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[PMID]:28884310
[Au] Autor:Alterio D; Gerardi MA; Cella L; Spoto R; Zurlo V; Sabbatini A; Fodor C; D'Avino V; Conson M; Valoriani F; Ciardo D; Pacelli R; Ferrari A; Maisonneuve P; Preda L; Bruschini R; Cossu Rocca M; Rondi E; Colangione S; Palma G; Dicuonzo S; Orecchia R; Sanguineti G; Jereczek-Fossa BA
[Ad] Endereço:Department of Radiotherapy, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy. daniela.alterio@ieo.it.
[Ti] Título:Radiation-induced acute dysphagia : Prospective observational study on 42 head and neck cancer patients.
[Ti] Título:Strahleninduzierte akute Dysphagie : Prospektive Beobachtungsstudie an 42 Kopf-Hals-Malignompatienten..
[So] Source:Strahlenther Onkol;193(11):971-981, 2017 Nov.
[Is] ISSN:1439-099X
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Acute toxicity in head and neck (H&N) cancer patients treated with definitive radiotherapy (RT) has a crucial role in compliance to treatments. The aim of this study was to correlate doses to swallowing-associated structures and acute dysphagia. METHODS: We prospectively analyzed 42 H&N cancer patients treated with RT. Dysphagia (grade ≥ 3) and indication for percutaneous endoscopic gastrostomy (PEG) insertion were classified as acute toxicity. Ten swallowing-related structures were considered for the dosimetric analysis. The correlation between clinical information and the dose absorbed by the contoured structures was analyzed. Multivariate logistic regression method using resampling methods (bootstrapping) was applied to select model order and parameters for normal tissue complication probability (NTCP) modelling. RESULTS: A strong multiple correlation between dosimetric parameters was found. A two-variable model was suggested as the optimal order by bootstrap method. The optimal model (Rs = 0.452, p < 0.001) includes V of the cervical esophagus (odds ratio [OR] = 1.016) and D of the cricopharyngeal muscle (OR = 1.057). The model area under the curve was 0.82 (95% confidence interval 0.69-0.95). CONCLUSION: Our results suggested that the absorbed dose to the cricopharyngeal muscle and cervical esophagus might play a relevant role in the development of acute RT-related dysphagia.
[Mh] Termos MeSH primário: Carcinoma de Células Escamosas/radioterapia
Transtornos de Deglutição/etiologia
Deglutição/efeitos da radiação
Neoplasias Otorrinolaringológicas/radioterapia
Lesões por Radiação/etiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Transtornos de Deglutição/terapia
Nutrição Enteral
Esôfago/efeitos da radiação
Feminino
Gastrostomia
Seres Humanos
Masculino
Meia-Idade
Músculos Faríngeos/efeitos da radiação
Estudos Prospectivos
Lesões por Radiação/terapia
Dosagem Radioterapêutica
Estatística como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170909
[St] Status:MEDLINE
[do] DOI:10.1007/s00066-017-1206-x


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[PMID]:28869195
[Au] Autor:Blanchard P; Frank SJ
[Ad] Endereço:Department of radiation oncology, MD Anderson cancer center, the university of Texas, Houston, Texas, États-Unis; Département de radiothérapie, Gustave-Roussy cancer campus, 114, rue Édouard-Vaillant, 94800 Villejuif, France. Electronic address: pierre.blanchard@gustaveroussy.fr.
[Ti] Título:[Proton therapy for head and neck cancers].
[Ti] Título:Place de la protonthérapie en cancérologie ORL..
[So] Source:Cancer Radiother;21(6-7):515-520, 2017 Oct.
[Is] ISSN:1769-6658
[Cp] País de publicação:France
[La] Idioma:fre
[Ab] Resumo:The absence of exit dose and the sharp lateral penumbra are key assets for proton therapy, which are responsible for its dosimetric superiority over advanced photon radiotherapy. Dosimetric comparisons have consistently shown a reduction of the integral dose and the dose to organs at risk favouring intensity-modulated proton therapy (IMPT) over intensity-modulated radiotherapy (IMRT). The structures that benefit the most of these dosimetric improvements in head and neck cancers are the anterior oral cavity, the posterior fossa, the visual apparatus and swallowing structures. A number of publications have concluded that these dosimetric differences actually translate into reduced toxicities with IMPT, for example with regards to reduced weight loss or need for feeding tube. Patient survival is usually similar to IMRT series, except in base of skull or sinonasal malignancies, where a survival advantage of IMPT could exist. The goals of the present review is to describe the major characteristics of proton therapy, to analyse the clinical data with regards to head and neck cancer patients, and to highlight the issue of patient selection and physical and biological uncertainties.
