ISSN:1043-3074    

DOI:10.1002/hed.2880130102

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1991

数据来源: WILEY

摘要:

AbstractFourteen patients with recurrent squamous cell carcinoma of the head and neck (SCCHN) were treated with 10 × 106U of nonrecombinant interferon alpha (IFN) intramuscularly (IM) daily for 3 days every 28 days. There were 11 men and 3 women, with ages ranging from 48 to 74 years. Patients had previously been treated with surgery (9 patients), radiotherapy (13 patients), or chemotherapy (8 patients). All patient had measurable disease by physical exam and radiologic evaluation and a performance status of ⩽2 (ECOG). Patients were treated for a minimum of 3 months and continued on therapy until disease progression. The dose and treatment schedule of IFN was well‐tolerated. Toxicities included low‐grade fever, mild anorexia, and malaise. Treatment was stopped in 1 patient due to the development of atrial fibrillation. One death occurred as a complication of aspiration pneumonia 2 weeks following the onset of therapy and was not felt to be related to IFN therapy. Of the 14 patients treated, there was 1 complete response (30+ months) of a base of tongue primary. Two patients had stabilization of disease (SD, 8 and 12 months). One patient had a mixed response with resolution of subcutaneous nodules. The remaining 10 patients died of progressive disease. Immunoogical assessment was performed on 8 patients. The 1 patient who has a complete response was noted to have markedly low pretreatment natural killer (NK) cell activity and subsequent sharp rise in activity after intial treatment. We conclude that low‐dose cyclic IFN is well‐tolerated in patients with recurrent SCCHN and has potential antitumo

ISSN:1043-3074    

DOI:10.1002/hed.2880130103

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1991

数据来源: WILEY

摘要:

AbstractForty‐two patients with mucosal melanoma of the head and neck were treated at the M. D. Anderson Cancer Center from 1944‐1989. Their records were evaluated regarding: location of the primary, stage of the disease at presentation, type of treatment, location of recurrences, and overall survival. These patients received the majority of their therapy at M. D. Anderson Cancer Center. The treatment consisted of surgery, radiotherapy, chemotherapy, immunotherapy, or a combination of these. The 5‐year survival rate was 40%. Twenty‐four of 27 patients who died with metastatic melanoma had local or regional disease concomitantly. Forty percent of patients were free of disease at 5 years; however, only 26% had long‐term survival. Although the majority of patients eventually succumbed to their disease, local and regional control was obtained initially in 92% of the group. These data indicate that prolonged survival is possible with mucosal melanoma of the head and neck; however, recurrence or metastasis remain possible many years after the initial

ISSN:1043-3074    

DOI:10.1002/hed.2880130104

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1991

数据来源: WILEY

摘要:

AbstractOne of the current national prospective clinical trials of the Head and Neck Intergroup explores the usage of chemotherapy in advanced operable head and neck cancer patients. The experimental arm consists of the addition of 3 courses of cisplatin‐containing chemotherapy to standard treatment defined as surgery followed by postoperative radiotherapy. In the design of the study it is necessary to define not only the extent of the surgery performed for each eligible lesion, but also to insure uniformity of surgery performed between surgeons and institutions. This will hopefully insure that any variation between the 2 arms of the study represent the effect of the chemotherapy. The procedure to obtain and confirm uniformity of surgery is multifaceted. It is, however, fundamentally based upon the current TNM staging system and therefore has intrinsic limitation

ISSN:1043-3074    

DOI:10.1002/hed.2880130105

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1991

数据来源: WILEY

摘要:

AbstractSwallowing function was evaluated with scintigraphy in 37 patients with head and neck cancer. The patients were examined before and during the course of either surgery, chemotherapy, and/or radiotherapy. A total of 118 scintigraphic studies were performed. Scintigraphic results of bolus flow and aspiration were correlated with clinical findings. Both scintigraphic and clinical studies indicated a worsened swallowing function in 12 patients. These same studies indicated improvement of swallowing in another 13 patients. In 11 patients, both studies revealed either no apparent change or mixed changes in swallowing function after the course of therapy. In only 1 patient was there disagreement between the scintigraphic and clinical assessment of swallowing function. It is our opinion that scintigraphy is a useful method for objective assessment of swallowing function during and after the course of treatment of head and neck cancer patients.

