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Abramson Cancer CenterNCI CANCERLIT® Search: Paranasal Sinus and Nasal Cavity Cancer - April 2002
National Cancer Institute®
Last Modified: April 1, 2002
Table of Contents
1
UI - 11843651
AU - Baron JA; Raines J; Bangert J; Hansen RC
TI -
Persistent nodule on the nose.
SO - Arch Dermatol 2002 Feb;138(2):259-64
AD - University of Arizona College of Medicine, Tucson, AZ, USA.
2
UI - 11905317
AU - Helman JI
TI -
Maxillectomy.
SO - Atlas Oral Maxillofac Surg Clin North Am 1997 Sep;5(2):75-89
AD - Section of Oral and Maxillofacial Surgery, Department of Surgery
(Medical School), Department of Oral Medicine, Pathology, and
Maxillofacial Surgery (Dental School), University of Michigan, Ann
Arbor, Michigan, USA.
3
UI - 11902539
AU - Dulguerov P; Allal A S; Calcaterra T C
TI -
Esthesioneuroblastoma: a meta-analysis and review.
SO - Lancet Oncol 2001 Nov;2(11):683-90
AD - Division of Head and Neck Surgery, Geneva University Hospital,
Switzerland. pavel.dulguerov@hcuge.ch
Our objective was to review recent developments in diagnosis, staging,
and treatment of esthesioneuroblastoma (ENB). A meta-analysis of
publications between 1990 and 2000 was carried out, and studies were
classified according to their main subject: origin/aetiology of ENB,
histopathological diagnosis, and treatment. Data so far point to the
basal progenitor cells of the olfactory epithelium as the origin of ENB.
Histopathological diagnosis remains difficult and is based on results of
antigen expression detected through a panel of antibodies by
immunohistochemistry. RT-PCR of HASH expression could be a specific
marker of ENB. Overall and disease-free survival at 5 years averaged 45%
(SD 22) and 41% (SD 21) in the studies included in the meta-analysis.
Survival in Hyams' grades I-II was 56% (SD 20) compared with 25% (SD 20)
in grades III-IV (odds ratio 6.2). In patients with metastases in
cervical lymph nodes (on average 5% of the total) survival was 29%,
compared with 64% for patients with N0 disease (odds ratio 5.1).
Survival according to treatment modalities was 65% for surgery plus
radiotherapy, 51% for radiotherapy and chemotherapy, 48% for surgery,
47% for surgery plus radiotherapy and chemotherapy, and 37% for
radiotherapy alone. The histopathological grading according to Hyams and
the presence of cervical lymph-node metastases emerged as prognostic
factors. A combination of surgery and radiotherapy seems to be the
optimum approach to treatment. The exact role of chemotherapy in
treatment protocols is still unclear. The role of elective neck
dissection is unclear.
4
UI - 11908335
AU - Duruisseau O; Yona L; Wagner I; Baglin AC; de Dieuleveult T; Chabolle F
TI -
[Inverted papilloma: endoscopic versus external surgery. Apropos of 28
cases]
SO - Ann Otolaryngol Chir Cervicofac 2001 Dec;118(6):344-51
AD - Service d'ORL et chirurgie cervico faciale, Hopital Foch, 40, rue Worth,
92150 Suresnes, France.
To evaluate the role of endoscopic versus external surgery in the
treatment of inverted papillomas, the clinical courses of 35 patients
over a period of 10 years were reviewed. 13 patients were treated
endoscopically whereas 15 were treated with an external approach. 7
patients with a post operative follow up of less than 12 months were
excluded from the study. Recurrences occurred in 4 patients, 2 patients
had been treated by endoscopic surgery and 2 by medial maxillectomy by
lateral rhinotomy. 3 patients were diagnosed with squamous cell
carcinoma. Salvage surgery was performed by an external procedure or
endoscopically depending on the extension of the recurrence. Late
complications occurred in both groups: cosmetic complaints and epiphora
were more frequently encountered after external treatment. Functional
complaints were noted after endoscopic treatment. If there is no
evidence of associated malignancy, if complete exposure of the tumor is
possible and long term follow up is feasible, the authors propose
endoscopic surgery as first line treatment to excise the body of the
tumor, assess it's extension, and remove the root of the tumor. If this
is not the case, medial maxillectomy by external approach should be
performed.
5
UI - 11819076
AU - Oddone M; Granata C; Dalmonte P; Biscaldi E; Rossi U; Toma P
TI -
Nasal glioma in an infant.
SO - Pediatr Radiol 2002 Feb;32(2):104-5
AD - Department of Radiology, Giannina Gaslini Hospital for Sick Children,
16147 Genoa, Italy.
6
UI - 11770150
AU - Nguyen HN; Tewfik TL; Schloss MD; Frenkiel S; Bernard C
TI -
Adenocarcinoma of the paranasal sinuses: two case reports in a child and
an adolescent.
SO - J Otolaryngol 2000 Dec;29(6):389-92
AD - Department of Otolaryngology, McGill University, Montreal, Quebec.
7
UI - 11892044
AU - Bernstein JM
TI -
The molecular biology of nasal polyposis.
SO - Curr Allergy Asthma Rep 2001 May;1(3):262-7
AD - Departments of Otolaryngology and Pediatrics, School of Medicine and
Biomedical Sciences, State University of New York at Buffalo, USA.
