10/5/2004 Atlanta, GA David Wahlberg Atlanta Jornal-Constitution Makers of a new cigarette claim it curbs the risk of cancer. Another is sold with the slogan, "Great taste, less toxins." Snuff in new teabag-like pouches can be sucked and tossed instead of spit out. And anyone care for a tobacco lozenge? Tobacco companies, reeling from lawsuit settlements, clean indoor air campaigns and growing public distrust are pitching a variety of "reduced-harm" products. The trend — to be discussed at a cancer conference in Atlanta this week — has ignited controversy over whether the potentially less risky offerings should be promoted as an alternative when smokers can't or won't quit. Many public health researchers wonder: is there such thing as a "safer cigarette" — or any kind of "safer tobacco?" The issue also has lit up the legal world. State attorneys general are questioning marketing claims. Bills in Congress calling for federal tobacco regulation and a buyout of tobacco quotas could restrict — or even expand — development of the "kinder, gentler" innovations. The ongoing federal trial seeking $280 billion from the tobacco industry for 50 years of alleged fraud could also have an impact. While the "reduced-harm" products and the furor over them are new, the reason health officials are cautious dates to the 1970s. Tobacco companies touted "low-tar" and "light" cigarettes as less harmful, and health authorities initially agreed. Then studies found that smokers compensated by puffing harder and inhaling more deeply, causing a new kind of cancer further down [...]

10/5/2004 Helen Pearson [email protected] Internal antioxidants may shield cells from radiation damage. US researchers have come up with a novel theory for how a tiny, tough bacterium can survive doses of radiation 2,000 times those that would fry a person. The unassuming red bacterium, called Deinococcus radiodurans, was discovered around 50 years ago in a batch of irradiated meat. Ever since, scientists have wondered how it can withstand radiation better than almost any other organism in the world. "They're better than cockroaches," says microbiologist James Imlay at the University of Illinois, Urbana. Researchers know that the bug is particularly good at patching up DNA damage wrought by radiation. Now Michael Daly of the Uniformed Services University of the Health Sciences in Bethesda, Maryland, and his team have come up with a possible explanation why. By comparing bacteria with different sensitivities to radiation, the team found that the most resistant bacteria tend to store up high levels of manganese and relatively low levels of iron. By contrast, the bacteria that shrivel up at a hint of radiation have little manganese and more iron. Artificially lowering the manganese levels also made bacteria more susceptible to radiation damage, the team reports report in Science (1). "It was quite stunning to us," Daly says. The marvels of manganese Daly suggests that the manganese helps to clear up damaging molecules, such as free radicals, that are released by the bugs' metabolism. This leaves the bacteria in a healthier state and better able to patch up [...]

10/5/2004 Guan-Cheng Huang, Shyun-Yeu Liu, Mei-Huei Lin, Yung-Yen Kuo and Young-Chau Liu Japanese Journal of Clinical Oncology 2004 34(9):499-504 Background: Platinum, 5-fluorouracil (5-FU) and taxanes are commonly used in chemotherapeutic modalities of various carcinomas. However, taxanes are rarely used in patients suffering from head and neck squamous cell carcinoma (HNSCC) in Taiwan. The purpose of this study was to assess whether there is a synergistic effect produced by incorporating Taxol (paclitaxel) with cisplatin, carboplatin or 5-FU in the combined treatment of oral squamous cell carcinoma (OSCC). Methods: OSCC cells were surgically excised from a Taiwanese patient and cultured into a cell line, OECM-1. The viability of OECM-1 after drug treatment was determined by an XTT labeling reagent. Results: The dose-dependent cytotoxicity of each drug was determined. The order of chemosensitivity of OECM-1 toward these drugs was Taxol, cisplatin, carboplatin and 5-FU, with 50% inhibitory concentrations (IC50s) of 10, 68, 332 and 3000 µM, respectively. In the combined drug treatment, low concentrations of platinum (10 µM) or 5-FU (500 µM) were included in the culture media with low cytotoxic concentrations of Taxol (0.025, 0.05 and 0.1 µM). When combined with 0.025 µM of Taxol, only cisplatin, rather than carboplatin and 5-FU, showed synergistic cytotoxicity with OECM-1. Cisplatin also acted synergistically with 0.05 and 0.1 µM of Taxol. On the other hand, carboplatin and 5-FU acted additively with low cytotoxic concentrations of Taxol (0.025, 0.05 and 0.1 µM). Conclusions: Our preliminary results suggest that there may be a beneficial outcome in incorporating [...]

