• [Study on the correlation between the expression of protein p53 at stage III nasopharyngeal carcinoma and its biological behavior, prognosis, p53

• [Pedicled pectoralis major musculocutaneous flaps]

• Local recurrence in head and neck cancer: relationship to radiation resistance and signal transduction.

• The role of brachytherapy in the management of oropharyngeal carcinomas: the Trento experience.

• Subjective functional results 1 year after surgery and postoperative radiation for oropharyngeal carcinoma.

• [PET scan in patients with epipharyngeal tumors]

• [Mouth and throat cancer; new developments]

• [Differentially expressed cDNA sequences homologous with known genes in human nasopharyngeal carcinoma]

• Locally advanced nasopharyngeal cancer.

• Nasopharyngeal carcinoma.

• Hypopharyngeal carcinoma.

• What's new in the biology and treatment of undifferentiated carcinoma of nasopharyngeal type?

• Fasciocutaneous free flaps for hypopharyngeal reconstruction.

• Expression of GSTM1 in angiofibromas.

• High false-positive rate of cytokeratin-19 in detecting circulating tumor cells for nasopharyngeal carcinoma.

• [Occupational exposure to wood dust. Health effects and exposure limit values]

• [Epidemiologic analysis of patients with laryngeal and hypopharyngeal cancer treated in the Department of Otolaryngology in Bialystok from

• Genetic alterations in squamous cell carcinomas of the hypopharynx with correlations to clinicopathological features.

• Single-bolus technique for spiral CT of laryngopharyngeal squamous cell carcinoma: comparison of different contrast material volumes, flow

• NasoNet, modeling the spread of nasopharyngeal cancer with networks of probabilistic events in discrete time.

• Aerosol particle and organic vapor concentrations at industrial work sites in Malaysia.

• [Delayed treatment of laryngeal and hypopharynx cancer in the North-Eastern part of Poland in years 1986-1999]

• [Transcriptional activation study of transforming gene Tx-related human nasopharyngeal carcinoma]

• Intensity-modulated radiotherapy versus conventional three-dimensional conformal radiotherapy for boost or salvage treatment of nasopharyngeal

• Long-term survival of nasopharyngeal carcinoma patients treated with adjuvant chemotherapy subsequent to conventional radical radiotherapy.

• Improved survival with perilymphatic interleukin 2 in patients with resectable squamous cell carcinoma of the oral cavity and oropharynx.

• [Structural and functional features of Epstein-Barr virus LMP-1 gene in patients with anaplastic carcinoma of the nasopharynx in Russia]

• [Malignant multifocal ENT tumors]

• Multimodal intensification therapy for previously untreated advanced resectable squamous cell carcinoma of the oral cavity, oropharynx, or

• A distinct expression of CC chemokines by macrophages in nasopharyngeal carcinoma: implication for the intense tumor infiltration by T

• Squamous cell carcinoma of the oropharynx: surgery, radiation therapy, or both.

1
UI - 11866991
AU - Xu S; Zhang W
TI - [Study on the correlation between the expression of protein p53 at stage III nasopharyngeal carcinoma and its biological behavior, prognosis, p53 gene mutation and the expression of LMP-1]
SO - Zhonghua Bing Li Xue Za Zhi 2001 Dec;30(6):456-9
AD - Department of Pathology, Medical College of Guiyang, Guiyang 550004, China.
OBJECTIVE: To investigate p53 protein expression at stage III nasopharyngeal differentiated non-keratinizing squamous carcinoma (DNKSC) and their correlation with biological behavior and prognosis;the relationship between p53 protein expression and p53 gene mutation and LMP-1 protein expression at 58 cases of stage III DNKSC. METHODS: Immunohistochemistry (Envision) was applied to detect p53 protein and LMP-1 protein expression. Non-isotopic PCR-SSCP was used to detect p53 gene mutation. RESULTS: The p53 protein expression showed general positive rates of 65.5% (38/58) in the patients with nasopharyngeal DNKSC, being significantly higher in the group surviving less than 5 years 82.1% (32/39) than in the group surviving longer than 5 years 31.6% (6/19) (P < 0.05). Besides, it was closely correlated with the local invasion to the cranial base, there was a significant difference between invasion 74.4% (29/39) and non-invasion 47.4% (9/19) (P < 0.05). The expression of LMP-1 protein rated 72.4% (42/58), exhibiting a positive correlation with the expression of p53 protein (r = 0.504). The p53 gene mutation was found in none of the cases (0/15). CONCLUSIONS: In stage III nasopharyngeal DNKSC, the expression of p53 protein is not related to p53 gene mutation, whereas it relates to the expression of LMP-1 protein. Declined expression of p53 protein is closely related to the time of survival, and the p53 protein expression is higher in the invasive carcinoma.

2
UI - 11998517
AU - Vendrell Marques JB; Zapater Latorre E; Ferrandis Pereperez E; Estelles
TI - Ferriol E; Brotons Durban S [Pedicled pectoralis major musculocutaneous flaps]
SO - Acta Otorrinolaringol Esp 2002 Jan;53(1):39-45
AD - Servicio de Otorrinolaringologia, Fundacion Instituto Valenciano de Oncologia, Valencia.
A retrospective series of 76 pedicled pectoralis major musculocutaneus flaps is presented. We used this technique in reconstruction after head and neck tumours resections and in complications of oncological surgery such as pharyngostomes or orostomes. Most of these flaps were used in reconstruction of oral cavity and in postradiotherapy salvaje surgery cases. We also analyse the presence of complications at the donor and receiver sites and its correlation with different parameters like protein levels, haemoglobin, administration of radiotherapy and its dose, previous quimiotherapy and the influence of systemic diseases.

