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PubMedDate not supplied

[Importance of upper digestive endoscopy using lugol dye solution for the diagnosis of superficial esophageal cancer and dysplasia in patients with head and neck neoplasms].

Head and neck cancer has a high incidence in Brazil, with cancer of the oral cavity being one of the five most common cancers among Brazilians. Alcohol and tobacco consumption may contribute to synchronous or metachronous head and neck cancer and esophageal cancer. A prospective study involving 60 patients with head and neck cancer was carried out at the State University of Campinas--UNICAMP, Campinas, SP, Brazil to screen for superficial esophageal cancer and dysplasia using endoscopy and a 2% lugol dye solution followed by biopsy of the suspicious areas. Five patients (8.3%) had superficial esophageal cancer, which was diagnosed as intraepithelial carcinoma in three of them (5.0%). In four patients, the superficial esophageal cancer was synchronous and in one it was metachronous to head and neck cancer. Five patients (8.3%) had dysplasias in the esophageal epithelium (three were classified as mild and two as moderate). These results demonstrate the value of endoscopic screening of the esophagus using lugol dye in patients with head and neck cancer, particularly since superficial esophageal cancer is extremely difficult to detect by conventional methods in asymptomatic patients.

Adult↗
PubMed2003

TP53 and head and neck neoplasms.

Head and neck cancer is an important health problem around the world, accounting for approximately 500,000 new cases each year of head and neck squamous cell carcinoma (HNSCC). Carcinogenesis of head and neck results from a dysregulation of cellular proliferation, differentiation, and cell death. The major etiologic agents are tobacco and alcohol consumption and for some cases, human papilloma virus (HPV) infection. All three factors are associated with the disruption of a cellular pathway essential for the maintenance of cellular integrity, the p53 pathway. The objective of this review is to point out the specificity of p53 gene (TP53) alterations in head and neck cancer in relation with chemocarcinogenesis and to discuss whether or not the determination of p53 alterations will be of clinical relevance in the management of head and neck cancer in terms of prognosis and response to treatments.

Alcohol Drinking↗
PubMed1990

[Phase II study with pirarubicin in pretreated progressive head-neck neoplasms].

Sixteen heavily pretreated patients (pts) (4 surgery + chemotherapie + radiotherapy; 4 chemotherapy + radiotherapy: 6 surgery + radiotherapy; 2 chemotherapy) and one previously untreated patient, who refused surgery and or radiotherapy, all with progressive disease, with advanced squamous cell carcinoma of the head and neck were included in a phase II study with pirarubicin 60 mg/m2 i.v. day 1 every 3-4 weeks (CT). All pts received at least one course of CT. 15 pts were evaluable for response, all 17 pts were evaluable for toxicity. Female (male ratio 1/16; mean age 56 (42-68) yrs, mean performance status 70% (50-70). Seventeen pts received a mean of 3 (1-8) courses, 2 pts had received only one course of CT. Response and toxicity were assessed according to WHO classification. Results after 1-8 courses of CT: 1 (7%) complete remission; 1 (7%) partial remission; 9 (60%) no change; 4 (26%) progressive disease. No toxicity of grade IV was observed. Mean duration of remission 16 weeks. Median survival time 7 (1-10) months. 9 pts died and 8 pts are alive; six of them had progressive disease.

Adult↗
PubMed1993

[Ultrasound diagnosis of regional lymph node metastasis of the neck in patients with head-neck neoplasms: sono-morphologic criteria and diagnostic accuracy].

High resolution sonography is generally considered a diagnostic tool with high sensitivity but low specificity in the assessment of cervical lymph node metastases. This study shows, that excellent sonographic results regarding sensitivity and specificity can be achieved, if sonomorphologic parameters, such as size, shape, delineation and type of echo pattern are included in the evaluation. We compared sonomorphology and histology of 82 patients operated for head and neck malignancies. The sonomorphological and histological findings in the largest lymph nodes in all neck areas were compared, and if a definite identification was possible, also in the second largest ones. Virtually, all longitudinal nodes of any size and practically all oval nodes of an axial diameter of up to 20 mm were found to be free of metastases, whereas 80% of round nodes with an axial diameter of up to 20 mm and practically all round and oval nodes exceeding 20 mm in axial diameter as well as irregularly shaped, poorly delineated and structurally inhomogeneous nodes demonstrated metastatic disease. On the basis of these results we have established the following criteria for the assessment of cervical lymph node metastases: All findings demonstrating longitudinal nodes of any size and oval nodes less than 20 mm in axial diameter are to be considered sonographically negative, whereas findings in which oval nodes exceeding 20 mm in axial diameter, as well as round, irregularly shaped, poorly delineated or inhomogeneous lymph nodes are found to be classified malignant. Of 58 sonographically positive neck areas, 54 were found to be malignant on histological examination, while 23 of 24 sonographically negative areas corresponded with histologically benign findings.(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma, Adenoid Cystic↗
PubMed1990

[Radiotherapy of head-neck neoplasms: prevention of inflammation of the mucosa by sucralfate treatment].

