Head & Neck Cancer

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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.

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.

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.

NASHVILLE, Tennessee-‘‘Historically, chemotherapy was only palliative in head and neck cancers, but chemotherapy regimens now in use actually do cure some patients,” Barbara A Murphy, MD, told a clinical investigators’ workshop. Dr. Murphy is Assistant Professor of Medicine at Vanderbilt-Ingram Cancer Center in Nashville, Tennessee. The workshop was sponsored by the University of Texas M. D. Anderson Cancer Center and Pharmacia Oncology.

BALTIMORE-Researchers at the Johns Hopkins School of Medicine and School of Hygiene and Public Health have found human papillomavirus (HPV) to be a likely cause of certain cancers of the head and neck, and also an indicator of improved survival.

Drs. Mark Singer and Eric Blom revolutionized the process of speech rehabilitation following total laryngectomy with their introduction of the tracheoesophageal puncture and insertion of a duck bill prosthesis.[1-5] The physiologic principles of the procedure are obvious, the surgical technique is simple, and the results in terms of fluent speech production are immediate and quite satisfactory. Dr. Blom is to be complimented for providing in this article, a succinct summary of the “current methods” available for speech rehabilitation for a patient facing total laryngectomy.

ALEXANDRIA, Va-Since she founded the Cancer Research Foundation of American (CRFA) in 1985, the year after her father’s death from head and neck cancer, Carolyn “Bo” Aldigé has become a persuasive and respected advocate for cancer

SAN ANTONIO-Accelerated radiation therapy given concomitantly with mitomycin C (Mutamycin) produced significantly improved results over standard radiation in patients with advanced head and neck cancer, Werner H. Dobrowsky, MD, reported at the at 41st Annual Scientific Meeting of the American Society for Therapeutic Radiology and Oncology.

Genetronics Biomedical Ltd announced interim dataand results of phase II clinical trials evaluating the company’s electroporation therapy (EPT) system, which combines an intratumoral injection of a chemotherapeutic agent with a pulsed electric field, in squamous cell carcinoma of the head and neck. Data from the trials, which were conducted in the United States and Canada, were presented at the 35th annual meeting of the American Society of Clinical Oncology (ASCO). Genetronics also announced preliminary data and results from a similar study conducted in Europe.

SAN ANTONIO-Local-regional control significantly improved with two radiotherapy fractionation variants delivering either increased total dose or shorter treatment time, compared with standard fractionation, in patients with locally advanced squamous cell carcinoma of the head and neck, Karen Fu, MD, reported at the 41st Annual Scientific Meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO).

BUFFALO, NY-Techniques developed over the past 20 years have improved outcomes for patients with head and neck cancers. Speakers at the Surgical Oncology Symposium sponsored by Roswell Park Cancer Institute described new surgical methods that offer further improvement in quality of life and new studies of preventive agents.

SAN ANTONIO -“Extraordinary” tumor control has been achieved in patients with far advanced squamous cell carcinomas of the head and neck with the triple combination of tirapazamine (investigational), cisplatin (Platinol), and radiotherapy, Lester J. Peters, MD, reported at the 41st Annual Scientific Meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO).