76
|
Lønbro S, Dalgas U, Primdahl H, Johansen J, Nielsen JL, Overgaard J, Overgaard K. Lean body mass and muscle function in head and neck cancer patients and healthy individuals--results from the DAHANCA 25 study. Acta Oncol 2013; 52:1543-51. [PMID: 23964657 DOI: 10.3109/0284186x.2013.822553] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Loss of lean body mass is common following radiotherapy in patients with head and neck squamous cell carcinoma (HNSCC) and may reduce maximal muscle strength and functional performance. However, the associations between lean body mass, muscle strength and functional performance are unclear and no studies in HNSCC patients have compared the levels of these variables to the levels seen in healthy individuals. PURPOSE The purpose of the present study was to investigate the associations between lean body mass, maximal muscle strength and functional performance in HNSCC patients and to compare the levels of these variables after radiotherapy and after progressive resistance training with the levels in healthy individuals. MATERIAL AND METHODS Lean body mass (dual energy X-ray absorptiometry), maximal muscle strength (isokinetic dynamometry) and functional performance (10 m max gait speed, 30 s chair rise, 30 s arm curl, stair climb) from HNSCC patients from the DAHANCA 25 trials and data from 24 healthy individuals were included. RESULTS Lean body mass and maximal muscle strength were significantly associated according to the gender and age-adjusted linear regression model (p < 0.0001). In addition, maximal muscle strength were associated with 30 s arm curl performance, 10 m max gait speed and 30 s chair rise (p < 0.0001). Multiple regression analyses showed that HNSCC patients expressed significant lower levels of the investigated variables after radiotherapy than healthy individuals (p < 0.0001), and that all differences were evened out after training. CONCLUSIONS Significant associations were found between lean body mass, maximal muscle strength and functional performance in HNSCC patients. Patients expressed lower levels of these variables compared with healthy individuals, suggesting that lean body mass is a clinically relevant health factor in HNSCC patients.
Collapse
|
77
|
Hey C, Lange BP, Eberle S, Zaretsky Y, Sader R, Stöver T, Wagenblast J. Water swallow screening test for patients after surgery for head and neck cancer: early identification of dysphagia, aspiration and limitations of oral intake. Anticancer Res 2013; 33:4017-4021. [PMID: 24023344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Patients with head and neck cancer (HNC) are at high risk for oropharyngeal dysphagia (OD) following surgical therapy. Early identification of OD can improve outcomes and reduce economic burden. This study aimed to evaluate the validity of a water screening test using increasing volumes postsurgically for patients with HNC (N=80) regarding the early identification of OD in general, and whether there is a need for further instrumental diagnostics to investigate the presence of aspiration as well as to determine the limitations of oral intake as defined by fiberoptic endoscopic evaluation of swallowing. OD in general was identified in 65%, with aspiration in 49%, silent aspiration in 21% and limitations of oral intake in 56%. Despite a good sensitivity, for aspiration of 100% and for limitations of oral intake of 97.8%, the presented water screening test did not satisfactorily predict either of these reference criteria due to its low positive likelihood ratio (aspiration=2.6; limitations of oral intake=3.1). However, it is an accurate tool for the early identification of OD in general, with a sensitivity of 96.2% and a positive likelihood ratio of 5.4 in patients after surgery for HNC.
Collapse
|
78
|
Funk CS, Warmling CM, Baldisserotto J. A randomized clinical trial to evaluate the impact of a dental care program in the quality of life of head and neck cancer patients. Clin Oral Investig 2013; 18:1213-1219. [PMID: 23989505 DOI: 10.1007/s00784-013-1068-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Accepted: 07/22/2013] [Indexed: 01/03/2023]
Abstract
OBJECTIVES A randomized clinical trial (RCT) to evaluate the impact of dental care program on the quality of life (QOL) of head and neck cancer patients under oncological treatment. MATERIALS AND METHODS The study design was a parallel RCT where 46 subjects with a diagnosis of head and neck primary neoplasy were randomly allocated to the control (CG) or test group (TG). Both groups received basic dental care but the TG received a complimentary care before and during, oncological therapy. Data related to general (WHOQOL-BREF) and specific (EORTC QLQ H&N 35) QOL were assessed before and 15 days after the conclusion of the oncological therapy. RESULTS The TG showed an improvement in the general and specific QOL, while the CG showed a worsening in these indexes but without significant difference. The variation between the initial and final measures in the TG shows a tendency of significant improvement along the time. A reduction in candidiasis (p < 0.05) and muccositis was observed in the TG. CONCLUSION In a short follow-up period, dental care was able to reduce damage from the oncological therapy especially related to muccositis and candidiasis, although the QOL was not significantly improved. However, a longer follow-up to measure the late side effects over the QOL of these patients is necessary. CLINICAL RELEVANCE Provision of continuous dental care for head and neck cancer patients can reduce deleterious side effects of the oncological treatment.