3
UI - 11895923
AU - Gupta AK; McKenna WG; Weber CN; Feldman MD; Goldsmith JD; Mick R;
TI - Machtay M; Rosenthal DI; Bakanauskas VJ; Cerniglia GJ; Bernhard EJ; Weber RS; Muschel RJ Local recurrence in head and neck cancer: relationship to radiation resistance and signal transduction.
SO - Clin Cancer Res 2002 Mar;8(3):885-92
AD - Department of Radiation Oncology, University of Pennsylvania, Philadelphia, Pennsylvania 19104-6072, USA. gupta@xrt.upenn.edu
PURPOSE: Locoregional recurrence is the dominant form of treatment failure in head and neck (H&N) cancer. The epidermal growth factor receptor (EGFR) is frequently amplified in this disease (4
UI - 12088254
AU - Bolner A; Mussari S; Fellin G; Pani G; Busana L; Caffo O; Tomio L
TI - The role of brachytherapy in the management of oropharyngeal carcinomas: the Trento experience.
SO - Tumori 2002 Mar-Apr;88(2):137-41
AD - Division of Radiotherapy, Ospedale S Chiara, Trento, Italy.
AIMS: This study was undertaken to determine the outcome of patients with oropharyngeal cancer treated at the Radiotherapy Department of the Santa Chiara Hospital (Trento, Italy) with brachytherapy alone or combined with external beam radiotherapy (EBRT). MATERIAL AND METHODS: We retrospectively reviewed the medical records of 87 patients with squamous cell carcinoma of the oropharynx treated by radiation therapy all patients had a minimum follow-up of one year. Tumor locations were 46 tonsillar region, 31 soft palate and 10 base of the tongue. The patients were staged as follows: 41 T1, 35 T2, 11 T3 with 70 N0, 9 N1 and 8 N2. They received either brachytherapy alone (14 patients) or a combination of external beam irradiation and brachytherapy (73 patients) using an afterloading iridium technique in a plastic tube. RESULTS: Overall primary tumor control, including salvage surgery, was 81/87 (93%). Control of metastatic cervical adenopathy was as follows: clinical stage N1, 5/9 patients; N2, 2/8 patients. The estimated five-year cause-specific survival and overall survival rates were 81% and 47%, respectively. After interstitial irradiation severe complications were limited to one case of osteoradionecrosis of the mandible and seven cases of mucosal ulcer. CONCLUSION: This study confirms that iridium-192 interstitial implant alone or as a boost after external beam irradiation is a safe and effective therapy in the management of oropharyngeal carcinomas.

5
UI - 11829194
AU - Klozar J; Lischkeova B; Betka J
TI - Subjective functional results 1 year after surgery and postoperative radiation for oropharyngeal carcinoma.
SO - Eur Arch Otorhinolaryngol 2001 Dec;258(10):546-51
AD - Department of Otolaryngology Head and Neck Surgery, Charles University, Motol Faculty Hospital, Prague, Czech Republic. jan.klozar@Ifmotol.cuni.cz
This study was conducted to find out what factors most influenced functional results and patient satisfaction at 1 year after treatment in a homogeneous group of patients who had undergone surgery and postoperative radiotherapy for the treatment of oropharyngeal carcinoma. Further aims were to find out the relation between the overall and specific disease-related results and to compare the two questionnaires used. The study group consisted of 102 patients, 23 women and 79 men, with an age range of 41-77 years (mean 45.7 years). Two questionnaires were used for evaluation. The University of Washington head and neck quality of life questionnaire (UW-QOL) includes information about nine disease-specific domains and three questions on general quality of life. The second questionnaire used was the performance status scale for head and neck cancer patients (PSS), containing information about three disease-specific domains. Functional results were influenced by the size of tumor and by the surgical method used. Results worsened with increasing T stage. The best results were found after pharyngotomy without mandibulotomy, worse results, following temporary mandibulotomy with osteosynthesis, and the poorest results were found in the group of patients who had undergone composite resection. Neither age and sex of the patients nor the course of healing influenced the functional results. All results were significantly correlated to one another. The general parameters were also closely related to specific domains. An important correlation was found between the parameters in the two questionnaires.

6
UI - 12077914
AU - Olajos J; Erfan J; Lengyel Z; Emri M; Fule E; Erdelyi L; Lengyel E; Esik
TI - O; Tron L [PET scan in patients with epipharyngeal tumors]
SO - Orv Hetil 2002 May 26;143(21 Suppl 3):1275-8
AD - Josa Andras Megyei Korhaz, Onkoradiologiai Osztaly, Nyiregyhaza.
Whole-body FDG PET examinations in 10 cases of epipharyngeal tumour (8 males, 2 females, mean age: 48 years) have been performed since January 1999. The PET examinations were aimed at the accurate staging, follow-up of the patients after the treatment, identification of recurrencies and localization of the unknown primary tumor. Functional imaging resulted in "upstaging" in 3 patients as compared to staging by the conventional diagnostic tools. Four additional patients with hyperplastic epipharyngeal tissue were investigated for occult primary cancer after negative results of multiple excisions, resulting in one case of primary epipharyngeal cancer. Correct staging, early detection of recurrencies, localization of occult primary tumor and the better post-therapeutic assessment of epipharyngeal masses all facilitate a more reasonable therapeutic approach, which may improve survival results.

7
UI - 11921969
AU - Meijer van Putten JB
TI - [Mouth and throat cancer; new developments]
SO - Ned Tijdschr Tandheelkd 1996 Jan;103(1):31-2

8
UI - 11938760
AU - Zhan F; Cao L; Hu C; Li G
TI - [Differentially expressed cDNA sequences homologous with known genes in human nasopharyngeal carcinoma]
SO - Hunan Yi Ke Da Xue Xue Bao 1999;24(2):103-6
AD - Cancer Research Institute, Hunan Medical University, Changsha 410078.
In order to search the tumor suppressor genes correlated with pathogenesis of human nasopharyngeal carcinoma(NPC), we applied the PCR-based subtractive hybridization technique of representational difference analysis (RDA) to the primary culture cells of normal human nasopharyngeal epithelial and HNE1, a poorly differentiated NPC cell line. Following four successive subtractions of HNE1 complementary DNA from normal human nasopharyngeal epithelial cells complementary DNA, difference products were cloned into pGEM-T easy vector and nucleotide sequences determined. Comparison of cDNA sequences against the databases identified 9 known genes. Known genes included TRIP1(TGF beta receptor interacting protein), TAF, ezrin, MHC II, actinin, Histone H1 zero, Cytokeratin 13, Squalene Synthetase and RNA Synthetase-like. Some of them have an effective suppressive ability on the tumor. In this study, we have demonstrated that cDNA RDA is an effective strategy for systematically isolating differences in gene expression between two related but functionally distinct cells. Our results also indicated that the NPC includes interaction of multigenes and this experiment offers a new route for NPC research.

