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1.
Support Care Cancer ; 28(1): 131-140, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30993449

RESUMO

OBJECTIVES: To investigate among patients treated with a total laryngectomy (TL) (1) Internet-use and Internet use to search for information on health and cancer (content); (2) which patients are most likely to use the Internet in general, for health-related and cancer-related purposes; (3) which other types of eHealth (community, communication, care) are used; and (4) preferences towards future use. METHODS: Patient members of the Dutch TL patient society were asked to complete a questionnaire on Internet use, health-related and cancer-related Internet use, types of eHealth, preferences towards future use, socio-demographics, clinical factors, and quality of life (QOL). Factors associated with Internet use and health-related and cancer-related Internet use were investigated using stepwise logistic regression analysis. RESULTS: In total, 279 TL patients participated, of whom 68% used the Internet. Of these, 63% used the Internet to search for information on health and 49% on cancer. Younger and higher educated TL patients and those with better QOL used the Internet more often. Patients with worse QOL searched more often for health-related information. Younger patients and those with shorter time since TL searched more often for cancer-related information. The current use of eHealth for communication, community, and care purposes among Internet users was limited (range, 2 to 15%). Many were interested in using these types of eHealth in the future (range, 21 to 72%). CONCLUSION: The majority used the Internet, especially to search for information on health and cancer, but only few for communication, community, or care purposes. Many were interested in future use.


Assuntos
Comportamento de Busca de Informação , Internet/estatística & dados numéricos , Neoplasias Laríngeas , Laringectomia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , Comunicação , Estudos Transversais , Feminino , Humanos , Neoplasias Laríngeas/epidemiologia , Neoplasias Laríngeas/psicologia , Neoplasias Laríngeas/terapia , Laringectomia/reabilitação , Laringectomia/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Qualidade de Vida , Apoio Social , Inquéritos e Questionários , Telemedicina/estatística & dados numéricos , Qualidade da Voz
2.
Medicine (Baltimore) ; 98(51): e18177, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31860963

RESUMO

INTRODUCTION: Laryngeal adenoid cystic carcinoma (LACC) is an extremely rare malignant neoplasm. The etiology of LACC remains unknown, and it is characterized by multiple recurrences, slow progression, and late distant metastasis. This study aimed to provide more information regarding the characteristics, diagnosis, and treatment of LACC by analyzing 3 clinical cases and reviewing the literature on this topic. PATIENT CONCERNS: Here, we present all 3 cases of LACC within the period between 2010 and 2019. Dyspnea was the most commonly observed symptom in these patients, followed by hoarseness, pharyngeal paresthesia, and difficulty swallowing. DIAGNOSIS: All patients were pathologically confirmed as LACC. INTERVENTIONS: All the patients underwent a combined therapy of surgical resection plus external irradiation. OUTCOMES: The follow-up time was between 2 and 6 years; no local recurrence occurred in any of the 3 patients. Lung metastasis was found in 1 patient 6 years after surgery. CONCLUSION: LACC is usually a slowly progressing cancer; the main treatment methods are surgery and radiotherapy, and the adequate radiotherapy dose should usually be greater than 60 Gy. The 5-year disease-specific survival rate is high; however, distant metastasis may still occur in patients with LACC even beyond 5 years after treatment. Therefore, patients with LACC require long-term surveillance.


Assuntos
Carcinoma Adenoide Cístico/diagnóstico , Neoplasias Laríngeas/diagnóstico , Adulto , Idoso , Carcinoma Adenoide Cístico/patologia , Carcinoma Adenoide Cístico/terapia , Terapia Combinada , Humanos , Neoplasias Laríngeas/patologia , Neoplasias Laríngeas/terapia , Laringe/patologia , Masculino , Pessoa de Meia-Idade
3.
Pan Afr Med J ; 34: 33, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31762901

RESUMO

Adenoid Cystic Carcinoma of larynx is extremely rare location. We herein describe an unusual clinical and radiological presentation of ACCL and review recent literature. We report a case of a 38-year-old woman with history of asthma, presented to our department with acute inspiratory dyspnea that required an emergency tracheotomy. Physical examination revealed a large anterior cervical mass without any lymphadenopathy suspecting thyroid origin. Cervical Computed Scan showed a tumor process between the thyroid lobe, the left edge of the subglottic area and first tracheal rings filling all the lumen, discussing either a laryngo-tracheal or thyroid origin. The patient underwent a panendoscopy under general anesthesia that confirmed a subglottic extension of the tumor and multiples biopsies showed a malignant salivary origin of the mass. After multidisciplinary discussion, the patient underwent total laryngectomy and thyroidectomy with bilateral selective neck dissections (levels II- IV). Anatomopathological examination confirmed the laryngeal location of Adenoid Cystic Carcinoma classified pT4aN0R0. Adjuvant radiation therapy was indicated. In our knowledge, only 10 cases were reported in the literature with this unusual presentation. Moreover, the case we report is in the subglottic floor without invasion of neither vocal cords nor trachea. Total laryngectomy with neck dissection remains the recommended therapeutic procedure for locally advanced ACCL. Adverse features such as close or positive margins, T3-4, intermediate or high grade neural and perineural spread, lymphatic or vascular invasion or lymph node metastases should indicate adjuvant treatment to improve the outcome. The lack of randomized multicentric study, implies the management of ACCL by skilled multidisciplinary team, to suggest adequate personalized treatment.