Collapse
|
79
|
Hey C, Lange BP, Aere C, Eberle S, Zaretsky Y, Sader R, Stöver T, Wagenblast J. Predictability of oral and laryngopharyngeal function for aspiration and limitation of oral intake in patients after surgery for head and neck cancer. Anticancer Res 2013; 33:3347-3353. [PMID: 23898102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Swallowing disorders are common in patients after surgery for head and neck cancer. The clinical assessment of oral and laryngopharyngeal abilities is widely used as a dysphagia assessment tool in this patient group, despite a lack of research. The goal of this study was to assess the predictability of clinical parameters for aspiration and limitation of oral intake. A swallowing disorder with the need for further intervention was identified by fiberoptic endoscopic evaluation of swallowing (FEES) in 65%, with aspiration in 49%, silently in 21%, and limited oral intake with tube dependency in 56% of studied patients. Four clinical parameters (dysglossia, wet voice, tongue motility, and tongue strength) correlated significantly with aspiration and limitation of oral intake. However, none of these clinical parameters was able to predict one of our two reference criteria, due to low positive likelihood ratios, mostly less than two. Clinical assessment is therefore inappropriate for early detection of swallowing disorders in such patients.
Collapse
|
80
|
Kumar P, Jain V, Thakar A, Aggarwal V. Effect of varying bulb height on articulation and nasalance in maxillectomy patients with hollow bulb obturator. J Prosthodont Res 2013; 57:200-5. [PMID: 23809296 DOI: 10.1016/j.jpor.2013.02.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Revised: 01/31/2013] [Accepted: 02/19/2013] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate the effect of bulb height of hollow bulb obturator prosthesis on articulation and nasalance. METHOD A total of 10 patients, who were to undergo maxillectomy falling under Aramany class-I and II, with normal speech and hearing pattern were selected for the study. They were provided 2 maxillary obturators, one extending full height of the defect and other with bulb height approximately up to inferior nasal concha. The patients were asked to wear each obturator for 6 weeks and the speech analysis was done to measure changes in articulation and nasalance at 6 different stages of treatment i.e. preoperative, postoperative (after complete healing), 24h and 6 weeks after providing full bulb height obturator and reduced bulb height obturator. Articulation was measured objectively for distortion, addition, substitution and omission by speech pathologist and nasalance was measured by Dr. SPEECH software. RESULT Comparison between full and reduced bulb height for nasalance and articulation, showed that there was no statistical significant difference (P>0.05) between the two for both the parametres. CONCLUSION Articulation and nasality improves after providing obturator. Articulation and nasalance both are independent of bulb height.
Collapse
|
81
|
Turnock A, Calder PC, West AL, Izzard M, Morton RP, Plank LD. Perioperative immunonutrition in well-nourished patients undergoing surgery for head and neck cancer: evaluation of inflammatory and immunologic outcomes. Nutrients 2013; 5:1186-99. [PMID: 23571650 PMCID: PMC3705342 DOI: 10.3390/nu5041186] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 03/21/2013] [Accepted: 03/26/2013] [Indexed: 12/16/2022] Open
Abstract
Limited work is available on the benefits of nutritional support enriched with arginine and n-3 fatty acids in surgical patients with head and neck cancer, particularly if well-nourished. We conducted a pilot study in these patients to examine effects on inflammatory markers and clinical outcome. Patients scheduled for radical resection of the oral cavity were randomised to 5 day preoperative and 5 day postoperative Impact® (IMN, n = 4), or no preoperative supplementary nutrition and Isosource® postoperatively (STD, n = 4). Plasma fatty acids, C-reactive protein (CRP), tumour necrosis factor (TNF)-α, interleukin (IL)-6 and IL-10 were measured at baseline, day of surgery and on postoperative days (POD) 2, 4 and 10. Postoperative complications were recorded. The (eicosapentaenoic acid plus docosahexaenoic acid) to arachidonic acid ratio was significantly higher in IMN patients on POD 2, 4 and 10 (P < 0.01). While not statistically significant, CRP, TNF-α, and IL-6 concentrations were higher in the STD group on POD2 while IL-10 was lower. Median length of stay was 10 (range 10–43) days in the IMN group and 21.5 (7–24) days in the STD group. Five complications were seen in the STD group and two in the IMN group. The results support the need for a larger trial focusing on clinical outcome.
Collapse
|
82
|
Xiao C, Hanlon A, Zhang Q, Ang K, Rosenthal DI, Nguyen-Tan PF, Kim H, Movsas B, Bruner DW. Symptom clusters in patients with head and neck cancer receiving concurrent chemoradiotherapy. Oral Oncol 2013; 49:360-6. [PMID: 23168337 PMCID: PMC3924732 DOI: 10.1016/j.oraloncology.2012.10.004] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Revised: 10/02/2012] [Accepted: 10/03/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVES This study is to identify symptom clusters for head and neck (HNC) patients treated with concurrent chemoradiotherapy. PATIENTS AND METHODS A secondary data analysis of 684 HNC patients treated on the Radiation Therapy Oncology Group (RTOG) 0129 trial comparing different RT fractionation schedules with concurrent chemotherapy was used to examine clusters. Treatment-related symptoms were measured by clinicians at three time-points during and after chemoradiotherapy using the National Cancer Institute Common Toxicity Criteria v2.0. Exploratory factor analysis was applied to identify symptom clusters, which was further verified by confirmatory factor analysis. Coefficients of congruence and alpha coefficients were employed to examine generalizability of cluster structures over different time-points and in different subgroups. RESULTS Two clusters were identified. The HNC specific cluster is composed of radiodermatitis, dysphagia, radiomucositis, dry mouth, pain, taste disturbance, and fatigue. The gastrointestinal (GI) cluster involves nausea, vomiting, and dehydration. With the exception of patients 65years old or older, diagnosed with larynx cancer, or with stage III cancer, the two clusters were generalizable to different subgroups defined by age, gender, race, education, marital status, history of tobacco use, treatments, primary sites, disease stages, and tube feedings, as well as to the three symptom assessment time-points. CONCLUSIONS The data provides preliminary support for two stable clusters in patients with HNC. These findings may serve to inform the symptom management in clinical practice. Moreover, the findings necessitate future research to examine the generalizability of identified clusters in the late symptom phase or other treatment modalities, and to understand the underlying biological mechanism.
