9/3/2006 Philadelphia, PA staff MedicalNewsToday.com While one of the Holy Grails in radiation oncology is to spare as much healthy tissue as possible during therapy, patients undergoing treatment for weeks at a time physically change. Patients can lose weight during a period of therapy. They might lose or gain fluid. Tumors may shrink or unfortunately, continue to grow. As a result, radiation target sites change, which can be problematic for treatment. Thomas Jefferson University Hospital in Philadelphia and the Kimmel Cancer Center at Jefferson are among the first centers in the nation to study the effect of incorporating a new technology - cone beam CT - into a source of radiation, namely a linear accelerator, in an attempt to find an answer to this vexing problem. The technology creates three-dimensional axial CT slices of a patient's tumor, enabling therapists and doctors to compare these images with initial treatment planning images to determine how precisely focused the radiation set-up is. They can then make position adjustments if necessary to deliver a more targeted therapy to the patient. The hope is that this technology will lead to more highly customized radiation treatments, where higher doses are directed at the tumor while sparing the patient's normal body structures. "Right now, cone beam is used as one additional means of verifying the accuracy of the radiation treatments that we deliver," says Mitchell Machtay, M.D., the Walter J. Curran Jr., M.D., associate professor of radiation oncology at Jefferson Medical College of Thomas Jefferson University and [...]

9/2/2006 Iowa City, IA staff CancerConsultants.com According to an article published in the American Journal of Medicine, gastroesophageal reflux disease (GERD) and smoking increase the risk of developing laryngeal cancer. Laryngeal cancer is considered a type of head and neck cancer and occurs in the larynx, which may also be referred to as the "voice box". Smoking and alcohol are thought to increase the risk of laryngeal cancer. GERD, also referred to as heartburn, is a condition in which the acidic contents of the stomach back up into the esophagus (the tube that connects the throat to the stomach). GERD may be responsible for the irritation of tissues of the esophagus, a condition referred to as Barrett’s esophagus. Researchers from the Cleveland Clinic recently conducted a study to evaluate potential effects of GERD on laryngeal cancer. This study included 96 patients with laryngeal cancer and 192 patients who did not have laryngeal cancer. - When considering all variables, smoking was associated with more than a six-fold increase in the development of laryngeal cancer. - GERD was associated with a two-fold increase of the development of laryngeal cancer. The researchers concluded that smoking and GERD increase the risk of developing laryngeal cancer. Only future clinical trials can determine if intervention against GERD can help reduce the risk of developing laryngeal cancer. Patients who smoke or have GERD may wish to speak with their physician regarding their individual risks of developing laryngeal cancer, as well as potential treatments for GERD. Source: Vaezi [...]

9/2/2006 Baltimore, MD Nancy Nairi Maserejian et al. American Journal of Epidemiology 2006 164(6):556-566; doi:10.1093/aje/kwj233 The authors prospectively evaluated fruit and vegetable consumption and the incidence of oral premalignant lesions among 42,311 US men in the Health Professionals Follow-up Study. Diet was assessed every 4 years by food frequency questionnaires. The authors confirmed 207 cases of clinically or histopathologically diagnosed oral premalignant lesions occurring between 1986 and 2002. Multivariate-adjusted relative risks were calculated from proportional hazards models. Significant inverse associations were observed with citrus fruits, citrus fruit juice, and vitamin-C-rich fruits and vegetables, indicating 30–40% lower risks with greater intakes (e.g., citrus fruit juice quintile 5 vs. quintile 1 relative risk = 0.65, 95% confidence interval: 0.42, 0.99). Inverse associations with fruits did not vary by smoking status and were stronger in analyses of baseline consumption, with a 10-year lag time to disease follow-up (quintile 5 vs. quintile 1 relative risk = 0.41, 95% confidence interval: 0.20, 0.82; p = 0.01). No associations were observed with total vegetables or with ß-carotene-rich or lycopene-rich fruits and vegetables. For current smokers, green leafy vegetables (ptrend = 0.05) and ß-carotene-rich fruits and vegetables (ptrend = 0.02) showed significant linear trends of increased risk (one additional serving/day relative risk = 1.7). The risk of oral premalignant lesions was significantly reduced with higher consumption of fruits, particularly citrus fruits and juices, while no consistent associations were apparent for vegetables. Authors: Nancy Nairi Maserejian1,2,3, Edward Giovannucci1,4,5, Bernard Rosner4, Athanasios Zavras2 and Kaumudi Joshipura1,2,6 Authors' affiliations: 1 [...]