Assuntos
Carcinoma Adenoide Cístico/diagnóstico , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias Laríngeas/diagnóstico , Neoplasias da Glândula Tireoide/diagnóstico , Adulto , Carcinoma Adenoide Cístico/patologia , Carcinoma Adenoide Cístico/terapia , Feminino , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/terapia , Humanos , Neoplasias Laríngeas/terapia , Laringectomia , Equipe de Assistência ao Paciente/organização & administração , Neoplasias da Glândula Tireoide/terapia , Tireoidectomia
4.
Medicine (Baltimore) ; 98(45): e17883, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31702662

RESUMO

RATIONALE: Of all the parts of the larynx, the glottis has the highest frequency of cancer. With disease progression, the vocal cord movement is affected and for advanced stages its anatomical and functional preservation is rarely achievable, if at all. PATIENT CONCERNS: Here we describe a 72-year-old patient who presented with hoarseness for a year and was only able to whisper. DIAGNOSIS: A computed tomography (CT) scan of the vocal cords (without contrast) showed higher density tissue. Histological examination disclosed a well-differentiated verrucous squamous cell carcinoma of the glottis. INTERVENTIONS: The patient was treated with the oncolytic ECHO-7 virus Rigvir without any of the standard treatments. OUTCOMES: As shown by CT scans, the patient has been stabilized, and the laryngeal functions are preserved with the virotherapy still ongoing. The patient was diagnosed over 4.2 years ago. LESSONS: Considering the present patient being treated with Rigvir without any standard treatment, the results suggest that Rigvir therapy could be a possible treatment for glottic cancer.


Assuntos
Neoplasias Laríngeas/terapia , Terapia Viral Oncolítica/métodos , Carcinoma de Células Escamosas de Cabeça e Pescoço/terapia , Idoso , Glote/diagnóstico por imagem , Glote/patologia , Humanos , Neoplasias Laríngeas/diagnóstico por imagem , Neoplasias Laríngeas/patologia , Masculino , Carcinoma de Células Escamosas de Cabeça e Pescoço/diagnóstico por imagem , Carcinoma de Células Escamosas de Cabeça e Pescoço/patologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento
5.
Acta Otolaryngol ; 139(10): 926-929, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31430221

RESUMO

Background: Pharyngocutaneous fístula (PCF) is a major complication of salvage laryngectomies, mainly secondary to the effect of radiotherapy. Aims/objectives: Our main objective is to study the effect of pectoralis major myofascial flap (PMMF) on the prevention of PCF. Materials and methods: We studied all total laryngectomies (TL) performed between 2001 and 2018, noting the use of previous chemoradiation, the type of suture and the use of flaps. We recorded and compared the incidence of PCF in all groups. Results: A total of 146 patients were included, divided into a primary TL group (117 patients) and salvage TL (29 patients). PMMF was used in 62% of salvage TLs. The rates of PCF were 5.98% in primary TL and 17.2% in salvage procedures. Among the salvage TL group, in patients with pharyngeal closure alone, a PCF developed in 36.4% of cases, compared to 5.56% in the PMMF group. We found a similar rate of fistulae when comparing primary TL and salvage TL with PMMF, highlighting the protective effect of the flap. Conclusions and significance: The use of PMMF in salvage TL reduces the incidence of PCF, achieving a rate similar to that attained with primary TL.


