IMRT in oral cavity cancer

4/18/2007 web-based article Gabriela Studer et al. Radiat Oncol, April 12, 2007; 2(1): 16 Background: Except for early T1,2 N0 stages, the prognosis for patients with oral cavity cancer (OCC) is reported to be worse than for carcinoma in other sites of the head and neck (HNC). The aim of this work was to assess disease outcome in OCC following IMRT. Between January 2002 and January 2007, 346 HNC patients have been treated with curative intensity modulated radiation therapy (IMRT) at the Department of Radiation Oncology, University Hospital Zurich. Fifty eight of these (16%) were referred for postoperative (28) or definitive (30) radiation therapy of OCC. 40 of the 58 OCC patients (69%) presented with locally advanced T3/4 or recurred lesions. Doses between 60 and 70Gy were applied, combined with simultaneous cisplatin based chemotherapy in 78%. Outcome analyses were performed using Kaplan Meier curves. In addition, comparisons were performed between this IMRT OCC cohort and historic in-house cohorts of 33 conventionally irradiated (3DCRT) and 30 surgery only patients treated over the last 10 years. Results: OCC patients treated with postoperative IMRT showed the highest local control (LC) rate of all assessed treatment sequence subgroups (92% LC at 2 years). Historic postoperative 3DCRT patients and patients treated with surgery alone reached LC rates of ~70-80%. Definitively irradiated patients revealed poorest LC rates with ~30 and 40% following 3DCRT and IMRT, respectively. T1 stage resulted in an expectedly significantly higher LC rate (95%, n=19, p<0.05) than T2-4 and recurred stages (LC ~50-60%, [...]

2009-04-15T11:51:06-07:00April, 2007|Archive|

Multimodal Intensification Regimens for Advanced, Resectable, Previously Untreated Squamous Cell Cancer of the Oral Cavity, Oropharynx, or Hypopharynx

4/17/2007 web-based article Daved E. Schuller, MD et al. Arch Otolaryngol Head Neck Surg. 2007;133:320-326 Objective: To determine the feasibility of, compliance with, and long-term survival with intensification treatment regimens for patients with advanced, resectable, previously untreated head and neck squamous cell carcinoma. Design: Prospective phase 2 clinical trial (3 similar, consecutively evolved trials). Setting: Comprehensive Cancer Center–Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The Ohio State University. Patients: One hundred twenty-three patients (median age, 60 years; range, 30-78 years) with previously untreated, resectable, advanced squamous cell carcinomas of the oral cavity, oropharynx, or hypopharynx. Interventions: Perioperative cisplatin chemoradiotherapy, surgical resection with intraoperative radiotherapy, and postoperative paclitaxel and cisplatin chemoradiotherapy. Main Outcome Measures: The feasibility, compliance, and long-term survival associated with the 3 intensification regimens. Results: Compliance with all 3 intensification regimens averaged 61% (75/123). Patient-directed noncompliance occurred in 16 patients (13%). The average locoregional (112/123, 91%) and systemic (106/123, 86%) disease control rates were excellent. Overall long-term disease-specific survival was 73%. Median time at risk was 62.5 months (range, 1 day to 100.4 months). Conclusions: The intensification regimens result in excellent disease control rates and long-term survival in this particular patient population. Future evolution of these regimens will include some modifications to further decrease toxic effects followed by phase 2 multi-institutional trials to determine whether the single-institutional experience can be duplicated. The results of these studies will determine whether phase 3 trials can be proposed. Authors: David E. Schuller, MD; Enver Ozer, MD; Amit Agrawal, [...]

2009-04-15T11:50:37-07:00April, 2007|Archive|

Mayfield cancer survivor urges people to get sores checked out

4/16/2007 Gloversville, NY Richard Nilsen The Leader-Herald (www.leaderherald.com) Sharlee Ringer of Mayfield said she hopes by telling her story she may be able to help someone. Ringer, a 35-year-old married mother of five who is active in the community, recently had part of her tongue removed and was having her tonsils removed today in an effort to stop the spread of the oral cancer she was diagnosed with Jan. 27. “I had noticed a lesion on my tongue last April, but I thought it was just a cold sore,” Ringer said. Ringer questioned if the cold sore was something more when it didn’t go away. But since she has never smoked or been exposed to other typical things that lead to oral cancer, she put off having the sore looked at. “When I finally got an appointment to have it removed, I had to postpone due to a respiratory infection,” she said. Each delay could worsen the condition, but at 35 and with no history of smoking, she didn’t imagine the problem could be cancer. “When the doctor called me in to a conference room to discuss the lesion he had removed, I knew it was cancer,” she said. The sore was found to be squamous cell carcinoma, the most common form of oral cancer. Ringer said she wanted to tell her story in order to make others aware. April is National Cancer Control Month. She said she’d like to get the word out because it is difficult to get [...]