9
UI - 12057137
AU - Ensley JF; Youssef E; Kim H; Yoo G
TI - Locally advanced nasopharyngeal cancer.
SO - Curr Treat Options Oncol 2001 Feb;2(1):15-23
AD - Department of Internal Medicine, Hematology-Oncology Division, Wayne State University, Barbara Ann Karmanos Cancer Institute, Detroit, MI, 48203, USA.
The Head and Neck Cancer Intergroup phase III clinical trial (Int 0099) for patients with locally advanced, squamous cell carcinomas (SCC) of the nasopharynx (or NPC) has been recently completed in the United States. The results of this study have defined the new standard of treatment for the group of patients studied. Patients with untreated, locally advanced stages III and IV NPC were randomized to a conventional course of radiation, or to radiation given concurrently with chemotherapy followed by three courses of combination chemotherapy. The 3-year progression-free survival (PFS) and overall survival (OS) were 24% versus 69% (P < 0.001) and 46% versus 76% (P < 0.001) for the control and experimental groups, respectively. Recent updates of these survival figures show that they have not changed appreciably. The considerable improvement in OS versus PFS for the patient group receiving radiation alone is accounted for primarily by re-treatment with concurrent radiation-chemotherapy, combination chemotherapy, and isolated salvage neck dissections. Highly significant differences in local control (41% vs 14%) and distant metastases (35% vs 13%) were demonstrated in favor of the chemoradiation treatment arm. The median age for these patients was 51 years, with a 2:1 male to female ratio. Although many patients had a significant history of tobacco exposure with or without alcohol use or abuse, only 24% had keratinizing or well-differentiated squamous (World Health Organization I) type tumors. Whether these results can be extrapolated to the more common Asian variety (WHO II and III) of advanced NPC must be addressed in future clinical trials.

10
UI - 12057084
AU - Al-Sarraf M; Reddy MS
TI - Nasopharyngeal carcinoma.
SO - Curr Treat Options Oncol 2002 Feb;3(1):21-32
AD - Rose Cancer Center, William Beaumont Hospital, 3577 West 13 Mile Road, Suite 404, Royal Oak, MI 48073, USA. mealsarraf@aol.com
Nasopharyngeal carcinoma is usually present as locally advanced (stage III or IV) disease. Before 1980, the primary treatment was radiotherapy. The 5-year survival rate of patients with stage IVM0 across the world was less than 30%. Local, regional, and systemic recurrences are high in these patients and contributed to the poor survival. Sequential chemotherapy followed by radiotherapy (especially with the combination of cisplatin and 5-fluorouracil infusion for three courses) resulted in a 5-year survival rate of up to 55% in patients with stage IV disease. Concurrent single-agent cisplatin and radiotherapy improved 5-year survival rate to up to 55% in these patients. Total treatment with concurrent chemoradiotherapy followed by adjuvant cisplatin and 5-fluorouracil infusion resulted in 5-year survival rate of approximately 75%. Reversing the sequence of treatment by giving chemotherapy followed by concurrent chemoradiotherapy may improve the 5-year survival to up to 90%. In patients with recurrent disease or systemic metastases, the chances of salvage and long remission (many years) is approximately 15% to 20% with the use of adequate and effective chemotherapy. Newer agents, alone or concomitant with radiotherapy, are being evaluated in these patients.

11
UI - 12057086
AU - Hinerman RW; Amdur RJ; Mendenhall WM; Villaret DB; Robbins KT
TI - Hypopharyngeal carcinoma.
SO - Curr Treat Options Oncol 2002 Feb;3(1):41-9
AD - Department of Radiation Oncology, University of Florida College of Medicine, PO Box 100385, Gainesville, FL 32610-0385, USA. hinerrw@shands.ufl.edu
For more than 20 years, the policy at the University of Florida has been to treat patients with favorable stage T1-T2 pyriform sinus carcinoma by using radiation therapy alone, or with a planned neck dissection if advanced nodal disease is present. This approach usually leaves the patient with nearly normal swallowing and speech, and provides bilateral coverage of the regional neck and retropharyngeal lymphatics. More advanced lesions often are not controlled with radiation alone and are usually considered for partial or total laryngopharyngectomy if the patient is medically operable. Radiation is usually administered postoperatively in this setting, unless the neck disease is thought to be unresectable, in which case preoperative radiation is given. Recent data have shown that adjuvant chemotherapy administered concomitantly with radiotherapy results in improved cure rates for patients with advanced disease compared with irradiation alone. Time-honored established guidelines are still used, although the edges have become blurred. Therefore, patients with larger primary tumors now may be considered for organ preservation treatment with irradiation and chemotherapy, reserving surgery for salvage situations. The subset of patients with advanced T4 pyriform sinus cancers (in whom cure with chemoradiation would likely result in tracheostomy and/or gastrostomy dependence) may be better served with elective surgery and postoperative irradiation. The definition of this subset of patients is unclear but probably includes patients with significant cartilage destruction and those who require pretreatment tracheostomy. The policy at the University of Florida is to treat essentially all pharyngeal wall cancers with external-beam irradiation alone.