Collapse
|
83
|
Woisard V, Espesser R, Ghio A, Duez D. [From intelligibility to comprehension, which measurement in practice?]. REVUE DE LARYNGOLOGIE - OTOLOGIE - RHINOLOGIE 2013; 134:27-33. [PMID: 24494329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
UNLABELLED The modelling of the tests assessing speech disorders in touch with the international classification of the functioning implies a reflection on measurement tools. The access to the sense of the message from decoding of the signal to the action infers at the interlocutor's justifies various methods. The objective of this work is to demonstrate the limit of the usual tests of intelligibility. MATERIAL AND METHOD A population of 10 subjects presenting a speech disorder secondary to a Head and Neck cancer and 2 subjects controls recorded a corpus of 80 syllables developed with the most frequent 16 French consonants and 5 vowels. The test of intelligibility consisted of a task of identification of consonants by a jury of 11 listeners. RESULTS About is the method used to estimate the informative value of the consonants tested, the uvular consonant /r/ and the nasal In/, /m/ are very well perceived. The weighting by the rate of confusion makes tipped over the position of labiodentales If/, /v/ and that of / p/. The just perception of the sound/p/ would be underestimated while sounds /v/ and /f/ would be overestimated. Sounds /g/, /k/, /j/ remain the least well received. This observation results probably from the profile of distortions produced by the selection of the population and probably from the frequency of the syllables containing these consonants in the french language for the sample of the corpus. CONCLUSION The rate of confusion appears as a fundamental element, inciting to look for more relevant methods of analysis of the results of the tests of intelligibility.
Collapse
|
84
|
Perrone F, Gharb BB, Rampazzo A, Ngo QD, Chen SH, Chen HC. Evaluation and management of complications or functional problems at the recipient site after esophageal and voice reconstruction with free ileocolon flap. Surgery 2012; 153:373-382.e2. [PMID: 23218128 DOI: 10.1016/j.surg.2012.08.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2012] [Accepted: 08/03/2012] [Indexed: 11/17/2022]
Abstract
BACKGROUND The free ileocolon flap has been considered a safe method of simultaneous restoration of swallowing and voice production; however, the management of complications at the recipient site and its impact on functional outcomes are lacking in the literature. METHODS We reviewed retrospectively all consecutive patients with combined defects of the cervical esophagus and larynx reconstructed with free ileocolon flap between July 2005 and December 2009 (follow-up of ≥18 months). Patients were evaluated during the follow-up period to judge the impact of revision surgery on functional outcomes. Complications were reviewed, and the appropriate management was reported. RESULTS Swallowing function was restored in 69% of patient; functional speech function was achieved in 59%. Fourteen of the 29 patients underwent revision surgery because of complications or to improve functions at the recipient site. The mean functional improvement after revision surgery was 1.0 point on the 5-point Likert scale for speech and 1.1 point on the 7-point Likert scale for swallowing (P < .01 each). CONCLUSION Continuous research over the last 10 years has allowed us to refine the technique and to make the outcome more predictable.
Collapse
|
85
|
Yeung DKW, Bhatia KS, Lee YYP, King AD, Garteiser P, Sinkus R, Ahuja AT. MR elastography of the head and neck: driver design and initial results. Magn Reson Imaging 2012; 31:624-9. [PMID: 23164497 DOI: 10.1016/j.mri.2012.09.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2012] [Revised: 08/20/2012] [Accepted: 09/21/2012] [Indexed: 12/28/2022]
Abstract
PURPOSE The purpose was to describe the design and fabrication of a driver suitable for magnetic resonance elastography (MRE) of the head and neck and to assess its performance in evaluating human parotid gland, lymph nodes and thyroid at 3.0 T. MATERIALS AND METHODS A head and neck driver was fabricated using a commercial transducer, headrest mould and piston extension. Driver performance was tested using a motion-sensitized spin-echo MRE pulse sequence. Six healthy volunteers and three patients (two metastatic nodes and one papillary carcinoma) were evaluated using MRE. Viscoelastic maps were computed to obtain storage modulus (G') and loss modulus (G") of the normal parotid and thyroid, metastatic node and thyroid cancer. Reproducibility was assessed by coefficient of variation. RESULTS All subjects completed MRE examination without discomfort. Initial G' and G" values were as follows: normal parotid gland, 1.12 kPa and 0.48 kPa; thyroid, 0.58 kPa and 0.42 kPa; metastatic node, 0.66 kPa and 0.58 kPa; and thyroid cancer, 0.17 kPa and 0.28 kPa. Based on parotid data, the coefficient of variation for G' and G" was 4.7% and 9.8%. CONCLUSION A new MRE driver for head and neck was successfully implemented, and our initial results suggested the device was suitable for the mechanical assessment of tissues in the head and neck.
