Search PubMed⌕ Search

Biomedical subjects

W K Hong

Publications and source records attributed to W K Hong.

At least 361 records · Page 20Linked to original sources
PubMed1988

Adjuvant chemotherapy of head and neck cancer: the past, the present, and the future.

In the past two decades, overall survival of head and neck cancer patients has not improved significantly, despite improvements in surgery and radiotherapy techniques. In the early stages, head and neck cancer can be cured with surgery and/or radiotherapy. However, in patients who present with locally advanced lesions after combined surgery and radiation treatment, local recurrences develop in 50% to 60%, distant metastases in 20% to 30%, and a second primary neoplasm in 10% to 40%. Five-year survival for patients with stages III or IV disease who undergo standard treatment ranges from 0 to 60%. Traditional chemotherapy has been used for those patients with recurrent disease after surgery and/or radiotherapy, but the results have been disappointing. Therefore, chemotherapy as an induction regimen has been incorporated into combined modality treatment. The following specific issues of adjuvant chemotherapy will be addressed: (1) rationale for theoretic advantages of induction chemotherapy in head and neck cancer; (2) critical review of controlled and uncontrolled studies of adjuvant chemotherapy; (3) sequential chemotherapy and radiotherapy; (4) simultaneous chemotherapy and radiotherapy in head and neck cancer; (5) issues of surgical and radiotherapy complications following induction chemotherapy; (6) ongoing clinical trials of chemotherapy in head and neck cancer in the United States; (7) development of effective induction regimens in head and neck cancer; (8) future directions of adjuvant chemotherapy in head and neck cancer.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Differential effects of retinoic acid on the in vitro growth and cell-surface glycoconjugates of 2 human head and neck squamous-cell carcinomas.

As a part of an assessment of the potential use of retinoids in preventive and adjuvant treatment of HNSCC, we examined the effects of beta-all-trans retinoic acid (RA) on the growth and cell-surface glycoconjugates of 2 HNSCC cell lines. These lines, designated 1483 and 183A, were established from an untreated patient with a well-differentiated SCC of the retromolar trigone and one with a poorly differentiated SCC of the tonsil. Whereas the 1483 cells were sensitive to RA in that their anchorage-dependent growth, their colony growth on solid substratum, and their anchorage-independent growth in semi-solid agarose gel were all inhibited in a dose-dependent fashion by RA concentrations in the range between 1 nM and 10 microM, the 183A cells were not inhibited by RA. Their anchorage-dependent growth and colony formation were stimulated by RA, whereas their anchorage-dependent colony formation was not altered. Cell-surface glycoconjugates were modulated by RA in the sensitive 1483 cells but not in the 183A cells. Treatment of the 1483 cells resulted in a large increase in the cell-surface labelling of high-molecular-weight (Mr greater than 400,000) galactoglycoconjugates and sialoglycoconjugates, as well as an Mr 280,000 sialoglycoconjugate. Glycoconjugates with similar electrophoretic mobilities in polyacrylamide gels were labelled intensely on the surface of the 183A cells even before RA treatment and only minor changes were noticed in their labelling after treatment. These results demonstrate that RA can exert different effects on different HNSCC lines, and suggest that correlations might exist between responsiveness to RA and the stage of differentiation of the HNSCC, and between modulation of cell growth and enhancement of cell-surface glycoconjugate glycosylation by RA.

Carbohydrates↗
PubMed1987

Estrogen receptors in normal salivary gland and salivary gland carcinoma.