The mucosal protective effect of sucralfate (Ulcogant) was evaluated in a prospective randomised clinical study during radiation therapy. Twenty-four patients received 1 g of a sucralfate suspension 4 times a day orally for 5 min each. This group was compared with a control group of 21 patients receiving standard oral hygiene consisting of frequent tooth cleaning and disinfection of the oral and pharyngeal mucosa. The radiation technique was telecobalt therapy in two opposing fields using the shrinking field technique, with an electron boost to the posterior lymph nodes; the dosage was 60-70 Gy in daily fractions of 2 Gy. Mucosal reactions, pain and difficulty in swallowing were recorded twice a week. We also checked the patient's weight during treatment. The patients showed significant differences in all parameters, and lower weight loss compared with the control group. Minimal or absent mucosal inflammation pain or dysphagia were found in 88%, 79% and 83% respectively, while 43% and 29% and 52% of the controls had such mild radiation side-effects. Local effectivity appeared to be less in the hypopharynx due to shorter time of application compared with mouth and oropharynx. There were no side-effects from the sucralfate. Sucralfate prophylaxis is effective and easy to apply in the protection of mucosa during irradiation therapy.

Adult↗
PubMed1998

[Diagnostic imaging of the salivary glands in patients undergoing radiotherapy of head and neck neoplasms].

INTRODUCTION: Radiotherapy of head and neck cancers changes the shape and function of the salivary glands included in the treated region. We investigated the morphological and functional alterations in the major salivary glands in 15 patients treated with radiotherapy for head and neck cancers (total dose: 55-66 Gy). MATERIAL AND METHODS: All the patients underwent B-mode and power Doppler US, CT and 99mTC salivary scintigraphy, before, at the end, and 60-80 days after radiotherapy. RESULTS: At the end of treatment, US showed irregular margins and inhomogeneous parenchymal echogenicity in 13 parotid and in eight submandibular glands. Doppler US showed of focal hyperemia and focally decreased or no intraparenchymal flow in nine parotid and in two submandibular glands. CT demonstrated parenchymal inhomogeneity with increased and decreased density areas, cancers irregular margins, and gland atrophy in 15 parotid and in eight submandibular glands. Salivary scintigraphy depicted injuries of the major salivary glands detecting their reduced pertechnetate uptake in 12 parotid and in eight submandibular glands, with a decreased drug excretion in 12 parotid and in 12 submandibular glands. DISCUSSION AND CONCLUSION: Our findings confirm that the major salivary glands are affected by radiotherapy, which makes their morphological and structural monitoring of vital importance. US is the technique of choice for its low cost and easy execution, and it is well accepted by the patients because it requires no exposure to ionizing radiations. Power Doppler provided no relevant information, but it confirmed the high resistance of small and middle caliber vessels after radiotherapy. Scintigraphy clearly showed the glands involvement demonstrating decreased uptake technetium secretion and excretion. In conclusion, US and CT are both extremely useful in the study of the morphological changes of the major salivary glands.

Adult↗
PubMed1989

[Study of multiregression analysis on NK activities and related clinical factors in patients with head and neck neoplasms].

NK activity in patients with head and neck neoplasms treated with radiation and chemotherapeutics was studied on the influence of 19 factors by using the method of multiregression analysis. Of these factors, BUN, WBC, the size of radiation portal, chemotherapy, radiation doses, total protein (T.P.), age and GOT were significantly influenced on the fluctuation of NK activity (p less than 0.05). In the studies of the size of radiation portal and its doses, NK activity showed a tendency to increase with radiation dose in small size of radiation portal and a tendency to reduce in large size of it.

Adult↗
PubMed2003

[Postoperative rupture of carotid artery in head and neck neoplasms].

OBJECTIVE: To explore the treatment of neoplasms in head and neck invaded the carotid artery. METHODS: Four cases with postoperative rupture of carotid artery invaded by the head and neck cancer were reviewed. The tumours were taken off from the carotid arteries and the carotid artery remained. RESULT: Rupture of carotid artery occurred in 4 patients within one week after radical neck dissection. One patient died because of its rupture again after repair. The other three survived after ligating the artery. CONCLUSION: The carotid artery involved by tumour of head and neck should be prepared for resection before operation. If the artery was obviously invaded by the tumour, both the tumour and artery should be resected together. Once the rupture of the artery occurred after operation, the artery must be ligated instead of being repaired.

Carotid Artery Diseases↗
PubMedDate not supplied

Ultrasonic analysis of head and neck neoplasms. Correlation with surgical findings.

Ultrasonography of head and neck neoplasms is useful in the preoperative evaluation of patients. Inflammatory masses demonstrate high reflectivity in a homogeneous pattern and have diffuse borders. Similarly, lipomas show medium to high reflectivity and have a homogeneous pattern, but are well outlined. Mixed tumors of the major salivary glands have a characteristic heterogeneous pattern and are well outlined. Malignant lesions demonstrate low reflectivity in a homogeneous or heterogeneous pattern and have poorly outlined or diffuse borders. Cysts of the head and neck are well outlined and devoid of interior echoes.

Adolescent↗
PubMed1987

Evaluation of poorly differentiated head and neck neoplasms. Immunocytochemistry techniques.

Despite the use of strict morphologic criteria, some head and neck neoplasms remain classified as "poorly differentiated" or "undifferentiated." To circumvent this diagnostic quandary, newer techniques primarily based on immunocytochemistry are being utilized to study tumor specimens. These methods rely on the binding of specific antibodies to cellular antigens in order to better define the tumor according to cell type. We treated six patients in whom a definitive pathologic diagnosis could not be obtained without the use of immunohistologic stains. In each case, the definition of a specific tumor category altered patient management. The approach to the evaluation of patients with undifferentiated head and neck neoplasms is important. Close cooperation between the clinician and pathologist is necessary in such cases; this is assisted by a knowledge of the uses and limitations of the current diagnostic modalities being used, as well as proper tissue handling and processing.

Adult↗