120 results on '"Otorhinolaryngologic Neoplasms therapy"'
Search Results
2. Kommentar zu „Kopf-Hals-Tumoren: Schlechterer Outcome nach Bluttransfusion?“.
- Subjects
- Humans, Blood Transfusion, Survival Rate, Otorhinolaryngologic Neoplasms therapy, Otorhinolaryngologic Neoplasms mortality, Transfusion Reaction
- Abstract
Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht.
- Published
- 2024
- Full Text
- View/download PDF
3. [Psychooncological Treatment of Patients with Head and Neck Cancer].
- Author
-
Moschen R and Riedl D
- Subjects
- Cognitive Behavioral Therapy, Cost of Illness, Interdisciplinary Communication, Intersectoral Collaboration, Neoplasm Recurrence, Local diagnosis, Neoplasm Recurrence, Local psychology, Neoplasm Recurrence, Local therapy, Otorhinolaryngologic Neoplasms diagnosis, Otorhinolaryngologic Neoplasms therapy, Palliative Care psychology, Psychotherapy, Psychodynamic, Quality of Life psychology, Sick Role, Stress, Psychological complications, Otorhinolaryngologic Neoplasms psychology, Psycho-Oncology methods
- Abstract
The aim of psychooncological interventions are to facilitate coping with the disease, to improve the psychological well-being and quality of life of the cancer patients as well as the strengthening of personal and social resources.Apart from general strain going along with oncological diseases and its treatment, patients with head and neck cancer often also suffer from impairment of the most basic human functions (speech, swallowing, food intake).Patients with head and neck cancer are one of the most distressed and burdened groups of cancer patients.Psychooncological interventions apply proven psychological and psychotherapeutic methods and techniques.Psychooncological treatment is based on the close interdisciplinary cooperation of different professional groups., (© Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2017
- Full Text
- View/download PDF
4. [Immunotherapy Against Head and Neck Cancer Stem Cells].
- Author
-
Coordes A, Ochsenreither S, Qian X, Hofmann VM, Meyer JE, Karl Hoffmann T, Kaufmann AM, and Albers AE
- Subjects
- Animals, Antigens, Neoplasm immunology, B7-H1 Antigen immunology, Carcinoma, Squamous Cell pathology, Cell Survival drug effects, Cell Survival immunology, Combined Modality Therapy, Epithelial-Mesenchymal Transition drug effects, Epithelial-Mesenchymal Transition immunology, Humans, Immunity, Cellular immunology, Neoplasm Recurrence, Local immunology, Neoplasm Recurrence, Local pathology, Neoplasm Recurrence, Local therapy, Neoplastic Stem Cells pathology, Otorhinolaryngologic Neoplasms pathology, Papillomavirus Infections immunology, Papillomavirus Infections pathology, Papillomavirus Infections therapy, Tumor Escape drug effects, Cancer Vaccines immunology, Cancer Vaccines therapeutic use, Carcinoma, Squamous Cell immunology, Carcinoma, Squamous Cell therapy, Neoplastic Stem Cells drug effects, Neoplastic Stem Cells immunology, Otorhinolaryngologic Neoplasms immunology, Otorhinolaryngologic Neoplasms therapy, Tumor Escape immunology
- Abstract
Immunotherapy against head and neck cancer stem cells Immunologic therapies like antibodies in solid tumors like squamous cell cancer of the head and neck are administered either alone or in combination with radiation and chemotherapy. Despite some respectable successes, the effect of this therapy reaches its limits due the ability of the tumor to escape the immune system. Cancer stem cells seem to play an important role in this process due to their intrinsic resistance to conventional therapy and the ability to regenerate tumor heterogeneity. This way they substantially contribute to the formation of recurrences and metastases. Therefore, future immunotherapies should target specifically this subpopulation, possibly in combination with other therapeutic modalities. In this review the immunologic features of cancer stem cells and their potential as target for immunotherapies is summarized., (© Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2017
- Full Text
- View/download PDF
5. [Editor's Comment].
- Author
-
Guntinas-Lichius O
- Subjects
- Female, Germany, Humans, Pregnancy, Otorhinolaryngologic Diseases diagnosis, Otorhinolaryngologic Diseases therapy, Otorhinolaryngologic Neoplasms diagnosis, Otorhinolaryngologic Neoplasms therapy
- Published
- 2016
- Full Text
- View/download PDF
6. [Head and Neck Cancer in Pregnancy - Recommendations for Diagnosis and Therapy With Case Report].
- Author
-
Mozet C, Kuhnt T, Sattler B, Remmele J, Thome U, Stepan H, Kluge R, Dietz A, and Knoedler M
- Subjects
- Adult, Carcinoma, Squamous Cell pathology, Chemoradiotherapy, Adjuvant adverse effects, Cisplatin administration & dosage, Cisplatin adverse effects, Combined Modality Therapy adverse effects, Diagnosis, Differential, Female, Gestational Age, Humans, Infant, Newborn, Magnetic Resonance Imaging, Neoplasm Staging, Otorhinolaryngologic Neoplasms pathology, Petrous Bone pathology, Positron Emission Tomography Computed Tomography, Pregnancy, Pregnancy Complications, Neoplastic pathology, Radiotherapy Dosage, Risk, Tomography, X-Ray Computed, Carcinoma, Squamous Cell diagnosis, Carcinoma, Squamous Cell therapy, Otorhinolaryngologic Neoplasms diagnosis, Otorhinolaryngologic Neoplasms therapy, Pregnancy Complications, Neoplastic diagnosis, Pregnancy Complications, Neoplastic therapy
- Abstract
Objective: The diagnosis of cancer in pregnancy is rare, but might become more relevant even for head and neck cancer patients due to a shift of age of primipara towards the last third of reproductive years. Unsureness exists about the risk and benefit of diagnostic and therapeutic cancer modalities for the unborn and established recommendations are still missing. But, according to recent data, even multimodal therapeutic approaches (e. g. surgery, radiation, chemotherapy) seem possible in face of pregnancy and should be traded against the risk of prematurity. Material and Methods: Our findings are discussed on the basis of a case report of a pregnant woman with advanced carcinoma of the outer ear canal and therapy options are formulated. Results: Sufficient performed diagnostic modalities do not reach imperilling uterus dosages. A growing number of case reports und studies did not detect any developmental disadvantage of children of prenatal exposed mothers by radiation or chemotherapy, whereas long-term impairments of premature infants are proven. Conclusion: In cancer in pregnancy, an immediate start of well-established therapy modalities like surgery and/or cisplatin-based chemoradiation seems to be possible without unjustifiable risks for the unborn., (© Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2016
- Full Text
- View/download PDF
7. [Grading of head and neck neoplasms].
- Author
-
Agaimy A and Weichert W
- Subjects
- Carcinoma classification, Carcinoma therapy, Carcinoma, Squamous Cell classification, Carcinoma, Squamous Cell therapy, Cell Transformation, Neoplastic pathology, Humans, Neoplasm Grading methods, Neoplasm Invasiveness, Otorhinolaryngologic Neoplasms classification, Otorhinolaryngologic Neoplasms therapy, Papillomaviridae pathogenicity, Papillomavirus Infections classification, Papillomavirus Infections pathology, Papillomavirus Infections therapy, Prognosis, Salivary Gland Neoplasms classification, Salivary Gland Neoplasms pathology, Salivary Gland Neoplasms therapy, Carcinoma pathology, Carcinoma, Squamous Cell pathology, Otorhinolaryngologic Neoplasms pathology
- Abstract
Tumors of the head and neck form a heterogeneous group of benign and malignant neoplasms with significant differences in biological behavior and therapeutic strategies. Squamous cell carcinomas (SCC) of the larynx, pharynx and oral cavity represent the most frequent and, thus, clinically most important malignant neoplasms in this anatomical region. Similar to other neoplasms, grading of head and neck malignancies is based on evaluation of the tumor histology usually including both architectural and cytological features; however, the current consensus grading for head and neck SCC is of limited prognostic and therapeutic value and the reproducibility is low. Therefore, novel grading criteria have been proposed that are based on additional parameters, such as the type of tumor growth pattern at the invasive front (so-called tumor budding). These novel algorithms, however, have not yet been officially endorsed into guidelines. Salivary gland (SG) neoplasms, although less frequent, constitute a second important pathologically and clinically complex group of tumors at this location. In contrast to SCC, grading of these tumors is of high clinical importance. Based on the large variety of carcinoma entities of the SG, both entity-specific (e. g. mucoepidermoid carcinoma) algorithms but also algorithms, which are solely based on the recognition of a specific carcinoma variant with subsequent automatic assignment of the tumor grade (e. g. acinic cell carcinoma and salivary duct carcinoma) are in use. In the sinonasal tract, grading is important for non-intestinal type adenocarcinoma and esthesioneuroblastoma. In this article the most important grading schemes and criteria for head and neck malignancies are presented and their prognostic and therapeutic implications are discussed.
- Published
- 2016
- Full Text
- View/download PDF
8. [Physical Properties of Squamous Cell Carcinoma Cells using Atomic Force Microscopy].
