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Burning charcoal in an enclosed space is now the second most-common method of committing suicide in Hong Kong. When the suicide is unsuccessful, the patients can still sustain extensive tissue destruction from both direct and indirect thermal burns. We report a series of three patients who sustained deep injuries that, after débridement, left exposed bones and joints needing acute coverage. Free tissue transfer was required in each case to close the wounds. This short series illustrates the extensive destruction that can occur from both contact burns and radiant heat injury and the reconstructive challenges that can result. Of particular note was that serial débridment was necessary in the radiant heat injury because of the evolving and more extensive nature of the wound.

The purpose of this study was to investigate the complications after maxillary swing nasopharyngectomy.Salvage nasopharyngectomy was performed for 338 patients during 1990 to 2012. Patient and tumor characteristics, perioperative and intraoperative information, and long-term morbidities were analyzed.There were significantly more patients with locally advanced tumors (rT3 and rT4) operated during the recent study period (2002-2012). However, the mean operative time and blood loss was significantly lower than in the earlier period (1990-2001). There was no hospital mortality. There was a significant reduction in the postoperative trismus and palatal fistula formation. Patients with locally advanced tumor, particularly those who required adjuvant chemoradiation, had a higher chance of facial numbness, nasal blockage, and swallowing problems after surgery.Salvage nasopharyngectomy via the maxillary swing approach is safe with acceptable long-term morbidities. Prevention of complications associated with surgery, particularly for patients with locally advanced tumors, is crucial to ensure the best outcome of surgery.

After adequate extirpation of tumours in the hypopharynx, the defect created should be reconstructed appropriately to provide optimal function. Local cervical skin flaps were first described and employed 60 years ago for the reconstruction of defects after pharyngolaryngectomy 1. However, the procedures involved had to be carried out in stages, which typically required 4 – 6 months for completion. In addition, the subsequent ability to swallow was frequently limited by the stenosis at the anastomotic junction. Nowadays, with more advanced techniques, reconstruction of the circumferential hypopharyngeal defect is nearly always performed at the time of resection as a single stage procedure 2. The most commonly employed reconstructive options include the use of myocutaneous flaps (pedicled pectoralis major flap or free anterolateral thigh flap) with the skin island sutured and fashioned as a tubular conduit, or the free visceral flap (free jejunal flap).

The purpose of this study was to investigate if nodal ratio has a prognostic role in the survival of patients with recurrent nasopharyngeal carcinoma (NPC) in the neck.Patients with recurrent NPC in the neck who were treated in Queen Mary Hospital from 2000 to 2011 were identified. Clinical data, pathological results, and survival outcome were analyzed.Only nodal ratio remained as a statistically significant predictor in multivariate analysis for nodal recurrence (p = .045) and nodal recurrence-free survival (p = .010). All other predictors lost significance when compared with each other and with nodal ratio. Nodal ratio was also a significant predictor for overall survival (OS) in univariate analysis (p = .001) but lost its significance in multivariate analysis. The cutoff points 10% and 15% effectively stratified the patients into 3 risk groups (p = .02).In patients with NPC with neck recurrence, nodal ratio (the ratio of positive nodes to the total number of nodes examined) is a strong predictor of further nodal recurrence and nodal recurrence-free survival. Nodal ratio also impacts the OS but loses its significance in multivariate analysis, including concurrent local recurrence. Stratification of patients into low, medium, and high-risk groups according to nodal ratio may have a potential role in guiding therapeutic decision-making. Therefore, further exploration in this area is warranted.

Objectives/Hypothesis Our previous report recommended that the management of ipsilateral otitis media with effusion (OME) after maxillary swing nasopharyngectomy was observation. The idea of introducing a stent into the eustachian tube (ET) at the nasopharyngeal side after nasopharyngectomy may prevent postoperative OME. The purpose of this study was to examine the feasibility of intraoperative ET stenting and the efficacy of preventing ipsilateral OME formation. Study Design Prospective cohort study. Methods From 2009 to 2011, 28 patients with nasopharyngectomy via the maxillary swing approach were recruited. Patients with curative resection were recruited (n = 21). ET stenting was performed intraoperatively using a 16-gauge Angiocath (BD Medical Systems, Franklin Lakes, NJ) with dimensions of 1.7 mm × 30 mm. The stent stays inplace indefinitely. The otologic status was evaluated using otoscopy, pure-tone audiogram, and tympanogram at 3 months, 6 months, and 1 year after the surgery. The outcomes were analyzed and compared with historical control. Results There were 9 (43%) patients with no OME at 6 months after surgery, and 15 (71%) patients had no OME at 1 year postoperatively. The results were statistically significant (P

