Ultima Vez Modificado: 1 de noviembre del 2001
Table of Contents
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UI - 21321918
AU - Subirana FX; Lorente J; Perez M; Quesada JL; Grasa J; Fortuny P; Rosello J; Quesada P
TI - [Antibiotic prophylaxis in oncologic pharyngolaryngeal surgery: ceftriaxone versus clindamycin and gentamycin]
SO - Acta Otorrinolaringol Esp 2001 Mar;52(2):142-5
AD - Servicio de Otorrinolaringologia, Hospital General Universitari del Vall D'Hebron, Universidad Autonoma, Barcelona.
There are many papers comparing two antibiotic protocols for the profilaxis of head and neck infections after laryngeal surgery. We present one prospective and randomised study in 60 patients comparing the efficacy of two protocols. The comparison was between ceftriaxone versus the association of clindamicyn and gentamicyn. In our database we included the risk factors for infection, the surgical approach, the duration of surgery and the patient characteristics. We observed an incidence of 28% of infection, with a 23.3% in the clindamicyn + gentamicyn group and a 33.3% in the ceftriaxone group. The differences between the two groups were not statistically significant. In this study we observed a small difference between the amount of alcohol comsuption, the effectiveness of the surgical drainage, the surgical approach and the presence of wound infection. The difference was not statistical significant due to the small group of patients. The profilaxis was adequate for the total laryngectomy and cordectomy group, with a higher incidence of wound infection in patients treated with a supraglottic laryngectomy.
UI - 21376170
AU - Nguyen-Tan PF; Le QT; Quivey JM; Singer M; Terris DJ; Goffinet DR; Fu KK
TI - Treatment results and prognostic factors of advanced T3--4 laryngeal carcinoma: the University of California, San Francisco (UCSF) and Stanford University Hospital (SUH) experience.
SO - Int J Radiat Oncol Biol Phys 2001 Aug 1;50(5):1172-80
AD - Department of Radiation Oncology, University of California, San Francisco, CA, USA. firstname.lastname@example.org
PURPOSE: To review the UCSF-SUH experience in the treatment of advanced T3--4 laryngeal carcinoma and to evaluate the different factors affecting locoregional control and survival. METHODS AND MATERIALS: We reviewed the records of 223 patients treated for T3--4 squamous cell carcinoma of the larynx between October 1, 1957, and December 1, 1999. There were 187 men and 36 women, with a median age of 60 years (range, 28--85 years). The primary site was glottic in 122 and supraglottic in 101 patients. We retrospectively staged the patients according to the 1997 AJCC staging system. One hundred and twenty-seven patients had T3 lesions, and 96 had T4 lesions; 132 had N0, 29 had N1, 45 had N2, and 17 had N3 disease. The overall stage was III in 93 and IV in 130 patients. Seventy-nine patients had cartilage involvement, and 144 did not. Surgery was the primary treatment modality in 161 patients, of which 134 had postoperative radiotherapy (RT), 11 had preoperative RT, 7 had surgery followed by RT and chemotherapy (CT), and 9 had surgery alone. Forty-one patients had RT alone, and 21 had CT with RT. Locoregional control (LRC) and overall survival (OS) were estimated using the Kaplan--Meier method. Log-rank statistics were employed to identify significant prognostic factors for OS and LRC. RESULTS: The median follow-up was 41 months (range, 2--367 months) for all patients and 78 months (range, 6--332 months) for alive patients. The LRC rate was 69% at 5 years and 68% at 10 years. Eighty-four patients relapsed, of which 53 were locoregional failures. Significant prognostic factors for LRC on univariate analysis were primary site, N stage, overall stage, the lowest hemoglobin (Hgb) level during RT, and treatment modality. Favorable prognostic factors for LRC on multivariate analysis were lower N stage and primary surgery. The overall survival rate was 48% at 5 years and 34% at 10 years. Significant prognostic factors for OS on univariate analysis were: primary site, age, overall stage, T stage, N stage, lowest Hgb level during RT, and treatment modality. Favorable prognostic factors for OS on multivariate analysis were lower N stage and higher Hgb level during RT. CONCLUSION: Lower N-stage was a favorable prognostic factor for LRC and OS. Hgb levels > or = 12.5 g/dL during RT was a favorable prognostic factor for OS. Surgery was a favorable prognostic factor for LRC but did not impact on OS. Correcting the Hbg level before and during treatment should be investigated in future clinical trials as a way of improving therapeutic outcome in patients with advanced laryngeal carcinomas.
