A robotic neck brace to characterize head‐neck motion and muscle electromyography in subjects with amyotrophic lateral sclerosis
	Directory of Open Access Journals (Sweden)
	Haohan Zhang; Biing‐Chwen Chang; Jinsy Andrews; Hiroshi Mitsumoto; Sunil Agrawal
	2019-09-01  Annals of Clinical and Translational Neurology
	DOI: 10.1002/acn3.50864  ISSN: 2328-9503  Volume: 6  Issue: 9  Pages: 1671-1680
	Full Text Available Abstract Objective This paper presents the first study where a dynamic neck brace was used to characterize the head motion of ALS patients while concurrently recording the surface electromyography (EMG) of the neck muscles. Methods Eleven ALS patients and 10 age‐matched healthy controls consented and participated in an experiment. Each participant was asked to perform three single‐plane motions of the head‐neck that included flexion–extension in the sagittal plane, lateral bending in the coronal plane, and axial rotation in the transverse plane. Each motion was performed in a cycle and was repeated five times at self‐selected speeds. Results During single‐plane flexion–extension under gravity, compared to healthy peers, ALS patients showed a shorter duration to reach the maximum flexion and an earlier EMG onset in the neck extensors starting from the neutral. The brace measures in activation of the neck muscles in ALS patients were well correlated with clinically measured scores, such as the ALSFRS‐r and the FVC. The activation duration of sternocleidomastoid, used to rotate the head, correlated well with the ALSFRS‐r and FVC in ALS patients during axial rotation. Interpretation The ability to synchronously activate a pair of muscles to execute single‐plane motions in ALS patients seems to have been compromised due to the disease and potentially results in head drop. The neck brace measures can be adapted in the clinic to complement self‐reporting in ALS patients and used to assess the head drop and progress of the disease.
2.	Head and neck cancer: optimization of radiotherapy of the neck
	OpenAIRE
	Vergeer, M.R.
	2019-09-25
	13655
3.	Neck Dissection Technique Commonality and Variance: A Survey on Neck Dissection Technique Preferences among Head and Neck Oncologic Surgeons in the American Head and Neck Society
	OpenAIRE
	Hemmat,Shirin M.; Wang,Steven J.; Ryan,William R.
	2017-11-22
	Abstract Introduction Neck dissection (ND) technique preferences are not well reported. Objective The objective of this study is to educate practitioners and trainees about surgical technique commonality and variance used by head and neck oncologic surgeons when performing a ND. Methods Online survey of surgeon members of the American Head and Neck Society (AHNS). Survey investigated respondents' demographic information, degree of surgical experience, ND technique preferences. Results In our study, 283 out of 1,010 (28%) AHNS surgeon members with a mean age of 50.3 years (range 32-77 years) completed surveys from 41 states and 24 countries. We found that 205 (72.4%) had completed a fellowship in head and neck surgical oncology. Also, 225 (79.5%) respondents reported completing more than 25 NDs per year. ND technique commonalities (>66% respondents) included: preserving level 5 (unless with suspicious lymph nodes (LN)), only excising the portion of sternocleidomastoid muscle involved with tumor, resecting lymphatic tissue en bloc, preservation of cervical sensory rootlets, not performing submandibular gland (SMG) transfer, placing one drain for unilateral selective NDs, and performing a ND after parotidectomy and thyroidectomy and before transcervical approaches to upper aerodigestive tract primary site. Variability existed in the sequence of LN levels excised, instrument preferences, criteria for drain removal, the timing of a ND with transoral upper aerodigestive tract primary site resections, and submandibular gland preservation. Results showed that 122 (43.1%) surgeons reported that they preserve the submandibular gland during the level 1b portion of a ND. Conclusions The commonalities and variances reported for the ND technique may help put individual preferences into context.
