Oral Oncol
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The optimal concurrent regimen, chemoradiotherapy (CRT) or bioradiotherapy (BRT), in locally advanced head and neck squamous cell carcinoma (LAHNSCC) remains controversial, especially in human papilloma virus-associated patients. ⋯ Our long-term results suggested better outcomes in LAHNSCC patients receiving concurrent cisplatin over cetuximab regardless of HPV/p16 status.
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Review Meta Analysis
Comparison of 18F-FDG PET/CT, MRI and SPECT in the diagnosis of local residual/recurrent nasopharyngeal carcinoma: A meta-analysis.
The objective of this study was to assess the overall diagnostic value of MRI, SPECT and 18F-FDG PET/CT in detecting local NPC residual/recurrence with a meta-analysis. We performed a systematic review with meta-analyses to compare the diagnostic performance of nuclear magnetic resonance Imaging (MRI), single photon emission computed tomography (SPECT) and 18-fluoro-2-deoxyglucose positron emission tomography (18F-FDG PET/CT) as imaging modalities for the detection of local residual or recurrent nasopharyngeal carcinoma (NPC). MEDLINE, EMBASE and publisher databases were searched in December 2014. ⋯ Both 18F-FDGPET/CT and SPECT are very accurate for the detection of local residual or recurrent NPC, they are superior to MRI in distinguishing recurrent NPC from fibrosis or scar tissue after RT in irradiated fields with distortion of normal architecture. For 18F-FDGPET/CT, the diagnostic accuracy PET/CT was not significantly different than that of PET alone. For SPECT, 201TI-SPECT and MIBI-SPECT have the same diagnostic accuracy.
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Review
Assessment and measurement of head and neck lymphedema: state-of-the-science and future directions.
Currently, assessment and measurement of lymphedema in head and neck cancer patients is difficult. The aims of this report are to examine the current state of science regarding available measurement of head and neck lymphedema, to identify gaps in clinical evaluation of head and neck lymphedema, and to propose future research directions for advancing the assessment of head and neck lymphedema. The authors conducted a comprehensive literature review based on PubMed, CINAHL, Cochrane database, EMBASE, and PsycINFO from 1989 to 2014. ⋯ The authors also reviewed information from the Oncology Nursing Society, National Lymphedema Network, National Cancer Institute, American Cancer Society, and other related healthcare professional association web sites. Based on the nature/characteristics of measurement reported in the literature, methods for assessment of head and neck lymphedema can be categorized into: (1) patient-reported outcome (PRO) measures (e.g., symptom tool), (2) clinician-reported outcome (CRO) measures based on clinical grading criteria via a clinical exam (external lymphedema evaluation by physical examination and internal edema examination via endoscopy), and (3) technical capacity/measurement techniques (e.g., imaging techniques). Although a number of measures have been reported in the literature, clinically useful PRO and CRO measures, and reliable and sensitive measurement techniques need to be validated to address gaps in assessment of head and neck lymphedema, and to be easily used in early identification of lymphedema and assessment of treatment/interventional effects.
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The purpose of this study was to evaluate the 7th edition UICC/AJCC staging system for nasopharyngeal carcinoma (NPC) patients who were treated with intensity modulated radiation therapy (IMRT). ⋯ When treated with IMRT, the difference in the LRFS, DSS, and OS between T1 and T2 patients diminished, indicating that it is rational to merge T2 into T1. The prognostic value of the N classification of the current staging system had not changed much compared to the 6th edition.
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To describe what is known about the epidemiology of oral human papillomavirus (HPV) infection. ⋯ Over the past several years new studies have informed our understanding of oral HPV infection. These data suggest oral HPV prevalence is higher in men than women and support the sexual transmission of HPV to the mouth by oral sex. Data is emerging suggesting that most oral HPV infections usually clear within a year on and describing risk factors for prevalent and persistent infection. Recent data support likely efficacy of the HPV vaccine for oral HPV, suggesting vaccination may reduce risk of HPV-related oropharyngeal cancer.