UI - 21384653
AU - Rosen A; Rhee TH; Kaufman R
TI - Prediction of aspiration in patients with newly diagnosed untreated advanced head and neck cancer.
SO - Arch Otolaryngol Head Neck Surg 2001 Aug;127(8):975-9
AD - Division of Otolaryngology, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark, NJ 07103, USA. ROSENAR@UMDNJ.EDU
OBJECTIVES: To determine the prevalence of aspiration in patients with newly diagnosed nontreated advanced head and neck cancer and to determine the ability of the clinical examination to predict aspiration in this patient population. DESIGN: A descriptive prevalence study of the presence of aspiration in patients with advanced (stages III and IV) head and neck cancer and a prospective correlation study between variables of the clinical evaluation with the criterion standard videofluoroscopy. SETTING: Regional veterans affairs medical center. PATIENTS: A consecutive sample of 27 patients without previous treatment or tracheostomy. INTERVENTIONS: All patients underwent evaluation by an otolaryngologist and speech pathologist prior to videofluoroscopy. MAIN OUTCOME MEASURES: Variables in the dysphagia evaluation (consisting of a directed medical history, physical examination, and food challenge), the self-rated 45-item questionnaire, and the clinicians "educated prediction" of aspiration were analyzed with reference to aspiration on videofluoroscopy using univariant analysis. RESULTS: The prevalence of aspiration determined by videofluoroscopy was 41% (11 of 27 patients). Two (6%) of 32 items in the medical history, 1 (4%) of 25 items in the physical examination, and 8 (50%) of 16 items in the food challenge were found to be statistically significantly correlated (P<.05) with aspiration on videofluoroscopy by univariate analysis. Nine (25%) of 45 items in the self-rated questionnaire were correlated with aspiration on videofluoroscopy. The clinicians' educated prediction of aspiration was not correlated with aspiration determined by videofluoroscopy. CONCLUSIONS: Clinical evaluation alone is inadequate in predicting patients who aspirated, determined objectively by videofluoroscopic swallowing study. Further study is needed to develop an efficient dysphagia evaluation to identify patients at risk for aspiration.
UI - 21183439
AU - Bondarenko IuH
TI - [Peculiarities of clinical diagnosis of the thyroid gland cancer invading trachea and larynx]
SO - Klin Khir 2000 Jun;(6):21-2
The experience of diagnosis of the thyroid gland (TG) spreaded cancer in 153 patients was summarized. Optimal differentiated surgical methods were applied depending on the affection severity of the main respiratory ways. Combined resection TG with part of trachea (larynx) in 18 patients was done, in 96--thyroidectomy, in 39--palliative intervention.
UI - 21225883
AU - Jackson SM; Hay JH; Flores AD
TI - Local control of T3N0 glottic carcinoma by 60 Gy given over five weeks in 2.4 Gy daily fractions. One more point on the biological effective dose (BED) curve.
SO - Radiother Oncol 2001 May;59(2):219-20
AD - Radiation Oncology, British Columbia Cancer Agency, Vancouver Cancer Centre, 600 West 10th Avenue, BC, V5Z 4E6, Vancouver, Canada.
