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NCI CANCERLIT® Search: Pharyngeal Cancer - February 2002
National Cancer Institute®
Last Modified: February 1, 2002
Table of Contents
1
UI - 9727957
AU - Anonymous
TI -
Preventing and controlling oral and pharyngeal cancer. Recommendations
from a National Strategic Planning Conference.
SO - MMWR Recomm Rep 1998 Aug 28;47(RR-14):1-12
for preventing and controlling oral and pharyngeal cancer in the United
States. The conference, which was cosponsored by the National Institute
of Dental Research of the National Institutes of Health and the American
Dental Association, included 125 experts in oral and pharyngeal cancer
prevention, treatment, and research; both the private and public sectors
were represented. Participants at the conference developed
recommendations concerning advocacy, collaboration, and coalition
building; public health policy; public education; professional education
and practice; and data collection, evaluation, and research. A follow-up
meeting consisting of selected participants of the 1996 conference was
in the political and scientific arenas since the 1996 conference were
considered, and 10 recommended strategies from the conference were
selected for priority implementation. These 10 strategies were to a)
establish a mechanism to implement and monitor the recommended
strategies developed during the conference; b) urge oral health
professionals to become more actively involved in community health; c)
require instruction in preventing and controlling tobacco and alcohol
use at all levels of training in dental, medical, nursing, and other
related health-care disciplines; d) encourage Medicaid, Medicare,
traditional insurance plans, and managed-care entities to consider
making oral cancer examinations an integral part of comprehensive
physical and oral examinations; e) designate federal funding for a
national program of oral cancer prevention, early detection, and
control; f) after assessing local needs, develop, implement, and
evaluate statewide models to educate all relevant groups; g) develop and
conduct a national promotional campaign to raise public awareness of
oral cancer and its link to tobacco use and heavy alcohol consumption;
h) develop health-care curricula that require competency in prevention,
diagnosis, and multidisciplinary management of oral and pharyngeal
cancer; i) sponsor and promote continuing education for health-care
professionals on the multidisciplinary management of all phases of oral
cancer and its sequelae; and j) strengthen organizational approaches to
reducing oral cancer by developing organized cooperative and
collaborative arrangements, funding formal centers, and involving
commercial firms. CDC will use these recommended strategies to develop
programs to reduce the burden of oral and pharyngeal cancer in the
United States. Through the Oral Cancer Roundtable, a group of conference
and meeting participants, CDC will communicate to interested agencies,
organizations, and state health departments ways in which they can
implement elements of the national plan. The Roundtable will help CDC
track the efforts and progress of these groups.
2
UI - 11748660
AU - Liu Y; Wang X; Lo AK; Wong YC; Cheung AL; Tsao SW
TI -
Latent membrane protein-1 of Epstein-Barr virus inhibits cell growth and
induces sensitivity to cisplatin in nasopharyngeal carcinoma cells.
SO - J Med Virol 2002 Jan;66(1):63-9
AD - Department of Anatomy, Faculty of Medicine, University of Hong Kong,
Hong Kong, People's Republic of China.
Nasopharyngeal carcinoma is closely associated with Epstein-Barr virus
(EBV) and the EBV encoded latent membrane protein-1 expression (LMP1) is
commonly found in the tumour cells. LMP1 has been shown to be involved
in modulation of cell growth in B cells but the biological properties of
LMP1 expression in nasopharyngeal carcinoma cells are less defined. In
this study, a full length LMP1 gene was introduced into an EBV negative
nasopharyngeal carcinoma cell line, CNE2, and five LMP1-expressing
clones were isolated. Expression of LMP1 did not confer cell growth
advantage in CNE2 cells; instead, it induced growth inhibition both in
vitro and in vivo. In addition, the LMP1 transfected cells were more
susceptible to cisplatin-induced cell death and showed 1.4-4.0-fold
increased sensitivity to cisplatin compared to the vector infected
control clones. The effect of LMP1 on the balance of Bcl-2 and Bax ratio
may play a role in inducing susceptibility to cisplatin-induced cell
death. These results demonstrated that LMP1 did not confer growth
advantage in CNE2 cells, suggesting that expression of LMP1 may not be
crucial in sustaining cell growth in established cell lines.
Alternatively, LMP1 alone may not be sufficient to facilitate
nasopharyngeal carcinoma cell growth and additional oncogenic factors
may be needed along with LMP1 in modulating the malignant property of
nasopharyngeal carcinoma. Copyright 2002 Wiley-Liss, Inc.
3
UI - 11770576
AU - Centers for Disease Control and Prevention
TI -
Promoting oral health: interventions for preventing dental caries, oral
and pharyngeal cancers, and sports-related craniofacial injuries. A
report on recommendations of the task force on community preventive
services.
SO - MMWR Recomm Rep 2001 Nov 30;50(RR-21):1-13
The Task Force on Community Preventive Services (the Task Force) has
conducted systematic reviews of the evidence of effectiveness of
selected population-based interventions to prevent and control dental
caries (tooth decay), oral (mouth) and pharyngeal (throat) cancers, and
sports-related craniofacial injuries. The Task Force strongly recommends
community water fluoridation and school-based or school-linked pit and
fissure sealant delivery programs for prevention and control of dental
caries. Using the rules of evidence it has established, the Task Force
found insufficient evidence of effectiveness or ineffectiveness of the
remaining interventions reviewed. Therefore, the Task Force makes no
recommendation for or against use of statewide or communitywide sealant
promotion programs, population-based interventions for early detection
of precancers and cancers, or population-based interventions to
encourage use of helmets, facemasks, and mouthguards to reduce
oral-facial trauma in contact sports. The Task Force's finding of
insufficient evidence indicates the need for more research on
intervention effectiveness. Until the results of such research become
available, readers are encouraged to judge the usefulness of these
interventions by other criteria. This report presents additional
information regarding the recommendations, briefly describes how the
reviews were conducted, and provides information designed to help apply
the strongly recommended interventions locally.