10/5/2004 Thomas Jeffereson University Innovations Report Boosting the blood count – in effect, curing anemia – in conjunction with radiation therapy won’t help patients with head and neck cancer fare any better than with radiation alone, says a national study led by Jefferson Medical College researchers. Physicians have known for decades that patients who have anemia and are undergoing radiation therapy, especially for head and neck cancer, do much worse in terms of controlling their cancer and survival. One theory proposes that anemia makes tumors more resistant to radiation because it promotes hypoxia, or a lack of oxygen, within the tumor, says Mitchell Machtay, M.D., Walter J. Curran Jr., M.D., associate professor and vice chair of radiation oncology at Jefferson Medical College of Thomas Jefferson University in Philadelphia and at Jefferson’s Kimmel Cancer Center. Hypoxia is known to cause such resistance. "The hope was that by correcting anemia, there would be a better oxygenation of the tumor environment and the tumor would be more sensitive to radiation and easier to kill," he says. To find out, he and his co-workers looked at 141 patients with head and neck cancer who had mild to moderate anemia. Of those, 71 patients were randomly assigned to receive the hormone erythropoietin during radiation therapy, while 70 were given only radiation. Erythropoietin spurs production of oxygen-carrying red blood cells. Yet, while erythropoietin significantly increased the red blood cell count and lessened the patients’ anemia, it didn’t help them have better tumor control or survival. Dr. [...]

10/5/2004 By - Neil Hayes ContraCostaTimes.com I was in Gig Harbor, WA., to interview Harry Frazee III, the grandson of the former Boston Red Sox owner who sold Babe Ruth to the New York Yankees, when I found out I had oral cancer. Two days later, I watched the De La Salle High School football team's 151-game winning streak come to a surreal end on the floor of Seahawks Stadium. That's when it became obvious that a series of seemingly unrelated events were in fact connected. In attempting to disprove baseball's most celebrated myth I had unwittingly awoken an angry ghost. We had both been cursed by the Bambino. It seems as if every Bay Area sports team has been cursed in the wake of one of the darkest weekends in Bay Area sports history. The Anaheim Angels celebrated a come-from-behind victory in Oakland that ended the A's four-year playoff run. The Los Angeles Dodgers rallied for seven runs in the bottom of the ninth inning to stun the Giants, whose postseason hopes died the following day. No shame in that for either team. In fact, both the A's and Giants got what they richly deserved. Neither team was good enough, plain and simple. Both teams overachieved to finish where they did. The Raiders swaggered into Houston and got pole-axed by the Texans. Instead of being 3-1 heading into Sunday's showdown with the Indianapolis Colts they're staring 2-3 right in the grill. The 0-and-49ers are the worst team in football, [...]

10/5/2004 Andre A. Konski et al. Fox Chase Cancer Center Intensity-modulated radiation therapy (IMRT)--the newest generation of precision-targeted, conformal radiation therapy--permits delivery of powerful radiation doses with extremely high precision while reducing radiation side effects on surrounding healthy tissue. However, because the technology is much more expensive to deliver than the previous conformal therapy, three-dimensional conformal radiation therapy (3-D CRT), there have been concerns about cost-effectiveness. A Fox Chase Cancer Center study presented today at the 46th Annual Meeting of the American Society for Therapeutic Radiology and Oncology in Atlanta, Ga., looked at prostate cancer treatment with IMRT and found it cost-effective because of the reduction in side effects and extended disease-free survival, requiring fewer additional treatments with either hormone therapy or chemotherapy. "Although more expensive, our study found IMRT to be cost-effective for men with intermediate-risk prostate cancer because it improved the quality-adjusted survival," said lead author Andre A. Konski, M.D., M.B.A., M.A., a radiation oncologist and clinical director of the Prostate Cancer Risk Assessment Program at Fox Chase. To determine if the benefits to patients are worth the cost from a payer's point of view, Fox Chase Cancer Center researchers developed a model to compare 3-D CRT to IMRT for a 70-year-old man with prostate cancer who has an intermediate-risk that the cancer would recur or progress. The disease states modeled included (1) no disease progression; (2) disease progression that responded to hormone therapy; (3) disease progression that did not respond or stopped responding to hormone therapy and [...]

10/4/2004 Athanassios Argiris, Yi Li, and Arlene Forastiere Cancer, September 27, 2004 Background: The current study was conducted to identify prognostic factors and report the characteristics of long-term survivors in patients with recurrent or metastatic carcinoma of the head and neck who were treated with cisplatin-based combination chemotherapy in two randomized, Phase III trials conducted by the Eastern Oncology Cooperative Group (ECOG) (E1393 and E1395). Methods: The authors analyzed prognostic factors for response and survival by combining data from the E1393 trial, which compared cisplatin plus paclitaxel at two dose levels, with data from the E1395 trial, which compared cisplatin plus paclitaxel with cisplatin plus 5-fluorouracil (5-FU), using logistic regression and Cox regression models. Results: A total of 399 eligible patients were included. The median follow-up was 4.7 years. The 1-year overall survival (OS) rate for all patients was 32%, the median OS was 7.8 months, and the objective response rate was 32%. On multivariate analysis, the following were found to be independent unfavorable predictors of objective response: weight loss of > 5%, an ECOG performance status of 1 (vs. 0), residual disease at the primary tumor site, a primary tumor site other than the oropharynx, prior radiation therapy (RT) (P = 0.056), and well/moderate tumor cell differentiation (P = 0.067). Independent unfavorable prognostic factors for OS were weight loss, an ECOG performance status of 1 (vs. 0), well/moderate tumor cell differentiation, a primary tumor in the oral cavity or hypopharynx, and prior RT. The following were found to be [...]

