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Rabdomiossarcoma de cabeça e pescoço: 24 casos e revisão da literatura; Rhabdomyosarcoma of the head and neck: 24 cases and literature review

MORETTI, Giovana; GUIMARÃES, Ricardo; OLIVEIRA, Karisa Martins de; SANJAR, Fernanda; VOEGELS, Richard Louis
Fonte: Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial Publicador: Associação Brasileira de Otorrinolaringologia e Cirurgia Cervicofacial
Tipo: Artigo de Revista Científica
POR
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O rabdomiossarcoma (RMS) é o tumor maligno de partes moles mais comum na infância, localizando-se principalmente na cabeça e pescoço. Apresenta comportamento clínico-biológico variado, devendo receber terapia individualizada. OBJETIVO: Descrever os dados de pacientes portadores de RMS de cabeça e pescoço diagnosticados e tratados em um hospital comparando-os aos da literatura. Forma de Estudo: Descritivo retrospectivo. MATERIAL E MÉTODO: Análise retrospectiva de dados de prontuários de 24 pacientes portadores de RMS de cabeça e pescoço diagnosticados e tratados em um hospital no período de 1994 a 2008. RESULTADOS: A média de idade foi de 7,79 anos. Quanto ao sexo, encontramos 54,17% do sexo masculino e 45,83% do sexo feminino. Todos os pacientes foram submetidos a quimioterapia (QT), sendo que 62,5% destes também realizaram radioterapia (RT) e 16,67% foram submetidos a cirurgia. Dos 24 pacientes, 8 (33,3%) foram a óbito, 6 (25%) encontravam-se livres de neoplasia e 2 ( 8,3%) apresentaram recidiva do tumor. CONCLUSÃO: O RMS de cabeça e pescoço frequentemente se apresenta com sintomas inespecíficos. Terapia multimodal individualizada deve ser realizada, incluindo cirurgia, quimioterapia e radioterapia.; Rhabdomyosarcoma (RMS) is a malignant tumor of soft tissues...

Sexual behaviours and the risk of head and neck cancers: a pooled analysis in the International Head and Neck Cancer Epidemiology (INHANCE) consortium

HECK, Julia E.; BERTHILLER, Julien; VACCARELLA, Salvatore; WINN, Deborah M.; SMITH, Elaine M.; SHAN`GINA, Oxana; SCHWARTZ, Stephen M.; PURDUE, Mark P.; PILARSKA, Agnieszka; ELUF-NETO, Jose; MENEZES, Ana; MCCLEAN, Michael D.; MATOS, Elena; KOIFMAN, Sergio;
Fonte: OXFORD UNIV PRESS Publicador: OXFORD UNIV PRESS
Tipo: Artigo de Revista Científica
ENG
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Background Sexual contact may be the means by which head and neck cancer patients are exposed to human papillomavirus (HPV). Methods We undertook a pooled analysis of four population-based and four hospital-based case-control studies from the International Head and Neck Cancer Epidemiology (INHANCE) consortium, with participants from Argentina, Australia, Brazil, Canada, Cuba, India, Italy, Spain, Poland, Puerto Rico, Russia and the USA. The study included 5642 head and neck cancer cases and 6069 controls. We calculated odds ratios (ORs) of associations between cancer and specific sexual behaviours, including practice of oral sex, number of lifetime sexual partners and oral sex partners, age at sexual debut, a history of same-sex contact and a history of oral-anal contact. Findings were stratified by sex and disease subsite. Results Cancer of the oropharynx was associated with having a history of six or more lifetime sexual partners [OR = 1.25, 95% confidence interval (CI) 1.01, 1.54] and four or more lifetime oral sex partners (OR = 2.25, 95% CI 1.42, 3.58). Cancer of the tonsil was associated with four or more lifetime oral sex partners (OR = 3.36, 95 % CI 1.32, 8.53), and, among men, with ever having oral sex (OR = 1.59, 95% CI 1.09...

