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Lockhart PB, Norris CM, Pulliam C. Dental factors in the genesis of squamous cell carcinoma of the oral cavity. Oral Oncol 1998; 34:133-9. [PMID: 9682777 DOI: 10.1016/s1368-8375(97)00086-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
This study investigated the role of dental factors in the genesis of squamous cell carcinomas of the oral cavity. 99 newly diagnosed patients with advanced head and neck cancer were evaluated for potential demographic, dental and prosthetic risk factors. Patients with extra-oral malignancies were used as controls in the analysis of dental factors in patients with intra-oral cancers. We performed multiple comparisons of these factors against the primary tumour sites. An analysis of dental and prosthetic factors and patients with intra-oral versus extra-oral tumours revealed no significant differences. However, all 28 intra-oral malignancies arose in areas in contact with teeth and/or appliances. For example, all 10 oral tongue lesions arose on the lateral borders and all six floor of (drop) mouth primary tumours developed at the flange extension of a lower denture. Patients with partial or full dentures had significantly lower node (N) scores than patients without a prosthesis. Although this paper suggests a relationship between dental factors and the genesis of oral squamous cell malignancies, a larger prospective study would be required to achieve definitive data. Patients at risk should be followed carefully for the development of chronic irritation from teeth and appliances.
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Affiliation(s)
- P B Lockhart
- Department of Dentistry, Carolinas Medical Center, Charlotte, North Carolina, USA.
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Tachikawa T, Kumazawa H, Hori Y, Sai S, Kita J, Yamashita T, Kumazawa T, Maehara Y, Kohnoe S. Chemosensitivity testing of human mouth carcinoma cell line. ACTA OTO-LARYNGOLOGICA. SUPPLEMENTUM 1993; 500:154-7. [PMID: 8452015 DOI: 10.3109/00016489309126201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The chemosensitivity of KB cells derived from oral epidermal carcinoma to various antitumor agents was analyzed using the MTT[3-(4,5-dimethyl-2-thiazoyl)-2,5-diphenyl-2H tetrazolium bromide] assay. Optical density (OD) for MTT assay was measured with dual wavelengths. The chemosensitivity of the drugs was evaluated by the 50% OD (OD50) of each drug concentration in the control group. Five platinum (Pt) drugs and 3 anthracycline (AC) drugs were used in this study. The chemosensitivity differed among the 5 Pt drugs. No significant difference was observed among the 3 AC drugs. A linear increase in OD corresponding to an increase in number of cells was observed. When 0.1 M sodium succinate (S.S.) was added to 0.4% MTT, the sensitivity increased five-fold compared to the control group without S.S. The MTT assay is a precise, rapid, easy and inexpensive experimental system useful for evaluation of antitumor drug sensitivity on tumor cell lines.
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Affiliation(s)
- T Tachikawa
- Department of Otolaryngology, Kansai Medical University, Osaka, Japan
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Deitmer T, Urbanitz D. Chemotherapy in head and neck cancer with bleomycin, cisplatinum, and methotrexate. J Cancer Res Clin Oncol 1988; 114:644-6. [PMID: 2462565 DOI: 10.1007/bf00398192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Results of chemotherapy in head and neck cancers are reported with a regimen of cisplatinum, bleomycin and methotrexate. In 63 previously untreated patients, the overall response rate was 73%, including 13/63 CR and 33/63 PR. The response rate in 20 previously treated tumors was 20%. The chemotherapy protocol was well tolerated without severe complications. Initial chemotherapy as a third modality in addition to radiotherapy and/or surgery is discussed.
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Affiliation(s)
- T Deitmer
- Hals-Nasen-Ohrenklinik, Universität Münster, Federal Republic of Germany
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Abstract
The use of chemotherapy in patients with head and neck cancer is increasing. In patients with recurrent head and neck cancer, a large number of chemotherapeutic drugs have shown antitumor activity. These drugs are discussed, and factors which influence response rate and survival are examined. New agents and treatment, including specific agents for combination chemotherapy, are presented. There has been a search for new treatments or procedures in patients with previously untreated and locally advanced cancer of the head and neck. The results, including studies of combined modality therapy and chemotherapy after surgery, are discussed. Chemotherapy in tumor of the salivary glands is briefly discussed, followed by an examination of intra-arterial therapy.
