Información sobre riesgo, prevención, detección, síntomas, diagnosis, tratamiento y apoyo para el cáncer.
Información sobre el tratamiento del cáncer incluyendo quirúrgica, quimioterapia, radioterapia, estudios clínicos, terapia con protón, medicina complementaria avanzadas.
OncoLink se complace en ofrecer una amplia lista de lista completa de los agentes quimioterapéuticos más comúnmente usados??. Esta guía de referencia incluye información sobre la forma en que cada fármaco se administra, cómo funcionan, y los pacientes los efectos secundarios comunes pueden experimentar.
Maneras que los pacientes de cáncer y las personas que le cuidan puedan enfrentar el cáncer, los efectos secundarios, nutrición, cuestiones en general sobre el apoyo para el cáncer, duelo/decisiones sobre el termino de vida, y experiencias compartidas por sobrevivientes.
National Cancer Institute®
Ultima Vez Modificado: 21 de noviembre del 2001
UI - 21385156
AU - Ali SM; Olivo M; Yuen GY; Chee SK
TI - Photodynamic-induced apoptosis of human nasopharyngeal carcinoma cells using Hypocrellins.
SO - Int J Oncol 2001 Sep;19(3):633-43
AD - Department of Medical Sciences, National Cancer Centre, 11 Hospital Drive, Singapore 169610. email@example.com
It has been reported that novel photosensitizers Hypocrellin A and B, lipid soluble perylquinone derivatives of the genus Hypericum have a strong photodynamic effect on tumors and viruses. The molecular mechanisms of tumor cell death induction by Hypocrellin A and B are poorly understood. In this study, we have examined the photodynamic effects of Hypocrellin A and B compounds in poorly differentiated (CNE2) and moderately differentiated (TW0-1) human nasopharyngeal carcinoma (NPC) cells. Using these cell lines we investigated the role of the apoptotic pathway in photosensitized Hypocrellin A and B-mediated cell death. Tumor cells photoactivated with Hypocrellin A and B showed cell size shrinkage and an increase in the sub-diploid DNA content. A loss of membrane phospholipid asymmetry associated with apoptosis was induced by both tumor cell lines as evidenced by the externalization of phosphatidylserine (PS). A dose-dependent increase in caspases-3 protease activity inhibitable by the tetrapeptide inhibitor DEVD-CHO was also observed in both cell lines. Western blot analysis of poly (ADP-ribose) polymerase, a caspase substrate, showed the classical cleavage pattern (116 to 85 kDa) associated with apoptosis in Hypocrellin A and B-treated cell lysates. In addition, caspase inhibition blocked the externalization of membrane PS, indicating that the loss of membrane phospholipid asymmetry is a downstream event of caspases activation. These results demonstrate that tumor cell death induced by Hypocrellin A and B is mediated by caspase proteases. In conclusion, this study identifies both Hypocrellins (A and B) as potent and promising photosensitizers for the treatment of NPC.
UI - 21392179
AU - Lai J; Tao Z; Xiao J; Yan Y; Wang X; Wang C; Zhou S; Tian Y
TI - Effect of photodynamic therapy (PDT) on the expression of pro-apoptotic protein Bak in nasopharyngeal carcinoma (NPC).
SO - Lasers Surg Med 2001;29(1):27-32
AD - Department of Otolaryngology, Xiang Ya Hospital, Hunan Medical University, Changsha, Hunan 410008 P.R. China. firstname.lastname@example.org
BACKGROUND AND OBJECTIVE: To investigate the effect of photodynamic therapy (PDT) on expression of the pro-apoptotic gene Bak in nasopharyngeal carcinoma (NPC). STUDY DESIGN/MATERIALS AND METHODS: Apoptosis and expression of the pro-apoptotic gene Bak on the tumor tissues from both pre- and post-PDT were determined using the in situ end labeling (ISEL), standard immunohistochemistry technique and western blot, respectively, in 24 patients with either persistent or recurrent NPC after radiotherapy. RESULTS: Before PDT, apoptotic index (AI) in tumor tissue was 1.2 +/- 0.6. At 6, 12, 24 and 48 hours after PDT, AI were 6.5 +/- 3.1, 23.6 +/- 8.3, 67.2 +/- 14.2 and 89.3 +/- 8.1, respectively. PDT caused apoptosis in a time-dependent fashion. Immunohistochemical assay indicated that 75% (18/24) of the patients had an upgrade expression of Bak protein in their tumor tissues after PDT. Increases in expression of Bak from PDT were also confirmed by western blot analysis. CONCLUSIONS: PDT probably causes NPC cell apoptosis through an upregulation of the pro-apoptotic protein Bak expression. Copyright 2001 Wiley-Liss, Inc.
UI - 21396148
AU - Kim S; Wu HG; Heo DS; Kim KH; Sung MW; Park CI
TI - Advanced hypopharyngeal carcinoma treatment results according to treatment modalities.
SO - Head Neck 2001 Sep;23(9):713-7
AD - Department of Therapeutic Radiology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744, Korea.
BACKGROUND: The purpose of this retrospective study is to compare the treatment results of locally advanced hypopharyngeal carcinoma according to treatment modalities. METHODS: Seventy-three patients with locally advanced hypopharyngeal carcinoma treated at the Department of Therapeutic Radiology, Seoul National University Hospital, between patients were treated with radiotherapy (RT) alone, 18 patients were treated with surgery and postoperative RT, and 32 patients were treated with neoadjuvant chemotherapy (CTx) and RT. Median follow-up period was 28 months. RESULTS: The overall 5-year survival rates were 15.7% for the RT alone group, 46.8% for surgery and postoperative RT group, and 43.0% for neoadjuvant CTx and RT group. The 5-year disease-free survival rates were 13.9%, 47.4%, and 30.7%, respectively. Surgery and postoperative RT or neoadjuvant CTx and RT showed superiority over RT alone in terms of both overall survival and disease-free survival rates. No significant differences were found in overall and disease-free survival rates between the surgery and postoperative RT group and neoadjuvant CTx and RT group (p =.15, p =.13). In the neoadjuvant CTx and RT group, 12 patients (38%) retained their larynx more than 5 years. CONCLUSION: Neoadjuvant CTx and RT is an effective strategy to achieve organ preservation without compromising the survival of patients with locally advanced hypopharyngeal carcinoma. Copyright 2001 John Wiley & Sons, Inc.
