• Effect of heparin on apoptosis in human nasopharyngeal carcinoma CNE2 cells.

• Oral and pharyngeal cancer: knowledge and opinions of dentists in British Columbia and Nova Scotia.

• Oral and pharyngeal cancer: practices and opinions of dentists in British Columbia and Nova Scotia.

• Present status of management of nasopharyngeal carcinoma.

• A clinical trial of active immunotherapy with anti-idiotypic vaccine in nasopharyngeal carcinoma patients.

• High frequency loss of heterozygosity on the long arms of chromosomes 13 and 14 in nasopharyngeal carcinoma in Southern China.

• Novel mutation of topoisomerase I in rendering cells resistant to camptothecin.

• Radiation-related cranial nerve palsy in patients with nasopharyngeal carcinoma.

• Detection of recurrent nasopharyngeal carcinomas with positron emission tomography using 18-fluoro-2-deoxyglucose in patients with indeterminate

• Image fusion between 18FDG-PET and MRI/CT for radiotherapy planning of oropharyngeal and nasopharyngeal carcinomas.

• Health-related quality of life for nasopharyngeal carcinoma patients with cancer-free survival after treatment.

• Squamous cell carcinoma of the tonsils: a molecular analysis of HPV associations.

• Preservation of laryngeal function in treatment of hypopharyngeal carcinoma.

• Nucleotide sequence analysis of a transforming gene isolated from nasopharyngeal carcinoma cell line CNE2: an aberrant human

• Recommendations on selected interventions to prevent dental caries, oral and pharyngeal cancers, and sports-related craniofacial injuries.

• Reviews of evidence on interventions to prevent dental caries, oral and pharyngeal cancers, and sports-related craniofacial injuries.

• A comparison of selected evidence reviews and recommendations on interventions to prevent dental caries, oral and pharyngeal cancers, and

• [Functional long-term results following hemipharyngo-hemilaryngectomy and microvascular reconstruction using the radial forearm flap]

• Prognostic value of multidrug resistance 1, glutathione-S-transferase-pi and p53 in advanced nasopharyngeal carcinoma treated with systemic

• Juvenile nasopharyngeal angiofibroma: long-term results in preoperative embolized and non-embolized patients.

• Immunohistochemical localization of interleukin-10 in human oral and pharyngeal carcinomas.

• Hypopharyngeal cancer: results of treatment based on radiation therapy and salvage surgery.

• Effects of breathing a hyperoxic hypercapnic gas mixture on blood oxygenation and vascularity of head-and-neck tumors as measured by

• Arterial baroreflex and peripheral chemoreflex function after radiotherapy for laryngeal or pharyngeal cancer.

• Single-nucleotide polymorphisms in NGX6 gene and their correlation with nasopharyngeal carcinoma.

• Long-term effects of Le Fort I osteotomy for resection of juvenile nasopharyngeal angiofibroma on maxillary growth and dental sensation.

• Exclusively endoscopic removal of juvenile nasopharyngeal angiofibroma: trends and limits.

• Carotid intima-media thickness in patients with head and neck irradiation for the treatment of nasopharyngeal carcinoma.

• Current concepts in imaging of laryngeal and hypopharyngeal cancer.

1
UI - 11787776
AU - Li HL; Ye KH; Zhang HW; Luo YR; Ren XD; Xiong AH; Situ R
TI - Effect of heparin on apoptosis in human nasopharyngeal carcinoma CNE2 cells.
SO - Cell Res 2001 Dec;11(4):311-5
AD - Department of Pharmacology, Pharmacy College, Jinan University, Guangzhou, China.
In order to study the mechanism of the effect of heparin on apoptosis in carcinoma cells, the nasopharyngeal carcinoma cell line CNE2 was used to identify the effect of heparin on apoptosis associated with the expression of c-myc, bax, bcl-2 proteins by use of Hoechst 33258 staining, terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL), agarose gel electrophoresis, and flow cytometry, as well as Western blot analysis. The results showed that heparin induced apoptosis of CNE2 cells including the morphologic changes such as reduction in the volume, and the nuclear chromatin condensation, as well as the "ladder pattern" revealed by agarose gel electrophoresis of DNA in a concentration-dependent manner. The number of TUNEL-positive cells was dramatically increased to 33.6+/-1.2% from 2.8+/-0.3% by treatment with heparin in different concentrations (10 to approximately 40 kU/L). The apoptotic index was increased to 32.5% from 3.5% by detecting SubG1 peaks on flow cytometry. Western blot analysis showed that levels of bcl-2, bax and c-myc were significantly overexpressed by treatment with the increase of heparin concentrations. These results suggest that heparin induces apoptosis of CNE2 cells, which may be regulated by differential expression of apoptosis-related genes.

2
UI - 12119092
AU - Clovis JB; Horowitz AM; Poel DH
TI - Oral and pharyngeal cancer: knowledge and opinions of dentists in British Columbia and Nova Scotia.
SO - J Can Dent Assoc 2002 Jul;68(7):415-20
AD - School of Dental Hygiene, Faculty of Dentistry, Dalhousie University, Halifax, Nova Scotia. l.clovis@dal.ca
Oral and pharyngeal cancers are largely preventable and can be successfully treated when diagnosed at an early stage. Dentists in British Columbia and Nova Scotia were surveyed regarding their knowledge pretested 41-item survey was mailed to a random sample of dentists in British Columbia and the population of dentists in Nova Scotia. A reminder postcard and one additional mailing were sent to nonrespondents. Of the 670 dentists supplying usable responses (response rate 55.2%) only 56.7% agreed that their knowledge of the subject was current. Most dentists correctly identified tobacco use (99.4%) and alcohol use (90.4%) as risk factors, but fewer correctly identified factors such as the use of spicy foods (57.0%) and poor oral hygiene (46.3%) as not being risk factors. Only 42.5% identified both erythroplakia and leukoplakia, in that order, as the conditions most likely associated with oral cancer. Indices of risk and diagnostic knowledge were constructed by summing the number of correct responses to items in each domain. On 16 risk factors the mean correct score was 9.2, and on 14 diagnostic procedures the mean correct score was 10.0. Only 38.5% of dentists had consistent levels of knowledge on both indices. Differences between the provinces were statistically significant (p < 0.01) for only 2 knowledge items. About three-quarters of all dentists (77.0%) were interested in taking continuing education courses. Dentists in British Columbia and Nova Scotia could benefit from undergraduate and continuing education courses to increase their knowledge of risk and diagnostic factors for oral cancer.