The molecular biologic events in the development of nasal polyps are now
becoming unraveled. It appears that eosinophils are the dominant
inflammatory cell present in this tissue. The events leading up to the
extravasation of eosinophils into the lamina propria nasal polyps are
regulated by the proinflammatory cytokines tumor necrosis factor-alpha
and interleukin-1 beta. These cytokines upregulate very late antigen-4
on the surface of eosinophils and vascular cell adhesion molecule-1 on
the surface of the endothelial blood vessel. Chemokines such as RANTES
(regulated upon activation, normal T-cell expressed and secreted) and
eotaxin are responsible for the movement of eosinophils into the lamina
propria of the nasal polyp. The release of major basic protein has an
effect on alteration of the epithelial architecture and on the sodium
and chloride flux into and out of the apical epithelial cell of the
tissue. Finally, the alteration of the surface epithelium results in a
defect in the migration of the cystic fibrosis transmembrane regulator
protein to the apical surface. These two events, the release of major
basic protein from the eosinophil and the alteration of the architecture
of the surface epithelium, lead to an increase in sodium absorption and
resultant edema: the hallmark of the pathology of the nasal polyp.
8
UI - 11920504
AU - Nibu K; Sugasawa M; Asai M; Ichimura K; Mochiki M; Terahara A; Kawahara
TI -
N; Asato H
Results of multimodality therapy for squamous cell carcinoma of
maxillary sinus.
SO - Cancer 2002 Mar 1;94(5):1476-82
AD - Department of Otolaryngology-Head and Neck Surgery, Graduate School of
Medicine, University of Tokyo, Tokyo, Japan. nibu@med.kobe-u.ac.jp
BACKGROUND: A wide variety of modalities, including surgery, radiation
therapy, and chemotherapy, alone or in combination, have been used for
the treatment of squamous cell carcinoma (SCC) of the maxillary sinus to
obtain better local control and maintain functions. However, there is
still much controversy with regard to the optimum treatment. METHODS:
From 1987 to 1999, 33 patients with SCC of maxillary sinus were treated
at the Department of Otolaryngology-Head and Neck Surgery, University of
Tokyo Hospital. The treatment consisted of 30-40 grays (Gy) of
preoperative radiotherapy with concomitant intraarterial infusion of
5-fluorouracil and cisplatin followed by surgery and 30-40 Gy of
postoperative radiotherapy, for tumors without skull base invasion. For
tumors invading the skull base, preoperative systemic chemotherapy with
or without radiotherapy was performed, instead of intraarterial
chemotherapy, then followed by skull base surgery. The surgical
procedures varied according to the extent of tumor. Results were
compared with those of the 108 patients treated in our hospital from
1976 to 1982. RESULTS: Partial maxillectomy was performed in 2 T2
patients and 12 T3 patients. Total maxillectomy was performed in 1 T2
patient, 3 T2 patients, and 7 T4 patients. Skull base surgery was
performed in eight T4 patients. Orbital content and hard palate were
preserved in 22 patients and 18 patients, respectively. The overall
5-year survival rates were 86% in T 3 patients and 67 % in T4 patients,
respectively. CONCLUSIONS: Our multimodal treatment has provided
favorable local control and survival outcome with good functional
results. Copyright 2002 American Cancer Society.
9
UI - 11577544
AU - Slavin RG
TI -
Nasal polyps and sinusitis.
SO - Clin Allergy Immunol 2002;16():295-309
AD - St. Louis University School of Medicine, St. Louis, Missouri, USA.
10
UI - 11844067
AU - Miura K; Mineta H; Yokota N; Tsutsui Y
TI -
Olfactory neuroblastoma with epithelial and endocrine differentiation
transformed into ganglioneuroma after chemoradiotherapy.
SO - Pathol Int 2001 Dec;51(12):942-7
AD - Division of Pathology, Second Department of Pathology, Hamamatsu
University School of Medicine, Japan. kmiura@hama-med.ac.jp
We report a 56-year-old man in whom an olfactory neuroblastoma with
epithelial and endocrine differentiation transformed into a mature
ganglioneuroma after chemoradiotherapy. The tumor arising from the
sphenoidal and maxillary sinuses showed rapid growth into the frontal
lobe and metastasis to the cervical lymph nodes. The patient showed
signs of a syndrome of inappropriate secretion of antidiuretic hormone
(SIADH). A radical craniofacial resection of the primary tumor was
performed after 16 Gy of local irradiation and systemic chemotherapy.
Three months after the operation, the patient died of mediastinal
metastasis. The biopsy before chemoradiotherapy showed a neuroblastoma
with Homer-Wright rosettes, fibrillary matrix, Flexner-Wintersteiner
rosettes and antidiuretic hormone production. After chemoradiotherapy,
the histology changed to that of a ganglioneuroma consisting of large
ganglion cells and Schwann cells without immature neuroblastoma
components. Although transformation to ganglioneuroma in an adrenal
neuroblastoma is common, an olfactory neuroblastoma showing
ganglioneuronal maturation after chemoradiotherapy has not been
reported. The pluripotent progenitor cells of the olfactory neurons may
be the origin and their existence explains why various neoplasms with
neuronal and epithelial differentiation arise from the olfactory mucosa.
11
UI - 11891956
AU - Patel SG; Prasad ML; Escrig M; Singh B; Shaha AR; Kraus DH; Boyle JO;
TI -
Huvos AG; Busam K; Shah JP
Primary mucosal malignant melanoma of the head and neck.
SO - Head Neck 2002 Mar;24(3):247-57
AD - Head and Neck Service, Memorial Sloan-Kettering Cancer Center, 1275 York
Avenue, New York, New York 10021, USA. shahj@mskcc.org
INTRODUCTION: The relative rarity of mucosal melanomas of the head and
neck (MMHN) has made analysis of treatment approaches difficult.
