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Abramson Cancer CenterNCI CANCERLIT® Search: Pharyngeal Cancer - January 2002
National Cancer Institute®
Last Modified: January 1, 2002
Table of Contents
1
UI - 10646842
AU - Claudio PP; Howard CM; Fu Y; Cinti C; Califano L; Micheli P; Mercer EW;
TI -
Caputi M; Giordano A
Mutations in the retinoblastoma-related gene RB2/p130 in primary
nasopharyngeal carcinoma.
SO - Cancer Res 2000 Jan 1;60(1):8-12
AD - Department of Pathology, Anatomy and Cell Biology, Thomas Jefferson
University, and Sbarro Institute for Cancer Research and Molecular
Medicine, Philadelphia, Pennsylvania 19107, USA.
Nasopharyngeal carcinoma (NPC) is an endemic cancer in southern China
and northern Africa, and its pathogenesis is not yet well defined at the
molecular level. Although the involvement of p53 and of the
retinoblastoma gene (RB/p105) in NPC has been well studied, there is
paucity of mutational data regarding the retinoblastoma-related gene
RB2/p130 in primary tumors and particularly in NPC. We have shown
previously that RB2/p130 could be rearranged in a nasopharyngeal cell
line. In the present study, we screened by single-strand conformation
polymorphism and sequence analysis the retinoblastoma-related gene
RB2/p130 for mutations within exons 19-22. Mutations in the RB2/p130
gene were detected in 3 of 10 primary human NPCs from Northern Africa
(30%). These findings, along with previous data showing that genetic
replacement of RB2/p130 restores a normal growth pathway in the
nasopharyngeal cell line Hone-1, strengthen the hypothesis that genetic
changes of RB2/p130 may be involved in the development and/or
progression of nasopharyngeal cancer and suggest that RB2/p130 could be
considered a tumor suppressor gene and may be a candidate for novel gene
therapeutic approaches for NPC.
2
UI - 11332876
AU - Schaffer M; Bonel H; Sroka R; Schaffer PM; Busch M; Sittek H; Reiser M;
TI -
Duhmke E
Magnetic resonance imaging (MRI) controlled outcome of side effects
caused by ionizing radiation, treated with 780 nm-diode laser --
preliminary results.
SO - J Photochem Photobiol B 2000 Dec;59(1-3):1-8
AD - Department of Radiation Therapy, University of Munich, Germany.
sroka@life.med.uni-muenchen.de
BACKGROUND and OBJECTIVE: Ionizing radiation therapy by way of various
beams such as electron, photon and neutron is an established method in
tumor treatment. The side effects caused by this treatment such as
ulcer, painful mastitis and delay of wound healing are well known, too.
Biomodulation by low level laser therapy (LLLT) has become popular as a
therapeutic modality for the acceleration of wound healing and the
treatment of inflammation. Evidence for this kind of application,
however, is not fully understood yet. This study intends to demonstrate
the response of biomodulative laser treatment on the side effects caused
by ionizing radiation by means of magnetic resonance imaging (MRI).
STUDY DESIGN/PATIENTS and METHODS: Six female patients suffering from
painful mastitis after breast ionizing irradiation and one man suffering
from radiogenic ulcer were treated with lambda=780 nm diode laser
irradiation at a fluence rate of 5 J/cm2. LLLT was performed for a
period of 4-6 weeks (mean sessions: 25 per patient, range 19-35). The
tissue response was determined by means of MRI after laser treatment in
comparison to MRI prior to the beginning of the LLLT. RESULTS: All
patients showed complete clinical remission. The time-dependent contrast
enhancement curve obtained by the evaluation of MR images demonstrated a
significant decrease of enhancement features typical for inflammation in
the affected area. CONCLUSION: Biomodulation by LLLT seems to be a
promising treatment modality for side effects induced by ionizing
radiation.
3
UI - 11407448
AU - Benazzo M; Bertino G; Lanza L; Occhini A; Mira E
TI -
Voice restoration after circumferential pharyngolaryngectomy with free
jejunum repair.
SO - Eur Arch Otorhinolaryngol 2001 May;258(4):173-6
AD - Clinica Otorinolaringoiatrica, Universita degli Studi di Pavia, IRCCS
Policlinico S. Matteo, Italy.
Speech restoration after circumferential pharyngolaryngectomy with free
jejunal repair for advanced tumors of the hypopharyngo-esophageal tract
remains a difficult problem to solve. We report here the results of
secondary voice restoration in six patients who received a Provox 2 type
prosthesis and intensive speech therapy after circumferential
pharyngolaryngectomy with free jejunum repair. No patient had operative
or post-operative complications due to insertion of the prosthesis. No
patient had to have the prosthesis removed during the follow-up (8 to 14
months). Analysis of some acoustic parameters of voice (fundamental
frequency, waveform perturbations) and qualitative characteristics of
speech (intelligibility, pleasantness and acceptability) demonstrated
that all the patients were able to produce satisfactory speech after
tracheojejunum puncture and speech therapy and were satisfied with their
own ability to communicate. Our results are reassuring and we therefore
advise that in patients undergoing free jejunum flap reconstruction of
the hypopharyngo-esophageal tract voice restoration should be attempted
by placing a voice prosthesis through a secondary tracheo-esophageal
puncture and providing intensive speech training.
