chemotherapy – Page 17 – Oral Cancer News

Connected nodes in throat cancer signal poor prognosis

Source: OncologyNurseAdvisor.com The presence of “matted” lymph nodes in persons with oropharyngeal squamous cell carcinoma (SCC)—that is, nodes that are connected together—was associated with a 3-year survival rate of 69%, compared with 94% among patients without matted nodes. Such a marker could help clinicians identify patients who are at heightened risk for metastasis and who might benefit from additional systemic therapy. Conversely, a person without matted nodes could be a candidate for less therapy, which would in turn reduce uncomfortable side effects. The study, led by Matthew E. Spector, MD, a resident in the department of otolaryngology – head and neck surgery at the University of Michigan Health System in Ann Arbor, focused on 78 previously untreated persons with stage III or IV oropharyngeal SCC. All patients were undergoing chemotherapy in combination with intensity-modulated radiation therapy (IMRT) as part of a clinical trial. The 3-year disease-specific survival rate for the 16 patients presenting with matted nodes was 69%, compared with 94% among the 61 other patients. Matted nodes were found to be a poor prognostic factor independent of tumor classification, human papillomavirus (HPV) status, epidermal growth factor receptor (EGFR), and smoking status. Matted nodes did appear to be an especially strong indicator of increased risk among HPV-positive persons, despite the fact that these patients had better overall outcomes than did those who were HPV-negative. The best outcomes were seen among HPV-positive nonsmokers. The investigators, who reported their findings in Head & Neck, say the reasons for the survival differences between [...]

Charlotte Parker2012-02-01T17:10:52-07:00February, 2012|Oral Cancer News|

Queensland researchers make cancer treatment breakthrough

Source: HealthCanal.com The culmination of 10 years of collaborative research between scientists from the Queensland Institute of Medical Research (QIMR) and The University of Hong Kong (HKU) Li Ka Shing Faculty of Medicine has led to a significant breakthrough in the treatment of nasopharyngeal carcinoma (NPC), an aggressive throat cancer with a high prevalence in South-East Asia. NPC is associated with Epstein-Barr virus infection in a manner similar to the association of hepatitis B virus and liver cancer. By using immunotherapy, the human body’s own immune system was used to successfully fight the disease. Professor Rajiv Khanna who heads the Australian Centre for Vaccine Development at QIMR said by enhancing the immune cells of NPC patients they have doubled the survival time of terminally ill patients. “The presence of EBV in the cancer cells gives the body’s immune system a definite target to help battle the NPC, resulting in few side-effects,” Professor Khanna said. “Patients who participated in the trial were in the late stages of the cancer and quite unwell, so it was important to ensure the treatment was non-invasive, non toxic and did not damage healthy cells. “By offering such targeted treatment, we were able to increase the expected time of patient survival from 200 to over 500 days, which is an extremely positive result. “We believe that if we offer this treatment in the earlier stages of NPC, accompanied with chemotherapy and radiation, we can further enhance survival rates.” Twenty four NPC patients were recruited at the [...]

Charlotte Parker2012-02-01T17:06:54-07:00February, 2012|Oral Cancer News|

Jaw Necrosis Common after Radiation for Oral Cancer

Source: MedpageToday.com Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco. Action Points Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal. Explain that osteoradionecrosis of the jaw (ORNJ) occurred more than twice as often as reported in the literature among patients with oral cancer treated with radiation. Point out that factors associated with the risk of ORNJ included female sex, no chemotherapy, and lower Charlson comorbidity index. PHOENIX -- Osteoradionecrosis of the jaw (ORNJ) occurred more than twice as often as reported in the literature, according to a population-based study of patients treated with radiation for oral cancer. A review of national medical records showed that 16.1% of patients had jaw complications or interventions consistent with ORNJ compared with published rates of 5% to 7%. However, when investigators applied the definition of ORNJ to patients who had interventions associated with jaw complications, the rate approximated the published rates, as reported here at the Multidisciplinary Head and Neck Cancer Symposium. "The rates of all jaw complications in the SEER-Medicare database are higher than reported rates from prospective and retrospective institutional reports," said Beth M. Beadle, MD, PhD, of the University of Texas MD Anderson Cancer Center in Houston. "If we limited the definition to interventions, the rates are similar to those of published reports." Radiation therapy has documented efficacy for locoregional [...]