Nasopharyngeal carcinoma (NPC) is a unique tumour which is endemic in Southern China including Hong Kong. While the treatment results for early disease are encouraging, patients with advanced cancer are uniformly associated with poor prognosis. Epstein-Barr virus (EBV), the first virus related to the development of human malignancy, plays an important role in the carcinogenesis of the disease. Over the past decades, researchers have been trying to identify EBV associated biomarkers which allows early diagnosis as well as accurate monitoring of treatment response. With the development of real time quantitative polymerase chain reaction, plasma EBV DNA has been studied with much enthusiasms for its potential role in the management of patients with NPC. Since then, numerous reports have been published regarding the applications of plasma EBV-DNA for early diagnosis, monitoring of treatment response after radiotherapy or surgery, and as a prognosticator predicting oncological results after curative therapy for primary disease or palliative treatments for patients with recurrent/metastatic cancer. On-going studies are performed to investigate its potential use in the screening of at-risk populations in the endemic geographic regions. In the future, it may allow pre-treatment risk stratification for individual patients, so that personalization of treatment protocols can be achieved with potentially better oncological outcome.

A model based on the concept of reduction in life expectancy (RLE model) as a result of long term exposure to toxicant has been developed which has normal life expectancy (NLT) as a fixed limiting point for a species. The model is based on the equation (LC50 = a ln(LT50) + b) where a and b are constants. It was evaluated by plotting ln LT50 against LC50 with data on organic toxicants obtained from the scientific literature. Linear relationships between LC50 and ln LT50 were obtained and a Calculated NLT was derived from the plots. The Calculated NLT obtained was in good agreement with the Reported NLT obtained from the literature. Estimation of toxicity at any exposure time and concentration is possible using the model. The use of NLT as a reference point is important since it provides a data point independent of the toxicity data set and limits the data to the range where toxicity occurs. This novel approach, which represents a departure from Haber's rule, can be used to estimate long term toxicity from limited available acute toxicity data for fish exposed to organic biocides.

Effects of Radiotherapy on Pharyngeal Reconstruction After Pharyngo-Laryngectomy

N-CBM-TAMO 2 was prepared by the same procedure as used for TAMO 1 . It was found to be a short-term kappa agonist and a long-term mu antagonist. The benzazepine 12 , (AS-300) was a potent selective D 1 antagonist. Both compounds suppressed cocaine and morphine self-administration in rats at doses which did not affect water consumption. The synthesis of N-CBM-TAMO ( 2 ) and AS-300 ( 12 ) is described. Both drugs block cocaine and morphine self-administration in rats.

Hetero-epitaxy of single-crystal perovskite SrTiO3 on GaAs(001) was achieved using molecular beam epitaxy. The growth was accomplished by deposition of a submonolayer of titanium on GaAs(001), followed by the co-deposition of strontium and titanium initiated at a low-temperature, low-oxygen-pressure condition. X-ray photoelectron spectroscopy showed that the Ti prelayer reacted with As and formed TiAs-like species on the As terminated GaAs(001) surface. Reflection-high-energy-electron diffraction showed that SrTiO3 grew coherently on the GaAs(001) at early stage of growth. This coherent behavior began to degrade when SrTiO3 thickness exceeded 20A. Cross-sectional transmission electron microscopy revealed an abrupt interface between SrTiO3 and GaAs and good crystallinity of the SrTiO3 film. An epitaxial relationship between SrTiO3 and GaAs was further confirmed by x-ray diffraction. The success of growth of SrTiO3 on GaAs paves the way for integration of various functional perovskite oxides with GaAs.

