting of short encounters and follow-up are mandatory. Examples of these principles as they apply to head-neck cancers are presented

  2. Brachytherapy in the treatment of head and neck cancer

    International Nuclear Information System (INIS)

    Yoo, Seong Yul

    1999-01-01

    Brachytherapy has been proved to be an effective method for the purpose of increasing radiation dose to the tumor and reducing the dose to the surrounding normal tissue. In head and neck cancer, the rationale of brachytherapy is as follows; Firstly, early small lesion is radiocurative and the major cause of failure is local recurrence. Secondly, it can diminish evidently the dose to the normal tissue especially masseteric muscle and salivary gland. Thirdly, the anatomy of head and neck is suitable to various technique of brachytherapy. On background of accumulated experience of LDR iridium brachytherapy of head and neck cancer for the last 15 years, the author reviewed the history of radioisotope therapy, the characteristics of radionuclides, and some important things in the method, clinical technique and treatment planning. The author analyzed the clinical result of 185 cases of head and neck cancer treated in the Korea Cancer Center Hospital. Finally the future prospect of brachytherapy of head and neck cancer is discussed

  3. 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 ...

  4. Head and neck cancer in South Asia: Macroeconomic consequences and the role of the head and neck surgeon.

    Science.gov (United States)

    Alkire, Blake C; Bergmark, Regan W; Chambers, Kyle; Lin, Derrick T; Deschler, Daniel G; Cheney, Mack L; Meara, John G

    2016-08-01

    Head and neck cancer constitutes a substantial portion of the burden of disease in South Asia, and there is an undersupply of surgical capacity in this region. The purpose of this study was to estimate the economic welfare losses due to head and neck cancer in India, Pakistan, and Bangladesh in 2010. We used publicly available estimates of head and neck cancer morbidity and mortality along with a concept termed the value of a statistical life to estimate economic welfare losses in the aforementioned countries in 2010. Economic losses because of head and neck cancer in India, Pakistan, and Bangladesh totaled $16.9 billion (2010 US dollars [USD]), equivalent to 0.26% of the region's economic output. Bangladesh, the poorest country, experienced the greatest proportional losses. The economic consequences of head and neck cancer in South Asia are significant, and building surgical capacity is essential to begin to address this burden. © 2016 Wiley Periodicals, Inc. Head Neck 38:1242-1247, 2016. © 2016 Wiley Periodicals, Inc.

  5. Second cancers following radiotherapy for early stage head and neck cancer

    International Nuclear Information System (INIS)

    Shibuya, Hitoshi; Yoshimura, Ryo-ichi; Oota, Sayako; Watanabe, Hiroshi; Miura, Masahiko

    2005-01-01

    Different site specificity of second primary cancer following treatment for early stage squamous cell carcinoma of the head and neck was found in the analysis of post-treatment long-term follow up cases. The highest risk of second primary cancer was observed in the oro-hypo-pharynx cancer groups, and the lowest risks were observed in the epi-pharynx cancer and maxillary sinus cancer groups. Squamous cell carcinoma in the irradiated head and neck region with long latency periods could be included in the radiation induced cancer from comparison with post-irradiation cases for malignant lymphoma, benign diseases as well as breast cancers. (author)

  6. 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.

  7. 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.

  8. 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.

  9. 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)

  10. 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

  11. A historical review of head and neck cancer in celebrities.

    Science.gov (United States)

    Folz, B J; Ferlito, A; Weir, N; Pratt, L W; Rinaldo, A; Werner, J A

    2007-06-01

    The illnesses of celebrity patients always receive more attention from the general public than those of ordinary patients. With regard to cancer, this fact has helped to spread information about the four major malignancies: breast cancer, prostatic cancer, lung cancer and colorectal cancer. Head and neck cancer, on the other hand, is still not well recognised by the lay public, although the risk factors are similar to those of lung cancer. It was the objective of this analysis to identify cases of celebrity patients, the description of which could help to increase awareness of head and neck cancer, its symptoms and risk factors. The Internet and medical literature databases were searched for celebrity patients who had suffered from head and neck cancer. The search revealed numerous famous head and neck cancer patients. However, only seven cases were documented well in the medical literature. Among the identified persons were one emperor, two United States presidents, a legendary composer, a world-renowned medical doctor, an outstanding athlete and an extraordinary entertainer. In spite of their exclusive position in society, these patients did not have a better prognosis compared with ordinary patients of their time. Only two of the group experienced long term survival and only one was cured. None of these influential figures used their influence to fund research or to promote knowledge about their respective diseases. The identified cases could help increase public awareness of head and neck cancer. Similar to activities in other oncologic fields, current celebrity head and neck cancer patients should be encouraged to discuss their diseases openly, which could have a positive effect on public health.

  12. 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.

  13. 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

  14. 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.

  15. 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.

  16. Head and neck cancer: Radiotherapeutic precepts in the management of the neck

    International Nuclear Information System (INIS)

    Million, R.R.; Cassisi, N.J.; Parsons, J.T.; Mendenhall, W.M.

    1986-01-01

    The authors provide a series of statements regarding the use of radiotherapy and surgery for metastatic squamous cancer to the neck. Some of these precepts are established facts requiring no additional documentation - for example, the combination of radiation and neck dissection for effective treatment of N2B neck disease or for subclinical disease, depending on extracapsular spread. Other precepts of the authors are not as generally accepted by head and neck surgeons, such as the mandatory staging of neck dissections following curative radiation therapy or the routine use of computerized tomography (CT) to confirm pathologic adenopathy. Most of the authors' precepts are supported by a combination of their personal clinical experience and hard data from the University of Florida, Gainesville

  17. 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.

  18. 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.

  19. Multidisciplinary management of head and neck cancer: First expert consensus using Delphi methodology from the Spanish Society for Head and Neck Cancer (part 1).

    Science.gov (United States)

    Mañós, M; Giralt, J; Rueda, A; Cabrera, J; Martinez-Trufero, J; Marruecos, J; Lopez-Pousa, A; Rodrigo, J P; Castelo, B; Martínez-Galán, J; Arias, F; Chaves, M; Herranz, J J; Arrazubi, V; Baste, N; Castro, A; Mesía, R

    2017-07-01

    Head and neck cancer is one of the most frequent malignances worldwide. Despite the site-specific multimodality therapy, up to half of the patients will develop recurrence. Treatment selection based on a multidisciplinary tumor board represents the cornerstone of head and neck cancer, as it is essential for achieving the best results, not only in terms of outcome, but also in terms of organ-function preservation and quality of life. Evidence-based international and national clinical practice guidelines for head and neck cancer not always provide answers in terms of decision-making that specialists must deal with in their daily practice. This is the first Expert Consensus on the Multidisciplinary Approach for Head and Neck Squamous Cell Carcinoma (HNSCC) elaborated by the Spanish Society for Head and Neck Cancer and based on a Delphi methodology. It offers several specific recommendations based on the available evidence and the expertise of our specialists to facilitate decision-making of all health-care specialists involved. Copyright © 2017. Published by Elsevier Ltd.

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

    African Journals Online (AJOL)

    big meta-analysis of chemotherapy in head and neck cancer. (MACH-NC) involving over ... and neck cancer of squamous cell histology, HIV infected who was down-staged ... of the submitted specimen confirmed ulcerated oral mucosa with an ...

  1. Overexpression of EMMPRIN isoform 2 is associated with head and neck cancer metastasis.

    Directory of Open Access Journals (Sweden)

    Zhiquan Huang

    Full Text Available Extracellular matrix metalloproteinase inducer (EMMPRIN, a plasma membrane protein of the immunoglobulin (Ig superfamily, has been reported to promote cancer cell invasion and metastasis in several human malignancies. However, the roles of the different EMMPRIN isoforms and their associated mechanisms in head and neck cancer progression remain unknown. Using quantitative real-time PCR, we found that EMMPRIN isoform 2 (EMMPRIN-2 was the only isoform that was overexpressed in both head and neck cancer tissues and cell lines and that it was associated with head and neck cancer metastasis. To determine the effects of EMMPRIN-2 on head and neck cancer progression, we transfected head and neck cancer cells with an EMMPRIN-2 expression vector and EMMPRIN-2 siRNA to exogenously modulate EMMPRIN-2 expression and examined the functional importance of EMMPRIN-2 in head and neck cancer invasion and metastasis. We found that EMMPRIN-2 promoted head and neck cancer cell invasion, migration, and adhesion in vitro and increased lung metastasis in vivo. Mechanistic studies revealed that EMMPRIN-2 overexpression promoted the secretion of extracellular signaling molecules, including matrix metalloproteinases-2(MMP-2, urokinase-type plasminogen activator(uPA and Cathepsin B, in head and neck cancer cells. While MMP-2 and uPA have been demonstrated to be important mediators of EMMPRIN signaling, the role of Cathepsin B in EMMPRIN-mediated molecular cascades and tumorigenesis has not been established. We found that EMMPRIN-2 overexpression and Cathepsin B down-regulation significantly inhibited the invasion, migration and adhesion of Tca8133 cells, suggesting that Cathepsin B is required for EMMPRIN-2 enhanced cell migration and invasion in head and neck cancer. The results of our study demonstrate the important role of EMMPRIN-2 in head and neck cancer progression for the first time and reveal that increased extracellular secretion of Cathepsin B may be a novel

  2. Overexpression of EMMPRIN isoform 2 is associated with head and neck cancer metastasis.

    Science.gov (United States)

    Huang, Zhiquan; Tan, Ning; Guo, Weijie; Wang, Lili; Li, Haigang; Zhang, Tianyu; Liu, Xiaojia; Xu, Qin; Li, Jinsong; Guo, Zhongmin

    2014-01-01

    Extracellular matrix metalloproteinase inducer (EMMPRIN), a plasma membrane protein of the immunoglobulin (Ig) superfamily, has been reported to promote cancer cell invasion and metastasis in several human malignancies. However, the roles of the different EMMPRIN isoforms and their associated mechanisms in head and neck cancer progression remain unknown. Using quantitative real-time PCR, we found that EMMPRIN isoform 2 (EMMPRIN-2) was the only isoform that was overexpressed in both head and neck cancer tissues and cell lines and that it was associated with head and neck cancer metastasis. To determine the effects of EMMPRIN-2 on head and neck cancer progression, we transfected head and neck cancer cells with an EMMPRIN-2 expression vector and EMMPRIN-2 siRNA to exogenously modulate EMMPRIN-2 expression and examined the functional importance of EMMPRIN-2 in head and neck cancer invasion and metastasis. We found that EMMPRIN-2 promoted head and neck cancer cell invasion, migration, and adhesion in vitro and increased lung metastasis in vivo. Mechanistic studies revealed that EMMPRIN-2 overexpression promoted the secretion of extracellular signaling molecules, including matrix metalloproteinases-2(MMP-2), urokinase-type plasminogen activator(uPA) and Cathepsin B, in head and neck cancer cells. While MMP-2 and uPA have been demonstrated to be important mediators of EMMPRIN signaling, the role of Cathepsin B in EMMPRIN-mediated molecular cascades and tumorigenesis has not been established. We found that EMMPRIN-2 overexpression and Cathepsin B down-regulation significantly inhibited the invasion, migration and adhesion of Tca8133 cells, suggesting that Cathepsin B is required for EMMPRIN-2 enhanced cell migration and invasion in head and neck cancer. The results of our study demonstrate the important role of EMMPRIN-2 in head and neck cancer progression for the first time and reveal that increased extracellular secretion of Cathepsin B may be a novel mechanism

  3. 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

  4. Unusual Cancers of the Head and Neck

    Science.gov (United States)

    ... more information). Unusual Cancers of the Head and Neck Nasopharyngeal Cancer See the PDQ summary on Childhood ... of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ ...

  5. Lhermitte's Sign Developing after IMRT for Head and Neck Cancer

    Directory of Open Access Journals (Sweden)

    Dong C. Lim

    2010-01-01

    Full Text Available Background. Lhermitte's sign (LS is a benign form of myelopathy with neck flexion producing an unpleasant electric-shock sensation radiating down the extremities. Although rare, it can occur after head and neck radiotherapy. Results. We report a case of Lhermitte's developing after curative intensity-modulated radiotherapy (IMRT for a patient with locoregionally advanced oropharyngeal cancer. IMRT delivers a conformal dose of radiation in head and neck cancer resulting in a gradient of radiation dose throughout the spinal cord. Using IMRT, more dose is delivered to the anterior spinal cord than the posterior cord. Conclusions. Lhermitte's sign can develop after IMRT for head and neck cancer. We propose an anterior spinal cord structure, the spinothalamic tract to be the target of IMRT-caused LS.

  6. 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.

  7. Cetuximab And The Head And Neck Squamous Cell Cancer.

    Science.gov (United States)

    Concu, Riccardo; Cordeiro, Maria Natalia Dias Soeiro

    2018-01-12

    The head and neck squamous cell cancer (HNSCC) is the most common type of head and neck cancer (more than 90%), and all over the world more than a half million people have been developing this cancer in the last years. This type of cancer is usually marked by a poor prognosis with a really significant morbidity and mortality. Cetuximab received early favor as an exciting and promising new therapy with relatively mild side effect, and due to this received authorization in the 2004 from the European Medicines Agency (EMA) and in the 2006 from the Food and Drug Association (FDA) for the treatment of patients with squamous cell cancer of the head and neck in combination with radiation therapy for locally advanced disease. In this work we will review the application and the efficacy of the Cetuximab in the treatment of the HNSCC. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  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. Metabolic microscopy of head and neck cancer organoids

    Science.gov (United States)

    Shah, Amy T.; Skala, Melissa C.

    2016-03-01

    Studies for head and neck cancer have primarily relied on cell lines or in vivo animal studies. However, a technique that combines the benefits of high-throughput in vitro studies with a complex, physiologically relevant microenvironment would be advantageous for understanding drug effects. Organoids provide a unique platform that fulfills these goals. Organoids are generated from excised and digested tumor tissue and are grown in culture. Fluorescence microscopy provides high-resolution images on a similar spatial scale as organoids. In particular, autofluorescence imaging of the metabolic cofactors NAD(P)H and FAD can provide insight into response to anti-cancer treatment. The optical redox ratio reflects relative amounts of NAD(P)H and FAD, and the fluorescence lifetime reflects enzyme activity of NAD(P)H and FAD. This study optimizes and characterizes the generation and culture of organoids grown from head and neck cancer tissue. Additionally, organoids were treated for 24 hours with a standard chemotherapy, and metabolic response in the organoids was measured using optical metabolic imaging. Ultimately, combining head and neck cancer organoids with optical metabolic imaging could be applied to test drug sensitivity for drug development studies as well as treatment planning for cancer patients.

  10. The Danish Head and Neck Cancer database

    DEFF Research Database (Denmark)

    Overgaard, Jens; Jovanovic, Aleksandar; Godballe, Christian

    2016-01-01

    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......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......) 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...

  11. Hypothyroidism after radiotherapy for head and neck cancer patients

    International Nuclear Information System (INIS)

    Ozawa, Hiroyuki; Saito, Hideyuki; Inagaki, Kouji; Mizutari, Kunio

    2004-01-01

    We report two cases of hypothyroidism with clinical symptoms that occurred after radiotherapy for cancer of the head and neck. The first patient underwent total laryngectomy without thyroidectomy for laryngeal cancer and partial gastrectomy for gastric cancer. Radiation of the neck was carried out postoperatively. Two years later, he developed chest pain and pericardial effusion was detected, leading to a diagnosis of myxedema due to hypothyroidism. The second patient received radiotherapy alone for laryngeal carcinoma. Two months later, a low serum sodium concentration and anemia were detected, both of which proved difficult to correct. The cause of these changes was found subsequently to be hypothyroidism. From the experience of these 2 cases, we measured thyroid function in 37 patients who had received neck radiation for head and neck cancers at our hospital over the past 10 years. In 13 of the 37 patients (35%), hypothyroidism was observed. The prevalence of hypothyroidism was higher in the 13 patients treated with both radiation and surgery, with 6 (46%) showing this condition, compared with 7 of the 24 patients (29%) who received radiation alone. The risk factor responsible for hypothyroidism was not evident from statistical analysis of these cases. We consider that thyroid function should be evaluated periodically in patients who have received neck radiotherapy, as it is often difficult to diagnose hypothyroidism from clinical symptoms. (author)

  12. 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

  13. Post-operative radiation therapy for advanced head and neck cancers

    International Nuclear Information System (INIS)

    Ang, Kian K.; Garden, Adam S.

    1996-01-01

    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

  14. [Managment of head and neck cancers during pregnancy].

    Science.gov (United States)

    Kiciński, Krzysztof; Skorek, Andrzej; Stankiewicz, Czesław

    2011-01-01

    The coincidence of malignant disease during pregnancy is uncommon. The incidence of cancer in pregnancy has increased, due to the tendency to postpone childbirth to an older age. Cancer complicates approximately 0.1% of all pregnancies. Managing head and neck cancers during pregnancy requires additional pregnancy-related understanding of the aetiological effect of pregnancy on cancer, knowledge of the direct and indirect effects of cancer on pregnancy, and the effect of diagnostic and treatment modalities on pregnancy. The timing of treatment is an important determinant on foetal wellbeing. A multidisciplinary approach should be adopted to enable parents and clinicians to make the best clinical decision. Clinicians must be cognizant with the ethical dilemmas of treatment. In head and neck cancers, pregnancy has no effect on maternal prognosis when compared to non-pregnant patients matched by age, cancer stage and treatment. Copyright © 2011 Polish Otolaryngology Society. Published by Elsevier Urban & Partner (Poland). All rights reserved.

  15. 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

  16. 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.

  17. 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.

  18. 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.

  19. Perceived difficulty quitting predicts enrollment in a smoking-cessation program for patients with head and neck cancer.

    Science.gov (United States)

    Duffy, Sonia A; Scheumann, Angela L; Fowler, Karen E; Darling-Fisher, Cynthia; Terrell, Jeffrey E

    2010-05-01

    To determine the predictors of participation in a smoking-cessation program among patients with head and neck cancer. This cross-sectional study is a substudy of a larger, randomized trial of patients with head and neck cancer that determined the predictors of smokers' participation in a cessation intervention. Otolaryngology clinics at three Veterans Affairs medical centers (Ann Arbor, MI, Gainesville, FL, and Dallas, TX), and the University of Michigan Hospital in Ann Arbor. 286 patients who had smoked within six months of the screening survey were eligible for a smoking-cessation intervention. Descriptive statistics and bivariate and multivariate logistic regression were used to determine the independent predictors of smokers' participation in an intervention study. Perceived difficulty quitting (as a construct of self-efficacy), health behaviors (i.e., smoking and problem drinking), clinical characteristics (i.e., depression and cancer site and stage), and demographic variables. Forty-eight percent of those eligible participated. High perceived difficulty quitting was the only statistically significant predictor of participation, whereas problem drinking, lower depressive symptoms, and laryngeal cancer site approached significance. Special outreach may be needed to reach patients with head and neck cancer who are overly confident in quitting, problem drinkers, and patients with laryngeal cancer. Oncology nurses are in an opportune position to assess patients' perceived difficulty quitting smoking and motivate them to enroll in cessation programs, ultimately improving quality of life, reducing risk of recurrence, and increasing survival for this population.

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

    African Journals Online (AJOL)

    Lack of baseline data in Tanzania concerning head and ... that there is a synergistic effect of alcohol consumption and tobacco use in causing head and neck cancers ... risk factors, while radiation around the head and neck is associated with ...

  1. 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

  2. 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.

  3. Predictors of Pain among Head and Neck Cancer Patients

    Science.gov (United States)

    Shuman, Andrew G.; Terrell, Jeffrey E.; Light, Emily; Wolf, Gregory T.; Bradford, Carol R.; Chepeha, Douglas; Jiang, Yunyun; McLean, Scott; Ghanem, Tamer A.; Duffy, Sonia A.

    2014-01-01

    Objective Pain is a strong contributor to cancer patients’ quality of life. The objective of this study was to determine predictors of pain 1 year after the diagnosis of head and neck cancer. Design Prospective, multi-site cohort study. Setting Three academically-affiliated medical centers. Patients Previously untreated patients with carcinoma of the upper aerodigestive tract (n=374). Main Outcome Measures Participants were surveyed pre-treatment and 1 year thereafter. Multivariate analyses were conducted to determine predictors of the SF-36 bodily pain score 1 year after diagnosis. Results The mean SF-36 bodily pain score at 1 year was 65, compared to 61 at diagnosis (p=.004), compared to 75 among population norms (lower scores indicate worse pain). Variables independently associated with pain included pre-treatment pain score (p<0.001), less education (p=0.02), neck dissection (p=0.001), feeding tube (p=0.05), xerostomia (p<0.001), depressive symptoms (p<0.001), taking more pain medication (p<0.001), less physical activity (p=.02), and poor sleep quality (p=0.006). Current smoking and problem drinking were marginally significant (p=0.07 and 0.08, respectively). Conclusions Aggressive pain management may be indicated for head and neck cancer patients who undergo neck dissections, complain of xerostomia, require feeding tubes, and have medical comorbidities. Treatment of modifiable risk factors such as depression, poor sleep quality, tobacco and alcohol abuse may also reduce pain and improve quality of life among head and neck cancer patients. PMID:23165353

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

    Energy Technology Data Exchange (ETDEWEB)

    Paoli, Severo de; Fonseca, Adenilson de Souza da; Paoli, Flavia de; Geller, Mauro [Centro Universitario Serra dos Orgaos, Teresopolis, RJ (Brazil)]. E-mail: severodepaoli@gmail.com; Presta, Giuseppe Antonio [Universidade Federal do Estado do Rio de Janeiro (UNIRIO), RJ (Brazil); Santos-Filho, Sebastiao David; Bernardo-Filho, Mario [Universidade do Estado do Rio de Janeiro (UERJ), RJ (Brazil). Inst. de Biologia Roberto Alcantara Gomes. Dept. de Biofisica e Biometria

    2008-12-15

    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)

  5. 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)

  6. A cost-effectiveness analysis of a preventive exercise program for patients with advanced head and neck cancer treated with concomitant chemo-radiotherapy

    NARCIS (Netherlands)

    Retèl, Valesca P.; van der Molen, Lisette; Hilgers, Frans J.M.; Rasch, Coen R.N.; l'Ortye, Annemiek A.A.M.H.J.; Steuten, Lotte M.G.; van Harten, Wim H.

    2011-01-01

    Background: Concomitant chemo-radiotherapy (CCRT) has become an indispensable organ, but not always function preserving treatment modality for advanced head and neck cancer. To prevent/limit the functional side effects of CCRT, special exercise programs are increasingly explored. This study presents

  7. 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.)

  8. Proton therapy for head and neck cancer: Rationale, potential indications, practical considerations, and current clinical evidence

    International Nuclear Information System (INIS)

    Mendenhall, Nancy P.; Malyapa, Robert S.; Su, Zhong; Yeung, Daniel; Mendenhall, William M.; Li, Zuofeng

    2011-01-01

    There is a strong rationale for potential benefits from proton therapy (PT) for selected cancers of the head and neck because of the opportunity to improve the therapeutic ratio by improving radiation dose distributions and because of the significant differences in radiation dose distribution achievable with x-ray-based radiation therapy (RT) and PT. Comparisons of dose distributions between x-ray-based and PT plans in selected cases show specific benefits in dose distribution likely to translate into improved clinical outcomes. However, the use of PT in head and neck cancers requires special considerations in the simulation and treatment planning process, and currently available PT technology may not permit realization of the maximum potential benefits of PT. To date, few clinical data are available, but early clinical experiences in sinonasal tumors in particular suggest significant improvements in both disease control and radiation-related toxicity

  9. Proton therapy for head and neck cancer: Rationale, potential indications, practical considerations, and current clinical evidence

    Energy Technology Data Exchange (ETDEWEB)

    Mendenhall, Nancy P.; Malyapa, Robert S.; Su, Zhong; Yeung, Daniel; Mendenhall, William M.; Li, Zuofeng (Univ. of Florida Proton Therapy Inst., Jacksonville, Florida (United States)), e-mail: menden@shands.ufl.edu

    2011-08-15

    There is a strong rationale for potential benefits from proton therapy (PT) for selected cancers of the head and neck because of the opportunity to improve the therapeutic ratio by improving radiation dose distributions and because of the significant differences in radiation dose distribution achievable with x-ray-based radiation therapy (RT) and PT. Comparisons of dose distributions between x-ray-based and PT plans in selected cases show specific benefits in dose distribution likely to translate into improved clinical outcomes. However, the use of PT in head and neck cancers requires special considerations in the simulation and treatment planning process, and currently available PT technology may not permit realization of the maximum potential benefits of PT. To date, few clinical data are available, but early clinical experiences in sinonasal tumors in particular suggest significant improvements in both disease control and radiation-related toxicity

  10. Clinical Applications of FDG PET and PET/CT in Head and Neck Cancer

    Directory of Open Access Journals (Sweden)

    Akram Al-Ibraheem

    2009-01-01

    Full Text Available 18F-FDG PET plays an increasing role in diagnosis and management planning of head and neck cancer. Hybrid PET/CT has promoted the field of molecular imaging in head and neck cancer. This modality is particular relevant in the head and neck region, given the complex anatomy and variable physiologic FDG uptake patterns. The vast majority of 18F-FDG PET and PET/CT applications in head and neck cancer related to head and neck squamous cell carcinoma. Clinical applications of 18F-FDG PET and PET/CT in head and neck cancer include diagnosis of distant metastases, identification of synchronous 2nd primaries, detection of carcinoma of unknown primary and detection of residual or recurrent disease. Emerging applications are precise delineation of the tumor volume for radiation treatment planning, monitoring treatment, and providing prognostic information. The clinical role of 18F-FDG PET/CT in N0 disease is limited which is in line with findings of other imaging modalities. MRI is usually used for T staging with an intense discussion concerning the preferable imaging modality for regional lymph node staging as PET/CT, MRI, and multi-slice spiral CT are all improving rapidly. Is this review, we summarize recent literature on 18F-FDG PET and PET/CT imaging of head and neck cancer.

  11. 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)

  12. 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.

  13. [Assessment of psychological status of inpatients with head and neck cancer before surgery].

    Science.gov (United States)

    Li, L; Wang, B Q; Gao, T H; Tian, J

    2018-01-07

    Objective: To investigate the prevalence and psychosocial characteristics in inpatients with head and neck cancer before surgery. Method: From September 2015 to December 2016, 237 consecutive inpatients with head and neck cancer who had been scheduled for surgery were prospectively enrolled in Department of Head and Neck Surgery of Shanxi Provincial Tumor Hospital. Mental health symptoms were systematically investigated using three psychological instruments: symptom checklist-90 (SCL-90), Zung self-rating anxiety scale (SAS) and Zung self-rating depression scale (SDS). SPSS 17.0 software was used to analyze the data. And he results of SCL-90, SAS and SDS were compared with the Chinese norm. For all statistical analyses, a P value psychological status in inpatients with head and neck cancer before surgery. Identifying these patients using proper screening instrument is of great important clinical implications for the early detection, management, and reduction of the distress associated with head and neck cancer.

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

    Science.gov (United States)

    Metastatic squamous neck cancer with occult primary treatment options include surgery, radiation therapy or a combination of both. Get detailed information about newly diagnosed or recurrent metastatic squamous neck cancer in this summary for clinicians.

  15. 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.

  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. 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.

  18. 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)

  19. 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

  20. Current and future state of chemoradiotherapy for head and neck cancer

    International Nuclear Information System (INIS)

    Fuwa, Nobukazu

    2002-01-01

    Radiation therapy was the conventional treatment for locally advanced, nonresectable head and neck cancer. However, therapeutic results were poor with this treatment modality, and chemoradiotherapy has been used in an effort to improve therapeutic results. Improved local-regional control and disease-free or overall survival have been shown in several randomized trials using a concurrent or alternative approach. Induction chemotherapy (neoadjuvant chemotherapy), however, has not been shown to improve local-regional control or survival. Induction chemotherapy followed by definitive radiotherapy may be useful in the selection of patients who are likely to benefit from non-surgical organ preservation treatment schemes. Further clinical trials are needed to clarify the most suitable combination of chemotherapy and radiation. Intraarterial chemotherapy combined with radiation therapy for head and neck cancer has been attempted for many years. However, the indications, clinical significance, and selection of suitable anti-cancer drugs remain unclarified. The modern superselective intraarterial approach should be re-evaluated. Many head and neck cancers have been found to overexpress the receptor to epidermal growth factor (EGFR). Antibodies such as IMC-C225 that specifically target EGF receptors with radiotherapy and/or chemotherapy may prove to be valuable contributors to the treatment of advanced head and neck cancer. (author)

  1. 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 ...

  2. Skin Cancer of the Head and Neck

    OpenAIRE

    Ouyang, Yun-Hsuan

    2010-01-01

    The majority of skin cancers of the head and neck are nonmelanoma skin cancers (NMSC). Basal cell carcinoma and squamous cell carcinoma are the most frequent types of NMSC. Malignant melanoma is an aggressive neoplasm of skin, and the ideal adjuvant therapy has not yet been found, although various options for treatment of skin cancer are available to the patient and physician, allowing high cure rate and excellent functional and cosmetic outcomes. Sunscreen protection and early evaluation of ...

  3. Molecular imaging of head and neck cancers. Perspectives of PET/MRI

    International Nuclear Information System (INIS)

    Stumpp, P.; Kahn, T.; Purz, S.; Sabri, O.

    2016-01-01

    The 18 F-fluorodeoxyglucose positron emission tomography-computed tomography ( 18 F-FDG-PET/CT) procedure is a cornerstone in the diagnostics of head and neck cancers. Several years ago PET-magnetic resonance imaging (PET/MRI) also became available as an alternative hybrid multimodal imaging method. Does PET/MRI have advantages over PET/CT in the diagnostics of head and neck cancers ?The diagnostic accuracy of the standard imaging methods CT, MRI and PET/CT is depicted according to currently available meta-analyses and studies concerning the use of PET/MRI for these indications are summarized. In all studies published up to now PET/MRI did not show superiority regarding the diagnostic accuracy in head and neck cancers; however, there is some evidence that in the future PET/MRI can contribute to tumor characterization and possibly be used to predict tumor response to therapy with the use of multiparametric imaging. Currently, 18 F-FDG-PET/CT is not outperformed by PET/MRI in the diagnostics of head and neck cancers. The additive value of PET/MRI due to the use of multiparametric imaging needs to be investigated in future research. (orig.) [de

  4. 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).

  5. A value framework in head and neck cancer care.

    Science.gov (United States)

    de Souza, Jonas A; Seiwert, Tanguy Y

    2014-01-01

    The care of head and neck squamous cell carcinoma has greatly evolved over the past 30 years. From single modality to a multidisciplinary care, there has also been a concurrent increase in treatment intensity, resulting, at many times, in more zealous regimens that patients must endure. In this article, we apply Porter's value model as a framework to balance survival, toxicities, cost, and trade-offs from a patient's perspective in head and neck cancer. This model defines value as the health outcome per dollar achieved. Domains and outcomes that are important to patients, including not only survival or short-term quality of life, but also functional outcomes, recovery, sustainability of recovery, and the lasting consequences of therapy are included in this framework. Other outcomes that are seldom measured in head and neck cancer, such as work disability and financial toxicities, are also included and further discussed. Within this value model and based on evidence, we further discuss de-escalation of care, intensity-modulated radiation therapy, newer surgical methods, and enhancements in the process of care as potential approaches to add value for patients. Finally, we argue that knowing the patient's preferences is essential in the value discussion, as the attribute that will ultimately provide the most value to the individual patient with head and neck cancer.

  6. Panendoscopy as a screening procedure for simultaneous primary tumors in head and neck cancer

    NARCIS (Netherlands)

    Dhooge, IJ; DeVos, M; Albers, FWJ; VanCauwenberge, PB

    Head and neck cancer is often associated with second primary neoplasms. These cancers most commonly involve other regions of the head and neck, esophagus, and lung. The majority of cases are also squamous cell carcinomas. In view of this rather frequent occurrence of multiple primary cancers and how

  7. 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.

  8. Anticancer activity of drug conjugates in head and neck cancer cells.

    Science.gov (United States)

    Majumdar, Debatosh; Rahman, Mohammad Aminur; Chen, Zhuo Georgia; Shin, Dong M

    2016-06-01

    Sexually transmitted oral cancer/head and neck cancer is increasing rapidly. Human papilloma virus (HPV) is playing a role in the pathogenesis of a subset of squamous cell carcinoma of head and neck (SCCHN). Paclitaxel is a widely used anticancer drug for breast, ovarian, testicular, cervical, non-small cell lung, head and neck cancer. However, it is water insoluble and orally inactive. We report the synthesis of water soluble nanosize conjugates of paclitaxel, branched PEG, and EGFR-targeting peptide by employing native chemical ligation. We performed a native chemical ligation between the N-hydroxy succinimide (NHS) ester of paclitaxel succinate and cysteine at pH 6.5 to give the cysteine-conjugated paclitaxel derivative. The thiol functionality of cysteine was activated and subsequently conjugated to multiarm thiol-PEG to obtain the paclitaxel branched PEG conjugate. Finally, we conjugated an EGFR-targeting peptide to obtain conjugates of paclitaxel, branched PEG, and EGFR-targeting peptide. These conjugates show anticancer activity against squamous cell carcinoma of head and neck cells (SCCHN, Tu212).

  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. 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

  11. 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...

  12. 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

  13. 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)

  14. Use of complementary and alternative medicine in head and neck cancer patients.

    Science.gov (United States)

    Lim, C M; Ng, A; Loh, K S

    2010-05-01

    To determine the prevalence and profile of patients who use complementary and alternative medicine, within a cohort of head and neck cancer patients. Cross-sectional survey. Ninety-three consecutive head and neck cancer patients being followed up at the department of otolaryngology head and neck surgery were surveyed using an interviewer-administered questionnaire. The prevalence of complementary and alternative medicine use was 67.8 per cent. Patients who used complementary and alternative medicine were more likely to be female, better educated and younger, compared with non-users. A total of 82.5 per cent (52/63) perceived complementary and alternative medicine to be effective, even though they were aware of the lack of research and endorsement by their physician regarding such medicine. The use of complementary and alternative medicine by head and neck cancer patients is common, regardless of efficacy or cost. Clinicians should routinely ask patients about their use of complementary and alternative medicine, to facilitate communication and enable appropriate use of such medicine.

  15. 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)

  16. 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)

  17. 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 cancer sites, especially for tooth brushing and dentist visits. The population attributable fraction for ≤ 2 out of 5 good 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.

  18. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Park, I. K.; Kim, J. C. [Kyungpook National Univ., Taegu (Korea, Republic of). Coll. of Medicine

    1997-09-01

    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

  20. 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.

  1. 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.

  2. The Danish Head and Neck Cancer fast-track program

    DEFF Research Database (Denmark)

    Roennegaard, Anders B.; Rosenberg, Tine; Bjørndal, Kristine

    2018-01-01

    -track clinical pathway solutions. Objectives: The objectives of this study were 1) to present the setup of the head and neck cancer (HNC) fast-track program at Odense University Hospital (OUH) as an example of the Danish model and 2) to present patient characteristics, diagnostic outcome, cancer detection rate...

  3. 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)

  4. Nurse-led psychosocial interventions in follow-up care for head and neck cancer patients

    NARCIS (Netherlands)

    de Goeij, IC

    2017-01-01

    Introduction: Head and neck cancer and its treatment frequently results in long-term physical problems, such as dry mouth, difficulty eating, impaired speech and/or altered shoulder function. In part because of these persisting problems, head and neck cancer patients are prone to deteriorated

  5. 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

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

    Science.gov (United States)

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

    2014-01-01

    Background: 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. Aim and Objective: To assess the relative risk of various Head & Neck cancers among different blood groups. Materials and Method: 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%. Results: 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. Conclusion: 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. PMID:24959511

  7. 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.

  8. Head and neck cancer in South Asia: macroeconomic consequences and the role of surgery.

    Science.gov (United States)

    Alkire, Blake C; Bergmark, Regan W; Chambers, Kyle; Cheney, Mack L; Meara, John G

    2015-04-27

    Head and neck cancer, for which the diagnosis and treatment are often surgical, comprises a substantial proportion of the burden of disease in South Asia. Further, estimates of surgical volume suggest this region faces a critical shortage of surgical capacity. We aimed to estimate the total economic welfare losses due to the morbidity and mortality of head and neck cancer in India, Pakistan, and Bangladesh for 1 year (2010). We used publicly available estimates from the Institute for Health Metrics and Evaluation regarding the morbidity and mortality of head and neck cancer in India, Pakistan, and Bangladesh, along with an economic concept termed the value of a statistical life, to estimate total economic welfare losses due to head and neck cancer in the aforementioned countries in the year 2010. The counterfactual scenario is absence of disease. Sensitivity analyses were done with regard to how the value of a statistical life changes with income. In 2010, the most conservative estimate of economic welfare losses due to head and neck cancer in the three studied countries is US$16·9 billion (2010 USD, PPP), equivalent to 0·26% of their combined gross domestic product (GDP). The welfare losses experienced by the population younger than 70 years of age accounted for US$15·2 billion (90% of the total losses). When adjusted for the size of their respective economies, Bangladesh, the poorest of the three countries, incurred the greatest loss (US$930 million), equivalent to 0·29% of its GDP. India and Pakistan experienced welfare losses of US$14·1 billion and US$1·9 billion, respectively. These figures are equivalent to 0·26% of the GDP for both countries. Oropharyngeal and hypopharyngeal cancer made up the largest share of the total burden at 39% (US$6·6 billion), followed closely by oral cavity cancer at 34% (US$5·7 billion). The burden of non-communicable diseases, to which cancer contributes greatly, is growing at a rapid pace in South Asia. Head and neck

  9. 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

  10. Dental problems of the patients with head and neck cancer after radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Shimizutani, Kimishige; Koseki, Yonoshin [Osaka Dental Univ. (Japan); Inoue, Toshihiko [and others

    1996-03-01

    The purpose of this study is to demonstrate dental problems such as changes of saliva flow rates (ml/min), taste sensation and DMF-teeth (D: decay, M: missing, F: filling) after radiation therapy for the patients with head and neck cancer. Between January 1990 and April 1995, a total of 56 patients with head and neck cancer after radiation therapy was reviewed to demonstrate dental problems at the Department of Oral Radiology, Osaka Dental University Hospital. The results were as follows. In the case of 7 inpatients with head and neck cancer (nasopharynx: 3, mouth floor: 2, tongue: 2), non-stimulating saliva flow rates for 5 minutes was nearly equal to 0 ml at the level of 60 Gy/6 weeks to 80 Gy/8 weeks. In the scoring system of the taste sensation after radiation therapy for 23 patients with oral cancer (tongue: 18, mouth floor: 5), distribution of the patients with 3 points (3 points stand for patients feel good as well as pretreatment) was 91% for sweetness, 78% for sharpness, 96% for bitterness and 96% for acidity, respectively. Concerning DMF-teeth after radiation therapy for 26 patients with head and neck cancer (nasopharynx: 10, oropharynx: 8, tongue: 8), changes of DMF-Teeth of the group of nasopharynx and oropharynx was more higher than that of the group of tongue comparing to report on the survey of dental diseases in Japan, 1993 as control. We emphasize that these data are more effective to improve their oral environments and to up their recognition for oral cavity in the patients with head and neck cancer pre or post-irradiation. (author).

