High rate of severe radiation dermatitis during radiation therapy with concurrent cetuximab in head and neck cancer: Results of a survey in EORTC institutes

Source: Radiother Oncol, October 30, 2008 Author: Christian Giro et al. Objective: Examination of the rate of grade III or grade IV radiation dermatitis during treatment of head and neck cancer (HNC) with radiotherapy (RT) and concurrent cetuximab in EORTC centres. Materials and Method: A questionnaire was sent to all members of the EORTC Radiation Oncology Group and Head and Neck Group (111 institutions) to evaluate the widespread use of cetuximab and radiotherapy in HNC and to estimate the frequency of grades III and IV skin reactions in the radiation portals associated with this protocol. Co-morbidities, RT schedules and co-medications were also recorded. Results: We received responses from 28 institutions in 11 countries. A total of 125 HNC patients from 15 institutions were treated with cetuximab and concurrent RT. Information about the skin reactions was available from 71 patients. Of these 36 had no grade III/IV adverse effects in the RT field, 15 had a grade III and 20 had grade IV radiation dermatitis. No detectable relation of grades III and IV radiation dermatitis with co-morbidities such as liver insufficiency or renal dysfunction was found. Conclusion: According to the results of the questionnaire, grade III/IV radiation dermatitis is observed in 49% of HNC patients treated with cetuximab and concurrent RT. A systematic clinical monitoring of cutaneous side effects during RT plus cetuximab is advised to ensure the safety of this protocol. Authors: Christian Giro, Bernhard Berger, Edwin Bolke, I Frank Ciernik, Frederic Duprez, Laura Locati, Sophie Maillard, Mahmut Ozsahin, Raphael [...]

2008-11-16T11:29:22-07:00November, 2008|Oral Cancer News|

Re-irradiation with concurrent chemotherapy in recurrent head and neck cancer: a decision analysis model based on a systematic review

Source: Clin Otolaryngol, August 1, 2008; 33(4): 331-7 Authors: V Paleri and CG Kelly Objectives: Local recurrence is the major cause of treatment failure in head and neck cancer patients after radiation or combined therapy. If surgically unresectable, management involves supportive care or chemotherapy with palliative intent. Recent studies have assessed the role of re-irradiating these patients with concurrent chemotherapy (CTReRT) and have reported improved local control. The aim of this study was to perform a decision analysis model comparing quality adjusted life years (QALYs) between patients undergoing CTReRT and best supportive care for radio-recurrent head and neck squamous cancer. Design: Outcome data from recent reviews on the topic were used. A decision analysis model was generated. An expert panel arrived at a consensus to assign utility values for the various health state outcomes when CTReRT is administered for recurrent cancer, or in the setting of palliative care for these patients. Main Outcome Measures: Quality adjusted life years from the decision analysis model. RESULTS: Patients who do not suffer a severe complication following CTReRT were assigned by the expert panel to have a utility value of 0.7, and those who suffered one, a utility value of 0.6. A value of 1.0 equates to perfect health and 0 to death. The utility value assigned in the setting of good palliation was 0.8, with 0.6 given when symptom control was less than optimal. The model showed superior QALYs for the CTReRT arm of approximately 5 weeks (20 weeks versus 15 weeks for [...]

2008-11-16T11:17:31-07:00November, 2008|Oral Cancer News|

Doctors warn of HPV link to developing oral cancer

Source: Tampa Bay Online (www2.tbo.com) Author: staff Ten years ago, most of Brian Nussenbaum's oral cancer patients were men older than 60 who used tobacco and drank heavily. Today, his patients look different, as does the risky behavior that seems to be leading to their cancer. Nussenbaum, an ear, nose and throat doctor at Washington University in St. Louis, estimates 70 percent of his cancer patients have tumors on the back of their tongues and tonsils caused by human papillomavirus-16. Most of those patients are between ages 45 and 55. About half are women. And experts suspect that all of them - men and women - got the HPV from oral sex. "We know now that 98 percent of cervical cancer is caused by HPV, and mostly HPV-16," he says. "But no one talks about how you can also get mouth cancer from it." Researchers at Johns Hopkins Kimmel Cancer Center reported a link between HPV and these specific throat cancers in 2000. The increase in HPV oral cancer stems from a shift in sexual behaviors, combined with a dramatic decrease in the number of tonsillectomies performed. Cancer from the HPV virus often develops on the tonsils. In a Johns Hopkins study, researchers concluded that people with HPV infections were 32 times more likely to develop oral cancer than those without HPV. These findings have ramifications for anyone who is sexually active. Parents have another reason to think hard about whether they want their adolescent daughters, and perhaps even sons, [...]

