Diagnostic performance of dynamic volume perfusion CT for differentiation of head and neck cancer from healthy tissue and post-therapeutic changes

BACKGROUND: Post-therapeutic tissue is bradytrophic and thus has low perfusion values in PCT. In contrast, malignant tissue is expected to show higher perfusion values as cancer growth partially depends on angiogenesis. OBJECTIVES: This prospective study investigates perfusion computed tomography (PCT) for the post-therapeutic detection of cancer in the head and neck region. METHODS: 85 patients underwent PCT for 1) initial work-up of head and neck cancer (HNC; n=22) or 2) for follow-up (n=63). Regions of interest (ROIs) were placed in confirmed tumour, a corresponding location of benign tissue, and reference tissue. Perfusion was calculated using a single input maximum slope algorithm. Statistical analysis was performed with the Mann-Whitney U-test. RESULTS: PCT allowed significant differentiation of malignant tissue from post-therapeutic tissue after treatment for HNC (p=0.018). Significance was even greater after normalization of perfusion values (p=0.007). PCT allowed highly significant differentiation of HNC from reference tissue (p<0.001). CONCLUSIONS: PCT provides significantly distinct perfusion values for malignant and benign as well as post-therapeutically altered tissue in the head and neck area, thus allowing differentiation of cancer from healthy tissue. Our results show that PCT in conjunction with a standard algorithm is a potentially powerful HNC diagnostic tool.

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Prevalence of Head and Neck Cancer in the State of Meghalaya: Hospital-based Study

International Journal of Head and Neck Surgery ◽

10.5005/jp-journals-10001-1127 ◽

2013 ◽

Vol 4 (1) ◽

pp. 1-5

Author(s):

Neizekhotuo Brian Shunyu ◽

Judita Syiemlieh

Keyword(s):

Head And Neck Cancer ◽

Retrospective Study ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Neck Region ◽

The State ◽

Civil Hospital ◽

High Prevalence ◽

Total Body

ABSTRACT In India, 20 to 40% of all cancer arises in the head and neck region. The highest rate is seen in the eastern and southern regions of our country. The alarming high prevalence of head and neck cancer (HNC) in this region has prompted us to undertake this retrospective study. This study is to give the picture on the prevalence of HNC in the region, as such studies are lacking, till date. This is a 5 years retrospective study of cancer patients from 2007 to 2011 who have been registered in Civil Hospital, Shillong. The period of study is short as registry before 2007 was not properly recorded, but the high prevalence of cancer especially HNC warranted the need to undertake this retrospective study. During the 5-year period, there were a total of 3,123 cancer patients, registered in Civil Hospital, Shillong. In this study, HNC and esophageal cancer constitute 2,207 (70.67%) cases of the total body malignancy (TBM) which is much higher than other studies done in other parts of the country. Fourth decade is the most common age group comprising of 471 cases which accounts for 32.72% of all HNC. This high prevalence of HNC in the young population of the region is alarming and hence needs a comprehensive afford to meet this challenge. This paper, therefore, is an attempt to quantify the spectrum of HNC in the region hoping that this paper will help the health professionals to understand the burden of HNC in the region, so as to generate strategies for future planning. How to cite this article Shunyu NB, Syiemlieh J. Prevalence of Head and Neck Cancer in the State of Meghalaya: Hospital-based Study. Int J Head and Neck Surg 2013;4(1):1-5.

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Raman Spectroscopy of Head and Neck Cancer: Separation of Malignant and Healthy Tissue Using Signatures Outside the “Fingerprint” Region

Biosensors ◽

10.3390/bios7020020 ◽

2017 ◽

Vol 7 (4) ◽

pp. 20 ◽

Cited By ~ 4

Author(s):

Stephen Holler ◽

Elaina Mansley ◽

Christopher Mazzeo ◽

Michael Donovan ◽

Maximiliano Sobrero ◽

...