Advances in diagnostic techniques and treatment interventions have had
obvious impact on outcomes in cutaneous melanoma, but the effects on
outcome in MMHN remain undefined. This study aims to assess the outcome
and identify clinical and histologic prognostic indicators in a recent
cohort of patients with MMHN treated at a single institution. METHODS:
The clinical records of 59 patients with the diagnosis of MMHN treated
at Memorial Sloan-Kettering Cancer Center (MSKCC) between 1978 and 1998
were retrospectively reviewed. Pathologic material on each of these
patients was prospectively reviewed by at least two pathologists (MP,
KB, or AH) for confirmation of diagnosis and assessment of histologic
variables. Survival was calculated by the Kaplan-Meier method. Clinical
(patient demographics, tumor characteristics, and treatment) and
histologic data (tumor thickness, melanosis, melanoma in situ, vascular
invasion, and multifocality) were analyzed for impact on outcome by both
univariate and multivariate analyses. RESULTS: Thirty-five patients
(59%) had sinonasal tumors (SNMM), whereas 24 (41%) had oral (ORMM)
tumors. Forty-seven patients (79.6%) were staged as stage I, 8 (13.6%)
as stage II, and 4 (6.8%) were classified as stage III. Regional
lymphatic metastases at presentation were more frequent in ORMM compared
with SNMM (25% vs 6%, p =.05). Surgery was used in all patients.
Adjuvant radiation therapy was used more frequently in the SNMM group
compared with the ORMM group (40% vs 17%, p =.04). The rates of local
failure for ORMM and SNMM were 51% and 50%, nodal failure rates were 42%
and 20%, and distant failure rates were 67% and 40%, respectively (p =
NS). With a median follow-up of 20 months, the 5-year disease-specific
survival rate was 44% (40% for ORMM vs 47% for SNMM, p = NS).
Significant prognostic factors for disease-specific survival on
univariate analysis included advanced clinical stage at presentation,
tumor thickness greater than 5 mm, presence of vascular invasion, and
development of nodal and distant metastases. On multivariate analysis,
however, regional nodal failure lost significance. CONCLUSIONS: Clinical
stage at presentation, tumor thickness greater than 5 mm, vascular
invasion on histologic studies, and development of distant failure are
the only independent predictors of outcome in MMHN. Copyright 2002 Wiley
Periodicals, Inc.
12
UI - 11891959
AU - Kummer E; Rasch CR; Keus RB; Tan IB; Balm AJ
TI -
T stage as prognostic factor in irradiated localized squamous cell
carcinoma of the nasal vestibule.
SO - Head Neck 2002 Mar;24(3):268-73
AD - Department of Head & Neck Oncology, The Netherlands Cancer
Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066CX
Amsterdam, The Netherlands.
BACKGROUND: To investigate the impact of T stage according to Wang on
the prognosis of irradiated nasal vestibule carcinoma. PATIENTS AND
METHODS: Treatment results of 47 patients were retrospectively analyzed.
Treatment consisted of external beam radiotherapy (n = 26) or
interstitial radiotherapy (n = 19) or a combination of both (n = 2) for
a primary, localized, squamous cell carcinoma of the nasal vestibule.
Mean follow-up was 5 years and 7 months. RESULTS: T1/T2 tumors: Local
control was achieved in 40 of 44 patients; surgical salvage was possible
in 2 of 4 local failures. Five patients had recurrences in the neck, and
four of them could be salvaged surgically. One patient had distant
metastases develop. T3 tumors (n = 3): no T3 tumor could locally be
cured by radiotherapy. One patient was salvaged surgically but died of
regional and distant metastases. Disease-specific survival is
significantly correlated with T stage according to Wang (p =.0001). Most
(85%) patients were smokers, and eight of them (20%) had a second
primary tumor develop in the lungs. CONCLUSIONS: The effect of
radiotherapy is significantly correlated with T stage (p =.0001) and
hence less successful in T3 lesions as primary treatment option. The
high incidence of second primary tumors in the lung is indicative for a
similar carcinogenic influence of smoking on the nasal vestibule.
Copyright 2002 Wiley Periodicals, Inc.
13
UI - 11861994
AU - Aung TH; Po YC; Wong WK
TI -
Hepatocellular carcinoma with metastasis to the skull base, pituitary
gland, sphenoid sinus, and cavernous sinus.
SO - Hong Kong Med J 2002 Feb;8(1):48-51
AD - Department of Neurosurgery, Princess Margaret Hospital, 2-10 Princess
Margaret Hospital Road, Kowloon, Hong Kong.
Two cases of hepatocellular carcinoma, with metastases to the skull
base, pituitary gland, sphenoid sinus, and cavernous sinus are reported.
Patients presented with diplopia, retro-orbital headache, and multiple
cranial nerves palsies. Pituitary metastases may require surgery as
palliative treatment, and for the confirmation of histology. One of the
current cases was diagnosed with hepatocellular carcinoma prior to
transphenoidal resection of the pituitary metastasis. The second patient
was found to have hepatocellular carcinoma after review of histology,
and the development of signs and symptoms relating to the primary
tumour.
14
UI - 11772496
AU - Mizokami H; Inokuchi A; Sawatsubashi M; Takagi S; Tsuda K; Tokunaga O
TI -
Adenoid cystic carcinoma of the lacrimal gland with wide and severe
myoepithelial differentiation.
SO - Auris Nasus Larynx 2002 Jan;29(1):77-82
AD - Department of Otolaryngology-Head and Neck Surgery, Saga Medical School,
Saga 849-8501, Japan.
Adenoid cystic carcinoma (ACC) of the lacrimal gland is the second most
common epithelial tumor for which different biologic courses can be
predicted by histologic criteria. Three main types of growth patterns,
cribriform; tubular; and solid have been identified. Tumors with solid
components frequently follow a more aggressive clinical course and show
worse prognosis than those with other patterns. We herein report a case
of ACC with wide and severe myoepithelial differentiation arising from
the lacrimal gland and presenting with aggressive clinical behavior.
Postoperative radiotherapy may be the treatment of choice to control
residual lesions and provide long-term survival even in the case of
incomplete resection. Despite extensive surgery and radiation therapy,
the prognosis of these tumors, especially with solid components, remains
extremely poor. Accurate diagnosis is important because tumor
histopathology is generally believed to be the most significant factor
in patient survival.