4
UI - 11425196
AU - Ferlito A; Shaha AR; Buckley JG; Rinaldo A
TI -
Selective neck dissection for hypopharyngeal cancer in the clinically
negative neck: should it be bilateral?
SO - Acta Otolaryngol 2001 Apr;121(3):329-35
AD - Department of Otolaryngology-Head and Neck Surgery, University of Udine,
Italy. clorl@dsc.uniud.it
5
UI - 11425214
AU - Markkanen-Leppanen M; Suominen E; Lehtonen H; Asko-Seljavaara S
TI -
Free flap reconstructions in the management of oral and pharyngeal
cancer.
SO - Acta Otolaryngol 2001 Apr;121(3):425-9
AD - Department of Otolaryngology, Helsinki University, Central Hospital,
Finland. mari.markkanen-leppanen@hus.fi
Fifty patients who had undergone microvascular free flap reconstruction
of the oral cavity or pharynx for malignancy between 1989 and 1995 were
retrospectively analysed to find factors predicting postoperative
complications and outcomes. The mean follow-up time was 2.6 years. More
than half (26/50) of the patients had a stage IV malignancy and 10
patients had a recurrent tumour. The overall flap success rate, with 2
flap losses, was 96%. Postoperative medical complications occurred in
29/50 (58%) cases. The recipient site of 10/50 (20%) flaps required
re-exploration. Mortality was 2%, with 1 death occurring within 30 days.
The mean survival rate after the microvascular operation was 1.6 years,
and the 3- and 5-year survival rates were 42% and 23%, respectively.
Patients with an oropharyngeal tumour seemed to have the best prognosis
and those with a hypopharyngeal tumour the poorest. Men had a threefold
greater risk of dying within < 1 year postoperatively compared with
women. Tumour stage was the strongest attribute influencing survival.
The risk of death after the microvascular procedure increased 2.8-fold
when the stage advanced from II to III or from II to IV. None of the
tested variables alone could predict complications.
6
UI - 11444190
AU - Maohuai C; Chang AR; Shikyuen L
TI -
Roles of DNA cytometry and detection of EBERs in predicting a diagnosis
of nasopharyngeal carcinoma.
SO - Anal Quant Cytol Histol 2001 Jun;23(3):207-12
AD - Department of Anatomical and Cellular Pathology, Chinese University of
Hong Kong, Hong Kong. mhchen@mailserv.stu.edu.cn
OBJECTIVE: To analyze the suitability of DNA cytometry and detection of
Epstein-Barr virus (EBV)-encoded RNAs (EBERs) on nasopharyngeal
brushings for predicting a diagnosis of nasopharyngeal carcinoma (NPC).
STUDY DESIGN: Cytologic preparations in 66 cases suspicious for NPC were
evaluated for NPC diagnosis in comparison with the histologic diagnosis.
Based on cytologic examination, 38 cases containing cytologically proven
cancer and 8 cases interpreted as cytologically negative for cancer with
adequate cellularity in the smear specimens were analyzed for DNA ploidy
with an image analyzer and for EBER expression by in situ hybridization
(ISH). RESULTS: Based on the cytologic diagnosis, DNA aneuploidy
analysis, DNA nondiploidy analysis and EBER detection demonstrated a
sensitivity of 50%, 84% and 92%, respectively, with the same
specificity, 100%, for predicting a diagnosis of cancer. Their negative
predictive values were 30%, 57% and 73%, respectively. There was a
significant difference between DNA aneuploidy analysis and EBER analysis
in sensitivity (P < .001) and in negative predictive value (P < .05) but
not between DNA nondiploidy analysis and EBER analysis even though EBER
analysis showed a slightly higher value in both parameters (P > .1 and P
> .5, respectively). CONCLUSION: ISH for EBERs in cytologic smears
showed a role superior to that of DNA aneuploidy analysis in the
diagnosis of NPC. Considering its advantages of simple experimental
conditions and lower cost as compared with DNA measurement, EBER
detection can play a practical and important diagnostic role in patients
suspected of having primary NPC.
7
UI - 11444191
AU - Maohuai C; Chang AR; Lo D
TI -
Nasopharyngeal carcinoma heterogeneity of DNA content identified on
cytologic preparations.