4
UI - 11776079
AU - Jiang N; Zhan F; Cao L; Yao K; Li G
TI -
c-myc gene inactivation during induction of nasopharyngeal carcinoma
cells with retinoic acid.
SO - Chin Med J (Engl) 2000 Sep;113(9):823-6
AD - Cancer Research Institute, Hunan Medical University, Changsha 410078,
China. njandjbz@public.cs.hn.cn
OBJECTIVE: To investigate the effects of retinoic acid (RA) on the
growth, morphology, oncogene expression and regulation of nasopharyngeal
carcinoma cells. METHODS: Nasopharyngeal carcinoma cell line (HNE1) was
induced by RA. The RA-treated and control cells were established and
cellular morphology and growth patterns were defined. Oncogene
expression and regulation were detected by Northern hybridization and
DNase-I hypersensitive site analysis. RESULTS: RA markedly inhibited
cell growth. The growth of HNE1 cells was reduced to 50% of the control
level on the 4th day of RA (10(-4) mol/L) treatment. After 4 days of
treatment, the rapidly growing polygonal cells were reversed into a slow
growing phenotype, with flattened morphology similar to fibroblast-like
cells. Northern hybridization showed that c-myc and c-Ha-ras expression
was high in HNE1 cells and undetectable in normal blood cells. c-myc was
down-regulated at 48 h of RA treatment. In contrast, the c-Ha-ras was
not affected. DNase I hypersensitive site analysis detected changes in
the regulatory elements of c-myc and c-Ha-ras genes. 5 hypersensitive
sites were found in the c-myc of HNE1 cells, while 3 hypersensitive
sites disappeared upon HNE1 induction. However, only 1 hypersensitive
site was found in c-Ha-ras of RA treated cells and controls. In normal
peripheral white blood cells, no DNase I hypersensitive sites were found
in the inactive c-myc and c-Ha-ras gene. CONCLUSION: RA can induce
differentiation in a nasopharyngeal carcinoma cell line at high
concentration of RA; HNE1 shows some similar patterns of DNase I
hypersensitive sites with the common one in other types of cells
expressing c-myc. The repression of c-myc expression with induction is
accompanied by the loss of 3 DNase-I hypersensitive sites; c-myc has
more than one inactive conformation.
5
UI - 11730993
AU - Erkal HS; Serin M; Cakmak A
TI -
Nasopharyngeal carcinomas: analysis of patient, tumor and treatment
characteristics determining outcome.
SO - Radiother Oncol 2001 Dec;61(3):247-56
AD - Department of Radiation Oncology, Ankara University Faculty of Medicine,
TR-06100, Ankara, Turkey.
PURPOSE: The present study reviews the experience in treatment of 447
patients with nasopharyngeal carcinomas, analyzing patient, tumor and
treatment characteristics determining outcome. MATERIALS AND METHODS:
There were 322 males and 125 females, their ages ranging from 7 to 85
years (median, 45 years). Two-hundred and seventy-two patients had World
Health Organization (WHO) type 3 carcinomas, 123 patients had T4 tumors
and 320 patients had metastatic cervical lymph nodes. Three-hundred and
eight patients were treated with radiation therapy alone and 139
patients with chemotherapy in combination with radiation therapy.
Cumulative radiation dose to primary tumor ranged from 50 to 76Gy
(median, 70Gy) and radiation dose to metastatic cervical lymph nodes
ranged from 46 to 74Gy (median, 66Gy). RESULTS: Follow-up ranged from
0.1 to 19.5 years (mean, 7.6 years). Local complete response was
achieved in 357 patients. In multivariate analysis, T-classification,
cumulative radiation dose to primary tumor and treatment with
chemotherapy in combination with radiation therapy predicted local
response. Nodal complete response was achieved in 272 patients. In
multivariate analysis, N-classification and radiation dose to metastatic
cervical lymph nodes predicted nodal response. Local failure was
observed in 70 patients, nodal failure in 35 patients and systemic
failure in 114 patients. Overall survival, disease-free survival and
disease-specific survival were 33, 32 and 37%, respectively, at 10
years. In multivariate analysis, age, T-classification,
N-classification, radiation dose and treatment with chemotherapy in
combination with radiation therapy predicted overall survival whereas
T-classification, N-classification, radiation dose and treatment with
chemotherapy in combination with radiation therapy predicted both
disease-free survival and disease-specific survival. CONCLUSIONS:
Radiation therapy alone appears to be an adequate and viable treatment
for patients with early-stage nasopharyngeal carcinomas, whereas
treatment with chemotherapy in combination with radiation therapy
appears to improve outcome for patients with advanced-stage
nasopharyngeal carcinomas.
6
UI - 11730994
AU - Fuwa N; Kano M; Toita T; Shikama N; Kodaira T; Matsumoto A; Kamata M;
TI -
Furutani K; Tatibana H
Alternating chemoradiotherapy for nasopharyngeal cancer using cisplatin
and 5-fluorouracil: a preliminary report of phase II study.
SO - Radiother Oncol 2001 Dec;61(3):257-60
AD - Department of Radiation Oncology, Aichi Cancer Center Hospital, 1-1
Kanokoden, Chikusaku, Nagoya, Japan.
Alternating chemoradiotherapy was performed in 35 patients with locally
advanced nasopharyngeal cancer. The median duration of follow-up was 20
months, and the 2-year progression free and overall survival rates were
83% (95% confidence interval: 66~101%) and 94% (95% CI: 84~105%),
respectively. This method may be useful in treating nasopharyngeal
cancer.
7
UI - 11730997
AU - Chao KS; Majhail N; Huang CJ; Simpson JR; Perez CA; Haughey B; Spector G
TI -
Intensity-modulated radiation therapy reduces late salivary toxicity
without compromising tumor control in patients with oropharyngeal
carcinoma: a comparison with conventional techniques.