15
UI - 8663944
AU - Mostafa BE
TI -
Fluticasone propionate is associated with severe infection after
endoscopic polypectomy.
SO - Arch Otolaryngol Head Neck Surg 1996 Jul;122(7):729-31
AD - Department of Otorhinolaryngology, Ain-Shams University, Cairo, Egypt.
OBJECTIVE: To test whether the use of fluticasone dipropionate nasal
spray after endoscopic ethmoidectomy for multiple polyps is associated
with a high incidence of infection. DESIGN. Randomized control study
comparing the incidence of infection with the use of beclomethasone
dipropionate or fluticasone propionate nasal spray after functional
endoscopic sphenoethmoidectomy. Patients were followed up for 6 to 12
months. PATIENTS AND METHODS: Sixty patients with recurrent bilateral
nasal polyps underwent functional endoscopic sphenoethmoidectomy and
were then randomly allocated into 2 groups of 30 patients each. One
group received beclomethasone dipropionate spray (100 micrograms in each
nostril every 12 hours), and the other group received fluticasone
propionate spray (100 micrograms/d in each nostril). RESULTS: In the
fluticasone propionate group, 6 patients (20%) developed acute
gram-positive pansinusitis requiring hospitalization and discontinuation
of treatment. CONCLUSION: The use of fluticasone dipropionate aqueous
nasal spray for the postoperative control of recurrent nasal polyps
seems to be associated with a high incidence of acute pansinusitis.
16
UI - 9087151
AU - Holmberg K; Juliusson S; Balder B; Smith DL; Richards DH; Karlsson G
TI -
Fluticasone propionate aqueous nasal spray in the treatment of nasal
polyposis.
SO - Ann Allergy Asthma Immunol 1997 Mar;78(3):270-6
AD - Department of Otorhinolaryngology, Molndal Hospital, Sweden.
BACKGROUND: Topical glucocorticoids are the medical treatment of choice
in a majority of patients suffering from nasal polyposis. Fluticasone
propionate is a fluorinated steroid reported to be highly effective when
used topically in the nose for seasonal and perennial allergic and
nonallergic rhinitis. OBJECTIVES: To evaluate the efficacy and
tolerability of intranasal fluticasone propionate in the treatment of
long-standing polyposis. METHODS: Fifty-five patients with long-standing
nasal polyposis were treated over a 26-week period with fluticasone
propionate aqueous nasal spray 200 micrograms bid, beclomethasone
dipropionate aqueous nasal spray 200 micrograms bid or placebo,
administered intranasally in an aqueous spray in a double-blind,
placebo-controlled parallel-group design at a single center. The primary
efficacy endpoint was the physicians' assessment of symptoms and polyp
score. Peak nasal inspiratory flow was performed twice daily and on
every visit to evaluate the effect of the corticosteroids on nasal air
flow. RESULTS: A significant difference in the primary efficacy endpoint
between fluticasone propionate aqueous nasal spray and beclomethasone
dipropionate aqueous nasal spray compared with placebo was seen after 14
weeks of treatment. This was further verified by the peak nasal
inspiratory flow results. There was some evidence of earlier onset in
the fluticasone propionate aqueous nasal spray group compared with the
beclomethasone dipropionate aqueous nasal spray group after 4 weeks in
terms of the primary efficacy endpoint. From the daily record cards
patients receiving fluticasone propionate aqueous nasal spray had a
significantly higher percentage of days on which they required no rescue
medication (P < .009) and a higher percentage of days with an overall
nasal blockage score on waking of < 2 (P < .013) when compared with
placebo-treated patients. No other statistically significant results
were found between the two active compounds. CONCLUSION: Fluticasone
propionate aqueous nasal spray 200 micrograms bid and beclomethasone
dipropionate aqueous nasal spray 200 micrograms bid are effective in
treating the symptoms of nasal polyps, with some evidence that
fluticasone propionate aqueous nasal spray has a faster onset of action
and is tolerated at least as well as beclomethasone dipropionate aqueous
nasal spray at the same dose.
17
UI - 9129872
AU - Wiseman LR; Benfield P
TI -
Intranasal fluticasone propionate. A reappraisal of its pharmacology and
clinical efficacy in the treatment of rhinitis.
SO - Drugs 1997 May;53(5):885-907
AD - Adis International Limited, Auckland, New Zealand. demail@adis.co.nz
The intranasal corticosteroid fluticasone propionate is an effective
agent for the treatment of rhinitis, demonstrating potent local
anti-inflammatory activity and little, if any, systemic activity.
Intranasal fluticasone propionate has shown clinical efficacy similar to
that of other intranasal corticosteroids, including beclomethasone
(administered at up to a 2-fold higher dosage than fluticasone),
budesonide, flunisolide and triamcinolone acetonide, and provides
greater relief from nasal symptoms (including nasal blockage) than
antihistamine agents and intranasal sodium cromoglycate. Its efficacy in
the treatment of seasonal allergic rhinitis and perennial allergic and
nonallergic rhinitis has been demonstrated in large well-controlled
studies in which the drug maintained adequate control of symptoms when
administered in a once daily dose of 200 micrograms. In addition,
fluticasone propionate has shown similar efficacy to that of
beclomethasone in the treatment of nasal polyps; however, its use in the
postoperative setting requires further investigation. Intranasal
fluticasone propionate is well tolerated in the majority of patients,
the incidence of adverse events being similar to that seen with placebo.
Pharmacoeconomic analyses indicate that intranasal fluticasone
propionate is significantly more cost-effective than the antihistamines
terfenadine and loratadine. Overall quality of life was improved to a
similar extent by fluticasone propionate and beclomethasone. In
conclusion, recent clinical experience has confirmed that intranasal
fluticasone propionate is a convenient, effective and well tolerated
alternative to other intranasal corticosteroids and antihistamines for
the treatment of rhinitis when administered once daily.