4.	Análise do gene TAX1BP1 em pacientes com câncer de cabeça e pescoço
	OpenAIRE (Portuguese)
	Mariangela Torreglosa Ruiz; Janayna Fernanda Balachi; Raquel Aldrighi Fernandes; Ana Lívia Silva Galbiatti; José Victor Maniglia; Érika Cristina Pavarino-Bertelli; Eny Maria Goloni-Bertollo
	2019-09-28
	No Brasil foram estimados 14.160 casos novos de câncer e cabeça e pescoço para o ano de 2008. O tabagismo e o etilismo são os principais fatores de riscos estabelecidos na etiologia dessa doença. OBJETIVO: Avaliar o polimorfismo T → A do gene TAX1BP1 (leu306ile) em pacientes com câncer de cabeça e pescoço e em uma população controle. CASUÍSTICA E MÉTODOS: Estudo retrospectivo onde foram avaliados o sexo, idade, tabagismo e etilismo de 191 pacientes com câncer de cabeça e pescoço e de 200 indivíduos sem história de neoplasia. A análise molecular foi realizada após extração de DNA genômico pela técnica de PCR-RFLP. RESULTADOS: Há predominância de pacientes do sexo masculino (84,82%), tabagistas (91,1%) e etilistas (77,49%). A avaliação molecular não mostrou diferença estatisticamente significante entre os dois grupos (p =0,32). A análise dos parâmetros clínicos e polimorfismos mostrou uma associação com câncer na cavidade oral (OR:2,38; IC 95%: 1,18-4,78; p = 0,01), os demais parâmetros não mostraram associação com o polimorfismo. CONCLUSÃO: Há evidências de associação entre o polimorfismo do gene TAX1BP1 e câncer de cavidade oral. Para os demais parâmetros analisados os resultados não sugerem uma associação com o polimorfismo do gene TAX1BP1. In Brazil, there were 14,160 new estimated cases of head and neck cancer for the year of 2008. Smoking and drinking are the main risk factors established in the etiology of this disease. AIM: to assess the T → A polymorphism in gene TAX1BP1 (leu306ile) in patients with head and neck cancer and a control population. SERIES AND METHODS: a retrospective study in which we assessed the gender, age, smoking and drinking habits of 191 patients with head and neck cancer and 200 individuals without history of neoplasia. The molecular analysis was carried out after genomic DNA extraction by the PCR-RFLP method. RESULTS: there is a predominance of males (84.82%), smokers (91.1%) and drinkers of alcohol (77.49%). Molecular assessment did not show statistically significant differences between the two groups (p =0.32). The analysis of clinical parameters and polymorphisms showed association with oral cavity cancer (OR: 2.38; CI 95%: 1.18-4.78; p = 0.01), the other parameters were not associated with the polymorphism. CONCLUSION: There is evidence of association between TAX1BP1 gene polymorphism and oral cavity cancer. For the remaining parameters analyzed, the results do not suggest association with the TAX1BP1 gene polymorphism.
5.	Saúde bucal e qualidade de vida no paciente pós-radioterapia de câncer de cabeça e pescoço
	OpenAIRE (Portuguese)
	Oliveira, Laura Cavalcanti de; Teixeira, Debora Foger; Rubira, Cássia Maria Fischer; Santos, Paulo Sérgio da Silva
	2019-09-28
6.	Head and neck mucosal melanoma: experience with 42 patients, with emphasis on the role of postoperative radiotherapy
	OpenAIRE
	Meleti, M.; Leemans, C.R.; de Bree, R.; Vescovi, P.; Sesenna, E.; van der Waal, I.
	2019-09-25
	Background. Treatment of head and neck mucosal melanoma remains a challenge. Surgery has traditionally been the main therapeutic approach. The role of postoperative radiotherapy has never been clearly established. Methods. The experience with a group of 42 patients (16 males, 26 females) with a primary head and neck mucosal melanoma is reported. Results. Eleven of 19 patients (57.9%) receiving surgery alone developed a regional lymphatic metastasis. For patients receiving postoperative radiotherapy (19 patients), regional metastatic spread occurred in 4 patients (21%). Percentages of local failure were 57.9% (11/19) and 26.3% (5/19) for patients treated with surgery alone and for those treated with surgery and radiotherapy, respectively. Distant metastases occurred in 10 of 19 patients (52.6%) receiving surgery alone and in 9 of 19 patients (47.3%) receiving both therapies. Conclusions. The present evaluation confirms a poor prognosis for patients with head and neck mucosal melanoma, independent of the treatment modality.
