Recurrent Squamous Cancer Research Articles

Long-Term Follow-Up Evaluation of Efficacy in Alpha-Emitting Radiation Therapy on Recurrent and Locally Advanced Squamous Cell Carcinomas in Multi-Center Clinical Study

<h3>Purpose/Objective(s)</h3> Diffusing Alpha-emitter Radiation Therapy (DaRT) represents a novel method to deliver alpha particles intratumorally via the decay of Radium-224. Early results demonstrated the feasibility, safety, and efficacy of DaRT with an associated 100% overall response rate at six weeks and a favorable toxicity profile. The purpose of the study was to report the long-term tumor control outcomes of DaRT for the treatment of locally advanced and recurrent squamous cancers (SCC) of the skin and head and neck. <h3>Materials/Methods</h3> This retrospective study evaluated the outcomes of patients with histologically-confirmed SCC of the skin and head and neck who either previously failed or were medically unfit for definitive therapy. For this study, 28 lesions in 23 patients were eligible and treated per protocol. Treatment was delivered via a percutaneous interstitial technique with placement of the radioactive DaRT to encompass the tumor volume with margin. Tumor control was assessed using serial radiographic imaging or clinical assessments. The median follow-up time was 28 months following treatment. <h3>Results</h3> Complete response to the Ra-224 DaRT treatment was observed in 22 lesions (22/28; 79%); 6 lesions (6/28, 21%) manifested a partial response. Among the 22 lesions with a CR, 9 (41%) developed a subsequent local relapse at the site of DaRT implantation at a median time of 6.2 months (range: 2.8-35.4 months). The 2-year local progression-free survival (PFS) probability at the implanted site was 50% (95% Confidence Interval, CI: 28-68%) for complete responders. The 2-year overall survival rates post-DaRT implantation was 65% (95% CI: 42%-81%) among all patients and was 77% (95% CI: 50%-91%) among complete responders. <h3>Conclusion</h3> Despite prior therapy among these recurrent, locally advanced tumors, Ra-224 DaRT treatment was well tolerated and associated with excellent 2-year tumor control outcomes. A pivotal US trial for marketing approval is already underway.

Initial Safety and Tumor Control Results From a “First-in-Human” Multicenter Prospective Trial Evaluating a Novel Alpha-Emitting Radionuclide for the Treatment of Locally Advanced Recurrent Squamous Cell Carcinomas of the Skin and Head and Neck

Our purpose was to report the feasibility and safety of diffusing alpha-emitter radiation therapy (DaRT), which entails the interstitial implantation of a novel alpha-emitting brachytherapy source, for the treatment of locally advanced and recurrent squamous cancers of the skin and head and neck. This prospective first-in-human, multicenter clinical study evaluated 31 lesions in 28 patients. The primary objective was to determine the feasibility and safety of this approach, and the secondary objectives were to evaluate the initial tumor response and local progression-free survival. Eligibility criteria included all patients with biopsy-proven squamous cancers of the skin and head and neck with either primary tumors or recurrent/previously treated disease by either surgery or prior external beam radiation therapy; 13 of 31 lesions (42%) had received prior radiation therapy. Toxicity was evaluated according to the Common Terminology Criteria for Adverse Events version 4.03. Tumor response was assessed at 30 to 45 days at a follow-up visit using the Response Evaluation Criteria in Solid Tumors, version 1.1. Median follow-up time was 6.7 months. Acute toxicity included mostly local pain and erythema at the implantation site followed by swelling and mild skin ulceration. For pain and grade 2 skin ulcerations, 90% of patients had resolution within 3 to 5 weeks. Complete response to the Ra-224 DaRT treatment was observed in 22 lesions (22/28; 78.6%); 6 lesions (6/28, 21.4%) manifested a partial response (>30% tumor reduction). Among the 22 lesions with a complete response, 5 (22%) developed a subsequent local relapse at the site of DaRT implantation at a median time of 4.9 months (range, 2.43-5.52 months). The 1-year local progression-free survival probability at the implanted site was 44% overall (confidence interval [CI], 20.3%-64.3%) and 60% (95% CI, 28.61%-81.35%) for complete responders. Overall survival rates at 12 months post-DaRT implantation were 75% (95% CI, 46.14%-89.99%) among all patients and 93% (95% CI, 59.08%-98.96%) among complete responders. Alpha-emitter brachytherapy using DaRT achieved significant tumor responses without grade 3 or higher toxicities observed. Longer follow-up observations and larger studies are underway to validate these findings.

