Adherence to the EAT-Lancet diet reduces the risk of head and neck cancers in 101,755 American adults: a prospective cohort study.

OBJECTIVES: The aim of this study was to explore the relationship between the EAT-Lancet diet (ELD) and head and neck cancers (HNCs) in 101,755 Americans enrolled in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. STUDY DESIGN: Prospective cohort study. METHODS: ELD score was calculated to assess participant's adherence to ELD. Cox hazard regression models were utilised to evaluate the association of ELD and dietary components with HNC risk. Restricted cubic spline (RCS) plots were employed to explore the linearity of the relationships. Predefined subgroup analyses and sensitivity analyses were performed to identify potential effect modifiers and to assess the stability of the findings, respectively. RESULTS: After a mean follow-up of 8.84 years, 279 cases of HNCs, including 169 cases of oral cavity and pharyngeal cancers and 110 cases of laryngeal cancer were recorded. This study observed a dose-response negative correlation between ELD and HNCs (hazard ratio [HR]Q4 vs Q1: 0.52; 95% confidence interval [CI]: 0.34, 0.80; P-trend = 0.003; HRper SD increment: 0.80; 95% CI: 0.71, 0.91), and oral cavity and pharyngeal cancers (HRQ4 vs Q1: 0.52; 95% CI: 0.31, 0.88; P-trend = 0.008; HRper SD increment: 0.78; 95% CI: 0.66, 0.92). Analysis using RCS plots indicated a significant linear association between adherence to the ELD and reduced risk of HNCs and oral cavity and pharyngeal cancers (P-nonlinearity > 0.05). Subgroup analysis did not reveal significant interaction factors (P-interaction > 0.05), and sensitivity analysis confirmed the robustness of this study. Additionally, negative correlations were found between the consumption of fruits and whole grains and HNCs (fruits: HRQ4 vs Q1: 0.58; 95% CI: 0.40, 0.84; P-trend = 0.010; whole grains: HRQ4 vs Q1: 0.51; 95% CI: 0.26, 0.97; P-trend = 0.004). CONCLUSION: Adherence to ELD contributes to the prevention of HNCs.

PREVENTING CARIES AFTER RADIOTHERAPY TO THE HEAD AND NECK REGION - A SYSTEMATIC REVIEW.

OBJECTIVES: Radiotherapy to the head and neck region (HN) bears the risk of a rampant development of caries, making intensified prevention necessary. Aim of this systematic review was to summarize the evidence on the efficacy of caries preventive measures in these patients. METHODS: Clinical studies investigating caries in patients with radiotherapy in the HN with at least 1 caries preventive intervention compared to any control were included. Reports in languages other than English or German were excluded. Records were identified on PubMed, Web of Science, Google Scholar, and Cochrane Library mid-January 2024. Risk of bias was assessed with RoB2. Results were summarized. Planned meta-analyses could not be performed, because of heterogenous data. RESULTS: Five studies were included, with a total of 355 participants. They were irradiated with up to 70 Gy and received different caries preventive interventions, including sodium fluoride or stannous fluoride gels, remineralizing solutions, an "Intraoral Fluoride Release System" and sucrose restricted diet. Caries score increased between 0.48 DMF-S and 9.2 DF-S per year. Largest differences in caries increments were measured between groups with insufficient and with rigorous fluoride application. CONCLUSIONS: The main limitations were compromised randomization, heterogeneity of patients and small sample sizes. Clinical studies on caries prevention after radiotherapy to the HN are lacking and the existing ones bear extensive limitations. However, the large effect size and broad consensus suggest the use of fluoride to be indispensable in preventing caries in these patients. The study was funded by the Medical Center - University of Freiburg and was not registered.

Aspirin intake and head and neck cancer: A pooled analysis within the INHANCE consortium.