Assuntos
Fístula Cutânea/prevenção & controle , Neoplasias Laríngeas/terapia , Laringectomia/efeitos adversos , Doenças Faríngeas/prevenção & controle , Fístula do Sistema Respiratório/prevenção & controle , Retalhos Cirúrgicos , Quimiorradioterapia/efeitos adversos , Estudos de Coortes , Fístula Cutânea/epidemiologia , Feminino , Humanos , Neoplasias Hipofaríngeas/patologia , Neoplasias Hipofaríngeas/terapia , Incidência , Neoplasias Laríngeas/patologia , Masculino , Doenças Faríngeas/epidemiologia , Fístula do Sistema Respiratório/epidemiologia , Terapia de Salvação/efeitos adversos
6.
Cancer Treat Rev ; 78: 42-51, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31437725

RESUMO

The poorly differentiated neuroendocrine carcinomas (NECs) of the larynx are rare tumors that comprise of a small cell-type (SCNEC) and a large cell-type (LCNEC). In order to consolidate the current knowledge about their characteristics and management a systematic review of the available literature was performed. The PubMed/Medline and Scopus databases search resulted in 141 articles published between 1972 and 2019, describing 273 patients: 230 cases were of SCNEC histology (84.2%) and 43 cases were LCNECs (15.8%). Comparing both histological entities, patients with LCNECs were older (63.2 vs. 58.7 years, p = 0.036) than SCNEC patients and had more often primary tumor in a supraglottic larynx (79.5 vs. 56.1%, p = 0.039), advanced-stage neck disease (N2-3, 56.8 vs. 40%, p = 0.061), surgery-based treatment (83.7 vs. 51.9%, p < 0.001) and had no radiotherapy (44.2 vs. 29%, p = 0.071). At presentation, systemic metastases were diagnosed in 12.1% of the patients, whereas disease relapse was experienced by two-thirds (65.3%) of those initially staged M0; systemic relapse, alone or in combination with local/regional recurrence, was the most frequent type of failure (in 71.9%). On multivariate analysis, more advanced disease stage and SCNEC histology adversely influenced disease-specific survival. Wide variations in the pattern of care, including radiotherapy doses and chemotherapy regimens, were found among long-term survivors without known disease at ≥ 24 months of follow-up (N = 36). We conclude that the most effective treatment for poorly differentiated NECs has yet to be determined.


Assuntos
Carcinoma de Células Grandes/patologia , Carcinoma Neuroendócrino/patologia , Carcinoma de Células Pequenas/patologia , Neoplasias Laríngeas/patologia , Carcinoma de Células Grandes/terapia , Carcinoma Neuroendócrino/terapia , Carcinoma de Células Pequenas/terapia , Terapia Combinada , Humanos , Neoplasias Laríngeas/terapia , Prognóstico , Taxa de Sobrevida
7.
J Surg Oncol ; 120(4): 698-706, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31273803

RESUMO

BACKGROUND: This study aimed to create a nomogram for postoperative prediction of the risk of recurrence in laryngeal squamous cell carcinoma patients who received laryngectomy alone and to assess indications for postoperative adjuvant treatments (POAT). METHODS: A retrospective analysis of 1571 newly diagnosed laryngeal carcinoma patients was conducted. Those patients were divided into two groups-the development cohort (n = 1102) and the validation cohort (n = 469). Patients were classified into three subgroups according to their individual points calculated from the nomogram. The efficiency of POAT was examined among various subgroups. RESULTS: Five variables, including pT classification, pN classification, surgical margin, tumor differentiation, and primary location, were included in the nomogram. The C-index was 0.753 in development cohort and 0.744 in validation cohort. Patients were classified into three subgroups with incremental risks of recurrence. In the high-risk group, patients receiving POAT showed significantly better recurrence-free survival (RFS) than did those receiving surgery alone, while POAT was not significantly associated with RFS in either the low- or moderate-risk groups. CONCLUSIONS: The risk of tumor recurrence in patients with laryngeal carcinoma was quantified by our newly constructed nomogram. Patients categorized as high-risk were found to benefit from POAT in RFS.


Assuntos
Carcinoma de Células Escamosas/secundário , Tomada de Decisões , Neoplasias Laríngeas/patologia , Recidiva Local de Neoplasia/patologia , Nomogramas , Medição de Risco/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/cirurgia , Carcinoma de Células Escamosas/terapia , Quimiorradioterapia Adjuvante , Terapia Combinada , Feminino , Seguimentos , Humanos , Neoplasias Laríngeas/cirurgia , Neoplasias Laríngeas/terapia , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/cirurgia , Recidiva Local de Neoplasia/terapia , Período Pós-Operatório , Valor Preditivo dos Testes , Estudos Retrospectivos , Fatores de Risco , Taxa de Sobrevida
8.
Asian Pac J Cancer Prev ; 20(7): 2051-2057, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-31350965