To access for possible hormone dependence, 19 samples of normal salivary gland tissue and 14 samples of salivary gland carcinoma were quantitatively analyzed for estrogen receptor (ER) content. A receptor protein content of greater than or equal to 1 fmol/mg of cytosol protein was considered positive. Ten (77%) of 13 histologically normal samples, and four (80%) of five tumor samples obtained from male patients contained ER by this criterion, as did five (83%) of six normal samples and eight (88%) of nine tumor samples obtained from female patients. Mean ER concentrations plus or minus SE in male-derived samples were 2.02 +/- .42 fmol/mg of cytosol protein for normal tissue and 4.35 +/- 1.5 fmol/mg of cytosol protein for tumor tissue; mean ER concentrations in female-derived samples were 3.48 +/- 1.1 fmol/mg of cytosol protein for normal tissue and 12.64 +/- 6.4 fmol/mg of cytosol protein for tumor tissue. Four of eight tumors in women had levels considered to be "hormonally dependent" in breast carcinoma. These findings indicate that salivary gland carcinomas may be hormone-dependent.

Adenocarcinoma↗
PubMed1987

Polyamine metabolism in carcinoma of the oral cavity compared with adjacent and normal oral mucosa.

In this study, polyamine biosynthesis required for cellular proliferation showed elevated levels in neoplastic cells. Putrescine, spermidine, and spermine, as well as the rate-limiting enzyme ornithine decarboxylase, were measured to evaluate differences in tissue concentration in squamous cell carcinoma of the oral cavity, and in the normal adjacent, buccal, and retromolar trigone tissues. Mean polyamine levels (nanomoles per gram of tissue +/- standard error of the mean) were significantly elevated in tumor tissue at 136 +/- 42 nmol/g for putrescine compared with 41 +/- 9 nmol/g in adjacent, 25 +/- 5 nmol/g in buccal, and 41 +/- 14 nmol/g in retromolar trigone tissues. Tumor spermidine was 415 +/- 41 nmol/g compared with 192 +/- 34 nmol/g in adjacent, 184 +/- 34 nmol/g in buccal, and 214 +/- 63 nmol/g in retromolar trigone tissues. Tumor spermine was 461 +/- 41 nmol/g compared with 236 +/- 30 nmol/g in adjacent, 233 +/- 35 nmol/g in buccal, and 269 +/- 59 nmol/g in retromolar trigone samples. Ornithine decarboxylase activity was highly variable in tumor tissues. High levels of polyamines appear to be specific for this malignancy, whereas ornithine decarboxylase activity is not. Measurement of polyamine content may be useful in evaluating epithelial changes in the oral cavity.

Carcinoma, Squamous Cell↗
PubMed1986

13-cis-retinoic acid in the treatment of oral leukoplakia.

13-cis-Retinoic acid has been reported to be effective in treating oral leukoplakia. We randomly assigned 44 patients with this disease to receive 13-cis-retinoic acid (24 patients) or placebo (20), 1 to 2 mg per kilogram of body weight per day for three months, and followed them for six months. There were major decreases in the size of the lesions in 67 percent (16 patients) of those given the drug and in 10 percent (2 patients) of those given placebo (P = 0.0002); dysplasia was reversed in 54 percent (13 patients) of the drug group and in 10 percent (2 patients) of the placebo group (P = 0.01). The clinical response to the drug correlated with the histologic response in 56 percent (9 of 16) of the patients evaluated. Relapse occurred in 9 of 16 patients two to three months after treatment ended. The toxic effects of the drug were acceptable in all but two patients. Cheilitis, facial erythema, and dryness and peeling of the skin were common; conjunctivitis and hypertriglyceridemia also occurred. All adverse reactions could be reversed by reducing the dose or temporarily discontinuing the drug. We conclude that 13-cis-retinoic acid, even in short-term use, appears to be an effective treatment for oral leukoplakia and has an acceptable level of toxicity.

Aged↗
PubMed1986

Combination chemotherapy and radiation therapy. The medical management of epidural spinal cord compression from testicular cancer.

Radiation and surgery are the mainstays of treatment for epidural spinal cord compression. There are reports in the literature, however, in which the use of chemotherapy alone or in combination with radiation and surgery has resulted in improved patient response. We present two patients with spinal cord compression from testicular cancer who developed progressive paraplegias that were successfully reversed with combination chemotherapy, steroids, and radiotherapy. In one case, the patient was unable to receive more than 600 rad (6 Gy) of radiation and his improvement was clearly related to the chemotherapy he received. In treating tumors causing spinal cord compression that are thought to be chemosensitive, one should consider adding chemotherapy to radiation or using chemotherapy alone if the options of surgery or radiation are not available.