7.	Sinais, sintomas e função vocal em indivíduos com disfagia tratados de câncer de cabeça e pescoço
	OpenAIRE (Portuguese)
	Felipe Moreti; Bruna Morasco-Geraldini; Simone Aparecida Claudino-Lopes; Elisabete Carrara-de Angelis
	2019-09-28
	RESUMO Objetivos Avaliar a presença de sinais e sintomas vocais e função vocal em indivíduos com disfagia, tratados de câncer de cabeça e pescoço – CCP e identificar os valores de corte dos respectivos instrumentos. Métodos Estudo prospectivo com 96 indivíduos (68 homens e 28 mulheres), divididos em grupo experimental – GE (pacientes tratados de CCP com disfagia, independente de queixa vocal) e grupo controle – GC (sem queixas autorrelatadas de voz e deglutição, pareados em média de idade e sexo com GE), que responderam a um questionário com dados de identificação e caracterização da amostra, Lista de Sinais e Sintomas Vocais – LSS, e dois protocolos de avaliação vocal (Índice de Função Glótica – IFG e Escala de Sintomas Vocais – ESV). Por fim, as notas de corte dos protocolos foram identificadas por meio da curva ROC (Receiver Operating Characteristic). Resultados Indivíduos do GE apresentaram mais sinais e sintomas vocais e maiores escores no IFG e ESV que os indivíduos do GC, além de pior autoavaliação vocal. Os três instrumentos apresentaram máxima área sob a curva ROC, com valores de corte ESV=17, IFG=4 e LSS=6 pontos. Conclusão Indivíduos tratados de CCP com disfagia apresentam mais sinais e sintomas vocais, pior autopercepção da disfunção vocal e maior prejuízo nos aspectos de limitação, emocional e físico da voz, que indivíduos vocalmente saudáveis. Os três instrumentos evidenciaram sensibilidade e especificidade máximas, podendo ser utilizados como ferramentas de triagem.
8.	Avaliação da influência da nulidade dos genótipos GSTT1 e GSTM1 na carcinogênese em cabeça e pescoço
	OpenAIRE (Portuguese)
	Eny Maria Goloni-Bertollo; Joice Matos Biselli; Léa Carolina deLima Corrêa; José Victor Maníglia; Andréa Regina Baptista Rossit; Mariângela Torreglosa Ruiz; Érika Cristina Pavarino-Bertelli
	2019-09-28
	OBJETIVO: Avaliar a influência dos genótipos nulos dos genes GSTT1 e GSTM1 na carcinogênese em cabeça e pescoço. MÉTODOS: Foram avaliadas as freqüências dos genótipos nulos GSTT1 e GSTM1 pela técnica de reação em cadeia de polimerase (PCR) multiplex em 45 pacientes com carcinoma espinocelular de cabeça e pescoço e 45 indivíduos sem história de doença neoplásica. Ambos os grupos foram compostos por indivíduos fumantes pareados por sexo, idade e etnia. RESULTADOS: O genótipo GSTT1 nulo foi encontrado em 24,4% dos pacientes e em 17,8% dos indivíduos controle (P = 0,606), enquanto 44,4% dos pacientes e 48,9% dos indivíduos controle revelou genótipo GSTM1 nulo (P = 0,832). Não foi observada correlação entre os genótipos nulos GSTT1 e GSTM1 e os sítios primários de tumor. CONCLUSÃO: Em nosso estudo não foi possível estabelecer a influência da nulidade dos genótipos GSTT1 e GSTM1 na carcinogênese em cabeça e pescoço. BACKGROUND: To evaluate the influence of GSTM1 and GSTT1 null genotypes in head and neck carcinogenesis. METHODS: The frequencies of GSTM1 and GSTT1 null genotypes were evaluated by multiplex polymerase chain reaction (PCR) in 45 patients with head and neck squamous cell carcinoma and in 45 control group individuals. Both groups were composed of smokers paired by gender, age and race. RESULTS: The GSTT1 null genotype was found in 24.4% of the patients and 17.7% of the control group (P= 0.606), while 44.4% of the patients and 48.8% of the control group were bearers of the GSTM1 null genotype (P=0.832). No associations between GSTT1 and GSTMI null genotypes and primary tumor sites were found. CONCLUSION: In our study, it was impossible to establish the influence of the GSTT1 and GSTM1 null genotypes in head and neck carcinogenesis.