RESUMO

Purpose: To determine factors affecting laryngeal preservation rate in laryngeal and hypopharyngeal cancer patients treated with organ preservation. Material and Methods: Retrospective study examining stage III to IV laryngeal and hypopharyngeal cancer patients who have been treated with organ preservation. Conventional radiation must be applied in all patients with minimum dose of 45 Gray. Weekly or triweekly chemotherapy can be adding during radiation. Salvage surgery should be considered in residual disease or local recurrence. Kaplan-Meier was used for survival analysis and, Log rank test and Cox proportional hazard test were used for uni and multivariate analysis. Results: From January 2010 to October 2014, there were 69 patients treated with laryngeal preservation and 53 patients received radiation dose 61-70 Gray. After completing radiation, we found that 44 patients have no residual tumor within 6 months and 33 patients can preserve their functional larynx later with complete response (median follow up 6 mo, range 0-46.3 mo). The 1-year, 2-year and 3-year laryngeal preservation rate was 49%, 36 % and 32 % respectively. On univariate analysis, lower nodal stage (p = 0.008), stage III disease (p = 0.046), tumor volume <10 ml (p = 0.005), no true vocal cord involvement (p = 0.016), dose 61-70 Gray (p < 0.001) and no interruption of treatment (p = 0.017) have better laryngeal preservation rates. ECOG performance status 2, higher nodal stage, stage IV, presence of true vocal cord involvement, upper airway obstruction before/during radiation and radiation dose below 61-70 Gray had an effect on worse overall survival when evaluated with univariate analysis statistical significance. Conclusion: For factors that affected laryngeal preservation in our study were nodal stage, group stage, tumor volume, true vocal cord involvement, radiation dose and treatment break time more than one week with statistical significance.


Assuntos
Quimiorradioterapia/mortalidade , Neoplasias Hipofaríngeas/patologia , Neoplasias Laríngeas/patologia , Tratamentos com Preservação do Órgão/mortalidade , Terapia de Salvação , Adulto , Idoso , Feminino , Seguimentos , Humanos , Neoplasias Hipofaríngeas/terapia , Neoplasias Laríngeas/terapia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Indução de Remissão , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do Tratamento
9.
Codas ; 31(3): e20180100, 2019 Jun 27.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31271578

RESUMO

The objective of this study was to verify the immediate effect of sensory and motor neuromuscular electrical stimulation (NMES), in the oral and pharyngeal phases of deglutition, in a 64 year male patient after laryngeal cancer treatment. Videofluoroscopy was performed during deglutition of 5 ml of honey and pudding, under three conditions: without stimulation, with sensory NMES, with motor NMES, randomly defined. The degree of dysfunction of deglutition (DOSS), the presence of food stasis (Eisenhuber scale), laryngeal penetration and laryngotracheal aspiration (PAS) and oral and pharyngeal transit time were evaluated. An evaluator without knowing about the applied stimulus. On the DOSS scale there was improvement with sensory and motor stimulation. In the PAS scale, there was improvement, both for the sensorial and motor stimulus in the honey consistency, but the worsening of the motor stimulus for the pudding consistency was observed. There was reduction of the residues in the base of the tongue with sensorial and motor stimulus for the consistency of pudding and honey; worsening motor stimulus in the posterior wall of the pharynx for honey consistency. There was no difference between stimulation levels regarding to oral and pharyngeal transit time. The results showed that NMES at the sensory and motor levels improved the degree of dysphagia in an individual after the treatment of laryngeal cancer, with greater benefits of the sensory level in relation to the motor regarding to the presence of penetration and residues.


Assuntos
Transtornos de Deglutição/etiologia , Transtornos de Deglutição/terapia , Terapia por Estimulação Elétrica/métodos , Neoplasias Laríngeas/complicações , Humanos , Neoplasias Laríngeas/terapia , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
10.
Eur Arch Otorhinolaryngol ; 276(10): 2635-2647, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31338576

RESUMO

INTRODUCTION: The tissues of the laryngeal region only rarely harbor primary cartilaginous lesions, and squamous cell carcinoma remains the most frequently encountered malignant tumor in this area. MATERIALS AND METHODS: We reviewed the salient histological features of cartilaginous laryngeal lesions to provide differential diagnostics and guidelines for distinguishing the benign from the malignant ones. RESULTS: Cartilaginous neoplasms of the larynx include chondroma and chondrosarcoma. Among the overarching group of all forms of laryngeal sarcoma, chondrosarcoma forms the most common entity in the larynx, followed by rhabdomyosarcoma. Cartilaginous tumors comprise about 0.1%-1% of all laryngeal neoplasms with chondrosarcomas being more frequently encountered than chondromas. Several neoplasms earlier reported as giant-cell tumors of the larynx would most likely, using current terminology, be classified as cases of undifferentiated pleomorphic sarcoma (previously known as malignant fibrous histiocytoma, giant-cell variant) or aneurysmal bone cyst. CONCLUSION: When true laryngeal sarcomas do exist, they may prove to be challenging lesions both for the pathologist and the treating clinician. The diagnostic problems are mainly a result of the infrequent exposure of clinicians and diagnosticians to these lesions.


