6/30/2008 web-based article Bhuvanesh Singh and David G. Pfister Journal of Clinical Oncology, Vol 26, No 19 (July 1), 2008: pp. 3114-3116 Integrated chemotherapy and radiation therapy have become the standard of care for most patients with advanced stage laryngopharyngeal cancers. The concurrent administration of these two modalities is the approach recommended by most experts at present.1 This strategy achieves higher rates of locoregional control compared to when chemotherapy is given as induction treatment before, or as an adjuvant after, radiation therapy.2-6 However, the benefits from concomitant chemoradiotherapy treatment are tempered by higher rates of treatment-related sequelae, especially in the short term. This issue is of particular concern in patients that fail to respond and who have to endure the adverse effects of treatment. Based on observations that response to chemotherapy predicts radiation response, initial combined modality trials used response to induction chemotherapy to select patients for subsequent organ preservation treatment with definitive radiation, reserving laryngectomy for chemoresistant patients.5,6 However, with a shift to concomitant administration of chemotherapy and radiation therapy, the opportunity for treatment selection based on initial response was lost.3 To maximize the potential value of induction chemotherapy in terms of patient selection while minimizing the delay in the start of concomitant treatment, Urba et al has promulgated an approach in larynx cancer in which one cycle of neoadjuvant chemotherapy is delivered to select patients for subsequent concomitant chemoradiotherapy.7 Their published work suggests that this approach offers advantages for survival improvement over historical controls. The group recently expanded [...]

6/30/2008 Bethesda, MD S Boroumand et al. J Cancer Educ, June 1, 2008; 23(2): 85-91 Background: Most oral cancers are diagnosed at late stages. Health care providers, particularly dentists, play a critical role in early detection of oral cancers and should be knowledgeable and skillful in oral cancer diagnosis. In this study, we assessed knowledge and opinions regarding oral cancer among dental students in Maryland. Methods: A cross-sectional survey was conducted among Maryland dental students in 2005. Results: The response rate was 59.6%. Knowledge of oral cancer was low among freshmen and significantly different from other classes. There was no statistically significant difference between 2nd-, 3rd- and 4th-year students in terms of level of oral cancer knowledge. The results revealed inadequate confidence among junior and senior students with regard to oral cancer examination and lymph node palpation. Conclusions: Findings from this study identify areas that need reinforcement in Maryland dental school's curriculum regarding oral cancer education. This survey approach could be a model for other dental schools in the United States or overseas. Authors: S Boroumand, AI Garcia, RH Selwitz, and HS Goodman Authors' affiliation: National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Maryland, USA

6/30/2008 Clichy, France C Le Tourneau et al. Acta Otolaryngol, June 1, 2008; 128(6): 706-12 Conclusions: Given that radiation therapy (RT) is currently initiated as soon as possible after surgery, our results indicate that the main prognostic factors of survival are pT and pN stages in patients treated with surgery and postoperative RT for locally advanced head and neck squamous cell carcinoma (HNSCC). Objectives: To determine the prognostic factors for survival in patients treated with surgery and postoperative RT for locally advanced HNSCC. Patients and methods. A retrospective study was performed on 308 consecutive patients treated from 1990 to 1998 with surgery and postoperative RT. In addition to histological factors, time-related factors were considered. Results: The median age of the whole cohort was 56 years (range 35-83). Median follow-up was 98 months. Median interval from surgery to the start of RT was 44 days (range 18-157), while median RT duration was 52 days (range 22-115). From univariate analysis of overall survival, statistically significant prognostic factors were pT stage (p<0.0001), pN stage (p=0.008), RT duration (p=0.01) and total treatment time (p=0.02). Perineural invasion, perivascular invasion, extranodal spread and positive resection margins did not appear to be related to survival. From multivariate analysis, the only statistically independent prognostic factors appeared to be pT and pN stages. Authors: C Le Tourneau, GM Jung, C Borel, G Bronner, H Flesch, and M Velten Authors' affiliation: Department of Medical Oncology, Beaujon University Hospital Clichy

