Familial clustering of nasopharyngeal carcinoma in non-endemic area. Report of three families. / Carcinoma nasofaríngeo familiar en zona no endémica. Presentación de 3 familias.

Nasopharyngeal carcinoma is the predominant tumour type arising in the nasopharynx. Its aetiology is multifactorial; racial and geographical distribution, EBV infection and environmental exposure to specific substances are considered risk factors. This condition is endemic in some Asian areas, where a genetic predisposition in its oncogenesis has been established. There is a strong susceptibility between nasopharyngeal carcinoma and HLA, where related specific haplotypes have been found. In areas where the incidence is low, there are few reported cases of families affected. We report 3 cases of families with nasopharyngeal carcinoma among siblings, in the non-Asian population, probably related to EBV infection.

Phase II study of panitumumab and paclitaxel as first-line treatment in recurrent or metastatic head and neck cancer. TTCC-2009-03/VECTITAX study.

OBJECTIVE: To evaluate the activity and safety profile of panitumumab in combination with paclitaxel in patients with recurrent or metastatic SCCHN. MATERIALS AND METHODS: The VECTITAX phase II, open-label, multicenter study included patients with confirmed metastatic and/or recurrent SCCHN deemed to be untreatable by surgery or radiotherapy and ECOG PS=0-1. All patients received paclitaxel (80mg/m2/week) and panitumumab (6mg/kg/2weeks) until disease progression or unacceptable toxicity. EQ-5D-3L andvisual analogic scale (VAS) were used to evaluate impact on quality of life (QoL). RESULTS: The study included 40 patients (ITT population): (median age: 61 years; 87% male). Previous treatment: 29 patients (73%) had undergone surgery, 34 (85%) had received prior radiotherapy and 23 (58%) prior systemic treatment for locally advanced disease. Confirmed response was observed in 19 patients (48%) which was a complete response in 15% of patients. Stable disease was observed in 11 patients (28%). Disease control rate was 75%. Median progression-free survival was 7.5 months (95%CI: 4.9-8.3) and median overall survival 9.9 months (95%CI: 7.9-16.3). Most frequent grade 3-4 adverse events were skin rash (25%); asthenia (17%); neurotoxicity (15%); hypomagnesemia (10%); neutropenia (10%). Permanent discontinuation of panitumumab or paclitaxel due to adverse events was required in 10 (25%) and 13 patients (33%), respectively. There was one toxic death due to febrile neutropenia. Patient-reported QoL was preserved with no decline of median VAS scores. CONCLUSION: Panitumumab and paclitaxel is an active combination, providing promising outcomes with preservation of the QoL and a favorable safety profile. (EudraCT: 2010-018898-37; NCT01264328).

[Other therapeutic alternatives: radiotherapy and chemotherapy]. / Otras alternativas terapéuticas: radioterapia y quimioterapia.

Paragangliomas are rare tumors and most are benign: less than 10% show criteria for malignancy. In the head and neck, the main locations are carotid, jugulo-tympanic and vagal. Surgery continues to be the mainstay of treatment but both external beam radiotherapy (EBRT) and stereotactic radiosurgery (SRS) have been shown to be effective therapeutic alternatives. EBRT requires large volumes to cover the lesion, while radiosurgery allows administration of a high dose in a smaller volume, with high precision, which should reduce the number of long-term complications. The results in terms of local control with both treatment modalities are good, as reflected in published series. The role of chemotherapy is restricted to malignant paragangliomas. The treatment used includes the combination of chemotherapy, which provides short-lasting responses, and the role of new molecular targets is currently being investigated. The present article reviews the indications and results of the non-surgical treatment of paragangliomas.