Assuntos
Carcinoma de Células Escamosas/diagnóstico , Condroma , Condrossarcoma , Cartilagens Laríngeas/patologia , Neoplasias Laríngeas , Neoplasias de Tecidos Moles , Biópsia/métodos , Neoplasias Ósseas/diagnóstico , Condroma/diagnóstico , Condroma/patologia , Condroma/terapia , Condrossarcoma/diagnóstico , Condrossarcoma/patologia , Diagnóstico Diferencial , Feminino , Humanos , Neoplasias Laríngeas/classificação , Neoplasias Laríngeas/diagnóstico , Neoplasias Laríngeas/patologia , Neoplasias Laríngeas/terapia , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Prognóstico , Neoplasias de Tecidos Moles/diagnóstico , Neoplasias de Tecidos Moles/patologia , Neoplasias de Tecidos Moles/terapia
11.
Anticancer Res ; 39(7): 3727-3737, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31262899

RESUMO

BACKGROUND/AIM: This study aims to investigate whether the combination of oncolytic viruses with chemoradiotherapy or other therapies is a promising strategy for cancer treatment. MATERIALS AND METHODS: The anticancer effects of measles virus (MeV) in combination with nimotuzumab in the treatment of laryngeal cancer were evaluated in vitro and in nude mice inoculated with Hep2 tumors. MTT assay and flow cytometry were used to examine cell death. RESULTS: Laryngeal cancer cells treated with MeV+nimotuzumab combination had a significantly lower survival rate compared to those treated with MeV or nimotuzumab alone (p<0.0001). In an animal model bearing human laryngeal tumor, the treated group had a higher survival rate (60%) compared to a untreated group (20%) (p<0.05), and the survival rate of the group treated with MeV+nimotuzumab combination was higher compared to the groups received single treatment. CONCLUSION: The MeV+nimotuzumab combination has greater anticancer activities in both laryngeal cancer cells and an animal model.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Antineoplásicos/uso terapêutico , Neoplasias Laríngeas/terapia , Vírus do Sarampo , Terapia Viral Oncolítica , Vírus Oncolíticos , Animais , Linhagem Celular Tumoral , Terapia Combinada , Humanos , Vacina contra Sarampo , Camundongos Nus , Células Vero
12.
Radiat Oncol ; 14(1): 101, 2019 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-31186027

RESUMO

BACKGROUND: The functional outcome after the treatment of laryngeal cancer is tightly related to the quality of life of affected patients. The aim of this study is to describe the long-term morbidity and functional outcomes associated with the different treatment modalities for laryngeal cancer. METHODS: Retrospective chart review of 477 patients undergoing curatively intended treatment for laryngeal cancer at our tertiary referral center from 2001 to 2014: Details on patient and disease characteristics, diagnostics and treatment related functional outcomes were analyzed. RESULTS: With a median follow-up of 51 months, the crude rate of functional larynx preservation was 74.6%. Radiotherapy +/- chemotherapy was the dominant treatment modality (n = 359-75.3%), whereas 24.7% (n = 118) underwent primary surgery, with 58.5% (69) receiving adjuvant treatment. The 5-year laryngectomy-free survival was 57% (95% CI, 48-66%) after surgery vs. 69% (95% CI, 64-75%) after chemoradiotherapy (p < 0.01). In stage III-IVB, these rates were 26% (95% CI, 16-39%) vs. 47% (95% CI, 36-59%), respectively (p < 0.01). Aspiration occurred in 7%, tracheostomy was necessary in 19.8% and feeding tube placement in 25.4%. Feeding tube and tracheostomy necessity was higher in the initially surgically treated group. Primary surgery (HR: 1.67, 95% CI: 1.19-2.32; p < 0.01), stage III-IVB (HR: 4.07, 95% CI: 2.97-5.60; p < 0.01) and tumor recurrence (HR: 3.83, 95% CI: 2.79-5.28; p < 0.01) remained as adverse factors for laryngectomy-free survival. CONCLUSIONS: Preserving the laryngeal function after cancer treatment is challenging. Advanced tumor stages, primary surgery and recurrence are related to a poor functional outcome. Therefore, the criteria for initial decision-making needs to be further refined.