UI - 21396157
AU - Martins AS
TI - Neck and mediastinal node dissection in pharyngolaryngoesophageal tumors.
SO - Head Neck 2001 Sep;23(9):772-9
AD - Head and Neck Service, Department of Surgery, Faculty of Medical Sciences, State University Of Campinas (Unicamp), Rua Roxo Moreira, No. 1234, Cidade Universitaria, 13083-591, Campinas, Sao Paulo, Brazil. email@example.com
BACKGROUND: Specific reports about neck node metastasis in cervical esophageal tumors and mediastinal node metastasis in patients with pharyngolaryngoesophageal tumors are lacking. This study was undertaken to evaluate the need for neck and mediastinal lymph node dissection when dealing with carcinomas of this region. METHODS: A retrospective review of the records of 34 patients who underwent total pharyngolaryngoesophagectomy and gastric transposition (TPLEGT) for squamous cell carcinoma of the pharyngoesophageal junction was done. Sixteen patients had esophageal carcinomas, 14 had hypopharyngeal carcinomas, and 4 had laryngeal carcinomas. The mediastinal dissection was designed to remove mainly the paratracheal and paraesophageal lymph nodes down to the aortic arch, without thoracotomy. Neck and mediastinal lymph node metastases were studied with specific reference to main primary site, and comparison with the literature was undertaken. RESULTS: Twenty-five neck dissections were performed in 19 patients and yielded positive nodes in 16 patients (47% of all patients). The neck nodes were positive in 75%, 64.2%, and 18.7% of the patients with laryngeal, hypopharyngeal, and esophageal carcinomas, respectively. Mediastinal dissection data were available on 27 patients, and 16 (59.2%) had mediastinal node metastasis. These mediastinal nodes were positive in 0%, 72.7%, and 61.5% of the patients with laryngeal, hypopharyngeal, and esophageal carcinomas, respectively. CONCLUSIONS: There is little controversy about neck dissections in tumors of the larynx and hypopharynx when a TPLEGT is contemplated. A similar situation applies to mediastinal dissections for cervical esophageal carcinomas. Although we observed a low incidence of positive neck nodes (18.7%) in patients with cervical esophageal carcinomas, there is a need for a larger prospective series. Our finding of 72.7% positive mediastinal nodes in hypopharyngeal carcinomas is high enough to deserve further study. Laryngeal carcinomas showed no positive mediastinal nodes in this series. Copyright 2001 John Wiley & Sons, Inc.
UI - 21396158
AU - Lam WW; Yuen HY; Wong KS; Leung SF; Liu KH; Metreweli C
TI - Clinically underdetected asymptomatic and symptomatic carotid stenosis as a late complication of radiotherapy in Chinese nasopharyngeal carcinoma patients.
SO - Head Neck 2001 Sep;23(9):780-4
AD - Department of Diagnostic Radiology and Organ Imaging, Prince of Wales Hospital, Shatin, New Territories, Hong Kong. firstname.lastname@example.org
BACKGROUND: Carotid artery stenosis is a late complication of radiotherapy to the neck region. This complication has, however, a significant impact with increased risk of stroke causing mortality and morbidity. Clinicians' awareness of this complication and early detection is therefore important. METHODS: Eighty patients with nasopharyngeal carcinoma (NPC) who had received radiotherapy were recruited for color Doppler ultrasonography of the carotid arteries. fifty-eight patients with newly diagnosed NPC who had never received any radiotherapy were recruited as controls. All patients with significant carotid stenosis were referred to the neurology clinic for further assessment. RESULTS: Twenty-four patients were found to have more than 50% diameter reduction in the extracranial carotid artery. Clinical assessment by a neurologist showed 9 of 24 patients had a history of transient ischemic attack, amaurosis fugax, or stroke. Seven of these patients had clinically detectable neck bruit. CONCLUSIONS: Clinicians attending to patients after radiotherapy for head and neck cancers should be aware of this long-term complication of radiotherapy. A detailed clinical history and incorporation of auscultation of carotid arteries in routine follow-up of postradiotherapy patients are recommended. Copyright 2001 John Wiley & Sons, Inc.
UI - 21396160
AU - Chua DT; Sham JS; Hung KN; Leung LH; Cheng PW; Kwong PW
TI - Salvage treatment for persistent and recurrent T1-2 nasopharyngeal carcinoma by stereotactic radiosurgery.
