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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A concurrent randomised controlled clinical trial to evaluate a combination of Bleomycin and radiation as against radiation only in the treatment of advanced oral cancer has been conducted at the Cancer Institute, Madras, since 1971. All T3 and T4 previously untreated oral squamous cell carcinomas with N0, N1 and N2 regional nodes, or N3 nodes confined to the submandibular region, without systemic metastases or gross infiltration of the temporal and infratemporal fossa producing total trismus, and in decent general health were eligible for the trial. Patients with gross active pulmonary tuberculosis were excluded, as were recurrent carcinomas. Age, external fungation of growth or radiological bone invasion were no bar. Randomisation was done by the sealed envelope technique. The study group received concurrent fractionated cobalt 60 teletherapy using two opposing fields and 10-15 mg of Intra-arterial or Intravenous Bleomycin. The controls received fractionated cobalt teletherapy and i.v. or i.m. distilled water on the same protocol as the Bleomycin cases. All cases were evaluated double blind 8 weeks after the end of radiation therapy, and were classified as 'favourable response' or 'failure'. The criterion of 'favourable response' was 'total clinical healing of the tumour within the volume of irradiation with no subsequent recurrence within that volume, whatever the length of follow up'. Anything else was reported as a failure. A long term follow up of 3 years is also available. 136 cases have completed the trial. The favourable response in the study group was 77% as against 20.9% in the control group. The differential response is statistically significant. The present study is the fourth in the series of combined therapeutic trials conducted in advanced oral squamous cell carcinoma since 1958. (Krishnamurthi and Shanta, 1963, 1965, 1967 and 1971). A concurrent randomised controlled clinical trial to evaluate the combination of Bleomycin and radiation as against radiation only in treatment of advanced oral cancer has been conducted at the Cancer Institute, Madras since 1971.
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PMID:Combined therapy of oral cancer bleomycin and radiation: a clinical trial. 6 44

In 1986, a new follow-up programme for patients with oral cancer was introduced in our department. The follow-up programme included liver function tests, tumour markers and radiological examination. 63 patients were monitored to the end of 1990. The results showed that serum Carcinoembryonic Antigen (CEA) assays were not sensitive enough to detect early cancer, recurrences or metastases. Neither was there any difference between the preoperative CEA levels of patients with and without recurrence during follow-up. The levels of salivary CEA, were similar to those of healthy individuals. Serum CA 19-9 values were consistently normal. In 1 patient, the first sign of liver metastases was a high 5-nucleotidase level. No recurrences were detected by radiological examination. In conclusion, the importance of frequent and careful clinical observation is emphasized; all 20 recurrences at the primary site and in local lymphnodes were detected by clinical examination. For detection of oral cancer recurrences, several laboratory and radiological examinations seem unnecessary. The cost-benefit of those examinations is significantly low.
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PMID:Tumour markers and radiological examinations in the follow-up of patients with oral cancer. 135 4

Persistent and/or late complications were analysed in 64 patients (183 fields) that were treated with combined hyperthermia and radiation therapy for advanced, recurrent or metastatic cancer. The incidence and type of complications were evaluated over a minimum follow-up period of 2 years from the onset of treatment (mean 38.7 months; range 24-82.5 months). The primary malignancies included: breast (39), melanomas (6), adenoid cystic carcinomas of salivary glands (4), prostate (4), soft tissue sarcomas (3), squamous cell carcinoma of head and neck (3), lymphomas (3), transitional cell carcinoma of bladder (1) and basal cell carcinoma of the skin (1). The persistent complications noted included induration and fibrosis (39 hyperthermia fields, 22 patients), ulceration at the site of prior tumour (three patients, three fields), and ulceration in normal tissue (one patient, one field). Brachial plexopathy developed in one patient treated for recurrent breast cancer, but she had active disease at that time. A squamous cell carcinoma of the skin developed within the treatment field in a breast cancer patient. Radionecrosis of the mandible was seen in one patient treated for a floor of the mouth cancer, and osteomyelitis with septic arthritis developed in one patient treated for a soft tissue sarcoma of the thigh. Univariate logistic regression analyses of pretreatment and radiation-hyperthermia treatment parameters revealed that maximal tumour temperature had a borderline significant correlation with the development of complications (p = 0.07). Multivariate analyses of the pretreatment and treatment parameters revealed the best-two-covariate model to predict complications included mean maximal tumour temperature and tumour type (macroscopic tumours had greater incidence of complications than for microscopic residual disease). The rate and type of persistent and/or late complications seen following combined radiation and hyperthermia did not appear to dramatically differ from those that would be anticipated from irradiation alone in this patient population, with the exception of an increased incidence of areas of induration and tumour necrosis.
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PMID:Persistent and/or late complications of combined radiation therapy and hyperthermia. 147 99