SO - Radiother Oncol 2001 Dec;61(3):275-80
AD - Department of Radiation Oncology, Washington University Medical Center,
St. Louis, MO, USA. chao@radonc.wustl.edu
BACKGROUND AND PURPOSE: Intensity-modulated radiation therapy (IMRT)
offers superior dosimetric conformity for normal tissue sparing in
patients with oropharyngeal cancer. In this study, acute and late
toxicity, and tumor control were compared between conventional beam
treated at the Mallinckrodt Institute of Radiology. There were 260
patients with tonsil primary tumors and 170 patients with tumors arising
from the base of the tongue. Twenty-four (6%) patients had stage I
disease, 88 (20%) had stage II, 128 (30%) had stage III, and 190 (44%)
had stage IV disease. Patients were divided into five treatment groups.
Group I consisted of 109 patients who received preoperative CRT. Group
II consisted of 142 patients who received postoperative CRT. Group III
consisted of 153 patients who received definitive CRT. Inverse planning
IMRT (Peacock, NOMOS) was used to treat 14 patients postoperatively
(Group IV) and 12 patients definitively without surgery (Group V). Acute
and late normal tissue side-effects were scored according to the
Radiation Therapy Oncology Group radiation morbidity criteria. The
median follow-up was 3.9 years. RESULTS: The 2-year local-regional
control values for the five studied groups were 78, 76, 68, 100 and 88%,
respectively. The 2-year disease-free survival values for the five
studied groups were 68, 74, 58, 92 and 80%, respectively. IMRT
significantly reduced the incidence of late xerostomia. CONCLUSIONS:
When IMRT was compared with conventional techniques, the dosimetric
advantage of IMRT did translate into a significant reduction of late
salivary toxicity in patients with oropharyngeal carcinoma. No adverse
impact on tumor control and disease-free survival was observed in
patients treated with IMRT.
8
UI - 11730998
AU - Claus F; De Gersem W; Vanhoutte I; Duthoy W; Remouchamps V; De Wagter C;
TI -
De Neve W
Evaluation of a leaf position optimization tool for intensity modulated
radiation therapy of head and neck cancer.
SO - Radiother Oncol 2001 Dec;61(3):281-6
AD - Division of Radiotherapy, Ghent University Hospital (GUH), De Pintelaan
185, 9000 Ghent, Belgium.
BACKGROUND AND PURPOSE: Since 1996, patients are treated at Ghent
University Hospital with a multi-segment technique using MultiLeaf
Collimators. The segments were obtained by using the Beam's eye view
projections of the planning target volume (PTV) and the organs at risk
(OARs), after which the segments weights were optimized. To investigate
if optimization of the leaf positions would further improve the
intensity modulated radiation therapy (IMRT) plans, a tool optimizing
leaf positions and segment weights simultaneously, was developed. This
tool is called SOWAT, which is the acronym for segment outline and
weight adapting tool. MATERIAL AND METHODS: The tool evaluates the
effects of changing the position of each collimating leaf of all
segments on the value of the objective function. Only changes that
improve the value of the objective function are retained. Between
with IMRT. Two patient groups were distinguished: pharyngeal and
laryngeal tumors (n=17) and sinonasal tumors (n=13). A specific set of
physical endpoints was evaluated for each group. Dose statistics of the
treatment plans without and with SOWAT were analyzed. RESULTS: When
using SOWAT for the pharyngeal and laryngeal cases, the PTV dose
homogeneity increased with a median of 11% (range 2-27%), while the
maximum dose to the spinal cord was decreased for 14 of the 17 patients.
In four plans where parotid function preservation was a goal, the
parotid mean dose was lower than 26 Gy in one plan without SOWAT, and in
four plans with SOWAT. For the sinonasal tumors, the PTV dose
homogeneity increased with a median of 7% (range 1-14%). SOWAT lowered
the mean dose to 53 of the 63 optic pathway structures (retina, optic
nerve and optic chiasm). SOWAT leaves the number of segments unchanged
and has little or no effect on the delivery time. CONCLUSIONS: SOWAT is
a powerful tool to perform the final optimization of IMRT plans, without
increasing the complexity of the plan or the delivery time.
9
UI - 11775871
AU - Wen Z; Xiao J; Tang F; Tian Y; Zhao S; Chen B
TI -
[Expression of telomerase and its RNA in nasopharyngeal carcinoma]
SO - Chin Med J (Engl) 2000 Jun;113(6):525-8
AD - Department of Ear, Nose and Throat, Xiangya Hospital, Hunan Medical
University, Changsha 410008, China.
OBJECTIVE: To study the activity of telomerase and the expression of its
RNA in nasopharyneal carcinoma (NPC) and HNE1 cell lines of NPC.
METHODS: Telomerase activity was detected with telomeric repeat
amplification protocol (TRAP) PCR ELISA kit in 41 cases of NPC, 14 cases
of tissues adjacent to the carcinoma, and 19 cases of chronic
nasopharyngitis, HNE1 cell lines of NPC, HL60 cell lines of leukemia,
TUL1 cell lines of lung cancer, as well as three other kinds of normal
control cells. The sensitivity and specificity of telomerase assay were
also analyzed. Moreover, the expression of human telomerase RNA (hTR)
was studied in 27 cases of NPC, 19 cases of adjacent nasopharyngeal
tissues, and 17 cases of control groups by RT-nested PCR. RESULTS: The
telomerase activity was found increased in NPC and in tissues adjacent
to NPC with absorbance value (A value) of 1.15 U +/- 0.78 U and 1.04 U
+/- 0.67 U respectively, compared with chronic nasopharyngitis (A = 0.18
U +/- 0.09 U). In NPC with cervical lymphnodes involvement the
telomerase activity (A = 1.25 U +/- 0.79 U) was higher than in those
without involvement (A = 1.02 U +/- 0.71 U), P < 0.05. The telomerase
activity was also observed in HNE1 cell lines (A = 1.26 U +/- 0.97 U)
and in other two kinds of cancer cell lines, but not in the three kinds
of normal control cells. By contrast, no significant difference was seen
in the expression of hTR among the three nasopharyngeal biopsy groups (P
> 0.05). Finally, the sensitivity of telomerase assay was high (at an
amount of 10(2) HNE1 cells), and the specificity was also high (after
inactivation by heat or RNase, the telomerase activity was very low).