SO - Head Neck 2001 Sep;23(9):791-8
AD - Department of Clinical Oncology, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong. email@example.com
OBJECTIVE: To study the efficacy of stereotactic radiosurgery in salvaging early-stage persistent and recurrent nasopharyngeal carcinoma (NPC) after primary radiotherapy. METHODS: A prospective single-arm study evaluating the response and outcome of patients with rT1-2 NPC treated by stereotactic radiosurgery. Eleven patients with rT1-2 were were treated for persistent disease occurring within 4 months after primary radiotherapy, six were treated for first recurrence, and one for third recurrence. Six patients had rT1 disease and five had rT2 disease. Most patients had disease not amenable to brachytherapy, surgery, or external re-irradiation. The median target volume was 5.8 cc (range, 3.3-16.9). Radiosurgery was performed with multiple noncoplanar arcs of photon, with a median dose of 12.5 Gy delivered to the 80% isodose line (range, 12-14 Gy). Median follow-up time after radiosurgery was 18 months (range, 9-30). RESULTS: Nine patients had complete regression of tumor as assessed by imaging, nasopharyngoscopy, and biopsy; one patient had partial regression of tumor; whereas one patient had static disease. The overall response rate was 91% (10 of 11) and the complete response rate was 82% (9 of 11). Two patients with complete response subsequently had local relapse develop, with one recurrence outside the treated volume 8 months after radiosurgery, and the other within the treated volume 6 months after radiosurgery. One patient with a partial response had neck node recurrence develop. Temporal lobe necrosis occurred in one patient but probably represents sequelae of primary radiation after reviewing the dosimetry. Ten patients are still alive, whereas one patient with local relapse had distant metastases develop and died. The estimated 1-year local control rate after radiosurgery was 82%. CONCLUSIONS: Our preliminary results indicate that stereotactic radiosurgery is an effective treatment modality for persistent and recurrent T1-T2 NPC, and early control rate seems to be comparable to other salvage treatments. More clinical experiences and longer follow-up are still needed to validate our results and to address fully the role of radiosurgery in salvaging local failures of NPC. Copyright 2001 John Wiley & Sons, Inc.
UI - 21396161
AU - Airoldi M; De Crescenzo A; Pedani F; Marchionatti S; Gabriele AM; Succo
TI - G; Rosti G; Bumma C Feasibility and long-term results of autologous PBSC transplantation in recurrent undifferentiated nasopharyngeal carcinoma.
SO - Head Neck 2001 Sep;23(9):799-803
AD - Department of Medical Oncology, San Giovanni Antica Sede Hospital, Via Cavour 31, 10123 Torino, Italy.
BACKGROUND: Recurrent undifferentiated nasopharyngeal carcinoma (UNPC) is a chemosensitive illness. Here we report long-term results of high-dose chemotherapy (HDC) as late intensification, with autologous peripheral blood stem cell (PBSC) support. METHODS: Six patients (5 men, 1 woman; median age 41years; median ECOG PS = 0) with recurrent UNPC (local, 2; local + nodal, 2; bone metastasis, 2) have been enrolled. All patients had been previously treated with neoadjuvant chemotherapy and radiotherapy; 3 of 4 local relapses had received a re-irradiation. Every patient received three courses of cisplatin + epirubicin and 1 cycle of epirubicin followed by PBSC collection. A median of 7.2 x 10(6)/kg (range, 4.5-18) CD34+ cells were reinfused. HDC was according ICE scheme: ifosfamide, 2.5 g/m(2)/d, + carboplatin, 300 mg/m(2)/d, + VP-16, 300 mg/m(2)/d days 1 through 4. RESULTS: After conventional chemotherapy, we had 1 CR (16%), 3 PR (50%), and 2 NC (34%). After HDC, we had 4 CR (66%),1 PR (17%), and 1 MR (17%). Toxicity was manageable. After a median follow-up of 30 months (range, 14-50), two patients are alive without disease (34%), one is alive with bone disease (16%), and three (50%) died of disease at 16, 18, and 24 months. CONCLUSIONS: HDC has an acceptable toxicity, can convert PR in CR, and seems effective, with long-lasting CRs. Copyright 2001 John Wiley & Sons, Inc.
UI - 21436644
AU - Hsu CC; Lai PH; Lee C; Huang WC
TI - Automated nasopharyngeal carcinoma detection with dynamic gadolinium-enhanced MR imaging.
SO - Methods Inf Med 2001;40(4):331-7
AD - Department of Computer Science and Engineering, National Sun Yat-Sen University, Kaohsiung, Taiwan, R.O.C.
OBJECTIVES: The purpose of this research is to develop an automatic medical diagnosis for segmenting nasopharyngeal carcinoma (NPC) with dynamic gadolinium-enhanced MR imaging. METHODS: This system is a multistage process, involving motion correction, head mask generation, dynamic MR data quantitative evaluation, rough segmentation, and rough segmentation refinement. Two approaches, a relative signal increase method and a slope method, are proposed for the quantitative evaluation of dynamic MR data. RESULTS: The NPC detection results obtained using the proposed methods had a rating of 85% in match percent compared with these lesions identified by an experienced radiologist. The match percent for the two proposed methods did not have significant differences. However, the computation cost for the slope method was about twelve times faster than the relative signal increase method. CONCLUSIONS: The proposed methods can identify the NPC regions quickly and effectively. This system can enhance the performance of clinical diagnosis.
UI - 21268639
AU - Paris J; Guelfucci B; Moulin G; Zanaret M; Triglia JM
TI - Diagnosis and treatment of juvenile nasopharyngeal angiofibroma.
SO - Eur Arch Otorhinolaryngol 2001 Mar;258(3):120-4
AD - Department of Oto-Laryngology, Head and Neck Surgery, La Timone University Hospital Center, Boulevard Jean Moulin, 13385 Marseille, France.
The aim of this retrospective study was to compare clinical and radiological findings and discuss optimal surgical approach in patients with juvenile nasopharyngeal angiofibroma (JNA). Forty-three cases of JNA were treated at our institution from 1975 to 1999. Thirty-three male patients aged between 8 and 25 years (mean 15.3) were included. Twenty-nine patients underwent primary surgical treatment at our institution and four were treated for recurrence following primary surgery elsewhere. Tumors were staged according to Fisch's staging. Preoperative embolization was performed in 22 cases. Surgical techniques consisted of the transantral approach, lateral rhinotomy approach, transmaxillary via midfacial degloving approach, and the subtemporal preauricular infratemporal fossa approach. Tumors were classified stage I in seven cases, stage II in 11, stage III in 13 and stage IV in two. The mean delay between the initial symptom and surgery was 14 months overall, 18 months for stage I, 14 for stage II, 13 for stage III and 12 for stage IV. The transantral approach was used in 11 patients, lateral rhinotomy approach in 11 cases, transmaxillary via midfacial degloving approach in three patients, and pre-auricular infra-temporal approach in eight patients. Mean follow-up after surgery was 56 months. Six patients had recurrent tumors. Surgery is the gold standard for treatment of JNA. Modern imaging techniques allow accurate diagnosis and staging of JNA. Our experience and a review of the literature shows that the surgical approach should be selected according to tumor stage.