12
UI - 11813890
AU - Carbone A; Dolcetti R; Shaha AR; Gloghini A; Molinari R; Rinaldo A;
TI - Boiocchi M; Wei WI; Ferlito A What's new in the biology and treatment of undifferentiated carcinoma of nasopharyngeal type?
SO - Acta Otolaryngol 2001 Dec;121(8):884-95
AD - Division of Pathology, National Cancer Institute, IRCCS, Aviano, Italy.

13
UI - 11917950
AU - Amin AA; Bassiouny M; Elsebai H; Riffat M; Fakhry S; Hewidi S; Khafagy M
TI - Fasciocutaneous free flaps for hypopharyngeal reconstruction.
SO - J Reconstr Microsurg 2002 Jan;18(1):1-5
AD - The National Cancer Institute, Cairo Univ, El-Haram, Egypt.
Considerable controversy persists regarding the optimal technique for hypopharyngeal reconstruction. The ideal procedure should provide low mortality and morbidity, short hospitalization, a high success rate, few complications, and the greatest potential for neopharyngeal speech and deglutition. In this study, a variety of fasciocutaneous free flaps were used for reconstruction of the hypopharynx. Over a two-year period, fasciocutaneous flaps were used for reconstruction of pharyngoesophageal segments following total laryngopharyngectomies in 16 patients at The National Cancer Institute, Cairo University, Cairo, Egypt. Flap survival, recipient vessels used, and complications were examined. The ultimate functional and cosmetic outcomes of free flaps were compared. Of the 16 patients included in this study, nine were males, and seven were females. Free flaps used for reconstruction included the radial forearm (8), lateral arm (2), anterolateral thigh (3), and posterolateral thigh (3) flaps. Free flaps were successful in 15 patients. One patient had total flap loss. Salvage surgery was successful for one flap that developed venous congestion. Eleven patients received adjuvant radiation therapy. The commonly used recipient vessels were the small arteries of the neck and the external jugular vein. Five patients developed minor pharyngocutaneous fistulas that healed spontaneously. Six patients developed anastomotic line stricture. Donor-site morbidity was more significant with the radial forearm flap, compared to other flaps. Fasciocutaneous free flaps have a definite place in pharyngoesophageal reconstruction. The flap should be selected with reference to the type of the defect and patient obesity; however, donor-site morbidity should also be considered.

14
UI - 12080991
AU - Gautham K; Ogale SB; Shraddha RU; Ajay D
TI - Expression of GSTM1 in angiofibromas.
SO - J Laryngol Otol 2002 May;116(5):352-4
AD - Department of ENT and Head - Neck Surgery, K.E.M. Hospital, Parel, Mumbai, India. gauthambhat@indiatimes.com
The aetiology of juvenile nasopharyngeal angiofibroma (JNA) is largely unknown. In this study, we have investigated the expression of glutathione S transferase M1 (GSTM1) gene in angiofibroma. The GSTM1 allele gene locus is normally found in all human beings. When this is not expressed there is an increased risk of developing a malignancy of the upper aerodigestive tract. In this study, we have assessed eight samples of JNA for the expression of GSTM1, by the polymerase chain reaction (PCR) followed by polyacrylamide gel electrophoresis (PAGE), three of the eight patients studied failed to express this gene. Further investigation in this area is warranted.

15
UI - 12079157
AU - Kao RH; Huang LC
TI - High false-positive rate of cytokeratin-19 in detecting circulating tumor cells for nasopharyngeal carcinoma.
SO - Chang Gung Med J 2002 Apr;25(4):238-44
AD - Division of Hematology-Oncology, Tzu Chi General Hospital, Hualien, Taiwan, ROC. rueykao@mail.tcu.edu.tw
BACKGROUND: Nasopharyngeal carcinoma (NPC) harbors a higher metastatic potential than other head and neck cancers. In order to seek a possible surrogate marker for early detection of recurrent or metastatic disease, we tested the feasibility of cytokeratin-19 (CK-19)-nested reverse-transcription polymerase chain reaction (RT-PCR) for detecting circulating tumor cells in NPC patients. METHODS: Two tubes of blood were sequentially collected in individual draws from 7 NPC patients and 15 healthy persons. Total ribonucleic acid (RNA) was extracted from blood cells and treated with deoxyribonuclease. The RNA was then subjected to RT and nested PCR with specific CK-19 primers. The reaction products were run on an agarose gel and visualized under UV light. The sequences of the products were determined using an ABI377 automatic sequencer. RESULTS: Among the 7 NPC cases, 4 cases presented CK- 19 expression with 2 in both tubes, 1 in the first tube, and 1 in the second tube. In the control group, 8 of 15 cases also presented CK-19 expression with 6 in both tubes and 2 in the second tube resulting in a 53.3% false-positive rate. Incidentally, an aberrant splicing product lacking exon 4 of CK-19 messenger RNA was discovered. CONCLUSION: Results of the present study indicate that the CK-19-nested RT-PCR is not suitable for detecting circulating tumor cells in NPC patients because of a high false-positive rate in the control group. The reason for the high rate of false-positives may be attributed to pseudogenes, different blood cell separation methods, or illegitimate expression of CK-19 in blood cells.

