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Cabeça e Pescoço

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By Alessandro Franciscon doctor
Laureen Ribassin-Majed, Sophie Marguet, Anne W M Lee, Wai Tong Ng, Jun Ma, Anthony T C Chan, Pei-Yu Huang, Guopei Zhu, Daniel T T Chua, Yong Chen, Hai-Qiang Mai, Dora L W Kwong, Shie-Lee Cheah, James Moon, Yuk Tung, Kwan-Hwa Chi, George Fountzilas, Jean Bourhis, Jean Pierre Pignon, Pierre Blanchard
Purpose The role of adjuvant chemotherapy (AC) or induction chemotherapy (IC) in the treatment of locally advanced nasopharyngeal carcinoma is controversial. The individual patient data from the Meta-Analysis of Chemotherapy in Nasopharynx Carcinoma database were used to compare all available treatments. Methods All randomized trials of radiotherapy (RT) with or without chemotherapy in nonmetastatic nasopharyngeal carcinoma were considered. Overall, 20 trials and 5,144 patients were included. Treatments were grouped into seven categories: RT alone (RT), IC followed by RT (IC-RT), RT followed by AC (RT-AC), IC followed by RT followed by AC (IC-RT-AC), concomitant chemoradiotherapy (CRT), IC followed by CRT (IC-CRT), and CRT followed by AC (CRT-AC)...
February 10, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Shao Hui Huang, John Waldron, Scott V Bratman, Jie Su, John Kim, Andrew Bayley, John Cho, Meredith Giuliani, Andrew Hope, Jolie Ringash, Aaron Hansen, John R de Almeida, David Goldstein, Bayardo Perez-Ordonez, Ilan Weinreb, Li Tong, Wei Xu, Brian O'Sullivan
PURPOSE: To report the outcome of ipsilateral radiation therapy (RT) in human papillomavirus (HPV)-positive (HPV+) patients and HPV-negative (HPV-) patients with T1-T2N0-N2b tonsillar cancer treated 25 years after our initial historical cohort. METHODS AND MATERIALS: Patients with T1-T2N0-N2b tonsillar cancer who received ipsilateral RT or bilateral RT between 1999 and 2014 were reviewed. Overall survival (OS), local control (LC), regional control (RC), and grade 3 to 4 late toxicity (LT) were compared between ipsilateral RT and bilateral RT within HPV+ and HPV- patients, separately...
May 1, 2017: International Journal of Radiation Oncology, Biology, Physics
Alan T Monroe, Sathya C Reddy, Anuj V Peddada
PURPOSE: To investigate the role of dose to the dorsal vagal complex (DVC) as an emetic stimulus in head-and-neck cancer patients treated with intensity modulated radiation therapy but without chemotherapy. METHODS AND MATERIALS: Seventy consecutively treated patients were analyzed for factors associated with nausea. The DVC was contoured on treatment planning scans using a previously published template and mean dose to the structure was analyzed for dose response...
July 2014: Practical Radiation Oncology
Parul Sinha, Dorina Kallogjeri, Hiram Gay, Wade L Thorstad, James S Lewis, Rebecca Chernock, Brian Nussenbaum, Bruce H Haughey
BACKGROUND: Due to unique biology and prognosis, precise identification of predictive parameters is critical for p16+ oropharyngeal squamous cell carcinoma (OPSCC). Prior studies showing absence of prognostication from extracapsular spread (ECS) and/or high N-classification in surgically-treated p16+ OPSCC necessitate new, evidence-based prognosticators. METHODS: A prospectively assembled cohort of 220, transoral surgery+neck dissection±adjuvant therapy-treated, p16+ OPSCC patients was analyzed...
