Impact of race on outcome after definitive radiotherapy for squamous cell carcinoma of the head and neck.

Background: The objective of the current study was to evaluate the impact of race (black vs. white) on the outcome of patients with invasive squamous cell carcinoma of the head and neck.

Methods: Between 1983 and 1997, 686 patients completed definitive, twice-daily radiotherapy (RT) alone or combined with a planned neck dissection; no patients received adjuvant chemotherapy.

Neck level-specific nodal metastases in oropharyngeal cancer: is there a role for selective neck dissection after definitive radiation therapy?

Purpose: To determine the extent of the required neck dissection for patients with persistent lymphadenopathy after definitive radiation therapy for oropharyngeal cancer. If feasible, a conservative approach using selective neck dissection would likely minimize the extent of neck fibrosis and other adverse sequelae.

Methods: Analysis of pretreatment and posttreatment radiologic scans and pathology reports of 76 patients with oropharyngeal carcinoma (35 tonsil; 41 base of tongue), who had radiologic evidence of persistent nodal disease for level-specific involvement.

Definitive radiotherapy alone or combined with a planned neck dissection for squamous cell carcinoma of the pharyngeal wall.

Background: In the current study,the authors analyzed the results of definitive radiotherapy for squamous cell carcinoma of the pharyngeal wall.

Methods: Between 1964 and 2000, 148 patients were treated with definitive radiotherapy. All patients had a 2-year minimum follow-up.

Radiotherapy alone or after subtotal resection for benign skull base meningiomas.

Background: The objective of the current study was to analyze the long-term local control and complications in a series of patients who were treated with radiotherapy for benign skull base meningiomas.

Methods: Between January 1984 and July 2001, 101 patients were treated with radiotherapy alone (n = 66) or after undergoing subtotal resection (n = 35). Sixty-one patients had previously untreated tumors, and 40 patients had tumors that were recurrent after prior surgery.

Does feeding tube placement predict for long-term swallowing disability after radiotherapy for head and neck cancer?

Purpose: To evaluate feeding tube use.

Materials And Methods: Nine hundred thirty-four patients were treated with radiotherapy (RT).

Results: Feeding tubes were placed in 235 patients (25%): 212 patients (22.

Role of radiotherapy in the treatment of neurosarcoidosis.

Neurosarcoidosis is usually managed with steroids, immunosuppressives, and other medications. Several small series suggest that radiotherapy might be useful in patients whose disease is refractory to conventional treatment. The purpose of this article is to report the outcome of 4 patients with neurosarcoidosis who were treated at the University of Florida.

Distant metastases after definitive radiotherapy for squamous cell carcinoma of the head and neck.

Purpose: To analyze parameters that influence the risk of distant metastases after definitive radiotherapy.

Methods: Between 1983 and 1997, 873 patients were treated with definitive radiotherapy and had follow-up for 2 years or more. Univariate and multivariate analyses were performed to evaluate risk factors that might influence the risk of distant metastases.

Parameters that predict local control after definitive radiotherapy for squamous cell carcinoma of the head and neck.

Purpose: To analyze parameters that may influence the likelihood of local control after definitive radiotherapy for head and neck cancer.

Methods: Between April 1980 and January 2000, 404 patients were treated with definitive RT alone (358 patients) or combined with adjuvant chemotherapy (46 patients) at our institution and were followed up for 0.25 to 20.

Radiation therapy for esthesioneuroblastoma: rationale for elective neck irradiation.

Purpose: Esthesioneuroblastoma is an uncommon malignancy of neural crest origin arising in the upper nasal cavity. We describe the University of Florida experience using radiation therapy (RT) in the treatment of this neoplasm, particularly the use of elective nodal irradiation.

Materials And Methods: Between May 1972 and August 1998, 22 patients received RT for esthesioneuroblastoma.

Oligodendroglioma: does deferring treatment compromise outcome?

This study reports the University of Florida experience treating oligodendrogliomas with the goal of identifying the factors that predict favorable outcome. Between 1958 and June 1998, 51 patients (aged 5-75 years) were diagnosed with pure oligodendroglioma at the University of Florida. Histologic grade was anaplastic in 19 patients, low-grade in 30 patients, and unknown in one patient.

A practical guideline for identifying research intent with projects that collect private, identifiable health information.

Radiation oncologists frequently engage in activities that involve the collection and analysis of data from medical records. Access to health information is an ethical issue because, if not done according to appropriate guidelines, it constitutes an invasion of privacy or breach in confidentiality. To protect patients for the social harm that may result from medical record review, our society has established laws and regulations that apply to projects that require medical record review.

Altered fractionation and/or adjuvant chemotherapy in definitive irradiation of squamous cell carcinoma of the head and neck.

Objective: To review the roles of altered fractionation and adjuvant chemotherapy in the treatment of patients with squamous cell carcinomas of the head and neck.

Study Design: Review of the pertinent literature.

Methods: The literature pertaining to altered fractionation and/or adjuvant chemotherapy for patients with squamous cell carcinomas of the head and neck was reviewed to define the optimal combination of radiotherapy and adjuvant chemotherapy.

Postoperative radiation therapy for squamous cell carcinoma of the head and neck.