16
UI - 12011734
AU - Carton M; Goldberg M; Luce D
TI - [Occupational exposure to wood dust. Health effects and exposure limit values]
SO - Rev Epidemiol Sante Publique 2002 Apr;50(2):159-78
AD - INSERM Unite 88. 14, rue du Val d'Osne. 94415 Saint-Maurice Cedex, France. marcel.goldberg@st-maurice.inserm.fr
This article presents a review of the health effects of occupational exposure to wood dusts and of the data that could be used for setting occupational exposure limits for this nuisance. The causal role of wood dust in the onset of sinonasal cancers is solidly established by numerous epidemiological studies, and the magnitude of the risk is particularly high for adenocarcinoma induced by exposure to hardwood dust. However, no current data allows to rule out the carcinogenic role of softwood dusts and, in the view of protecting the health of the workers, it does not seem relevant to distinguish these two types of wood. Various impairments of the lung function have been frequently associated with exposure to both 'allergenic' and 'non-allergenic' wood dusts and may occur at very low concentrations. According to the SUMER 94 and CAREX studies, about 200 000 workers are currently exposed to wood dusts in France (about 1% of the working population between 1990 and 1994). When taking into account full professional careers, the percentage of workers having been occupationally exposed can be estimated to be about 15% for men and 5% for women. Measurements performed in France between 1987 and 2000 show that exposure levels are high, about 50% of the samplings being over 1mg/m(3) (actual TWA in France). Although the studies present limits, particularly for the quantitative assessment of individual exposure levels, it seems that nonmalignant effects are susceptible to arise at the level of 1mg/m(3); a limit value of 0.5mg/m(3) would credibly allow to protect exposed workers from most of the risks of nonmalignant pulmonary effects. However, it is impossible to assure that this value will avoid the induction of sinonasal cancer, even if this level is certainly lower than the levels to which the cases of sinonasal cancers published in the literature were exposed.

17
UI - 12053663
AU - Rzewnicki I; Luczaj J; Olszewska E; Lachowicz M
TI - [Epidemiologic analysis of patients with laryngeal and hypopharyngeal cancer treated in the Department of Otolaryngology in Bialystok from 1986-1999]
SO - Otolaryngol Pol 2002;56(1):19-21
AD - Klinika Otolaryngologii AM w Bialymstoku.
Epidemiological analysis of patients with the larynx cancer, who were treated in the Department of Otolaryngology in Bialystok from 1996 to 1999 was performed. The following aspects were assessed: a) number of patients, b) gender, c) age, d) place of living, e) primary site of the tumour. The results in years 1996-1999 were compared with the earlier published results in years 1986-1994. Altogether 1431 patients (1340-93.6% males and 91-6.4% females) in that period and there were similar numbers of hospitalizations every year. Among patients there were 28-33% farmers, 41-46% labourers, 5-9% white collar workers, the others were old age pensioners. 55-59% patients came from the rural areas and 41-45% patients from urban areas. The most common site of the primary tumour was the supraglottic region (831-58.1%), then glottis (421-29.4%) and rarely in the subglottic region (5-0.3%). Hypopharynx was the tumor primary site in 174 (12.2%) patients. The analysis showed that the numbers of patients with cancer of the larynx or hypopharynx are similar in each year. A constant increase in number of female patients; coming from the rural area, farmers or labourers was found. Increasing incidence rate of supraglottic tumours and little decrease in the number of glottic tumours were also found.

18
UI - 12076699
AU - Rodrigo JP; Gonzalez MV; Lazo PS; Ramos S; Coto E; Alvarez I; Garcia LA;
TI - Suarez C Genetic alterations in squamous cell carcinomas of the hypopharynx with correlations to clinicopathological features.
SO - Oral Oncol 2002 Jun;38(4):357-63
AD - Department of Otolaryngology, Hospital Central de Asturias, University of Oviedo, Instituto Universitario de Oncologia, Oviedo, Spain. jrodrigo@hcas.insalud.es
The objective of this study is to describe the molecular alterations in carcinomas in one specific location of the head and neck, the hypopharynx. Thirty-seven hypopharyngeal squamous cell carcinomas were studied. The DNA from tumour and healthy tissue was evaluated for amplification of the 11q13 region and of the MYC and ERBB1 oncogenes, for integration of the Human Papillomavirus (HPV), and for loss of heterozygosity (LOH) at p53 and NAT2 loci.The most common alteration was the amplification of the 11q13 region (78% of the cases), followed by LOH at p53 locus (70%). MYC amplification was found in 19% of the cases, ERBB1 amplification in 29%, LOH at NAT2 locus in 25%, and integration of the HPV in 29%. 11q13 amplification was related with nodal metastases and higher tumour recurrence rates. These findings confirm that 11q13 amplification is one of the most frequent genetic alterations in hypopharyngeal squamous cell carcinomas, and that it may have prognostic significance in these tumours.

19
UI - 12091679
AU - Keberle M; Tschammler A; Hahn D
TI - Single-bolus technique for spiral CT of laryngopharyngeal squamous cell carcinoma: comparison of different contrast material volumes, flow rates, and start delays.
SO - Radiology 2002 Jul;224(1):171-6
AD - Department of Radiology, University of Wurzburg, Josef-Schneider-Strasse 2, 97080 Wurzburg, Germany. marc.keberle@mail.uni-wuerzburg.de
PURPOSE: To evaluate different contrast material volumes, flow rates, and start delays for contrast material enhancement of neck structures and squamous cell carcinoma to determine the most effective examination protocol. MATERIALS AND METHODS: Seventy patients with squamous cell carcinoma were prospectively randomized into four groups for examination with different protocols (125 mL of contrast material administered at a flow rate of 2.5 mL/sec, 100 mL at 2.0 mL/sec, 90 mL at 1.5 mL/sec, or 70 mL at 1.0 mL/sec). Dynamic series were performed on the tumors and relevant anatomic structures to obtain time-attenuation curves. The protocols were compared (analysis of variance and Tukey-Kramer tests) with regard to time and level of maximum tumor enhancement and carotid arterial enhancement of more than 150 HU. One selected protocol was tested in 30 additional routine examinations with start delays of 40 seconds (for laryngeal and/or hypopharyngeal tumors, 3-mm collimation) and 45 seconds (for oropharyngeal tumors, 5-mm collimation). RESULTS: Except for the 70-mL bolus administered at 1.0 mL/sec, the other protocols performed similarly well, yielding comparable maximum tumor enhancement at 52 seconds and later. In spite of a smaller volume of 90 mL, due to the prolonged flow time at 1.5 mL/sec, carotid arterial enhancement of more than 150 HU was prolonged (when compared with that in 100- or 125-mL protocols). As a result of these circumstances, injection of 90 mL at 1.5 mL/sec was considered more effective, providing no significant differences in tumor (P =.39) or carotid arterial (P =.52) enhancement between routine examinations and dynamic series. CONCLUSION: A single bolus of 90 mL administered at 1.5 mL/sec appears to be the most desirable protocol for contrast enhancement.