Cessation of alcohol drinking, tobacco smoking and the reversal of head and neck cancer risk

MARRON, Manuela; BOFFETTA, Paolo; ZHANG, Zuo-Feng; ZARIDZE, David; WÜNSCH-FILHO, Victor; WINN, Deborah M.; WEI, Qingyi; TALAMINI, Renato; SZESZENIA-DABROWSKA, Neonila; STURGIS, Erich M.; SMITH, Elaine; SCHWARTZ, Stephen M.; RUDNAI, Peter; PURDUE, Mark P.
Fonte: OXFORD UNIV PRESS Publicador: OXFORD UNIV PRESS
Tipo: Artigo de Revista Científica
ENG
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Background Quitting tobacco or alcohol use has been reported to reduce the head and neck cancer risk in previous studies. However, it is unclear how many years must pass following cessation of these habits before the risk is reduced, and whether the risk ultimately declines to the level of never smokers or never drinkers. Methods We pooled individual-level data from case-control studies in the International Head and Neck Cancer Epidemiology Consortium. Data were available from 13 studies on drinking cessation (9167 cases and 12 593 controls), and from 17 studies on smoking cessation (12 040 cases and 16 884 controls). We estimated the effect of quitting smoking and drinking on the risk of head and neck cancer and its subsites, by calculating odds ratios (ORs) using logistic regression models. Results Quitting tobacco smoking for 1-4 years resulted in a head and neck cancer risk reduction [OR 0.70, confidence interval (CI) 0.61-0.81 compared with current smoking], with the risk reduction due to smoking cessation after >= 20 years (OR 0.23, CI 0.18-0.31), reaching the level of never smokers. For alcohol use, a beneficial effect on the risk of head and neck cancer was only observed after >= 20 years of quitting (OR 0.60, CI 0.40-0.89 compared with current drinking)...

A clinical experience of the supraclavicular flap used to reconstruct head and neck defects in late-stage cancer patients

Alves, Helio R. N.; Ishida, Luis C.; Ishida, Luís Henrique; Besteiro, Julio Morais; Gemperli, Rolf; Faria, Jose C. M.; Ferreira, Marcus Castro
Fonte: ELSEVIER SCI LTD; OXFORD Publicador: ELSEVIER SCI LTD; OXFORD
Tipo: Artigo de Revista Científica
ENG
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The supraclavicular island flap has been widely used in head and neck reconstruction, providing an alternative to the traditional techniques like regional or free flaps, mainly because of its thin skin island tissue and reliable vascularity. Head and neck patients who require large reconstructions usually present poor clinical and healing conditions. An early experience using this flap for late-stage head and neck tumour treatment is reported. Forty-seven supraclavicular artery flaps were used to treat head and neck oncologic defects after cutaneous, intraoral and pharyngeal tumour resections. Dissection time, complications, donor and reconstructed area outcomes were assessed. The mean time for harvesting the flaps was 50 min by the senior author. All donor sites were closed primarily. Three cases of laryngopharyngectomy reconstruction developed a small controlled (salivary) leak that was resolved with conservative measures. Small or no strictures were detected on radiologic swallowing examinations and all patients regained normal swallowing function. Five patients developed donor site dehiscence. These wounds were treated with regular dressing until healing was complete. There were four distal flap necroses in this series. These necroses were debrided and closed primarily. The supraclavicular flap is pliable for head and neck oncologic reconstruction in late-stage patients. High-risk patients and modified radical neck dissection are not contraindications for its use. The absence of the need to isolate the pedicle offers quick and reliable harvesting. The arc of rotation on the base of the neck provides adequate length for pharyngeal...

Condições socioeconômicas e câncer de cabeça e pescoço; Socioeconomic standings and head and neck cancer

Boing, Antonio Fernando
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 07/12/2007 PT
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Foi realizado estudo caso-controle de base hospitalar, envolvendo pacientes diagnosticados com câncer de cabeça e pescoço e que participaram do "Estudo Multicêntrico Latino-americano de Fatores Ambientais, Vírus e Câncer da Cavidade Oral e Laringe" do projeto "Genoma Clínico do Câncer". Foram incluídos pacientes atendidos no Hospital Heliópolis, no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo e no Instituto do Câncer Arnaldo Vieira de Carvalho entre novembro de 1998 e dezembro de 2005. Consideraram-se casos os pacientes com diagnóstico histologicamente confirmado de câncer de boca, faringe ou laringe e controles pessoas atendidas nos mesmos hospitais por outros motivos que não neoplasia maligna e doenças associadas com os fatores de risco do câncer de cabeça e pescoço. A análise empregou regressão logística não-condicional baseada em modelo hierárquico de determinação. No nível mais distal foram incluídas as variáveis demográficas (sexo, cor de pele e idade), seguidas pela escolaridade (série mais elevada que a pessoa cursou) e ocupação (exercida por mais tempo). No nível mais proximal, foram considerados o consumo de tabaco e de álcool. Também foi investigado se a associação de instrução e ocupação com câncer de cabeça e pescoço se mediava apenas por padrões diferenciais de consumo de álcool e tabaco entre os estratos sociais...