Nitric oxide (NO) donors such as sodium nitroprusside (SNP, 0.01-1 micrograms) or 3-morpholino-sydnonimine (SIN-1, 0.1-10 micrograms) administered intracerebroventricularly (i.c.v) produced a dose-dependent potentiation of beta-endorphin-induced antinociception assessed by the tail-flick test in ICR mice. The same i.c.v. treatment with SNP or SIN-1 did not affect the antinociception induced by mu-, delta-, or kappa-opioid receptor agonists. The goal of the present study was to determine if the potentiation of the beta-endorphin-induced antinociception by NO donors is mediated by the activation of NO-cGMP system. Co-administration of hemoglobin (30-120 micrograms) or methylene blue (1.25-5 micrograms), but not N omega-nitro-L-arginine (1-5 micrograms) given i.c.v. dose-dependently attenuated the potentiating effects of SNP or SIN-1 on beta-endorphin-induced antinociception. However, the same i.c.v. treatments of mice with hemoglobin, methylene blue or N omega-nitro-L-arginine did not directly affect the i.c.v. administered beta-endorphin-induced antinociception. On the other hand, the treatment of mice with a combination of NO donor (SNP, 0.1 micrograms or SIN-1, 1 microgram) and zaprinast (a cGMP phosphodiesterase inhibitor, 1 microgram) further potentiated beta-endorphin-induced antinociception. These results indicate that the potentiating effect of SNP or SIN-1 on beta-endorphin-induced antinociception is mediated by the increased production of NO-cyclic GMP in the brain. However, the NO-cGMP system is not directly involved in the beta-endorphin-induced antinociception.

We report effusive evaporation of Ga2O3 thin films on GaAs(001) substrates in a production-type molecular-beam epitaxy system. A polycrystalline Ga2O3 charge heated in a high-temperature effusion cell is used as the evaporation source. The Ga2O3–GaAs structures are characterized by atomic force microscopy (AFM), Rutherford backscattering spectroscopy (RBS), ellipsometry, and transmission electron microscopy (TEM). The Ga2O3 films are amorphous and stoichiometric by transmission electron diffraction and RBS, respectively. Under optimal growth conditions, the Ga2O3 film surface has a typical roughness of 2–3 A as revealed by AFM, while the Ga2O3–GaAs interface is atomically abrupt as confirmed by the cross-sectional TEM. Such amorphous and stoichiometric Ga2O3 oxide paves the way for GaAs gate dielectrics applications.

Amorphous Ga2O3 films are deposited onto the GaAs(001) surface using effusive evaporation from a high-purity polycrystalline Ga2O3 source. The Ga2O3–GaAs structure is characterized by cross-sectional transmission electron microscopy, electron diffraction, and photoluminescence intensity measurements. As-deposited Ga2O3 films are found to be amorphous forming an atomically abrupt interface of low interface state density Dit with GaAs. For oxide films with a thickness tox⩾127 A, rapid thermal annealing above a critical temperature Tc=720 °C induces Ga2O3 bulk crystallization resulting in structural deformation of the Ga2O3–GaAs interface and complete destruction of its low Dit character. Preliminary data suggest that the critical temperature Tc may increase in the limit of very thin Ga2O3 films.

The formation of interfacial layers between silicon and the overgrown epitaxial SrTiO3 as a function of the growth temperature has been studied in detail using x-ray photoelectron spectroscopy and high-resolution transmission electron microscopy. Models for the chemical compositions and atomic bonding states have been established. With a good understanding of the mechanisms of the interfacial layer formations, the molecular-beam epitaxy growth process can be well controlled to form high-quality, single-crystalline oxide films, as well as a desired interface between the grown oxide and silicon substrate. The epitaxial relationship has been found to be SrTiO3 (001)∥Si(001), and SrTiO3 〈100〉∥Si〈110〉.

