9/26/2005 Japan Madhup Rastogi et al. Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyi155 Objective: The purpose of this study was to evaluate the efficacy of radiotherapy and concurrent mitomycin-C (MC) plus 5-fluorouracil (5FU) infusion in locally advanced squamous cell carcinoma of head and neck (SCCHN). Methods: Sixty-nine patients with SCCHN (6 Stage III and 63 Stage IV patients) were treated with external beam radiotherapy (70 Gy) and simultaneous intravenous chemotherapy with 5FU (600 mg/m2/day, Days 1-5) and MC (10 mg/m2, Days 5 and 36). Results: After a mean follow-up of 28.5 months, 59.4% of patients were alive without disease. Complete response was seen in 76.8% of patients. The 3 years overall survival, locoregional relapse-free survival and disease-free survival was 62.3, 89.8 and 49.5%, respectively. Treatment was well tolerated (Grade III mucositis in 43.5% and Grade II leukopenia in 5.8%). Conclusions: This concurrent chemoradiotherapy regimen offers a curative option for our patients where primary and nodal disease is fairly large resulting in hypoxic radioresistant tumors. Authors: Madhup Rastogi 1, Madhu Srivastava 1, Kundan S. Chufal 2, M. C. Pant 1, Kirti Srivastava 1, and Madanlal B. Bhatt 1 Authors' affiliations: 1 Department of Radiotherapy, King George's Medical University, Lucknow, Uttar Pradesh, India 2 Department of Oncology, Batra Hospital and Medical Research Center, New Delhi, India

9/26/2005 Scotland staff News.scotsman.com Increasing numbers of young people are being hit by mouth cancer, sparking new warnings about the disease. Mouth cancer was once considered to mostly affect older men, but it is now becoming more common in younger people and women. It is possible that binge-drinking and smoking could be helping to fuel rising rates of the disease as these are key risk factors. Now the British Dental Health Foundation (BDHF) is warning people of all ages that they need to start checking their mouths regularly if rising rates of mouth cancer are to be stopped. The ratio of women to men suffering mouth cancer has grown by a third in the last 10 years, although men are still twice as likely to develop the disease. Mouth cancer is sometimes called oral cancer and can affect the lips, tongue, cheeks and throat. Every year in the UK, there are 4,300 new cases diagnosed and 1,700 deaths. The most common causes of mouth cancer are smoking and drinking alcohol to excess - people who do both are up to 30 times more likely to develop the condition than those who do not. Having a poor diet is also linked to the disease. But the BDHF said about 25% of mouth cancer cases in younger people involved none of these common risk factors. The foundation said this meant it was vital people learnt to be aware of the possible symptoms, even if they led a healthy lifestyle.

9/25/2005 Iowa City, IA M Yao et al. Int J Radiat Oncol Biol Phys, October 1, 2005; 63(2): 410-21 Purpose: To review the University of Iowa experience with intensity-modulated radiotherapy (IMRT) in the treatment of head-and-neck squamous cell carcinoma. Methods and Materials: From October 1999 to April 2004, 151 patients with head-and-neck squamous cell carcinoma were treated with IMRT for curative intent. One patient was lost to follow-up 2 months after treatment and therefore excluded from analysis. Of the remaining 150 patients, 99 were treated with definitive IMRT, and 51 received postoperative IMRT. Sites included were nasopharynx, 5; oropharynx, 56; larynx, 33; oral cavity, 29; hypopharynx, 8; nasal cavity/paranasal sinus, 8; and unknown primary, 11. None of the patients treated with postoperative IMRT received chemotherapy. Of 99 patients who had definitive IMRT, 68 patients received concurrent cisplatin-based chemotherapy. One patient received induction cisplatin-based chemotherapy, but no concurrent chemotherapy was given. Three clinical target volumes (CTV1, CTV2, and CTV3) were defined. The prescribed doses to CTV1, CTV2, and CTV3 in the definitive cohort were 70-74 Gy, 60 Gy, and 54 Gy, respectively. For high-risk postoperative IMRT, the prescribed doses to CTV1, CTV2, and CTV3 were 64-66 Gy, 60 Gy, and 54 Gy, respectively. For intermediate-risk postoperative IMRT, the prescribed doses to CTV1, CTV2, and CTV3 were 60 Gy, 60 Gy, and 54 Gy. Results: The median follow-up was 18 months (range, 2-60 months). All living patients were followed for at least 6 months. There were 11 local-regional failures: 7 local failures, [...]