6/30/2008 Ann Arbor, MI Francis P. Worden et al. Journal of Clinical Oncology, Vol 26, No 19 (July 1), 2008: pp. 3138-3146 Response and Survival Positively Associated With HPV16 Copy Number Purpose: To test induction chemotherapy (IC) followed by concurrent chemoradiotherapy (CRT) or surgery/radiotherapy (RT) for advanced oropharyngeal cancer and to assess the effect of human papilloma virus (HPV) on response and outcome. Patients and Methods: Sixty-six patients (51 male; 15 female) with stage III to IV squamous cell carcinoma of the oropharynx (SCCOP) were treated with one cycle of cisplatin (100 mg/m2) or carboplatin (AUC 6) and with fluorouracil (1,000 mg/m2/d for 5 days) to select candidates for CRT. Those achieving a greater than 50% response at the primary tumor received CRT (70 Gy; 35 fractions with concurrent cisplatin 100 mg/m2 or carboplatin (AUC 6) every 21 days for three cycles). Adjuvant paclitaxel was given to patients who were complete histologic responders. Patients with a response of 50% or less underwent definitive surgery and postoperative radiation. Pretreatment biopsies from 42 patients were tested for high-risk HPV. Results: Fifty-four of 66 patients (81%) had a greater than 50% response after IC. Of these, 53 (98%) received CRT, and 49 (92%) obtained complete histologic response with a 73.4% (47 of 64) rate of organ preservation. The 4-year overall survival (OS) was 70.4%, and the disease-specific survival (DSS) was 75.8% (median follow-up, 64.1 months). HPV16, found in 27 of 42 (64.3%) biopsies, was associated with younger age (median, 55 v 63 years; [...]

6/29/2008 Washington, DC Robert Boyd origin.montereyherald.com Viruses aren't always the bad guys. Sure, they can cause colds, measles, AIDS and other miseries. But with some tinkering, these tiny organisms may become a new and better way to treat cancer. In the last few years, scientists have been genetically engineering various viruses so they attack cancer cells but leave healthy cells alone. These "oncolytic" — cancer-destroying — viruses are being tested in hundreds of terminally ill patients for whom surgery, radiation and chemotherapy have failed. Several of these experimental viruses target malignant brain tumors, like the incurable glioma that's afflicting Sen. Edward Kennedy, D-Mass. "The past two years have seen several major advances in oncolytic virotherapy," David Kirn, the president of Jennerex Biotherapeutics Inc., a biotechnology firm in San Francisco, reported in the journal Gene Therapy in April. "A large number of clinical trials have been carried out. Safety in humans has been demonstrated in more than 800 patients." So far, no cancer-killing virus has received U.S. government approval for general use in humans, but dozens of clinical trials are under way to determine their safety and effectiveness. Some could be ready for doctors to use in the next two or three years, said Dr. Frank McCormick, a cancer researcher at the University of California-San Francisco. He cautioned, however, that many hurdles remain to be overcome before viral therapy will be part of usual medical practice. Ways must be found to defeat the body's natural immune system, which is primed to [...]

6/25/2008 Minneapolis, MN staff NewsRX (www.newsrx.com) According to a study from the United States, "Whole human saliva possesses tremendous potential in clinical diagnostics, particularly for conditions within the oral cavity such as oral cancer. Although many have studied the soluble fraction of whole saliva, few have taken advantage of the diagnostic potential of the cells present in saliva, and none have taken advantage of proteomics capabilities for their study." "We report on a novel proteomics method with which we characterized for the first time cells contained in whole saliva from patients diagnosed with oral squamous cell carcinoma. Our method uses three dimensions of peptide fractionation, combining the following steps: preparative IEF using free flow electrophoresis, strong cation exchange step gradient chromatography, and microcapillary reverse-phase liquid chromatography. We determined that the whole saliva samples contained enough cells, mostly exfoliated epithelial cells, providing adequate amounts of total protein for proteomics analysis. From a mixture of four oral cancer patient samples, the analysis resulted in a catalogue of over 1000 human proteins, each identified from at least two peptides, including numerous proteins with a role in oral squamous cell carcinoma signaling and tumorigenesis pathways. Additionally proteins from over 30 different bacteria were identified, some of which putatively contribute to cancer development. The combination of preparative IEF followed by strong cation exchange chromatography effectively fractionated the complex peptide mixtures despite the closely related physiochemical peptide properties of these separations (pI and solution phase charge, respectively). Furthermore compared with our two-step method combining preparative IEF [...]

6/24/2008 Seoul, South Korea Won Il Jang et al. Japanese Journal of Clinical Oncology 2008 38(6):395-401 Objective: To evaluate treatment outcome and to determine optimal treatment strategy for patients with clinically lymph node-negative (N0) oral cavity squamous cell carcinoma (SCC). Methods: Two hundred and twenty-seven patients with oral cavity SCC received radiotherapy with curative intent. We retrospectively analyzed 69 patients with clinically N0 disease. Forty-three patients were treated with surgery followed by radiotherapy (S+EBRT) and 26 with radiotherapy alone (EBRT). The median doses administered were 63.0 Gy for S+EBRT and 70.2 Gy for EBRT. Results: The rates of occult metastasis were 60% for T1, 69% for T2, 100% for T3 and 39% for T4, respectively, among patients who underwent neck dissection. A contralateral occult metastasis occurred only in two patients. The median follow-up was 39 months (range, 6–170 months). The 5-year overall survival (OS), disease-free survival (DFS), local control (LC) and regional control (RC) rates for all patients were 56, 50, 66 and 79%, respectively. The 5-year OS, DFS, LC and RC rates were 67/39% (P < 0.01), 66/24% (P < 0.01), 87/30% (P < 0.01) and 73/89% (P = 0.11) for S+EBRT/EBRT, respectively. Conclusions: The risk for occult neck metastasis is high in patients with oral cavity SCC; therefore, elective neck treatment should be considered. Excellent RC for subclinical disease can be achieved with radiotherapy alone. However, external beam radiotherapy alone to primary tumor resulted in poor LC and combined treatment with surgery and radiotherapy appeared to be a [...]