BACKGROUND: Aspirin intake might be inversely associated with head and neck cancer (HNC). Thus, we investigated this relationship within the International Head and Neck Cancer Epidemiology (INHANCE) consortium. METHODS: Four case-control studies within the INHANCE consortium were included (2024 cases, 4196 controls). Study-specific odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression and subsequently pooled with DerSimonian-Laird random-effects model. Nonlinearity of the relationship between duration of intake and HNC was modeled with fractional polynomials. RESULTS: Aspirin was inversely associated with HNC overall (OR = 0.48; 95% CI: 0.26, 0.91). Results for laryngeal cancer were similar (OR = 0.54; 95% CI: 0.30, 0.96). Analysis on duration of intake confirmed findings for HNC overall, showing also inverse associations for oropharyngeal and laryngeal cancer. CONCLUSIONS: This study suggests that aspirin intake may reduce the risk of HNC, driven mainly by decreases in risk for laryngeal and oropharyngeal cancer.

Medical students' knowledge about human papillomavirus (HPV), HPV vaccine and head and neck cancer.

The Human Papillomavirus (HPV) is a sexually transmitted infection that significantly affects the population worldwide. HPV preventive methods include vaccination, prophylactics, and education. Different types of cancers associated with HPV usually take years or decades to develop after infections, such as Head and Neck Cancer(HNC). Therefore, HPV prevention can be considered cancer prevention. A sample of medical students in Puerto Rico was evaluated to assess their knowledge about HPV, HPV vaccine, and HNC through two previously validated online questionnaires composed of 38 dichotomized questions, we measured HPV, HPV vaccination(HPVK), and HNC knowledge (HNCK). Out of 104 students surveyed, the mean HPVK score obtained was 20.07/26, SD = 3.86, while the mean score for HNCK was 6.37/12, SD = 1.78. Bidirectional stepwise regression showed study year and HPV Vaccine name had been the most influential variables on HPVK and HNCK. MS1 participants scored lower than MS2-MS4 participants, with no significant difference between MS2-MS4 scores. The results reveal knowledge gaps in HPV/HPV Vaccine and HNC among surveyed medical students. Our findings also suggest an association between knowledge of personal vaccination status, self-perceived risk, and how uncertainty in these factors may affect the medical students' understanding of HPV, HPV vaccination, and associated cancers.

Two by Two Factorial Design using Metformin and Curcumin for Second Primary Head and Neck Cancer Prevention Trial.

OBJECTIVE: The 2x2 factorial design is an effective method that allows for multiple comparisons, especially in the context of interactions between different interventions, without substantially increasing the required sample size. In view of the considerable preclinical evidence for Curcumin and Metformin in preventing the development and progression of head and neck squamous cell carcinoma (HNSCC), this study describes the protocol of the clinical trial towards applying the drug combination in prevention of second primary tumors. METHODS: We have applied the trial design to a large phase IIB/III double-blind, multi-centric, placebo-controlled, randomized clinical trial to determine the safety and efficacy of Metformin and Curcumin in the prevention of second primary tumours (SPT) of the aerodigestive tract following treatment of HNSCC (n=1,500) [Clinical Registry of India, CTRI/2018/03/012274]. Patients recruited in this trial will receive Metformin (with placebo), Curcumin (with placebo), Metformin, and Curcumin or placebo alone for a period of 36 months. The primary endpoint of this trial is the development of SPT, while the secondary endpoints are toxicities associated with the agents, incidence of recurrence, and identifying potential biomarkers. In this article, we discuss the 2x2 factorial design and how it applies to the head and neck cancer chemoprevention trial. CONCLUSION: 2x2 factorial design is an effective trial design for chemoprevention clinical trials where the effectiveness of multiple interventions needs to be tested parallelly.

In vitro cytotoxicity of curcuminoids against head and neck cancer HNO97 cell line / Citotoxicidade in vitro de curcuminoides contra a linhagem de células HNO97 de câncer de cabeça e pescoço

