radiotherapy – Page 5 – Oral Cancer News

Dental Implants Installed in Irradiated Jaws – A Systematic Review

Source: Journal of Dental ResearchPublished: October 24, 2013By: 1. L. Chambrone12. J. Mandia Jr23. J.A. Shibli34. G.A. Romito1,*5. M. Abrahao21. 1Division of Periodontics, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil 2. 2Department of Otorhinolaryngology and Head and Neck Surgery, Federal University of São Paulo, São Paulo, Brazil 3. 3Department of Periodontology and Oral Implantology, Dental Research Division, Guarulhos University, SP, Brazil 1. ↵*[email protected] Abstract The aim of this study was to assess the survival rate of titanium implants placed in irradiated jaws. MEDLINE, EMBASE, and CENTRAL were searched for studies assessing implants that had been placed in nongrafted sites of irradiated patients. Random effects meta-analyses assessed implant loss in irradiated versus nonirradiated patients and in irradiated patients treated with hyperbaric oxygen (HBO) therapy. Of 1,051 potentially eligible publications, 15 were included. A total of 10,150 implants were assessed in the included studies, and of these, 1,689 (14.3%) had been placed in irradiated jaws. The mean survival rate in the studies ranged from 46.3% to 98.0%. The pooled estimates indicated a significant increase in the risk of implant failure in irradiated patients (risk ratio: 2.74; 95% confidence interval: 1.86, 4.05; p < .00001) and in maxillary sites (risk ratio: 5.96; 95% confidence interval: 2.71, 13.12; p < .00001). Conversely, HBO therapy did not reduce the risk of implant failure (risk ratio: 1.28; 95% confidence interval: 0.19, 8.82; p = .80). Radiotherapy was linked to higher implant failure in the maxilla, and HBO therapy did not improve implant survival. Most included publications reported data on [...]

Charlotte Parker2013-10-31T17:53:12-07:00October, 2013|Oral Cancer News|

Leaders in Dentistry: Dr. Ezra Cohen

Source: Dr. Bicuspid By: Donna Domino, Features Editor Date: July 17, 2013 May 21, 2013 — DrBicuspid.com is pleased to present the next installment of Leaders in Dentistry, a series of interviews with researchers, practitioners, and opinion leaders who are influencing the practice of dentistry. We spoke with Ezra Cohen, MD, an associate professor of medicine and the co-director of the head and neck cancer program at the University of Chicago, and the associate director for education at the university’s Comprehensive Cancer Center. Dr. Cohen specializes in head and neck, thyroid, and salivary gland cancers, and is an expert in novel cancer therapies who has conducted extensive research in molecularly targeted agents in the treatment of these cancers. His research interests include discovering how cancers become resistant to existing treatments and overcoming these mechanisms and ways to combine radiotherapy with novel agents. Here Dr. Cohen discusses trends in the incidence, detection, and treatment of oral and head and neck cancers. DrBicuspid.com: What’s the significance of your recent finding that there may be five distinct subgroups of the human papillomavirus (HPV)? Dr. Cohen: The purpose of the research was trying to define molecular subgroups of head and neck cancer (HNC) to inform therapy and outcomes a lot more than we do now as defined by stage and anatomic site. We were taking advantage of a cohort of patients that we treated in a similar fashion at the University of Chicago with a chemotherapy regimen that we commonly use here. The patients [...]