Assuntos
Carcinoma de Células Escamosas/mortalidade , Quimiorradioterapia/mortalidade , Neoplasias Laríngeas/mortalidade , Laringectomia/mortalidade , Recidiva Local de Neoplasia/mortalidade , Terapia de Salvação , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/terapia , Terapia Combinada , Feminino , Humanos , Neoplasias Laríngeas/patologia , Neoplasias Laríngeas/terapia , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/terapia , Estadiamento de Neoplasias , Qualidade de Vida , Estudos Retrospectivos , Taxa de Sobrevida , Resultado do Tratamento
13.
Auris Nasus Larynx ; 46(6): 882-888, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31176493

RESUMO

OBJECTIVE: The present study aimed to retrospectively analyze the long-term efficacy and toxicity of concurrent chemoradiotherapy with nedaplatin and S-1 for head and neck squamous cell carcinoma. METHODS: The study enrolled 53 patients (23 with stage II disease, 13 with stage III disease, and 17 with stage IV disease). S-1 was administered orally twice a day for 14 days, followed by a two-week rest period. Nedaplatin was intravenously administered on day 4. Where possible, two courses of chemotherapy were performed. Radiotherapy was started with the administration of S-1. We analyzed the clinical response, survival rate, acute adverse events, and late swallowing toxicity. RESULTS: The complete response rates for the primary tumor and neck lymph node metastases were 94.3% and 79.3%, respectively. The five-year overall survival rate was 79.5%, the five-year disease-specific survival rate was 84.8%, and the five-year relapse-free survival rate was 73.7%. The main acute adverse events were leukopenia, neutropenia, mucositis, and dermatitis. No patient had severe nephrotoxicity. Late swallowing toxicity was observed in 13 patients. CONCLUSIONS: The low toxicity, and low nephrotoxicity of chemoradiotherapy with nedaplatin and S-1 have a positive impact on long-term survival. The combination of nedaplatin and S-1 can be used instead of cisplatin and 5-fluorouracil as a safer regimen, especially in patients with some complications and those requiring treatment in an outpatient setting.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Quimiorradioterapia/métodos , Neoplasias de Cabeça e Pescoço/terapia , Carcinoma de Células Escamosas de Cabeça e Pescoço/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Combinação de Medicamentos , Feminino , Humanos , Neoplasias Laríngeas/terapia , Masculino , Pessoa de Meia-Idade , Neoplasias Bucais/terapia , Compostos Organoplatínicos/administração & dosagem , Ácido Oxônico/administração & dosagem , Neoplasias Faríngeas/terapia , Tegafur/administração & dosagem , Resultado do Tratamento
14.
Nan Fang Yi Ke Da Xue Xue Bao ; 39(5): 554-560, 2019 May 30.
Artigo em Chinês | MEDLINE | ID: mdl-31140419

RESUMO

OBJECTIVE: To investigate the effect of sputum ubiquitin ligase (Cbl-b) gene known-down on the cytotoxicity of H9 T lymphocytes against human laryngeal squamous cancer Hep-2 cells and explore the underlying mechanism. METHODS: CD4+ T lymphocytes isolated from 12 patients with laryngeal squamous carcinoma and 12 healthy individuals were examined for Cbl-b mRNA expressions using RT-PCR. H9 T lymphocytes cultured in 96-well plates were transfected with Cbl-b siRNA via liposomes followed by treatment with an anti-IL-2 monoclonal antibody, with H9 T lymphocytes transfected with a scrambled sequence as the negative control. The expressions of Cbl-b mRNA and protein in the cells were detected using real-time fluorescent quantitative PCR and Western blotting, respectively. The killing effect of the treated T lymphocytes against Hep-2 cells was assessed using the cell counting kit (CCK-8). The positive expression rates of CD69 and CD25 on the surface of H9 T lymphocytes were determined using flow cytometry, and the levels of interleukin-2 (IL-2) and interferon-gamma (INF-γ) in the culture supernatants of H9 T lymphocytes were detected with ELISA. RESULTS: The CD4+ T lymphocytes from patients with laryngeal squamous carcinoma showed significantly increased Cbl-b mRNA level compared with those from healthy individuals (P < 0.05). Transfection of H9 T lymphocytes with Cbl-b siRNA significantly reduced the expression levels of Cbl-b mRNA and protein (P < 0.05), which were not significantly affected by subsequent treatment of the cells with the anti-IL-2 antibody (P>0.05). At different target-effector ratios, the Cbl-b siRNA-transfected cells showed significantly higher Hep-2 cell killing rates and higher positivity rates of CD69 and CD25 expressions than the blank and negative control cells and the cells with both Cbl-b siRNA transfection and anti-IL-2 treatment (P < 0.05). Cbl-b silencing in H9 T lymphocytes resulted in significantly increased levels of IL-2 and INF-γ in the supernatant as compared with those in the blank and negative control groups (P < 0.05). CONCLUSIONS: Cbl-b gene silencing effectively enhances the killing effect of H9 T lymphocytes against Hep-2 cells in vitro probably as the result of enhanced IL-2 secretion and T lymphocyte activation.


