3/5/2007 Barcelona, Spain Bruce Sylvester Doctor's Guide (www.docguide.com) Addition of fluorodeoxyglucose (FDG)-positron emission tomography (PET) to computed tomography (CT) alters gross tumour volume readings for a significant number of patients with head and neck cancer, which can affect treatment decisions. The findings were presented in an oral session here on February 23rd at the International Meeting on Innovative Approaches in Head and Neck Oncology, sponsored by the European Head and Neck Society and the European Society for Therapeutic Radiology and Oncology (EHNS-ESTRO). "Our findings suggest that, for tumours of the head and neck which are to be treated with primary chemoradiography, combined FDG-PET-CT will provide optimal treatment guidance compared to CT alone," said presenter and lead investigator Christian Terhaard, MD, PhD, associate professor of radiology, University of Utrecht, Utrecht, The Netherlands. The investigators compared the CT and FDG-PET-CT images of 109 patients treated at the University Medical Centre in Utrecht between 2003 and 2006 for primary squamous cell carcinoma of the head and neck (95%) or for recurrent disease (5%). The scans were taken using the same mould for each patient. A radiation oncologist and a nuclear medicine physician matched and analysed the images and evaluated them for differences in the gross tumour volume and change of treatment preference. Tumours were located in the pharynx (76%), larynx (11%) and oral cavity (13%). Advanced T-stage (tumour size and extent of primary tumour) of T3-4 appeared in 46% of the subjects; neck nodes were positive in 61%. The researchers reported that the [...]

3/4/2007 Barcelona, Spain Bruce Sylvester Doctor's Guide (www.docguide.com) Free-flap reconstruction following head and neck cancer surgery produces acceptable quality-of-life outcomes, researchers reported here at the International Meeting on Innovative Approaches in Head and Neck Oncology, sponsored by the European Head and Neck Society and the European Society for Therapeutic Radiology and Oncology (EHNS-ESTRO). "While the outcomes were acceptable, clearly new reconstructive procedures are also needed," said lead investigator and presenter Gilles Poissonnet, MD, surgeon, Centre Antoine Lacassagne, Nice, France, in an oral session here on February 24th. Dr. Poissonnet and colleagues enrolled 65 consecutive patients who underwent head and neck reconstructive surgery with free flaps between 2004 and 2005. Before surgery and both 6 months and 12 months after surgery, subjects completed 2 questionnaires -- the European Organisation for Research and Treatment of Cancer quality-of-life questionnaires (QLQ-C30 and QLQ-H&N35). The investigators looked at predictive factors of poor quality of life including age, comorbidities, preoperative radiotherapy, tumour stage, type of surgery, and type of defect repaired. Results showed that global quality of life decreased slightly at 6 months after surgery and remained fairly constant at 6 and 12 months. Physical functioning, role functioning and social functioning declined significantly at the 1-year evaluation (P < .05), and emotional and cognitive functioning remained stable. Pain decreased significantly after treatment (P < .05). Eating, speaking, and sensorial problems increased significantly, with a slight deterioration between 6 and 12 months. The authors concluded, "Free flap reconstruction of head and neck defects allows good functional results [...]

3/4/2007 Houston, TX Martha V. Mar et al. Journal of Nuclear Medicine Technology Volume 35, Number 1, 2007 10-16 In patients with head and neck tumors, preoperative lymphoscintigraphy can be used to map lymphatic drainage patterns and identify sentinel lymph nodes. However, it is very difficult to determine the exact locations of head and neck sentinel nodes on preoperative lymphoscintigraphy without the use of anatomic landmarks. Lymph nodes in the head and neck are grouped into 7 regions, or levels, on the basis of anatomic landmarks. In patients undergoing standard lymphoscintigraphy, obtaining lateral marker images that show important anatomic landmarks can help with the localization of sentinel nodes. However, technical problems often render marker images of little or no use. Hybrid SPECT/CT (single photon emission controlled tomography) lymphoscintigraphic imaging facilitates the localization of sentinel nodes by reliably showing the relationships between sentinel nodes and important anatomic structures. After reading this article, the reader should understand the lymph node level classification system for head and neck melanomas, be able to describe the technique used for the imaging of sentinel nodes in the head and neck region, and be able to demonstrate how SPECT/CT lymphoscintigraphic imaging can enable precise sentinel node localization and thus help to ensure minimal dissection. Authors: Martha V. Mar1, Scott A. Miller2, E. Edmund Kim1 and Homer A. Macapinlac1 Authors' affiliations: 1 Department of Nuclear Medicine, The University of Texas M.D. Anderson Cancer Center, Houston, Texas; and 2 Department of Imaging Physics, The University of Texas M.D. Anderson [...]

