Neck Cancer

Source: www.ncbi.nlm.nih.gov --- 13 days ago
Related Articles Promising newer molecular-targeted therapies in head and Neck Cancer. Drugs. 2008;68(12):1609-19 Authors: Wang LX, Agulnik M Head and Neck Cancer (HNC) is the fifth most common Cancer in the world. In the US alone, HNC accounts for 3-5% of all malignancies annually. Squamous cell carcinoma arising from the mucosa of the upper aerodigestive tract is the most common type of HNC and accounts for 90% of HNC diagnoses. Despite continued advances in the therapeutic options, the disease-free survival, functional outcome, toxicity of therapy and overall survival have remained less than optimal for patients with locally advanced, recurrent or metastatic disease. Therefore, new approaches for the treatment of patients with HNC, particularly patients with advanced stage, are clearly needed. Among the new therapies, molecular-targeted and biological therapies have gained special attention. While clinical trial data support the use of epidermal growth factor receptor (EGFR) inhibition in metastatic and locally advanced HNC, numerous trials are seeking to establish a clear role for new therapies targeting EGFR, the receptor for the type I insulin-like growth factor, as well as anti-angiogenesis agents. PMID: 18681486 [PubMed - in process] ...

Source: www.ncbi.nlm.nih.gov --- 4 hours ago
Related Articles Metastatic ovarian Cancer in the head and Neck. Ear Nose Throat J. 2008 Jun;87(6):318 Authors: Avitia S, Hamilton JS, Osborne RF PMID: 18561112 [PubMed - indexed for MEDLINE] ...

Source: www.ncbi.nlm.nih.gov --- 16 hours ago
Related Articles Quality of life in elderly patients with head and Neck Cancer one year after diagnosis. Head Neck. 2004 Dec;26(12):1045-52 Authors: Derks W, de Leeuw RJ, Hordijk GJ, Winnubst JA BACKGROUND: Little is known about quality of life (QOL) in elderly patients. METHODS: Seventy-eight older (> or =70 years) and 105 younger patients (45-60 years) with carcinoma of the oral cavity, pharynx (stage > or =II), or larynx (stage > or =III) completed the European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life Questionnaire and EORTC Head and Neck Cancer Quality of Life Questionnaire before treatment. Fifty-one older and 70 younger patients completed all follow-up questionnaires at 3, 6, and 12 months. RESULTS: Before and after treatment, the physical functioning of the older patients was worse than that of younger patients. This difference remained relatively constant during follow-up and is probably related to normal aging. At baseline and 3 months, no other differences were found between both groups. At 6 months, younger patients reported more pain, but at 12 months no relevant differences were found. CONCLUSIONS: Treatment did not affect QOL differently in older and younger patients. Therefore, standard treatment should always be considered, irrespective of the patient's age. PMID: 15459917 [PubMed - indexed for MEDLINE] ...

Source: www.ncbi.nlm.nih.gov --- 7 days ago
Related Articles Anemia During Sequential Induction Chemotherapy and Chemoradiation for Head and Neck Cancer: The Impact of Blood Transfusion on Treatment Outcome. Int J Radiat Oncol Biol Phys. 2008 Aug 7; Authors: Bhide SA, Ahmed M, Rengarajan V, Powell C, Miah A, Newbold K, Nutting CM, Harrington KJ PURPOSE: Sequential treatment (chemotherapy followed by concomitant chemoradiation; CCRT) is increasingly being used for radical treatment of squamous cell Cancer of the head and Neck (SCCHN), which results in increased myelosuppression. In this study, we review the incidence of anemia and the effect of a policy of hemoglobin (Hb) maintenance by blood transfusion on disease outcomes in these patients. METHODS AND MATERIALS: Retrospective review of the records of patients with SCCHN treated with sequential CCRT formed the basis of this study. The incidence of anemia and statistics on blood transfusion were documented. For the purpose of outcome analyses, patients were divided into four categories by (1) transfusion status, (2) nadir Hb concentration, (3) number of transfusion episodes, and (4) number of units of blood transfused (NOUT). Data on 3-year locoregional control (LRC), relapse-free survival (RFS), disease-specific survival (DSS), and overall survival (OS) were analyzed. RESULTS: One hundred and sixty-nine patients were identified. The median follow-up was 23.6 months. The RFS (52% vs. 41%, p = 0.03), DSS (71% vs. 66%, p = 0.02), ...

