The relationship of nasopharyngeal carcinomas and second independent malignancies based on the Radiation Therapy Oncology Group experience

Article Abstract:

While nasopharyngeal cancer is not common in the United States, it occurs more frequently in China. When Chinese move to the United States, their risk of nasopharyngeal cancer is reduced, but remains higher than that of others. Nasopharyngeal cancer is also associated with the Epstein-Barr virus, and it seems, therefore, that the development of nasopharyngeal cancer is a complex interaction of genetic background, environmental influences, and viral infection. Since many patients treated for cancer are more likely than members of the general population to develop a second cancer, an investigation was undertaken to determine the likelihood of second cancers in patients with nasopharyngeal cancer and patients with head and neck cancer. Consulting the database of the Radiation Therapy Oncology Group, over 5,500 patients were identified who had cancer of the head or neck. Of these, 121 patients were identified who had squamous cell carcinoma of the nasopharynx; they were treated only with irradiation for their initial management, and experienced total regression of the tumor. An overall incidence of second malignancies of 4.1 percent was found in this group. This rate of cancer development is not significantly different from that which would be expected from a normal population of the same age distribution as the nasopharyngeal cancer patients. This is in contrast to the case for head and neck cancer, in which the patients have a significantly higher likelihood of developing a second cancer. The authors suggest that these findings might be explained by the concept of ''field carcinogenesis''. According to this concept, different factors contributing to the development of cancer affect different anatomical fields. Presumably, the factors contributing to head and neck cancer would affect a much larger field than those contributing to nasopharyngeal cancer. Therefore, since a much larger susceptible area is present in the head and neck cancer patients, their probability of developing a second cancer is greater as well. (Consumer Summary produced by Reliance Medical Information, Inc.)

Statistics, Cancer, Cancer recurrence, Nose cancer

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Concomitant cisplatin chemotherapy and radiotherapy in advanced mucosal squamous cell carcinoma of the head and neck: long-term results of the Radiation Therapy Oncology Group Study 81-17

Article Abstract:

The effects of the anticancer agent cisplatin combined with standard radiation treatment were assessed in 124 patients with advanced mucosal squamous cell carcinoma of the head and neck. A complete response, indicated by the elimination of the tumor, was initially observed in 73 percent of patients treated with this regimen. The percentage of patients experiencing a complete response increased to 90 percent when the hard protein keratin was no longer detected in the sample taken for microscopic examination. Of all cancerous sites, the nasopharynx had the highest complete response, at 89 percent. Four years after the start of treatment, the control rate was estimated at 43 percent and survival was estimated at 34 percent. Both the control of the tumor by drug therapy and radiation and the survival of patients were greater in cases without evidence of keratin in specimens than in those where keratin was detected in the specimens. Therapy with cisplatin and irradiation was associated with an early toxic effect on the kidney, leading to death in one case and life-threatening kidney damage in two others. Late toxic effects of this treatment regimen included necrosis, or tissue death; fibrosis, or the formation of fiber-like tissue; and the development of a fistula, an abnormal tube-like passage from a normal cavity or tube to a free surface or to another cavity. Further studies are needed to compare the effectiveness of combined cisplatin and irradiation with that of irradiation alone in treating patients with advanced mucosal carcinomas of the head and neck. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Squamous cell carcinoma, Cisplatin

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Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck

Article Abstract:

Inspite of using resection and postperative radiotherapy, high-risk squamous-cell carcinoma of the head and neck frequently occurs in the original tumour bed. Tests are conducted on the postoperative administration of cisplatin and radiotherapy which would improve the rate of local and regional control.

United States, Usage, Diagnosis, Postoperative care

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