Seventy patients with T3N0 glottic cancer who received a total dose of 60 Gy in twenty-five 2.4 Gy daily fractions over 5 weeks had an initial post radiation primary recurrence free rate of 65% at 5 years. This provides one more point for the dose response for T3 glottic cancer Radiother Oncol (1999) 15.
UI - 21386805
AU - Hoitinga SJ
TI - [CBO guideline 'Larynx carcinoma']
SO - Ned Tijdschr Geneeskd 2001 Jul 21;145(29):1430-1
UI - 21230828
AU - Mantz CA; Vokes EE; Kies MS; Mittal B; Witt ME; List MA; Weichselbaum RR; Haraf DJ
TI - Sequential induction chemotherapy and concomitant chemoradiotherapy in the management of locoregionally advanced laryngeal cancer.
SO - Ann Oncol 2001 Mar;12(3):343-7
AD - Department of Cellular and Radiation Oncology, University of Chicago, Illinois, USA.
PURPOSE: To determine overall survival, progression-free survival, rate of voice preservation, and patterns of failure in locoregionally advanced laryngeal cancer treated with induction chemotherapy with or without surgery followed by concomitant chemoradiation. BACKGROUND: Locoregionally advanced laryngeal cancer has been conventionally treated with either surgery and adjuvant radiotherapy or radiotherapy alone, and clinical and functional outcomes have been poor. Chemoradiotherapy has been demonstrated to improve functional outcome and disease control over conventional treatment in recent randomized head and neck trials. PATIENTS AND METHODS: Advanced head and neck cancer patients were enrolled onto two consecutive phase II studies. Induction treatment consisted of three cycles of cisplatin, 5-fluorouracil (5-FU), leucovorin, and interferon-alpha 2b (PFL-IFN) followed by surgery for residual disease. Surgical intent was to spare the larynx when possible. All patients then proceeded to concomitant chemoradiation consisting of seven or eight cycles of 5-FU, hydroxyurea, and a planned total radiotherapy dose of 7000 cGy (FHX). RESULTS: A subset of thirty-two laryngeal cancer patients with predominantly stage IV disease comprises the study group for this report. Clinical CR was observed in 59% of patients following induction therapy. The median follow-up was 63.0 months for surviving patients and 44.5 months for all patients. At five years, overall survival is 47%, progression-free survival is 78%, and locoregional control is 78%. No distant failures were observed. Voice preservation with disease control was 75% at five years. Only two total laryngectomies were performed during the course of treatment and follow-up. Treatment-related toxicity accounted for two deaths. CONCLUSIONS: The addition of concomitant chemoradiotherapy to induction chemotherapy for locoregionally advanced laryngeal cancer appears to increase locoregional control and survival rates. PFL-IFN-FHX resulted in high rates of disease cure and voice preservation in a group of patients that has traditionally fared poorly in both clinical and functional outcome.
UI - 21230121
AU - Akatov VS; Evtodienko YV; Leshchenko VV; Teplova VV; Potselueva MM; Kruglov AG; Lezhnev EI; Yakubovskaya RI
TI - Combined vitamins Bl2b and C induce the glutathione depletion and the death of epidermoid human larynx carcinoma cells HEp-2.
SO - Biosci Rep 2000 Oct;20(5):411-7
AD - Laboratory of Cytotechnology, Institute of Theoretical and Experimental Biophysics, Russian Academy of Sciences, Pushchino, Moscow Region. email@example.com
The combination of hydroxocobalamin (vitamin B12b) and ascorbic acid (vitamin C) can cause the death of tumor cells at the concentrations of the components at which they are nontoxic when administered separately. This cytotoxic action on epidermoid human larynx carcinoma cells HEp-2 in vitro is shown to be due to the hydrogen peroxide generated by the combination of vitamins B12b and C. The drop in the glutathione level preceding cell death was found to be the result of combined action of the vitamins. It is supposed that the induction of cell death by combined action of vitamins B12b and C is connected to the damage of the cell redox system.