2009-04-15T11:50:13-07:00April, 2007|Archive|

Oral rinse may detect head and neck cancer

4/16/2007 web-based article staff SpiritIndia.com A simple oral rinse could detect the early development of head and neck squamous cell carcinoma, according to researchers at the University of Miami’s Sylvester Comprehensive Cancer Center. Their strategy involves the detection of CD44, a protein biomarker for HNSCC tumors, combined with the detection of cancer-related altered DNA, and could reliably distinguish cancer from benign diseases. Currently, only 50 percent of head and neck cancer patients are cured of the disease. While late-stage HNSCC has a poor prognosis, cure rates exceed 80 percent if caught early enough. "Head and neck cancers are devastating for all patients. They are particularly challenging for the poor and disadvantaged, who often do not have the adequate, regular care that makes early detection more likely," said Elizabeth Franzmann, M.D., assistant professor of otolaryngology at Miami. "Our study has shown that an oral rinse test, simple enough to be administered at any community health center, is likely to detect cancer about 90 percent of the time." While CD44 appears on the surface of cells in healthy tissue, it is elevated at least seven- fold times in head and neck cancer. Dr. Franzmann and her colleagues theorized that CD44 could be detected in an oral rinse, which would flush out the CD44 protein by washing over the cellular membranes of interest in the throat and mouth. According to Dr. Franzmann, their study began with an attempt to find if soluble CD44, alone, was sufficient to distinguish between cancer and other diseases. [...]

2009-04-15T11:47:45-07:00April, 2007|Archive|

New Device From LED Dental May Allow Earlier Detection of Oral Cancer

4/16/2007 New Rochelle, NY press release Genetic Engineering & Biotechnology News (ww.genengnews.com) The Food and Drug Administration recently gave LED Dental Inc. clearance to use its VELscope Oral Cancer Screening System to assist dentists in detecting cancerous growths that may be missed with traditional examinations, and also help surgeons ensure that all diseased tissue is successfully removed when excising cancerous lesions. This approval is based on studies conducted by scientists at the British Columbia Cancer Agency. The studies reported cases that demonstrated VELscope's ability to facilitate the detection of lesions that were not visible by an expert under conventional white light visualization. Oral Cancer: The Forgotten Disease Oral cancer is one of the few forms of cancer that have not experienced a significantly decreased mortality rate in the past 30 years. Deaths from oral cancer are higher than from cervical, testicular, laryngeal or thyroid cancer. It is estimated that over 34,000 Americans will develop oral cancer in 2007, and that only about half of them will be alive in five years. One American dies of this disease every hour of every day. The traditional profile of an oral cancer victim is that of a heavy user of tobacco and alcohol who is at least 40 years old. However, the number of victims who do not fit this profile has been growing at an alarming rate in recent years. One reason may be the growth in the occurrence of the human papilloma virus (HPV), one strain of which is now thought [...]

2009-04-15T11:47:21-07:00April, 2007|Archive|

Genomic Targets in Saliva

4/15/2007 Los Angeles, CA BERNHARD G ZIMMERMANNa, NOH JIN PARKa AND DAVID T WONGabcde Ann. N.Y. Acad. Sci. 1098: 184–191 (2007) Saliva, the most accessible and noninvasive biofluid of our body, harbors a wide spectrum of biological analytes informative for clinical diagnostic applications. While proteomic constituents are a logical first choice as salivary diagnostic analytes, genomic targets have emerged as highly informative and discriminatory. This awareness, coupled with the ability to harness genomic information by high-throughput technology platforms such as genome-wide microarrays, ideally positions salivary genomic targets for exploring the value of saliva for detection of specific disease states and augmenting the diagnostic and discriminatory value of the saliva proteome for clinical applications. Buccal cells and saliva have been used as sources of genomic DNA for a variety of clinical and forensic applications. For discovery of disease targets in saliva, the recent realization that there is a transcriptome in saliva presented an additional target for oral diagnostics. All healthy subjects evaluated have approximately 3,000 different mRNA molecules in their saliva. Almost 200 of these salivary mRNAs are present in all subjects. Exploration of the clinical utility of the salivary transcriptome in oral cancer subjects shows that four salivary mRNAs (OAZ, SAT, IL8, and IL1b) collectively have a discriminatory power of 91% sensitivity and specificity for oral cancer detection. Data are also now in place to validate the presence of unique diagnostic panels of salivary mRNAs in subjects with Sjögren's disease. Authors: Bernhard G. Zimmeran(a), Noh Jin Park(a), David T. Wont [...]