CONCLUSIONS: A high frequency of telomerase activity is commonly seen in
NPC, adjacent nasopharyngeal tissues, and HNE1 cell lines and is closely
associated with NPC with cervical lymphnodes involvement. Both
sensitivity and specificity of the telomerase assay are high. However,
owing to the fact that the expression of hTR has no obvious difference
between NPC and normal tissues and does not always correspond with the
telomerase activity, it would be better to do TRAP as well as hTR assays
for the activity and expression in assessing the carcinogenesis of NPC.
So, more intensive study on the role of hTR in the carcinogenesis of NPC
and on the exact relationship between hTR and telomerase is needed.
10
UI - 11776615
AU - Yang J; Tang X; Deng L
TI -
[Detailed deletion mapping of chromosome 9p21-22 in nasopharyngeal
carcinoma]
SO - Zhonghua Zhong Liu Za Zhi 1999 Nov;21(6):419-21
AD - Cancer Research Institute, Hunan Medical University, Changsha 410078.
OBJECTIVE: To further refine the extent of deletion on chromosome
9p21-22 in nasopharyngeal carcinoma(NPC) and provide evidence for
discovering new tumor suppressor genes. METHODS: Loss of heterozygosity
(LOH) on chromosome 9p21-22 was analyzed in 25 paired blood and tumor
samples by using 11 high-density microsatellite polymorphic markers.
RESULTS: Of the 25 cases, 17(68.0%) showed LOH at one or more loci.
Higher frequencies of LOH were found at four loci: D9S161(35.0%),
D9S1678(31.6%), D9S263 (33.3%) and D9S1853(33.3%). In 6 cases,
contiguous stretch of allelic loss was found. CONCLUSION: The minimal
common region of deletion might be defined between D9S161 and D9S1853
(approximately 2.7 cM in length) at 9p21.1, suggesting that inactivation
of one or more tumor suppressor genes located in this region may be an
important step in NPC.
11
UI - 11776622
AU - Qiu Y; Tian Y; Xiao J
TI -
[The role of cytokeratin 13 gene in human nasopharyngeal carcinoma]
SO - Zhonghua Zhong Liu Za Zhi 1999 Nov;21(6):444-6
AD - Department of Otolaryngology, Xiang Ya Hospital, Hunan Medical
University, Changsha 410008.
OBJECTIVE: To study the significance of cytokeratin 13 (CK13) gene
expression and its methylation in human nasopharyngeal carcinoma (NPC).
METHODS: The expression of CK13 in 32 cases of NPC and 8 cases of
chronic inflammatory diseases of nasopharyngeal epithelia (CIDNE) was
studied using Northern blot hybridization. The methylation pattern of
CK13 gene was analyzed by Southern blot hybridization using methylation
sensitive restriction endonuclease Hpa II and Msp I in NPC cell lines
HNE1 and normal human primary cultures of nasopharyngeal epithelial
cells. RESULTS: High expression of CK13 gene was found in 8(100%) CIDNE,
low-expression of the gene in 12(37.5%) NPC, negative expression in
9(28.1%) and high expression in 11(34.4%). The degree of methylation was
increased in NPC cell lines HNE1, compared to that of normal human
primary cultures of nasopharyngeal epithelial cells. CONCLUSION: The
expression of the CK13 gene in NPC is partly or completely down
regulated. It is possibly related to hyper-methylation of CK13 gene.
12
UI - 11755817
AU - Harn HJ; Fan HC; Chen CJ; Tsai NM; Yen CY; Huang SC
TI -
Microsatellite alteration at chromosome 11 in primary human
nasopharyngeal carcinoma in Taiwan.
SO - Oral Oncol 2002 Jan;38(1):23-9
AD - Department of Pathology, Tri-Service General Hospital, National Defense
Medical Center, Taipei, Taiwan. duke@ndmc.ndmctsgh.edu.tw
Nasopharyngeal carcinoma (NPC) is one of the common cancers in Taiwan
but is rare in western countries. The development of NPC involves
multiple genetic changes in tumorigenesis and progression of the
disease. To better understand genetic alterations in chromosome 11 which
occur in human (NPC), we examined tumor specimens and corresponding
non-cancerous tissue from 30 cases of NPC, using five microsatellite
polymorphic markers whose location has previously been defined. To
determine the clinical characteristics of MSI(+) or LOH, we performed
correlation analysis of the findings with clinicopathological
parameters. Loss of heterozygosity (LOH) was identified in 18 (60%) of
30 cases on at least one of the five markers. A high frequency of LOH
was found at the two loci: D11S912 (7/30, 23.33%) and D11S934 (6/30,
20.00%), both of which are located within 11q23-24. We also found that
14 specimens (14/30, 46.67%) exhibited microsatellite instability
(MSI(+)). Five (5/30, 16.67%) specimens exhibited MSI(+) in the
transformation growth factor beta receptor type II (TGF-beta RII) exon 3
which also exhibited on chromosome 11. LOH was found to be significantly
correlated with the T (tumor size) value (P=0.022) of Ho's system.
MSI(+) showed a significant correlation with the N (lymph node) value of
the UICC system (P=0.031). Our results suggest that multiple putative
tumor suppressor genes on chromosome 11 play a role in the development
of NPC. MSI(+) expression showed a predisposition to occur in the late
stage of NPC while LOH tended to occur in early stages of NPC. The
behavior of mutated TGF-beta RII exon 3, which appeared to serve as a
dysfunction brake during nasopharyngeal carcinogenesis, may be a target
gene in the defected mismatch repair system.