- Author
-
Kristin J, Steeger S, Schreyer T, Hansen S, Glaas MF, Stenin I, Getzlaff M, and Schipper J
- Subjects
- Carcinoma, Squamous Cell physiopathology, Carcinoma, Squamous Cell therapy, Cell Adhesion physiology, Cell Line, Tumor, Cell Nucleus physiology, Cell Nucleus ultrastructure, Epithelial Cells physiology, Humans, Otorhinolaryngologic Neoplasms physiopathology, Otorhinolaryngologic Neoplasms therapy, Temperature, Ultrasonic Therapy, Carcinoma, Squamous Cell ultrastructure, Elastic Modulus physiology, Epithelial Cells ultrastructure, Imaging, Three-Dimensional, Microscopy, Atomic Force, Otorhinolaryngologic Neoplasms ultrastructure
- Abstract
Introduction: Malignant and benign cells differ according to their elasticity. An atomic force microscope is a useful tool for measuring these mechanical cell properties. If cells of different dignity show different resonance behavior, due to their different elasticity, a selective ablation of specific tissue types by ultrasound would be possible. The goal is a highly selective ablation of tumor tissue without damaging healthy tissue., Materials and Methods: We performed elasticity measurements of tumor cells (UD-01 cell line) with an atomic force microscope. In a further step, an ultrasound applicator has been positioned and the morphological changes of the cells during the treatment were documented., Results: Different elasticities on the squamous cells were measured, depending on the location. Below a defined maximum amplitude the morphological cell changes were caused solely by ultrasonic excitation., Summary: The atomic force microscope is suitable for the determination of the individual cell elasticity. The data collected could be the basis for treatment modalities that lead to a very selective damage for malignant cells., (© Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2016
- Full Text
- View/download PDF
9. [Introduction of the Screening Tool OncoFunction for Functional Follow-up of Head and Neck Patients].
- Author
-
Zebralla V, Pohle N, Singer S, Neumuth T, Dietz A, Stier-Jarmer M, and Boehm A
- Subjects
- Adult, Aged, Female, Guidelines as Topic, Humans, Male, Middle Aged, Neoplasm Staging, Otorhinolaryngologic Neoplasms pathology, Patient Satisfaction, Quality of Life, Terminology as Topic, Aftercare organization & administration, Disability Evaluation, Mass Screening methods, Medical Records Systems, Computerized organization & administration, Medical Records, Problem-Oriented, Otorhinolaryngologic Neoplasms therapy, Outcome Assessment, Health Care organization & administration, Postoperative Complications diagnosis, Software, Surveys and Questionnaires
- Abstract
Introduction: The follow-up for head and neck cancer (HNC) focussed on therapy control. Accessory long term functionality is important. Impairment of function is observed, but a comparable documentation is not established. Additional we frequently see psychooncological comorbidities, what complicates the assessment. This was the reason why Tschiesner et al. developed on the base of the "ICF Core set for head and neck cancer" a guideline for the Assessment of Function in HNC. In consequence of good results in other tumour entities we developed an electronic version (OncoFunction)., Methods: In a proof of concept study all patients of our follow up consultation from 07/13 to 03/14 were included. OncoFunction was given to patients in a digital form using tablet computers. The results were visible to the physician in a concentrated form before consultation and were supplemented by a physician questionnaire. Furthermore we evaluated the usability in 202 patients., Results: We had 682 patient contacts. 530 patient contacts (77, 7%) used the questionnaire. The physician questionnaire was answered in 470 times. Finally there are from 69.8% of the patient contacts full datasets available. Between users and non-users of the questionnaire we see no difference., Conclusion: The use of a computer-based screening and feedback system (OncoFunction) in clinical use is feasible and excellent assessed by patients. The patient data are visible in a compact form for the physician and problems can clear addressed to the patient. One more benefit is the standardized follow up documentation and the use of comparable data in research., (© Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2016
- Full Text
- View/download PDF
10. [Mucosal Melanoma of the Head and Neck].
- Author
-
Thierauf J, Veit J, Döscher J, Theodoraki MN, Greve J, and Hoffmann TK
- Subjects
- Aged, Combined Modality Therapy, Humans, Melanoma pathology, Middle Aged, Neoplasm Invasiveness, Neoplasm Staging, Prognosis, Melanoma diagnosis, Melanoma therapy, Otorhinolaryngologic Neoplasms diagnosis, Otorhinolaryngologic Neoplasms pathology, Otorhinolaryngologic Neoplasms therapy, Respiratory Mucosa pathology
- Abstract
Primary mucosal malignant melanoma of the head and neck is a rare tumor entity with poor clinical outcome. Its growth pattern is characterized by an infiltrative and local destructive behavior. So far no risk factors could be identified. There are practically no early symptoms of the disease, as intermitting nose bleeding or nasal obstruction typically occur in advanced stage. The standard of care remains radical tumor resection with adjuvant radiation in cases of close margin resection. Other therapeutic options like the use of interferon, antibodies or conventional chemotherapeutics have not demonstrated significant clinical benefit so far. Current efforts to investigate the biological and genomic characteristics of these tumors have been constrained by its low incidence. In order to better characterize this rare tumor entity and to establish effective novel targeted therapies it will be necessary to establish an interdisciplinary and multicentric task force., (© Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2015
- Full Text
- View/download PDF
11. [Current aspects of oncology].
- Author
-
Wollenberg B
- Subjects
- Humans, Otorhinolaryngologic Neoplasms genetics, Genetic Testing trends, Medical Oncology trends, Otolaryngology trends, Otorhinolaryngologic Neoplasms diagnosis, Otorhinolaryngologic Neoplasms therapy, Otorhinolaryngologic Surgical Procedures trends
- Published
- 2015
- Full Text
- View/download PDF
12. [Circulating tumor cells in head and neck cancer].
- Author
-
Guntinas-Lichius O and Pachmann K
- Subjects
- Biopsy, Disease Progression, Humans, Neoplasm Seeding, Neoplasm Staging, Otorhinolaryngologic Neoplasms therapy, Prognosis, Neoplastic Cells, Circulating pathology, Otorhinolaryngologic Neoplasms pathology
- Abstract
Circulating tumor cells are defined as tumor cells which are circulating in the peripheral blood of the cancer patient. While several large studies have investigated the role of circulating tumor cells in other solid tumors, the importance of these tumor cells in patients with head and neck cancer was turned into the focus not until the recent years. In other solid tumor the presence of circulating tumor cells often seems to be a negative prognostic marker and seems to be a marker for therapy response. The present article wants to give an overview about the knowledge on circulating tumor cells and their clinical relevance in head and neck cancer. The methodology to detect circulating tumor cells will be critically reflected. The future potential of the detection of circulating tumor cells in head and neck cancer patients will be discussed., (© Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2015
- Full Text
- View/download PDF
13. [Molecular approaches to systemic therapy of adenoid cystic carcinoma of the head and neck area].
- Author
-
Büchsenschütz K, Veit JA, Schuler PJ, Thierauf J, Laban S, Fahimi F, Bankfalvi A, Lang S, Sauerwein W, and Hoffmann TK
- Subjects
- Carcinoma, Adenoid Cystic genetics, Carcinoma, Adenoid Cystic pathology, DNA Mutational Analysis, Genetic Therapy methods, Humans, Immunologic Factors therapeutic use, Immunotherapy, Precision Medicine, Signal Transduction drug effects, Antineoplastic Agents therapeutic use, Biological Products therapeutic use, Carcinoma, Adenoid Cystic drug therapy, Genetic Markers genetics, Molecular Targeted Therapy, Otorhinolaryngologic Neoplasms therapy
- Abstract
The adenoid cystic carcinoma (ACC) is a neurotropic salivary gland tumor with a high blood-borne metastasis tendency. The treatment of choice for localized disease consists of radical surgical resection and, depending on resection status, adjuvant radiotherapy. Due to the high recurrence rate with limited local therapeutic options and frequent occurrence of distant metastases, one is confronted inevitably with the search for an adequate systemic therapy. ACC shows little response to a variety of chemotherapeutic agents, partial or complete remissions are extremely rare. Beside classical chemotherapies, immunotherapeutics and targeted therapies with more favorable side effect profiles were tested in trials, but due to the small number of patients, a definitive statement on the effectiveness can be hardly made. This results in the need for prospective multicenter studies that allow clear recommendations for systemic therapy of the tumor. The present paper gives an overview of the sub-cellular and genetic characteristics of ACC, which represent possible targets for systemic therapies and have partly already been included in running clinical trials., (© Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2014
- Full Text
- View/download PDF
14. [Decision process in a multidisciplinary cancer team with limited evidence].
- Author
-
Lassalle R, Marold J, Schöbel M, Manzey D, Bohn S, Dietz A, and Boehm A
- Subjects
- Clinical Competence, Consensus, Humans, Otorhinolaryngologic Neoplasms diagnosis, Patient Safety, Surveys and Questionnaires, Uncertainty, Video Recording, Cooperative Behavior, Decision Support Techniques, Evidence-Based Medicine, Interdisciplinary Communication, Otorhinolaryngologic Neoplasms therapy
- Abstract
Background: The Head and Neck Cancer Tumor Board is a multispeciality comprehensive conference that brings together experts with different backgrounds to make group decisions about the appropriate treatment. Due to the complexity of the patient cases and the collaboration of different medical disciplines most of these decisions have to be made under uncertainty, i. e., with-out knowing all relevant factors and without being quite sure about the outcome., Methods: To develop effective team decision making under uncertainty, it is necessary to understand how medical experts perceive and handle uncertainties. The aim of this field study was to develop a knowledge base by exploring additionally the factors that influence group decision making processes. A structured nonparticipant observational study was employed to address the research goal. Video data were analyzed by 2 independent observers using an observation checklist. A total of 20 videotaped case discussions were studied. Observations were complemented by a questionnaire gathering subjective evaluations of board members about the process and quality of their decisions (N=15)., Results: The results show that uncertainty is recognized by board members. Reasons for uncertainty may stem from the complexity of the cases (e. g. therapy options) or the assessment from different disciplines coming together at the board., Conclusion: With respect to handling uncertainty and guaranteeing an optimal decision making process potential for improvement could be defined. This pertains to the handling of different levels of competence, the promotion of a positive discussion culture as well as structuring of the decision making process., (© Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2014
- Full Text
- View/download PDF
15. [Role of miRNA in malignoma of the head and neck].
