head and neck cancer – Page 17

Tea, coffee and oral cancer risk

Source: Nature.com-Evidence Based Dentistry Question: Is there a relationship between coffee and tea intake and head and neck cancers? Data sources Pooled individual-level data from nine case–control studies of head and neck cancers, including 5,139 cases and 9,028 controls. Study selection Nine case-control studies were selected from the International Head and Neck Cancer Epidemiology (INHANCE) consortium pool of 33 studies, which included information on coffee (caffeinated and decaffeinated) and tea drinking and cancer of the oral cavity and pharynx. Seven studies also included information on laryngeal cancer. Data extraction and synthesis Data from individual studies were checked for inconsistencies and pooled in a standardised way into a common database, including a range of sociodemographic, behavioural, lifestyle and health information. Data on consumption across studies were then converted into cups of de/caffeinated tea or coffee per day. The association between head and neck cancers and caffeinated coffee, decaffeinated coffee or tea intake was assessed by estimating the odds ratios (OR) and the corresponding 95% confidence intervals (95% CI) using a two-stage random-effects logistic regression model with the maximum likelihood estimator. Pooled ORs were also estimated with a fixed-effects logistic regression model. In addition, a test for heterogeneity among studies was conducted. Results Caffeinated coffee intake was inversely associated with the risk of cancer of the oral cavity and pharynx: the ORs were 0.96 (95% CI, 0.94–0.98) for an increment of one cup per day and 0.61 (95% CI, 0.47–0.80) in drinkers of >4 cups per day versus non-drinkers. This latter estimate [...]

Oral Cancer Foundation News Team - A2011-03-29T10:00:32-07:00March, 2011|Oral Cancer News|

Reirradiation for head-and-neck cancer: delicate balance between effectiveness and toxicity

Source: HighWire- Stanford University PURPOSE: To analyze the effectiveness and toxicity of reirradiation (re-RT) for head-and-neck cancer. METHODS AND MATERIALS: A retrospective data analysis was performed of 58 patients who underwent re-RT with curative intent. Re-RT was given as definitive treatment in 53% of patients, whereas salvage surgery preceded reirradiation in 47%. The median cumulative RT dose was 119 Gy (range, 76-140). Concurrent chemotherapy was administered with re-RT (CRT) in 57% of patients. Event-free survival was defined as survival without recurrence and without serious toxicity (?Grade 3). RESULTS: Median follow-up was 57 months (range, 9-140). Locoregional (LR) control was 50% at 2 and 5 years. The 2-year and 5-year overall survival (OS) was 42% and 34%. The following factors were associated with improved OS: postoperative re-RT (vs. primary re-RT), treatment with RT only (vs. CRT) and interval >3 years between previous RT and re-RT. For patients treated with postoperative re-RT and definitive re-RT, the 5-year OS was 49% and 20%, respectively. Patients treated with CRT had a 5-year OS of 13%. Serious (late) toxicity ?Grade 3 was observed in 20 of 47 evaluable patients (43%). Three cases of treatment-related death were recorded. The 2- and 5-year serious toxicity-free interval was 59% and 55%, respectively. Associated with increased risk of serious toxicity were CRT and higher re-RT dose. The event-free survival rates at 2 and 5 years were 34% and 31%, respectively. CONCLUSIONS: Re-RT in head-and-neck cancer is associated with poor survival rates of 13-20% in patients with inoperable disease treated [...]

Oral Cancer Foundation News Team - A2011-03-12T11:28:37-07:00March, 2011|Oral Cancer News|

New-generation radiation treatment, a first-line therapy for patients with large head and neck tumours