13
UI - 11755814
AU - Ferlito A; Shaha AR; Rinaldo A
TI -
The incidence of lymph node micrometastases in patients pathologically
staged N0 in cancer of oral cavity and oropharynx.
SO - Oral Oncol 2002 Jan;38(1):3-5
AD - Department of Otolaryngology-Head and Neck Surgery, University of Udine,
Policlinico Universitario, Piazzale S. Maria della Misericordia, 33100
Udine, Italy. clorl@dsc.uniud.it
The presence of nodal metastasis in head and neck cancer is an important
prognostic factor and crucial in making critical decisions regarding
postoperative radiation treatment and follow up. The final documentation
of nodal metastasis is still based on routine histopathological
evaluation of the lymph nodes in the neck. The newer technologies
including immunohistochemistry, molecular analysis and subserial
sectioning may increase the detection of lymph node micrometastases in
patients pathologically staged N0 in cancer of oral cavity and
oropharynx.
14
UI - 11755826
AU - Kovacs AF; Turowski B
TI -
Chemoembolization of oral and oropharyngeal cancer using a high-dose
cisplatin crystal suspension and degradable starch microspheres.
SO - Oral Oncol 2002 Jan;38(1):87-95
AD - Clinic for Maxillofacial Plastic Surgery, Klinikum der Johann Wolfgang
Goethe-Universitat Haus 21, Theodor-Stern-Kai 7, 60590 Frankfurt am
Main, Germany. a.kovacs@em.uni-frankfurt.de
The aim of the study was to achieve intensification of intraarterial
chemotherapy of head and neck cancer with high-dose cisplatin by
establishing a new method of chemoembolization which can be routinely
used without the earlier drawbacks of the method (low drug dosage due to
early occlusion of the small head and neck vessels, danger of local
damage). Thirty two patients with previously untreated oral and
oropharyngeal squamous cell carcinomas of all stages were treated by at
least one superselective chemoembolization via femoral approach using a
new preparation format of 150 mg/m(2) cisplatin which is an aqueous
crystal suspension. In defined cases, combination with the delivery of
degradable starch microspheres (DSM). Systemic neutralization with
sodium thiosulfate. Primary end points were tolerance and response.
Subsequent treatment was surgery or radiation. Chemoembolization
succeeded in all 37 interventions to date. Overall response after one
cycle was 64.7% using the cisplatin crystal suspension only (n=17) and
86.6% using additional DSM chemoembolization (n=15), as assessed 3 weeks
after treatment. Systemic toxicity was extremely low, local side-effects
(pain, swelling, small necrosis) were pronounced after additional
delivery of DSM. There have been three complications (tracheotomy due to
swelling, temporary facial paralysis twice due to embolization of the
geniculate ganglion). Using the high-dose cisplatin crystal suspension,
chemoembolization can routinely be used in the head and neck area as
neoadjuvant therapy. Response was better than with former comparable
regimens. The additional delivery of DSM was complicated, restricted to
certain areas and unreliable in the dosage needed and might be omitted,
therefore.
15
UI - 11802047
AU - Stoeckli SJ; Pfaltz M; Steinert H; Schmid S
TI -
Histopathological features of occult metastasis detected by sentinel
lymph node biopsy in oral and oropharyngeal squamous cell carcinoma.
SO - Laryngoscope 2002 Jan;112(1):111-5
AD - Clinic of Otorhinolaryngology-Head and Neck Surgery, University Hospital
Zurich, Frauenklinikstrasse 24, CH-8091 Zurich, Switzerland.
stoeckli@orl.usz.ch
OBJECTIVES: Sentinel lymph node biopsy has been introduced for head and
neck cancer with promising results. Research in breast cancer has
revealed different histopathological features of occult lymph node
metastasis with possibly different clinical and prognostic implications.
The aim of the study was to evaluate the histopathological features of
occult metastasis detected by sentinel lymph node in oral and
oropharyngeal squamous cell carcinoma. STUDY DESIGN: Prospective.
METHODS: According to Hermanek (5), occult metastasis was differentiated
into isolated tumor cells and infiltration of lymph node parenchyma
smaller than 2 mm in diameter (micrometastasis) and larger than 2 mm in
diameter (metastasis). RESULTS: Occult metastases were found in 6 of 19
(32%) sentinel lymph nodes. Three patients showed micrometastasis with a
mean size of 1.4 mm (range, 1.2-1.5 mm), the first with three separate
micrometastases within the same sentinel lymph node, the second with an
additional cluster of isolated tumor cells within the same sentinel
lymph node, and the third with an additional micrometastasis in one
lymph node of the elective neck dissection. Two patients had
macrometastasis (3.4 and 8 mm), both with multiple metastases in the
elective neck dissection. One patient had two clusters of isolated tumor
cells in the sentinel lymph node and an additional cluster of isolated
tumor cells in one lymph node of the elective neck dissection.
CONCLUSIONS: Occult metastasis can be subdivided histopathologically in
isolated tumor cells, micrometastasis, and macrometastasis. We present
the first study describing a great variety of these subtypes in sentinel
lymph nodes from head and neck squamous cell carcinoma. Because the
independent prognostic factor and clinical relevance of these subtypes
is still unclear, we emphasize the importance of reporting these
findings uniformly and according to well-established criteria.
16
UI - 11802048
AU - Tsai MH; Lin CD; Hsieh YY; Chang FC; Tsai FJ; Chen WC; Tsai CH
TI -
Prognostic significance of the proline form of p53 codon 72 polymorphism
in nasopharyngeal carcinoma.
SO - Laryngoscope 2002 Jan;112(1):116-9
AD - Department of Otolaryngology, China Medical College Hospital, No. 2
Yuh-Der Road, Taichung 400, Taiwan.
OBJECTIVES/ HYPOTHESIS: An important tumor suppressor gene, p53, plays a
role in the regulation of cell progression and prevention of
carcinogenesis. Mutated p53 is related to cell progression and
malignancy. We aimed to evaluate the association between nasopharyngeal
carcinoma and p53 polymorphism. STUDY DESIGN: Case control study.
