Evaluation of speech outcomes using English version of the Speech Handicap Index in a cohort of head and neck cancer patients.
Oral Oncol. 2012 Jan 28;
Authors: Dwivedi RC, St Rose S, Chisholm EJ, Bisase B, Amen F, Nutting CM, Clarke PM, Kerawala CJ, Rhys-Evans PH, Harrington KJ, Kazi R
Abstract
The aim of this study was to explore post-treatment speech impairments using English version of Speech Handicap Index (SHI) (first speech-specific questionnaire) in a cohort of oral cavity (OC) and oropharyngeal (OP) cancer patients. Sixty-three consecutive OC and OP cancer patients in follow-up participated in this study. Descriptive analyses have been presented as percentages, while Mann-Whitney U-test and Kruskall-Wallis test have been used for the quantitative variables. Statistical Package for Social Science-15 statistical software (SPSS Inc., Chicago, IL) was used for the statistical analyses. Over a third (36.1%) of patients reported their speech as either average or bad. Speech intelligibility and articulation were the main speech concerns for 58.8% and 52.9% OC and 31.6% and 34.2% OP cancer patients, respectively. While feeling of incompetent and being less outgoing were the speech-related psychosocial concerns for 64.7% and 23.5% OC and 15.8% and 18.4% OP cancer patients, respectively. Worse speech outcomes were noted for oral tongue and base of tongue cancers vs. tonsillar cancers, mean (SD) values were 56.7 (31.3) and 52.0 (38.4) vs. 10.9 (14.8) (P<0.001) and late vs. early T stage cancers 65.0 (29.9) vs. 29.3 (32.7) (P<0.005). The English version of the SHI is a reliable, valid and useful tool for the evaluation of speech in HNC patients. Over one-third of OC and OP cancer patients reported speech problems in their day-do-day life. Advanced T-stage tumors affecting the oral tongue or base of tongue are particularly associated with poor speech outcomes.
PMID: 22289636 [PubMed - as supplied by publisher]
Comparison of the NCI-CTCAE version 4.0 and version 3.0 in assessing chemoradiation-induced oral mucositis for locally advanced nasopharyngeal carcinoma.
Oral Oncol. 2012 Jan 28;
Authors: Liu YJ, Zhu GP, Guan XY
Abstract
To compare the role of CTCAE version 4.0 (v4.0) and version 3.0 (v3.0) in assessing chemoradiation-induced oral mucositis (OM) for locally advanced nasopharyngeal carcinoma (LA-NPC). Patients with LA-NPC were recruited into the study. All eligible participants received docetaxel and cisplatin-based induction chemotherapy followed by intensity modulated radiation therapy concurrent with cisplatin. OM was assessed before and weekly during radiotherapy (RT), using CTCAE v3.0 (clinical exam) and v4.0 separately. OM-related quality of life (QOL) was also evaluated in these patients with the EORTC Quality of Life Questionnaire – Head and Neck module (QLQ-H&N35). From June 2010 to February 2011, 23 eligible patients were enrolled. A highly significant correlation (rho=0.838, p=0.000) and a non-significant difference (p=0.167) in OM grades were found between the two CTCAE versions. However, the trend lines showed that the mean grade determined by CTCAE v3.0 reached a plateau while the mean grade determined by v4.0 continued to increase after the fourth week during RT. Changing trends of several QOL subscale mean scores were similar to that of OM mean grade evaluated by CTCAE v4.0. Both grades of the two CTCAE versions were significantly and positively correlated with scores of several QOL subscales. Nonetheless, the correlation coefficients related to CTCAE v4.0 were higher than those related to v3.0 (rho: 0.727-0.865 versus 0.727-0.778). CTCAE v4.0 could serve as a good surrogate for v3.0 (clinical exam) in assessing chemoradiation-induced oral mucositis. Moreover, CTCAE v4.0 has a few subtle advantages over v3.0 under some circumstances such as delegating QOL. However, there is still no “gold standard” assessment scale for oral mucositis. Therefore, the appropriate tool should be carefully chosen according to the purpose of assessment.
PMID: 22289637 [PubMed - as supplied by publisher]
Hypoxia-induced up-regulation of apelin is associated with a poor prognosis in oral squamous cell carcinoma patients.