- Author
-
Coordes A, Lenarz M, Kaufmann AM, and Albers AE
- Subjects
- Carcinoma, Squamous Cell diagnosis, Cell Transformation, Neoplastic genetics, Disease Progression, Early Diagnosis, Epithelial-Mesenchymal Transition genetics, Exons genetics, Gene Expression Regulation, Neoplastic genetics, Genetic Markers genetics, Humans, Introns genetics, Neoplasm Recurrence, Local diagnosis, Neoplasm Recurrence, Local genetics, Neoplasm Recurrence, Local therapy, Neoplastic Stem Cells metabolism, Oncogene Proteins, Viral genetics, Otorhinolaryngologic Neoplasms diagnosis, Otorhinolaryngologic Neoplasms therapy, Phenotype, Prognosis, Carcinoma, Squamous Cell genetics, MicroRNAs genetics, Otorhinolaryngologic Neoplasms genetics
- Abstract
Despite optimized therapeutic strategies, the long-term survival of head and neck squamous cell carcinomas (HNSCC) has improved in recent years only slightly. Most studies on the tumor cell genome focus on protein-coding genes (exons). Data on changes within the non-coding sequences (introns) are limited. miRNAs (microRNA, miR) are small non-coding single-stranded RNAs that control gene expression at the posttranscriptional level by interacting with the mRNA. miRNA functions include many biological processes and control up to 50 % of human genes. They can have oncogenic or tumor suppressive functions. Altered expression patterns of miRNAs are involved in carcinogenesis and tumor progression even in HNSCC, or those processes (increased resistance to radiation or chemotherapy) that could be responsible for the poor long-term prognosis by forming metastases and inoperable local recurrences. Therefore, we here present miRNA groups, which are involved in these processes and may serve as new potential therapeutic treatment targets. miRNAs may also serve as biomarkers for early diagnosis, evaluation and monitoring of treatment and tumor recurrence. Alterations in miRNA expression before and after chemotherapy are therefore of high interest. In the long run, this knowledge could lead to more effective therapies with improved therapeutic outcome of HNSCC., (© Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2014
- Full Text
- View/download PDF
16. [Diagnosis and therapy of bleeding in ENT].
- Author
-
Schulz T and Eßer D
- Subjects
- Adenoidectomy, Algorithms, Diagnosis, Differential, Ear Diseases diagnosis, Ear Diseases etiology, Ear Diseases therapy, Epistaxis diagnosis, Epistaxis etiology, Gastrointestinal Hemorrhage diagnosis, Gastrointestinal Hemorrhage etiology, Gastrointestinal Hemorrhage therapy, Hemorrhage therapy, Hemostatic Techniques, Humans, Oral Hemorrhage diagnosis, Oral Hemorrhage etiology, Oral Hemorrhage therapy, Otorhinolaryngologic Diseases therapy, Otorhinolaryngologic Neoplasms complications, Otorhinolaryngologic Neoplasms diagnosis, Otorhinolaryngologic Neoplasms therapy, Postoperative Hemorrhage diagnosis, Postoperative Hemorrhage etiology, Postoperative Hemorrhage therapy, Tonsillectomy, Tracheostomy, Hemorrhage diagnosis, Hemorrhage etiology, Otorhinolaryngologic Diseases diagnosis, Otorhinolaryngologic Diseases etiology
- Abstract
Bleeding in the oral cavity, nose or ear are common events in the daily routine of ENT specialists. Apart from trivial cases that often get outpatient treatment, there are numerous cases of serious bleeding that require stationary treatment and if necessary, an operative or interventional therapy. In the following section the most frequent types of bleeding, their diagnosis and therapy will be explained., (© Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2013
- Full Text
- View/download PDF
17. [Optimizing diagnosis, medical management and planning of surgery - optimizing diagnosis - II].
- Author
-
Simmen D and Jones N
- Subjects
- AIDS-Related Opportunistic Infections diagnosis, AIDS-Related Opportunistic Infections etiology, AIDS-Related Opportunistic Infections therapy, Adult, Child, Chronic Disease, Diagnosis, Differential, Endoscopy, Humans, Intradermal Tests, Medical History Taking, Otorhinolaryngologic Diseases therapy, Otorhinolaryngologic Neoplasms therapy, Rhinitis diagnosis, Rhinitis etiology, Rhinitis therapy, Rhinitis, Allergic, Perennial diagnosis, Rhinitis, Allergic, Perennial etiology, Rhinitis, Allergic, Perennial therapy, Rhinitis, Allergic, Seasonal diagnosis, Rhinitis, Allergic, Seasonal etiology, Rhinitis, Allergic, Seasonal therapy, Sinusitis diagnosis, Sinusitis etiology, Sinusitis therapy, Tomography, X-Ray Computed, Otorhinolaryngologic Diseases diagnosis, Otorhinolaryngologic Diseases etiology, Otorhinolaryngologic Neoplasms diagnosis, Otorhinolaryngologic Neoplasms etiology
- Published
- 2013
- Full Text
- View/download PDF
18. [Hyperspectral imaging in head & neck oncology].
- Author
-
Gerstner AO, Martin R, Westermann S, Mahlein AK, Schmidt K, Thies B, and Laffers W
- Subjects
- Early Diagnosis, Endoscopy methods, Humans, Microscopy methods, Neoplasm Staging, Otorhinolaryngologic Neoplasms pathology, Sensitivity and Specificity, Diagnostic Imaging methods, Image Enhancement methods, Image Interpretation, Computer-Assisted methods, Otorhinolaryngologic Neoplasms diagnosis, Otorhinolaryngologic Neoplasms therapy, Spectrum Analysis methods
- Abstract
Hyperspectral Imaging has long been established in other scientific disciplines than medicine (e. g. earth science) as a means for objective classification of image data information. Some 10 years ago it was first introduced into medicine. Due to its immanent advantages - non-destructive specimen, compatibility with established optical tools (microscope, endoscope), objectivity, and user-independence - several attempts have been made in order to use its potential for the treatment of cancer patients. This publication reviews which methods have been developed for analogue issues in disciplines other than medicine, how these can be transferred into medicine, and what the perspectives are for the traditional innovative field of head-and-neck-oncology., (© Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2013
- Full Text
- View/download PDF
19. [Significance of autopsy in patients with head and neck cancer].
- Author
-
Sesterhenn AM, Szalay A, Zimmermann AP, Werner JA, Barth PJ, and Wiegand S
- Subjects
- Adult, Aged, Aged, 80 and over, Biopsy, Cause of Death, Comorbidity, Disease Progression, Disease-Free Survival, Female, Germany, Humans, Lymphatic Metastasis pathology, Male, Middle Aged, Neoplasm Grading, Neoplasm Staging, Otorhinolaryngologic Neoplasms mortality, Otorhinolaryngologic Neoplasms therapy, Predictive Value of Tests, Quality Assurance, Health Care, Survival Rate, Utilization Review, Autopsy statistics & numerical data, Otorhinolaryngologic Neoplasms pathology
- Abstract
Background: Nowadays, the morphological assessment of samples obtained from living patients has a greater importance than the scientific knowledge which is gained by autopsy. Therefore, the aim of the study was a retrospective analysis of causes of death in patients with head and neck cancer., Material and Methods: The autopsy rate, clinical parameters of oncologic patients as well as autopsy findings like lethal complications, distant metastases and second primary tumors were retrospectively analyzed., Results: From 1968 to 2007 in 91 patients with malignant tumors of the head and neck an autopsy was performed. In these 39 years an autopsy was performed in 45.9% of dead oncologic patients. Autopsy findings revealed distant metastases in 46.2% and second primary tumors in 17.6% of the patients. 49.5% of the patients died from pneumonia, 20.9% from tumor bleeding and 10% from progressive cachexia., Conclusion: The study confirms the global trend of a decline in autopsy numbers in the last 3 decades. However, as an important instrument of quality assurance autopsies continue to play an essential and indispensable role in medical research., (© Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2012
- Full Text
- View/download PDF
20. [Biology and relevance of stem cells in squamous head and neck cancer: latest insights and review of literature].
- Author
-
Oker N, Kaufmann AM, and Albers AE
- Subjects
- Biomarkers, Tumor analysis, Carcinoma, Squamous Cell pathology, Carcinoma, Squamous Cell secondary, Carcinoma, Squamous Cell therapy, Cell Transformation, Neoplastic pathology, Disease Progression, Humans, Neoplasm Recurrence, Local pathology, Neoplasm Recurrence, Local physiopathology, Neoplasm Recurrence, Local therapy, Neoplasm Seeding, Neoplastic Stem Cells pathology, Otorhinolaryngologic Neoplasms pathology, Otorhinolaryngologic Neoplasms therapy, Carcinoma, Squamous Cell physiopathology, Neoplastic Stem Cells physiology, Otorhinolaryngologic Neoplasms physiopathology
- Abstract
The initiation, growth, recurrence and metastasis of head and neck squamous cell carcinomas (HNSCC) and other cancers have recently been related to the presence of cancer stem cells (CSC). Cancer stem cells have some characteristics in common with tissue stem cells like unlimited self renewal and the expression of stem cell factors. CSC express specific markers that vary considerably depending on tumor type or tissue of origin--the discovery of an universal marker has not yet been made. Compared to the bulk tumor mass, CSC are less sensitive to chemo- and radiotherapy and also have a lower immunogenicity. Another concept that explains the seeding of metastases is the epithelial-mesenchymal transition of CSC. CSC-targeted therapies may change the prognosis of patients with HNSCC in the future. Recent knowledge on the role of CSC in HNSCC is reviewed, and known CSC markers as well as possible therapeutic targets are described., (© Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2012
- Full Text
- View/download PDF
21. [Update oropharyngeal dysphagia part 2: etiology and therapy].
