radiotherapy – Page 7 – Oral Cancer News

Cisplatin Aids Survival of High-Risk Head and Neck Cancer

Source: Oncology Report Adding chemotherapy to radiotherapy improved 10-year survival of resectable head and neck carcinomas among high-risk patients who had microscopically involved resection margins and/or extracapsular spread of disease – but not in high-risk patients who only had tumor in multiple lymph nodes. The findings come from a long-term update and unplanned subset analysis of 410 evaluable patients from the RTOG (Radiation Therapy Oncology Group) 9501 phase III study, which previously showed no overall survival advantage from the addition of cisplatin chemotherapy to radiation. The new data are "good news," according to lead author Dr. Jay Cooper, director of Maimonides Cancer Center in Brooklyn, N.Y. "We now can eradicate some advanced head and neck tumors that we couldn’t before by adding chemotherapy to radiation therapy. At the same time, we can spare other patients who would not do better with the addition of chemotherapy from its side effects," he said at a head and neck cancer symposium sponsored by the American Society for Radiation Therapy. The RTOG 9501 study randomized 459 patients with high-risk, resected head and neck cancers to receive either radiation therapy of 60 Gy in 6 weeks (RT), or identical radiotherapy plus cisplatin at 100 mg/m2 IV on days 1, 22, and 43 (RT+CT). When reported at a median follow-up of 45.9 months, the locoregional control rate was significantly higher in the combined-therapy group than in the group given radiotherapy alone (hazard ratio for locoregional recurrence, 0.61); disease-free survival was significantly longer with combined therapy (HR [...]

Charlotte Parker2012-02-08T10:06:10-07:00February, 2012|Oral Cancer News|

Cisplatin aids survival of high-risk head and neck cancer

Source: www.oncologyreport.com Author: Miriam E. Tucker Adding chemotherapy to radiotherapy improved 10-year survival of resectable head and neck carcinomas among high-risk patients who had microscopically involved resection margins and/or extracapsular spread of disease – but not in high-risk patients who only had tumor in multiple lymph nodes. The findings come from a long-term update and unplanned subset analysis of 410 evaluable patients from the RTOG (Radiation Therapy Oncology Group) 9501 phase III study, which previously showed no overall survival advantage from the addition of cisplatin chemotherapy to radiation. The new data are "good news," according to lead author Dr. Jay Cooper, director of Maimonides Cancer Center in Brooklyn, N.Y. "We now can eradicate some advanced head and neck tumors that we couldn’t before by adding chemotherapy to radiation therapy. At the same time, we can spare other patients who would not do better with the addition of chemotherapy from its side effects," he said at a head and neck cancer symposium sponsored by the American Society for Radiation Therapy. The RTOG 9501 study randomized 459 patients with high-risk, resected head and neck cancers to receive either radiation therapy of 60 Gy in 6 weeks (RT), or identical radiotherapy plus cisplatin at 100 mg/m2 IV on days 1, 22, and 43 (RT+CT). When reported at a median follow-up of 45.9 months, the locoregional control rate was significantly higher in the combined-therapy group than in the group given radiotherapy alone (hazard ratio for locoregional recurrence, 0.61); disease-free survival was significantly longer with [...]

Oral Cancer Foundation News Team - A2012-02-03T19:44:50-07:00February, 2012|Oral Cancer News|

Implications of the Oropharyngeal Cancer Epidemic

Source: Journal of Clinical Oncology Chaturvedi et al,1 analyzing specimens back to 1984, validate the long-held hypothesis that infection with human papillomavirus (HPV) has increased oropharyngeal squamous cell carcinoma (OPSCC) incidence in the US. They find the incidence of OPSCC in men—who have higher risks of both HPV-positive and HPV-negative OPSCC than women—similar to that of cervical cancer in women. From 1988 to 2004, incidence of HPV-negative OPSCC decreased in parallel with smoking whereas incidence of HPV-positive OPSCC increased at about 7.5% per year, so the percentage of OPSCC that was HPV-positive went from less than 20% to more than 70%. HPV-positive and HPV-negative OPSCC are etiologically and clinically distinct,2,3 with HPV-positive disease having better outcome.4–6 In the current study,1 the hazard ratio of 0.3 for HPV-positive/HPV-negative in survival analysis essentially balances the difference in prevalence so each form of OPSCC now accounts for a similar number of deaths. Notably, the authors found that outcomes for HPV-positive OPSCC have improved over time, whereas outcomes for HPV-negative OPSCC are as dismal as they were 25 years ago. The authors argue convincingly that vaccination to prevent oral HPV infections should be evaluated and that better treatments for both types of OPSCC should be developed. We are unlikely to get a better picture of the recent history of OPSCC in the United States. This study used all available OPSCC specimens from the three Surveillance, Epidemiology, and End Results (SEER) registries that participate in the Residual Tissue Repositories Program, analyzed them in several ways, [...]