Webmaster2013-07-19T07:48:02-07:00July, 2013|Oral Cancer News|

SSRI Prevents Depression in Head, Neck Cancer

Source: MedPage TodayBy Salynn Boyles, Contributing WriterPublished: June 21, 2013 Prophylactic escitalopram cut the incidence of depression in head and neck cancer patients by more than 50% and improved quality of life, a clinical trial showed. Significantly fewer patients taking the antidepressant developed depression, when compared with those on placebo (10% vs 24.6%; stratified log-rank test, P=.04), according to a study in the June 20 issue of JAMA Otolaryngology Head and Neck Surgery. "Depression is very common among patients with this disease, but it is not easy to predict who will become depressed at the beginning of treatment," University of Nebraska Medical Center professor of head and neck oncology William Lydiatt, MD, told MedPage Today. "That's why the prevention paradigm may offer considerable benefit at an acceptable risk." As many as half of head and neck cancer patients develop clinical depression within months of their diagnosis and suicide rates are among the highest in patients with a medical illness, Lydiatt noted. "The burden of treatment is extensive and frequently includes dysphagia, disfigurement, voice alterations, mucositis, need for tracheostomy and feeding tubes, fatigue and depression," the researchers wrote. They chose the generic version of the popular SSRI Lexapro for the trial to give patients an affordable treatment option that's well tolerated in the elderly. The randomized, double-blind trial included 148 newly diagnosed head and neck cancer patients entering treatment who did not yet have a diagnosis of depression. The patients were stratified by sex, site of disease, stage, and primary modality of [...]

Charlotte Parker2013-06-21T14:10:07-07:00June, 2013|Oral Cancer News|

‘Dentist should have spotted my cancer’

Source: menmedia.co.uk Author: staff An NHS dentist who advised a patient to treat what turned out to be a life-threatening oral cancer with mouthwash is being sued for tens of thousands of pounds in damages. Paula Drabble, 58, went to Pinfold Dental Practice, in Hattersley, Hyde, in June 2008 with concerns about a white lesion on her gum. She was told by her dentist, Ian Hughes, it was nothing serious, a court heard. Mrs Drabble of Mottram Moor, Mottram, Hyde, had five further appointments with Mr Hughes and was advised to ‘manage’ her complaint with mouthwash. She was eventually referred to hospital in April 2009, and ‘seriously invasive cancer’ diagnosed. She had surgery, including removal of affected bone, followed by radiotherapy and chemotherapy. She has now made a good recovery and has begun a High Court fight for damages, claiming Mr Hughes was negligent to have not spotted the cancer and referred her to hospital earlier. Timothy Briden, for Mrs Drabble, told the court his client had developed the patch on her gum some years earlier. The lesion was found to be benign by medics at the University Dental Hospital in Manchester and she was discharged in 2004 with a letter being sent to Mr Hughes, warning him to ‘re-refer if you notice or indeed Mrs Drabble notices any changes’. Marcus Dignum, for Mr Hughes, denied that his client was at fault in failing to spot the cancer. He said: “Plainly the court will have every sympathy with Mrs Drabble [...]

Oral Cancer Foundation News Team - A2013-01-21T06:56:22-07:00January, 2013|Oral Cancer News|

Neoadjuvant chemo does not improve oral cancer survival rates

Source: www.drbicuspid.com Author: DrBicuspid Staff Patients with advanced resectable oral squamous cell carcinoma (OSCC) who undergo surgery do not benefit from improved survival after induction with docetaxel, cisplatin, and fluorouracil (TPF), according to a new study (Journal of Clinical Oncology, November 5, 2012). Study author Zhi-yuan Zhang, MD, PhD, from Shanghai Jiao Tong University School of Medicine, and colleagues assessed 256 patients with resectable locally advanced OSCC. A total of 222 patients completed the full treatment protocol. They received two cycles of TPF induction chemotherapy (75 mg/m2 of docetaxel on day 1, 75 mg/m2 of cisplatin on day 1, and 750 mg/m2 of fluorouracil on days 1 to 5) followed by radical surgery and postoperative radiotherapy versus upfront radical surgery and postoperative radiotherapy. The primary end point was overall survival. Secondary end points included local control and safety. After a median follow-up of 30 months, there was no significant difference in overall survival or disease-free survival between patients treated with or without TPF induction, the study authors noted. Patients in the induction chemotherapy arm with a clinical response or favorable pathologic response had superior overall survival and locoregional and distant control. "Our study failed to demonstrate that TPF induction chemotherapy improves survival compared with upfront surgery in patients with resectable stage III or IVA OSCC," the authors concluded. The lack of survival benefit indicates that TPF induction chemotherapy without selection could not benefit OSCC patients in general, Dr. Zhang told Reuters Health in a news story. "On the other hand, [...]