- Author
-
Reiter R and Brosch S
- Subjects
- Adult, Age Factors, Aged, Aged, 80 and over, Cooperative Behavior, Deglutition Disorders therapy, Enteral Nutrition, Humans, Infant, Infant, Newborn, Interdisciplinary Communication, Laryngoscopy, Otorhinolaryngologic Neoplasms surgery, Otorhinolaryngologic Neoplasms therapy, Pneumonia, Aspiration etiology, Pneumonia, Aspiration prevention & control, Postoperative Complications etiology, Postoperative Complications therapy, Risk Factors, Tracheostomy, Deglutition Disorders etiology
- Abstract
Oropharyngeal dysphagia is a common problem, especially in the elderly. There is a wide range of causes: neurological disorders (such as stroke), osteophytes of the cervical spine, malignancies of the head and neck, as a consequence of radiotherapy or side effect from medication or simply "dysphagia of aging". Where oral feeding is sufficiently impaired then this route may have to be bypassed by percutaneous enteral gastrostomy. When aspiration is a risk, then a cuffed tracheostomy tube may be required. Individual needs must be addressed, usually, and best, by a multidisciplinary team., (© Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2012
- Full Text
- View/download PDF
22. [Current oncologic concepts and emerging techniques for imaging of head and neck squamous cell cancer].
- Author
-
Sadick M, Schoenberg SO, Hoermann K, and Sadick H
- Subjects
- Carcinoma, Squamous Cell therapy, Cell Hypoxia physiology, Combined Modality Therapy, Cooperative Behavior, Diffusion Magnetic Resonance Imaging, Early Diagnosis, Head and Neck Neoplasms therapy, Humans, Image Interpretation, Computer-Assisted, Interdisciplinary Communication, Lymphatic Metastasis pathology, Magnetic Resonance Imaging, Multimodal Imaging, Neoplasm Staging, Otorhinolaryngologic Neoplasms pathology, Otorhinolaryngologic Neoplasms therapy, Pathology, Patient Care Team, Positron-Emission Tomography, Prognosis, Squamous Cell Carcinoma of Head and Neck, Tomography, X-Ray Computed, Carcinoma, Squamous Cell diagnosis, Diagnostic Imaging, Head and Neck Neoplasms diagnosis, Otorhinolaryngologic Neoplasms diagnosis
- Abstract
The incidence of head and neck squamous cell carcinoma (HNSCC) is increasing and currently they account for 5% of all malignancies worldwide. Inspite of ongoing developments in diagnostic imaging and new therapeutic facilities, HNSCC still represents a multidisciplinary challenge. One of the most important prognostic factors in HNSCC is the presence of lymph node metastases. Patients with confirmed nodal involvement have a considerable reduction of their 5-year overall survival rate. In the era of individually optimised surgery, chemotherapy and intensity modulated radiotherapy, the main role of pre- and posttherapeutic imaging remains cancer detection at an early stage and accurate follow-up. The combined effort of early diagnosis and close patient monitoring after surgery and/or radio-chemotherapy influences disease progression and outcome prediction in patients with HNSCC. This review article focuses on currrent oncologic concepts and emerging tools in imaging of head and neck squamous cell cancer. Besides the diagnostic spectrum of the individual imaging modalities, their limitations are also discussed. One main part of this article is dedicated to PET-CT which combines functional and morphological imaging. Furthermore latest developments in MRT are presented with regard to lymph node staging and response prediction. Last but not least, a clinical contribution in this review explains, which information the head and neck surgeon requires from the multimodality imaging and its impact on operation planning., (© Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2012
- Full Text
- View/download PDF
23. [Systemic therapy strategies for head-neck carcinomas: current status].
- Author
-
Hoffmann TK
- Subjects
- Antineoplastic Combined Chemotherapy Protocols therapeutic use, Carcinoma, Squamous Cell pathology, Combined Modality Therapy, Head and Neck Neoplasms pathology, Humans, Immunotherapy, Molecular Targeted Therapy, Neoadjuvant Therapy, Neoplasm Staging, Otorhinolaryngologic Neoplasms pathology, Palliative Care, Quality of Life, Squamous Cell Carcinoma of Head and Neck, Treatment Outcome, Carcinoma, Squamous Cell therapy, Chemoradiotherapy, Adjuvant methods, Head and Neck Neoplasms therapy, Otorhinolaryngologic Neoplasms therapy
- Abstract
Head and neck cancers, most of which are squamous cell tumours, have an unsatisfactory prognosis despite intensive local treatment. This can be attributed, among other factors, to tumour recurrences inside or outside the treated area, and metastases at more distal locations. These tumours therefore require not only the standard surgical and radiation treatments, but also effective systemic treatment. The main option here is antineoplastic chemotherapy, which is firmly established in the palliative treatment of recurrent or metastatic stages of disease, and is used with curative intent in the form of combined simultaneous or adjuvant chemoradiotherapy in patients with inoperable or advanced tumour stages. Neoadjuvant treatment strategies for tumour reduction before surgery have yet to gain acceptance. Induction chemotherapy protocols before radiotherapy have to date been used in patients at high risk of distant metastases or as an aid for decision-making ("chemoselection") in those with extensive laryngeal cancers, prior to definitive chemoradiotherapy or laryngectomy. Triple-combination induction therapy (taxanes, cisplatin, 5-fluorouraeil) shows high remission rates with significant toxicity and, in combination with (chemo-)radiotherapy, is currently being compared with simultaneous chemoradiotherapy the current gold standard with regards to efficacy and long-term toxicity. A further systemic treatment strategy, called 'targeted therapy', has been developed to help increase specificity and reduce toxicity. An example of targeted therapy, EGFR-specific antibodies, can be used in palliative settings and, in combination with radiotherapy, to treat advanced head and neck cancers. A series of other novel biologicals such as signal cascade inhibitors, genetic agents, or immunotherapies, are currently being evaluated in large-scale clinical studies, and could prove useful in patients with advanced, recurring or metastatic head and neck cancers. When developing a lasting, individualised systemic tumour therapy, the critical evaluation criteria are not only efficacy and acute toxicity but also (Iong-term) quality-of-life and the identification of dedicated predictive biomarkers., (© Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2012
- Full Text
- View/download PDF
24. [Supportive therapy in medical therapy of head and neck tumors].
- Author
-
Link H
- Subjects
- Anemia pathology, Anemia therapy, Anti-Bacterial Agents therapeutic use, Antineoplastic Agents adverse effects, Diarrhea chemically induced, Diarrhea therapy, Erythropoietin therapeutic use, Granulocyte Colony-Stimulating Factor therapeutic use, Humans, Nausea chemically induced, Nausea therapy, Neutropenia pathology, Opportunistic Infections pathology, Otorhinolaryngologic Neoplasms pathology, Pain Management methods, Pneumonia pathology, Vomiting chemically induced, Vomiting therapy, Neutropenia therapy, Opportunistic Infections therapy, Otorhinolaryngologic Neoplasms therapy, Palliative Care methods, Pneumonia therapy
- Abstract
Fever during neutropenia may be a symptom of severe life threatening infection, which must be treated immediately with antibiotics. If signs of infection persist, therapy must be modified. Diagnostic measures should not delay treatment. If the risk of febrile neutropenia after chemotherapy is ≥ 20%, then prophylactic therapy with G-CSF is standard of care. After protocols with a risk of febrile neutropenia of 10-20%, G-CSF is necessary, in patients older than 65 years or with severe comorbidity, open wounds, reduced general condition. Anemia in cancer patients must be diagnosed carefully, even preoperatively. Transfusions of red blood cells are indicated in Hb levels below 7-8 g/dl. Erythropoiesis stimulating agents (ESA) are recommended after chemotherapy only when hemoglobin levels are below 11 g/dl. The Hb-level must not be increased above 12 g/dl. Anemia with functional iron deficiency (transferrin saturation < 20%) should be treated with intravenous iron, as oral iron is ineffective being not absorbed. Therapy of pain must follow diagnostic and treatment standards. Nausea or emesis following chemotherapy can be classified as minimal, low, moderate and high. The antiemetic prophylaxis should be escalated accordingly. In chemotherapy with low emetogenic potential steroids are sufficient, in the moderate level 5-HT3 receptor antagonists (setrons) are added, and in the highest level Aprepitant as third drug., (© Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2012
- Full Text
- View/download PDF
25. [Preservation of organ function in head and neck cancer].