Oral Cancer Foundation News Team - A2011-11-09T15:24:59-07:00November, 2011|Oral Cancer News|

EU grants orphan drug status to BioAlliance Pharma’s clonidine Lauriad

Source: www.pharmabiz.com Author: staff European Commission has granted orphan drug designation to BioAlliance Pharma SA's clonidine Lauriad for prevention of radiotherapy-induced oral mucositis in patients with head and neck cancer. Oral mucositis is a very frequent inflammation of the oral mucosa in head and neck cancer patients treated with radio- and chemotherapy (98,000 new patients estimated per year in Europe). Severe oral mucositis occurs in 60% of these patients and may induce intense oral pain and eating disability requiring artificial nutritional support. In 20 to 30% of cases, patients have to be hospitalized and the disease may result in a modification or a stop of the radiotherapy treatment in more than 10% of them. Radiotherapy-induced oral mucositis has currently no preventive cure. In Europe, the orphan designation is granted for medicinal products in diseases affecting less than 5/10,000 patients. This status permits to benefit from incentives related to the clinical development, thus enabling a faster registration, and an extra protection with a 10- year commercial exclusivity after market authorization. “The European designation for clonidine Lauriad as an orphan drug is key in shortening its development timeline, optimizing costs and reinforcing its future market access. Clonidine Lauriad, currently in Phase II clinical trial, is the second product from our “Orphan Oncology Products” portfolio to be granted orphan status in Europe. The portfolio comprises assets with high commercial potential and will leverage our future growth”, stated COO, Judith Greciet. Dedicated to cancer and supportive care treatment with a focus on resistance targeting [...]

Oral Cancer Foundation News Team - A2011-11-06T10:14:20-07:00November, 2011|Oral Cancer News|

GP96 is over-expressed in oral cavity cancer and is a poor prognostic indicator for patients receiving radiotherapy

Source: http://7thspace.com Author: Chien-Yu Lin et al. Oral cavity cancers (ORC) are the most common cancers, and standard treatment is radical surgery with postoperative radiotherapy. However, locoregional failure remains a major problem, indicating radioresistance an important issue. Our previous work has shown that GP96 contributed to radioresistance in nasopharyngeal and oral cancer cell lines. In this study, we determined clinical significance of GP96 in ORC by evaluation of GP96 expression and its association with disease prognosis in patients receiving radiotherapy Methods: Total of 79 ORC patients (77 males, median age: 48 years old) receiving radical surgery and postoperative radiotherapy between Oct 1999 and Dec 2004 were enrolled. Patients in pathological stages II, III and IV were 16.5%, 16.5% and 67%, respectively. For each patient, a pair of carcinoma tissue and grossly adjacent normal mucosa was obtained. GP96-expression was examined by western blot analysis, and the association with clinicopathological status was determined. Results: Three-year locoregional control (LRC), distant metastasis-free survival (DMFS), disease-specific survival (DSS) and overall survival (OS) rates were 69%, 79%, 63% and 57%, respectively. We found that 55 patients (70%) displayed GP96-overexpression in the tumor tissue, which correlated with a higher pN stage (p=0.020) and tumor depth (>10 mm) (p=0.045). Nodal extracapsular spreading (ECS) and GP96-overexpression predicted adverse LRC (p=0.049 and p=0.008). When stratified by nodal ECS, the adverse impact of GP96 remained significant in three-year LRC (p=0.004). In multivariate analysis, GP96-overexpression was also an independent predictor of LRC, DSS and OS (p=0.018, p=0.011 and p=0.012). Conclusion: GP96 may [...]