[Mh] Termos MeSH primário: Neoplasias de Cabeça e Pescoço/radioterapia
Terapia com Prótons
[Mh] Termos MeSH secundário: Seres Humanos
Neoplasias Otorrinolaringológicas/radioterapia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171005
[Lr] Data última revisão:
171005
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170905
[St] Status:MEDLINE


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[PMID]:28812103
[Au] Autor:Möbius P; Preidl RHM; Weber M; Amann K; Neukam FW; Wehrhan F
[Ad] Endereço:Department of Oral and Maxillofacial Surgery, University Hospital of Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany. patrick.moebius@fau.de.
[Ti] Título:Re-expression of pro-fibrotic, embryonic preserved mediators in irradiated arterial vessels of the head and neck region.
[Ti] Título:Reexpression profibrotischer, embryonal konservierter Mediatoren in bestrahlten arteriellen Gefäßen der Kopf- und Halsregion..
[So] Source:Strahlenther Onkol;193(11):951-960, 2017 Nov.
[Is] ISSN:1439-099X
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Surgical treatment of head and neck malignancies frequently includes microvascular free tissue transfer. Preoperative radiotherapy increases postoperative fibrosis-related complications up to transplant loss. Fibrogenesis is associated with re-expression of embryonic preserved tissue developmental mediators: osteopontin (OPN), regulated by sex-determining region Y­box 9 (Sox9), and homeobox A9 (HoxA9) play important roles in pathologic tissue remodeling and are upregulated in atherosclerotic vascular lesions; dickkopf-1 (DKK1) inhibits pro-fibrotic and atherogenic Wnt signaling. We evaluated the influence of irradiation on expression of these mediators in arteries of the head and neck region. MATERIALS AND METHODS: DKK1, HoxA9, OPN, and Sox9 expression was examined immunohistochemically in 24 irradiated and 24 nonirradiated arteries of the lower head and neck region. The ratio of positive cells to total cell number (labeling index) in the investigated vessel walls was assessed semiquantitatively. RESULTS: DKK1 expression was significantly decreased, whereas HoxA9, OPN, and Sox9 expression were significantly increased in irradiated compared to nonirradiated arterial vessels. CONCLUSION: Preoperative radiotherapy induces re-expression of embryonic preserved mediators in arterial vessels and may thus contribute to enhanced activation of pro-fibrotic downstream signaling leading to media hypertrophy and intima degeneration comparable to fibrotic development steps in atherosclerosis. These histopathological changes may be promoted by HoxA9-, OPN-, and Sox9-related inflammation and vascular remodeling, supported by downregulation of anti-fibrotic DKK1. Future pharmaceutical strategies targeting these vessel alterations, e. g., bisphosphonates, might reduce postoperative complications in free tissue transfer.
[Mh] Termos MeSH primário: Arteríolas/efeitos da radiação
Proteínas de Homeodomínio/metabolismo
Peptídeos e Proteínas de Sinalização Intercelular/metabolismo
Terapia Neoadjuvante
Osteopontina/metabolismo
Neoplasias Otorrinolaringológicas/radioterapia
Retalho Perfurante/irrigação sanguínea
Retalho Perfurante/patologia
Complicações Pós-Operatórias/patologia
Lesões por Radiação/patologia
Fatores de Transcrição SOX9/metabolismo
[Mh] Termos MeSH secundário: Arteríolas/metabolismo
Arteríolas/patologia
Fibrose
Seres Humanos
Neoplasias Otorrinolaringológicas/patologia
Neoplasias Otorrinolaringológicas/cirurgia
Transdução de Sinais/efeitos da radiação
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (DKK1 protein, human); 0 (Homeodomain Proteins); 0 (Intercellular Signaling Peptides and Proteins); 0 (SOX9 Transcription Factor); 0 (SOX9 protein, human); 0 (SPP1 protein, human); 0 (homeobox protein HOXA9); 106441-73-0 (Osteopontin)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170817
[St] Status:MEDLINE
[do] DOI:10.1007/s00066-017-1192-z


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[PMID]:28616822
[Au] Autor:Ursino S; D'Angelo E; Mazzola R; Merlotti A; Morganti R; Cristaudo A; Paiar F; Musio D; Alterio D; Bacigalupo A; Russi EG; Lohr F
[Ad] Endereço:Radiation Oncology, University Hospital S. Chiara, Via Roma 55, 56126, Pisa, Italy. stefano.ursino@med.unipi.it.