  11. Dental problems of the patients with head and neck cancer after radiation therapy

    International Nuclear Information System (INIS)

    Shimizutani, Kimishige; Koseki, Yonoshin; Inoue, Toshihiko

    1996-01-01

    The purpose of this study is to demonstrate dental problems such as changes of saliva flow rates (ml/min), taste sensation and DMF-teeth (D: decay, M: missing, F: filling) after radiation therapy for the patients with head and neck cancer. Between January 1990 and April 1995, a total of 56 patients with head and neck cancer after radiation therapy was reviewed to demonstrate dental problems at the Department of Oral Radiology, Osaka Dental University Hospital. The results were as follows. In the case of 7 inpatients with head and neck cancer (nasopharynx: 3, mouth floor: 2, tongue: 2), non-stimulating saliva flow rates for 5 minutes was nearly equal to 0 ml at the level of 60 Gy/6 weeks to 80 Gy/8 weeks. In the scoring system of the taste sensation after radiation therapy for 23 patients with oral cancer (tongue: 18, mouth floor: 5), distribution of the patients with 3 points (3 points stand for patients feel good as well as pretreatment) was 91% for sweetness, 78% for sharpness, 96% for bitterness and 96% for acidity, respectively. Concerning DMF-teeth after radiation therapy for 26 patients with head and neck cancer (nasopharynx: 10, oropharynx: 8, tongue: 8), changes of DMF-Teeth of the group of nasopharynx and oropharynx was more higher than that of the group of tongue comparing to report on the survey of dental diseases in Japan, 1993 as control. We emphasize that these data are more effective to improve their oral environments and to up their recognition for oral cavity in the patients with head and neck cancer pre or post-irradiation. (author)

  12. Cetuximab in locally advanced head-and-neck cancer: defining the population

    Science.gov (United States)

    Ho, C.

    2010-01-01

    Encouraging data for targeted therapy in head-and-neck squamous cell carcinoma are opening new options for treatment. Phase III trials of cetuximab, an antibody directed against the epidermal growth factor receptor (egfr) have demonstrated benefit in the locally advanced and metastatic settings. Recognizing the importance of emerging therapies, Cancer Care Ontario published guideline recommendations for egfr-targeted therapy in stage iii and iv head-and-neck cancer. The present paper takes a further look at the population for whom an offer of cetuximab therapy may be appropriate. PMID:20697514

  13. The protective role of carotenoids and polyphenols in patients with head and neck cancer

    Directory of Open Access Journals (Sweden)

    Hui-Ping Chang

    2015-02-01

    Full Text Available Head and neck cancer is a critical global health problem and approximately 650,000 patients per year are diagnosed with this type of cancer. In addition, head and neck cancer exhibits a high recurrence rate, readily causing second primary cancers in other locations, often yielding a poor prognosis. Current medical and surgical treatment options result in considerable impairment of speaking and swallowing functions, with side effects such as nausea, vomiting, bone marrow suppression, and renal damage, thereby impairing patients' quality of life. Thus, developing a prevention and therapeutic intervention strategy for head and neck cancer is vital. Phytochemicals have been shown to have a unique ability to protect cells from damage and modulation of cell repair. The chemopreventive activities of phytochemicals have also been demonstrated to be associated with their antioxidant properties and the induction and stimulation of intercellular communication via gap junctions, which play a role in the regulation of cancer cell cycle, differentiation, apoptosis, and stagnate cancer cell growth. Phytochemicals can also regulate cancer cell signaling pathways, reduce the invasion and metastasis of cancer cells, and protect normal cells during treatment, thus reducing the damage caused by chemotherapy and radiotherapy. The most studied of the chemopreventive effects of phytochemicals are the carotenoids and phenolics. In this review, we investigated the multiple mechanisms of carotenoids and polyphenols (PPs for use in preventing head and neck cancer, reducing the side effects of chemotherapy and radiotherapy, improving patient survival rates, and reducing the occurrence rate of second primary cancers.

  14. 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

  15. 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.

  16. Head and neck cancer burden and preventive measures in Central and South America.

    Science.gov (United States)

    Perdomo, Sandra; Martin Roa, Guillermo; Brennan, Paul; Forman, David; Sierra, Mónica S

    2016-09-01

    Central and South America comprise one of the areas characterized by high incidence rates for head and neck cancer. We describe the geographical and temporal trends in incidence and mortality of head and neck cancers in the Central and South American region in order to identify opportunities for intervention on the major identified risk factors: tobacco control, alcohol use and viral infections. We obtained regional- and national-level incidence data from 48 population-based cancer registries in 13 countries and cancer deaths from the WHO mortality database for 18 countries. Age-standardized incidence (ASR) and mortality (ASMR) rates per 100,000 person-years were estimated. Brazil had the highest incidence rates for oral and pharyngeal cancer in the region for both sexes, followed by Cuba, Uruguay and Argentina. Cuba had the highest incidence and mortality rates of laryngeal cancer in the region for males and females. Overall, males had rates about four times higher than those in females. Most countries in the region have implemented WHO recommendations for both tobacco and alcohol public policy control. Head and neck squamous-cell cancer (HNSCC) incidence and mortality rates in the Central and South America region vary considerably across countries, with Brazil, Cuba, French Guyana, Uruguay and Argentina experiencing the highest rates in the region. Males carry most of the HNSCC burden. Improvement and implementation of comprehensive tobacco and alcohol control policies as well as the monitoring of these factors are fundamental to prevention of head and neck cancers in the region. Copyright © 2015 International Agency for Research on Cancer. Published by Elsevier Ltd.. All rights reserved.

  17. Role of infectious agents in the carcinogenesis of brain and head and neck cancers

    Directory of Open Access Journals (Sweden)

    Alibek Kenneth

    2013-02-01

    Full Text Available Abstract This review concentrates on tumours that are anatomically localised in head and neck regions. Brain cancers and head and neck cancers together account for more than 873,000 cases annually worldwide, with an increasing incidence each year. With poor survival rates at late stages, brain and head and neck cancers represent serious conditions. Carcinogenesis is a multi-step process and the role of infectious agents in this progression has not been fully identified. A major problem with such research is that the role of many infectious agents may be underestimated due to the lack of or inconsistency in experimental data obtained globally. In the case of brain cancer, no infection has been accepted as directly oncogenic, although a number of viruses and parasites are associated with the malignancy. Our analysis of the literature showed the presence of human cytomegalovirus (HCMV in distinct types of brain tumour, namely glioblastoma multiforme (GBM and medulloblastoma. In particular, there are reports of viral protein in up to 100% of GBM specimens. Several epidemiological studies reported associations of brain cancer and toxoplasmosis seropositivity. In head and neck cancers, there is a distinct correlation between Epstein-Barr virus (EBV and nasopharyngeal carcinoma (NPC. Considering that almost every undifferentiated NPC is EBV-positive, virus titer levels can be measured to screen high-risk populations. In addition there is an apparent association between human papilloma virus (HPV and head and neck squamous cell carcinoma (HNSCC; specifically, 26% of HNSCCs are positive for HPV. HPV type 16 was the most common type detected in HNSCCs (90% and its dominance is even greater than that reported in cervical carcinoma. Although there are many studies showing an association of infectious agents with cancer, with various levels of involvement and either a direct or indirect causative effect, there is a scarcity of articles covering the role of

  18. Palliative radiotherapy in locally advanced head and neck cancer-A prospective trial

    Directory of Open Access Journals (Sweden)

    Ghoshal Sushmita

    2004-01-01

    Full Text Available AIM: To evaluate the role of palliative radiotherapy for symptom control in patients with locally advanced head and neck cancer. MATERIALS AND METHODS: 25 patients with stage 3 and stage 4 head and neck cancer were treated with a short course of palliative radiotherapy (30 Gray (Gy in 10 fractions over 2 weeks. Baseline symptoms were assessed using a 11 point numerical scale for pain, dysphagia, cough, insomnia and dyspnoea. The primary end point was relief of symptoms in the fourth week after radiotherapy. Percentage symptom relief was quantified by the patient using a rupee scale. RESULTS: All 22 patients with pain and 90% of patients with dysphagia, dyspnoea and disturbed sleep had greater than 50% relief in symptoms after radiotherapy. Cough was relieved in sixty percent of cases. CONCLUSION: A short course of radiation can be an effective method of symptom palliation in head and neck cancers.

  19. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Cohen, M A; Lownie, J F [University of the Witwatersrand, Johannesburg (South Africa). Dept. of Surgery

    1982-08-01

    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.

  1. Positron emission tomography-computed tomography protocol considerations for head and neck cancer imaging.

    Science.gov (United States)

    Escott, Edward J

    2008-08-01

    Positron emission tomographic-computed tomographic (PET-CT) imaging of patients with primary head and neck cancers has become an established approach for staging and restaging, as well as radiation therapy planning. The inherent co-registration of PET and CT images made possible by the integrated PET-CT scanner is particularly valuable in head and neck cancer imaging due to the complex and closely situated anatomy in this part of the body, the varied sources of physiologic and benign 2-deoxy-2-[F-18]fluoro-D-glucose (FDG) tracer uptake that occurs in the neck, and the varied and complex posttreatment appearance of the neck. Careful optimization of both the CT and the PET portion of the examination is essential to insure the most accurate and clinically valuable interpretation of these examinations.

  2. Cancer of the head and neck

    International Nuclear Information System (INIS)

    Leignel, D.; Toledano, A.; Calais, G.; Gardner, M.; Valinta, D.; Halimi, P.; Alberini, J.L.; Plantet, M.M.; Banal, A.; Hans, S.; Floiras, J.L.; Labib, A.; Djemaa, A.; Naoun, L.; Bali, M.; Melais, K.; George, L.; Cazalet, M.; Gross, E.; Padovani, L.; Cowen, D.; Pignon, T.; Bannour, N.; Guedouar, R.; Bouaouina, N.; Mege, A.; Lapeyre, M.; Graff, P.; Marchesi, V.; Aletti, P.; Marchal, C.; Peiffert, D.; Serre, A.; Ailleres, N.; Lemanski, C.; Hay, M.H.; Llacer Moscardo, C.; Allaw, A.; Azria, D.; Dubois, J.B.; Fenoglietto, P.; Maalej, M.; Nasr, C.; Chaari, N.; Hentati, D.; Kochbati, L.; Besbes, M.; Benjelloun, H.; Benchakroun, N.; Houjami, M.; Jouhadi, H.; Tawfiq, N.; Acharki, A.; Sahraoui, S.; Benider, A.; Racadot, S.; Mercier, M.; Dessard-Diana, B.; Bensadoun, R.J.; Martin, M.; Malaurie, E.; Favrel, V.; Housset, M.; Journel, C.; Calais, G.; Huet, J.; Pillet, G.; Hennequin, C.; Haddad, E.; Diana, C.; Blaska-Jaulerry, B.; Henry-Amar, M.; Gehanno, P.; Baillet, F.; Mazeron, J.J.; Chaouache, C.K.; Tebra Mrad, T.M.S.; Bannour, B.N.S.; Bouaouina, B.N.; Favrel, V.; Khodri, M.; Chapet, O.; Nguyen, D.; Ardiet, J.; Romestaing, P.; Thillays, F.; Bardet, E.; Rolland, F.; Maingan, P.; Campion, L.; Mahe, M.A.

    2005-01-01

    Thirteen articles are presented in relation with head and neck cancer. Chemoradiotherapy, medical examinations using nuclear techniques such PET scanning, fractionated radiotherapy after a chemotherapy, analysis of dose volume for patients treated by irradiation with a combined chemotherapy, dosimetry, conformal radiotherapy with intensity modulation, dosimetry in brachytherapy, association of radiotherapy and chemotherapy in the treatment of nose pharynx carcinomas, recurrence, are the different subjects treated in this part. (N.C.)

  3. Moving Toward Bioadjuvant Approaches to Head and Neck Cancer Prevention

    International Nuclear Information System (INIS)

    Saba, Nabil F.; Hammond, Anthea; Shin, Dong M.; Khuri, Fadlo R.

    2007-01-01

    Head and neck squamous cell carcinoma affects >45,000 Americans annually. Patients who are successfully treated for their primary tumor are at high risk of developing a second primary tumor, making effective preventive strategies highly desirable for this disease. Although a landmark study in 1990 suggested some benefit of high-dose retinoids in head and neck cancer prevention, subsequent trials using more tolerable doses have shown limited clinical success. Newer preventive strategies have included bioadjuvant therapy combining retinoids with interferon and α-tocopherol, combinations of molecularly targeted agents, and oncolytic viruses. Furthermore, considerable evidence has supported a cancer protective role for several nutrients, including green tea and curcumin analogs. Natural compounds such as these with favorable long-term safety profiles might be particularly suited to the cancer prevention setting, in which patients will usually tolerate only moderate risk and toxicity

  4. 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.

  5. Comparison between Japanese and French interstitial brachytherapy for head and neck cancer

    International Nuclear Information System (INIS)

    Nose, Takayuki; Koizumi, Masahiko; Nishiyama, Kinji; Inoue, Toshihiko

    2001-01-01

    Interstitial brachytherapy is the optimal radiotherapy modality for head and neck cancer because the highest dose conformity can be achieved, and implanted tubes can move synchronously with the tumor movement. Compared with radical surgery, interstitial brachytherapy can achieve equivalent local control with less morbidity and less functional deficit. In Japan, because of technical limitations, interstitial brachytherapy has been confined to treatment of small tongue cancers. To improve our head and neck cancer treatment, technical limitations should be eliminated and a wider indication for interstitial brachytherapy should be achieved. In France, interstitial brachytherapy has been technically more developed and widely indicated than in Japan. We analyzed the differences between Japanese (Osaka) and French (Lyon and Nancy) techniques, to improve our interstitial brachytherapy. Implant devices and techniques: French applicators (Longcip 1) are more flexible and more suitable for loop techniques of the soft palate, the base of the tongue, and the vallecula, than applicators available in Japan. Various implant techniques are established especially for the oropharynx in France. Mandibular protection: Lead blocks used in France can more effectively shield the mandible than our silicone spacers. We showed the dosimetric results in an experimental treatment setting. Dose specification: The five-mm dose specification method used in Japan can work only for easy cases, such as small oral tongue cancers and mouth floor cancers. For complicated implants, such as for the oropharynx, the CTV-based dose specification method used in France is essential for sufficient irradiation. Indications: The indication for head and neck interstitial brachytherapy in Japan is limited mostly to small oral tongue cancers. The indication in France is wider, including the oral cavity, the oropharynx, and postoperative cases. We can refine our head and neck cancer treatment if we combine French

  6. 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)

  7. 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)

  8. 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....

  9. 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.

  10. 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.

  11. 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

  12. Effect of cell-phone radiofrequency on angiogenesis and cell invasion in human head and neck cancer cells.

    Science.gov (United States)

    Alahmad, Yaman M; Aljaber, Mohammed; Saleh, Alaaeldin I; Yalcin, Huseyin C; Aboulkassim, Tahar; Yasmeen, Amber; Batist, Gerald; Moustafa, Ala-Eddin Al

    2018-05-13

    Today, the cell phone is the most widespread technology globally. However, the outcome of cell-phone radiofrequency on head and neck cancer progression has not yet been explored. The chorioallantoic membrane (CAM) and human head and neck cancer cell lines, FaDu and SCC25, were used to explore the outcome of cell-phone radiofrequency on angiogenesis, cell invasion, and colony formation of head and neck cancer cells, respectively. Western blot analysis was used to investigate the impact of the cell phone on the regulation of E-cadherin and Erk1/Erk2 genes. Our data revealed that cell-phone radiofrequency promotes angiogenesis of the CAM. In addition, the cell phone enhances cell invasion and colony formation of human head and neck cancer cells; this is accompanied by a downregulation of E-cadherin expression. More significantly, we found that the cell phone can activate Erk1/Erk2 in our experimental models. Our investigation reveals that cell-phone radiofrequency could enhance head and neck cancer by stimulating angiogenesis and cell invasion via Erk1/Erk2 activation. © 2018 Wiley Periodicals, Inc.

  13. 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.

  14. 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.

  15. 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.

  16. 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)

  17. Chemotherapy for head and neck cancer

    International Nuclear Information System (INIS)

    Pfister, David G.

    1997-01-01

    Purpose/Objective: The role of chemotherapy in the management of squamous cell carcinoma of the upper aerodigestive tract is undergoing rapid evolution. Historically, the use of chemotherapy was limited to patients with incurable disease who had exhausted all surgical and radiation therapy options. The results of recent randomized trials, however, suggest an increasing role for chemotherapy as part of primary management in patients with unresectable disease; advanced larynx or hypopharynx cancer with the intent of larynx preservation, or advanced nasopharynx cancer. This refresher course will provide a comprehensive overview of the current indications for chemotherapy in the management of these malignancies, and will highlight areas of controversy and future directions of investigation. More specifically, the following areas will be emphasized. 1. The identification of drugs commonly used in the management of head and neck cancer, their customary dosing and side effects. 2. The impact of induction and/or adjuvant chemotherapy combined with surgery and radiation therapy as defined by randomized trials, including a discussion of the Head and Neck Contracts program and the Intergroup adjuvant trial. 3. The development of larynx/function preservation treatment programs, including a review of the Veterans Administration and EORTC larynx preservation studies. 4. The evolving role of chemotherapy as part of innovative combined modality programs, especially in patients with unresectable disease. The rationale and utility of sequential versus concomitant/alternating chemotherapy-radiation strategies, and relevant randomized clinical trials comparing the different strategies will be discussed. 5. The appropriate application of chemotherapy in the palliative setting, including a discussion of the relative merits of single-agent versus combination chemotherapy

  18. 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

  19. ''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)

  20. 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

  1. 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)

  2. 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)

  3. Arsenic, cadmium, chromium and nickel in cancerous and healthy tissues from patients with head and neck cancer

    International Nuclear Information System (INIS)

    Khlifi, Rim; Olmedo, Pablo; Gil, Fernando; Hammami, Bouthaina; Chakroun, Amine; Rebai, Ahmed; Hamza-Chaffai, Amel

    2013-01-01

    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 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. ► Heavy metal exposure via occupational exposures may increase the risk of HNC

  4. 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)

  5. 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)

  6. Unilateral Cervical Polyneuropathies following Concurrent Bortezomib, Cetuximab, and Radiotherapy for Head and Neck Cancer

    Directory of Open Access Journals (Sweden)

    Alhasan Elghouche

    2016-01-01

    Full Text Available We report a constellation of cervical polyneuropathies in a patient treated with concurrent bortezomib, cetuximab, and cisplatin alongside intensity modulated radiotherapy for carcinoma of the tonsil with neck metastasis. The described deficits include brachial plexopathy, cervical sensory neuropathy, and oculosympathetic, recurrent laryngeal, and phrenic nerve palsies within the ipsilateral radiation field. Radiation neuropathy involving the brachial plexus is typically associated with treatment of breast or lung cancer; however, increased awareness of this entity in the context of investigational agents with potential neuropathic effects in head and neck cancer has recently emerged. With this report, we highlight radiation neuropathy in the setting of investigational therapy for head and neck cancer, particularly since these sequelae may present years after therapy and entail significant and often irreversible morbidity.

  7. 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.

  8. Fractionation schedules for cancers of the head and neck

    International Nuclear Information System (INIS)

    Harari, Paul M.

    1995-01-01

    Purpose/Objective: This refresher course reviews current research activity and treatment results in the field of radiation therapy fractionation. The presentation emphasizes worldwide studies of altered fractionation, highlighting head and neck cancer as the primary teaching model. Basic radiobiological principles guiding the development of altered fractionation regimens, and advancing the understanding of fractionation effects on normal and tumor tissue are reviewed. A 'standard' prescription of 2 Gy x 35 fractions = 70 Gy may not provide the optimal balance between primary tumor control and late normal tissue effects for all patients with squamous cell carcinoma of the head and neck. The last decade has witnessed the treatment of thousands of head and neck cancer patients with curative radiotherapy using altered fractination schedules designed to improve overall treatment results. Although the number of different fractionation regimens currently being investigated continues to increase, the common guiding principles behind their design are relatively simple. Common fractionation terminology (i.e., accelerated hyperfractionation) will be reviewed, as well as a brief summary of radiobiological concepts pertaining to tumor potential doubling time, tumor proliferation kinetics, overall treatment time and fraction size-dependence of acute and late tissue effects. Several well known head and neck fractionation schedules from around the world (Manchester Christie Hospital-United Kingdom, Princess Margaret Hospital-Canada, Massachusetts General Hospital-USA, MD Anderson Hospital-USA, University of Florida-USA, Mount Vernon Hospital CHART-United Kingdom, RTOG and EORTC trials-USA and Europe) will be summarized with regard to design-rationale, treatment technique and results. The design of several current cooperative group trials investigating altered head and neck fractionation will be presented, as well as concepts prompting the pilot evaluation of several brand new

  9. 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)

  10. Resection of recurrent neck cancer with carotid artery replacement.

    Science.gov (United States)

    Illuminati, Giulio; Schneider, Fabrice; Minni, Antonio; Calio, Francesco G; Pizzardi, Giulia; Ricco, Jean-Baptiste

    2016-05-01

    The management of patients with recurrent neck cancer invading the carotid artery is controversial. The purpose of this study was to evaluate overall survival rate, primary patency of vascular reconstructions, and quality-adjusted life-years (QALYs) after en bloc resection of the carotid artery and tumor with in-line polytetrafluoroethylene (PTFE) carotid grafting, followed by radiotherapy. From 2000 to 2014, 31 consecutive patients with recurrent neck cancer invading the carotid artery underwent en bloc resection and simultaneous carotid artery reconstruction with a PTFE graft, which was associated in 18 cases with a myocutaneous flap. The primary tumor was a squamous cell carcinoma of the larynx in 17 patients and of the hypopharynx in 7, an undifferentiated carcinoma of unknown origin in 4, and an anaplastic carcinoma of the thyroid in 3. All of the patients underwent postoperative radiotherapy (50-70 Gy), and 10 of them also underwent chemotherapy (doxorubicin and cisplatin). None of the patients died or sustained a stroke during the first 30 days after the index procedure. Postoperative morbidity consisted of 6 transitory dysphagias, 3 vocal cord palsies, 2 wound dehiscences, 1 transitory mandibular claudication, and 1 partial myocutaneous flap necrosis. No graft infection occurred during follow-up. Fifteen patients (48%) died from metastatic cancer during a mean follow-up of 45.4 months (range, 8-175 months). None of the patients showed evidence of local recurrence, stroke, or thrombosis of the carotid reconstruction. The 5-year survival rate was 49 ± 10%. The overall number of QALYs was 3.12 (95% confidence interval, 1.87-4.37) with a significant difference between patients without metastasis at the time of redo surgery (n = 26; QALYs, 3.74) and those with metastasis (n = 5; QALYs, 0.56; P = .005). QALYs were also significantly improved in patients with cancer of the larynx (n = 17; QALYs, 4.69) compared to patients presenting with other types of

  11. 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.

  12. 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)

  13. 18F-deoxyglucose-PET in the detection of recurrence in head and neck cancer

    International Nuclear Information System (INIS)

    Chen Yingrui; Li Weixiong; Gu Meixin; Xie Songxi

    2002-01-01

    Objective: To evaluate 18 F-deoxyglucose-positron emission tomography (FDG-PET) in the detection of suspicious recurrence in head and neck cancers, as compared with CT/MRI imaging. Methods: Thirty-seven patients with clinically suspicious recurrences in head and neck cancers underwent FDG-PET, with 34 checked with CT/MRI imaging. The final diagnosis of recurrence were proved by pathology or clinical following-up. Results: FDG-PET detected recurrence successfully in 32 of 37 (86.5%) patients with 3 false positives and 2 false negatives. The FDG-PET sensitivity, specificity and accuracy in defining local recurrence were 91.7%, 76.9%, 86.5%, respectively; and those of CT/MRI were 68.2%, 75.0%, 61.8%, respectively. Conclusion: In comparison with CT/MRI, FDG-PET possesses a high accuracy in detecting recurrence in head and neck cancers

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

    Energy Technology Data Exchange (ETDEWEB)

    Nguyen, Nam P. [Department of Radiation Oncology, University of Texas Southwestern Medical Center at Dallas, VA North Texas Health Care System, Radiation Oncology Service (140), 4500 S, Lancaster Road, Dallas, TX 72516 (United States)]. E-mail: NamPhong.Nguyen@med.va.gov; Moltz, Candace C. [Audiology and Speech Pathology Service (126), VA North Texas Health Care System, Dallas, TX 75216 (United States); Frank, Cheryl [Audiology and Speech Pathology Service (126), VA North Texas Health Care System, Dallas, TX 75216 (United States); Karlsson, Ulf [Department of Radiation Oncology, East Carolina University, Greenville, NC 27858 (United States); Nguyen, Phuc D. [Department of Radiation Oncology, University of Texas Southwestern Medical Center at Dallas, VA North Texas Health Care System, Radiation Oncology Service (140), 4500 S, Lancaster Road, Dallas, TX 72516 (United States); Vos, Paul [Department of Biostatistics, East Carolina University, Greenville, NC 27858 (United States); Smith, Herbert J. [Radiology Service, VA North Texas Health Care System, Dallas, TX 75216 (United States); Dutta, Suresh [Department of Radiation Oncology, University of Southern California, Los Angeles, CA 90033 (United States); Nguyen, Ly M. [Public Health School, University of Michigan, Ann Arbor, MI 48109 (United States); Lemanski, Claire [Department of Radiation Oncology, Val D' Aurelle, Montpellier (France); Chan, Wayne [Radiation Oncology Service, VAMC, Jackson, MS 39216 (United States); Sallah, Sabah [Division of Hematology/Oncology Research, Novo Nordisk, Athens (Greece)

    2006-09-15

    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.

  15. 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

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

    OpenAIRE

    Chen, Allen M.; Cao, Minsong; Hsu, Sophia; Lamb, James; Mikaeilian, Argin; Yang, Yingli; Agazaryan, Nzhde; Low, Daniel A.; Steinberg, Michael L.

    2017-01-01

    Purpose: To report a single-institutional experience using magnetic resonance imaging (MRI) guided radiation therapy for the reirradiation of recurrent and second cancers of the head and neck. Methods and materials: Between October 2014 and August 2016, 13 consecutive patients with recurrent or new primary cancers of the head and neck that occurred in a previously irradiated field were prospectively enrolled in an institutional registry trial to investigate the feasibility and efficacy of ...

  17. 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)

  18. Oral care for patients with head and neck cancer in Hokkaido University Hospital

    International Nuclear Information System (INIS)

    Hata, Hironobu; Yamazaki, Yutaka; Imamachi, Kenji

    2011-01-01

    We have been providing oral care for patients with head and neck cancer in Hokkaido University Hospital since 2007. In this paper, we report clinical statistics of the 254 head and neck cancer patients who received oral care. About 80 percent of these patients were treated with radiation therapy, so it is important to cope with adverse events related to such therapy. Oral care is helpful for cancer patients when it is started as soon as possible (at least 1 week before radiation therapy is started). The percentage of patients who could start oral care 4 days before radiation therapy gradually increased to about 60 percent by fiscal 2009. In fiscal 2010, the percentage decreased to its lowest level of 37.9 percent. To start oral care for all patients 7 days before irradiation, we are going to change our system and start oral care in the outpatient period. In their hometowns, oral care was continued for only 19 (27.0 percent) of the 74 patients who could not visit our hospital. An important task for our project is to establish a medical cooperation system for discharged patients treated for head and neck cancer. (author)

  19. Postoperative radiotherapy after laser surgery with or without chemotherapy in head and neck evolved cancers

    International Nuclear Information System (INIS)

    Ryll, L.; Pradier, O.; Nitsche, M.; Christiansen, H.; Hess, C.

    2007-01-01

    We compared concurrent combination chemoradiotherapy and adjuvant radiotherapy after laser surgery in patients with stage 3/4 non metastatic squamous cell head and neck cancer. Combination chemotherapy and concurrent irradiation after laser surgery was not superior to surgery and postoperative radiotherapy for resectable advanced squamous cell head and neck cancer. However, the collective is small, and the follow-up to short to conclude. (authors)

  20. 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)

  1. Causes of death in long-term survivors of head and neck cancer.

    Science.gov (United States)

    Baxi, Shrujal S; Pinheiro, Laura C; Patil, Sujata M; Pfister, David G; Oeffinger, Kevin C; Elkin, Elena B

    2014-05-15

    Survivors of head and neck squamous cell carcinoma (HNSCC) face excess mortality from multiple causes. We used the population-based Surveillance, Epidemiology, and End Results (SEER) cancer registry data to evaluate the causes of death in patients with nonmetastatic HNSCC diagnosed between 1992 and 2005 who survived at least 3 years from diagnosis (long-term survivors). We used competing-risks proportional hazards regression to estimate probabilities of death from causes: HNSCC, second primary malignancy (SPM) excluding HNSCC, cardiovascular disease, and other causes. We identified 35,958 three-year survivors of HNSCC with a median age at diagnosis of 60 years (range = 18-100 years) and a median follow-up of 7.7 years (range = 3-18 years). There were 13,120 deaths during the study period. Death from any cause at 5 and 10 years was 15.4% (95% confidence interval [CI] = 15.0%-15.8%) and 41.0% (95% CI = 40.4%-41.6%), respectively. There were 3852 HNSCC deaths including both primary and subsequent head and neck tumors. The risk of death from HNSCC was greater in patients with nasopharynx or hypopharynx cancer and in patients with locally advanced disease. SPM was the leading cause of non-HNSCC death, and the most common sites of SPM death were lung (53%), esophagus (10%), and colorectal (5%) cancer. Many long-term HNSCC survivors die from cancers other than HNSCC and from noncancer causes. Routine follow-up care for HNSCC survivors should expand beyond surveillance for recurrent and new head and neck cancers. © 2014 American Cancer Society.

  2. 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

  3. 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 ...

  4. Head, Neck, and Oral Cancer

    Medline Plus

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

  5. Psychosocial aspects of head and neck cancer--a review of the literature.

    Science.gov (United States)

    Pruyn, J F; de Jong, P C; Bosman, L J; van Poppel, J W; van Den Borne, H W; Ryckman, R M; de Meij, K

    1986-12-01

    This study is a systematic analysis of the literature on psychosocial aspects in head and neck cancer patients. Patients with head and neck cancer experience a variety of physical as well as psychosocial problems. Physical problems include swallowing or chewing, speech and physical appearance. Psychosocial problems include anxiety, depression, loss of self-esteem and uncertainty about the future. Because of these problems, isolation from friends typically occurs, re-employment is difficult, and there are social and sexual tensions within families. Information and support by professionals, partners and/or fellow patients are related to positive rehabilitation outcomes such as the acquisition of speech, increases in constructive social functioning and decreases in depression.

  6. Molecular Imaging and Precision Medicine in Head and Neck Cancer.

    Science.gov (United States)

    Mena, Esther; Thippsandra, Shwetha; Yanamadala, Anusha; Redy, Siddaling; Pattanayak, Puskar; Subramaniam, Rathan M

    2017-01-01

    The concept of using tumor genomic profiling information has revolutionized personalized cancer treatment. Head and neck (HN) cancer management is being influenced by recent discoveries of activating mutations in epidermal growth factor receptor and related targeted therapies with tyrosine kinase inhibitors, targeted therapies for Kristen Rat Sarcoma, and MET proto-oncogenes. Molecular imaging using PET plays an important role in assessing the biologic behavior of HN cancer with the goal of delivering individualized cancer treatment. This review summarizes recent genomic discoveries in HN cancer and their implications for functional PET imaging in assessing response to targeted therapies, and drug resistance mechanisms. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Head, Neck, and Oral Cancer

    Science.gov (United States)

    ... find out more. Oral, Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed ... find out more. Oral, Head and Neck Pathology Oral, Head and Neck Pathology Close to 49,750 Americans will be diagnosed ...

  8. Head, Neck, and Oral Cancer

    Medline Plus

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

  9. Dysphagia and mucositis after concurrent chemoradiotherapy for head and neck cancer

    International Nuclear Information System (INIS)

    Tsuneyuki, Miki; Maeda, Tatsuyoshi; Yonezawa, Koichiro; Morimoto, Koichi; Tanimoto, Hitoshi; Saito, Miki; Otsuki, Naoki; Nibu, Ken-ichi

    2010-01-01

    A speech therapist performs swallowing rehabilitation in this hospital because concurrent chemoradiotherapy (CCRT) for head and neck cancer is commonly associated with, dysphagia. An evaluation of oral mucositis and dysphagia after CCRT was conducted to determine the relationship between swallowing rehabilitation and swallowing disability. A total of 51 patients (44 males and 7 females) with a mean age of 63 years (range, 39 to 80), underwent CCRT with or without neck dissection between April 2008 and November 2009. Oral mucositis and dysphagia were graded at the end of CCRT according to Common Terminology Criteria for Adverse Events (CTCAE), version 4.0. Seventeen of 51 patients underwent swallowing rehabilitation, exercise and education on muscle strengthening programs before and during CCRT. The average grades of oral mucositis of patients with nasopharyngeal, oropharyngeal, hypopharyngeal, and laryngeal cancer patients were 1.8, 2.1, 1.8, and 0.8, respectively. There was a lower incidence of oral mucositis in patients with laryngeal cancer than in those with oropharyngeal or hypopharyngeal cancer. The average grades of dysphagia of patients with nasopharyngeal, oropharyngeal, hypopharyngeal, and laryngeal cancer were 2.4, 2.7, 2.2, and 1.2. Dysphagia was most severe in the patients with oropharyngeal cancer, while it was minimal in those with laryngeal cancer. Seventeen diligent patients that underwent swallowing rehabilitation every day rarely developed severe dysphagia. (author)

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

    NARCIS (Netherlands)

    Sealy, Martine

    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 is a multidimensional

  11. Head and Neck Cancer—Health Professional Version

    Science.gov (United States)

    Head and neck cancers include hypopharyngeal, laryngeal, lip and oral cavity, metastatic squamous neck, nasopharyngeal, oropharyngeal, paranasal sinus, and salivary gland cancers. Find evidence-based information on head and neck cancer treatment, causes and prevention, research, screening, and statistics.

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

    Science.gov (United States)

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

    2018-06-01

    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.

  13. 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

  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. 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

  17. Aspiration rate following chemoradiation for head and neck cancer: An underreported occurrence

    International Nuclear Information System (INIS)

    Nguyen, Nam P.; Frank, Cheryl; Moltz, Candace C.; Vos, Paul; Smith, Herbert J.; Bhamidipati, Prabhakar V.; Karlsson, Ulf; Nguyen, Phuc D.; Alfieri, Alan; Nguyen, Ly M.; Lemanski, Claire; Chan, Wayne; Rose, Sue; Sallah, Sabah

    2006-01-01

    Background and purpose: We would like to assess the prevalence of aspiration before and following chemoradiation for head and neck cancer. Patients and methods: We reviewed retrospectively the Modified Barium Swallow (MBS) in 63 patients who underwent concurrent chemotherapy and radiation for head and neck cancer. MBS was performed prior to treatment to determine the need for immediate gastrostomy tube placement. MBS was repeated following treatment to assess the safety of oral feeding prior to removal of tube feeding. All patients were cancer free at the time of the swallowing study. No patient had surgery. Dysphagia severity was graded on a scale of 1-7. Tube feedings were continued if patients were diagnosed to have severe aspiration (grade 6-7) or continued weight loss. Patients with abnormal swallow (grade 3-7) received swallowing therapy following MBS. Results: Before treatment, there were 18 grade 1, 18 grade 2, 9 grade 3, 8 grade 4, 3 grade 5, 3 grade 6, and 4 grade 7. Following chemoradiation, at a median follow-up of 2 months (1-10 months), one patient had grade 1, eight patients had grade 2, nine patients had grade 3, eight patients had grade 4, 13 patients had grade 5, seven patients had grade 6, and 11 patients had grade 7. Six patients died from aspiration pneumonia (one before, three during, and two post-treatment), and did not have the second MBS. Overall, 37/63 (59%) patients developed aspiration, six of them (9%) fatal. If we excluded the 10 patients who had severe aspiration at diagnosis and the six patients who died from pneumonia, the prevalence of severe aspiration was 33% (21/63). Conclusions: Aspiration remained a significant morbidity following chemoradiation for head and neck cancer. Its prevalence is underreported in the literature because of its often silent nature. Diagnostic studies such as MBS should be part of future head and neck cancer prospective studies to assess the prevalence of aspiration, and for rehabilitation

  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. 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.

  20. Dental consultation in patients planned for/undergoing/post radiation therapy for head and neck cancers: a questionnaire-based survey.

    Science.gov (United States)

    Mainali, Apeksha; Sumanth, K N; Ongole, Ravikiran; Denny, Ceena

    2011-01-01

    Mouth and pharyngeal cancers account for approximately 6% of cancers worldwide. Radiotherapy is one of the means of treatment of head and neck cancer. Consultation with a dental team experienced in caring for patients undergoing treatment for head and neck cancer will improve the quality of life of such patients. To evaluate the attitude of oncologists toward dental consultation to patients planning for/prior to/undergoing/post radiation therapy for head and neck cancers and to evaluate the number of radiation oncologists who encounter oral complaints and consider worth referring to a dentist. A questionnaire-based study was carried out following mailing of covering letter and self-administered questionnaire comprising 11 items, to 25 radiation oncology centers selected in India based on convenient sampling. Out of the 25 centers, we received response from 20 centers with 60 completely filled questionnaires. Five centers did not respond for further correspondences. The study indicated a need for awareness and education among radiation oncologists regarding dental consultation in patients planned/undergoing /post radiation therapy for head and neck cancer.

  1. 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

  2. A randomized trial of specialized versus standard neck physiotherapy in cervical dystonia.

    Science.gov (United States)

    Counsell, Carl; Sinclair, Hazel; Fowlie, Jillian; Tyrrell, Elaine; Derry, Natalie; Meager, Peter; Norrie, John; Grosset, Donald

    2016-02-01

    Anecdotal reports suggested that a specialized physiotherapy technique developed in France (the Bleton technique) improved primary cervical dystonia. We evaluated the technique in a randomized trial. A parallel-group, single-blind, two-centre randomized trial compared the specialized outpatient physiotherapy programme given by trained physiotherapists up to once a week for 24 weeks with standard physiotherapy advice for neck problems. Randomization was by a central telephone service. The primary outcome was the change in the total Toronto Western Spasmodic Torticollis Rating (TWSTR) scale, measured before any botulinum injections that were due, between baseline and 24 weeks evaluated by a clinician masked to treatment. Analysis was by intention-to-treat. 110 patients were randomized (55 in each group) with 24 week outcomes available for 84. Most (92%) were receiving botulinum toxin injections. Physiotherapy adherence was good. There was no difference between the groups in the change in TWSTR score over 24 weeks (mean adjusted difference 1.44 [95% CI -3.63, 6.51]) or 52 weeks (mean adjusted difference 2.47 [-2.72, 7.65]) nor in any of the secondary outcome measures (Cervical Dystonia Impact Profile-58, clinician and patient-rated global impression of change, mean botulinum toxin dose). Both groups showed large sustained improvements compared to baseline in the TWSTR, most of which occurred in the first four weeks. There were no major adverse events. Subgroup analysis suggested a centre effect. There was no statistically or clinically significant benefit from the specialized physiotherapy compared to standard neck physiotherapy advice but further trials are warranted. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. 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.

