Second primary esophageal or lung cancer in patients with head and neck carcinoma in Taiwan: incidence and risk in relation to primary index tumor site

2010 ◽  
Vol 137 (1) ◽  
pp. 115-123 ◽  
Author(s):  
Min-Chi Chen ◽  
Ping-Tsung Chen ◽  
Chunghuang Hubert Chan ◽  
Cheng-Ta Yang ◽  
Chih-Cheng Chen ◽  
...  
1994 ◽  
Vol 12 (5) ◽  
pp. 946-953 ◽  
Author(s):  
S G Urba ◽  
A A Forastiere ◽  
G T Wolf ◽  
R M Esclamado ◽  
P W McLaughlin ◽  
...  

PURPOSE We designed a protocol to evaluate the possibility of organ preservation in patients with advanced, resectable carcinoma of the head and neck. The regimen consisted of intensive chemotherapy followed by radiation therapy alone for patients with good response to treatment. The end points of the study were response rate, organ preservation, toxicity, and survival. PATIENTS AND METHODS Forty-two eligible patients with carcinoma of the oral cavity, oropharynx, hypopharynx, larynx, and paranasal sinuses were enrolled. Induction chemotherapy consisted of three cycles of mitoguazone, fluorouracil (5-FU), and high-dose continuous infusion cisplatin. Patients who had a complete response to chemotherapy, or whose tumor was downstaged to T1N1, were treated with definitive radiation therapy, to a total dose of 66 to 73.8 Gy. Patients with residual disease greater than T1N1 underwent surgery and postoperative radiation. RESULTS The overall response rate to chemotherapy was 84%, with a 43% complete response rate, and a 68% complete response rate at the primary tumor site. Sixty-nine percent of patients (29 of 42) were initially spared surgery to the primary tumor site, and four of these patients (14%) required neck dissection only, after radiation therapy. These tumor sites included oral cavity, oropharynx, hypopharynx, larynx, and sinuses. Eventually, five of these patients (17%) required salvage surgery and eight patients (28%) had unresectable or metastatic relapses. With a median follow-up duration of 38.5 months, 36% of all patients have had preservation of the primary tumor site and remain disease-free. The median survival duration is 26.8 months. Toxicity was substantial, with a 70% incidence of grade 3 to 4 granulocytopenia and two septic deaths. CONCLUSION Organ preservation without apparent compromise of survival was achieved in patients with selected nonlaryngeal sites of head and neck carcinoma. Larger site-specific trials with less toxic regimens conducted in randomized fashion are required to extend these data.


Cancer ◽  
2006 ◽  
Vol 106 (7) ◽  
pp. 1536-1547 ◽  
Author(s):  
Nicolien Kasperts ◽  
Ben J. Slotman ◽  
C. Rene Leemans ◽  
Remco de Bree ◽  
Patricia Doornaert ◽  
...  

1983 ◽  
Vol 92 (4) ◽  
pp. 369-372 ◽  
Author(s):  
Thomas W. Grossman ◽  
Robert J. Toohill ◽  
James A. Duncavage ◽  
Roger H. Lehman ◽  
Thomas C. Malin

A retrospective study was conducted of 696 patients with squamous cell carcinoma of the head and neck seen over a 10-year period. Special focus was placed on secondary esophageal primaries in this group in an effort to define the role of esophagoscopy in the management of these patients. Second primary esophageal lesions were infrequently encountered (17 of 696, or 2.4% of the patients). Diagnostic accuracy of the esophagogram in a series of patients with index head and neck tumors and in a separate series of patients with index esophageal lesions was found to be high (98 + %). Based upon this study, we do not feel that esophagoscopy is always indicated as part of the initial workup for all head and neck cancer patients. Rather, we consider the barium swallow esophagogram to be a relatively safe and acceptably accurate alternative in most cases, with esophagoscopy reserved for specific indications.


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