[Ti] Título:A comparison of swallowing dysfunction after three-dimensional conformal and intensity-modulated radiotherapy : A systematic review by the Italian Head and Neck Radiotherapy Study Group.
[Ti] Título:Ein Vergleich von Schluckstörungen nach dreidimensionaler konformaler und intensitätsmodulierter Strahlentherapie : Ein systematischer Review der "Italian Head and Neck Radiotherapy Study Group"..
[So] Source:Strahlenther Onkol;193(11):877-889, 2017 Nov.
[Is] ISSN:1439-099X
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:PURPOSE: Dysphagia is one of the most important treatment-related side effects in head and neck cancer (HNC), as it can lead to severe life-threating complications such as aspiration pneumonia and malnutrition. Intensity-modulated radiotherapy (IMRT) could reduce swallowing dysfunction by producing a concave dose distribution and reducing doses to the swallowing-related organs at risk (SWOARs). The aim of this study was to review the current literature in order to compare swallowing outcomes between IMRT and three-dimensional conformal radiotherapy (3DCRT). METHODS: A search was conducted in the PubMed and Embase databases to identify studies on swallowing outcomes, both clinically and/or instrumentally assessed, after 3DCRT and IMRT. Dysphagia-specific quality of life and objective instrumental data are summarized and discussed. RESULTS: A total of 262 papers were retrieved from the searched databases. An additional 23 papers were retrieved by hand-searching the reference lists. Ultimately, 22 papers were identified which discussed swallowing outcomes after 3DCRT and IMRT for HNC. No outcomes from randomized trials were identified. CONCLUSION: Despite several methodological limitations, reports from the current literature seem to suggest better swallowing outcomes with IMRT compared to 3DCRT. Further improvements are likely to result from the increased use of IMRT plans optimized for SWOAR sparing.
[Mh] Termos MeSH primário: Carcinoma de Células Escamosas/radioterapia
Transtornos de Deglutição/diagnóstico
Deglutição/efeitos da radiação
Neoplasias Otorrinolaringológicas/radioterapia
Lesões por Radiação/diagnóstico
Radioterapia Conformacional/efeitos adversos
Radioterapia de Intensidade Modulada/efeitos adversos
[Mh] Termos MeSH secundário: Seres Humanos
Órgãos em Risco/efeitos da radiação
Dosagem Radioterapêutica
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170616
[St] Status:MEDLINE
[do] DOI:10.1007/s00066-017-1160-7


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[PMID]:28514365
[Au] Autor:Boiko NV; Panchenko SN
[Ad] Endereço:Rostov State Medical University, Russian Ministry of Health, Rostov-on-Don, Russia, 344006.
[Ti] Título:[The detection of the human papilloma virus during hyperplastic processes in the nose, ears and throat].
[Ti] Título:Obnaruzhenie virusa papillomy cheloveka pri giperplasticheskikh protsessakh v LOR-organakh..
[So] Source:Vestn Otorinolaringol;82(2):51-54, 2017.
[Is] ISSN:0042-4668
[Cp] País de publicação:Russia (Federation)
[La] Idioma:rus
[Ab] Resumo:The objective of the present work was to carry out the virological and histological studies of various neoplastic and hyperplastic processes in the nose, ears, and throat with a view to identifying the presence of human papilloma virus and Epstein-Barr virus. The brush biopsies and remote neoplasms obtained from 18 patients (including 2 children and 16 adults) presenting with various ENT diseases and tumours were available for the virological investigation with the use of the polymerase chain reaction (PCR) and a system MY09-MY11 degenerate primers . The histological study of biopsies and remote neoplasms was carried out by means of conventional light microscopy. The virological and histological studies conducted in parallel confirmed the diagnostic significance of morphological changes at the tissue and cellular levels caused by the human papilloma virus.
[Mh] Termos MeSH primário: Orelha
Herpesvirus Humano 4/isolamento & purificação
Nariz
Neoplasias Otorrinolaringológicas
Papillomaviridae/isolamento & purificação
Faringe
[Mh] Termos MeSH secundário: Adulto
Biópsia/métodos
Criança
Orelha/patologia
Orelha/virologia
Feminino
Seres Humanos
Hiperplasia/diagnóstico
Hiperplasia/virologia
Masculino
Nariz/patologia
Nariz/virologia
Neoplasias Otorrinolaringológicas/patologia
Neoplasias Otorrinolaringológicas/virologia
Faringe/patologia
Faringe/virologia
Estatística como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170713
[Lr] Data última revisão:
170713
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170518
[St] Status:MEDLINE
[do] DOI:10.17116/otorino201782251-54


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[PMID]:28502275
[Au] Autor:Hui A; Hong P; Bezuhly M
[Ad] Endereço:Faculty of Medicine,Dalhousie University,Halifax,Nova Scotia,Canada.