  4. 10th International Symposium on Head And Neck Skin Cancer

    NARCIS (Netherlands)

    van den Brekel, Michiel W. M.; Balm, Alfons J. M.; Lohuis, Peter J. F. M.; van der Veen, J. P. Wietse

    2011-01-01

    Since 1993, ten multidisciplinary symposia were organized at The Netherlands Cancer Institute on the diagnosis and treatment of malignancies of the head and neck. The symposia are meant to provide up-to-date teaching for physicians by world-renowned speakers. The previous symposia dealt with

  5. 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.

  6. 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

    This study aimed to determine the incidence rates of refeeding phenomena (defined as a decline in p-phosphate) and refeeding syndrome (RFS; defined as development of clinical symptoms in addition to a decline in p-phosphate) in head and neck cancer patients, and to identify risk factors. Fifty......-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...... presented a higher prevalence of head and neck pain, eating difficulties, higher p-phosphate levels, lower p-transferrin levels, and, in men, lower b-hemoglobin levels. Patients who developed symptoms had a decline in p-phosphate ≥0.22 mmol/l. At baseline, these patients had higher p-phosphate levels...

  7. Inactivation of the Tumor Suppressor Genes Causing the Hereditary Syndromes Predisposing to Head and Neck Cancer via Promoter Hypermethylation in Sporadic Head and Neck Cancers

    OpenAIRE

    Smith, Ian M.; Mithani, Suhail K.; Mydlarz, Wojciech K.; Chang, Steven S.; Califano, Joseph A.

    2010-01-01

    Fanconi anemia (FA) and dyskeratosis congenita (DC) are rare inherited syndromes that cause head and neck squamous cell cancer (HNSCC). Prior studies of inherited forms of cancer have been extremely important in elucidating tumor suppressor genes inactivated in sporadic tumors. Here, we studied whether sporadic tumors have epigenetic silencing of the genes causing the inherited forms of HNSCC. Using bisulfite sequencing, we investigated the incidence of promoter hypermethylation of the 17 Fan...

  8. 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

  9. 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

  10. 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 ...

  11. 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)

  12. Taste dysfunction in irradiated patients with head and neck cancer

    International Nuclear Information System (INIS)

    Zheng, Wen-Kai; Yamamoto, Tomoya; Komiyama, Sohtaro

    2002-01-01

    Taste disorders caused by radiation therapy for head and neck cancer are common. This prospective study of 40 patients with head and neck cancer assessed changes in taste sensations during radiation therapy. The relationship between the time course and the degree of taste disorder was studied. The taste recognition threshold and supra-threshold taste intensity performance for the four basic tastes were measured using the whole-mouth taste method before, during, and after radiation therapy. Bitter taste was affected most. An increase in threshold for sweet taste depended upon whether the tip of tongue was included within the radiation field. The slope of the taste intensity performance did not change during or after radiotherapy. The pattern of salivary dysfunction was different from that of taste dysfunction. The main cause of taste disorders during radiation support the hypothesis that taste dysfunction is due to damage to the taste buds in the radiation field. (author)

  13. Taste dysfunction in irradiated patients with head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Zheng, Wen-Kai; Yamamoto, Tomoya; Komiyama, Sohtaro [Kyushu Univ., Fukuoka (Japan). Faculty of Medicine; Inokuchi, Akira [Saga Medical School (Japan)

    2002-04-01

    Taste disorders caused by radiation therapy for head and neck cancer are common. This prospective study of 40 patients with head and neck cancer assessed changes in taste sensations during radiation therapy. The relationship between the time course and the degree of taste disorder was studied. The taste recognition threshold and supra-threshold taste intensity performance for the four basic tastes were measured using the whole-mouth taste method before, during, and after radiation therapy. Bitter taste was affected most. An increase in threshold for sweet taste depended upon whether the tip of tongue was included within the radiation field. The slope of the taste intensity performance did not change during or after radiotherapy. The pattern of salivary dysfunction was different from that of taste dysfunction. The main cause of taste disorders during radiation support the hypothesis that taste dysfunction is due to damage to the taste buds in the radiation field. (author)

  14. Measuring quality of life in patients with head and neck cancer: Update of the EORTC QLQ-H&N Module, Phase III

    DEFF Research Database (Denmark)

    Singer, Susanne; Araújo, Cláudia; Arraras, Juan Ignacio

    2015-01-01

    BACKGROUND: The objective of this study was to pilot test an updated version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Head and Neck Module (EORTC QLQ-H&N60). METHODS: Patients with head and neck cancer were asked to complete a list of 60 head...... and neck cancer-specific items comprising the updated EORTC head and neck module and the core questionnaire EORTC QLQ-C30. Debriefing interviews were conducted to identify any irrelevant items and confusing or upsetting wording. RESULTS: Interviews were performed with 330 patients from 17 countries......, representing different head and neck cancer sites and treatments. Forty-one of the 60 items were retained according to the predefined EORTC criteria for module development, for another 2 items the wording was refined, and 17 items were removed. CONCLUSION: The preliminary EORTC QLQ-H&N43 can now be used...

  15. Combined neck dissection and postoperative radiation therapy in the management of the high-risk neck: a matched-pair analysis

    International Nuclear Information System (INIS)

    Lundahl, Robert E.; Foote, Robert L.; Bonner, James A.; Suman, Vera J.; Lewis, Jean E.; Kasperbauer, Jan L.; McCaffrey, Thomas V.; Olsen, Kerry D.

    1998-01-01

    Purpose: The purpose of this study was to determine the efficacy of postoperative adjuvant radiation therapy with regard to reducing the rate of recurrence in the neck, cancer-related death, and death from any cause in patients with squamous cell carcinoma of the head and neck region metastatic to neck nodes. Methods: This was a retrospective review of patients with pathologically confirmed nodal metastases who underwent neck dissection and postoperative adjuvant radiation therapy for squamous cell carcinoma of the head and neck region. Time to recurrence in the dissected area of the neck, any recurrence in the neck, cancer-related death, and death from any cause were estimated with the Kaplan-Meier method. A matched-pair analysis was performed utilizing a cohort of patients who underwent neck dissection without postoperative radiation therapy. The patients from the two cohorts were matched according to previously reported high-risk features for cancer recurrence and death. Cox hazards models for the matched pairs were used to evaluate the relative risk of subsequent recurrence in the dissected side of the neck, any neck recurrence, cancer-related death, and overall survival. Materials: The medical records and pathologic slides of 95 consecutive patients with pathologically confirmed nodal metastases from squamous cell carcinoma of the head and neck region who underwent neck dissection and postoperative adjuvant radiation therapy between January 1974 and December 1990 were reviewed. Previously published data from 284 patients with squamous cell carcinoma of the head and neck region treated with neck dissection alone between January 1970 and December 1980 were used for a matched-pair analysis. Results: The relative risks for recurrence in the dissected side of the neck, any neck recurrence (dissected neck or delayed undissected neck metastasis), cancer-related death, and death from any cause for patients treated with operation alone relative to those treated with

  16. Radiosensitization of head and neck cancer cells by the phytochemical agent sulforaphane

    International Nuclear Information System (INIS)

    Kotowski, Ulana; Heiduschka, Gregor; Brunner, Markus; Fahim, Tammer; Thurnher, Dietmar; Czembirek, Cornelia; Eder-Czembirek, Christina; Schmidt, Rainer

    2011-01-01

    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.)

  17. 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.)

  18. 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

  19. Counseling Is Effective for Smoking Cessation in Head and Neck Cancer Patients

    DEFF Research Database (Denmark)

    Klemp, Ingrid; Wangsmo Steffenssen, Mia Charlotte; Bakholdt, Vivi T.

    2016-01-01

    PURPOSE: The purpose of this systematic review was to describe the efficacy of smoking cessation counseling and the resulting quit rate in patients with head and neck cancer. MATERIALS AND METHODS: A systematic literature search was conducted in the PubMed, Embase, and Cochrane databases. Predictor...... variables were smoking cessation counseling and smoking cessation interventions. The outcome was smoking cessation. Data collection and quality assessment were performed independently by 2 of the authors. Selected publications were assessed for potential risk of bias, and the level of evidence was evaluated...... in patients who received smoking cessation counseling compared with those who received usual care. CONCLUSIONS: This review shows that counseling supplemented with nicotine replacement therapy increases the possibility for smoking cessation in patients with head and neck cancer....

  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. Immunotherapy for head and neck cancer patients: shifting the balance

    NARCIS (Netherlands)

    Turksma, A.W.; Braakhuis, B.J.M.; Bloemena, E.; Meijer, C.J.L.M.; Leemans, C.R.; Hooijberg, E.

    2013-01-01

    Head and neck squamous cell carcinoma is the sixth most common cancer in the western world. Over the last few decades little improvement has been made to increase the relatively low 5-year survival rate. This calls for novel and improved therapies. Here, we describe opportunities in immunotherapy

  2. The role of EGFR-targeting strategies in the treatment of head and neck cancer

    Directory of Open Access Journals (Sweden)

    Dequanter D

    2012-07-01

    Full Text Available Didier Dequanter, Mohammad Shahla, Pascal Paulus, Philippe H LothaireDepartment of Surgery, CHU Charleroi (Hopital Andre Vésale, Montigny le Tilleul, BelgiumAbstract: With its targeted mechanism of action and synergistic activity with current treatment modalities, cetuximab is a potentially valuable treatment option for patients with recurrent and/or metastatic squamous cell cancer of the head and neck who have progressed on cisplatin-based chemotherapy. The use of cetuximab in combination with radiotherapy as definitive treatment for locoregionally advanced squamous cell cancer of the head and neck is generally restricted to patients unfit to receive cisplatin-based chemoradiation, which is still considered the standard of care. The effect of this epidermal growth factor receptor antagonist occurs without any change in the pattern and the severity of toxicity usually associated with head and neck radiation.Keywords: cetuximab, SCCHN, radiotherapy

  3. The role of computed tomography in the radiotherapy of head and neck cancer

    International Nuclear Information System (INIS)

    Hokama, Yukio; Miura, Kentaro; Katsuyama, Naofumi; Nakano, Masao; Noda, Yutaka; Yamashiro, Masahiro

    1983-01-01

    The clinical usefullness of computed tomography (CT) was evaluated in 20 patients with carcinoma of the head and neck before, during and after radiotherapy. The role of CT in the radiotherapy of head and neck cancer was studied. In case of carcinoma of nasopharynx and maxillary antrum, bone destruction and tumor configuration in soft tissue were well delineated and usefull for clinical staging and radiotherapy planning. Neck lymph node involvement was also well detected, especially by using contrast enhancement. CT revealed also the structure of metastatic lesion to neck lymph node, for example central necrosis. Many authors have reported the usefullness of CT for radiotherapy planning. But we would emphasize the contribution in the observation of tumor regression by radiotherapy, and follow-up after the therapy. (author)

  4. Epidemiology and Molecular Biology of Head and Neck Cancer.

    Science.gov (United States)

    Jou, Adriana; Hess, Jochen

    2017-01-01

    Head and neck cancer is a common and aggressive malignancy with a high morbidity and mortality profile. Although the large majority of cases resemble head and neck squamous cell carcinoma (HNSCC), the current classification based on anatomic site and tumor stage fails to capture the high level of biologic heterogeneity, and appropriate clinical management remains a major challenge. Hence, a better understanding of the molecular biology of HNSCC is urgently needed to support biomarker development and personalized care for patients. This review focuses on recent findings based on integrative genomics analysis and multi-scale modeling approaches and how they are beginning to provide more sophisticated clues as to the biological and clinical diversity of HNSCC. © 2017 S. Karger GmbH, Freiburg.

  5. Supportive care for head and neck cancer patients receiving radiotherapy

    International Nuclear Information System (INIS)

    Zenda, Sadamoto

    2015-01-01

    Recently (chemo-)radiotherapy has been widely used in head and neck cancer with definite evidence. As long survivor has increased, social problems associated with late toxicity have become more. Late toxicities induced by radiotherapy for head and neck lesion are often severe. Xerostomia is one of the severe late toxicities conventionally and dysphagia after chemoradiotherapy is a new topic. Some industrial development (ex. Intensity Modulated Radiotherapy: IMRT) play a great role in toxicity management. Multidisciplinary approach (cooperation between not only physicians but also nurses and dentists) is necessary to control toxicities. The research of supportive care will be needed same as definitive treatment in the future. (author)

  6. [Psychological care of patients with head and neck cancer].

    Science.gov (United States)

    Moya, Mélanie

    2015-09-01

    Treatments for head and neck cancers are generally complex and debilitating. Surgery, often mutilating, profoundly affects the relationship between oneself and others and causes verbal communication, breathing and swallowing difficulties. The functional and aesthetic sequelae are a constant reminder to the patient of the disease and make them conscious of their appearance. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  7. 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 ...

  8. Head and Neck Cancer—Patient Version

    Science.gov (United States)

    Head and neck cancers include cancers in the larynx (voice box), throat, lips, mouth, nose, and salivary glands. Start here to find information on head and neck cancer treatment in adults and children, causes and prevention, screening, research, and statistics.

  9. PET with a dual-head coincidence gamma camera in head and neck cancer: A comparison with computed tomography and dedicated PET

    International Nuclear Information System (INIS)

    Zimny, M.

    2001-01-01

    Positron emission tomography with 18 F-fluoro-deoxyglucose (FDG PET) is a promising imaging tool for detecting and staging of primary or recurrent head and neck cancer. The aim of this study was to evaluate a dual-head gamma camera modified for coincidence detection (KGK-PET) in comparison to computed tomography (CT) and dedicated PET (dPET). 50 patients with known or suspected primary or recurrent head and neck cancer were enrolled. 32 patients underwent KGK-PET and dPET using a one-day protocol. The sensitivity for the detection of primary/ recurrent head and neck cancer for KGK-PET and CT was 80% and 54%, respectively, specificity was 73% and 82%, respectively. The sensitivity and specificity for the detection of lymph node metastases based on neck sides with KGK-PET was 71% (CT: 65%) and 88% (CT: 89%) respectively. In comparison to dPET, KGK-PET revealed concordant results in 32/32 patients with respect to primary tumor/recurrent disease and in 55/60 evaluated neck sides. All involved neck sides that were missed by KGK-PET were also negative with dPET. These results indicate that in patients with head and neck cancer KGK-PET reveals information, that are similar to dPET and complementary to CT. (orig.) [de

  10. 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

  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. 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)

  13. 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

  14. The INHANCE consortium: toward a better understanding of the causes and mechanisms of head and neck cancer.

    Science.gov (United States)

    Winn, D M; Lee, Y-C A; Hashibe, M; Boffetta, P

    2015-09-01

    The International Head and Neck Cancer Epidemiology (INHANCE) consortium is a collaboration of research groups leading large epidemiology studies to improve the understanding of the causes and mechanisms of head and neck cancer. The consortium includes investigators of 35 studies who have pooled their data on 25 500 patients with head and neck cancer (i.e., cancers of the oral cavity, oropharynx, hypopharynx, and larynx) and 37 100 controls. The INHANCE analyses have confirmed that tobacco use and alcohol intake are key risk factors of these diseases and have provided precise estimates of risk and dose response, the benefit of quitting, and the hazard of smoking even a few cigarettes per day. Other risk factors include short height, lean body mass, low education and income, and a family history of head and neck cancer. Risk factors are generally similar for oral cavity, pharynx, and larynx, although the magnitude of risk may vary. Some major strengths of pooling data across studies include more precise estimates of risk and the ability to control for potentially confounding factors and to examine factors that may interact with each other. The INHANCE consortium provides evidence of the scientific productivity and discoveries that can be obtained from data pooling projects. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. 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.

  16. Oral mucositis in head and neck cancer: risk, biology, and management.

    Science.gov (United States)

    Sonis, Stephen T

    2013-01-01

    Of the toxicities associated with conventional forms of treatment for head and neck cancers, probably none has such a consistent legacy as oral mucositis.1 Despite the fact that mucosal injury was noted as far back as Marie Curie's first forays into therapeutic radiation, an effective intervention has yet to be developed. In addition to its historic link to radiation, new therapeutic strategies including induction chemotherapy often produce mucositis, and targeted therapies appear to alter mucositis risk and its severity and course.2 The symptomatic effect of oral mucositis is profound. Disabling oral and oropharyngeal pain prevents patients from eating normally, requires opiate analgesics, and in some cases results in alteration or discontinuation of anticancer therapy.3 Furthermore, the health and economic consequences of oral mucositis are far from trivial. The incremental cost of oral mucositis in patients with head and neck cancer exceeds $17,000 (USD).4.

  17. 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.

  18. 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.

  19. Brachial Plexus-Associated Neuropathy After High-Dose Radiation Therapy for Head-and-Neck Cancer

    International Nuclear Information System (INIS)

    Chen, Allen M.; Hall, William H.; Li, Judy; Beckett, Laurel; Farwell, D. Gregory; Lau, Derick H.; Purdy, James A.

    2012-01-01

    Purpose: To identify clinical and treatment-related predictors of brachial plexus–associated neuropathies after radiation therapy for head-and-neck cancer. Methods and Materials: Three hundred thirty patients who had previously completed radiation therapy for head-and-neck cancer were prospectively screened using a standardized instrument for symptoms of neuropathy thought to be related to brachial plexus injury. All patients were disease-free at the time of screening. The median time from completion of radiation therapy was 56 months (range, 6–135 months). One-hundred fifty-five patients (47%) were treated by definitive radiation therapy, and 175 (53%) were treated postoperatively. Radiation doses ranged from 50 to 74 Gy (median, 66 Gy). Intensity-modulated radiation therapy was used in 62% of cases, and 133 patients (40%) received concurrent chemotherapy. Results: Forty patients (12%) reported neuropathic symptoms, with the most common being ipsilateral pain (50%), numbness/tingling (40%), motor weakness, and/or muscle atrophy (25%). When patients with <5 years of follow-up were excluded, the rate of positive symptoms increased to 22%. On univariate analysis, the following factors were significantly associated with brachial plexus symptoms: prior neck dissection (p = 0.01), concurrent chemotherapy (p = 0.01), and radiation maximum dose (p < 0.001). Cox regression analysis confirmed that both neck dissection (p < 0.001) and radiation maximum dose (p < 0.001) were independently predictive of symptoms. Conclusion: The incidence of brachial plexus–associated neuropathies after radiation therapy for head-and-neck cancer may be underreported. In view of the dose–response relationship identified, limiting radiation dose to the brachial plexus should be considered when possible.

  20. Treatment results of chemoradiotherapy with 5-FU/CDGP for head and neck cancer

    International Nuclear Information System (INIS)

    Himei, Kengo; Katayama, Norihisa; Takemoto, Mitsuhiro; Kuroda, Masahiro; Nomiya, Shigenobu; Onoda, Tomoo; Tominaga, Susumu; Kanazawa, Susumu

    2006-01-01

    We investigated the safety and efficacy of alternative and concurrent chemoradiotherapy with 5-fluorouracil (FU)/nedaplatin (CDGP) for head and neck cancer. From January 2003 to August 2005, 19 patients with head and neck squamous cell carcinoma were treated in our institution. Alternative chemoradiotherapy (ACRT) was performed for 8 cases of nasopharyngeal cancer. Concurrent chemoradiotherapy (CCRT) was performed for 11 cases of other head and neck cancer. Median total dose of radiotherapy was 63 Gy. ACRT consisted of 5-FU at a dose of 500 mg/m 2 on days 1-5 and 28-32 and CDGP at a dose of 60 mg/m 2 on days 6 and 33. CCRT consisted of 5-FU at a dose of 500 mg/m 2 on days 1-4 and 28-31 and CDGP at a dose of 60 mg/m 2 on days 5 and 32. Median follow-up period was 13 months. CR+PR was admitted in five cases (63%) with ACRT, and in 9 cases (82%) with CCRT. Non-hematological adverse effects of grade 3 were admitted in eight cases (100%) of ACRT, and in 9 cases (82%) of CCRT. Chemoradiotherapy attained good results and non-hematological adverse effects were able to be managed by preserved treatment. (author)

  1. 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)

  2. 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....

  3. Metastatic Squamous Neck Cancer with Occult Primary Treatment (PDQ®)—Patient Version

    Science.gov (United States)

    Metastatic squamous neck cancer with occult primary (unknown primary) treatment options include surgery, radiation therapy, or a combination of both. Learn more about the diagnosis and treatment of these tumors in this expert-reviewed summary.

  4. Pre-Radiation dental considerations and management for head and neck cancer patients.

    Science.gov (United States)

    Kufta, Kenneth; Forman, Michael; Swisher-McClure, Samuel; Sollecito, Thomas P; Panchal, Neeraj

    2018-01-01

    Treatment of head and neck cancer (HNC) is accompanied by a high rate of morbidity, and complications can have a lifelong, profound impact on both patients and caregivers. Radiation-related injury to the hard and soft tissue of the head and neck can significantly decrease patients' quality of life. The purpose of this study is to provide patent-specific guidelines for managing the oral health and related side effects of HNC patients treated with radiation therapy. Based on reviewed articles retrieved on the PubMed database, guidelines for management of the oral health of this patient population were organized into three separate categories: cancer, patient, and dentition. The location, type, and staging of the cancer, along with the radiation used to treat the cancer significantly impact dental treatment. Several unique patient characteristics such as motivation, presence of support system, socioeconomic status, nutrition, and race have all been found to affect outcomes. Dental disease and available supportive dental management was found to significantly impact treatment and quality of life in this patient population. By comprehensively assessing unique cancer, patient, and dental-related factors, this review provides individualized evidence-based guidelines on the proper management of this complex and vulnerable patient population. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. Palliation of inoperable head and neck cancer: combined intra-arterial infusion chemotherapy and irradiation

    International Nuclear Information System (INIS)

    Armstrong, A.L.; Meeker, W.R.

    1978-01-01

    Palliation of unresectable head and neck cancer remains a difficult problem. Because of excellent results reported by others with infusion of vinblastine, methotrexate, and 5-fluorouracil into the external carotid artery followed by irradiation before curative surgery, we applied this technic to 22 patients with advanced head and neck cancer. Fifteen patients from this group who had chemotherapy infusion followed by radiation therapy are compared with 21 patients who received radiation therapy alone. Both groups were similar in distribution of primary site, histology, and TNM stage. Of 15 patients, 14 (93%) had partial or complete tumor regression after both arterial chemotherapy infusion and irradiation, while 14 of 17 patients (82%) receiving primary irradiation had partial or complete response. Drug toxicity and complications related to infusion occurred in all patients. Most patients in both groups had short survivals (mean of 14.1 months in infusion chemotherapy and radiation vs 9.1 months in primary irradiation). One patient remains alive in the infusion group and two in the control group; however, all have recurrent disease. Results indicate a slight increase in survival time with the addition of infusion chemotherapy to irradiation in palliative treatment of head and neck cancer

  6. 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

  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. Smoking has a negative impact upon health related quality of life after treatment for head and neck cancer

    DEFF Research Database (Denmark)

    Jensen, Kenneth; Jensen, Anders Bonde; Grau, Cai

    2006-01-01

    To examine the influence of smoking on observer based morbidity scores and patient assessed health related quality of life after treatment for head and neck cancer. The results of EORTC C30 and H&N35 questionnaires and DAHANCA morbidity scores were studied according to smoking status in 114...... recurrence free head and neck cancer patients. In contrast to observer based toxicity scoring, smoking had a significantly negative influence on 20 of the 33 quality of life scales. Previous smokers had quality of life scores in between never smokers and continuous smokers. Smoking after treatment of head...... and neck cancer adversely influenced a wide range of quality of life endpoints. Quitters had better quality of life than patients who continued to smoke after treatment, suggesting that smoking cessation may improve quality of life in addition to reducing the risk of new cancer. Udgivelsesdato: 2007-Feb...

  9. 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.

  10. 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...

  11. Prevalence, incidence, and risk factors for shoulder and neck dysfunction after neck dissection: A systematic review.

    Science.gov (United States)

    Gane, E M; Michaleff, Z A; Cottrell, M A; McPhail, S M; Hatton, A L; Panizza, B J; O'Leary, S P

    2017-07-01

    Shoulder pain and dysfunction may occur following neck dissection among people being treated for head and neck cancer. This systematic review aims to examine the prevalence and incidence of shoulder and neck dysfunction after neck dissection and identify risk factors for these post-operative complications. Electronic databases (Pubmed, CINAHL, EMBASE, Cochrane) were searched for articles including adults undergoing neck dissection for head and neck cancer. Studies that reported prevalence, incidence or risk factors for an outcome of the shoulder or neck were eligible and assessed using the Critical Review Form - Quantitative Studies. Seventy-five articles were included in the final review. Prevalence rates for shoulder pain were slightly higher after RND (range, 10-100%) compared with MRND (range, 0-100%) and SND (range, 9-25%). The incidence of reduced shoulder active range of motion depended on surgery type (range, 5-20%). The prevalence of reduced neck active range of motion after neck dissection was 1-13%. Type of neck dissection was a risk factor for shoulder pain, reduced function and health-related quality of life. The prevalence and incidence of shoulder and neck dysfunction after neck dissection varies by type of surgery performed and measure of dysfunction used. Pre-operative education for patients undergoing neck dissection should acknowledge the potential for post-operative shoulder and neck problems to occur and inform patients that accessory nerve preservation lowers, but does not eliminate, the risk of developing musculoskeletal complications. Copyright © 2016 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  12. 14-3-3 zeta is a molecular target in guggulsterone induced apoptosis in Head and Neck cancer cells

    International Nuclear Information System (INIS)

    Macha, Muzafar A; Matta, Ajay; Chauhan, SS; Siu, KW Michael; Ralhan, Ranju

    2010-01-01

    The five-year survival rates for head and neck squamous cell carcinoma (HNSCC) patients are less than 50%, and the prognosis has not improved, despite advancements in standard multi-modality therapies. Hence major emphasis is being laid on identification of novel molecular targets and development of multi-targeted therapies. 14-3-3 zeta, a multifunctional phospho-serine/phospho-threonine binding protein, is emerging as an effector of pro-survival signaling by binding to several proteins involved in apoptosis (Bad, FKHRL1 and ASK1) and may serve as an appropriate target for head and neck cancer therapy. Herein, we determined effect of guggulsterone (GS), a farnesoid X receptor antagonist, on 14-3-3 zeta associated molecular pathways for abrogation of apoptosis in head and neck cancer cells. Head and neck cancer cells were treated with guggulsterone (GS). Effect of GS-treatment was evaluated using cell viability (MTT) assay and apoptosis was verified by annexin V, DNA fragmentation and M30 CytoDeath antibody assay. Mechanism of GS-induced apoptosis was determined by western blotting and co-IP assays using specific antibodies. Using in vitro models of head and neck cancer, we showed 14-3-3 zeta as a key player regulating apoptosis in GS treated SCC4 cells. Treatment with GS releases BAD from the inhibitory action of 14-3-3 zeta in proliferating HNSCC cells by activating protein phosphatase 2A (PP2A). These events initiate the intrinsic mitochondrial pathway of apoptosis, as revealed by increased levels of cytochrome c in cytoplasmic extracts of GS-treated SCC4 cells. In addition, GS treatment significantly reduced the expression of anti-apoptotic proteins, Bcl-2, xIAP, Mcl1, survivin, cyclin D1 and c-myc, thus committing cells to apoptosis. These events were followed by activation of caspase 9, caspase 8 and caspase 3 leading to cleavage of its downstream target, poly-ADP-ribose phosphate (PARP). GS targets 14-3-3 zeta associated cellular pathways for reducing

  13. 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...

  14. Cancer of the head and neck; Cancers de la tete et du cou

    Energy Technology Data Exchange (ETDEWEB)

    Leignel, D.; Toledano, A.; Calais, G.; Gardner, M.; Valinta, D.; Halimi, P.; Alberini, J.L.; Plantet, M.M.; Banal, A.; Hans, S.; Floiras, J.L.; Labib, A.; Djemaa, A.; Naoun, L.; Bali, M.; Melais, K.; George, L.; Cazalet, M.; Gross, E.; Padovani, L.; Cowen, D.; Pignon, T.; Bannour, N.; Guedouar, R.; Bouaouina, N.; Mege, A.; Lapeyre, M.; Graff, P.; Marchesi, V.; Aletti, P.; Marchal, C.; Peiffert, D.; Serre, A.; Ailleres, N.; Lemanski, C.; Hay, M.H.; Llacer Moscardo, C.; Allaw, A.; Azria, D.; Dubois, J.B.; Fenoglietto, P.; Maalej, M.; Nasr, C.; Chaari, N.; Hentati, D.; Kochbati, L.; Besbes, M.; Benjelloun, H.; Benchakroun, N.; Houjami, M.; Jouhadi, H.; Tawfiq, N.; Acharki, A.; Sahraoui, S.; Benider, A.; Racadot, S.; Mercier, M.; Dessard-Diana, B.; Bensadoun, R.J.; Martin, M.; Malaurie, E.; Favrel, V.; Housset, M.; Journel, C.; Calais, G.; Huet, J.; Pillet, G.; Hennequin, C.; Haddad, E.; Diana, C.; Blaska-Jaulerry, B.; Henry-Amar, M.; Gehanno, P.; Baillet, F.; Mazeron, J.J.; Chaouache, C.K.; Tebra Mrad, T.M.S.; Bannour, B.N.S.; Bouaouina, B.N.; Favrel, V.; Khodri, M.; Chapet, O.; Nguyen, D.; Ardiet, J.; Romestaing, P.; Thillays, F.; Bardet, E.; Rolland, F.; Maingan, P.; Campion, L.; Mahe, M.A

    2005-11-15

    Thirteen articles are presented in relation with head and neck cancer. Chemoradiotherapy, medical examinations using nuclear techniques such PET scanning, fractionated radiotherapy after a chemotherapy, analysis of dose volume for patients treated by irradiation with a combined chemotherapy, dosimetry, conformal radiotherapy with intensity modulation, dosimetry in brachytherapy, association of radiotherapy and chemotherapy in the treatment of nose pharynx carcinomas, recurrence, are the different subjects treated in this part. (N.C.)

  15. The role of USG in neck monitoring after surgery of malignant neoplasms of head and neck

    International Nuclear Information System (INIS)

    Szmeja, Z.; Kordylewska, M.; Dziamska, K.; Szyfter, W.; Kruk-Zagajewska, A.

    1994-01-01

    Metastases to regional lymph nodes of the neck in patients with larynx cancer are a more frequent cause of death in comparison to local recurrence. Thus it is necessary to thoroughly examine the treatment and after the treatment. The ultrasound examination introduced significant diagnostic value in the diagnosis of malignant cancers. Ultrasound monitoring of the lymphatic system after surgical treatment or radiation allows to diagnose early metastases which are not visible in palpation examination. In over 200 patients after surgical treatment of larynx cancer several ultrasound examinations of the neck were carried out. The time following the end of the treatment was 4 months to l 8 years. In the ultrasound examination of the neck changes in the lymphatic system were observed, which were not clinically manifested in 10 patients. Metastases to regional lymph nodes of the neck were most frequently observed in the first year after the operation. Patients who were diagnosed with metastases before operation and patients with supraglottic cancers were at more risk of having metastases. The ultrasound examination of the neck should be a routine, systematically repeated examination in the observation of patients after larynx cancer operation. (author)

  16. 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.

  17. Intraobserver and Interobserver Variability in GTV Delineation on FDG-PET-CT Images of Head and Neck Cancers

    International Nuclear Information System (INIS)

    Breen, Stephen L.; Publicover, Julia; De Silva, Shiroma; Pond, Greg; Brock, Kristy; O'Sullivan, Brian; Cummings, Bernard; Dawson, Laura; Keller, Anne; Kim, John; Ringash, Jolie; Yu, Eugene; Hendler, Aaron; Waldron, John

    2007-01-01

    Purpose: To determine if the addition of fluorodeoxyglucose positron emission tomography (FDG-PET) data changes primary site gross tumor volumes (GTVs) in head and neck cancers. Methods and Materials: Computed tomography (CT), contrast-enhanced CT, and FDG-PET-CT scans were obtained in 10 patients with head and neck cancers. Eight experienced observers (6 head and neck oncologists and 2 neuro-radiologists) with access to clinical and radiologic reports outlined primary site GTVs on each modality. Three cases were recontoured twice to assess intraobserver variability. The magnitudes of the GTVs were compared. Intra- and interobserver variability was assessed by a two-way repeated measures analysis of variance. Inter- and intraobserver reliability were calculated. Results: There were no significant differences in the GTVs across the image modalities when compared as ensemble averages; the Wilcoxon matched-pairs signed-rank test showed that CT volumes were larger than PET-CT. Observers demonstrated the greatest consistency and were most interchangeable on contrast-enhanced CT; they performed less reliably on PET-CT. Conclusions: The addition of PET-CT to primary site GTV delineation of head and neck cancers does not change the volume of the GTV defined by this group of expert observers in this patient sample. An FDG-PET may demonstrate differences in neck node delineation and in other disease sites

  18. Motives that head and neck cancer patients have for contacting a specialist nurse - an empirical study.

    Science.gov (United States)

    Salander, Pär; Isaksson, Joakim; Granström, Brith; Laurell, Göran

    2016-11-01

    The purpose of this study is to systematically explore the motives for patients with head and neck cancer to contact a specialist nurse during two years postdiagnosis. Research focusing on the role of specialist nurses in cancer care almost exclusively concern cancers other than head and neck cancer. Qualitative, descriptive study based on the contacts between patients with head and neck cancer and a specialist nurse. Patients were invited to contact a specialist nurse by telephone. The specialist nurse took systematic field notes, that is, she registered who contacted her, the nature of the call and the outcome. Sixty patients were included. In descending order, the motives for contact were questions about practical and uncomplicated matters, consultations about medical troubles/worries, presenting a report of the patient's situation, requests for additional information about the treatment plan and requests for medical information. The pattern of the patients' motivations for calling was not related to medical or social factors, suggesting that the initiative to make contact is very much a question of the complexity of individual life circumstances. Very few referrals were sent from the specialist nurse to other professionals. The specialist nurse turned out to be more than just a coordinator of health-care resources. The findings bring up questions about the potential of the nurse's function as a coordinator, but also as a potential attachment figure, and questions about the nurse's relationships to other professionals. When implementing a specialist nurse function, it is important to decide whether the function should be inspired by a broader relational perspective. In addition to the indispensible competence and experience in the clinical field of head and neck cancer, training in counselling and acquaintance with object-relational psychology will then be desirable. © 2016 John Wiley & Sons Ltd.

  19. 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

  20. Usefulness of cimetidine and superselective intra-arterial chemotherapy for advanced head and neck cancer

    International Nuclear Information System (INIS)

    Yokoyama, Junkichi; Ito, Shin; Ohba, Shinichi; Haruyama, Takuo; Fujimaki, Mitsuhisa; Ikeda, Katsuhisa; Hanaguri, Makoto

    2011-01-01

    Since 1995, we have conducted intra-arterial chemotherapy for advanced head and neck cancer to improve prognosis and to preserve significant organs. Novel approaches have increased the organ preservation rate in spite of frequent distant metastasis. Cimetidine, a kind of H2-blocker, inhibits the development of E-selectin on vascular endothelial cells, and contributes to a decrease in distant metastasis and improvement in prognosis for digestive cancer. To evaluate the decrease in distant metastasis and its relation to the administration of Cimetidine when used concurrently with intra-arterial chemotherapy for advanced head and neck cancer. 153 patients treated by intra-arterial chemotherapy for stage IV head and neck cancer from May 2000 to December 2008 were divided into two groups: the Cimetidine group (114 patients) and the non-Cimetidine group (39 patients). Analysis of distant metastasis between the two groups was performed retrospectively. Intra-arterial chemotherapy was administered at 150 mg/m 2 of cisplatin (CDDP) four times per week. In the Cimetidine group, 800 mg of Cimetidine was administered for a period of more than one year prior to treatment. Fluorodeoxyglucose positron emission tomography (FDG-PET) was performed 2 months after the treatment. Pulmonary CT was performed every 6 months, and chest X-ray examination was conducted every three months. The median period of observation was 45 months for the Cimetidine group and 64 months for the non-Cimetidine group (p<0.05). Distant metastasis was detected in 10 out of the 39 cases in the non-Cimetidine group and in 6 out of the 114 cases in the Cimetidine group (p<0.05). Metastatic organs consisted of: 8 cases in lungs, 5 cases in bones, 2 cases in brain, and 1 case in retroperitoneum. The mean time of distant metastasis after treatment was 6.9 months (2-20). Combined intra-arterial chemotherapy and Cimetidine is useful for the treatment of advanced head and neck cancer due to increased loco

  1. 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)

  2. 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).

  3. Evaluation of PET/MRI for Tumor Volume Delineation for Head and Neck Cancer.

    Science.gov (United States)

    Wang, Kyle; Mullins, Brandon T; Falchook, Aaron D; Lian, Jun; He, Kelei; Shen, Dinggang; Dance, Michael; Lin, Weili; Sills, Tiffany M; Das, Shiva K; Huang, Benjamin Y; Chera, Bhishamjit S

    2017-01-01

    Computed tomography (CT), combined positron emitted tomography and CT (PET/CT), and magnetic resonance imaging (MRI) are commonly used in head and neck radiation planning. Hybrid PET/MRI has garnered attention for potential added value in cancer staging and treatment planning. Herein, we compare PET/MRI vs. planning CT for head and neck cancer gross tumor volume (GTV) delineation. We prospectively enrolled patients with head and neck cancer treated with definitive chemoradiation to 60-70 Gy using IMRT. We performed pretreatment contrast-enhanced planning CT and gadolinium-enhanced PET/MRI. Primary and nodal volumes were delineated on planning CT (GTV-CT) prospectively before treatment and PET/MRI (GTV-PET/MRI) retrospectively after treatment. GTV-PET/MRI was compared to GTV-CT using separate rigid registrations for each tumor volume. The Dice similarity coefficient (DSC) metric evaluating spatial overlap and modified Hausdorff distance (mHD) evaluating mean orthogonal distance difference were calculated. Minimum dose to 95% of GTVs (D95) was compared. Eleven patients were evaluable (10 oropharynx, 1 larynx). Nine patients had evaluable primary tumor GTVs and seven patients had evaluable nodal GTVs. Mean primary GTV-CT and GTV-PET/MRI size were 13.2 and 14.3 cc, with mean intersection 8.7 cc, DSC 0.63, and mHD 1.6 mm. D95 was 65.3 Gy for primary GTV-CT vs. 65.2 Gy for primary GTV-PET/MRI. Mean nodal GTV-CT and GTV-PET/MRI size were 19.0 and 23.0 cc, with mean intersection 14.4 cc, DSC 0.69, and mHD 2.3 mm. D95 was 62.3 Gy for both nodal GTV-CT and GTV-PET/MRI. In this series of patients with head and neck (primarily oropharynx) cancer, PET/MRI and CT-GTVs had similar volumes (though there were individual cases with larger differences) with overall small discrepancies in spatial overlap, small mean orthogonal distance differences, and similar radiation doses.

  4. 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 ...