18
UI - 9604976
AU - Lund VJ; Flood J; Sykes AP; Richards DH
TI -
Effect of fluticasone in severe polyposis.
SO - Arch Otolaryngol Head Neck Surg 1998 May;124(5):513-8
AD - Institute of Laryngology and Otology, Royal National Throat, Nose and
Ear Hospital, London, England.
OBJECTIVES: To investigate the effect of intranasal corticosteroids in
the treatment of polyps in patients with severe polyposis listed for
surgical treatment and to determine the treatment effect on the
progression of the disease. DESIGN: A double-blind, randomized,
parallel-group, placebo-controlled, 12-week study at a single center.
SETTING: A tertiary referral center in London, England. PATIENTS:
Thirty-four patients with severe polyposis listed for endoscopic
surgical treatment. INTERVENTION: By random allocation, fluticasone
propionate aqueous nasal spray (FPANS), 200 microg twice a day;
beclomethasone dipropionate aqueous nasal spray, 200 microg twice a day;
or placebo nasal spray twice a day was administered. Patients received 2
actuations to each nostril in the morning and in the evening. MAIN
OUTCOME MEASURES: Efficacy end points were the need for polypectomy at
the end of treatment, the results of acoustic rhinometry, the polyp
score, the peak nasal inspiratory flow rate, and an assessment of
symptoms. RESULTS: The polyp score was significantly decreased in the
FPANS-treated group (P < or = .01). The nasal cavity volume was
significantly increased in both the FPANS-treated group and the group
receiving beclomethasone compared with placebo (P < or = .01) at the end
of treatment. The percentage change in the mean morning peak nasal
inspiratory flow rate was greater in the FPANS-treated group, with a
significant effect observed at week 2 (P = .01). Nasal blockage was
significantly decreased in both active groups compared with the group
receiving placebo. No significant difference was observed between the
treatment groups in the number of patients requiring polypectomy.
CONCLUSIONS: Fluticasone and beclomethasone aqueous nasal sprays are
effective in treating the symptoms of severe nasal polyps. There was
some evidence that the group treated with FPANS responded more quickly
to intervention and that the magnitude of the response was greater than
in the group receiving beclomethasone.
19
UI - 9794620
AU - Ishibashi T; Tanaka T; Nibu K; Ishimoto S; Kaga K
TI -
Keratinocyte growth factor and its receptor messenger RNA expression in
nasal mucosa and nasal polyps.
SO - Ann Otol Rhinol Laryngol 1998 Oct;107(10 Pt 1):885-90
AD - Department of Otolaryngology, Tokyo University Branch Hospital, Japan.
To examine the potential biologic role of fibroblast growth factors
(FGFs) in nasal polyps and nasal mucosa during chronic inflammatory
conditions, we investigated messenger RNA (mRNA) expression of three
members of the FGF family -- acidic FGF, basic FGF, and keratinocyte
growth factor (KGF)-- in nasal polyp tissues, as well as in hyperplastic
nasal mucosa. Using the sensitive method reverse
transcription-polymerase chain reaction (RT-PCR), we demonstrated that
of the examined FGFs, KGF had the most abundant mRNA expression in nasal
polyps and nasal mucosa. We also found that significantly higher levels
of KGF mRNA were expressed in nasal polyps than in nasal mucosa, whereas
mRNA expression of acidic FGF and basic FGF was relatively low in these
tissues. In addition, we showed that KGF receptor mRNA was present in
most of the nasal mucosa; however, none or little was expressed in nasal
polyps. These results suggest that KGF might play an important role in
nasal epithelial proliferation and that excessive synthesis of KGF in
nasal polyp stroma may contribute to hypertrophy of the nasal mucosa in
patients with chronic sinusitis associated with nasal polyposis.
20
UI - 9893189
AU - Hamilos DL; Thawley SE; Kramper MA; Kamil A; Hamid QA
TI -
Effect of intranasal fluticasone on cellular infiltration, endothelial
adhesion molecule expression, and proinflammatory cytokine mRNA in nasal
polyp disease.
SO - J Allergy Clin Immunol 1999 Jan;103(1 Pt 1):79-87
AD - Department of Medicine , Washington University School of Medicine, St
Louis, MO 63110, USA.
BACKGROUND: Nasal polyp (NP) disease demonstrates a gradual response to
treatment with intranasal steroids. We hypothesized that various
inflammatory features that promote NP eosinophilia would show a
differential sensitivity to treatment with intranasal fluticasone.
OBJECTIVES: We conducted a double-blind, placebo-controlled trial of 4
weeks of intranasal fluticasone propionate or matching placebo to assess
their effectiveness in reducing NP inflammatory cells, expression of
endothelial vascular cell adhesion molecule (VCAM)-1 and P-selectin, and
expression of cytokines involved in induction of a group of adhesion
molecules (ie, IL-4, IL-13, TNF-alpha, and IL-1beta). METHODS: Twenty
subjects (9 women and 11 men) with severe chronic sinusitis and NP were
studied. Systemic and intranasal steroids were withheld for a minimum of
1 month and 2 weeks, respectively, before the study. Biopsy specimens of
NPs were obtained 1 week before and 4 weeks after treatment with
intranasal fluticasone 100 microg or placebo per nostril administered
twice daily. Biopsy specimens were snap frozen for immunostaining or
fixed in paraformaldehyde for in situ hybridization. Pretreatment to
posttreatment results were analyzed with Wilcoxon's signed-rank test.
RESULTS: Fluticasone treatment significantly reduced NP eosinophilia (P
=.02) and CD4(+) T lymphocytes (P =.02). Eosinophils expressing the
marker EG2 were more significantly reduced (P =.007). Fluticasone also
reduced the expression of P-selectin (P =.005) and the number of IL-4
and IL-13 mRNA+ cells (P =.02 and.05, respectively). In contrast,
fluticasone did not significantly reduce expression of endothelial
VCAM-1 or the number of TNF-alpha or IL-1beta mRNA+ cells in the polyps.