May 2015: Oral Oncology
Brian O'Sullivan, Shao Hui Huang, Jie Su, Adam S Garden, Erich M Sturgis, Kristina Dahlstrom, Nancy Lee, Nadeem Riaz, Xin Pei, Shlomo A Koyfman, David Adelstein, Brian B Burkey, Jeppe Friborg, Claus A Kristensen, Anita B Gothelf, Frank Hoebers, Bernd Kremer, Ernst-Jan Speel, Daniel W Bowles, David Raben, Sana D Karam, Eugene Yu, Wei Xu
BACKGROUND: Human papillomavirus-related (HPV+) oropharyngeal cancer is a rapidly emerging disease with generally good prognosis. Many prognostic algorithms for oropharyngeal cancer incorporate HPV status as a stratification factor, rather than recognising the uniqueness of HPV+ disease. The International Collaboration on Oropharyngeal cancer Network for Staging (ICON-S) aimed to develop a TNM classification specific to HPV+ oropharyngeal cancer. METHODS: The ICON-S study included patients with non-metastatic oropharyngeal cancer from seven cancer centres located across Europe and North America; one centre comprised the training cohort and six formed the validation cohorts...
April 2016: Lancet Oncology
Michael A Samuels, Laura M Freedman, Nagy Elsayyad
For decades, the standard of care for radiation treatment of early larynx cancers has been conventional treatment using opposed lateral fields encompassing the larynx and overlying neck structures, including the adjacent carotid arteries. While intensity-modulated radiotherapy (IMRT) has replaced conventional radiotherapy for all other head/neck cancer situations, the use of IMRT to treat early glottic cancers remains controversial. The article reviews the published experience with IMRT for this clinical situation and provides a detailed review of the literature on radiation-induced carotid toxicity and how it might apply to the controversy...
November 2016: Future Oncology
Pierre Blanchard, Bertrand Baujat, Victoria Holostenco, Abderrahmane Bourredjem, Charlotte Baey, Jean Bourhis, Jean-Pierre Pignon
INTRODUCTION: The recently updated meta-analysis of chemotherapy in head and neck cancer (MACH-NC) demonstrated the benefit of the addition of chemotherapy in terms of overall survival in head and neck squamous cell carcinoma (HNSCC). The magnitude of the benefit according to tumour site is unknown as well as their potential interactions with patient or trial characteristics. METHODS: Eighty seven randomized trials performed between 1965 and 2000 were included in the present analysis...
July 2011: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Jimmy J Caudell, Philip E Schaner, Renee A Desmond, Ruby F Meredith, Sharon A Spencer, James A Bonner
PURPOSE: Intensification of radiotherapy and chemotherapy for head-and-neck cancer may lead to increased rates of dysphagia. Dosimetric predictors of objective findings of long-term dysphagia were sought. METHODS AND MATERIALS: From an institutional database, 83 patients were identified who underwent definitive intensity-modulated radiotherapy for squamous cell carcinoma of the head and neck, after exclusion of those who were treated for a second or recurrent head-and-neck primary lesion, had locoregional recurrence at any time, had less than 12 months of follow-up, or had postoperative radiotherapy...
February 1, 2010: International Journal of Radiation Oncology, Biology, Physics
David J Adelstein, Shlomo A Koyfman, Adel K El-Naggar, Ehab Y Hanna
The salivary gland cancers are uncommon neoplasms of the head and neck, which exhibit considerable pathologic, biological, and clinical diversity. Surgical resection, often with postoperative radiation, is the standard therapeutic approach, and the results after treatment vary widely depending on the tumor histology. Chemotherapy has been of only limited palliative benefit in patients with advanced disease, and there has been little exploration of its use in definitive management. Recent investigation has focused on identification of the characteristic molecular signatures and genomic alterations of the specific histologic subtypes...
July 2012: Seminars in Radiation Oncology
R Mazzola, F Ricchetti, A Fiorentino, S Fersino, N Giaj Levra, S Naccarato, G Sicignano, S Albanese, G Di Paola, D Alterio, R Ruggieri, F Alongi
OBJECTIVE: Dysphagia remains a side effect influencing the quality of life of patients with head and neck cancer (HNC) after radiotherapy. We evaluated the relationship between planned dose involvement and acute and late dysphagia in patients with HNC treated with intensity-modulated radiation therapy (IMRT), after a recontouring of constrictor muscles (PCs) and the cricopharyngeal muscle (CM). METHODS: Between December 2011 and December 2013, 56 patients with histologically proven HNC were treated with IMRT or volumetric-modulated arc therapy...