Volatile aromatic hydrocarbons (VAHs: benzene, toluene, ethylbenzene, mp-xylene, o-xylene, styrene, naphthalene) in residential indoor air in Brisbane, Australia were measured in 32 houses. The total VAHs (TVAHs) levels ranged between 2 and 137μg/m(3) and were lower than the most of the houses in the literature data. The VAHs were believed to originate from heat insulation systems, building material products as well motor vehicles but naphthalene and styrene originated from other sources. Internal garages had concentrations which are higher than the indoor air by 25-50% due to the presence of motor vehicles and may be a major source of indoor VAHs. However indoor concentrations are higher than that in the outdoor ambient air. The age of the house was found to be negatively related to VAHs concentrations in the houses with the half-life of TVAH at approximately 13years. The concentration levels of benzene, toluene, ethylbenzene and styrene are well below the guideline values set by agencies from Hong Kong, Japan, Germany and the WHO while the concentration level of naphthalene in one house exceeded the guideline value from Germany.

The purpose of this study was to investigate the treatment outcome of radiation-induced squamous cell carcinoma (SCC) of the nasopharynx after radiotherapy (RT) for nasopharyngeal carcinoma (NPC).We conducted a retrospective review of patients who underwent radiation therapy for NPC, which resulted in radiation-induced SCC of the nasopharynx.Between 1998 and 2011, 24 patients had radiation-induced SCC of the nasopharynx. The median age of diagnosis was 68.2 years. The majority of patients (66.7%) presented with early-stage NPC initially, and they were treated with RT alone (n = 18) or concurrent chemoradiation (n = 6). The mean latency period for the second malignancy was 10.5 years. All the patients were treated with maxillary-swing nasopharyngectomy. Clear resection margin was achieved in 66.7%, and 75% of those with involved margin received adjuvant RT. The mean follow-up duration was 48.2 months. The overall 5-year actuarial local tumor control was 56% and the overall 5-year disease-free survival was 38%.Radiation-induced SCC of the nasopharynx is rare after RT for NPC. The prognosis remained poor despite aggressive surgery and adjuvant RT.

The purpose of this study was to investigate the prognostic factors for salvage nasopharyngectomy.A retrospective review was conducted on maxillary swing nasopharyngectomy performed between 1998 and 2010. Univariate and multivariate analyses identified prognostic factors affecting actuarial local tumor control and overall survival.The median follow-up duration was 52 months. Among the 268 patients, 79.1% had clear resection margins. The 5-year actuarial local tumor control and overall survival was 74% and 62.1%, respectively. On multivariate analysis, tumor size, resection margin status, and gross tumor in the sphenoid sinus were independent prognostic factors for local tumor control. For overall survival, resection margin status, synchronous cervical nodal recurrence, and cavernous sinus invasion had a negative influence on overall survival after surgery.Extent of nasopharyngectomy should be tailored to the individual tumor to achieve clear resection margins. Cavernous sinus invasion is associated with poor survival outcome, and detailed counseling and meticulous surgical planning is crucial in such circumstances.

The purpose of this study was to analyze the surgical management of recurrent retropharyngeal lymph node metastasis after radiotherapy for nasopharyngeal carcinoma (NPC).We conducted a prospective analysis of preoperative imaging, surgical approach, and oncological results.Between 1990 and 2011, 82 patients were included. The mean size of the retropharyngeal lymph node on MRI was 1.6 cm, and the mean standardized uptake value maximum (SUVmax) on positron emission tomography (PET) scan was 6.8. All the retropharyngeal lymph nodes were resected via the maxillary swing approach. Among the resected retropharyngeal lymph nodes, 87.8% contained viable tumor cells. The rate of microscopic extracapsular spread was 30.6%. The mean follow-up duration was 38 months. The 5-year actuarial tumor control and the overall disease-free survival of patients who underwent surgeries for isolated recurrent retropharyngeal lymph node metastasis was 79.6% and 59%, respectively.A PET scan is potentially useful in diagnosing persistent or recurrent retropharyngeal lymph node after previous radiotherapy for NPC. The maxillary swing approach allows surgical resection with clear margins in order to achieve the best oncological outcome.