Source: www.ncbi.nlm.nih.gov --- 10 days ago
Related Articles Small field radiotherapy of head and Neck Cancer patients is responsible for oxidatively damaged DNA/oxidative stress on the level of a whole organism. Int J Cancer. 2008 Aug 7; Authors: Roszkowski K, Gackowski D, Rozalski R, Dziaman T, Siomek A, Guz J, Szpila A, Foksinski M, Olinski R It is possible that oxidatively damaged DNA which arises as a result of radiotherapy may be involved in the therapeutic effect of the ionizing radiation and in the side effects. Therefore, for the first time, the broad spectrum of oxidatively damaged DNA biomarkers: urinary excretion of 8-oxodG (8-oxo-7,8-dihydro-2'-deoxyguanosine), 8-oxoGua (8-oxo-7,8-dihydroguanine) as well as the level of oxidatively damaged DNA in leukocytes, was analyzed in head and Neck Cancer patients (n = 27) undergoing fractionated radiotherapy using methodologies which involve HPLC (high-performance liquid chromatography) prepurification followed by gas chromatography with isotope dilution mass spectrometry detection and HPLC/EC. Of all the analyzed parameters in the majority of patients, only urinary excretion of the modified nucleoside significantly increased over the initial level in the samples collected 24 hr after the last fraction. However, for the distinct subpopulation of 10 patients, a significant increase in the level of 8-oxodG in cellular DNA and a simultaneous drop in urinary 8-oxoGua (the repair product of oxidative DNA damage) were detected aft ...

Source: www.ncbi.nlm.nih.gov --- 15 hours ago
Related Articles Improved outcomes in patients with head and Neck Cancer using a standardized care protocol for postoperative alcohol withdrawal. Arch Otolaryngol Head Neck Surg. 2008 Aug;134(8):865-72 Authors: Lansford CD, Guerriero CH, Kocan MJ, Turley R, Groves MW, Bahl V, Abrahamse P, Bradford CR, Chepeha DB, Moyer J, Prince ME, Wolf GT, Aebersold ML, Teknos TN OBJECTIVE: To show clinical benefit in the main outcome measures by the use of a standardized protocol for identification, characterization, and treatment of alcohol withdrawal syndrome (AWS) in postoperative patients with head and Neck Cancer. DESIGN: Prospective cohort study with a retrospective cohort control. SETTING: Tertiary care university. PATIENTS: A total of 26 consecutive postoperative patients with AWS were selected from among 652 patients with head and Neck Cancer to be enrolled in the protocol from March 2003 through March 2005. Controls consisted of 14 of 981 consecutive patients with AWS from March 2000 through December 2002. INTERVENTION: Application of a standardized care protocol. MAIN OUTCOME MEASURES: Sensitivity and specificity of preoperative screening for AWS risk, predictability of outcomes, length of stay, transfers to the intensive care unit (ICU), AWS symptoms, postoperative morbidity and mortality, doses of pharmacotherapy required, and charges. RESULTS: Protocol patients demonstrated significantly fewer AWS-related ICU transfers and less deliri ...

Source: www.ncbi.nlm.nih.gov --- 10 days ago
Related Articles Acquired cisplatin resistance in the head-Neck Cancer cell line Cal27 is associated with decreased DKK1 expression and can partially be reversed by overexpression of DKK1. Int J Cancer. 2008 Aug 7; Authors: Gosepath EM, Eckstein N, Hamacher A, Servan K, von Jonquieres G, Lage H, Györffy B, Royer HD, Kassack MU Head and Neck cancers are treated by a combination of surgery, radiotherapy and/or chemotherapy. The clinical success of cisplatin-based chemotherapy, mostly in combination with 5-FU or a taxane, is however limited by multifactorial intrinsic or acquired resistance. So far, known genes involved in cisplatin resistance do not sufficiently allow the prediction of Cancer chemosensitivity. Thus, the purpose of this study was to search for further genes involved in cisplatin resistance by differential gene expression analysis of the parental tongue Cancer cell line Cal27 and its 10-fold more resistant sub-cell line Cal27cis, which was obtained by treating Cal27 with increasing concentrations of cisplatin. As found by the suppression subtractive hybridization, expression of DKK1, an inhibitor of canonical WNT signaling, was decreased in Cal27cis. Microarray analysis, qPCR and ELISA confirmed the approximately 2-fold difference in expression. Cisplatin treatment and serum starvation increased by 2-fold the secretion of DKK1 in Cal27 and Cal27cis, thus rendering DKK1-levels significantly different in both cell lines und ...