December 2014: British Journal of Radiology
Arlene A Forastiere, Qiang Zhang, Randal S Weber, Moshe H Maor, Helmuth Goepfert, Thomas F Pajak, William Morrison, Bonnie Glisson, Andy Trotti, John A Ridge, Wade Thorstad, Henry Wagner, John F Ensley, Jay S Cooper
PURPOSE: To report the long-term results of the Intergroup Radiation Therapy Oncology Group 91-11 study evaluating the contribution of chemotherapy added to radiation therapy (RT) for larynx preservation. PATIENTS AND METHODS: Patients with stage III or IV glottic or supraglottic squamous cell cancer were randomly assigned to induction cisplatin/fluorouracil (PF) followed by RT (control arm), concomitant cisplatin/RT, or RT alone. The composite end point of laryngectomy-free survival (LFS) was the primary end point...
March 1, 2013: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Carlos Suárez, Juan P Rodrigo, Carsten C Bödeker, José L Llorente, Carl E Silver, Jeroen C Jansen, Robert P Takes, Primoz Strojan, Phillip K Pellitteri, Alessandra Rinaldo, William M Mendenhall, Alfio Ferlito
BACKGROUND: The definitive treatment for head and neck paraganglioma (PG) is surgical excision. Unfortunately, surgery, particularly of vagal paraganglioma (VPG; "glomus vagale") and foramen jugulare ("glomus jugulare") tumors, may be complicated by injuries to the lower cranial nerves, a high price to pay for treatment for a benign tumor. Alternatively these tumors may be followed without treatment, or irradiated. The purpose of this review was to compare the existing evidence concerning the efficacy and safety of surgery, external beam radiotherapy (EBRT), and stereotactic radiosurgery (SRS), for jugular paragangliomas (JPGs) and VPGs...
August 2013: Head & Neck
Angela C Chi, Terry A Day, Brad W Neville
Oral cavity squamous cell carcinoma (OC-SCC) is the most common malignancy of the head and neck (excluding nonmelanoma skin cancer). Recent trends have shown a dramatic rise in the incidence of oropharyngeal squamous cell carcinoma (OP-SCC), with a marked increase in lesions related to human papillomavirus infection. This update presents the latest evidence regarding OC-SCC and OP-SCC. In particular, the authors compare and contrast tumors at these two sites with respect to epidemiology, etiopathogenesis, clinicopathologic presentation, clinical assessment, imaging, management, and prognosis...
September 2015: CA: a Cancer Journal for Clinicians
A Mirabile, M Airoldi, C Ripamonti, A Bolner, B Murphy, E Russi, G Numico, L Licitra, P Bossi
Pain in head and neck cancer represents a major issue, before, during and after the oncological treatments. The most frequent cause of pain is chemo/radiation related oral mucositis, which involves 80% of the patients and worsens their quality of life inhibiting speaking, eating, drinking or swallowing and sometimes reducing the treatment compliance, the maximum dose intensity and thus the potential efficacy of treatment. Nevertheless pain is still often under estimated and undertreated. An Italian multidisciplinary group of head and neck cancer specialists met with the aim of reaching a consensus on pain management in this setting...
March 2016: Critical Reviews in Oncology/hematology
Paolo Bossi, Davide Farina, Gemma Gatta, Davide Lombardi, Piero Nicolai, Ester Orlandi
Paranasal sinus cancers are rare diseases, accounting for about 5% of all head and neck malignancies. The variety of histological types and the overlapping pathological features with other entities constitute difficulties in pathologic interpretation, often requiring a skilled interpretation or a second opinion. Treatment of locally advanced disease relies on surgery and radiation therapy for operable disease, with a possible role for systemic treatment in selected histologies within a multimodal approach; unresectable paranasal sinus cancers are generally treated with a combination of radiotherapy and chemotherapy...