3
UI - 12119093
AU - Clovis JB; Horowitz AM; Poel DH
TI - Oral and pharyngeal cancer: practices and opinions of dentists in British Columbia and Nova Scotia.
SO - J Can Dent Assoc 2002 Jul;68(7):421-5
AD - School of Dental Hygiene, Faculty of Dentistry, Dalhousie University, Halifax, Nova Scotia. l.clovis@dal.ca
Oral and pharyngeal cancers are associated with high mortality rates, a situation usually attributed to late-stage diagnosis. Dentists in British Columbia and Nova Scotia were surveyed regarding their practices pretested, 41-item survey was mailed to a random sample of dentists in British Columbia (n = 817) and the population of dentists in Nova Scotia (N = 423). A reminder postcard and one additional mailing were sent to nonrespondents. Of the 670 dentists supplying usable responses (response rate 55.2%), only 56.7% agreed that their knowledge of the subject was current. Of 8 health history items, dentists assessed 5 on average, with most (88.0%) asking about the patients' current use of tobacco. A total of 72.7% of the responding dentists performed an oral cancer examination for all edentulous patients at every appointment, but 10.9% never did so. Similarly, 70.7% of the dentists always provided an oral cancer examination at the initial appointment for patients 40 years of age and older, but 9.8% never did so. Undergraduate training related to oral cancer examination was reported as good by only 52.2% of the dentists. About three-quarters of all dentists (77.0%) were interested in taking continuing education courses on this subject. Differences between the 2 provinces were not statistically significant (p > 0.01). Dentists in British Columbia and Nova Scotia could benefit from undergraduate and continuing education courses to increase their knowledge of health history assessment, examination for oral and pharyngeal cancers, and risk reduction strategies, such as counselling about tobacco cessation.

4
UI - 12113121
AU - Wei WI; Sham JS
TI - Present status of management of nasopharyngeal carcinoma.
SO - Expert Rev Anticancer Ther 2001 Jun;1(1):134-41
AD - Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong.
Contemporary imaging with endoscopic examination determines tumor extent and this is reflected in the revised staging system. Radiotherapy remains the primary treatment modality. The use of intensity-modulated radiotherapy aims at enhanced tumor control while reducing adverse effects. Concurrent chemotherapy has shown to improve survival, although its efficacy in endemic regions requires confirmation. Determination of circulating cell-free Epstein-Barr virus DNA might detect early recurrence. For patients who developed recurrence in the neck, surgery provides good salvage. For small tumor in the nasopharynx, good results can be obtained with reirradiation therapy, brachytherapy or surgery. The salvage option depends on the size and location of the tumor as well as the expertise available. The long-term effects of these treatment modalities might be significant.

5
UI - 12133300
AU - Li G; Xie L; Zhou G; Fu H; Zhou J; Sun Q
TI - A clinical trial of active immunotherapy with anti-idiotypic vaccine in nasopharyngeal carcinoma patients.
SO - Chin Med J (Engl) 2002 Apr;115(4):567-70
AD - Cancer Research Institute, Xiang-Ya School of Medicine, Central South University, Changsha 410078, China.
OBJECTIVE: To investigate the effect of active immunotherapy with anti-idiotypic vaccine in patients with nasopharyngeal carcinoma (NPC). METHODS: Anti-idiotypic antibodies (2H4/5D3) bearing the internal image of the NPC antigen were used in active immunotherapy in NPC patients receiving radiotherapy. Antibodies and cytokine levels in patient sera were determined using ELISA before and after active immunotherapy. IL-2 mRNA expression in the peripheral blood mononuclear cells (PBMC) was measured by in situ hybridization. RESULTS: Nineteen patients with NPC at stage IV were treated with alum-precipitated 2H4 or 5D3. Neither hypersensitivity nor adverse side effects were observed. The levels of anti-anti-idiotypic antibodies (Ab3) and anti-NPC antibodies (Ab1') were increased. Human anti-mouse antibodies (HAMA) were seen in 19 patients of the experimental group; the levels of Ab1' did not increase in the control group. Serum IL-2, IFN-gamma and TNF-alpha levels were increased in most patients in the experimental group, while no differences were observed in Ab1' and cytokine levels between pre- and post-therapy in the control group. In addition, IL-2 mRNA expression in PBMCs from NPC patients was closely related to serum IL-2 (r = + 0.8829) levels by in situ hybridization. CONCLUSIONS: Anti-idiotype vaccine is safe for clinical active immunotherapy. Anti-idiotypic vaccine might be able to enhance humoral and/or cellular immunity in NPC patients receiving radiotherapy.

6
UI - 12133301
AU - Shao J; Li Y; Wu Q; Liang X; Yu X; Huang L; Hou J; Huang X; Ernberg I;
TI - Hu LF; Zeng Y High frequency loss of heterozygosity on the long arms of chromosomes 13 and 14 in nasopharyngeal carcinoma in Southern China.
SO - Chin Med J (Engl) 2002 Apr;115(4):571-5
AD - Cancer Center, Sun Yat-Sen University of Medical Sciences, Guangzhou 510060, China.
OBJECTIVE: To investigate the loss of heterozygosity (LOH) on chromosomal arms 13q and 14q in nasopharyngeal carcinoma (NPC) using 21 microsatellite polymorphic markers and to study whether there is a correlation between LOH and clinicopathologic parameters and/or Epstein-Barr virus (EBV) infection in NPC. METHODS: Sixty cases of NPC were studied using polymerase chain reaction based microsatellite analysis with genescan and genotyping techniques. RESULTS: LOH was detected on 13q in 78% of NPC tumors, high frequency LOH loci (more than 30%) clustered to 13q12.3-q14.3 and 13q32. On chromosome 14q, LOH was detected in 80% of NPC tumors; high frequency LOH loci clustered to 14q11-q13, 14q21-q24 and 14q32. High frequency LOH at 13q31-q32 correlated with a lower level of EBV infection; LOH on chromosome 14q was closely associated with poor differentiation of NPC tumor cells. CONCLUSION: Our results suggest that in NPC, LOH on chromosome 13q and 14q are common genetic events, and putative tumor suppressor genes (TSG) residing in these regions may be involved in tumorigenesis.