Source: Medical News Today Biologically targeted BNCT treatment is based on producing radiation inside a tumour using boron-10 and thermal neutrons. Boron-10 is introduced into cancer cells with the help of a special carrier substance (phenylalanine), after which the tumour is irradiated with lowenergy neutrons. The latter react with the boron to generate high-LET radiation, which may destroy the cancer cells. One to two BNCT treatment sessions may be sufficient to destroy a tumour, while keeping the impact of radiation on surrounding healthy tissue to a minimum. A research reactor is currently used as the neutron source, but dedicated neutron accelerators being designed for BNCT. Clinical trials to assess the efficacy and safety of BNCT in the treatment of locally recurrent head and neck cancer have been carried out at the Department of Oncology at Helsinki University Central Hospital (HUCH). OCF Apart from palliative chemotherapy, conventional treatment was no longer considered possible for the patients treated in the BNCT trials. A total of 30 patients referred to HUCH's Department of Oncology from hospitals around Finland took part in the trial. 76% of patients responded well to the treatment and 30% were still alive two years after treatment; although only one patient has survived 55 months. The results of the study, conducted by Professor Heikki Joensuu, have recently been published in the International Journal of Radiation Oncology, Biology, Physics. BNCT treatment is provided by Boneca Corporation, which is based at the main campus of Helsinki University Central Hospital and is the [...]

Oral Cancer Foundation News Team - A2011-03-12T11:27:48-07:00March, 2011|Oral Cancer News|

Study IDs dysphagia risk after head/neck cancer treatment

Source: www.DrBicuspid.com February 28, 2011 -- A team of Danish researchers has developed a predictive model for determining which head and neck cancer patients are at risk of developing dysphagia (swallowing disfunction) following intensity-modulated radiotherapy (IMRT). Hanna Rahbek Mortensen, PhD, and colleagues presented results from a large prospective trial, the DAHANCA 6 & 7 study, at last week's International Conference on Innovative Approaches in Head and Neck Oncology in Barcelona, Spain. "We followed 1,476 patients with squamous cell carcinoma of the head and neck, and found out the existence of factors related to the cancer itself, to the patient and to the treatment influencing the development of dysphagia," Mortensen said in a press release. Dysphagia may be acute or late. Risk factors for developing severe acute dysphagia were large tumors, spreading of cancer cells to the lymph nodes, swallowing problems at the time of diagnosis, six treatments per week, and tumor location other than the vocal cords, the researchers noted. Risk factors for developing late dysphagia were large tumors, swallowing problems at the time of diagnosis, and tumor location other than the vocal cords. Although 83% of all head and neck cancer patients develop some kind of dysphagia, this predictive model will have a major impact on patient quality of life, the researchers noted. "These results are very important," said Dr. J.A. Langendijk from the University Medical Center of Groningen. "Today, with the increasing use of IMRT, the dose to the salivary glands is reduced, resulting in lower risks on xerostomia. [...]

Oral Cancer Foundation News Team - A2011-02-28T16:49:12-07:00February, 2011|Oral Cancer News|

Reirradiation with intensity-modulated radiotherapy in recurrent head and neck cancer.

Source: HighWire- Stanford University In this retrospective investigation we analyzed outcome and toxicity after intensity-modulated reirradiation of recurrent head and neck cancer. METHODS: Thirty-eight patients with local recurrent head and neck cancer were evaluated. The median dose of initial radiotherapy was 61 Gy. Reirradiation was carried out with step-and-shoot intensity-modulated radiotherapy (median dose: 49 Gy). RESULTS: Median overall survival was 17 months, and the 1- and 2-year overall survival rates were 63% and 34%. The 1- and 2-year local control rates were 57% and 53%. Distant spread occurred in 34%, and reirradiation induced considerable late toxicity in 21% of the patients. Thirty-two percent showed increased xerostomia after reirradiation. The risk for xerostomia was significantly higher for cumulative mean doses of ?45 Gy to parotid glands. Considering median cumulative maximum doses of 53 Gy to the spinal cord and 63 Gy to the brainstem, no late toxicities were observed. CONCLUSIONS: Reirradiation with intensity-modulated radiotherapy in recurrent head and neck cancer is feasible with acceptable toxicity and yields encouraging rates of local control and overall survival. � 2011 Wiley Periodicals, Inc. Head Neck, 2011.

