ISSN:1043-3074    

DOI:10.1002/hed.2880120102

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

年代:1990

数据来源: WILEY

摘要:

AbstractThe National Cancer Institute Organ Systems Program‐sponsored Upper Aerodigestive Cancer Task Force workshops are specifically designed to enhance interactions between basic science and clinical investigators and between academic institutions and the community, and ultimately will contribute to more expeditious clinical advances. The third workshop in this series focused on the rapidly expanding area of chemoprevention of upper aerodigestive epithelial cancers. The first two sessions were devoted to discussion of in vitro and animal‐model data documenting the multistep process of squamous differentiation and carcinogenesis, associated molecular and biochemical alterations, and modulation by chemopreventive agents. Animal‐model studies have identified several promising chernopreventive agents and synergistic combinations for clinical trial. The last two sessions reviewed nutritional epidemiology, major methodologic issues of large intervention studies, and the novel concept of biologic markers as intermediate endpoints for chemoprevention t

ISSN:1043-3074    

DOI:10.1002/hed.2880120103

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

年代:1990

数据来源: WILEY

摘要:

AbstractTwenty‐six patients with head and neck tumors were submitted to 27 microvascular reconstructive procedures. In 15, the mandible was reconstructed using the rib (4), iliac crest (7), and scapula (4). Nine patients underwent craniofacial reconstructions with the latissimus dorsi (5), rectus abdominis (2), greater omentum (2), and scapular (1) flaps. Two patients received a jejunum (1) and a stomach plus greater omentum (1) flaps for pharyngoesophageal reconstruction. Three illustrative cases, one from each group, are presented in detail. Good results were obtained in 22 patients (85%), with both functional and morphological rehabilitation. There were five flap losses (two in the same patient) due to thrombosis of the microvascular anastomoses. There was no operative mortality, and the average operative time was 11 hours. The good results observed in these very advanced cases show that there is a place for these complex procedures in the treatment of selected cases of head and neck tumor

ISSN:1043-3074    

DOI:10.1002/hed.2880120104

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

年代:1990

数据来源: WILEY

摘要:

AbstractA retrospective analysis was performed on 410 patients with nasopharyngeal carcinoma of squamous or undifferentiated histotype. All patients were classified according to the classification of the American Joint Committee for Cancer Staging and End‐Results Reporting (AJC) and to that of the International Union Against Cancer (UICC, Geneva, 1978). The following prognostic factors were investigated by means of a Weibull multiple regression model: sex, age, histology, primary tumor extent, and nodal metastasis extent. With the exception of sex, all factors significantly influenced survival. With regards to nodal extent, only the level of the involved nodes was a significant variable. Both AJC and UICC classifications, when applied to the entire series of patients, appeared to be unsatisfactory. The authors propose an alternative classification based on a prognostic scoring system directly derived from the Weibull mode

ISSN:1043-3074    

DOI:10.1002/hed.2880120105

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

年代:1990

数据来源: WILEY

摘要:

AbstractThe prognostic significance of tumor regression following radiotherapy was evaluated in 1,897 patients with oro‐ and pharyngo‐laryngeal cancer. Complete tumor regression occurred in 62% and 80% at the end of treatment and 2 months later, respectively. Complete regression was significantly higher for early tumors than for advanced stages and for exophytic lesions compared to deeply infiltrative cancers. Depending on tumor location, 75% to 90% of T1, T2stages and 50% to 80% of more advanced tumors were locally controlled in patients who experienced complete tumor regression at 2 months. The local failure rate was at least 80% for those who did not have complete regression. The local failure rate for the incomplete responder was the same for early and advanced tumors. Complete tumor clearance following radiotherapy is a reliable indicator of permanent local control. Tumor regression after a dose of 5,000 to 5,500 cGy should be used as a guide to select patients who could be treated by either radical irradiation or surg

ISSN:1043-3074    

DOI:10.1002/hed.2880120106

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

年代:1990

数据来源: WILEY

摘要:

AbstractThe serum level of a variety of substances shows significant changes in head and neck cancer patients. Such substances are collectively called biochemical tumor markers. To date, most markers lack a high degree of specificity and sensitivity. However, serial measurement of markers showing elevated pretreatment levels may help in monitoring response to therapy. Other potential uses of tumor markers include earlier detection of recurrence and/or metastasis, and possible prediction of prognosis. Measurement of more than one marker seems to enhance the diagnostic accuracy of the test. Some markers show significant correlations with various immune parameters in head and neck cancer patients and may have a possible role in potentiating the immunodepressed status of such patients. A review of currently reported tumor markers in head and neck cancer showing their nature, sources, uses, and limitations is presented.