3/2/2007 Rancho Mirage, CA Jennifer R. Grandis, MD Medscape Today (www.medscape.com) Introduction: The Multidisciplinary Head and Neck Cancer Symposium, cosponsored by the American Society for Therapeutic Radiology and Oncology and the American Society of Clinical Oncology, was held in Rancho Mirage, California, from January 18-20, 2007. Several presentations focused on advances in the medical management of patients with head and neck cancer (HNC). Despite increasing awareness of the cancer-inducing effects of tobacco, the incidence of HNC has not decreased worldwide. Efforts to prevent these tumors through pharmacologic intervention have largely failed, and early detection strategies have not been successful. Thus, most patients with HNC present with advanced (stages III and IV) disease. Oral cavity tumors are treated primarily with surgical resection due to the toxicity of radiation in this region (eg, osteoradionecrosis). Advanced tumors of the pharynx and larynx are generally treated with combined modality therapy (chemoradiation [CRT]), with surgery reserved for neck dissection when the patient presents with advanced neck disease (N2 or N3) and/or has an incomplete response in the neck to CRT. The major advance in the management of HNC continues to be the integration of targeted therapeutics into treatment regimens. Inhibiting the Epidermal Growth Factor Receptor: The landmark Radiation Therapy Oncology Group trial[1] comparing the epidermal growth factor receptor (EGFR) monoclonal antibody cetuximab plus radiation vs radiation alone led to approval of this agent by the US Food and Drug Administration (FDA) in 2006 for the treatment of HNC. Cetuximab was the first drug approved for [...]

3/1/2007 web-based article Miranda Hitti WebMD (www.mebmd.com) Human papillomavirus is common among U.S. women, especially those in their early 20s, says the CDC. Human papillomavirus (HPV) is America's most common sexually transmitted infection. HPV infection typically clears within two years, and most infected people don't realize they have the virus. However, some strains of HPV can cause cervical, anal, and other genital cancers, note the CDC's Eileen Dunne, MD, MPH, and colleagues. Dunne's team calculated the total number of U.S. women aged 14-59 with HPV infection from 2003 to 2004. More than one in four U.S. women in that age range -- nearly 27% -- had HPV infection. That equals nearly 25 million U.S. women, according to the CDC. About 3 million had any of the four HPV strains targeted by Gardasil, a vaccine designed to prevent cervical cancer and genital warts, the CDC estimates. HPV Infection in Young Women HPV infection was most common among women aged 20-24. Nearly half of the women in that age group (49%) had HPV infection. A third of women aged 14-24 had HPV infection. That's nearly 7.5 million -- far more than previous estimates that 4.6 million women in that age range had HPV. Older women were less likely to have HPV infection, the study shows. Data came from 1,921 women who submitted self-collected vaginal swabs for a national health study conducted from 2003 to 2004. The findings appear in The Journal of the American Medical Association. Vaccine's Impact The data was gathered [...]

2/28/2007 Barcelona, Spain Bruce Sylvester Doctor's Guide (www.docguide.com) Re-irradiation combined with chemotherapy after salvage surgery improves progression-free survival rates in patients with head and neck cancer but does not affect their overall survival rate, researchers report. "In this first randomised trial on the subject, we found that this combination treatment can indeed improve disease-free survival after salvage surgery, but we note that there was no effect on overall survival," said investigator and presenter Dominique de Raucourt, MD, radiologist, Centre Francois Baclesse, Caen, France. Dr. de Raucourt presented the results in an oral session here on February 24th at the International Meeting on Innovative Approaches in Head and Neck Oncology. The meeting was co-sponsored by the European Head and Neck Society (EHNS) and the European Society for Therapeutic Radiology and Oncology (ESTRO). The investigators enrolled 130 head and neck cancer patients who had been treated with salvage surgery. Patients were randomised to receive either full dose re-irradiation combined with chemotherapy (arm A) or no postoperative treatment after the salvage surgery (arm B). Eligibility for enrolment included the following criteria: recurrence of disease or appearance of second primary cancer site in a previously irradiated area (up to at least 45 Gy); absence of distant metastasis; salvage surgery with macroscopic complete resection; possibility of starting adjuvant treatment within 6 weeks after salvage surgery. Subjects in arm A received 60 Gy radiation within 12 weeks combined with concomitant 5-fluorouracil (5FU) and hydroxyurea. After the end of the trial the 29 surviving subjects who did [...]

2/28/2007 New Rochelle, NY press release Genetic Engineering News (www.genengnews.com) Auriga Laboratories, Inc., a specialty pharmaceutical company with products for the treatment of acute respiratory diseases and dermatological conditions, announces the launch of Aquoral(TM) for the treatment of xerostomia, also known as "dry mouth." This new, patent-pending, prescription-only product introduction marks Auriga's entrance into the $1 billion xerostomia marketplace. Beginning in March, Aquoral will be rolled out to high-prescribing physicians nationwide via Auriga's expanding 200-member national sales force. Auriga will also launch www.aquoral.com as part of a direct-to-patient campaign. "Millions of people suffer from dry mouth caused by prescription medications or medical conditions," said Alan Roberts, Auriga's senior vice president of scientific affairs. "Left untreated, dry mouth can have significant consequences including increased tooth decay, mouth ulcerations and infections, painful and difficult speech and swallowing. Aquoral offers a novel, non-systemic approach to treating this widespread condition. It is a lipid-based solution that moistens and lubricates the oral cavity, but unlike water-based, saliva substitutes, forms a lipidic film that helps reduce additional moisture loss and protects against further inflammation." A recent poll conducted by the Academy of General Dentistry (AGD) revealed that more than 80 percent of dental patients complain about dry mouth and dry mouth symptoms(1). Dry mouth is listed as a side effect for over 400 prescription drugs, including popular antidepressants, anti-anxiety medications, and treatments for overactive bladder. There are an estimated 300 million prescriptions written annually for these dry mouth causing medications. In some instances the dry mouth [...]

