Smoking cessation intervention for patients with head and neck cancer: A prospective randomized controlled trial.

AIMS: To evaluate the effectiveness of a brief smoking cessation intervention in head and neck cancer patients (HNCP). STUDY DESIGN: A prospective randomized controlled trial that randomly assigns participants in two groups: a usual care group (UCG), and a standardized intervention group (SIG). MATERIAL AND METHODS: Patients with a confirmed diagnosis of head and neck squamous cell carcinoma (HNSCC) and who are active smokers were prospectively approached by one of 4 trained Ear-nose-throat (ENT) residents. Participants were randomized into a UCG, and a SIG consisting of a brief perioperative smoking cessation intervention based on National Institute of Health (NIH) "5A's" model along with an informative motivational document and nicotine patch therapy (NPT) offered for 8 weeks in gradually decreasing doses. OBJECTIVE: The evaluation of abstinence at 3, 6 and 12 months after enrollment. RESULTS: 56 subjects were randomized into the UCG (N = 29, 52%), and the SIG (N = 27, 48%). The overall smoking cessation rates were not statistically different between the two groups; we observed at 3 months cessation rates of 57.1% vs. 57.7% (p = 0.96); at 6 months, 42.9% vs. 24% (p = 0.148); and at 12 months, 33.3% vs. 20.8% (p = 0.318), for the UCG and the SIG respectively. CONCLUSION: This study failed to show the effectiveness of a combined brief smoking cessation approach led by and ENT resident in HNSCC patients. A multifaceted approach addressing different pharmacological treatments, factors contributing to smoking maintenance, mainly alcohol dependence and mood disturbances and dealing with relapse risks through close face-to-face or phone call follow-ups may have better outcomes and should be evaluated in upcoming trials.

Outcomes after radiation therapy for T2N0/stage II glottic squamous cell carcinoma.

BACKGROUND: We report outcomes for patients with T2N0M0 glottic squamous cell carcinoma (SCC) treated with radiation therapy (RT). METHODS: Patients who received definitive RT for T2 glottic SCC from 2000 through 2013 were retrospectively reviewed. RESULTS: One hundred and thirteen patients were analyzed (median follow-up time 91 months; 85 patients received three-dimensional conformal radiotherapy [3D-CRT] and 28 received intensity-modulated radiation therapy [IMRT]). Fractionation was conventional (58%) or altered (42%); 20 patients (18%) received concurrent chemotherapy. Five-year local control was 83% for the 3D-CRT vs 81% for the IMRT group (P = .76). The ultimate locoregional control at 5 years was 100% for IMRT vs 91% for 3D-CRT (P = .1). The 5-year overall survival (OS) was 78% for 3D-CRT vs 81% for IMRT (P = .83). On multivariate analysis, younger age was the only independent predictor of improved OS (P = .0002). CONCLUSIONS: Oncologic and survival outcomes were excellent for patients with T2N0 glottic cancer. Patients treated with IMRT and 3D-CRT had no statistically significant differences in all investigated endpoints.

Magnetic resonance-guided high-intensity focused ultrasound combined with radiotherapy for palliation of head and neck cancer-a pilot study.

BACKGROUND: Radiotherapy is a critical component of the multidisciplinary management of cancers of the head and neck. It may comprise the primary curative treatment modality or is used in an adjuvant setting to improve local control and survival by preventing seeding and reseeding of distant metastases from persistent reservoirs of locoregional disease. Although considerable advances have been made recently in the fields of radiotherapy, systemic treatment and surgery for head and neck tumours, locoregional recurrence rates remain high and treatment side effects may have severe impact on patients' quality of life. Magnetic resonance-guided high-intensity focused ultrasound (MRg-HIFU) is a novel technique in the treatment of cancer that has the potential to improve tumour cure rates and decrease treatment-related toxicity. Clinical applications of HIFU are being used increasingly for the treatment of several tumour sites, for example uterine leiomyomas and prostate cancer. METHODS/DESIGN: The pilot study presented here is an initial step toward utilizing MRg-HIFU for head and neck cancer treatment. The rationale for novel treatment options in head and neck cancer is reviewed as well as emerging evidence that support the increasing clinical utilization of MRg-HIFU. DISCUSSION: This pilot study aims to assess safety, toxicity and feasibility of MRg-HIFU treatments to the head and neck region and to evaluate changes caused by MRg-HIFU within the treated tumour regions based on post-treatment MRI.

Radiation-induced rupture of the superficial femoral artery: a case report.

BACKGROUND: Radiation-induced necrosis and arteriopathy are well-known iatrogenic pathologic entities. However, radiation-induced rupture of the superficial femoral artery is an exceptional life-threatening event. REPORT: We hereby report a case of radiation-induced rupture of the superficial femoral artery that was successfully treated by fascial stitching then by an endovascular approach by stenting. RESULTS: Infection, skin stiffness, and major tissue loss in a previously irradiated field are important limiting factors to an open surgical approach. CONCLUSION: It is important to consider using a combined approach for selected patients.

[Chemoradiotherapy in early stage Hodgkin's lymphoma]. / Chimio-radiothérapie dans les lymphomes de Hodgkin-Stades précoces.

OBJECTIVE: To evaluate the response to and toxicities of chemo-radiotherapy (CT-RT) in patients with early stage Hodgkin lymphoma treated in our institution. MATERIALS AND METHODS: Retrospective study of 42 patients with early stage Hodgkin lymphoma treated between 2002 and 2007. RESULTS: The age of patients ranges from 11 to 57 with a mean of 30.7 years; the sex-ratio is 0.8 (19 males and 23 females). There are 33 cases of nodular-sclerosing Hodgkin lymphoma, 6 of mixed cellularity, one lymphocyte-rich, one interfollicular and one granulomatous. As for the stages, 31 Hodgkin lymphomas are stage IIA, 6 stage IA, 3 bulky and 2 stage IAe. The ABVD protocol was given to 38 patients, the VBVP to 3 patients and the ABV to one patient. IFRT was used with dose ranging from 19.8 to 39.6 Gy. The acute toxicity of chemotherapy was hematologic only, grade 1 anemia accounting for 11.1% and grade 2 anemia for 14.8%, grade 1 leukopenia for 51.8%, grade 2 leukopenia for 333% and grade 3 leukopenia for 14.8%. Dysphagia, radiodermitis and radiomucositis were seen after radiotherapy, accounting for 16.5%, 4.6% and 9.1% respectively. No long-term toxicity of the combined therapy was found. During the follow-up period, one relapse occurred and no death was reported. CONCLUSION: The overall survival (OS), the disease free survival (DFS) and the toxicities of the combined therapy CT-RT of the patients with early stage Hodgkin lymphoma stage IA and IIA treated in our institution were similar to those seen in the literature.