SO - Anal Quant Cytol Histol 2001 Jun;23(3):213-7
AD - Department of Anatomical and Cellular Pathology, Chinese University of
Hong Kong, Hong Kong. mhchen@mailserv.stu.edu.cn
OBJECTIVE: To evaluate tumor heterogeneity of DNA content in
nasopharyngeal carcinoma (NPC) performed on cytologic specimens. STUDY
DESIGN: Image cytometric analysis of DNA ploidy status of 40 NPCs was
performed on nasopharyngeal brushing smears stained with the Feulgen
method after hematoxylin eosin staining. If the DNA distribution pattern
from the same tumor exhibited diploid, aneuploid or/and tetraploid peaks
or some combination of these patterns, the presence of tumor
heterogeneity of DNA content was identified. RESULTS: Thirty-four cases
(85%) had a nondiploid DNA pattern among the 40 NPCs. Twenty-eight cases
exhibited tumor heterogeneity of DNA content (70%). Of the 28 tumors, 13
(46%) had a combination of diploid and tetraploid patterns, 10 (37%) had
a combination of diploid and aneuploid patterns, 3 cases (11%) had a
combination of tetraploid and aneuploid patterns, and 2 cases had two
aneuploid stem lines. The relationship between DNA ploidy pattern and
tumor histologic and cytologic morphology was also examined. CONCLUSION:
There is a high incidence of DNA content heterogeneity in NPC. The
relevance of tumor heterogeneity to the biologic behavior of NPC awaits
further study. DNA quantification with image cytometry on destained
cytologic preparations is feasible and reliable.
8
UI - 11452402
AU - Berberoglu S; Ilhan I; Cetindag F; Sunter O
TI -
Nasopharyngeal carcinoma in Turkish children: review of 33 cases.
SO - Pediatr Hematol Oncol 2001 Jul-Aug;18(5):309-15
AD - Oncology Hospital, Department of Pediatric Oncology, Demetevler, Ankara,
Turkey. aohc@ato.org.tr
A retrospective and prospective analysis is reported of epidemiological,
clinical, and therapeutic aspects of 33 children with nasopharyngeal
carcinoma who were treated in a single institution over a period of 10
years. Twenty-three male and 10 female children ranging from 9 to 17
years were referred to our center. Histopathology was WHO type 3
carcinoma in 21, WHO type 2 in 8, WHO type 1 in 1, and unclassified in 3
patients. Disease extent was T2a (n = 15), T2b (n = 2), T3 (n = 11), and
T4 (n = 5); N1 (n = 5), N2 (n = 12), and N3a (n = 16). Five patients had
base of skull invasion. Four patients had M1 disease on admission. Four
patients were treated with irradiation only. Three patients received
neoadjuvant, 4 patients received adjuvant, and 22 patients received
neoadjuvant + adjuvant chemotherapy in addition to radiotherapy.
Patients received 50-72 Gy to the primary tumor and involved nodes and
45-50 Gy to uninvolved regions. Chemotherapy consisted of combinations
of cisplatin, fluorouracil or Adriamycin, vincristine, and
cyclophosphamide. Twenty-nine patients (88%) attained locoregional
control. Overall, 10 patients died with progressive disease or
infectious complications, and 2 patients are still receiving therapy.
Three patients are still living with multiple metastases and stable
disease. Eight patients were lost to follow-up. Twelve patients are
alive without relapse 3 and 63 months from diagnosis. Seven patients had
6 relapses at distant and 1 relapse at local site. The median time for
first relapse was 8 months. Overall, the 5-year survival rate was 63%
and disease-free survival rate was 53%. Although the locoregional
control rate is high, long-term survival rates will be the real test of
the impact of chemotherapy. Further studies are needed to confirm the
optimal combination of effective chemotherapeutic agents and
radiotherapy.
9
UI - 11167143
AU - Tsuchiya K; Shirato H; Nishioka T; Yamazaki A; Hashimoto S; Kagei K;
TI -
Oomori K; Yasuda M; Shindo M; Miyasaka K
Pretreatment apoptotic scores do not predict response to radiation
therapy in oropharyngeal squamous cell carcinoma.
SO - Oral Oncol 2001 Feb;37(2):159-63
AD - Department of Radiology, School of Medicine, Hokkaido University, North
15 West 7, Kita-ku, Sapporo 060-8638, Japan.
The prognostic value of tumor apoptosis was studied in patients with
oropharyngeal squamous cell carcinoma treated with radical radiotherapy.
Forty-eight patients with oropharyngeal squamous cell carcinoma who
received radical radiotherapy between 1990 and 1995 were enrolled in the
study. The radiation treatment for all patients involved the
administration of 65 Gy in 26 fractions over a 6.5-week period. The
apoptotic index (AI; the apoptotic cell count per 1000 tumor cells ) was
distributed from 0 to 10 with a median at 2 and a mode of 1. There was a
significant linear correlation between the AI and mitotic index (MI)
(r=0.393, 95% confidence interval: 0.129-0.605). The cause-specific
5-year survival for patients with AI greater than the median was 46% and
for the counterpart was 41%. There was no difference in cause-specific
survival between AI/MI greater than the median (50%) and AI/MI smaller
than the median (36%). The number of patients was too small to draw
definite conclusions, but the AI and the AI/MI before treatment were not
shown to have a prognostic value for oropharyngeal squamous cell
carcinoma in our study. The primary sites and treatment methods may
influence the prognostic value of AI even for the same histological
types.
10
UI - 11036246
AU - Nunes DN; Kowalski LP; Simpson AJ
TI -
Detection of oral and oropharyngeal cancer by microsatellite analysis in
mouth washes and lesion brushings.
SO - Oral Oncol 2000 Nov;36(6):525-8
AD - Laboratory of Cancer Genetics, Ludwig Institute for Cancer Research, Rna
Prof. Antonio Prudente, 109 - 4th floor, 01509-010, SP, Sao Paulo,
Brazil.