2009-04-15T11:46:58-07:00April, 2007|Archive|

HPV Linked to Head and Neck Cancer

4/4/2007 Baltimore, MD press release Johns Hopkins Medicine (www.hopkinscancercenter.net) For Dr. Maura Gillison the human papillomavirus was a smoking gun. Having proven that the virus is present in tumor cells of a subset of patients with head and neck cancer—those patients that didn’t fit the risk profile for the disease—this new faculty member has now set out to discover how this new finding will affect screening, prognosis and treatment of head and neck cancers. There is a common factor among one quarter of all head and neck cancers. It is the sexually transmitted human papillomavirus (HPV). Maura Gillison, M.D., Ph.D., assistant professor of oncology, intrigued by evidence of HPV DNA in head and neck cancers wanted to find out what role this virus might be playing in this form of cancer. “The fact that the virus had been detected in some head and neck cancers was no secret, but most scientists attributed it to laboratory contamination. I couldn’t help but wonder what if it wasn’t,” she says. When she began the experiment, Gillison truly expected the results to be negative, that she would not find HPV in the tumor cells. Instead her studies not only confirmed the presence of HPV, but also uncovered another interesting outcome. She was able to prove infection with the virus was associated with head and neck cancers, primarily oropharyngeal cancers, including those of the pharynx, tonsils, and base of tongue. And to her surprise, she also found that these patients typically fared better than those [...]

2009-04-15T11:42:45-07:00April, 2007|Archive|

Finely honed focus

4/14/2007 Toronto, Ontario, Canada Barbara Turnbull Toronto Star (www.thestar.com) Hi-tech radiation imaging, 3-D planning increase intensity with fewer downsides Once his mask is snapped to the table, Ross Harrison can barely blink. That's crucial to the course of radiation he'll finish at Princess Margaret Hospital in a few weeks. It follows surgery that removed a cancerous growth from his neck last February. Harrison is one of approximately 7,500 patients who receive radiation here each year, one of the largest and most respected cancer treatment facilities in the world. "They certainly go out of their way to make people comfortable," says the 65-year-old retired forestry products specialist. Harrison expects to fully recover, and anticipates a summer of golf, gardening and cycling when he returns home to his wife, a retired schoolteacher, and their two cats in Sault St. Marie. Almost 400 professionals plan and deliver radiation to cancer patients at PMH each year. The process begins with physicians, who spend hours on a computerized planning system with multiple images of the body site to be radiated. Slice by slice, millimetre by millimetre, a pattern for radiation – which can take between one and 42 treatments – is painstakingly contoured for each patient. "There is a lot of judgment," says Dr. Mary Gospodarowicz, PMH's head of radiation medicine. New technology allows the precise shaping of radiation beams to the tumour site, which minimizes the volume of tissue being treated, reducing toxicity and sparing healthy cells. "If you have a normal structure next [...]

2009-04-15T11:46:35-07:00April, 2007|Archive|

Free Screenings Offered At April 14 Oral Cancer Walk In Harlem

4/14/2007 Vancouver, British Columbia, Canada press release E-dental.com Free oral cancer screenings will be offered Saturday, April 14 at the second annual Oral Cancer Walk in Harlem. Screenings given with the VELscope device are completely free of pain and inconvenience and take only one or two minutes. The Oral Cancer Walk, which is being led by the New York University Chapter of the Student National Dental Association, is being conducted to raise awareness of a disease that kills one American every hour of every day. The 5-year survival rate for oral cancer is only 50-to-60 percent, but early detection can result in survival rates of 80 percent or higher. VELscope is intended to be used in conjunction with conventional "white light" examination to help dentists and other healthcare providers discover oral abnormalities, including those that may be, or lead to, oral cancer. Registration and oral cancer screenings begin at 9:00 a.m. at Marcus Garvey Park, 121st Street and Madison Avenue in Harlem. The walk starts at 11:00 a.m.

2009-04-15T11:46:00-07:00April, 2007|Archive|

Secular Trend in U.S. Black-White Disparities in Selected Alcohol-related Cancer Incidence Rates

4/13/2007 Hartford, CT Anthony P. Polednak Alcohol and Alcoholism 2007 42(2):125-130 Aims: To examine secular trends in incidence rates for the cancer types most strongly associated with alcohol in African Americans (blacks) and whites. Methods: Average annual age-standardized incidence rates (ASIRs) for years of diagnosis 1973–1975 through 2000–2002 were analysed for squamous cell carcinomas of the oral cavity pharynx, oesophagus and larynx in U.S. blacks and whites by sex, using data from a group of high-quality population-based cancer registries. Also examined were National Health Interview Survey (NHIS) results on prevalence of current drinking and cigarette smoking among the U.S. population, and U.S. age-standardized mortality rates for alcoholic liver disease-damage from 1979 to 2003. Results: In 1973–1975, ASIRs were greater in blacks than whites for cancers of the oesophagus and larynx but not oral cavity pharynx, and peaks in the disparity reached in the 1980’s were followed by declines except for laryngeal cancer (the cancer most strongly associated with tobacco). By 2000–2002, black–white disparities in ASIRs were highest for oesophagus (black/white ratio 4.3 for males and 2.9 for females) but lower for laryngeal cancer and small or non-existent for oral cavity pharynx. NHIS data showed that by the 1970s the U.S. black/white ratios of prevalence were slightly > 1.0 for current smoking but 0.9 (and 0.7 by 1997 and 2003) for current drinking. Disparities in alcoholic liver disease had disappeared by 2003. Conclusions: Further declines in black–white disparities in cancer rates may occur (allowing for lag times), but the larger disparities [...]

2009-04-15T11:43:56-07:00April, 2007|Archive|
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