Tabagismo, consumo de álcool e câncer de cabeça e pescoço nas regiões Sudeste, Sul e Centro-Oeste do Brasil; Smoking, alcohol consumption and head and neck cancer in Southeast, South and Midwest of Brazil

Sakaguti, Suely Aparecida Kfouri
Fonte: Biblioteca Digitais de Teses e Dissertações da USP Publicador: Biblioteca Digitais de Teses e Dissertações da USP
Tipo: Dissertação de Mestrado Formato: application/pdf
Publicado em 30/04/2013 PT
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Introdução. Considerando-se a incidência e os reflexos na qualidade de vida, os tumores de cabeça e pescoço constituem-se em relevante problema de saúde pública. A medida de efeito dos principais fatores de risco, tabaco e álcool, no risco de acometimento de cânceres de cabeça e pescoço tem sido pouco relatada no Brasil. Objetivo. Verificar as variações de risco decorrentes do tabagismo e do consumo de bebidas alcoólicas no câncer de cabeça e pescoço nas regiões Sudeste, Sul e Centrooeste do Brasil. Sujeitos e Métodos. Estudo caso-controle de base hospitalar conduzido entre setembro de 1998 e maio de 2003, com base em 1.594 casos diagnosticados com carcinoma espinocelular de cabeça e pescoço, confirmados histologicamente, em hospitais das cidades de São Paulo e Rio de Janeiro (Sudeste), Porto Alegre e Pelotas (Sul), Goiânia (Centro-oeste), e 1.292 controles. Os pacientes foram entrevistados por meio de questionários com informações sobre características e hábitos, bem como dados clínicos e laboratoriais para o diagnóstico de câncer de cabeça e pescoço. A OR (odds ratio) e IC 95 por cento (intervalo com 95 por cento de confiança) para câncer de cabeça e pescoço associados ao tabaco e álcool foram estimados por regressão logística não condicional. O modelo foi ajustado por idade...

Genetic variability of vascular endothelial growth factor and prognosis of head and neck cancer in a Brazilian population

Ruiz,M.T.; Biselli,P.M.; Maniglia,J.V.; Pavarino-Bertelli,E.C.; Goloni-Bertollo,E.M.
Fonte: Associação Brasileira de Divulgação Científica Publicador: Associação Brasileira de Divulgação Científica
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2010 EN
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Vascular endothelial growth factor (VEGF) is one of the most potent endothelial cell mitogens and plays a critical role in angiogenesis. Polymorphisms in this gene have been evaluated in patients with several types of cancer. The objectives of this study were to determine if there was an association of the -1154G/A polymorphism of the VEGF gene with head and neck cancer and the interaction of this polymorphism with lifestyle and demographic factors. Additionally, the distribution of the VEGF genotype was investigated with respect to the clinicopathological features of head and neck cancer patients. The study included 100 patients with histopathological diagnosis of head and neck squamous cell carcinoma. Patients with treated tumors were excluded. A total of 176 individuals 40 years or older were included in the control group and individuals with a family history of neoplasias were excluded. Analysis was performed after extraction of genomic DNA using the real-time PCR technique. No statistically significant differences between allelic and genotype frequencies of -1154G/A VEGF polymorphism were identified between healthy individuals and patients. The real-time PCR analyses showed a G allele frequency of 0.72 and 0.74 for patients and the control group...