ISSN:1043-3074    

DOI:10.1002/hed.2880120107

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

年代:1990

数据来源: WILEY

摘要:

AbstractFrom January 1987 to May 1988, 16 patients with advanced squamous cell carcinoma of the head and neck received combined treatment, based on an alternating schedule of chemotherapy and multiple fractions per day (MFD)‐radiotherapy. The chemotherapy regimen consisted of cisplatin, 20 mg/m2, followed by 5‐fluorouracil (5‐FU), 200 mg/m2i.v. push, from days 1 to 5 during weeks 1, 5, and 9. Radiotherapy was administered in two courses of 32 Gy each (total dose, 64 Gy) during weeks 2 and 3 and 6 and 7. Each course was given in two fractions per day, 5 days per week. The 16 patients were evaluated for toxicity and response. We observed 7 complete responders, 6 partial responders, and 3 nonresponders. The overall response rate was 81%. Toxicity was heavy: 44% of the patients developed grade III‐IV mucositis. Our results suggest that cisplatin and 5‐fluorouracil alternating with MFD‐radiotherapy is effective; however, a new less toxic scheduling must be d

ISSN:1043-3074    

DOI:10.1002/hed.2880120108

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

年代:1990

数据来源: WILEY

摘要:

AbstractAcute toxic shock syndrome (TSS), initially described in association with the use of super absorbent tampons in menstruating women, has complicated a variety of surgical procedures. Recent attention in head and neck surgery has focused on absorbent packing materials, such as those used in postoperative nasal care. It is important to maintain a high index of suspicion in all postoperative patients to fever, hypotension, and erythroderma. We report TSS following submandibular gland excision.

ISSN:1043-3074    

DOI:10.1002/hed.2880120109

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

年代:1990

数据来源: WILEY

摘要:

AbstractTwenty‐three tracheoesophageal speech failures were prospectively evaluated by clinical parameters and transnasal air insufflation at 3 L per minute. The results of testing allow an accurate indication of the etiology of the speech failure. Pharyngoesophageal spasm accounted for 79% of the failures; hypopharyngeal strictures for 26%. One patient was found to have both pharyngoesophageal spasm and a hypopharyngeal stricture. A modified air insufflation test result greater than 20 mm Hg reliably identified all tracheoesophageal speech failures prior to tracheoesophageal puncture. Clinical parameters were not helpful in identifying speech failures. Successful treatment of the specific etiology of the failure resulted in a reduction of the measured intraesophageal pressures. Ninety‐one percent of the tracheoesophageal speech failures were successfully rehabilitated and achieved fluent tracheoesophageal speech. Successful rehabilitation was associated with long‐term tracheoesophageal speec

ISSN:1043-3074    

DOI:10.1002/hed.2880120110

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

年代:1990

数据来源: WILEY

摘要:

AbstractModification of the single flap for neck dissection is described and illustrated based on experience with 33 cases of squamous cell carcinoma of the oral cavity. The advantages of this modified incision are that there are no three‐point junctions. Hence, it can be used after previous radiotherapy to the neck; the vertical limb is well posterior to the carotid artery, and the horizontal limb can be conveniently extended upward and forward to permit a combined resection of the jaw and/or tongue. To avoid necrosis at the apex of the skin flap, particularly after previous radiotherapy, a margin of about 1 cm can be removed prophylactically from the apex. This incision is recommended particularly for neck dissections in squamous cell carcinomas of the oral cavity in patients who have had previous radiotherapy and/or when resection of the mandible or the tongue is to be done at the same time. The incision is not recommended for bilateral neck dissections, nor for neck dissection combined with total laryngectomy or thyroidectom

ISSN:1043-3074    

DOI:10.1002/hed.2880120111

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

年代:1990

数据来源: WILEY