Weekly methotrexate in squamous cell cancers of head and neck

15539 Background: The aim was to evaluate response rates and toxicity of weekly methotrexate in locally advanced or recurrent squamous cell cancers of the head and neck region. Methotrexate, oldest non-platinum drugs active in squamous cell cancer of head and neck, was selected for its cost-effectiveness and ease of administration. Methods: Patients with locally advanced, inoperable or recurrent squamous cancers were selected. Sites included anterior two-third tongue, buccal mucosa, alveolus, base tongue, larynx and maxilla. Methotrexate 1 mg/Kg was given intramuscularly on outpatient basis once a week for 6 to 8 weeks along with hydration. Patients who responded well and became resectable were encouraged to undergo surgery. All patients were followed up in the clinic every monthly. Results: Total 19 patients were entered on the study over a duration of 24 months. 12 out of 19 patients had partial response (63%), 5 had stable disease (26%) and 2 patients had disease progression. Symptomatic relief ranged from 25% to 100%. Maximum response duration was 12 weeks. Treatment naïve patients had rapid response. In 5 patients disease became clearly resectable. Toxicity was grade II-III oral mucositis in patients with previous radiation. Sample size is small for a subset analysis. Conclusions: Weekly methotrexate is a simple, cost-effective regimen for palliation in advanced recurrent squamous cell cancers of head and neck region. It should also be evaluated further in large scale trials and especially in neo-adjuvant setting in locally advanced squamous cell cancers of the head and neck region given its rapidity of response and brief duration of therapy. No significant financial relationships to disclose.

Vaginal cytology following primary hysterectomy for cervical cancer: Is it useful?

Vaginal intraepithelial neoplasia (VAIN) is usually detected in patients with synchronous or antecedent cervical or vulval intraepithelial or invasive cancer. VAIN has the potential to progress to malignancy. To determine the incidence and severity and analyse the management of vaginal dysplasia in patients undergoing primary hysterectomy for cervical cancer. A retrospective study (1984-1998) identified 210 primary invasive cervical cancers. One-hundred and twenty-three patients had a primary hysterectomy. In follow-up six patients were found to have dyskaryosis in a second vaginal smear. Biopsies in the six patients with colposcopic lesions showed VAIN II (n=2), VAIN III (n=1),VAIN III / possible early invasion (n = 1) and invasive carcinoma (n=2). One patient with recurrent squamous cancer received salvage radiotherapy and one with recurrent adenocarcinoma received high dose progestogens and topical 5-fluorouracil. All patients are disease-free at follow-up.

421 A phase II trial of docetaxel in squamous cell cancer of the head and neck

Docetaxel was given as a 100 mg/m2 intravenous injection, once every 3 weeks; in patients with metastatic or recurrent squamous cancer of the head and neck. Patients were pretreated with steroids and antihis-tamines. Twenty eight patients were entered. All had previous radiotherapy and 9 had cisplatinum/FUra based induction chemotherapy > 12 months previously. The remaining 19 had no prior chemotherapy. There was a 50% response rate (4 CR and 10 PR) among all patients. Response among patients treated with prior induction chemotherapy was 40%. The median duration of response was 4 months. 43% of the patients experienced leukopenia (WBC

Synchronous radiation and cytotoxic chemotherapy for locally advanced or recurrent squamous cancer of the vulva