CONCLUSIONS: We conclude that intranasal fluticasone reduced NP
inflammation but that expression of proinflammatory cytokines and
endothelial VCAM-1 were relatively unaffected by fluticasone treatment.
These latter inflammatory features may contribute to the persistence of
NP disease despite intranasal steroid treatment.
21
UI - 10334231
AU - Saunders MW; Wheatley AH; George SJ; Lai T; Birchall MA
TI -
Do corticosteroids induce apoptosis in nasal polyp inflammatory cells?
In vivo and in vitro studies.
SO - Laryngoscope 1999 May;109(5):785-90
AD - Department of Otolaryngology-Head and Neck Surgery, University of
Bristol, United Kingdom.
OBJECTIVE/HYPOTHESIS: Corticosteroids are an effective treatment for
nasal polyposis. The exact mechanism of action is not certain. Recent
research demonstrates that apoptosis (programmed cell death) in
inflammatory cells is an important factor in the resolution of
inflammation, and apoptosis is induced in eosinophils in cell culture
with steroids. We hypothesized that inflammatory cell apoptosis is a key
feature of regression of nasal polyps on exposure to steroids and
examined this hypothesis in vivo and in vitro. METHODS: A double-blind,
placebo-controlled pilot study of fluticasone propionate aqueous nasal
spray (FPANS) in nasal polyposis in humans in vivo was undertaken, and
the effect of treatment on indices of cell death and proliferation
measured. In addition, explants of nasal polyp tissue were maintained in
vitro in short-term tissue culture with dexamethasone at increasing
doses (0.1-50 micromol) over varying time intervals and then analyzed
for similar indices of proliferation and cell death. RESULTS: Apart from
a marginal increase in apoptotic:mitotic ratio in epithelium, little
difference between the effect of FPANS and placebo was demonstrated in
vivo. However, in vitro, apoptotic index was significantly increased in
the stromal layers in relation to time of incubation (P = .0169), and a
significant dose-response relationship was demonstrated at 24 hours
between stromal cell apoptosis and dexamethasone concentration (P =
.001). Eosinophil apoptosis was confirmed by in situ end labeling and
transmission electron microscopy. No steroid or time effect on
epithelial cells was demonstrated in vitro. CONCLUSION: Corticosteroids
induce apoptosis in inflammatory cells in human nasal polyps in vitro.
This is not reflected by a similar response to FPANS at 14 days in vivo,
but may still play a part in regression of polyps with other forms of
administration or at other time points.
22
UI - 10442547
AU - Holmstrom M
TI -
Clinical performance of fluticasone propionate nasal drops.
SO - Allergy 1999;54 Suppl 53():21-5
AD - Department of Otorhinolaryngology, Huddinge University Hospital,
Karolinska Institute, Stockholm, Sweden.
The efficacy and safety of fluticasone propionate (FP) nasal drops were
investigated in two multicentre, randomized, placebo-controlled trials.
Patients received FP 400 microg once or twice daily for 12 weeks and
then FP 400 microg once daily for a further 12 weeks. FP 400 microg
significantly reduced polyp size and improved peak nasal inspiratory
flow, rhinitis symptoms and sense of smell when administered twice
daily. Significant reductions in polyp size were not achieved with once
daily administration, but clinical benefits were observed for peak nasal
inspiratory flow. Both dosing regimens were well tolerated, with an
overall incidence of adverse events which was similar to placebo.
23
UI - 10606936
AU - Penttila M; Poulsen P; Hollingworth K; Holmstrom M
TI -
Dose-related efficacy and tolerability of fluticasone propionate nasal
drops 400 microg once daily and twice daily in the treatment of
bilateral nasal polyposis: a placebo-controlled randomized study in
adult patients.
SO - Clin Exp Allergy 2000 Jan;30(1):94-102
AD - Tampere University Hospital, Tampere, Finland.
BACKGROUND: Topical corticosteroids are the accepted medical adjunct to
surgery in patients suffering from nasal polyposis. Fluticasone
propionate (FP) is a potent, topically active corticosteroid which has
been formulated as nasal drops specifically for the treatment of
polyposis. OBJECTIVES: To evaluate dose-related efficacy and
tolerability of FP nasal drops (FPND) in the treatment of mild to
moderate bilateral polyposis; in a double-blind, placebo-controlled,
multicentre international study. METHODS: Adult patients (n = 142) with
bilateral nasal polyps were randomized to receive either FPND 400 microg
once daily (o.d.), FPND 400 microg twice daily (b.i.d.) or placebo for
12 weeks. The majority then entered a further 12 week open period during
which all patients received FPND 400 microg o.d. The primary efficacy
endpoint was the physicians' visual assessment of polyp size. Secondary
clinical endpoints were nasal blockage and overall rhinitis (0-3
scores), peak nasal inspiratory flow (PNIF), olfactory function tests,
and requirement for polypectomy. The patients also kept twice daily
records of symptom scores, peak nasal inspiratory flow (PNIF) and use of
rescue medication. RESULTS: At the end of the 12 week randomized
treatment period, polyp size was reduced significantly by FPND 400
microg b.i.d. as compared with placebo (P = 0.006). Clinical assessments
of nasal blockage and overall rhinitis showed significant improvements
at several stages of treatment with both doses of FPND. Clinic PNIF was
also improved significantly by both doses of FPND in comparison with
placebo, and FPND 400 microg b.i.d. was significantly more effective
than 400 microg o.d. (P = 0.045). Patient diary card scores supported
the clinical assessments. Two patients on placebo required polypectomy
and all treatments were well tolerated with a similar incidence of
adverse events. CONCLUSION: FPND 400 microg once or twice daily is an
effective and well-tolerated treatment for bilateral nasal polyposis.