Oral squamous cell carcinoma (OSCC) is a malignant tumour of Head and Neck Cancer (HNC). The recent therapeutic approaches used to treat cancer have adverse side effects. The natural agents exhibiting anticancer activities are generally considered to have a robust therapeutic potential. Curcuminoids, one of the major active compounds of the turmeric herb, are used as a therapeutic agent for several diseases including cancer. In this study, the cytotoxicity of curcuminoids was investigated against OSCC cell line HNO97. Our data showed that curcuminoids significantly inhibits the proliferation of HNO97 in a time and dose-dependent manner (IC50=35 μM). Cell cycle analysis demonstrated that curcuminoids increased the percentage of G2/M phase cell populations in the treated groups. Treating HNO97 cells with curcuminoids led to cell shrinking and increased detached cells, which are the typical appearance of apoptotic cells. Moreover, flow cytometry analysis revealed that curcuminoids significantly induced apoptosis in a time-dependent manner. Furthermore, as a response to curcuminoids treatment, comet tails were formed in cell nuclei due to the induction of DNA damage. Curcuminoids treatment reduced the colony formation capacity of HNO97 cells and induced morphological changes. Overall, these findings demonstrate that curcuminoids can in vitro inhibit HNC proliferation and metastasis and induce apoptosis.

O carcinoma de células escamosas oral (OSCC) é um tumor maligno do câncer de cabeça e pescoço (HNC). As recentes abordagens terapêuticas usadas para tratar o câncer têm efeitos colaterais adversos. Os agentes naturais que exibem atividades anticâncer são geralmente considerados como tendo um potencial terapêutico robusto. Curcuminoides, um dos principais compostos ativos da erva cúrcuma, são usados como agente terapêutico para várias doenças, incluindo câncer. Neste estudo, a citotoxicidade dos curcuminoides foi investigada contra a linha de células OSCC HNO97. Nossos dados mostraram que os curcuminoides inibem significativamente a proliferação de HNO97 de forma dependente do tempo e da dose (IC50 = 35 μM). A análise do ciclo celular demonstrou que os curcuminoides aumentaram a porcentagem de populações de células da fase G2 / M nos grupos tratados. O tratamento das células HNO97 com curcuminoides levou ao encolhimento celular e ao aumento das células destacadas, que são a aparência típica das células apoptóticas. Além disso, a análise de citometria de fluxo revelou que os curcuminoides induziram significativamente a apoptose de uma maneira dependente do tempo. Além disso, em resposta ao tratamento com curcuminoides, caudas de cometa foram formadas nos núcleos das células devido à indução de danos ao DNA. O tratamento com curcuminoides reduziu a capacidade de formação de colônias das células HNO97 e induziu alterações morfológicas. No geral, esses achados demonstram que os curcuminoides podem inibir in vitro a proliferação e metástase de HNC e induzir apoptose.

Infecciones en pacientes con tumores sólidos de sistema nervioso central y de cabeza y cuello / Infections in patients with solid tumors of the central nervous system and head and neck

Los tumores sólidos representan el 90% de las patologías oncohematológicas que se diagnostican en Argentina. Las infecciones son una de las complicaciones más frecuentes, causando una importante morbimortalidad, y en muchos casos retrasan la prosecución de los tratamientos específicos. La incidencia y tipo de infección depende del sitio específico del tumor, los fenómenos post obstructivos, el tipo e intensidad del tratamiento que se administre, las comorbilidades del paciente y la epidemiología local, entre otros factores. En forma constante se van incorporando nuevos tratamientos al arsenal terapéutico, tales como nuevos esquemas de quimioterapia, terapias blanco e inmunoterapia, y el manejo de las complicaciones asociadas a los mismos representa un desafío para el equipo tratante.En esta revisión abordamos la epidemiología, prevención y manejo de las complicaciones infecciosas más frecuentes en los pacientes con tumores de sistema nervioso central y de cabeza y cuello

Solid tumours represent 90 percent of the oncohematologic pathologies diagnosed in Argentina. Infections are one of the most frequent complications causing important morbidity and mortality and delay in prosecution of their specific treatment. The type of infection depends on the specific site of the tumour, the presence of post obstructive phenomena, the treatment administered, comorbidity and local epidemiology, among others. New therapies are being continuously incorporated to the armamentarium of cancer treatment such as new chemotherapies regimes, target therapy and immunotherapy. The management of adverse events and infectious complications associated with them are a challenge for the physician in charge of these patients.The epidemiology, prevention and management of the most frequent infectious complications in patients with tumours of the central nervous system and head and neck are reviewed in this paper

Câncer de cabeça e pescoço: causas, prevenção e tratamento / Head and neck cancer: causes, prevention and treatment