20
UI - 12069762
AU - Galan SF; Aguado F; Diez FJ; Mira J
TI - NasoNet, modeling the spread of nasopharyngeal cancer with networks of probabilistic events in discrete time.
SO - Artif Intell Med 2002 Jul;25(3):247-64
AD - Departamento de Inteligencia Artificial, Facultad de Ciencias de la UNED, Paseo senda del rey 9, Madrid 28040, Spain. seve@dia.uned.es
The spread of cancer is a non-deterministic dynamic process. As a consequence, the design of an assistant system for the diagnosis and prognosis of the extent of a cancer should be based on a representation method that deals with both uncertainty and time. The ultimate goal is to know the stage of development of a cancer in a patient before selecting the appropriate treatment. A network of probabilistic events in discrete time (NPEDT) is a type of Bayesian network for temporal reasoning that models the causal mechanisms associated with the time evolution of a process. This paper describes NasoNet, a system that applies NPEDTs to the diagnosis and prognosis of nasopharyngeal cancer. We have made use of temporal noisy gates to model the dynamic causal interactions that take place in the domain. The methodology we describe is general enough to be applied to any other type of cancer.

21
UI - 12109256
AU - Armstrong RW; Rood MJ; Sani S; Mohamed M; Rashid M; Jab AT; Landsberger
TI - S Aerosol particle and organic vapor concentrations at industrial work sites in Malaysia.
SO - Asia Pac J Public Health 2001;13(1):24-9
AD - Department of Community Health, Universiti Kebangsaan, Bangi, Selangor, Malaysia.
The objective of this study was to establish baseline data about air pollutants potentially related to nasopharyngeal carcinoma (NPC) in the Federal Territory and Selangor, Malaysia. During 1991-1993, ambient air quality was monitored at 42 work sites representing ten industrial sectors: adhesive manufacturing, foundries, latex processing, metalworking, plywood/veneer milling, ricemilling, rubber tire manufacturing, sawmilling, shoemaking, and textile related industries. At each work site, aerosol particle size distributions and concentrations of formaldehyde, benzene, toluene, isopropyl alcohol, and furfural were measured. Mean aerosol particle concentrations ranged from 61 micrograms/m3 in foundries to 5,578 micrograms/m3 in ricemills, with five industries (adhesives, metalworking, ricemilling, sawmilling, and shoemaking) exceeding the US EPA 24-hr ambient air standard for PM-10. Formaldehyde concentrations exceeded the threshold limit value (TLV) in adhesives factories. Other vapours and elements measured were well below TLVs.

22
UI - 12094641
AU - Rzewnicki I; Luczaj J; Olszewska E
TI - [Delayed treatment of laryngeal and hypopharynx cancer in the North-Eastern part of Poland in years 1986-1999]
SO - Otolaryngol Pol 2002;56(2):169-71
AD - Klinika Otolaryngologii AM w Bialymstoku.
The authors estimated larynx and hypopharynx cancer in patients treated in the Department of Otolaryngology Medical Academy in Bialystok between 1996-1999 and compared the observed state to the data from 1986-1995. At the same time, we tried to determine the causes of delayed treatment based on patients' reports and medical case histories divided according to patients and medical procedures. As in years: 1986-1995, a significant percentage of tumour progression as also observed in the present day. The T3 and T4 tumour comprised about 65% of all larynx and hypopharynx cancers in particular five-year periods. The T1 and T2 tumours included only 34% of the cases. Clinical evaluation of the lymph nodes showed that high grade of tumour progression was accompanied by unilateral or bilateral lymph node metastases (N2 and N3--about 67%). Among the causes of the delayed treatment, patients' ignorance of the first symptoms (43-51%) and ignoring follow-up visit (30-32%) are being still the most dominant ones. According to medical procedures the delay ensued mostly because the effect of apparent improvement after the treatment (36%) and, unfortunately, due to wrong diagnosis (30-31%). Nowadays, it seems to be more difficult to obtain medical advice, specifically as far as specialists are concerned.

23
UI - 12016793
AU - Peng B; Cao L; Li G; Yao K
TI - [Transcriptional activation study of transforming gene Tx-related human nasopharyngeal carcinoma]
SO - Hunan Yi Ke Da Xue Xue Bao 1999;24(3):239-41
AD - Institute of Cancer Research, Hunan Medical University, Changsha 410078.
Tx gene is the DNA sequence with transforming activity which was cloned from the epithelial cell line (CNE2) of human nasopharyngeal carcinoma(NPC). The goal of this study is to find transcriptional activated site on the Tx 2.8 kb fragment using DNase-I hypersensitivity assay, by which understanding the role of the Tx in carcinogenesis of NPC. The results showed no DNase-I hypersensitivity site on the fragment. It suggests that Tx 2.8 kb fragment homogenous to Ig kappa C might be regulated by the specific mechanism of immunoglobulin gene, rather than that of oncogenes.