Oral Oncol. 2012 Jan 27;
Authors: Heo K, Kim YH, Sung HJ, Li HY, Yoo CW, Kim JY, Park JY, Lee UL, Nam BH, Kim EO, Kim SY, Lee SH, Park JB, Choi SW
Abstract
Recently, apelin has been shown to be a novel angiogenic factor in various cancers including lung, breast and brain cancer. However, there is limited information regarding the expression and role of apelin in oral cavity cancer. In this study, we determined that apelin expression was localized in the cytoplasm of oral squamous cell carcinoma at various intensities. Strong apelin expression significantly correlated with tumor recurrence and disease-free survival. Using a multivariate analysis, we demonstrated that apelin was an independent prognostic factor for on disease-free survival, age, lymph node metastasis and CA9 expression. Moreover, apelin expression was up-regulated under hypoxic conditions, and exogenous apelin enhanced the proliferation and migration of oral cancer cells. Based on these results, we propose that the presence of hypoxia-induced apelin is a new prognostic factor and potential therapeutic target for oral squamous cell carcinoma.
PMID: 22285858 [PubMed - as supplied by publisher]
mTOR expression and prognosis in elderly patients with laryngeal carcinoma: Uni- and multivariate analyses.
Oral Oncol. 2012 Jan 27;
Authors: Marioni G, Staffieri A, Lora L, Fermo S, Giacomelli L, La Torre FB, Favaretto N, Valentini E, Manzato E, Blandamura S
Abstract
Cancer is common in the elderly, who may also be frail, which can complicate the choice of the best therapeutic approach. We sought to examine whether the serine-threonine kinase mTOR, a “master switch” in cancer cells that modulates metabolism, the cell cycle, and apoptosis, might help in clinical decision-making. The aim of the present study was thus to assess the potential prognostic role of mTOR in elderly patients with laryngeal carcinoma (LSCC). mTOR expression was determined immunohistochemically in 54 consecutive elderly (⩾65years old) patients with LSCC. On univariate analysis, nodal involvement and pathological stage correlated strongly with the elderly LSCC patients’ prognosis in terms of disease recurrence rate and disease-free survival (DFS). Patients whose mTOR expression was >35.3% had a significantly higher recurrence rate (p=0.003) and shorter DFS (p=0.013). In the multivariate model, N status (p=0.001) and mTOR expression (p=0.026) maintained an independent prognostic significance in relation to DFS. mTOR probably influences the aggressive LSCC phenotype in elderly patients and its expression in elderly LSCC cases can be considered a prognostic marker potentially useful for identifying patients at higher risk of disease recurrence, and N0 patients at higher risk of recurrence who may benefit from more aggressive treatment. Since rapalogs (as mTOR inhibitors) might have an effect on LSCC, further investigations are needed to ascertain these agents’ role in therapeutic strategies for advanced LSCC in elderly patients.
PMID: 22285859 [PubMed - as supplied by publisher]
HMGB1 is overexpressed in tumor cells and promotes activity of regulatory T cells in patients with head and neck cancer.
Oral Oncol. 2012 Jan 19;
Authors: Wild CA, Brandau S, Lotfi R, Mattheis S, Gu X, Lang S, Bergmann C
Abstract
HMGB1 has gained a prominent role in cancer development and is implicated in tumor escape phenomena. To date, only few data are available on effects of HMGB1 on regulatory T cells (Treg) in cancer patients. This study evaluates the prevalence of HMGB1 and its effects on Treg in patients with head and neck squamous cell carcinoma (HNSCC). Sixty-seven patients with HNSCC and seventeen healthy donors were included in this study. Tumor tissues of patients were analyzed for expression of HMGB1 employing immunofluorescence and qRT-PCR. HMGB1 serum levels were assessed using ELISA. Tumor-infiltration and Treg from peripheral blood were phenotyped with flow cytometry and immunofluorescence microscopy. Migration and suppressive function of Treg upon HMGB1 stimulation was analyzed in chemotaxis assays and CFSE assays. HMGB1 is overexpressed in tumor cells of HNSCC, and serum levels are significantly elevated. Tumor-infiltrating Treg express HMGB1-recognizing receptors, TLR4 and RAGE. HMGB1 is a chemoattractant for Treg and promotes their suppressive function. Our data provide new aspects how the HMGB1 tumor-derived danger signal augments function of Treg in patients with HNSCC.
PMID: 22265157 [PubMed - as supplied by publisher]
International incidence of oropharyngeal cancer: A population-based study.
Oral Oncol. 2012 Jan 18;
Authors: de Camargo Cancela M, de Souza DL, Curado MP
Abstract
The incidence of oropharyngeal cancer is not well documented as it is rarely described according to the anatomic definition but usually grouped with oral cavity subsites. The aim of this study was to calculate oropharyngeal cancer incidence and compare it to oral cavity cancer incidence. Age-standardized incidence rates (ASR) of oropharyngeal cancer were calculated for the period between 1998 and 2002, based on data from Cancer Incidence in 5 Continents, Volume IX (CI5-IX). These ASRs were compared with previously published oral cavity cancer data. Among males, the highest ASRs were observed in France, Slovakia, Slovenia and Brazil. The highest oral cavity/oropharyngeal cancer rate ratio was observed in Pakistan, among males (6.2) and females (13.5). The results provide an overview of oropharyngeal cancer incidence and constitute a basis for the development of primary and secondary prevention, according to geographical variations and topography.