9.	Polimorfismos GSTT1 e GSTM1 em indivíduos tabagistas com carcinoma espinocelular de cabeça e pescoço
	OpenAIRE (Portuguese)
	Joice Matos Biselli; Renata Cristina de Angelo Calsaverini Leal; Mariângela Torreglosa Ruiz; Eny Maria Goloni-Bertollo; José Victor Maníglia; Andréa Regina Baptista Rossit; Érika Cristina Pavarino-Bertelli
	2019-09-28
	A variabilidade em genes relacionados aos processos de ativação e detoxificação de carcinógenos pode interferir na suscetibilidade ao câncer. OBJETIVO: Investigar a relação entre os polimorfismos GSTT1 e GSTM1 nulos e o risco para o carcinoma espinocelular de cabeça e pescoço em indivíduos tabagistas. MATERIAL E MÉTODO: Este estudo caso-controle foi realizado na Faculdade de Medicina de São José do Rio Preto, Brasil. Foram avaliadas as freqüências dos genótipos nulos GSTT1 e GSTM1 por PCR multiplex em 60 pacientes com carcinoma espinocelular de cabeça e pescoço e 60 indivíduos sem a doença. RESULTADOS: A cavidade oral foi o sítio de tumor mais freqüente. O genótipo GSTT1 nulo foi encontrado em 33,3% dos pacientes e em 23,3% dos indivíduos controles (p=0,311). Os grupos caso e controle apresentaram freqüências do genótipo GSTM1 nulo de 35% e 48,3%, respectivamente (p=0,582). Não foram encontradas associações entre o hábito etilista e genótipos nulos GSTT1 e GSTM1 em ambos os grupos (valores de p>0,05). O gênero masculino e o hábito etilista foram prevalentes em ambos os grupos. CONCLUSÃO: Neste estudo não foi possível estabelecer uma correlação entre os genótipos nulos GSTT1 e GSTM1 e o carcinoma espinocelular de cabeça e pescoço em indivíduos tabagistas. Gene variability related to carcinogen activation and detoxification may interfere with susceptibility to head and neck cancer. AIM: To investigate the relation between GSTT1 and GSTM1 null polymorphisms and the risk of head and neck squamous cell carcinoma in cigarette smokers. MATERIAL AND METHOD: A case-control study conducted at the Sao Jose do Rio Preto Medical School, Brazil. GSTM1 and GSTT1 null genotype frequencies were evaluated by multiplex PCR in 45 cigarette smokers with head and neck squamous cell carcinomas and 45 cigarette smokers without this disease. RESULTS: The oral cavity was the most prevalent tumor site for squamous cell carcinoma. The GSTT1 null genotype was found in 33.3% of the Experimental Group and 23.3% of the Control Group (p= 0.311). Experimental and Control Groups had GSTM1 null genotype frequencies of 35% and 48.3% (p=0.582). No association between alcohol consumption and GSTT1 and GSTMI null genotypes was found in these groups (p-values>0.05). There were more men, and alcohol consumption was prevalent in both groups. CONCLUSION: In this study we were unable to show a correlation between GSTM1 and GSTT1 genotypes and the development of head and neck squamous cell carcinomas in cigarette smokers.
10.	A importância da endoscopia digestiva alta com solução de lugol no diagnóstico de câncer superficial e displasia em esôfago de doentes com neoplasias de cabeça e pescoço
	OpenAIRE (Portuguese)
	Alfio José TINCANI; Nelson BRANDALISE; Nelson Adami ANDREOLLO; Luiz Roberto LOPES; Ciro Garcia MONTES; Albina ALTEMANI; Antonio S. MARTINS
	2019-09-28
	Os tumores localizados em região de cabeça e pescoço apresentam alta incidência em nosso meio, principalmente se associados com fatores etiológicos ligados aos hábitos de etilismo e tabagismo. Estes mesmos hábitos relacionam-se também com a incidência de câncer em esôfago. Assim sendo, é de se esperar que estes pacientes venham a apresentar outra neoplasia primária neste último órgão. Foi realizado estudo prospectivo com 60 pacientes portadores de câncer em mucosa da região de cabeça e pescoço na Disciplina de Cirurgia de Cabeça e Pescoço e no Serviço de Endoscopia Digestiva do Gastrocentro - UNICAMP, com o objetivo de diagnosticar neoplasias malignas superficiais no esôfago, caracterizadas como segundo tumor primário, e displasias. A endoscopia digestiva alta foi indicada utilizando-se a solução de lugol a 2%, para coloração do epitélio esofagiano, evidenciando-se em 33 pacientes (55%), 42 áreas iodo-claras (suspeitas de neoplasias), que foram submetidas a biopsias para estudo anatomopatológico. Foram