No abstract available.
Drug Therapy, Combination* ; Head and Neck Neoplasms* ; Head* ; Humans

Facial Neoplasms ; drug therapy ; Head and Neck Neoplasms ; drug therapy ; Humans ; Mouth Neoplasms ; drug therapy

Head and neck cancers comprise a heterogenous group of cancers that require a multidisciplinary approach. Surgery, radiation therapy, chemotherapy and, more recently, target therapy are often employed in various combinations in an attempt to eradicate both clinically apparent and occult disease. The role of chemotherapy in multimodality treatment for locally advanced head and neck squamous cell carcinoma, although firmly established, presents several unresolved issues. Concomitant platinum-based chemoradiation (CRT) is a standard treatment for unresectable, resectable but nonsurgically treated, and postoperative high-risk patients with locally advanced head and neck squamous cell carcinoma. Cetuximab administered concomitantly with radiotherapy has not been directly compared with CRT but offers a potential different approach using a noncytotoxic systemic agent. In recent years taxanes have been shown activity in head and neck cancers and are being incorporated into neo-adjuvant and concomitant chemotherapy regimens.
Carcinoma, Squamous Cell ; Chemoradiotherapy ; Drug Therapy* ; Head ; Head and Neck Neoplasms* ; Humans ; Neck ; Radiotherapy ; Taxoids ; Cetuximab

Patients who have the head and neck cancer are usually treated by surgery, radiation therapy, chemotherapy, or combinations of them. These treatments can induce variable degree of aspiration with dysphagia. The type and severity of aspiration depends on the size and location of the original tumor, the structures involved, and the treatment modality used for treatment. The management of aspiration after the head and neck cancer's treatment begins with an accurate evaluation for the cause and mechanism of aspiration through modified barium swallow (MBS) and fiberoptic endoscopic examination of swallowing (FEES). Then, the clinician can use postures, maneuvers, and exercises to treat the swallow disorder and to help the patient achieve optimal function. To achieve optimal swallowing without aspiration, multidimensional rehabilitation by various medical personnel is definitely necessary.
Barium ; Deglutition ; Deglutition Disorders ; Drug Therapy ; Exercise ; Head and Neck Neoplasms ; Head ; Humans ; Neck ; Posture ; Rehabilitation

BACKGROUND AND OBJECTIVES: Treatment of head and neck cancer with cisplatin-based combination chemotherapy has yielded increased complete response rates. In spite of the initial good response, recurrent cancer after chemotherapy does not respond to cisplatin based chemotherapy. In recent years, the analogues of taxol have used in a new chemotherapy treatments for head and neck cancer. The purpose of this study was to develop the acquired resistance to cisplatin in head and neck cancer cell line and to study the cross-resistance of docetaxel and 5-fluorouracil (5-FU) as compared to the parental cells in vitro. SUBJECTS AND METHOD: Two different human head and neck cancer cell lines (PNUH-12, SNU-899) were studied. We developed two cisplatin resistant cell lines (PNUH-12 R1, SNU-899 R1) by exposing them to near continuous increasing concentration of cisplatin. The morphology, growth curve of resistant cell lines were studied and the resistance of these cell lines to the cisplatin, docetaxel and 5-FU were compared to that of parental cells by MTT assay. RESULTS: The pattern of growth and shape of PNUH-12 R1 and SNU 899 R1 cell lines showed similarity to their parent cell lines. The growth curve of these cell lines were suppressed when compared with the parental cells. When compared to the parental cells, PNUH-12 R1 cells were 2.0-fold, 3.8-fold, and 1.4-fold resistant, and SNU 899 R1 cells 3.5-fold, 6.7-fold, and 15.0-fold resistant to cisplatin, docetaxel and 5-FU, respectively. CONCLUSION: In our study, cisplatin resistant cell lines of head and neck cancer have strong cross-resistance to docetaxel. However, there was difference in cross-resistance to 5-FU between these cell lines.
Cell Line* ; Cisplatin* ; Drug Therapy ; Drug Therapy, Combination ; Fluorouracil ; Head and Neck Neoplasms* ; Head* ; Humans ; Paclitaxel ; Parents