  5. Metachronous Second Primary Malignancies after Head and Neck Cancer in a Korean Cohort (1993-2010.

    Directory of Open Access Journals (Sweden)

    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

  6. COAGULATION PROFILE IN PATIENTS PRESENTING WITH MALIGNANCIES WITH SPECIAL REFERENCES TO HEAD AND NECK EPITHELIAL CANCERS, LEUKAEMIAS AND LYMPHOMAS

    Directory of Open Access Journals (Sweden)

    Kaberee Bhuyan

    2016-04-01

    Full Text Available BACKGROUND Cancer can cause activation of coagulation in many ways and there is definite evidence of abnormalities in haemostatic mechanism which is seen by the presence of one or more circulating markers of haemostatic activation & this is found to be potentiated by the release of tissue factors or procoagulants from normal tissue destructions during tumour development. OBJECTIVES • To evaluate the range of different types of haemostatic abnormalities in haematological and epithelial malignancies, especially the head and neck epithelial malignancies. • To look for the differences in the grades of these abnormalities in metastatic & non-metastatic malignancies. • To understand the prognostic value of routine tests of coagulation while predicting the outcome of the patient. • MATERIALS AND METHODS The study was conducted in the Department of Pathology, Gauhati Medical College & Hospital, Guwahati from July 2004 to June 2005. 70 cases comprising of head and neck epithelial malignancies, leukaemias and lymphomas without clinical presentation of haemorrhage or thrombosis were selected and coagulation profiles were seen. RESULTS AND OBSERVATION Out of 70 cases of both sexes & different age groups prior to therapeutic intervention, metastatic cases were 22, non-metastatic cases were 29, and 19 cases belonged to leukaemias and lymphomas. The commonest age group affected was 51–60 yrs. and male: female was 3.7: 1. The most frequent abnormality was 41 cases (58.57% of FDP positivity in the serum followed by 36 cases (51.43% of hyperfibrinogenaemia; 32 cases (45.71% shortened bleeding time, etc. DISCUSSION Activated coagulation in cancer leads to increased fibrin deposition stimulated by the destroyed tissues; increased FDPs being a strong marker of coagulation and fibrinolytic activation; increased platelet aggregation by the micro vesicles shed by tumour cells; prolonged PT & APTT being well known markers for disseminated intravascular

  7. Matrix Metalloproteinases: The Gene Expression Signatures of Head and Neck Cancer Progression

    Energy Technology Data Exchange (ETDEWEB)

    Iizuka, Shinji [Sanford-Burnham Medical Research Institute, 10901 North Torrey Pines Road, La Jolla, CA 92037 (United States); Ishimaru, Naozumi; Kudo, Yasusei, E-mail: yasusei@tokushima-u.ac.jp [Department of Oral Molecular Pathology, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-8-15 Kuramoto, Tokushima 770-8504 (Japan)

    2014-02-13

    Extracellular matrix degradation by matrix metalloproteinases (MMPs) plays a pivotal role in cancer progression by promoting motility, invasion and angiogenesis. Studies have shown that MMP expression is increased in head and neck squamous cell carcinomas (HNSCCs), one of the most common cancers in the world, and contributes to poor outcome. In this review, we examine the expression pattern of MMPs in HNSCC by microarray datasets and summarize the current knowledge of MMPs, specifically MMP-1, -3, -7 -10, -12, -13, 14 and -19, that are highly expressed in HNSCCs and involved cancer invasion and angiogenesis.

  8. [Validation of the German version of Eating Assessment Tool for head and neck cancer patients].

    Science.gov (United States)

    Zaretsky, Eugen; Steinbach-Hundt, Silke; Pluschinski, Petra; Grethel, Isabel

    2018-04-10

    The assessment of subjective swallowing complaints constitutes an important element in a multidimensional, modern management of head and neck cancer patients suffering from dysphagia. For this purpose, an internationally recognized and validated 10-item questionnaire EAT-10 is used that was developed and validated by Belafski et al. in 2008. The purpose of the present study is the translation of EAT-10 into the German language and its validation for head and neck cancer patients. After the translation of EAT-10 into German according to the guidelines for the translation of foreign measuring instruments, a validation of gEAT-10 was carried out on the basis of the sample of 210 head and neck cancer patients. The reliability was determined by means of the internal consistency (Cronbach's Alpha) and item-total correlations (Spearman). The construct validity was verified by the uni- and multivariate analyses of the distribution of gEAT-10 total scores depending on gender, age, BMI, tumor stage and localization as well as type of the oncological therapy. The internal consistency amounted to α = .94, the item-total correlations varied between ρ = .59 and ρ = .85. No significant associations between gEAT-10 total scores and gender as well as age were identified in univariate calculations. Such associations were found for BMI, tumor stage and localization as well as type of the oncological therapy. However, only the tumor stage yielded a significant result in a regression. The gEAT-10 was shown to be a reliable and construct valid questionnaire for the assessment of subjective swallowing complaints in patients with head and neck cancer. © Georg Thieme Verlag KG Stuttgart · New York.

  9. 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

  10. 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.

  11. 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

  12. 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

  13. Supportive use of megestrol acetate (Megace) with head/neck and lung cancer patients receiving radiation therapy

    International Nuclear Information System (INIS)

    McQuellon, Richard P.; Moose, Dawn B.; Russell, Gregory B.; Case, L. Douglas; Greven, Katherine; Stevens, Michael; Shaw, Edward G.

    2002-01-01

    Purpose: The purpose of this study was to measure the effect of megestrol acetate (MA) on weight loss and quality of life (QOL) in patients with cancer of the lung or head and neck undergoing curative radiation therapy. Methods and Materials: This was a Phase III, placebo-controlled, double-blind randomized study. Patients received either 800 mg/day of MA (20 milliliters po qAM) or placebo over a 12-week period. Patients received radiation of the head and neck or thorax using a dose of at least 50 Gy, either alone or with chemotherapy. Weight was assessed weekly, whereas QOL was assessed at baseline and at 4, 8, and 12 weeks. Results: Patient characteristics on the MA arm (16 lung, 12 head/neck; mean age: 60 years) were similar to those on the placebo arm (17 lung, 11 head/neck; mean age: 65.8 years). Patients in the MA group had a mean weight loss over 12 weeks of 2.7 pounds, whereas the placebo group had a mean weight loss of 10.6 pounds. There was a significant time by treatment interaction (p=0.001), with the difference in weight between treatment groups being most pronounced after 6 weeks. Although overall QOL was similar in both arms of the study, several QOL subscale items did differ significantly. Compared to the placebo-treated patients, head-and-neck cancer patients in the MA arm reported the ability to eat as much as they liked (p=0.02 at 12 weeks), and lung cancer patients in the MA arm reported significantly better appetite at 4 weeks (p=0.03) and 8 weeks (p=0.001). Conclusion: MA used prophylactically is useful as an appetite stimulant; it can help patients maintain weight over the course of curative radiotherapy of the head and neck or lung and can improve specific aspects of QOL

  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. Swing of the Surgical Pendulum: A Return to Surgery for Treatment of Head and Neck Cancer in the 21st Century?

    International Nuclear Information System (INIS)

    Holsinger, F. Christopher; Weber, Randal S.

    2007-01-01

    Treatment for head and neck cancer has evolved significantly during the past 100 years. Beginning with Bilroth's total laryngectomy on New Year's Day in 1873, 'radical' surgery remained the only accepted treatment for head and neck cancer when optimal local and regional control was the goal. Bigger was still better when it came to managing the primary tumor and the neck. The 'commando' procedure and radical neck dissection were the hallmarks of this first generation of treatments of head-and-neck cancer. With the advent of microvascular reconstructive techniques, larger and more comprehensive resections could be performed. Despite these large resections and their 'mutilating' sequelae, overall survival did not improve. Even for intermediate-stage disease in head-and-neck cancer, the 5-year survival rate did not improve >50%. Many concluded that more than the scalpel was needed for optimal local and regional control, especially for intermediate- and advanced-stage disease. Most important, the multidisciplinary teams must identify and correlate biomarkers in the tumor and host that predict for a response to therapy and for optimal functional recovery. As the pendulum swings back, a scientific approach using tissue biomarkers for the response to treatment in the setting of multidisciplinary trials must emerge as the new paradigm. In the postgenomic era, treatment decisions should be made based on functional and oncologic parameters-not just to avoid perceived morbidity

  16. 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.

  17. 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

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

    NARCIS (Netherlands)

    Jager-Wittenaar, Harriët; Dijkstra, Pieter; Dijkstra, Gerard; Bijzet, Johan; Langendijk, Johannes A.; van der Laan, Bernard; Roodenburg, Jan

    2017-01-01

    In patients with cancer, weight loss can be related to simple starvation, disturbed metabolism, 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 population,

  19. Stereotactic Body Radiotherapy for Head and Neck Tumors

    Science.gov (United States)

    2016-04-18

    Squamous Cell Carcinoma of the Head and Neck; Nasopharyngeal Carcinoma; Salivary Gland Cancer; Head and Neck Sarcoma; Paraganglioma of Head and Neck; Chordoma of Head and Neck; Chondrosarcoma of Head and Neck; Angiofibroma of Head and Neck

  20. 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

  1. Primary transoral robotic surgery with concurrent neck dissection for early stage oropharyngeal squamous cell carcinoma implemented at a Danish head and neck cancer center

    DEFF Research Database (Denmark)

    Rubek, Niclas; Channir, Hani Ibrahim; Charabi, Birgitte Wittenborg

    2017-01-01

    (RT) with or without concomitant chemotherapy. This is the first study in Scandinavia from a head and neck cancer centre that aims to demonstrate the feasibility of performing primary transoral robotic surgery (TORS) and concurrent neck dissection for patients with early stage OPSCC. Between September...... bilateral neck dissection. Due to an upstaging following surgery, 13 patients were referred to adjuvant therapy. Four of these patients received RT and two patients received concomitant chemo-radiation (CCR) therapy. Seven patients declined the recommended adjuvant therapy one of whom later developed an N......-site recurrence and received salvage surgery with postoperative RT. In summary, 43% of the patients were referred to adjuvant therapy following primary surgery which was mainly due to N-site stage migration and ECE. Primary TORS and concurrent neck dissection is a safe and feasible procedure that may...

  2. Bridging Gaps in Multidisciplinary Head and Neck Cancer Care: Nursing Coordination and Case Management

    International Nuclear Information System (INIS)

    Wiederholt, Peggy A.; Connor, Nadine P.; Hartig, Gregory K.; Harari, Paul M.

    2007-01-01

    Patients with advanced head and neck cancer face not only a life-threatening malignancy, but also a remarkably complex treatment regimen that can affect their cosmetic appearance and ability to speak, breathe, and swallow. These patients benefit from the coordinated interaction of a multidisciplinary team of specialists and a comprehensive plan of care to address their physical and psychosocial concerns, manage treatment-related toxicities, and prevent or limit long-term morbidities affecting health-related quality of life. Although little has been published on patient-provider communication with a multidisciplinary team, evidence has suggested that gaps often occur in communication between patients and providers, as well as between specialists. These communication gaps can hinder the multidisciplinary group from working toward common patient-centered goals in a coordinated 'interdisciplinary' manner. We discuss the role of a head-and-neck oncology nurse coordinator at a single institution in bridging gaps across the continuum of care, promoting an interdisciplinary team approach, and enhancing the overall quality of patient-centered head-and-neck cancer care

  3. A randomized study of accelerated fractionation radiotherapy with and without mitomycin C in the treatment of locally advanced head and neck cancer

    DEFF Research Database (Denmark)

    Ezzat, M.; Shouman, T.; Zaza, K.

    2005-01-01

    Objectives: This single-institution study evaluates the feasibility of accelerated fractionation radiotherapy (AF) with and without mitomycin C (MMC) in the treatment of locally advanced head and neck cancer. Patients and Methods: Between May 1998 and October 2001, sixty patients with locally...... advanced stage III and IV of head and neck cancer were randomized into three treatment arms: (1) conventional fractionation radiotherapy (CF) (5 fractions per week); (2) accelerated fractionation radiotherapy (AF) (6 fractions per week); and (3) AF plus Mitomycin C (MMC). Results: The 2-year overall....... Key Words: Head and Neck cancer , Radiotherapy , Altered fractionation , Mitomycin C....

  4. The role of Human papillomavirus in head and neck cancer and the impact on radiotherapy outcome

    International Nuclear Information System (INIS)

    Lassen, Pernille

    2010-01-01

    The profound influence of Human papillomavirus (HPV) on the epidemiological pattern and clinical course of head and neck cancer (HNSCC) has led to a change in the traditional understanding of this disease entity. Separate therapeutic strategies based on tumour HPV status are under consideration and in this light provision of knowledge concerning the influence of tumour HPV on the radiation response in HNSCC appears highly relevant. This review provides a summary of the current understanding of the role of HPV in head and neck cancer with specific focus on the viral impact on radiotherapy outcome of HNSCC.

  5. Clinical value of sentinel lymph node diagnostics in head and neck cancer

    International Nuclear Information System (INIS)

    Kampen, W.U.; Hoeft, S.; Maune, S.

    2006-01-01

    The concept of the so-called sentinel lymph node (SLN), being the first node draining a malignant tumor and thus carrying the highest risk of metastatic disease, is already frequently applied in patients suffering from malignant melanoma and breast cancer. It is the aim of this concept, to reduce postoperative morbidity by omitting a conventional lymph node dissection if the SLN is proven to be free of any tumor cells. First clinical studies showed promising results also in patients with head and neck cancer. However, both the anatomical localization of the primary tumor and the very complex lymphatic, frequently bilateral drainage pattern may lead to significant methodological problems. Besides a skilful intraoperative usage of the gamma probe, the precise preoperative staging of the respective patient for determination of the N0 status and the assiduous histopathological analysis of the excised SLN are extremely important to reach a maximum of sensitivity in this clinical setting. This paper summarizes the data published on the SLN concept in patients with head and neck cancer, describes the several methodological aspects of labeling the SLN with radiocolloides and reviews the today's impact of the SLN method in clinical routine. (orig.)

  6. Consumption of vegetables and fruits and risk of subtypes of head-neck cancer in the Netherlands Cohort Study

    NARCIS (Netherlands)

    Maasland, D.H.E.; Brandt, P.A. van den; Kremer, B.; Goldbohm, R.A.; Schouten, L.J.

    2015-01-01

    There is limited prospective data on the relationship between consumption of vegetables and fruits and the risk of head-neck cancer (HNC) subtypes [i.e., oral cavity cancer (OCC), oro-/hypopharyngeal cancer (OHPC) and laryngeal cancer (LC)]. Therefore, we investigated these associations within the

  7. A critical evaluation of lymph node ratio in head and neck cancer

    NARCIS (Netherlands)

    de Ridder, M.; Marres, C. C. M.; Smeele, L. E.; van den Brekel, M. W. M.; Hauptmann, M.; Balm, A. J. M.; van Velthuysen, M. L. F.

    2016-01-01

    In head and neck squamous cell carcinoma (HNSCC), the search for better prognostic factors beyond TNM-stage is ongoing. Lymph node ratio (LNR) (positive lymph nodes/total lymph nodes) is gaining interest in view of its potential prognostic significance. All HNSCC patients at the Netherlands Cancer

  8. Use of diffusion-weighted imaging (DWI) in PET/MRI for head and neck cancer evaluation

    International Nuclear Information System (INIS)

    Queiroz, Marcelo A.; Schulthess, Gustav von; Huellner, Martin; Kuhn, Felix; Veit-Haibach, Patrick; Huber, Gerhardt; Meerwein, Christian; Kollias, Spyros

    2014-01-01

    The purpose of this study was to analyze whether diffusion-weighted imaging (DWI) adds significant information to positron emission tomography/magnetic resonance imaging (PET/MRI) on lesion detection and characterization in head and neck cancers. Seventy patients with different head and neck cancers were enrolled in this prospective study. All patients underwent sequential contrast-enhanced (ce) PET/computed tomography (CT) and cePET/MRI using a tri-modality PET/CT-MR setup either for staging or re-staging. First, the DWI alone was evaluated, followed by the PET/MRI with conventional sequences, and in a third step, the PET/MRI with DWI was evaluated. McNemar's test was used to evaluate differences in the accuracy of PET/MRI with and without DWI compared to the standard of reference. One hundred eighty-eight (188) lesions were found, and of those, 118 (62.8 %) were malignant and 70 (37.2 %) were benign. PET/MRI without DWI had a higher accuracy in detecting malignant lesions than DWI alone (86.8 % vs. 60.6 %, p < 0.001). PET/MRI combined with DWI detected 120 concurrent lesions (89 malignant and 31 benign), PET/MRI alone identified 48 additional lesions (20 malignant and 28 benign), and DWI alone detected 20 different lesions (nine malignant and 11 benign). However, lesions detected on DWI did not change overall staging. SUV maximum and mean were significantly higher in malignant lesions than in benign lesions. DWI parameters between malignant and benign lesions were not statistically different. The use of DWI as part of PET/MRI to evaluate head and neck cancers does not provide remarkable information. Thus, the use of DWI might not be needed in clinical PET/MRI protocols for the staging or restaging of head and neck cancers. (orig.)

  9. 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.

  10. 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

  11. Quality of life of head and neck cancer patients in urban and regional areas: An Australian perspective.

    Science.gov (United States)

    Pateman, Kelsey A; Cockburn, Nicole L; Batstone, Martin D; Ford, Pauline J

    2018-06-01

    Head and neck cancer treatment affects quality of life. There are differences in quality of life outcomes and perceived supportive care needs between cancer patients living in metropolitan and regional-remote areas. This study investigated quality of life over the first 6 months following head and neck cancer diagnosis and observed differences in quality of life by geographical location. Prospective observational study. Tertiary hospital in Brisbane, Australia. Newly diagnosed patients who were referred for the diagnosis, and/or treatment of head and neck cancer. Quality of life was measured by the University of Washington Quality of Life Survey, version 4 (UW-QoL). Participants completed the UW-QoL questionnaire prior to starting treatment, 1 month and 6 months post treatment. Metropolitan and regional or remote status was classified according to the Australian Standard Geographic Classification-Remoteness Area system. Ninety-five participants were included at baseline; 49 and 41 participants completed the 1-month and 6-month follow-ups, respectively. Scores in most UW-QoL domains decreased between baseline and 1 month post treatment and increased towards pre-treatment scores at the 6-month follow-up (except for anxiety and saliva). Pain at baseline was significantly worse in the regional-remote participants compared with metropolitan participants. No other statistically significant differences in UW-QoL score by geographical location were observed. The findings generally did not support significant differences in quality of life outcome between metropolitan and regional-remote head and neck cancer patients. The difference in pain experience between metropolitan and regional-remote groups requires further investigation. © 2018 National Rural Health Alliance Ltd.

  12. TCGA head Neck

    Science.gov (United States)

    Investigators with The Cancer Genome Atlas (TCGA) Research Network have discovered genomic differences – with potentially important clinical implications – in head and neck cancers caused by infection with the human papillomavirus (HPV).

  13. Radiation-induced cancers of the head and neck, (3)

    International Nuclear Information System (INIS)

    Umatani, Katsunori; Satoh, Takeo; Yoshino, Kunitoshi; Takagi, Tadashi; Fujii, Takashi; Hatta, Chihiro; Maetani, Chikahide; Lu, Bo

    1989-01-01

    This paper discusses twenty patients with radiation-induced cancers of the head and neck treated in the Department of Otorhinolaryngology, the Center for Adult Diseases, Osaka, from January 1979 to December 1985. The most common site of radiation-induced cancers was the hypopharynx and cervical esophagus (70%). We found synchronous double cancers in 2 out of the 20 patients (10%). One patient had hypopharyngeal cancer and thyroid cancer, and the other had oropharyngeal cancer and thyroid cancer. All of the laryngeal cancers were in the supraglottic area. Cancer of the hypopharynx and cervical esophagus occurred more frequently in females (1:3.7 males-females ratio). Half of the patients (10/20) had received irradiation for tuberculous cervical adenitis and 8 patients had been irradiated for malignant tumors. The averaged latent period in the patients who had irradiated for benign conditions was 37.4 years, and that for malignant diseases was 16.0 years. Therefore the latent period of the former was 2.3 times as long as that of the latter. The incidence of radiation-induced cancers in all the patients who had the cancer of the hypopharynx and cervical esophagus was 9% and that of the laryngeal cancer was 0.7%. The incidence of radiation-induced cancers in the hypopharynx and cervical esophagus remarkably differed from that in the larynx. However, it was suggested that the larynx was as resistant to radiation induction as the hypopharynx. Six of the 20 patients (30%) had radiation-induced thyroid tumors. Among them, the incidence of cancers was 33%. (author)

  14. The effect of Mepitel Film on acute radiation-induced skin reactions in head and neck cancer patients: a feasibility study.

    Science.gov (United States)

    Wooding, Hayley; Yan, Jing; Yuan, Ling; Chyou, Te-Yu; Gao, Shanbao; Ward, Iain; Herst, Patries M

    2018-01-01

    Mepitel Film significantly decreases acute radiation-induced skin reactions in breast cancer patients. Here we investigated the feasibility of using Mepitel Film in head and neck cancer patients (ACTRN12614000932662). Out of a total of 36 head and neck cancer patients from New Zealand (NZ) (n = 24) and China (n = 12) recruited between June 2015 and December 2016, 33 patients complied with protocol. Of these, 11 NZ patients followed a management protocol; 11 NZ patients and 11 Chinese patients followed a prophylactic protocol. An area of the neck receiving a homogenous radiation dose of > 35 Gy was divided into two equal halves; one half was randomized to Film and the other to either Sorbolene cream (NZ) or Biafine cream (China). Skin reaction severity was measured by Radiation Induced Skin Reaction Assessment Scale and expanded Radiation Therapy Oncology Group toxicity criteria. Skin dose was measured by thermoluminescent dosimeters or gafchromic film. Film decreased overall skin reaction severity (combined Radiation Induced Skin Reaction Assessment Scale score) by 29% and moist desquamation rates by 37% in the Chinese cohort and by 27 and 28%, respectively in the NZ cohort. Mepitel Film did not affect head movements but did not adhere well to the skin, particularly in males with heavy beard stubble, and caused itchiness, particularly in Chinese patients. Mepitel Film reduced acute radiation-induced skin reactions in our head and neck cancer patients, particularly in patients without heavy stubble. Advances in knowledge: This is the first study to confirm the feasibility of using Mepitel Film in head and neck cancer patients.

  15. 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 tobacco and alcohol. Distinct molecular profiles separate them from HPV-negative cancers and show similarities with HPV-positive cervical SCC. There is evidence that HPV-positive HNSCC is a sexually transmitted disease. Patients with HPV-positive HNSCC are often diagnosed at a late stage with large cystic......-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....

  16. 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.

  17. Prevalence and risk factors of depressive disorder in caregivers of patients with head and neck cancer.

    Science.gov (United States)

    Lee, Yu; Lin, Pao-Yen; Chien, Chih-Yen; Fang, Fu-Min

    2015-02-01

    The purpose of this study is to examine the prevalence and risk factors of depressive disorder in caregivers of patients with head and neck cancer. Study subjects were recruited from a multidisciplinary outpatient clinic for head and neck cancer in a medical center from February to July 2012. Caregivers of patients with head and neck cancer were enrolled and assessed using the Structured Clinical Interview for the DSM-IV, Clinician Version, the Short Form 36 Health Survey, and the Family APGAR index. The main aim of the study was to examine the difference in demographic data and clinical characteristics between the caregivers with and without depressive disorders. In addition, a stepwise forward model of logistic regression was used to test the possible risk factors. One hundred and forty-three caregivers were included in the study. The most prevalent psychiatric disorder was depressive disorder (14.7%), followed by adjustment disorder (13.3%). Nearly one-third of the caregivers had a psychiatric diagnosis. By using logistic regression analysis, it was found that unemployment (odds ratio (OR) = 3.16; 95% CI, 1.04-9.68), lower social functioning (OR = 1.43; 95% CI, 1.18-1.72), and lower educational level (OR = 1.16; 95% CI, 1.01-1.34) were significant risk factors for the depressive disorder. The clinical implication of our results is the value of using the standardized structured interview for early diagnosis of depressive disorder in caregivers of head and neck cancer patients. Early screening and management of depression in these caregivers will raise their quality of life and capability to care patients. Copyright © 2014 John Wiley & Sons, Ltd.

  18. 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

  19. Development and preliminary evaluation of a rehabilitation consult for survivors of head and neck cancer: an intervention mapping protocol.

    Science.gov (United States)

    McEwen, Sara E; Davis, Aileen M; Jones, Jennifer M; Martino, Rosemary; Poon, Ian; Rodriguez, Ana Maria; Ringash, Jolie

    2015-01-09

    Evidence suggests that rehabilitation interventions can improve function and quality of life in survivors of head and neck cancer (HNC), but there is a lack of coordinated, integrated services, and those offered are inconsistent. To address these gaps, we will develop and conduct preliminary evaluation of a rehabilitation consult, built on the theoretical foundations of goal setting and self-management, and composed of a brief functional evaluation, a resource compendium, and collaborative goal-setting and action planning processes. The development of the rehabilitation consult will be guided by intervention mapping, which consists of six steps: 1. Needs assessment; 2. Definition of program objectives; 3. Selection of theory-based intervention methods; 4. Production and pretesting; 5. Adoption, implementation and sustainability planning; 6. Process and effect evaluation. Within the intervention mapping framework, an iterative process of constructing drafts and mini-evaluations with consumers and experts will be used, modifying the rehabilitation consult intervention until a version suitable for formal evaluation is established. The rehabilitation consult will then be evaluated using a prospective, mixed method, single group design with 30 survivors of head and neck cancer. Outcomes will be assessed pre- and post-intervention and at 6-month follow-up. Survivors of head and neck cancer have among the most complex rehabilitation needs of all cancer patients. The rehabilitation consult is expected to improve knowledge and uptake of rehabilitation resources and strategies in survivors of head and neck cancer and thereby improve long-term function and quality of life. If the rehabilitation consult is effective in cancer patients with such high and diverse needs, this project will produce a toolkit that will be adaptable for other types of cancer in other jurisdictions.

  20. 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.

  1. Uroporphyrinogen decarboxylase is a radiosensitizing target for head and neck cancer.

    Science.gov (United States)

    Ito, Emma; Yue, Shijun; Moriyama, Eduardo H; Hui, Angela B; Kim, Inki; Shi, Wei; Alajez, Nehad M; Bhogal, Nirmal; Li, Guohua; Datti, Alessandro; Schimmer, Aaron D; Wilson, Brian C; Liu, Peter P; Durocher, Daniel; Neel, Benjamin G; O'Sullivan, Brian; Cummings, Bernard; Bristow, Rob; Wrana, Jeff; Liu, Fei-Fei

    2011-01-26

    Head and neck cancer (HNC) is the eighth most common malignancy worldwide, comprising a diverse group of cancers affecting the head and neck region. Despite advances in therapeutic options over the last few decades, treatment toxicities and overall clinical outcomes have remained disappointing, thereby underscoring a need to develop novel therapeutic approaches in HNC treatment. Uroporphyrinogen decarboxylase (UROD), a key regulator of heme biosynthesis, was identified from an RNA interference-based high-throughput screen as a tumor-selective radiosensitizing target for HNC. UROD knockdown plus radiation induced caspase-mediated apoptosis and cell cycle arrest in HNC cells in vitro and suppressed the in vivo tumor-forming capacity of HNC cells, as well as delayed the growth of established tumor xenografts in mice. This radiosensitization appeared to be mediated by alterations in iron homeostasis and increased production of reactive oxygen species, resulting in enhanced tumor oxidative stress. Moreover, UROD was significantly overexpressed in HNC patient biopsies. Lower preradiation UROD mRNA expression correlated with improved disease-free survival, suggesting that UROD could potentially be used to predict radiation response. UROD down-regulation also radiosensitized several different models of human cancer, as well as sensitized tumors to chemotherapeutic agents, including 5-fluorouracil, cisplatin, and paclitaxel. Thus, our study has revealed UROD as a potent tumor-selective sensitizer for both radiation and chemotherapy, with potential relevance to many human malignancies.

  2. 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,.

  3. 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...

  4. CT-guided iodine-125 seed permanent implantation for recurrent head and neck cancers

    Energy Technology Data Exchange (ETDEWEB)

    Jiang, Yu L; Meng, Na; Wang, Jun J; Jiang, Ping [Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191 (China); Yuan, Hui SH; Liu, Chen [Department of Radiology, Peking University Third Hospital, Beijing, 100191 (China); Qu, Ang; Yang, Rui J [Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191 (China)

    2010-07-30

    To investigate the feasibility, and safety of {sup 125}I seed permanent implantation for recurrent head and neck carcinoma under CT-guidance. A retrospective study on 14 patients with recurrent head and neck cancers undergone {sup 125}I seed implantation with different seed activities. The post-plan showed that the actuarial D90 of {sup 125}I seeds ranged from 90 to 218 Gy (median, 157.5 Gy). The follow-up was 3 to 60 months (median, 13 months). The median local control was 18 months (95% CI, 6.1-29.9 months), and the 1-, 2-, 3-, and 5- year local controls were 52%, 39%, 39%, and 39%, respectively. The 1-, 2-, 3-, and 5- survival rates were 65%, 39%, 39% and 39%, respectively, with a median survival time of 20 months (95% CI, 8.7-31.3 months). Of all patients, 28.6% (4/14) died of local recurrence, 7.1% (1/14) died of metastases, one patient died of hepatocirrhosis, and 8 patients are still alive to the date of data analysis. CT-guided {sup 125}I seed implantation is feasible and safe as a salvage or palliative treatment for patients with recurrent head and neck cancers.

  5. An opioid-based pain control program for head and neck cancer patients undergoing chemoradiation therapy achieves a high completion rate of radiation

    International Nuclear Information System (INIS)

    Kato, Kengo; Matsuura, Kazuto; Zenda, Sadamoto

    2011-01-01

    Appropriate supportive care is essential for intensive chemoradiation therapy (CRT), and pain management is an important supportive care for CRT for head and neck cancer. We developed an opioid-based pain control program for head and neck cancer patients undergoing CRT, and assessed its efficacy and safety. 110 head and neck cancer patients undergoing platinum-based concomitant CRT were enrolled from 10 cancer centers or university hospitals. Their pain caused by CRT was managed with a four-step opioid-based pain control program, and adverse events and usage of opioid were analyzed. 101 suitable cases of 110 patients were analyzed. 53% of cases suffered grade 3-4 mucositis. The rate of completion of radiotherapy was 99% and the rate of unplanned breaks in radiotherapy was 13%. The usage rate of opioid was 83% and the rate of compliance with the pain control program was 92%. The median maximum quantity of morphine used per day was 35 mg. No patient had to stop the opioid program or radiotherapy due to adverse effects of opioids. An opioid-based pain control program for head and neck cancer patients undergoing CRT achieves a high completion rate of radiation. (author)

  6. Impact of Pretreatment Body Mass Index on Patients With Head-and-Neck Cancer Treated With Radiation

    International Nuclear Information System (INIS)

    Pai, Ping-Ching; Chuang, Chi-Cheng; Tseng, Chen-Kan; Tsang, Ngan-Ming; Chang, Kai-Ping; Yen, Tzu-Chen; Liao, Chun-Ta; Hong, Ji-Hong; Chang, Joseph Tung-Chieh

    2012-01-01

    Purpose: To investigate the association of pretreatment body mass index (preT BMI) with outcomes of head-and-neck cancer in patients treated with radiotherapy (RT). Methods and Materials: All 1,562 patients diagnosed with head-and-neck cancer and treated with curative-intent RT to a dose of 60 Gy or higher were retrospectively studied. Body weight was measured both at entry and at the end of RT. Cancer-specific survival (CSS), overall survival (OS), locoregional control (LRC), and distant metastasis (DM) were analyzed by preT BMI ( 2 vs. ≥25 kg/m 2 ). The median follow-up was 8.6 years. Results: Patients with lower preT BMI were statistically significantly associated with poorer CSS and OS than those with higher preT BMI. There was no significant difference between preT BMI groups in terms of LRC and DM. Body weight loss (BWL) during radiation did not influence survival outcomes. However, in the group with higher preT BMI, CSS, OS, and DM-free survival of patients with less BWL during radiation were statistically longer when compared with greater BWL. Conclusion: This study demonstrates that higher preT BMI positively influenced survival outcomes for patients with head-and-neck cancer. Patients with higher preT BMI who were able to maintain their weight during radiation had significantly better survival than patients with greater BWL.

  7. 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.

  8. Overexpression of EMMPRIN Isoform 2 Is Associated with Head and Neck Cancer Metastasis

    OpenAIRE

    Huang, Zhiquan; Tan, Ning; Guo, Weijie; Wang, Lili; Li, Haigang; Zhang, Tianyu; Liu, Xiaojia; Xu, Qin; Li, Jinsong; Guo, Zhongmin

    2014-01-01

    Extracellular matrix metalloproteinase inducer (EMMPRIN), a plasma membrane protein of the immunoglobulin (Ig) superfamily, has been reported to promote cancer cell invasion and metastasis in several human malignancies. However, the roles of the different EMMPRIN isoforms and their associated mechanisms in head and neck cancer progression remain unknown. Using quantitative real-time PCR, we found that EMMPRIN isoform 2 (EMMPRIN-2) was the only isoform that was overexpressed in both head and n...

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

    Science.gov (United States)

    Chen, Allen M; Cao, Minsong; Hsu, Sophia; Lamb, James; Mikaeilian, Argin; Yang, Yingli; Agazaryan, Nzhde; Low, Daniel A; Steinberg, Michael L

    2017-01-01

    To report a single-institutional experience using magnetic resonance imaging (MRI) guided radiation therapy for the reirradiation of recurrent and second cancers of the head and neck. Between October 2014 and August 2016, 13 consecutive patients with recurrent or new primary cancers of the head and neck that occurred in a previously irradiated field were prospectively enrolled in an institutional registry trial to investigate the feasibility and efficacy of MRI guided radiation therapy using a 0.35-T MRI scanner with a cobalt-60 radiation therapy source called the ViewRay system (ViewRay Inc., Cleveland, OH). Eligibility criteria included biopsy-proven evidence of recurrent or new primary squamous cell carcinoma of the head and neck, measurable disease, and previous radiation to >60 Gy. MRI guided reirradiation was delivered either using intensity modulated radiation therapy with conventional fractionation to a median dose of 66 Gy or stereotactic body radiation therapy (SBRT) using 7 to 8 Gy fractions on nonconsecutive days to a median dose of 40 Gy. Two patients (17%) received concurrent chemotherapy. The 1- and 2-year estimates of in-field control were 72% and 72%, respectively. A total of 227 daily MRI scans were obtained to guide reirradiation. The 2-year estimates of overall survival and progression-free survival were 53% and 59%, respectively. There were no treatment-related fatalities or hospitalizations. Complications included skin desquamation, odynophagia, otitis externa, keratitis and/or conjunctivitis, and 1 case of aspiration pneumonia. 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.

  10. 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)

  11. 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

  12. International Cancer of the Head and Neck, Genetics and Environment (InterCHANGE) Study

    Science.gov (United States)

    2013-10-29

    Evaluate the Association Between Certain Environmental Exposures (e.g. Cigarette Smoking, Alcohol Drinking, Betel Nut Chewing…) and Head and Neck Cancers; Assess the Effect of Genetic Factors, Including Both SNP and Copy Number Variation (CNV) Through Analysis of Both Main Effect and Gene-gene Interaction

  13. A Phase 1 Study of Everolimus + Weekly Cisplatin + Intensity Modulated Radiation Therapy in Head-and-Neck Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Fury, Matthew G. [Department of Medicine, Head and Neck Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Department of Medicine, Weill Cornell Medical College, New York, New York (United States); Lee, Nancy Y. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Sherman, Eric; Ho, Alan L. [Department of Medicine, Head and Neck Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Department of Medicine, Weill Cornell Medical College, New York, New York (United States); Rao, Shyam [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Heguy, Adriana [Department of Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Shen, Ronglai [Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Korte, Susan; Lisa, Donna [Department of Medicine, Head and Neck Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Ganly, Ian; Patel, Snehal; Wong, Richard J.; Shaha, Ashok; Shah, Jatin [Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Haque, Sofia [Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Katabi, Nora [Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Pfister, David G. [Department of Medicine, Head and Neck Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Department of Medicine, Weill Cornell Medical College, New York, New York (United States)

    2013-11-01

    Purpose: Elevated expression of eukaryotic protein synthesis initiation factor 4E (eIF4E) in histologically cancer-free margins of resected head and neck squamous cell carcinomas (HNSCCs) is mediated by mammalian target of rapamycin complex 1 (mTORC1) and has been associated with increased risk of disease recurrence. Preclinically, inhibition of mTORC1 with everolimus sensitizes cancer cells to cisplatin and radiation. Methods and Materials: This was single-institution phase 1 study to establish the maximum tolerated dose of daily everolimus given with fixed dose cisplatin (30 mg/m{sup 2} weekly × 6) and concurrent intensity modulated radiation therapy for patients with locally and/or regionally advanced head-and-neck cancer. The study had a standard 3 + 3 dose-escalation design. Results: Tumor primary sites were oral cavity (4), salivary gland (4), oropharynx (2), nasopharynx (1), scalp (1), and neck node with occult primary (1). In 4 of 4 cases in which resected HNSCC surgical pathology specimens were available for immunohistochemistry, elevated expression of eIF4E was observed in the cancer-free margins. The most common grade ≥3 treatment-related adverse event was lymphopenia (92%), and dose-limiting toxicities (DLTs) were mucositis (n=2) and failure to thrive (n=1). With a median follow up of 19.4 months, 2 patients have experienced recurrent disease. The maximum tolerated dose was everolimus 5 mg/day. Conclusions: Head-and-neck cancer patients tolerated everolimus at therapeutic doses (5 mg/day) given with weekly cisplatin and intensity modulated radiation therapy. The regimen merits further evaluation, especially among patients who are status post resection of HNSCCs that harbor mTORC1-mediated activation of eIF4E in histologically negative surgical margins.

  14. A Phase 1 Study of Everolimus + Weekly Cisplatin + Intensity Modulated Radiation Therapy in Head-and-Neck Cancer

    International Nuclear Information System (INIS)

    Fury, Matthew G.; Lee, Nancy Y.; Sherman, Eric; Ho, Alan L.; Rao, Shyam; Heguy, Adriana; Shen, Ronglai; Korte, Susan; Lisa, Donna; Ganly, Ian; Patel, Snehal; Wong, Richard J.; Shaha, Ashok; Shah, Jatin; Haque, Sofia; Katabi, Nora; Pfister, David G.

    2013-01-01

    Purpose: Elevated expression of eukaryotic protein synthesis initiation factor 4E (eIF4E) in histologically cancer-free margins of resected head and neck squamous cell carcinomas (HNSCCs) is mediated by mammalian target of rapamycin complex 1 (mTORC1) and has been associated with increased risk of disease recurrence. Preclinically, inhibition of mTORC1 with everolimus sensitizes cancer cells to cisplatin and radiation. Methods and Materials: This was single-institution phase 1 study to establish the maximum tolerated dose of daily everolimus given with fixed dose cisplatin (30 mg/m 2 weekly × 6) and concurrent intensity modulated radiation therapy for patients with locally and/or regionally advanced head-and-neck cancer. The study had a standard 3 + 3 dose-escalation design. Results: Tumor primary sites were oral cavity (4), salivary gland (4), oropharynx (2), nasopharynx (1), scalp (1), and neck node with occult primary (1). In 4 of 4 cases in which resected HNSCC surgical pathology specimens were available for immunohistochemistry, elevated expression of eIF4E was observed in the cancer-free margins. The most common grade ≥3 treatment-related adverse event was lymphopenia (92%), and dose-limiting toxicities (DLTs) were mucositis (n=2) and failure to thrive (n=1). With a median follow up of 19.4 months, 2 patients have experienced recurrent disease. The maximum tolerated dose was everolimus 5 mg/day. Conclusions: Head-and-neck cancer patients tolerated everolimus at therapeutic doses (5 mg/day) given with weekly cisplatin and intensity modulated radiation therapy. The regimen merits further evaluation, especially among patients who are status post resection of HNSCCs that harbor mTORC1-mediated activation of eIF4E in histologically negative surgical margins

  15. 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.