PMID: 22265333 [PubMed - as supplied by publisher]
Transoral robotic surgery for hypopharyngeal squamous cell carcinoma: 3-Year oncologic and functional analysis.
Oral Oncol. 2012 Jan 18;
Authors: Park YM, Kim WS, Virgilio AD, Lee SY, Seol JH, Kim SH
Abstract
The recent trend in treatment of hypopharyngeal cancer is organ preservation in order to maintain swallowing and speech function as well as improve quality of life. Transoral robotic surgery (TORS) can remove hypopharyngeal lesions successfully without an external incision, preserving physiologic functions of affected organs. However, studies have yet to assess the oncologic and functional results of TORS for the treatment of hypopharyngeal cancer. This prospective study evaluated the oncologic and functional results of TORS for the treatment of hypopharyngeal cancer obtained at our institution over a period of 3years and confirmed the validity of TORS as a surgical organ-preserving strategy. Between April 2008 and September 2011, 23 patients who were diagnosed with hypopharyngeal cancer underwent TORS for removal of a primary lesion. The da Vinci Robotic system (Intuitive Surgical Inc., Sunnyvale, California) was used to remove the lesion. The Kaplan-Meier method was used to analyze overall survival and disease-free survival. Videopharyngogram study (VEF) was performed and functional outcome swallowing scale (FOSS) was utilized to measure and evaluate swallowing function. Acoustic wave form analysis was conducted to evaluate voice status. Overall survival at 3years was 89% and disease-free survival was 84%. On the VEF study, serious aspiration or delay of swallowing was not observed during the pharyngeal stage of the swallowing process. Overall, 96% of the patients showed favorable swallowing abilities with an FOSS score ranging from 0 to 2. The fundamental frequency variation (vF0) and jitter were increased upon acoustic waveform analysis (vF0=2.71±0.063, Jitter=2.01±0.034), but the harmonic-to-noise ratio (HNR) and shimmer were maintained close to the normal range (HNR=1.28±0.001, Shim=1.74±0.036). The oncologic and functional results of TORS were quite acceptable for the treatment of hypopharyngeal cancer. TORS is a valid treatment option as a surgical, organ-preserving strategy for select patients with hypopharyngeal cancer.
PMID: 22265334 [PubMed - as supplied by publisher]
Platelet-rich therapies in the treatment of intravenous bisphosphonate-related osteonecrosis of the jaw: A report of 32 cases.
Oral Oncol. 2012 Jan 18;
Authors: Mozzati M, Gallesio G, Arata V, Pol R, Scoletta M
Abstract
Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is an important complication in cancer patients taking intravenous BPs (BPs). In most cases, BRONJ is associated with an oral surgery procedure involving jaw bone. Currently, BRONJ management remains controversial, and there is no definitive standard of care for this disease. In fact, several articles in the recent literature discuss treatments that range from topical to surgical treatment, without definitive conclusion about treatment. A clinical study was conducted on 32 patients treated with i.v BPs for oncologic pathologies affected by BRONJ. The patients were treated by resection of the necrotic bone with primary closure of the mucosa over the bony defect using plasma rich in growth factors (PRGF). Orthopanoramic and computed tomography were performed before and after surgery. No intraoperative complications were observed, and all 32 cases were treated successfully. Our data on the use of PRGF demonstrate positive results for this surgical treatment. PRGF may enhance vascularization and regeneration of osseous and epithelial tissues.
PMID: 22265335 [PubMed - as supplied by publisher]
Primary malignant melanoma, of head and neck: A comprehensive review of literature.
Oral Oncol. 2012 Jan 18;
Authors: Vikey AK, Vikey D
Abstract
Malignant melanoma; since long time is considered as deadly disease, but risk factor is minimized due to new technologies, substantial literatures, and promising treatments. The diverse etiopathogenesis; including physical carcinogens, bio-molecules, biological behavior, anatomical locations, and negligence; contribute to complexity of disease. So even after advanced medical technology, malignant melanoma is the challenge to doctors as well as common public. There is increase in incidence rate day by day, which directly attributes to recent concept of sun beds or tanning beds and global climate. After considering its severity, different researches are carried out in the field of radiology and biotechnology. But again these are not sufficient to control the disease. However; to reduce the mortality there is need of general public awareness regarding causative factors and preventive measures. Many literatures recently advocate for long time survival of malignant melanoma, after its early detection and treatment.
PMID: 22265336 [PubMed - as supplied by publisher]
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