Adrenal Cortex Hormones↗
PubMed1986

Epirubicin: a review of the pharmacology, clinical activity, and adverse effects of an adriamycin analogue.

Epirubicin (4'-epidoxorubicin) is an antineoplastic agent derived from doxorubicin. The compounds differ in the configuration of the hydroxyl group at the 4' position. Epirubicin, like doxorubicin, exerts its antitumor effects by interference with the synthesis and function of DNA and is most active during the S phase of the cell cycle. Epirubicin is administered by intravenous (IV) injection. It is metabolized by the liver and primarily eliminated in the bile. About 10% of the drug is eliminated in the urine. Dosage adjustments are recommended for patients with liver metastases or elevated liver function tests. The elimination half-life of epirubicin is 30 to 40 hours. Clinical studies indicate activity in breast cancer, non-Hodgkin's lymphomas, ovarian cancer, soft-tissue sarcomas, and pancreatic cancer. There is also evidence of activity against gastric cancer, small-cell lung cancer, and acute leukemia. Epirubicin has limited activity as a single agent against head and neck tumors or non-small-cell lung cancer, but may be beneficial in combination with other agents. The overall activity of epirubicin appears to be comparable with that of doxorubicin. However, more studies are needed to define its role in combination chemotherapeutic regimens. The acute dose-limiting toxicity of epirubicin is myelosuppression. Nausea, vomiting, and alopecia are also common. Epirubicin may cause transient cardiac arrhythmias and alterations of the electrocardiogram. Chronic therapy is limited, but available data indicate that epirubicin can be administered in higher cumulative doses than doxorubicin before cardiotoxicity limits further therapy.

Bone Marrow↗
PubMed1985

Patterns of relapse in locally advanced head and neck cancer patients who achieved complete remission after combined modality therapy.

Relapse patterns in patients with locally advanced head and neck cancer who achieved complete remission were evaluated. After combined modality therapy with induction chemotherapy followed by surgery and/or radiotherapy, 71 of 103 patients were clinically free of disease. The 5-year recurrence rate was estimated at 51%, with a 39% local and 26% distant failure rate by 5 years. The factors significantly affecting the relapse patterns were: the site of the primary tumor (those with oral cavity lesions were more likely to fail locally, whereas hypopharynx patients had a higher risk of distant metastases); the type of definitive local treatment (those patients who received surgery and radiotherapy were at lower risk of pure local failure); TN Stage (patients with T4N3 or T3N3 tumor were at higher risk of both local and distant failure); and time to response and presence of oropharyngeal lesions (patients who had a longer period from diagnosis to final complete response [CR] and patients with oropharyngeal primaries were at higher risk for simultaneous local and distant failure). Type of chemotherapy, patient age, tumor differentiation, and response to induction chemotherapy did not significantly influence the patterns of relapse. A combined modality approach with induction chemotherapy, surgery, and/or radiotherapy does not seem to reduce the incidence of distant metastases significantly.

Adult↗
PubMed1985

The value of the bone scan and bone marrow biopsy staging small cell lung cancer.

The charts of 112 patients with small cell lung cancer were reviewed in a retrospective fashion in order to define the role of the radionuclide bone scan and bone marrow biopsy in the staging of this disease. Both a radionuclide bone scan and bone marrow biopsy were performed on all patients at the time of diagnosis. Sixty-one percent of patients had a negative bone scan and negative biopsy; 22% had a positive bone scan and negative biopsy; 8% had a negative scan and positive biopsy; and 9% had a positive scan and positive biopsy. In 21 of the 44 patients with osseous involvement, no other focus of distant metastasis was found. The bone scan showed greater than or equal to 3 areas of increased uptake in 15 patients, 2 areas of increased uptake in 13 patients, and 1 area in 7 patients. The number of patients with bone marrow biopsy results positive for tumor in these 3 groups were 5, 3, and 2, respectively. Our study shows a lack of correlation between bone scan and bone marrow biopsy results. The bone scan and bone marrow biopsy identify independent patterns of osseous metastasis. Both procedures should be performed in the evaluation of patients with small cell lung cancer.