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Affiliation(s)
- M Al-Sarraf
- Division of Oncology, School of Medicine, Wayne State University/Harper Grace Hospitals, Detroit, Michigan 48201
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Jacobs C, Goffinet DR, Goffinet L, Kohler M, Fee WE. Chemotherapy as a substitute for surgery in the treatment advanced resectable head and neck cancer. A report from the Northern California Oncology Group. Cancer 1987; 60:1178-83. [PMID: 3304610 DOI: 10.1002/1097-0142(19870915)60:6<1178::aid-cncr2820600604>3.0.co;2-s] [Citation(s) in RCA: 160] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
This trial determines the feasibility for patients with resectable Stages III/IV head and neck cancer who achieved a complete response to induction chemotherapy of eliminating surgery from their treatment program. Thirty patients were treated with three cycles of cisplatin and 5-fluorouracil (5-FU), followed by reendoscopy and biopsy. Twelve patients achieved a complete pathologic response at the primary and received radiation (interstitial and/or external beam) only. The remainder underwent surgical resection and postoperative radiation. At 2 years, the relapse-free survival was 52%, and the survival was 53% for the entire group. For the 12 complete responders who had surgery eliminated, the relapse-free survival was 60%, and the survival was 70%. This pilot study suggests that for patients with resectable disease who achieve a complete pathologic response to induction chemotherapy at their primary, it is feasible to omit surgery and treat with primary radiation without compromise in survival. This approach warrants further study in a randomized trial.
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Teo P, Ho JH, Choy D, Choi P, Tsui KH. Adjunctive chemotherapy to radical radiation therapy in the treatment of advanced nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys 1987; 13:679-85. [PMID: 3570892 DOI: 10.1016/0360-3016(87)90285-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Sixty-eight consecutive patients with previously untreated nasopharyngeal carcinoma (NPC) with advanced cervical lymph nodal metastases were studied retrospectively for the effectiveness of combining chemotherapy with radical radiation therapy (RT). In 1981 and 1982, 36 patients were treated with radical radiation therapy alone (arm 1). In 1983, 13 patients were given 2 courses of VBMF prior to RT (arm 2). In 1984, 19 patients were given radical RT sandwiched between 2 courses of PVBMF before and 2 after (arm 3). The three arms were comparable in patient characteristics with similar stages of the disease, sex, age distribution, and rates of completion of the prescribed treatments. There was no significant difference in actuarial or disease-free survival between arm 1 and 3 or arm 2 and 3, but arm 1 compared favorably with arm 2 in actuarial survival (X2 = 9.533, p = 0.002). The distant relapses in arms 2 and 3 occurred at significantly shorter times after diagnosis than those in arm 1 (t = 4.1083, p = 0.0001). Postponement of radiation therapy by chemotherapy might have accounted for the earlier distant relapses in arm 2 and 3. Radiation therapy alone given in radical dose had been demonstrated to achieve significantly more complete responses in cervical nodal metastases than either forms of chemotherapy (VBMF or PVBMF) given just two courses prior to radiation therapy (p less than 0.00003). More controlled clinical trials must be completed before acceptance of chemotherapy as part of a standard radical treatment for advanced nasopharyngeal carcinoma with advanced cervical lymph nodal metastases. In all future trials, closer integration in time sequence between the two treatment modalities is indicated. Meanwhile cervical nodal status (CR vs, PR plus NR) at the end of any treatment was shown to be of paramount prognostic significance.
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Taylor SG. Integration of chemotherapy into the combined modality therapy of head and neck squamous cancer. Int J Radiat Oncol Biol Phys 1987; 13:779-83. [PMID: 3553113 DOI: 10.1016/0360-3016(87)90299-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Thyss A, Schneider M, Santini J, Caldani C, Vallicioni J, Chauvel P, Demard F. Induction chemotherapy with cis-platinum and 5-fluorouracil for squamous cell carcinoma of the head and neck. Br J Cancer 1986; 54:755-60. [PMID: 3801272 PMCID: PMC2001551 DOI: 10.1038/bjc.1986.237] [Citation(s) in RCA: 55] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
One hundred and eight patients with squamous cell carcinoma of the upper aerodigestive tract (UADT) (T3, T4, NO-N3; 17% stage II, 54% stage III, 27% stage IV) were given three courses of chemotherapy before any local treatment. The regimen consisted of cis-platinum 100 mg m-2 on day 1 and 5-fluorouracil 1000 mg m-2 on days 2-6; drugs were administered by continuous infusion. The toxicity of this protocol was acceptable, as 82% of the patients were able to receive the initially scheduled drug dose. The overall response rate of 86.5% included a 35% rate of complete lesion regression. The effect of this regimen on primary tumours was especially remarkable--87.5% responses, including 47.5% complete responses. Results for lymph node metastases were not as good--66% responses, including 33% complete responses. The best results were obtained for tumours of the oropharynx and hypopharynx; oral cavity lesions were the most refractory. For those patients who were subsequently operated on, histological examination of the surgical specimen either confirmed sterilization or demonstrated the persistence of small disease foci. After local treatment, which consisted of radiotherapy alone for 69% of patients, the lesion control rate was 80%. At 18 months follow-up, the survival rate for patients who achieved a complete response with chemotherapy was significantly better than that for patients with a response of less than 50%.