diagnosticados cinco carcinomas superficiais de esôfago (8,3%), sendo que três deles eram intra-epiteliais -- in situ (5,0%) e cinco áreas de displasia (8,3%). Concluiu-se que o método de coloração da mucosa esofagiana com a solução de lugol a 2%, através da endoscopia digestiva alta, apresenta alta sensibilidade e baixa especificidade para o diagnóstico de um segundo tumor primário e de displasia, em pacientes portadores de carcinoma em mucosa de região de cabeça e pescoço. Head and neck cancer has a high incidence in Brazil, with cancer of the oral cavity being one of the five most common cancers among Brazilians. Alcohol and tobacco consumption may contribute to synchronous or metachronous head and neck cancer and esophageal cancer. A prospective study involving 60 patients with head and neck cancer was carried out at the State University of Campinas -UNICAMP, Campinas, SP, Brazil to screen for superficial esophageal cancer and dysplasia using endoscopy and a 2% lugol dye solution followed by biopsy of the suspicious areas. Five patients (8.3%) had superficial esophageal cancer, which was diagnosed as intraepithelial carcinoma in three of them (5.0%). In four patients, the superficial esophageal cancer was synchronous and in one it was metachronous to head and neck cancer. Five patients (8.3%) had dysplasias in the esophageal epithelium (three were classified as mild and two as moderate). These results demonstrate the value of endoscopic screening of the esophagus using lugol dye in patients with head and neck cancer, particularly since superficial esophageal cancer is extremely difficult to detect by conventional methods in asymptomatic patients.
11.	Detailed Atlas of the Head and Neck
	OpenAIRE
	Royster, Henry P.
	2019-07-01
12.	EUS of the neck: A comprehensive anatomical reference for the staging of head and neck cancer (with videos)
	OpenAIRE
	Sharma, Malay; Pathak, Amit; Shoukat, Abid; Rameshbabu, Chittapuram Srinivasan; Goyal, Sumit; Bansal, Raghav; Hamza, Rooby; Charaya, Kshitij
	2019-09-25
	The use of EUS has application in the nodal staging of head and neck cancer. The technique and the anatomy of head and neck region using EUS have not been described. EUS from three stations in thoracic esophagus, cervical esophagus, and hypopharynx can allow imaging of head and neck. In this article we describe the normal structures from the three stations. The EUS imaging of head and neck can give relevant and additional information in malignancies of head and neck.
13.	Unknown primary head and neck squamous cell carcinoma in the era of fluorodeoxyglucose-positron emission tomography/CT and intensity-modulated radiotherapy
	OpenAIRE
	de Ridder, Mischa; Klop, Martin; Hamming-Vrieze, Olga; de Boer, JanPaul; Jasperse, Bas; Smit, Laura; Vogel, Wouter; van den Brekel, Michiel; Al-Mamgani, Abrahim
	2019-09-25
	Background The diagnosis and treatment of head and neck carcinoma of unknown primary (CUP) have changed with the introduction of fluorodeoxyglucose-positron emission tomography (FDG-PET)/CT and intensity-modulated radiotherapy (IMRT), with potential implications for outcome. Methods We conducted a retrospective analysis of 80 patients with head and neck CUP who were PET-staged and treated with curative intention using IMRT between 2006 and 2016 in the Netherlands Cancer Institute. Patient, tumor, and treatment demographics were recorded and oncologic outcomes were analyzed. Results Local control was 100% in mucosal irradiated patients. Regional control was 90%. Ten patients developed distant metastases, which were associated with N3, extracapsular extension (ECE) and lower neck positive lymph nodes. Overall survival (OS) at 5 years was 62% and disease-specific survival was 78%. ECE, N3 neck, multiple levels of positive lymph nodes, and positive lymph nodes in the lower neck were associated with worse prognosis. Conclusion Locoregional outcome of head and neck CUP managed with modern techniques is good. Future research needs to focus on reducing toxicity and patients prone for distant metastasis.
14.	Macrocystic (Mammary Analogue) Secretory Carcinoma: An Unusual Variant and a Pitfall in the Differential Diagnosis of Cystic Lesions in the Head and Neck.