UI - 21401855
AU - Stranadko EF; Garbuzov MI; Zenger VG; Nasedkin AN; Markichev NA; Riabov
TI - MV; Leskov IV [Photodynamic therapy of recurrent and residual oropharyngeal and laryngeal tumors]
SO - Vestn Otorinolaringol 2001;(3):36-9
Photodynamic therapy (PDT) was given to 61 patients with recurrent cancer of the tongue, oral mucosa, lower lip, oro- and nasopharynx, larynx. Photosensitizers photogem and photosens of Russian produce were employed. The radiation was given twice with the interval 24 and 48 hours, the exposure to light 3 to 30 min. The impact was external, through the instrumental canal of the fibroscope, by intracavitary and interstitial techniques. The response was assessed within 4-6 weeks after the PDT course. The effect was observed in 95.1% patients. Its duration ranged from 4 months to 5 years. Complete resorption of the tumor was achieved in 57.4%. The treatment failed in 4.9% patients.
UI - 21411333
AU - Lessard JL; Robinson RA; Hoffman HT
TI - Differential expression of ras signal transduction mediators in verrucous and squamous cell carcinomas of the upper aerodigestive tract.
SO - Arch Pathol Lab Med 2001 Sep;125(9):1200-3
AD - Department of Pathology, University of Iowa, Iowa City, IA 52243, USA.
CONTEXT: ras gene mutations and expression of its gene product have been described in verrucous and squamous cell carcinomas. Other downstream signal-transduction mediators, extracellular signal-regulated kinases 1 and 2 (ERK-1 and ERK-2) and Raf-1, have not yet been as extensively studied. OBJECTIVE: To determine patterns of expression of ERK-1, ERK-2, and Raf-1 in verrucous and squamous cell carcinomas of the upper aerodigestive tract. DESIGN: Seventeen verrucous carcinomas and 10 squamous cell carcinomas of the upper aerodigestive tract were examined for the immunohistochemical expression of ERK-1, ERK-2, and Raf-1 product. RESULTS: Raf-1 expression was intensely expressed in the most basal portions of the epithelium in verrucous carcinomas, but was minimally expressed in the suprabasalar areas. Anti-Raf-1 staining of the squamous cell carcinomas was diffuse and patchy throughout the tumor cells and was weak in intensity. There was no geographic preference of staining. The cytoplasmic expression of both ERK-1 and ERK-2 was predominantly negative in the most basal layers of the epithelium in the verrucous carcinomas, but was positive in the suprabasalar region of the epithelium. Immunohistochemical expression of ERK-1 and ERK-2 in the squamous carcinomas was diffuse throughout the tumor. CONCLUSION: There is strong correlation of the geographic expression of these mediators of ras signal transduction in verrucous and squamous carcinomas, but the cause of these differences remains unclear at present. The expression of these mediator proteins may have potential for diagnosis, as well as in understanding the biologic behavior of these lesions.
UI - 21453605
AU - Howard DJ; Lloyd G; Lund V
TI - Recurrence and its avoidance in juvenile angiofibroma.
SO - Laryngoscope 2001 Sep;111(9):1509-11
AD - Institute of Laryngology & Otology, University College London, UK.
OBJECTIVE: Angiofibroma is a highly vascular lesion for which a wide range of surgical approaches has been recommended. Irrespective of the approach, a significant and often rapid recurrence rate is reported in all major series. AIM: To consider the impact of lessons learned from imaging on the recurrence rate of angiofibroma. MATERIAL AND METHODS: From a cohort of 90 male patients with histologically proven angiofibroma, 40 individuals were studied. The recurrence rate in 20 treated thereafter. In the latter group, an additional exploration of the basisphenoid had been undertaken. RESULTS: The two cohorts were comparable in age range (7-27 y and 11-24 years, respectively), and all had been treated by midfacial degloving. In the first group, 8 recurrences occurred which were multiple in 1 patient. In the next 19 patients, the area of the pterygoid canal was meticulously explored and the basisphenoid drilled to remove all residual tumor. No recurrences have occurred in this group during a follow-up of between 6 months to 3 years. CONCLUSION: Meticulous removal of angiofibroma infiltrating the pterygoid canal and basisphenoid is paramount to avoid "recurrence."
UI - 21453602
AU - Schramm VL Jr; Imola MJ
TI - Management of nasopharyngeal salivary gland malignancy.
SO - Laryngoscope 2001 Sep;111(9):1533-44
AD - Center for Craniofacial-Skull Base Surgery, Denver, Colorado, USA.
OBJECTIVE: The objective of this study was to evaluate the oncological outcome and complication rate following surgical treatment of nasopharyngeal salivary gland malignancy. STUDY DESIGN: Retrospective case review at tertiary care skull base center. METHODS: Pertinent medical records were reviewed from 23 patients presenting with minor salivary gland malignancy. Clinical presentation, prior treatment, histological type and grade, clinical stage, details of surgical treatment, and postoperative adjuvant radiation therapy were studied. Survival and recurrence data were analyzed using the Kaplan-Meier and Cox proportional hazards methods. RESULTS: Histological types included 11 adenoid cystic carcinomas, 8 mucoepidermoid carcinomas, and 4 cases of adenocarcinoma not otherwise specified. All patients underwent primary surgical resection, and the lateral infratemporal middle fossa approach was used in 20 patients. Prior radiation therapy had been administered in 6 patients who presented for treatment of recurrent disease, and the remaining 17 patients underwent planned postoperative radiation therapy. Elective neck dissection was undertaken in 15 patients, and occult neck disease was present in 47%. Disease specific survival was 67% at 5 years and 48% at 10 years. High-grade tumors had a significantly poorer outcome (P =.035) with a relative risk of 4.6 compared with low-grade disease. Local control was seen to be 77% at 5 years. CONCLUSIONS: Planned combined surgery and radiation therapy achieves survival outcomes and recurrence rates in nasopharyngeal salivary gland malignancy comparable to results reported using the same treatment for minor salivary gland tumors cancer originating elsewhere in the head and neck. Because of the high rate of occult neck metastases, we recommend elective neck dissection as part of the surgical treatment with this disease entity. The lateral infratemporal middle fossa approach provides safe and adequate access to resect the vast majority of these tumors with acceptable complication rates. A reliable form of vascularized reconstruction is necessary to prevent serious postoperative complications, and we currently prefer the gastro-omental free flap.