Charlotte Parker2012-02-01T16:34:06-07:00February, 2012|Oral Cancer News|

Squamous cell subgroups respond differently to treatment

Source: www.medscape.com Author: Nancy A. Melville A long-term follow-up of patients with head and neck squamous cell carcinoma suggests that only certain high-risk subgroups benefit from radiation plus chemotherapy. This information will spare patients who will not benefit from undergoing the additional treatment. According to the study, presented here at the 2012 Multidisciplinary Head and Neck Cancer Symposium, patients with microscopically involved resection margins and/or extracapsular spread of disease had a lower risk for cancer recurrence with radiation plus chemotherapy 10 years later, whereas those with tumors in multiple lymph nodes did not benefit from combination treatment; they fared better with radiation alone. "The clinical implication of these findings is that the high-risk group of patients is not as homogenous a group as we believed it was before the study started," lead author Jay S. Cooper, MD, director of the Maimonides Cancer Center, in Brooklyn, New York, told Medscape Medical News. Dr. Cooper and his colleagues analyzed 10 years of follow-up data from the Radiation Therapy Oncology Group (RTOG) 9501/Intergroup phase 3 trial, which examined 410 patients with high-risk resected head and neck cancers. The patients were considered high risk for cancer recurrence because they had microscopically involved resection margins, extracapsular spread of disease, or multiple lymph node involvement. "The allocation was equally divided [according to treatment regimen] at the beginning of the study; the groups were not intended to be balanced for the different [risk] factors," Dr. Cooper said. "We thought they were all equally important." The treatment regimen [...]

Oral Cancer Foundation News Team - A2012-01-28T08:34:43-07:00January, 2012|Oral Cancer News|

Third Head and Neck Indication for Erbitux

Source: The ASCO Post, January 1, 2012, Volume 3, Issue 1, Matthew Stenger In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs.Cetuximab (Erbitux) was recently approved by the FDA for use in combination with platinum-based therapy plus fluorouracil (5-FU) for the first-line treatment of patients with recurrent locoregional disease or metastatic squamous cell carcinoma of the head and neck.1-3 Cetuximab has prior indications in combination with radiation therapy in locally or regionally advanced squamous cell head and neck cancer and in recurrent or metastatic head and neck cancer that has progressed after platinum-based therapy. It also has indications in colorectal cancer. The most recent approval is based primarily on results of a study conducted outside the United States in 442 patients with metastatic or locally recurrent squamous cell carcinoma of the head and neck who were not suitable for curative treatment with surgery or radiation. The study used a European Union (EU)-approved cetuximab rather than the U.S.-approved cetuximab (Erbitux). Erbitux provides approximately 22% higher exposure than the EU-approved cetuximab; these pharmacokinetic data, together with the results of the study conducted in Europe and other data using Erbitux establish the safety and efficacy of Erbitux at the recommended dose.In this trial, the addition of cetuximab (n = 222) to platinum-based therapy plus 5-FU (n = 220) significantly increased median overall survival from 7.4 to 10.1 months, representing a 20% reduction in risk of death [...]

