radiotherapy – Page 13 – Oral Cancer News

Analysis of prognostic factors in patients with oropharyngeal squamous cell carcinoma treated with radiotherapy alone or in combination with systemic chemotherapy

Source: Arch Otolaryngol Head Neck Surg. 2008;134(11):1196-1204 Authors: Paola A. G. Pedruzzi, MD et al. Objective: To assess the prognostic significance of several factors in oropharyngeal squamous cell carcinoma treated with radiotherapy alone or in combination with chemotherapy. Design: Retrospective study. Setting: Erasto Gaertner Hospital, Curitiba, Brazil, and A. C. Camargo Hospital, São Paulo, Brazil. Patients: A total of 361 patients treated for squamous cell carcinoma from January 1, 1990, to December 31, 2001. Interventions: Radiotherapy alone or with chemotherapy. Main Outcome Measures: Disease-free survival, overall survival, and treatment response. Results: Most tumors were located at the tonsil (46.8%) or base of the tongue (28.0%) and were at clinical stage III or IV (92.8%). Treatment response was associated with Zubrod scale score, weight loss, number of comorbidities, symptom-severity and Piccirillo stages, hemoglobin level, tumor site, macroscopic appearance of the tumor, and clinical stage. The 5-year overall survival rate was 17.6% and disease-free survival rate was 16.2%. The significant prognostic variables were age; Zubrod scale score; weight loss; comorbidities; Berg, Piccirillo, and symptom-severity staging; involvement of adjacent soft-tissue areas and bone; lymph node mobility; clinical stage; and radiotherapy doses. The multivariate analysis showed Zubrod scale score, symptom-severity staging system, Berg staging system, comorbidities, and radiotherapy dose as independent prognostic factors. Conclusion: A combination of clinical factors, such as symptoms, patients' general status, weight loss, and comorbidities, leads to a relevant stage of clinical severity that can be associated with the TNM stage as predictors of survival in oropharyngeal carcinoma. Authors: Paola [...]

Oral Cancer Foundation News Team - A2008-11-18T03:43:52-07:00November, 2008|Oral Cancer News|

High rate of severe radiation dermatitis during radiation therapy with concurrent cetuximab in head and neck cancer: Results of a survey in EORTC institutes

Source: Radiother Oncol, October 30, 2008 Author: Christian Giro et al. Objective: Examination of the rate of grade III or grade IV radiation dermatitis during treatment of head and neck cancer (HNC) with radiotherapy (RT) and concurrent cetuximab in EORTC centres. Materials and Method: A questionnaire was sent to all members of the EORTC Radiation Oncology Group and Head and Neck Group (111 institutions) to evaluate the widespread use of cetuximab and radiotherapy in HNC and to estimate the frequency of grades III and IV skin reactions in the radiation portals associated with this protocol. Co-morbidities, RT schedules and co-medications were also recorded. Results: We received responses from 28 institutions in 11 countries. A total of 125 HNC patients from 15 institutions were treated with cetuximab and concurrent RT. Information about the skin reactions was available from 71 patients. Of these 36 had no grade III/IV adverse effects in the RT field, 15 had a grade III and 20 had grade IV radiation dermatitis. No detectable relation of grades III and IV radiation dermatitis with co-morbidities such as liver insufficiency or renal dysfunction was found. Conclusion: According to the results of the questionnaire, grade III/IV radiation dermatitis is observed in 49% of HNC patients treated with cetuximab and concurrent RT. A systematic clinical monitoring of cutaneous side effects during RT plus cetuximab is advised to ensure the safety of this protocol. Authors: Christian Giro, Bernhard Berger, Edwin Bolke, I Frank Ciernik, Frederic Duprez, Laura Locati, Sophie Maillard, Mahmut Ozsahin, Raphael [...]

Oral Cancer Foundation News Team - A2008-11-16T11:29:22-07:00November, 2008|Oral Cancer News|

Cerebrovascular disease risk in older head and neck cancer patients after radiotherapy

Source: Journal of Clinical Oncology, Vol 26, No 31 (November 1), 2008: pp. 5119-5125 Authors: Grace L. Smith et al. Purpose: Cerebrovascular disease is common in head and neck cancer patients, but it is unknown whether radiotherapy increases the cerebrovascular disease risk in this population. Patients and Methods: We identified 6,862 patients (age > 65 years) from the Surveillance, Epidemiology, and End Results (SEER) –Medicare cohort diagnosed with nonmetastatic head and neck cancer between 1992 and 2002. Using proportional hazards regression, we compared risk of cerebrovascular events (stroke, carotid revascularization, or stroke death) after treatment with radiotherapy alone, surgery plus radiotherapy, or surgery alone. To further validate whether treatment groups had equivalent baseline risk of vascular disease, we compared the risks of developing a control diagnosis, cardiac events (myocardial infarction, percutaneous coronary intervention, coronary artery bypass graft, or cardiac death). Unlike cerebrovascular risk, no difference in cardiac risk was hypothesized. Results: Mean age was 76 ± 7 years. Ten-year incidence of cerebrovascular events was 34% in patients treated with radiotherapy alone compared with 25% in patients treated with surgery plus radiotherapy and 26% in patients treated with surgery alone (P