2008-11-16T08:03:40-07:00November, 2008|Oral Cancer News|

Sweetest word for a mother to hear

Source: www.journallive.co.uk Author: Neil MacKay It is a memorable moment in any mother’s life when her child utters their first word. But when Daniel Sewell said “Mam” for the first time it was an extra special for his mum Alison. For Daniel was given a “new” tongue during pioneering surgery for mouth cancer at Newcastle’s Royal Victoria Infirmary more than three years ago, and doctors warned Alison that he may never talk properly. Surgeons had to take out three-quarters of his tongue and replace it with muscle from his abdominal lining. Now, after three years in remission, four-year-old Daniel is a happy, talkative primary school pupil. Both he and Alison, 43, of Coronation Street, Crook, County Durham, are backing the British Dental Health Foundation’s Mouth Cancer Action Week, which runs next week. Daniel’s father Richard spotted his badly swollen tongue when he was 13 months old and his quick action saved the tot’s life – early detection of oral cancer means a survival chance of 90%. Alison said: “I was just as ignorant as anyone about mouth cancer. I always presumed it was about the older generation and was linked with smoking and the like. “When we found out Daniel had cancer, we had the shock of our lives. It was so hard for the first few weeks and we didn’t know which way it was going to go. If we hadn’t noticed when we did I really don’t think he would have made it. Mouth cancer is a silent [...]

2008-11-16T07:46:00-07:00November, 2008|Oral Cancer News|

Adult smoking is at record low

Source: www2.journalnow.com Author: Richard Craver A rate below 20 percent has more symbolic than commercial significance, tobacco analyst says Smoking among U.S. adults hit a record low during 2007, with less than one in five lighting up. Although breaking through the 20 percent threshold was applauded by anti-smoking groups last week, they acknowledged that an ambitious goal of a 12 percent adult-smoking rate by 2010 is not likely to happen. The goal was set in November 2000 as part of the Healthy People 2010 project. "If we want to see far more people quit smoking, we need expanded access to stop-smoking programs, continued progress in eliminating secondhand smoke exposure and ongoing investment in programs that work," said Dr. Matthew McKenna, the director of the Office on Smoking and Health at the U.S. Centers for Disease Control and Prevention. The agency reported that 43.4 million U.S. adults smoked in 2007, or 19.8 percent, compared with 45.3 million in 2006, or 20.8 percent. The rate essentially was unchanged from 2004 through 2006. The peak of U.S. adult smokers was 53.5 million in 1983, according to U.S. government figures. The number of adult men who smoke still exceeds women -- 22 percent of men smoke, compared with 17.4 percent of women. The number of white adult smokers was 21.4 percent, compared with 19.8 percent for blacks and 13.3 percent for Hispanics. The report also found that the percentage of everyday smokers who have tried to quit smoking has dropped from 47 percent in [...]

2008-11-15T12:43:05-07:00November, 2008|Oral Cancer News|

Dietary factors and oral and pharyngeal cancer risk

Source: Oral Oncol, November 4, 2 Authors: Ersilia Lucenteforte et al We reviewed data from six cohort studies and approximately 40 case-control studies on the relation between selected aspects of diet and the risk of oral and pharyngeal cancer. Fruit and vegetables were inversely related to the risk: the pooled relative risk (RR) for high vegetable consumption was 0.65 from three cohort studies on upper aerodigestive tract cancers and 0.52 from 18 case-control studies of oral and pharyngeal cancer; corresponding RRs for high fruit consumption were 0.78 and 0.55. beta-carotene, vitamin C and selected flavonoids have been inversely related to the risk, but it is difficult to disentangle their potential effect from that of fruit and vegetables. Whole grain, but not refined grain, intake was also favorably related to oral cancer risk. The results were not consistent with reference to other foods beverages, and nutrients, but it is now possible to exclude a strong relation between these foods and oral and pharyngeal cancer risk. In western countries, selected aspects of diet may account for 20-25% of oral and pharyngeal cancer, and the population attributable risk increases to 85-95% when tobacco and alcohol consumption are also considered. Authors: Ersilia Lucenteforte, Werner Garavello, Cristina Bosetti, and Carlo La Vecch Authors' affiliation: Dipartimento di Epidemiologia, Istituto di Ricerche Farmacologiche "Mario Negri", via Giuseppe La Masa 19, 20156 Milan, Italy

2008-11-15T09:58:35-07:00November, 2008|Oral Cancer News|

HPV virus helps cervical and head and neck cancers resist treatment and grow and spread

Source: www.sciencedaily.com Author: staff The human papillomavirus (HPV) allows infected cervical and head and neck cancer cells to maintain internal molecular conditions that make the cancers resistant to therapy and more likely to grow and spread, resulting in a poor prognosis for patients, researchers with UCLA's Jonsson Cancer Center found. Virtually all human cancers experience a state called intratumoral hypoxia, or a low amount of oxygen within the tumor. In the UCLA study, researchers showed that the HPV-positive cancers adapted to and took advantage of the hypoxic environment by expressing a protein that activates a cell signaling pathway that helps the cancers survive, grow and spread. The study is published in the Nov. 4, 2008 issue of the journal Cancer Cell. The research, done on cells in culture and in animal models, may lead to the development of new therapies that target the cell signaling pathway, thereby interrupting ability of the cancer cells to thrive, said Dr. Matthew Rettig, senior author of the study and a researcher at UCLA's Jonsson Comprehensive Cancer Center. "There is potential for therapeutic intervention based on this finding," said Rettig, an associate professor of urology and medicine. The finding is crucial because 90 to 98 percent of cervical cancers are caused by HPV. Cervical cancer is the second most common cancer in women worldwide, with more than 500,000 cases diagnosed annually. In all, 200,000 women die from cervical cancer every year. In oral cavity and pharynx cancers, the HPV virus is linked to about 20 [...]