METHODS: All individuals were divided into two groups: nasopharyngeal
carcinoma (n = 50) and non-nasopharyngeal carcinoma groups (n = 59).
Their p53 codon 72 polymorphisms (arginine [Arg] homozygotes,
heterozygotes, proline [Pro] homozygotes) were detected by polymerase
chain reaction. Associations between nasopharyngeal carcinoma and p53
polymorphism were evaluated. RESULTS: Distributions of various p53
polymorphisms significantly differed between the two groups. We noted a
dominant presentation of Pro homozygotes in the nasopharyngeal carcinoma
population over that in the non-nasopharyngeal carcinoma population.
Proportions of Pro homozygotes and heterozygotes and Arg homozygotes
were 32%, 28%, and 40% in the nasopharyngeal carcinoma population and
were 13.5%, 44.1%, and 42.4% in the non-nasopharyngeal carcinoma
population, respectively. CONCLUSIONS: An association exists between
nasopharyngeal carcinoma and p53 codon 72 polymorphism. The p53 Pro
homozygotes are to a higher risk of development of nasopharyngeal
carcinoma.
17
UI - 11801955
AU - Shnayder Y; Kuriakose MA; Yee H; Chen FA; DeLacure MD; Xue XN; Jagirdar
TI -
J
Adhesion molecules as prognostic factors in nasopharyngeal carcinoma.
SO - Laryngoscope 2001 Oct;111(10):1842-6
AD - Division of Head and Neck Surgery and Oncology, Department of
Otolaryngology, New York University School of Medicine, New York, NY
10016, USA.
OBJECTIVE/HYPOTHESIS: To identify the significance of molecular markers
in determining the risk of recurrence and distant metastases in
nasopharyngeal carcinoma. STUDY DESIGN: In this retrospective case
study, we evaluated archival nasopharyngeal carcinoma specimens for
patterns of expression of E-cadherin, beta-catenin, c-erb-B2, and Ki-67,
which have been demonstrated to be important in other tumors. METHODS:
Fifty-four cases of nasopharyngeal carcinoma were identified, with a
maximum follow-up of 13 years. The histopathological sections were
stained using an automated immunohistochemical stainer (NexES, Ventana
Medical Systems, Tucson, AZ) for E-cadherin (Zymed Laboratories [San
Francisco, CA] and Transduction Laboratories [Lexington, KY] clones),
beta-catenin (Zymed), c-erb-B2 (Ventana Medical Systems), and Ki-67
(Novocastra, Burlingame, CA). The numbers of positively staining cells
were scored as follows: 0%, 1% to 33%, 34% to 66%, or greater than 67%.
RESULTS: E-cadherin (Zymed) stained positively in only one case. The
Transduction Laboratories clone demonstrated a spectrum of staining in
all cases, from complete to disrupted to no identifiable membranous
staining. The staining was consistently absent at the advancing tumor
border, regardless of stage. The loss of beta-catenin expression did not
correlate with that of E-cadherin or with clinical outcomes. No staining
was identified for c-erb-B2. Ki-67 staining was variable and did not
correlate with clinical outcomes. CONCLUSIONS: Altered expression or
loss of E-cadherin, or both, may result in loss of function,
particularly at the infiltrating edge, with resultant loss of cell
polarity, cell migration, and eventual metastasis. The interpretation of
E-cadherin staining depends on antibody source. In contrast to recent
studies, beta-catenin expression is not altered and c-erb-B2 expression
not identified, suggesting that these markers are not important in the
prognosis of nasopharyngeal carcinoma.
18
UI - 10993929
AU - Feng P; Ren EC; Liu D; Chan SH; Hu H
TI -
Expression of Epstein-Barr virus lytic gene BRLF1 in nasopharyngeal
carcinoma: potential use in diagnosis.
SO - J Gen Virol 2000 Oct;81(Pt 10):2417-23
AD - Department of Microbiology, Faculty of Medicine and Institute of
Molecular Agrobiology, National University of Singapore, Block MD4/4A, 5
Science Drive 2, Singapore 117597, Republic of Singapore.
Tumour cells of undifferentiated nasopharyngeal carcinoma (NPC)
consistently harbour Epstein-Barr virus (EBV) genes. Expression of mRNA
transcripts associated with EBV latency has been demonstrated in such
cells. However, expression of EBV lytic genes has not been well
elucidated, although various lines of evidence have suggested that there
is EBV replication in NPC tumour cells. We have studied mRNA expression
of representative EBV lytic genes by RT-PCR in nasopharynx biopsies
obtained from NPC and control individuals. In both NPC and control
biopsies, EBV lytic genes BZLF1, BALF2 and BCLF1 were detected readily.
However, BRLF1 was detected in NPC biopsies only. The BRLF1 gene was
then cloned and expressed in vitro, and the protein product, Rta, was
used as an antigen to detect specific antibodies by immunoprecipitation
in plasma samples obtained from NPC patients and healthy controls. IgG
antibodies directed against Rta were detected in 44 of 53 NPC plasma
samples (83.0%), but only in 1 of 53 control samples (1.9%).
Furthermore, the antibody binding regions were found in the C-terminal
two-thirds of Rta. This serological result confirms indirectly that
BRLF1 is specifically expressed in NPC tumour cells. Rta might play an
important role in NPC pathogenesis, considering its multiple functions
in EBV replication and cell cycles. Moreover, the detection of IgG
antibodies directed against Rta could be developed into a diagnostic
parameter for NPC.
19
UI - 11801968
AU - Sinha UK; Chang KE; Shih CW
TI -
Reconstruction of pharyngeal defects using AlloDerm and
sternocleidomastoid muscle flap.