9/25/2005 Virginia, USA staff myDNA (www.mydna.com) Upper aerodigestive tract cancer patients used to have few treatment options. Fortunately, radiation therapy (RT) has proven to be an effective treatment - either on its own or in combination with surgery. But, despite the benefits, RT can also be associated with several long-term side effects, including depression. Many cross-sectional and longitudinal studies have looked at the impact that this treatment modality can have on the long-term quality of life of head and neck cancer survivors. On the other hand, few studies have assessed the effect of acute toxicities of radiation therapy on the quality of life during the treatment process. These acute toxicities can be more severe when chemotherapeutic agents that have a synergistic effect on the cancerous and normal tissues are used concomitantly. The quality of life of head and neck cancer patients during radiation has not been explored before. British researchers planned a prospective study to assess the impact that radiation therapy has on the quality of life during the treatment process. They speculated that the health related quality of life would decrease over the period of radiation therapy and that patients would be increasingly depressed as the treatment progressed caused by the side effects of the treatment. The authors of "Deterioration in Quality of Life and Depressive Symptoms during Radiation Therapy for Head and Neck Cancer," are Mr. Vinidh Paleri FRCS, Carol Downes, and Charles Kelly FRCR, all from the Freeman Hospital, University of Newcastle upon Tyne, United Kingdom. Their [...]

9/25/2005 Bethesda, MD press release Journal of the National Cancer Institute, Vol. 97, No. 18, 1315, September 21, 2005 A new study of French women has found that high beta-carotene intake—through a combination of diet or supplementation—is associated with a higher risk of tobacco-related cancers in smokers, but the risk of these cancers decreases with increasing beta-carotene intake in nonsmokers. The study appears in the September 21 issue of the Journal of the National Cancer Institute. Some observational studies have found that beta-carotene consumption is associated with a decreased risk of cancer. However, some intervention studies have suggested that high doses of the antioxidant, given through supplementation, may be associated with an increased risk of lung cancer and digestive cancers in smokers. To investigate the relationships of beta-carotene intake from both diet and supplementation with the risk of tobacco-related cancers—which include colorectal, thyroid, ovarian, cervical, and lung cancers in addition to less common cancers—Marie-Christine Boutron-Ruault, M.D., Ph.D., of INSERM in Villejuif, France, and colleagues used information from questionnaires given in 1994 to nearly 60,000 women from the French Etude Epidémiologique de Femmes de la Mutuelle Générale de l'Education Nationale (E3N) prospective study. The researchers assessed diet, supplement use, and smoking status in these women and followed them for a median of 7.4 years. During the follow-up period, 700 women developed a type of cancer known to be related to smoking. Among women who never smoked, beta-carotene intake was inversely associated with the risk of developing a tobacco-related cancer, with a [...]

9/22/2005 England Rachel Stevenson The Independent (news.independent.co.uk) Imperial Tobacco, the group behind the Regal, John Player and Superkings cigarette brands, said yesterday it was entering the market for smokeless tobacco despite a ban on the product in the EU. The company has bought a 43.2 per cent stake in Skruf, a Swedish manufacturer of smokeless tobacco known as "snus". The EU banned "snus" and most other forms of smokeless tobacco in 1992, but Sweden, where the product is hugely popular, negotiated an exemption from the ban when it joined the EU in 1995. "Snus", sold in tins, is moist, loose tobacco put in small teabag-like pouches that are placed under the lip. They produce a similar experience to smoking a cigarette. The product was banned because it was deemed attractive to children, who could become easily hooked and move on to cigarettes. There is also research to suggest the product could increase the risk of oral cancer. Imperial hopes to capture some of the huge Swedish demand for "snus". While cigarette sales have been in decline there, more than 200 million tins of "snus" are sold every year and rising. Skruf's chairman and founder, Adam Gillberg, said: "With this alliance, we will get the resources and the muscles that we need to grow." The company has 1 per cent of the Swedish market. The tobacco industry claims "snus" is far less harmful than cigarettes, containing less of the carcinogenic chemicals that are in cigarettes. It also eradicates the danger of [...]

9/22/2005 Pendleton, Oregon Rukmini Callimachi The Guardian (www.guardian.co.uk) Bryan Richardson hadn't learned algebra when he straddled his first bull at age 13. By then, he'd already been chewing tobacco for four years, starting when he was 9. The two habits - chewing and riding bulls - have long been partners on the professional rodeo circuit. But this past week, one of the nation's oldest rodeos took its best shot at that marriage. Tobacco companies were prevented from giving out free samples of snuff at the Pendleton Round-Up, where for 95 years cowboys have come to test their mettle. Now 24, Richardson goes through one tin of Copenhagen a day, relying on its familiar rush to get through each violent ride, as he did this weekend when he mounted Poison and rode the snorting brahma bull to first place. His prize included a hand-hewn saddle, a pair of trophy spurs, a fancy cowboy hat - but no free snuff, a staple that men on the rodeo circuit have come to depend on. “At $10 a can, that's $10 bucks a day and $70 bucks a week. You do the math. It's expensive,” said Richardson of Dallas, Texas. “It's just about so expensive I was thinkin' of quittin' this week, now that they're not giving us any for free.” “It should be free,” lamented Zack Oakes, a 22-year-old bull rider from Meade, Wash., who said he, too, started chewing when he was 9. “It's dang sure nice for them to help us [...]

