chemoradiation

Expand+Bcl2 and human papilloma virus 16 as predictors of outcome following concurrent chemoradiation for advanced oropharyngeal cancer

Source: Clin Cancer Res; 16(7); 2138–46 Authors: Anthony C. Nichols et al. Purpose: Oropharyngeal squamous cell carcinoma (OPSCC) associated with human papilloma virus (HPV) is rapidly growing in incidence. Despite better prognosis than OPSCC associated with traditional risk factors, treatment failure still occurs in a significant proportion of patients. We had identified the antiapoptotic protein Bcl2 as a marker for poor outcome in advanced OPSCC treated with concurrent chemoradiation. To determine whether Bcl2 and HPV together might further characterize treatment response, we examined whether the prognostic value of Bcl2 was independent of HPV status. Experimental Design: Pretreatment tumor biopsies from 68 OPSCC patients were tested for HPV by in situ hybridization and were immunostained for Bcl2 to evaluate relations with disease-free (DFS) and overall survival following platin-based concurrent chemoradiation. Median follow-up among surviving patients was 47 months (range, 10-131 months). Results: Bcl2 and HPV independently predicted DFS and overall survival. Hazard ratios (with 95% confidence interval) for positive versus negative status in bivariate Cox proportional hazard analysis of DFS were 6.1 (1.8-21) for Bcl2 and 0.11 (0.035-0.37) for HPV. Only 1 of 32 HPV-positive/Bcl2-negative tumors recurred. Pretreatment Bcl2 expression was specifically associated with distant metastasis; five of six distant metastases occurred in the <40% of patients whose primary tumors were Bcl2 positive. Conclusions: Independent of HPV status, pretreatment Bcl2 expression identifies a subset of OPSCC patients having increased risk of treatment failure, particularly through distant metastasis, after concurrent chemoradiation. Considering HPV and Bcl2 together should help in devising better personalized [...]

Oral Cancer Foundation News Team - A2010-04-04T08:52:04-07:00April, 2010|Oral Cancer News|

Genmab says FDA lifts hold on zalutumumab studies

Source: www.reuters.com Author: staff Danish biotechnology firm Genmab said on Thursday: - The U.S. Food and Drug Administration lifted a partial clinical hold on zalutumumab studies being conducted under a U.S. Investigational New Drug application. - Enrolment of patients can now resume in the Phase II study in patients with head and neck cancer considered incurable with standard treatment and the Phase I/II frontline study of zalutumumab in combination with chemo-radiation. Note: 1. Reporting by Copenhagen newsroom

Oral Cancer Foundation News Team - A2009-07-16T12:08:09-07:00July, 2009|Oral Cancer News|

Clinical and dosimetric factors associated with a prolonged feeding tube requirement in patients treated with chemoradiotherapy (CRT) for head and neck cancers

Source: Annals of Oncology, doi:10.1093/annonc/mdp268 Authors: A. S. Gokhale et al. Background: Patients treated with chemoradiotherapy (CRT) for head and neck cancers often require feeding tubes (FTs) due to toxicity. We sought to identify factors associated with a prolonged FT requirement. Patients and methods: We retrospectively reviewed 80 patients treated with CRT for head and neck cancers. The pharyngeal constrictors (PCs), supraglottic larynx (SGL), and glottic larynx (GL) were contoured and the mean radiation doses and the volumes of each receiving >40, 50, 60, and 70 Gy (V40, V50, V60, and V70) were determined. Results: A total of 33 of 80 patients required a FT either before or during the course of CRT. Fifteen patients required the FT for ≥6 months. On univariate analysis, significant factors associated with a prolonged FT requirement were mean PC dose, PC-V60, PC-V70, SGL dose, SGL-V70, and advanced T3–T4 disease. Multivariate analyses found both PC-V70 and T3-T4 disease as significant factors .The proportions of patients requiring a FT ≥6 months were 8% and 28% for treatment plans with PC-V70 <30% and ≥30%, respectively. Conclusions: Increased radiation dose to the PCs is associated with a higher risk of a prolonged FT need. Dose sparing of the PC muscles may reduce this risk. Authors: A. S. Gokhale1, B. T. McLaughlin2, J. C. Flickinger1, S. Beriwal1,*, D. E. Heron1, R. L. Ferris3, J. Johnson3, M. K. Gibson2, A. Argiris2 and R. P. Smith1 Authors' affiliatons: 1 Department of Radiation Oncology 2 Division of Hematology–Oncology, Department of Medicine 3 [...]

Oral Cancer Foundation News Team - A2009-07-15T13:03:53-07:00July, 2009|Oral Cancer News|

Planned neck dissection unnecessary in some patients with advanced stage oropharyngeal cancer

Source: www.docguide.com Author: Louise Gagnon The use of a neck dissection is not always necessary in patients with advanced stage oropharyngeal cancer, according to a retrospective study presented here at the 2nd World Congress of the International Academy of Oral Oncology (IAOO). "Our message is that you don't have to do a planned neck dissection," said John Yoo, MD, Department of Otolaryngology-Head and Neck Surgery, London Health Sciences Centre/University of Western Ontario, London, Ontario. Chemoradiation is now the standard of care in most centres for patients with advanced oropharyngeal cancer, noted Dr. Yoo. "You can follow those patients to see if they relapse or have persistent disease," he explained in an interview on July 10. "You can salvage them if that occurs. The trend is towards not doing a planned neck dissection, but to follow the patients." Patients received external beam irradiation in addition to platinum-based chemotherapy. They were staged pathologically and radiologically. They were reassessed at 6 to 8 weeks after treatment for residual disease. Neck dissections were performed only if clinicians had clinical or radiological evidence of residual disease. Dr. Yoo and colleagues retrospectively analysed 62 patients (49 males, 13 females) treated at the London Regional Cancer Centre between 1999 and 2005. The mean age of patients was 56, and the median follow-up was 32 months. A total of 15 patients were N3 staged, and 47 were N2 stage. Specifically, 18 were stage N2a, another 18 were stage N2b, and 11 were stage N2c. There was a complete [...]

Oral Cancer Foundation News Team - A2009-07-15T04:11:30-07:00July, 2009|Oral Cancer News|