Câncer de cabeça e pescoço é o quinto tipo de câncer mais comum e a taxa de sobrevivência não tem mudado nos últimos anos. OBJETIVO: Determinar os fatores de risco, causas, tratamento e prevenção do câncer de cabeça e pescoço. MÉTODO: Nós detalhamos os fatores de risco, causas, tratamento e prevenção da doença por meio de pesquisa nos bancos de dados PUBMED, MEDLINE e SciELO. RESULTADOS: Álcool e fumo ainda são os principais fatores de risco. Outros fatores podem influenciar o desenvolvimento do carcinoma de cabeça e pescoço. A opção de tratamento principal é terapia cirúrgica e sua utilização seguida por radioterapia é uma prática comum de tratamento em fases iniciais da doença. Existem terapias que visam agir em componentes moleculares genéticos específicos para o desenvolvimento do tumor. A cessação do cigarro, limitação de ingestão de álcool, evitar a exposição à fumaça do cigarro, a carcinogênicos ambientais, detecção precoce de infecção por HPV, manutenção da saúde bucal, bons hábitos alimentares e controle do stress podem ser medidas de prevenção da doença. CONCLUSÃO: Investigações adicionais são necessárias para completa compreensão do desenvolvimento do carcinoma de cabeça e pescoço e isso irá fornecer novos caminhos e melhora na intervenção e abordagens terapêuticas.

Although head and neck carcinoma ranks fifth among cancer types, patient survival rates have not changed significantly over the past years. OBJECTIVE: To determine the risk factors, causes, therapies, and prevention measures for head and neck cancer. METHOD: Risk factors, causes, therapies, and preventive measures for this disease were searched on databases PUBMED, MEDLINE, and SCIELO. RESULTS: Alcohol and tobacco are still atop risk factors. Other factors may influence the development of head and neck carcinoma. Surgery is the main treatment option, and the addition of radiotherapy following surgery is frequent for patients in the early stages of the disease. Other therapies target specific genetic molecular components connected to tumor development. Disease preventive measures include smoking cessation, limiting alcohol intake, preventing exposure to tobacco smoke and environmental carcinogenic agents, early detection of infection by HPV, maintaining oral health, good eating habits, and managing stress. CONCLUSION: Additional research is needed for a more thorough understanding of the development of head and neck carcinomas and to shed light on new ways to improve therapeutic approaches and interventions.

COX-2 inhibitors: chemoprevention of head and neck cancer / Inibidores de COX-2: quimioprevenção de tumor de cabeça e pescoço

Objective: In addition to the well-established pathophysiological role that COX-2 plays in inflammation, recent evidence implies that this isoform may also be involved in multiple biologic events throughout the tumorigenic process. Many epidemiological studies demonstrate that nonsteroidal anti-inflammatory drugs (NSAIDs) reduce the risk of a wide range of tumors. Further, COX-2 is chronically over expressed in many premalignant, malignant, and metastatic human cancers, and levels of over expression have been shown to significantly correlate to invasiveness, prognosis, and survival in some cancers. Conclusions: This article presents a broad overview of the growing evidence that COX-2 plays a pivotal role throughout oncogenesis and summarizes the rationale to explore the use of COX-2 inhibitors for the prevention or treatment of cancer as a single agent or in combination with current anticancer modalities. Epidemiological data and preclinical studies have generated compelling interest in the potential use of COX-2 inhibitors in chemoprevention and chemotherapy of human tumours.

Objetivos: Além do papel fisiopatológico bem definido que a COX-2 desempenha na inflamação, a evidênciarecente sugere que essa isoforma também pode estar envolvida em eventos biológicos múltiplos durante oprocesso de tumorigênese. Vários estudos epidemiológicos demonstram que anti-inflamatórios não esteroides (AINEs) reduzem o risco de uma grande variedade de tumores. Além disso, sabe-se que há sobre-expressãocrônica da COX-2 em muitos tumores humanos pré-malignos, malignos e metastáticos, tendo sido demonstradacorrelação dessa sobre-expressão com a invasão, o prognóstico e a sobrevida de alguns tumores. Conclusões:Este artigo apresenta uma visão ampla da crescente evidência de que a COX-2 desempenha papel fundamentalna oncogênese e resume os fundamentos para explorar o uso de inibidores COX-2 para a prevenção ou o tratamentodo câncer como um único agente ou em combinação com atuais modalidades anticancerígenas. Dadosepidemiológicos e estudos pré-clínicos têm gerado grande interesse no uso potencial de inibidores COX-2 naquimioprofilaxia e quimioterapia de tumores humanos.