[Ti] Título:Use of acellular dermal matrices in laryngotracheal and pharyngeal reconstruction: systematic review.
[So] Source:J Laryngol Otol;131(7):585-592, 2017 Jul.
[Is] ISSN:1748-5460
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Acellular dermal matrices are increasingly used in laryngotracheal and pharyngeal reconstruction, but specific indications and the type of acellular dermal matrix used vary. The authors systematically reviewed outcomes relating to acellular dermal matrix use in head and neck reconstruction. METHODS: Electronic databases were searched through 1 May 2016 for literature on acellular dermal matrix use in laryngotracheal and pharyngeal reconstruction. Studies were appraised for surgical indications, outcomes and study design. RESULTS: Eleven publications with 170 cases were included. Eight articles reported on acellular dermal matrix use in oncological reconstruction. Most studies were case series; no high-level evidence studies were identified. Graft extrusion was more common in non-oncological applications. In general, post-oncological reconstruction with an acellular dermal matrix demonstrated complication rates similar to those reported without an acellular dermal matrix. CONCLUSION: Evidence in support of acellular dermal matrix use in head and neck reconstruction is generally poor. Prospective comparative studies are required to define the indications, safety and effectiveness of acellular dermal matrices in laryngotracheal and pharyngeal reconstruction.
[Mh] Termos MeSH primário: Derme Acelular
Carcinoma de Células Escamosas/cirurgia
Cervicoplastia/métodos
Neoplasias Otorrinolaringológicas/cirurgia
[Mh] Termos MeSH secundário: Carcinoma de Células Escamosas/patologia
Seguimentos
Neoplasias Laríngeas/cirurgia
Estadiamento de Neoplasias
Neoplasias Otorrinolaringológicas/patologia
Neoplasias Faríngeas/cirurgia
Retalhos Cirúrgicos/cirurgia
Neoplasias da Traqueia/cirurgia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170516
[St] Status:MEDLINE
[do] DOI:10.1017/S0022215117001049


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[PMID]:28477871
[Au] Autor:Bernichon E; Rancoule C; Vallard A; Langrand-Escure J; Mery B; Guy JB; Magné N
[Ad] Endereço:Institut de cancérologie Lucien-Neuwirth, département d'oncologie médicale, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest-en-Jarez cedex, France.
[Ti] Título:[Immunotherapy: Activation of a system not a pathway].
[Ti] Título:Immunothérapie : après le focus sur les voies de signalisation, l'activation d'un système..
[So] Source:Bull Cancer;104(5):462-475, 2017 May.
[Is] ISSN:1769-6917
[Cp] País de publicação:France
[La] Idioma:fre
[Ab] Resumo:Immunotherapy is on the roll. After revolutionary effects in melanoma, immunotherapy is invading other locations. If current treatments, chemotherapies or targeted therapies block one pathway, immunotherapy should be understood as the activation of a whole system. Indeed, oncogenesis process is defined as an escape of the immune system and the stimulation of this system can block the carcinogenic process. The aim of the present review is to describe the place of immunotherapy in the treatment of solid cancers.
[Mh] Termos MeSH primário: Imunoterapia/métodos
Neoplasias/terapia
[Mh] Termos MeSH secundário: Anticorpos Monoclonais/uso terapêutico
Anticorpos Monoclonais Humanizados/uso terapêutico
Vacinas Anticâncer/uso terapêutico
Feminino
Neoplasias Gastrointestinais/terapia
Neoplasias dos Genitais Femininos/terapia
História do Século XIX
História do Século XX
História do Século XXI
Seres Humanos
Imunidade Celular
Imunoterapia/história
Ipilimumab
Neoplasias Renais/terapia
Neoplasias Pulmonares/terapia
Melanoma/imunologia
Melanoma/terapia
Neoplasias/imunologia
Neoplasias/patologia
Neoplasias Otorrinolaringológicas/terapia
Evasão Tumoral/imunologia
[Pt] Tipo de publicação:HISTORICAL ARTICLE; JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Antibodies, Monoclonal); 0 (Antibodies, Monoclonal, Humanized); 0 (Cancer Vaccines); 0 (Ipilimumab); 31YO63LBSN (nivolumab); 52CMI0WC3Y (atezolizumab); DPT0O3T46P (pembrolizumab)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170508
[St] Status:MEDLINE


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[PMID]:28424840
[Au] Autor:Yamazaki H; Demizu Y; Okimoto T; Ogita M; Himei K; Nakamura S; Suzuki G; Yoshida K; Kotsuma T; Yoshioka Y; Oh R
[Ad] Endereço:Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajiicho Kawaramachi Hirokoji, 602-8566, Kamigyo-ku, Kyoto, Japan. hideya10@hotmail.com.