Oral Cancer Foundation News Team - A2012-01-07T17:15:00-07:00January, 2012|Oral Cancer News|

Distant Metastases in Head-and-Neck Squamous Cell Carcinoma Treated with Intensity-modulated Radiotherapy

Source: International Journal of Radiation Oncology, Biology and Physics (IJROBP Online) December 2011 PURPOSE: To determine the pattern and risk factors for distant metastases in head-and-neck squamous cell carcinoma (HNSCC) after curative treatment with intensity-modulated radiotherapy (IMRT). METHODS AND MATERIALS: This was a retrospective study of 284 HNSCC patients treated in a single institution with IMRT. Sites included were oropharynx (125), oral cavity (70), larynx (55), hypopharynx (17), and unknown primary (17). American Joint Committee on Cancer stage distribution includes I (3), II (19), III (42), and IV (203). There were 224 males and 60 females with a median age of 57. One hundred eighty-six patients were treated with definitive IMRT and 98 postoperative IMRT. One hundred forty-nine patients also received concurrent cisplatin-based chemotherapy. RESULTS: The median follow-up for all patients was 22.8 months (range, 0.07-77.3 months) and 29.5 months (4.23-77.3 months) for living patients. The 3-year local recurrence-free survival, regional recurrence-free survival, locoregional recurrence-free survival, distant metastasis-free survival, and overall survival were 94.6%, 96.4%, 92.5%, 84.1%, and 68.95%, respectively. There were 45 patients with distant metastasis. In multivariate analysis, distant metastasis was strongly associated with N stage (p = 0.046), T stage (p<0.0001), and pretreatment maximum standardized uptake value of the lymph node (p = 0.006), but not associated with age, gender, disease sites, pretreatment standardized uptake value of the primary tumor, or locoregional control. The freedom from distant metastasis at 3 years was 98.1% for no factors, 88.6% for one factor, 68.3% for two factors, and 41.7% for three factors (p <0.0001 by log-rank [...]

Oral Cancer Foundation News Team - A2011-12-27T12:48:17-07:00December, 2011|Oral Cancer News|

Quality-of-Life Outcomes in Transoral Robotic Surgery

Source: SAGE Journals Online Abstract Objective. To report long-term, health-related quality-of-life (HRQOL) outcomes in patients treated with transoral robotic surgery (TORS). Study Design. Prospective, longitudinal, clinical study on functional and HRQOL outcomes in TORS. Setting. University tertiary care facility. Subjects and Methods. Patients who underwent TORS were asked to complete a Head and Neck Cancer Inventory before treatment and at 3 weeks and 3, 6, and 12 months postoperatively. Demographic, clinicopathological, and follow-up data were collected. Results. Sixty-four patients who underwent TORS were enrolled. A total of 113 TORS procedures were performed. The mean follow-up time was 16.3 ± 7.49 months. The HRQOL was assessed at 3 weeks and at 3, 6, and 12 months, with a response rate of 78%, 44%, 41%, and 28%, respectively. TORS was performed most frequently for squamous cell carcinoma (88%). There was a decrease from baseline in the speech, eating, aesthetic, social, and overall QOL domains immediately after treatment. At the 1-year follow-up, the HRQOL scores in the aesthetic, social, and overall QOL domains were in the high domain. Patients with malignant lesions had significantly lower postoperative HRQOL scores in the speech, eating, social, and overall QOL domains (P < .05). Patients who underwent adjuvant radiation therapy or chemotherapy and radiation therapy had lower postoperative scores in the eating, social, and overall QOL domains (P < .05). Conclusion. The preliminary data show that patients who undergo TORS for malignancies and receive adjuvant therapy tend to have lower HRQOL outcomes. TORS is a promising, minimally [...]

Oral Cancer Foundation News Team - A2011-12-27T10:58:43-07:00December, 2011|Oral Cancer News|