- Author
-
Tschiesner U
- Subjects
- Chemoradiotherapy, Adjuvant adverse effects, Chemoradiotherapy, Adjuvant psychology, Combined Modality Therapy, Humans, Laryngeal Neoplasms pathology, Laryngeal Neoplasms psychology, Laryngeal Neoplasms therapy, Laryngectomy adverse effects, Laryngectomy psychology, Laryngectomy rehabilitation, Mouth Neoplasms pathology, Mouth Neoplasms psychology, Mouth Neoplasms therapy, Neck Dissection psychology, Neoplasm Staging, Organ Sparing Treatments psychology, Oropharyngeal Neoplasms pathology, Oropharyngeal Neoplasms psychology, Oropharyngeal Neoplasms therapy, Otorhinolaryngologic Neoplasms pathology, Otorhinolaryngologic Neoplasms psychology, Palliative Care, Prognosis, Quality of Life, Rehabilitation, Vocational, Surveys and Questionnaires, Organ Sparing Treatments methods, Otorhinolaryngologic Neoplasms therapy
- Abstract
Preservation of function is a crucial aspect for the evaluation of therapies applied in the field of head and neck cancer. However, preservation of anatomic structures does not equalize preservation of function. Particularly for the evaluation of alternative treatment options with equivalent oncologic outcome functional outcome becomes increasingly important. Present studies collect with varying emphasize (1) the effects of therapy on essential body functions, (2) additional therapy-induced toxic effects, and (3) health-related quality of life. The present article summarizes vital aspects of clinical research from the last years. Preservation of function after surgical and non-surgical treatment approaches are presented according to tumour localisation and staging criteria. Additional methodological aspects of study design and documentation as well as challenges and present activities for the transformation into clinical practise are discussed., (© Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2012
- Full Text
- View/download PDF
26. [Basics of tumor development and importance of human papilloma virus (HPV) for head and neck cancer].
- Author
-
Wittekindt C, Wagner S, Mayer CS, and Klußmann JP
- Subjects
- Carcinoma, Squamous Cell genetics, Cell Transformation, Neoplastic genetics, Combined Modality Therapy, DNA Damage genetics, DNA, Viral genetics, Gene Silencing, Genes, Tumor Suppressor, Genetic Markers genetics, Head and Neck Neoplasms genetics, Humans, Oncogene Proteins, Viral genetics, Oropharyngeal Neoplasms genetics, Oropharyngeal Neoplasms pathology, Oropharyngeal Neoplasms therapy, Otorhinolaryngologic Neoplasms therapy, Papillomavirus Infections genetics, Prognosis, Squamous Cell Carcinoma of Head and Neck, Carcinoma, Squamous Cell pathology, Cell Transformation, Neoplastic pathology, Cell Transformation, Viral genetics, Head and Neck Neoplasms pathology, Otorhinolaryngologic Neoplasms pathology, Papillomavirus Infections pathology
- Abstract
Head and Neck Squamous Cell Carcinoma (HNSCC) are the 6th most common cancers worldwide. While the incidence of larynx-hypopharynx carcinoma decreases, actually an increase in oropharyngeal squamous cell carcinoma (OSCC) is observed. Classical risk factors for HNSCC are smoking and alcohol. Though, it was shown recently for 25 to 60% of OSCC, to be associated with an infection by oncogenic human papilloma virus (HPV). The development of "common" head-neck-tumors is substantially enhanced by an accumulation of genetic changes, which lead to an inactivation of tumor suppressor genes or to an activation of proto-oncogenes. A more or less uniform sequence of different DNA-damages leads to genetic instability. In this context, an early and frequent event is deletion on the short arm of chromosome 9, which results in inactivation of the p16-gene. On the contrary, for HPV-induced carcinogenesis, expression of the viral proteins E6 and E7 is most important, since E6 and E7 lead to inactivation of the cellular tumor-suppressor-proteins p53 and Rb. The process of natural transoral infection is not yet clear. However, as a matter of fact peroral HPV-infection is not seldom and in most cases such an infection heals completely and uneventfully. Smoking seems to increases the probability for developing an HPV-associated tumor. The association of HNSCC with HPV can be proven with established methods in clinical diagnostics. In addition to classical prognostic factors, diagnosis of an HPV-association may become important for future therapies. Prognostic relevance of HPV probably surmounts many known risk-factors, for instance regional metastasis. Until now, no other molecular markers are established in clinical routine. Future therapy concepts may vary for the two subgroups of patients, especially patients with HPV-associated OSCC may take advantage of a less aggressive postoperative treatment. Finally an outlook will be given on possible target-aimed therapies, of which so far only antibodies against EGF-receptors are established in clinical practice., (© Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2012
- Full Text
- View/download PDF
27. [Computer assistance to improve therapy planning for head neck oncology].
- Author
-
Boehm A, Müller S, Pankau T, Straub G, Bohn S, Fuchs M, and Dietz A
- Subjects
- Combined Modality Therapy, Decision Support Techniques, Documentation methods, Humans, Multimodal Imaging, Neoplasm Staging, Otorhinolaryngologic Neoplasms diagnosis, Otorhinolaryngologic Neoplasms pathology, Positron-Emission Tomography, Prognosis, Radiotherapy Planning, Computer-Assisted methods, Software, Tomography, X-Ray Computed, Tumor Burden, Otorhinolaryngologic Neoplasms therapy, Patient Care Planning, Therapy, Computer-Assisted methods
- Abstract
The ongoing development in therapies of head and neck malignomas has led to a further differentiation of treatment options. Complex surgical procedures, a wide variety of multi modal therapy options, changing radiation technologies (IMRT - Intensity-modulated radiation therapy) and numerous "targeted therapies" emphasize the need for a precise treatment plan. Beside this, imaging has seen significant improvements beyond the technical ones, e. g. with the implementation of PET/CT scanners. This increase in pre-therapeutic data volume, together with a diversification of treatment options calls for a further discussion of the basics of therapeutic decisions. Planning relevant data processing by computer assisted systems can aid in these decisions. This work describes the current status of relevant computer assisted systems undergoing first testing for head and neck cancer therapy planning. Here, the integration of 3-dimensional patient data plays a central role. This planning tool forms the integrated base for a further development in the areas of radiation planning, documentation and study management., (© Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2011
- Full Text
- View/download PDF
28. [Inappropriate and insufficient nutrition in ENT tumors].
- Author
-
Büntzel J, Büntzel H, Micke O, and Mücke R
- Subjects
- Humans, Diet Therapy methods, Nutrition Disorders etiology, Nutrition Disorders therapy, Nutritional Support methods, Otorhinolaryngologic Neoplasms complications, Otorhinolaryngologic Neoplasms therapy
- Abstract
Tumours of the upper aerodigestive tract cause malnutrition in the majority of ENT cancer patients. This situation is complicated by multimodal treatment regimens (including surgery and/or irradiation). The resulting malnutrition is a disease entity in its own right and requires special treatment concepts. Effective screening tools (NRS 2002) need to be introduced and data such as body mass index and bioimpedance analysis need to be gathered. The nutrition plan for individual ENT patients differs according to the grade of malnutrition and dysphagia. Oral nutrition should always form the basis of any nutrition programme, such that logopedic therapy is required in all cases of dysphagia. Artifical, oral high-energy nutrition is a pharmacological procedure as well as enteral feeding via PEG or PEJ. Partial or total parenteral nutrition (central venous access) should be restricted to crisis interventions or fast-track regimens.
- Published
- 2011
- Full Text
- View/download PDF
29. [Current developments in measuring quality of life with instruments of the European organisation for research and treatment of cancer (EORTC)].
- Author
-
Singer S, Hofmeister D, Spiegel K, and Boehm A
- Subjects
- Activities of Daily Living classification, Activities of Daily Living psychology, Europe, Germany, Humans, Neoplasms psychology, Otorhinolaryngologic Neoplasms psychology, Outcome Assessment, Health Care statistics & numerical data, Psychometrics statistics & numerical data, Reproducibility of Results, Software, Translating, Cross-Cultural Comparison, Neoplasms therapy, Otorhinolaryngologic Neoplasms therapy, Quality of Life psychology, Surveys and Questionnaires
- Abstract
Since many years, the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Group develops and validates measures for the assessment of quality of life in cancer patients, using high standards of methodology. These questionnaires are meant to be used primarily in clinical trials.As treatment strategies are changing and because of some -methodological criticism, the head and neck module EORTC QLQ-H&N35 is currently being revised and updated.In this paper, we will present the current state of work and other recent developments regarding the EORTC Quality of Life questionnaire development., (© Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2011
- Full Text
- View/download PDF
30. [Promising approaches of translational research in head and neck cancer].
- Author
-
Dietz A
- Subjects
- Carcinoma, Squamous Cell mortality, Carcinoma, Squamous Cell pathology, Combined Modality Therapy, Humans, Neoplasm Staging, Otorhinolaryngologic Neoplasms mortality, Otorhinolaryngologic Neoplasms pathology, Prognosis, Survival Rate, Carcinoma, Squamous Cell therapy, Otorhinolaryngologic Neoplasms therapy, Translational Research, Biomedical trends
- Published
- 2011
- Full Text
- View/download PDF
31. [HPV-associated head and neck cancer. The basics of molecular and translational research].