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Rose C, Lustig R, McIntosh N, Teicher B. A clinical trial of Fluosol DA 20% in advanced squamous cell carcinoma of the head and neck. Int J Radiat Oncol Biol Phys 1986; 12:1325-7. [PMID: 3759553 DOI: 10.1016/0360-3016(86)90164-1] [Citation(s) in RCA: 54] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Fluosol DA 20% (Fluosol) enhances the response of several rodent tumors to radiation and oxygen. This is a Phase I/II study of Fluosol and oxygen breathing in the radiation treatment of advanced squamous cell carcinoma of the head and neck. Fifteen patients with Stage III/IV tumors entered and completed this trial. Patients received 1.8 Gy/fraction to 45 Gy, at which time the spinal cord was shielded and gross disease was carried to 68-72 Gy. 8 ml/kg (11 patients) or 9 ml/kg (4 patients) Fluosol was infused prior to the first fraction each week for the first 5 weeks. All patients inspired 100% oxygen before and during the initial 25 fractions. The infusions were well-tolerated. Four acute reactions that responded to diphenhydramine or steroids were observed in the 75 infusions. 8/15 patients exhibited liver function abnormalities of 2-3X normal which fell after therapy was discontinued. Normal mucosal reactions were enhanced despite the 1.8 Gy fraction size. 10/15 patients required at least one treatment break: the mean dose achieved before the break was 35 Gy. Tumor clearance was also accelerated. Thirteen patients had primary tumor clearance, but one had a local recurrence. Ten had primary and nodal clearance and 2/3 with nodal persistence had salvage surgery with fibrosis only at pathologic review. One patient, locally controlled, developed distant metastases. Thus, 10/15 patients are NED, but followup time is short.
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Amichetti M, Bolner A, Busana L, Fellin G, Pani G, Piffer S, Valdagni R, Ambrosini G. Neoadjuvant Chemotherapy with Vincristine, Bleomycin and Methotrexate Combined with Radiotherapy in Advanced Head and neck Squamous Cell Carcinoma. TUMORI JOURNAL 1986; 72:301-6. [PMID: 2426850 DOI: 10.1177/030089168607200311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
From September 1980 to August 1981, 25 patients with advanced head and neck squamous cell carcinoma were treated at the Centro Oncologico, Trento, by a chemo-radiotherapeutic combination. The treatment protocol consisted of 4–6 courses of VBM (vincristine, bleomycin and methotrexate) followed by conventional radiotherapy (65 Gy). Only to VBM responders (15 patients) were administered 10 cycles of vincristine-methotrexate. At the end of induction chemotherapy an overall response of 60 % (12 % complete, 48 % partial) was obtained. At the end of radiotherapy the responses were 52.5 % complete and 35.5 % partial, for an overall response of 88 %. The overall survival at 60 months was 8 %. This combined approach, in spite of the satisfactory immediate local response rate, does not offer advantages for survival in comparison to conventional treatment modalities.
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Abstract
Seventy-two patients with advanced resectable head and cancer received two courses of induction chemotherapy before definitive therapy. Forty-six patients were treated with platinol, Oncovin (vincristine), and bleomycin. Twenty-six received Platinol (cisplatin), Velban (vinblastine), and 5-fluorouracil (5-FU). Although both regimens had an overall response rate of 80% or more, the bleomycin-containing regimen had a higher complete response rate and better long-term disease control, with greater than 60% probability of remaining disease-free (36 month minimum follow-up). As given in this regimen, the 5-FU regimen was well tolerated but had a higher incidence of stomatitis and a low rate of complete responses. When the two regimens were compared to a historical control, the regimen with Platinol, Oncovin, and bleomycin was significantly better.
