survival – Page 6 – Oral Cancer News

Adjuvant radiotherapy helpful in early, node-positive oral cancer

Source: www.acr.org Author: David Douglas Postoperative radiotherapy significantly improves survival in patients with early T stage oral cavity squamous cell carcinoma and a single positive lymph node, researchers report in the March issue of Archives of Otolaryngology: Head and Neck Surgery. "Even for small primary tumors of the oral cavity, the presence of a single positive lymph node may be an indication to offer radiation despite the relatively early stage of these tumors," lead author Dr. Mark G. Shrime told Reuters Health by email. "This is especially true in T2 tumors of the tongue and the floor of mouth." Dr. Shrime of Boston University Medical Center and colleagues examined data on more than 1500 patients who had surgery between 1983 and 2004. Patients who had postoperative radiotherapy had significantly better 5-year overall survival (54.2% versus 41.4%). The largest advantage was in patients with T2 primary tumors (48.8% versus 32.5%). The difference in patients with T1 tumors (63.4% versus 56.5%) was not statistically significant. Also, the authors report, adjuvant radiotherapy was particularly effective in T2 tumors of the tongue (improving 5-year survival from 37.9% to 52.3%) and floor of the mouth (boosting survival from 17.7% to 39.9%). For all other sites, adjuvant radiotherapy was not associated with improved overall 5-year survival. The 5-year cause-specific survival rate was 64.3% in patients treated with surgery alone, versus 72.1% in patients who also had radiotherapy. While the results appear encouraging, the researchers call for "further analysis with either large multi-institutional series or more detailed [...]

Oral Cancer Foundation News Team - A2010-03-29T20:32:34-07:00March, 2010|Oral Cancer News|

Metabolic activity of head and neck cancer may help guide treatment

Source: www.oncologystat.com Author: Staff The metabolic activity of head and neck squamous cell carcinoma on pretreatment imaging independently predicts outcomes in patients who undergo intensity-modulated radiation therapy, new data show. This imaging information can be used to tailor treatment, especially to reduce the risk of distant metastases, lead investigator Dr. Min Yao said at a head and neck cancer symposium sponsored by the American Society for Radiation Oncology. Higher standardized uptake value (SUV) of the primary tumor and of the lymph nodes predicted worse outcomes in multivariate analyses presented by Dr. Yao, a radiation oncologist at the Case Western Reserve University, Cleveland. "Several papers have shown that the standardized uptake value (SUV) is a prognostic factor in head and neck cancer," Dr. Yao told attendees. Most of these studies were small series, involved patients receiving conventional radiation therapy, and did not evaluate SUV of the primary tumor and lymph nodes separately. Dr. Yao and his colleagues analyzed outcomes in 177 patients treated for head and neck squamous cell carcinoma with intensity-modulated radiation therapy (IMRT) between 1999 and 2006. The patients had a pretreatment positron emission tomography scan using fluorodeoxyglucose as the tracer (FDG-PET), and the maximal SUV was determined for both the primary tumor and the involved lymph nodes. The patients then underwent IMRT with curative intent. Seventy-seven percent of the patients were male. Twenty-nine percent were receiving IMRT postoperatively, whereas the rest were receiving it as definitive therapy. The cancer was most commonly located in the oropharynx (49%) and [...]

Oral Cancer Foundation News Team - A2010-03-18T08:51:12-07:00March, 2010|Oral Cancer News|