UI - 21453616
AU - Deng YF; Tian F; Lu YD; Chen ZC; Xie DH; Yang XM; Shao XY
TI - Mutation and abnormal expression of the fragile histidine triad gene in nasopharyngeal carcinoma.
SO - Laryngoscope 2001 Sep;111(9):1589-92
AD - Department of Otorhinolaryngology, Second Affiliated Hospital, Xiang-Ya Medical College of Central South University, Changsha, Hunan, China. firstname.lastname@example.org
OBJECTIVE: To determine alterations of fragile histidine triad (FHIT) gene in nasopharyngeal carcinoma and the correlation of FHIT gene with nasopharyngeal carcinogenesis. STUDY DESIGN: Prospective study. METHODS: A total of 28 nasopharyngeal carcinoma and 16 normal nasopharyngeal epithelium specimens were examined for abnormalities of FHIT gene by nested reverse-transcriptase-polymerase chain reaction and DNA sequencing. RESULTS: The deletion of FHIT gene was not observed in 16 normal nasopharyngeal epithelium specimens. In 28 cases of nasopharyngeal carcinoma tissues, 12 (42.9%) exhibited FHIT aberrant transcripts. Complementary DNA sequencing revealed exonic deletion, small DNA insertion, synonymous mutation in exon 8, or frameshift mutation in exon 5. CONCLUSIONS: The present results suggest that the FHIT gene may play an important role in the pathogenesis of nasopharyngeal carcinoma and may be one of the candidate tumor suppressor genes in nasopharyngeal carcinoma.
UI - 21453626
AU - Dedo HH; Yu KC
TI - CO(2) laser treatment in 244 patients with respiratory papillomas.
SO - Laryngoscope 2001 Sep;111(9):1639-44
AD - Department of Otolaryngology-Head and Neck Surgery, University of California, San Francisco, San Francisco, California 94117, USA.
OBJECTIVE: Respiratory papillomas (RP) tend to recur and the difficulty in eradicating the disease makes their treatment frustrating. Meticulous CO(2) laser excisions every 2 months has been the most effective treatment to date. This article analyzes the results of this plan in 244 patients with RP in the nose, nasopharynx, pharynx, hypopharynx, larynx, trachea, lung parenchyma, and skin. METHODS: Two hundred forty-four patients with recurrent RP were treated by the senior author with CO(2) laser excisions and, in some cases, podophyllum and alpha interferon. Demographics, initial distribution of papillomas, number of operations performed on each patient, and current results were evaluated. RESULTS: Careful laser excisions of RPs every 2 months achieved "remission" of disease (no visible RP on indirect or often direct laryngoscopy 2 mo after last removal) in 37% of patients, "clearance" of the disease process (no RP clinically apparent for 3 y after last removal) in 6%, and "cure" (no clinical recurrence for 5 y after last removal) in 17%. Juvenile-onset RP tends to follow a more aggressive course than adult-onset RP. Four patients (1.6%) developed malignant transformation of their papillomas. Except for ones in lung parenchyma, RP in areas other than the true vocal cords tend to be cleared faster because aggressive removal does not cause hoarseness. Lung parenchyma RPs are eventually fatal because of pulmonary failure from abscesses and cysts resulting from a lack of effective treatment. CONCLUSION: Frequent and meticulously performed CO(2) laser excisions can achieve significant voice and airway improvement, and some clinical "cures." However, effective antiviral medicines and/or immunologic agents are needed to achieve true cures with elimination of all human papilloma virus 6 and 11 viruses.
UI - 21449310
AU - Zito J; Fitzpatrick P; Amedee R
TI - Juvenile nasopharyngeal angiofibroma.
SO - J La State Med Soc 2001 Aug;153(8):395-8
AD - Department of Otolaryngology-Head and Neck Surgery at Tulane University Health Sciences Center, New Orleans, Louisiana, USA.
Juvenile nasopharyngeal angiofibroma is a rare yet potentially destructive vascular tumor that typically affects adolescent males. While the etiology of these tumors remains unknown, great advances have been made in their diagnosis and treatment. When juvenile nasopharyngeal angiofibroma is diagnosed at an early stage, the prognosis is generally very good, as patients can be treated with a combination of pre-operative embolization and surgical resection. Advanced juvenile nasopharyngeal angiofibroma is much more difficult to treat, since orbital and intracranial involvement are common in the natural progression of the disease. However, due to the rather innocuous presenting symptoms (commonly, nasal obstruction and epistaxis), diagnosis most often occurs in the later stages of the disease. For this reason, it is important for all physicians to have a high degree of suspicion for juvenile nasopharyngeal angiofibroma when evaluating a male adolescent with these symptoms.
UI - 21453157
AU - O'Sullivan B; Warde P; Grice B; Goh C; Payne D; Liu FF; Waldron J;
TI - Bayley A; Irish J; Gullane P; Cummings B The benefits and pitfalls of ipsilateral radiotherapy in carcinoma of the tonsillar region.