SO - Laryngoscope 2001 Nov;111(11 Pt 1):1910-6
AD - Department of Otolaryngology-Head and Neck Surgery, Keck School of
Medicine, University of Southern California, Los Angeles, California
90033, USA. sinha@hsc.usc.edu
OBJECTIVE: To report our experience in reconstructing pharyngeal defects
that cannot be closed primarily, using acellular dermal matrix
(AlloDerm, LifeCell Corp., Branchburg, NJ) and sternocleidomastoid (SCM)
muscle flap. STUDY DESIGN: Prospective, nonrandomized, nonblinded study
in the setting of an academic tertiary care medical center. METHODS:
Fourteen patients underwent reconstruction of through-and-through
defects of partial pharyngectomy for squamous cell carcinoma using
AlloDerm graft. Primary closure of the defects was not possible because
of substantial loss of pharyngeal tissue. The graft was reinforced with
superiorly based SCM muscle flap in 10 patients. The remaining four
patients did not receive any flap. Eleven lesions involved the lateral
pharyngeal wall, and three were piriform sinus lesions. Patients were
followed for a period ranging from 3 to 20 months. Outcome measures were
determined on several parameters including graft take rate, evidence of
graft contracture, postoperative complications, resumption of diet,
intelligibility of speech, and decannulation. All patients were
evaluated by a speech pathologist by means of a bedside swallowing
examination. Five patients had videofluoroscopic studies. The three
patients with piriform sinus lesions underwent videostroboscopic
examination to assess vocal cord function. RESULTS: There was a high
success rate for graft take. Two patients developed postoperative
fistulas that resolved with conservative management.One of the 10
patients with SCM flap and one of the 4 patients without SCM flap
developed fistulas. Clinically significant graft contracture or
pharyngeal stenosis was not observed in any patients. All patients
resumed oral intake. Ten patients resumed a normal diet, two tolerated a
soft diet, and two could take purees. Decannulation was successful in
all patients. Two of the three patients with piriform sinus lesions had
vocal cord palsies after surgery resulting in breathy dysphonia. They
underwent type I thyroplasty for vocal rehabilitation. All patients had
intelligible speech. CONCLUSIONS: Thick AlloDerm, reinforced with SCM
muscle or cervical soft tissue, provides a useful alternative option for
reconstruction of pharyngeal defects that cannot be closed primarily. It
is safe and effective and provides excellent functional outcomes.
20
UI - 11802211
AU - Cheng WM; Chan KH; Chen HL; Luo RX; Ng SP; Luk W; Zheng BJ; Ji MF; Liang
TI -
JS; Sham JS; Wang DK; Zong YS; Ng MH
Assessing the risk of nasopharyngeal carcinoma on the basis of EBV
antibody spectrum.
SO - Int J Cancer 2002 Feb 1;97(4):489-92
AD - Cancer Research Institute of Zhong Shan City, Zhongshan, China.
We have evaluated the performance of 3 new EBV ELISA for the diagnosis
of nasopharyngeal carcinoma (NPC). The tests were specific for EBNA 1
IgA, EBNA 1 IgG and zta IgG, respectively. Their distinct antigenic
specificity permits these assays to be used in concert in an approach
that differentiates patients and apparently healthy subjects on the
basis of their antibody spectrum. By so exploiting a distinguishing
feature of NPC first described by the late Werner Henle that the
patients sustain high levels of a broad spectrum of serum EBV
antibodies, this approach achieved a sensitivity of 92% and a
specificity of 93%, surpassing the performance of each of these assays
individually. The enhanced performance is especially useful in
population screening. It was shown that relative risk of NPC sustained
by apparently healthy subjects residing in a high incidence area for NPC
in the Pearl River estuary in Southern China may vary according to EBV
antibody spectrum. The risk of the cancer was markedly reduced with odds
ratios of 0.009 for 59% of those who had low level of all 3 antibodies.
The risk was increased as antibody spectrum broadens and the risk was
the highest with an odds ratio of 138 for 0.4% of those who had high
levels of all 3 antibodies. Thus, EBV antibody spectrum may serve to
guide follow-up measures for early detection of the cancer and/or risk
counseling according to level of the risk of the cancer sustained by the
screened individuals. Copyright 2001 Wiley-Liss, Inc.
21
UI - 11802221
AU - Lin JC; Chen KY; Wang WY; Jan JS; Liang WM; Wei YH
TI -
Evaluation of cytokeratin-19 mRNA as a tumor marker in the peripheral
blood of nasopharyngeal carcinoma patients receiving concurrent
chemoradiotherapy.
SO - Int J Cancer 2002 Feb 1;97(4):548-53
AD - Institute of Clinical Medicine, College of Medicine, National Yang-Ming
University, Taipei, Taiwan, Republic of China. jclin@vghtc.vghtc.gov.tw
The reverse transcriptase-polymerase chain reaction (RT-PCR) technique
is a tool capable of detecting minute quantities of circulating tumor
cell-derived transcripts. Nasopharyngeal carcinoma (NPC) is a rapidly
growing tumor of epithelial origin and high metastatic potential. The
aim of our study is to investigate the clinical value of circulating
distant metastasis were uniformly treated by concurrent
chemoradiotherapy. Peripheral blood samples were collected prospectively
before treatment and subjected to a nested RT-PCR assay. Measures were
taken to prevent contamination and pseudogene interference. PCR products
of positive results were verified by restriction enzyme Hae II and
direct sequencing. Under our nested RT-PCR experimental conditions,
33.3% (19/57) clinically nonmetastatic NPC patients had CK-19 mRNA in
their blood. The positive detection rates of CK-19 mRNA in the
peripheral blood for different stages were 20.0% for stage II, 31.6%
stage III and 43.5% stage IV (p = 0.1335). After a median follow-up time
of 35 months, 2 patients had recurrences of their primary tumors and 14
developed distant metastases without locoregional recurrence. Nine of 19
(47.4%) CK-19 mRNA-positive patients and 5 of 38 (13.2%) CK-19
mRNA-negative patients developed distant metastasis (p = 0.00826). The
3-year metastasis-free survival rates were 49.9% for patients with
detectable CK-19 and 85.9% for those with undetectable CK-19 (p =
0.0089, log-rank test). Our data suggest that the presence of CK-19 mRNA
in the peripheral blood may be a potential marker of micrometastasis for
NPC. Copyright 2001 Wiley-Liss, Inc.