2/28/2007 Barcelona, Spain Bruce Sylvester Doctor's Guide (www.docguide.com) Sentinel node biopsy (SNB) is an accurate method of assessing the neck status of patients with squamous cell cancer grade T1T2 NO (early stage tumours) of the oral cavity, researchers report. The findings were presented in an oral session here on February 24th at the International Meeting on Innovative Approaches in Head and Neck Oncology, sponsored by the European Head and Neck Society (EHNS) and the European Society for Therapeutic Radiology and Oncology (ESTRO). "We saw a remarkable lack of false negatives in our use of sentinel node biopsy for assessing the patients. It is a viable procedure," said lead investigator and presenter Gerard Mamelle, MD, clinical oncologist, Institut Gustave Roussy, Villejuif, France. In the first part of their study, the investigators included 55 subjects; 53 of the subjects underwent SNB and an elective neck dissection (END) during the same surgery. The investigators compared results of pathological examinations with stepped serial sectioning and immunohistochemistry of sentinel nodes to results of routine pathologal examinations of remaining END nodes. They found positive sentinel nodes in 12 subjects, and no false positives among them. For up to 3 years after the tests, there was no node recurrence for any patient with negative sentinel node findings. In a second part of their study, 48 new subjects underwent SNB without END. Sentinel node was not found in 4 subjects. Eleven of the remaining 44 subjects (25%) had a positive sentinel node. And follow-up showed node recurrence in [...]

2/26/2007 Salt Lake City, UT press release PRNewswire (www.prnewswire.com) BSD Medical Corp. today reviewed the presentations made at the annual conference of the American College of Radiation Oncology (ACRO) held February 22-24 in San Diego. The emphasis was on the clinical science behind hyperthermia therapy for treating cancer and BSD Medical's advanced systems used to deliver the therapy. In addition to a 45-minute lecture by Dr. Mark Hurwitz of Harvard Medical School on the results of clinical studies on hyperthermia and the technological capabilities now emerging to deliver the cancer therapy, a commercial exhibit by BSD Medical also showcased the science supporting the therapy and the advanced features of the BSD's cancer therapy systems. The Science The lecture included a review of Phase III clinical studies that have been conducted adding hyperthermia to radiation treatments as compared to radiation treatments alone. * In a clinical study conducted in Italy involving 41 patients (44 nodes) with inoperable Stage IV head and neck cancer, patients receiving hyperthermia and radiation therapy had an 83% complete response rate compared to 41% for patients who received radiation therapy alone, and the 3-year local relapse-free survival rate was 24% for patients receiving only radiation and 68% for those who received both radiation and hyperthermia therapy. (See International Journal of Radiation Oncology, Biology, Physics Vol. 28, pp. 163-169.) * In an international clinical study conducted in Denmark, the Netherlands and Norway involving 128 patients with recurrent or metastatic malignant melanoma, patients who received hyperthermia therapy along with [...]

2/26/2007 Staten Island, NY Diane O'Donnell Staten Island Advance (www.silive.com) TomoTherapy combines daily CT scans to check for any changes in size or location of a tumor with the ability to target it with high doses of radiation while decreasing damage to the surrounding healthy tissues and organs Paul Lewek takes off his Mets baseball cap and settles his lanky 6-foot-5 frame onto a movable table connected to a large donut-shaped machine. For the 57-year-old retired cop, this is day 11 of his 6 1/2 week Monday to Friday regimen of TomoTherapy, a relatively new approach to treating cancerous tumors. After having his right tonsil and a golf ball-size mass removed from his neck in December to battle advanced tonsillar cancer, Lewek shruggingly accepts the routine. Lewek is the first head-and-neck cancer patient to be treated with the more than $3 million, state-of-the-art machine at TomoTherapy of Staten Island, housed in West Brighton-based Regional Radiology. The TomoTherapy Hi-Art System machine, which debuted on the Island last month, is one of only two in the New York City area and 71 nationwide. According to Patty Kitowski, marketing communications manager of Madison, Wis.-based TomoTherapy Incorporated, which created the machine, there are 102 units worldwide. TomoTherapy combines daily CT scans to check for any changes in size or location of a tumor with the ability to accurately target it with high doses of radiation while sparing healthy surrounding tissue to a greater degree than was previously possible. The process is achieved through Image [...]