head and neck cancer – Page 19

Simulation of scattering dffects of irradiation on surroundings using the example of titanium dental implants: a Monte Carlo approach

Source: International Journal of Cancer Research and Treatment Authors: REINHARD E. FRIEDRICH1, MANUEL TODROVIC2 and ANDREAS KRÜLL2 Correspondence to: Professor R.E. Friedrich, Oral and Maxillofacial Surgery, Eppendorf Medical Center, University of Hamburg, Martinist. 52, D-20246 Hamburg, Germany. Tel: +49 40428033259, Fax: +49 428038120, email:[email protected] Abstract Occasionally, head and neck cancer patients treated with high-energy X-rays and gamma rays have titanium dental implants. The aim of this study was to calculate alterations in the irradiated bone caused by a foreign body, representing a titanium implant in size and physical qualities, using a stochastic (Monte Carlo) simulation. A clinical linear accelerator was simulated using BEAM/EGS4. The calculations showed that the presence of an implant results in differences of the dose distribution all around the implant. Titanium dental implants in the field of irradiation were capable of causing significant radiation scattering. The risk for dose enhancement was notably important for the bone in direct contact with the foreign body. Therapists involved in radiation planning should consider the impact of dental implants on the radiation beam as a putative cause of osteoradionecrosis.

Charlotte Parker2010-07-01T14:56:38-07:00July, 2010|Oral Cancer News|

New strategies in head and neck cancer: understanding resistance to epidermal growth factor receptor inhibitors

Source: HighWire Author: Staff The epidermal growth factor receptor (EGFR) is a validated target in squamous cell carcinoma of the head and neck (HNSCC). However, despite high expression of EGFR in these cancers, EGFR inhibitor monotherapy has only had modest activity. Potential mechanisms of resistance to EGFR-targeted therapies involve EGFR and Ras mutations, epithelial-mesenchymal transition, and activation of alternative and downstream pathways. Strategies to optimize EGFR-targeted therapy in head and neck cancer involve not only the selection for patients most likely to benefit but also the use of combination therapies to target the network of pathways involved in tumor growth, invasion, angiogenesis, and metastasis.

Charlotte Parker2010-06-30T13:03:30-07:00June, 2010|Oral Cancer News|

Molecular targeted therapies in head and neck cancer – An update of recent developements

Source: HighWire Author: Staff ABSTRACT: Targeted therapies have made their way into clinical practice during the past decade. They have caused a major impact on the survival of cancer patients in many areas of clinical oncology and hematology. Indeed, in some hematologic malignancies, such as chronic myelogenous leukemia or non-Hodgkin's lymphomas, biologicals and antibodies specifically designed to target tumour-specific proteins have revolutionized treatment standards. In solid tumours, new drugs targeting EGF- or VEGF- receptors are now approved and are entering clinical practise for treatment of colon, lung, kidney and other cancers, either alone or in combination with conventional treatment approaches.Recent data have now shown that molecular targeted therapy might display efficacy in patients with head and neck squamous cell carcinoma (HNSCC) as well. The evaluated biologicals are generally well tolerated from HNSCC patients, who usually have the burden of multiple co-morbidities that interfere with conventional systemic treatment options. Therefore, molecular targeted therapies offer new treatment options even for heavily pretreated and seriously ill patients usually unable to tolerate chemotherapy or radiation therapy.The two most promising and advanced strategies are the blockage of growth-factor based cellular signalling and interference with angiogenesis-related pathways. But inhibitors of alternative targets, such as Scr and proteasomes, have already been evaluated in early clinical trials with HNSCC patients.

Charlotte Parker2010-06-30T13:02:15-07:00June, 2010|Oral Cancer News|

Human papillomavirus-active head and neck cancer and ethnic health disparities

Source: Medical College of Georgia Authors: PM Weinberger, MA Merkley, SS Khichi, JR Lee, A Psyrri, LL Jackson, and WS Dynan OBJECTIVES/HYPOTHESIS: Mortality for black males with head and neck squamous cell carcinoma (HNSCC) is twice that of white males or females. Human papillomavirus (HPV)-active HNSCC, defined by the concurrent presence of high-risk type HPV DNA and host cell p16(INK4a) expression, is associated with decreased mortality. We hypothesized that prevalence of this HPV-active disease class would be lower in black HNSCC patients compared to white patients. STUDY DESIGN:: Multi-institutional retrospective cohort analysis. METHODS:: Real-time polymerase chain reaction was used to evaluate for high-risk HPV DNA presence. Immunohistochemistry for p16(INK4a) protein was used as a surrogate marker for HPV oncoprotein activity. Patients were classified as HPV-negative (HPV DNA-negative, p16(INK4a) low), HPV-inactive (HPV DNA-positive, p16(INK4a) low), and HPV-active (HPV DNA-positive, p16(INK4a) high). Overall survival and recurrence rates were compared by Fisher exact test and Kaplan-Meier analysis. RESULTS:: There were 140 patients with HNSCC who met inclusion criteria. Self-reported ethnicity was white (115), black (25), and other (0). Amplifiable DNA was recovered from 102/140 patients. The presence of HPV DNA and the level of p16(INK4a) expression were determined, and the results were used to classify these patients as HPV-negative (44), HPV-inactive (33), and HPV-active (25). Patients with HPV-active HNSCC had improved overall 5-year survival (59.7%) compared to HPV-negative and HPV-inactive patients (16.9%) (P = .003). Black patients were less likely to have HPV-active disease (0%) compared to white patients (21%) (P = .017). [...]

