Head & Neck (HEAD NECK-J SCI SPEC)

Publications in this journal

• Article: Genetic relationship between multiple squamous cell carcinomas arising in the oral cavity.

  Montebugnoli L, Leonardi E, Morandi L, Farnedi A, Gissi D, Marchetti C, Tarsitano A, Balbi T, Gentile L, Cocchi R, Foschini MP
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  ABSTRACT: BACKGROUND: Histological and clinical criteria are generally used to differentiate second primary tumors (SPTs) from local recurrences. The purpose of the present study was to apply mitochondrial DNA (mtDNA) D-loop analysis to differentiate SPTs from local recurrences and to validate the clinical classification. METHODS: The study population consisted of 20 consecutive patients presenting multiple oral neoplastic lesions for a total of 25 paired lesions. The mtDNA D-loop analysis was performed by direct sequencing and phylogenetic clusterization. RESULTS: Agreement between mtDNA analysis and clinical classification was found in 19 cases. Discrepancies arose in 6 cases in which the clinical criteria based only on the spatial or temporal distance of the second lesion from the index tumor had led to a diagnosis of SPT (2 cases) or local recurrence (4 cases). CONCLUSION: The present data highlight the value of mtDNA analysis in establishing the clonal relationship between the index tumor and the second neoplastic lesion.
  Head & Neck 04/2013;
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  Available from: netpoint.com.br

  Article: Using fluorodeoxythymidine to monitor anti-EGFR inhibitor therapy in squamous cell carcinoma xenografts.

  David M Atkinson, Michelle J Clarke, Ann C Mladek, Brett L Carlson, David P Trump, Mark S Jacobson, Brad J Kemp, Val J Lowe, Jann N Sarkaria
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  ABSTRACT: 3'-18F-fluoro-3'-deoxy-fluorothymidine (18F-FLT), a nucleoside analog, could monitor effects of molecularly targeted therapeutics on tumor proliferation. We tested whether (18)F-FLT positron emission tomography (PET) uptake changes are associated with antitumor effects of erlotinib in A431 xenografts or cetuximab in SCC1 xenografts. Compared with pretreatment FLT PET scans, 3 days of erlotinib in A431 reduced the standardized uptake value (SUV) by 18%, whereas placebo increased SUV by 1% (p = .005). One week of cetuximab in SCC1 reduced SUV by 62%, whereas placebo reduced SUV by 16% (p = .005). FLT uptake suppression following anti-epidermal growth factor receptor (EGFR) treatment was associated with reduced tumor thymidine kinase-1 (TK1) activity. In vitro TK1 knockdown studies confirmed the importance of TK1 activity on intracellular FLT accumulation suppression. 18F-FLT PET imaging detects tumor responses to EGFR-inhibitors within days of starting therapy. This technique may identify patients likely to benefit from EGFR-inhibitors early in their treatment course.
  Head & Neck 07/2008; 30(6):790-9.
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  Available from: netpoint.com.br

  Article: Outcomes following reirradiation of patients with head and neck cancer.

  David P Goldstein, Lucy Hynds Karnell, Min Yao, G Parker Chamberlin, Thanh X Nguyen, Gerry F Funk
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  ABSTRACT: This study reports the outcomes for patients with head and neck cancer who received reirradiation with palliative or curative intent. A retrospective review of 41 patients treated with curative (n = 28) or palliative (n = 13) reirradiation was conducted. Survival was calculated from the start of the reirradiation. Radiation-related toxicities were classified according to Radiation Therapy Oncology Group criteria. Disease-related problems included adverse events during or after reirradiation that were not directly related to reirradiation. The observed 1-year survival for all patients was 39.0% (23.0% palliative, 46.3% curative). Median survival for all patients was 10.2 months. Seventy-five percent of curative and 53.8% of palliative patients had grade 3 or 4 radiation-related toxicities and/or major disease-related problems. A second course of radiotherapy in patients with head and neck cancer should be offered with a clear understanding that survival is poor and many of these patients will suffer severe radiation-related or disease-related insults to their quality of life during and after treatment.
  Head & Neck 07/2008; 30(6):765-70.
• Article: Response to paclitaxel in adenoid cystic carcinoma of the salivary glands.

