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Accurately calculating setup errors is crucial in ensuring quality assurance for patients undergoing radiation therapy treatment. This cross-sectional study aimed to determine the systematic, random, and planning target volume (PTV) margin errors for patients with head and neck cancer (n=48) and breast cancer (n=50). The treatment setup was performed using electronic portal imaging (EPIDs) and irradiated using Elekta linac. The errors were calculated using the van Herk formula. The systematic error for the head and neck was 0.89, 0.43, and 1.49 mm on the x, y, and z-axis, respectively, and 0.39, 0.74, 0.38 for the breast cases. The random error was 0.82, 0.68, 0.94 mm for the head and neck and 0.66, 0.72, 0.79 mm for the breast. The PTV margin shifting error for the head and neck were 2.79, 1.55, and 4.38 mm, while it was 1.43, 2.35, and 1.50 mm for the breast. The setup errors varied according to the tumor location. The study highlights the potential benefits of using EPIDs for reducing uncertainties in setup verification procedures. [ABSTRACT FROM AUTHOR]

Abstract Objective Besides angiotensin converting enzyme 2 (ACE2), an active involvement of proteases (FURIN and/or TMPRSS2) is important for cellular entry of SARS‐CoV‐2. Therefore, a simultaneous expression profiling of entry proteins in a tissue might provide a better risk assessment of SARS‐CoV‐2 infection as compared to individual proteins. In an attempt to understand the relative susceptibility of oral squamous cell carcinoma (OSCC) lesions as compared to the normal oral mucosa (NOM) for SARS‐CoV‐2 attachment/entry, this study examined the mRNA and protein expression profiles of ACE2, FURIN, and TMPRSS2 in the corresponding tissues using public transcriptomic and proteomics datasets. Methods and methods Public transcriptomic and proteomics datasets (the Cancer Genome Atlas (TCGA)/the Genotype‐Tissue Expression (GTEx), the Human Protein Atlas (HPA), and two independent microarray datasets) were used to examine the expression profiles of ACE2, TMPRSS2 and FURIN in NOM and OSCC. Results ACE2, TMPRSS2, and FURIN mRNAs were detected in NOM, however, at lower levels as compared to other body tissues. Except for moderate up‐regulation of FURIN, expression levels of ACE2 and TMPRSS2 mRNA were unchanged/down‐regulated in OSCC as compared to the NOM. Conclusions These results indicate that NOM may serve as a possible site for SARS‐CoV‐2 attachment, however, to a lesser extent as compared to organs with higher expression levels of the SARS‐CoV‐2 entry proteins. However, the evidence is lacking to suggest that expression status of entry proteins predisposes OSCC lesions to additional risk for SARS‐CoV‐2 attachment/entry as compared to NOM.

Considering that India's middle class is not far above the International Poverty line and illness makes our population vulnerable to fall back into poverty. There is a pressing need to identify cost effective palliative chemotherapy medicines for the common man in India and apply the principles of pharmacoeconomics as an important priority in deciding the palliative chemotherapy medicines for the cancer patients. Pharmacoeconomics identifies and compares the costs and consequences of drug therapy to healthcare systems and society. This review article aims at compiling the current data available on the pharmacoeconomically cost effective palliative chemotherapy available for head and neck cancers and is meant to highlight important palliative chemotherapy medicines in head and neck cancers, comparing its cost and improvement in Quality of Life (QOL), TWIST (Time Without Symptoms or Toxicities) score/symptom control, Response Rate, survival advantage to overall guide the decisions of patient and their families in a ethically justified manner. [ABSTRACT FROM AUTHOR]

