New protocol improves prognosis for advanced head/neck cancer

9/20/2003 New York Reuters Health Induction chemotherapy appears to reduce distant disease failure rates following intensive concomitant chemoradiotherapy when administered to patients with advanced head and neck cancer. Physicians at a Chicago-area network of hospitals observed high locoregional control, organ preservation, and overall survival rates when they treated patients with intensified concomitant chemoradiotherapy. The biggest problem appeared to be distant failure. To eradicate systemic micrometastases, Dr. Everett E. Vokes, of the University of Chicago, and colleagues added an inductive regimen of carboplatin and paclitaxel administered in 6 weekly cycles. According to their report in the Journal of Clinical Oncology for January 15, three patients presented with stage III disease and 66 with stage IV disease. After 6 weeks, 87% of 61 patients with remaining disease following initial organ-preserving surgery exhibited a response and 35% a complete response. Beginning 2 to 3 weeks later, the patients underwent five cycles of treatment with paclitaxel, fluorouracil, hydroxyurea and twice-daily radiation therapy administered every other week. The patients were then followed for a median of 28 months. Fifty patients survived until the end of the study period in 2002, for an overall survival rate of 70%, the report indicates. Ten had died of disease persistence or recurrence and three of complications related to therapy. Five died of unrelated causes and one of a second malignancy. "The great majority of patients were treated without disabling surgery," the physicians note. The 3-year progression-free rate among those who survived was 80%. Systemic progression occurred in five subjects. [...]

2009-03-22T20:45:57-07:00September, 2003|Archive|

HPV Test Catching On as the More Definitive Cervical Cancer Screening

9/20/2003 Associated Press A more definitive cervical cancer-screening test that helps reduce uncertainty in diagnosing the disease is gaining support from doctors and health insurers. Aetna, the nation's largest health insurer, on Wednesday became the latest plan to cover the new DNA test that checks for the presence of a virus that studies show causes more than 99 percent of cervical cancers. The test is used when a Pap smear proves inconclusive, which happens about 5 percent of the time. Kaiser Permanente, United Healthcare and most Blue Cross and Blue Shield plans already cover the test for human papillomavirus, or HPV, according to the test's maker, Digene Corp. of Gaithersburg, Maryland. About 400,000 U.S. women had the HPV test in the past year, a Digene spokeswoman said. If the test shows no sign of HPV, a woman is assured she doesn't have cancer. If the HPV virus present, there is a greater likelihood the woman has cancer and she is sent for additional testing which most likely include a biopsy. ``Aetna is a bellwether for the adoption of HPV testing as a standard of care in cervical cancer screening,'' said Evan Jones, Chairman and CEO of Digene Corporation. About 50 million Pap smears are performed annually in the United States. Before the HPV test was approved by the Food and Drug Administration in 1999, women who had an inconclusive Pap test would have to get another Pap test or an outpatient procedure that would likely include a biopsy. The results [...]

2009-03-22T20:35:15-07:00September, 2003|Archive|

Accelerated radiotherapy improves head and neck cancer outcomes

9/19/2003 New York Reuters Health An accelerated course of radiotherapy that involves six fractions per week instead of five improves survival and offers other benefits for patients with head and neck cancer, new research indicates. The findings, which are published in the September 20th issue of The Lancet, are based on a randomized trial of 1476 patients with squamous-cell cancer of the head and neck. Regardless of whether patients were randomized to six or five fractions per week, most received a total of 66 to 68 Gy in 33 to 34 fractions, lead author Dr. Jens Overgaard, from Aarhus University in Denmark, and colleagues note. The exception was patients with well differentiated T1 glottic tumors, who received a total dose of 62 Gy. Median treatment times for the six- and five-fraction regimens were 39 and 46 days, respectively, the authors note. Disease-specific survival at 5 years in the six-fraction group was 73%, while the rate in the five-fraction group was significantly lower--66% (p = 0.01). Overall survival was comparable for both groups, a finding that may reflect the general poor health that typifies head and neck cancer patients. The locoregional control rate with the six-fraction regimen was 70%, significantly higher than the 60% rate seen with the five-fraction regimen (p = 0.0005). Similarly, the corresponding primary tumor control rates were 76% and 64% (p = 0.0001). In contrast, neck-node control did not differ significantly between the groups. Another benefit of the six-fraction regimen was improved voice preservation among patients with [...]

2009-03-22T20:34:31-07:00September, 2003|Archive|
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