Microvascular surgeons always hold strong belief against the use of vasopressors during free flap surgery. Our aim is to study the safety of intra-operative vasopressors on free jejunal flap reconstruction.A retrospective chart review was performed on patients undergoing free jejunal flap reconstruction, aiming at investigating the intra-operative use of vasopressors and the potential complications associated.Between 1984 and 2012, 110 free jejunal flaps were performed for reconstruction of circumferential pharyngeal defects created after resection of cancers of the hypopharynx. Intra-operative vasopressor was given in 81 (73.6%) patients. The most common vasopressors used were ephedrine (42.7%), phenylephrine (14.5%) or both (42.8%). They were administered to the patients before the start of flap harvesting (n = 32, 29.1%), during the flap harvesting (n = 30, 27.3%), during microvascular anastomosis (n = 20, 18.2%), or they were given more than once during the whole operation (n = 28, 25.4%). The incidence of intra-operative re-anastomosis due to thrombosis was 4.5% and the post-operative flap failure rate was 5.4%. There was no significant relationship between the administration of vasopressor during surgery and the need for intra-operative re-anastomosis, post-operative flap failure and the timing of flap failure. Similarly, there was also no relationship between the timing of vasopressor administration and the above variables. The long-term stricture rate was 2.7%, the risk of which was not increased by the intra-operative use of vasopressors.The intra-operative use of vasopressors is safe in free jejunal flap reconstruction.

The strong associations between oral squamous cell carcinoma (OSCC) and dietary habits such as alcohol consumption (A), betel quid chewing (B) and cigarette smoking (C) and its predominance in men have been well documented; however, systemic analysis of OSCC is limited. Our study applied high-throughput screening methods to identify causative epigenetic targets in a cohort of men with ABC-associated OSCC. We identified BEX1 and LDOC1 as two epigenetically silenced X-linked tumour suppressors and demonstrated a functional link between the transcription of BEX1 and LDOC1 and promoter hypermethylation. Methylation of the BEX1 and LDOC1 promoters was associated significantly (p 0.0001) with OSCC and were detected in 75% (42/56) and 89% (50/56) of the samples, respectively. We observed concordant increases in the methylation of both genes in 71% (40/56) of the tumours, and potent in vitro and in vivo growth inhibitory effects in OSCC cells ectopically expressing BEX1 and/or LDOC1. Restored expression of BEX1 and LDOC1 suppressed the nuclear factor-κB (NF-κB) signalling pathway, which is the most frequently hyperactivated signalling pathway in OSCC. This suppression might result from decreased p50 and p65 expression. These findings suggest that silencing of BEX1 and LDOC1 by promoter hypermethylation might represent a critical event in the molecular pathogenesis of OSCC and account for the oncogenic effects of ABC exposure and the male predominance of OSCC occurrence. Microarray data are available in the Gene Expression Omnibus (GEO; http://www.ncbi.nlm.nih.gov/geo/)

To validate Epstein-Barr virus BamHI-A rightward transcript 7 microRNA (ebv-miR-BART7) expression in plasma from patients with nasopharyngeal carcinoma (NPC) and explore the oncogenic role of ebv-miR-BART7 in NPC cells.Plasma ebv-miR-BART7 levels were measured using real-time quantitative RT-PCR. Effects on cell proliferation, invasion, migration, and resistance to cisplatin were studied on NPC cells using real-time cell analyzer.The plasma ebv-miR-BART7 level was significantly higher in patients with NPC in comparison with that from healthy individuals. The ebv-miR-BART7 was detectable in all the patient plasma samples and was independent of the EBV DNA level. In vitro expression of ebv-miR-BART7 enhanced proliferation, migration, and invasion of NPC cells. Furthermore, NPC cells expressing ebv-miR-BART7 were more resistant to cisplatin. High-throughput gene expression analysis suggested that ebv-miR-BART7 affects multiple cancer-related pathways.Our results indicate that plasma ebv-miR-BART7 could be used in NPC screening, especially in cases where EBV DNA is not detectable. The association of ebv-miR-BART7 with common oncogenic pathways suggests that ebv-miR-BART7 is a potential biomarker for undifferentiated NPC.

Head and neck cancer is the sixth most common type of Cancer worldwide. Since conventional treatment regimens are nonselective and are associated with systemic toxicities, intense investigations focus on molecular targeted therapy with high selectivity and low adverse effects. mTOR signaling pathway has been found to be activated in head and neck cancer, making it attractive for targeted therapy. In addition, expression levels of mTOR and downstream targets eIF4E, 4EBP1, S6K1, and S6 are potential diagnostic and prognostic biomarkers for head and neck cancer. mTOR inhibitors, such as rapamycin and its derivatives temsirolimus and everolimus, exhibit inhibitory effects on head and neck cancer in both in vitro cell line model and in vivo xenograft model. A large number of clinical trials have been initiated to evaluate the therapeutic effects of mTOR inhibitors on patients with head and neck cancer. mTOR inhibitor has potential as a single therapeutic agent or in combination with radiation, chemotherapeutic agents, or other targeted therapeutic agents to obtain synergistic repression on head and neck cancer.