  Brian G Till, Renato G Martins
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  ABSTRACT: Paclitaxel is not considered to be an active drug in adenoid cystic carcinoma (ACC) of the salivary glands. We report 2 consecutive cases of patients with ACC who responded to paclitaxel. The patients were: (1) a 58-year-old man with recurrent ACC who developed pulmonary metastases, had progressive disease after a good response to first-line chemotherapy, and then achieved a partial response to weekly single- agent paclitaxel; and (2) a 46-year-old woman with extensive thoracic ACC metastases who achieved a significant response after 2 cycles of paclitaxel chemotherapy. The first patient died of progressive disease approximately 4 months after completing paclitaxel therapy, and the second patient had disease control after 6 cycles of paclitaxel. Systemic weekly paclitaxel produced a significant response in 2 patients with ACC of the head and neck, and its use in this disease merits further study.
  Head & Neck 07/2008; 30(6):810-4.
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  Available from: sbccp.org.br

  Article: Aggressive angiomyxoma of supraclavicular fossa: a case report.

  Chien-Yu Pai, Shin Nieh, Jih-Chin Lee, Chung-Ping Lo, Herng-Sheng Lee
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  ABSTRACT: Aggressive angiomyxoma (AAM) is a rare myxoid mesenchymal tumor that occurs almost exclusively in the adult pelvic-perineal region and predominantly in females. Only 1 case of AAM occurring outside this region has been reported. Here we report another such case. The patient was referred for evaluation of a firm nonmovable mass of the supraclavicular fossa that had progressively enlarged within the previous year. MRI showed an infiltrative growth pattern with adhesion to adjacent anatomic structures. Wide excision was attempted, but a clear margin could not be achieved. The histopathology revealed characteristic features of AAM, including stellate to spindle-shaped tumor cells set in a myxoid background, with hyalinizing thick-walled vessels and characteristic immunophenotype. Accurate diagnosis and a definite surgical margin are crucial because AAM is locally aggressive and easily recurrent. Our case deserves attention because it shows that AAM may exist in the head and neck.
  Head & Neck 07/2008; 30(6):821-4.
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  Available from: sbccp.org.br

  Article: Horizontal supraglottic partial laryngectomy for selected squamous carcinoma of the vallecula.

  Laurent Laccourreye, Dominique Garcia, Madeleine Ménard, Daniel Brasnu, Ollivier Laccourreye, F Christopher Holsinger
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  ABSTRACT: Our aim was to determine the incidence of local control in patients with selected squamous carcinoma of the vallecula treated with horizontal supraglottic laryngectomy; to analyze the consequences of local recurrence in terms of nodal recurrence, distant metastasis, survival, causes of death, overall local control, and laryngeal preservation; and to identify any clinical factors predictive of these outcomes. This was a retrospective nonrandomized case series in a university teaching hospital. An inception cohort of 95 previously untreated patients were followed until death or for a minimum of 5 years. According to the 2002 Union Internationale Contre le Cancer (UICC) staging classification system, the tumor was classified as T1, T2, and T3 in 13, 60, and 22 patients, respectively, while disease in 67 patients was considered to be in stages III to IV. All patients underwent a horizontal partial supraglottic partial laryngectomy. Ninety-four patients had an associated neck dissection. An induction chemotherapy regimen was used in 91 patients; postoperative radiation therapy was given for 49 patients. The main outcome measures were local recurrence, nodal recurrence, distant metastasis, and survival. The 1-, 3-, and the 5-year actuarial survival estimates were 86.3%, 64.2%, and 47.4%, respectively. Overall, the main causes of death were as follows: metachronous second primary tumor (47.2% of patients), intercurrent disease (16.7%), distant metastasis (15.3%), local recurrence (6.3%), and nodal recurrence, (4.2%). The 1-, 3-, and 5-year actuarial local recurrence rates were 4.5%, 11%, and 11%, respectively. Nine patients developed a local recurrence; 3 were successfully salvaged. Using multivariate analysis, no single variable was found to increase the risk for local recurrence. The overall laryngeal preservation rate and local control rate were 89.5% (85/95) and 93.4% (89/95), respectively. Local recurrence was associated with a significant increase in nodal recurrence (p <.04) and distant metastasis (p = .03). Based on this experience, horizontal partial supraglottic laryngectomy appears to be a valid approach for functional organ-preservation in patients with selected T1-T3 SCC of the vallecula.
  Head & Neck 07/2008; 30(6):756-64.
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  Available from: netpoint.com.br

  Article: Intraoperative radiation therapy as an "early boost" in locally advanced head and neck cancer: preliminary results of a feasibility study.