Collapse
|
86
|
Chin CJ, Franklin JH, Turner B, Moukarbel RV, Chandarana S, Fung K, Yoo J, Doyle PC. A novel tool for the objective measurement of neck fibrosis: validation in clinical practice. J Otolaryngol Head Neck Surg 2012; 41:320-326. [PMID: 23092834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023] Open
Abstract
BACKGROUND Radiotherapy is commonly used to treat neoplasms of the head and neck, and fibrosis is a known side effect. The Cutometer is a device that quantifies properties of the skin. The goal of the study was to validate the Cutometer in normal neck tissues and then quantify fibrosis in radiated necks. METHODS We performed a prospective study of 251 patients. The elasticity and stiffness parameters were recorded. Control patients were compared to determine the correlation between their left and right sides. Next, the treatment groups were compared using a nonparametric test (Kruskal-Wallis). RESULTS We found a significant correlation between the left and right sides of the control patients' necks, supporting the view that the Cutometer provides reproducible measurements in the normal neck. Furthermore, the Cutometer demonstrated reduced elasticity in necks treated with radiation, surgery-radiation, and chemoradiation. No significant difference in stiffness was seen. CONCLUSION The Cutometer may serve as a valuable and valid tool for the measurement of neck skin elasticity. Radiated patients have a quantifiable decrease in their skin elasticity.
Collapse
|
87
|
Kyrgidis A, Triaridis S, Kontos K, Patrikidou A, Andreadis C, Constantinidis J, Vahtsevanos K, Antoniades K. Quality of life in breast cancer patients with bisphosphonate-related osteonecrosis of the jaws and patients with head and neck cancer: a comparative study using the EORTC QLQ-C30 and QLQ-HN35 questionnaires. Anticancer Res 2012; 32:3527-3534. [PMID: 22843941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND/AIM This exploratory study aimed at examining the diagnostic utility, validity and reliability of already established quality of life (QoL) measures in cancer patients with osteonecrosis of the jaws (ONJ). PATIENTS AND METHODS This was a prospective, observational, controlled clinical study. Female patients diagnosed with metastatic breast cancer and stage 2 or 3 ONJ (group I), metastatic breast cancer alone (group II), or cancer of the oral cavity (group III) were questioned. The EORTC QLQ-C30 version 3.0 and the QLQ-HN35 head and neck-specific questionnaires were used. RESULTS Completed questionnaires were obtained from 64 patients. Overall internal consistency was acceptable to excellent with a Cronbach's alpha of 0.728 to 0.892. The Spearman-Brown coefficient was 0.888 and 0.872 for QLQ-C30 and HN35, respectively. Several scales of the questionnaire were sensitive to patient group: Global health status/Qol, HN Social eating, HN Pain, HN Swallowing, HN Senses, Role Function. Symptom intensity correlated with ONJ stage (2 vs. 3). CONCLUSION EORTC QLQ-HN35 in conjunction with QLQ-C30 is a valid and informative tool in assessing QoL in patients with metastatic breast cancer and ONJ. Administration of the instrument to patients with ONJ of various nationalities is feasible and such efforts would greatly assist in recording the additional health burden created by this complication of bisphosphonate therapy. The use of HN35 module may be feasible in patients with any type of metastatic cancer who develop ONJ.
Collapse
|
88
|
Schiavi F, Demattè S, Cecchini ME, Taschin E, Bobisse S, Del Piano A, Donner D, Barbareschi M, Manera V, Zovato S, Erlic Z, Savvoukidis T, Barollo S, Grego F, Trabalzini F, Amistà P, Grandi C, Branz F, Marroni F, Neumann HPH, Opocher G. The endemic paraganglioma syndrome type 1: origin, spread, and clinical expression. J Clin Endocrinol Metab 2012; 97:E637-41. [PMID: 22456618 DOI: 10.1210/jc.2011-2597] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Anecdotal evidence suggests a high incidence in Trentino, Italy, of head and neck paragangliomas (HNPGL), a rare autosomal dominant disease called paraganglioma type 1 syndrome and caused by germ-line mutations of the SDHD gene. OBJECTIVE The aim of this study was to investigate the origin, spread, and clinical expression of the disease in this geographic region. DESIGN, SETTING, AND PARTICIPANTS Trentino natives with HNPGL were recruited for establishing clinical expression of the disease, presence of a founder effect, and age of common ancestor. A large sample of the local population was recruited for determination of mutation prevalence and spread. MAIN OUTCOME MEASURES SDHD genetic testing was offered to first-degree relatives, and clinical surveillance was offered to at-risk carriers. The hypothesis of a founder effect was explored by haplotype analysis, and time to the most recent common ancestor was estimated by decay of haplotype sharing over time. RESULTS A total of 287 of the 540 recruited individuals from 95 kindreds carried the SDHD c.341A>G p.Tyr114Cys mutation. The prevalent phenotype was bilateral or multiple HNPGL, with low prevalence of pheochromocytoma and malignant forms. Penetrance was high. A common ancestor was dated between the 14th and 15th century, with the mutation spreading from the Mocheni Valley, a geographic, cultural and, presumably, a genetic isolate to 1.5% of the region's population. CONCLUSIONS A combination of particular demographic, geographical, and historical conditions has resulted in the oldest and largest SDHD founder effect so far characterized and has transformed a rare disease into an endemic disease with major public health implications.