Oral Cancer Foundation News Team - A2012-11-11T19:34:34-07:00November, 2012|Oral Cancer News|

DNA alone inadequate to identify HPV-related cancers

Source: www.oncologypractice.com Author: Mary Ann Moon Testing for the presence of human papillomavirus DNA alone, especially using polymerase chain reaction methods, is not adequate to identify which head and neck squamous cell carcinomas are caused by the virus, according to two studies published online Sept. 18 in Cancer Research. Identifying HPV-driven malignancies is important because they respond better to treatment and have better outcomes than those unrelated to HPV infection. Indeed, treatment of head and neck squamous cell carcinoma (HNSCC) may soon be guided by the tumor’s HPV status, since trials are now underway to determine whether de-escalation of chemo- and radiotherapy is safe and effective in such patients. At present, however, the biomarkers that are best suited to making this identification are unclear. Case Series Assesses Biomarkers In the first study, researchers assessed the usefulness of four biomarkers in determining which HNSCCs in a case series were driven by HPV. They began by examining fresh-frozen tumor biopsy samples from 199 German adults diagnosed as having oropharyngeal squamous cell cancer between 1990 and 2008. The four biomarkers were HPV-16 viral load, viral oncogene RNA (E6 and E7), p16INK4a, and RNA patterns similar to those characteristic of cervical carcinomas (CxCa RNA), said Dr. Dana Holzinger of the German Cancer Research Center at Heidelberg (Germany) University and her associates. The simple presence of HPV DNA in a tumor sample was found to be a poor indicator of prognosis, likely because it often signaled past HPV infections or recent oral exposure, rather than [...]

Oral Cancer Foundation News Team - A2012-09-24T13:36:21-07:00September, 2012|Oral Cancer News|

Study will evaluate Panitumumab regimen in advanced SCCHN

Source: http://www.onclive.com/ Author: staff Canadian researchers are investigating standard fractionation radiotherapy with concurrent high-dose cisplatin versus accelerated fractionation radiotherapy with panitumumab in patients with locally advanced stage III and IV squamous cell carcinoma of the head and neck (SCCHN). The NCIC Clinical Trials Group has completed accrual for the randomized phase III study, which has a planned sample size of 320 patients with SCC of the oral cavity, oropharynx, larynx, or hypopharynx. The trial was launched in December 2008, and the Data Safety and Monitoring Committee recommended continuing the trial in October 2011. Patients assigned to arm I will undergo standard fractionation radiotherapy once daily, five days a week, for seven weeks; they will also receive cisplatin intravenously over one hour on days 1, 22, and 43 of radiotherapy. Participants assigned to arm II will undergo accelerated fractionation radiotherapy once or twice daily, five days a week, for six weeks; they will also receive panitumumab intravenously over 30-90 minutes one week prior to and on days 15 and 36 of radiotherapy. The primary endpoint is progression-free survival (PFS), while secondary endpoints include overall survival, local and regional PFS, distant metastases, adverse events, swallowing-related quality of life, functional swallowing outcomes, and economic assessments. The FDA has approved panitumumab under the brand name Vectibix for the treatment of patients with metastatic colorectal carcinoma with disease progression on or following chemotherapy regimens containing fluoropyrimidine, oxaliplatin, and irinotecan. Panitumumab is a human IgG2 kappa monoclonal antibody that binds specifically to human epidermal growth factor [...]

Oral Cancer Foundation News Team - A2012-09-11T08:18:26-07:00September, 2012|Oral Cancer News|

The Impact of Timing of EGFR and IGF-1R Inhibition for Sensitizing Head and Neck Cancer to Radiation