Oral Cancer Foundation News Team - A2011-02-09T11:45:36-07:00February, 2011|Oral Cancer News|

Reducing xerostomia through advanced technology

Source: The Lancet Oncology Radiation-related xerostomia has been the most significant and disabling side-effect of radiotherapy for head and neck cancer for more than 50 years. With the PARSPORT trial, reported in The Lancet Oncology, the largest and best designed of several randomised trials focusing on xerostomia, radiation oncologists and their partners in physics and dosimetry should take pride that significant progress has been made. Before the introduction of intensity-modulated radiotherapy (IMRT), more than 80% of survivors experienced substantial dry mouth syndrome and associated effects on dental health, swallowing, taste, and quality of life. By contrast, Nutting and colleagues report about 25% of 2-year survivors had significant clinician-rated xerostomia. Taken together with two randomised trials of IMRT for nasopharyngeal cancer, there is now compelling evidence of the power of advanced technology in reducing toxicity from head and neck radiotherapy. Can even better use of technology help us to further reduce xerostomia? The parotid glands provide watery saliva during eating, which is largely replaceable by consuming more water or lubricants. The submandibular, sublingual, and minor salivary glands provide mucinous saliva, associated with the resting sense of moisture and dry mouth symptoms. Future work should systematically explore the prioritisation of different components of the salivary gland system. A clinical benefit from sparing the submandibular glands may be seen, beyond that seen by sparing the parotid glands. The mean dose delivered to the minor salivary glands within the oral cavity has also been reported to be a significant factor in patient-reported xerostomia. Further possibilities include gland repair [...]

Oral Cancer Foundation News Team - A2011-01-31T14:08:42-07:00January, 2011|Oral Cancer News|

Parotid-sparing intensity modulated versus conventional radiotherapy in head and neck cancer (PARSPORT): a phase 3 multicentre randomised controlled trial

The Lancet Oncology, Early Online Publication, 13 January 2011 Dr Christopher M Nutting FRCR a b , James P Morden MSc b, Kevin J Harrington FRCR a b, Teresa Guerrero Urbano PhD c, Shreerang A Bhide FRCR a, Catharine Clark PhD d, Elizabeth A Miles MPhil e, Aisha B Miah FRCR a, Kate Newbold FRCR a, MaryAnne Tanay MSc a, Fawzi Adab FRCR f, Sarah J Jefferies FRCR g, Christopher Scrase FRCR h, Beng K Yap FRCR i, Roger P A'Hern MSc b, Mark A Sydenham BSc b, Marie Emson BSc b, Emma Hall PhD b, on behalf of the PARSPORT trial management group† Summary Background Xerostomia is the most common late side-effect of radiotherapy to the head and neck. Compared with conventional radiotherapy, intensity-modulated radiotherapy (IMRT) can reduce irradiation of the parotid glands. We assessed the hypothesis that parotid-sparing IMRT reduces the incidence of severe xerostomia. Methods We undertook a randomised controlled trial between Jan 21, 2003, and Dec 7, 2007, that compared conventional radiotherapy (control) with parotid-sparing IMRT. We randomly assigned patients with histologically confirmed pharyngeal squamous-cell carcinoma (T1—4, N0—3, M0) at six UK radiotherapy centres between the two radiotherapy techniques (1:1 ratio). A dose of 60 or 65 Gy was prescribed in 30 daily fractions given Monday to Friday. Treatment was not masked. Randomization was by computer-generated permuted blocks and was stratified by centre and tumor site. Our primary endpoint was the proportion of patients with grade 2 or worse xerostomia at 12 months, as assessed by [...]

Oral Cancer Foundation News Team - A2011-01-17T11:52:14-07:00January, 2011|Oral Cancer News|

