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At least 19 recordsLinked to original sources
PubMedDate not supplied

[Radiotherapy of tonsillar neoplasms. Evaluation of treatment results and late complications].

The aim of this study is to analyse the results of radiation treatment of 72 patients with squamous cell carcinoma of the tonsil, irradiated with 60Co. Three-year local control rates of 80% in T2 stage and 40% in T3 stage were noted. Total doses of 60-65 Gy in T2 lesions and at least 70 Gy in T3 lesions, fractionated in 2.0 Gy fractions, give a high loco-regional control probability. Overall treatment time is an important factor for local control of cancer of the tonsil. With treatment time prolonged over 40-45 days, local control rate decreases rapidly. Neck lymph nodes status influences the response of cancer of the tonsil. It suggests delivery of higher total dose in the region of primary lesion when neck lymph nodes are advanced, in stage N2 and N3 then in N0 a and N1.

Adult↗
PubMed1978

[Tonsillar neoplasms].

While it is generally accepted that the treatment of choice in carcinoma of the tonsil is transcutaneous radiotherapy (including lymphatic drainage), opinion on additional surgical interventions is still divided. The possible operations are extended tonsillectomy followed by radical neck dissection or the composite operation with partial mandibulectomy. The importance of the composite operation for T3 stage tumors is emphasized. Chemotherapy (bleomycin) was rarely used in our patients, and only initially in extensive carcinoma.

Bleomycin↗
PubMed1975

Osteoradionecrosis of the mandible. Treatment with hyperbaric oxygen.

Hyperbaric oxygen used in the treatment of 14 patients with intractable osteonecrosis of the mandible produced a favorable response in relief of pain, elimination of extraoral draining sinus tracts, the return of osseous union in areas of the abnormal fracture, and the rapid dissolution of sequestrum without suppuration, so that further loss of hard and soft tissue was minimized. This treatment is a more conservative approach in the management of osteoradionecrosis.

Adult↗
PubMed1978

Oral and oropharyngeal carcinoma: surgical treatment in irradiated and nonirradiated patients.

Surgical treatment was used in 45 cases of oral cavity carcinoma and in 23 cases of oropharyngeal carcinoma. The three-year cure rate was 47% for oral cavity tumors and 9% for orophayngeal lesions. The cure rate was substantially higher in female patients than in males and in white patients than in nonwhites. Results of composite resections in 23 previously irradiated patients and 23 nonirradiated patients with T-2 and T-3 lesions are compared. The irradiated patients with oral cavity carcinoma had a lower cure rate and a much greater incidence of postoperative morbidity than the patients treated with operation alone. Surgical results for oropharyngeal carcinomas were poor in both radiated and nonirradiated patients, although the incidence of postoperative morbidity and mortality was higher in the irradiated group.

Female↗
PubMed1979

Squamous cell carcinoma of the tonsil and tongue-base region.

From 1969 through 1975, 145 patients were treated for squamous cell carcinoma of the tonsil and tongue-base region; 119 received initial treatment, and salvage operations were done in 26. The overall five-year survival rate was 42%. Cervical metastasis was the most important determinant of survival. Pathologic stage I or II disease was controlled by surgical treatment. In patients with stage III or IV disease, operation alone controlled the primary lesion better than radiation alone or combined preoperative radiation and surgical treatment. With operation alone, however the rate of neck recurrence was higher than with the other two methods of treatment. In advanced disease, surgical treatment combined with postoperative radiation should be considered. Mandibular osteotomy and excision of the primary lesion are as effective in local tumor control as composite resection. In patients with a tumor-free margin, osteotomy can be used to preserve the mandible.

Aged↗
PubMed1987

A comparison of flow cytometric DNA analyses of fresh and fixed squamous cell carcinomas.

Aberrations in chromosome number, ploidy abnormalities, have been associated with malignancy and are predictive of outcome. Automated flow cytometry has made DNA analysis applicable to many solid tumors. Analysis can be performed on fixed specimens, allowing archival retrieval. The techniques, however, are unique and must be individually tested for each tumor type. Presently, few studies have been applied to head and neck cancers. This series of flow cytometric DNA analyses compares the results of 17 fresh and fixed head and neck squamous cell carcinoma specimens. Aneuploidy was present to a significant degree (47%). The method produced interpretable results in 100% of cases, with 100% reproducibility. Fresh and fixed tumor specimens yielded comparable results 76% of the time and, in fact, interpretability of fixed specimens was superior. This series demonstrates a practical and accurate flow cytometric DNA assay for fixed squamous cell carcinoma specimens, facilitating rapid retrospective ploidy analysis.