Oropharyngeal cancer, human papilloma virus, and clinical trials

Source: Journal of Clinical Oncology, Vol 28, No 1 (January 1), 2010: pp. 1-3 Author: Danny Rischin As advances in our understanding of the molecular biology of cancer have evolved in recent years, cancers that were once considered to be relatively homogeneous diseases are now being recognized as comprising distinct subtypes. These subtypes may differ in etiology, molecular profile, sensitivity to treatment, and prognosis. Examples include luminal (mainly estrogen receptor–positive), human epidermal growth factor receptor 2–positive, and basal breast cancer subtypes1; non–small-cell lung cancer associated with EGFR2 or EML4-ALK3 mutations; and melanoma associated with BRAF (V600E)4 or c-KIT mutations.5 In head and neck cancer, we have traditionally combined squamous cell carcinomas of the oral cavity, oropharynx, larynx, and hypopharynx in clinical trials. This has been justified on the basis of similar etiology (tobacco and alcohol) and similar sensitivity to radiotherapy and systemic therapy. However, it has also been recognized that there are differences in clinical behavior, treatment outcome, and prognosis with regard to primary site. Although surgery has remained the primary treatment for oral cavity cancers, organ preservation with primary chemoradiotherapy has been widely used over the last two decades for cancers of the oropharynx, larynx, and hypopharynx. It has become apparent over this same time period that a new subtype of oropharyngeal cancer resulting from human papilloma virus (HPV) has emerged.6 The proportion of HPV-associated oropharyngeal cancer has steadily increased, and in many countries, this subtype now represents the majority of new oropharyngeal cancers.7,8 HPV-associated oropharyngeal cancer differs from [...]

Oral Cancer Foundation News Team - A2009-12-30T13:03:03-07:00December, 2009|Oral Cancer News|

A 25-year analysis of veterans treated for tonsillar squamous cell carcinoma

Source: Arch Otolaryngol Head Neck Surg, November 1, 2009; 135(11) Authors: JJ Jaber et al. Objective: To determine the recurrence and survival outcome based on treatment date, type of treatment, stage of disease, and comorbidity and the recurrence and survival differences based on smoking status as a surrogate for human papillomavirus status in veterans treated for tonsillar squamous cell carcinoma (SCC). Design: Outcome cohort study. Setting: Tertiary care Department of Veterans Affairs hospital. Patients: A consecutive sample from 1981 through 2006 of 683 patients treated for oropharyngeal SCC was screened, and 141 patients with tonsillar SCC without distant metastatic spread and a minimum of 2 years of follow-up were included. Main outcome measures: Disease-free survival (DFS), disease-specific survival (DSS), and overall survival (OS). Results: Disease-free survival was significantly better in cohort II (treated during or after 1997) compared with cohort I (treated before 1997) (2- and 5-year DFS, 82% vs 64% and 67% vs 48%; P = .02). Disease-specific survival was better in the surgical vs nonsurgical group (2- and 5-year DSS, 77% vs 46% and 67% vs 30%; P

Oral Cancer Foundation News Team - A2009-11-28T08:01:30-07:00November, 2009|Oral Cancer News|

Presence of rash associated with improved survival in patients receiving adjuvant Erbitux® for locally advanced head and neck cancer

Source: professional.cancerconsultants.com Author: staff A multicenter randomized trial has shown that patients with locoregionally advanced head and neck cancer receiving adjuvant Erbitux® (cetuximab) and radiotherapy who develop a rash have a better survival than patients receiving this therapy who don’t develop a rash. The details of this five-year follow-up of a Phase III randomized study were published early online in the Lancet Oncology on November 7, 2009.[1] Standard treatment for head and neck cancer is largely determined by the stage and by the specific locations within the head or neck area where the cancer has spread. The patient’s overall medical condition is also a deciding factor. Treatment typically consists of radiation therapy, chemotherapy with surgery, or surgery alone. Erbitux is a monoclonal antibody that binds to the epithelial growth factory receptor (EGFR) and inhibits the receptor’s effects on cellular replication. Erbitux is currently FDA-approved for treatment of head and neck cancer. Researchers involved in an international study have previously reported that the addition of Erbitux to radiation therapy improves survival over radiation therapy alone in the treatment of head and neck cancer. The results of this randomized trial with a 54-month follow-up were published in the February 9, 2006, issue of the New England Journal of Medicine. This trial included 424 patients; approximately half were treated with Erbitux plus high-dose radiation therapy, and the other half received high-dose radiation therapy alone. This study now has a follow-up of more than five years. The Following table summarizes some of the findings [...]