Source: www.ncbi.nlm.nih.gov --- 11 days ago
Related Articles p53 mutation in histologically normal mucosa of the aero-digestive tract is not a marker of increased risk for second primary carcinoma in head and Neck Cancer patients. Eur Arch Otorhinolaryngol. 2008 Aug 8; Authors: Escher A, Piotet E, Waridel F, Iggo R, Monnier P Head and Neck Cancer patients are at high risk for developing second primary tumors. This is known as field cancerization of the aero-digestive tract. In a previous study, we showed that patients with multiple primary tumors were more likely to have p53 mutations in histologically normal mucosae than patients presenting with an isolated tumor. Based on this observation, we postulated that p53 mutations in normal tissue samples of patients bearing a single primary tumor could have a clinical value as a biomarker for the risk of developing second primary tumors. Thirty-five patients presenting with a single primary tumor were followed-up for a median of 51 months (range 1 month to 10.9 years) after biopsies of histologically normal squamous cell mucosa had been analyzed for p53 mutations with a yeast functional assay at the time of the primary tumor. During this follow-up, recurrences and non-sterilization of the primary tumor, occurrence of lymph node metastases, and of second primary tumors were evaluated. Sixteen (45.7%) patients were found to have p53 mutations in their normal squamous cell mucosa, and 19 (54.3%) patients showed no mutation. No relationshi ...

Source: www.ncbi.nlm.nih.gov --- 12 days ago
Related Articles The AFTER intervention: a structured psychological approach to reduce fears of recurrence in patients with head and Neck Cancer. Br J Health Psychol. 2008 May;13(Pt 2):223-30 Authors: Humphris G, Ozakinci G Head and Neck Cancer and its treatment have profound effects on function, self-image, and mental health. Fears of recurrence are one of the major concerns of Cancer survivors that endure and can influence the patients' ability to adjust and plan for the future. This paper describes the design and development of the adjustment to the fear, threat or expectation of recurrence (AFTER) intervention which targets recurrence fears, inappropriate checking behaviour, and beliefs about Cancer, adopting recognized cognitive behavioural and health psychology principles, particularly Leventhal's self-regulation model. The intervention includes structured sessions, manualized delivery by a specialist nurse, invitation to caregiver, expression of fears, examination and change of beliefs, and checking behaviour. Initial testing showed acceptability (nurse satisfaction ratings by patient) of the intervention which may have applicability for patients who have been treated with Cancer at other sites. PMID: 18492319 [PubMed - indexed for MEDLINE] ...

Source: www.ncbi.nlm.nih.gov --- 18 days ago
Related Articles Salivary flow rates measured during radiation therapy in head and Neck Cancer patients: A pilot study assessing salivary sediment formation. J Prosthet Dent. 2008 Aug;100(2):142-6 Authors: Chambers MS, Tomsett KL, Artopoulou II, Garden AS, El-Naggar AK, Martin JW, Keene HJ STATEMENT OF PROBLEM: Xerostomia often occurs in patients being managed for head and Neck Cancer who receive radiation therapy. Although accurate salivary sampling can be therapeutically important to measure during radiation, sampling errors can occur because of salivary sediments. Determining the impact that salivary sediments have on measured salivary flow rates during radiation is important for management of patients. PURPOSE: The purpose of this study was to assess the magnitude of error associated with the inclusion of nonsalivary components (sediment) in the calculation of whole stimulated saliva flow rates prior to and during radiation therapy (SS and SSR) in patients with head and Neck Cancer. MATERIAL AND METHODS: Whole paraffin-stimulated saliva was collected in large-mouth centrifuge tubes from 20 patients with head and Neck Cancer prior to and during the third week of radiation therapy. Gravimetric methods were used to calculate the flow rates at g/5 min. After centrifugation, supernatant saliva was removed and the sediment was oven-dried to remove residual moisture. Sediment weight was subtracted from the original weight of saliva specim ...

Source: www.ncbi.nlm.nih.gov --- 41 days ago
Related Articles Folate in head and Neck squamous cell Cancer chemoprevention: purposely left out? J Clin Oncol. 2008 Jul 10;26(20):3463 Authors: Bossi P, Locati LD, Licitra L, Tagliabue E PMID: 18612165 [PubMed - in process] ...