Oral Cancer Foundation News Team - A2011-10-15T06:06:51-07:00October, 2011|Oral Cancer News|

Prevalence and Treatment Management of Oropharyngeal Candidiasis in Cancer Patients: Results of the French Candidoscope Study

Source: RedJournal.org Purpose The aim of this pharmaco-epidemiological study was to evaluate the prevalence of oropharyngeal candidiasis (OPC) in cancer patients treated with chemotherapy and/or radiotherapy. Methods and Materials Signs and symptoms of OPC were noted for all patients. Antifungal therapeutic management was recorded in OPC patients. Patients receiving local antifungal treatments were monitored until the end of treatment. Results Enrolled in the study were 2,042 patients with solid tumor and/or lymphoma treated with chemotherapy and/or another systemic cancer treatment and/or radiotherapy. The overall prevalence of OPC was 9.6% (95% confidence interval, 8.4%–11.0%] in this population. It was most frequent in patients treated with combined chemoradiotherapy (22.0%) or with more than two cytotoxic agents (16.9%). Local antifungal treatments were prescribed in 75.0% of OPC patients as recommended by guidelines. The compliance to treatment was higher in patients receiving once-daily miconazole mucoadhesive buccal tablet (MBT; 88.2%) than in those treated with several daily mouthwashes of amphotericin B (40%) or nystatin (18.8%). Conclusion OPC prevalence in treated cancer patients was high. Local treatments were usually prescribed as per guidelines. Compliance to local treatments was better with once-daily drugs. This news story was resourced by the Oral Cancer Foundation, and vetted for appropriateness and accuracy.

Oral Cancer Foundation News Team - A2011-09-20T10:51:07-07:00September, 2011|Oral Cancer News|

Palifermin Decreases Severe Oral Mucositis of Patients Undergoing Postoperative Radiochemotherapy for Head and Neck Cancer: A Randomized, Placebo-Controlled Trial

Source: OncologyStat.com TAKE-HOME MESSAGE This randomized, placebo-controlled trial found that weekly palifermin was associated with decreased incidence and duration of severe oral mucositis in patients undergoing postoperative chemoradiotherapy for head and neck cancer. SUMMARY OncologySTAT Editorial Team Combined chemoradiotherapy (CRT) offers improved outcomes after resection of locally advanced head and neck cancer but also increases the risk of oral mucositis, a debilitating and potentially dose-limiting toxicity of locoregional treatment. Palifermin, an analogue of keratinocyte growth factor, is FDA approved to prevent and treat mucositis in patients undergoing high-dose myelotoxic therapy for hematologic malignancies. In this multicenter, randomized, placebo-controlled trial, Henke et al evaluated whether palifermin reduces severe oral mucositis in patients undergoing CRT after surgical resection of locally advanced head and neck cancer. Adult patients receiving postoperative CRT for high-risk stage II to IVB head and neck squamous cell carcinoma and with an ECOG performance status of 0 to 2 were enrolled from 38 centers in Europe, Australia, and Canada. Eligible study patients were stratified by tumor location (oral cavity/oropharynx or hypopharynx/larynx) and residual tumor (R0 [complete resection] or R1 [incomplete resection]). Study patients received a radiation dose of 60 Gy (R0 group) or 66 Gy (R1 group) plus cisplatin 100 mg/m2 on days 1 and 22, with the study drug administered 3 days prior to starting CRT and then weekly for 6 weeks. Patients who underwent radiotherapy after 6 weeks received an additional 100 mg/m2 of cisplatin and study drug. Oral saline rinses, topical anesthetics, feeding tubes, and hematopoietic [...]

Oral Cancer Foundation News Team - A2011-09-20T10:21:43-07:00September, 2011|Oral Cancer News|

Fighting cancer with scorpions?