Purpose: To discuss the role of postoperative radiation therapy (RT) for patients with squamous cell carcinoma of the head and neck.

Results: Patients with adverse pathologic features have a high likelihood of local-regional recurrence and a decreased probability of survival after surgery alone. Postoperative RT reduces the risk of local-regional failure and probably improves survival.

Stage IE primary non-Hodgkin's lymphoma of bone.

The results of treatment of 28 patients with Stage IE primary lymphoma of bone were evaluated. Nine patients were treated with curative intent with irradiation alone and 19 patients received radiotherapy combined with adjuvant chemotherapy. Local control was 100%.

Planned neck dissection after definitive radiotherapy for squamous cell carcinoma of the head and neck.

Background: To define the role of planned neck dissection after definitive radiotherapy for patients with node-positive squamous cell carcinoma of the head and neck.

Methods: Review of the pertinent literature.

Results: Radiotherapy alone produces a relatively high likelihood of regional control for patients with early-stage neck disease.

Malignant tumors of the nasal cavity and paranasal sinuses.

Purpose: To evaluate the role of radiation therapy in patients with nasal cavity and paranasal sinus tumors.

Materials And Methods: Between October 1964 and July 1998, 78 patients with malignant tumors of the nasal cavity (48 patients), ethmoid sinus (24 patients), sphenoid sinus (5 patients), or frontal sinus (1 patient) were treated with curative intent by radiation therapy alone or in the adjuvant setting. There were 25 squamous cell carcinomas, 14 undifferentiated carcinomas, 31 minor salivary gland tumors (adenocarcinoma, adenoid cystic carcinoma, and mucoepidermoid carcinoma), 8 esthesioneuroblastomas, and 1 transitional cell carcinoma.

Squamous cell carcinoma of the oropharynx: surgery, radiation therapy, or both.

Background: The treatment of patients with squamous cell carcinoma (SCC) of the oropharynx remains controversial. No randomized trial has addressed adequately the question of whether surgery (S), radiation therapy (RT), or combined treatment is most effective.

Methods: Treatment results from North American academic institutions that used S with or without adjuvant RT (S +/- RT) or used RT alone or followed by neck dissection (RT +/- ND) for patients with SCC of the tonsillar region or the base of tongue were compiled through a MEDLINE search (from 1970 to August, 2000) and from the references cited in each report.

Expressive disclosure and health outcomes in a prostate cancer population.

Objective: This pilot study explored the feasibility and the efficacy of a brief, well-defined psychosocial intervention (expressive disclosure) in improving behavioral, medical, immunological, and emotional health outcomes in men with diagnosed prostate cancer.

Method: Thirty prostate cancer patients receiving outpatient oncology care were randomized into experimental (disclosure) and control (non-disclosure) groups. All had been previously treated by surgery or radiation within the last 4 years and were being monitored without further intervention for change in PSA levels.

Hypopharyngeal carcinoma.

For more than 20 years, the policy at the University of Florida has been to treat patients with favorable stage T1-T2 pyriform sinus carcinoma by using radiation therapy alone, or with a planned neck dissection if advanced nodal disease is present. This approach usually leaves the patient with nearly normal swallowing and speech, and provides bilateral coverage of the regional neck and retropharyngeal lymphatics. More advanced lesions often are not controlled with radiation alone and are usually considered for partial or total laryngopharyngectomy if the patient is medically operable.

Early laryngeal cancer.

For early-stage laryngeal cancer, both surgery and radiotherapy are effective treatment modalities, offering a high rate of local control and cure for this select group of patients. The probability of obtaining local control for early glottic cancer is similar when comparing the results of radiation therapy, cordectomy, and hemilaryngectomy. Radiation therapy has been the treatment of choice for all previously untreated T1 and T2 vocal cord cancers at our institution.

Voice rehabilitation after total laryngectomy and postoperative radiation therapy.

Purpose: The purpose of this study was to evaluate voice rehabilitation after laryngectomy and postoperative irradiation for patients with squamous cell carcinoma of the larynx and hypopharynx.

Patients And Methods: Between December 1983 and December 1998, 173 patients underwent a total laryngectomy and postoperative irradiation and had follow-up from 3 to 188 months (median, 38 months). Three patients were lost to follow-up at 63, 39, and 4 months after treatment.

Carcinoma of the supraglottic larynx: treatment results with radiotherapy alone or with planned neck dissection.

Purpose: To present the results of radiotherapy with or without neck dissection for squamous cell carcinoma of the supraglottic larynx treated at the University of Florida and to compare these data with those obtained after conservation surgery.

Methods And Materials: Continuous-course radiotherapy alone or combined with a planned neck dissection was used to treat 274 patients with squamous cell carcinoma of the supraglottic larynx between 1964 and 1998. All patients had follow-up for a minimum of 2 years, and 250 (91%) had follow-up for 5 years or more.

Radiotherapy for carcinoma in situ of the true vocal cords.

Purpose: To report long-term rates of tumor control after radiotherapy (RT) for carcinoma in situ (CIS) of the true vocal cords (TVC). A comprehensive literature review was performed, and outcomes with other modalities of treatment for CIS of the TVC were compared.

Methods And Materials: Thirty patients with CIS of the TVC were treated between July 1967 and May 1998 with curative intent using megavoltage RT.