Objective: Besides angiotensin converting enzyme 2 (ACE2), an active involvement of proteases (FURIN and/or TMPRSS2) is important for cellular entry of SARS‐CoV‐2. Therefore, a simultaneous expression profiling of entry proteins in a tissue might provide a better risk assessment of SARS‐CoV‐2 infection as compared to individual proteins. In an attempt to understand the relative susceptibility of oral squamous cell carcinoma (OSCC) lesions as compared to the normal oral mucosa (NOM) for SARS‐CoV‐2 attachment/entry, this study examined the mRNA and protein expression profiles of ACE2, FURIN, and TMPRSS2 in the corresponding tissues using public transcriptomic and proteomics datasets. Methods and methods: Public transcriptomic and proteomics datasets (the Cancer Genome Atlas (TCGA)/the Genotype‐Tissue Expression (GTEx), the Human Protein Atlas (HPA), and two independent microarray datasets) were used to examine the expression profiles of ACE2, TMPRSS2 and FURIN in NOM and OSCC. Results: ACE2, TMPRSS2, and FURIN mRNAs were detected in NOM, however, at lower levels as compared to other body tissues. Except for moderate up‐regulation of FURIN, expression levels of ACE2 and TMPRSS2 mRNA were unchanged/down‐regulated in OSCC as compared to the NOM. Conclusions: These results indicate that NOM may serve as a possible site for SARS‐CoV‐2 attachment, however, to a lesser extent as compared to organs with higher expression levels of the SARS‐CoV‐2 entry proteins. However, the evidence is lacking to suggest that expression status of entry proteins predisposes OSCC lesions to additional risk for SARS‐CoV‐2 attachment/entry as compared to NOM. [ABSTRACT FROM AUTHOR]

Introduction. The diagnosis of a primary tumor of the central nervous system is a source of huge fear and anxiety for a patient, because the prognosis is usually unfavorable. Very often, the cancer is accompanied by depression, which reduces the effectiveness of treatment and worsens the patient’s functioning in everyday life. The aim. The aim of the study is to determine the cause-and-effect relationship between quality of life and incidence of depression, as well as the side effects of treatment in people treated with radiation for head cancer. Material and methods. The study group consisted of 103 patients during treatment in the Radiotherapy Ward of the Specialist Hospital in Nowy Sącz. The research tools were: the WHO QOL-Bref questionnaire, the Beck Depression Scale and a questionnaire of the author’s own design regarding patients treated with radiation therapy for head cancer. Results. The general perception of the quality of life in the studied group was 2.88 points, the general perception of the patient’s own health was 1.88 points. The average quality of life was the highest in the environmental field: 62.50 ± 23.21, while the lowest in the physical field: 44.24 ± 28.65. Conclusions. Both the overall assessment of the quality of life in the assessed areas and the perception of health by patients treated with radiation therapy for head cancer are low. [ABSTRACT FROM AUTHOR]

Head and neck cancers are the most common cancers in the body. Treatments are determined on the basis of the location and stage of the primary tumor. The goal of treatment is to eliminate the tumor, prevent recurrence or metastasis, and maintain the quality of life. There are several treatments available for the management of head and neck cancers, including surgery, radiation therapy, chemotherapy, new molecular agents, and a combination of them. Transoral robotic technique is a short-time operation using a type of robotic machine in which the patient undergoes anesthesia for a shorter time and the side effects of this operation and the time of hospitalization are less than open surgery. Due to the importance of speed and accuracy in head and neck cancer surgery and the importance of application of robotics in surgery, the present study was designed and implemented to review the application of robotics in the management of head and neck cancers. In this review study, the keywords: application, robotic, surgical, head cancer, transoral robotic surgery (TORS), and neck cancer, were searched in ISI, PubMed, Scopus, Google scholar databases. Related articles written domestically or abroad that have covered areas such as the background of transoral robotic surgery, maintaining organ function and approaches, the advantages and disadvantages of TORS, the affordability of TORS, the combination of TORS with other therapeutic approaches published from 2003 to 2019 were reviewed. The use of robotic surgery for precise operations such as head and neck cancers seems to be essential. More advanced robotic devices are expected to expand the surgery treatment for head and neck cancers as well as the results of using TORS for oncologic optimization and acceptability of results while maintaining organ function and patient's quality of life.