SO - Int J Radiat Oncol Biol Phys 2001 Oct 1;51(2):332-43
AD - Department of Radiation Oncology, Wharton Head and Neck Centre, The Princess Margaret Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada. email@example.com
PURPOSE: Ipsilateral techniques designed to restrict treatment to the primary tumor and neck on the same side have been used in selected cases of cases of carcinoma of the tonsillar region at our institution for many years. The primary purpose of this study is to evaluate the risk of failure in the opposite neck in cases selected for unilateral radiotherapy over a 21-year period. METHODS AND MATERIALS: Ipsilateral radiotherapy techniques were used in 228 of 642 patients with carcinoma of the tonsillar region from 1970 to 1991. Local control, regional lymph-node control (including contralateral failure), and survival were calculated for different degrees of tumor extent treated with these techniques. RESULTS: Mean follow-up was 7 years. Cases tended to be T1 and T2, with N0 disease. The 3-year actuarial local control rate was 77% and cause-specific survival was 76%. Opposite neck failure was seen in 8 patients (crude rate of 3.5%). In the earlier period of the study, primary coverage was problematic in a proportion of cases and resulted in higher rates of local failure. CONCLUSION: Appropriately selected cases of carcinoma of the tonsil show minimal risk of failure in the opposite neck with ipsilateral techniques. Patients should undergo computed tomography planning to ensure adequate target coverage.
UI - 21453158
AU - Jen YM; Hsu WL; Chen CY; Hwang JM; Chang LP; Lin YS; Su WF; Chen CM; Liu
TI - DW; Chao HL Different risks of symptomatic brain necrosis in NPC patients treated with different altered fractionated radiotherapy techniques.
SO - Int J Radiat Oncol Biol Phys 2001 Oct 1;51(2):344-8
AD - Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China. firstname.lastname@example.org
PURPOSE: To report our observation of excessive temporal lobe necrosis in nasopharyngeal carcinoma (NPC) patients treated with 160 cGy b.i.d. radiotherapy technique. During the same period, patients treated with 120 cGy b.i.d. have not shown a similar tendency. Our experience may be useful for designing unconventional radiotherapy regimens for NPC fractionated radiotherapy. Seventy patients were treated with the hyperfractionated technique, and 11 were treated using the accelerated-hyperfractionated scheme. Hyperfractionated radiotherapy was delivered using 120 cGy b.i.d. separated by 6-h intervals throughout the course. A minimum tumor dose of 8000 cGy was the standard dose over an 8-week period. With the accelerated-hyperfractionated scheme, 160 cGy was given twice daily, also with an interval of 6 h. The minimum tumor dose ranged between 6840 and 7640 cGy, with 7 of the 11 patients receiving 7000 cGy. The arrangement of portals was the same for both regimens. The follow-up period for patients alive was from 32 to 102 months with a median of 61 months for the hyperfractionated patients. For the accelerated-hyperfractionated group, it ranged from 67 to 82 months with a median of 72 months. No patient was lost to follow-up. RESULTS: At the time of analysis, 49 of the 70 patients in the hyperfractionated group were alive. In the accelerated group, 8 of the 11 patients were alive. The estimated radiation dose to the temporal lobe for the hyperfractionated group was 6000-7440 cGy with a median of 7080 cGy. For the accelerated-hyperfractionated group, the dose range was 4480-6700 cGy with a median of 6400 cGy. Of the 70 patients treated with hyperfractionated radiotherapy, none developed symptomatic brain necrosis, despite the higher total dose to the temporal lobe in general. In contrast, 3 of the 11 (27%) patients irradiated using the accelerated-hyperfractionated regimen suffered from temporal lobe necrosis at 16, 19, and 40 months after completion of radiotherapy. CONCLUSION: An excessive incidence of temporal lobe necrosis was noted when an accelerated-hyperfractionated regimen with 160 cGy b.i.d. was used in NPC patients with a median brain dose of 6400 cGy. There has been no such event in patients treated using a hyperfractionated regimen with 120 cGy and a median brain dose of 7000 cGy. The real causes of this discrepancy are not known. However, a high sensitivity of the human brain to a change in fraction size may play a role.
UI - 21458876
AU - Chien CR; Chen SW; Hsieh CY; Liang JA; Yang SN; Huang CY; Lin FJ
TI - Retrospective comparison of the AJCC 5th edition classification for nasopharyngeal carcinoma with the AJCC 4th edition: an experience in Taiwan.
SO - Jpn J Clin Oncol 2001 Aug;31(8):363-9
AD - Department of Radiation Therapy and Oncology, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
OBJECTIVE: The aim of this study was to compare the new AJCC 5th edition classification system for nasopharyngeal carcinoma (NPC) with the AJCC 4th edition by re-evaluating the staging of patients treated in Taiwan. METHODS: From 1992 through 1996, 117 NPC patients without distant metastasis were treated using complete courses of radiotherapy. All patients had complete CT examinations of the nasopharynx and neck. Each patient was re-staged according to the 5th edition of the AJCC classification system. Their overall survival (OS), loco-regional relapse-free survival (LRRFS), distant metastasis-free survival (DMFS) and disease-free survival (DFS) were compared between the two staging systems, using the Kaplan-Meier method, log-rank test, Wilcoxon test and Cox proportional hazard model. RESULTS: After a median follow-up of 58.3 months, the 5-year OS for stage I, II, III and IV was 88, 86, 61 and 48%, respectively, according to the new staging. A more even distribution of patients was noted among the patients classified according to the AJCC 5th edition than the 4th edition. The distribution of stages I, II, III and IV was 13.7, 37.6, 15.4 and 33.3%, respectively, using the new staging system, whereas it was 0.8, 14.5, 20.5 and 64.2%, respectively, using the old staging system. More statistically significant differences among 5th edition stages and T classifications than the 4th edition were also noted. CONCLUSIONS: The 5th edition of the AJCC staging system appears to have a more even distribution of patients and more statistically significant differences in predicting prognosis than the 4th edition, mostly in stages and T classification.
