Current use of chemotheraphy for head and neck cacer

1984 ◽  
Vol 98 (8) ◽  
pp. 819-828 ◽  
Author(s):  
Randall P. Morton
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Combined Modality Therapy ◽  
Single Agent ◽  
Postal Survey ◽  
Cytotoxic Chemotherapy ◽  
Controlled Clinical Trials ◽  
Multiple Agent ◽  
Medical Oncologists

SummaryA postal survey of 100 members of the Association of Head and Neck Oncologists of Great Britain was conducted in the first 6 months of 1983. The sample consisted principally of Otolaryngologists (50 per cent), Radiotherapists (14 per cent), Medical Oncologists (10 per cent), Oral Surgeons (10 per cent) and Plastic Surgeons (10 per cent). More than 80 per cent of those who completed the questionnaire used chemotherapy for Head and Neck cancer (72 per cent used it for palliation, and 64 per cent as part of combined modality therapy). There was great variation in the chemotherapeutic regimens used by the various responders. Furthermore, most responders used more than one regimen. Methotrexate was the agent most frequently used. No specific regimen, either single-agent or multiple-agent, enjoyed universal acceptance, although the combination of Vincristine, Bleomycin and Methotrexate was popular. Chemotherapy was thought by most responders to have a useful but as yet undefined place in the management of Head and Neck cancer. This survey underlines the need for prospective, controlled, clinical trials into the efficacy of cytotoxic chemotherapy for Head and Neck cancer.

Combined therapy for stage III-IV head and neck cancer: preliminary results.

1984 ◽  
Vol 2 (7) ◽  
pp. 804-810 ◽  
Author(s):  
S H Krasnow ◽  
M H Cohen ◽  
A Johnston-Early ◽  
M L Citron ◽  
B E Fossieck ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Response Rate ◽  
Combined Modality Therapy ◽  
Combined Therapy ◽  
Stage Iii ◽  
Combined Modality Treatment ◽  
Combined Modality ◽  
Rbc Deformability

As part of a combined modality treatment program using chemotherapy, surgery, and/or radiotherapy, 25 patients with previously untreated stage III or IV head and neck cancer received initial combination chemotherapy. Pathologically confirmed complete remission was noted in nine patients (36%). The overall objective major response rate (with all patients included in analysis) was 68%. The chemotherapy regimen included bleomycin, cisplatin, vinblastine, methotrexate, and 5-fluorouracil. A novel concept of drug scheduling was used, based on chemotherapy-induced improvement in RBC deformability. The underlying concept is that improved RBC deformability results in improved capillary blood flow and thereby, increased drug delivery to tumor cells. Treatment resulted in moderate hematologic and renal toxicity with no treatment-related deaths. This exceptionally high, pathologically confirmed complete response rate will hopefully provide a mechanism by which combined modality therapy can adequately be tested for its ability to prolong survival of patients with advanced head and neck cancer.

scholarly journals STAT3 Modulation of Regulatory T Cells in Response to Radiation Therapy in Head and Neck Cancer

2019 ◽  
Vol 111 (12) ◽  
pp. 1339-1349 ◽  
Author(s):  
Ayman J Oweida ◽  
Laurel Darragh ◽  
Andy Phan ◽  
David Binder ◽  
Shilpa Bhatia ◽  
...  
Keyword(s):  
T Cells ◽  
Head And Neck Cancer ◽  
Regulatory T Cells ◽  
Head And Neck ◽  
Neck Cancer ◽  
Single Agent ◽  
Effector T Cells ◽  
Enzyme Linked Immunosorbent Assay ◽  
Tumor Control ◽  
Stat3 Inhibition