Collapse
|
89
|
Lin HY, Hou SC, Chen SC, Kao MC, Yu CC, Funayama S, Ho CT, Way TD. (-)-Epigallocatechin gallate induces Fas/CD95-mediated apoptosis through inhibiting constitutive and IL-6-induced JAK/STAT3 signaling in head and neck squamous cell carcinoma cells. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2012; 60:2480-2489. [PMID: 22313388 DOI: 10.1021/jf204362n] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
In this study, we examined the effects of several plant-derived natural compounds on head and neck squamous cell carcinoma (HNSCC) cells. The results revealed that (-)-epigallocatechin gallate (EGCG) demonstrated the most efficient cytotoxic effects on HNSCC cells. We then investigated the underlying molecular mechanism for the potent proapoptotic effect of EGCG on HNSCC. Cell apoptosis was observed in the EGCG-treated SAS and Cal-27 cells in a time- and dose-dependent manner. In concert with the caspase-8 activation by EGCG, an enhanced expression in functional Fas/CD95 was identified. Consistent with the increased Fas/CD95 expression, a drastic decrease in the Tyr705 phosphorylation of STAT3, a known negative regulator of Fas/CD95 transcription, was shown within 15 min in the EGCG-treated cells, leading to downregulation of the target gene products of STAT3, such as bcl-2, vascular endothelial growth factor (VEGF), mcl-1, and cyclin D1. An overexpression in STAT3 led to resistance to EGCG, suggesting that STAT3 was a critical target of EGCG. Besides inhibiting constitutive expression, EGCG also abrogated the interleukin-6 (IL-6)-induced JAK/STAT3 signaling and further inhibited IL-6-induced proliferation on HNSCC cells. In comparison with apigenin, curcumin, and AG490, EGCG was a more effective inhibitor of IL-6-induced proliferation on HNSCC cells. Overall, our results strongly suggest that EGCG induces Fas/CD95-mediated apoptosis through inhibiting constitutive and IL-6-induced JAK/STAT3 signaling. This mechanism may be partially responsible for EGCG's ability to suppress proliferation of HNSCC cells. These findings provide that EGCG may be useful in the chemoprevention and/or treatment of HNSCC.
Collapse
|
90
|
Malecka-Massalska T, Smolen A, Zubrzycki J, Lupa-Zatwarnicka K, Morshed K. Bioimpedance vector pattern in head and neck squamous cell carcinoma. JOURNAL OF PHYSIOLOGY AND PHARMACOLOGY : AN OFFICIAL JOURNAL OF THE POLISH PHYSIOLOGICAL SOCIETY 2012; 63:101-104. [PMID: 22460467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Accepted: 02/20/2012] [Indexed: 05/31/2023]
Abstract
Direct bioimpedance measures (resistance, reactance, phase angle (PA)) determined by bioelectrical impedance analysis (BIA) detect changes in tissue electrical properties. The study was conducted to evaluate soft tissue hydration and mass through pattern analysis of vector plots as height, normalized resistance, and reactance measurements by bioelectric impedance vector analysis in patients with head and neck cancer. Whole-body measurements were made with ImpediMed bioimpedance analysis in 56 adult, white, male subjects 42 to 79 years old: 28 patients with head and neck squamous cell carcinoma (H&NC) and 28 healthy volunteers matched by sex, age and BMI as a control group. All patients were previously untreated and without active nutritional interventions. Mean vectors of H&NC group vs. the control group were characterized by an increased normalized resistance component with a reduced reactance component (separate 95% confidence limits, P<0.05), indicating a decreased ionic conduction (dehydration) with loss of dielectric mass (cell membranes and tissue interfaces) of soft tissue. Monitoring vector displacement trajectory toward the reference target vector position may represent useful feedback in support therapy planning of individual patients before surgery in patients with head and neck cancer in order to reduce post-operational complications.