Primary mucosal melanomas of the head and neck (HNMM), albeit being rare, are rapidly lethal. Here we report the experience of patients with HNMM treated in our institution over a 32-year period.We aim to review our experience in managing HNMM patients over a 32-year period.Retrospective study.Thirty-five patients diagnosed with HNMM from 1978 to 2009 were retrospectively reviewed, with an emphasis on predictors on survival outcome.Twenty-four patients received curative resection, 6 of them followed by adjuvant radiotherapy. Neck dissections were performed in 8 patients. Four patients received radiotherapy as primary treatment. Seven patients were treated conservatively. The overall mean and median survivals were 50 and 26 months, respectively. The median survival of stage I, II, and III diseases in our group of patients were 39, 10, and 16 months, respectively. The 1-year and 5-year overall survival rates were 65.7% and 22.9%, respectively. Age above 60 (p = 0.007), nodal involvement (p = 0.047;) and stage at presentation (p = 0.046) were shown to be associated with worse overall survival. Sites of tumour did not seem to impact on survival. On multivariate analysis, only age (below or above 60) was found to be statistically significant [RR 4.79 (1.65-13.9), p = 0.004].Oral cavity melanomas are more likely to have nodal involvement at presentation. Prognosis of HNMM remains grave. Current evidence still supports surgery as the best chance of cure. Role of adjuvant radiotherapy is controversial and does not appear to improve overall survival. Similarly, role of neck dissection is ill-defined.

Squamous cell carcinoma (SCC) of tongue is an aggressive head and neck cancer with high propensity of regional spreading and invasion. Tongue carcinoma cells treated with curcumin, the major curcuminoid of the turmeric, demonstrated reduction in adhesion, migration, and invasion ability. High-throughput microarray analysis indicated that curcumin treatment suppressed matrix metallopeptidase 10 (MMP10) expression. MMP10 is overexpressed in tongue carcinoma tissues in comparison with the normal epithelia. Curcumin treatment on tongue carcinoma cell lines suppressed MMP10 expression at both mRNA and protein levels. Our results suggested that curcumin is a promising inhibitor to tongue cancer cells migration and invasion.

List of illustrations Acknowledgement A Note on Dynasties and Reigns Introduction 1. A Culture in Flux: Historical Background 2. Embodying the Text through Blood Writing 3. Nourishing the Parent with One's Own Flesh 4. Chaste Widows as Entertainment and Revenants 5. Exposing and Burning the Body for Rain 6. Conclusion Character Glossary Abbreviations and Conventions Bibliography Index

Objectives/Hypothesis: The use of myringotomy with ventilation tube insertion after maxillary swing nasopharyngectomy was originally described to prevent the occurrence of otitis media with effusion. The outcome of this otologic procedure has never been reviewed and discussed. The purpose of this study is to examine the role of myringotomy with ventilation tube insertion in this group of patients. Study Design: Retrospective review. Methods: One hundred forty-two patients with maxillary swing nasopharyngectomy were recruited from 1999 to 2008. The otologic status was evaluated using otoscopy, pure tone audiogram, and tympanogram at 3 months, 6 months, and then yearly after the operation. The results were reviewed periodically during that 10-year period. During this period, there were three groups; the first group had myringotomy with ventilation tube inserted, the second group had myringotomy alone, and the third group had no myringotomy performed. Results: There were significantly (P < .0001) more patients in the myringotomy with ventilation tube insertion group who suffered from adverse otologic complications such as discharging grommet, discharging chronic suppurative otitis media, and perforated eardrum when compared with patients with myringotomy alone and patients without myringotomy at 3 months, 6 months, and 12 months. There were no differences in the incidence of acute otitis media among all three groups of patients. Conclusions: Patients who underwent maxillary swing nasopharyngectomy and myringotomy with ventilation tube insertions suffered from more otologic complications. The routine use of myringotomy with or without ventilation tube insertion for this group of patients is not recommended.