24
UI - 12062607
AU - Hsiung CY; Yorke ED; Chui CS; Hunt MA; Ling CC; Huang EY; Wang CJ; Chen
TI - HC; Yeh SA; Hsu HC; Amols HI Intensity-modulated radiotherapy versus conventional three-dimensional conformal radiotherapy for boost or salvage treatment of nasopharyngeal carcinoma.
SO - Int J Radiat Oncol Biol Phys 2002 Jul 1;53(3):638-47
AD - Department of Radiation Oncology, Chang Gung Memorial Hospital, 123 Ta-Pei Road, Niao Sung Hsian, Kaohsiung Hsien, Taiwan. hsiungcy@hotmail.com
PURPOSE: To compare intensity-modulated radiotherapy (IMRT) and conventional three-dimensional conformal radiotherapy (3D-CRT) for the boost treatment of new-onset nasopharyngeal carcinoma (NPC) or the salvage treatment of locally recurrent NPC. METHODS AND MATERIALS: Between January 14 and February 23, 2000, 5-field 3D-CRT treatment plans were generated for 14 consecutive NPC patients using the ADAC Pinnacle planning system in Chang Gung Memorial Hospital, Kaohsiung, Taiwan. The planning data of these patients were later transferred to Memorial Sloan-Kettering Cancer Center, where new IMRT plans, also using 5-7 radiation fields were created for each patient using an inverse treatment planning system. The IMRT and 3D-CRT plans were compared for all 14 patients. The relationship between the anatomic shapes and locations of targets and the results of different plans were studied. RESULTS: Target doses were more homogeneous in IMRT plans. The average maximal brainstem dose (D(05), the dose received by 5% of the brainstem volume) decreased from 30.9% of the prescription dose with 3D-CRT to 15.3% and 14.7% with 5- and 7-field IMRT, respectively (p = 0.004 and 0.003, respectively, compared with 3D-CRT, paired Student's t test). Five anatomic factors were found that predicted greater benefits with IMRT. These factors were (1) vertical length of target >7 cm, (2) minimal distance between target and brainstem <0.1 cm, (3) maximal AP overlap of target and brainstem >0.6 cm, (4) maximal AP overlap of target and spinal cord >1 cm, and (5) vertical overlap of target and eyes >0 cm. For the 7 patients with at least 1 of these 5 anatomic factors, the benefits achieved by IMRT planning would have been greater than the benefits for the other 7 patients (p = 0.005, Fisher's exact test). CONCLUSION: For boost or salvage treatment of NPC, lower normal tissue doses and more homogeneous target doses were achieved with IMRT plans. For NPC patients with at least 1 of the 5 anatomic factors, IMRT is highly recommended.

25
UI - 12062608
AU - Prasad U; Wahid MI; Jalaludin MA; Abdullah BJ; Paramsothy M;
TI - Abdul-Kareem S Long-term survival of nasopharyngeal carcinoma patients treated with adjuvant chemotherapy subsequent to conventional radical radiotherapy.
SO - Int J Radiat Oncol Biol Phys 2002 Jul 1;53(3):648-55
AD - Department of Otorhinolaryngology, Faculty of Medicine, University of Malaya Medical Center, Kuala Lumpur 50603, Malaysia. prasad@ummc.um.edu.my
PURPOSE: To assess the long-term survival of patients with nasopharyngeal carcinoma (NPC) who were treated with conventional radical radiotherapy (RT) followed by adjuvant chemotherapy. METHODS AND MATERIALS: Ninety-one newly diagnosed patients with Stage III and IV (American Joint Committee on Cancer, 1988) NPC, seen at the University The tumor dose was 70 Gy delivered in 35 fractions, 5 fractions weekly. Three cycles of chemotherapy, each consisting of 5-fluorouracil, 1 g/m(2)/d on Days 1-4 and cisplatin 100 mg/m(2) on Day 1, were administered 3 weeks after RT completion. Thirty-six patients had Stage II, 10 had Stage III, and 45 had Stage IV disease (AJCC 1997 staging system). RESULTS: After a median follow-up of 61 months, the 5-year overall survival rate for all 91 patients was 80.1%, the disease-free survival rate was 76%, and the locoregional control rate was 85%. The 3-year overall survival rate for Stage II was 94.3%; it was 80% for Stage III and 79.8% for Stage IV (p = 0.0108). The 3-year DFS rate for Stage II was 90%; it was 80% for Stage II and 65% for Stage IV. The rate of distant failure for Stage IV was 8.9%. CONCLUSION: Radical RT followed by adjuvant chemotherapy was effective in our patients with locoregionally advanced NPC. The long-term results appear encouraging, even for patients with Stage IV disease. This single institution experience deserves further investigation in prospective trials.

26
UI - 12115321
AU - De Stefani A; Forni G; Ragona R; Cavallo G; Bussi M; Usai A; Badellino
TI - F; Cortesina G Improved survival with perilymphatic interleukin 2 in patients with resectable squamous cell carcinoma of the oral cavity and oropharynx.
SO - Cancer 2002 Jul 1;95(1):90-7
AD - Dipartimento di Fisiopatologia Clinica, University of Torino, Torino, Italy. adestefani@ircc.mauriziano.it
BACKGROUND: The current randomized, multicenter, Phase III trial was conducted to determine whether the disease free interval and overall survival of patients with T2-T4,N0-N3,M0 squamous cell carcinoma (SCC) of the oral cavity or oropharynx could be extended through the combination of surgery (and radiotherapy, if required) with perilymphatic recombinant IL-2 (rIL-2). METHODS: Patients with a resectable T2-T4,N0-N3,M0 SCC of the oral cavity and oropharynx were assigned randomly to receive surgery and radiotherapy or to receive IL-2, surgery, and radiotherapy. Five thousand units of rIL-2 were injected around the ipsilateral cervical lymph node chain daily for 10 days before surgery. After surgery, contralateral 5-day rIL-2 courses were administered monthly for 1 year. The differences in disease free and overall survival between the two groups of patients were evaluated statistically. RESULTS: Two hundred two patients finished the study. No significant complications related to rIL-2 were encountered, and surgery and radiotherapy were not hampered by its prior administration. Multivariate analysis conducted to determine the extent to which survival was influenced by rIL-2 and the other variables showed that rIL-2 significantly lengthened disease free survival (P < 0.01) and that this resulted in longer overall survival (P < 0.03). CONCLUSIONS: The data emerging from this trial indicate that perilymphatic administration of low, nontoxic doses of rIL-2 is a simple and manageable way to delay recurrences of SCC. Copyright 2002 American Cancer Society.