Abstract Background Radioresistance represents a major problem in the treatment of head and neck cancer (HNC) patients. To improve response, understanding tumor microenvironmental factors that contribute to radiation resistance is important. Regulatory T cells (Tregs) are enriched in numerous cancers and can dampen the response to radiation by creating an immune-inhibitory microenvironment. The purpose of this study was to investigate mechanisms of Treg modulation by radiation in HNC. Methods We utilized an orthotopic mouse model of HNC. Anti-CD25 was used for Treg depletion. Image-guided radiation was delivered to a dose of 10 Gy. Flow cytometry was used to analyze abundance and function of intratumoral immune cells. Enzyme-linked immunosorbent assay was performed to assess secreted factors. For immune-modulating therapies, anti–PD-L1, anti-CTLA-4, and STAT3 antisense oligonucleotide (ASO) were used. All statistical tests were two-sided. Results Treatment with anti-CD25 and radiation led to tumor eradication (57.1%, n = 4 of 7 mice), enhanced T-cell cytotoxicity compared with RT alone (CD4 effector T cells [Teff]: RT group mean = 5.37 [ 0.58] vs RT + αCD25 group mean =10.71 [0.67], P = .005; CD8 Teff: RT group mean = 9.98 [0.81] vs RT + αCD25 group mean =16.88 [2.49], P = .01) and induced tumor antigen-specific memory response (100.0%, n = 4 mice). In contrast, radiation alone or when combined with anti-CTLA4 did not lead to durable tumor control (0.0%, n = 7 mice). STAT3 inhibition in combination with radiation, but not as a single agent, improved tumor growth delay, decreased Tregs, myeloid-derived suppressor cells, and M2 macrophages and enhanced effector T cells and M1 macrophages. Experiments in nude mice inhibited the benefit of STAT3 ASO and radiation. Conclusion We propose that STAT3 inhibition is a viable and potent therapeutic target against Tregs. Our data support the design of clinical trials integrating STAT3 ASO in the standard of care for cancer patients receiving radiation.

Antiproliferative effects of rapamycin as a single agent and in combination with carboplatin and paclitaxel in head and neck cancer cell lines

2007 ◽  
Vol 62 (2) ◽  
pp. 305-313 ◽  
Author(s):  
Nasredine Aissat ◽  
Christophe Le Tourneau ◽  
Aïda Ghoul ◽  
Maria Serova ◽  
Ivan Bieche ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cell Lines ◽  
Cancer Cell ◽  
Neck Cancer ◽  
Single Agent ◽  
Cancer Cell Lines ◽  
Antiproliferative Effects

Combined modality therapy utilizing a cisplatin combination for effective chemotherapy in patients with previously untreated head and neck cancer

1986 ◽  
Vol 152 (4) ◽  
pp. 451-455 ◽  
Author(s):  
John R. Jacobs ◽  
Julie Kish ◽  
John F. Ensley ◽  
Khurshid Ahmad ◽  
Arthur Weaver ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Combined Modality Therapy ◽  
Combined Modality

SURVIVAL AFTER "PALLIATIVE" CYTOTOXIC CHEMOTHERAPY FOR HEAD-AND-NECK CANCER

The Lancet ◽  
1983 ◽  
Vol 322 (8360) ◽  
pp. 1205 ◽  
Author(s):  
P.M. Stell ◽  
R.P. Morton ◽  
I.T. Campbell ◽  
J.A. Wilson
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Cytotoxic Chemotherapy

The impact of medical comorbidities on the quality of care for patients with head and neck cancer.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e16030-e16030
Author(s):  
Brenda Ernst ◽  
Mary T Busowski ◽  
Randal S. Weber ◽  
Thomas D. Shellenberger
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Quality Indicators ◽  
Neck Cancer ◽  
Combined Modality Therapy ◽  
Performance Status ◽  
Care Quality ◽  
Chronic Obstructive ◽  
Medical Comorbidities ◽  
The Impact

e16030 Background: Objectively assessing the treatment of patients with cancer offers a basis for raising the standard of care. Quality indicators provide criteria by which the safety of care can be measured and compared to defined benchmarks. However, variables influencing the metrics in quality can limit generalizability and applicability. Medical comorbidities pose significant threats to the care of patients with head and neck cancer. We sought to investigate the impact of medical comorbidities on quality indicators for patients undergoing management by the multidisciplinary team. Methods: Comorbidities were assessed in relation to quality indicators in 49 patients treated for squamous cell carcinoma of the head and neck over a 16-month period. Treatment with surgery, radiation, and chemotherapy was classified by the number and type of modalities delivered. Surgical procedures were stratified by high and low acuity as defined by extent. By univariate and multivariate analysis, medical comorbidities were correlated with length of hospital stay, readmission within 30 days, return to the operating room within 7 days, 30-day mortality, use of blood products, and surgical site infection. Results: Cardiovascular disease was present in 49% of patients, diabetes mellitus in 12%, liver disease in 8%, previous congestive heart failure in 4%, and chronic obstructive pulmonary disease in 17%. The presence of any single comorbidity was correlated with each of the negative indicators (p<0.05), and with multiple negative indicators (p<0.05). Comorbidities occurred more frequently in patients undergoing high acuity surgery (p<0.05) and combined modality therapy (p<0.05). Decreasing performance status and major clinical predictors were the factors most strongly associated with negative quality indicators. Conclusions: Approaches to adjust for comorbid status are critical to accurate assessment of quality indicators. Risk stratification of patients at initial evaluation can offer valuable criteria for selecting treatment. Evaluation and management of comorbidities by evidence-based guidelines may improve care.

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