24
UI - 10998024
AU - Keith P; Nieminen J; Hollingworth K; Dolovich J
TI -
Efficacy and tolerability of fluticasone propionate nasal drops 400
microgram once daily compared with placebo for the treatment of
bilateral polyposis in adults.
SO - Clin Exp Allergy 2000 Oct;30(10):1460-8
AD - McMaster University Medical Centre, Hamilton, Ontario, Canada,
Paijat-Hame Hospital, Lahti, Finland, GlaxoWellcome Research &
Development, UK.
BACKGROUND: Chronic eosinophilic rhinosinusitis underlies a range of
respiratory disorders including nasal polyposis. Surgical and medical
methods are used to control polyps, with topical steroids commonly being
used for their anti-inflammatory properties. Fluticasone propionate
nasal drops (FPND) is a formulation developed specifically for an
effective and well tolerated corticosteroid treatment of nasal
polyposis. OBJECTIVES: To assess efficacy and tolerability of FPND in
the treatment of bilateral nasal polyposis in adults. METHODS: This
multicentre, randomized, parallel-group study compared FPND 400
microgram once daily (o.d.) with placebo for 12 weeks in adult patients
with mild to moderate bilateral polyposis. The primary efficacy endpoint
was visual assessment of polyp size by the physician at monthly clinic
visits. Nasal blockage, rhinitis, peak nasal inspiratory flow (PNIF),
olfactory function and requirement for polypectomy were also assessed at
visits. The patients kept diary card records of symptoms, PNIF, and use
of rescue antihistamine. Additional safety data were provided by a
12-week open extension, when all patients received FPND 400 microgram
o.d. RESULTS: After 12 weeks double-blind treatment with FPND (n = 52)
or placebo (n = 52), polyp size was reduced in 27% and 16% of patients,
respectively; clinical reduction of nasal blockage significantly
favoured FPND over placebo (55% vs 22%; P = 0.002), and clinic PNIF had
increased significantly with FPND (by 52 L/min vs -3 L/min for placebo;
P < 0.001). Diary card measurements showed significant benefits of FPND
vs placebo for daily PNIF, nasal blockage, rhinitis and use of
loratadine rescue medication. Both treatments were well tolerated and no
serious adverse events occurred during randomized treatment. Epistaxis
was more frequent with FPND than placebo but was generally mild and did
not result in withdrawals. Mean serum cortisol levels did not change
significantly with either treatment. CONCLUSION: This study showed FPND
400 microgram o.d. to be an effective and well tolerated treatment for
bilateral nasal polyposis in adults.
25
UI - 11447383
AU - Hamilos DL; Leung DY; Muro S; Kahn AM; Hamilos SS; Thawley SE; Hamid QA
TI -
GRbeta expression in nasal polyp inflammatory cells and its relationship
to the anti-inflammatory effects of intranasal fluticasone.
SO - J Allergy Clin Immunol 2001 Jul;108(1):59-68
AD - Departments of Medicine and Otolaryngology, Ear, Nose and Throat
Surgery, Washington University School of Medicine, St Louis, MO 63110,
USA.
BACKGROUND: Nasal polyposis disease is an inflammatory disorder with
intense eosinophilic infiltration of respiratory mucosa that is often
difficult to control with topical steroids. Recent evidence suggests
that overexpression of the glucocorticoid receptor splice variant GRbeta
in inflammatory cells might contribute to steroid insensitivity in
diseases such as asthma. OBJECTIVE: The purposes of this investigation
were to determine whether nasal polyp (NP) inflammatory cells
overexpress GRbeta and to examine whether GRbeta overexpression is
associated with insensitivity to the potent topical steroid fluticasone
propionate (FP). METHODS: Biopsies were obtained from 10 subjects with
NPs before and 4 weeks after treatment with intranasal FP. Middle
turbinates biopsies from 6 healthy, nonallergic subjects served as
normal controls. Biopsies were immunostained for inflammatory cell
markers as well as GRbeta and probed for various cytokine mRNA. The
anti-inflammatory response to FP was examined in relation to
pretreatment levels of GRbeta expression. RESULTS: The total numbers of
inflammatory cells were increased in NPs. The percentage of inflammatory
cells expressing GRbeta was also increased (40.5% +/- 19.2% vs 16.1% +/-
4.0%, P =.009). GRbeta expression in NPs was almost exclusive to T
lymphocytes, eosinophils, and macrophages. An inverse correlation was
observed between the baseline inflammatory cell GRbeta expression and
the reduction after FP treatment in EG2-positive eosinophils,
CD4-positive T lymphocytes, endothelial VCAM-1 expression, and IL-4
mRNA-positive cells. NPs that were "FP-insensitive" in terms of
suppression of eosinophil numbers (major basic protein-positive) had a
significantly greater percentage of GRbeta-positive inflammatory cells,
a higher ratio of GRbeta-positive/GRalpha-positive cells, and increased
numbers of GRbeta-positive eosinophils and macrophages in comparison
with those that were "FP-sensitive." "FP-insensitive" NPs also
demonstrated a higher percentage of IL-5-positive inflammatory cells
expressing GRbeta before and after FP treatment. CONCLUSION: GRbeta
expression appears to be a marker of steroid insensitivity in NPs.
Expression of GRbeta by NP inflammatory cells, particularly T cells and
eosinophils, might render them resistant to suppression by topical
steroids and thereby contribute to persistent NP inflammation.
26
UI - 11767483
AU - Gadzhimirzaev GA; Shakhnazarov AM
TI -
[A case of a breast cancer metastasis to the frontal sinus]
SO - Vestn Otorinolaringol 2001;(6):55
27
UI - 11753306
AU - Pigno MA
TI -
Conventional prosthetic rehabilitation after free flap reconstruction of
a maxillectomy defect: a clinical report.