7
UI - 12097280
AU - Chang JY; Liu JF; Juang SH; Liu TW; Chen LT
TI - Novel mutation of topoisomerase I in rendering cells resistant to camptothecin.
SO - Cancer Res 2002 Jul 1;62(13):3716-21
AD - Division of Cancer Research, National Health Research Institutes, 100 Taipei, Taiwan, Republic of China. jychang@nhri.org.tw
To identify mechanisms of camptothecin (CPT) resistance and the relationship between CPT-resistant cells and other anticancer agents, a CPT-resistant cell line (CPT30) and its partial revertant cell line (CPT30R) were established from a human nasopharyngeal carcinoma cell line (HONE-1). CPT30 and CPT30R cells displayed a 14- and 3.5-fold resistance to CPT compared with HONE-1 cells, respectively. The resistant and partial revertant cell lines showed cross-resistance to topotecan and increased sensitivity to cisplatin, carboplatin, and 1,3-bis(chloroethyl)-1-nitrosurea. The topoisomerase (Top) I catalytic activity of CPT30 and CPT30R cells was 30% and 200%, respectively, compared with that of HONE-1 cells. The expression of Top I protein and mRNA levels in CPT30 cells was 40% and 30% less than that in HONE-1 cells, respectively, whereas in CPT30R cells, the levels of Top I protein and mRNA were 50% and 20% higher, respectively, than that in HONE-1 cells. Both the resistant and revertant cell line whole-cell lysates demonstrated different levels of sensitivity to CPT in in vitro assays in comparison with that of HONE-1 cells. Furthermore, CPT exhibited 15- and 7-fold better binding affinity in stabilizing protein-linked DNA breaks in HONE-1 cells than in CPT30 and CPT30R cells, respectively. Direct DNA sequencing of the reverse transcription-PCR product and genomic DNA revealed a point mutation resulting in E418K mutation in the Top I of both CPT30 and CPT30R cells. Wild-type Top I RNA and genomic DNA were also detected in these two cell lines. A yeast system was used to examine whether this mutation could be responsible for CPT resistance. Our results showed that a single amino acid change (E418K) resulted in CPT resistance. Therefore, quantitative and qualitative changes in Top I were responsible for CPT resistance in CPT30 cells. CPT resistance in CPT30R cells was caused by mutation of Top I.

8
UI - 12124841
AU - Lin YS; Jen YM; Lin JC
TI - Radiation-related cranial nerve palsy in patients with nasopharyngeal carcinoma.
SO - Cancer 2002 Jul 15;95(2):404-9
AD - Department of Otolaryngology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China. yskuolin@ndmctsgh.edu.tw
BACKGROUND: Cranial nerve palsy is a rare complication after patients with nasopharyngeal carcinoma (NPC) receive radiotherapy using a technique that delivers 180-200 centigrays (cGy) per day. Cranial neuropathy is of particular clinical interest in terms of making a differential diagnosis, because it is also a common presenting manifestation in patients with NPC. Cranial neuropathy may lead to distressing signs and symptoms in these patients, and their treatment has not been addressed in previous reports. This article presents the authors' experience with radiotherapy-related cranial nerve palsy in patients with NPC. METHODS: Nineteen patients were diagnosed with radiation-related neuropathy. Patients with recurrent tumors or with a suspicion of persistent or recurrent tumors were excluded. Most patients were treated using 180 cGy or 200 cGy per fraction per day. The total dose was 7000-13,000 cGy to the nasopharynx and 5000-9000 cGy to the neck. Unilateral vocal cord paralysis alone and hearing loss were not included in the analysis. RESULTS: There were 15 male patients and 4 female patients. The latency before palsy occurred was 12-240 months. Single nerve palsy developed in four patients, including two patients with hypoglossal palsy and two patients with recurrent laryngeal palsy. Two patients had three nerve palsies each. The other 13 patients presented with 2 nerve palsies each. Vagus and hypoglossal palsy appeared to be a frequent combination and occurred in 11 patients. Overall, there were 17 patients with hypoglossal palsy (7 bilateral, 8 left-sided, and 2 right-sided), 11 patients with vagus palsy (2 bilateral, 7 left-sided, and 2 right-sided), 6 patients with recurrent laryngeal nerve palsy (5 bilateral), and 2 patients with accessory palsies (all bilateral). Marked neck fibrosis was present in 12 patients. Patients who had vocal cord paralysis suffered from easy choking and hoarseness. Severe respiratory difficulty occurred in two patients who had bilateral vocal cord palsy. Surgical procedures included laryngoplasty, tracheostomy, and gastrostomy. Quality of life improved considerably after patients underwent surgery. CONCLUSIONS: Radiotherapy-related cranial nerve palsy may occur in patients with NPC after they receive conventional radiotherapy. Hypoglossal nerve palsy was found the most frequently in this series, followed by vagus nerve palsy and recurrent laryngeal nerve palsy. Neck fibrosis and the course of the three nerves through the neck may be important risk factors for the development of palsy. The diagnosis must be made only after the possibilities of tumor-induced palsy and idiopathic palsy are excluded. Surgery is helpful in improving the quality of life in many patients. Copyright 2002 American Cancer Society.DOI 10.1002/cncr.10668

9
UI - 12029444
AU - Tsai MH; Shiau YC; Kao CH; Shen YY; Lin CC; Lee CC
TI - Detection of recurrent nasopharyngeal carcinomas with positron emission tomography using 18-fluoro-2-deoxyglucose in patients with indeterminate magnetic resonance imaging findings after radiotherapy.
SO - J Cancer Res Clin Oncol 2002 May;128(5):279-82
AD - Department of Otolaryngology, China Medical College Hospital, Taichung, Taiwan.
PURPOSE: The aim of this study was to evaluate the effectiveness of positron emission tomography (PET) using 18-fluoro-2-deoxyglucose (FDG) to detect recurrent nasopharyngeal carcinomas (NPC) when magnetic resonance imaging (MRI) findings are indeterminate. PATIENTS AND METHODS: After radiotherapy, 28 NPC patients with indeterminate MRI findings were included. MRI, FDG-PET, and biopsy were performed at least 4 months after radiotherapy and within 1 week. The final results were based on histopathologic findings and a clinical follow-up of at least 6 months. RESULTS: For detecting recurrent NPC in indeterminate MRI findings, the sensitivity, specificity and accuracy of FDG-PET were 100.0%, 92.9% and 96.4%, respectively. CONCLUSIONS: Based on these results, we can recommend FDG-PET for detecting recurrent NPC when MRI findings are indeterminate.