Genetic alterations in Ki-ras and Ha-ras genes in Juvenile Nasopharyngeal Angiofibromas and head and neck cancer

Coutinho,Cláudia Malheiros; Bassini,Alessandra Simões; Gutiérrez,Leonardo Guilhermino; Butugan,Ossamu; Kowalski,Luiz Paulo; Brentani,Maria Mitzi; Nagai,Maria Aparecida
Fonte: Associação Paulista de Medicina - APM Publicador: Associação Paulista de Medicina - APM
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/05/1999 EN
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CONETXT: Ras gene mutations have been associated to a wide range of human solid tumors. Members of the ras gene family (Ki-ras, Ha-ras and N-ras) are structurally related and code for a protein (p21) known to play an important role in the regulation of normal signal transduction and cell growth. The frequency of ras mutations is different from one type of tumor to another, suggesting that point mutations might be carcinogen-specific. OBJECTIVES: To study the occurrence of Ki-ras and Ha-ras mutations. We also studied the relative level of Ha-ras mRNA in 32 of the head and neck tumors. DESIGN: Case series. SETTING: University referral unit. PARTICIPANTS: 60 head and neck tumors and in 28 Juvenile Nasopharyngeal Angiofibromas (JNA). DIAGNOSTIC TEST: Using PCR-SSCP we examined the occurrence of Ki-ras and Ha-ras mutations. The relative level of Ha-ras mRNA was examined by Northern blot analysis. RESULTS: None of the head and neck tumors or JNA samples showed evidence of mutations within codons 12, 13, 59 and 61 of Ki-ras or Ha-ras genes. However, 17 (53%) of the tumors where gene expression could be examined exhibited increased levels of Ha-ras mRNA compared with the normal tissue derived from the same patient. CONCLUSIONS: Our results demonstrate for the first time that mutations of Ki-ras and Ha-ras genes are not associated with the development of JNA and confirm previous reports indicating that activating ras mutations are absent or rarely involved in head and neck tumors from western world patients. Furthermore...

Carotid reconstruction in patients operated for malignant head and neck neoplasia

Nishinari,Kenji; Wolosker,Nelson; Yazbek,Guilherme; Malavolta,Luiz Caetano; Zerati,Antônio Eduardo; Kowalski,Luiz Paulo
Fonte: Associação Paulista de Medicina - APM Publicador: Associação Paulista de Medicina - APM
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/07/2002 EN
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CONTEXT: Patients with malignant head and neck neoplasia may present simultaneous involvement of large vessels due to the growth of the tumoral mass. The therapeutic options are chemotherapy, radiotherapy, surgery or combined treatments. OBJECTIVE: To analyze the result of surgical treatment with carotid reconstruction in patients with advanced malignant head and neck neoplasia. DESIGN: Prospective. SETTING: Hospital do Câncer A.C. Camargo, São Paulo, Brazil. PARTICIPANTS: Eleven patients operated because of advanced malignant head and neck neoplasia that was involving the internal and/or common carotid artery. MAIN MEASUREMENTS: By means of clinical examination, outpatient follow-up and duplex scanning, we analyzed the patency of the carotid grafts, vascular and non-vascular complications, disease recurrence and survival of the patients. RESULTS: Six patients (54.5%) did not present any type of complication. There was one vascular complication represented by an occlusion of the carotid graft with a cerebrovascular stroke in one hemisphere. Non-vascular complications occurred in five patients (45.5%). During the follow-up, eight patients died (72.7%), of whom seven had loco-regional tumor recurrence and one had pulmonary and hepatic metastases (at an average of 9 months after the operation). Seven of these patients presented functioning grafts. The three patients still alive have no tumor recurrence and their grafts are functioning (an average of 9 months has passed since the operation). CONCLUSIONS: Patients with advanced malignant head and neck neoplasia involving the carotid artery that are treated surgically present a prognosis with reservations. When the internal and/or common carotid artery is resected en-bloc with the tumor...

Animal Models of Cancer in the Head and Neck Region

Kim, Seungwon
Fonte: Korean Society of Otorhinolaryngology-Head and Neck Surgery Publicador: Korean Society of Otorhinolaryngology-Head and Neck Surgery
Tipo: Artigo de Revista Científica
EN
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Animal models that resemble the cancers of the head and neck region are of paramount importance in studying the carcinogenesis of these diseases. Although several methods for modeling cancer in the head and neck are available, none are fully satisfactory. Subcutaneous xenograft models of cancer in nude mice are often used in preclinical studies. However, these models are problematic in several aspects as they lack the specific interactions that exist between the tumor cells and their native environment. Establishment of tumors at the orthotopic sites restore these distinct patterns of interactions between the tumor and the host organs that are lost or altered when the tumors are established in ectopic sites. With regard to the transgenic model of cancer in the head and neck region, it should be kept in mind that the transgene used to drive the malignant transformation may not be representative of the carcinogenic process found in human tumors. Low penetrance of tumor formation also translates into high cost and time commitment in performing studies with transgenic models. In this review, we will discuss some of the commonly used methods for modeling cancer in the head and neck region including squamous cell carcinoma of the head and neck as well as thyroid carcinoma.