SO - J Prosthet Dent 2001 Dec;86(6):578-81
AD - The University of Texas Health Science Center at San Antonio, Texas
78229-3900, USA. pigno@uthscsa.edu
Microvascular free flap reconstruction of maxillectomy defects has been
advocated as a more desirable treatment option than conventional
prosthetic rehabilitation. Free flap reconstruction can successfully
separate the oral and sinonasal cavities, but the reconstructed defect
may not improve the treatment outcome when compared with conventional
prosthetic rehabilitation of a nonsurgically reconstructed defect. In
this report, the prosthetic management of a patient who underwent
immediate microvascular free flap reconstruction of a unilateral
maxillectomy defect is described, and the issue of surgical versus
nonsurgical reconstruction is discussed.
28
UI - 11949376
AU - Piff C
TI -
A patient's perspective: living with facial cancer.
SO - J Tissue Viability 2001 Apr;11(2):64-6
29
UI - 11926916
AU - Steele MH; Suskind DL; Moses M; Kluka E; Liu DC
TI -
Orbitofacial masses in children: an endoscopic approach.
SO - Arch Otolaryngol Head Neck Surg 2002 Apr;128(4):409-13
AD - Division of Otolaryngology, University of Chicago, 5841 S Maryland Ave,
MC1035, Chicago, IL 60637, USA.
OBJECTIVE: To describe an endoscopic approach for pediatric orbitofacial
masses. DESIGN: A retrospective medical chart review. SETTING:
Tertiary-care children's hospital. PARTICIPANTS: Patients (4 boys, 7
girls) ranged in age from 6 months to 11 years. All children underwent
endoscopic excision of an orbitofacial mass. INTERVENTION: A single port
approach was used in all but the initial case. The scalp incision was
placed approximately 2.0 cm behind the frontal hairline. A subgaleal
dissection was performed to minimize risk of nerve injury. Under
endoscopic visualization, the mass was resected. MAIN OUTCOME MEASURES:
Ability to successfully excise the mass endoscopically, and the
incidence of complication. RESULTS: All lesions were successfully
resected endoscopically. The surgical time varied from 30 to 105 minutes
(mean, 50.5 minutes). Pathologic examination revealed 10 dermoid cysts
and 1 neurofibroma. Two children had transient frontalis branch palsies
that resolved spontaneously. There was 1 unilateral frontal hypoesthesia
in the patient with the neurofibroma (an expected result). There were no
other complications. CONCLUSIONS: An endoscopic approach to pediatric
orbitofacial tumors is safe and effective. Although the risk of nerve
injury may be higher, a thorough knowledge of frontotemporal anatomy and
careful dissection will minimize this risk. The distinct advantage of an
endoscopic approach is the absence of any facial scar in these young
patients.
30
UI - 11926922
AU - Zur KB; Brandwein M; Wang B; Som P; Gordon R; Urken ML
TI -
Primary description of a new entity, renal cell-like carcinoma of the
nasal cavity: van Meegeren in the house of Vermeer.
SO - Arch Otolaryngol Head Neck Surg 2002 Apr;128(4):441-7
AD - Box 1189, Mount Sinai School of Medicine, 1 Gustave Levy Pl, New York,
NY 10021, USA.
BACKGROUND: Few sinonasal malignancies can manifest, histologically, as
clear cell neoplasia. The most likely such tumor to be encountered is
metastatic renal cell carcinoma. Primary sinonasal tumors that can
appear as clear cell malignancies include squamous cell carcinoma and
mucoepidermoid carcinoma. Primary salivary clear cell carcinoma occurs
almost exclusively in the oral cavity and has not been described in the
nasal cavity. OBJECTIVE: To report a unique sinonasal clear cell
malignancy that mimicked metastatic renal carcinoma. STUDY DESIGN: Case
report. OUTCOME MEASUREMENTS: Radiography, histology, histochemistry,
immunohistochemistry, and electron microscopy. RESULTS: Histologically,
the tumor was identical to renal cell carcinoma. No evidence of renal
malignancy was found by abdominal computed tomographic scan or
gadolinium-enhanced magnetic resonance imaging. Histochemistry confirmed
the presence of tumor glycogen but no mucin. Immunohistochemistry
confirmed strong expression of low- and high-molecular-weight keratin
and S100, and no vimentin expression. Electron microscopy showed tumor
myofibroblastic differentiation and cytoplasmic glycogen, neutral lipid
vacuoles, and cholesterol. CONCLUSIONS: There was no clinical evidence
of renal cell carcinoma. The immunohistochemical and ultrastructural
findings were inconsistent with the diagnosis of renal cell carcinoma
and showed features also inconsistent with the diagnosis of primary
salivary clear cell carcinoma. We therefore conclude that this tumor
represents a new and distinct entity, notable in its presentation as a
"counterfeit renal cell carcinoma."
31
UI - 11928098
AU - Umeda M; Minamikawa T; Yokoo S; Komori T
TI -
Metastasis of maxillary carcinoma to the parapharyngeal space: rationale
and technique for concomitant en bloc parapharyngeal dissection.
SO - J Oral Maxillofac Surg 2002 Apr;60(4):408-13; discussion 413-4
AD - Department of Oral and Maxillofacial Surgery, Kobe University Graduate
School of Medicine, Kobe, Japan. ume@med.kobe-u.ac.jp
PURPOSE: En bloc resection of the primary tumor and regional lymph nodes
is the classic method of surgery in cases of head and neck cancer, but
it is not performed in cases of carcinoma of the maxillary gingiva or
antrum for anatomic reasons. One of the reasons for the poor prognosis
of patients with maxillary cancer and N+ stage necks is thought to be
recurrence in the parapharyngeal space, which is out of the surgical
field in radical neck dissection. The purpose of this study was to
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