10
UI - 12095574
AU - Nishioka T; Shiga T; Shirato H; Tsukamoto E; Tsuchiya K; Kato T; Ohmori
TI - K; Yamazaki A; Aoyama H; Hashimoto S; Chang TC; Miyasaka K Image fusion between 18FDG-PET and MRI/CT for radiotherapy planning of oropharyngeal and nasopharyngeal carcinomas.
SO - Int J Radiat Oncol Biol Phys 2002 Jul 15;53(4):1051-7
AD - Division of Radiation Oncology, Department of Radiology, School of Medicine, Hokkaido University, Sapporo, Japan. trout@radi.med.hokudai.ac.jp
PURPOSE: Accurate diagnosis of tumor extent is important in three-dimensional conformal radiotherapy. This study reports the use of image fusion between (18)F-fluoro-2-deoxy-D-glucose positron emission tomography (18FDG-PET) and magnetic resonance imaging/computed tomography (MRI/CT) for better targets delineation in radiotherapy planning of head-and-neck cancers. METHODS AND MATERIALS: The subjects consisted of 12 patients with oropharyngeal carcinoma and 9 patients with nasopharyngeal carcinoma (NPC) who were treated with radical 18FDG-PET and MRI/CT was performed using an automatic multimodality image registration algorithm, which used the brain as an internal reference for registration. Gross tumor volume (GTV) was determined based on clinical examination and 18FDG uptake on the fusion images. Clinical target volume (CTV) was determined following the usual pattern of lymph node spread for each disease entity along with the clinical presentation of each patient. RESULTS: Except for 3 cases with superficial tumors, all the other primary tumors were detected by 18FDG-PET. The GTV volumes for primary tumors were not changed by image fusion in 19 cases (89%), increased by 49% in one NPC, and decreased by 45% in another NPC. Normal tissue sparing was more easily performed based on clearer GTV and CTV determination on the fusion images. In particular, parotid sparing became possible in 15 patients (71%) whose upper neck areas near the parotid glands were tumor-free by 18FDG-PET. Within a mean follow-up period of 18 months, no recurrence occurred in the areas defined as CTV, which was treated prophylactically, except for 1 patient who experienced nodal recurrence in the CTV and simultaneous primary site recurrence. CONCLUSION: This preliminary study showed that image fusion between 18FDG-PET and MRI/CT was useful in GTV and CTV determination in conformal RT, thus sparing normal tissues.

11
UI - 12095563
AU - Fang FM; Chiu HC; Kuo WR; Wang CJ; Leung SW; Chen HC; Sun LM; Hsu HC
TI - Health-related quality of life for nasopharyngeal carcinoma patients with cancer-free survival after treatment.
SO - Int J Radiat Oncol Biol Phys 2002 Jul 15;53(4):959-68
AD - Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. a7323630@ms14.hinet.net
PURPOSE: To evaluate the health-related quality of life (HR-QOL) of nasopharyngeal cancer (NPC) patients with cancer-free survival after treatment and to investigate the factors correlated with their HR-QOL. METHODS AND MATERIALS: One hundred eighty-two NPC patients with cancer-free survival of more than 2 years after treatment were enrolled in the study. Data from the same number of people without a history of cancer, who had come to the hospital for health checkups, were also collected for comparison. The Chinese SF-36 questionnaire and nine items about head-and-neck functional impairments (HNFI) were self-reported by all participants at the clinics. Data relating to sociodemographic factors, cancer stage, and treatment of NPC survivors were analyzed. RESULTS: Psychometric tests revealed the excellent internal reliability (Cronbach's alpha: 0.87-0.96) and discriminative validity of the Chinese SF-36 used in Taiwan. Most functional domains of the Chinese SF-36 and all nine HNFI items were significantly worse in NPC survivors than in control subjects. No cancer or treatment-related variables significantly correlated with any functional domains of SF-36 or any items of HNFI for NPC survivors. Economic status, educational level, occupational status, and the number of comorbidities were the variables that significantly correlated with most functional domains of SF-36 for NPC survivors. Patients with more sufficient economic status, higher educational levels, with employment, or without comorbidity tended to enjoy better HR-QOL as detected by the SF-36. Salivation, hearing, and swallowing dysfunctions were the top three HNFI that disturbed NPC survivors. Economic status remained the most significant variable correlated with HNFI, including salivation, swallowing, neck stiffness, taste, and phonation. Survivors with better economic status reported less severe HNFI. CONCLUSIONS: NPC survivors had worse HR-QOL than healthy control subjects in the study. Socioeconomic status was the most significant variable that correlated with the HR-QOL of NPC survivors. This result might indicate that patients' superior individual characteristics and financial resources are important variables determining their ability to cope with cancer and treatment complications affecting their HR-QOL.

