Florian Veelken’s research while affiliated with University of Cologne and other places

Quality of life (QOL) should be improved during palliative chemotherapy for end-stage recurrent head and neck cancer. Therefore, we evaluated QOL in head and neck cancer patients during palliative chemotherapy with cisplatin and docetaxel. Thirty patients were included in a prospective study between 2003 and 2007. Response, time-to-progression, overall survival, performance, and toxicity were estimated. QOL was assessed using the EORTC QLQ-C30 and the QLQ-H&N35 questionnaires at baseline, and after each chemotherapy cycle. The response rate was 17%. Sixty-three percent had stable disease. The median time-to-progression was 3.5 months. The median overall survival was 9.2 months. The QLQ-C30 score constipation and the QLQ-H&N35 scores swallowing, senses problems, speech problems, coughing, weight gain showed significant improvement. Only some aspects of QOL are maintained or improved. The QLQ-H&N35 questionnaire seems to be more appropriate to measure QOL, but needs to be improved to account for the peculiarities of modern palliative chemotherapy.

The incidence of wound botulism is increasing dramatically among intravenous drug users. Efficient intensive care and early treatment with antitoxin is essential to avoid lethal courses. The clinical picture of botulism is of descending, symmetric, flaccid paralysis. Early symptoms include cranial nerve palsies resulting in blurred vision and diplopia, difficulty in focusing, ptosis, facial weakness, dysphagia, dysphonia, and dysarthria. Because patients presenting with dysarthria and dysphagia will often be seen by an ear, nose and throat specialist initially, this rare but upcoming neurologic disease must be considered in the differential diagnoses.

Response rates of presently used palliative chemotherapy for end-stage recurrent head and neck cancer are poor, but the regimes cause important toxicity. A prospective phase II study was conducted to evaluate the activity and toxicity of a weekly combination of cisplatin and docetaxel in patients with recurrent head and neck cancer. From July 2003 to November 2004, 21 patients with metastatic neck disease were enrolled. Treatment consistent of 25 mg/m cisplatin and 35 mg/m docetaxel once a week for 3 weeks followed by 1 week without treatment for each cycle. The primary end point was median survival. Secondary end points were response rate (RECIST), time to progression, toxicity (NCI-CTC), and quality-of-life (EORTC QLQ-C30, QLQ-H&N35). Eight patients (42%) showed a partial response. Eight patients (42%) had stable disease. Progressive disease was seen in three patients (16%). The median follow-up time was 7.2 months (95% confidence interval [CI], 5.9-9.3 months). The median time to progression was 3.5 months (95% CI, 2.0-5.0 months). The median overall survival was 10.7 months (95% CI, 6.4-15.0 months). Grade 3 toxicities occurred in two patients (10%). A grade 4 adverse event was not recorded. Most global quality-of-life scores but not head and neck-specific scores are deteriorated after last chemotherapy. Weekly docetaxel and cisplatin is active in recurrent head and neck cancer and shows an excellent toxicity profile. Its influence on the stabilization of quality of life is less significant.

Myoepitheliomas of the salivary glands are rare benign tumors composed of spindle-shaped myoepithelial cells, but may show plasmacytoid, epitheloid and clear cell-types that principally exhibit myoepithelial but not ductal differentiation. These tumors are mainly located in the major salivary glands and have sometimes abundant, acellular, mucoid or hyaline stroma but lack chondroid and myxochondroid foci, probably representing the one end of the spectrum of pleomorphic adenoma. Lipomatosis in the form of isolated small islands or scattered single lipocytes, is quite uncommon, and a large amount of adipose tissue in a pleomorphic adenoma and myoepithelioma is a rarity and only described in major salivary glands. We present the case report of a 38-year old man with a myoepithelioma of the minor palatinal salivary glands with extensive lipomatosis as an example of this rare phenomena.

To study the significance by analyzing the expression of angiopoietin-1 (Ang-1) and Angiopoietin-2 (Ang-2) in the tissues of squamous cell carcinoma (SCC) of the head and neck areas and in normal mucosa tissues. The expression of Ang-1 and Ang-2 in 45 tumor samples and 7 normal mucosa tissues were determined by the immunohistochemical method with avidin-biotin-peroxidase complex technique. The results were scored by two independent observers and analyzed statistically. The positive expression of Ang-1 and Ang-2 existed in the endothelial cells, epithelial cells and also in SCC cells. The positive expression rates of Ang-1 in tumor samples was 78% in the endothelial cells, and 87% in SCC cells. The positive expression rates of Ang-2 in tumor samples was 69% in the endothelial cells, and 76% in SCC cells. The scores of positive expression of Ang-1 and Ang-2 were higher in endothelial cells and in SCC cells of tumor tissues than that of normal mucosa tissues (rank sum test, P < 0. 05). There was positive correlation between the expression of Ang-1 and Ang-2 in the endothelial cells and also in SCC cells (Chi-square test with contingency table, P < 0.05). Ang-1 expression in endothelial cells of tumor tissues was higher in clinical stage III-IV than that in clinical stage I-II (rank sum test, P < 0.05). Ang-2 expression in both endothelial cells and SCC cells, were higher in clinical stage II-IV than that in clinical stage I-II (rank sum test, P < 0.05). There was no statistical significance for degrees of Ang-1 and Ang-2 expression in different histological grades (P > 0.05). The expressions of Ang-1 and Ang-2 in advanced SCC were remarkable. Ang-1 and Ang-2 may play a critical role during the progress of SCC of head and neck areas.

Unter den benignen Speicheldrüsentumoren stellen Myoepitheliome eine seltene Entität dar. Sie kommen vorwiegend in den großen Speicheldrüsen vor. Die Tumore leiten sich von den umkleidenden Myoepithelzellen der Speicheldrüsenazini ab und stellen eine Differenzialdiagnose zum malignen Myoepitheliom (myoepitheliales Karzinom) sowie verschiedenen anderen epithelialen und mesenchymalen Speicheldrüsentumoren dar. Eine Lipomatosis des Tumorparenchyms in Form isolierter Fettgewebsinseln oder verstreut liegender Lipozyten ist in pleomorphen Adenomen oder Myoepitheliomen der großen Speicheldrüsen in ganz vereinzelten Fallberichten beschrieben, jedoch in kleinen Speicheldrüsen unbekannt. Wir berichten erstmals über ein Myoepitheliom der palatinalen kleinen Speicheldrüsen eines 38-jährigen Patienten, welches eine lipomatöse Komponente aufweist.