3/25/2005 Vancourver, British Columbia, Canada Graeme G Duncan et al. Head Neck, March 21, 2005 Background: The National Cancer Institute of Canada Clinical Trials Group undertook a multicenter, randomized, double-blind controlled trial of an oral antimicrobial versus placebo to prevent and treat mucositis. We present the quality of life (QOL) analysis for this trial. Methods: One hundred thirty-eight patients were randomly assigned. QOL data were collected every 2 weeks before, during, and after radiotherapy. The European Organization for Research and Treatment of Cancer Quality of Life questionnaire (EORTC QLQ-C30) and a Trial Specific Checklist (TSC) were used. Results: The antimicrobial lozenge did not impact QOL. The principal acute side effect of radiotherapy is oral pain, affecting more than 90% of patients. Role function is impacted during treatment, and patients experience fatigue. Appetite was reported to markedly increase during radiotherapy. There was a dramatic and persistent increase in dry mouth. Conclusions: This study highlights the benefits of combining the EORTC QLQ-30 with an "oral" TSC in a randomized controlled trial and provides valuable baseline data for their use with an objective mucositis scoring system. Authors: Graeme G Duncan, Joel B Epstein, Dongsheng Tu, Samy El Sayed, Andrea Bezjak, Jon Ottaway, and Joe Pater Authors' Affiliation: Department of Radiation Oncology, British Columbia Cancer Agency, Vancouver Centre, 600 West 10th Ave, Vancouver, BC, Canada

3/25/2005 Atlanta, Georgia Caroline H Shiboski et al. American Cancer Society, Cancer, March 16, 2005 Background: An increasing incidence of oral carcinoma among young adults has been reported in the U.S. and Europe. Although the association between human papillomavirus infection and tonsillar carcinoma is now well established, to the authors' knowledge little is known about incidence trends in tonsillar carcinoma among younger adults. The objective of the current study was to explore the trends in both oral cavity and pharyngeal squamous cell carcinoma (SCC) in younger U.S. populations, in particular tongue and tonsillar SCC. Methods: Using the 1973-2001 Surveillance, Epidemiology and End Results (SEER) database, we computed age, race, and site-specific trends of oral and pharyngeal (excluding nasopharynx) carcinoma incidence rates. The percent change (PC) and annual percent change (APC) were computed to explore trends in incidence rates over time. Results: There were 2262 SCC of the oral cavity and 1251 SCC of the pharynx reported to the SEER program from 1973 to 2001 in adults aged 20-44 years. There was a statistically significant increase in the incidence of oral tongue SCC (APC = +2.1; P < 0.001), base of tongue SCC (APC = +1.7; P = 0.04), and palatine tonsil SCC (APC = +3.9; P < 0.001) among younger white individuals, whereas the incidence of SCC in all other oral and pharyngeal sites decreased or remained constant. Conclusions: The increase in tonsil SCC incidence from 1973 to 2001 paralleled the increase in tongue SCC, whereas SCC in all other [...]

3/24/2005 USA Florian Dammann et al. AJR 2005; 184:1326-1331 (American Roentgen Ray Society) Objective: We sought to evaluate the efficiency of 18FDG PET, CT, and MRI for the preoperative staging of squamous cell carcinoma (SCC) of the head and neck region. Conclusion: MRI is recommended as the method of choice in the preoperative evaluation of SCC of the oral cavity and the oropharynx. PET can provide relevant diagnostic information in case of equivocal findings by MRI or CT. Routine use of PET, however, does not appear to be necessary if optimized MRI is available. Authors: Florian Dammann, Marius Horger, Marcus Mueller-Berg, Heinz Schlemmer, Claus Claussen, Juergen Hoffman, Susanne Eschmann and Roland Bares Authors Affiliation: Dept. of Diagnostic Radiology, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, Tuebingen D-72076, Germany

3/22/2005 New York, NY Charnicia E. Huggins Reuters News (www.reuters.com) Many student athletes, particularly football and baseball players, in Mississippi's junior and senior high schools, use tobacco -- as do their coaches -- according to the results of two new studies. Further, an oral screening conducted among student athletes in a third study, revealed that many students with a history of tobacco use had an oral lesion, which can be an early warning sign of mouth cancer. These studies, conducted by former athletes who are researchers at the University of Mississippi School of Dentistry, were presented on Thursday in Baltimore, Maryland during the 83rd General Session of the International Association for Dental Research. Based on the findings, "early intervention" by dentists and other healthcare providers is needed, to decrease the risk of oral cancer among athletes who use tobacco, Dr. Kyle Hunt, who was involved in all three studies, told Reuters Health. He warned that if signs of oral cancer are not detected early, the risk of death increases. Among the 698 seventh through twelfth graders surveyed in the first study, nearly 23 percent of boys said they had ever used tobacco in comparison to about 3 percent of girls, according to Hunt and his team. White athletes were more likely to report a history of tobacco use and were more likely to have used smokeless tobacco than were their black peers. Further, a history of tobacco use was especially common among football and baseball players, who were more likely [...]