Keyword(s):

Raman Spectroscopy ◽

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Healthy Tissue ◽

Fingerprint Region

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Management of radiation therapy-induced mucositis in head and neck cancer patients. Part I: Clinical significance, pathophysiology and prevention

Oncology Reviews ◽

10.4081/oncol.2008.116 ◽

2011 ◽

pp. 102-113

Author(s):

Wei Cheong Ngeow ◽

Wen Lin Chai ◽

Rosnah Binti Zain

Keyword(s):

Radiation Therapy ◽

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Patients ◽

Clinical Significance ◽

Neck Cancer ◽

Neck Region ◽

Clinical Problem ◽

Important Clinical Problem ◽

Oropharyngeal Mucositis

Oropharyngeal mucositis is the acute inflammatory and ulcerative reaction of the oral mucosa following radiation therapy to the head and neck region. It is such a common problem that nearly all head and neck cancer patients develop some degree of mucositis. This complication is usually transient in nature but it also represents an important clinical problem as it is a painful, debilitating, dose-dependent side effect for which there is no widely acceptable prophylaxis or effective treatment. As several authoritative groups have recently either undertaken systematic reviews or issued guidelines on the management of mucositis, it is the aim of this review to provide instead an overview of all the possible remedies available, as well as highlighting to researchers the gaps that need to be filled. The first part of this review outlines the clinical significance and pathophysiology of radiation-induced mucositis, and looks into some of the preventive approaches available.

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Head & neck cancer

10.1093/med/9780199235636.003.0004 ◽

2011 ◽

Author(s):

Thankamma Ajithkumar ◽

Ann Barrett ◽

Helen Hatcher ◽

Natalie Cook

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Survival Rates ◽

Neck Region ◽

Head Neck Cancer ◽

Term Survival ◽

Second Primaries ◽

Time Of Presentation

The head and neck region encompasses anatomical sites below the brain and above the clavicles, excluding skin and thyroid. The sites most commonly involved with cancer are the oral cavity, larynx, and pharynx. Overall 5-year survival rates for head and neck cancer have improved only slightly over the past two decades remaining at just over 50%. This figure in part reflects the population who present with this disease in terms of age and comorbidity (typically about 15% intercurrent death rates at 5 years), as well as the tendency to develop second primaries and metastases. The poor long-term survival rates may also reflect the fact that 60% of patients with head and neck cancer have advanced disease at the time of presentation (stage III/IV disease). The dominant treatment failure in head and neck cancer is locoregional relapse and this remains the main focus for clinicians involved in the management of these patients....

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Chemoembolization of Head and Neck Cancer with Carboplatine Microcapsules

Acta Radiologica ◽

10.1177/02841851960371p111 ◽

1996 ◽

Vol 37 (1P1) ◽

pp. 52-56 ◽

Cited By ~ 4

Author(s):

N. Tomura ◽

M. Kobayashi ◽

H. Hirano ◽

J. Watarai ◽

Y. Okamoto ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Neck Region ◽

Therapeutic Modality ◽

Hematologic Toxicity ◽

Head And Neck Region ◽

Catheter System ◽

Coaxial Catheter ◽

Coaxial Catheter System

Fourteen patients with malignant tumor in the head and neck region were treated with infusion of carboplatine microcapsules (CBDCA-mc) via percutaneous superselective catheterization. A microcatheter was advanced into a feeding artery using a coaxial catheter system. Eleven patients had over 30% reduction of the tumor size on CT within 1 month after embolization. Twelve patients had an increased amount of low attenuation tissue in the tumor on CT after embolization, suggesting increased necrosis in the tumor. No definite hematologic toxicity was found. A majority of patients complained of moderate pain in the embolized region immediately after embolization, easily relieved by i.v. analgesics. Chemoembolization using CBDCA-mc may be an effective therapeutic modality in advanced cases of head and neck cancer.

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The acid-producing capacity and anti-microbial activity of Lactobacillus species isolated from patients treated for cancer in the head and neck region

10.21203/rs.2.9525/v1 ◽

2019 ◽

Author(s):

