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At least 415 records · Page 23Linked to original sources
PubMed1984

A study of the effect of misonidazole in conjunction with radiotherapy for the treatment of head and neck cancer. MRC working party on misonidazole in head and neck cancer.

The effect of the hypoxic cell sensitiser misonidazole as an adjuvant to radiotherapy of head and neck cancer was tested in a randomised double blind study. Patients with squamous carcinoma of the upper alimentary and respiratory tract, excluding those with early disease for which the prognosis was good, who were deemed suitable for radical radiotherapy and fit to receive the drug were entered into the study. Two radiotherapy regimes were employed, 10 fractions in 3 weeks to a modal tumour dose of 4000-4500 cGy, and 20 fractions in 4 weeks to a modal tumour dose of 5000-5750 cGy. Participating radiotherapists opted for one of the two schemes. Misonidazole or placebo capsules were administered 4 to 5 hours before each fraction of radiotherapy to a total of 11 to 13 g/m2. 168 patients were treated with 10 fractions and 99 with 20 fractions, between March 1979 and November 1981, when entry was stopped because of the high incidence of drug toxicity and lack of benefit. The estimated hazard ratio for local control was 0.89, indicating a slight advantage to misonidazole which was not statistically significant (p = 0.5). Peripheral neuropathy occurred in 56 patients who received misonidazole, and was more severe when treatment was given in 10 fractions.

Adult↗
PubMed1994

[Characteristics of human papillomavirus (HPV) infection in papilloma of the head and neck--detection of HPV according to clinical features and type specificity in the head and neck].

Papilloma which develops in the head and neck is known to exhibit different clinical features depending on the region, age of onset and tumor growth. We detected human papillomavirus (HPV) DNA using molecular biological methods, and evaluated the characteristics of HPV infection. The subjects examined were 8 cases of laryngeal papilloma, 17 of nasal papilloma, 21 of oral papilloma, 1 of pharyngeal papilloma and 1 of esophageal papilloma. The detection rate of HPV was 100% in the larynx, 29% in the nasal cavity, and 5% in the oral cavity, showing a large difference in the detection rate depending on the region. As a whole, the detection rate of HPV was higher in the upper airway, while almost no HPV was detected in the upper digestive tract. In the current examination, either HPV6a or HPV11a was detected in all cases of laryngeal papilloma, suggesting that HPV plays a very important role in the development of laryngeal papilloma. However, there was no specific relationship between the type of HPV and the age of onset or tumor growth. Among the nasal papilloma cases, one case each of HPV6a, HPV11a and unknown-type HPV was detected in exophytic nasal papilloma. In the inverted papilloma cases, although HPV was detected in two of 14 cases, we could not classify the HPV into any of the known types. There was a large difference in the detection rate of HPV between different modes of tumor growth: the detection rate of HPV in the exophytic type was 100%, while that in the inverted type was 14%. In 21 cases of oral papilloma, with the exception of the case in which HPV6a was detected at the floor of the mouth, no HPV was detected in any case including the 15 cases with papilloma of the soft palate. These results suggest that HPV influences tumor development differently in oral papilloma even when macroscopic and histological findings are the same as those of laryngeal or nasal papilloma, and that there are differences in the mechanism of development and exacerbating factors of these tumors. In the two cases of laryngeal papilloma in which HPV6a was detected, a deletion was found in the non-coding region. However, there was no difference in clinical features between these two cases. The difference in the HPV detection rate is related to clinical features, showing that HPV greatly influences the clinical features of tumors.

Adult↗
PubMed2000

Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data. MACH-NC Collaborative Group. Meta-Analysis of Chemotherapy on Head and Neck Cancer.

BACKGROUND: Despite more than 70 randomised trials, the effect of chemotherapy on non-metastatic head and neck squamous-cell carcinoma remains uncertain. We did three meta-analyses of the impact of survival on chemotherapy added to locoregional treatment. METHODS: We updated data on all patients in randomised trials between 1965 and 1993. We included patients with carcinoma of the oropharynx, oral cavity, larynx, or hypopharynx. FINDINGS: The main meta-analysis of 63 trials (10,741 patients) of locoregional treatment with or without chemotherapy yielded a pooled hazard ratio of death of 0.90 (95% CI 0.85-0.94, p<0.0001), corresponding to an absolute survival benefit of 4% at 2 and 5 years in favour of chemotherapy. There was no significant benefit associated with adjuvant or neoadjuvant chemotherapy. Chemotherapy given concomitantly to radiotherapy gave significant benefits, but heterogeneity of the results prohibits firm conclusions. Meta-analysis of six trials (861 patients) comparing neoadjuvant chemotherapy plus radiotherapy with concomitant or alternating radiochemotherapy yielded a hazard ratio of 0.91 (0.79-1.06) in favour of concomitant or alternating radiochemotherapy. Three larynx-preservation trials (602 patients) compared radical surgery plus radiotherapy with neoadjuvant chemotherapy plus radiotherapy in responders or radical surgery and radiotherapy in non-responders. The hazard ratio of death in the chemotherapy arm as compared with the control arm was 1.19 (0.97-1.46). INTERPRETATION: Because the main meta-analysis showed only a small significant survival benefit in favour of chemotherapy, the routine use of chemotherapy is debatable. For larynx preservation, the non-significant negative effect of chemotherapy in the organ-preservation strategy indicates that this procedure must remain investigational.

Antineoplastic Agents↗
PubMed1975

[Regional neck lymph nodes and primary tumors. 2. The reactive neck lymph node lesion].