Microsatellite allele losses are characteristic features of head and
neck squamous cell carcinoma and can be used as molecular markers for
malignancy. We have investigated the detection of microsatellite allele
loss in mouth washes and lesions brushings from 19 patients with
squamous cell carcinoma of the oral cavity and oropharynx as a means of
tumour detection. In 84% of the analysed cases, allele loss previously
identified in the tumour of these patients, was detected in these easily
obtained specimens. No alterations were found in material derived from
10 healthy individuals. Success of detection was independent of tumour
stage, suggesting that this approach may be useful for early diagnosis
as well as for follow-up.
11
UI - 11120480
AU - Zavras AI; Douglass CW; Joshipura K; Wu T; Laskaris G; Petridou E;
TI -
Dokianakis G; Segas J; Lefantzis D; Nomikos P; Wang YF; Diehl SR
Smoking and alcohol in the etiology of oral cancer: gender-specific risk
profiles in the south of Greece.
SO - Oral Oncol 2001 Jan;37(1):28-35
AD - Department of Oral Health Policy & Epidemiology, Harvard School of
Dental Medicine, 188 Longwood Avenue, Suite 004, Boston, MA 02115, USA.
Oral and pharyngeal cancer (OC) mortality is very low in Greece,
especially among men, compared to other European countries. We conducted
a case-control study of OC in Athens, and obtained information on
tobacco, alcohol use and other potential risk factors and confounding
variables for 110 incident cases and 115 hospital-based controls. We
used multivariate logistic regression to estimate odds ratios (ORs) and
95% confidence intervals (CIs). Tobacco smoking (pack years,
P(trend)=0.01) and alcohol use (drinks/week, P(trend)=0.07) were
independent risk factors, with a multiplicative effect for combined
exposures (OR, 8.3; 95% CI, 2.4-29.1, for >28 alcohol drinks/week and
>50 pack years of cigarette smoking). The type of alcoholic beverage
also seemed important: drinking ouzo and tsipouro (liquors of high
ethanol concentration) was associated with greater increased OC risk
than drinking comparable amounts of wine, beer or dark spirits. While
alcohol drinking is more common for male cases versus controls, few men
reported regularly consuming large quantities of ethanol associated with
highest risk of OC in other studies. This may partially explain the low
rates of male OC mortality in Greece. Among the 38% of our cases who
were women, however, neither smoking nor alcohol drinking frequencies
were significantly elevated compared to controls, and so the etiology of
OC risk in females requires further investigation.
12
UI - 11120481
AU - Daskalopoulou D; Papanastasiou C; Markidou S; Rapidis AD
TI -
The diagnostic value of fine needle aspiration cytology in Waldeyer's
ring lymphomas.
SO - Oral Oncol 2001 Jan;37(1):36-41
AD - Department of Cytology, Greek Anticancer Institute, St Savvas Hospital,
171 Alexandras Avenue, 11522, Athens, Greece.
Fine needle aspiration cytology (FNAC) is a well-established diagnostic
technique for tumours in the head and neck area. In recent years FNAC
has been established as an accurate and useful method for the diagnosis
of nodal malignant lymphoproliferative disease. The purpose of the
present study was to determine and evaluate the accuracy of FNAC in the
diagnosis of primary malignant lymphoma of Waldeyer's ring. The cases of
29 patients suffering from tumours of the oro- and nasopharynx, in which
the diagnosis of lymphoma was established by FNAC during the years
1991-1998, were collected and analysed. Twelve of the patients had a
previous history of lymphoma, and FNAC was used to establish the
diagnosis of recurrent disease. In 17 patients with no previous history
of malignancy FNAC was used to diagnose primary extranodal non-Hodgkin's
lymphomas (NHLs). In two patients FNAC failed to diagnose NHL. In all
patients cytological findings were complemented and compared with those
of a histopathological examination after open biopsy. In two cases a
difference in the specific histological type of the lymphoma was noted.
The findings from the present study (sensitivity 93.10% and positive
predictive value 100%) indicated that FNAC is a useful and accurate
method in establishing diagnosis of Waldeyer's ring lymphomas.
13
UI - 11530473
AU - Antoniv VF; Rishko NM; Popadiuk VI; Pronchenko SV
TI -
[Clinical classification of benign ENT tumor]
SO - Vestn Otorinolaringol 2001;(4):24-7
The proposed clinical classification of benign ENT tumors is based on
division of anatomic regions (the ear, nose, pharynx, larynx) into
sections and fragments and allows to assess the spread of any ENT tumor.
Moreover, it agrees with TNM classification. The symbols "T" and R are
used which denote four variants (T1-4) or R1-4 for the tumor and
recurrence, respectively.
14
UI - 11526145
AU - Dardari R; Hinderer W; Lang D; Benider A; El Gueddari B; Joab I;
TI -
Benslimane A; Khyatti M
Antibody responses to recombinant Epstein-Barr virus antigens in
nasopharyngeal carcinoma patients: complementary test of ZEBRA protein
and early antigens p54 and p138.
