Long-term results of a prospective multicenter phase II study to preserve the larynx function using concomitant boost radiochemotherapy with Carboplatin.

Purpose: This prospective phase II study was undertaken to assess the feasibility of a larynx preservation protocol with simultaneous radiochemotherapy.

Patients And Methods: Between 3/1998 and 10/2000, 42 patients with moderately advanced cancer of the larynx (n=25) and hypopharynx (n=17) eligible for total laryngectomy (LE) were treated in a prospective larynx preservation study. The study protocol scheduled 66Gy in 5 weeks using a concomitant boost technique and 70mg/m(2) Carboplatin on days 1-5 in weeks 1 and 5.

Efficacy of intensified hyperfractionated and accelerated radiotherapy and concurrent chemotherapy with carboplatin and 5-fluorouracil: updated results of a randomized multicentric trial in advanced head-and-neck cancer.

Purpose: To prove an expected benefit of concurrent radiochemotherapy (RCT), a two-arm randomized multicentric study was performed. In a subgroup analysis the influence of pretherapeutical hemoglobin level (p-Hb) on survival under locoregional control (SLC) was tested.

Patients And Methods: The study included primarily untreated Stage III/IV (International Union Against Cancer [UICC]) oropharyngeal and hypopharyngeal carcinomas.

[Organ preservation in advanced laryngeal and hypopharyngeal carcinoma by primary radiochemotherapy. Results of a multicenter phase II study].

Introduction: Regarding the promising results of international trials we conducted the first German prospective multicentre phase II trial for organ preservation with primary simultaneous chemoradiation in advanced laryngeal and hypopharyngeal cancer.

Patients And Methods: 28 of 30 recruited patients suffering from stage II and III (UICC) laryngeal and hypopharyngeal cancer were treated with primary simultaneous chemoradiation within an organ preservation program and monitored in follow-up of one year. Exclusion criteria included tumor infiltration of the laryngeal cartilage, bilateral neck nodes (N2c) and need for flap reconstruction in case of laryngectomy.

Intensified hyperfractionated accelerated radiotherapy limits the additional benefit of simultaneous chemotherapy--results of a multicentric randomized German trial in advanced head-and-neck cancer.

Purpose: To demonstrate the efficacy of radiochemotherapy (RCT) as the first choice of treatment for advanced unresectable head-and-neck cancer. To prove an expected benefit of simultaneously given chemotherapy, a two-arm randomized study with hyperfractionated accelerated radiochemotherapy (HF-ACC-RCT) vs. hyperfractionated accelerated radiotherapy (HF-ACC-RT) was initiated.

[Incidence of salivary fistulas in relation to timing of oral nutrition after laryngectomy].

Background And Objective: A pharyngocutaneous fistula is the most common complication after total laryngectomy. In Germany, a traditional recommendation is to use a nasogastric tube for feeding for 10-14 days postoperatively because many surgeons believe that oral feeding after surgery contributes to fistula development. However, there is no international agreement about when to begin oral feeding after total laryngectomy.

Surgical treatment for hypopharynx carcinoma: feasibility, mortality, and results.

This study seeks to evaluate treatment modalities, mortality after surgery, survival, and local control rates for a consecutive cohort of patients with cancer of the hypopharynx treated according to a prospective protocol that favors surgery as an initial approach to the disease. The charts of 228 consecutive patients with previously untreated hypopharyngeal squamous cell carcinoma were reviewed. Outcome measures (overall survival, disease specific survival, and local control) were calculated using the Kaplan-Meier estimator.

[Clinical manifestation of Ewing's sarcoma as a retrotonsillar pharyngeal tumor].

Background: Ewing's sarcoma is a malignant tumour which usually arises from bony structures. It can be found in dia- or metaphysis of bones of the extremities but as well in 50% of cases in skeletal parts of the trunk. Clinically patients often present with various symptoms as there are pain, swelling and progredient loss of function if extremities are involved.

[Quality assurance in ENT tumor surgery].

Background And Objective: Quality control is of special importance in head and neck oncology since the quality of medical care constitutes a vital parameter for the diseased patient. In contrast to other medical specialties, no quality assurance program for head and neck cancer patients has yet been established in Germany. Therefore, a survey was conducted to assess the quality assurance instruments that are in use today in otorhinolaryngology-head and neck (ORL-HNS) centers.

[Prognostic value of hemoglobin level for primary radiochemotherapy of head-neck carcinomas].

The pretherapeutic hemoglobin level (Hb) has been postulated to constitute a prognostic marker for outcome after primary chemoradiation of patients with advanced cancer of the head and neck. However, this hypothesis has not been tested systematically in large study samples. In the years 1992-1997, 125 patients with advanced head and neck cancer (stages III/IV UICC) were treated with primary chemoradiation in two different prospective multicentric trials, 62 patients in trial A (phase II, 1992-1995), and 63 in trial B (phase III, 1995-1997).

[Prognostic relevance of proliferation marker Ki-67 (MIB 1), PCNA and p53 in combined surgically and radiologically treated cancers of the oropharynx and mouth cavity].

Study Design: A matched-pair study on the relationship between proliferation associated markers Ki-67, PCNA, and p53 and treatment failure in carcinomas of the oropharynx and oral cavity.

Material And Method: Fifty-six T1-T3 carcinomas of the oropharynx or oral cavity, treated uniformly with primary surgery and postoperative irradiation, were investigated. Twenty-eight patients had recurrent disease and were matched with 28 patients with nonrecurrent disease regarding stage and location of tumor as well as age and therapy.