February 2016: Critical Reviews in Oncology/hematology
Aymen Lagha, Nesrine Chraiet, Soumaya Labidi, Hela Rifi, Mouna Ayadi, Sarra Krimi, Bassem Allani, Henda Raies, Slim Touati, Hamouda Boussen, Lotfi Kochbati, Amel Mezlini
The concept of larynx preservation in locally advanced laryngeal or hypopharyngeal squamous cell carcinoma has evolved during the last three decades, especially with the advancement of nonsurgical strategies. These nonsurgical strategies include: (1) radiotherapy alone; (2) concomitant chemoradiotherapy (CCRT); and (3) induction chemotherapy followed by radiotherapy or CCRT and concurrent anti-epidermal growth factor receptor (EGFR). To date, the best approach for larynx preservation has yet to be defined. In this article, we review and discuss important recent randomized phase II/III trials investigating larynx preservation in order to facilitate the selection of an appropriate strategy in the clinical setting...
November 2013: Critical Reviews in Oncology/hematology
Hideya Yamazaki, Kinji Nishiyama, Eiichi Tanaka, Masahiko Koizumi, Masashi Chatani
PURPOSE: To investigate in a prospective randomized study the effect of radiation fraction size and overall treatment time on the local control of early glottic carcinoma. METHODS AND MATERIALS: Between December 1993 and December 2001, 180 patients with early glottic carcinoma (T1N0M0) were treated at our department. The patients were randomly allocated to either treatment arm A (radiation fraction size 2 Gy, n = 89) or B (2.25 Gy, n = 91). The total radiation dose administered was 60 Gy in 30 fraction within 6 weeks for minimal tumors (two-thirds of the vocal cord or less) or 66 Gy in 33 fractions in 6...
January 1, 2006: International Journal of Radiation Oncology, Biology, Physics
K K Fu, T F Pajak, A Trotti, C U Jones, S A Spencer, T L Phillips, A S Garden, J A Ridge, J S Cooper, K K Ang
PURPOSE: The optimal fractionation schedule for radiotherapy of head and neck cancer has been controversial. The objective of this randomized trial was to test the efficacy of hyperfractionation and two types of accelerated fractionation individually against standard fractionation. METHODS AND MATERIALS: Patients with locally advanced head and neck cancer were randomly assigned to receive radiotherapy delivered with: 1) standard fractionation at 2 Gy/fraction/day, 5 days/week, to 70 Gy/35 fractions/7 weeks; 2) hyperfractionation at 1...
August 1, 2000: International Journal of Radiation Oncology, Biology, Physics
Anne W M Lee, Brigette B Y Ma, Wai Tong Ng, Anthony T C Chan
Nasopharyngeal carcinoma of the undifferentiated subtype is endemic to southern China, and patient prognosis has improved significantly over the past three decades because of advances in disease management, diagnostic imaging, radiotherapy technology, and broader application of systemic therapy. Despite the excellent local control with modern radiotherapy, distant failure remains a key challenge. Advances in molecular technology have helped to decipher the molecular pathogenesis of nasopharyngeal carcinoma as well as its etiologic association with the Epstein-Barr virus...
October 10, 2015: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Thomas J Galloway, John A Ridge
Squamous cell carcinoma of an unknown primary (SCCUP) of the head and neck is a rare disease. As a diagnosis of exclusion, the manner in which it is assigned merits consideration. Despite the development and refinement of several techniques designed to locate an occult tumor, including cross-sectional anatomic imaging, functional imaging, and transoral surgical techniques, delineating SCCUP remains an active clinical problem. Its relative rarity has prevented prospective study of the entity. Hence, investigators must rely on retrospective analyses to understand the disease and its appropriate treatment...
October 10, 2015: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
2015-09-23 17:01:10
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