6/24/2008 Los Angeles, CA press release Fox Business (www.foxbusiness.com) Canopus BioPharma, Inc. is pleased to announce that the South African Medicines Control Council has granted approval for a Phase II study in 30 cancer patients evaluating the protective effect of CB1400 on the gastrointestional tract from radiation-induced mucositis. This new trial is an important step forward in the development of CB1400 as a novel, preventative, anti-mucositis agent. Oral and gastrointestinal (GI) mucositis is a painful, debilitating, and sometimes fatal, side-effect of radiation therapy and cancer chemotherapy. No preventative mucositis medicines are available, and few treatments are effective. With some cancer therapies, oral mucositis can develop in over 90% of patients. Consequently, it is a widespread problem with considerable economic and healthcare implications. There is a real need for an effective and well-tolerated mucositis prophylactic. The US market for a preventative mucositis agent is estimated to be over $1 billion per annum. In work carried out on behalf of Canopus, CB1400 has already been shown to have protective and antimutagenic effects when tested in an animal model of mucositis. Complete protection of the GI tract was seen in gamma-radiated mice pre-treated with oral CB1400 (100 mg/kg/day). Even with high doses of radiation (10Gy), there was no evidence of mucositis: weight gain was observed in the CB1400 pre-treated groups; all mice treated with placebo died. Canopus BioPharma Inc. has applied to undertake further clinical studies with leading oncologists in Australia, South Africa and the USA, investigating CB1400 as a preventative mucositis agent [...]

6/23/2008 web-based article Erik P Sulman et al. Int J Radiat Oncol Biol Phys, June 13, 2008 Purpose: Institutional and cooperative group experience has demonstrated the feasibility of reirradiation for head and neck cancer. Limited data are available regarding the use of intensity-modulated radiotherapy (IMRT) for this indication. We reviewed our initial experience using IMRT for previously irradiated head and neck cancer patients. Methods and Materials: Records of 78 consecutive patients reirradiated with IMRT for head and neck cancer between 1999 and 2004 were reviewed; 74 cases were analyzed. Reirradiation was defined as any overlap between original and new radiation treatment volumes regardless of the time interval between initial and subsequent treatment. Severe reirradiation-related toxicity was defined as toxic events resulting in hospitalization, corrective surgery, or patient death. Longitudinal estimates of survival were calculated by Kaplan-Meier technique. Results: Twenty (27%) patients underwent salvage surgical resection and 36 (49%) patients received chemotherapy. Median follow-up from reirradiation was 25 months. Median time interval between initial radiation and reirradiation was 46 months. Median reirradiation dose was 60 Gy. Median lifetime radiation dose was 116.1 Gy. The 2-year overall survival and locoregional control rates were 58% and 64%, respectively. Severe reirradiation related toxicity occurred in 15 patients (20%); one treatment-related death was observed. Conclusions: The use of IMRT for reirradiation of recurrent or second primary head and neck cancers resulted in encouraging local control and survival. Reirradiation-related morbidity was significant, but may be less severe than previously published reports using conventional techniques. Authors: Erik [...]

6/23/2008 London, England staff Dentistry.uk.co A report revealing an alarming number of dental patients going without mouth cancer checks has prompted a tide of protest from dentists throughout the UK. The survey revealed that 71% of people said their dentist had never checked them for the condition. And 87% said their dentist had never even spoken to them about it. Dr Nigel Carter, chief executive of the British Dental Health Foundation (BDHF), said: ‘Mouth cancer is a very serious condition. ‘It kills more than cervical cancer and testicular cancer combined, and yet a staggering 23% of people have never even heard of it. ‘The problem here appears to be twofold. First, not enough dentists are carrying out the checks, and second, those that do carry them out are failing to communicate this to their patients, missing a perfect opportunity to educate them on the dangers of mouth cancer. ‘NHS dentists are expected to carry out dental check-ups in a very short space of time, and it appears that many do not feel they have the time to carry out this important activity.' The National Mouth Cancer Survey questioned 500 adults across 10 UK cities in April 2008 and was coducted by the BDHF and Medicash. However, Mr Gill, a partner at Dean Road Dental Practice in South Shields, said: ‘It is something that is done, but not said. ‘When having a good look around the mouth, we look for these things. It is what we do. It is part of [...]