El cáncer de cabeza y cuello: factores de riesgo y prevención / Head and neck cancer: risk factors and prevention

La frecuencia del carcinoma epidermoide originado en mucosas de cabeza y cuello ha aumentado mundialmente en la última década, sobre todo en países con economías emergentes; el cáncer de cavidad oral ocupa el sexto lugar de todas las neoplasias. Aquí se lleva a cabo una revisión de la literatura en relación a la epidemiología y factores de riesgo en cáncer de cabeza y cuello, y se hace énfasis en la prevención del carcinoma originado en mucosas de vías aerodigestivas superiores. Se concluye que el pronóstico de los pacientes con cáncer de cabeza y cuello depende de la etapa clínica, y si bien la identificación de población en riesgo y de lesiones precursoras, así como el diagnóstico precoz disminuyen la tasa de mortalidad, el esfuerzo mayor debe hacerse en la prevención primaria.

The frequency of squamous cell carcinoma originating in head and neck mucosae has increased worldwide in the last decade, particularly in countries with emerging economies; oral cavity cancer is ranked in 6th place for all neoplasias. We conducted a literature review related to epidemiology and risk factors in head and neck cancer in order to analyze the most significant etiological factors and to emphasize prevention of carcinoma originating in head and neck mucosae. The prognosis in head and neck cancer patients depends on the clinical stage at time of diagnosis; therefore, identification of high-risk populations, precancerous lesions and early diagnosis decrease mortality. Nevertheless, the major effort must be on primary prevention.

Alteração da auto-imagem dos pacientes portadores de neoplasia de cabeça e pescoço em cuidados paliativos / Change the self image of patients with head and neck cancer in palliative care

Com o avanço tecnológico da medicina e dos recursos por ela utilizados, está sendo possível identificar um aumento significativo de pacientes fora de possibilidades terapêuticas de cura portadores de neoplasias malignas, sobretudo, em pacientes laringectomizados. Sendo assim, é necessário desenvolver estratégias para otimização de ações à esta clientela utilizando abordagem da assistência paliativa. O objetivo deste trabalho foi descrever através de relatos da moderna literatura como pacientes oncológicos portadores de câncer em estágio avançado de cabeça e pescoço enfrentam sua auto-imagem alterada. Uma vez que, essa clientela desenvolve, na maioria das vezes, lesões tumorais ulceradas que implicam grandes curativos, apresentam multilações significativas, como perda de voz por traqueostomias permanentes, uso de sondas para alimentação, além de outras conseqüências para sua vida social, profissional e lazer, algumas passíveis de adaptações, as quais devem ser trabalhadas pela equipe de enfermagem.

Alteração da auto-imagem dos pacientes portadores de neoplasia de cabeça e pescoço em cuidados paliativos

Com o avanço tecnológico da medicina e dos recursos por ela utilizados, está sendo possível identificar um aumento significativo de pacientes fora de possibilidades terapêuticas de cura portadores de neoplasias malignas, sobretudo, em pacientes laringectomizados. Sendo assim, é necessário desenvolver estratégias para otimização de ações à esta clientela utilizando abordagem da assistência paliativa. O objetivo deste trabalho foi descrever através de relatos da moderna literatura como pacientes oncológicos portadores de câncer em estágio avançado de cabeça e pescoço enfrentam sua auto-imagem alterada. Uma vez que, essa clientela desenvolve, na maioria das vezes, lesões tumorais ulceradas que implicam grandes curativos, apresentam multilações significativas, como perda de voz por traqueostomias permanentes, uso de sondas para alimentação, além de outras conseqüências para sua vida social, profissional e lazer, algumas passíveis de adaptações, as quais devem ser trabalhadas pela equipe de enfermagem