UI - 21390890
AU - Bai S; Fei S; Zhang X
TI - [Loss of heterozygosity on chromosome RB1.20 locus and p110RB1 protein state in squmous cell carcinomas of larynx]
SO - Zhonghua Er Bi Yan Hou Ke Za Zhi 1998 Apr;33(2):110-2
AD - Second Clinical College, China Medical University, Shenyang 110003.
OBJECTIVE: To study the RB1 gene in squamous cell carcinoma of larynx(ISCC) and to find clue for discovering and locating new suppressor gene. METHODS: Loss of heterozygosity (LOH) of microsatellite polymorphic sequence on chromosomes 13 at RB1.20 locus of 58 LSCC patients were analyzed. The p110RB1 protein state was detected by immunohistochemical staining using the polyclonal antibody to the RB1 products. RESULTS: It showed that 3 cases in the preinvasive stage (i.e. carcinoma in situ) had no any LOH on chromosome 13. Forty percent of the 55 invasive LSCC showed LOH at RB1.20 locus. By immunohistochemical staining p110RB1 protein negative reaction was observed in 8 LSCCs in which 6 cases associated with LOH at RB1.20 locus. CONCLUSIONS: RB1 gene was inactivated in some LSCCs. It is putative that there is another tumor suppressor gene on chromosome 13 near by RB1.20 locas. The inactivation of the genes at the chromosome 13q region including RB1 involved genesis and development of invasive LSCC.
UI - 21390891
AU - Cai X; Wang T; Shi L
TI - [Nonepithelial malignant neoplasms of the larynx and hypopharynx]
SO - Zhonghua Er Bi Yan Hou Ke Za Zhi 1998 Apr;33(2):113-6
AD - First Affiliated Hospital of Shandong Medical University, Jinan 250012.
OBJECTIVES: Nonepithelial Malignant Neoplasms of the larynx and hypopharynx are rare. Their clinical features, diagnosis and treatment were discussed. METHODS: From 1985 to 1996, 23 cases of nonepithelial malignant neoplasms of the larynx and 3 cases of hypopharynx were diagnosed. There were 21 males and 5 females. Age of the patients ranged from 16 to 65 years. Laryngeal tumours included 11 cases of sarcomas, 1 extramedullary plasmocytoma, 9 lymphomas and 2 malignant melanomas. Hypopharyngeal tumours included 1 leiomyosarcoma and 2 malignant melanomas. Extensive resection was the first treatment for 21 patients. Then, according to their histopathologic features, irradiation or/and chemotherapy were chosen. RESULTS: Follow-up period was from 6 months to 10 years. There were 12 patients survived for 4 to 10 years, including 6 cases of laryngeal sarcomas, 2 supraglottic lymphomas, 2 malignant melanomas of the larynx, 1 malignant melanoma and 1 leiomyosarcoma of the hypopharynx. CONCLUSIONS: Characteristics for these tumours were: 1. usually covered by intact mucosa; 2. laryngeal tumours rarely metastasize to the cervical lymph nodes; 3. difficulties in histopathological diagnosis, and immunohistochemistry is helpful to differentiation and determination.
UI - 21436071
AU - Loff B
TI - Australia ponders law after passive smoking trial.
SO - Lancet 2001 Sep 1;358(9283):738
UI - 21336337
AU - Jackel MC; Mitteldorf C; Schweyer S; Fuzesi L
TI - Clinical relevance of Fas (APO-1/CD95) expression in laryngeal squamous cell carcinoma.
SO - Head Neck 2001 Aug;23(8):646-52
AD - Department of Otorhinolaryngology, Georg-August-University of Gottingen, Robert-Koch-Str. 40, D-37075 Gottingen, Germany.