Source: www.ncbi.nlm.nih.gov --- 29 days ago
Related Articles Factors associated with fatigue, sleep, and cognitive function among patients with head and Neck Cancer. Head Neck. 2008 Jul 18; Authors: Rogers LQ, Courneya KS, Robbins KT, Rao K, Malone J, Seiz A, Reminger S, Markwell SJ, Burra V BACKGROUND.: Fatigue, sleep disturbances, and cognitive impairment are prevalent and clinically important problems among head and Neck Cancer patients. Our study aim was to determine the most important correlates of these problems among patients with head and Neck Cancer. METHODS.: A cross-sectional, self-administered survey was completed by 58 (response rate 79%) patients with head and Neck Cancer in an academic oncology clinic. RESULTS.: Multiple linear-regression analyses demonstrated that fatigue was associated with younger age (beta = -0.22), previous radiation therapy (beta = 0.23), fewer months since Cancer diagnosis (beta = -0.25), and depression (beta = 0.40). Sleep dysfunction was associated with younger age (beta = -0.31) and higher symptom index (beta = 0.39). Cognitive dysfunction was associated with higher symptom index only (beta = -0.49). CONCLUSIONS.: Younger age, previous radiation, more recent Cancer diagnosis, depression, and more severe symptoms may be associated with fatigue, sleep, and/or cognitive dysfunction. These results suggest at-risk subgroups warranting more aggressive screening and potentially supportive care interventions. (c) 2008 Wiley Periodicals, Inc. He ...

Source: www.ncbi.nlm.nih.gov --- 4 days ago
Sirolimus as a potential radiosensitizer in squamous cell Cancer of the head and Neck. Head Neck. 2008 Aug 14; Authors: Shinohara ET, Maity A, Jha N, Lustig RA BACKGROUND.: An estimated 34,000 cases of squamous cell carcinomas of the head and Neck (HNSCC) will be diagnosed in 2007 with 7500 estimated deaths. Radiation is commonly used to treat these patients. Preclinical studies have suggested that sirolimus may be an effective radiosensitizer in HNSCC. METHODS.: The present case report describes a patient, status post liver transplant, who was switched to sirolimus for immunosupression. The patient subsequently underwent radiation therapy for a T2N0M0 SCC of the larynx. RESULTS.: The patient had an unusually early response to radiation, with a clinical complete response after 7 fractions of radiation. However, the patients also had toxicity earlier than expected and required a break from radiation after 11 fractions. CONCLUSIONS.: To the authors' knowledge, this is the first observation to suggest that sirolimus is an effective radiosensitizer in patients with HNSCC. We hope that our results will create interest in future clinical studies. (c) 2008 Wiley Periodicals, Inc. Head Neck, 2008. PMID: 18704962 [PubMed - as supplied by publisher] ...

Source: www.moreover.com --- 26 days ago
NEW YORK (Reuters Health) - Progressive resistance exercise training following surgery helps reduce upper extremity pain and dysfunction in certain head and Neck Cancer survivors, according to Canadian researchers. 'The trial,' lead investigator Dr. ...

Source: www.ncbi.nlm.nih.gov --- 29 days ago
Related Articles The association of psycho-social factors and survival in head and Neck Cancer. Clin Otolaryngol. 2008 Apr;33(2):83-9 Authors: Mehanna HM, De Boer MF, Morton RP OBJECTIVE: Update a previous review examining associations between psycho-social factors and survival in head and Neck Cancer patients. DATA SOURCES: Searched Cochrane, Psych info and Embase for the period from 1 January 1995 to 1 June 2007, as well as personal and article reference lists and article archives. STUDY SELECTION: Identified articles assessed by consensus for eligibility using following criteria: survival as outcome measure; psycho-social factors as prognostic indicators; results specifically for head and Neck Cancer patients, not including oesophageal or thyroid Cancer. Seven of 64 articles fulfilled criteria. DATA EXTRACTION: Data abstracted independently by two reviewers using pre-determined proformas. Quality also rated using Scottish Intercollegiate Guidelines Network 50 tool. DATA SYNTHESIS: At baseline, expression of intense psycho-social complaints, higher self-perceived physical ability and self-reported high physical functioning were significantly associated with increased survival. Uncertainty about the diagnosis and treatment was found to be a negative prognostic indicator, as was being single, poor cognitive function, baseline fatigue and alcoholism. Overall quality of life and head and Neck pain 12 months after date of diagnosis were ...

Source: www.ncbi.nlm.nih.gov --- 32 days ago
Factors Associated with Long-Term Dysphagia After Definitive Radiotherapy for Locally Advanced Head-and-Neck Cancer. Int J Radiat Oncol Biol Phys. 2008 Jul 15; Authors: Caudell JJ, Schaner PE, Meredith RF, Locher JL, Nabell LM, Carroll WR, Magnuson JS, Spencer SA, Bonner JA 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 a ...