OBJECTIVE: To obtain detailed understanding on the gene regulation of natural compounds in altering prognosis of head and neck squamous cell carcinomas (HNSC). METHODS: Gene expression data of HNSC samples and peripheral blood mononuclear cells (PBMCs) of HNSC patients were collected from Gene Expression Omnibus (GEO). Differential gene expression analysis of GEO datasets were achieved by the GEO2R tool. Common differentially expressed gerres (DEGs) were screened by comparing DEGs of HNSC with those of PBMCs. The combination was further analyzed for regulating pathways and biological processes that were affected. RESULTS: Totally 110 DEGs were retrieved and identified to be involved in biological processes related to tumor regulation. Then 102 natural compounds were screened for a combination such that the expression of all 110 commonly DEGs was altered. A combination of salidroside, ginsenoside Rd, oridonin, britanin, and scutellarein was chosen. A multifaceted, multi-dimensional tumor regression was showed by altering autophagy, apoptosis, inhibiting cell proliferation, angiogenesis, metastasis and inflammatory cytokines production. CONCLUSIONS This study has helped develop a unique combination of natural compounds that will markedly reduce the propensity of development of drug resistance in tumors and immune evasion by tumors. The result is crucial to developing a combinatorial natural therapeutic cocktail with accentuated immunotherapeutic potential.
Humans ; Leukocytes, Mononuclear ; Head and Neck Neoplasms/drug therapy* ; Squamous Cell Carcinoma of Head and Neck/drug therapy* ; Immunotherapy ; Prognosis

Head and neck squamous cell carcinoma has emerged as the sixth most commonly occurring cancer worldwide and despite advances in diagnostics and therapeutics, the treatment results and survival outcomes still remain poor, especially in advanced cancers. Due to the complexity of the local anatomic structures and the importance as vital functioning organs, the head and neck area following conventional treatment modalities such as surgery, chemotherapy, or radiotherapy often result as a devastating consequence both esthetically and functionally. In order to minimize the treatment related sequelae and at the same time maximize treatment effect, tumor-specific molecular targeted therapy has become an area under active research. Several molecular targeted agents, including the representative epidermal growth factor receptor (EGFR)-inhibitors have been developed and its therapeutic effects investigated. However, therapeutic resistance has newly risen as a main problem following targeted therapy due to a variety of resistance mechanisms. This review article looks at the major acquired resistance mechanisms following targeted agents administration including EGFR inhibitors and many others and strategies to overcome the resistance to achieve precision medicine.
Carcinoma, Squamous Cell ; Drug Therapy ; Head and Neck Neoplasms* ; Head* ; Molecular Targeted Therapy ; Neck ; Radiotherapy ; Receptor, Epidermal Growth Factor

BACKGROUND AND OBJECTIVES: Telomerase activity appears to be associated with cell immortalisation and malignant progres-sion. Telomerase activity has been found in the majority of human tumours, but not in most somatic cells or tissues. We studied the change in the telomerase activity by cisplatin and 5-fluorouracil (5-FU) in head and neck cancer cell lines. SUBJECTS AND METHODS: Three different human head and neck cancer cell lines (PNUH-12, SNU-899, HEp-2) were studied. Cell cytotoxi-city and change of telomerase activity by 5-FU and cisplatin treatment were assessed by MTT and TRAP assays. RESULTS: The telomerase activity was detected in the head and neck cancer cell lines. After the cisplatin treatment, the telomerase activity was decreased in a concentration-dependent manner. However, after 5-FU treatment, the telomerase activity showed a slight decrease or no change at the concentration similar to that of cisplatin in the inhibition of tumor growth. CONCLUSION: Our results can explain one of the reasons why cisplatin is more effective than 5-FU in the chemotherapy of head and neck cancer.
Cell Line* ; Cisplatin* ; Drug Therapy ; Fluorouracil* ; Head and Neck Neoplasms* ; Head* ; Humans ; Telomerase*