Topographic classification of lymphatic nodes with reactive changes and with metastasis makes evident, that the regional lymph nodes have not only changes, caused by inflammation but also by growth of tumor. Thus, the lymph nodes are accomodation of defense and in the second place as an accommodation of discharge. The regional lymph nodes respond independent of the extent of the primary tumor. The regional metastasis are nearly always localized in the center of lymph nodes with reactiv changes. Lymph nodes with follicular lymphatic hyperplasia are situated in the immediate environment of the metastasis. Lymph nodes with sinus-reaction are extended before the metastasis, in direction of lymph discharge. By super imposed projection of the results of histological evaluation of cervical glands with metastasis in the neck, one obtains to some extent an impression of the defense activity by the lymph nodes at the time of the operation.

Head and Neck Neoplasms↗
PubMed1983

[Technics for irradiation of the neck in the treatment of lymph node metastases from solid tumors of the head and neck region].

Some common irradiation techniques for nodal metastasis of head and neck solid tumors are described and analyzed, that can be performed by means of a cobalt unit or by high energy electron beams. Limits and indications of each technique are evaluated particularly referring to dose distribution in the target volume and to isoeffect levels (TDF, CRE) that can be expected in normal tissues, at the end of treatment for different regimes.

Cobalt Radioisotopes↗
PubMed1994

[A prospective randomized trial of adjuvant chemotherapy with UFT for head and neck carcinoma. Head and Neck UFT Study Group].

A prospective randomized trial was performed in 67 institutions for the purpose to evaluate the efficacy of adjuvant chemotherapy after radical treatment of head and neck carcinoma. A comparison was made between the following two groups; one-year oral administration of UFT, 300 mg/day, after radical treatment (UFT group); and a non-treatment group. Patients were classified under the following three categories; 1) stage II-IV, receiving radical surgery; 2) stage II, receiving radical radiotherapy; and 3) nasopharyngeal cancer. The numbers of cases were 424, 111 and 25, respectively, and they were randomized into two groups. The numbers of eligible cases were 398, 105 and 25, respectively. Statistical analysis was performed in the cases receiving radical surgery and in those receiving radical radiotherapy. As the results, in cases receiving radical surgery no significant difference was observed in 3-year survival rates (77.9% for UFT group vs 72.9% for non-treatment group) or 3-year relapse-free rates (73.4% for UFT group vs 66.2% for non-treatment group) between the two groups. However, the distant relapse rate was significantly lower in the UFT group than in the non-treatment group (7.9% vs 14.6%; p = 0.034). In the cases receiving radical radiotherapy, no significant differences was observed in either 3-year survival rates or 3-year relapse-free rates. Thus it was suggested that UFT maintenance therapy might suppress the distant metastasis after radical surgery. We considered a further confirmative trial for patients at high risk of distant metastasis after radical surgery to be advisable.

Administration, Oral↗
PubMed1994

[A comparative clinical study on the treatment of head and neck tumors by adjuvant chemotherapy with HCFU--Second Study by Kinki Head and Neck Tumor Study Group].

In the first study by the "Kinki Head and Neck Tumor Study Group," we performed a comparative study to investigate intergroup difference between a control group consisting of patients given radical treatment only, and a HCFU group consisting of patients receiving long-term administration of HCFU after radical treatment. We earlier reported that subsequent observations by stratification revealed a favorable tendency in the cumulative disease-free rate in Stage II and Stage III patients in the HCFU group. In the second study, the same methods of treatment as in the first study were compared in a prospective control study. No differences were found between the two groups in Stage II patients. In Stage III patients, however, the disease-free rate tended to increase significantly in the HCFU group as in the first study.

Adult↗
PubMed1998

A comparison of the effectiveness of three neck-hold killing traps in occluding carotid arteries in the neck of the brushtail possum.

AIMS: To compare the potential humaneness of three types of neck-hold killing traps in terms of the blood vessels that are occluded, and to examine the anatomy of the blood vessels that supply blood to the possum's brain. METHOD: The prevalence of occlusion of the common carotid arteries and the trachea was examined in 33 possums which were caught with Timms, LDL and Conibear 160 traps. The anatomy of the blood supply to the brain was examined in six possums using a resin casting technique. RESULTS: The prevalence of complete bilateral common carotid artery occlusion was 77% for the Timms trap, 45% for the LDL trap and 22% for the Conibear 160 trap. The major route for blood supply to the brain was via the common carotid arteries. CONCLUSION: Where the aim is to kill possums quickly by ischaemia of the brain, the Timms trap is to be preferred over the LDL and Conibear 160 traps.

Journal Article↗
PubMed1978

Bladder neck hypertrophy and wide bladder neck anomaly (WBNA).

The urodynamic findings of 247 patients with a neurogenic bladder dysfunction were analyzed to evaluate factors which influence the X-ray picture of the bladder neck and urethra. Patients were classified according to the classification of Bors and Commarr, additionally different types of reflex detrusor activity could be differentiated in cases suffering from a supranuclear lesion. As the micturition cystourethrography of female patients with a supranuclear lesion looks similar to the X-ray picture of young girls with a WBNA a second analysis was made to compare the urodynamics of both groups. It is to note that in supranuclear lesions detrusor-sphincter dyssynergia and the type of reflex detrusor activity mainly form the shape of the posterior urethra, neither the duration of the lesion nor the level of spinal cord injury have any influence.

Female↗
PubMed1999

[Respiratory insufficiency and lipomatosis of the neck (Madelung's neck)].

A case of Madelungs neck is reported. After two operations in three years the patient developed respiratory insufficiency and transferred to our hospital in state of severe suffocation for tracheotomy. The factors leading to suffocation, such as inspiratory dyspnea, factors influencing the patient to undergo an operation and therapy, and difficulties encountered by an ENT surgeon in managing a respiratory crisis by tracheotomy are highlighted. The reported case illustrates an emergency tracheotomy in a very advanced stage of the disease.

Airway Obstruction↗