Oral cancers represent approximately 3% of all cancers diagnosed in the United States. Oral cancer is one-fifth as common as cancer of the breast, colon, and lung but more than twice as common as cervical cancer. Incidence rates for oral cancer are highest among older men. Epidemiologic data identify alcohol and tobacco as major risk factors associated with the disease. Screening for oral cancer is a simple, non-invasive procedure which can be easily incorporated into the comprehensive assessment of older patients. Oral cancer screening can detect early, localized lesions which are associated with an improved prognosis. Five-year survival rates are more than four times greater in individuals with localized lesions than those with distant metastases. Since older Americans visit their physician more often than their dentist, the physician's medical examination provides an excellent opportunity to screen for oral cancers.
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PMID:Oral cancer screening in the elderly. 174 Jun 6

Today, in the treatment of oral cancer, combined resection and reconstructive surgery has shown marked progress. Especially, the surgical procedures of bone graft after mandibulectomy have been seen widespread application. In the treatment of nasopharyngeal cancer, adjuvant chemotherapy after therapeutic dose of irradiation indicates a better survival rate than radiation alone, and in advanced nasopharyngeal cancer, a wide resection is effective for cure. In the surgical treatment of hypopharyngeal cancer, by the immediate reconstruction of pharynx with jejunum, patients can eat orally in a short time. The most important problem in the treatment of head and neck cancer is development of effective chemotherapy against distant metastases.
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PMID:[Recent progress in the treatment of oral and pharyngeal cancer]. 188 78

One hundred and forty nine patients with carcinoma of the tongue or floor of mouth were treated with interstitial irradiation (+/- external beam therapy) using caesium needles or iridium wires between 1970 and 1986. Multivariate analysis showed the main predictors of outcome to be tumour stage, site and histology. Caesium and iridium techniques gave similarly good local control rates of 90% at 5 years for T1 and T2 tumours when used as the standard departmental method. Local failure was shown to have a major impact on the risk of dying from disease and elective neck irradiation (ENI) conferred a favourable benefit on neck control and survival provided the primary site was controlled. Patients less than 40 years of age appeared to have an unfavourable prognosis. Radical irradiation including interstitial techniques gives excellent results in early oral cancer and is the treatment of choice for T2 tumours. We recommend elective neck irradiation in patients at high risk of developing lymph node metastases.
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PMID:Interstitial irradiation for carcinoma of the tongue and floor of mouth: Royal Marsden Hospital Experience 1970-1986. 192 54

Sera from 47 healthy controls, 18 normal individuals with the habit of tobacco chewing, 43 patients with oral precancerous (PC) conditions, and 40 patients with oral cancer (OC) were studied for the levels of total sialic acid (TSA), lipid-bound sialic acid (LSA), mucoid proteins, and protein-bound hexoses (PBH) (galactose and mannose). The changes in the glycoconjugate levels were insignificant between the controls and the normal tobacco chewers. All four parameters were significantly elevated in oral PC patients compared with controls. The levels of PBH and LSA showed significant increase in the oral PC patients compared with the normal tobacco chewers. A significant increase was observed in the levels of TSA, LSA, mucoid proteins, and PBH in OC patients compared with controls, normal tobacco chewers, and patients with oral PC. Increasing levels of all the biomarkers were found with progression of the malignant disease. Elevations in the levels of TSA and LSA were statistically significant in Stage IV patients compared with Stage III patients. The patients with metastases had higher levels of the biomarkers than the patients with primary OC. However, elevations only in LSA levels were statistically significant. These results suggest that evaluations of the serum glycoconjugate levels may be useful in diagnosis of the patients with oral PC or OC. In addition to their value in early detection, they can also help in staging of the disease.
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PMID:Usefulness of serum glycoconjugates in precancerous and cancerous diseases of the oral cavity. 198 9