  16. Genome Stability Pathways in Head and Neck Cancers

    Science.gov (United States)

    O'Byrne, Kenneth J.; Panizza, Benedict; Richard, Derek J.

    2013-01-01

    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. PMID:24364026

  17. 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.

  18. Measured adiposity in relation to head and neck cancer risk in the European prospective investigation into cancer and nutrition

    NARCIS (Netherlands)

    Ward, Heather A.; Wark, Petra A.; Muller, David C.; Steffen, Annika; Johansson, Mattias; Norat, Teresa; Gunter, Marc J.; Overvad, Kim; Dahm, Christina C.; Halkjær, Jytte; Tjønneland, Anne; Boutron-Ruault, Marie Christine; Fagherazzi, Guy; Mesrine, Sylvie; Brennan, Paul; Freisling, Heinz; Li, Kuanrong; Kaaks, Rudolf; Trichopoulou, Antonia; Lagiou, Pagona; Panico, Salavatore; Grioni, Sara; Tumino, Rosario; Vineis, Paolo; Palli, Domenico; Peeters, Petra H.M.; Bueno-De-Mesquita, H. Bas; Weiderpass, Elisabete; Agudo, Antonio; Quiros, Jose Ramon; Larranaga, Nerea; Ardanaz, Eva; Huerta, Jose María; Sanchez, María Jose; Laurell, Goran; Johansson, Ingegerd; Westin, Ulla; Wallstrom, Peter; Bradbury, Kathryn E.; Wareham, Nicholas J.; Khaw, Kay Tee; Pearson, Clare; Boeing, Heiner; Riboli, Elio

    2017-01-01

    Background: Emerging evidence from cohort studies indicates that adiposity is associated with greater incidence of head and neck cancer. However, most studies have used self-reported anthropometry which is prone to error. Methods: Among 363,094 participants in the European Prospective Investigation

  19. Measured Adiposity in Relation to Head and Neck Cancer Risk in the European Prospective Investigation into Cancer and Nutrition.

    NARCIS (Netherlands)

    Ward, Heather A; Wark, Petra A; Muller, David C; Steffen, Annika; Johansson, Mattias; Norat, Teresa; Gunter, Marc J; Overvad, Kim; Dahm, Christina C; Halkjær, Jytte; Tjønneland, Anne; Boutron-Ruault, Marie-Christine; Fagherazzi, Guy; Mesrine, Sylvie; Brennan, Paul; Freisling, Heinz; Li, Kuanrong; Kaaks, Rudolf; Trichopoulou, Antonia; Lagiou, Pagona; Panico, Salavatore; Grioni, Sara; Tumino, Rosario; Vineis, Paolo; Palli, Domenico; Peeters, Petra H M; Bueno-de-Mesquita, H Bas; Weiderpass, Elisabete; Agudo, Antonio; Quirós, Jose Ramón; Larrañaga, Nerea; Ardanaz, Eva; Huerta, José María; Sánchez, María-José; Laurell, Göran; Johansson, Ingegerd; Westin, Ulla; Wallström, Peter; Bradbury, Kathryn E; Wareham, Nicholas J; Khaw, Kay-Tee; Pearson, Clare; Boeing, Heiner; Riboli, Elio

    Background: Emerging evidence from cohort studies indicates that adiposity is associated with greater incidence of head and neck cancer. However, most studies have used self-reported anthropometry which is prone to error.Methods: Among 363,094 participants in the European Prospective Investigation

  20. Head and neck cancers. Generalities and potential positron emission tomography with 18Flurodesoxyglucose indications

    International Nuclear Information System (INIS)

    Carpentier, Ph.; Gauthier, H.; Lefebvre, J.L.

    2003-01-01

    Head and neck cancers occur in patients after a long history of tobacco consumption and alcohol abuse. They are diagnosed most often at advanced stages, carry both a local and nodal aggressiveness with a notable risk of distant metastases. They are frequently associated to synchronous or metachronous cancers of the same origin (head and neck, esophagus, lung). They often require combined and heavy therapies. The post-therapeutic follow up may be difficult. If morphologic imaging is mandatory for an appropriate decision making, there is an emerging role for PET at various times of the patients' care (initial work up, treatment planning and follow-up) despite possible physiologic uptake in this area. PET may be of interest for diagnosis, metastatic lymph node from an unknown primary, assessment of response to treatment and follow up as well as radiotherapy targeting. (author)

  1. Head and neck cancer: metronomic chemotherapy

    International Nuclear Information System (INIS)

    De Felice, Francesca; Musio, Daniela; Tombolini, Vincenzo

    2015-01-01

    In the era of personalized medicine, head and neck squamous cell carcinoma (HNSCC) represents a critical oncologic topic. Conventional chemotherapy regimens consist of drugs administration in cycles near or at the maximum tolerated dose (MDT), followed by a long drug-free period to permit the patient to recover from acute toxicities. Despite this strategy is successful in controlling the cancer process at the beginning, a significant number of HNSCC patients tend to recurred or progress, especially those patients with locally advanced or metastatic disease. The repertoire of drugs directed against tumor cells has greatly increased and metronomic chemotherapy (MC) could be an effective treatment option. It is the purpose of this article to review the concept of MC and describe its potential use in HNSCC. We provide an update of ongoing progress and current challenges related to this issue

  2. 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

  3. Transoral robotic surgery in head and neck cancer.

    Science.gov (United States)

    Hans, S; Delas, B; Gorphe, P; Ménard, M; Brasnu, D

    2012-02-01

    Robots have invaded industry and, more recently, the field of medicine. Following the development of various prototypes, Intuitive Surgical® has developed the Da Vinci surgical robot. This robot, designed for abdominal surgery, has been widely used in urology since 2000. The many advantages of this transoral robotic surgery (TORS) are described in this article. Its disadvantages are essentially its high cost and the absence of tactile feedback. The first feasibility studies in head and neck cancer, conducted in animals, dummies and cadavers, were performed in 2005, followed by the first publications in patients in 2006. The first series including more than 20 patients treated by TORS demonstrated the feasibility for the following sites: oropharynx, supraglottic larynx and hypopharynx. However, these studies did not validate the oncological results of the TORS technique. TORS decreases the number of tracheotomies, and allows more rapid swallowing rehabilitation and a shorter length of hospital stay. Technical improvements are expected. Smaller, more ergonomic, new generation robots, therefore more adapted to the head and neck, will probably be available in the future. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  4. Identification of genomic copy number variations associated with specific clinical features of head and neck cancer.

    Science.gov (United States)

    Zagradišnik, Boris; Krgović, Danijela; Herodež, Špela Stangler; Zagorac, Andreja; Ćižmarević, Bogdan; Vokač, Nadja Kokalj

    2018-01-01

    Copy number variations (CNSs) of large genomic regions are an important mechanism implicated in the development of head and neck cancer, however, for most changes their exact role is not well understood. The aim of this study was to find possible associations between gains/losses of genomic regions and clinically distinct subgroups of head and neck cancer patients. Array comparative genomic hybridization (aCGH) analysis was performed on DNA samples in 64 patients with cancer in oral cavity, oropharynx or hypopharynx. Overlapping genomic regions created from gains and losses were used for statistical analysis. Following regions were overrepresented: in tumors with stage I or II a gain of 2.98 Mb on 6p21.2-p11 and a gain of 7.4 Mb on 8q11.1-q11.23; in tumors with grade I histology a gain of 1.1 Mb on 8q24.13, a loss of a large part of p arm of chromosome 3, a loss of a 1.24 Mb on 6q14.3, and a loss of terminal 32 Mb region of 8p23.3; in cases with affected lymph nodes a gain of 0.75 Mb on 3q24, and a gain of 0.9 Mb on 3q26.32-q26.33; in cases with unaffected lymph nodes a gain of 1.1 Mb on 8q23.3, in patients not treated with surgery a gain of 12.2 Mb on 7q21.3-q22.3 and a gain of 0.33 Mb on 20q11.22. Our study identified several genomic regions of interest which appear to be associated with various clinically distinct subgroups of head and neck cancer. They represent a potentially important source of biomarkers useful for the clinical management of head and neck cancer. In particular, the PIK3CA and AGTR1 genes could be singled out to predict the lymph node involvement.

  5. 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

    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......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...

  6. Comparison of FDG PET and CT/MRI in the diagnosis of cervical lymph node metastasis of head and neck cancer: a level-by-level based study

    International Nuclear Information System (INIS)

    Yang, You Jung; Kim, J. S.; Kim, S. Y.; Nam, S. Y.; Lee, W. W.; Ryu, J. S.; Yeo, J. S.; Moon, D. H.

    2002-01-01

    We compared diagnostic accuracy of FDG PET and CT/MRI for regional lymph node metastasis of head and neck cancer according to the level of cervical lymph node. Thirty-two patients (M/F=27/5, 56±10yr) with head and neck cancer (glottic cancer; 16, tongue cancer; 9, others; 7) uncerwent FDG PET and CT/MRI (29/3) within 1 month before elective surgery with neck dissection (bilateral in 21, unilateral in 11). Whole body and additional regional neck images were acquired 1 hr after injection of FDG (555 MBq). PET images were visually interpreted according to the cervical lymph node level by 2 nuclear physicians independently without CT/MRI information. The findings of PET and CT/MRI were confirmed by the surgical pathology(153 levels of 43 neck dissections). There were 32 positive levels and 121 negative levels for metastatic lymph node lesions in pathology. The diagnostic sensitivity of PET [88%(28/32)] was significantly higher than that of CT/MRI [63%(20/32)] (p=0.021), whereas the specificity of PET [93%(113/121)] was similar to that of CT/MRI [92%(111/121)] (p>0.05). FDG PET was more sensitive than conventional CT/MRI in detecting metastatic lymph node of head and neck cancer

  7. 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...... of the dysphagia outcomes during and after treatment. Adherence to exercises was poor and dropouts due to especially fatigue were very frequent in both groups. Systematic swallowing exercises had no impact on swallowing outcomes within the first year after RT. Despite repeated supervised sessions, adherence...

  8. NRS-2002 for pre-treatment nutritional risk screening and nutritional status assessment in head and neck cancer patients.

    Science.gov (United States)

    Orell-Kotikangas, Helena; Österlund, Pia; Saarilahti, Kauko; Ravasco, Paula; Schwab, Ursula; Mäkitie, Antti A

    2015-06-01

    The aim of this study was to assess the value of nutritional risk screening-2002 (NRS-2002) as a nutritional risk screening and status assessment method and to compare it with nutritional status assessed by subjective and objective methods in the screening of head and neck cancer patients. Sixty-five consecutive patients (50 male), with a median age of 61 years (range, 33-77), with head and neck squamous cell carcinoma (HNSCC) were enrolled prior to cancer therapy. Nutritional status was assessed by NRS-2002, patient-generated subjective global assessment (PG-SGA), handgrip strength (HGS) and mid-arm muscle area (MAMA). Twenty-eight percent of patients were at nutritional risk based on NRS-2002, and 34 % were malnourished according to PG-SGA, while 43 % had low HGS. NRS-2002 cut-off score of ≥3 compared with the nutritional status according to PG-SGA showed 77 % specificity and 98 % sensitivity (K = 0.78). NRS-2002 was able to predict malnutrition (PG-SGA BC) both in men (p nutrition screening in head and neck cancer patients prior to oncological treatment.

  9. 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

  10. Retrospective study of 48 cases of post-operative radiotherapy for head and neck cancer

    International Nuclear Information System (INIS)

    Mnejja, W.; Yahiaoui, S.; Siala, W.; Daoud, J.; Ghorbel, A.; Frikha, M.

    2011-01-01

    The authors report a study which aimed at assessing therapeutic results after post-operative radiotherapy of 48 patients suffering from head and neck cancers. The analysis is made in terms of cancer control, survival without recurrence and global survival. The post-operative radiotherapy improves the disease control rate. Ganglionary attack and capsular failure are survival prognosis factors. The concomitant association of chemo-therapy and radiotherapy should improve therapeutic results. Short communication

  11. Modern molecular biomarkers of head and neck cancer. Part I. Epigenetic diagnostics and prognostics: Systematic review.

    Science.gov (United States)

    Juodzbalys, Gintaras; Kasradze, David; Cicciù, Marco; Sudeikis, Aurimas; Banys, Laurynas; Galindo-Moreno, Pablo; Guobis, Zygimantas

    2016-01-01

    Nearly half of the head and neck cancer cases are diagnosed in late stages. Traditional screening modalities have many disadvantages. The aim of the present article was to review the scientific literature about novel head and neck cancer diagnostics - epigenetic biomarkers. A comprehensive review of the current literature was conducted according to the PRISMA guidelines by accessing the NCBI PubMed database. Authors conducted the search of articles in English language published from 2004 to 2015. A total of thirty three relevant studies were included in the review. Fifteen of them concerned DNA methylation alterations, nine evaluation of abundancies in histone expressions and nine miRNA expression changes in HNC. Considerable number of epigenetic biomarkers have been identified in both tumor tissue and salivary samples. Genes with best diagnostic effectiveness rates and further studying prospects were: TIMP3, DCC, DAPK, CDH1, CCNA1, AIM1, MGMT, HIC1, PAX1, PAX5, ZIC4, p16, EDNRB, KIF1A, MINT31, CD44, RARβ , ECAD. Individual histone and miRNA alterations tend to be hnc specific. Prognostic values of separate biomarkers are ambiguous. No established standards for molecular assay of head and neck cancer was found in order to elude the paradoxical results and discrepancies in separate trials.

  12. Conservative neck dissection in oral cancer patients: A 5 years retrospective study

    Directory of Open Access Journals (Sweden)

    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. Topographic Pattern Distribution of Head And Neck Squamous Cell ...

    African Journals Online (AJOL)

    FINEPRINT

    value of 71% of SCC in Turkey. Nevertheless a similar report documented a relatively lower value especially in. Yemen where head and neck SCC constituted only 8% of all head and neck cancers. Reports from Yemen revealed that oral cavity SCC was the most common topographic site of all head and. 3 neck cancers.

  14. Endovascular Management of Patients with Head and Neck Cancers Presenting with Acute Hemorrhage: A Single-Center Retrospective Study

    Energy Technology Data Exchange (ETDEWEB)

    Vilas Boas, P. P.; Castro-Afonso, L. H. de; Monsignore, L. M.; Nakiri, G. S. [University of São Paulo, Division of Interventional Neuroradiology, Ribeirão Preto Medical School (Brazil); Mello-Filho, F. V. de [University of São Paulo, Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School (Brazil); Abud, D. G., E-mail: dgabud@fmrp.usp.br [University of São Paulo, Division of Interventional Neuroradiology, Ribeirão Preto Medical School (Brazil)

    2017-04-15

    PurposeAcute hemorrhage associated with cancers of the head and neck is a life-threatening condition that requires immediate action. The aim of this study was to assess the safety and efficacy of endovascular embolization for acute hemorrhage in patients with head and neck cancers.Materials and MethodsData were retrospectively collected from patients with head and neck cancers who underwent endovascular embolization to treat acute hemorrhage. The primary endpoint was the rate of immediate control of hemorrhage during the first 24 h after embolization. The secondary endpoints were technical or clinical complications, rate of re-hemorrhage 24 h after the procedure, time from embolization to re-hemorrhage, hospitalization time, mortality rate, and time from embolization to death.ResultsFifty-one patients underwent endovascular embolization. The primary endpoint was achieved in 94% of patients. The rate of technical complications was 5.8%, and no clinical complication was observed. Twelve patients (23.5%) had hemorrhage recurrence after an average time of 127.5 days. The average hospitalization time was 7.4 days, the mortality rate during the follow-up period was 66.6%, and the average time from embolization to death was 132.5 days.ConclusionEndovascular embolization to treat acute hemorrhage in patients with head and neck cancers is a safe and effective method for the immediate control of hemorrhage and results in a high rate of hemorrhage control. Larger studies are necessary to determine which treatment strategy is best for improving patient outcomes.

  15. Endovascular Management of Patients with Head and Neck Cancers Presenting with Acute Hemorrhage: A Single-Center Retrospective Study

    International Nuclear Information System (INIS)

    Vilas Boas, P. P.; Castro-Afonso, L. H. de; Monsignore, L. M.; Nakiri, G. S.; Mello-Filho, F. V. de; Abud, D. G.

    2017-01-01

    PurposeAcute hemorrhage associated with cancers of the head and neck is a life-threatening condition that requires immediate action. The aim of this study was to assess the safety and efficacy of endovascular embolization for acute hemorrhage in patients with head and neck cancers.Materials and MethodsData were retrospectively collected from patients with head and neck cancers who underwent endovascular embolization to treat acute hemorrhage. The primary endpoint was the rate of immediate control of hemorrhage during the first 24 h after embolization. The secondary endpoints were technical or clinical complications, rate of re-hemorrhage 24 h after the procedure, time from embolization to re-hemorrhage, hospitalization time, mortality rate, and time from embolization to death.ResultsFifty-one patients underwent endovascular embolization. The primary endpoint was achieved in 94% of patients. The rate of technical complications was 5.8%, and no clinical complication was observed. Twelve patients (23.5%) had hemorrhage recurrence after an average time of 127.5 days. The average hospitalization time was 7.4 days, the mortality rate during the follow-up period was 66.6%, and the average time from embolization to death was 132.5 days.ConclusionEndovascular embolization to treat acute hemorrhage in patients with head and neck cancers is a safe and effective method for the immediate control of hemorrhage and results in a high rate of hemorrhage control. Larger studies are necessary to determine which treatment strategy is best for improving patient outcomes.

  16. Chemotherapy for head and neck cancer

    International Nuclear Information System (INIS)

    Pfister, David G.

    1995-01-01

    Purpose/Objective: The role of chemotherapy in the management of squamous cell carcinoma of the upper aerodigestive tract is undergoing rapid evolution. Historically, the use of chemotherapy was limited to patients with incurable disease who had exhausted all surgical and radiation therapy options. The results of recent randomized trials, however, suggest an increasing role for chemotherapy as part of primary management in patients seeking to avoid potentially morbid surgical procedures or with unresectable disease. This refresher course will provide a comprehensive overview of the current indications for chemotherapy in the management of these malignancies, and will highlight areas of controversy and future directions of investigation. More specifically, the following areas will be emphasized. 1. The identification of drugs commonly used in the management of head and neck cancer, their customary dosing and side effects. 2. The impact of induction and/or adjuvant chemotherapy combined with surgery and radiation therapy as defined by randomized trials, including a discussion of the Head and Neck Contracts program and the Intergroup adjuvant trial. 3. The development of larynx/function preservation treatment programs, including a review of the Memorial Hospital experience with larynx preservation and the Veterans Administration larynx preservation study. 4. The evolving role of chemotherapy as part of innovative combined modality programs, especially in patients with unresectable disease. The rationale and utility of sequential versus concomitant/alternating chemotherapy-radiation strategies, and relevant randomized clinical trials comparing the different strategies will be discussed. 5. The appropriate application of chemotherapy in the palliative setting, including a discussion of the relative merits of single-agent versus combination chemotherapy

  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. 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

    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...... 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...... and Treatment of Cancer quality of life questionnaires. At 1-year follow-up, the percentages of overall and disease-free survival were 76% and 89%, respectively. Electrochemotherapy is an effective option for skin cancers of the HN area and can be considered a feasible alternative to standard treatments when...

  19. The radiotherapy effect on the quality of life of patients with head and neck cancer; O efeito da radioterapia sobre a qualidade de vida dos pacientes com cancer de cabeca e pescoco

    Energy Technology Data Exchange (ETDEWEB)

    Sawada, Namie Okino; Dias, Adriana Marques; Zago, Marcia Maria Fontao [Sao Paulo Univ., Ribeirao Preto, SP (Brazil). Escola de Enfermagem. Dept. de Enfermagem Geral e Especializada

    2006-07-01

    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)

  20. Human papilloma virus infection in head and neck cancer.

    Science.gov (United States)

    Tribius, Silke; Hoffmann, Markus

    2013-03-01

    The causal link between cervical cancer and human papilloma virus (HPV) is well known. It is now becoming clear that some types of squamous-cell carcinoma of the head and neck, particularly oropharyngeal carcinoma (OPC), are also linked to HPV infection. The development of vaccines against certain HPV genotypes has changed the management strategy for HPV-associated diseases of the uterine cervix. An analogous approach is now being considered for the prevention of HPV-associated diseases of the head and neck. We review pertinent articles retrieved by a selective search of the literature for phase II and III trials providing evidence about a possible effect of HPV status on the survival rates of patients with OPC. Seven trials fulfilled our search criteria: four phase III trials with retrospective HPV analysis and three phase II trials with retrospective and prospective HPV analysis. Patients with HPV-positive OPC survive significantly longer than those with HPV-negative OPC. Tobacco smoking has been identified as a negative prognostic factor in patients with either HPV-negative or HPV-positive disease. The established treatment strategy for OPC in patients with and without the traditional risk factors (tobacco and alcohol consumption) is now being reconsidered in the light of what we have learned about the role of HPV infection. Ongoing and projected clinical trials with risk-factor stratification may soon lead to changes in treatment. Further study is needed to answer the question whether HPV infection in the head and neck region is carcinogenic.

  1. Unilateral and bilateral neck SIB for head and neck cancer patients. Intensity-modulated proton therapy, tomotherapy, and RapidArc

    Energy Technology Data Exchange (ETDEWEB)

    Stromberger, Carmen; Budach, Volker; Ghadjar, Pirus; Wlodarczyk, Waldemar; Marnitz, Simone [Charite - Universitaetsmedizin Berlin, Department of Radiation Oncology and Radiotherapy, Berlin (Germany); Cozzi, Luca; Fogliata, Antonella [Humanitas Cancer Center Milan, Radiotherapy and Radiosurgery Department, Milan (Italy); Jamil, Basil [Klinikum Frankfurt Oder, Praxis fuer Strahlentherapie, Frankfurt Oder (Germany); Raguse, Jan D. [Clinic for Oral and Maxillofacial Surgery, Berlin (Germany); Boettcher, Arne [Charite - Universitaetsmedizin Berlin, Department of Otorhinolaryngology, Berlin (Germany)

    2016-04-15

    To compare simultaneous integrated boost plans for intensity-modulated proton therapy (IMPT), helical tomotherapy (HT), and RapidArc therapy (RA) for patients with head and neck cancer. A total of 20 patients with squamous cell carcinoma of the head and neck received definitive chemoradiation with bilateral (n = 14) or unilateral (n = 6) neck irradiation and were planned using IMPT, HT, and RA with 54.4, 60.8, and 70.4 GyE/Gy in 32 fractions. Dose distributions, coverage, conformity, homogeneity to planning target volumes (PTV)s and sparing of organs at risk and normal tissue were compared. All unilateral and bilateral plans showed excellent PTV coverage and acceptable dose conformity. For unilateral treatment, IMPT delivered substantially lower mean doses to contralateral salivary glands (< 0.001-1.1 Gy) than both rotational techniques did (parotid gland: 6-10 Gy; submandibular gland: 15-20 Gy). Regarding the sparing of classical organs at risk for bilateral treatment, IMPT and HT were similarly excellent and RA was satisfactory. For unilateral neck irradiation, IMPT may minimize the dry mouth risk in this subgroup but showed no advantage over HT for bilateral neck treatment regarding classical organ-at-risk sparing. All methods satisfied modern standards regarding toxicity and excellent target coverage for unilateral and bilateral treatment of head and neck cancer at the planning level. (orig.) [German] Planvergleich von intensitaetsmodulierter Protonentherapie (IMPT), Tomotherapie (HT) und RapidArc-Therapie (RA) fuer Patienten mit Plattenepithelkarzinomen der Kopf-Hals-Region unter Anwendung des simultan integrierten Boost-Konzepts (SIB). Fuer 20 Patienten mit Plattenepithelkarzinomen der Kopf-Hals-Region und bilateraler (n = 14) oder unilateraler (n = 6) zervikaler primaerer Radiochemotherapie erfolgte eine IMPT-, HT- und RA-Planung mit 54,4, 60,8 und 70,4 GyE/Gy in 32 Fraktionen. Die Dosisverteilung, Abdeckung, Konformitaet und Homogenitaet der PTVs sowie die

  2. Anticancer Effect and Apoptosis Induction of Cymbopogon citratus Plant on Head and Neck HTB43 Cancer Cell Lines

    International Nuclear Information System (INIS)

    Yen, N.; Zainah Adam; Arapoc, D.J.; Mohamed Zaffar Ali Mohamed Amiroudine; Shafii Khamis

    2016-01-01

    Lemongrass (Cymbopogon citratus) is a major crop in Asia, South and Central America, Africa and other tropical countries. It is commonly used as a culinary herb in Asian cuisine and also as medicinal herb in India. The objective of the present study was to investigate the anticancer effect of Cymbopogon citratus essential oil on human head and neck cancer cell lines. Lemongrass essential oil was obtained from fresh lemongrass leaves using the microwave extractor. The yield of the highly purified oil obtained was 0.62 %. The oil was investigated for its in-vitro cytotoxicity and apoptosis induction against human head and neck HTB43 cancer cell lines. The results showed promising cytotoxic effects with IC_5_0 value of 15.42 ± 6.10 μg/ ml (HTB43) respectively. In addition, the essential oil has found inducing apoptotic effect within HTB43 cells (25.71 ± 1.43 %). These preliminary results indicated that the oil had apoptosis-based cytotoxicity against head and neck cancer cells. However, further investigations need to be carried out in order to elucidate the anti-cancer properties of the oil. The phytochemicals properties of the active compounds found in the oil also need to be studied. (author)

  3. Burden, quality of life and distress of the main caregiver in head and neck, cervix and rectal cancer patients

    Directory of Open Access Journals (Sweden)

    Miguel I

    2017-03-01

    Full Text Available Purpose: Based on Portuguese experience, current practice does not focus sufficiently on the caregiver needs through caring of the cancer patient. Understanding the impact of different tumor types on caregiver burden, quality of life, and distress may help with organizing resources more efficiently to provide enhanced support for patients and caregivers. Methods: Ninety main caregivers of patients with cervix, rectal and head and neck cancer were interviewed at Instituto Português de Oncologia de Lisboa Francisco Gentil. The Portuguese versions of Zarit Burden Interview, Caregiver Quality of Life Index - Cancer (CQOLC Scale and the distress thermometer were used. Results: The majority of caregivers were female (76.7%, median age was 45.5years (20-79, 40% were spouses and 38.7% sons/daughters. Zarit Burden Interview average score was 25.2 ± 11.6, higher on head and neck cancer group. 59.5% of caregivers had moderate burden and no cases of severe burden. Mean quality of life score was 64.8 ± 15.8 which was lower in the head and neck group. Average distress score across the three groups was seven and rectal group presented a lower score than the other two groups. A subgroup analysis (gender, kinship relation, employment status and cohabitation before starting care of caregivers characteristics showed no statistical differences. Conclusion: There were little differences in the experience of caring within caregivers based on the three different cancer groups, although caregivers of patients with head and neck cancer scored consistently worse in the three scales studied. More efforts should be taken to optimize coping strategies for these caregivers, as well as non-cohabitant and active caregivers, who had a worse caring experience.

  4. Management of somatic pain induced by head-and-neck cancer treatment: definition and assessment. Guidelines of the French Oto-Rhino-Laryngology- Head and Neck Surgery Society (SFORL).

    Science.gov (United States)

    Binczak, M; Navez, M; Perrichon, C; Blanchard, D; Bollet, M; Calmels, P; Couturaud, C; Dreyer, C; Espitalier, F; Testelin, S; Albert, S; Morinière, S

    2014-09-01

    The authors present the guidelines of the French Oto-Rhino-Laryngology- Head and Neck Surgery Society (Société Française d'Oto-rhino-Laryngologie et de Chirurgie de la Face et du Cou [SFORL]) for the management of somatic pain induced by head-and-neck cancer treatment, and in particular the instruments needed for the definition and initial assessment of the various types of pain. A multidisciplinary work group was entrusted with a review of the scientific literature on the above topic. Guidelines were drawn up, based on the articles retrieved and the group members' individual experience. They were then read over by an editorial group independent of the work group. The final version was established in a coordination meeting. The guidelines were graded as A, B, C or expert opinion, by decreasing level of evidence. The priority is to eliminate tumoral recurrence when pain reappears or changes following head-and-neck cancer treatment. Neuropathic pain screening instruments and pain assessment scales should be used to assess pain intensity and treatment efficacy. Functional rehabilitation sessions should be prescribed to reduce musculoskeletal pain and prevent ankylosis and postural disorder. Psychotherapy and mind-body therapy, when available, should be provided in case of chronic pain. In case of recalcitrant complex pain, referral should be made to a multidisciplinary pain structure. The management of somatic pain induced by head-and-neck cancer treatment above all requires identifying and assessing the intensity of the various types of pain involved, their functional impact and their emotional component. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  5. 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

  6. Dysphagia training after head and neck cancer fails to follow legislation and national recommendations

    DEFF Research Database (Denmark)

    Fredslund, Sara Vinther; Høgdal, Nina; Christensen, Malene Bæk

    2015-01-01

    INTRODUCTION: Dysphagia is a known sequela after head and neck cancer (HNC) and causes malnutrition, aspiration pneumonia and a reduced quality of life. Due to improved survival rates, the number of patients with sequelae is increasing. Evidence on the ideal HNC-specific rehabilitation of dysphag...

  7. 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

  8. P53 overexpression and outcome of radiation therapy in head and neck cancers

    Energy Technology Data Exchange (ETDEWEB)

    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 [College of Medicine, The Catholic Univ., Seoul (Korea, Republic of)

    1999-03-01

    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.

  9. Radiation-induced cancer after radiotherapy for non-Hodgkin's lymphoma of the head and neck: a retrospective study

    Directory of Open Access Journals (Sweden)

    Hayashi Keiji

    2009-07-01

    Full Text Available Abstract Background survivors of non-Hodgkin's lymphoma (NHL are well known to be at an increased risk of second malignancies. In this study, we evaluated the incidence and clinical features of head and neck cancer (HNC occurring after radiotherapy (RT for NHL. Materials and methods We investigated the clinical records of 322 patients who had received RT for early-stage NHL of the head and neck at our institute between 1952 and 2000. Results There were 4 patients with a second HNC developing in the irradiated field, consisting of 2 patients with gum cancer, 1 case with tongue cancer and 1 case with maxillary sinus cancer. The pathological diagnosis in all the 4 patients was squamous cell carcinoma (SCC. Two of the patients (one with gum cancer and one with maxillary sinus cancer died of the second HNC, while the remaining 2 patients are still living at the time of writing after therapy for the second HNC, with neither recurrence of the second tumor nor relapse of the primary tumor. The ratio of the observed to the expected number (O/E ratio of a second HNC was calculated to be 12.7 (95%CI, 4.07–35.0, and the absolute excess risk (AER per 10,000 person-years was 13.3. The median interval between the RT and the diagnosis of the second HNC was 17.0 years (range, 8.7 to 22.7 years. Conlusion The risk of HNC significantly increased after RT for early-stage NHL. These results suggest that second HNC can be regarded as one of the late complications of RT for NHL of the head and neck.

  10. Validating a benchmarking tool for audit of early outcomes after operations for head and neck cancer

    OpenAIRE

    Tighe, D.; Sassoon, I.; McGurk, M.

    2017-01-01

    INTRODUCTION In 2013 all UK surgical specialties, with the exception of head and neck surgery, published outcome data adjusted for case mix for indicator operations. This paper reports a pilot study to validate a previously published risk adjustment score on patients from separate UK cancer centres. METHODS A case note audit was performed of 1,075 patients undergoing 1,218 operations for head and neck squamous cell carcinoma under general anaesthesia in 4 surgical centres. A logistic regressi...

  11. 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

  12. 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.

  13. Factors Associated With Long-Term Dysphagia After Definitive Radiotherapy for Locally Advanced Head-and-Neck Cancer

    International Nuclear Information System (INIS)

    Caudell, Jimmy J.; Schaner, Philip E.; Meredith, Ruby F.; Locher, Julie L.; Nabell, Lisle M.; Carroll, William R.; Magnuson, J. Scott; Spencer, Sharon A.; Bonner, James A.

    2009-01-01

    Purpose: The use of altered fractionation radiotherapy (RT) regimens, as well as concomitant chemotherapy and RT, to intensify therapy for locally advanced head-and-neck cancer can lead to increased rates of long-term dysphagia. Methods and Materials: We identified 122 patients who had undergone definitive RT for locally advanced head-and-neck cancer, after excluding those who had been treated for a second or recurrent head-and-neck primary, had Stage I-II disease, developed locoregional recurrence, had <12 months of follow-up, or had undergone postoperative RT. The patient, tumor, and treatment factors were correlated with a composite of 3 objective endpoints as a surrogate for severe long-term dysphagia: percutaneous endoscopic gastrostomy tube dependence at the last follow-up visit; aspiration on a modified barium swallow study or a clinical diagnosis of aspiration pneumonia; or the presence of a pharyngoesophageal stricture. Results: A composite dysphagia outcome occurred in 38.5% of patients. On univariate analysis, the primary site (p = 0.01), use of concurrent chemotherapy (p = 0.01), RT schedule (p = 0.02), and increasing age (p = 0.04) were significantly associated with development of composite long-term dysphagia. The use of concurrent chemotherapy (p = 0.01), primary site (p = 0.02), and increasing age (p = 0.02) remained significant on multivariate analysis. Conclusion: The addition of concurrent chemotherapy to RT for locally advanced head-and-neck cancer resulted in increased long-term dysphagia. Early intervention using swallowing exercises, avoidance of nothing-by-mouth periods, and the use of intensity-modulated RT to reduce the dose to the uninvolved swallowing structures should be explored further in populations at greater risk of long-term dysphagia

  14. 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.

  15. A cost-effectiveness analysis of a preventive exercise program for patients with advanced head and neck cancer treated with concomitant chemo-radiotherapy

    Directory of Open Access Journals (Sweden)

    Retèl Valesca P

    2011-11-01

    Full Text Available Abstract Background Concomitant chemo-radiotherapy (CCRT has become an indispensable organ, but not always function preserving treatment modality for advanced head and neck cancer. To prevent/limit the functional side effects of CCRT, special exercise programs are increasingly explored. This study presents cost-effectiveness analyses of a preventive (swallowing exercise program (PREP compared to usual care (UC from a health care perspective. Methods A Markov decision model of PREP versus UC was developed for CCRT in advanced head and neck cancer. Main outcome variables were tube dependency at one-year and number of post-CCRT hospital admission days. Primary outcome was costs per quality adjusted life years (cost/QALY, with an incremental cost-effectiveness ratio (ICER as outcome parameter. The Expected Value of Perfect Information (EVPI was calculated to obtain the value of further research. Results PREP resulted in less tube dependency (3% and 25%, respectively, and in fewer hospital admission days than UC (3.2 and 4.5 days respectively. Total costs for UC amounted to €41,986 and for PREP to €42,271. Quality adjusted life years for UC amounted to 0.68 and for PREP to 0.77. Based on costs per QALY, PREP has a higher probability of being cost-effective as long as the willingness to pay threshold for 1 additional QALY is at least €3,200/QALY. At the prevailing threshold of €20,000/QALY the probability for PREP being cost-effective compared to UC was 83%. The EVPI demonstrated potential value in undertaking additional research to reduce the existing decision uncertainty. Conclusions Based on current evidence, PREP for CCRT in advanced head and neck cancer has the higher probability of being cost-effective when compared to UC. Moreover, the majority of sensitivity analyses produced ICERs that are well below the prevailing willingness to pay threshold for an additional QALY (range from dominance till €45,906/QALY.

  16. A cost-effectiveness analysis of a preventive exercise program for patients with advanced head and neck cancer treated with concomitant chemo-radiotherapy

    International Nuclear Information System (INIS)

    Retèl, Valesca P; Molen, Lisette van der; Hilgers, Frans JM; Rasch, Coen RN; L'Ortye, Annemiek AAMHJ; Steuten, Lotte MG; Harten, Wim H van

    2011-01-01

    Concomitant chemo-radiotherapy (CCRT) has become an indispensable organ, but not always function preserving treatment modality for advanced head and neck cancer. To prevent/limit the functional side effects of CCRT, special exercise programs are increasingly explored. This study presents cost-effectiveness analyses of a preventive (swallowing) exercise program (PREP) compared to usual care (UC) from a health care perspective. A Markov decision model of PREP versus UC was developed for CCRT in advanced head and neck cancer. Main outcome variables were tube dependency at one-year and number of post-CCRT hospital admission days. Primary outcome was costs per quality adjusted life years (cost/QALY), with an incremental cost-effectiveness ratio (ICER) as outcome parameter. The Expected Value of Perfect Information (EVPI) was calculated to obtain the value of further research. PREP resulted in less tube dependency (3% and 25%, respectively), and in fewer hospital admission days than UC (3.2 and 4.5 days respectively). Total costs for UC amounted to €41,986 and for PREP to €42,271. Quality adjusted life years for UC amounted to 0.68 and for PREP to 0.77. Based on costs per QALY, PREP has a higher probability of being cost-effective as long as the willingness to pay threshold for 1 additional QALY is at least €3,200/QALY. At the prevailing threshold of €20,000/QALY the probability for PREP being cost-effective compared to UC was 83%. The EVPI demonstrated potential value in undertaking additional research to reduce the existing decision uncertainty. Based on current evidence, PREP for CCRT in advanced head and neck cancer has the higher probability of being cost-effective when compared to UC. Moreover, the majority of sensitivity analyses produced ICERs that are well below the prevailing willingness to pay threshold for an additional QALY (range from dominance till €45,906/QALY)

  17. Value of retrospective image fusion of 18F-FDG PET and MRI for preoperative staging of head and neck cancer: Comparison with PET/CT and contrast-enhanced neck MRI

    International Nuclear Information System (INIS)

    Kanda, Tomonori; Kitajima, Kazuhiro; Suenaga, Yuko; Konishi, Jyunya; Sasaki, Ryohei; Morimoto, Koichi; Saito, Miki; Otsuki, Naoki; Nibu, Ken-ichi; Sugimura, Kazuro

    2013-01-01

    Purpose: To assess the clinical value of retrospective image fusion of neck MRI and 18 F-fluorodeoxyglucose ( 18 F-FDG) PET for locoregional extension and nodal staging of neck cancer. Materials and methods: Thirty patients with carcinoma of the oral cavity or hypopharynx underwent PET/CT and contrast-enhanced neck MRI for initial staging before surgery including primary tumor resection and neck dissection. Diagnostic performance of PET/CT, MRI, and retrospective image fusion of PET and MRI (fused PET/MRI) for assessment of the extent of the primary tumor (T stage) and metastasis to regional lymph nodes (N stage) was evaluated. Results: Accuracy for T status was 87% for fused PET/MRI and 90% for MRI, thus proving significantly superior to PET/CT, which had an accuracy of 67% (p = 0.041 and p = 0.023, respectively). Accuracy for N status was 77% for both fused PET/MRI and PET/CT, being superior to MRI, which had an accuracy of 63%, although the difference was not significant (p = 0.13). On a per-level basis, the sensitivity, specificity and accuracy for detection of nodal metastasis were 77%, 96% and 93% for both fused PET/MRI and PET/CT, compared with 49%, 99% and 91% for MRI, respectively. The differences for sensitivity (p = 0.0026) and accuracy (p = 0.041) were significant. Conclusion: Fused PET/MRI combining the individual advantages of MRI and PET is a valuable technique for assessment of staging neck cancer

  18. 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)

  19. 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

  20. Validation of the sentinel lymph node biopsy technique in head and neck cancers of the oral cavity.

    Science.gov (United States)

    Radkani, Pejman; Mesko, Thomas W; Paramo, Juan C

    2013-12-01

    The purpose of this study was to present our experience and validate the use of sentinel lymph node (SLN) mapping in patients with head and neck cancers. A retrospective review of a prospectively collected database of patients with a diagnosis of squamous cell carcinomas of the head and neck from 2008 to 2011 was done. The group consisted of a total of 20 patients. The first node(s) highlighted with blue, or identified as radioactive by Tc99-sulfur radioactive colloid, was (were) identified as the SLNs. In the first seven patients, formal modified neck dissection was performed. In the remaining 13 patients, only a SLN biopsy procedure was done. At least one SLN was identified in all 20 patients (100%). Only one patient (5%) had positive nodes. In this case, the SLN was also positive. In the remaining 19 cases, all lymph nodes were negative. After an average of 24 months of follow-up, there have been three local recurrences (15%) but no evidence of distant metastatic disease. SLN mapping in head and neck cancers is a feasible technique with a high identification rate and a low false-negative rate. Although the detection rate of regional metastatic disease compares favorably with published data as well as the disease-free and overall survival, further studies are warranted before considering this technique to be the "gold standard" in patients with oral squamous cell carcinoma and a negative neck by clinical examination and imaging studies.

