Head & Neck Cancer

Effective radiotherapy for patients with cancer should include maximal tumor cell killing with minimal injury to normal tissue. Radiation doses that can be delivered, without causing severe damage to surrounding normal

A conventional course of radiation for squamous cell carcinoma in the United States is generally 70 Gy in 7 weeks, with a once-daily dose of 1.8 to 2 Gy. This schedule has a modest success rate in curing head and neck cancer. The

ZUHL, Germany-Amifostine (Ethyol) used as cytoprotective therapy can reduce the occurrence of xero-stomia, loss of taste, and fibrosis associated with radiochemotherapy for head and neck cancer. Results of three studies were reported by Jens Buentzel, MD, PhD, vice chairman of the Department of Otolaryngology, Head and Neck Oncology, Zentralklinikum Zuhl, Germany.

ST. LOUIS-To determine whether cytoprotective amifostine (Ethyol) can reduce the incidence of hypothyroidism in patients with head and neck cancer treated with radiotherapy, a trial is set to begin at Washington University in St. Louis. The proposed trial is currently undergoing institutional review board (IRB) consideration and has not yet enrolled patients.

PHILADELPHIA-For head and neck cancer patients, subcutaneous (SC) amifostine (Ethyol) provides equal protection against radiation-induced grade 2 acute xerostomia compared to intravenous (IV) amifostine, Pramila Rani Anné, MD, reported. She cautioned, however, that SC amifostine should be used only in clinical trials until ways to prevent cutaneous toxicities are worked out.

ST. LOUIS-Intensity modulated radiation therapy (IMRT) and use of radioprotectant agents may help reduce late-appearing radiation side effects, reported K. S. Clifford Chao, MD. Dr. Chao is associated radiation oncologist, Department of Radiation Oncology at the Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis.

The combination of chemotherapy and radiation offers patients with advanced cancer of the larynx greater hope of preserving

Given the well-established role of angiogenesis (or new blood vessel formation) in tumor growth and metastasis, antiangiogenic therapy, a concept first proposed by Dr. Judah Folkman,[1] has become increasingly recognized as a promising

Traditionally, the role of chemotherapy in the treatment ofsquamous carcinoma of the head and neck has been confined to patients with

With the understanding of the mechanism of malignant transformation has come the knowledge that oncogene products are frequently growth factors, growth factor receptors, or elements of growth factor signal-transduction pathways. Overexpression

Nonsurgical approaches to preservation of the larynx in the treatment of laryngeal carcinoma include either radiation alone or chemotherapy and radiation in combination. In light of the common use of total laryngectomy,

Matrix Pharmaceutical, Inc, announced that the US Food and Drug Administration (FDA) has accepted the filing of a New Drug Application (NDA) for cisplatin/epinephrine (IntraDose) injectable gel for the treatment of refractory or recurrent head

BOSTON-By reducing radiation to the parotid glands, intensity modulated radiation therapy (IMRT) allows head and neck cancer patients to maintain more saliva flow after therapy. Clifford K.S. Chao, MD, of Washington University School of Medicine, St. Louis, reported the study results at the 42nd Annual Meeting of the American Society for Therapeutic Radiology and Oncology.

This issue of Oncology features an excellent review of gene therapy for head and neck cancers. Lamont and colleagues have highlighted the principles of genetic intervention, the current state of available therapies, and the results of human trials in an organized and coherent manner.

Lamont et al have presented a very clear and concise review of current gene therapy strategies in the management of squamous cell carcinoma of the head and neck. While the presentation highlighted the most important work to date in this expanding field, it also made reference to some controversies and challenges that we are now facing. With this in mind, I would like to expand on and clarify several points raised by the authors.

Despite advances in surgery, radiotherapy, and chemotherapy, survival of patients with squamous cell carcinoma of the head and neck has not significantly improved over the past 30 years. Locally recurrent or refractory disease is particularly difficult to treat. Repeat surgical resection and/or radiotherapy are often not possible, and long-term results for salvage chemotherapy are poor. Recent advances in gene therapy have been applied to recurrent squamous cell carcinoma of the head and neck. Many of these techniques are now in clinical trials and have shown some efficacy. This article discusses the techniques employed in gene therapy and summarizes the ongoing protocols that are currently being evaluated in clinical trials. [ONCOLOGY 15(3):303-314, 2001]

ALZA Corporation and MedImmune, Inc, recently announced the results of a phase III study evaluating the use of amifostine (Ethyol) in the care of head and neck cancer patients who received radiation therapy. Recently published in the Journal of

BOSTON-Despite substantially increased acute toxicity, patients with inoperable head and neck tumors benefited from accelerated radiation therapy in a randomized clinical trial reported by Jean Bourhis, MD, PhD, at the American Society for Therapeutic Radiology and Oncology (ASTRO) annual meeting.

Minimally invasive surgery for esophagectomy may lower the morbidity often associated with open esophagectomy, according to a study conducted by surgeons at the University of Pittsburgh Medical Center and published in the September

Patients with recurrent squamous cell carcinoma of the head and neck have a poor prognosis. Thalidomide (Thalomid) has antitumor and antiangiogenic properties. We conducted a phase II trial to determine toxicity, response rate, and survival in

Selective neck dissection is a procedure that is primarily indicated in patients with clinically negative nodal disease in which there is a high risk of occult metastases. Others have advocated its use for patients with

Selective neck dissection is a procedure that is primarily indicated in patients with clinically negative nodal disease in which there is a high risk of occult metastases. Others have advocated its use for patients with

This is an open-label, nonrandomized phase I study to determine the maximum tolerated dose and dose-limiting toxicity of UFT plus leucovorin when given concomitantly with hyperfractionated radiotherapy in patients with head and neck cancer. The study period is determined by the course of radiotherapy, which is given as 1.7 Gy per fraction twice daily for 5 days (Monday to Friday) in 2 consecutive weeks, followed by 1 week of rest, and subsequently another 2 weeks of radiotherapy (Monday to Friday plus Monday to Thursday).

Cisplatin plus fluorouracil (5-FU) is widely accepted as neoadjuvant and adjuvant chemotherapy in the treatment of head and neck squamous cell carcinoma; UFT is also an active agent against this disease. In the first retrospective study, we examined the efficacy of UFT as adjuvant chemotherapy in patients with maxillary cancer.

Selective neck dissection is a procedure that is primarily indicated in patients with clinically negative nodal disease in which there is a high risk of occult metastases. Others have advocated its use for patients with