Biopsy↗
PubMed1985

Plasma exchange in six patients with advanced cancers of the head and neck.

Six patients with advanced squamous cell cancers of the head and neck, with serum IgA greater than or equal to 400 mg/dl and IgE less than or equal to 1000 IU/ml, underwent a trial of six 2-liter plasma exchanges over a 2-3-week period. Disease progressed in patients 1, 2, and 4, who died on days 44, 72, and 159. The tumor in patients 3 and 6 regressed significantly, repeatedly in patient 3 over each of four courses of apheresis. Tumor recurred in both patients after cessation of treatment, and they died at days 420 and 79. Patient 5, with inoperable disease, received full-dose radiotherapy immediately following the course of apheresis, and showed complete response in the primary lesion and a major response in the extensive lymph node metastases, dying on day 421 of apparently unrelated causes. Serum IgE in the three patients experiencing tumor regression rose paradoxically during plasmapheresis. Only patient 3 had an elevated level of soluble E-receptor suppressor factor prepheresis; the serum of patient 6 was lymphocytotoxic prepheresis but this activity decreased or disappeared during each of the exchanges studied. Controlled trials are now indicated.

Aged↗
PubMed1985

The influence of cytoreductive surgery on the response to chemotherapy of a rat renal cancer.

The potential ability of cytoreductive surgery to increase the effectiveness of chemotherapy (vindesine) was tested utilizing male Wistar Lewis rats transplanted simultaneously with intraperitoneal and flank implants of a spontaneously arising renal adenocarcinoma. Cytoreduction was accomplished in some animals by removing the flank tumor 5-7 weeks following implantation; all animals received vindesine (IP injection of 0.5 mg/kg on two successive weeks). While vindesine reduced tumor growth, in no case did the addition of cytoreductive surgery enhance the effect of chemotherapy. The addition of cytoreductive surgery to marginally effective chemotherapy was found to be ineffective or even detrimental.

Animals↗
PubMed1985

Transformation of lymphoma to amyloidoma following radiation therapy.

A 62-year-old man presented with a localized upper-extremity small cell lymphoma with plasmacytoid features and an associated IgM lambda serum immunoglobulin level of 1,730 g/dl. The tumor was treated with 5,960 rad over 47 days. On completion of radiation therapy, the tumor had regressed only minimally, and the monoclonal immunoglobulin level had decreased by 63 per cent; repeat biopsy revealed that the lymphoma had been replaced by a virtually acellular mass of amyloid. It is postulated that radiation therapy accelerated the tissue conversion of lambda light chain into the beta-pleated sheet structure characteristic of amyloid fibrils.

Amyloid↗
PubMed1985

Elevated plasma von Willebrand factor levels and arterial occlusive complications associated with cisplatin-based chemotherapy.

Factor-VIII-related von Willebrand factor (vWF) multimers are synthesized by endothelial cells, and plasma vWF antigen levels are elevated in some disorders associated with endothelial cell perturbation. We studied 13 patients during cisplatin-based combination chemotherapy for squamous cell carcinoma of the head and neck, esophagus, or lung. Before therapy, 3 of the patients had vWF antigen levels that were greater than or equal to 400% of normal; and further elevations occurred during chemotherapy. Two of these patients had cerebrovascular accidents, and the third had complications similar to the hemolytic-uremic and acute respiratory distress syndromes. No abnormalities in plasma vWF patterns were detected. Elevated plasma vWF antigen levels before therapy may identify a subgroup of patients at special risk for arterial occlusive complications following cisplatin-based chemotherapy.

Antineoplastic Combined Chemotherapy Protocols↗