22
UI - 8892451
AU - Teo P; Yu P; Lee WY; Leung SF; Kwan WH; Yu KH; Choi P; Johnson PJ
TI -
Significant prognosticators after primary radiotherapy in 903
nondisseminated nasopharyngeal carcinoma evaluated by computer
tomography.
SO - Int J Radiat Oncol Biol Phys 1996 Sep 1;36(2):291-304
AD - Clinical Oncology Department, Prince of Wales Hospital, Shatin, Hong
Kong.
PURPOSE: To evaluate the significant prognosticators in nasopharyngeal
carcinoma (NPC). METHODS AND MATERIALS: From 1984 to 1989, 903
treatment-naive nondisseminated (MO) NPC were given primary radical
radiotherapy to 60-62.5 Gy in 6 weeks. All patients had computed
tomographic (CT) and endoscopic evaluation of the primary tumor.
Potentially significant parameters (the patient's age and sex, the
anatomical structures infiltrated by the primary lesion, the cervical
nodal characteristics, the tumor histological subtypes, and various
treatment variables were analyzed by both monovariate and multivariate
methods for each of the five clinical endpoints: actuarial survival,
disease-free survival, free from distant metastasis, free from local
failure, and free from regional failure. RESULTS: The significant
prognosticators predicting for an increased risk of distant metastases
and poorer survival included male sex, skull base and cranial nerve(s)
involvement, advanced Ho's N level, and presence of fixed or partially
fixed nodes or nodes contralateral to the side of the bulk of the
nasopharyngeal primary. Advanced patient age led to significantly worse
survival and poorer local tumor control. Local and regional failures
were both increased by tumor infiltrating the skull base and/or the
cranial nerves. In addition, regional failure was increased
significantly by advancing Ho's N level. Parapharyngeal tumor
involvement was the strongest independent prognosticator that determined
distant metastasis and survival rates in the absence of the overriding
prognosticators of skull base infiltration, cranial nerve(s) palsy, and
cervical nodal metastasis. CONCLUSIONS: The significant prognosticators
are delineated after the advent of CT and these should form the
foundation of the modern stage classification for NPC.
23
UI - 10421542
AU - Ozyar E; Yildiz F; Akyol FH; Atahan IL
TI -
Comparison of AJCC 1988 and 1997 classifications for nasopharyngeal
carcinoma. American Joint Committee on Cancer.
SO - Int J Radiat Oncol Biol Phys 1999 Jul 15;44(5):1079-87
AD - Department of Radiation Oncology, Hacettepe University, Faculty of
Medicine, Ankara, Turkey. enis@ada.net.tr
PURPOSE: A comparison of American Joint Committee on Cancer (AJCC) 1988
and 1997 nasopharyngeal carcinoma (NPC) classifications was made in
terms of patient distribution and efficacy in predicting prognosis.
METHODS AND MATERIALS: Between 1993-1997, 90 patients (64 M, 26 F) with
non-metastatic NPC were treated. The mean age was 42.02 (range: 9-82)
years old. Histopathological diagnosis was WHO 2 and 3 in 83 (92.2%)
patients. All patients were prospectively staged using AJCC 1988 and
modified Ho's classifications (1989) and these data were stored in a
computer database. Retrieval of this information enabled us to restage
patients according to the AJCC 1997. Median follow-up was 38 months.
RESULTS: According to the AJCC 1988 there were 2 (2.2%), 6 (6.7%), 13
(14.4%), and 69 (76.7%) patients in Stage I, II, III and IV,
respectively. Same figures were 8 (8.8%), 21 (23.3%), 26 (28.9%), and 35
(38.8%), according to AJCC 1997. Three year overall survival (OS) rates
were 100%, 100%, 67%, and 62% for patients Stage I, II, III, and IV
according to the AJCC 1988 and 100%, 72%, 65%, and 55%, (I vs. IV; p =
0.03, I vs. III; p = 0.05) respectively, according to the AJCC 1997.
Three year loco-regional relapse free survival (LRRFS) rates were 50%,
100%, 100%, and 83% (I vs. III; p = 0.03) for patients in Stage I, II,
III, and IV according to the AJCC 1988. Same figures were 88%, 90%, 89%,
and 85% according to the AJCC 1997. Three year distant metastasis free
survival (DMFS) rates were 100%, 100%, 82%, and 67% for patients in
Stage I, II, III, and IV according to the AJCC 1988. Same figures were
100%, 74%, 80%, and 57% (I vs. IV; p = 0.03) according to the AJCC 1997.
We did not observe any significant difference in LRRFS among T stages
for both staging system and the N stage was the primary determinant for
DMFS in both systems. CONCLUSIONS: We observed a better patient
distribution with AJCC 1997 comparing to AJCC 1988. The new
classification also attained better statistical significances among
stages in the OS and DMFS rates.
24
UI - 10802366
AU - Altun M; Tenekeci N; Kaytan E; Meral R
TI -
Locally advanced nasopharyngeal carcinoma: computed tomography findings,
clinical evaluation, and treatment outcome.
SO - Int J Radiat Oncol Biol Phys 2000 May 1;47(2):401-4
AD - Department ofRadiation Oncology, University of Istanbul, Istanbul,
Turkey. altun@istanbul.edu.tr
PURPOSE: We present our experience with computed tomography (CT) for
delineating the extent of bone erosion in nasopharyngeal carcinoma (NPC)
and propose that a new subdivision of Stage T4 disease be added to the
staging criteria for cases of minimal bone disease, defined as erosion
of the base of the sphenoid or the pterygoid without cranial nerve (CN)
involvement. METHODS AND MATERIALS: We retrospectiv
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