Head & Neck Cancer

Despite advances in surgery, radiotherapy, and chemotherapy, survival of patients with squamous cell carcinoma of the head and neck has not significantly improved over the past 30 years. Locally recurrent or refractory disease is particularly difficult to treat. Repeat surgical resection and/or radiotherapy are often not possible, and long-term results for salvage chemotherapy are poor. Recent advances in gene therapy have been applied to recurrent squamous cell carcinoma of the head and neck. Many of these techniques are now in clinical trials and have shown some efficacy. This article discusses the techniques employed in gene therapy and summarizes the ongoing protocols that are currently being evaluated in clinical trials. [ONCOLOGY 15(3):303-314, 2001]

ALZA Corporation and MedImmune, Inc, recently announced the results of a phase III study evaluating the use of amifostine (Ethyol) in the care of head and neck cancer patients who received radiation therapy. Recently published in the Journal of

BOSTON-Despite substantially increased acute toxicity, patients with inoperable head and neck tumors benefited from accelerated radiation therapy in a randomized clinical trial reported by Jean Bourhis, MD, PhD, at the American Society for Therapeutic Radiology and Oncology (ASTRO) annual meeting.

Minimally invasive surgery for esophagectomy may lower the morbidity often associated with open esophagectomy, according to a study conducted by surgeons at the University of Pittsburgh Medical Center and published in the September

Patients with recurrent squamous cell carcinoma of the head and neck have a poor prognosis. Thalidomide (Thalomid) has antitumor and antiangiogenic properties. We conducted a phase II trial to determine toxicity, response rate, and survival in

Selective neck dissection is a procedure that is primarily indicated in patients with clinically negative nodal disease in which there is a high risk of occult metastases. Others have advocated its use for patients with

Selective neck dissection is a procedure that is primarily indicated in patients with clinically negative nodal disease in which there is a high risk of occult metastases. Others have advocated its use for patients with

This is an open-label, nonrandomized phase I study to determine the maximum tolerated dose and dose-limiting toxicity of UFT plus leucovorin when given concomitantly with hyperfractionated radiotherapy in patients with head and neck cancer. The study period is determined by the course of radiotherapy, which is given as 1.7 Gy per fraction twice daily for 5 days (Monday to Friday) in 2 consecutive weeks, followed by 1 week of rest, and subsequently another 2 weeks of radiotherapy (Monday to Friday plus Monday to Thursday).

Cisplatin plus fluorouracil (5-FU) is widely accepted as neoadjuvant and adjuvant chemotherapy in the treatment of head and neck squamous cell carcinoma; UFT is also an active agent against this disease. In the first retrospective study, we examined the efficacy of UFT as adjuvant chemotherapy in patients with maxillary cancer.

Selective neck dissection is a procedure that is primarily indicated in patients with clinically negative nodal disease in which there is a high risk of occult metastases. Others have advocated its use for patients with

NASHVILLE, Tennessee-‘‘Historically, chemotherapy was only palliative in head and neck cancers, but chemotherapy regimens now in use actually do cure some patients,” Barbara A Murphy, MD, told a clinical investigators’ workshop. Dr. Murphy is Assistant Professor of Medicine at Vanderbilt-Ingram Cancer Center in Nashville, Tennessee. The workshop was sponsored by the University of Texas M. D. Anderson Cancer Center and Pharmacia Oncology.

Chemotherapy is an integral part of treatment for patients with nasopharyngeal carcinoma. Chemotherapy can achieve long-term survival rates of up to 15% to 20%, even in patients with recurrent or metastatic disease. In

Based on the positive results of two independent, corroborative, placebo-controlled phase III clinical studies in head and neck cancer, Matrix Pharmaceuticals, Inc, has announced plans to submit a new drug application for a cisplatin/epinephrine

BALTIMORE-Researchers at the Johns Hopkins School of Medicine and School of Hygiene and Public Health have found human papillomavirus (HPV) to be a likely cause of certain cancers of the head and neck, and also an indicator of improved survival.

Drs. Mark Singer and Eric Blom revolutionized the process of speech rehabilitation following total laryngectomy with their introduction of the tracheoesophageal puncture and insertion of a duck bill prosthesis.[1-5] The physiologic principles of the procedure are obvious, the surgical technique is simple, and the results in terms of fluent speech production are immediate and quite satisfactory. Dr. Blom is to be complimented for providing in this article, a succinct summary of the “current methods” available for speech rehabilitation for a patient facing total laryngectomy.

Total laryngectomy is the surgical procedure traditionally used to treat patients with advanced-stage cancer of the larynx. The impairments resulting from removal of such a small organ are, indeed, profound. They include

ALEXANDRIA, Va-Since she founded the Cancer Research Foundation of American (CRFA) in 1985, the year after her father’s death from head and neck cancer, Carolyn “Bo” Aldigé has become a persuasive and respected advocate for cancer

SAN ANTONIO-Accelerated radiation therapy given concomitantly with mitomycin C (Mutamycin) produced significantly improved results over standard radiation in patients with advanced head and neck cancer, Werner H. Dobrowsky, MD, reported at the at 41st Annual Scientific Meeting of the American Society for Therapeutic Radiology and Oncology.