PURPOSE: In locally advanced head and neck cancer, radiation therapy is currently unsatisfactory because the end result is often limited regional disease control and survival. A clinical study was carried out to compare the effectiveness between the radiation therapy and the combined chemotherapy and radiation therapy. MATERIALS AND METHOD: Thirty-six patients with previously untreated, locally advanced squamous cell carcinoma of the head and neck were treated with radiotherapy alone and combined chemo-radiotherapy. Induction chemotherapy was administered 2~3 cycles, consisting of intravenous cisplatin (100 mg/m2 on day 1) and 5-fluorouracil (1000 mg/m2/day for 5 days as a continuous infusion) every 4 weeks followed by 7~8 weeks of radiation therapy for a total dose of 60~75 Gy. RESULTS: 1) Among 36 locally advanced head and neck cancer, 17 patients received radiation therapy alone and 19 patients received combined chemo-radiotherapy, respectively. 2) Response rate was 47% (complete response 29%, and partial response 18%) in radiation therapy group and 79% (complete response 37%, and partial response 42%) in combined chemo-radiotherapy group (p<0.05). 3) In median survival, radiation therapy group was 13 months and combined chemo- radiotherapy group was 15 months. Both groups were not significantly different (p>0.05). 4) Treatment related mortality was not noted, but the toxic effects were seen on the half cases of the both groups. Grade II toxicities were similar between the two arms. CONCLUSION: Combined chemotherapy and radiation therapy was more effective in local control but not superior in survival than radiation therapy alone. Continuous evaluation and identification of proper sequence for the therapeutic modality is supposed to prolong the survival of patients.
Arm ; Carcinoma, Squamous Cell ; Cisplatin ; Drug Therapy* ; Fluorouracil ; Head and Neck Neoplasms* ; Head* ; Humans ; Induction Chemotherapy ; Mortality ; Neck ; Radiotherapy

PURPOSE: To investigate set-up errors, suggest the adequate planning target volume (PTV) margin and image-guided radiotherapy frequency in head and neck (H&N) cancer treated with intensity-modulated radiotherapy (IMRT) assessed by kV cone-beam computed tomography (CBCT). METHODS: We analyzed 360 CBCTs in 60 patients with H&N cancer treated with IMRT. The target delineation was contoured according to ICRU62. PTVs were generated by adding a 3–5 mm margin in all directions to the respective clinical target volumes. The kV CBCT images were obtained at first three days of irradiation and weekly thereafter. The overall mean displacement, range, systematic (∑) and random (σ) errors were calculated. Adequate PTV margins were calculated according to the van Herk formula (2.5∑ + 0.7r). RESULTS: The mean of set-up errors was less than 2 mm in any direction. The overall frequency of set-up displacements greater than 3 mm was 3.9% in medial-lateral (ML) direction, 8% in superior-inferior (SI) direction, and 15.5% in anterior-posterior (AP) direction. The range of translations shifts was 0–9 mm in ML direction, 0–5 mm in SI direction and 0–10 mm in AP direction, respectively. After systematic set-up errors correction, the adequate margin to overcome the problem of set-up errors was found to be less than 3 mm. CONCLUSION: Image-guided kV CBCT was effective for the evaluation of set-up accuracy in H&N cancer. The kV CBCT at first three fractions and followed-by weekly appears adequate for reducing significantly set-up errors in H&N cancer treated with IMRT technique. Finally, 3–5 mm PTV margins appear adequate and safe to overcome the problem of set-up errors.
Cone-Beam Computed Tomography ; Drug Therapy ; Head and Neck Neoplasms ; Head ; Humans ; Neck ; Radiotherapy ; Radiotherapy, Image-Guided ; Radiotherapy, Intensity-Modulated ; Translations