9/1/2006 New York, NY David Biello ScientificAmerican.com Cancer results from cells gone wild. Proliferating out of control, the cells spawn malignant growths that can travel throughout the human body, spreading the disease. Some patients' immune systems are able to recognize such tumors and begin to attack them, and research has shown that boosting the patients' levels of such tumor-infiltrating lymphocytes can help defeat deadly cancer. Now scientists have transformed immune cells into cancer fighters outside the body--and prompted complete remission in two subjects when those cells were reintroduced. Immune cells such as lymphocytes, also known as T cells and pictured in blue above, recognize health threats via special receptors on the cell surface. Steven Rosenberg of the National Cancer Institute and his colleagues first cloned the genes governing the cancer-recognizing receptor in immune cells from a patient who had successfully beaten back melanoma. The researchers introduced this genetic information into regular T cells from 17 melanoma patients via retrovirus. After chemotherapy, these patients had severely weakened immune systems, with few actively circulating lymphocytes. The scientists infused the engineered lymphocytes back into their weakened systems and discovered that such cells could persist, making up between 9 percent and 56 percent of the T cell population one month after treatment in 15 of the 17 patients. Two patients out of the 17 experienced profound benefits from this infusion. The engineered lymphocytes of a 52-year-old man with melanoma destroyed a tumor in his armpit and shrank a liver growth by 89 percent, allowing [...]

9/1/2006 New Orleans, LA Andre A. Konski et al. Journal of Clinical Oncology, Vol 24, No 25 (September 1), 2006: pp. 4177-4183 Purpose: This study evaluated whether males without partners were disadvantaged for survival in Radiation Therapy Oncology Group (RTOG) head and neck cancer clinical trials. Methods: Patients treated on three RTOG trials were studied. The Cox proportional hazards model was used to determine if sex and the interaction between sex and marital/partner status were independent prognostic variables for overall survival controlling for Karnofsky performance status, tumor stage, nodal stage, primary site, and protocol treatment. Results: A total of 1,901 patients (1,509 men) were entered onto the three RTOG trials, with 1,822 (1,438 men) analyzable patients. Prognostic variables independent of disease-related variables for survival in multivariate analyses restricted to men were age, marital/partner status, and income. Conclusion: The apparent disadvantage of unpartnered men is striking, even after controlling for disease and other demographic variables. Possible explanations could easily be tested in observational studies, leading to evaluation of simple interventions to improve their outcome. Authors: Andre A. Konski, Thomas F. Pajak, Benjamin Movsas, James Coyne, Jonathan Harris, Clement Gwede, Adam Garden, Sharon Spencer, Christopher Jones, Deborah Watkins-Bruner Authors' affiliations: From the Departments of Radiation Oncology and Population Sciences, Fox Chase Cancer Center; Statistical Headquarters, Radiation Therapy Oncology Group; Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA; Department of Interdisciplinary Oncology, H. Lee Moffitt Cancer Center, Tampa, FL; Department of Radiation Oncology, M.D. Anderson Cancer Center, Houston TX; Department of Radiation Oncology, [...]

9/1/2006 Dallas/Fort Worth staff Star-Telegram.com (www.dfw.com) Water's good. Sugar-free gum helps. But Listerine may dry out your mouth. Saliva is a health drink for your teeth and mouth. The three pints produced by the salivary glands each day contain antibacterial substances that protect teeth from cavities. Like all body fluids, saliva is a near cousin to blood, so it contains calcium and phosphorus that teeth absorb. It also functions as an overall lubricant for the mouth, preventing food from sticking to your teeth and gums. By neutralizing gastric acid and keeping the flow of food and drink through the mouth and esophagus on the right course, saliva may help check gastro-esophageal reflux, a leading of cause of heartburn. A serious lack of saliva -- the medical term is xerostomia (pronounced zer-o-STO'-me-ah) -- may develop for several reasons. It's a side effect of many medications. It may result from autoimmune diseases such as lupus and Sjögren's syndrome. Head and neck cancer patients struggle with dry mouth after receiving radiation treatments. Dry mouth is another reason you should see a dentist regularly. During a routine exam, dentists are supposed to look for little pools of saliva in the bottom of the mouth. The inside of your salivary glands are there, so dryness there is a bad sign. The treatment depends on the cause and its severity. Doctors and dentists no longer believe that old age by itself causes clinically significant dry mouth. But salivary glands do tend to become less productive with [...]

8/31/2006 Houston, TX Anne S. Tsao et al. Journal of Clinical Oncology, Vol 24, No 25 (September 1), 2006: pp. 4163-4169 Purpose: To investigate the feasibility of combining concomitant boost accelerated radiation with docetaxel and cisplatin and assess the regimen's toxicity, locoregional control rate, and survival in patients with locally advanced head and neck cancer (HNSCC). Patients & Methods: Patients with stage III-IV HNSCC were eligible. Phase I included two schedules of docetaxel and cisplatin: arm 1, once per week during weeks 1 to 4; arm 2, every 21 days for weeks 1 and 4. Radiation consisted of 72 Gy in 42 fractions over 6 weeks (concomitant boost). Results: Twenty patients were enrolled in phase I. The arm 1 maximum-tolerated dose (MTD) was defined at docetaxel 15 mg/m2 and cisplatin 20 mg/m2 based on prolonged mucositis in 29% of patients. The initial dose level in arm 2 was above the MTD. In total, 52 patients were treated using the arm 1 regimen in phase II. Acute toxicity included grade 3 mucositis and dermatitis in 81% and 44% of patients. The 2-year locoregional control rate was 71%. The 2-year progression-free and overall survival rates were 61% and 65%. Median survival was 37.8 months. Late effects included feeding tube dependence in 17% of patients alive and free of disease. Conclusion: Locoregional control, survival, and acute toxicity with this regimen were comparable with other trials utilizing taxanes and/or platins and concomitant conventional or altered fractionation radiation. Our data suggest that chemotherapy added to [...]

