Efficacy and toxicity of docetaxel combination chemotherapy for advanced squamous cell cancer of the head and neck.

The aim of the present study was to evaluate the clinical effectiveness and toxicity of docetaxel with 5-fluorouracil and cisplatin as combination treatment in patients with curable or metastatic/recurrent head and neck cancer by a retrospective cohort study of patients treated at a single institution between 2007 and 2012. Patients with locally advanced, metastatic and/or recurrent squamous cell carcinoma of the head and neck (SCCHN), who were treated with a combination therapy including docetaxel, were considered as eligible. Survival data, clinical side effects, quality of life (QoL) and toxicity profile were retrieved from patient charts, analyzed and scored according to the National Cancer Institute Common Toxicity Criteria, version 4, and the Response Evaluation Criteria In Solid Tumors, version 1.1. An overall response rate of 86% and a 3-year survival of 65.1% were observed. The median progression-free survival was 32 months. The cumulative incidence after 3 years was 16.9% for local recurrence and 10.4% for distant metastasis. Leukopenia (58%) and anemia (51%) were the most common hematological toxicities, followed by hepatotoxicity (53%) and nausea (27%). A total of 31% of the patients experienced a compromise in their QoL following therapy completion. In conclusion, docetaxel in combination with cisplatin and 5-fluorouracil was found to effectively prolong survival in patients with locally advanced and/or recurrent metastatic SCCHN. The overall survival, progression-free survival and response rates were in accordance with those reported by previous clinical trials. Therefore, this therapy protocol is recommended for patients with SCCHN in the curative as well as the palliative settings.

Impact of xylomethazoline on eustachian tube function in healthy participants.

INTRODUCTION: The use of decongestants is common in otitis media eustachian tube (ET) dysfunction. However, the underlying mechanism and the type of action on the complex middle ear pressure equalization system are poorly understood. Here, by use of the pressure chamber, we investigated the impact of intranasal decongestive therapy (xylomethazoline) on ET function. MATERIALS AND METHODS: Thirty healthy participants (60 ears) were exposed to a predetermined profile of phases of compression and decompression in a hypobaric and hyperbaric pressure chamber. ET opening pressure, ET opening duration, ET opening frequency, and ET closing pressure were determined before and after intranasal application of xylomethazoline. RESULTS: A significantly higher number of ET openings (ET opening frequency) in passive equalization condition could be measured after application of decongestants than before. No significant difference could be found in the values of ET opening pressure, ET opening duration, and ET closing pressure parameters before in comparison with the values after application of xylomethazoline. CONCLUSION: We conclude that xylomethazoline might only have a minor effect during active and passive middle ear pressure equalization. Larger cohorts and targeted application of decongestants should be tested to confirm these preliminary data and to find new evidence on the effects of decongestants.

Modelling the lactate response to short-term all out exercise.

BACKGROUND: The maximum post exercise blood lactate concentration (BLCmax) has been positively correlated with maximal short-term exercise (MSE) performance. However, the moment when BLCmax occurs (TBLCmax) is rather unpredictable and interpretation of BLC response to MSE is therefore difficult. METHODS: We compared a 3- and a 4-parameter model for the analysis of the dynamics of BLC response to MSEs lasting 10 (MSE10) and 30 s (MSE30) in eleven males (24.6 +/- 2.3 yrs; 182.4 +/- 6.8 cm; 75.1 +/- 9.4 kg). The 3-parameter model uses BLC at MSE-start, extra-vascular increase (A) and rate constants of BLC appearance (k1) and disappearance (k2). The 4-parameter model includes BLC at MSE termination and amplitudes and rate constants of increase (A1, y1) and decrease (A2, y2) of post MSE-BLC. RESULTS: Both models consistently explained 93.69 % or more of the variance of individual BLC responses. Reduction of the number of parameters decreased (p < 0.05) the goodness of the fit in every MSE10 and in 3 MSE30. A (9.1 +/- 2.1 vs. 15.3 +/- 2.1 mmol l-1) and A1 (7.1 +/- 1.6 vs. 10.9 +/- 2.0 mmol l-1) were lower (p < 0.05) in MSE10 than in MSE30. k1 (0.610 +/- 0.119 vs. 0.505 +/- 0.107 min-1), k2 (4.21 10-2 +/- 1.06 10-2 vs. 2.45 10-2 +/- 1.04 10-2 min-1), and A2 (-563.8 +/- 370.8 vs. -1412.6 +/- 868.8 mmol l-1), and y1 (0.579 +/- 0.137 vs. 0.489 +/- 0.076 min-1) were higher (p < 0.05) in MSE10 than in MSE30. No corresponding difference in y2 (0.41 10-2 +/- 0.82 10-2 vs. 0.15 10-2 +/- 0.42 10-2 min-1) was found. CONCLUSION: The 3-parameter model estimates of lactate appearance and disappearance were sensitive to differences in test duration and support an interrelation between BLC level and halftime of lactate elimination previously found. The 4-parameter model results support the 3-parameter model findings about lactate appearance; however, parameter estimates for lactate disappearance were unrealistic in the 4-parameter model. The 3-parameter model provides useful information about the dynamics of the lactate response to MSE.