Carcinoma, Squamous Cell↗
PubMed1977

High-energy photon and electron beam.

The optimum radiation treatment plan for any given clinical situation can be achieved by combining various irradiation modalities and beam energies. The availability of equipment that provides photon and electron beams of energies from 4 MeV to 25 MeV permits optimal dose distribution throughout the treatment volume. Since no difference in the biological effectiveness of electrons compared with megavoltage photons has been demonstrated in laboratory studies, there is no hesitation in combining electrons with photons. The selection of the various energies, the combination of electrons with photons, and the ratio of the given doses of each beam depend on the location of the tumor and the maximum depth to be treated. With the use of one beam alone, a combination of 25 MeV and 4 to 6 MeV photon beams, or a combination of photons and electrons, the most effective treatment plan with the available beams can be designed for any clinical situation.

Adult↗
PubMed1977

Treatment of the neck in patients with squamous cell carcinoma of the head and neck.

A retrospective study of 702 patients with clinically positive nodes associated with squamous cell carcinoma of the oral cavity, supraglottic larynx, and hypopharynx observed from 1954 to 1968 was done. The policies of treatment for the neck were not standardized during those years. Three hundred eleven patients who survived 24 months with the primary lesion controlled were divided into two groups: 1) those whose neck was treated by surgery alone; and 2) those who had combined radiation therapy and surgery to the neck, to test the efficacy of the two forms of treatment. For the three sites, the recurrence rate in the necks for the surgically treated group was 14% for stage N1, 26% for N2 and 34% N3. Rates for the group receiving combined treatment were 2%, 11% and 25% respectively. Results of the study also showed that elective irradiation, 5,000 rads in five weeks, will prevent metastasis from occurring in the NO staged neck.

Carcinoma, Squamous Cell↗
PubMed1979

Swallowing disorders in three types of head and neck surgical patients.

This study examined swallowing transit times and motility problems in three groups of patients following ablative surgery for oropharyngeal carcinoma and in a control group of 10 normal subjects. A total of 30 patients was studied: 10 after anterior floor of mouth resection, 12 after tonsil/base of tongue resection, and 8 after supraglottic laryngectomy. Videofluoroscopic studies of liquid, thin paste, thick paste, and thick paste plus liquid swallows were completed 1 week post-initiation of oral feeding following surgery. From the videotapes, oral and pharyngeal transit times were measured, and motility disturbances were defined during each stage of the swallow. All three types of patients in this study showed severe problems with swallowing. The anterior floor of mouth resection patients had problems with preparation for the swallow and oral transit. Tonsil/base of tongue resection patients had slowing in the preparation for the swallow and in the oral and pharyngeal stages. After supraglottic laryngectomy, patients showed only slight slowing in oral transit and pharyngeal transit as compared to other types of surgical patients.

Adult↗
PubMedDate not supplied

Management of stage I-II diffuse aggressive non-Hodgkin's lymphoma of the Waldeyer's ring: combined modality therapy versus radiotherapy alone.

Twenty five patients with stage I and II diffuse aggressive non-Hodgkin's lymphoma of the Waldeyer's ring were reviewed. There were 19 patients with diffuse histiocytic, 4 diffuse lymphocytic poorly differentiated and 2 diffuse mixed lymphoma. Their median age was 51 years. There were 12 males and 13 females. Eight patients had stage I, and 17 had stage II disease. There was a significantly higher incidence of involvement of the left side of the Waldeyer's ring compared to the right (p = 0.0251). Fifteen patients received radiotherapy alone, and ten had radiotherapy and chemotherapy. The median durations of follow-up were 42 (range 8-162) and 44 (range 8-97) months respectively. All patients had complete remission but 9 patients (36 per cent) subsequently had relapse of their lymphomas. Stomach was the commonest site of relapse (44 per cent). The disease free survival and overall survival at 5 years were 59 per cent and 57 per cent respectively. Higher relapse rate was observed in the radiotherapy alone group (60 per cent) as compared to the combined modality therapy group (0 per cent). Patients who received combined modality therapy had significantly superior 5 years disease free survival (100 per cent versus 32 per cent, p less than 0.01) and overall survival (81 per cent versus 40 per cent, p less than 0.05). After radiotherapy alone, patients with stage II disease appeared to have a high relapse rate than those with stage I disease (70 per cent versus 40 per cent) but the difference did not reach statistical significance due to small sample sizes. The histological subtypes did not appear to affect their prognosis. All patients with stage I and II diffuse aggressive non-Hodgkin's lymphoma of the Waldeyer's ring should have gastrointestinal barium studies at initial staging, and a prospective randomised study on these patients comparing radiotherapy alone and combined modality therapy should be performed.