Collapse
|
91
|
Head BA, Heitz L, Keeney C, Myers J, Appana SN, Studts JL, Bumpous J, Pfeifer M. The relationship between weight loss and health-related quality of life in persons treated for head and neck cancer. Support Care Cancer 2011; 19:1511-8. [PMID: 20730547 PMCID: PMC4177674 DOI: 10.1007/s00520-010-0975-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2010] [Accepted: 07/29/2010] [Indexed: 11/27/2022]
Abstract
PURPOSE This study explores the relationship between weight loss, health-related quality of life (HRQOL), and symptom burden in patients treated for head and neck cancers. METHODS Participants completed the Functional Assessment of Cancer Therapy-Head and Neck (FACT-H&N) and the Memorial Symptom Assessment Scale (MSAS) pre-treatment, mid-treatment, and post-treatment. Weights were recorded prior to treatment and at the post-treatment follow-up visit, and percentage weight loss was tabulated. Relationships between weight loss, HRQOL, and symptom burden were evaluated using the nonparametric Spearman rho. A simple linear regression model was developed to examine the influence weight loss has on HRQOL in a predictive manner. RESULTS Average weight loss per patient was 12 lb with a modal value of 19. Weight loss was found to be significantly correlated with decreases in physical well-being, functional well-being, the Head and Neck specific subscale, and composite QOL scores. No significant correlations were found between weight loss and symptom burden as measured by the MSAS. Linear regression suggested that a 10% decrease in baseline weight resulted in a 19% decrease in the FACT-H&N score. CONCLUSION The strong association between weight loss and HRQOL supports the importance of efforts to prevent weight loss via patient education, aggressive monitoring, and immediate intervention to stop or reverse weight loss during treatment. New approaches to the weight loss and wasting experienced by patients should be developed and tested.
Collapse
|
92
|
Schrey A, Kinnunen I, Vahlberg T, Minn H, Grénman R, Taittonen M, Aitasalo K. Blood pressure and free flap oxygenation in head and neck cancer patients. Acta Otolaryngol 2011; 131:757-63. [PMID: 21413842 DOI: 10.3109/00016489.2011.554438] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSION This study suggests that although oxygen partial pressure in tissue (p(ti)O(2)) measurement is a feasible method for continuous postoperative monitoring of free flaps, low correlation between blood pressure (BP) and p(ti)O(2) might predict compromised overall outcome. Thus, it is of utmost importance to keep the BP optimal for adequate perfusion of re-anastomosed tissue transfers. OBJECTIVE Optimal BP is an important factor in assuring adequate blood flow in a free flap. Tissue oxygenation in free flaps as a postoperative monitoring target is in routine clinical use in some clinics. Correlation between p(ti)O(2) and systemic BP was investigated. METHODS Ten consecutive patients underwent resection of head and neck squamous cell carcinoma followed by microvascular reconstruction with a free microvascular flap. P(ti)O(2) of each flap was continuously monitored for 3 postoperative days with a polarographic measurement system. BP was measured invasively and continuously during the operation and during the first postoperative day at the intensive care unit. The correlation coefficient between p(ti)O(2) and BP was analysed. RESULTS The correlation coefficient between p(ti)O(2) and BP was relatively high in all patients with uneventful flap survival (r (mean) = 0.63, n = 5). In flaps with haemodynamic problems or compromised flap vitality the correlation appeared low (r(mean) = -0.02, n = 5).
Collapse
|
93
|
Sethom A, Ben Salem S, Ben Dhia I, Mrabet A, Souissi A, Dkhil I, Mehdi F, Allani R, Bouattour R, Khelifi T, Ben Othmen C, Guermazi N, Chebbi MK. [Head and neck cancer of aircrew personnel in aeronautical medical expertise]. LA TUNISIE MEDICALE 2011; 89:391-393. [PMID: 21484693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND ENT cancers due to their location and treatment encompass a number of physical symptoms related to swallowing and communication disorders. AIM To evaluate flight capacity of aircrew personnel with ENT cancer and consequences on fitness and waiver criteria. CASES REPORT Case 1: A 52 years old smoker pilot whish present laryngeal epidermoid carcinoma staged T3M0N0 and treated by total laryngectomy with curative radio-therapy (70Gy). Metastasis occurred on lumgth and death heaped after acute respiratory failure. Case 2: A 55 years old mechanic whish had rhinopharyngeal undifferentiated carcinoma staged T4N2M0 and treated with radiochemotherapy with favourable follow-up. Inability for flight was proclaimed because of severe psychological impact. Case 3: Concerned a vesiculograpillary carcinoma of thyroid gland occurring in a 46 years old helicopter pilot. After total thyroidectomy and iodine treatment, the patient has obtained complete fitness to flight. CONCLUSION Fitness to flight can be controversed in ENT cancer occurs. Epidemio-clinical paraclinical, functionnel and operational criterias must be considered when wainer to be proclaimed.