2008-11-15T09:51:58-07:00November, 2008|Oral Cancer News|

Bone healing after dental extractions in irradiated patients: a pilot study on a novel technique for volume assessment of healing tooth sockets.

Source: Clin Oral Investig, November 5, 2008 Author: Jimoh Olubanwo Agbaje et al. The aim of this study was to evaluate longitudinally the bone-healing process by measuring volumetric changes of the extraction sockets in head and neck cancer patients undergoing radiotherapy after tooth extraction. A total group of 15 patients (nine males, six females) undergoing tooth extraction at the Department of Periodontology (University Hospital KULeuven) were enrolled after giving informed consent. In seven patients, teeth presenting a risk for complications and eventual radionecrosis were extracted prior to the radiotherapeutical procedure. Monitoring of bone healing was performed by evaluating the volumetric changes of the alveoli by cone beam CT scanning (CBCT) at extraction and after 3 and 6 months. In parallel, a similar longitudinal evaluation of extraction sites was done in a control group of eight patients. Within this pilot-study, a total of 15 healing extraction sockets were evaluated and followed up. There was a significant difference in volumetric fill up of extraction sockets in test group vs. control group at three (37.1 +/- 7.9%) vs. (54.6 +/- 4.0%) and 6 months (47.2 +/- 8.8%) vs. (70.0 +/- 7.3%), respectively. The present pilot study demonstrated the clinical usefulness of CBCT for evaluation of extraction socket healing. The study objectively demonstrates the delayed bone healing after tooth extraction in irradiated head and neck cancer patients. Considering the limitations of this pilot study, a potential effect of radiotherapy on further jaw bone healing after pre-therapeutic tooth extractions should be further explored.

2008-11-13T16:12:21-07:00November, 2008|Oral Cancer News|

Study suggests Merck’s Gardasil is effective in males

Source: money.cnn.com Author: Peter Loftus A new study suggests Merck & Co.'s (MRK) Gardasil vaccine, which is primarily given to prevent cervical cancer in girls and women, may also be effective in preventing genital warts and penile cancer when given to males. Merck hopes the company-funded study will support roughly doubling the target population for the vaccine, which could help jump-start sagging sales. The Whitehouse Station, N.J., company said it remains on track to apply by year end for Food and Drug Administration approval to market Gardasil to boys and men ages 9 to 26 for prevention of external genital lesions caused by certain viral strains. "This is groundbreaking data," said Anna Giuliano, professor of medicine and epidemiology at University of South Florida, who co-authored the study. "To demonstrate that Gardasil prevents infection and disease at a very high level in males - that's the other half of the world." It was the first study to demonstrate Gardasil's effectiveness in males - prior studies had shown it could produce a positive immune response in males. The vaccine, which was launched in 2006, is currently approved in the U.S. for girls and women ages 9 through 26 to prevent cervical, vulvar and vaginal cancers, as well as genital warts and other lesions caused by certain viral strains. These diseases, in both males and females, share the same cause: Human papillomavirus, or HPV, which is transmitted through sexual contact. The cancers in men caused by HPV, however, are rarer than cervical cancer. [...]

2008-11-13T16:09:00-07:00November, 2008|Oral Cancer News|

Does surgical resection of pulmonary metastases of head and neck cancer improve survival?

Source: Annals of Surgical Oncology 15:2915-2926 (2008) Author: Hauke Winter, MD et al. Background: The prognosis of patients with metastasized head and neck cancer is poor. Limited experience exists with the benefit of resection of lung metastases and systematic mediastinal and hilar lymph node dissection on survival of patients with head and neck carcinoma. Methods: Eighty patients undergoing metastasectomy for pulmonary metastases of primary head and neck cancer entered the study. Multivariate analysis was performed by Cox regression analysis. Survival differences between patients operated and those not operated on were analyzed by matched pair analysis. Results: From 1984 until 2006, pulmonary metastases were diagnosed in 332 patients treated for head and neck cancer; 80 of these were admitted to our department for resection. Metastases of the primary head and neck tumor were confirmed histologically in 67 patients. The median overall survival after resection of lung metastases was 19.4 months and was statistically significantly better compared with patients who were not operated on (P < .001). The multivariate analysis after metastasectomy revealed that incomplete resection of pulmonary lesions, complications associated with surgery, and adjuvant therapy of the primary tumor are independent negative prognostic factors for survival. We observed a trend to improved survival in patients without hilar or mediastinal lymph node metastases. Conclusion: The survival rate of patients operated on was statistically significantly higher than that of patients with conservative treatment. Even patients with multiple or bilateral pulmonary lesions after curative treatment of a primary tumor should be operated on if [...]

2008-11-13T16:05:15-07:00November, 2008|Oral Cancer News|
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