Adolescent↗
PubMed1991

Epstein-Barr virus and carcinomas: undifferentiated carcinomas but not squamous cell carcinomas of the nasopharynx are regularly associated with the virus.

The Epstein-Barr virus (EBV) is consistently associated with undifferentiated nasopharyngeal carcinoma (NPC). There is, however, conflicting evidence as to whether squamous cell NPCs are also EBV-associated. Moreover, it has been proposed that other epithelial tumours, particularly thymomas and thymic carcinomas, should be included in the group of EBV-associated neoplasias. However, since the viral DNA in these studies was demonstrated only in extracted DNA, the cellular origin of the viral DNA is uncertain. We have therefore investigated 152 epithelial tumours from various sites for the presence of EBV-DNA by in situ hybridization with 35S-labelled probes. Sixty-eight of 77 undifferentiated NPCs showed an EBV-specific autoradiographic signal, thus confirming the strong association of this tumour type with EBV even in geographical areas where undifferentiated NPC is not endemic. None of eight squamous cell NPCs showed an EBV-specific signal. All of 15 carcinomas with a similar morphology to undifferentiated NPC but from different anatomic sites (thymus, tonsil, breast) were EBV-negative as were 9 thymomas, 26 squamous cell carcinomas of the palatine tonsil, and 14 cervical carcinomas. Our results therefore suggest a unique association of EBV with undifferentiated NPC and support concepts assigning different biological properties to undifferentiated NPC as compared with squamous cell NPC.

Carcinoma, Squamous Cell↗
PubMed1989

Natural killer cells and metastases from pharyngeal carcinoma.

Natural killer cell activity was assessed in 100 previously untreated pharyngeal carcinoma patients. Diminished natural killer cell function in these patients was associated with an increased risk of death from uncontrolled regional and distant metastases. During the assessment, the cell line MDA686-Ln was established from a metastatic pharyngeal carcinoma of a patient with low natural killer cell cytotoxicity. The initially cytotoxicity-resistant cell line could be lysed when natural killer cell cytotoxicity was enhanced in vitro either through enrichment of a Leu 19+ natural killer cell population by fluorescent-activated cell sorting or by interleukin-2 activation. Additionally, increased circulating immune complexes were identified in these patients, subsequently isolated, and found to block natural killer cell reactivity against MDA686-Ln. In light of this negative interaction, 38 patients were randomly evaluated for both circulating immune complex levels and natural killer cell function. Both parameters examined together were complementary in defining the risk of death with disease; four of five deaths occurred in patients with both high circulating immune complex levels and low natural killer cell function. Results support the biologic modification of natural killer cell activity for controlling metastatic pharyngeal carcinoma and point to the potential confounding influence of circulating immune complex.

Adult↗
PubMed1987

Hodgkin's lymphoma of the oropharyngeal region: report of four cases and diagnostic value of monoclonal antibodies in detecting antigens associated with Reed-Sternberg cells.

In a review of more than 500 cases from the Lymphoma Registry, Department of Anatomic Pathology, University Hospital Purpan, Université Paul Sabatier, Toulouse, France, four cases of primary lesions in the oropharyngeal region were found. There were two lesions in the palatine tonsil, one in the nasopharynx, and one in the parotid gland. The average age of the patients was 54.5 years (range, 37 to 70 years), and all patients were men. The histologic types were lymphocyte predominance (one case), nodular-sclerosis (one case), and mixed cellularity (two cases). The patients were respectively staged as IAa, IIAa, and IIIA. They were treated with radiation, chemotherapy, or both. All four patients are now free of tumor and have been followed from 18 months to more than 6 years after definitive diagnosis and appropriate therapy. Immunohistochemistry significantly contributes to the differential diagnosis of atypical Hodgkin's disease from non-Hodgkin's lymphomas, especially in extranodal sites. Dako-EMA and Leu-M1 monoclonal antibodies are reactive, respectively, with L and H variants (Dako-EMA+, Leu-M1-) in the lymphocyte predominance type (Type 1) and with Reed-Sternberg cells (Dako-EMA-, Leu-M1+) in the nodular-sclerosis (Type 2), mixed cellularity (Type 3), and lymphocyte depletion (Type 4) types.

Adult↗