Collapse
|
94
|
Macdonald KI, Mark Taylor S, Trites JRB, Fung EW, Barnsley PG, Dunbar MJ, Lorne Leahey J, Hart RD. Effect of fibula free flap harvest on the gait of head and neck cancer patients: preliminary results. J Otolaryngol Head Neck Surg 2011; 40 Suppl 1:S34-S40. [PMID: 21453659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
OBJECTIVE To determine the impact of fibula free flaps (FFFs) on gait. DESIGN Prospective trial. SETTING FFF patients who gave consent were enrolled. METHODS At preoperative and 3-month postoperative visits, patients walked 30 m with the Walkabout Portable Gait Monitor (WPGM), a portable device developed at Dalhousie University that records acceleration of the centre of mass. Gaitview software provided several outputs for analysis: vertical (VA) and forward (FA) asymmetry, horizontal to vertical power ratio (HVP), vertical to forward power ratio (VFP), velocity, and step length. Patients were compared pre- and postoperatively and to age-matched control data with a Student paired t-test. Patients completed a self-comorbidity questionnaire and a point evaluation system (PES) with subjective questions on gait. PES data were compared to a Mann-Whitney U test using SPSS, version 15.0.1. MAIN OUTCOME MEASURES Gaitview output and PES questionnaire. RESULTS From September 2008 to January 2010, 12 patients enrolled in the study. Eight provided 3-month postoperative data. The Gaitview analysis showed that none of the six parameters changed postoperatively. The VA and FA preoperatively and at 3 months postoperatively were 21.3 versus 24.2, p > .50, and 65.4 versus 74.9, p > .50, respectively. The HVP and VFP preoperatively and postoperatively were 133.4 versus 138.9, p > .50, and 129.6 versus 122.8, p > .50, respectively. The velocity and step length preoperatively and postoperatively were 125.9 versus 119.5 cm/s, p > .50, and 76.0 versus 74.9 cm, p > .50, respectively. The subjective PES questionnaire did not change significantly (p = .26). CONCLUSION Preliminary findings confirm that the FFF is associated with little subjective or objective gait impairment.
Collapse
|
95
|
Speyer R, Heijnen BJ, Baijens LW, Vrijenhoef FH, Otters EF, Roodenburg N, Bogaardt HC. Quality of life in oncological patients with oropharyngeal dysphagia: validity and reliability of the Dutch version of the MD Anderson Dysphagia Inventory and the Deglutition Handicap Index. Dysphagia 2011; 26:407-14. [PMID: 21279522 PMCID: PMC3224721 DOI: 10.1007/s00455-011-9327-3] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2010] [Accepted: 01/06/2011] [Indexed: 01/19/2023]
Abstract
Quality of life is an important outcome measurement in objectifying the current health status or therapy effects in patients with oropharyngeal dysphagia. In this study, the validity and reliability of the Dutch version of the Deglutition Handicap Index (DHI) and the MD Anderson Dysphagia Inventory (MDADI) have been determined for oncological patients with oropharyngeal dysphagia. At Maastricht University Medical Center, 76 consecutive patients were selected and asked to fill in three questionnaires on quality of life related to oropharyngeal dysphagia (the SWAL-QOL, the MDADI, and the DHI) as well as a simple one-item visual analog Dysphagia Severity Scale. None of the quality-of-life questionnaires showed any floor or ceiling effect. The test-retest reliability of the MDADI and the Dysphagia Severity Scale proved to be good. The test-retest reliability of the DHI could not be determined because of insufficient data, but the intraclass correlation coefficients were rather high. The internal consistency proved to be good. However, confirmatory factor analysis could not distinguish the underlying constructs as defined by the subscales per questionnaire. When assessing criterion validity, both the MDADI and the DHI showed satisfactory associations with the SWAL-QOL (reference or gold standard) after having removed the less relevant subscales of the SWAL-QOL. In conclusion, when assessing the validity and reliability of the Dutch version of the DHI or the MDADI, not all psychometric properties have been adequately met. In general, because of difficulties in the interpretation of study results when using questionnaires lacking sufficient psychometric quality, it is recommended that researchers strive to use questionnaires with the most optimal psychometric properties.
Collapse
|
96
|
Sumita Y, Liu Y, Khalili S, Maria OM, Xia D, Key S, Cotrim AP, Mezey E, Tran SD. Bone marrow-derived cells rescue salivary gland function in mice with head and neck irradiation. Int J Biochem Cell Biol 2011; 43:80-7. [PMID: 20933096 PMCID: PMC3403826 DOI: 10.1016/j.biocel.2010.09.023] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2010] [Revised: 09/03/2010] [Accepted: 09/28/2010] [Indexed: 02/07/2023]
Abstract
Treatment for most patients with head and neck cancers includes ionizing radiation. A consequence of this treatment is irreversible damage to salivary glands (SGs), which is accompanied by a loss of fluid-secreting acinar-cells and a considerable decrease of saliva output. While there are currently no adequate conventional treatments for this condition, cell-based therapies are receiving increasing attention to regenerate SGs. In this study, we investigated whether bone marrow-derived cells (BMDCs) can differentiate into salivary epithelial cells and restore SG function in head and neck irradiated mice. BMDCs from male mice were transplanted into the tail-vein of 18Gy-irradiated female mice. Salivary output was increased in mice that received BMDCs transplantation at week 8 and 24 post-irradiation. At 24 weeks after irradiation (IR), harvested SGs (submandibular and parotid glands) of BMDC-treated mice had greater weights than those of non-treated mice. Histological analysis shows that SGs of treated mice demonstrated an increased level of tissue regenerative activity such as blood vessel formation and cell proliferation, while apoptotic activity was increased in non-transplanted mice. The expression of stem cell markers (Sca-1 or c-kit) was detected in BMDC-treated SGs. Finally, we detected an increased ratio of acinar-cell area and approximately 9% of Y-chromosome-positive (donor-derived) salivary epithelial cells in BMDC-treated mice. We propose here that cell therapy using BMDCs can rescue the functional damage of irradiated SGs by direct differentiation of donor BMDCs into salivary epithelial cells.