Consider dental issues before beginning cancer treatment

Soure: www.curetoday.com/ Author: Lacey Meyer Dentists advise resolving tooth and gum issues before starting cancer treatment. Bettye Davis admits she has never had very good teeth. But when she received a diagnosis of salivary gland cancer, she was surprised that her oncologist recommended she visit a dentist before beginning radiation treatments to her jaw. “When we first saw her, she still had quite a few teeth, but she had severe periodontal disease and severe bone loss,” says Dennis Abbott, DDS, Davis’ dentist. Knowing radiation would do more damage, he recommended removing the remainder of her teeth and allowing time to heal before she began 33 radiation treatments. “We knew that if we took the teeth out after radiation, we risked the bone not healing well, which would have meant osteonecrosis, dead bone in her mouth, and lots of systemic problems.” According to the National Cancer Institute, eliminating pre-existing dental and mucosal infections and instituting a comprehensive oral hygiene protocol before and throughout therapy can reduce the severity and frequency of oral complications from cancer therapy. Abbott says the NCI recommendations, as well as an increasing number of studies, are bringing more recognition to the importance of dental issues before, during and after cancer treatment. A Proactive Approach Abbott’s goal is to help patients maintain healthy teeth and reduce the risk of future infection with an oral care plan that eliminates or stabilizes disease that could produce complications during or following therapy. These complications can range from irradiated bone and gums [...]

Oral Cancer Foundation News Team - A2011-12-22T15:08:57-07:00December, 2011|Oral Cancer News|

UI professors: HPV editorial misses the mark

Source: The Daily Iowan The Nov. 29 editorial "Recommend Pap smears, not vaccines, to prevent cervical cancer" completely missed the mark with regard to HPV vaccines. We are researchers and clinicians at the University of Iowa who study and treat HPV and other infectious diseases. It is disturbing to think that the article might dissuade individuals from getting a safe and effective vaccine that can prevent cancer. First of all, it has been conclusively demonstrated that the vaccines are effective at preventing HPV infection. Cervical cancer is caused by HPV. Additionally, cancers of the head and neck are linked to HPV, including cancers in males. It has been clearly shown that the vaccines prevent the development of precursors to cervical cancer. In the editorial, Dr. Diane Harper was quoted as saying, "If doctors tell patients that this vaccination will prevent cancer, they're telling them a lie." This statement from Dr. Harper is simply misleading. In the vaccine studies, non-treatment of precursor lesions in the placebo group in the context of a clinical trial was considered unethical, and therefore, any precursor lesions were treated. Subsequent development of cancer in the placebo group was prevented by the required ethical treatment. Thus, the trials could not evaluate prevention of advanced cancer, per se. Because it takes cervical cancer a long time to develop, it will take about 15 more years to have data on incidence rates of cervical cancer from a large vaccinated general population. Because the vaccines prevent HPV infection and HPV-associated [...]

Oral Cancer Foundation News Team - A2011-12-08T10:31:17-07:00December, 2011|Oral Cancer News|

FDA Approves Cetuximab for Late-Stage Head and Neck Cancer

Source: The Oncology Report The Food and Drug Administration on Nov. 7 approved cetuximab as an initial treatment of late-stage head and neck cancer in combination with chemotherapy. Cetuximab, marketed as Erbitux by Bristol-Myers Squibb, is an epidermal growth factor receptor (EGFR) antagonist, administered as an intravenous infusion. Previously, it was approved in combination with radiation therapy for the initial treatment of locally or regionally advanced squamous cell carcinoma. It was also approved for use alone in patients with recurrent locoregional disease or metastatic disease whose disease has progressed following platinum-based chemotherapy. The newly approved indication is for the treatment of these recurrent or metastatic patients as an initial therapy in combination with platinum-based therapy with 5-fluorouracil (5-FU), a BMS spokesperson said. (At press time, the company had not yet issued a statement on the approval.) Erbitux was initially approved in 2004 to treat EGFR-positive late-stage colon cancer after patients stopped responding to chemotherapy and was approved in 2006 for the treatment of head and neck cancer. The newly approved indication is for "recurrent locoregional disease or metastatic squamous cell carcinoma of the head and neck in combination with platinum-based therapy with 5-FU," according to the revised label, posted on the FDA Web site. The two previously approved indications for head and neck cancer were for "locally or regionally advanced squamous cell carcinoma of the head and neck in combination with radiation therapy," and for "recurrent or metastatic squamous cell carcinoma of the head and neck progressing after platinum-based therapy. [...]

Oral Cancer Foundation News Team - A2011-11-09T11:05:16-07:00November, 2011|Oral Cancer News|