Metastasis of genitourinary tumors to the head and neck region

Ogunyemi, Ore; Rojas, A.; Hematpour, K.; Rogers, D.; Head, C.; Bennett, C.
Fonte: Springer-Verlag Publicador: Springer-Verlag
Tipo: Artigo de Revista Científica
EN
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105.9%
The objective of the present study is to characterize genitourinary tumors (GU) metastatic to the head and neck and to determine long-term prognoses. Using a retrospective chart review of 734 patients treated between January 1995 and May 2005 with an ICD-9 code pertaining to a metastatic head and neck cancer, we found 37 patients with primary GU tumors. There were 24 cases of prostate cancer, 10 cases of renal cell carcinoma, and 4 cases of transitional cell carcinoma. Sixteen of 24 patients (67%) with prostate cancer had a cranial metastasis while 6 of 9 (67%) patients with renal cell carcinoma had cerebral metastasis. We concluded that prolonged survival is possible in prostate cancer patients treated aggressively with radiation and chemotherapy, indicating that early detection and aggressive screening are important in these patients.

Integration of a smoking cessation program in the treatment protocol for patients with head and neck and lung cancer

de Bruin-Visser, J. C.; Ackerstaff, A. H.; Rehorst, H.; Retèl, V. P.; Hilgers, F. J. M.
Fonte: Springer-Verlag Publicador: Springer-Verlag
Tipo: Artigo de Revista Científica
EN
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Smoking is the main causative factor for development of head and neck and lung cancer. In addition, other malignancies such as bladder, stomach, colorectal, kidney and pancreatic cancer have a causative relation with smoking. Continued smoking after having been diagnosed with cancer has many negative consequences: effectiveness of radiotherapy is diminished, survival time is shortened and risks of recurrence, second primary malignancies and treatment complications are increased. In view of the significant health consequences of continued smoking, therefore, additional support for patients to stop smoking seems a logical extension of the present treatment protocols for smoking-related cancers. For prospectively examining the effect of nursing-delivered smoking cessation programme for patients with head and neck or lung cancer, 145 patients with head and neck or lung cancer enrolled into this programme over a 2-year period. Information on smoking behaviour, using a structured, programme specific questionnaire, was collected at baseline, and after 6 and 12 months. At 6 months, 58 patients (40%) had stopped smoking and at 12 months, 48 patients (33%) still had refrained from smoking. There were no differences in smoking cessation results between patients with head and neck and lung cancer. The only significant factor predicting success was whether the patient had made earlier attempts to quit smoking. A nurse-managed smoking cessation programme for patients with head and neck or lung cancer shows favourable long-term success rates. It seems logical...

Neuroendocrine Neoplasms of the Head and Neck: Some Suggestions for the New WHO Classification of Head and Neck Tumors

Xu, Bin; Chetty, Runjan; Perez-Ordoñez, Bayardo
Fonte: Springer US Publicador: Springer US
Tipo: Artigo de Revista Científica
Publicado em 05/03/2014 EN
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As knowledge and understanding in pathology evolve, classifications and nomenclature also change to reflect those advances. The 2005 World Health Organization Classification of Head and Neck Tumours was a significant step towards diagnostic standardization of head and neck neuroendocrine carcinomas; however, in the last 10 years there have been new data supporting the recognition of “large cell neuroendocrine carcinoma” as a distinctive high grade carcinoma in the head and neck, a lesion not included in the 2005 Classification. In addition, the terms “middle ear adenoma” and “carcinoid tumor of middle ear” are still widely used to describe a neoplasm that is neither a pure adenoma nor a carcinoid tumor but a lesion with variable mixed exocrine and endocrine differentiation. Largely using the diagnostic criteria of the WHO classification of neuroendocrine carcinomas of the lung, we propose the terms “neuroendocrine carcinoma, grade 1”; “neuroendocrine carcinoma, grade 2”; “neuroendocrine carcinoma, grade 3, large cell type”; and “neuroendocrine carcinoma, grade 3, small cell type” for the classification of neuroendocrine carcinomas of the head and neck in a future WHO classification. In addition, we also proposed the term “mixed epithelial neuroendocrine tumor” of the middle ear as an alternative for “middle ear adenoma” and “carcinoid tumor of the middle ear”.