Prognostic significance of Ki-67 (MIB1), PCNA and p53 in cancer of the oropharynx and oral cavity.

Up to now results concerning the prognostic value of tumor proliferation markers in squamous cell head and neck carcinoma have been equivocal. Beside biological reasons, different treatment modalities are hypothetically responsible for contradictory findings. The aim of this study was to investigate the relationship between proliferative capacity, represented by the immunohistochemical labeling index of proliferation markers Ki-67, PCNA and p53 status, and treatment failure in a matched-pair study design of recurrent and non-recurrent carcinoma initially treated with primary surgery combined with curative post-operative radiation.

[Results of a prospective randomized trial with induction chemotherapy for cancer of the oral cavity and tonsils].

Although induction chemotherapy administered prior to local therapy produces encouraging initial response rates in head and neck cancer, randomized studies have failed to demonstrate an improvement in survival rates. All randomized studies included only patients with advanced stage III and IV disease. In our opinion, this is the main reason for the low rate of complete responses demonstrated in the randomized trials (maximum 18%).

[Value of monoclonal antibodies (PC 10, MIB1, p53 and LeuM 1) for assessing the prognosis of patients with squamous epithelial carcinoma of the larynx after partial laser resection].

An immunohistochemical analysis with monoclonal antibodies against Ki-67 (MIB 1), PCNA (PC10), p53 and Lewis X antigen was performed on 47 squamous carcinomas of the larynx after partial laser resection. Ki-67 index and expression of Lewis X antigen correlated significantly with both tumor recurrence rate and tumor-free interval. A much weaker relationship was found for the expression of proliferating cell nuclear antigen (PCNA), and no correlation existed with p53 expression.

[Preliminary results of a prospective randomized study of primary chemotherapy in carcinoma of the oral cavity and pharynx].

Although induction chemotherapie given prior to local therapy produces encouraging initial response rates in head and neck cancer, randomized studies have failed to demonstrate an advantage in survival. All randomized studies have included only patients with far advanced stage III and IV disease. To us this is the main reason for the low rate of complete responses demonstrated (maximum, 18%).

Transoral laser resection with staged discontinuous neck dissection for oral cavity and oropharynx squamous cell carcinoma.

Transoral laser resection of oral cavity and oropharynx squamous cell carcinoma (OOSCC) is a widely accepted approach in the absence of cervical lymph node metastases. This study investigated the results of transoral laser surgery and discontinuous neck dissection (ND) for OOSCC with clinically obvious or suspected cervical node metastases. One hundred seventeen patients with infiltrating oral carcinoma were treated for cure with transoral resection of the primary and staged ND.

[Cisplatin/5-FU versus carboplatin/5-FU. 5 year follow-up].

Between March 1986 and October 1987, 73 patients with advanced squamous cell carcinomas of the head and neck underwent initial chemotherapy before surgery and/or radiotherapy. Chemotherapy consisted of three courses of carboplatin/5-FU or cisplatin/5-FU. Pretreatment tumor states, remission rates and ages of the patients were comparable.

[Results of accelerated radiotherapy and simultaneous carboplatin administration in inoperable head-neck cancers].

Until now, radical irradiation has been the treatment of choice for patients with unresectable squamous cell carcinomas of the head and neck. In spite of improved radiation techniques, conventional radiotherapy remains mainly palliative for patients with advanced and unresectable disease stages. Our own results with accelerated radiotherapy (2 x 2.

[Detection of 8 oncogenes in squamous epithelial cancers of the head and neck].

Squamous cell carcinomas of the head and neck from 50 untreated patients were analyzed for rearranged or amplified proto-oncogenes by Southern blot hybridization. The bcl-1 and hst genes were coamplified 8- to 32-fold in 5 of 46 patients (11%) and the c-erb A1 and c-erb B2 genes 32-fold in 1 of 46 patients (2%). Eight to 16-fold amplification of c-myc was observed in 4 of 46 tumor samples (8%), while 4-fold amplification of Ha-ras was found in 2 of 46 tumor samples (4%).

Induction chemotherapy in primary resectable head and neck tumors - a prospective randomized trial.

Although induction chemotherapy prior to local therapy produces encouraging initial response rates in head and neck cancer, randomized studies have failed to demonstrate an advantage in survival. All randomized studies included only patients with far advanced stage III and IV disease which appears to be the main reason for the low rate of complete responses (max. 18%) in these trials.

Accelerated split-course radiation and simultaneous chemotherapy in patients with unresectable head and neck-cancer.

Forty-nine patients with unresectable squamous cell carcinomas of the head and neck were treated with accelerated radiotherapy (2 x 2.1 Gy/day, day 1-4 in week 1,2,5 and 6, total dose of 67.2 Gy) and simultaneous carboplatin (50 Mg/M2/ treatment day).

Analysis of protooncogenes in squamous-cell carcinomas of the head and neck (scchn).

We have analysed DNA and RNA from 40 untreated head and neck cancers for amplified and overexpressed proto-oncogenes by Southern and Northern blot hybridisation. Coamplification but no expression of the bcl-1 and the hst genes was found in 12.5% of the patients.

Coamplification of the hst and bcl-1 oncogenes in advanced squamous cell carcinomas of the head and neck.

Squamous cell carcinomas of the head and neck from 40 untreated patients were analysed for rearranged or amplified proto-oncogenes by Southern blot hybridisation. The bcl-1 and the hst genes were coamplified 8-32-fold in 5 patients (12.5%).