Head and neck cancers refers to cancer arising in the head or neck regions including parnasal sinuses, nasal cavity, nasopharynx, oral cavity, salivary gland, oropharynx, pharynx, hypopharynx, larynx, and lymph node. Histologically, squamous cell carcinoma is the predominant form. The cancer progenitor cells are premalignant cells in the mucosa layer of head and neck. Cumulative genetic and epigenetic alterations lead to behavioural changes from hyperplasia to invasive carcinoma. Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide. It is the 4th most common cancer among men in the European Union (Black et al., 1997). In United State, over 12,000 patients died from HNSCC every year (Altekruse et al., 2008). Globally, there are approximately 650,000 new cases of HNSCC and 350,000 patients dying from HNSCC annually (Parkin et al., 2005). Most patients will develop local-regional disease with cervical lymph node involvements. HNSCC is heterogeneous in nature. Early disease might not have any symptoms. Further, the inconspicuous locations of some HNSCC make it difficult to be identified at the early stages. Thus, patients arrive at the clinic by large present late and have poor prognosis. The overall survival rate of HNSCC patients is about 50% (Stell, 1989; Argiris et al, 2004). Development of local recurrence, distant metastasis and secondary primary tumor is also common in HNSCC. Despite the advances of cancer treatment in last several decades, the overall survival rate of HNSCC did not have much improvement (Stell, 1989; Argiris and Eng, 2003).

Head and neck cancer is the sixth large type of cancer in the world. The treatment regimens for head and neck cancer encompass surgery, radiotherapy and chemotherapy. However, all current treatment regimens for head and neck cancer have adverse effects. Therefore, continuing investigations have been undertaken to seek less toxic therapies to reduce treatment morbidity for head and neck cancer. Substantial evidence has demonstrated that curcumin inhibited proliferation, migration, invasion and metastasis and induced apoptosis via modulating multiple signaling pathways in head and neck cancer. Curcumin also suppressed the growth of xenograft derived from head and neck cancer in vivo in animal models. This review summarizes the evidence demonstrating potential use of curcumin as a single chemotherapeutic agent or in combination with other chemotherapeutic agents and radiation to minimize their toxicity in head and neck cancer. Although curcumin has been shown to be safe at doses of 8 g/d in both phase I and phase II clinical trials, its bioavailability is poor. Overcoming the poor bioavailability of curcumin in the near future would facilitate its clinical use.

Laryngeal carcinoma is a common head and neck cancer with poor prognosis. Patients with laryngeal carcinoma usually present late leading to the reduced treatment efficacy and high rate of recurrence. Despite the advance in the use of molecular markers for monitoring human cancers in the past decades, there are still no reliable markers for use to screen laryngeal carcinoma and follow the patients after treatment. Epigenetics emerged as an important field in understanding the biology of the human malignancies. Epigenetic alterations refer to the dysregulation of gene, which do not involve the alterations of the DNA sequence. Major epigenetic changes including methylation imbalance, histone modification, and small RNA dysregulation could play a role in the development of human malignancies. Global epigenetic change is now regarded as a molecular signature of cancer. The characteristics and behavior of a cancer could be predicted based on the specific epigenetic pattern. We here provide a review on the understanding of epigenetic dysregulation in laryngeal carcinoma. Further knowledge on the initiation and progression of laryngeal carcinoma at epigenetic level could promote the translation of the knowledge to clinical use.

Nasopharyngeal carcinoma (NPC) is a common head and neck cancer. The incidence rate is higher in southern China and Southeast Asia in comparison with the Western countries. Radiotherapy is the standard treatment of NPC as the cancer cells are sensitive to ionizing radiation. Radiation treatment has good local control to patients with early NPC. It is essential to monitor the response of the NPC cells to radiation treatment in advance in order to select suitable treatment choice for the patients. This review aims to discuss the potential use of biomarkers in monitoring the responsiveness of NPC cells to radiation treatment. © 2012 by the authors; licensee MDPI, Basel, Switzerland., published_or_final_version