SO - J Clin Microbiol 2001 Sep;39(9):3164-70
AD - Institut Pasteur du Maroc, Casablanca, Morocco.
Serological tests based on the antibodies directed against the
Epstein-Barr virus early antigen (EA) and viral capsid antigen (VCA),
which have been recognized as tumor markers for nasopharyngeal carcinoma
(NPC), are routinely used to help in the diagnosis of this malignancy.
The detection of these antibodies reveals very low titers, found only in
a small proportion of young compared with older NPC patients. This is a
problem for the diagnosis of NPC, especially among Maghrebians, among
whom young people are also affected, and emphasizes the necessity to
search for more reliable markers. The present study reports results of
immunoglobulin G (IgG) and IgA responses of NPC patients to recombinant
EA antigens p54 (BMRF1) and p138 (BALF2), VCA complex antigens p18
(BFRF3) and p23 (BLRF2), and EBNA antigen p72 (BKRF1). Our results show
that IgA-EA-p54 and -p138 (IgA-EA-p54+138) antibodies have a diagnostic
value for detection of NPC (70%), compared with IgA-VCA-p18+23 and
IgA-EBNA-p72, which have limited diagnostic value, especially in young
patients. It is also noteworthy that IgA-EA-p54+138 can detect a high
percentage (64%) of NPC cases negative by immunofluorescence. These
results, however, clearly show that a single test cannot achieve the
objective of detecting all NPC patients, and it seems advisable to
combine different tests for the diagnosis of NPC. The combination of
IgG-ZEBRA with IgA-EA-p54+138 improved the sensitivity of detection of
NPC to 95% in the overall NPC population. The use of IgA-EA-p54+138 in
combination with IgG-ZEBRA will facilitate detailed studies on the
pattern of antibody response, which may result in the development of
useful serological markers to guide the treatment of NPC.
15
UI - 11553216
AU - Peracchia A; Bonavina L; Botturi M; Pagani M; Via A; Saino G
TI -
Current status of surgery for carcinoma of the hypopharynx and cervical
esophagus.
SO - Dis Esophagus 2001;14(2):95-7
AD - Department of Surgery, University of Milan, Ospedale Maggiore
Policlinico IRCCS, Milano, Italy. alberto.peracchia@unimi.it
Hypopharynx and cervical esophagus represent a critical location for a
squamous cell carcinoma, a neoplasm that usually requires extensive
surgery. Although morbidity and mortality of resection have markedly
decreased over the past decade, the major issue in these patients
remains quality of life owing to the need for combination with a
laryngectomy to provide radical treatment. Chemoradiation therapy has
the potential to downstage and even cure the disease without altering
quality of life dramatically. Today, in the absence of randomized
trials, the choice between surgery and definitive chemoradiotherapy
should be based on clear information and the patient's preference.
Salvage surgery is feasible and effective in selected patients.
16
UI - 11555153
AU - Izarzugaza MI; Esparza H; Aguirre JM
TI -
Epidemiological aspects of oral and pharyngeal cancers in the Basque
Country.
SO - J Oral Pathol Med 2001 Oct;30(9):521-6
AD - Departamento de Sanidad del Gobierno Vasco, Scio de Registros e
Informacion Sanitaria, C/Donostia-San Sebastian 1, 01010
Vitoria-Gasteiz, Basque Country, Spain. info5-san@ej-gv.es
Oral and pharyngeal cancer is an entity constituted by a group of
tumours that arise in several heterogeneous anatomical sites, and for
this reason it is difficult to establish comparisons. The aim of the
study was to describe the characteristics of oropharyngeal cancer in the
Basque Autonomous Community (BAC), to learn the incidence rate and to
establish comparisons. Data of cases are from the Basque Country Cancer
Registry for the period 1986-1994, and the methodology used is
descriptive. We included 2548 cases, and the sex ratio was 7.4:1.
Diagnosis was made by histology in most cases (99%). The crude incidence
rate was 24.1/100,000 population for men and 3.1/100,000 for women.
Higher incidence rates were found in the tongue (6.6), lip (5.8) and
oropharynx (4.9). No variation was found in the incidence during the
period. In comparison with other Spanish registries, there is a high
incidence in men of cancer in the oral cavity. The results obtained show
the characteristics of oral and pharyngeal cancer in the BAC and its
magnitude, highlighting the importance of future preventive actions.
17
UI - 11579473
AU - Ebihara S
TI -
[Surgical treatment of carcinoma of the hypopharynx and cervical
esophagus]
SO - Nippon Geka Gakkai Zasshi 2001 Sep;102(9):632-6
AD - Division of Head and Neck Surgery, National Cancer Center Hospital,
Kashiwa, Japan.