27
UI - 11882974
AU - Gurtsevich VE; Shcherbak LN; Novikova EV; Hahn P; Belousova NV; Arkhipov
TI - VV; Grasser FA; Muller-Lantzsch N; Pavlish OA [Structural and functional features of Epstein-Barr virus LMP-1 gene in patients with anaplastic carcinoma of the nasopharynx in Russia]
SO - Vestn Ross Akad Med Nauk 2002;(1):53-9
Epstein-Barr virus (EBV) is known to be closely associated with the development of anaplastic nasopharyngeal carcinoma (NPC) in some malignancy endemic regions in South-East Asia. LMP1 gene is one of the EBV latent genes, which encodes a latent membrane protein. LMP1 gene is thought to be a classical oncogene since it morphologically transforms cells in vitro and induces tumors in experimental animals in vivo. LMP1 is one of a few genes which is expressed in NPC tissues. It was first shown that C-terminus of LMP1 gene obtained from NPC patients in South-East Asia contained a deletion of 30 base pairs (bp). However, this deleted LMP1 gene was then found in the EBV isolates persisting among healthy virus carriers and patients with other EBV-associated abnormalities from both NPC endemic and non-endemic regions. The aim of this investigation was to accomplish a molecular biological analysis of EBV LMP1 genes obtained from Russian NPC patients. To this end, the authors isolated and sequenced the LMP1 clones amplified from the tumor tissues from 7 NPC patients at the N. N. Blokhin Russian Cancer Research Center and primary blood lymphocytes (PBL) from 6 healthy donors. As a result, the authors could not find the deletion of the above-mentioned 30 bp in NPC LMP1 clones, but could in one healthy donor (PBL-2). A functional analysis revealed no significant differences between LMP1 variants with or without 30 bp deletion in their capacity to activate NF kappa B and jun/AP-1 transcription factors. Nevertheless, Russian NPC-derived LMP1 variants as compared with those from PBLs featured some specific amino acid exchanges. These data indicate that the 30 bp deletion of LMP1 gene is not a factor that predisposes to NPC in Russia.

28
UI - 12056159
AU - Vakker AV
TI - [Malignant multifocal ENT tumors]
SO - Vestn Otorinolaringol 2002;(2):37-9
Of 6787 patients with ENT cancer, multifocal tumors were detected in 319 cases (4.7%). 306(95.9%) patients had two tumors, 13(4.1%)--three tumors. Synchronous and metachroneous tumors were diagnosed in 39.2 and 60.8% patients, respectively. Primary tumors located more frequently in the larynx (n = 146) and pharynx (n = 50). The second tumors were more often found in the lungs (25.5%), pharynx (22.1%), oral cavity (13.2%). In 84.9% patients with multifocal tumors the first and the second lesions arose in the same organ system--respiratory and gastrointestinal tracts. Metachroneous tumors developed more often 2-5 years (49.1%) after cure of the primary tumor.

29
UI - 12115349
AU - Schuller DE; Grecula JC; Agrawal A; Rhoades CA; Orr DA; Young DC; Malone
TI - JP; Merz M Multimodal intensification therapy for previously untreated advanced resectable squamous cell carcinoma of the oral cavity, oropharynx, or hypopharynx.
SO - Cancer 2002 Jun 15;94(12):3169-78
AD - Department of Otolaryngology, Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Ohio State University, Columbus, Ohio 43210, USA. schuller-1@medctr.osu.edu
BACKGROUND: An intensified treatment regimen for previously untreated Stage III and IV resectable oral cavity, oropharyngeal, or hypopharyngeal squamous cell carcinoma was analyzed to assess disease control, patient compliance, and toxicity. METHODS: Forty three patients with previously untreated, advanced, resectable squamous cell carcinoma of the oral cavity, oropharynx, or hypopharynx were enrolled in a prospective Phase II institutional clinical trial at a tertiary care comprehensive cancer center. This regimen was a continuum of multimodal treatment in a contracted time interval. It included preoperative slightly accelerated hyperfractionated radiotherapy with concurrent cisplatin, followed immediately with surgery and intraoperative radiotherapy, and completed with early postoperative weekly paclitaxel (beginning on Day 6 after surgery), two additional cisplatin cycles, and concurrent once daily radiotherapy beginning on Day 28 after surgery. RESULTS: The current trial was designed to reduce the toxicity of the systemic therapy while maintaining or improving locoregional/distant disease control and patient compliance. There were 43 patients enrolled, and the range of time at risk was 2.6 to 24.7 months (median, 14.6 months). Of the 43 registered patients, 43 were evaluable. The locoregional (100%) and systemic (93%) disease control rates were excellent, with low rates of patient noncompliance (21%) and reduced levels of toxicity. CONCLUSIONS: An intensive treatment regimen that improves disease control and treatment compliance is clearly feasible for this patient population. Future plans include modifications to continue to reduce toxicity and expansion to a multi-center Phase II trial to determine if the single institutional results can be duplicated. Copyright 2002 American Cancer Society.

30
UI - 11172294
AU - Tang KF; Tan SY; Chan SH; Chong SM; Loh KS; Tan LK; Hu H
TI - A distinct expression of CC chemokines by macrophages in nasopharyngeal carcinoma: implication for the intense tumor infiltration by T lymphocytes and macrophages.
SO - Hum Pathol 2001 Jan;32(1):42-9
AD - Department of Microbiology, Faculty of Medicine, National University of Singapore, Republic of Singapore.
Nasopharyngeal carcinoma (NPC) is characterized by harboring Epstein-Barr virus genes in the tumor cells and an intense infiltration of leukocytes in the tumor tissue. These infiltrating cells are mainly composed of T lymphocytes and macrophages. The mechanism of this intense infiltration has long been a puzzle. We attempted to address this issue by studying the expression of CC chemokines, which are responsible for recruiting both T cells and macrophages, by a

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