8/27/2006 Syndey, Australia Danny Buttler Herald Sun (www.news.com.au) Smokers and cigarette sellers are going to extraordinary levels to avoid graphic new tobacco warnings. Retailers are displaying packets upside down so the explicit health warnings are not visible to customers. And smokers are requesting specific packs, which have statistical warnings rather than gruesome images of smoking-related illnesses. Other are buying cheap plastic cigarette packet covers or transferring their smokes to "retro" glo-mesh containers. The trend comes as new research shows more than half of Victorians want plain paper packaging on tobacco products. Shocking images of gangrenous limbs, cancerous mouths and choked arteries were introduced to Victoria in March. Southbank Newsagency is one cigarette seller that has turned packets upside-down to keep the vivid images from the public eye. "We do it so we or the customers who don't smoke don't have to see them," Sue Lomax said. "They make me feel ill, they turn my stomach." Ms Lomax said smokers had been requesting staff hunt through their favourite brand to find packets without the stomach-churning images. "They come and ask for the ones with statistics," she said. "They don't want to see the teeth or the feet." Quit executive director Todd Harper said the reaction of smokers showed the new packaging was making people think twice about their potentially fatal habit. "It highlights that they are having an impact if consumers are going to such lengths that they don't want certain images on their packets. "My guess is that they would [...]

8/26/2006 Chicago, IL John Otrompke www.docguide.com Researchers who are evaluating the safety of pioglitazone in nondiabetic patients with precancerous leukoplakia say the drug can be delivered safely for 90 days to non-diabetic people with oral leukoplakia. Nelson Rhodus, MD, professor of oral medicine, department of diagnostic and biological sciences, University of Minnesota, Minneapolis, Minnesota, and colleagues conducted a phase 2a trial to evaluate the safety of pioglitazone in nondiabetic patients with high-risk oropharyngeal leukoplagia. Their findings were presented in a poster session here at the 2006 annual meeting of the American Head and Neck Society (AHNS). Leukoplakia is a precancerous oral condition which affects 1% of the U.S. adult population. Individuals with the condition are at relatively high-risk for conversion to malignancy, with 5% of those with leukoplakia going on to develop oral cancer. By comparison, 1% of those with colonic polyps go on to develop intestinal cancer, the poster said. The researchers undertook this study because the thiazolidinedione class of drugs, commonly used for treatment of type 2 diabetes, bind to peroxisome proliferating-activated receptor (PPAR) gamma nuclear receptors and are therefore theorized to drive dysplastic cells to decrease proliferation and increase maturation. The trial enrolled patients with precancerous leukoplakia but no oral cancer, diabetes, prior radiation to the oral cavity, or serious oral infections between January of 2004 and March of 2006. All patients received 45 mg daily of pioglitazone for 12 weeks. Researchers evaluated laboratory abnormalities using paired Student's t-test and clinical side effects using National Cancer Institute [...]

8/26/2006 Chicago, Il John Otrompke www.docguide.com Treatment with an intranodal vaccine prepared by feeding apoptotic autologous tumor cells to dendritic cells may benefit some patients with squamous cell head and neck cancer, but lymph node sterility may limit the viability of the treatment for certain patients. Thirty patients with stage III/IV resectable squamous cell carcinoma of the head and neck were assessed for the experimental treatment as part of a trial reported here at the annual meeting of the American Head and Neck Society (AHNS). Lymph nodes from the patients were processed, and sterile tumor cells were recovered from 10 of the 30 patients. Lymph nodes from five of the patients in the trial underwent leukapheresis to generate immature dendritic cells, which were then coincubated with apoptotic cells, according to the abstract by Theresa L. Whiteside, PhD, professor of pathology and otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, and colleagues. The researchers evaluated the dendritic cell vaccines for cell recovery, viability, purity, and potency and delivered them to four of the patients. Of the four patients who received the vaccine, none showed toxic effects, and all are alive with no evidence of cancer. The patients all generated immune responses to the vaccines. However, the researchers noted in their abstract, autologous tumor sterility and small cell numbers limited this vaccination strategy to few enrolled subjects. Source: Presentation title: Dendritic Cell (DC)-Based Vaccine for Patients With SCCHN Using Autologous Tumor Cells as Immunogens. Abstract s012_AHNS