Oral Cancer Foundation News Team - A2009-11-17T19:52:44-07:00November, 2009|Oral Cancer News|

Erbitux recognized by ASCO as a 2009 major cancer advance as first SCCHN treatment to improve survival in 30 years

Source: www.vwd.de Author: press release The American Society of Clinical Oncology (ASCO) has once again recognized Erbitux® (cetuximab) as one of the major clinical cancer advances of 2009. This year Erbitux was selected by ASCO for providing the first significant increase in survival for 30 years in the treatment of patients with first-line recurrent and/or metastatic squamous cell carcinoma of the head and neck(SCCHN).1 ASCO Clinical Advances Report1 The ASCO report, ‘Clinical Cancer Advances 2009: Major Research Advances in Cancer Treatment, Prevention and Screening’, published this week in the Journal of Clinical Oncology, is an independent assessment of the most significant clinical cancer research studies of the past year. Erbitux was singled out for the pivotal first-line SCCHN study, the first randomized trial in 30 years to identify a regimen that increases survival for patients with recurrent and/or metastatic SCCHN. The report commented that, “The ability to improve overall survival with chemotherapy has proven elusive over the last 30 years in several randomized trials comparing different chemotherapy regimens in this setting. Thus, the results of this trial are particularly noteworthy and are changing clinical practice.” This is the second consecutive year that Erbitux has featured in the ASCO ‘Advances’ list.3 In 2008 it was recognized for extending survival in the first-line treatment of NSCLC and for the role of KRAS tumor status in predicting whether patients with newly diagnosed metastatic colorectal cancer will respond to Erbitux.2 “Merck Serono is honored that Erbitux is recognized by ASCO two years in a [...]

Oral Cancer Foundation News Team - A2009-11-16T22:39:55-07:00November, 2009|Oral Cancer News|

Intensity-modulated radiation offers treatment advantages over conventional therapy for head and neck cancer

Source: www.docguide.com Author: John Otrompke Patients treated with simultaneously integrated boost treatment using intensity-modulated radiation therapy (IMRT) experience better overall survival, disease-free survival, and local recurrence rates, as well as decreased dermatitis and better postoperative salivary function that those treated with conventional radiation. "IMRT treatment was described as 'boosted' because we use 2 different doses in the same patient, who gets a dose of 2.12 gy to 1 part of their anatomy, while another part gets 1.8 gy," said Sebastien Clavel, MD, University of Montreal, Montreal, Quebec, on November 3 at the American Society of Therapeutic Radiology and Oncology (ASTRO) 51st Annual Meeting. In the study, 249 patients with stage III and IV oropharyngeal carcinoma were treated between 2000 and 2007. Of these, 100 received IMRT, while 149 patients received conventional radiation therapy. After a 33-month median follow-up, 95.4% of those treated with IMRT were still alive, compared with 75.8% of those in the conventional arm. Disease-free survival was 89.3% for the IMRT group, compared with 71.6% in the conventional radiation arm. In addition, local control was 92.4% in the IMRT patients, compared with 85.3% in the conventional group. "With the old technique, the rays were shooting from both sides, whereas with IMRT, the rays come from all directions," said Dr. Clavel. "When using IMRT, we also always give them a 3-mm margin with the skin, both of which result in fewer cases of dermatitis." IMRT patients experienced a 20% decrease in dermatitis grades 3 and 4. "If we are [...]

Oral Cancer Foundation News Team - A2009-11-11T08:45:27-07:00November, 2009|Oral Cancer News|

Cetuximab continues to increase survival in patients with head and neck cancer for up to 5 years