This paper discusses several recent advances in surgical methods for
treatment of cancer of the hypopharynx and cervical esophagus. The
standard surgical technique for the primary lesion is
laryngo-pharyngo-esophagectomy in which the larynx is usually resected
to prevent postoperative aspiration even if the cancer does not directly
involve the larynx. Another common technique is total laryngectomy plus
partial resection of the hypopharynx, where a very limited lesion in the
unilateral pyriform sinus is resected with the surrounding
hypopharyngeal mucosa and larynx. In this case, the defect in the
hypopharyngeal mucosa is primarily sutured or reconstructed with a graft
based on its size. Experience has demonstrated that the larynx can be
preserved without any postoperative aspiration if it is not involved by
cancer and surgeons design the lines of resection and the postoperative
shape of the reconstructed area to prevent aspiration. It has also been
demonstrated that even if a part of the larynx is involved and must be
resected, the remaining portion of the larynx can sometimes be preserved
without any distinct aspiration. There are two common surgical
techniques for neck lymph nodes. Radical neck dissection is the classic
one, in which the lymphatic tissues together with the surrounding
structures, including the sternocleidomastoid muscle, internal jugular
vein, and accessory nerve are resected. Conservative neck dissection
resects the lymphatic tissues only and preserves other structures.
Currently, the standard surgical technique is conservative neck
dissection. Radical neck dissection is rarely performed now because its
morbidity is much higher and its superiority in treatment results has
not been established.
18
UI - 11593775
AU - Daniilidis J; Constantinidis J; Fountzilas G
TI -
[Combined radiochemotherapy in locally advanced nasopharyngeal
carcinoma]
SO - HNO 2001 Sep;49(9):732-8
AD - Hals-Nasen-Ohren-Klinik, Aristoteles-Universitat Thessaloniki, Klinikum
AHEPA, 54006 Thessaloniki/Griechenland. orlcln@med.auth.gr
BACKGROUND: Nasopharyngeal cancer (NPC) is a tumor of epidermoid origin
with an entirely different biological behavior than other carcinoma of
the head and neck region. PATIENTS/METHODS: A retrospective analysis was
performed in 93 cases with locally advanced NPC treated with induction
chemotherapy followed by radiation therapy (RT; 79 patients) or
concomitant RT and chemotherapy. RESULTS: Totally 66 patients (71%)
achieved a complete response (CR), 68% of the patients treated with
induction chemotherapy followed by RT, 86% with concomitant
chemoradiotherapy. After a median follow-up of 5.5 years 28 out of these
66 relapsed, 25 of them locoregionally. Median time to progression was
22.5 months, median overall survival (OS) 45 months, 5-year actuarial
survival was 41.5%. Age, T and N classification, histological type and
type of chemotherapy were independent significant factors for OS.
CONCLUSIONS: Combined chemotherapy and RT in patients with locally
advanced NPC result in a high CR rate. The main problem remains the
locoregional control. Randomized studies are needed in order to define
the optimal use of chemotherapy in combination with RT.
19
UI - 11601334
AU - Zhan F; Cao L; Bin L; Jiang N; Deng L; Xie Y; Tan G; Li G
TI -
cDNA representational difference analysis of differentially expressed
cDNA sequences in human nasopharyngeal carcinoma.
SO - Chin Med J (Engl) 1999 Jun;112(6):538-42
AD - Cancer Research Institute, Hunan Medical University, Changsha 410078,
China.
OBJECTIVE: To search differentially expressed sequences correlated with
pathogenesis of human nasopharyngeal carcinoma (NPC), including the
candidates of tumor suppressor genes. METHODS: Representational
difference analysis (RDA) was performed to isolate differentially
expressed sequences between cDNA from normal human primary cultures of
nasopharyngeal epithelial cells and cDNA from NPC cell line HNE1. The
source of differentially expressed products were proved by Southern
blot, Northern blot and in situ hybridization. The fragments were cloned
with pGEM-T easy kit and sequenced by the chain termination reaction.
RESULTS: Four differentially expressed cDNA fragments were isolated in
the fourth subtractive hybridization using cDNA from normal human
nasopharyngeal epithelial cells as tester amplicon and cDNA from NPC
cell line HNE1 as driver amplicon by cDNA RDA. These differential cDNA
fragments revealed that they really came from the tester amplicon and
were not expressed or down-regulated in the NPC HNE1 cells. Some of the
genes were expressed only in human nasopharyngeal epithelial cells but
deleted or down-regulated in the biopsies of NPC. Of these obtained
clones, some were the sequences of the human known genes including
house-keeping genes, the others represented novel gene sequences.
CONCLUSION: The differentially expressed products including the
candidates of tumor-suppressor genes may be associated with the
initiation of the NPC.
20
UI - 11601057
AU - Liu Y; Zhang L; Gu P
TI -
[The effects of 6A8 cDNA transfection on biological behavior of tumor
cells]
SO - Zhonghua Yi Xue Za Zhi 1999 Apr;79(4):292-4
AD - Institute of Basic Medical Sciences, Peking Union Medical College,
Chinese Academy of Medical Sciences, Beijing 100005.
OBJECTIVE: To investigate the effects of antisense 6A8 cDNA on the
malignant behavior of tumor. METHODS: Highly metastatic clonal variant
CNE-2L2 from nasopharygeal carcinoma cell line(CNE-2Z) was transfected
with antisense 6A8 cDNA or mock plasmid. Their adhesion, locomotion,
proteolytic ability, in vitro invasion, in vivo growth and metastasis
were comparatively studied with the wild CNE-2L2 cells. RESULTS:
Antisense 6A8 cDNA transfected CNE-2L2 showed less adhesion to FN and
LN, weakened locomotive ability and proteolytic ability, retarded in
vivo growth and much less metastasis. CONCLUSION: Transfection of
antisense 6A8 cDNA obviously decreased the malignant behavior of tumor
cells.