Charlotte Parker2010-06-23T11:16:51-07:00June, 2010|Oral Cancer News|

Nashville hygienists partner with Oral Cancer Foundation to raise awareness of a silent killer

Source: The Oral Cancer Foundation Author: Staff Locals join together for second annual Oral Cancer walk and free screening event NEWPORT BEACH, Calif., June 10 /PRNewswire-USNewswire/ -- For the second year, the Nashville Area Dental Hygienists Society (NADHS) has organized a successful walk to promote oral cancer awareness for a disease that affects so many, yet so few know about. Hundreds of Nashville locals gathered for the "Boot Scootin' for Oral Cancer Screening II" event that recently took place at Nashville's Centennial Park to raise disease awareness, and funds for the Non-Profit Oral Cancer Foundation (OCF). The walk was lead by NADHS president Nicki Raines, who encouraged the organization to embrace the cause of oral cancer detection when she began her two-year presidential term. Her committee worked countless hours to ensure that the event would top last year's successful effort. Nicki's team was able to generate a local buzz for the walk through posters displayed at area Starbucks and Panera Bread stores, and via news releases sent to all local media. Local merchants rallied to support the event. Attendees were treated to coffee donated by Starbucks, water donated by Kroger's, and donuts donated by Krispy Kreme. Whole Foods, Trader Joe's, Wal-Mart and other Nashville area merchants came together to show their support by donating products for the auction and raffle that took place after the walk. Nashville superstars George Strait, Tim McGraw, Faith Hill and Brooks and Dunn were represented through autographed memorabilia, which brought their fans to the raffle. [...]

Charlotte Parker2010-06-14T19:59:10-07:00June, 2010|OCF In The News, Oral Cancer News|

New oral cancer data could prompt new treatments

Source: The Columbus Disbatch Author: Misti Crane Doctors are focusing increasingly on the role that human papilloma virus plays in oral cancer, and new research is prompting hope that treatments can be better tailored to patients. People with oral cancer have a better chance of surviving if the cancer is linked to HPV, according to a new study led by an Ohio State University researcher. Dr. Maura Gillison and her colleagues found that 82 percent of those with HPV-positive tumors in the back of their mouths survived at least three years, compared with 57percent of those with mouth tumors not tied to HPV. Their study included 323 oropharyngeal cancer patients. HPV, which is spread by sexual contact, is the virus that also causes cervical cancer. It can cause cancer of the mouth through oral sex. The research took into account other risk factors such as tobacco use. It was published online yesterday in the New England Journal of Medicine. This study should prompt more studies and advances in treatment, Gillison said. For example, it could be that patients with a better prognosis could have less radiation and suffer fewer side effects, she said. Side effects of treatment include trouble swallowing, dental problems, difficulty speaking and inflexibility in the neck. Gillison also presented new data yesterday at the American Society of Clinical Oncology meeting in Chicago. The data showed a worse outcome for smokers who have HPV-positive cancers than for patients with the same type of cancer who don't smoke. The risk [...]

Charlotte Parker2010-06-09T10:00:14-07:00June, 2010|OCF In The News, Oral Cancer News|

New report compares radiation approaches in head and neck cancer

Source: MedScape Today Author: Nick Mulcahy June 1, 2010 — Intensity-modulated radiation therapy (IMRT) for head and neck cancer leads to fewer cases of xerostomia, but has not yet been proven to be more successful than any other kind of radiation therapy in reducing tumors or improving survival, according to a new comparative-effectiveness review funded by the federal Agency for Healthcare Research and Quality (AHRQ). The review compares the effectiveness of 4 types of radiotherapy (IMRT, 3DCRT, 2DRT, and proton-beam therapy) in terms of tumor control, overall survival, adverse events, and quality-of-life issues. Many scientists consider IMRT to be theoretically better able to target cancerous cells while sparing healthy tissue than either 3DCRT or 2DRT, but more research is needed, the authors of the report point out. The report, entitled Comparative Effectiveness and Safety of Radiotherapy Treatments for Head and Neck Cancer, is authored by the Blue Cross and Blue Shield Association's Technology Evaluation Center Evidence-Based Practice Center. The late adverse effect of xerostomia, also known as dry mouth, is less common than in the past because the use of IMRT has allowed radiation oncologists to spare most patients' salivary glands from radiation as part of treatment planning, an expert recently told Medscape Oncology. Sparing salivary glands has become standard among clinicians who use IMRT, said Avraham Eisbruch, MD, professor of radiation oncology at the University of Michigan Medical School and Comprehensive Cancer Center in Ann Arbor. Dr. Eisbruch's comments came in the context of his study on the use of IMRT [...]