  Laura Marucci, Barbara Pichi, Giuseppe Iaccarino, Paolo Ruscito, Giuseppe Spriano, Giorgio Arcangeli
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  ABSTRACT: The acute toxicity of intraoperative radiation therapy (IORT) delivered as an "early boost" after tumor resection in patients with locally advanced head and neck cancer was evaluated. Twenty-five patients were enrolled in the study. All patients underwent surgery with radical intent, and 17 had microvascular flap reconstruction. The IORT was delivered in the operating room. Twenty patients received adjuvant external beam radiation therapy (EBRT). Five patients experienced various degrees of complications in the postoperative period, all of which were treated conservatively. One patient had a partial flap necrosis after EBRT that was treated with flap removal. Six deaths were recorded during the mean follow-up period of 8 months; none of the deaths were related to radiation treatment. This feasibility study shows that the use of IORT as an early boost is feasible with no increase in acute toxicity directly attributable to radiation.
  Head & Neck 07/2008; 30(6):701-8.
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  Available from: sbccp.org.br

  Article: N2-N3 neck nodal control without planned neck dissection for clinical/radiologic complete responders-results of Trans Tasman Radiation Oncology Group Study 98.02.

  June Corry, Lester Peters, Richard Fisher, Andrew Macann, Michael Jackson, Bev McClure, Danny Rischin
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  ABSTRACT: The aim of this study was to determine the incidence of isolated nodal failure in patients with N2/3 disease who achieved a complete clinical and radiological response (CR) at 12 weeks postchemoradiation, when no planned neck dissection was performed. We analyzed the nodal response and subsequent neck control of 102 patients with initial N2/3 disease treated on the Trans Tasman Radiation Oncology Group 98.02 study. With a median 4.3 years follow-up, the patterns of first failure in the CR patients were local 4%, local and nodal 2%, distant 28%, and locoregional plus distant (within 1 month) 6%. There were no patients who had only neck failure. Patients in this trial with N2/3 disease who obtained a clinical and radiological complete response to chemoradiation had a zero incidence of isolated neck failure without a planned neck dissection. The continued use of planned neck dissections in this patient subset cannot be justified.
  Head & Neck 07/2008; 30(6):737-42.
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  Article: Increased midsagittal tongue velocity as indication of articulatory compensation in patients with lateral partial glossectomies.

  Orchid Rastadmehr, Tim Bressmann, Ron Smyth, Jonathan C Irish
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  ABSTRACT: The purpose of this study was to describe the impact of partial lateral glossectomy on midsagittal tongue movement during speech. Using B-mode ultrasound, the midsagittal tongue movement of 10 patients with lateral partial glossectomy during a standardized reading passage was analyzed before and after surgery. Six normal adults served as control speakers. The main outcome measure was the tongue velocity during speech. The technique of defect reconstruction (local vs flap) was included as a covariate in the analysis. Following the surgery, all patients significantly increased the velocity of the midsagittal tongue movements during the reading passage. The results demonstrated that the patients with partial glossectomy compensated for the lateral tongue resections by increasing the velocity of the residual tongue during speech. The study provides first insights into the biomechanical aspects of spontaneous articulatory compensation following lateral tongue resections.
  Head & Neck 07/2008; 30(6):718-26; discussion 726-7.
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  Available from: netpoint.com.br

  Article: Fluorescent labeled anti-EGFR antibody for identification of regional and distant metastasis in a preclinical xenograft model.

  John P Gleysteen, J Robert Newman, David Chhieng, Andra Frost, Kurt R Zinn, Eben L Rosenthal
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  ABSTRACT: Detection of regional and distant metastatic disease has significant implications for patient management. Fluorescent imaging may be a useful technique for metastasis detection and removal. Anti-epidermal growth factor receptor antibody (cetuximab) and isotype-matched control antibody (immunoglobulin G [IgG]) were labeled with a near-infrared fluorophore (Cy5.5), then systemically administered to mice with tumors resulting from either intraoral or intravenous injections of head and neck squamous cell carcinoma. Mice were sacrificed before undergoing fluorescent stereomicroscopy to assess pulmonary or cervical lymph node metastasis. Fluorescent areas were serially excised until wound bed demonstrated negative fluorescence. Mice bearing pulmonary metastases displayed diffuse background after IgG-Cy5.5 injection, but demonstrated a speckled fluorescent pattern across lung surface following cetuximab-Cy5.5 injection. Mice bearing cervical metastases demonstrated clear fluorescence of primary tongue tumor and bilateral cervical nodes. Fluorescence correlated with histopathology. These data suggest that cetuximab-Cy5.5 may have clinical utility in the detection and guided the removal of regional and distant micrometastasis.
  Head & Neck 07/2008; 30(6):782-9.
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  Available from: sbccp.org.br

  Article: Results of endoscopic resection followed by radiotherapy for primarily diagnosed adenocarcinomas of the paranasal sinuses.