  1. Curcumin and Other Polyphenolic Compounds in Head and Neck Cancer Chemoprevention

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    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.

  2. Circulating Vitamin D in relation to cancer incidence and survival of the head and neck and oesophagus in the EPIC cohort

    NARCIS (Netherlands)

    Fanidi, Anouar; Muller, David C.; Midttun, Øivind; Ueland, Per Magne; Vollset, Stein Emil; Relton, Caroline; Vineis, Paolo; Weiderpass, Elisabete; Skeie, Guri; Brustad, Magritt; Palli, Domenico; Tumino, Rosario; Grioni, Sara; Sacerdote, Carlotta; Bueno-De-Mesquita, H. B.; Peeters, Petra H.; Boutron-Ruault, Marie Christine; Kvaskoff, Marina; Cadeau, Claire; Huerta, José María; Sánchez, Maria José; Agudo, Antonio; Lasheras, Cristina; Quirós, J. Ramón; Chamosa, Saioa; Riboli, Elio; Travis, Ruth C.; Ward, Heather; Murphy, Neil; Khaw, Kay Tee; Trichopoulou, Antonia; Lagiou, Pagona; Papatesta, Eleni Maria; Boeing, Heiner; Kuehn, Tilman; Katzke, Verena; Steffen, Annika; Johansson, Anders; Brennan, Paul; Johansson, Mattias

    2016-01-01

    Experimental and epidemiological data suggest that vitamin D play a role in pathogenesis and progression of cancer, but prospective data on head and neck cancer (HNC) and oesophagus cancer are limited. The European Prospective Investigation into Cancer and Nutrition (EPIC) study recruited 385,747

  3. 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)

  4. 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.

  5. Influence of body composition on survival in patients with head and neck cancer.

    Science.gov (United States)

    Karnell, Lucy Hynds; Sperry, Steven M; Anderson, Carryn M; Pagedar, Nitin A

    2016-04-01

    Recent evidence has suggested links between obesity and outcomes for various types of cancer. This study investigates the impact that body composition has on survival in patients with head and neck cancer. Data prospectively collected from 578 patients were analyzed using Cox regression models to determine independent associations that pretreatment body mass index (BMI) and 3-month weight change have on observed survival. Higher BMIs were associated with better survival (p < .001). Five-year rates ranged from 33.8% for underweight to 75.3% for overweight/obese patients. Patients with stable weight had the highest 5-year rate (72.6%; p = .019), whereas patients who gained ≥5% had worse survival (45.8%) than those who lost ≥5% (65.8%). BMI independently predicted survival, whereas weight change was not an independent predictor. This demonstrated association between BMI and survival provides useful information when offering prognoses and investigating optimal treatments © 2015 Wiley Periodicals, Inc. Head Neck 38: E261-E267, 2016. © 2015 Wiley Periodicals, Inc.

  6. Development of a unique phantom to assess dose error of metal artifact in head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Min Young; Kang, Sang Won; Suh, Tae Suk [Dept. of Biomedical Engineering, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of); Lee, Jeong Woo [Dept. of Radiation Oncology, Konkuk University Medical Center, Seoul (Korea, Republic of); Park, Ji Yeon [Dept. of Pediatrics and Molecular Imaging Program at Stanford, Stanford University, Stanford (United States)

    2016-04-15

    The artifacts not only blur the CT images and lead to inaccuracies in diagnosis, but also make the delineation of anatomical structures intractable, which is important in image-guided intervention procedures. These artifacts obscure the underlying anatomy, leading to uncertainty in the delineation of the target volumes and compromising the integrity of the density representation that is crucial for accurate dose calculation. Because head and neck cancer patients tend to be over the age of 50 years, they constitute a group likely to have dental prostheses. This kind of side effects considerably disturbs the therapeutic procedure. Radiation scatter from high atomic number (Z) materials is established to cause both soft tissue and bony complications in the oral cavity, making scattered radiation an important factor in head and neck region radiotherapy planning. In this study, we carried out theoretical analysis of the metal artifact, that is, streak artifact and dark artifact, and also critical analysis of dosimetric effect which cause by dental implants in CT images of head and neck cancer patients with the genuine teeth and implants inserted humanoid phantom. The phantom provides a unique and useful tool in head and neck dosimetry research. It can be used in the development of new imaging instrumentation, image acquisition strategies, and image processing and reconstruction methods.

  7. [The application of microvascular anastomotic coupler in vascular anastomosis of free tissue flap for reconstruction of defect after head and neck cancer resection].

    Science.gov (United States)

    Zhang, Y J; Wang, Z H; Li, C H; Chen, J

    2017-09-07

    Objective: To investigate the application and operation skills in vein anastomosis by microvascular anastomotic coupler (MAC) in reconstruction of defects after head and neck cancer resection. Methods: From August 2015 to July 2016, in Department of Head and Neck Surgery, Sichuan Cancer Hosipital, 17 cases underwent the reconstruction of defects after head and neck cancer resection with free tissue flaps, including forearm flaps in 11 casess, anterolateral flaps in 4 casess and fibula flaps in 2 casess. Totally 17 MAC were used, including 14 MAC for end-to-end anastomosis and 3 MAC for end-to-side anastomosis. SPSS 22.0 software was used to analyze the data. Results: Venous anastomoses in 17 free tissue flaps were successfully completed, with no anastomotic errhysis. All flaps survived well. The time required for vascular anastomoses with MAC varied 2-9 min, with average time of (4.2±2.3) min, which was significantly shorter than that with manually anastomosis (17.4 ± 2.7) min ( t =15.1, P anastomosis in free tissue flap for reconstruction of defect after head and neck cancer resection, which requires for less operation time and shows good results.

  8. DMF-T index in patients undergoing radiation therapy with LINAC X-ray radiation for head and neck cancer at Department of Radiotherapy, Dr. Hasan Sadikin Hospital

    Directory of Open Access Journals (Sweden)

    S. Sabrina

    2007-11-01

    Full Text Available Radiation therapy for head and neck cancer frequently caused severe salivary gland dysfunction. The salivary gland dysfunction possibly decreased the protective function of saliva and caused dental caries. The purpose of this study was to obtain an illustration about DMF-T index in patient undergoing radiation therapy with LINAC X-ray radiation for head and neck cancer at Department of Radiotherapy, Dr. Hasan Sadikin Hospital in January-February 2007. The study was a simple descriptive. The study was conducted on 7 males and 9 females undergoing radiation therapy with LINAC X-ray radiation for head and neck cancer. The ages of patient are between 37 years and 77 years. The severity of caries was measured by DMF-T index. DMF-T index in 16 patient undergoing radiation therapy with LINAC X-ray radiation for head and neck cancer at Dr. Hasan Sadikin Hospital is 10.6 as the result of this study. The conclusion of this study showed that the DMF-T index in 16 patient undergoing radiation therapy with LINAC X-ray radiation for head and neck cancer at Dr. Hasan Sadikin Hospital had very high grade based on WHO classification, which the value was over 6.6.

  9. 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

  10. 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

  11. Controversies surrounding Human Papilloma Virus infection, head & neck vs oral cancer, implications for prophylaxis and treatment

    OpenAIRE

    Campisi, G.; Giovannelli, L.

    2009-01-01

    Head & Neck Cancer (HNC) represents the sixth most common malignancy worldwide and it is historically linked to well-known behavioural risk factors, i.e., tobacco smoking and/or the alcohol consumption. Recently, substantial evidence has been mounting that Human Papillomavirus (HPV) infection is playing an increasing important role in oral cancer. Because of the attention and clamor surrounding oral HPV infection and related cancers, as well as the use of HPV prophylactic vaccines, in this in...

  12. Analysis of the frequency and degree of temporomandibular disorder in patients with head and neck cancer undergoing radiotherapy

    Directory of Open Access Journals (Sweden)

    Douglas Roberto Pegoraro

    Full Text Available Abstract Introduction: Head and neck cancer is responsible for an increasing incidence of primary malignant neoplasm cases worldwide. Radiotherapy is one of the treatments of choice for this type of cancer, but it can cause adverse effects, such as temporomandibular disorder. The objective of this study was to characterize the degree and frequency of temporomandibular disorder in patients with head and neck cancer undergoing radiotherapy. Method: This research was quantitative, descriptive and exploratory. The sample consisted of 22 patients that answered assessment questions and the Helkimo anamnestic questionnaire, modified by Fonseca (1992. The data were collected from May to October 2014, and statistically analyzed using the Chi-square test, with a significance level of p ≤ 0.05. Results: Of the 22 patients, 86.4 % were male, with a mean age of 58.86 ± 9.41 years. Temporomandibular disorder was present in 31.8% of the subjects, based on the assessment prior to radiotherapy, and in 59.1% in the post-treatment assessment. Among all questions, the most frequent was "Do you use only one side of the mouth to chew?" with 22.7% "yes" answers, both at the first assessment and at the post treatment. Conclusion: According to the results of this study, temporomandibular disorder is a disease that is present with a high prevalence in people diagnosed with head and neck cancer undergoing radiotherapy.

  13. Cetuximab: its unique place in head and neck cancer treatment

    Directory of Open Access Journals (Sweden)

    Specenier P

    2013-04-01

    Full Text Available Pol Specenier, Jan B Vermorken Department of Medical Oncology, Antwerp University Hospital, Edegem, Belgium Abstract: Head and neck cancer is the sixth most common cancer worldwide. At present, globally about 650,000 new cases of squamous cell carcinoma of the head and neck (SCCHN are diagnosed each year. The epidermal growth factor receptor (EGFR is almost invariably expressed in SCCHN. Overexpression of the EGFR is a strong and independent unfavorable prognostic factor in SCCHN. Cetuximab is a chimeric monoclonal antibody, which binds with high affinity to the extracellular domain of the human EGFR, blocking ligand binding, resulting in inhibition of the receptor function. It also targets cytotoxic immune effector cells towards EGFR-expressing tumor cells (antibody dependent cell-mediated cytotoxicity. The addition of cetuximab to radiotherapy (RT improves locoregional control and survival when compared to RT alone. The addition of cetuximab to platinum-based chemoradiation (CRT is feasible but does not lead to an improved outcome. Cetuximab plus RT has never been compared prospectively to CRT, which therefore remains the standard treatment for patients with locoregionally advanced SCCHN for whom surgery is not considered the optimal treatment, provided they can tolerate CRT. The addition of cetuximab to platinum-based chemotherapy prolongs survival in patients with recurrent or metastatic SCCHN. The combination of a platinum-based regimen and cetuximab should be considered as the standard first line regimen for patients who can tolerate this treatment. Keywords: SCCHN, cetuximab, recurrent metastatic, locoregionally advanced, chemoradiation

  14. Parotid Gland Sparing With Helical Tomotherapy in Head-and-Neck Cancer

    International Nuclear Information System (INIS)

    Voordeckers, Mia; Farrag, Ashraf; Everaert, Hendrik; Tournel, Koen; Storme, Guy; Verellen, Dirk; De Ridder, Mark

    2012-01-01

    Purpose: 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. Methods and Materials: Data from 76 consecutive patients treated with helical tomotherapy (Hi-Art Tomotherapy) at 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 and N35). Results: 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 <26 Gy was 51.2%. Quality of life evaluation demonstrated an initial deterioration of almost all scales and items in QLQ-C30 and QLQ-H and N35. Most items improved in time, and some reached baseline values 18 months after treatment. Conclusion: DVH analysis, scintigraphic evaluation of 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 <34 Gy and doses <26 Gy to a maximum 47% of the

  15. Impact of Intensity-Modulated Radiotherapy on Health-Related Quality of Life for Head and Neck Cancer Patients: Matched-Pair Comparison with Conventional Radiotherapy

    International Nuclear Information System (INIS)

    Graff, Pierre; Lapeyre, Michel; Desandes, Emmanuel; Ortholan, Cecile; Bensadoun, Rene-Jean; Alfonsi, Marc; Maingon, Philippe; Giraud, Philippe; Bourhis, Jean; Marchesi, Vincent; Mege, Alice; Peiffert, Didier

    2007-01-01

    Purpose: To assess the benefit of intensity-modulated radiotherapy (IMRT) compared with conventional RT for the quality of life (QOL) of head and neck cancer survivors. Methods and Materials: Cross-sectional QOL measures (European Organization for Research and Treatment of Cancer QOL questionnaire C30 and head and neck cancer module) were used with a French multicenter cohort of patients cured of head and neck cancer (follow-up ≥ 1 year) who had received bilateral neck RT (≥ 45 Gy) as a part of their initial treatment. We compared the QOL mean scores regarding RT modality (conventional RT vs. IMRT). The patients of the two groups were matched (one to one) according to the delay between the end of RT and the timing of the QOL evaluation and the T stage. Each QOL item was divided into two relevant levels of severity: 'not severe' (responses, 'not at all' and 'a little') vs. 'severe' (responses 'quite a bit' and 'very much'). The association between the type of RT and the prevalence of severe symptoms was approximated, through multivariate analysis using the prevalence odds ratio. Results: Two comparable groups (67 pairs) were available. Better scores were observed on the head and neck cancer module QOL questionnaire for the IMRT group, especially for dry mouth and sticky saliva (p < 0.0001). Severe symptoms were more frequent with conventional RT concerning saliva modifications and oral discomfort. The adjusted prevalence odds ratios were 3.17 (p = 0.04) for dry mouth, 3.16 (p = 0.02) for sticky saliva, 3.58 (p = 0.02) for pain in the mouth, 3.35 (p = 0.04) for pain in the jaw, 2.60 (p = 0.02) for difficulties opening the mouth, 2.76 (p = 0.02) for difficulties with swallowing, and 2.68 (p = 0.03) for trouble with eating. Conclusion: The QOL assessment of head and neck cancer survivors demonstrated the benefit of IMRT, particularly in the areas of salivary dysfunction and oral discomfort

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

    International Nuclear Information System (INIS)

    Nisa, Lluís; Aebersold, Daniel Matthias; Giger, Roland; Caversaccio, Marco Domenico; Borner, Urs; Medová, Michaela; Zimmer, Yitzhak

    2015-01-01

    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

  17. Boron Neutron Capture Therapy in the Treatment of Locally Recurred Head and Neck Cancer

    International Nuclear Information System (INIS)

    Kankaanranta, Leena; Seppaelae, Tiina; Koivunoro, Hanna; Saarilahti, Kauko; Atula, Timo; Collan, Juhani; Salli, Eero; Kortesniemi, Mika; Uusi-Simola, Jouni; Maekitie, Antti; Seppaenen, Marko; Minn, Heikki; Kotiluoto, Petri; Auterinen, Iiro; Savolainen, Sauli; Kouri, Mauri; Joensuu, Heikki

    2007-01-01

    Purpose: Head and neck carcinomas that recur locally after conventional irradiation pose a difficult therapeutic problem. We evaluated safety and efficacy of boron neutron capture therapy (BNCT) in the treatment of such cancers. Methods and Materials: Twelve patients with inoperable, recurred, locally advanced (rT3, rT4, or rN2) head and neck cancer were treated with BNCT in a prospective, single-center Phase I-II study. Prior treatments consisted of surgery and conventionally fractionated photon irradiation to a cumulative dose of 56-74 Gy administered with or without concomitant chemotherapy. Tumor responses were assessed using the RECIST (Response Evaluation Criteria in Solid Tumors) criteria and adverse effects using the National Cancer Institute common toxicity grading v3.0. Intravenously administered boronophenylalanine-fructose (BPA-F, 400 mg/kg) was used as the boron carrier. Each patient was scheduled to be treated twice with BNCT. Results: Ten patients received BNCT twice; 2 were treated once. Ten (83%) patients responded to BNCT, and 2 (17%) had tumor growth stabilization for 5.5 and 7.6 months. The median duration of response was 12.1 months; six responses were ongoing at the time of analysis or death (range, 4.9-19.2 months). Four (33%) patients were alive without recurrence with a median follow-up of 14.0 months (range, 12.8-19.2 months). The most common acute adverse effects were mucositis, fatigue, and local pain; 2 patients had a severe (Grade 3) late adverse effect (xerostomia, 1; dysphagia, 1). Conclusions: Boron neutron capture therapy is effective and safe in the treatment of inoperable, locally advanced head and neck carcinomas that recur at previously irradiated sites

  18. Effect of psychosocial distress on outcome for head and neck cancer patients undergoing radiation.

    Science.gov (United States)

    Chen, Allen M; Hsu, Sophia; Felix, Care; Garst, Jordan; Yoshizaki, Taeko

    2018-03-01

    To determine the impact of pretreatment psychosocial distress on compliance to radiation therapy (RT) and clinical outcomes for patients with head and neck cancer STUDY DESIGN: Self-reported responses to the mood and anxiety domains of the University of Washington Quality of Life instrument were reviewed among 133 patients with newly diagnosed head and neck cancer prior to initiating RT. Varying definitions were used (total number of unexpectedly missed RT days, >5 days continuous interruption of RT outside of weekends, >10 days continuous interruption of RT, and failure to complete prescribed course of RT) to analyze the effect of psychosocial disruption on compliance. Survival was determined using the Kaplan-Meier method. The prevalence of pretreatment depression and anxiety was 23% and 47%, respectively. Continuous RT breaks >5 days occurred in 46%, 33%, 10%, 9%, and 0% of patients whose mood was rated as "extremely depressed," "somewhat depressed," "neither in a good mood or depressed," "generally good," and "excellent," respectively (P = .0016). The corresponding proportion of patients who did not complete their planned RT was 23%, 11%, 5%, and 3%, and 0%, respectively (P = .043). The 2-year overall survival of patients who were "extremely depressed" or "somewhat depressed" at baseline was 71% versus 86% for all others (P = .026). Depression was independently associated with decreased overall survival on logistical regression analysis. Pretreatment depression predicted for decreased RT compliance and inferior survival for head and neck cancer. Additional research to overcome potential barriers to treatment in this setting may be warranted. 4. Laryngoscope, 128:641-645, 2018. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  19. 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

  20. 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.

  1. 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.

  2. 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)

  3. [BIPADDLED SPLIT PECTORALIS MAJOR MYOCUTANEOUS FLAPS FOR IMMEDIATE RECONSTRUCTION OF ORAL MUCOSAL DEFECTS AND NECK DEFECTS AFTER RESECTION OF RECURRENT ORAL CANCER].

    Science.gov (United States)

    Chen, Jie; Jiang, Canhua; Li, Ning; Gao, Zhengyang; Chen, Lichun; Wu, Xiaoshan; Chen, Xinqun; Jian, Xinchun

    2015-07-01

    To investigate the feasibility of the bipaddled split pectoralis major myocutaneous flap for immediate reconstruction of oral mucosal defects and neck defects after resection of recurrent oral cancer. Six patients with oral mucosal defects combined with neck defects after recurrent oral cancer resection were treated with bipaddled split pectoralis major myocutaneous flap between September 2013 and September 2014. There were 5 males and 1 female with an average age of 54.7 years (range, 45-62 years), including 4 cases of recurrent tongue cancer, 1 case of recurrent mandibular gingival cancer, and 1 case of mouth floor carcinoma. All patients underwent local recurrence at 8 to 14 months after first operation, with no distant metastasis. The defects of the intraoral mucosa was 4.0 cm x 2.5 cm to 6.5 cm x 3.5 cm and the defect of the neck skin was 5.5 cm x 3.5 cm to 7.5 cm x 5.0 cm. The pectoralis major myocutaneous flaps (14.0 cm x 3.5 cm to 17.0 cm x 5.5 cm) were incised at the level of the 3rd to the 4th rib, and then split down along the muscle fiber till about 2 cm away from the thoracoacromial vessels, forming 2 independent skin paddles with 1-2 branch vessels to the pedicles of the distal ones. The distal skin paddles were used for oral reconstruction while the proximal paddles for repair of neck defects. The chest donor sites were sutured directly. Cervical haematoma and infection happened in 1 patient respectively after operation, and were cured after symptomatic treatment. All 6 split pectoralis major myocutaneous flaps with 12 skin paddles completely survived. All patients were followed up 6 to 18 months (mean, 11 months). One patient died of pulmonary metastasis at 8 months after operation and the other 5 survived without relapse or metastasis during follow-up. The intraoral paddles showed good shape with satisfactory speech function and swallowing recovery. The paddles also healed perfectly on the neck with flat outlooks, and all patients obtained full

  4. Xeroderma pigmentosum, complementation group D expression in H1299 lung cancer cells following benzo[a]pyrene exposure as well as in head and neck cancer patients.

    Science.gov (United States)

    Lin, Chang-Shen; Chiou, Wen-Yen; Lee, Ka-Wo; Chen, Tzu-Fen; Lin, Yuan-Jen; Huang, Jau-Ling

    2016-01-01

    DNA repair genes play critical roles in response to carcinogen-induced and anticancer therapy-induced DNA damage. Benzo[a]pyrene (BaP), the most carcinogenic polycyclic aromatic hydrocarbon (PAH), is classified as a group 1 carcinogen by International Agency for Research on Cancer. The aims of this study were to (1) evaluate the effects of BaP on DNA repair activity and expression of DNA repair genes in vitro and (2) examine the role of xeroderma pigmentosum, complementation group D (XPD) mRNA expression in human head and neck cancers. Host cell reactivation assay showed that BaP inhibited nucleotide excision repair in H1299 lung cancer cells. DNA repair through the non-homologous end-joining pathway was not affected by BaP. Real-time quantitative reverse-transcription polymerase chain reaction (RT-PCR) and Western blot demonstrated that XPD was downregulated by BaP treatment. BaP exposure did not apparently affect expression of another 11 DNA repair genes. BaP treatment increased the DNA damage marker γ-H2AX and ultraviolet (UV) sensitivity, supporting an impairment of DNA repair in BaP-treated cells. XPD expression was also examined by quantitative RT-PCR in 68 head and neck cancers, and a lower XPD mRNA level was found in smokers' cancer specimens. Importantly, reduced XPD expression was correlated with patient 5-year overall survival rate (35 vs. 56%) and was an independent prognostic factor (hazard ratio: 2.27). Data demonstrated that XPD downregulation was correlated with BaP exposure and human head and neck cancer survival.

  5. 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.

  6. The Impact of Radiation Treatment Time on Survival in Patients With Head and Neck Cancer

    International Nuclear Information System (INIS)

    Shaikh, Talha; Handorf, Elizabeth A.; Murphy, Colin T.; Mehra, Ranee; Ridge, John A.; Galloway, Thomas J.

    2016-01-01

    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 49 days, accelerated RTT was defined as <40 days, and standard RTT was defined as 40 to 49 days. We used χ"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.

  7. A Quest for Initiating Cells of Head and Neck Cancer and Their Treatment

    International Nuclear Information System (INIS)

    Chen, Chao; Köberle, Beate; Kaufmann, Andreas M.; Albers, Andreas E.

    2010-01-01

    The biology of head and neck squamous cell carcinomas (HNSCC) and other cancers have been related to cancer stem-like cells (CSC). Specific markers, which vary considerably depending on tumor type or tissue of origin, characterize CSC. CSC are cancer initiating, sustaining and mostly quiescent. Compared to bulk tumors, CSC are less sensitive to chemo- and radiotherapy and may have low immunogenicity. Therapeutic targeting of CSC may improve clinical outcome. HNSCC has two main etiologies: human papillomavirus, a virus infecting epithelial stem cells, and tobacco and alcohol abuse. Here, current knowledge of HNSCC-CSC biology is reviewed and parallels to CSC of other origin are drawn where necessary for a comprehensive picture

  8. 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.

  9. Imediate and long term therapeutic results from association of chemotherapy and radiotherapy in head neck cancer

    International Nuclear Information System (INIS)

    Monti, C.R.

    1987-01-01

    A analysis of 922 cases of head and neck cancer observed from March of 1977 to March of 1987 is presented. The actual position of the combined treatment of radiotherapy and chemotherapy is reported. (author) [pt

  10. Value of retrospective image fusion of {sup 18}F-FDG PET and MRI for preoperative staging of head and neck cancer: Comparison with PET/CT and contrast-enhanced neck MRI

    Energy Technology Data Exchange (ETDEWEB)

    Kanda, Tomonori [Department of Radiology, Kobe University Graduate School of Medicine, Kobe (Japan); Department of Radiology, Hyogo Cancer Center, Hyogo (Japan); Kitajima, Kazuhiro, E-mail: kitajima@med.kobe-u.ac.jp [Department of Radiology, Kobe University Graduate School of Medicine, Kobe (Japan); Suenaga, Yuko; Konishi, Jyunya [Department of Radiology, Kobe University Graduate School of Medicine, Kobe (Japan); Sasaki, Ryohei [Division of Radiation Oncology, Department of Radiology, Kobe University Graduate School of Medicine, Kobe (Japan); Morimoto, Koichi; Saito, Miki; Otsuki, Naoki; Nibu, Ken-ichi [Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe (Japan); Sugimura, Kazuro [Department of Radiology, Kobe University Graduate School of Medicine, Kobe (Japan)

    2013-11-01

    Purpose: To assess the clinical value of retrospective image fusion of neck MRI and {sup 18}F-fluorodeoxyglucose ({sup 18}F-FDG) PET for locoregional extension and nodal staging of neck cancer. Materials and methods: Thirty patients with carcinoma of the oral cavity or hypopharynx underwent PET/CT and contrast-enhanced neck MRI for initial staging before surgery including primary tumor resection and neck dissection. Diagnostic performance of PET/CT, MRI, and retrospective image fusion of PET and MRI (fused PET/MRI) for assessment of the extent of the primary tumor (T stage) and metastasis to regional lymph nodes (N stage) was evaluated. Results: Accuracy for T status was 87% for fused PET/MRI and 90% for MRI, thus proving significantly superior to PET/CT, which had an accuracy of 67% (p = 0.041 and p = 0.023, respectively). Accuracy for N status was 77% for both fused PET/MRI and PET/CT, being superior to MRI, which had an accuracy of 63%, although the difference was not significant (p = 0.13). On a per-level basis, the sensitivity, specificity and accuracy for detection of nodal metastasis were 77%, 96% and 93% for both fused PET/MRI and PET/CT, compared with 49%, 99% and 91% for MRI, respectively. The differences for sensitivity (p = 0.0026) and accuracy (p = 0.041) were significant. Conclusion: Fused PET/MRI combining the individual advantages of MRI and PET is a valuable technique for assessment of staging neck cancer.

  11. Efficacy of a high-observation protocol in major head and neck cancer surgery: A prospective study.

    Science.gov (United States)

    Barber, Brittany; Harris, Jeffrey; Shillington, Cameron; Rychlik, Shannon; Dort, Joseph; Meier, Michael; Estey, Angela; Elwi, Adam; Wickson, Patty; Buss, Michael; Zygun, David; Ansari, Kal; Biron, Vincent; O'Connell, Daniel; Seikaly, Hadi

    2017-08-01

    The purpose of this study was to optimize an existing clinical care pathway (CCP) for head and neck cancer with a high-observation protocol (HOP) and to determine the effect on length of intensive care unit (ICU) admission and length of stay in hospital (LOS). The HOP mandated initiation of spontaneous breathing trials before the conclusion of the surgery, weaning of sedation, and limiting mechanical ventilation. All patients with head and neck cancer undergoing primary surgery on the HOP were compared to a historical cohort regarding length of ICU admission, ICU readmissions, and LOS. Ninety-six and 52 patients were observed in "historical" and "HOP" cohorts. The length of ICU admission (1.9 vs 1.2 days; p = .021), LOS (20.3 vs 14.1 days; p = .020), and ICU readmissions (10.4% vs 1.9%; p = .013) were significantly decreased in the "HOP" cohort. Rapid weaning of sedation and limiting mechanical ventilation may contribute to a shorter length of ICU admission and LOS, as well as decreased ICU readmissions. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1689-1695, 2016. © 2017 Wiley Periodicals, Inc.

  12. Two Cases of Pneumatosis Intestinalis during Cetuximab Therapy for Advanced Head and Neck Cancer

    Directory of Open Access Journals (Sweden)

    James A. Miller

    2015-01-01

    Full Text Available Pneumatosis intestinalis is a rare but known potential complication of treatment with cetuximab. Here we present two cases of pneumatosis intestinalis occurring in patients who were receiving cetuximab as treatment for advanced head and neck cancer. In both cases, cetuximab was discontinued after discovery of the pneumatosis intestinalis.

  13. Regional control of melanoma neck node metastasis after selective neck dissection with or without adjuvant radiotherapy

    NARCIS (Netherlands)

    Hamming-Vrieze, Olga; Balm, Alfons J. M.; Heemsbergen, Wilma D.; Hooft van Huysduynen, Thijs; Rasch, Coen R. N.

    2009-01-01

    OBJECTIVE: To examine the effect of adjuvant radiotherapy on regional control of melanoma neck node metastasis. DESIGN: A single-institution retrospective study. SETTING: Tertiary care cancer center. PATIENTS: The study included 64 patients with melanoma neck node metastasis who were treated with

  14. Validation of a cylindrical phantom for verification of radiotherapy treatments in head and neck with special techniques

    International Nuclear Information System (INIS)

    Vargas, Nicolas M.; Garcia, Marcia; Piriz, Gustavo; Perez, Niurka

    2011-01-01

    Verification of radiotherapy treatments in head and neck requires, among other things, small volume chambers and a phantom to reproduce the geometry and density of the anatomical structure. New documents from the ICRU (International Commission on Radiation Units and Measurements), Report 83, established the need for quality control in radiotherapy with special techniques such as IMRT (intensity-modulated radiation therapy). In this study, we built a cylindrical acrylic phantom with standing water, containing seven measuring points in the transverse plane and free location (0-20 cm) in the longitudinal plane. These points of measurement are constituted by cavities for the accommodation of the ionization chamber of 7 mm of mayor diameter (semi flex, pinpoint with build cup). The results of the phantom validation yielded percentage differences less than 1% in fixed beams and less than 2.5% in arc therapy for TPS Eclipse calculation. The preparation of this phantom, particularly made to verify the head and neck treatments, was simple and reliable for checking the dose in radiotherapy with fixed beams and/or special techniques such as arc therapy or IMRT, so that will be sent to various radiotherapy centers in the country for dosimetric verification in such treatments. (author)

  15. Validation of a cylindrical phantom for verification of radiotherapy treatments in head and neck with special techniques

    Energy Technology Data Exchange (ETDEWEB)

    Vargas, Nicolas M.; Garcia, Marcia, E-mail: nimoralesv@gmail.com [Universidad de La Frontera, Temuco (Chile). Dept. de Ciencias Fisicas; Piriz, Gustavo [Instituto Nacional del Cancer, Santiago (Chile). Fisica Medica; Perez, Niurka [Instituto de Salud Publica, Santiago (Chile). QA Radioterapia. Inst. de Salud Publica

    2011-07-01

    Verification of radiotherapy treatments in head and neck requires, among other things, small volume chambers and a phantom to reproduce the geometry and density of the anatomical structure. New documents from the ICRU (International Commission on Radiation Units and Measurements), Report 83, established the need for quality control in radiotherapy with special techniques such as IMRT (intensity-modulated radiation therapy). In this study, we built a cylindrical acrylic phantom with standing water, containing seven measuring points in the transverse plane and free location (0-20 cm) in the longitudinal plane. These points of measurement are constituted by cavities for the accommodation of the ionization chamber of 7 mm of mayor diameter (semi flex, pinpoint with build cup). The results of the phantom validation yielded percentage differences less than 1% in fixed beams and less than 2.5% in arc therapy for TPS Eclipse calculation. The preparation of this phantom, particularly made to verify the head and neck treatments, was simple and reliable for checking the dose in radiotherapy with fixed beams and/or special techniques such as arc therapy or IMRT, so that will be sent to various radiotherapy centers in the country for dosimetric verification in such treatments. (author)

  16. 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.

  17. Incidence and risk factors of hypomagnesemia in head and neck cancer patients treated with cetuximab

    Directory of Open Access Journals (Sweden)

    Tomohiro Enokida

    2016-09-01

    Full Text Available Background Hypomagnesemia is a common adverse event during cetuximab (Cmab treatment. However, few reports have investigated the incidence and risk factors of hypomagnesemia in head and neck cancer patients treated with Cmab. Methods We retrospectively reviewed 131 head and neck cancer patients who received Cmab-containing therapy. Main eligibility criteria were ≥3 Cmab administrations, no prior EGFR-directed therapy, and no prophylactic Mg supplementation.Results Median baseline serum Mg level and number of Cmab administrations were 2.2 mg/dl and eight, respectively. Overall incidence of hypomagnesemia was 50.4% (grade 1, 46.6%; grade 2, 3.1%; grade 3, 0%; grade 4, 0.8% and differed between patients treated with palliative chemotherapy and bioradiation (Cmab and radiation (63% vs. 24%; p<0.01. Independent risk factors were low baseline serum Mg [Odds ratio (OR 161.988, 95% confidence interval (CI 9.436-2780.895], ≥7 Cmab administrations (OR 3.56, 95% CI 1.16-13.98, and concurrent administration of platinum (cisplatin; OR 23.695, 95% CI 5.219-107.574, carboplatin; OR 5.487, 95% CI 1.831-16.439. Respective incidence of hypomagnesemia in patients in high- (concurrent platinum and ≥7 Cmab administrations and low-risk (no concurrent platinum and <7 Cmab administrations groups was 66.0% and 6.6% (P<0.001, OR 28.0. Conclusion Cmab is associated with a significant risk of hypomagnesemia in patients with head and neck cancer with longer term administration and concurrent platinum therapy. High-risk patients should be treated with particular care.

  18. Survival of dental implants in native and grafted bone in irradiated head and neck cancer patients: a retrospective analysis.

    Science.gov (United States)

    Buddula, Aravind; Assad, Daniel A; Salinas, Thomas J; Garces, Yolanda I

    2011-01-01

    To study the long-term survival of dental implants placed in native or grafted bone in irradiated bone in subjects who had received radiation for head and neck cancer. A retrospective chart review was conducted for all patients who received dental implants following radiation treatment for head and neck cancer between May 1, 1987 and July 1, 2008. Only patients irradiated with a radiation dose of 50 Gy or greater and those who received dental implants in the irradiated field after head and neck radiation were included in the study. The associations between implant survival and patient/implant characteristics were estimated by fitting univariate marginal Cox proportional hazards models. A total of 48 patients who had prior head and neck radiation had 271 dental implants placed during May 1987-July 2008. There was no statistically significant difference between implant failure in native and grafted bone (P=0.76). Survival of implants in grafted bone was 82.3% and 98.1% in maxilla and mandible, respectively, after 3 years. Survival of implants in native bone in maxilla and mandible was 79.8% and 100%, respectively, after 3 years. For implants placed in the native bone, there was a higher likelihood of failure in the maxilla compared to the mandible and there was also a tendency for implants placed in the posterior region to fail compared to those placed in the anterior region. There was no significant difference in survival when implants were placed in native or grafted bone in irradiated head and neck cancer patients. For implants placed in native bone, survival was significantly influenced by the location of the implant (maxilla or mandible, anterior or posterior).

  19. Effect of megestrol acetate and prepulsid on nutritional improvement in patients with head and neck cancers undergoing radiotherapy

    International Nuclear Information System (INIS)

    Chen, Hui-Chun; Leung, Stephen Wan; Wang, Chong-Jong; Sun, Li-Min; Fang, Fu-Min; Hsu, Jia-Hwa

    1997-01-01

    Background and purpose: Anorexia is a common problem in cancer patients who receive radiotherapy. In this current study, we attempt to determine the effect of megestrol acetate and prepulsid on appetite and nutritional improvement in patients with head and neck cancers undergoing radiotherapy. Materials and Methods: One hundred twenty-nine consecutive patients with head and neck cancers treated between July 1993 and June 1994 were prospectively randomized to receive either megestrol acetate, 40 mg qid (megace group), prepulsid, 5 mg tid (cisapride group), or a placebo treatment (control group) during radiotherapy. Before radiotherapy, body weight (kg), appetite score, performance status, biochemical parameters and hematological parameters were evaluated, and the above-noted clinical and biochemical parameters were assessed and recorded every other week. All patients received 6- 10 MV X-rays or Co-60 γ-ray to head and neck region for a full course of radiotherapy, 61.2-75.6 Gy/7-9 weeks. Results: Forty-eight patients were enrolled in the megace group, 41 patients in the cisapride group, and 40 patients in the control group. At the 2nd, 4th, 6th and 8th week, as the radiation dose escalated, the megace group had significantly less body weight loss than did the cisapride and control groups (P = 0.045, 0.024, 0.006, 0.003, respectively). The appetite scores of the megace group were significantly higher than those of the cisapride and control groups (P 0.0001). However, there were no statistically significant differences in the change of albumin level among these three groups at the 2nd, 4th, 6th and 8th week (P > 0.05, respectively). Conclusions: Megestrol acetate can significantly decrease the degree of body weight loss, and can prevent the deterioration of appetite in patients with head and neck cancers receiving radiotherapy. However, prepulsid lacks the above-mentioned clinical benefits

  20. Head and Neck Cancers

    Science.gov (United States)

    ... and neck include the following: Paan (betel quid) . Immigrants from Southeast Asia who use paan (betel quid) ... use this content on your website or other digital platform? Our syndication services page shows you how. ...

  1. 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.

  2. Work-related experiences of head and neck cancer survivors: an exploratory and descriptive qualitative study

    NARCIS (Netherlands)

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

    2017-01-01

    This exploratory and descriptive study contributes to the growing knowledge about the return-to-work (RTW) experience of head and neck cancer (HNC) survivors. Viewing RTW as a process, participants were asked to consider the work-related experience with HNC at different phases: (1) at

  3. Understanding behavioral mechanisms for physical activity in head and neck cancer patients: a qualitative study

    NARCIS (Netherlands)

    Sealy, Martine; Stuiver, M.M.; Midtgard, Julie; van der Schans, Cees; Roodenburg, Jan L N; Jager-Wittenaar, Harriët

    2017-01-01

    Rationale: Head and neck cancer (HNC) patients often have adverse changes in body composition. Loss of muscle mass and strength frequently occur, even when dietary intake is adequate. Nascent evidence suggests that a healthy lifestyle, including adequate physical activity (PA) and diet, may prevent

  4. 18F-Fdg-PET-guided Planning and Re-Planning (Adaptive) Radiotherapy in Head and Neck Cancer: Current State of Art.