Head and neck cancers are the most common cancers in the body. Treatments are determined on the basis of the location and stage of the primary tumor. The goal of treatment is to eliminate the tumor, prevent recurrence or metastasis, and maintain the quality of life. There are several treatments available for the management of head and neck cancers, including surgery, radiation therapy, chemotherapy, new molecular agents, and a combination of them. Transoral robotic technique is a short-time operation using a type of robotic machine in which the patient undergoes anesthesia for a shorter time and the side effects of this operation and the time of hospitalization are less than open surgery. Due to the importance of speed and accuracy in head and neck cancer surgery and the importance of application of robotics in surgery, the present study was designed and implemented to review the application of robotics in the management of head and neck cancers. In this review study, the keywords: application, robotic, surgical, head cancer, transoral robotic surgery (TORS), and neck cancer, were searched in ISI, PubMed, Scopus, Google scholar databases. Related articles written domestically or abroad that have covered areas such as the background of transoral robotic surgery, maintaining organ function and approaches, the advantages and disadvantages of TORS, the affordability of TORS, the combination of TORS with other therapeutic approaches published from 2003 to 2019 were reviewed. The use of robotic surgery for precise operations such as head and neck cancers seems to be essential. More advanced robotic devices are expected to expand the surgery treatment for head and neck cancers as well as the results of using TORS for oncologic optimization and acceptability of results while maintaining organ function and patient's quality of life. [ABSTRACT FROM AUTHOR]

Online support groups have become a familiar source of social support for people with a variety of health issues. To date, no research has investigated the use of such groups by people with head and neck cancer (H&N). The aim of this study was to assess the types of social support, both sought and offered, within online support groups (OSGs) for head and neck cancer. Data was collected from 18 OSGs and two coding schemes; the Social Support Behaviour Code and the scheme of Coursaris & Liu (2009), were used to analyse the content of support-seeking and support-offering messages. The results suggested that the most frequently offered types of social support by group members were informational (43.4%) and emotional (32.4%), followed by esteem (15.6%) and network support (6.1%), whereas little tangible assistance was offered (2.4%). The content of support-seeking messages included group members sharing personal experience (31.5%), with the most frequent sought support being informational support (25.5%). The OSGs can be advantageous to people with H&N cancer, especially for those with appearance or speech problems to mitigate their embarrassment and facilitate interaction with others. The present findings suggest that such OSGs can be promising sources of H&N cancer-related informational and emotional support for the recipients, whether they are patients, family members or carers.

Background: Lung or head and neck cancers are known for their high prevalence and mortality rates. Chemotherapy and radiotherapy are usually recommended as cancer treatment for these malignancies; however, they can negatively impact both the physical and mental status of patients. Hence, it is reasonable to consider resistance and aerobic exercise training to prevent these negative health outcomes. Further, several factors prevent patients from attending outpatient exercise training programs, and, therefore, a semisupervised home-based exercise training program may be seen as a well-accepted alternative., Objective: The aim of this study will be to investigate the effects of a semisupervised home-based exercise training program on physical performance, body composition, and self-reported outcomes; changes in the initial cancer treatment dose prescribed; number of hospitalizations at 3, 6, and 9 months; and 12-month survival in people with primary lung or head and neck cancer., Methods: Participants will be randomly allocated to the training group (TG) or control group (CG). The TG will undergo semisupervised home-based resistance and aerobic exercise training throughout their cancer treatment. The resistance training will be performed using elastic bands (TheraBand) twice a week. The aerobic training (ie, brisk walk) will be performed for at least 20 minutes per day outdoors. The equipment and tools used during the training sessions will be provided. This intervention will start the week before treatment commencement, will be performed throughout the duration of the treatment, and will continue for 2 weeks after treatment completion. The CG will undergo usual care (ie, cancer treatment with no formal exercise prescription). Assessments will take place 2 weeks before the beginning of the usual cancer treatment and 2 weeks after treatment completion. The measures of physical function (peripheral muscle strength, functional exercise capacity, and physical activity), body composition, and self-reported outcomes (symptoms of anxiety and depression, health-related quality of life, and symptoms related to the disease and treatment) will be collected. We will report on any change in the initial cancer treatment dose prescribed; number of hospitalizations at 3, 6, and 9 months; and 12-month survival., Results: In February 2021, the clinical trial registration was approved. Recruitment and data collection for the trial are ongoing (as of April 2023, 20 participants had already been randomized), and findings of this study are likely to be published late in 2024., Conclusions: This exercise training as a complementary treatment for patients with cancer is likely to promote positive effects on the health outcomes assessed, over and above any change in the CG, and prevent the reduction of initial cancer treatment dose prescribed. If these positive effects are shown, they will likely impact long-term outcomes such as hospitalizations and 12-month survival., Trial Registration: Brazilian Clinical Trials Registry (ReBEC) RBR-5cyvzh9; https://ensaiosclinicos.gov.br/rg/RBR-5cyvzh9., International Registered Report Identifier (irrid): PRR1-10.2196/43547., (©Isis Grigoletto, Vinicius Cavalheri, Luis Alberto Gobbo, Karina Pozo, Enio Rodrigues Maia Filho, Diogo Gonçalves Ribeiro, Nara Ielo, Fabiano Francisco De Lima, Ercy Mara Cipulo Ramos. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 24.05.2023.)