  Sofie Bogaerts, Vincent Vander Poorten, Sandra Nuyts, Walter Van den Bogaert, Mark Jorissen
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  ABSTRACT: Adenocarcinoma is the most frequent histological subtype of paranasal sinus malignancy diagnosed in Belgium. Classical treatment consists of an external surgical approach (lateral rhinotomy with medial maxillectomy or craniofacial resection) followed by radiotherapy. The role, possibilities, and limitations of endoscopic sinus surgery (ESS) are to date unknown. We studied 44 patients with primary (not treated previously) adenocarcinoma treated with endoscopic sinus surgery and radiotherapy between 1992 and 2004. The median follow-up of the patients alive at the end of the study period was 36 months. For the 3-year follow-up, the overall survival, disease-specific survival, and local control rate were 81%, 91%, and 73%, respectively. Corresponding rates for the 5-year follow-up were 53%, 83%, and 62%. Union Internationale Contre le Cancer T classification did not appear to influence these results. Endoscopic sinus surgery followed by radiotherapy for primary adenocarcinoma of the paranasal sinuses gives oncological results comparable to those of standard external approaches.
  Head & Neck 07/2008; 30(6):728-36.
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  Available from: sbccp.org.br

  Article: PNL2 melanocytic marker in immunohistochemical evaluation of primary mucosal melanoma of the head and neck.

  Luc G Morris, Yong Hannah Wen, Daisuke Nonaka, Mark D DeLacure, David I Kutler, Youming Huan, Beverly Y Wang
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  ABSTRACT: Histologic diagnosis of mucosal melanoma of the head and neck is difficult, requiring immunohistochemical stains which are less reliable than in cutaneous lesions. PNL-2 is a novel marker that has not been examined in mucosal melanoma. Nine formalin-fixed tissue sections of mucosal melanoma were stained with PNL-2, human melanoma black (HMB)-45, Melan-A, S-100, and microphthalmia transcription factor (MITF). Disease in all 9 patients arose from the sinonasal mucosa. Rates of diffuse positive staining with the 4 stains were PNL-2 (77.8%), HMB-45 (77.8%), Melan-A (50%), S-100 (87.5%), and MITF (40%). In 3 patients, PNL2 staining was superior to Melan-A or MITF. We report the first characterization of PNL-2 staining in head and neck mucosal melanoma. PNL-2 demonstrates high sensitivity for mucosal melanoma, likely superior to Melan-A and MITF, and comparable to HMB-45, with specificity superior to S-100. We advocate inclusion of PNL2 as an important adjunctive marker in the evaluation of these lesions.
  Head & Neck 07/2008; 30(6):771-5.
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  Available from: sbccp.org.br

  Article: Management of sinonasal undifferentiated carcinoma.

  Emily D Tanzler, Christopher G Morris, Christine A Orlando, John W Werning, William M Mendenhall
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  ABSTRACT: Our aim was to report the outcomes of treatment for sinonasal undifferentiated carcinoma (SNUC). Between September 1992 and October 2005, 15 patients were treated with curative intent with surgery (n=1), surgery and adjuvant radiotherapy (n=9), and definitive radiotherapy (RT) (n=5). Follow-up ranged from 11 to 151 months (median, 30); follow-up on living patients ranged from 12 to 151 months (median, 22). No patient was lost to follow-up. Seven patients (47%) developed a recurrence from 3 to 50 months (median, 9) after treatment. The 3-year outcomes were: local control, 78%; locoregional control, 65%; distant metastasis-free survival, 82%; cause-specific survival, 77%, and survival, 67%. The local control rates versus treatment modality were: surgery, 0/1 (0%); surgery and postoperative RT, 7/7 (100%); preoperative RT and surgery, 2/2 (100%); and definitive RT, 2/5 (40%). One patient (7%) treated with surgery and postoperative RT sustained a fatal complication. Combined surgery and adjuvant RT likely offer the best chance of cure compared with either modality alone. The impact of adjuvant chemotherapy is unclear.
  Head & Neck 06/2008; 30(5):595-9.