12
UI - 11948119
AU - Strome SE; Savva A; Brissett AE; Gostout BS; Lewis J; Clayton AC;
TI - McGovern R; Weaver AL; Persing D; Kasperbauer JL Squamous cell carcinoma of the tonsils: a molecular analysis of HPV associations.
SO - Clin Cancer Res 2002 Apr;8(4):1093-100
AD - Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota 55905, USA.
BACKGROUND: The role of human papilloma virus (HPV) in the pathogenesis and biological behavior of tonsillar squamous cell carcinoma (TSCC) are areas of intense investigation. METHODS: This study used PCR analysis to identify HPV in paraffin-embedded tonsillar and nodal tissue from 52 patients with TSCC and 48 age (+/-5 year)/gender-matched controls with benign tonsillar hyperplasia. Results were correlated with HLA-DRB1 haplotype and clinical outcome. RESULTS: HPV was identified in 46% of patients with TSCC and 6% of controls. DNA sequencing showed the presence of HPV type 16 in 21 patients (40%) with TSCC. There was no statistically significant association between HLA-DRB1 expression and TSCC or HPV infection. Fifteen of 16 patients with HPV-positive TSCC with regional metastases had evidence of HPV in pathologically involved lymph nodes. In eight HPV 16-positive TSCC patients with lymph node metastasis, PCR testing identified HPV 16 in 17 of 23 histologically negative lymph nodes. Patients with HPV-positive TSCC without metastatic disease had no evidence of HPV in their lymphatic tissue. Clinically, HPV-associated carcinoma was present in younger patients in comparison with HPV-negative TSCC patients (mean age, 56.6 versus 66 years; P = 0.001). The odds for patients with HPV infection to develop TSCC were 18.2 times greater than for patients without HPV infection (95% confidence interval 4.6, 73.1). There was no statistically significant association between presence of HPV and cause-specific survival (hazard ratio = 2.5 for HPV negative versus positive; P = 0.26), after adjusting for age in a Cox proportional hazards regression analysis. CONCLUSION: HPV is an independent risk factor for TSCC. Identification of HPV in the histologically positive and negative lymph nodes of patients with HPV-positive TSCC/metastatic disease supports the role of HPV in the oncogenesis of TSCC.

13
UI - 12123560
AU - Wang T; Li X; Lu Y; Yu Z
TI - Preservation of laryngeal function in treatment of hypopharyngeal carcinoma.
SO - Chin Med J (Engl) 2002 Jun;115(6):892-6
AD - Department of Otorhinolaryngology, Qilu Hospital, Shandong University, Jinan 250012, China.
OBJECTIVE: To study the surgical technique and results of laryngeal function preservation in treatment of hypopharyngeal carcinoma. METHODS: A retrospective review of 305 patients with malignant neoplasms of the hypopharynx (279 males, 26 females, age ranging from 14 to 77 years) was performed from 1978 to 1996. In the 305 patients (stage I, n = 6; stage II, n = 12; stage III, n = 82; stage IV, n = 205), the sites of origin were pyriform sinus (n = 234), postcricoid (n = 21), posterior pharyngeal wall (n = 35) and superior hypopharynx (n = 15). Of the 305 patients, 206 (67.54%, stage I, n = 6; stage II, n = 12; stage III, n = 65; stage IV, n = 123) were surgically treated with laryngeal function preserved and 99 (32.46%, stage III, n = 17; stage IV, n = 82) had no laryngeal function preserved.All had 55-75 Gy radiotherapy according to their need. RESULTS: A total of 206 patients (67.54%) were surgically treated with laryngeal function preserved, totally (voice, respiration and deglutition) in 139 (67.5%) and partially (voice and deglutition) in 67 (32.5%). 99 patients (32.46%) had no laryngeal function preserved. The overall 5-year survival rate of the 305 patients was 44.8%, which segregated to 83% (stage I), 71% (stage II), 58% (stage III), and 36% (stage IV). The 5-year survival of the laryngeal function preserved group was 48% (n = 66), the rate of complications 28% (n = 58) and the rate of residual tumor 5.8% (n = 12), compared with the no laryngeal function preserved group 37% (n = 20), 31.3% (n = 31), and 6% (n = 6) (P > 0.05). CONCLUSION: Only a small proportion of patients (31/305, 10%) with hypopharyngeal carcinoma who require total laryngectomy and preservation of the laryngeal function is feasible for eradication of tumor and preservation of laryngeal function.

14
UI - 11913778
AU - Li M; Ren W; Weng XX; Liao W; Xia LQ; Deng X; Cao Y
TI - Nucleotide sequence analysis of a transforming gene isolated from nasopharyngeal carcinoma cell line CNE2: an aberrant human immunoglobulin kappa light chain which lacks variable region.
SO - DNA Seq 2001 Dec;12(5-6):331-5
AD - Cancer Research Institute, Xiangya School of Medicine, Center Southern University, Changsha, Hunan, People's Republic of China.
A transforming gene, designated Tx, was isolated from a human nasopharyngeal carcinoma (NPC) cell line CNE2 by transfection and molecular cloning techniques. The Tx gene was analyzed using computer-based bioinformatics and compared with the known sequences in EMBL and GenBank databases. We found that Tx contains human immunoglobulin kappa light chain constant region, five intact joining regions J1-J5, five recombination signal sequences and an N-segment besides classic regulatory sequences such as TATA boxes, CAAT boxes, poly A signals, etc. Interestingly, Tx also contains several binding sites for nuclear transcription factors such as NF-kappaB, NF-IL6, TFIID, etc. In conclusion, there are only several base pairs mutations or deletions compared with normal Ig K JC gDNA fragment. In all, Tx is an aberrant human immunoglobulin kappa light chain that contains the constant region, five joining regions, which lacks the variable regions.

15
UI - 12091092
AU - Task Force on Community Preventive Services
TI - Recommendations on selected interventions to prevent dental caries, oral and pharyngeal cancers, and sports-related craniofacial injuries.
SO - Am J Prev Med 2002 Jul;23(1 Suppl):16-20

16
UI - 12091093
AU - Truman BI; Gooch BF; Sulemana I; Gift HC; Horowitz AM; Evans CA; Griffin
TI - SO; Carande-Kulis VG; The Task Force on Community Preventive Services Reviews of evidence on interventions to prevent dental caries, oral and pharyngeal cancers, and sports-related craniofacial injuries.
SO - Am J Prev Med 2002 Jul;23(1 Suppl):21-54
AD - Office of the Director, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. Btruman@cdc.gov
This report presents the results of systematic reviews of effectiveness, applicability, other positive and negative effects, economic evaluations, and barriers to use of selected population-based interventions intended to prevent or control dental caries, oral and pharyngeal cancers, and sports-related craniofacial injuries. The related systematic reviews are linked by a common conceptual approach. These reviews form the basis of recommendations by the Task Force on Community Preventive Services (the Task Force) about the use of these selected interventions. The Task Force recommendations are presented in this supplement.