Charlotte Parker2010-06-04T16:26:20-07:00June, 2010|Oral Cancer News|

HPV-Positive head and neck cancer: favorable prognosis does not lead to clear choices for changes in treatments

Source: OncologyStat Author: Thomas F. Pajak CHANDLER, Ariz. (EGMN) - Human papillomavirus infection is clearly a prognostic factor in patients with head and neck cancer. But whether HPV status can be used to guide treatment decisions is far from clear, according to speakers at a head and neck cancer symposium sponsored by the American Society for Radiation Oncology. The Investigator's Perspective Across trials that tested different regimens in heterogeneous populations with head and neck cancer, patients with HPV-positive disease have had at least a one-half reduction in the risk of death, relative to their counterparts with HPV-negative disease, began Dr. Maura L. Gillison, a professor of medicine and epidemiology at Ohio State University in Columbus. "Clearly, HPV tumor status is prognostic," she said, citing multiple factors that might explain why HPV-positive patients have better survival outcomes. Certain attributes that track with HPV positivity - better performance status, younger age, lower T stage, and absence of anemia - are also favorable prognostic factors, she noted. And HPV positivity confers a better response to both radiation therapy and induction chemotherapy. In addition, data from the RTOG (Radiation Therapy Oncology Group) 0129 trial of chemoradiation show that HPV-positive patients are less likely than their HPV-negative peers to experience a locoregional failure and to develop second primaries, although rates of distant metastases are similar. "What we can conclude at this point is that the relative survival for the HPV-positive patient appears independent of therapy, as long as that therapy is within the standard of [...]

Charlotte Parker2010-04-19T22:22:16-07:00April, 2010|Oral Cancer News|

Small atypical cervical nodes detected on sonography in patients with squamous cell carcinoma of the head and neck

Source: Journal of Ultrasound in Medicine Author: Staff Probability of Metastasis Heung Cheol Kim, MD, Dae Young Yoon, MD, Suk Ki Chang, MD, Heon Han, MD, So Jung Oh, MD,Jin Hwan Kim, MD, Young-Soo Rho, MD, Hwoe Young Ahn, MD, Keon Ha Kim, MD andYoon Cheol Shin, MD Department of Radiology, Kangwon National University College of Medicine, Chuncheon, Korea (H.C.K., H.H.); Department of Radiology, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea (H.C.K.); Departments of Radiology (D.Y.Y., S.K.C.) and Otorhinolaryngology and Head and Neck Surgery (S.J.O., J.H.K., Y.-S.R., H.Y.A.), Ilsong Memorial Institute of Head and Neck Cancer, and Department of Thoracic Surgery (Y.C.S.), Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, Korea; and Department of Radiology, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea (K.H.K.). Address correspondence to Dae Young Yoon, MD, Department of Radiology, Ilsong Memorial Institute of Head and Neck Cancer, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, 445 Gil-dong, Kangdong-gu, Seoul 134-701, Korea. E-mail: [email protected] Objective. The purpose of this study was to assess the probability of metastasis of small atypical cervical lymph nodes detected on sonography in patients with squamous cell carcinoma (SCC) of the head and neck. Methods. We reviewed, retrospectively and blindly, sonographic findings of 148 patients (118 men and30 women; mean age, 58.2 years) who underwent curative neck dissection. Each lymph node was classified by using a 4-point scale: 1, definitely benign; 2, indeterminate (small [short-axis diameter <10 mm for levels I and II and <7 mm for levels III–VI] atypical node); 3, definitely metastatic; and [...]

Charlotte Parker2010-04-10T10:22:24-07:00April, 2010|Oral Cancer News|

Sharp rise in HPV-related oropharyngeal carcinoma — a legacy of the “sexual revolution”?

Source: MedScape Today Author: Zosia Chustecka March 30, 2010 — The incidence of oropharyngeal carcinoma related to human papillomavirus (HPV) has been increasing in recent years, and there is speculation that this is the result of the "sexual revolution" of the 1960s. This increase in the incidence of HPV-related oropharyngeal cancer has important public health implications, British experts warn in an editorial published online March 25 in the British Medical Journal. HPV-related oropharyngeal carcinoma appears to be a new and distinct disease entity, with better survival than the classic non-HPV-related disease, they point out. "These patients are typically younger and employed, and — because outcomes seem to be more favorable than for patients with non-HPV-related carcinoma — they will live longer with the functional and psychological sequelae of their treatment. Consequently, they need prolonged support from health, social, and other services, and may require help returning to work," write the authors, headed by Hisham Mehanna, BMedSc, MB ChB, FRCS, director of the Institute of Head and Neck Studies and Education at University Hospital in Coventry, United Kingdom. However, currently, there is no good evidence to support managing patients with HPV-related head and neck cancer differently from those whose tumors are not HPV-related, the researchers write. Several studies are being planned to evaluate different treatment options, and Dr. Mehanna and colleagues urge clinicians to offer all patients with oropharyngeal cancer the opportunity to enroll in a clinical trial. However, until data from those trials are available, "we suggest that clinicians should not change their [...]

Charlotte Parker2010-04-01T19:38:46-07:00April, 2010|Oral Cancer News|