Collapse
|
97
|
Sturgis EM. The International Head and Neck Cancer Epidemiology consortium. Head Neck 2010; 33:141. [PMID: 21225903 DOI: 10.1002/hed.21670] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2010] [Accepted: 10/06/2010] [Indexed: 11/06/2022] Open
|
98
|
Rieger JM, Tang JAL, Harris J, Seikaly H, Wolfaardt J, Glaum R, Schmelzeisen R, Buchbinder D, Jacobson A, Lazarus C, Markowitz E, Okay D, Urken M, Aitasalo K, Happonen RP, Kinnunen I, Laine J, Soukka T. Survey of current functional outcomes assessment practices in patients with head and neck cancer: initial project of the head and neck research network. J Otolaryngol Head Neck Surg 2010; 39:523-531. [PMID: 20828515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
BACKGROUND Functional outcomes assessment has become increasingly important in informing treatment decisions in the area of head and neck cancer. However, consistency of assessment methods across studies has been lacking. For the literature to inform clinical decision making, consensus regarding outcomes measurements is necessary. OBJECTIVE The Head and Neck Research Network (HNRN) was founded in January 2008 to become a conduit for high-quality research in the area of functional outcomes in patients with head and neck defects. The present study surveyed experts in functional outcomes assessment to determine what are considered the most important tools for assessing speech and swallowing and what background patient characteristics are important to capture. DESIGN, PARTICIPANTS, AND MEASURES Respondents to the online survey included 54 participants with a background in speech-language pathology, with the majority of respondents from the United States, Canada, and the United Kingdom. RESULTS AND CONCLUSIONS The results from the survey indicated that clinicians consider both subjective and objective measures as important to use when assessing function. More advanced technical tools were often rated as less important; however, it also was noted that clinicians were most often not able to access these tools or were unfamiliar with them.
Collapse
|
99
|
Yung E, Asavasopon S, Godges JJ. Screening for head, neck, and shoulder pathology in patients with upper extremity signs and symptoms. J Hand Ther 2010; 23:173-85; quiz 186. [PMID: 20149960 DOI: 10.1016/j.jht.2009.11.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2009] [Revised: 11/05/2009] [Accepted: 11/11/2009] [Indexed: 02/03/2023]
Abstract
UNLABELLED NARRATIVE REVIEW: Conditions of the head, neck, thorax, and shoulder may occur simultaneously with arm pathology or produce symptoms perceived by the patient to originate in the elbow, wrist, or hand. Identification of the tissue disorder and associated impairments, followed by matching the rehabilitative intervention to address these issues, leads to optimal outcomes. With this goal in mind, the hand therapist needs to recognize clinical findings that signal potentially serious medical conditions of the brain, cervical region, chest, or shoulder. Additionally, less serious but potentially debilitating, musculoskeletal or neurogenic pain from proximal sources must also be differentiated from somatic pain originating in the elbow, wrist, or hand so that the clinician can decide to further examine and intervene or refer to an appropriate health care provider. This article describes clinical findings that suggest the presence of serious medical pathology in the head, neck, or thorax and presents a screening algorithm to assist in discriminating pain derived from local structures in the distal arm from referred pain originating in the more proximal regions of the shoulder, thorax, neck, or brain. LEVEL OF EVIDENCE 5.
Collapse
|
100
|
Jiménez-Heffernan A, Gómez-Millán J, Sánchez De Mora E, Delgado Moreno J, Delgado Gil MM, Salgado C, Contreras Puertas P, Bermúdez Morales MC, López J, Paz Expósito J. [Quantitative salivary gland scintigraphy in head and neck cancer patients following radiotherapy]. REVISTA ESPANOLA DE MEDICINA NUCLEAR 2010; 29:165-171. [PMID: 20462671 DOI: 10.1016/j.remn.2010.02.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2009] [Revised: 02/22/2010] [Accepted: 02/24/2010] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To assess the role of quantitative salivary gland scintigraphy (SGS) in the detection of functional impairment of salivary glands in patients with head and neck cancer treated with radiotherapy (RT). MATERIAL AND METHODS We studied 19 patients (17 men), mean age 62.4 years (44-75). Three studies were performed to each patient: baseline, 3 and 18 months after RT. SGS was acquired for 25 minutes following injection of 3.7 MBq/kg of (99m)Tc-pertechnetate with lemon juice at the end of minute 15. Excretion fraction (EF), counts per minute/pixel/MBq (CMPM) and uptake percentage were obtained from time-activity curves from ROIs placed over parotid (PG) and submandibular glands (SMG) and related to the doses received by the PG. RESULTS EF showed a significant reduction from the baseline to the 3 months study (p<0.001) for the PG and SMG and from the baseline to the 18 months study for the SMG (p<0.001). A significant improvement of EF was seen from the 3 months to the 18 months study for the PG (p<0.05). CMPM did not change significantly from the baseline to the 3 months and 18 months studies for the PG and showed a significant reduction (p<0.01) for the SMG from the baseline to 18 months study. The uptake percentage did not change significantly between studies. A moderate association was observed between the doses to PG and the 3m study parameters. CONCLUSIONS EF was more sensitive than uptake in assessing post-RT impairment of salivary function. In addition, it reflected functional recovery of parotid glands over time.
Collapse
|