10/4/2004 TL Chow, TK Chow, TT Chan, NF Yu, SC Fung, and SH Lam J Oral Maxillofac Surg, October 1, 2004; 62(10): 1225-8 Purpose Contralateral neck failure after therapy for squamous cell carcinoma of the oral cavity and oropharynx has rarely been studied in detail. We aimed to examine the pattern and outcome of contralateral neck relapse and possible predictive clinicopathologic factors. Patients and methods Seventy-three patients undergoing surgery for cancer of oral cavity/oropharynx with curative intent were recruited from the hospital head and neck cancer registry. The age, gender, tumor site, primary tumor laterality, TNM status, clinical N status, pathologic T status, ipsilateral pathologic N status, tumor stage, status of residual disease, histopathologic differentiation, postoperative radiotherapy, local relapse, distant relapse, extracapsular spread of lymph node metastasis and neck dissection were evaluated for association with contralateral neck relapse. Results Seven patients developed ipsilateral, 5 patients developed contralateral, and 3 patients developed bilateral neck recurrence after therapy. Only 1 patient with contralateral or bilateral neck relapse survived after salvage therapy. Ipsilateral positive nodal status was the only significant clinicopathologic parameter associated with contralateral neck relapse, which occurred rather commonly in well-lateralized tumors. Conclusion Contralateral and ipsilateral neck relapses are similar in occurrence. Pathologic positive nodal status is associated with a higher incidence of contralateral neck relapse. Aggressive and comprehensive adjuvant radiotherapy to the neck plus close surveillance in the first 2 years postoperatively might curtail the frequency and mortality due to contralateral neck failure.

10/4/2004 Russell W. Hinerman et al. Head Neck, September 30, 2004 Background: The purpose of this study was to analyze factors influencing outcome in patients who received postoperative irradiation for advanced squamous cell carcinoma of the oral cavity. Methods: Between October 1964 and November 2000, 226 patients with 230 previously untreated primary invasive squamous cell carcinomas of the oral cavity were treated postoperatively with continuous-course external beam irradiation. All patients had a minimum follow-up of 2 years (analysis, November 2002). No patient was lost to follow-up. Results: The 5-year actuarial rates of locoregional control by pathologic American Joint Committee on Cancer stage were: stage I, 100%; stage II, 84%; stage III, 78%; and stage IV, 66%. Recurrence of cancer above the clavicles developed in 55 patients (24%). In multivariate analysis of locoregional control, positive margins, vascular invasion, perineural invasion, extracapsular extension, and T classification remained significant. Conclusions: This article provides additional data defining relatively favorable and unfavorable groups of patients in the postoperative setting. Dose recommendations are re-examined and selectively increased for high-risk patients. Russell W. Hinerman, William M. Mendenhall, Christopher G. Morris, Robert J. Amdur, John W. Werning, and Douglas B. Villaret Department of Radiation Oncology, University of Florida Shands Cancer Center, PO Box 100385, Gainesville, FL 32610-0385

10/4/2004 Diana C. G. et al. J Biomed Opt, September 1, 2004; 9(5): 940-950 Autofluorescence spectroscopy shows promising results for detection and staging of oral (pre-)malignancies. To improve staging reliability, we develop and compare algorithms for lesion classification. Furthermore, we examine the potential for detecting invisible tissue alterations. Autofluorescence spectra are recorded at six excitation wavelengths from 172 benign, dysplastic, and cancerous lesions and from 97 healthy volunteers. We apply principal components analysis (PCA), artificial neural networks, and red/green intensity ratio's to separate benign from (pre-)malignant lesions, using four normalization techniques. To assess the potential for detecting invisible tissue alterations, we compare PC scores of healthy mucosa and surroundings/contralateral positions of lesions. The spectra show large variations in shape and intensity within each lesion group. Intensities and PC score distributions demonstrate large overlap between benign and (pre-)malignant lesions. The receiver-operator characteristic areas under the curve (ROC-AUCs) for distinguishing cancerous from healthy tissue are excellent (0.90 to 0.97). However, the ROC-AUCs are too low for classification of benign versus (pre-)malignant mucosa for all methods (0.50 to 0.70). Some statistically significant differences between surrounding/contralateral tissues of benign and healthy tissue and of (pre-)malignant lesions are observed. We can successfully separate healthy mucosa from cancers (ROC-AUC>0.9). However, autofluorescence spectroscopy is not able to distinguish benign from visible (pre-)malignant lesions using our methods (ROC-AUC<0.65). The observed significant differences between healthy tissue and surroundings/contralateral positions of lesions might be useful for invisible tissue alteration detection. Diana C. G. De Veld, Marina Skurichina, Max J. H. [...]