[Ti] Título:Reirradiation for recurrent head and neck cancers using charged particle or photon radiotherapy.
[Ti] Título:Erneute Bestrahlung von wiederkehrenden Kopf-Hals-Tumoren mittels Ionen- oder Photonenstrahlentherapie..
[So] Source:Strahlenther Onkol;193(7):525-533, 2017 Jul.
[Is] ISSN:1439-099X
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To examine the outcomes of reirradiation for recurrent head and neck cancers using different modalities. METHODS: This retrospective study included 26 patients who received charged particle radiotherapy (CP) and 150 who received photon radiotherapy (117 CyberKnife radiotherapy [CK] and 36 intensity-modulated radiotherapy [IMRT]). Inverse probability of treatment weighting (IPTW) involving propensity scores was used to reduce background selection bias. RESULTS: Higher prescribed doses were used in CP than photon radiotherapy. The 1­year overall survival (OS) rates were 67.9% for CP and 54.1% for photon radiotherapy (p = 0.15; 55% for CK and 51% for IMRT). In multivariate Cox regression, the significant prognostic factors for better survival were nasopharyngeal cancer, higher prescribed dose, and lower tumor volume. IPTW showed a statistically significant difference between CP and photon radiotherapy (p = 0.04). The local control rates for patients treated with CP and photon radiotherapy at 1 year were 66.9% (range 46.3-87.5%) and 67.1% (range 58.3-75.9%), respectively. A total of 48 patients (27%) experienced toxicity grade ≥3 (24% in the photon radiotherapy group and 46% in the CP group), including 17 patients with grade 5 toxicity. Multivariate analysis revealed that younger age and a larger planning target volume (PTV) were significant risk factors for grade 3 or worse toxicity. CONCLUSION: CP provided superior survival outcome compared to photon radiotherapy. Tumor volume, primary site (nasopharyngeal), and prescribed dose were identified as survival factors. Younger patients with a larger PTV experienced toxicity grade ≥3.
[Mh] Termos MeSH primário: Radioterapia com Íons Pesados/métodos
Recidiva Local de Neoplasia/radioterapia
Neoplasias Otorrinolaringológicas/radioterapia
Fótons/uso terapêutico
Radiocirurgia
Radioterapia de Intensidade Modulada
Reirradiação
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Masculino
Meia-Idade
Recidiva Local de Neoplasia/mortalidade
Neoplasias Otorrinolaringológicas/mortalidade
Modelos de Riscos Proporcionais
Lesões por Radiação/etiologia
Dosagem Radioterapêutica
Estudos Retrospectivos
Fatores de Risco
Análise de Sobrevida
Resultado do Tratamento
Carga Tumoral
Adulto Jovem
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170916
[Lr] Data última revisão:
170916
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170421
[St] Status:MEDLINE
[do] DOI:10.1007/s00066-017-1129-6


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[PMID]:28412985
[Au] Autor:Harrison L; Corbridge R
[Ad] Endereço:Department of ENT,Head and Neck Surgery,Northampton General Hospital,UK.
[Ti] Título:Active surveillance management of head and neck paragangliomas: case series and review of the literature.
[So] Source:J Laryngol Otol;131(7):580-584, 2017 Jul.
[Is] ISSN:1748-5460
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Head and neck paragangliomas are rare. They are usually slow-growing, benign, non-catecholamine secreting tumours, traditionally treated with surgical excision. Complications of surgical excision include lower cranial nerve palsies, stroke and death. METHOD: A retrospective case note analysis was conducted of patients with head and neck paragangliomas treated with a watch-and-scan policy from March 2003 to September 2015, and the relevant literature was reviewed. RESULTS: Fifteen head and neck paragangliomas were identified. None of the patients developed a new lower cranial nerve palsy or progression of their presenting hearing loss during the follow-up period. Five patients displayed an increase in maximum linear dimension of 4 mm over an average of 57.4 months. A review of the literature showed that a watch-and-surveillance scan policy is evolving as a treatment option for head and neck paragangliomas without malignant risk factors. CONCLUSION: Readily available surveillance scanning in head and neck paragangliomas enables the monitoring of head and neck paragangliomas, which may allow for avoidance of major surgery.