    Science.gov (United States)

    Farina, Eleonora; Ferioli, Martina; Castellucci, Paolo; Farina, Arianna; Zanirato Rambaldi, Giuseppe; Cilla, Savino; Cammelli, Silvia; Fanti, Stefano; Morganti, Alessio G

    2017-12-01

    A review of the literature is proposed as a contribution to current knowledge on technical, physical, and clinical issues about PET-guided planning and re-planning radiotherapy (RT) in head and neck cancer. PubMed and Scopus electronic databases were searched for articles including clinical trials. Search terms were "gross tumor volume (GTV) delineation", "head and neck cancer", "radiotherapy", "adaptive radiotherapy" in combination with "PET". A 18 F-FDG-PET and CT-scan comparison in GTV definition for RT planning of head and neck cancer was shown in twenty-seven clinical trials with a total of 712 patients. Only two clinical trials focused on PET-guided adaptive radiotherapy (ART) with a total of 31 patients. 18 F-FDG-PET is able to achieve an accurate and precise definition of GTV boundaries during RT planning, especially in combination with CT-scan. ART strategies are proposed to evaluate tumor volume changes, plan boost irradiation on metabolically active residual neoplasm and protect organs at risk (OaRs). Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  5. Occupational Therapy for the Head and Neck Cancer Patient.

    Science.gov (United States)

    Park, Priscilla; Hashmi, Mahjabeen

    2018-01-01

    Occupational therapy is a health profession concerned with promoting health and well-being through occupation. A diagnosis of head and neck cancer (HNC) often invokes fear and anxiety because of the potential negative impact of the diagnosis and/or treatment on lifestyle and well-being. Occupational therapists perform a unique and important role in addressing quality of life concerns for HNC patients through applied expertise in lifestyle management, facilitating the use of positive coping strategies and daily routine management. Occupational therapy concurrently assists HNC patients to effectively manage the debilitating stress and anxiety associated with HNC diagnosis, treatment, and recovery while facilitating a return to prior or adapted daily routines.

  6. Utility of FMISO PET in advanced head and neck cancer treated with chemoradiation incorporating a hypoxia-targeting chemotherapy agent

    Energy Technology Data Exchange (ETDEWEB)

    Hicks, Rodney J. [Peter MacCallum Cancer Centre, Centre for Molecular Imaging, Melbourne (Australia); University of Melbourne, Department of Medicine, St Vincent' s Medical School, Melbourne (Australia); Rischin, Danny [University of Melbourne, Department of Medicine, St Vincent' s Medical School, Melbourne (Australia); Peter MacCallum Cancer Centre, Division of Haematology and Medical Oncology, Melbourne (Australia); Fisher, Richard [Peter MacCallum Cancer Centre, Centre for Biostatistics and Clinical Trials, Melbourne (Australia); Binns, David [Peter MacCallum Cancer Centre, Centre for Molecular Imaging, Melbourne (Australia); Scott, Andrew M. [Austin Hospital, Centre for PET, and Ludwig Institute for Cancer Research, Melbourne (Australia); Peters, Lester J. [Peter MacCallum Cancer Centre, Division of Radiation Oncology, Melbourne (Australia)

    2005-12-01

    The purpose of the study was to evaluate [{sup 18}F]fluoromisonidazole (FMISO) PET in advanced head and neck cancer during hypoxia-targeting therapy. Fifteen of 16 patients in a phase I trial of chemoradiation plus tirapazamine (specific cytotoxin for hypoxic cells) in advanced (T3/4 and/or N2/3) head and neck cancer underwent serial [{sup 18}F]fluorodeoxyglucose (FDG) and FMISO PET. We have previously reported excellent early clinical outcome of these patients and now review FMISO PET results in the context of longer follow-up of this patient cohort. Based on blinded qualitative scoring by two readers, FMISO PET was positive in 13/15 patients at baseline: 12/15 of primary sites and 8/13 neck nodes were scored as positive. All sites of corresponding FDG and FMISO abnormality at baseline showed marked qualitative reduction of uptake within 4 weeks of commencing therapy, consistent with effective hypoxia-targeted therapy. With a median follow-up of 6.9 years, there have been only four locoregional failures, while three other patients have died of metachronous lung cancer. The 5-year overall survival was 50% (95% CI 27-73%), the 5-year failure-free survival was 44% (95% CI 22-68%) and the 5-year freedom from locoregional failure was 68% (95% CI 38-88%). The high prevalence of hypoxia demonstrated on FMISO PET imaging is consistent with the advanced disease stage of these patients and would be expected to predict an adverse prognosis. Evidence of the early resolution of FMISO abnormality during treatment, associated with excellent locoregional control in this patient cohort, supports further investigation of hypoxia-targeting agents in advanced head and neck cancer. (orig.)

  7. Utility of FMISO PET in advanced head and neck cancer treated with chemoradiation incorporating a hypoxia-targeting chemotherapy agent

    International Nuclear Information System (INIS)

    Hicks, Rodney J.; Rischin, Danny; Fisher, Richard; Binns, David; Scott, Andrew M.; Peters, Lester J.

    2005-01-01

    The purpose of the study was to evaluate [ 18 F]fluoromisonidazole (FMISO) PET in advanced head and neck cancer during hypoxia-targeting therapy. Fifteen of 16 patients in a phase I trial of chemoradiation plus tirapazamine (specific cytotoxin for hypoxic cells) in advanced (T3/4 and/or N2/3) head and neck cancer underwent serial [ 18 F]fluorodeoxyglucose (FDG) and FMISO PET. We have previously reported excellent early clinical outcome of these patients and now review FMISO PET results in the context of longer follow-up of this patient cohort. Based on blinded qualitative scoring by two readers, FMISO PET was positive in 13/15 patients at baseline: 12/15 of primary sites and 8/13 neck nodes were scored as positive. All sites of corresponding FDG and FMISO abnormality at baseline showed marked qualitative reduction of uptake within 4 weeks of commencing therapy, consistent with effective hypoxia-targeted therapy. With a median follow-up of 6.9 years, there have been only four locoregional failures, while three other patients have died of metachronous lung cancer. The 5-year overall survival was 50% (95% CI 27-73%), the 5-year failure-free survival was 44% (95% CI 22-68%) and the 5-year freedom from locoregional failure was 68% (95% CI 38-88%). The high prevalence of hypoxia demonstrated on FMISO PET imaging is consistent with the advanced disease stage of these patients and would be expected to predict an adverse prognosis. Evidence of the early resolution of FMISO abnormality during treatment, associated with excellent locoregional control in this patient cohort, supports further investigation of hypoxia-targeting agents in advanced head and neck cancer. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Lluís Nisa

    2015-03-01

    Full Text Available 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.

  9. 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.

    1995-01-01

    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) Optimal integration of radiotherapy with surgery and/or chemotherapy. 5) The nutritional management of head and neck cancer patients including enteral and parenteral nutrition. 6) The use of medications to reduce the severity of acute symptomatology before, during and after radiation therapy

  10. 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

  11. 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

  12. Circulating Tumor DNA in Predicting Outcomes in Patients With Stage IV Head and Neck Cancer or Stage III-IV Non-small Cell Lung Cancer

    Science.gov (United States)

    2018-01-12

    Metastatic Squamous Neck Cancer With Occult Primary Squamous Cell Carcinoma; Salivary Gland Squamous Cell Carcinoma; Stage IIIA Non-small Cell Lung Cancer; Stage IIIB Non-small Cell Lung Cancer; Stage IV Non-small Cell Lung Cancer; Stage IV Squamous Cell Carcinoma of the Hypopharynx; Stage IV Squamous Cell Carcinoma of the Nasopharynx; Stage IVA Salivary Gland Cancer; Stage IVA Squamous Cell Carcinoma of the Larynx; Stage IVA Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVA Squamous Cell Carcinoma of the Oropharynx; Stage IVA Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVA Verrucous Carcinoma of the Larynx; Stage IVA Verrucous Carcinoma of the Oral Cavity; Stage IVB Salivary Gland Cancer; Stage IVB Squamous Cell Carcinoma of the Larynx; Stage IVB Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVB Squamous Cell Carcinoma of the Oropharynx; Stage IVB Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVB Verrucous Carcinoma of the Larynx; Stage IVB Verrucous Carcinoma of the Oral Cavity; Stage IVC Salivary Gland Cancer; Stage IVC Squamous Cell Carcinoma of the Larynx; Stage IVC Squamous Cell Carcinoma of the Lip and Oral Cavity; Stage IVC Squamous Cell Carcinoma of the Oropharynx; Stage IVC Squamous Cell Carcinoma of the Paranasal Sinus and Nasal Cavity; Stage IVC Verrucous Carcinoma of the Larynx; Stage IVC Verrucous Carcinoma of the Oral Cavity; Tongue Cancer; Untreated Metastatic Squamous Neck Cancer With Occult Primary

  13. 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...

  14. Fractionated BNCT for locally recurrent head and neck cancer: Experience from a phase I/II clinical trial at Tsing Hua Open-Pool Reactor

    International Nuclear Information System (INIS)

    Wang, Ling-Wei; Chen, Yi-Wei; Ho, Ching-Yin; Hsueh Liu, Yen-Wan; Chou, Fong-In; Liu, Yuan-Hao; Liu, Hong-Ming; Peir, Jinn-Jer; Jiang, Shiang-Huei; Chang, Chi-Wei; Liu, Ching-Sheng; Wang, Shyh-Jen; Chu, Pen-Yuan; Yen, Sang-Hue

    2014-01-01

    To introduce our experience of treating locally and regionally recurrent head and neck cancer patients with BNCT at Tsing Hua Open-Pool Reactor in Taiwan, 12 patients (M/F=10/2, median age 55.5 Y/O) were enrolled and 11 received two fractions of treatment. Fractionated BNCT at 30-day interval with adaptive planning according to changed T/N ratios was feasible, effective and safe for selected recurrent head and neck cancer in this trial. - Highlights: • We treated 12 patients with recurrent Head and Neck (H and N) cancer after radical surgery and radiotherapy since 2010. • Four complete response (CR) and 3 partial response (PR) were found. Total response rate was 58%. • Two patients had local control longer than one year. • No grade 4 or higher toxicity was noted for both acute and chronic effects

  15. Dose Sparing of Brainstem and Spinal Cord for Re-Irradiating Recurrent Head and Neck Cancer with Intensity-Modulated Radiotherapy

    International Nuclear Information System (INIS)

    Chen, Chin-Cheng; Lee, Chen-Chiao; Mah, Dennis; Sharma, Rajiv; Landau, Evan; Garg, Madhur; Wu, Andrew

    2011-01-01

    Because of the dose limit for critical structures such as brainstem and spinal cord, administering a dose of 60 Gy to patients with recurrent head and neck cancer is challenging for those who received a previous dose of 60-70 Gy. Specifically, previously irradiated head and neck patients may have received doses close to the tolerance limit to their brainstem and spinal cord. In this study, a reproducible intensity-modulated radiation therapy (IMRT) treatment design is presented to spare the doses to brainstem and spinal cord, with no compromise of prescribed dose delivery. Between July and November 2008, 7 patients with previously irradiated, recurrent head and neck cancers were treated with IMRT. The jaws of each field were set fixed with the goal of shielding the brainstem and spinal cord at the sacrifice of partial coverage of the planning target volume (PTV) from any particular beam orientation. Beam geometry was arranged to have sufficient coverage of the PTV and ensure that the constraints of spinal cord o , patients could be treated by 18 fields. Six patients met these criteria and were treated in 25 minutes per fraction. One patient exceeded a 30 o Cobb's angle and was treated by 31 fields in 45 minutes per fraction. We have demonstrated a new technique for retreatment of head and neck cancers. The angle of cervical spine curvature plays an important role in the efficiency and effectiveness of our approach.

  16. 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

  17. PET/MRI in head and neck cancer: initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Platzek, Ivan; Laniado, Michael [Dresden University Hospital, Department of Radiology, Dresden (Germany); Beuthien-Baumann, Bettina [Dresden University Hospital, Department of Nuclear Medicine, Dresden (Germany); Schneider, Matthias [Dresden University Hospital, Oral and Maxillofacial Surgery, Dresden (Germany); Gudziol, Volker [Dresden University Hospital, Department of Otolaryngology, Dresden (Germany); Langner, Jens; Schramm, Georg; Hoff, Joerg van den [Institute of Bioinorganic and Radiopharmaceutical Chemistry, Helmholtz-Zentrum Dresden-Rossendorf, Dresden (Germany); Kotzerke, Joerg [Dresden University Hospital, Nuclear Medicine, Dresden (Germany)

    2013-01-15

    To evaluate the feasibility of PET/MRI (positron emission tomography/magnetic resonance imaging) with FDG ({sup 18}F-fluorodeoxyglucose) for initial staging of head and neck cancer. The study group comprised 20 patients (16 men, 4 women) aged between 52 and 81 years (median 64 years) with histologically proven squamous cell carcinoma of the head and neck region. The patients underwent a PET scan on a conventional scanner and a subsequent PET/MRI examination on a whole-body hybrid system. FDG was administered intravenously prior to the conventional PET scan (267-395 MBq FDG, 348 MBq on average). The maximum standardized uptake values (SUV{sub max}) of the tumour and of both cerebellar hemispheres were determined for both PET datasets. The numbers of lymph nodes with increased FDG uptake were compared between the two PET datasets. No MRI-induced artefacts where observed in the PET images. The tumour was detected by PET/MRI in 17 of the 20 patients, by PET in 16 and by MRI in 14. The PET/MRI examination yielded significantly higher SUV{sub max} than the conventional PET scanner for both the tumour (p < 0.0001) and the cerebellum (p = 0.0009). The number of lymph nodes with increased FDG uptake detected using the PET dataset from the PET/MRI system was significantly higher the number detected by the stand-alone PET system (64 vs. 39, p = 0.001). The current study demonstrated that PET/MRI of the whole head and neck region is feasible with a whole-body PET/MRI system without impairment of PET or MR image quality. (orig.)

  18. A systematic literature review of health state utility values in head and neck cancer.

    Science.gov (United States)

    Meregaglia, Michela; Cairns, John

    2017-09-02

    Health state utility values (HSUVs) are essential parameters in model-based economic evaluations. This study systematically identifies HSUVs in head and neck cancer and provides guidance for selecting them from a growing body of health-related quality of life studies. We systematically reviewed the published literature by searching PubMed, EMBASE and The Cochrane Library using a pre-defined combination of keywords. The Tufts Cost-Effectiveness Analysis Registry and the School of Health and Related Research Health Utilities Database (ScHARRHUD) specifically containing health utilities were also queried, in addition to the Health Economics Research Centre database of mapping studies. Studies were considered for inclusion if reporting original HSUVs assessed using established techniques. The characteristics of each study including country, design, sample size, cancer subsite addressed and demographics of responders were summarized narratively using a data extraction form. Quality scoring and critical appraisal of the included studies were performed based on published recommendations. Of a total 1048 records identified by the search, 28 studies qualified for data extraction and 346 unique HSUVs were retrieved from them. HSUVs were estimated using direct methods (e.g. standard gamble; n = 10 studies), multi-attribute utility instruments (MAUIs; n = 13) and mapping techniques (n = 3); two studies adopted both direct and indirect approaches. Within the MAUIs, the EuroQol 5-dimension questionnaire (EQ-5D) was the most frequently used (n = 11), followed by the Health Utility Index Mark 3 (HUI3; n = 2), the 15D (n = 2) and the Short Form-Six Dimension (SF-6D; n = 1). Different methods and types of responders (i.e. patients, healthy subjects, clinical experts) influenced the magnitude of HSUVs for comparable health states. Only one mapping study developed an original algorithm using head and neck cancer data. The identified studies were considered

  19. The Effect of Topical Application of Royal Jelly on Chemoradiotherapy-Induced Mucositis in Head and Neck Cancer: A Preliminary Study

    Directory of Open Access Journals (Sweden)

    Kohichi Yamauchi

    2014-01-01

    Full Text Available Purpose. One of the common side effects experienced by head and neck cancer patients on chemoradiotherapy is mucositis. Severe mucositis may be controllable by limiting cancer therapy, but it has resulted in decreasing the completion rate of chemoradiotherapy. The efficacy of royal jelly (RJ as prophylaxis against chemoradiotherapy-induced mucositis was evaluated through clinical scoring of oral and pharyngeal mucositis. Methods. In this randomized, single-blind (physician-blind, clinical trial, 13 patients with head and neck cancer requiring chemoradiation were randomly assigned to two groups. Seven patients assigned to the study group received RJ, and 6 patients were assigned to the control group. RJ group patients took RJ three times per day during treatment. The patients in both groups were evaluated twice a week for the development of mucositis using Common Terminology Criteria for Adverse Events version 3.0. Results. A significant reduction in mucositis was seen among RJ-treated patients compared with controls (P<0.001. Conclusion. This study demonstrated that prophylactic use of RJ was effective in reducing mucositis induced by chemoradiotherapy in head and neck cancer patients. However, further studies are needed because of the small sample size and the absence of double blinding.

  20. 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

  1. Compounds From Celastraceae Targeting Cancer Pathways and Their Potential Application in Head and Neck Squamous Cell Carcinoma: A Review.

    Science.gov (United States)

    Hernandes, Camila; Pereira, Ana Maria Soares; Severino, Patricia

    2017-02-01

    Squamous cell carcinoma of the head and neck is one of the most common cancer types worldwide. It initiates on the epithelial lining of the upper aerodigestive tract, at most instances as a consequence of tobacco and alcohol consumption. Treatment options based on conventional therapies or targeted therapies under development have limited efficacy due to multiple genetic alterations typically found in this cancer type. Natural products derived from plants often possess biological activities that may be valuable in the development of new therapeutic agents for cancer treatment. Several genera from the family Celastraceae have been studied in this context. This review reports studies on chemical constituents isolated from species from the Celastraceae family targeting cancer mechanisms studied to date. These results are then correlated with molecular characteristics of head and neck squamous cell carcinoma in an attempt to identify constituents with potential application in the treatment of this complex disease at the molecular level.

  2. Prevalence and management of pulmonary comorbidity in patients with lung and head and neck cancer

    DEFF Research Database (Denmark)

    Gottlieb, Magnus; Marsaa, Kristoffer; Godtfredsen, Nina S

    2015-01-01

    BACKGROUND: The simultaneous presence of cancer and other medical conditions (comorbidity) is frequent. Cigarette smoking is the major risk factor for as well head and neck cancer (HNC) and lung cancer (LC) as chronic obstructive pulmonary disease (COPD). COPD is the most common comorbidity in LC...... guidelines. Secondary outcome was feasibility, i.e. the proportion of eligible patients that accepted follow-up in the pulmonary clinic for 24 weeks in addition to oncological treatment. The design of the randomized trail is described in detail. RESULTS: In total 130 patients of whom 65% had LC and 35% HNC...

  3. Nutritional status, food intake, and dysphagia in long-term survivors with head and neck cancer treated with chemoradiotherapy: a cross-sectional study.

    Science.gov (United States)

    van den Berg, Manon G A; Rütten, Heidi; Rasmussen-Conrad, Ellen L; Knuijt, Simone; Takes, Robert P; van Herpen, Carla M L; Wanten, Geert J A; Kaanders, Johannes H A M; Merkx, Matthias A W

    2014-01-01

    The aim of this study was to evaluate nutritional status, food intake, and dysphagia in long-term head and neck cancer survivors. Thirty-two patients with stage III-IV head and neck cancer treated by chemoradiotherapy were invited to evaluate nutritional status (malnutrition, relative weight loss), food intake (food modification; quality), and dysphagia. At a median follow up of 44 months, 6 of 32 patients were at risk for malnutrition. Women (p = .049) and patients with high body mass index before treatment (p = .024) showed more weight loss. None of the 32 patients could eat a "full diet." Six patients used nutritional supplements/tube feeding. Low dysphagia-related quality of life scores were significantly correlated to increased food modification (r = 0.405; p = .024). Nutritional advice in patients with head and neck cancer is still necessary years after chemoradiation and should focus on nutritional status, food modification, and quality, in accord with recommended food groups. Copyright © 2013 Wiley Periodicals, Inc.

  4. 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)

  5. Postoperative radiotherapy after laser surgery with or without chemotherapy in head and neck evolved cancers; Radiotherapie postoperatoire apres chirurgie laser avec ou sans chimiotherapie dans les cancers evolues de la tete et du cou

    Energy Technology Data Exchange (ETDEWEB)

    Ryll, L.; Pradier, O. [Centre Hospitalier Universitaire Morvan, Dept. de Cancerologie, Brest (France); Nitsche, M.; Christiansen, H.; Hess, C. [Universitatsklinikum, Dept. de Cancerologie, Goettingen (Germany)

    2007-11-15

    We compared concurrent combination chemoradiotherapy and adjuvant radiotherapy after laser surgery in patients with stage 3/4 non metastatic squamous cell head and neck cancer. Combination chemotherapy and concurrent irradiation after laser surgery was not superior to surgery and postoperative radiotherapy for resectable advanced squamous cell head and neck cancer. However, the collective is small, and the follow-up to short to conclude. (authors)

  6. The incidence of late neck recurrence in N0 maxillary sinus squamous cell carcinomas after superselective intra-arterial chemoradiotherapy without prophylactic neck irradiation.

    Science.gov (United States)

    Sakashita, Tomohiro; Homma, Akihiro; Hatakeyama, Hiromitsu; Kano, Satoshi; Mizumachi, Takatsugu; Furusawa, Jun; Yoshida, Daisuke; Fujima, Noriyuki; Onimaru, Rikiya; Tsuchiya, Kazuhiko; Yasuda, Koichi; Shirato, Hiroki; Fukuda, Satoshi

    2014-10-01

    The efficacy of elective neck irradiation (ENI) for patients with N0 carcinoma of the maxillary sinus has been controversial. The purpose of our study was to investigate the incidence of late neck recurrence and the mortality rate from regional disease in patients with N0 maxillary sinus cancer after superselective cisplatin infusion and concomitant radiotherapy (RADPLAT) without ENI. We retrospectively analyzed 48 patients with N0 maxillary sinus cancer who underwent RADPLAT. Chemotherapy consisted of 100-120 mg/m(2) superselective intra-arterial cisplatin administered at a median rate of four times weekly. Concurrent radiation therapy was administered at a median dose of 65 Gy without ENI. Late neck recurrence was observed in 8.3% (4/48). Three patients underwent salvage neck dissection and survived without any evidence of disease. The remaining patient did not undergo neck dissection due to coexistence with distant metastasis, and he died of regional disease. The mortality rate from regional disease was calculated to be 2% (1/48). The incidence of late neck recurrence was not frequent, and the mortality rate from regional disease was low. Salvage neck dissection was considered to be feasible for patients with late neck recurrence. When definitive radiotherapy and concomitant chemotherapy are applied, it is considered that ENI is not required for cases of N0 maxillary sinus cancer.

  7. Genetics Home Reference: head and neck squamous cell carcinoma

    Science.gov (United States)

    ... and neck squamous cell carcinoma Head and neck squamous cell carcinoma Printable PDF Open All Close All Enable Javascript ... Consumer Version: Overview of Mouth, Nose, and Throat Cancers Orphanet: Squamous cell carcinoma of head and neck University of Michigan ...

  8. Survival of dental implants in native and grafted bone in irradiated head and neck cancer patients: A retrospective analysis

    Directory of Open Access Journals (Sweden)

    Aravind Buddula

    2011-01-01

    Full Text Available Aim: To study the long-term survival of dental implants placed in native or grafted bone in irradiated bone in subjects who had received radiation for head and neck cancer. Materials and Methods: A retrospective chart review was conducted for all patients who received dental implants following radiation treatment for head and neck cancer between May 1, 1987 and July 1, 2008. Only patients irradiated with a radiation dose of 50 Gy or greater and those who received dental implants in the irradiated field after head and neck radiation were included in the study. The associations between implant survival and patient/implant characteristics were estimated by fitting univariate marginal Cox proportional hazards models. Results: A total of 48 patients who had prior head and neck radiation had 271 dental implants placed during May 1987-July 2008. There was no statistically significant difference between implant failure in native and grafted bone (P=0.76. Survival of implants in grafted bone was 82.3% and 98.1% in maxilla and mandible, respectively, after 3 years. Survival of implants in native bone in maxilla and mandible was 79.8% and 100%, respectively, after 3 years. For implants placed in the native bone, there was a higher likelihood of failure in the maxilla compared to the mandible and there was also a tendency for implants placed in the posterior region to fail compared to those placed in the anterior region. Conclusion: There was no significant difference in survival when implants were placed in native or grafted bone in irradiated head and neck cancer patients. For implants placed in native bone, survival was significantly influenced by the location of the implant (maxilla or mandible, anterior or posterior.

  9. 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

  10. Polymorphism of regulatory region of GHRL gene (-2531C>T) as a promising predictive factor for radiotherapy-induced oral mucositis in patients with head neck cancer.

    Science.gov (United States)

    Brzozowska, Anna; Homa-Mlak, Iwona; Mlak, Radosław; Gołębiowski, Paweł; Mazurek, Marcin; Ciesielka, Marzanna; Małecka-Massalska, Teresa

    2018-03-22

    The purpose of this study was to investigate the relationship between single nucleotide polymorphisms (SNP; rs1629816) in the regulatory region (c.-2531C>T) of the ghrelin (GHRL) gene and the occurrence and severity of oral mucositis caused by radiotherapy (RT) in patients with head and neck cancer. Oral mucositis in 65 patients with head and neck cancer who underwent irradiation were assessed according to Radiation Therapy Oncology Group (RTOG)/European Organisation for Research and Treatment of Cancer (EORTC) scale. The DNA from patients with head and neck cancer was isolated from whole blood. The genotypes were determined using the minisequencing method (SNaPshot PCR). The frequency of occurrence of the GHRL gene (c.-2531C>T, rs1629816) genotypes were as follows: AA = 21.5%; GA = 40%; and GG = 38.5%. In case of AA genotype, there was a 7-fold decrease of the risk of occurrence of oral mucositis (of grades 2 and 3) in the sixth week of RT (AA vs GA or GG, respectively: 17.9% vs 82.1% patients; odds ratio [OR] 0.14; 95% confidence interval [CI] 0.02-0.98; P = .0481). No statistically significant differences were observed between the volume of oral cavity contours (V30, V40, and V50) depending on the GHRL genotype in patients with head and neck cancer. The study results have demonstrated an association between the AA genotype of the GHRL gene and the risk of more severe oral mucositis attributed to RT in patients with head and neck cancer. © 2018 Wiley Periodicals, Inc.

  11. The association of lifetime physical inactivity with head and neck cancer: a hospital-based case-control analysis.

    Science.gov (United States)

    Platek, Alexis J; Cannioto, Rikki A; Etter, John Lewis; Kim, Jae; Joseph, Janine M; Gulati, Nicholas R; Schmitt, Kristina L; Callahan, Emily; Khachatryan, Edgar; Nagy, Ryan; Minlikeeva, Albina; Brian Szender, J; Singh, Anurag K; Danziger, Iris; Moysich, Kirsten B

    2017-10-01

    Despite mounting epidemiological evidence suggesting an inverse association between recreational physical activity and cancer risk, evidence associated with head and neck cancer is scant. We conducted a case-control analysis to examine the associations of lifetime physical inactivity with the risk of head and neck squamous cell carcinoma (HNSCC). We utilized data from the Patient Epidemiology Data System at Roswell Park Cancer Institute (RPCI). Participants included 246 patients with HNSCC and 504 cancer-free controls who received medical services at RPCI between 1990 and 1998. Participants were considered physically inactive if they did not participate in any regular, weekly recreational physical activity throughout their lifetime, prior to diagnosis. Multivariate logistic regression models were utilized to estimate odds ratios (OR) and 95% confidence intervals (CI) representing the association between lifetime physical inactivity and HNSCC risk. We observed a significant positive association between recreational physical inactivity and HNSCC risk (OR = 2.73, 95% CI 1.87-3.99, p physical inactivity associates with HNSCC independent of BMI. In addition, physical inactivity may be a modifiable risk factor among never smokers. These data add to the growing body of evidence suggesting that physical inactivity may be an independent risk factor for cancer.

  12. Surgical Management of Perineural Spread of Head and Neck Cancers.

    Science.gov (United States)

    Solares, C Arturo; Mason, Eric; Panizza, Benedict J

    2016-04-01

    The surgical management of perineural spread of head and neck cancers has become an integral part in the contemporary treatment of this pathology. We now understand that tumour spreads within the epineurium and in a continuous fashion. We also can rely on the accuracy of magnetic resonance neurography in detecting and defining the extent of disease. With modern skull base techniques and a greater understanding of the anatomy in this region, specific operations can be designed to help eradicate disease. We review the current approaches and techniques used that enable us to better obtain tumour free margins and hence improve survival.

  13. 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.

  14. 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

  15. Oral sex and human papilloma virus-related head and neck squamous cell cancer: a review of the literature.

    Science.gov (United States)

    Shah, Ankit; Malik, Akshat; Garg, Apurva; Mair, Manish; Nair, Sudhir; Chaturvedi, Pankaj

    2017-11-01

    Head neck squamous cell carcinomas (HNSCCs) are a significant cause of morbidity and mortality all around the world. Just like tobacco and alcohol, Human papilloma virus (HPV) infection is now recognized to play a role in the pathogenesis of a subset of HNSCCs. Unprotected sexual behaviours with the HPV carrier plays an important role in transmission of this virus. The global incidence of head and neck cancers is declining, but the incidence of HPV related head and neck cancers is rapidly increasing over the last few decades. However, most institutions do not mandate documentation of sexual history or counselling of patients regarding sexual practices like they do for tobacco and alcohol addictions in HNSCC patients. The aim of this review of literature is to analyse if there is a strong evidence to correlate oral sex with HPV related HNSCC and counsel the patient's regarding sexual behaviours. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. 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

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

    Directory of Open Access Journals (Sweden)

    Andreas Maier

    2010-01-01

    Full Text Available 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 laryngectomized patients with cancer of the larynx or hypopharynx and 49 German patients who had suffered from oral cancer. The speech recognition provides the percentage of correctly recognized words of a sequence, that is, the word recognition rate. Automatic evaluation was compared to perceptual ratings by a panel of experts and to an age-matched control group. Both patient groups showed significantly lower word recognition rates than the control group. Automatic speech recognition yielded word recognition rates which complied with experts' evaluation of intelligibility on a significant level. Automatic speech recognition serves as a good means with low effort to objectify and quantify the most important aspect of pathologic speech—the intelligibility. The system was successfully applied to voice and speech disorders.

  18. Femoral neck fracture following groin irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Grigsby, Perry W; Roberts, Heidi L; Perez, Carlos A

    1995-04-30

    Purpose: The incidence and risk factors are evaluated for femoral neck fracture following groin irradiation for gynecologic malignancies. Methods and Materials: The radiation therapy records of 1313 patients with advanced and recurrent cancer of the vagina, vulva, cervix, and endometrium, treated at the Mallinckrodt Institute of Radiology from 1954 to 1992, were reviewed. Median follow-up was 12.7 years. From this group, 207 patients were identified who received irradiation to the pelvis and groins with anterposterior-posterior anterior (AP-PA), 18 MV photons. Data were reviewed regarding irradiation dose to the femoral neck and other presumed risk factors including age, primary site, stage, groin node status, menopausal status, estrogen use, cigarette use, alcohol consumption, and osteoporosis. Results: The per-patient incidence of femoral neck fracture was 4.8% (10 out of 207). Four patients developed bilateral fractures. However, the cumulative actuarial incidence of fracture was 11% at 5 years and 15% at 10 years. Cox multivariate analysis of age, weight, and irradiation dose showed that only irradiation dose may be important to developing fracture. Step-wise logistic regression of presumed prognostic factors revealed that only cigarette use and x-ray evidence of osteoporosis prior to irradiation treatment were predictive of fracture. Conclusion: Femoral head fracture is a common complication of groin irradiation for gynecologic malignancies. Fracture in our database appears to be related to irradiation dose, cigarette use, and x-ray evidence of osteoporosis. Special attention should be given in treatment planning (i.e., shielding of femoral head/neck and use of appropriate electron beam energies for a portion of treatment) to reduce the incidence of this complication.

  19. Femoral neck fracture following groin irradiation

    International Nuclear Information System (INIS)

    Grigsby, Perry W.; Roberts, Heidi L.; Perez, Carlos A.

    1995-01-01

    Purpose: The incidence and risk factors are evaluated for femoral neck fracture following groin irradiation for gynecologic malignancies. Methods and Materials: The radiation therapy records of 1313 patients with advanced and recurrent cancer of the vagina, vulva, cervix, and endometrium, treated at the Mallinckrodt Institute of Radiology from 1954 to 1992, were reviewed. Median follow-up was 12.7 years. From this group, 207 patients were identified who received irradiation to the pelvis and groins with anterposterior-posterior anterior (AP-PA), 18 MV photons. Data were reviewed regarding irradiation dose to the femoral neck and other presumed risk factors including age, primary site, stage, groin node status, menopausal status, estrogen use, cigarette use, alcohol consumption, and osteoporosis. Results: The per-patient incidence of femoral neck fracture was 4.8% (10 out of 207). Four patients developed bilateral fractures. However, the cumulative actuarial incidence of fracture was 11% at 5 years and 15% at 10 years. Cox multivariate analysis of age, weight, and irradiation dose showed that only irradiation dose may be important to developing fracture. Step-wise logistic regression of presumed prognostic factors revealed that only cigarette use and x-ray evidence of osteoporosis prior to irradiation treatment were predictive of fracture. Conclusion: Femoral head fracture is a common complication of groin irradiation for gynecologic malignancies. Fracture in our database appears to be related to irradiation dose, cigarette use, and x-ray evidence of osteoporosis. Special attention should be given in treatment planning (i.e., shielding of femoral head/neck and use of appropriate electron beam energies for a portion of treatment) to reduce the incidence of this complication

  20. Incidence and Risk Factors of Refeeding Syndrome in Head and Neck Cancer Patients-An Observational Study.

    Science.gov (United States)

    Rasmussen, Stine Ostenfeldt; Kristensen, Marianne Boll; Wessel, Irene; Andersen, Jens Rikardt

    2016-01-01

    This study aimed to determine the incidence rates of refeeding phenomena (defined as a decline in p-phosphate) and refeeding syndrome (RFS; defined as development of clinical symptoms in addition to a decline in p-phosphate) in head and neck cancer patients, and to identify risk factors. Fifty-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 presented a higher prevalence of head and neck pain, eating difficulties, higher p-phosphate levels, lower p-transferrin levels, and, in men, lower b-hemoglobin levels. Patients who developed symptoms had a decline in p-phosphate ≥0.22 mmol/l. At baseline, these patients had higher p-phosphate levels, higher alcohol consumption, and lower p-transferrin and p-sodium levels, as well as a higher prevalence of eating difficulties, low handgrip strength (HGS), and a history of radiation therapy. The risk factors most strongly associated with the development of refeeding phenomena and RFS were pain, eating difficulties, low HGS, high alcohol intake, and previous radiation therapy.

  1. Primary malignant head and neck tumours in Ghana: a survey of ...

    African Journals Online (AJOL)

    Aim: To determine the incidence of primary head and neck cancers seen at Korle Bu Teaching hospital, Ghana. Methods: A retrospective study of histopathological records of diagnosed head and neck cancers from 1989-2008. Results: 2,041 of 4,546 reports were malignant. 1342 were primary cancers. These were studied ...

  2. Utilization of intensity modulated beam radiotherapy (IMBXRT) to diminish dose to the parotid gland in head and neck cancer

    International Nuclear Information System (INIS)

    Shiao, W. Woo; Grant, Walter H.; Butler, E. Brian

    1996-01-01

    Purpose/Objective: To determine if intensity conformal modulated radiotherapy could diminish the radiation dose to the parotid gland in the treatment of primary head and neck cancer. Materials and Methods: The NOMOS Peacock treatment system was utilized in the planning and delivery of conformal radiotherapy for the following diseases: 1) an oropharyngeal cancer that extends from the soft palate to the tonsillar fossa without nodal disease, 2) laryngeal hypopharyngeal cancer without nodal disease, 3) and adenocystic carcinoma, that originated in the hard palate. Patients were treated to areas suspicious for microscopic disease (nodal disease in 1 and 2, perineural spread in 3) at 2 Gy per fraction for a tc of 50 Gy in five weeks. The primary disease was treated at 2.4 Gy per fraction for a total of 60 Gy over five weeks. The percent of the volume of each parotid gland receiving < 20 Gy, <25 Gy and <30 Gy retrospectively was determined for each of the above mentioned optimized plans. The patients were observed for the clinical development of xerostomia. Results: No patient developed clinically apparent xerostomia within one month of completion of radiotherapy. Conclusion: IMBXRT could reduce the volume to parotid glands receiving high radiation doses. Sparing of the parotid glands appear to be most easily accomplished when irradiating head and neck tumors that do not require regional nodal treatment. For head and neck cancer that requires nodal treatment it is possible to spare a significant portion of the parotid glands if the disease originates below the hyoid bone where the primary site is not in close proximity to the parotid glands. Objective salivary flow data are being obtained pre ar post treatment, to confirm the subjective impression of lack of clinical xerostomia. IMBXRT is potentially beneficial in decreasing the morbidity of xerostomia related to head and neck irradiation

  3. Effect of CT contrast on volumetric arc therapy planning (RapidArc and helical tomotherapy) for head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Alan J.; Vora, Nayana [Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA (United States); Suh, Steve [Department of Radiation Physics, City of Hope National Medical Center, Duarte, CA (United States); Liu, An, E-mail: aliu@coh.org [Department of Radiation Physics, City of Hope National Medical Center, Duarte, CA (United States); Schultheiss, Timothy E. [Department of Radiation Physics, City of Hope National Medical Center, Duarte, CA (United States); Wong, Jeffrey Y.C. [Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA (United States)

    2015-04-01

    The objectives of the study were to evaluate the effect of intravenous contrast in the dosimetry of helical tomotherapy and RapidArc treatment for head and neck cancer and determine if it is acceptable during the computed tomography (CT) simulation to acquire only CT with contrast for treatment planning of head and neck cancer. Overall, 5 patients with head and neck cancer (4 men and 1 woman) treated on helical tomotherapy were analyzed retrospectively. For each patient, 2 consecutive CT scans were performed. The first CT set was scanned before the contrast injection and secondary study set was scanned 45 seconds after contrast. The 2 CTs were autoregistered using the same Digital Imaging and Communications in Medicine coordinates. Tomotherapy and RapidArc plans were generated on 1 CT data set and subsequently copied to the second CT set. Dose calculation was performed, and dose difference was analyzed to evaluate the influence of intravenous contrast media. The dose matrix used for comparison included mean, minimum and maximum doses of planning target volume (PTV), PTV dose coverage, and V{sub 45} {sub Gy}, V{sub 30} {sub Gy}, and V{sub 20} {sub Gy} organ doses. Treatment planning on contrasted images generally showed a lower dose to both organs and target than plans on noncontrasted images. The doses for the points of interest placed in the organs and target rarely changed more than 2% in any patient. In conclusion, treatment planning using a contrasted image had insignificant effect on the dose to the organs and targets. In our opinion, only CT with contrast needs to be acquired during the CT simulation for head and neck cancer. Dose calculations performed on contrasted images can potentially underestimate the delivery dose slightly. However, the errors of planning on a contrasted image should not affect the result in clinically significant way.

