Recurrent, unresectable head and neck squamous cancer is a complex problem. Evidence for the efficacy of treatment is scant in this area and given the large number of patient and tumor variables involved in the recurrent tumor, several factors play a role in deciding the choice of management. The results of treatment are very poor and associated with significant toxicity. Thus, the quality of life outcome following treatment should play a major role in the choice of treatment. Unfortunately, generation of quality-of-life data is hampered by several factors, not least of which are the ethical issues raised by end of life care. This article reviews the relevant literature, summarizes existing evidence and draws conclusions, identifies gaps in the knowledge and offers guidance for further research.
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http://dx.doi.org/10.1586/era.10.13 | DOI Listing |
J Periodontal Res
January 2025
Department of Surgery, Stanford University School of Medicine, Stanford, California, USA.
Aim: To investigate additional factors contributing to the pathophysiology of chemotherapy-induced oral mucositis and periodontitis beyond the systemic immune suppression caused by the chemotherapeutic agent 5-Fluorouracil (5-FU).
Methods: 5-Fluorouracil was topically delivered to the non-keratinized, rapidly proliferating junctional epithelium (JE) surrounding the dentition, and acts as an immunologic and functional barrier to bacterial ingression. Various techniques, including EdU incorporation, quantitative immunohistochemistry (qIHC), histology, enzymatic activity assays, and micro-computed tomographic (μCT) imaging, were employed to analyze the JE at multiple time points following topical 5-FU treatment.
J Cardiothorac Surg
January 2025
Section of Cardiothoracic Surgery, Department of Heart Disease, Haukeland University Hospital, Jonas Lies vei 65, 5021, Bergen, Norway.
Background: A broncho-esophageal fistula (BEF) is a medical and surgical disaster. Treatment of BEF is often limited to palliative stent treatment that may migrate or cause erosions and tissue necrosis. Surgical repair of BEF is the only established definite treatment.
View Article and Find Full Text PDFJ Craniomaxillofac Surg
January 2025
Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
The potential of large language models (LLMs) in medical applications is significant, and Retrieval-augmented generation (RAG) can address the weaknesses of these models in terms of data transparency and scientific accuracy by incorporating current scientific knowledge into responses. In this study, RAG and GPT-4 by OpenAI were applied to develop GuideGPT, a context aware chatbot integrated with a knowledge database from 449 scientific publications designed to provide answers on the prevention, diagnosis, and treatment of medication-related osteonecrosis of the jaw (MRONJ). A comparison was made with a generic LLM ("PureGPT") across 30 MRONJ-related questions.
View Article and Find Full Text PDFRadiother Oncol
January 2025
Department of Nursing, Shanghai Proton and Heavy Ion Center, Shanghai Engineering Research Center of Proton and Heavy Ion Radiation Therapy, Shanghai 201315 China. Electronic address:
Background And Purpose: Few studies have examined the factors associated with xerostomia during proton and carbon ion radiotherapy for head and neck cancer (HNC), which are reported to have fewer toxic effects compared to traditional photon-based radiotherapy. This study aims to evaluate the performance of machine learning approaches in predicting grade 2 + xerostomia in adults with HNC receiving proton and carbon ion radiotherapy.
Materials And Methods: A retrospective study involving 1,769 adults with HNC who completed proton or carbon ion radiotherapy was conducted.
Background And Purpose: To develop a normal tissue complication probability (NTCP) model for predicting grade ≥ 2 acute oral mucositis (AOM) in head and neck cancer patients undergoing carbon-ion radiation therapy (CIRT).
Methods And Materials: We retrospectively included 178 patients, collecting clinical, dose-volume histogram (DVH), radiomics, and dosiomics data. Patients were randomly divided into training (70%) and test sets (30%).
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