Assuntos
Carcinoma de Células Escamosas , Inativação Gênica , Neoplasias Laríngeas , Linfócitos T , Carcinoma de Células Escamosas/genética , Carcinoma de Células Escamosas/terapia , Humanos , Neoplasias Laríngeas/genética , Neoplasias Laríngeas/terapia , Ativação Linfocitária , RNA Interferente Pequeno
15.
Am J Clin Oncol ; 42(6): 527-533, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31136370

RESUMO

OBJECTIVE: Chemoradiotherapy (cRT) and total laryngectomy (TL) are acceptable treatments for locally advanced laryngeal squamous cell carcinoma (LSSC). We aimed to compare the outcomes in patients receiving full-dose treatment. METHODS: We identified 11,237 patients in the National Cancer Database treated 2004 to 2015 for T3-4N0-3 LSCC with either TL (with 60 to 80 Gy of adjuvant RT) or cRT (70 to 80 Gy). We evaluated differences in overall survival (OS) using Kaplan-Meier and Cox proportional hazards modeling. RESULTS: For patients with T3 disease, there was no difference in OS regardless of N stage (N0: hazard ratio [HR]=0.94, P=0.38; N+: HR=0.92, P=0.19). TL was associated with improved OS in patients with T4 disease (N0: HR=1.39, P<0.001; N+: HR=1.22, P=0.001). CONCLUSION: In patients who receive optimal therapy, both TL and cRT offer similar outcomes in T3 but not T4a disease.


Assuntos
Carcinoma de Células Escamosas/terapia , Quimiorradioterapia/métodos , Bases de Dados Factuais , Neoplasias Laríngeas/terapia , Laringectomia/métodos , Idoso , Carcinoma de Células Escamosas/patologia , Feminino , Seguimentos , Humanos , Neoplasias Laríngeas/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Retrospectivos , Taxa de Sobrevida
17.
Artigo em Chinês | MEDLINE | ID: mdl-31137102

RESUMO

Laryngeal squamous cell carcinoma is one of the common head and neck cancers, and it ranks the second in the incidence of head and neck cancers. Smoking and alchol are considered the main causes of the disease in the past. Since 1982, when scholars first proposed that human papillonavirus(HPV) was associated with the development of laryngeal cancer, there have been a large number of studies on the correlation between HPV and laryngeal cancer, but the results are different. Therefore, this article summarizes the progress of related researches on the relationship between HPV and laryngeal cancer in recent years, and explores the impact of HPV on the treatment strategy of laryngeal cancer.


Assuntos
Carcinoma de Células Escamosas , Neoplasias Laríngeas , Papillomaviridae , Infecções por Papillomavirus , Carcinoma de Células Escamosas/terapia , Carcinoma de Células Escamosas/virologia , Humanos , Neoplasias Laríngeas/terapia , Neoplasias Laríngeas/virologia , Infecções por Papillomavirus/complicações
18.
Prep Biochem Biotechnol ; 49(7): 659-670, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31066619

RESUMO

Small interfering RNA (siRNA)-based gene silencing strategy has high potential on suppressing specific molecular targets, involved in cancer progression. However, the lack of an effective nanocarrier system that safely delivers siRNA to its target still limits the clinical applications of siRNA. This study aimed to develop albumin-sericin nanoparticles (Alb-Ser NPs) as a novel siRNA delivery system for laryngeal cancer treatment. Nanoparticle formulations composed of albumin and sericin at different ratios (1:1, 2:1, 1:2 w/w) were synthesized by desolvation method. The nanoparticles were modified with poly-L-lysine (PLL) for siRNA binding and decorated with hyaluronic acid (HA) to target laryngeal cancer cell line, Hep-2. HA/PLL/Alb-Ser NPs were individually loaded with siRNAs for casein kinase 2 (CK2), Absent, Small, or Homeotic-Like (ASH2L), and Cyclin D1 genes, which are overexpressed in Hep-2 cells. Downregulation of genes was confirmed by real-time PCR (RT-PCR). Size, morphological, and thermogravimetric characterizations revealed that Alb-Ser NPs having 2:1 (w/w) ratio are the most optimized formulation. Between 36.8 and 61.3% of siRNA entrapment efficiencies were achieved. HA/PLL-siRNA/Alb-Ser (2:1) NPs-mediated gene silencing resulted in a significant inhibition of cell growth and induction of apoptosis in cells. Our findings showed that HA/PLL/Alb-Ser (2:1) NPs were promising as a siRNA carrier.