[Mh] Termos MeSH primário: Neoplasias Otorrinolaringológicas/diagnóstico
Neoplasias Otorrinolaringológicas/terapia
Paraganglioma Extrassuprarrenal/diagnóstico
Paraganglioma Extrassuprarrenal/terapia
Conduta Expectante
[Mh] Termos MeSH secundário: Adulto
Idoso
Comorbidade
Doenças dos Nervos Cranianos/diagnóstico
Progressão da Doença
Feminino
Seguimentos
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Neoplasias Primárias Múltiplas/diagnóstico
Neoplasias Primárias Múltiplas/terapia
Estudos Retrospectivos
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170418
[St] Status:MEDLINE
[do] DOI:10.1017/S0022215117000809


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[PMID]:27905113
[Au] Autor:Pellini Ferreira B; Redman M; Baker KK; Martins R; Eaton KD; Chow LQM; Baik CS; Goulart B; Lee SM; Santana-Davila R; Rodriguez CP
[Ad] Endereço:Department of Medicine, University of Central Florida College of Medicine, Orlando, Florida, U.S.A.
[Ti] Título:Predictors of outcome with cetuximab and paclitaxel for head and neck squamous cell carcinoma.
[So] Source:Laryngoscope;127(7):1583-1588, 2017 Jul.
[Is] ISSN:1531-4995
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Identify predictors of outcome in patients with recurrent/metastatic head and neck squamous cell carcinoma (RMHNSCC) treated with weekly cetuximab and paclitaxel (CP). STUDY DESIGN: Retrospective analysis. METHODS: Patients with RMHNSCC treated with CP were identified and patient data was recorded. The Kaplan-Meier method was used to estimate outcomes, and Cox regression analysis was used to examine outcome predictors. RESULTS: Fifty-nine patients initiated CP between January 2007 and June 2014. Median age was 56 (range: 39-80) years. The most common primary sites were the oropharynx in 22 (37%) patients, oral cavity in 19 (32%), and larynx in 11 (19%). Eastern Cooperative Oncology Group performance status (ECOG PS) was 0 in seven (12%), 1 in 32 (54%), and 2 in 16 (28%) patients. In 44 (75%) patients, CP was used as a first-line R/M regimen. Median number of cycles was five (range: 1-29). Dose modifications were necessary in 27 (46%) patients. The objective response rate was 47.5%, with 27 (45.8%) partial responses and one (2%) complete response. With a median follow-up of 13.4 months, median progression-free (PFS) and overall survival (OS) were 7.7 and 13.2 months, respectively. On multivariable analysis, an ECOG of 2 of 3 was associated with inferior OS (hazard ratio [HR]: 3.94; P = 0.01; 95% confidence interval [CI]: 1.1-14.04) and PFS (HR: 7.29; P < 0.01; 95% CI: 2.1-26.0) compared to an ECOG 0 of 1. First-line CP administration was associated with superior PFS compared to second line (HR: 2.6; P = 0.02; 95% CI:1.2-5.5). CONCLUSIONS: CP is well tolerated in this population of patients, with favorable tumor efficacy. First-line use and an ECOG 0 of 1 points appears to confer superior outcomes. LEVEL OF EVIDENCE: 4. Laryngoscope, 127:1583-1588, 2017.
[Mh] Termos MeSH primário: Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Carcinoma de Células Escamosas/tratamento farmacológico
Cetuximab/administração & dosagem
Neoplasias Otorrinolaringológicas/tratamento farmacológico
Paclitaxel/administração & dosagem
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos
Carcinoma de Células Escamosas/mortalidade
Carcinoma de Células Escamosas/patologia
Cetuximab/efeitos adversos
Intervalo Livre de Doença
Esquema de Medicação
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Recidiva Local de Neoplasia/tratamento farmacológico
Recidiva Local de Neoplasia/patologia
Neoplasias Otorrinolaringológicas/mortalidade
Paclitaxel/efeitos adversos
Prognóstico
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
P88XT4IS4D (Paclitaxel); PQX0D8J21J (Cetuximab)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170822
[Lr] Data última revisão:
170822
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161202
[St] Status:MEDLINE
[do] DOI:10.1002/lary.26422



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