  4. 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.

  5. Chemotherapy and radiotherapy for elderly head and neck cancer patients

    International Nuclear Information System (INIS)

    Fujii, Masato

    2012-01-01

    Among head and neck cancers, cases affecting elderly people are increasing. Radical treatment is sometimes difficult in advanced cases of elderly patients. With progressive cancer, because radical surgery is often difficult, radiotherapy is chosen and may be used together with chemotherapy when overall status is good. However, according to the meta-analysis of Pignon et al., the chemoradiotherapy for elderly patients 71 years old or older, the hazard ratio becomes approximately 0.95, and there is little chemotherapy combined effect. In terms of 5-year survival rate, chemotherapy combined effect is -0.7%. Chemotherapy effect in elderly patients is not clear in past clinical trials. We examined 50 cases 75 years or older treated mainly by radiotherapy at Tokyo Medical Center between February, 2003 and August, 2011. In all, 21 of the 50 patients died, including four who died due to other cancers, while pneumonia accounted for five other deaths. These results suggested that various complications are often present and multiple primary cancers often occur in elderly people. With chemotherapy for elderly people, the effect of radiotherapy treatment and quality of life of the patients should be considered fully based on characteristics of elderly people, and a treatment plan devised accordingly. It is also necessary to undertake care after treatment. (author)

  6. 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. |

  7. Oropharyngeal dysphagia: the experience of patients with non-head and neck cancers receiving specialist palliative care.

    Science.gov (United States)

    Roe, Justin W G; Leslie, Paula; Drinnan, Michael J

    2007-10-01

    Difficulty swallowing is a well-documented symptom in head and neck cancer and oesophageal malignancy. The frequency of oropharyngeal swallowing difficulties in the palliative phase of other malignancies is less reported. 1) To describe the patient experience of swallowing and associated difficulties while receiving specialist palliative care for malignancies other than those affecting the head and neck and 2) to identify the quality of life issues for the participants with dysphagia and compare with normative and dysphagic data provided by SWAL-QOL. Four month prospective pilot study - questionnaire design. Acute teaching hospital. Eleven patients receiving specialist palliative care. Participants were interviewed using a modified version of the SWAL-QOL, a validated quality of life assessment tool for use specifically with people with oropharyngeal dysphagia. Eight quality of life domains were explored as well as fourteen dysphagic symptoms. Seven of the 11 participants had dysphagic symptoms detailed in the SWAL-QOL and a further two patients reported transient dysphagic symptoms since diagnosis of their disease. Nine participants reported an impact on their quality of life and three reported a considerable impact in four or more domains. Eight of the 11 participants had self-selected softer textured foods. A notable group were three patients with lung cancer and one with lung metastases with a history of vocal fold motion impairment, all of who had experienced dysphagic symptoms since diagnosis. Patients with cancers not affecting the head and neck are at risk of developing symptoms of oropharyngeal dysphagia and subsequently, compromized nutrition, hydration and quality of life. Areas for further research are suggested.

  8. Pretreatment Quality of Life Predicts for Locoregional Control in Head and Neck Cancer Patients: A Radiation Therapy Oncology Group Analysis

    International Nuclear Information System (INIS)

    Siddiqui, Farzan; Pajak, Thomas F.; Watkins-Bruner, Deborah; Konski, Andre A.; Coyne, James C.; Gwede, Clement K.; Garden, Adam S.; Spencer, Sharon A.; Jones, Christopher; Movsas, Benjamin

    2008-01-01

    Purpose: To analyze the prospectively collected health-related quality-of-life (HRQOL) data from patients enrolled in two Radiation Therapy Oncology Group randomized Phase III head and neck cancer trials (90-03 and 91-11) to assess their value as an independent prognostic factor for locoregional control (LRC) and/or overall survival (OS). Methods and Materials: HRQOL questionnaires, using a validated instrument, the Functional Assessment of Cancer Therapy-Head and Neck (FACT-H and N), version 2, were completed by patients before the start of treatment. OS and LRC were the outcome measures analyzed using a multivariate Cox proportional hazard model. Results: Baseline FACT-H and N data were available for 1,093 patients and missing for 417 patients. No significant difference in outcome was found between the patients with and without baseline FACT-H and N data (p = 0.58). The median follow-up time was 27.2 months for all patients and 49 months for surviving patients. Multivariate analyses were performed for both OS and LRC. Beyond tumor and nodal stage, Karnofsky performance status, primary site, cigarette use, use of concurrent chemotherapy, and altered fractionation schedules, the FACT-H and N score was independently predictive of LRC (but not OS), with p = 0.0038. The functional well-being component of the FACT-H and N predicted most significantly for LRC (p = 0.0004). Conclusions: This study represents, to our knowledge, the largest analysis of HRQOL as a prognostic factor in locally advanced head and neck cancer patients. The results of this study have demonstrated the importance of baseline HRQOL as a significant and independent predictor of LRC in patients with locally advanced head and neck cancer

  9. 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.

  10. Free fibula flap: assessment of quality of life of patients with head and neck cancer who have had defects reconstructed.

    Science.gov (United States)

    Zhang, Xu; Li, Meng-Jie; Fang, Qi-Gen; Li, Zhen-Ning; Li, Wen-Lu; Sun, Chang-Fu

    2013-11-01

    This study investigated the quality of life (QoL) of patients with head and neck cancer undergoing immediate reconstruction of the mandible with free fibula flap. From March 2006 to January 2011, the QoL of 42 patients was assessed using the Medical Outcomes Study Short Form 36 and the University of Washington QoL (version 4) questionnaires. The assessments were performed at least 24 months after surgery. A total of 31 of the 42 questionnaires (73.8%) were returned. The length of harvested fibula varied from 17.5 to 26.1 cm. In the Short Form 36, the lowest-scoring domain was vitality, whereas the highest scores occurred in physical role. According to the University of Washington QoL, the key domains affected by surgery are chewing, speech, and appearance. The domain of pain has the best score. There was a significant effect on the QoL of patients with head and neck cancer with resections of the mandible who had undergone free fibula flap reconstruction. Data from this study may provide useful information for physicians and patients, which may be of value during discussion of treatment modalities for head and neck cancers.

  11. Follow-up strategies in head and neck cancer other than upper aerodigestive tract squamous cell carcinoma

    NARCIS (Netherlands)

    Digonnet, Antoine; Hamoir, Marc; Andry, Guy; Vander Poorten, Vincent; Haigentz, Missak; Langendijk, Johannes A.; de Bree, Remco; Hinni, Michael L.; Mendenhall, William M.; Paleri, Vinidh; Rinaldo, Alessandra; Werner, Jochen A.; Takes, Robert P.; Ferlito, Alfio

    Post-therapy follow-up for patients with head and neck cancer other than upper aerodigestive tract squamous cell carcinoma should meet several objectives: to detect both local, regional or distant recurrences, to evaluate acute and long-term treatment-related side effects, to guide the

  12. A Novel External Carotid Arterial Sheath System for Intra-arterial Infusion Chemotherapy of Head and Neck Cancer.

    Science.gov (United States)

    Ii, Noriko; Fuwa, Nobukazu; Toyomasu, Yutaka; Takada, Akinori; Nomura, Miwako; Kawamura, Tomoko; Sakuma, Hajime; Nomoto, Yoshihito

    2017-07-01

    The purpose of this study was to describe a novel system for treating advanced head and neck cancer consisting of an external carotid arterial sheath (ECAS) and a microcatheter to inject drugs retrogradely into multiple feeding arteries through the superficial temporal artery (STA). Four consecutive patients with head and neck cancer that had more than one feeding artery were enrolled in this study. The ECAS was made of polyurethane and surface-coated with heparin resin to prevent thrombus formation, allowing it to remain in place for a prolonged period of time. The ECAS was inserted through the STA, and its tip was placed between the maxillary artery and facial artery. The tumor-feeding arteries were selected using a hooked-shaped microcatheter through the ECAS. A total of 13 target arteries were selected in the four patients. The microcatheter inserted via the ECAS was used to catheterize ten arteries (five lingual arteries and five facial arteries). The remaining three lingual arteries were directly selected by the catheter without ECAS. All of the target arteries were able to be catheterized superselectively. The technical success rate was 100%. Vascular occlusion, which might have been caused by the ECAS, was observed in one patient. No neurologic toxicities occurred. This ECAS system is a new approach for retrograde superselective intra-arterial chemotherapy that covers the entire tumor with anticancer drugs. It has the potential to increase the effectiveness of therapy for advanced head and neck cancer. Level 4, Case Series.

  13. Oral cancer

    Science.gov (United States)

    Cancer - mouth; Mouth cancer; Head and neck cancer; Squamous cell cancer - mouth; Malignant neoplasm - oral ... National Cancer Institute. PDQ lip and oral cavity cancer ... September 25, 2015. www.cancer.gov/types/head-and-neck/hp/lip- ...

  14. Accuracy of field alignment in radiotherapy of head and neck cancer utilizing individualized face mask immobilization: a retrospective analysis of clinical practice

    International Nuclear Information System (INIS)

    Hess, Clemens F.; Kortmann, Rolf-D.; Jany, Ralf; Hamberger, Andreas; Bamberg, Michael

    1995-01-01

    Deviations between simulation and first check films were quantitatively assessed for 95 unselected head and neck cancer patients. All measured deviations -- calculated on the basis of a total of 190 simulation and 380 verification films -- were normally distributed, with mean values of 0-3 mm and standard deviations of 3-5 mm. Of the absolute deviations, 50% and 95% were within 3 mm and 9 mm, respectively. These results should be considered in clinical practice when prescribing safety margins and adequate cut off doses for sparing critical organs in head and neck cancer

  15. 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.

  16. 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)

  17. Clinical and scientific impact of human papillomavirus on head and neck cancer.

    Science.gov (United States)

    Friedman, Jeffrey M; Stavas, Mark J; Cmelak, Anthony J

    2014-10-10

    Head and neck cancer (HNC) arises from the skull base to the clavicles and is the fifth most common cancer in the world by incidence. Historically, in the developed world HNC was associated with tobacco use and alcohol consumption, and the combination of the two produced a synergistic increase in risk. However, beginning in 1983, investigators have found a significant and growing proportion of HNC patients with human papillomavirus-positive (HPV) tumors who neither drank nor used tobacco. Since that time, there has been increased interest in the molecular biology of HPV-positive HNC. Multiple studies now show that HPV has shifted the epidemiological landscape and prognosis of head and neck squamous cell carcinoma (HNSCC). These studies provide strong evidence for improved survival outcomes in patients with HPV-positive HNSCC compared to those with HPV-negative HNSCC. In many reports, HPV status is the strongest predictor of locoregional control, disease specific survival and overall survival. In response to these findings, there has been significant interest in the best management of HPV-positive disease. Discussions within major cooperative groups consider new trials designed to maintain the current strong survival outcomes while reducing the long-term treatment-related toxicities. This review will highlight the epidemiological, clinical and molecular discoveries surrounding HPV-related HNSCC over the recent decades and we conclude by suggesting how these findings may guide future treatment approaches.

  18. 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)

  19. Top 10 research priorities in head and neck cancer: Results of an Alberta priority setting partnership of patients, caregivers, family members, and clinicians.

    Science.gov (United States)

    Lechelt, Leah A; Rieger, Jana M; Cowan, Katherine; Debenham, Brock J; Krewski, Bernie; Nayar, Suresh; Regunathan, Akhila; Seikaly, Hadi; Singh, Ameeta E; Laupacis, Andreas

    2018-03-01

    The epidemiology, etiology, and management of head and neck cancer are evolving. Understanding the perspectives and priorities of nonresearchers regarding treatment uncertainties is important to inform future research. Using the James Lind Alliance approach, patients, caregivers, and clinicians responded to a survey regarding their unanswered questions about treating and managing head and neck cancer. Distinct uncertainties were extracted from responses and sorted into themes. Uncertainties already answered in the literature were removed. Those remaining were ranked by patients and clinicians to develop a short list of priorities, which were discussed at a workshop and reduced to the top 10. One hundred sixty-one respondents posed 818 uncertainties, culminating in 77 for interim ranking and 27 for discussion at a workshop. Participants reached consensus on the top 10, which included questions on prevention, screening, treatment, and quality of life. Nonresearchers can effectively collaborate to establish priorities for future research in head and neck cancer. © 2017 Wiley Periodicals, Inc.

  20. The Role of Central Neck Lymph Node Dissection in the Management of Papillary Thyroid Cancer.

    Science.gov (United States)

    Shirley, Lawrence A; Jones, Natalie B; Phay, John E

    2017-01-01

    Papillary thyroid cancer (PTC) is the most common thyroid malignancy, and cervical nodal metastases are frequent at presentation. The most common site for nodal metastases from PTC is the central compartment of the ipsilateral neck in the paratracheal and pretracheal regions. The decision to resect these lymph nodes at the time of thyroidectomy often depends on if nodes with suspected malignancy can be identified preoperatively. If nodal spread to the central neck nodes is known, then the consensus is to remove all nodes in this area. However, there remains significant controversy regarding the utility of removing central neck lymph nodes for prophylactic reasons. Herein, we review the potential utility of central neck lymph node dissection as well as the risks of performing this procedure. As well, we review the potential of molecular testing to stratify patients who would most benefit from this procedure. We advocate a selective approach in which patients undergo clinical neck examination coupled with ultrasound to detect any concerning lymph nodes that warrant additional evaluation with either fine needle aspiration or excisional biopsy in the operating room. In lieu of clinical lymphadenopathy, we suggest the use of patient and disease characteristics as identified by multiple groups, such as the American Thyroid Association and European Society of Endocrine Surgeons, which include extremes of ages, large primary tumor size, and male gender, when deciding to perform central neck lymph node dissection. Patients should be educated on the potential long-terms risks versus the lack of known long-term benefits.

  1. The Role of Central Neck Lymph Node Dissection in the Management of Papillary Thyroid Cancer

    Directory of Open Access Journals (Sweden)

    Lawrence A. Shirley

    2017-06-01

    Full Text Available Papillary thyroid cancer (PTC is the most common thyroid malignancy, and cervical nodal metastases are frequent at presentation. The most common site for nodal metastases from PTC is the central compartment of the ipsilateral neck in the paratracheal and pretracheal regions. The decision to resect these lymph nodes at the time of thyroidectomy often depends on if nodes with suspected malignancy can be identified preoperatively. If nodal spread to the central neck nodes is known, then the consensus is to remove all nodes in this area. However, there remains significant controversy regarding the utility of removing central neck lymph nodes for prophylactic reasons. Herein, we review the potential utility of central neck lymph node dissection as well as the risks of performing this procedure. As well, we review the potential of molecular testing to stratify patients who would most benefit from this procedure. We advocate a selective approach in which patients undergo clinical neck examination coupled with ultrasound to detect any concerning lymph nodes that warrant additional evaluation with either fine needle aspiration or excisional biopsy in the operating room. In lieu of clinical lymphadenopathy, we suggest the use of patient and disease characteristics as identified by multiple groups, such as the American Thyroid Association and European Society of Endocrine Surgeons, which include extremes of ages, large primary tumor size, and male gender, when deciding to perform central neck lymph node dissection. Patients should be educated on the potential long-terms risks versus the lack of known long-term benefits.

  2. Usability of advanced pneumatic compression to treat cancer-related head and neck lymphedema: A feasibility study.

    Science.gov (United States)

    Mayrovitz, Harvey N; Ryan, Shelly; Hartman, James M

    2018-01-01

    This functional usability study assessed ease of use, fit, comfort, and potential clinical benefits of advanced pneumatic compression treatment of cancer-related head and neck lymphedema. Patient-reported comfort and other treatment aspects were evaluated and multiple face and neck measurements were obtained on 44 patients with head and neck lymphedema before and after 1 treatment session to assess usability and treatment-related lymphedema changes. A majority of the patients (82%) reported the treatment was comfortable; most patients (61%) reported feeling better after treatment, and 93% reported that they would be likely to use this therapy at home. One treatment produced overall small but highly statistically significant reductions in composite metrics (mean ± SD) of the face (82.5 ± 4.3 cm vs 80.9 ± 4.1 cm; P < .001) and neck (120.4 ± 12.2 cm vs 119.2 ± 12.1 cm; P < .001) with no adverse events. Results found the treatment to be safe, easy to use, and well tolerated while demonstrating edema reduction after a single initial treatment. © 2017 The Authors Head & Neck Published by Wiley Periodicals, Inc.

  3. Associations among human papillomavirus, inflammation, and fatigue in patients with head and neck cancer.

    Science.gov (United States)

    Xiao, Canhua; Beitler, Jonathan J; Higgins, Kristin A; Glazer, Toby; Huynh, Linh Kha; Paul, Sudeshna; Felger, Jennifer C; Wommack, Evanthia C; Saba, Nabil F; Shin, Dong M; Bruner, Deborah W; Miller, Andrew H

    2018-05-09

    Human papillomavirus (HPV) infection has contributed to an increased incidence of squamous cell carcinoma of the head and neck (SCCHN). Fatigue is a major side effect of SCCHN and its treatment. However, to the authors' knowledge, the association between HPV and fatigue has not been examined to date, nor is it known whether HPV influences biological mechanisms of fatigue, including inflammation. Patients with SCCHN who were without distant metastasis were assessed at baseline (pre-radiotherapy) and 1 month and 3 months postradiotherapy. Fatigue was measured using the Multidimensional Fatigue Inventory. Peripheral inflammation was assessed by plasma C-reactive protein (CRP), interleukin 1 receptor antagonist (IL-1ra), soluble tumor necrosis factor receptor 2 (sTNFR2), and IL-6. Mixed effect models were used to examine associations. A total of 94 patients who were newly diagnosed were enrolled; 53% had HPV-related tumors. Patients with HPV-unrelated tumors had higher fatigue and higher plasma CRP, sTNFR2, and IL-6 over time, especially at baseline and 3 months after intensity-modulated radiotherapy compared with those with HPV-related tumors (all P < .05). However, fatigue and plasma sTNFR2 increased more significantly from baseline to 1 month after radiotherapy in the HPV-related group compared with the HPV-unrelated group (both P < .01). Controlling for significant covariates, HPV status and inflammation were found to be independent predictors of fatigue over time. HPV status is an important marker of vulnerability to the behavioral and immune consequences of SCCHN and its treatment, providing support for different symptom management strategies. Special emphasis should be placed on addressing marked persistent fatigue in patients with HPV-unrelated tumors, whereas attention should be paid to the large increases in fatigue during treatment among patients with HPV-related tumors. Cancer 2018. © 2018 American Cancer Society. © 2018 American Cancer Society.

  4. Shoulder morbidity after non-surgical treatment of the neck.

    NARCIS (Netherlands)

    van Wouwe, V.; de Bree, R.; Kuik, D.J.; de Goede, C.J.T.; de Leeuw, I.M.; Leemans, C.R.

    2009-01-01

    Background and purpose: Reports on shoulder function after non-surgical treatment are not available. In the present study shoulder morbidity after surgical and non-surgical treatment of the neck is determined and compared. Materials and methods: In 100 head and neck cancer patients 174 neck sides

  5. Posttraumatic stress disorder symptoms in newly diagnosed patients with head and neck cancer and their partners.

    Science.gov (United States)

    Posluszny, Donna M; Dougall, Angela Liegey; Johnson, Jonas T; Argiris, Athanassios; Ferris, Robert L; Baum, Andrew; Bovbjerg, Dana H; Dew, Mary Amanda

    2015-09-01

    Head and neck cancer is a life-threatening illness requiring aversive treatments. Despite clear potential for posttraumatic stress disorder (PTSD) symptoms in both patients and their partners, research is scant. Newly diagnosed patients and partners (number of dyads = 42) completed questionnaires to assess symptoms of PTSD, anxiety, and depression, as well as demographic, medical, and attitudinal variables. Partners had higher average levels of PTSD symptoms than patients (p = .023). More partners (28.6%) met criteria for estimated PTSD caseness than did patients (11.9%). There were no significant differences in levels of other anxiety or depression symptoms. Perceived threat of disease appeared to be a stronger correlate of PTSD symptom levels than medical variables in patients and partners. A diagnosis of head and neck cancer elicits significant levels of PTSD symptoms in patients, and even higher levels among partners. Identified correlates of distress, including perceived threat of disease, are potential intervention targets. © 2014 Wiley Periodicals, Inc.

  6. Monoisocentric three-beam split field technique for conventional treatment in the head and neck cancer using asymmetrical collimators

    International Nuclear Information System (INIS)

    Sriram Prasath, S.; Prabagaran, C.; Sanyal, B.; Sarkar, B.

    2008-01-01

    The importance of treatment planning of head and neck malignancies arises from the necessity to achieve homogenous doses to localized target volume surrounded by normal structures, which can produce acute and long-term morbidity. In many radiotherapy departments, a commonly employed strategy is a 3-field technique. Bilateral parallel-opposed fields are matched to anterior lower neck field. When the target extends to the lower neck regions, abutment of upper and lower neck fields is required. Field matching represents a technical challenge for the Medical Physicist and Radiation Oncologist to treat multiple fields while avoiding their overlap on the spinal cord. The aim of this work is to review merits, limitations and recent approaches to optimize matchline dose in Monoisocentric technique in conventional treatment for head and neck cancers. Although the technique has many advantages, it is subjected to some systematic and random errors due to equipment and patient setup accuracies. To decrease the magnitude of matchline inhomogeneities, multi leaf collimator have been used. This method is viable and represents alternative approaches to the problem of field matching using the asymmetric jaws

  7. Usefulness of Integrated PET/MRI in Head and Neck Cancer: A Preliminary Study

    International Nuclear Information System (INIS)

    Lee, Soo Jin; Seo, Hyo Jung; Cheon, Gi Jeong; Kim, Ji Hoon; Kim, E. Edmund; Kang, Keon Wook; Paeng, Jin Chul; Chung, Junekey; Lee, Dong Soo

    2014-01-01

    The new modality of an integrated positron emission tomography/magnetic resonance imaging (PET/MRI) has recently been introduced but not validated. Our objective was to evaluate clinical performance of 18 F-fluoro-2-deoxyglucose ( 18 F-FDG) PET/MRI in patients with head and neck cancer. This retrospective study was conducted between January 2013 and February 2013. Ten patients (eight men, two women; mean age, 61.4±13.4 years) with histologically proven head and neck tumors were enrolled.Whole-body PET/MRI and regional positron emission tomography (PET) with dedicated MRI were sequentially obtained. Maximum standardized uptake value (SUVmax), SUVmean, metabolic tumor volume, total lesion glycolysis and contrast enhancement were analyzed. A total of ten whole-body positron emission tomography (PET), ten regional positron emission tomography (PET), ten dedicated MRI and ten regional PET/gadolinium-enhanced T1-weighted (Gd)-MRI images were analyzed for initial staging. Two nuclear medicine physicians analyzed positron emission tomography (PET) and PET/MRI with a consensus. One radiologist analyzed dedicated MRI. The primary lesions and number of metastatic lymph nodes analyzed from each image were compared. Eight patients were diagnosed with head and neck cancer (one tongue cancer, four tonsillar cancers, one nasopharyngeal cancer and two hypopharyngeal cancers) by histological diagnosis. Two benign tumors (pleomorphic adenoma and Warthin tumor) were diagnosed with surgical operation. Whole-body positron emission tomography (PET) and regional positron emission tomography (PET) attenuated by MRI showed good image quality for the lesion detection. Whole-body positron emission tomography (PET) and regional positron emission tomography (PET) detected ten primary sites and compensated for a missed lesion on dedicated MRI. A discordant number of suspicious lymph node metastases was noted according to the different images; 22, 16, 39 and 40 in the whole-body positron

  8. Shorter CAG repeat length in the AR gene is associated with poor outcome in head and neck cancer

    DEFF Research Database (Denmark)

    Rosa, Fabíola Encinas; dos Santos, Rodrigo Mattos; Poli-Frederico, Regina Célia

    2007-01-01

    microsatellite instability (MSI) and loss of heterozygosity (LOH) in these tumors. DESIGN: Matched samples of blood and head and neck tumors were evaluated using two methodologies, silver-stained gels to perform the analyses of MSI and LOH, and automated analysis to confirm these results and for genotyping...... of the AR [CAG](n) repeat length. Sixty-nine individuals without cancer were used as a control group for both procedures. The Log-rank test was used to compare overall survival and disease-free survival curves. The Cox proportional hazards regression models were performed to determine the [CAG](n) repeats......: These results suggest that short [CAG](n) repeat length (poor prognosis in a subset of male patients with head and neck cancer and that AR gene microsatellite instability is uncommon in these tumors....

  9. The relationship between physical impairments, quality of life and disability of the neck and upper limb in patients following neck dissection.

    Science.gov (United States)

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

    2018-05-16

    The purpose of this study was to examine the relationship between physical impairments, quality of life and disability in patients following neck dissection, with consideration of patient and clinical characteristics. Cross-sectional study of patients < 5 years after neck dissection for head and neck cancer. Quality of life and self-reported disability were measured with the Neck Dissection Impairment Index, Quick Disabilities of the Arm, Shoulder and Hand, and Neck Disability Index. Active neck and shoulder range of motion and isometric muscle strength were also assessed. Generalised linear modelling was used to explore relationships between variables. Eighty-four participants (68% male, median age 61 years) demonstrated reduced quality of life (median (interquartile range) score = 76 (49, 93) from 0 (worst) to 100 (best)), and mild levels of upper limb (14 (2, 32)) and neck disability (14 (6, 28)) (from 0 (best) to 100 (worst)). Bilateral neck dissection was associated with reduced quality of life (coeff (95% CI) = - 12.49 (- 24.69, - 0.29)). Post-operative chemoradiation therapy was associated with reduced quality of life (- 21.46 (- 37.57, - 5.35)) and neck disability (0.71 (0.10, 1.32)). Measures of shoulder flexibility or strength were associated with quality of life and self-reported disability. Quality of life and musculoskeletal disability after neck dissection are associated with factors from multiple domains including physical motor function and treatment modality. Having reduced shoulder flexibility or strength is related to functional deficits and quality of life after neck dissection for head and neck cancer.

  10. 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.

  11. Physiologic and pathologic calcifications and ossifications in the face and neck

    Energy Technology Data Exchange (ETDEWEB)

    Keberle, M. [Medizinische Hochschule Hannover, Diagnostische Radiologie, Hannover (Germany); Robinson, S. [DiagnoseZentrumUrania, Wien (Austria)

    2007-08-15

    The aim was to give a systematic presentation of physiologic and pathologic calcifications and ossifications in the face and neck with a special emphasis on clinical relevance. In a sometimes subacute setting one should recognize specific calcifications which often lead to important diagnoses such as fungal sinusitis or sclerosing labyrinthitis. In a more chronic situation intraocular calcifications in small children are pathognomonic for retinoblastoma. Juxtatumoral sclerosis of the laryngeal cartilage in laryngopharyngeal carcinoma is usually caused by tumor infiltration of the cartilage resulting in a higher tumor stage and, this way, has a major impact on the therapeutical strategy. Calcified lymph nodes are mainly unspecific but can be the result of tuberculosis or metastases of thyroid cancer. Cross-sectional imaging methods, most of all computed tomography, are ideally suited to reveal head and neck calcifications and ossifications, especially those which are clinically relevant. (orig.)

  12. 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)

  13. Skin dose differences between intensity-modulated radiation therapy and volumetric-modulated arc therapy and between boost and integrated treatment regimens for treating head and neck and other cancer sites in patients

    International Nuclear Information System (INIS)

    Penoncello, Gregory P.; Ding, George X.

    2016-01-01

    The purpose of this study was (1) to evaluate dose to skin between volumetric-modulated arc therapy (VMAT) and intensity-modulated radiation therapy (IMRT) treatment techniques for target sites in the head and neck, pelvis, and brain and (2) to determine if the treatment dose and fractionation regimen affect the skin dose between traditional sequential boost and integrated boost regimens for patients with head and neck cancer. A total of 19 patients and 48 plans were evaluated. The Eclipse (v11) treatment planning system was used to plan therapy in 9 patients with head and neck cancer, 5 patients with prostate cancer, and 5 patients with brain cancer with VMAT and static-field IMRT. The mean skin dose and the maximum dose to a contiguous volume of 2 cm"3 for head and neck plans and brain plans and a contiguous volume of 5 cm"3 for pelvis plans were compared for each treatment technique. Of the 9 patients with head and neck cancer, 3 underwent an integrated boost regimen. One integrated boost plan was replanned with IMRT and VMAT using a traditional boost regimen. For target sites located in the head and neck, VMAT reduced the mean dose and contiguous hot spot most noticeably in the shoulder region by 5.6% and 5.4%, respectively. When using an integrated boost regimen, the contiguous hot spot skin dose in the shoulder was larger on average than a traditional boost pattern by 26.5% and the mean skin dose was larger by 1.7%. VMAT techniques largely decrease the contiguous hot spot in the skin in the pelvis by an average of 36% compared with IMRT. For the same target coverage, VMAT can reduce the skin dose in all the regions of the body, but more noticeably in the shoulders in patients with head and neck and pelvis cancer. We also found that using integrated boost regimens in patients with head and neck cancer leads to higher shoulder skin doses compared with traditional boost regimens.

  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; Tse, Vincent

    2017-07-01

    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.

  15. Characterization of changes in total body composition for patients with head and neck cancer undergoing chemoradiotherapy using dual-energy x-ray absorptiometry.

    Science.gov (United States)

    Jackson, William; Alexander, Neil; Schipper, Matthew; Fig, Lorraine; Feng, Felix; Jolly, Shruti

    2014-09-01

    Patients with head and neck cancer experience significant weight loss secondary to concurrent chemoradiotherapy (CCRT). Using dual-energy X-ray absorptiometry (DEXA) scans, we characterize total body composition changes during and after CCRT in order to develop novel clinical care models that will improve the patient's quality of life (QOL). Sixty DEXA scans were obtained from 12 patients undergoing CCRT for locally advanced squamous cell head and neck cancer. DEXAs were performed at baseline, during treatment, completion of CCRT, and then 1 and 2 months posttreatment. Mean weight loss by treatment end was 9.5 kg (10.2%; p = .0002). On average, lean body mass (LBM) decreased 10.2% (p = .001), and fat body mass (FBM) decreased 11.1% (p = .001) during CCRT. LBM began to normalize after completion of treatment, whereas FBM continued to decline. Substantial loss of muscle and FBM occurs in patients undergoing CCRT for head and neck cancer. To prevent long-term disability and QOL decline after curative CCRT, clinical care interventions incorporating aggressive nutrition/exercise counseling are needed. Copyright © 2013 Wiley Periodicals, Inc.

  16. The effectiveness of thyme honey for the management of treatment-induced xerostomia in head and neck cancer patients: A feasibility randomized control trial.

    Science.gov (United States)

    Charalambous, Andreas; Lambrinou, Ekaterini; Katodritis, Nicos; Vomvas, Dimitrios; Raftopoulos, Vasilios; Georgiou, Morpho; Paikousis, Lefkios; Charalambous, Melanie

    2017-04-01

    Radiation-induced xerostomia is one of the most common side effects that head and neck cancer patients experience during and after treatment. Despite the various methods for the prevention and treatment of radiation-induced xerostomia, it remains highly prevalent among patients treated for head and neck cancers negatively influencing their lives. The purpose of this study was to evaluate the effectiveness of thyme honey as a means for managing radiation-induced xerostomia. This was a parallel randomised controlled trial with two equal arms, the experimental arm (thyme honey) and the control arm (saline). 72 head and neck cancer patients receiving radiotherapy or/and chemotherapy or/and surgery were recruited in a specialised cancer centre. Patients in both arms followed the same administration protocol with thyme honey and saline respectively. Identical assessments at baseline, 1 month and 6 months following completion of the intervention were performed in both arms including the National Cancer Institute (NCI) xerostomia scale and the Xerostomia Questionnaire (XQ) additionally to weekly oral clinical assessments. The ClinicalTrials.gov Identifier for this study is NCT01465308. Linear Mixed Models revealed the statistically significant effect of the intervention on xerostomia (F = 8.474 p xerostomia. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Goal processes & self-efficacy related to psychological distress in head & neck cancer patients and their partners

    NARCIS (Netherlands)

    Offerman, Marinella P. J.; Schroevers, Maya J.; van der Velden, Lilly-Ann; de Boer, Maarten F.; Pruyn, Jean F. A.

    Purpose and objective of the research: In this cross-sectional study we used a self-regulation perspective to better understand the experience of psychological distress in head & neck (H&N) cancer patients and their partners. We examined which goals they valued and the extent to which patients and

  18. Determination and delineation of nodal target volumes for head-and-neck cancer based on patterns of failure in patients receiving definitive and postoperative IMRT

    International Nuclear Information System (INIS)

    Chao, K.S. Clifford; Wippold, Franz J.; Ozyigit, Gokhan; Tran, Binh N.; Dempsey, James F.

    2002-01-01

    Purpose: We present the guidelines for target volume determination and delineation of head-and-neck lymph nodes based on the analysis of the patterns of nodal failure in patients treated with intensity-modulated radiotherapy (IMRT). Methods and Materials: Data pertaining to the natural course of nodal metastasis for each head-and-neck cancer subsite were reviewed. A system was established to provide guidance for nodal target volume determination and delineation. Following these guidelines, 126 patients (52 definitive, 74 postoperative) were treated between February 1997 and December 2000 with IMRT for head-and-neck cancer. The median follow-up was 26 months (range 12-55), and the patterns of nodal failure were analyzed. Results: These guidelines define the nodal target volume based on the location of the primary tumor and the probability of microscopic metastasis to the ipsilateral and contralateral (Level I-V) nodal regions. Following these guidelines, persistent or recurrent nodal disease was found in 6 (12%) of 52 patients receiving definitive IMRT, and 7 (9%) of 74 patients receiving postoperative IMRT had failure in the nodal region. Conclusion: On the basis of our clinical experience in implementing inverse-planning IMRT for head-and-neck cancer, we present guidelines using a simplified, but clinically relevant, method for nodal target volume determination and delineation. The intention was to provide a foundation that enables different institutions to exchange clinical experiences in head-and-neck IMRT. These guidelines will be subject to future refinement when the clinical experience in head-and-neck IMRT advances

  19. 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.

  20. A Phase III placebo-controlled trial of oral pilocarpine in patients undergoing radiotherapy for head-and-neck cancer

    International Nuclear Information System (INIS)

    Warde, Padraig; O'Sullivan, Brian; Aslanidis, Julie; Kroll, Barbaranne; Lockwood, Gina; Waldron, John; Payne, David; Bayley, Andrew; Ringash, Jolie; Kim, John; Liu, F.-F.; Maxymiw, Walter; Sprague, Shelley; Cummings, Bernard J.

    2002-01-01

    Purpose: To test the hypothesis that the use of oral pilocarpine during and after radiotherapy (RT) for head-and-neck cancer would reduce the symptoms of post-RT xerostomia. Methods and Materials: One hundred thirty patients were randomized in a double-blind method to receive either pilocarpine (5-mg tablets) or placebo three times daily starting on Day 1 of RT and continuing for 1 month after treatment. The eligibility criteria included a planned dose of >50 Gy as radical or postoperative RT for head-and-neck cancer, with at least 50% of both parotid glands included in the treatment fields. The primary outcome measure was the severity of xerostomia as assessed by a patient-completed linear analog scale 3 months after RT. Secondary outcome measures included quality of life during therapy (as assessed by the McMaster University Head-and-Neck Questionnaire) and severity of mucositis during RT (as assessed using Radiation Therapy Oncology Group scales). Results: No difference was observed between the pilocarpine-treated patients and the placebo group in the severity of xerostomia score as assessed by linear analog scale at baseline and 1, 3, and 6 months after treatment (repeated measures analysis, p=0.92). No difference was apparent in the severity of mucositis during RT; 56.3% of patients receiving pilocarpine had Grade III/IV mucositis compared with 50.8% treated with placebo. No difference in quality of life was noted between the treatment groups during or after RT. The questionnaire score at 3 months after RT was 5.0 (SD 1.0). in the pilocarpine group and 4.9 (SD 0.9) in the placebo group. Conclusion: We were unable to detect a beneficial effect of pilocarpine on RT-induced xerostomia when administered during RT for head-and-neck cancer

  1. Feasibility of Primary Tumor Culture Models and Preclinical Prediction Assays for Head and Neck Cancer: A Narrative Review

    International Nuclear Information System (INIS)

    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 with surgery, usually in combination with high-dose cisplatin chemoradiation. However, adding cisplatin to radiotherapy is associated with an increase in severe acute toxicity, while conferring only a minor overall survival benefit. Hence, there is a strong need for a preclinical model to identify patients that will respond to the intended treatment regimen and to test novel drugs. One of such models is the technique of culturing primary human tumor tissue. This review discusses the feasibility and success rate of existing primary head and neck tumor culturing techniques and their corresponding chemo- and radiosensitivity assays. A comprehensive literature search was performed and success factors for culturing in vitro are debated, together with the actual value of these models as preclinical prediction assay for individual patients. With this review, we aim to fill a gap in the understanding of primary culture models from head and neck tumors, with potential importance for other tumor types as well

  2. Feasibility of Primary Tumor Culture Models and Preclinical Prediction Assays for Head and Neck Cancer: A Narrative Review

    Energy Technology Data Exchange (ETDEWEB)

    Dohmen, Amy J. C., E-mail: a.dohmen@nki.nl [Department of Head and Neck Surgery and Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, Amsterdam 1066 CX (Netherlands); Department of Cell Biology, the Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, Amsterdam 1066 CX (Netherlands); Swartz, Justin E. [Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Center Utrecht, Heidelberglaan 100, Utrecht 3508 GA (Netherlands); Van Den Brekel, Michiel W. M. [Department of Head and Neck Surgery and Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, Amsterdam 1066 CX (Netherlands); Willems, Stefan M. [Department of Pathology, University Medical Center Utrecht, Heidelberglaan 100, Utrecht 3508 GA (Netherlands); Spijker, René [Medical library, Academic Medical Center, Amsterdam 1100 DE (Netherlands); Dutch Cochrane Centre, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Heidelberglaan 100, Utrecht 3508 GA (Netherlands); Neefjes, Jacques [Department of Cell Biology, the Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, Amsterdam 1066 CX (Netherlands); Zuur, Charlotte L. [Department of Head and Neck Surgery and Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, Amsterdam 1066 CX (Netherlands)

    2015-08-28

    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 with surgery, usually in combination with high-dose cisplatin chemoradiation. However, adding cisplatin to radiotherapy is associated with an increase in severe acute toxicity, while conferring only a minor overall survival benefit. Hence, there is a strong need for a preclinical model to identify patients that will respond to the intended treatment regimen and to test novel drugs. One of such models is the technique of culturing primary human tumor tissue. This review discusses the feasibility and success rate of existing primary head and neck tumor culturing techniques and their corresponding chemo- and radiosensitivity assays. A comprehensive literature search was performed and success factors for culturing in vitro are debated, together with the actual value of these models as preclinical prediction assay for individual patients. With this review, we aim to fill a gap in the understanding of primary culture models from head and neck tumors, with potential importance for other tumor types as well.

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