- Author
-
Wittekindt C, Wagner S, and Klussmann JP
- Subjects
- Biomarkers, Tumor genetics, Carcinoma, Squamous Cell pathology, Carcinoma, Squamous Cell therapy, Cell Transformation, Neoplastic genetics, Cell Transformation, Neoplastic pathology, Cyclin-Dependent Kinase Inhibitor p16 genetics, DNA, Viral genetics, ErbB Receptors genetics, Gene Expression Regulation, Neoplastic genetics, Human papillomavirus 16 genetics, Humans, Oropharyngeal Neoplasms genetics, Oropharyngeal Neoplasms virology, Otorhinolaryngologic Neoplasms pathology, Otorhinolaryngologic Neoplasms therapy, Papillomavirus Infections pathology, Papillomavirus Infections therapy, Prognosis, Signal Transduction genetics, Virus Latency genetics, Carcinoma, Squamous Cell genetics, Carcinoma, Squamous Cell virology, Otorhinolaryngologic Neoplasms genetics, Otorhinolaryngologic Neoplasms virology, Papillomavirus Infections genetics, Papillomavirus Infections virology, Translational Research, Biomedical
- Abstract
Translational research refers to the interfaces between preclinical research and targeted short- and medium-term developments through to clinical standards. There are two distinct groups of oropharyngeal malignancies: those caused by tobacco and alcohol abuse and those caused by HPV infection. Although the prognosis of patients in the latter group is significantly better, this is not taken into consideration in the choice of treatment. However, less intensive use of radiotherapy, chemotherapy, or surgery, as well as targeted multimodal therapeutic approaches, is under research. This article summarizes the main events in the HPV life cycle, with emphasis on carcinogenic mechanisms and potential new molecular targets. Identifying distinct tumor entities of the oropharynx enables the design and development of new preventive and therapeutic strategies to reduce the incidence and mortality of HPV-associated oropharyngeal cancers in the near future.
- Published
- 2011
- Full Text
- View/download PDF
32. [Translational research in head and neck cancer. Biological characteristics and general aspects].
- Author
-
Dietz A and Wichmann G
- Subjects
- Biological Specimen Banks, Biomarkers, Carcinoma, Squamous Cell mortality, Carcinoma, Squamous Cell pathology, Carcinoma, Squamous Cell therapy, Cell Transformation, Neoplastic genetics, Cell Transformation, Neoplastic pathology, Chemoradiotherapy, Adjuvant, Chromosome Deletion, Combined Modality Therapy, Cyclin-Dependent Kinase Inhibitor p16 genetics, Disease-Free Survival, ErbB Receptors genetics, Gene Expression Regulation, Neoplastic genetics, Humans, Neoplasm Staging, Otorhinolaryngologic Neoplasms mortality, Otorhinolaryngologic Neoplasms pathology, Otorhinolaryngologic Neoplasms therapy, Papillomavirus Infections genetics, Papillomavirus Infections pathology, Prognosis, Signal Transduction genetics, Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization, TOR Serine-Threonine Kinases genetics, Tumor Suppressor Protein p53 genetics, Biomarkers, Tumor genetics, Carcinoma, Squamous Cell genetics, Gene Expression Profiling, Otorhinolaryngologic Neoplasms genetics, Translational Research, Biomedical
- Abstract
Translational research in head and neck oncology is subject to the same laws as all other solid tumors. It is based on the one hand on a solid framework of well prepared clinical studies and / or workflows according to consensus criteria with comparable documentation of clinical outcomes, while on the other on methodolgically solid and reproducible laboratory research within an effeciently interacting network. Translationally applicable single molecular markers from basic research [with the exception of p16(INK4a) as a surrogate marker for human papillomavirus (HPV)] have not found their way into clinical routine in head and neck squamous cell carcinoma (HNSCC). "Correlated gene sets" and "metagenes", including genetic profiling (omics) within clinically characterized patient groups, play an increasing role in the translational research of HNSCC. Although methodological problems currently hinder clinical oncological research, increasing focus on translational research can be observed.
- Published
- 2011
- Full Text
- View/download PDF
33. [Translational approaches in cancer stem cell research].
- Author
-
Mozet C, Wichmann G, and Dietz A
- Subjects
- Animals, Antigens, CD genetics, Asymmetric Cell Division genetics, Cell Death genetics, Gene Expression Regulation, Neoplastic genetics, Humans, Mice, Mice, Nude, Neoplasm Transplantation, Otorhinolaryngologic Neoplasms therapy, Receptors, Notch genetics, Signal Transduction genetics, Transplantation, Heterologous, Biomarkers, Tumor genetics, Cell Transformation, Neoplastic genetics, Cell Transformation, Neoplastic pathology, Neoplastic Stem Cells pathology, Otorhinolaryngologic Neoplasms genetics, Otorhinolaryngologic Neoplasms pathology, Translational Research, Biomedical
- Abstract
There has been a growing body of evidence in recent years to indicate that the presence of cancer stem cells may be responsible for tumour development and early recurrence after conventional therapy strategies such as surgery, radiation, or chemotherapy. Although this concept of a small subpopulation of cancer cells with stem cell properties is not new as such and was already discussed by Virchow decades ago, the identification of cells of this kind in human malignancies was first successful in 1997 in acute myeloid leukemia. The recent identification of cancer stem cells and the detection of their fundamental signalling pathways (e.g. Hedgehog, Notch) may offer new therapeutic options in the future and become part of a therapeutic concept. In this article, we introduce the cancer stem cell model, provide an overview of current cancer stem cell markers in different human malignancies as well as head and neck squamous cell carcinoma, and discuss studies on the first targeted therapies against cancer stem cells and their signalling pathways.
- Published
- 2011
- Full Text
- View/download PDF
34. [Innovations in biomarker development: a pathway towards individualized cancer therapy?].
- Author
-
Dumitru CA, Hoffmann TK, Lehnerdt G, Zeidler R, Lang S, and Brandau S
- Subjects
- Carcinoma, Squamous Cell genetics, Carcinoma, Squamous Cell pathology, Carcinoma, Squamous Cell therapy, Chromosome Aberrations, Early Diagnosis, Human papillomavirus 16, Humans, Immunoenzyme Techniques, Otorhinolaryngologic Neoplasms genetics, Otorhinolaryngologic Neoplasms pathology, Otorhinolaryngologic Neoplasms therapy, Papillomavirus Infections diagnosis, Papillomavirus Infections genetics, Papillomavirus Infections pathology, Papillomavirus Infections therapy, Prognosis, Proteomics, Reverse Transcriptase Polymerase Chain Reaction, Treatment Outcome, Biomarkers, Tumor analysis, Carcinoma, Squamous Cell diagnosis, Otorhinolaryngologic Neoplasms diagnosis
- Abstract
Despite multiple medical and scientific achievements, cancer remains a leading cause of death worldwide. Next to imaging technologies, molecular methods for early detection and for monitoring of the course of disease are of increasing interest. Thus, over the past years numerous studies have focused on the identification of biomarkers for cancer diagnosis, prognosis and response to therapy. The study of biomarkers seems to pose a high degree of complexity because many different types of molecules may, in principle, serve as potential biomarkers. In addition, these molecules can be produced either by the tumor or by the tumor-host in response to the presence of cancer. In this review the authors will address several major topics encompassed by the field of biomarker research. They will discuss the primary sources from which biomarker candidates can be 'mined' as well as the technological or methodological challenges associated with identification of biomarkers. Furthermore, the review will focus on current biomarker candidates for head and neck squamous cell carcinoma (HNSCC), with particular interest on several molecules yielding potential relevance for detection and prognosis of this type of cancer. Finally, several biomarker candidates with predictive potential for the response to therapy of HNSCC patients will be discussed, since identifying such molecules is crucial for developing individually-tailored and improved therapeutic strategies., (© Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2011
- Full Text
- View/download PDF
35. [Implication of stem cells in the biology and therapy of head and neck cancer].
- Author
-
Wollenberg B
- Subjects
- Antigens, CD34 analysis, Cell Transformation, Neoplastic pathology, Humans, Immunotherapy, Neoplasm Invasiveness, Otorhinolaryngologic Neoplasms therapy, Stem Cell Transplantation, Neoplastic Stem Cells pathology, Otorhinolaryngologic Neoplasms pathology
- Abstract
Stem cells play a central role in re- and generation of tissues. Special importance has been attributed to them in cancer biology. 2 entities can be discriminated: cancer infiltrating stem cells and cancer initiating stem cells. Infiltrating stem cells will be attracted to the tumor in order to be remodelled for tumor expansion, e. g. endothelial cells or other cancerous tissue components, yet these cells are per se benign. Malignant cancer stem cells are capable to generate a new tumor, histologically identical with the cancer they originate from. Many steps in cancer stem cell biology are not understood to date. It is still believed that CSC are only a minor cell fraction in tumor but capable to differentiate in hierarchical manner into any other tissue type. These stem cells are undergoing many steps of differentiation and dedifferentiation in a steady state. The factors of the micromilieu contributing to this are largely not understood. Still these steps are regarded as the key to tumor initiation, metastases and resistance to therapy. The biological functions and associated signal transduction pathways, e. g. self renewal pathways will be the key to future therapeutical strategies., (© Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2011
- Full Text
- View/download PDF
36. [Current therapy concepts in head and neck tumors. Post ASCO Congress].
- Author
-
Knecht R
- Subjects
- Combined Modality Therapy, Humans, Otorhinolaryngologic Neoplasms diagnosis, Prognosis, Otorhinolaryngologic Neoplasms therapy
- Published
- 2010
- Full Text
- View/download PDF
37. [Coagulation factors as potential tumour markers in patients with head and neck carcinomas?].