17
UI - 12091094
AU - Gooch BF; Truman BI; Griffin SO; Kohn WG; Sulemana I; Gift HC; Horowitz
TI - AM; Evans CA Jr A comparison of selected evidence reviews and recommendations on interventions to prevent dental caries, oral and pharyngeal cancers, and sports-related craniofacial injuries.
SO - Am J Prev Med 2002 Jul;23(1 Suppl):55-80
AD - Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. Bgooch@cdc.gov

18
UI - 11967777
AU - Hagen R
TI - [Functional long-term results following hemipharyngo-hemilaryngectomy and microvascular reconstruction using the radial forearm flap]
SO - Laryngorhinootologie 2002 Mar;81(3):233-42
AD - Klinik fur Hals-Nasen-Ohrenkrankheiten, Plastische Operationen, Katharinenhospital Stuttgart, Germany. hagen.hno@katharinenhospital.de
BACKGROUND: The surgical treatment of advanced hypopharyngeal carcinomas with infiltration of the laryngeal skeleton often includes total laryngectomy for functional reasons, although tumor infiltration is limited to only one half of the larynx. When not only the infiltrated half of the thyroid cartilage but also the cricoid cartilage of the involved side has to be removed, in spite of adequate reconstruction using local or pedicled flaps (f. e. pectoralis major flap) persistent dysphagia and aspiration prevent oral food intake and closure of the tracheostoma. These functional disturbances are increased by the negative effects of postoperative radiotherapy, which has to be applied in most of the cases for oncological reasons. The routine use of free, microvascularly anastomosed flaps for reconstruction of defects following removal of extended carcinomas of the mouth, the tongue or the oropharynx as well as in total pharyngolaryngectomy led to considerable improvements in functional rehabilitation of swallowing and speech. An improved functional outcome is also reported following partial resections of the hypopharynx and reconstruction by means of these thin and pliable transplants (f. e. replacement of the entire posterior hypopharyngeal wall). METHOD: Since 1991 in 30 patients with a T3 or T4 squamous cell carcinoma of the piriform sinus a complete hemipharyngo-hemilaryngectomy including resection of the involved thyroid and cricoid cartilage was carried out. For reconstruction a radial forearm flap was dissected with two separate epithelial islands: The smaller island was used to create an epithelialized endolarynx, which allows complete closure of the glottis by the healthy vocal chord. With the bigger second island the hypopharynx was replaced, creating a highly mobile, adaptable neo-piriform-sinus, which was suspended to the ipsilateral half of the hyoid bone. Parts of the both islands were sutured together to create a new aryepiglottic fold. The laryngeal skeleton intentionally was not reconstructed. RESULTS: One year evaluation revealed 25 of the 30 patients swallowing normal diet and being decannulated. 4 patients could take up a soft diet, 1 patient with a severe stricture at the entrance to the esophagus however had to be laryngectomized for functional reasons. Most of the patients judged their postoperative voice as satisfactory, although there was a different impairment of the voice (quite normal up to a marked hoarseness). During follow-up (up to 10 years) 4 patients developed a local recurrence, in 3 cases a secondary metastasis after neck dissection occurred. In 3 patients a second primary was detected (oropharynx 2, esophagus 1), 3 patients died with lung metastases. CONCLUSION: Rehabilitation of normal swallowing and a satisfying voice restoration without a permanent tracheostoma following complete hemipharyngo-hemilaryngectomy can obviously be improved by the use of microvascular transplants (here radial forearm flap) in comparison to other surgical techniques. The necessary radical extirpation of these extended carcinomas also is guaranteed like in total laryngectomy, so that in spite of the advanced tumor stage an organ preserving surgery can be offered. A prolonged course of swallowing rehabilitation however has to be taken into consideration.

19
UI - 12138237
AU - Hsu CH; Chen CL; Hong RL; Chen KL; Lin JF; Cheng AL
TI - Prognostic value of multidrug resistance 1, glutathione-S-transferase-pi and p53 in advanced nasopharyngeal carcinoma treated with systemic chemotherapy.
SO - Oncology 2002;62(4):305-12
AD - Department of Oncology, National Taiwan University Hospital, Taipei, ROC.
OBJECTIVE: Nasopharyngeal carcinoma (NPC) is one of the dominant cancers in South China and Taiwan. Although NPC is highly chemosensitive, the use of chemotherapy for treating patients with recurrent or metastatic NPC has not been very successful. The emergence of drug resistance may be one of the major reasons. However, the mechanisms of drug resistance of NPC have never been addressed before. In this study, we sought to clarify the role of classical drug resistance markers in predicting the chemosensitivity and the prognosis of patients with advanced NPC. METHODS: In a cohort of 202 consecutive patients diagnosed at the Department of Pathology of the National Taiwan University Hospital, 44 patients with adequately preserved pretreatment tumor tissues and complete clinical information regarding the details of chemotherapy and tumor response were identified. The expression of multidrug resistance (MDR1), glutathione-S-transferase-pi (GSTpi), and p53 were determined by immunohistochemistry. Tumor response to chemotherapy and survival of the patients were the endpoints of this analysis. RESULTS: Thirty-four patients received cisplatin-based regimens, and 28 of them were enrolled in a prospective trial using a doxorubicin-containing regimen. The overall response rate was 70%. Expression of MDR1 was seen in only 5 cases (11%) and was associated with a significantly worse overall survival, yet did not appear to predict chemoresistance to the doxorubicin-containing regimen. Overexpression of p53 was seen in 22 patients, and surprisingly, was correlated with chemoresponse and a trend towards better survival. GSTpi expression was demonstrated in 13 cases (30%) and was not correlated with chemoresistance to cisplatin-containing regimens and overall survival. CONCLUSION: In this relatively small cohort, positive MDR1 immunostaining predicted a poor overall survival for recurrent or metastatic NPC patients receiving chemotherapy. Overexpression of p53 by immunohistochemical staining, however, was associated with a better response rate to systemic chemotherapy and a trend towards better survival. Copyright 2002 S. Karger AG, Basel

