Prevention of second primary tumors with isotretinoin in squamous-cell carcinoma of the head and neck

Article Abstract:

Although surgery and radiotherapy are effective against primary squamous-cell carcinoma (a type of cancer) of the head and neck, tumors recur in between 30 and 50 percent of treated patients. An additional 20 to 30 percent of treated patients develop distant metastasis (spread), and yet another large group develop a second primary tumor. Second primary tumors account for most deaths among patients treated for early disease. Retinoids, a class of compounds derived from vitamin A, appear to be active against cancers of the epithelia (the lining of the mouth, respiratory tract, and lung). To test the effectiveness of a synthetic retinoid, isotretinoin, 100 patients, who had undergone surgery or radiotherapy, or both, were evaluated for primary squamous-cell carcinoma of the oral cavity, pharyngeal area, or larynx. All of the patients were free of disease when the study began. They were randomly assigned to receive either isotretinoin or placebo (an inactive drug) for 12 months, and monitored for several months longer by regular physical examinations, laboratory tests, and chest X-rays. Failure of the primary treatment (a cancer at the same or nearby site) or the appearance of second primary tumors (which could be at different sites) were noted. The results showed that the proportion of placebo and isotretinoin patients did not differ in regard to disease progression; however, the isotretinoin group had significantly fewer second primary tumors (4 percent as compared with 24 percent). Toxic effects due to the drug included skin dryness, lip inflammation, increased blood levels of triglycerides, and conjunctivitis (inflammation of the membrane covering the eyeball). One third of the patients in the isotretinoin group dropped out of treatment because of side effects or noncompliance; these patients were included in the statistical analysis, so the true effect of isotretinoin may be considerably better than it appeared. The findings suggest that isotretinoin could be a valuable chemopreventive agent against carcinoma of the head and neck. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Drug therapy, Head and neck cancer, Isotretinoin

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The influence of resection and aneuploidy on mortality in oral leukoplakia

Article Abstract:

The complete resection of oral leukoplakia does not prevent carcinoma and that, oral carcinoma arising from aneuploid leukoplakia has aggressive clinical behavior despite the use of standard treatment. The oral erythroplakia with aneuploidy, which is rare and aggressive, is associated with a high risk of death.

United States, Diagnosis, Complications and side effects, Influence, Excision (Surgery), Aneuploidy

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Molecular markers of the risk of oral cancer

Article Abstract:

An examination for chromosomal changes in tissue samples from patients with oral leukoplakia may identify those with a high risk of developing oral cancer. Oral leukoplakia is considered a precursor of oral cancer and patients with normal chromosomes are unlikely to develop cancer.

Editorial

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