Cost of living and the late effects after cancer treatments

Source: Cure Today Author: Kathy Latour Cancer patients are living longer, but if radiation was part of their treatment, late effects may be a problem. Sam LaMonte, MD, knew he had cancer as soon as he touched the lump in his neck. It was 1991, and LaMonte, a head and neck surgeon in Pensacola, Florida, had just stepped down as the president of the Florida division of the American Cancer Society (ACS). “I told my partners I thought it was cancer, and they were in complete denial,” he recalls. “I wasn’t, because I had been feeling cancer in people’s necks my whole life.” LaMonte was right. A biopsy revealed cancer; the primary site was found at the base of his tongue. The diagnosis: stage 3 squamous cell head and neck cancer. The treatment: radiation twice a day for eight weeks. LaMonte, 50, resumed his career three months after he finished treatment. He picked up where he left off with the ACS, joining the national board and becoming the ACS poster boy for survivor issues even after he retired in 2002. Then in 2004, his doctor discovered from an X-ray that LaMonte’s left carotid artery was 100 percent blocked, and the right was 60 percent blocked. The damage, his doctor said, was the result of radiation that had saved his life 15 years earlier. LaMonte was a stroke waiting to happen. He had never had a symptom. “I was dumb as a door,” LaMonte says in retrospect. “So was my radiation oncologist [...]

Charlotte Parker2011-01-07T11:39:07-07:00January, 2011|Oral Cancer News|

Prereferral Head and Neck Cancer Treatment

Source: Archives of Otolaryngology- Head and Neck Surgery Objective To evaluate the prereferral treatment of patients referred to our tertiary care center with recurrent or persistent head and neck cancer for compliance with National Comprehensive Cancer Network (NCCN) guidelines. Design A prospective recruitment and retrospective chart review. Patients The study included new patients identified at multidisciplinary treatment planning conference from October 1, 2008, to February 1, 2009, who had received prior treatment at an outside institution and presented to our department with recurrent or persistent disease. Main Outcome Measures All facets of prior care were examined, including the time from initial symptoms to diagnosis and whether their prereferral treatment was compliant with or deviated from NCCN guidelines for head and neck cancer. Results A total of 566 consecutive new patients were identified, of whom 107 (18.9%) had persistent or recurrent disease. The average time from first presentation with initial symptoms to diagnosis among patients who presented with persistent disease was 23.8 weeks. Nearly half of the patients who presented with persistent or recurrent disease had either endocrine (21.5%) or cutaneous (24.2%) primary cancers, with the rest of the cases being distributed among 10 other sites. Of the patients who presented with recurrent or persistent disease, 43.0% had prereferral care that was noncompliant with NCCN guidelines. Of these patients, 58.7% had inadequate surgical management, 15.2% were treated for the wrong diagnosis, 10.9% received inadequate adjuvant therapy, 4.4% received inadequate radiotherapy, and 10.9% refused indicated recommended treatment. Conclusions Significant deviation from NCCN [...]

Oral Cancer Foundation News Team - A2010-12-22T11:28:19-07:00December, 2010|Oral Cancer News|

Predicting the Prognosis of Oral Squamous Cell Carcinoma After First Recurrence

Source: Archives of Otolaryngology- Head and Neck Surgery Objectives To describe the clinicopathologic features of oral squamous cell carcinoma in patients who develop locoregional recurrence of disease, to identify factors that predict prognosis in the subset of patients treated with salvage surgery, and to determine the adjusted effect of time to recurrence. Design Cohort study. Setting A head and neck cancer institute in Sydney, New South Wales, Australia. Patients A total of 77 patients who underwent salvage surgery for oral squamous cell carcinoma that had been treated initially by surgery, radiotherapy, or surgery with postoperative radiotherapy. Main Outcome Measures Univariable and multivariable analysis of clinical and pathologic risk factors. Results Median time to recurrence from initial treatment was 7.5 months (range, 0.9-143.9 mo), with 86% of recurrences occurring within the first 24 months. Surgical salvage was attempted in 77 patients who had experienced recurrence at the primary site (n = 39), ipsilateral neck (n = 27), and contralateral neck (n = 11). Time to recurrence, initial treatment modality, and site of failure were independent prognostic variables. Conclusions The relationship of these prognostic variables displays a dynamic interaction. Initial combined-modality treatment and shorter time to recurrence were associated with worse outcome, while the effect of site of recurrence (local vs regional) was dependent on an interaction with the time to recurrence. The result of this interaction was that local recurrence was worse for those who experienced it early (eg, <6 mo after the initial treatment) and nodal recurrence was worse for those who experienced it late (eg, [...]

Oral Cancer Foundation News Team - A2010-12-22T11:11:20-07:00December, 2010|Oral Cancer News|