20
UI - 11876606
AU - Petruson K; Rodriguez-Catarino M; Petruson B; Finizia C
TI - Juvenile nasopharyngeal angiofibroma: long-term results in preoperative embolized and non-embolized patients.
SO - Acta Otolaryngol 2002 Jan;122(1):96-100
AD - Department of Otorhinolaryngology, Sahlgrenska University Hospital, Goteborg, Sweden. Karin.Petruson@orlss.gu.se
A treatment and follow-up study of 32 patients with juvenile nasopharyngeal angiofibroma (JNA) was performed at our clinic between 1974 and 1998. The majority had undergone surgery either via an antral approach or with a lateral rhinotomy. In the 1970s, surgery was combined with ligature of the external carotid artery and, since 1981, it has been combined with preoperative embolization. Two patients received radiotherapy (45 Gy) as primary treatment and the 3 cases of multiple recurrence received radiotherapy (30-45 Gy) as secondary treatment. No recurrence was found in patients treated with radiotherapy. The overall recurrence rate was 25%; the recurrence rate in non-embolized patients was 8% and among embolized patients it was 41%. We found no statistically verified differences in recurrence rate between embolized and non-embolized patients. No statistically significant difference was found in either recurrence or peroperative bleeding when comparing preoperatively embolized patients with non-embolized patients. Regression analyses showed that the only factor affecting recurrence was age, i.e. the younger the patient was at diagnosis the greater the risk of developing recurrence. The development of imaging and embolization techniques will hopefully contribute in the future towards reducing the recurrence rate.

21
UI - 12150611
AU - Chandler SW; Rassekh CH; Rodman SM; Ducatman BS
TI - Immunohistochemical localization of interleukin-10 in human oral and pharyngeal carcinomas.
SO - Laryngoscope 2002 May;112(5):808-15
AD - Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown 26506-9200, USA.
OBJECTIVES/HYPOTHESIS: Interleukin-10 (IL-10) is an immunosuppressive cytokine with numerous, well-described effects on the human cellular and humoral immune response. The oncogenic potential of IL-10 has been previously investigated in bronchogenic carcinoma, nasopharyngeal carcinoma, Waldeyer's ring carcinoma, and serum supernatants of patients with squamous cell carcinoma of the head and neck (SCCHN). The purpose of the study was to determine the prevalence and cellular localization of IL-10 in human SC-CHN. STUDY DESIGN: Immunohistochemistry of archival tissues. METHODS: Paraffin-embedded archival tissues were retrospectively obtained from 98 patients with oral and pharyngeal squamous cell carcinoma. Using a standard immunohistochemical technique, these specimens were stained with a polyclonal antibody to IL-10. RESULTS: Using these methods, we found specific localization of antigenic IL-10 to individual tumor cells in 65% of tumors studied. Intensity of staining was significantly, but inversely, related to tumor grade and N stage; there also existed a significant staining predisposition for oral cavity lesions when samples from this site were compared with tissues derived from elsewhere in the pharynx. Furthermore, IL-10 was not localized to normal epithelial keratinocytes or inflammatory cells at the level of sensitivity achieved by the immunohistochemical methods used in the study. CONCLUSIONS: The findings demonstrate that IL-10 can be specifically localized to human oral and pharyngeal cancer cells. These data also suggest an inverse association for both tumor grade and N stage with specific tumor marker staining. Future studies should investigate the role of this cytokine in the pathogenesis of human SCCHN.

22
UI - 12150614
AU - Godballe C; Jorgensen K; Hansen O; Bastholt L
TI - Hypopharyngeal cancer: results of treatment based on radiation therapy and salvage surgery.
SO - Laryngoscope 2002 May;112(5):834-8
AD - Department of Otorhinolaryngology, Head and Neck Surgery, Odense University Hospital, Denmark. godballe@dadlnet.dk
OBJECTIVES: The purpose of this study is to present the treatment results and to identify possible prognostic indicators in patients with hypopharyngeal squamous cell carcinoma (HPC). STUDY DESIGN: A consecutively admitted series of 110 patients was analyzed retrospectively. The female male ratio was 29: 81. The sites of the tumors were: pyriform fossa (72%), postcricoid area (18%), and posterior pharyngeal wall (10%). T-status was T1: 15%, T2: 26%, T3: 28%, and T4: 37%. N-status was N0: 27%, N1: 33%, N2: 26%, and N3: 14%. METHODS: One hundred three patients (94%) were treated with curative intent. Two of these received primary surgery; the remaining 101 patients had primary radiotherapy. Seven patients (6%) received no or only palliative treatment. RESULTS: The 5- and 10-year estimates for crude survival (CS) were 16% and 7% and disease-specific survival (DSS) 28% and 23%, respectively. In the group of patients treated with curatively intended radiotherapy, 71 recurrences were observed at the time of analysis. The 5- and 10-year RFS estimates were both 17%. The values for CS were 18% and 8% and the values for DSS were 31% and 26%, respectively. Univariate survival analyses of age, sex, T-status, N-status, and TNM staging did not show any significant influence on survival. CONCLUSIONS: We conclude that the survival of patients with HPC treated with primary radiotherapy and salvage surgery is poor and that other treatment modalities have to be considered.

23
UI - 12128119
AU - Rijpkema M; Kaanders JH; Joosten FB; van der Kogel AJ; Heerschap A
TI - Effects of breathing a hyperoxic hypercapnic gas mixture on blood oxygenation and vascularity of head-and-neck tumors as measured by magnetic resonance imaging.
SO - Int J Radiat Oncol Biol Phys 2002 Aug 1;53(5):1185-91
AD - Department of Radiology, University Medical Center Nijmegen, Nijmegen, The Netherlands. M.Rijpkema@rdiag.azn.nl
PURPOSE: For head-and-neck tumors, breathing a hyperoxic hypercapnic gas mixture and administration of nicotinamide has been shown to result in a significantly improved tumor response to accelerated radiotherapy (ARCON, Accelerated Radiotherapy with CarbOgen and Nicotinamide). This may be caused by improved tumor oxygenation, possibly mediated by vascular effects. In this study, both blood oxygenation and vascular effects of breathing a hyperoxic hypercapnic gas mixture (98% O2 + 2% CO2) were assessed by magnetic resonance imaging (MRI) in patients with head-and-neck tumors. METHODS AND MATERIALS: Tumor vascularity and oxygenation were investigated by dynamic gadolinium contrast-enhanced MRI and blood oxygen level dependent (BOLD) MRI, respectively. Eleven patients with primary head-and-neck tumors were each measured twice; with and without breathing the hyperoxic hypercapnic gas mixture. RESULTS: BOLD MR imaging revealed a significant increase of the MRI time constant of transverse magnetization decay (T2*) in the tumor during hypercapnic hyperoxygenation, which correlates to a decrease of the deoxyhemoglobin concentration. No changes in overall tumor vascularity were observed, as measured by the gadolinium contrast uptake rate in the tumor. CONCLUSION: Breathing a hyperoxic hypercapnic gas mixture improves tumor blood oxygenation in patients with head-and-neck tumors, which may contribute to the success of the ARCON therapy.