3/21/2005 Christopher Perry et al. Arch Otolaryngol Head Neck Surg. 2005;131:198-203 Objective: To determine whether isotretinoin (or 13-cis-retinoic acid) decreases the risk of second primary cancers in patients previously treated for cure of head and neck squamous cell carcinoma. Design: Randomized, double-blind, placebo-controlled trial. Setting: Two head and neck multidisciplinary cancer clinics in university teaching hospitals taking cases from 4 to 5 million people in Queensland, Australia, combined to enter appropriate patients into this trial. Patients: One hundred fifty-one patients with their first head and neck squamous cell carcinoma treated with high expectation for cure and living close by. They were randomized into 3 arms to receive 3 years of treatment. Interventions: Patients took isotretinoin at a high dose (1.0 mg/kg per day) or a moderate dose (0.5 mg/kg per day) or placebo. Group 1 took the high dose for 1 year and then the moderate dose for 2 years. Group 2 took the moderate dose for 3 years. Group 3 took placebo for 3 years. Main Outcome Measures: The diagnosis of a second primary malignancy of the head and neck, lung, or bladder was regarded as the end point signifying failure of therapy. Issues of drug adverse effect profile and impact on survival were measured. Results: There was no significant difference in the occurrence of second primary disease (P = .90), the recurrence of primary disease (P = .70), or disease-free time (P = .80) between the treatment and nontreatment arms. Numbers were too small to find differences in [...]

3/21/2005 Yorkshire, England The Huddersfield Daily Examiner A man who overcame throat cancer is now working to raise awareness of how the disease affects people's lives. John Hodgson, 57, of Hepworth, is chairman of Communicating Head and Neck Cancer Yorkshire (Chancy), which is organising a conference for healthcare workers on Friday, May 27. Head and neck cancers are quite rare, which means that many health professionals do not regularly encounter them. The conference, at Pontefract Racecourse, aims to give health workers the chance to hear patients' views on treatments and the challenges they have faced while battling such cancers. The conference - for 80 delegates - will be followed by a race night to raise cash for the Macmillan Cancer Relief charity. Mr Hodgson was diagnosed with throat cancer in 2000, after visiting his GP about a lump in his neck. After intensive chemo- therapy, radiotherapy and an operation he has overcome the disease. But he was left with a slight hearing problem, his voice tires easily and he has just 12 teeth. All those with fillings had to be removed before radiotherapy. He said: "I am the exception among head and neck cancer patients in that I haven't got much of a speech impediment. "Some people have their voiceboxes removed or have throats or tongues rebuilt. "It affects the way you eat and we hope to help medical professionals understand that it has quite a profound after-effect. "They can then provide better support to patients." It was while Mr [...]

3/21/2005 Mark Perkiss New Jersey Times (www.nj.com) Wendy Guerra of South Brunswick says she deserves the right to go to a restaurant, bar or nightclub of her choice without having to worry that a nearby smoker might trigger a potentially fatal asthma attack. On the other hand, Larry Williams of Trenton says he and other smokers deserve the right to light up while they sit and drink in their favorite bar instead of being forced to go outside. The two typify the conflict of rights and freedoms with which lawmakers are grappling as they consider a proposed law barring smoking in indoor workplaces, including restaurants, bars, casinos and private clubs, such as American Legion or Veterans of Foreign Wars posts. "I'm an ex-smoker so I understand their point of view, but my health is more important," said Guerra, 54, who suffers from severe asthma. "I can't go to any restaurant I want to because they might allow smoking. I can't go to bars or nightclubs or shows. "I've had to leave parties of family occasions at restaurants because of smoking," she said. "Why should I have to suffer like that because someone else wants to smoke? It's not fair." Williams, 49, a regular at the Ivy Inn, a Princeton Borough bar that draws many smokers, takes the opposite view. "I have rights and this law would take those away from me," he said. "I respect people who don't smoke and I try not to smoke near them. They should respect [...]