UI - 92133256
AU - Laterza E; Inaspettato G; Ricci F; Macri A; Veraldi GF; Cordiano C
TI - [Treatment of malignant stenosis of the cervical esophagus]
SO - Acta Otorhinolaryngol Ital 1991;11(3):265-73
AD - Cattedra di Chirurgia d'Urgenza e Pronto Soccorso, Universita di Verona.
UI - 21469556
AU - Triboulet JP; Mariette C; Chevalier D; Amrouni H
TI - Surgical management of carcinoma of the hypopharynx and cervical esophagus: analysis of 209 cases.
SO - Arch Surg 2001 Oct;136(10):1164-70
AD - Service de Chirurgie Digestive et Generale, Clinique Chirurgicale Adultes est, Chru Lille Hopital Huriez, Place de Verdun, 59037 Lille CEDEX, France. email@example.com
BACKGROUND: Free jejunal transfer has become the standard technique for reconstruction of the pharynx and hypopharynx, especially with proximal neoplastic lesions, whereas gastric tube interposition is the technique of choice for reconstruction of the hypopharynx and cervical esophagus when resection extends below the thoracic inlet. HYPOTHESIS: Surgical ablation is a viable option for advanced hypopharyngeal and cervical esophageal neoplasms, with stomach interposition a safe and preferred method of reconstruction. DESIGN: Retrospective analysis. SETTING: University hospital that is a regional referral institution for esophageal cancer treatment and complex digestive reconstructions after esophagectomy. PATIENTS: We reviewed the records of 209 patients who majority of patients had advanced cancer: hypopharyngeal in 131 cases and cervical esophageal in 78 cases. INTERVENTIONS: Pharyngolaryngectomy and total esophagectomy with pharyngogastric anastomoses (n = 127); pharyngolaryngectomy, cervical esophagectomy, and reconstruction with free jejunal transplant (n = 77); and pharyngolaryngectomy and total esophagectomy with pharyngocolic anastomoses (n = 5). MAIN OUTCOME MEASURES: Postoperative mortality and morbidity, long-term survival, and prognostic factors influencing survival. RESULTS: The postoperative in-hospital mortality rate was 4.8% (10 patients), with a postoperative morbidity rate of 38.3%. Alimentary continuity was achieved using the stomach (127 patients), colon (5 patients), or free jejunal autograft (77 patients). The 1-year and 5-year survival rates were 62% and 24%, respectively. There was no significant difference with regard to the survival between gastric transposition and free jejunal autograft, but there were fewer complications in the gastric pull-up group (33% vs 47%, P<.05). The significant adverse factors affecting survival were tumor cervical localization, postoperative complications, disease stages pT3 and pT4 for the cervical esophageal tumors, microscopic pharyngeal penetration, or incomplete resection. The significant beneficial factors were tumor hypopharyngeal localization and postoperative radiotherapy. CONCLUSIONS: Surgical ablation is a viable option for advanced hypopharyngeal and cervical esophageal neoplasms, with stomach interposition the preferred method of reconstruction. Although the prognosis is poor, satisfactory short-term palliation can be achieved. The significant adverse factors affecting survival should be taken into account to select the candidates for surgery.
UI - 21301905
AU - Chiesa F; De Paoli F
TI - Distant metastases from nasopharyngeal cancer.
SO - ORL J Otorhinolaryngol Relat Spec 2001 Jul-Aug;63(4):214-6
AD - Head and Neck Division, European Institute of Oncology, Milan, Italy. firstname.lastname@example.org
Undifferentiated carcinoma is the most frequent nasopharyngeal cancer; it has a typical pathognomonic histological pattern, a close relationship to Epstein-Barr virus (EBV), a peculiar natural history and a good prognosis. It has an early tendency to locally spread to the parapharyngeal space. Nodal involvement is highly frequent (70-90%) and bulky regardless of the size of the primary. Literature reports up to 11% distant metastases at presentation and up to 87% at autoptic studies. Pretreatment work-up should include: personal history, clinical and fiberscopic examination, magnetic resonance imaging (MRI) or computed tomography (CT) scan of the base of the skull and neck, histology of the primary and cytology of neck lumps, bone marrow aspiration and biopsy, and EBV serological profile. Clinical and pathological factors predicting possible distant spread are primary tumor and node extension, and treatment failure. Up to now no reliable predictive biological markers have been identified. After treatment, distant metastases are found in about 30% of patients within 5 years and generally have a bad prognosis. Metastatic nodes above the clavicle, in absence of locoregional failure, aggressively treated with chemoradiotherapy, have a disease-free survival longer than 5 years. The following is the suggested posttreatment work-up for early diagnosis of these salvageable patients: clinical and fiberscopic evaluation every 3 months for 2 years and later on every 6 months; skull base and neck MRI or CT scan, and chest CT scan at 6, 12, 18, 24, 36, 48 and 60 months; EBV serological evaluation. Copyright 2001 S. Karger AG, Basel
UI - 21301907
AU - Goodwin WJ
TI - Distant metastases from oropharyngeal cancer.
SO - ORL J Otorhinolaryngol Relat Spec 2001 Jul-Aug;63(4):222-3
AD - Department of Otolaryngology, University of Miami, FL 33136, USA. email@example.com
Distant metastasis is a significant problem in patients with carcinoma of the oropharynx, occurring in approximately 15-20% off all patients over the course of the disease. It is, however, a relatively uncommon first site of failure, as compared to local and regional recurrence. Distant spread occurs most commonly to the lungs, in patients who present with advanced disease, and especially in those with pathologically proven lymph nodes at multiple levels of the neck or in the lower neck. Metastasis to distant sites also occurs more often in patients who recur locally or in the neck. Copyright 2001 S. Karger AG, Basel
UI - 21301908
AU - Spector GJ
TI - Distant metastases from laryngeal and hypopharyngeal cancer.