Source: www.docguide.com Author: staff Adding cetuximab to radiation therapy prolongs survival in patients with locally advanced head and neck cancer compared with radiotherapy alone, and this improvement persists for up to 5 years. As such, this combined treatment should be considered as a standard option for patients with advanced head and neck cancer, according to a study published online first and appearing in an upcoming issue of The Lancet Oncology. The use of chemoradiotherapy has been shown to improve survival and has become a popular treatment, but is not ideal because of its associated side-effects and increased toxicity. In 1999, a trial commenced to examine the effect of adding cetuximab to radiotherapy in patients with locally advanced head and neck cancers of the oropharynx, hypopharynx, and larynx. In total, 424 patients were randomly assigned to 6 to 7 weeks of radiotherapy alone (n = 213) or radiotherapy and cetuximab (n = 211). The primary results of the trial showed that patients treated with cetuximab had a 13% improvement in absolute disease control and 10% improvement in absolute survival at 3 years without increased side-effects, compared with patients given radiotherapy alone. In the current article, James Bonner, MD, University of Alabama, Birmingham, Alabama, and colleagues reported the long-term 5-year outcomes of patients involved in the original trial. Overall, findings showed an improvement in absolute survival of about 9% in patients given cetuximab compared with those given radiotherapy alone (36.4% vs 45.6%) at 5 years. Interestingly, patients treated with cetuximab who developed [...]

Oral Cancer Foundation News Team - A2009-11-07T11:26:48-07:00November, 2009|Oral Cancer News|

Xenograft models of head and neck cancers

Source: 7thspace.com Author: Daisuke Sano, Jeffrey Myers Head and neck cancers are among the most prevalent tumors in the world. Despite advances in the treatment of head and neck tumors, the survival of patients with these cancers has not markedly improved over the past several decades because of our inability to control and our poor understanding of the regional and distant spread of this disease. One of the factors contributing to our poor understanding may be the lack of reliable animal models of head and neck cancer metastasis. The earliest xenograft models in which human tumor cells were grown in immunosuppressed mice involved subcutaneous implantation of human head and neck cancer cell lines. Subcutaneous xenograft models have been popular because they are easy to establish, easy to manage, and lend themselves to ready quantitation of the tumor burden. More recently, orthotopic xenograft models, in which the tumor cells are implanted in the tumor site of origin, have been used with greater frequency in animal studies of head and neck cancers. Orthotopic xenograft models are advantageous for their ability to mimic local tumor growth and recapitulate the pathways of metastasis seen in human head and neck cancers. In addition, recent innovations in cell labeling techniques and small-animal imaging have enabled investigators to monitor the metastatic process and quantitate the growth and spread of orthopically implanted tumors. This review summarizes the progress in the development of murine xenograft models of head and neck cancers. We then discuss the advantages and disadvantages of [...]

Oral Cancer Foundation News Team - A2009-08-19T06:09:41-07:00August, 2009|Oral Cancer News|

HPV infection drives disparity in head and neck cancer survival

Source: www.cancer.gov/ncicancerbulletin Author: Carmen Phillips A new study provides what researchers are calling a “missing link” that helps to explain why black patients with head and neck cancer live significantly shorter after treatment than white patients. Unlike several other cancers, where racial disparities in outcomes have been attributed in large part to socioeconomic factors, this new study points directly at a biological difference: infection rates of human papillomavirus type 16 (HPV 16). The study, published July 29 in Cancer Prevention Research, is the latest to show that head and neck cancer patients, particularly those with cancer of the oropharynx, who are HPV 16-positive have superior outcomes with standard treatment (concurrent chemotherapy and radiation) compared with those who are HPV 16-negative. But this study is the first to show that black patients with head and neck cancer have dramatically lower rates of HPV infection than white patients and that HPV status directly correlates with the significant survival disparities between the two patient groups. The finding that so few black patients are HPV positive “in a completely statistical sense explains why historically we have seen that black patients [with head and neck cancer] do poorly,” said Dr. Kevin J. Cullen, the study’s senior author and director of the University of Maryland (UMD) Marlene and Stewart Greenebaum Cancer Center. Digging Deeper The researchers performed a retrospective analysis of data from 95 black and 106 white patients with similar stages of head and neck cancer who received similar treatments at the Greenebaum Cancer Center, [...]

Oral Cancer Foundation News Team - A2009-08-12T05:22:03-07:00August, 2009|Oral Cancer News|