International Journal of Gynecology & ObstetricsVolume 42, Issue 1 p. 93-93 Citations from the literature oncology Synchronous radiation and cytotoxic chemotherapy for locally advanced or recurrent squamous cancer of the vulva A.H. Russell, A.H. RussellSearch for more papers by this authorJ.B. Mesic, J.B. MesicSearch for more papers by this authorS.A. Scudder, S.A. ScudderSearch for more papers by this authorP.J. Rosenberg, P.J. RosenbergSearch for more papers by this authorL.H. Smith, L.H. SmithSearch for more papers by this authorW.K. Kinney, W.K. KinneySearch for more papers by this authorD.E. Townsend, D.E. TownsendSearch for more papers by this authorJ.D. Trelford, J.D. TrelfordSearch for more papers by this authorM.H. Taylor, M.H. TaylorSearch for more papers by this authorC.L. Zukowski, C.L. ZukowskiSearch for more papers by this authorK.G. McMahon, K.G. McMahonSearch for more papers by this author A.H. Russell, A.H. RussellSearch for more papers by this authorJ.B. Mesic, J.B. MesicSearch for more papers by this authorS.A. Scudder, S.A. ScudderSearch for more papers by this authorP.J. Rosenberg, P.J. RosenbergSearch for more papers by this authorL.H. Smith, L.H. SmithSearch for more papers by this authorW.K. Kinney, W.K. KinneySearch for more papers by this authorD.E. Townsend, D.E. TownsendSearch for more papers by this authorJ.D. Trelford, J.D. TrelfordSearch for more papers by this authorM.H. Taylor, M.H. TaylorSearch for more papers by this authorC.L. Zukowski, C.L. ZukowskiSearch for more papers by this authorK.G. McMahon, K.G. McMahonSearch for more papers by this author First published: July 1993 https://doi.org/10.1016/0020-7292(93)90498-LAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume42, Issue1July 1993Pages 93-93 RelatedInformation

Synchronous radiation and cytotoxic chemotherapy for locally advanced or recurrent squamous cancer of the vulva

Between July 1987 and September 1991 a program of external beam radiation and synchronous, radiopotentiating chemotherapy was employed to treat 25 women with locoregionally advanced or locoregionally recurrent squamous cancer of the vulva. Of 18 previously untreated patients, 1 was Stage II, 10 were Stage III, 6 were Stage IVA, and 1 was Stage IVB. Reasons for patient referral for nonsurgical management included the presence of initially unresectable disease (5 patients), disease extent which would have necessitated partial or total exenteration if treated surgically (9 patients), disease extent predictive of inadequate surgical margins (less than 1 cm gross margin) if treated by less than exenterative surgery (8 patients), and severe comorbid illness precluding surgical management (3 patients). Complete clinical response was obtained in 16 of 18 previously untreated patients (89%) and in 4 of 7 patients with recurrent disease following vulvar surgery (57%). Of 20 patients achieving a complete clinical response, 3 patients have relapsed within the irradiated volume at 11, 38, and 48 months following completion of treatment. Fourteen patients remain alive and continuously cancer free from 2–52 months after completion of treatment (median follow-up 24 months). This experience suggests that initial management with radiation and chemotherapy may offer some patients with locally advanced squamous cancer of the vulva an alternative to exenterative surgery and may hold curative potential for some patients with surgically unresectable or medically inoperable disease.

Synchronous radiation and cytotoxic chemotherapy for locally advanced or recurrent squamous cancer of the vulva

Synchronous radiation and cytotoxic chemotherapy for locally advanced or recurrent squamous cancer of the vulva

A phase II study of cisplatin and cytosine arabinoside for recurrent squamous cell carcinoma of the head and neck.

Based on experimental data suggesting synergy between cisplatin and cytosine arabinoside, 17 patients with recurrent squamous cancer of the head and neck were treated with this combination. The response rate was 18% with no complete responses, and the partial responses were of brief duration. There were moderate hematologic and gastrointestinal toxicities and two therapy-related deaths. The study was stopped early because of low response. When compared to results reported for cisplatin alone, the combination of cisplatin and cytosine arabinoside offered no clear advantage.