BACKGROUND: Expression of Fas receptors renders tumor cells potentially susceptible to the host immune system. In squamous cell carcinomas of the head and neck, Fas has recently been found to be down-regulated in some cases; its prognostic value and correlation with clinicopathologic parameters, however, is yet to be delineated. METHODS: Paraffin-embedded specimens of 88 primary laryngeal squamous cell carcinomas were investigated for Fas protein expression by immunohistochemistry. Apoptotic tumor cells were visualized using the nick end labeling method. To assess the immunologic reaction to the neoplasm, the intensity of lymphoplasmocytic stroma reaction was determined. The mean follow-up time amounted to 45.9 months (range, 1-144 months). RESULTS: In tumor-adjacent normal mucosa and in most well-differentiated tumors, Fas expression was restricted to basal and parabasal cell layers. A diffuse pattern of staining reactions predominated in high-grade lesions (p <.001). The degree of Fas expression revealed a positive relationship with the intensity of lymphoplasmocytic stroma reaction (p =.002) but was unrelated to clinicopathologic parameters and to apoptotic rates of tumors. Neither Fas nor the lymphoplasmocytic stroma reaction had any impact on patient survival. CONCLUSIONS: Up-regulation of cell surface Fas expression in laryngeal carcinoma seems to have a stimulatory effect on the immune cell infiltration of the stromal tissue. Its lack of clinical relevance might be due to an inhibition of intracellular Fas signal transduction, which represents a frequent strategy of tumor cells to escape Fas-mediated apoptosis.
UI - 21443355
AU - Rafferty MA; Fenton JE; Jones AS
TI - An overview of the role and inter-relationship of epidermal growth factor receptor, cyclin D and retinoblastoma protein on the carcinogenesis of squamous cell carcinoma of the larynx.
SO - Clin Otolaryngol 2001 Aug;26(4):317-20
AD - Department of Otolaryngology/Head and Neck Surgery, University of Liverpool, UK.
Recent developments in both molecular and cellular biology have improved the understanding of the tumorigenesis of laryngeal squamous cell carcinoma. Loco-regional recurrence of this condition still poses a significant oncological management dilemma for a subset of these tumours. Therefore, the possibility that specific tumour characteristics (demonstrable by immunohistochemical and molecular biological study) may aid the clinician in choosing the optimal treatment for a specific tumour holds great promise. This article concentrates on the role and inter-relationship of epidermal growth factor receptor status on the function of cyclin D, and how this is related to the presence of retinoblastoma protein. A review of recent studies evaluating these markers, the potential clinical utility of these findings and the possible directions for further study are discussed.
UI - 21442490
AU - Peretti G; Nicolai P; Piazza C; Redaelli de Zinis LO; Valentini S; Antonelli AR
TI - Oncological results of endoscopic resections of Tis and T1 glottic carcinomas by carbon dioxide laser.
SO - Ann Otol Rhinol Laryngol 2001 Sep;110(9):820-6
AD - Department of Otolaryngology, University of Brescia, Italy.
A cohort of 88 patients with glottic cancer (13 Tis, 75 T1) who underwent endoscopic CO2 laser excision between January 1995 and June 1997 was prospectively studied. The mean follow-up was 43 months (range, 30 to 60 months). The depth and extent of the excision (graded according to the European Laryngological Society Classification, which includes 5 types of resection) were based on the results of a preoperative and intraoperative diagnostic test battery. Five patients died of other diseases, and none of glottic cancer. Of the 12 patients who developed a local recurrence, 5 underwent a second endoscopic procedure, 5 a total laryngectomy, and 1 a supracricoid laryngectomy, and 1 was treated with radiotherapy. The 5-year local control rate with endoscopic surgery alone, according to the Kaplan-Meier method, was 91%. None of the variables (8 related to the tumor and 2 to the treatment) tested in a univariate analysis by the log-rank test was found to have a significant impact on disease-free survival rates. The present study confirmed that endoscopic partial cordectomy for Tis and T1 glottic cancers can be regarded as a valid alternative to radiotherapy in terms of oncological results.
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