21
UI - 11596029
AU - Yu CL; Fielding R; Chan CL; Sham JS
TI -
Chinese nasopharyngeal carcinoma patients treated with radiotherapy:
association between satisfaction with information provided and quality
of life.
SO - Cancer 2001 Oct 15;92(8):2126-35
AD - Unit for Behavioral Sciences, Department of Community Medicine, The
University of Hong Kong, Hong Kong SAR, China.
BACKGROUND: Nasopharyngeal carcinoma (NPC) is highly prevalent in
southern China. Prominent acute side effects of radiotherapy create
problems in daily living and working that can generate considerable
financial difficulties. A better adjustment to a diagnosis of NPC
appears to be associated with an improved rate of recovery, a better
quality of life (QoL), a quicker return to work, and normal functioning.
Patient satisfaction with physician consultation and the way information
is provided in particular may have significant bearing on QoL. The
current study reports on short-term QoL after radiotherapy in NPC
patients as a function of satisfaction with the information provided.
METHODS: Newly referred Hong Kong Chinese NPC patients (n = 211)
completed interview measures at baseline before the initiation of
radiotherapy, at 4 months after baseline (immediate posttreatment
consultation) (FU 1), and again at 8 months (short-term postradiation
period) after baseline (FU 2). Satisfaction with the information
provided was measured by five items selected from the cognitive subscale
of the Medical Interview Satisfaction Scale (MISS). QoL was measured by
the Chinese version of the Functional Assessment of Cancer
Therapy-General Scale (FACT-G (Ch)). RESULTS: After adjustment for
overall patient satisfaction (the PSQ-9), optimism, worry about family,
anger, eating ability, subjective health, family income, and occupation
at FU 1, treatment between baseline and FU 1, and disease recurrence
after baseline, the 5-item MISS at FU 1 (beta = 0.21, P < 0.01) was
found to significantly predict patient QoL at FU 2. Adjustment for
baseline QoL and disease stage did not appear to alter this relation
(beta = 0.20, P < 0.01). CONCLUSIONS: To the authors' knowledge, there
is very little research concerning NPC. The results of the current study
reinforced the need to improve physicians' information provision during
consultations with Chinese NPC patients shortly after the end of
treatment. Copyright 2001 American Cancer Society.
22
UI - 11597797
AU - Lu TX; Mai WY; Teh BS; Hu YH; Lu HH; Chiu JK; Carpenter LS; Woo SY;
TI -
Butler EB
Important prognostic factors in patients with skull base erosion from
nasopharyngeal carcinoma after radiotherapy.
SO - Int J Radiat Oncol Biol Phys 2001 Nov 1;51(3):589-98
AD - Department of Radiation Oncology, Cancer Center, Sun Yat-sen University
of Medical Sciences, Guangzhou, People's Republic of China.
PURPOSE: To evaluate the long-term outcome and prognostic factors in
patients with skull base erosion from nasopharyngeal carcinoma after
nasopharyngeal carcinoma were found on computed tomography (CT) to have
skull base erosion. The mean age was 41 years (range 16-66). Ninety-six
patients had World Health Organization type III undifferentiated
carcinoma, and 4 had type I. The metastatic workup, including chest
radiography, liver ultrasound scanning, and liver function test was
negative. All patients underwent external beam RT (EBRT) alone to 66-80
Gy during 6-8 weeks. A daily fraction size of 2 Gy was delivered using
60Co or a linear accelerator. No patient received chemotherapy. All
patients were followed at regular intervals after irradiation. The
median follow-up was 22.3 months (range 2-174). Survival of the cohort
was computed by the Kaplan-Meier method. The potential prognostic
factors of survival were examined. Multivariate analyses were performed
using the Cox regression model. RESULTS: The 1, 2, 5, and 10-year
overall survival rate for the cohort was 79%, 41%, 27%, and 13%,
respectively. However, the subgroup of patients with both anterior
cranial nerve (I-VIII) and posterior cranial nerve (IX-XII) involvement
had a 5-year survival of only 7.7%. A difference in the time course of
local recurrence and distant metastasis was observed. Both local
recurrence and distant metastasis often occurred within the first 2
years after RT. However, local relapse continued to occur after 5 years.
In contrast, no additional distant metastases were found after 5 years.
The causes of death included local recurrence (n = 59), distant
metastasis (n = 21), both local recurrence and distant metastasis (n =
1), and unrelated causes (n = 5). After multivariate analysis, complete
recovery of cranial nerve involvement, cranial nerve palsy, and headache
after irradiation were found to be independent prognostic factors in
this cohort. CONCLUSIONS: We present one of the longest follow-ups of
patients with nasopharyngeal carcinoma invading the skull base. Our
results demonstrate the importance of cranial nerve involvement,
recovery of headache, and cranial nerve palsy. These factors should be
carefully evaluated from the history, physical examination, and imaging
studies. A subgroup of patients with skull base involvement had
long-term survival after RT alone. The findings of this study are
important as a yardstick against which more aggressive strategies, such
as combined radiochemotherapy and altered fractionation RT can be
compared.