The serum level of immunosuppressive substance (IS) was studied in 40 patients with primary oral cancer and in 79 patients without cancer. Its usefulness was evaluated as a parameter for monitoring therapy as well as recurrence of the tumors. Mean values for serum IS in patients with cancer and patients without were 687 +/- 284 micrograms/mL and 464 +/- 153 micrograms/mL, respectively. Normal healthy controls had a mean value of 431 +/- 105 micrograms/mL, with the cutoff value set at 641 micrograms/mL (mean +2 SD). Patients without cancer who had a severe infectious disease showed conspicuously high serum IS levels, and these values were closely correlated with their C-reactive protein values. The positive rate of IS increased in all patients with oral cancer was 58%. The mean level of serum IS in cancer patients was significantly higher than that of the controls (P less than .01), and the level was found to be more elevated as the stage of the disease advanced (stage I to III, 48%; stage IV, 68%). Histologic analysis of the tumor cells in patients with squamous cell carcinoma (SCC) showed that the mean serum IS level of those who had poorly differentiated SCC was much higher (937 +/- 181 micrograms/mL) than that of patients with well-differentiated SCC (616 +/- 159 micrograms/mL). Patients who had recurrent or metastatic cancer, or those who died from the cancer exhibited marked elevation of the serum IS levels, whereas patients who remained free of cancer in the follow-up period showed significantly lower serum IS levels. The rise and fall of the serum IS level was closely correlated with the disease progression and/or remission. These data strongly suggest that serum IS is a useful parameter for monitoring the disease stage as well as the effect of therapy on patients with oral cancer.
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PMID:Evaluation of the serum level of immunosuppressive substance in oral cancer patients. 199 88

In the U.S. oral cancer accounts for 2.1% of all cancers and 1% of cancer deaths. Two to three times as many males as females are affected. Blacks have more intra-oral cancer than whites, and their incidence and mortality rates have increased in recent years. The etiologic process very likely involves several factors. The major etiologic agents are tobacco (all types) and alcoholic beverages. Herpes simplex virus, human papilloma virus, and Candida have been implicated. Host factors include poor state of dentition, nutritional aberrations, cirrhosis of liver, lichen planus, and immunologic impairmant. Cellular changes include amplification of some oncogenes, alterations in antigen expression, production of gamma-glutamyl transpeptidase, and disturbance of keratin and involucrin production. Experimentally, cancer is readily produced on the hamster cheek pouch and rat oral mucosa. Unlike oral cancer in humans, most experimental lesions are exophytic, and they rarely metastasize.
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PMID:Oral cancer. 212 24

Malignant tumors of the oral cavity make up approximately 4% of all cancers occurring in men and 2% in women. In spite of this relatively small incidence, the functional and cosmetic disabilities resulting from this disease produce a profound impact on those stricken. Although the oral cavity is one of the most accessible areas to inspection and palpation, most patients developing oral cavity cancer present with advanced disease. Regional metastases are present in approximately 30% of these patients. A number of therapeutic modalities are available for management of cancer of the oral cavity. The most important include surgical excision, radiation therapy, chemotherapy, or a combination of two or more of these modalities. Surgery and radiotherapy are equally successful in controlling smaller tumors, but advanced tumors are best treated with a combination of surgery and irradiation with or without the addition of chemotherapy. Although combined therapy continues to become more common, it has had little impact on survival rates. Most patients dying of oral cavity cancer die of local regional disease. It is this group of patients that will benefit from newer surgical approaches that can provide an opportunity to increase control of local disease. We believe that an interdisciplinary approach combining the skills of the head and neck oncologic surgeon and the Mohs surgeon may provide a more effective method of controlling oral cancer, while at the same time lessening the functional and cosmetic deformities that frequently result following surgical treatment of this disease. Complete microscopic analysis of all surgical margins (as opposed to random analysis of isolated margins) theoretically should ensure better local control of cancers involving the oral cavity.
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PMID:Cancer of the oral cavity and Mohs surgery. 267 89


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