3/21/2005 Robert L. Ferris et al. Cancer Research 65, 2147-2156, March 15, 2005 Clinical staging of cervical lymph nodes from patients with squamous cell carcinoma of the head and neck (SCCHN) has only 50% accuracy compared with definitive pathologic assessment. Consequently, both clinically positive and clinically negative patients frequently undergo neck dissections that may not be necessary. To address this potential overtreatment, sentinel lymph node (SLN) biopsy is currently being evaluated to provide better staging of the neck. However, to fully realize the potential improvement in patient care afforded by the SLN procedure, a rapid and accurate SLN analysis is necessary. We used quantitative reverse transcription–PCR (QRT-PCR) to screen 40 potential markers for their ability to detect SCCHN metastases to cervical lymph nodes. Seven markers were identified with good characteristics for identifying metastatic disease, and these were validated using a set of 26 primary tumors, 19 histologically positive lymph nodes, and 21 benign nodes from patients without cancer. Four markers discriminated between positive and benign nodes with accuracy >97% but only one marker, pemphigus vulgaris antigen (PVA), discriminated with 100% accuracy in both the observed data and a statistical bootstrap analysis. A rapid QRT-PCR assay for PVA was then developed and incorporated into a prototype instrument capable of performing fully automated RNA isolation and QRT-PCR. The automated analysis with PVA provided perfect discrimination between histologically positive and benign lymph nodes and correctly identified two lymph nodes with micrometastatic tumor deposits. These assays were completed (from tissue to result) in 30 [...]

3/21/2005 www.cancerconsultants.com Researchers from Duke University have reported that anemic patients with advanced head and neck cancers treated with radiation therapy have poorer outcomes than comparable patients without anemia. The details of this retrospective analysis were reported in the March 15, 2005 issue of the International Journal of Radiation Oncology Biology Physics.[1] Hypoxia is known to interfere with the therapeutic effectiveness of radiation therapy and chemotherapy. It has been suggested that clinical anemia can reduce responses to radiation therapy and chemotherapy. In the current study, researchers evaluated outcomes of 159 patients with head and neck cancer treated with a standardized radiation and chemotherapy regimen. Radiation was hyperfractionated and the chemotherapy drug was cisplatin. This group of patients had a median hemoglobin of 13.6 g/dL. The researchers compared outcomes of patients who had hemoglobin levels of 13.0 g/dL with those who had levels below 13.0 g/dL. The five-year failure-free survival was 75% for patients with a hemoglobin of 13.0 g/dL or higher, compared to 50% for those with a lower hemoglobin level. However, patients with anemia appeared to have on average more extensive disease at the time of treatment. These authors concluded that anemia was associated with a worse outcome, but that the cause was unknown. They proposed prospective trials of erythropoietin (Procrit® or Aranesp®) to determine if correction of anemia improves outcome. Comments: Preliminary results from a Radiation Therapy Oncology Group (RTOG) study indicated that erythropoietin improved hemoglobin levels in anemic patients with head and neck cancers receiving only radiation [...]

3/21/2005 National Cancer Institute Clinical Trial Results As reported at the American Society of Clinical Oncology annual meeting, New Orleans, LA, 2004 Background: Head and neck cancers account for three percent of all cancers in the United States. Most of these cancers begin in squamous cells found in the lining of structures in the head and neck. Initial treatment options for patients with advanced head and neck cancer include radiation therapy, chemotherapy combined with radiation treatment, or surgery followed by radiation and/or chemotherapy plus radiation for patients whose tumors can be surgically removed. Many head and neck cancer cells overexpress (make too much of) a protein called the epidermal growth factor receptor (EGFR), which may help cancer cells to grow more aggressively. Cetuximab is a monoclonal antibody that attaches to and blocks EGFRs. Early studies suggested that treatment with cetuximab would boost the effectiveness of radiation therapy in patients with head and neck cancer. The Study: A total of 424 patients in the United States and Europe were enrolled in this study. All had tumors in their tonsils, tongue, or voicebox that may have involved lymph nodes, but had not spread to other parts of the body. Patients were randomly assigned to receive either radiation therapy alone or radiation plus weekly cetuximab. Patients were followed up for a median of just over three years. The study’s principal investigator was James A. Bonner, M.D., of the University of Alabama at Birmingham. (See the protocol summary.) Results: Median survival for patients treated [...]