23
UI - 11642420
AU - Young YH; Lu YC
TI -
Mechanism of hearing loss in irradiated ears: a long-term longitudinal
study.
SO - Ann Otol Rhinol Laryngol 2001 Oct;110(10):904-6
AD - Department of Otolaryngology, National Taiwan University Hospital,
Taipei.
A 10-year longitudinal follow-up study of hearing was conducted in
patients with nasopharyngeal carcinoma (NPC) in order to elucidate the
mechanism of hearing loss in irradiated ears. Ten NPC patients were
subjected to a battery of audiological tests before irradiation and 6
months, 5 years, and 10 years after irradiation. The tests included pure
tone audiometry, tympanometry, eustachian tube function testing, and
myringotomy to confirm middle ear effusion. The prevalences of otitis
media with effusion (OME) were 25%, 25%, 40%, and 25% at the 4 testing
periods described above, respectively. The prevalences of chronic otitis
media were 0%, 0%, 15%, and 25%, respectively. In myringotomized ears (n
= 17), the mean hearing levels for both air conduction and bone
conduction were preserved from the preirradiation period to 10 years
after irradiation. In contrast, in grommeted ears (n = 3), the mean
hearing levels for both air conduction and bone conduction deteriorated
progressively from the preirradiation period to 10 years after
irradiation. We conclude that hearing can be preserved in NPC patients
10 years after irradiation if middle ear inflammation is well
controlled. We do not recommend grommet insertion in irradiated NPC
patients with OME, as it may result in persistent otorrhea and hearing
deterioration.
24
UI - 11605038
AU - Steinhart H; Bohlender JE; Constantinidis J; Urbschat S; Fischer U; Iro
TI -
H; Pahl S; Meese E
Genetic imbalances in preinvasive tissue of hypopharynx provide evidence
for cytogenetic heterogeneity.
SO - Oncol Rep 2001 Nov-Dec;8(6):1229-31
AD - Department of Otorhinolaryngology, University of Erlangen-Nuremberg,
D-91054 Erlangen, Germany. helmut.steinhart@hno.imed.uni-erlangen.de
Multiple chromosomal aberrations have been reported in head and neck
squamous cell carcinoma (HNSCC). But less information is available on
specific patterns of chromosomal amplifications which distinguish
different areas of head and neck tumors. To elucidate genetic mechanisms
causing the aggressive growth and high proliferation of hypopharyngeal
squamous cell carcinoma (SCC), we performed reverse chromosome painting
(RCP) on a total of eight hypopharyngeal SCC including invasive
carcinoma and preinvasive tissue. Five hypopharyngeal invasive
carcinomas showed amplifications on chromosome 3q. Furthermore, we
detected gains on chromosomes 11q and 6p. Compared to the histologically
classified preinvasive tissues, we found amplified alterations on
chromosome 6p, 11q and 12q, but none of them showed gains on chromosome
3q. This observed heterogeneity in hypopharyngeal SCC might reflect a
specific role of chromosome 3q as a late event in the highly invasive
capacity of these SCC.
25
UI - 11605053
AU - Shotelersuk V; Ittiwut C; Shotelersuk K; Triratanachat S; Poovorawan Y;
TI -
Mutirangura A
Fibroblast growth factor receptor 3 S249C mutation in virus associated
squamous cell carcinomas.
SO - Oncol Rep 2001 Nov-Dec;8(6):1301-4
AD - Genetics Unit, Department of Pediatrics, King Chulalongkorn Memorial
Hospital, Bangkok 10330, Thailand. vorasuk.s@chula.ac.th
An S249C mutation in fibroblast growth factor receptor 3 (FGFR3) gene
was recently identified in patients with cervical carcinomas (CC).
However, its importance in cervical tumorigenesis is still inconclusive.
Apart from CC, nasopharyngeal carcinoma (NPC) is the other major virus
associated squamous cell carcinoma. We sought to clarify the frequency
of the FGFR3 S249C mutation in 75 primary CC in the Thai population and
to determine its prevalence in 69 primary NPC by PCR and restriction
enzyme digestion. None of the patients but one NPC showed the enzyme
digestion pattern consistent with the mutation. This is the first report
demonstrating the role of FGFR3 in the development of human NPC. This
study confirms the low frequency of the FGFR3 S249C mutation in CC.
Nevertheless, the discovery of the mutation, not only in CC as reported
by previous studies, but in NPC based on this report, suggests that
FGFR3 may play a significant role in human CC and NPC development.
26
UI - 11669328
AU - El-Weshi A; Khafaga Y; Allam A; Mosseri V; Ibrahim E; El-Serafi M;
TI -
El-Badawi S
Neoadjuvant chemotherapy plus conventional radiotherapy or accelerated
hyperfractionation in stage III and IV nasopharyngeal carcinoma--a phase
II study.
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