Matilda Rahne ◽

Amina Basic ◽

Annica Almståhl

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Microbial Activity ◽

Neck Cancer ◽

Neck Region ◽

Restriction Enzymes ◽

Lactobacillus Species ◽

Polymorphism Analysis ◽

Head And Neck Region ◽

Frequent Species

Abstract Background: Lactobacillus are acid-producing bacteria associated with caries development. Some Lactobacillus have also anti-microbial properties. In patients treated for cancer in the head and neck region, a marked increase in Lactobacillus has previously been reported. The consequences of this ecological shift towards a Lactobacillus friendly environment are, however, still unknown. Little is known about the prevalence of different Lactobacillus species and their characteristics in these patients. The aim of this study was therefore to identify Lactobacillus isolates from patients with head and neck cancer and to determine their acid-producing capacity and anti-microbial activity. Methods: Lactobacillus isolates were collected from 21 patients pre-treatment, six and 12 months post treatment. For identification to species level, the isolates were subjected to DNA-extraction, amplification of 16S and restriction fragment length polymorphism analysis using the restriction enzymes Hpa II and Hae III. The acid-producing capacity was analyzed using a colorimetric fermentation test in microtiter plates. The anti-microbial activity of the isolates against Streptococcus mutans associated with caries, and the mucosal pathogens Staphylococcus aureus, Candida albicans and Enterococcus faecalis was determined by determining inhibitory zones on agar plates. Results: The most frequent species were L. paracasei (n=21), L. casei/rhamnosus (n=17) and L. fermentum (n=10). The highest proportion showing acid-producing capacity using sugars and sugar-alcohols was found among L. paracasei and the lowest proportions were seen for L. fermentum. Seventy-one strains showed an anti-microbial activity against S. mutans, one strain against S. aureus and none against C. albicans or E. faecalis. Conclusion: The most frequent species Lactobacillus species isolated from patients with head and neck cancer were L. paracasei, L. casei/rhamnosus and L. fermentum of which L. paracasei showed the best acid-producing capacity. A weak anti-microbial activity against S. mutans was frequently detected. Further studies are needed to increase the knowledge of the role and characteristics of oral Lactobacillus.

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Management of radiation therapy-induced mucositis in head and neck cancer patients. Part II: supportive treatments

Oncology Reviews ◽

10.4081/oncol.2008.164 ◽

2011 ◽

Vol 2 (3) ◽

pp. 164

Author(s):

Wei Cheong Ngeow ◽

Wen Lin Chai ◽

Rosnah Binti Zain

Keyword(s):

Radiation Therapy ◽

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Neck Region ◽

Clinical Problem ◽

Important Clinical Problem ◽

Oropharyngeal Mucositis ◽

Pharmaceutical Agents

Oropharyngeal mucositis is the acute inflammatory and ulcerative reaction of the oral mucosa following radiation therapy to the head and neck region. It is such a common problem that nearly all head and neck cancer patients develop some degree of mucositis. This complication is usually transient in nature but it also represents an important clinical problem as it is a painful, debilitating, dose-dependent side effect for which there is no widely acceptable prophylaxis or effective treatment. As several authoritative groups have recently either undertaken systematic reviews or issued guidelines on the management of mucositis, it is the aim of this review instead, to provide an overview of all the remedies and pharmaceutical agents available, as well as highlighting to researchers the gaps that need to be filled.

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The diagnostic performance of perfusion CT in the detection of local tumor recurrence in head and neck cancer

Clinical Hemorheology and Microcirculation ◽

10.3233/ch-209209 ◽

2020 ◽

Vol 76 (2) ◽

pp. 171-177

Author(s):

Daniel Troeltzsch ◽

Stefan Markus Niehues ◽

Tabea Fluegge ◽

Norbert Neckel ◽

Max Heiland ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Tumor Recurrence ◽

Perfusion Ct ◽

Post Treatment ◽

Local Tumor ◽

Local Tumor Recurrence ◽

Maximum Slope ◽

Imaging Tool

BACKGROUND: Detecting local tumor recurrence from post-treatment changes in head and neck cancer (HNC) remains a challenge. Based on the hypothesis that post-therapeutically altered tissue is bradytroph, lower perfusion values are expected in perfusion CT (PCT) while higher perfusion values are expected in recurrent malignant tissue. OBJECTIVES: This prospective study investigates PCT for post-treatment recurrent HNC detection with a maximum slope algorithm. METHODS: A total of 80 patients who received PCT of the head and neck for post-therapy follow-up, of which 63 had no tumor recurrence and 17 presented a histopathologically confirmed recurrence were examined. Regions of interest were placed in the location of the initial tumor, in reference ipsilateral nuchal muscle tissue and the corresponding internal carotid artery. Perfusion was calculated using a single-input maximum slope algorithm. RESULTS: With PCT, recurrent HNC can be differentiated from post-treatment tissue (p < 0.05). It further allows delineating recurrent tumor tissue from benign nuchal tissue of reference (p < 0.05). PCT data of patients with and without recurrent HNC are comparable as perfusion values of reference tissues in patients with and without HNC do not differ (p > 0.05). CONCLUSIONS: PCT in combination with a commercially available maximum slope algorithm offers radiologists a reliable imaging tool to detect recurrent head and neck cancer within post-therapeutically altered tissue.