Analysis of selected risk factors for nodal metastases in head and neck cutaneous squamous cell carcinoma

Szewczyk, Mateusz; Pazdrowski, Jakub; Golusiński, Paweł; Dańczak-Pazdrowska, Aleksandra; Marszałek, Sławomir; Golusiński, Wojciech
Fonte: Springer Berlin Heidelberg Publicador: Springer Berlin Heidelberg
Tipo: Artigo de Revista Científica
EN
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Cutaneous squamous cell carcinoma (cSCC) accounts for 20 % of all skin malignancies and 20 % of deaths. In contrast to mucosal SCC, treatment results are very good. However, regional metastases are present in 5–20 % of cases, and the prognosis for patients with metastases is 50 % lower. It has been reported that several risk factors are responsible for the head and neck lymph node regional metastasis, such as: poor cell differentiation, local recurrence, immunosuppression, and tumour dimension. Multivariate analysis of metastatic neck lesions in head and neck cSCC. Retrospective analysis of patients treated at our department for head and neck cSCC. The study includes 100 patients: 66 males (66 %) and 34 females (34 %), aged 26–98 years (mean age 74.6). The tumour was evaluated for: sex predilection, local recurrence, stage (according to 7th edition of American Joint Committee on Cancer TNM staging), differentiation, and site. Most patients (79 cases; 79 %) were treated for primary cSCC, while the other 21 patients presented local recurrence of cSCC. Neck metastases were diagnosed in five patients with primary cSCC and in three with recurrent cSCC. No distant metastasis was observed. The most common tumour location was the auricle (29 cases; 29 %). Neck dissection was performed most frequently in patients with lip tumours (17/22 cases; 77 %). Neck metastasis was diagnosed most often in patients with cSCC on the lip (2 patients) and buccal region (2 patients). The most common tumour location in males was the auricle (25/66 cases; 38 %) whereas in females the nasal and buccal regions were the most common locations...

O polimorfismo do gene p5372(RP) no câncer de cabeça e pescoço: estudo de associação e meta-análise; p5372(RP) polymorphism in head and neck cancer: an association and meta-analysis study

SILVA, Antonio Márcio Teodoro Cordeiro
Fonte: Universidade Federal de Goiás; BR; UFG; Doutorado em Biologia; Ciencias Biologicas Publicador: Universidade Federal de Goiás; BR; UFG; Doutorado em Biologia; Ciencias Biologicas
Tipo: Tese de Doutorado Formato: application/pdf
POR
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Head and neck cancer arises in the oral cavity and nearby regions, larynx, pharynx, including oropharynx, nasopharynx, and hipopharynx. Extensive epidemiologic studies have revealed that chronic tobacco smoking and alcohol consumption as the two main risk factors associated with the multifactorial etiology of head and neck cancers. Additionally, nutritional status, HPV infection, and genetic polymorphism were also related with the disease. A frequently studied polymorphism in Squamous Cell Carcinoma (SCC) of head and neck is a G-to-C SNP (Single Nucleotide Polymorphism) at codon 72 in the p53 gene, which codes for an Arg or Pro (Arginine or Proline) in P53 protein. In order to investigate the distribution and potential association of that SNP in SCC, biological samples were obtained from 331 cases of head and neck SCC from Araújo Jorge Hospital and 271 healthy control individuals from Goiânia (Brazil) population. DNA was isolated and subsequently used for PCR amplification to genotype cases and controls with respect to their p5372 SNP. Additionaly, a meta-analysis was carried out using 29 relevant case-control studies that used p5372 SNP genotyping in SCC of the head and neck. Allelic frequencies for cases were 73.3% and 27.7% for Arg and Pro...