	Europe PubMed Central
	Hernandez-Prera JC; Holmes BJ; Valentino A; Harshan M; Bacchi CE; Petersson F; Liu KK; Najfeld V; Wenig BM
	2019-11-01  Am J Surg Pathol
	Volume: 43  Issue: 11  Pages: 1483-1492  PMID: 31464708
15.	Identifying cutoff scores for the EORTC QLQ-C30 and the head and neck cancer-specific module EORTC QLQ-H&N35 representing unmet supportive care needs in patients with head and neck cancer
	OpenAIRE
	Jansen, Femke; Snyder, Claire F; Leemans, C René; Verdonck-de Leeuw, Irma M
	2019-09-25
	BACKGROUND: This study investigates cutoff scores for the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30-questions (EORTC QLQ-C30) and head and neck cancer-specific module (QLQ-H&N35) to identify patients with head and neck cancer who may require clinical attention. METHODS: Ninety-six patients with head and neck cancer completed the EORTC QLQ-C30/H&N35 and questions on supportive care needs. For all EORTC domains with the ability to discriminate between patients with and without unmet needs (area under the receiver operating characteristic curve [AUC] ≥0.70), the accuracy (eg, sensitivity and specificity) of potential cutoff scores were calculated. RESULTS: Cutoff scores (sensitivity ≥0.80 and specificity ≥0.60) of 90 (functioning domains) and 5 to 10 (symptom domains) were found on 7 of 28 continuous EORTC QLQ-C30/H&N35 domains. Borderline cutoff scores (sensitivity ≥0.70 and specificity ≥0.60 or sensitivity ≥0.80 and specificity ≥0.50) were found on 5 other domains. CONCLUSIONS: This study provided cutoff scores on the EORTC QLQ-C30 and H&N35 based on patients' perceptions of their needs for supportive care. Future research is needed on the replicability of these cutoff scores. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1493-E1500, 2016.
16.	The effect of head and neck position on the thoracolumbar kinematics in the unridden horse
	OpenAIRE
	Gomez, Alvares, C.B.; Rhohin, M.; Bobbert, M.F.; Meyer, H.; Weishaupt, M.A.; Johnston, C.; van Weeren, P.R.
	2019-09-25
	Reasons for performing study: In many equestrian activities a specific position of head and/or neck is required that is dissimilar to the natural position. There is controversy about the effects of these positions on locomotion pattern, but few quantitative data are available. Objectives: To quantify the effects of 5 different head and neck positions on thoracolumbar kinematics of the horse. Methods: Kinematics of 7 high level dressage horses were measured walking and trotting on an instrumented treadmill with the head and neck in the following positions: HNP2=neck raised, bridge of the nose in front of the vertical; HNP3=as HNP2 with bridge of the nose behind the vertical; HNP4=head and neck lowered, nose behind the vertical; HNP5=head and neck in extreme high position; HNP6 = head and neck forward and downward. HNP1 was a speed-matched control (head and neck unrestrained). Results: The head and neck positions affected only the flexion-extension motion. The positions in which the neck was extended (HNP2, 3, 5) increased extension in the anterior thoracic region, but increased flexion in the posterior thoracic and lumbar region. For HNP4 the pattern was the opposite. Positions 2, 3 and 5 reduced the flexion-extension range of motion (ROM) while HNP4 increased it. HNP5 was the only position that negatively affected intravertebral pattern symmetry and reduced hindlimb protraction. The stride length was significantly reduced at walk in positions 2, 3, 4 and 5. Conclusions: There is a significant influence of head/neck position on back kinematics. Elevated head and neck induce extension in the thoracic region and flexion in the lumbar region; besides reducing the sagittal range of motion. Lowered head and neck produces the opposite. A very high position of the head and neck seems to disturb normal kinematics. Potential relevance: This study provides quantitative data on the effect of head/neck positions on thoracolumbar motion and may help in discussions on the ethical acceptability of some training methods. © 2006 EVJ Ltd.