Source: AntiCancer Research Abstract Background: Targeting the epidermal growth factor receptor (EGFR) improved radiotherapy outcome by 10-15% in head and neck tumors (HNSCC). We tested the therapeutic benefits of co-targeting EGFR and insulin-like growth factor-1 receptor (IGF-1R) to further enhance tumor response to radiation. Materials and Methods: Mice bearing FaDu tumor xenografts were treated with ganitumab (previously known as AMG479, an anti-IGF-1R antibody), panitumumab (an anti-EGFR antibody), or both in combination with fractionated doses of radiation. Tumor growth delay and tumor cure/recurrence served as end-points. Results: The best tumor growth delay was achieved when ganitumab and panitumumab were given concurrently with radiation. Tumor cure/recurrence studies showed that combining ganitumab, panitumumab and radiation resulted in significantly higher radiocurability rates than use of either of the agents given with radiation. Conclusion: These findings provide the rationale for clinical testing of the combination of ganitumab and panitumumab for the treatment of HNSCC. This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

Charlotte Parker2012-07-26T09:29:45-07:00July, 2012|Oral Cancer News|

Tobacco Smoking and Increased Risk of Death and Progression for Patients With p16-Positive and p16-Negative Oropharyngeal Cancer

Source: Journal of Clinical Oncology Purpose Tobacco smoking is associated with oropharynx cancer survival, but to what extent cancer progression or death increases with increasing tobacco exposure is unknown. Patients and Methods Patients with oropharynx cancer enrolled onto a phase III trial of radiotherapy from 1991 to 1997 (Radiation Therapy Oncology Group [RTOG] 9003) or of chemoradiotherapy from 2002 to 2005 (RTOG 0129) were evaluated for tumor human papillomavirus status by a surrogate, p16 immunohistochemistry, and for tobacco exposure by a standardized questionnaire. Associations between tobacco exposure and overall survival (OS) and progression-free survival (PFS) were estimated by Cox proportional hazards models. Results Prevalence of p16-positive cancer was 39.5% among patients in RTOG 9003 and 68.0% in RTOG 0129. Median pack-years of tobacco smoking were lower among p16-positive than p16-negative patients in both trials (RTOG 9003: 29 v 45.9 pack-years; P = .02; RTOG 0129: 10 v 40 pack-years; P < .001). After adjustment for p16 and other factors, risk of progression (PFS) or death (OS) increased by 1% per pack-year (for both, hazard ratio [HR], 1.01; 95% CI, 1.00 to 1.01; P = .002) or 2% per year of smoking (for both, HR, 1.02; 95% CI, 1.01 to 1.03; P < .001) in both trials. In RTOG 9003, risk of death doubled (HR, 2.19; 95% CI, 1.46 to 3.28) among those who smoked during radiotherapy after accounting for pack-years and other factors, and risk of second primary tumors increased by 1.5% per pack-year (HR, 1.015; 95% CI, 1.005 to [...]

Charlotte Parker2012-06-11T10:02:05-07:00June, 2012|Oral Cancer News|

The UK’s first robotic mouth cancer operation

Source: www.privatehealth.co.uk Author: staff Pioneering surgery which allows doctors to remove cancer in the mouth using a minimally invasive technique is now available at the Wellington Hospital. Traditionally, the only way to remove Squamous Cell Carcinoma – cancer of the oropharynx which encompasses the tonsils and base of the tongue – has been to split the jaw, take out the cancer and repair the neck with tissue from the forearm. This 10-hour procedure requires two surgical teams and often has complications. Patients are in hospital for at least three weeks and need months of rehabilitation to help them swallow and speak again. Because the treatment is so invasive, many doctors try to avoid it using chemotherapy and radiotherapy instead. However, surgery is often the best chance of a cure. The new one-hour technique called Transoral Robotic Surgery allows the cancer to be removed without splitting the jaw or taking tissue from other parts of the body. Instead, the tonsils are accessed through the mouth using a specially designed robotic machine. Developed in the US in 2009 and now approved by the American Food and Drug Administration and licensed for use in the UK, it uses the Da Vinci robot to access this difficult to reach area. It gives the surgeon greater precision, dexterity and accuracy while carrying out the procedure and the patient has no stitches. Infection rates are reduced which speeds up recovery rates, patients are in hospital for just a week and are able to swallow normally soon afterwards [...]

Oral Cancer Foundation News Team - A2012-05-30T13:56:28-07:00May, 2012|Oral Cancer News|