- Author
-
Greve J, Schuler PJ, Bas M, Adamzik M, Brandau S, Arweiler-Harbeck D, Lang S, and Hoffmann TK
- Subjects
- Adult, Aged, Aged, 80 and over, Antithrombin III analysis, Blood Coagulation Tests, Carcinoma, Squamous Cell pathology, Carcinoma, Squamous Cell therapy, Combined Modality Therapy, Humans, Male, Middle Aged, Neoplasm Recurrence, Local blood, Neoplasm Recurrence, Local pathology, Neoplasm Staging, Otorhinolaryngologic Neoplasms pathology, Otorhinolaryngologic Neoplasms therapy, Peptide Hydrolases analysis, Predictive Value of Tests, Biomarkers, Tumor analysis, Blood Coagulation Factors analysis, Carcinoma, Squamous Cell blood, Otorhinolaryngologic Neoplasms blood
- Abstract
Objective: Carcinomas can have influence on the coagulation system by different factors. Locally pathological changes of metabolism, neo-vascularisation, oxygenation and tissue pressure as well as locally and systemically activities of the tumor cells, are part of it. The coagulation situation in patients with head and neck carcinomata is characterized only insufficiently till now., Material and Methods: In a prospective pilot study 20 male patients with squamous-cell carcinomas of the head and neck area were subjected to a detailed coagulation diagnostics pre and post therapeutically and, age and sex corrected, compared with a control group (n=37)., Results: For the routine parameters PTT, Quick, TZ and INR no differences between the groups could be recognized. For the tumour patients a statistically significant increase arose for the acute phase proteins like factor I (fibrinogen), factor VIII, factor IX, von- Willebrand antigen and activity before therapy. Increased values were found also for plasmin, factor II, factor V and the thrombin-antithrombin-III-complex (TAT) whereas the values for antithrombin-III were degraded significantly. In the tumour patients the pre-therapeutical increased values for the activation marker TAT brought themselves back to normal after the tumour ablative therapy., Conclusions: TAT could be suitable as a potential tumour marker but also for relapse tumours. To evidence this, a study of longer duration and with a larger number of patients is necessary., (© Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2010
- Full Text
- View/download PDF
38. [Current therapy options in recurrent head and neck cancer].
- Author
-
Boehm A, Wichmann G, Mozet C, and Dietz A
- Subjects
- Carcinoma, Squamous Cell mortality, Carcinoma, Squamous Cell pathology, Combined Modality Therapy, Humans, Neoplasm Recurrence, Local mortality, Neoplasm Recurrence, Local pathology, Neoplasm Staging, Neoplasms, Second Primary mortality, Neoplasms, Second Primary pathology, Otorhinolaryngologic Neoplasms mortality, Otorhinolaryngologic Neoplasms pathology, Palliative Care, Prognosis, Salvage Therapy, Survival Rate, Carcinoma, Squamous Cell therapy, Neoplasm Recurrence, Local therapy, Neoplasms, Second Primary therapy, Otorhinolaryngologic Neoplasms therapy
- Abstract
Recurrent disease is one of the main reasons for the persistently poor prognosis of squamous cell carcinoma of the head and neck (HNSCC; European 5-year survival, 42%). The main treatment option for primary and secondary malignancy as well as recurrent disease is surgical therapy. If R0 resection (resection margin >5 mm) for a primary tumor is not viable, survival probability is reduced by 50%. In recurrent or secondary tumors with R1- or -2 resection or in the presence of non-resectable metastases, a palliative situation results in more than 80% of cases. In the case of surgery following radiotherapy or radiochemotherapy, attention should be paid to the criteria for salvage surgery (tissue perfusion, fibrosis, wound healing) and the procedure adapted to focus on functionality. In the case of relapse, primary surgery can potentially be supplemented with adjuvant therapy protocols such as (re-) irradiation, as well as possibly with chemotherapeutic agents or targeted therapies. Interdisciplinary collaboration and case discussions should take place in the context of a tumor board.
- Published
- 2010
- Full Text
- View/download PDF
39. [Post-therapeutic imaging strategies and follow-up in head and neck malignant tumours].
- Author
-
Aschenbach R and Esser D
- Subjects
- Combined Modality Therapy, Contrast Media administration & dosage, Diagnosis, Differential, Disease Progression, Follow-Up Studies, Humans, Lymphatic Metastasis pathology, Neoplasm Recurrence, Local pathology, Neoplasm Staging, Neoplasms, Unknown Primary diagnosis, Neoplasms, Unknown Primary pathology, Neoplasms, Unknown Primary therapy, Otorhinolaryngologic Neoplasms pathology, Otorhinolaryngologic Neoplasms secondary, Prognosis, Sensitivity and Specificity, Image Enhancement, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Neoplasm Recurrence, Local diagnosis, Otorhinolaryngologic Neoplasms diagnosis, Otorhinolaryngologic Neoplasms therapy, Positron-Emission Tomography, Tomography, X-Ray Computed
- Abstract
Post-therapeutic imaging is crucial for treatment planning and control in patients with malignant lesions in the head and neck. Focussed on CT, PET-CT and MRI, imaging strategies for post-therapeutic follow-up have been developed and investigated during the last few years. This review should help to interpret the results of these studies and make the reader familiar with the latest developments.
- Published
- 2010
- Full Text
- View/download PDF
40. [Oncological follow-up].
- Author
-
Esser D
- Subjects
- Biomarkers, Tumor blood, Diagnostic Imaging, Endoscopy, Follow-Up Studies, Humans, Neoplasm Recurrence, Local diagnosis, Neoplasms, Second Primary diagnosis, Otorhinolaryngologic Neoplasms diagnosis, Otorhinolaryngologic Neoplasms therapy
- Published
- 2010
- Full Text
- View/download PDF
41. [Endoscopy in otorhinolaryngology].
- Author
-
Stasche N
- Subjects
- Equipment Design, Humans, Image Enhancement, Otorhinolaryngologic Diseases therapy, Otorhinolaryngologic Neoplasms therapy, Bronchoscopes, Esophagoscopes, Otorhinolaryngologic Diseases diagnosis, Otorhinolaryngologic Neoplasms diagnosis
- Published
- 2009
- Full Text
- View/download PDF
42. [Current opinion in treatment of soft tissue sarcoma].
- Author
-
Dietz A and Frerich B
- Subjects
- Biopsy, Combined Modality Therapy, Humans, Neoplasm Invasiveness, Neoplasm Staging, Otorhinolaryngologic Neoplasms diagnosis, Otorhinolaryngologic Neoplasms mortality, Otorhinolaryngologic Neoplasms pathology, Prognosis, Sarcoma diagnosis, Sarcoma mortality, Sarcoma pathology, Survival Rate, Otorhinolaryngologic Neoplasms therapy, Sarcoma therapy
- Abstract
The present work discusses soft tissue sarcoma in the head and neck area, due to the rare occurrence and the sparse data situation is still a large number of unexplained riddles. The head and neck surgeon plays the central role in the diagnosis and treatment of the vast majority of soft tissue sarcoma in the head and neck area. It is crucial that these tumors immediately should be send to specialized centers. An larger excisional biopsy should be avoided. When histology and tumor extension are secured an interdisciplinary treatment concept should be discussed, or the patient if possible will be introduced in ongoing clinical studies.
- Published
- 2009
- Full Text
- View/download PDF
43. [Synovial sarcoma of the head and neck].
- Author
-
Kuehnemund M, Friedrichs N, and Bootz F
- Subjects
- Adolescent, Adult, Biomarkers, Tumor analysis, Child, Combined Modality Therapy, Female, Follow-Up Studies, Humans, Lymph Nodes pathology, Lymphatic Metastasis diagnosis, Lymphatic Metastasis pathology, Magnetic Resonance Imaging, Male, Mucin-1 analysis, Neoplasm Staging, Otorhinolaryngologic Neoplasms pathology, Otorhinolaryngologic Neoplasms therapy, Sarcoma, Synovial pathology, Sarcoma, Synovial therapy, Vimentin analysis, Otorhinolaryngologic Neoplasms diagnosis, Sarcoma, Synovial diagnosis
- Abstract
Background: Synovial sarcoma (SS) is a mesenchymal malignancy, which predominantly occurs at the lower extremities of young adults. Only 3 % of the SS show a primary manifestation in the head and neck region., Methods: A retrospective chart review (years 2002 - 2006) of our Department of Otorhinolaryngology, head and neck surgery, School of Medicine, Bonn, Germany, was performed searching for patients with primary head and neck manifestations of SS., Patients: Four patients (2 female, 2 male) with a median age of 21 (12 - 28) years were assessed at our facility., Results: The location of the SS was the oropharynx respectively, infiltrating adjacent structures. 3 patients underwent radical surgery followed by chemotherapy, 2 in combination with irradiation. 1 patient underwent primary chemotherapy and irradiation. The histological diagnosis was a biphasic SS as well as a monophasic SS in 2 patients respectively. Fluorescence-in-situ-hybridization was performed in order to detect the distinctive chromosomal translocation t(X;18). 2 patients were in complete remission at the recent follow-up, 1 patient died 14 months after diagnosis due to a lethal carotidal haemorrhage. 1 patient was lost to follow-up., Conclusions: The aggressive character of the SS as well as its high recurrence rate afford a radical therapeutic scheme enclosing surgical, chemotherapeutical and radiological treatment as well as a thorough follow-up. The genetic translocation t(X;18) leads the way to the right diagnosis. The prognosis of head and neck SS must be considered as poor. SS should be taken into consideration in head and neck tumors of unclear nature.
- Published
- 2008
- Full Text
- View/download PDF
44. [ENT oncology].
- Author
-
Burian M
- Subjects
- Austria, Cooperative Behavior, Humans, Patient Care Team, Carcinoma, Squamous Cell therapy, Otorhinolaryngologic Neoplasms therapy
- Published
- 2008
- Full Text
- View/download PDF
45. [Secondary malignant lymphedema in head and neck tumors].