Evaluation of relative transmitted dose for a step and shoot head and neck intensity modulated radiation therapy using a scanning liquid ionization chamber electronic portal imaging device

Mohammadi, M.; Bezak, E.
Fonte: Medknow Publications and Media Pvt. Ltd. Publicador: Medknow Publications and Media Pvt. Ltd.
Tipo: Artigo de Revista Científica
Publicado em //2012 EN
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105.82%
The dose delivery verification for a head and neck static intensity modulated radiation therapy (IMRT) case using a scanning liquid ionization chamber electronic portal imaging device (SLIC-EPID) was investigated. Acquired electronic portal images were firstly converted into transmitted dose maps using an in-house developed method. The dose distributions were then compared with those calculated in a virtual EPID using the Pinnacle3 treatment planning system (TPS). Using gamma evaluation with the DDmax and DTA criteria of 3%/2.54 mm, an excellent agreement was observed between transmitted dose measured using SLIC-EPID and that calculated by TPS (gamma score approximately 95%) for large MLC fields. In contrast, for several small subfields, due to SLIC-EPID image blurring, significant disagreement was found in the gamma results. Differences between EPID and TPS dose maps were also observed for several parts of the radiation subfields, when the radiation beam passed through air on the outside of tissue. The transmitted dose distributions measured using portal imagers such as SLIC-EPID can be used to verify the dose delivery to a patient. However, several aspects such as accurate calibration procedure and imager response under different conditions should be taken into the consideration. In addition...

Influence of periodontitis on the experience of oral mucositis in cancer patients undergoing head and neck radiotherapy.

Khaw, Arlene Bee Hong
Fonte: Universidade de Adelaide Publicador: Universidade de Adelaide
Tipo: Tese de Doutorado
Publicado em //2014
Relevância na Pesquisa
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Background and aim: Virtually all patients who receive head and neck radiotherapy develop some degree of oral mucositis. Severe oral mucositis may necessitate an interruption of the course of radiotherapy and thus can serve as a dose-limiting factor. Periodontitis is a host-driven inflammatory response to a pathogenic bacterial biofilm in the subgingival environment, resulting in the progressive destruction of the tissues that support the teeth, specifically the gingiva, periodontal ligament, and alveolar bone. This disease affects more than 50% of the population. Considering that radiation-induced oral mucositis and periodontitis are both characterised by the continuing presence of systemic inflammation, they may be associated through a primed inflammatory response as proposed by the “two-hit” model. Alternatively, both conditions may be correlated as they represent a dysregulation of the inflammatory response. To date, no studies have looked into the association between these conditions. The aim of this study is to determine whether the severity of oral mucositis is associated with the severity of periodontitis in cancer patients undergoing head and neck radiotherapy. Materials and methods: Eighty-five consecutive patients seeking dental clearance prior to head and neck radiotherapy were assessed for their eligibility for participation in the study. Forty-one patients met the inclusion criteria. The severity of oral mucositis was measured according to the WHO system. The severity of periodontitis was assessed clinically and radiographically. Gingival crevicular fluid was sampled and levels of eight cytokines were determined using a multiplexed bead immunoassay. The association between radiation-induced oral mucositis and periodontitis was analysed using logistic and linear regression...

PATIENT RELATED DIAGNOSTIC DELAY, SYMPTOM APPRAISAL AND LAY CONSULTATION IN HEAD AND NECK CANCER

Queenan, JOHN
Fonte: Quens University Publicador: Quens University
Tipo: Tese de Doutorado
EN; EN
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The objectives of this thesis were to; 1) identify established risk factors and gaps in the current peer reviewed literature relating to factors associated with patient related diagnostic delay in head and neck cancer, 2) describe and document patients’ personal responses to symptoms of head and neck cancer, the characteristics of the patients’ lay-consultants and the responses that the patients received from their lay-consultants and 3) assess the association between patient/network-related diagnostic delay and a) whether the patient felt any urgency to investigate their symptoms, b) whether the patient told someone in their social network about their symptoms (lay-consultancy) and c) lay-consultant influence. The first manuscript is a scoping review that demonstrates that there is a lack of studies that address; the personal symptom experiences of patients, the psycho-social processes of help-seeking and the independent effects of suspected risk factors for head and neck cancer. The results of the first manuscript also provided me with guidance on what the important confounders of our primary relationship of interest were most likely to be. The second manuscript suggests that patient related delay may be influenced by the patients’ mistaken belief that their symptoms were non-urgent with or without the influence of their lay-consultant. The third manuscript provides evidence that the primary barrier to seeking help from an HCP is whether or not those individuals experiencing symptoms think they are urgent enough to warrant further investigation. The study found no evidence to support the assertion that increased risk of delay is associated with decreased lay-consultancy. The results of this thesis indicate that most of the patient related delay occurs during the individuals’ symptom appraisal process with or without input from their social network. I think that individuals at risk of late stage presentation of head and neck cancer should be provided with targeted information encouraging them to seek help from a health care provider if the key signs or symptoms of head and neck cancer have not resolved within three weeks.; Thesis (Ph.D...