9/21/2005 Susan T. Mayne, Scott M. Lippman Journal of the National Cancer Institute, Vol. 97, No. 18, 1319-1321, September 21, 2005 A growing body of literature indicates that chemopreventive agents may have very different effects in populations that differ by lifestyle or host factors. One such factor of paramount importance is smoking status, which has been shown to predict the effects of micronutrients such as beta-carotene or related compounds in smoking-related cancer prevention trials. Some nutrients that appear to reduce the risk of cancer in nonsmokers may actually increase the risk of cancer in smokers, whereas other preventive nutrients may work better in smokers than nonsmokers. Two landmark trials, the Alpha-Tocopherol Beta-Carotene (ATBC) Cancer Prevention Study and Carotene and Retinol Efficacy Trial (CARET), first revealed an important impact of smoking status on chemoprevention. The ATBC trial was a randomized 2 x 2 factorial prevention trial of daily -tocopherol and/or beta-carotene in more than 29 000 male smokers from Finland (1). Unexpectedly, the men who were randomly assigned to receive supplemental beta-carotene had a statistically significantly higher lung cancer risk than did men who did not receive beta-carotene. This harmful effect occurred in men who smoked 20 cigarettes or more per day but not in men who smoked less (all ATBC participants were smokers). Therefore, the ATBC suggested that smoking intensity modified the cancer preventive effect of a nutrient. Subsequently, the CARET of beta-carotene combined with retinol to prevent lung cancer in men and women smokers and/or asbestos workers found that [...]

9/20/2005 Boston, MA Lori J. Wirth et al. Journal of Clinical Oncology, 10.1200/JCO.2005.02.4182 Purpose: Effective and tolerable palliative treatments are needed for patients with incurable squamous cell carcinoma of the head and neck (SCCHN). Single-agent targeted therapies have limited activity in this setting. The feasibility of adding celecoxib to gefitinib for the treatment of incurable SCCHN is unknown. Patients and Methods: Nineteen patients with unresectable recurrent locoregional and/or distant metastatic SCCHN with progressive disease after at least one prior chemotherapy or chemoradiotherapy regimen were enrolled onto this single-institution phase I study. Three dose levels were explored: (1) celecoxib 200 mg twice daily plus gefitinib 250 mg daily; (2) celecoxib 400 mg twice daily plus gefitinib 250 mg daily; and (3) celecoxib 400 mg twice daily plus gefitinib 500 mg daily. Results: No dose-limiting toxicities were encountered at any dose level. The most common toxicities were acneiform rash, diarrhea, hand reaction, dyspepsia, and anemia. Four of 18 patients assessable for response (22%; 95% CI, 2% to 42%) achieved a confirmed partial response. Conclusion: The combination of gefitinib 500 mg daily plus celecoxib 400 mg twice daily is well-tolerated. The encouraging responses seen in this early study suggest further evaluation of epidermal growth factor receptor and cyclooxygenase-2 inhibitors in SCCHN is warranted. Authors: Lori J. Wirth, Robert I. Haddad, Neal I. Lindeman, Xiaojun Zhao, Jeffrey C. Lee, Victoria A. Joshi, Charles M. Norris Jr, and Marshall R. Posner Authors' affiliations: Department of Adult Oncology, Dana-Farber Cancer Institute; the Department of Medicine, Pathology, [...]

9/20/2005 New York, NY staff Cancerpage.com Antioxidant vitamins may reduce the severity of adverse effects of radiation therapy but may increase the risk of recurrence of the underlying tumor, according to a report by Canadian researchers. Although many patients take vitamin and mineral supplements in the hope of improving cancer treatment outcomes, the authors point out, few studies have examined the efficacy and safety of adjuvant antioxidant vitamin supplementation in this setting. Dr. Isabelle Bairati from Laval University Cancer Research Center, Quebec City and colleagues examined whether daily supplementation with alpha-tocopherol and beta-carotene could reduce the rate and severity of acute adverse effects of radiation therapy in 540 patients with head and neck cancer. Severe acute adverse effects during radiation therapy occurred in fewer patients in the supplement group (19.2%) than in the control group (24.8%), the authors report in the August 20th issue of the Journal of Clinical Oncology. There was a tendency for less severe adverse effects during radiation therapy at any site and overall among those receiving antioxidants, the results indicate. Combined treatment with alpha-tocopherol and beta-carotene was associated with a significant 62% reduction in adverse effects overall and a similar reduction among patients with cancer of the larynx. However, local recurrence of tumor was 37% more likely among patients in the supplementation group, the investigators report, and was somewhat higher among patients treated with both antioxidants. In light of these findings, the researchers observe that "randomized controlled trials should be conducted to provide clear scientific evidence [...]