Assuntos
Técnicas de Transferência de Genes , Neoplasias Laríngeas/terapia , Nanopartículas/química , RNA Interferente Pequeno/administração & dosagem , Terapêutica com RNAi , Sericinas/química , Albumina Sérica Humana/química , Caseína Quinase II/genética , Linhagem Celular Tumoral , Ciclina D1/genética , Proteínas de Ligação a DNA/genética , Portadores de Fármacos/química , Humanos , Neoplasias Laríngeas/genética , Nanopartículas/ultraestrutura , Proteínas Nucleares/genética , RNA Interferente Pequeno/genética , RNA Interferente Pequeno/uso terapêutico , Terapêutica com RNAi/métodos , Fatores de Transcrição/genética
19.
Otolaryngol Head Neck Surg ; 161(2): 288-296, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31060436

RESUMO

OBJECTIVE: The aim of the current study was to determine the incidence of organ function preservation failure (OFPF) in patients with head and neck squamous cell carcinoma (HNSCC) treated by (chemo)radiotherapy and to identify its risk factors. STUDY DESIGN: Retrospective cohort analysis. SETTING: Tertiary cancer care center. SUBJECTS AND METHODS: A single-center retrospective cohort analysis was done (n = 703) in which OFPF after (chemo)radiotherapy was assessed. OFPF was defined as local failure or pure functional failure in the absence of local failure because of major surgical intervention (total laryngectomy, commando resection, permanent tracheostomy) or feeding tube dependence >2 years. RESULTS: OFPF occurred in 153 patients (21.8%). Reasons for OFPF were local failure in 103 patients (14.6%) and functional failure in 50 patients (7.2%). Evidence of functional failure included need for total laryngectomy (n = 9, 1.3%), commando resection (n = 2, 0.3%), permanent tracheostomy (n = 16, 2.3%), and/or long-term feeding tube for functional reasons (n = 23, 3.3%). In a Cox proportional hazards model, OFPF was worse for patients with T4 tumors (hazard ratio [HR] <0.5 and P < .001 for all other stages), for laryngeal vs oropharyngeal cancer (HR, 1.83; 95% confidence interval [CI], 1.20-2.79, P = .005, hypopharyngeal not significant), and for smokers (HR, 1.68; 95% CI, 1.10-2.56, P = .015). Exploratory multivariate analysis by tumor site showed that T4 tumor and pretreatment tracheostomy were the strongest predictive factors for OFPF in laryngeal and hypopharyngeal carcinoma while T4 tumor and smoking were predictive for poor OFPF in oropharyngeal carcinoma. CONCLUSION: This work shows a detrimental effect of smoking on functional outcomes after (chemo-)radiotherapy for HNSCC. Moreover, T4 tumor, laryngeal subsite, and pretreatment tracheostomy are strong predictors of OFPF.


Assuntos
Carcinoma de Células Escamosas/terapia , Quimiorradioterapia , Neoplasias Hipofaríngeas/terapia , Neoplasias Laríngeas/terapia , Neoplasias Orofaríngeas/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Laringectomia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Traqueostomia , Falha de Tratamento
20.
Ear Nose Throat J ; 98(7): E92-E96, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30983390

RESUMO

Although definitive chemoradiation (CRT) has been used for locally advanced laryngeal cancer for more than 2 decades, studies focusing on CRT failures in advanced laryngeal cancer are scarce. In this study, we aimed to determine the failure patterns and the survival outcomes in the patients who had recurrence after concurrent CRT for laryngeal cancer. Clinical records of the patients who had definitive concurrent CRT for laryngeal cancer between 2001 and 2014 at a tertiary referral center were reviewed. The end points of the study were 1-, 2-, and 3-year overall survival (OS) and disease-specific survival (DSS).In our results, there were 48 failures and the mean time period from the first diagnosis of disease to the diagnosis of recurrence was 18.0 months (range 2-72; standard deviation: 15.6). The most common recurrence pattern was local recurrence in 21 (47.9%) patients followed by regional recurrence in 11 (22.9%) patients. The 1 and 3 years OS rates were 41.7%, and 19.2% for the entire cohort, and 64.5%, and 29.7% for the patients who had not systemic recurrence at presentation of recurrence, respectively. The 1 and 3 years DSS rates were 43.5%, and 20.0% for the entire cohort, and 69.0%, and 31.8% for the patients who had not systemic recurrence at presentation of recurrence, respectively. All patients who had systemic recurrence initially (n = 13) died within 9 months (median = 4 months, range: 1-9 months). This study reveals that survival outcomes are unfavorable in the CRT failures and careful patient selection is critical to minimize failures. In the presence of systemic recurrence, disease course is aggressive.


Assuntos
Quimiorradioterapia/mortalidade , Neoplasias Laríngeas/mortalidade , Recidiva Local de Neoplasia/mortalidade , Adulto , Idoso , Feminino , Humanos , Neoplasias Laríngeas/terapia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Taxa de Sobrevida , Falha de Tratamento
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