17.	Efeito agudo da Transcutaneous Electric Nerve Stimulation (TENS) sobre a hipossalivação induzida pela radioterapia na região de cabeça e pescoço: um estudo preliminar
	OpenAIRE (Portuguese)
	Émille Dalbem Paim; Fabricio Edler Macagnan; Vera Beatris Martins; Virgilio Gonzales Zanella; Bruno Guimarães; Monalise Costa Batista Berbert
	2019-09-28
	RESUMO Objetivo Verificar o efeito agudo da eletroestimulação sobre o fluxo salivar de pacientes com hipossalivação. Método Ensaio clínico não controlado que avaliou o efeito de uma única aplicação da Transcutaneous Electric Nerve Stimulation (TENS) sobre o fluxo salivar de 15 pacientes com hipossalivação induzida por radioterapia (RT), utilizada no tratamento de câncer de cabeça e pescoço. A média de idade dos pacientes foi de 56,8 ± 6,46 anos e o gênero masculino foi predominante (73%). A TENS foi programada com 50Hz de frequência, 250μs de largura de pulso e a intensidade foi ajustada ao longo dos 20 minutos conforme máxima tolerância. Os eletrodos foram fixados bilateralmente sobre a região das glândulas salivares. A avaliação do fluxo salivar foi realizada por meio de sialometria estimulada, antes e imediatamente após a aplicação da TENS. Resultados Em 80% dos casos, o tratamento oncológico incluiu quimioterapia. A RT foi aplicada em 80% dos casos na região e orofaringe, com intensidade média de 64,6 ± 7,27 Gy. Após a TENS, o fluxo salivar aumentou significativamente (p = 0,0051), passando de 0,05 (0,00; 0,40) mL/min para 0,10 (0,07;0,40) mL/min. A resposta à TENS foi diretamente correlacionada à intensidade da corrente elétrica tolerada (r = 0,553; p = 0,032) e à dose utilizada na RT (r = -0,514; p = 0,050). Conclusão A TENS aumentou significativamente o fluxo salivar de pacientes com hipossalivação induzida pela RT.
18.	Personnalisation de la dose et du fractionnement de la radiothérapie des cancers de la tête et du cou
	OpenAIRE (French)
	Blanchard, P; Biau, J; Castelli, J; Tao, Y; Graff, P; Nguyen, F
	2019-09-26
	National audience; Les cancers des voies aérodigestives supérieures correspondent à un ensemble de maladies variées, pour lesquelles les volumes de traitement et la dose prescrite sont à individualiser en fonction de chaque patient. L’objectif de cet article est de passer en revue les principaux facteurs décisionnels concernant la définition des volumes cibles, la prescription de la dose, ainsi que les voies de recherche en cours d’exploration. Les recommandations de délinéation, les doses prescrites, l’utilisation de modifications de fractionnement, les principaux facteurs pronostiques, la place des papillomavirus humains et l’apport de l’imagerie moléculaire sont successivement évoqués.
19.	Relationship between swallow-specific quality of life and fiber-optic endoscopic evaluation of swallowing findings in patients with head and neck cancer
	OpenAIRE
	Florie, Michelle; Baijens, Laura; Kremer, Bernd; Kross, Kenneth; Lacko, Martin; Verhees, Femke; Winkens, Bjorn
	2019-09-25
20.	CD8+ and Regulatory T cells Differentiate Tumor Immune Phenotypes and Predict Survival in Locally Advanced Head and Neck Cancer
	Directory of Open Access Journals (Sweden)
	Alessia Echarti; Markus Hecht; Maike Büttner-Herold; Marlen Haderlein; Arndt Hartmann; Rainer Fietkau; Luitpold Distel
	2019-09-01  Cancers
	DOI: 10.3390/cancers11091398  ISSN: 2072-6694  Volume: 11  Issue: 9  Pages: 1398
	Keywords: CD8+, regulatory T cells, FoxP3+, head and neck squamous cell carcinoma, immune dessert, inflamed, excluded
	Full Text Available Background: The tumor immune status “inflamed”, “immune excluded”, and “desert” might serve as a predictive parameter. We studied these three cancer immune phenotypes while using a simple immunohistochemical algorithm. Methods: Pre-treatment tissue samples of 280 patients with locally advanced HNSCC treated with radiochemotherapy were analyzed. A double staining of CD8+ cytotoxic T cells (CTL) and FoxP3+ (Treg) was performed and the cell density was evaluated in the intraepithelial and stromal compartment of the tumor. Results: The classification of tumors as “immune desert” when stromal CTL were ≤ 50 cells/mm2, “inflamed” when intraepithelial CTL were > 500 cells/mm2, and as “excluded” when neither of these definitions met these cut off values allowed the best discrimination regarding overall survival. These groups had median OS periods of 37, 61, and 85 months, respectively. In “immune desert” and “immune excluded” tumors high Treg tended to worsen OS, but in “inflamed” tumors high Treg clearly improved OS. Conclusions: We propose that, in locally advanced HNSCC, the tumor immune state “inflamed”, “immune excluded”, and “immune desert” can be defined by intraepithelial and stromal CTL. Tregs can further subdivide these groups. The opposing effects of Tregs in the different groups might be the reason for the inconsistency of Tregs prognostic values published earlier.