- Author
-
Hammerl B and Döller W
- Subjects
- Antineoplastic Agents therapeutic use, Combined Modality Therapy, Diagnosis, Differential, Disease Progression, Humans, Lymphedema etiology, Male, Middle Aged, Neoplasm Recurrence, Local therapy, Octreotide therapeutic use, Oropharyngeal Neoplasms therapy, Palliative Care, Physical Therapy Modalities, Selenium therapeutic use, Lymphedema therapy, Otorhinolaryngologic Neoplasms therapy
- Abstract
The occurrence of edema is a serious problem of patients suffering from cancer and may have various causes. Particularly, the secondary malignant lymphedema poses a special threat to patients. In some cases, it indicates the progression of illness, and in fact also results in mutilating physical changes, which add to the already existing impairments caused by the cancer disease. So far therapeutic interventions are limited. Current management consists of physical therapy and pharmacological interventions. There are few powerful studies concerning the efficiency and hardly any concerning combined or comparative treatment in the literature. Most of them focus on the management of lymphedema in breast cancer patients. Preventive measures and supportive therapy are rarely being discussed. In this case report, we describe the successful use of Selen and Sandostatin in treating a facial edema of a patient with advanced head-neck cancer.
- Published
- 2008
- Full Text
- View/download PDF
46. [Palliative care in patients with head and neck cancer].
- Author
-
Namjesky A
- Subjects
- Disease Progression, Female, Humans, Middle Aged, Neoplasm Invasiveness, Neoplasm Staging, Otorhinolaryngologic Neoplasms pathology, Otorhinolaryngologic Neoplasms psychology, Patient Care Team, Quality of Life psychology, Self Care psychology, Terminal Care methods, Terminal Care psychology, Tracheostomy psychology, Otorhinolaryngologic Neoplasms therapy, Palliative Care methods
- Abstract
Progressive cancer leads to loss of quality of life. This is particularly true for head and neck cancers as they dramatically affect the patients and in addition to this psychological burden cause a lot of physical disabilities. Patients struggle against retreat and helplessness of their environment, feel ostracized and not any longer being a human. In advanced diseases, surgery is not the first choice of treatment. Ostensible control of symptoms, care of relatives and notice of psychosocial facts are the most important therapeutic issues in these patients. They gain the greatest benefit from palliative care with good control of symptoms. This is highlighted by the following case reports.
- Published
- 2008
- Full Text
- View/download PDF
47. [Best supportive care in head and neck cancer].
- Author
-
Salzwimmer M
- Subjects
- Antiemetics therapeutic use, Carcinoma, Squamous Cell mortality, Carcinoma, Squamous Cell pathology, Combined Modality Therapy, Neoplasm Staging, Otorhinolaryngologic Neoplasms mortality, Otorhinolaryngologic Neoplasms pathology, Prognosis, Quality of Life, Radiation Injuries diagnosis, Radiation Injuries pathology, Radiation Injuries therapy, Survival Rate, Carcinoma, Squamous Cell therapy, Otorhinolaryngologic Neoplasms therapy, Palliative Care
- Abstract
Head and neck cancer make up about 6% of all tumours worldwide. The distribution pattern shows clear prevalence among males, peaking between the ages of 50 and 60. In 2002, incidence in Europe stood at 143,000, with mortality at 68,000. Over 90% of all head and neck malignancies are squamous cell cancer. The most common carcinogens are tobacco and alcohol. By the time the tumour is first diagnosed, more than two thirds of all patients are staged III or IV according to UICC. Although intensive research has been carried out in the last few years, both in the field of surgery and in conservative cancer treatments (radiotherapy, chemotherapy or immunotherapy), the overall survival rates have unfortunately not markedly increased.
- Published
- 2008
- Full Text
- View/download PDF
48. [Recommendation for guidelines in the treatment of squamous cell cancer of the upper aerodigestive tract].
- Author
-
Burian M
- Subjects
- Algorithms, Austria, Carcinoma, Squamous Cell pathology, Cooperative Behavior, Humans, Neoplasm Staging, Otorhinolaryngologic Neoplasms pathology, Patient Care Team, Carcinoma, Squamous Cell therapy, Otorhinolaryngologic Neoplasms therapy, Practice Guidelines as Topic
- Abstract
If we look at the historical development of the treatment of head and neck cancer, we can see that initially, decisions about therapy lay solely in the hands of the surgeons (Otorhinolaryngologists, oral and maxilla-facial surgeons) This was also true of the decision as to whether an operation was feasible or whether primary radio therapy was to be carried out. At the end of the last century, after chemotherapy had become an integral part of curative therapy, inter-disciplinary conferences (tumour boards) were set up so that the surgeons could make joint decisions about therapy together with radio oncologists and medical oncologists. In addition, the increasingly important role of chemotherapy in curative therapy in the last fifteen years has led to a marked increase in the number of clinical studies in head and neck cancer. Inter-disciplinary treatment decisions can be based only on current scientific knowledge and are geared towards a standard treatment as recommended for an individual tumour stage. It is precisely in the upper aerodigestive tract that there are various therapeutical procedures, due to the different site of primaries (oral cavity, oro-, hypoparynx and larynx) and the different grade of locoregional metastasis. One possible way to assure a high degree of transparency of these various therapies and making them available to a high number of colleagues is the development guidelines [1]. Many medical associations and organisations in Austria are currently engaged in the formulation and definition of guidelines, in order to provide the highest possible quality of medical treatment and care for each individual patient. By guidelines are meant recommendations for treatments which allow a certain amount of flexibility in the treatment and provide a medical consensus in line with current scientific knowledge. In principle, they are binding, but in exceptional but reasonable cases, they may (and even must) be departed from. The following proposal is designed to provide a basis for the formulation of guidelines for the treatment of head and neck cancer in Austria. It was put together with help from ENT specialists, medical oncologists and radio oncologists from across Austria. One advantage was certainly the fact that several foreign associations had already drawn up guidelines which could be referred to [2, 3]. Since guidelines are dynamic in nature and must be constantly adapted to correspond to current medical knowledge and research, they are often only available today on websites. For this reason, links to relevant sites are given at the end of this article.
- Published
- 2008
- Full Text
- View/download PDF
49. [Current status of head and neck cancer therapy in the elderly].
- Author
-
Sesterhenn AM
- Subjects
- Age Factors, Aged, Aged, 80 and over, Carcinoma, Squamous Cell mortality, Carcinoma, Squamous Cell pathology, Combined Modality Therapy, Geriatric Assessment, Humans, Neoplasm Staging, Otorhinolaryngologic Neoplasms mortality, Otorhinolaryngologic Neoplasms pathology, Prognosis, Quality of Life, Survival Rate, Carcinoma, Squamous Cell therapy, Otorhinolaryngologic Neoplasms therapy
- Abstract
In the years to come health care systems of western industrialized nations are going to be increasingly faced with the results of demographic changes. Especially the part of elderly citizens will grow steadily. Thus, also an increasing number of malignant diseases not only in the head & neck area is expected. Decision-making in cancer therapy for elderly patients is challenging for medical professional since this subject is accompanied by a high rate of uncertainness. For fear of aggressive therapy regimens with subsequent increase of morbidity, in many cases only incomplete diagnostic and therapeutic measures are taken. Reviewing the literature there is almost complete international consensus, that patients suffering from squamous cell cancer of the head & neck should be treated with curative intention, if thorough preoperative assessment of present comorbidities is performed. Furthermore aggressive treatment options should not be excluded. An optimal medical adjustment of relevant concomitant diseases clearly improves the starting point. In comparison to younger control groups therapy associated complications do not occur significantly higher. For this reason elderly patients should be treated with curative intention. Age itself should never be a sole factor deciding which curative therapy should be undertaken. Exceptions could be made in patients with severe general comorbidity.
- Published
- 2007
- Full Text
- View/download PDF
50. [Role of epigenetics in the carcinogenesis of head and neck carcinomas - possible new targeted therapy?].
- Author
-
Weber A, Dietz A, Tischoff I, and Tannapfel A
- Subjects
- Antimetabolites, Antineoplastic pharmacology, Apoptosis drug effects, Apoptosis genetics, Azacitidine analogs & derivatives, Azacitidine pharmacology, Carcinoma, Squamous Cell diagnosis, Cell Division drug effects, Cell Division genetics, DNA Methylation drug effects, DNA Modification Methylases antagonists & inhibitors, Decitabine, Gene Expression Regulation, Neoplastic physiology, Genes, Suppressor drug effects, Otorhinolaryngologic Neoplasms diagnosis, Promoter Regions, Genetic drug effects, Promoter Regions, Genetic genetics, Tumor Cells, Cultured drug effects, Carcinoma, Squamous Cell genetics, Carcinoma, Squamous Cell therapy, Epigenesis, Genetic genetics, Otorhinolaryngologic Neoplasms genetics, Otorhinolaryngologic Neoplasms therapy, Targeted Gene Repair methods
- Abstract
In search of new targeted therapies for squamous cell carcinoma of the head neck (HNSCC), a better understanding of the carcinogenesis is of outmost importance. Recent studies show that not only genetic but also epigenetic alterations initiate the multistep process of tumordevelopment. Epigenetic changes lead to altered gene expression without alterations of the DNA sequence. The best characterized epigenetic change is the methylation of the promoter region of genes, especially of tumorsuppressor genes. The methylation of the promoter region blocks the promoter and therefore represses transcription. The loss of the gene products of tumorsuppressor genes leads to increased proliferation and decreased apoptosis. Methylation of tumorsuppressor genes was shown in precancerous lesions of HNSCC, which emphasizes the importance of methylation as an early biomarker. Several studies of tumor cell cultures show reactivated expression of proteins and as a result reduction of proliferation and induction of apoptosis after treatment with demethylating agentens. This presents a very promising new option for a targeted therapy.
- Published
- 2007
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.