24
UI - 12128121
AU - Timmers HJ; Karemaker JM; Wieling W; Kaanders JH; Folgering HT; Marres
TI - HA; Lenders JW Arterial baroreflex and peripheral chemoreflex function after radiotherapy for laryngeal or pharyngeal cancer.
SO - Int J Radiat Oncol Biol Phys 2002 Aug 1;53(5):1203-10
AD - Department of Internal Medicine, University Medical Center, Nijmegen, The Netherlands. H.Timmers@aig.azn.nl
PURPOSE: Denervation of the carotid sinus causes baroreflex and chemoreflex failure, resulting in labile hypertension and loss of hypoxic responsiveness. We investigated whether radiation therapy for laryngeal or pharyngeal cancer affects baroreflex and chemoreflex function. METHODS AND MATERIALS: Twelve patients were studied after radiation therapy for locally advanced laryngeal or pharyngeal cancer (11 male, 1 female, age: 56.0 +/- 7.9 years), 3.3 years (median; range 1.0-4.7) after radiotherapy and 15 healthy controls (11 male, 4 female, 53.4 +/- 9.2 years). We measured baroreflex sensitivity (phenylephrine), blood pressure level and variability (24-h Spacelabs and 5-h Portapres recordings), responses to cardiovascular reflex tests, and the ventilatory responses to normocapnic and hypercapnic hypoxia. RESULTS: Baroreflex sensitivity was lower in patients (9.7 +/- 7.8 ms/mm Hg) than in controls (17.5 +/- 10.3 ms/mm Hg, p = 0.011). Mean office blood pressure was significantly higher in patients (141.5 +/- 27.8/89.2 +/- 10.6 mm Hg, 63.3 +/- 12.3 bpm) than in controls (117.3 +/- 10.1/75.1 +/- 6.8 mm Hg, 61.8 +/- 10.8 bpm). Blood pressure variability was not different between groups, nor were the responses to reflex tests. The normo/hypercapnic ventilatory response to hypoxia was similar in patients (0.21 +/- 0.10/1.37 +/- 0.60 L/min/%) and controls (0.22 +/- 0.16/1.19 +/- 0.78 L/min/%). CONCLUSIONS: Radiation therapy for laryngeal or pharyngeal carcinoma does not affect chemoreflex function, but results in an attenuated baroreflex sensitivity. Clinically relevant blood pressure lability is absent however.

25
UI - 12098778
AU - Xiong W; Zeng ZY; Li XL; Li WF; Li J; He L; Li GY
TI - Single-nucleotide polymorphisms in NGX6 gene and their correlation with nasopharyngeal carcinoma.
SO - Sheng Wu Hua Xue Yu Sheng Wu Wu Li Xue Bao (Shanghai) 2002 Jul;34(4):512-5
AD - Cancer Research Institute, Xiangya Medical School of Central South University, Changsha 410078, China. Ligy@public.cs.hn.cn
Nasopharyngeal carcinoma (NPC) is rare in most parts of the world, but prevalent in southern China. Recently, a NGX6 gene was cloned, which is located in the region of minimal heterozygosity deletion at 9p21.3-22.1 and is down-expressed in NPC. The latest results suggest that the NGX6 gene is a candidate tumor suppressor for NPC. A correlation study using 2 single-nucleotide polymorphisms (SNPs) within NGX6 gene by means of dynamic allele specific hybridization (DASH) was performed in 105 unrelated case subjects and 183 control subjects which matched to the NPC cases in age, sex and residence. Significant results were obtained for one SNP mark (rs879284), which was located at -237 bp 5' up-stream of NGX6 gene, and the relative risk of this SNP mark was 3.93 (genotype CT) and 2.27 (genotype TT). The result has proved again that NGX6 gene may play a certain role in oncogenesis and development of nasopharyngeal carcinoma. The SNP mark rs879284 may influence on the expression of NGX6 gene due to its location on chromosome.

26
UI - 12162772
AU - Lowlicht RA; Jassin B; Kim M; Sasaki CT
TI - Long-term effects of Le Fort I osteotomy for resection of juvenile nasopharyngeal angiofibroma on maxillary growth and dental sensation.
SO - Arch Otolaryngol Head Neck Surg 2002 Aug;128(8):923-7
AD - Department of Surgery, Section of Otolaryngology, Yale School of Medicine, New Haven, Conn, USA.
OBJECTIVE: To analyze the long-term effects of the Le Fort I osteotomy approach for the resection of juvenile nasopharyngeal angiofibroma (JNA) on maxillary growth and dental sensation. DESIGN: Prospective collection of structured data. SETTING: Tertiary care academic teaching hospital. PATIENTS: Between 1993 and 1998, 5 adolescents (aged 10-14 years) constituted the evaluable cohort among 14 patients who underwent Le Fort I osteotomy for JNA resection. Mean follow-up was 47.2 months. INTERVENTIONS: The Le Fort I osteotomy approach was used to resect JNA. Cephalometric x-ray films were taken at various postoperative intervals to assess maxillary growth. The results were matched against age-correlated predictions from Dentofacial Planner software. MAIN OUTCOME MEASURES: Horizontal and vertical maxillary growth were each measured anteriorly and posteriorly by comparing interval postoperative cephalometric x-ray films. Dental sensation was longitudinally evaluated by performing interval pulp testing postoperatively. RESULTS: (1) Average vertical growth of the maxilla achieved 30% of predicted growth anteriorly (P =.02). (2) Average horizontal growth matched predicted growth in all patients. (3) All patients demonstrated long-term maxillary dental denervation. CONCLUSIONS: Le Fort I osteotomy prov

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