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Comparative study of efficacy and toxicities of cisplatin vs vinorelbine as radiosensitisers in locally advanced head and neck cancer

The Journal of Laryngology & Otology ◽

10.1017/s0022215107007645 ◽

2007 ◽

Vol 122 (2) ◽

pp. 188-192 ◽

Cited By ~ 7

Author(s):

S K Sarkar ◽

N B Patra ◽

J Goswami ◽

S Basu

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Locally Advanced ◽

Neck Region ◽

Standards Of Care ◽

Comparable Efficacy ◽

Advanced Head ◽

Conventional Fractionation ◽

Significant Difference

AbstractIntroduction:Currently, concomitant chemoradiation using cisplatin is one of the standards of care for the management of head and neck cancer, but at the cost of increased acute toxicity. Our aim was to assess whether vinorelbine was less toxic and of at least comparable efficacy, if not better, compared with cisplatin.Materials and methods:A total of 72 patients with squamous cell carcinoma in the head and neck region were recruited, 40 in arm A and 32 in arm B. Patients in arm A received 40 mg/m2 cisplatin weekly. Patients in arm B received 6 mg/m2 vinorelbine weekly. Both arms also received 66 Gy of radiation in conventional fractionation.Results and analysis:There was no statistically significant difference in response rate or toxicities between the two arms, except for nausea and/or vomiting, which was significantly less frequent in the vinorelbine arm.Conclusion:Vinorelbine was as effective as cisplatin in controlling locoregional disease in locally advanced head and neck cancer, but was only marginally less toxic than cisplatin.

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Oropharyngeal Candidiasis in Patients Undergoing Radiotherapy for Head and Neck Cancer: Literature Review

Journal of Health Sciences ◽

10.17921/2447-8938.2018v20n2p119-121 ◽

2018 ◽

Vol 20 (2) ◽

pp. 119

Author(s):

Thaináh Bruna dos Santos Zambrano ◽

Solange De Paula Ramos ◽

Nora Gavilanes ◽

Ricardo Sergio Almeida

Keyword(s):

Head And Neck Cancer ◽

Oral Cavity ◽

Head And Neck ◽

Neck Cancer ◽

Oral Hygiene ◽

Web Of Science ◽

Neck Region ◽

Candida Spp ◽

Head And Neck Region ◽

The Relationship

AbstractCandidiasis is closely related to patients undergoing head and neck radiotherapy due to the immunosuppressive state, induced xerostomia, mucositis and difficulties in establishing adequate oral hygiene. Therefore, the aim of this study was to discuss the relationship between candidal infections and the radiotherapy of the head and neck region, based on available scientific literature. In order to identify the studies included or considered in this study, a search strategy was carried out for the following databases: SCOPUS, Web of Science and PubMed. Inclusion criteria were publications that addressed key words: Candida spp. of the oral cavity and head and neck cancer. Therefore, this work exposes the necessity for studies relating candidal infections with radiotherapy treatment of the head and neck region. However, it is possible suggest that colonization and infection by Candida spp. can be increased by radiotherapy. Additionally, it can be suggested that patients irradiated at the head and neck region should be periodically investigated for the presence of pathogenic yeasts in the oral cavity, followed by greater care with oral hygiene and nutrition.Keywords: Candida Spp. Xerostomia. Oral Health. Publications.ResumoA candidíase está intimamente relacionada com pacientes submetidos a radioterapia de cabeça e pescoço devido ao estado imunossupressor, xerostomia induzida, mucosite e dificuldades no estabelecimento de higiene bucal adequada. Portanto, o objetivo deste estudo foi discutir a relação entre infecções por Candida spp. e a radioterapia da região da cabeça e pescoço, com base na literatura científica disponível. Para identificar os estudos incluídos ou considerados neste estudo, foi realizada uma estratégia de busca para os seguintes bancos de dados: SCOPUS, Web of Science e PubMed. Os critérios de inclusão foram publicações que abordavam as palavras-chave: Candida spp. da cavidade oral e câncer de cabeça e pescoço. Desta forma, este trabalho expõe a necessidade de estudos relacionados às infecções por Candida spp. com tratamento de radioterapia da região da cabeça e pescoço. No entanto, podemos sugerir que a colonização e a infecção por Candida spp. pode ser aumentada por radioterapia. Além disso, pode-se sugerir que os pacientes irradiados na região da cabeça e pescoço devem ser investigados periodicamente quanto à presença de leveduras patogênicas na cavidade bucal, seguido de maiores cuidados com higiene bucal e nutrição.Palavras-chave: Candida Spp. Xerostomia. Saúde Bucal. Publicações.

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