Source: www.ncbi.nlm.nih.gov --- 46 days ago
Related Articles Radiotherapy treatment for head and Neck Cancer: a dietetic review from referral to discharge. Proc Nutr Soc. 2008 May;67(OCE):E143 Authors: Brady OJ, Donnelly MM, Horgan AM, Maher MA PMID: 18598471 [PubMed - as supplied by publisher] ...

Source: www.ncbi.nlm.nih.gov --- 25 days ago
Related Articles Methotrexate and Leucovorin Double-modulated 5-Fluorouracil Combined with Cisplatin (MPFL) in Metastatic/Recurrent Head and Neck Cancer. J Chin Med Assoc. 2008 Jul;71(7):336-41 Authors: Chang PM, Teng HW, Chen PM, Chang SY, Chu PY, Tsai TL, Tai SK, Wang YF, Huang JL, Yang MH Background: To determine the efficacy and safety profile of the combination of cisplatin and 5-fluorouracil modulated both by methotrexate and leucovorin in metastatic/recurrent squamous cell carcinoma of the head and Neck. Methods: Twenty-eight patients were treated with cisplatin 40 mg/m2/day continuous infusion for 24 hours on day 1; high-dose 5-fluorouracil 2,000 mg/m2/day and leucovorin 100 mg/m2/day continuous infusion for 48 hours on days 1 and 2; methotrexate 40 mg/m2/day as a bolus infusion 4 hours before 5-fluorouracil and leucovorin on day 1. The treatment was repeated every 2 weeks in a cycle. Results: The overall response rate was 25%, and 14% of the patients achieved stable disease status. Subgroup analysis demonstrated significantly improved overall survival in the disease-control group (12.0 months vs. 5.3 months, p < 0.001). Only 3 (10.7%) patients developed grade 3-4 neutropenia, and none developed grade 3-4 non-hematologic toxicity. Conclusion: This multiagent-containing regimen has an excellent safety profile and improved survival in disease-control group of patients with metastatic/recurrent squamous cell carcinoma of the head ...

Source: www.ncbi.nlm.nih.gov --- 29 days ago
Related Articles Implementing the National Institute of Clinical Excellence improving outcome guidelines for head and Neck Cancer: developing a business plan with reorganisation of head and Neck Cancer services. Clin Otolaryngol. 2008 Apr;33(2):149-51 Authors: Jeannon JP, Abbs I, Calman F, Gleeson M, Lyons A, Hussain K, McGurk M, O'Connell M, Probert D, Ng R, Simo R The implementation of the National Institute of Clinical Excellence improving outcome guidelines (NICE-IOG) manual for head and Neck Cancer may have a huge potential cost implication. Head and Neck Cancer is a rare disease which utilises large quantities of resources which can only be provided in a tertiary centre. Head and Neck Cancer services should be centralised into a single site for each Cancer network. A new higher tariff rate for complex head and Neck Cancer cases is needed which recognises the true cost of this work. Each network should set its own tariff to make head and Neck Cancer care financially viable. PMID: 18429872 [PubMed - indexed for MEDLINE] ...

Source: www.ncbi.nlm.nih.gov --- 41 days ago
Related Articles Relationships between acute reactions to radiotherapy in head and Neck Cancer patients and parameters of radiation-induced DNA damage and repair in their lymphocytes. Int J Radiat Biol. 2008 May 9;:1-8 Authors: Rzeszowska-Wolny J, Palyvoda O, Polanska J, Wygoda A, Hancock R Purpose: To study the relationship between lymphocyte radiosensitivity measured in vitro and acute reactions to radiotherapy in patients with head and Neck Cancer. Materials and methods: Acute reactions were measured in 34 patients using the Dische scale. Lymphocyte radiosensitivity was measured using the alkaline comet assay, the micronucleus assay, the nuclear division index and morphological assessment of apoptosis. Results: There was a weak, statistically significant correlation between in vitro radiosensitivity measured as the rate of DNA damage repair and the cumulative radiation dose exerting the maximum acute reaction scored (r = -0.366, p = 0.039, n = 34). Subgroup analyses showed that for patients with a low level of radiation-induced DNA damage there was a statistically significant relationship between lymphocyte radiosensitivity measured as inhibition of proliferation and acute toxicity (r = -0.621, p = 0.007, n = 18). For patients with a high level of residual DNA damage, there was a relationship between lymphocyte radiosensitivity measured using the micronucleus assay and acute toxicity (r = -0.597, p = 0.023, n = 14). Conclusions: Com ...