Source: www.foxnews.com Author: Chris Kilham In the fight against cancer, scientists and medical researchers around the world are developing new medicines from seemingly unlikely natural substances. Recent reported developments involve the use of a bacteria found in soil, a poison from a highly toxic scorpion, and the virus that causes herpes. All three demonstrate novel properties that may save lives in cases of otherwise hard to treat killer cancers. The use of bacteria for health and therapeutic purposes is in fact quite common. Various beneficial bacteria within the human digestive tract support digestion and elimination, help to detoxify the body, reduce the risk of some types of disease, and help to maintain overall health. These bacteria are widely available in supplements, and in various “live, active” yogurts. But ever since Edward Jenner developed the first vaccine (for cow pox) in 1796, bacteria have also played central roles in the development of vaccines against several diseases, including against tuberculosis, and even for plague, as in the case of Yersinia pestis. A team from North Carolina State University is developing an oral vaccine against deadly Anthrax poisoning, using Lactobacillus acidophilus, a common beneficial bacteria used to culture yogurt. Recent findings from Britain’s University of Nottingham show another ingenious use for bacteria, in the treatment of cancers. A team of scientists led by Professor Nigel Minton has reported that the bacteria Clostridium sporogenes a species widespread in nature, can be used as a vehicle to deliver anovel enzyme that activates a cancer drug [...]

Oral Cancer Foundation News Team - A2011-09-09T05:49:57-07:00September, 2011|Oral Cancer News|

Stroke and TIA risk doubled by radiotherapy, study finds

Source: www.imt.ie Author: Mary Anne Kenny The risk of transient ischaemic attack (TIA) or ischaemic stroke is at least doubled by head and neck radiotherapy, a problem increasing in urgency as patients survive their malignancies longer, an Australian review of the literature has concluded. Besides case reports, the reviewers found 77 studies of stroke, TIA or rates of carotid stenosis in patients who had received radiation therapy for primary or secondary cancers of the head or neck region. The 17 epidemiological studies revealed that the procedures appear to “at least double” the relative risk of TIA or stroke, with the exception of adjuvant neck radiotherapy for breast cancer where no association was found. Radiotherapy for breast cancer resulted in only the carotid artery only being minimally exposed to radiation, the authors reported in Stroke. The evidence for radiation vasculopathy (defined as chronic occlusive cerbrovascular disease affecting medium- and large-diameter arteries) was strongest where the exposure occurred in childhood, but the exact magnitude of the increase was unclear due to heterogeneity in the studies. Considering the 17 imaging studies, the reviewers found they repeatedly showed “an increased prevalence of haemodynamically significant carotid stenosis” when there was a history of head and neck radiotherapy. The most significant radiologic evidence implicating radiotherapy in TIA and stroke was the spatial distribution of the vascular disease itself, they said. “It signposts the [radiotherapy] field.” Two theories of the pathogenesis of radiation vasculopathy were presented in the literature, they said. One was that it was an [...]

Oral Cancer Foundation News Team - A2011-08-11T07:21:03-07:00August, 2011|Oral Cancer News|

Ischemic Stroke, Transient Ischemic Attack after Head & Neck Radiotherapy

Source: AHA Journals Author: Chris Plummer, PhD; Robert D. Henderson, PhD; John D. O'Sullivan, MD; Stephen J. Read, PhD Abstract Background and Purpose—Cerebrovascular disease can complicate head and neck radiotherapy and result in transient ischemic attack and ischemic stroke. Although the incidence of radiation vasculopathy is predicted to rise with improvements in median cancer survival, the pathogenesis, natural history, and management of the disease are ill defined. Methods—We examined studies on the epidemiology, imaging, pathogenesis, and management of medium- and large-artery intra- and extra-cranial disease after head and neck radiotherapy. Controlled prospective trials and larger retrospective trials from the last 30 years were prioritized. Results—The relative risk of transient ischemic attack or ischemic stroke is at least doubled by head and neck radiotherapy. Chronic radiation vasculopathy affecting medium and large intra- and extra-cranial arteries is characterized by increasing rates of hemodynamically significant stenosis with time from radiotherapy. Disease expression is the likely consequence of the combined radiation insult to the intima-media (accelerating atherosclerosis) and to the adventitia (injuring the vasa vasorum). Optimal medical treatment is not established. Carotid endarterectomy is confounded by the need to operate across scarred tissue planes, whereas carotid stenting procedures have resulted in high restenosis rates. Conclusions—Head and neck radiotherapy significantly increases the risk of transient ischemic attack and ischemic stroke. Evidence-based guidelines for the management of asymptomatic and symptomatic (medium- and large-artery) radiation vasculopathy are lacking. Long-term prospective studies remain a priority, as the incidence of the problem is anticipated to rise with improvements in [...]

Charlotte Parker2011-08-08T12:12:22-07:00August, 2011|Oral Cancer News|