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Posner MR, Weichselbaum RR, Fitzgerald TJ, Clark JR, Rose C, Fabian RL, Norris CM, Miller D, Tuttle SA, Ervin TJ. Treatment complications after sequential combination chemotherapy and radiotherapy with or without surgery in previously untreated squamous cell carcinoma of the head and neck. Int J Radiat Oncol Biol Phys 1985; 11:1887-93. [PMID: 2414254 DOI: 10.1016/0360-3016(85)90268-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
One hundred consecutive patients with previously untreated advanced squamous cell carcinoma of the head and neck were treated with induction combination chemotherapy followed by definitive surgery and/or radiotherapy, and were evaluated for radiotherapy related toxicity. The induction regimen consisted of cisplatin, bleomycin and methotrexate/leucovorin. Acute toxicity consisted predominantly of mucositis and weight loss, and was mild or moderate by degree in 94% of patients. Six percent of patients experienced severe or life threatening acute toxicities. Two acute toxic deaths were noted in this series, one from a combination of mucositis, weight loss and infection and one from hypoglycemia of unknown origin. Thirty-five percent of patients had radiation treatment interrupted briefly because of acute toxicity. Toxicity was greatest in patients who were nonresponders to induction chemotherapy and such may have been related to the continued presence of advanced tumor. Radiotherapy dose, surgical intervention and age did not have an impact on the presence or degree of acute toxicity. Late toxicities included: hypothyroidism in 32% of patients tested: osteoradionecrosis in 5% of patients, associated primarily with a composite resection (4 of 5 cases); and soft tissue ulcerations in 3%. Taken together, these data indicate that induction combination chemotherapy did not significantly increase the toxicity of subsequent radiotherapy with or without surgery.
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Weichselbaum RR, Clark JR, Miller D, Posner MR, Ervin TJ. Combined modality treatment of head and neck cancer with cisplatin, bleomycin, methotrexate-leucovorin chemotherapy. Cancer 1985; 55:2149-55. [PMID: 2579724 DOI: 10.1002/1097-0142(19850501)55:9+<2149::aid-cncr2820551418>3.0.co;2-w] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The multidisciplinary treatment results of 114 patients with advanced, untreated Stage III and IV squamous cell carcinoma of the head and neck region are reported. Induction chemotherapy with two cycles of cisplatin 20 mg/m2/day intravenous bolus days 1 through 5, bleomycin 10 mg/m2/day as a continuous infusion days 3 through 7, and methotrexate 200 mg/m2 intravenous bolus on days 15 and 22 with leucovorin rescue was utilized before definitive surgery and/or radiation therapy. The total response rate was 78% with 30 (26%) patients achieving complete response and 59 (52%) patients achieving partial response. Patient age, performance status, histologic grade of tumor, and tumor site did not predict response to chemotherapy. Induction chemotherapy was well tolerated with myelosuppression and nephrotoxicity being dose-limiting in a few patients. The toxicity of subsequent local treatment with surgery and/or radiation is reported with an analysis of local treatment failures. A strong correlation was noted between local control of tumor and postchemotherapy tumor size before local treatment.
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Inuyama Y, Fujii M, Tanaka J, Takaoka T, Hosoda H, Kohno N, Saito S. Neoadjuvant chemotherapy in maxillary sinus carcinoma with cisplatinum and peplomycin intraarterial infusion. Auris Nasus Larynx 1985; 12 Suppl 2:S249-54. [PMID: 2425790 DOI: 10.1016/s0385-8146(85)80068-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The purpose of this paper is to present our preliminary assessment of a new multimodal treatment including neoadjuvant chemotherapy with cisplatinum and peplomycin for maxillary sinus carcinoma. Fifteen patients with squamous cell carcinoma of the maxillary sinus carcinoma seen at Keio University Hospital, with Stage III and IV disease, were enrolled in this trial between January 1982 and January 1985. Regimen of chemotherapy was as follows: day 1, 50 mg/m2 of cisplatinum, intraarterial infusion over 2 hr, days 2-6, peplomycin at a dose of 5 mg/day, intraarterial infusion over 5 hr. Routinely, radiotherapy of 40 Gy by Linac was given to the primary site, concomitantly combined with 5-fluorouracil intraarterial injections only during the first 10 days, 2 weeks after the end of initial chemotherapy. Additional treatment was performed according to the extent of residual tumor. Response to initial chemotherapy revealed that complete response was achieved in 7 and partial response in 6 out of 15 patients with a response rate of 87%. Nine patients required no surgical intervention while 6 underwent a surgical resection. Median follow-up in this group of patients is 20 months. Thirty-month survival rate calculated by Kaplan-Meier's method was 83%. Chemotherapy toxicity was mild in most cases. This pilot study does not provide conclusive survival information, but the results obtained are encouraging.
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