Evaluation of an educational video to improve the understanding of radiotherapy side effects in head and neck cancer patients = : Avaliação de vídeo educacional para melhoria da compreensão dos efeitos colaterais associados à radioterapia em pacientes com câncer de cabeça e pescoço; Avaliação de vídeo educacional para melhoria da compreensão dos efeitos colaterais associados à radioterapia em pacientes com câncer de cabeça e pescoço

Jose Ribamar Sabino Bezerra Junior
Fonte: Biblioteca Digital da Unicamp Publicador: Biblioteca Digital da Unicamp
Tipo: Tese de Doutorado Formato: application/pdf
Publicado em 19/03/2013 PT
Relevância na Pesquisa
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O câncer de cabeça e pescoço representa o sexto tipo mais comum em todo mundo e é uma preocupação crescente das agências de saúde pública. O tratamento é baseado em cirurgia, radioterapia e quimioterapia, isoladas ou em conjunto e, são responsáveis por importantes sequelas que afetam negativamente as atividades diárias dos pacientes, contribuindo para uma diminuição na qualidade de vida. Entretanto, as informações prévias ao tratamento e a compreensão destas complicações pelos pacientes são insuficientes para prepará-los para o tratamento. Na literatura médica a utilização de vídeos educativos é documentada como uma ferramenta importante na transmissão de informações prévias a tratamentos complexos, demonstrando resultados promissores na melhoria da compreensão dos pacientes. No entanto, a utilização de vídeos educacionais esclarecendo as complicações do tratamento direcionadas aos pacientes com câncer de cabeça e pescoço é escassa, não havendo nenhum artigo que se dedique exclusivamente a estes pacientes. Portanto, o objetivo deste estudo foi avaliar o efeito de um vídeo educativo sobre a melhoria da compreensão dos pacientes com câncer de cabeça e pescoço submetidos à radioterapia sobre as complicações do tratamento. Para isto...

Clinical and epidemiological characteristics of patients in the head and neck surgery department of a university hospital

Ruback,Maurício José Cabral; Galbiatti,Ana Lívia; Arantes,Lidia Maria Rebolho Batista; Marucci,Gustavo Henrique; Russo,Anelise; Ruiz-Cintra,Mariangela Torreglosa; Raposo,Luiz Sérgio; Maniglia,José Victor; Pavarino,Érika Cristina; Goloni-Bertollo,Eny
Fonte: Associação Paulista de Medicina - APM Publicador: Associação Paulista de Medicina - APM
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/01/2012 EN
Relevância na Pesquisa
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CONTEXT AND OBJECTIVES: Head and neck cancer is the fifth most common type of cancer worldwide. The objective of this study was to evaluate the clinical and epidemiological parameters in a head and neck surgery service. DESIGN AND SETTING: Cross-sectional study using patients' records, developed in otolaryngology and head and neck department of a university hospital in the northwest of the state of São Paulo. METHODS: A total of 995 patients in the head and neck surgery service between January 2000 and May 2010 were evaluated. The variables analyzed included: age, gender, skin color, tobacco and alcohol consumption, primary site, staging and histological tumor type, treatment and number of deaths. RESULTS: The disease was more frequent among men (79.70%), smokers (75.15%) and alcohol abusers (58.25%). The most representative sites were oral cavity (29.65%) and larynx (24.12%) for the primary site; squamous cell carcinoma (84.92%) was the most frequent histological type, and surgery (29.04%) and radiotherapy (14.19%) were the most common treatments. CONCLUSION: The cancer that affects patients assisted by the head and neck surgery service occurs mainly men, smokers and alcohol abusers, and the oral cavity and larynx are the sites with the highest incidence. The high rate of patients with stages III and IV indicates late diagnosis by the treatment centers...