Oral Cancer Foundation News Team - A2008-10-31T07:46:40-07:00October, 2008|Oral Cancer News|

Do we need more intense radiotherapy in locally advanced head and neck cancers? Results from a large randomized trial from the GORTEC

Source: www.medicalnewstoday.com Author: staff The objective of the trial was to test new therapeutic approaches in patients with locally advanced head and neck carcinomas. These cancers are generally treated with conventional radiotherapy (RT), con¬comitant with chemotherapy (CT), which is a well accepted standard therapeutic approach. The main question was whether giving more intense RT using a marked acceleration of RT was able to increase the tumour control? For this purpose, 3 regimens were compared in a large randomised trial including 840 patients with locally advanced head and neck carcinoma. The first was a very intense, accelerated RT without CT (very intense RT), the second was a combination of accelerated RT + CT (intense-RT + CT) and the last regimen was a combination of conventional RT + CT (Classical RT +CT). The distribution of the main characteristics of the patients and tumours was well balanced between the 3 treatments arms. The tolerance of the 3 different regimens was relatively close, although a trend was observed in favour of classical RT + CT. With a median follow-up of 4.6 years, no significant difference was seen between the 2 RT-CT arms in survival, tumour control and survival without disease progression. On the other hand the very intense RT was inferior to classical RT + CT in terms of survival without cancer progression. This study was the first to test whether a more intense RT can improve the outcome of patients with head and neck carcinoma, when the patients are treated with concomitant RT-CT. [...]

Oral Cancer Foundation News Team - A2008-09-28T21:29:33-07:00September, 2008|Oral Cancer News|

Seven patients affected by Royal Adelaide Hospital mistake

Source: The Independent Weekly (www.independentweekly.com.au) Author: staff Seven cancer patients may have suffered due to errors with their treatment at the Royal Adelaide Hospital, a review has found. Tabling the details in the South Australian parliament today, Health Minister John Hill said the impact on the individuals concerned was considered small but real. "The consulting oncologist will be contacting these patients to ensure they continue to have ongoing checks on their future health, though the patients will not require additional treatment," Mr Hill said. Earlier this year it was revealed more than 800 patients received incorrect radiation treatments at the RAH after one of its four linear accelerators was found to be delivering a dose five per cent below the recommended level between 2004 and 2006. The government ordered a review of all treatments on the machine during that period, bringing in a cancer expert from interstate. That review found most of the patients concerned had not been affected by the error. But it found there was the possibility of a reduced survival rate for five patients suffering from high-grade brain tumours. It also revealed a head and neck cancer patient had their care compromised by two per cent and required future monitoring and ordered future monitoring for a prostate cancer patient who received radiotherapy as the only treatment for the condition. SA Health chief executive Tony Sherbon said that while the review found the majority of patients did not have their treatments compromised, some would suffer psychological distress. "Some [...]

Oral Cancer Foundation News Team - A2008-09-10T07:11:56-07:00September, 2008|Oral Cancer News|

Radiation treatment breaks and ulcerative mucositis in head and neck cancer

Source: The Oncologist, Vol. 13, No. 8, 886-898, August 2008 Authors: Gregory Russo et al. Unplanned radiation treatment breaks and prolongation of the radiation treatment time are associated with lower survival and locoregional control rates when radiotherapy or concurrent chemoradiotherapy is used in the curative treatment of head and neck cancer. Treatment of head and neck cancer is intense, involving high-dose, continuous radiotherapy, and often adding chemotherapy to radiotherapy. As the intensity of treatment regimens has escalated in recent years, clinical outcomes generally have improved. However, more intensive therapy also increases the incidence of treatment-related toxicities, particularly those impacting the mucosal lining of the oral cavity, pharynx, and cervical esophagus, and results in varying degrees of ulcerative mucositis. Ulcerative mucositis is a root cause of unscheduled radiation treatment breaks, which prolongs the total radiation treatment time. Alterations in radiotherapy and chemotherapy, including the use of continuous (i.e., 7 days/week) radiotherapy to ensure constant negative proliferative pressure, may improve efficacy outcomes. However, these approaches also increase the incidence of ulcerative mucositis, thereby increasing the incidence of unplanned radiation treatment breaks. Conversely, the reduction of ulcerative mucositis to minimize unplanned breaks in radiotherapy may enhance not only tolerability, but also efficacy outcomes. Several strategies to prevent ulcerative mucositis in radiotherapy for head and neck cancer have been evaluated, but none have demonstrated strong efficacy. Continued investigation is needed to identify superior radiation treatment regimens, technology, and supportive care that reduce unplanned radiation treatment breaks with the goal of improving clinical outcomes in [...]

Oral Cancer Foundation News Team - A2008-09-01T09:36:49-07:00September, 2008|Oral Cancer News|