Genetronics Biomedical Ltd announced interim dataand results of phase II clinical trials evaluating the company’s electroporation therapy (EPT) system, which combines an intratumoral injection of a chemotherapeutic agent with a pulsed electric field, in squamous cell carcinoma of the head and neck. Data from the trials, which were conducted in the United States and Canada, were presented at the 35th annual meeting of the American Society of Clinical Oncology (ASCO). Genetronics also announced preliminary data and results from a similar study conducted in Europe.

SAN ANTONIO-Local-regional control significantly improved with two radiotherapy fractionation variants delivering either increased total dose or shorter treatment time, compared with standard fractionation, in patients with locally advanced squamous cell carcinoma of the head and neck, Karen Fu, MD, reported at the 41st Annual Scientific Meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO).

BUFFALO, NY-Techniques developed over the past 20 years have improved outcomes for patients with head and neck cancers. Speakers at the Surgical Oncology Symposium sponsored by Roswell Park Cancer Institute described new surgical methods that offer further improvement in quality of life and new studies of preventive agents.

SAN ANTONIO -“Extraordinary” tumor control has been achieved in patients with far advanced squamous cell carcinomas of the head and neck with the triple combination of tirapazamine (investigational), cisplatin (Platinol), and radiotherapy, Lester J. Peters, MD, reported at the 41st Annual Scientific Meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO).

The findings of two clinical studies of C225, a monoclonal antibody (epidermal growth factor receptor inhibitor) being developed by ImClone Systems (New York City), were presented at the 1999 annual meeting of the American Society of Clinical Oncology (ASCO). The studies demonstrated the effectiveness of C225 in eliciting a clinical response in patients with advanced head and neck cancer when used in combination with standard radiotherapy and chemotherapeutic agents.

Tumors of the head and neck continue to pose challenges for afflicted patients and their treating physicians. Because the complex and vital anatomy often involved affects the ability to communicate and interact socially, head and neck tumors can have a devastating effect on the patient’s quality of life. Due to the inherently complex nature of such tumors and their rarity, a comprehensive textbook devloted to their management is certain to be useful.

Traditionally, treatment for locally advanced resectable head and neck cancer has been surgical resection followed by postoperative radiation. In unresectable patients, primary radiation has been the mainstay of

Gene therapy has the potential to provide cancer treatments based on novel mechanisms of action with potentially low toxicities. This therapy may provide more effective control of locoregional recurrence in diseases like non–small-cell lung cancer (NSCLC) as well as systemic control of micrometastases. Despite current limitations, retroviral and adenoviral vectors can, in certain circumstances, provide an effective means of delivering therapeutic genes to tumor cells. Although multiple genes are involved in carcinogenesis, mutations of the p53 gene are the most frequent abnormality identified in human tumors. Preclinical studies both in vitro and in vivo have shown that restoring p53 function can induce apoptosis in cancer cells. High levels of p53 expression and DNA-damaging agents like cisplatin (Platinol) and ionizing radiation work synergistically to induce apoptosis in cancer cells. Phase I clinical trials now show that p53 gene replacement therapy using both retroviral and adenoviral vectors is feasible and safe. In addition, p53 gene replacement therapy induces tumor regression in patients with advanced NSCLC and in those with recurrent head and neck cancer. This article describes various gene therapy strategies under investigation, reviews preclinical data that provide a rationale for the gene replacement approach, and discusses the clinical trial data available to date. [ ONCOLOGY 13(Suppl 5):148-154, 1999]

Tumors of the head and neck continue to pose challenges for afflicted patients and their treating physicians. Because the complex and vital anatomy often involved affects the ability to communicate and interact socially, head and neck tumors can have a devastating effect on the patient’s quality of life. Due to the inherently complex nature of such tumors and their rarity, a comprehensive textbook devloted to their management is certain to be useful.

Single-agent, intratumoral gene therapy that targetsthe p53 gene is well tolerated and shows evidence of antitumor activity in patients with recurrent squamous cell carcinoma of the head and neck, according to the preliminary results of phase II clinical

ROCKVILLE, Md-The FDA has approved Ethyol (amifostine for injection) as a therapy to decrease the incidence of moderate-to-severe xerostomia in patients undergoing postoperative radiation treatment for head and neck cancer. The approval came only 2 weeks after the Oncologic Drugs Advisory Committee (ODAC) recommendation.

The 14 reports in this special supplement discuss theuse of the cytoprotectant amifostine in patients withcancer of the head and neck, esophagus, lung, andcervix, as well as those with lymphoma and acutemyelogenous leukemia. Discussions focus on thepotential of this agent to both reduce radiation sideeffects such as xerostomia and permit doseescalation of chemotherapy and/or radiotherapy.Improvements in treatment outcome and quality oflife as a result of cytoprotection are examined.