ISSN:1043-3074    

DOI:10.1002/hed.2880130106

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1991

数据来源: WILEY

摘要:

AbstractHistologic analysis of squamous cell carcinoma of the lower alveolus shows 2 basic patterns of tumor spread in relation to the mandible: an infiltrative one and an expansive one. While the tumor invades the mandible by destroying the bone or through cortical defects or some spaces in the infiltrative form, the tumor does this only by eroding the bone in the expansive form, in which the degree of bone resorption seems to be proportional to tumor advancement. A comparison between radiologic and histologic features discloses that the radiologically detected bone defects are not necessarily correlated with the patterns of bone involvement. However, most lesions with erosive bone defects show the expansive pattern histologically, and the extent of the radiologically detected bone defect is roughly in accordance with the histologic extent of bone involvement. These results lead us to believe that some squamous carcinoma of the lower alveolus could be treated successfully without sacrificing the continuity of the mandible.

ISSN:1043-3074    

DOI:10.1002/hed.2880130107

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1991

数据来源: WILEY

摘要:

AbstractFree tissue transfer has become an important adjunct in the reconstruction of head and neck cancer patients. Despite the success, the added time required to perform free flap reconstructions continues to be a concern for some head and neck surgeons. In order to investigate whether this added time increases the risk of medical complications to the patient, 20 consecutive free flap patients were compared to 20 age‐, site‐, and histology‐matched controls. These patients were analyzed for demographic data, American Society of Anesthetic risk scores, stage, tumor site, and pre‐ and postoperative medical problems. The mean occurrence of medical problems preoperatively was 1.1 occurrences per patient for the flap group and 1.5 occurrences per patient for the control group. Postoperatively, there were 0.75 occurrences per flap group and 0.9 occurrences for the control group. Neither of these was statistically significant. The length of hospitalization was 13.5 days for the control group and 15.9 days for the flap group. Again, this was not statistically significant. The only significant statistic difference was the length of the procedure: 6.95 hours for the control group and 11.0 hours for the flap group, which had apvalue of less than 0.001. In conclusion, this study indicates that length of procedure alone should not be a determining factor in deciding whether or not to use immediate microvascular reconstruction in head and neck cancer p

ISSN:1043-3074    

DOI:10.1002/hed.2880130108

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1991

数据来源: WILEY

摘要:

AbstractA case of a tumor of the vagus nerve, showing typical features of a neurofibroma, is presented. The natural history is reviewed, and several technical investigations, with particular reference to the contributions of magnetic resonance imaging and immuno‐histochemical techniques in the differential diagnosis, are discusse

ISSN:1043-3074    

DOI:10.1002/hed.2880130109

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1991

数据来源: WILEY

摘要:

AbstractCongenital middle ear encephalocele (CMEE) is a rare entity, previously reported in only 29 patients. It might originate from dehiscence of the tegmen tympani or antri or the bony plate of the posterior fossa. The common presenting symptoms are spontaneous cerebrospinal fluid (CSF) otorrhea and/or rhinor‐rhea, persistent “serous otitis media,” conductive hearing loss, and, occasionally, recurrent meningitis. We report a case of CMEE initially seen with progressive facial paresis, review the previously reported cases of CMEE, and discuss the pathogenesis and surgical manag

ISSN:1043-3074    

DOI:10.1002/hed.2880130110

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1991

数据来源: WILEY

ISSN:1043-3074    

DOI:10.1002/hed.2880130111

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1991

数据来源: WILEY