SO - ORL J Otorhinolaryngol Relat Spec 2001 Jul-Aug;63(4):224-8
AD - Department of Otolaryngology--Head and Neck Surgery, Washington University, St. Louis, MO 63110, USA. firstname.lastname@example.org
A retrospective tumor registry analysis of patients with squamous cell carcinoma (SCC) of the larynx and hypopharynx who were treated with curative intent in the Department of Otolaryngology--Head and Neck Surgery at Washington University School of Medicine and Barnes Hospital sex and tumor differentiation did not affect the incidence of distant metastases. The overall incidence of distant metastases was 8.5% (217/2,550 patients) with the following distribution: glottis 4.4%, supraglottis 3.6%, subglottis 14%, aryepiglottic fold 16%, pyriform sinus 17% and posterior hypopharynx 17.6%. The overall 5-year disease-specific survival for distant metastases was 6.4%. Distant metastases were related to advanced local disease (T3 + T4), lymph node metastases at presentation (N+), tumor location (hypopharynx) and locoregional tumor recurrence (p < or = 0.028). A meta-analysis of variables which predispose to a higher incidence of distant metastases indicate that tumor location (hypopharynx > larynx), advanced primary disease (T3 + T4), regional disease (N+), locoregional recurrences, and advanced regional metastases (N2 + N3) are statistically significant. Copyright 2001 S. Karger AG, Basel
UI - 21341700
AU - Yoshizaki T; Horikawa T; Qing-Chun R; Wakisaka N; Takeshita H; Sheen TS;
TI - Lee SY; Sato H; Furukawa M Induction of interleukin-8 by Epstein-Barr virus latent membrane protein-1 and its correlation to angiogenesis in nasopharyngeal carcinoma.
SO - Clin Cancer Res 2001 Jul;7(7):1946-51
AD - Department of Otolaryngology, School of Medicine, Kanazawa University, Kanazawa 920-8641, Japan. email@example.com
PURPOSE: The EBV latent membrane protein-1 (LMP-1) is a multifunctional protein. Recently, the contribution of LMP-1 to the metastasis of nasopharyngeal carcinoma (NPC) has been suggested. Angiogenesis is a key step for metastasis. Thus, the association of LMP-1 to neovascularization of NPC was examined in this study. EXPERIMENTAL DESIGN: The association of LMP-1 to angiogenesis in 39 patients with NPC was evaluated by immunohistochemical study, and then induction of angiogenic factors by LMP-1 was examined by ELISA and luciferase reporter assay. RESULTS: In an immunohistochemical study, the expression of LMP-1 was significantly correlated to microvessel counts (P = 0.0003), suggesting that LMP-1 may induce some angiogenic factors. Therefore, we studied the relationship between LMP-1 expression and interleukin-8 (IL-8), vascular endothelial growth factor (VEGF), and basic fibroblast growth factor (bFGF) expression by immunohistochemical analysis. IL-8, VEGF, and bFGF expression were correlated to microvessel counts, but only IL-8 expression was significantly correlated to LMP-1 expression (P < 0.0001). Transfection with LMP-1 expression plasmid induced IL-8 protein expression in C33A cells. The expression of LMP-1 transactivated IL-8 promoter, as demonstrated by IL-8 promoter luciferase reporter assay. Mutation of the nuclear factor kappaB responsive element in the IL-8 promoter region completely abolished transactivation by LMP-1, whereas mutation of the activator protein responsive element did not affect promoter activity. CONCLUSION: These results suggested that LMP-1 induces expression of IL-8 through the nuclear factor kappaB binding site, which may contribute in part to angiogenesis in NPC.
UI - 21453579
AU - Major MS; Bumpous JM; Flynn MB; Schill K
TI - Quality of life after treatment for advanced laryngeal and hypopharyngeal cancer.
SO - Laryngoscope 2001 Aug;111(8):1379-82
AD - Division of Otolaryngology, Department of Surgery, University of Louisville School of Medicine, Louisville, KY 40292, U.S.A.
OBJECTIVES: To compare health-related quality of life measures after treatment for advanced (stages III and IV) laryngeal and hypopharyngeal cancers. STUDY DESIGN: Retrospective chart review and patient response to Health Status Questionnaire-12 (HSQ-12). METHODS: Our study included 54 patients identified from the Tumor Registry of the University of Louisville Brown Cancer Center who were diagnosed and treated between 1995 and 2000. Demographics, tumor data, and treatment information were obtained from the Tumor Registry database. Questionnaires were mailed to all patients and included telephone follow-up. Comparative data and responses were analyzed for the 24 patients who responded to the survey. RESULTS: Fifteen patients were treated with chemotherapy and radiation therapy (CRT). Six patients underwent surgery with postoperative radiation therapy (SRT). The remaining three patients were treated with radiation therapy but were not used in this analysis. The average follow-up was 35 months after treatment. The CRT and SRT groups were statistically similar regarding age, sex, duration of follow-up, tumor grade, and tumor stage. Laryngeal primary tumors were more common in the SRT group than in the CRT group (P =.005). Eight domains were assessed by the HSQ-12: physical functioning, role-physical, bodily pain, health perception, energy/fatigue, social functioning, role-mental, and mental health. No statistical differences were found between the CRT and SRT groups, except for role limitations attributable to physical health (P =.007). CONCLUSIONS: These results indicate that only one of eight domains differs significantly between treatment groups when using the HSQ-12. Two-year survival end-point analysis of global he
Endocrine System Cancers
Head and Neck Cancers
Urinary Tract Cancers
Bone Marrow Transplants
General Treatment Concerns
Newly Diagnosed Patients
Causes and Prevention
Legal and Financial Information for Patients
Cancer Resource List
Resources for Young Adults