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There have been no reports concerning the independent predictors of response and disease-free survival (DFS) in oral cancer in India, where the highest incidence is reported. The authors analyzed the outcome of radical radiation therapy of 378 patients with oral cancer and found that the complete response rate within 6 months of completion of treatment was 45% and the 5-year DFS was 34% (95% confidence interval 29% to 39%). Regional lymph node in involvement (P

Cancer of the mucous lining of the mouth is not particularly common in the United States, but in some parts of India it is the most common cancer among men and the third most common among women. This seems to be a result of the common use of betel quid, a chewing mixture containing tobacco and other herbs. These cancers of the buccal mucosa are generally treated with radiation. However, if the cancer returns after radiotherapy, then surgery must be used to salvage the case. In a retrospective analysis of 78 patients with recurrent oral cancer, men were found to outnumber women by more than two to one. Fifty-six of the patients required hemimandibulectomy, or a removal of much of the jaw because of the presence of invasive cancer. In 54 patients, enough tissue had to be removed from the mouth that reconstructive surgery was required to close the surgical wound. The five-year disease-free survival rate after the surgical salvage treatment was 59.7 percent. As might be expected, the stage of the recurrent tumor was a primary determinant of the ultimate survival of the patient. Also significant to the ultimate case outcome was the degree to which the tumor had infiltrated the skin. A total of 31 patients experienced recurrence of the cancer after surgery, but in five of these cases it was possible to complete a second salvage operation. At present, these five patients are alive without evidence of disease. These results suggest that surgery is far superior to chemotherapy as a means for salvaging cases of cancer of the mouth mucosa after recurrence following radiotherapy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Oral leukoplakia (OL), or smoker's tongue, is common in smokers and tobacco chewers. It is characterized by the presence of leathery patches or plaques (precancerous lesions) on the surface of the tongue. The ability of vitamin A and beta-carotene (a precursor of vitamin A) to reverse OL was evaluated in fishermen from India who chewed tobacco on a daily basis. Treatment with vitamin A (60 milligrams per week) for six months caused complete remission of OL in 57 percent of the tobacco chewers, and micronucleated (abnormal) cells were reduced in 96 percent of the tobacco chewers. Beta-carotene (2.2 millimoles per week) reduced micronucleated cells in 98 percent of the cases and caused remission of OL in 14.8 percent of the cases. When treatment with either vitamin A or beta-carotene was stopped, the leukoplakia and cell abnormalities reappeared. It was found that lower doses of these vitamins were able to maintain the beneficial effects of the initial, higher-dose treatments for at least eight more months. (Consumer Summary produced by Reliance Medical Information, Inc.)

Deficiencies in the immune response are associated with the development of certain diseases. The immune response involves the interaction of blood cells and a complex network of mediators. Specialized white blood cells called lymphocytes can either stimulate (helper cells) or suppress (suppressor cells) various aspects of the immune response. The relationship between suppressor cell activity and the development and prognosis of cervical cancer was studied among 229 patients in various stages of the disease. Blood samples were taken before and after radiotherapy treatment, and concanavalin-A-induced suppressor cell activity was measured. Suppressor cell activity before treatment corresponded well to the extent of the disease. Patients who remained disease-free six months after radiotherapy had a significant decrease in suppressor cell activity. Conversely, patients with evidence of recurrence maintained high suppressor cell activity compared with levels in the disease-free patients in comparable disease stages. The immune response of patients with recurrent disease appears to be altered, although the mechanism regulating suppressor cell activity is not clearly understood. It is suggested that concanavalin-A-induced suppressor cell activity can be used to predict the disease course in patients with cervical cancer. (Consumer Summary produced by Reliance Medical Information, Inc.)