Online support groups have become a familiar source of social support for people with a variety of health issues. To date, no research has investigated the use of such groups by people with head and neck cancer (H&N). The aim of this study was to assess the types of social support, both sought and offered, within online support groups (OSGs) for head and neck cancer. Data was collected from 18 OSGs and two coding schemes; the Social Support Behaviour Code and the scheme of Coursaris & Liu (2009), were used to analyse the content of support-seeking and support-offering messages. The results suggested that the most frequently offered types of social support by group members were informational (43.4%) and emotional (32.4%), followed by esteem (15.6%) and network support (6.1%), whereas little tangible assistance was offered (2.4%). The content of support-seeking messages included group members sharing personal experience (31.5%), with the most frequent sought support being informational support (25.5%). The OSGs can be advantageous to people with H&N cancer, especially for those with appearance or speech problems to mitigate their embarrassment and facilitate interaction with others. The present findings suggest that such OSGs can be promising sources of H&N cancer-related informational and emotional support for the recipients, whether they are patients, family members or carers. [ABSTRACT FROM AUTHOR]

Background: Changes in lipid profile have been associated with malignancy because of their key role in the maintenance the integrity of the cell membrane. This study evaluated the alterations in serum lipid profile in untreated patients of oral submucus fibrosis (OSMF), oral leukoplakia, and oral lichen planus and proven cases of oral cancer with respect to healthy controls. Materials & Methods: In this case control study, 20 clinically and histopathologically proven patients of oral precancer and oral cancer each were compared with 20 healthy controls. In these groups, serumlipids including: (i) Total cholesterol. (ii) Triglycerides (TGL). (iii) High density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol (LDL) and very low density lipoprotein cholesterol (VLDL) were analyzed. Results: Decrease in plasma total cholesterol, triglycerides, HDL, LDL, VLDL in the subjects with the oral precancer and oral cancer as compared to the controls was statistically significant. There was also decrease in plasma levels of TGL and VLDL in oral cancer subjects as compared to precancer subjects. Thus, it was found that there is an inverse relationship between plasma lipid levels and patients. Conclusion: Post operative morbidity was increasing along with more operating time and increase in the depth of mandibular third molar impaction. [ABSTRACT FROM AUTHOR]

Summary: Although the benefit of extra-oral implants in the reconstruction of maxillofacial oncological defects is undisputable, some relevant issues need to be clarified. The purpose of this retrospective study was to evaluate the relationship between implants placed during ablation (DA-implants) and after ablation (AA-implants) of the tumor with respect to implant survival. In total, 103 implants were assessed: 44 nasal implants (17 patients) and 59 orbital implants (18 patients). All patients received their implant-retained maxillofacial epithesis between 1997 and 2010, with a mean follow-up of 35months (range 8–156months). The survival rate of DA-implants was 90.0% for the orbital region and 93.5% for the nasal region. The survival rate of the AA-implants for the orbital and the nasal region was 82.8% and 61.5%, respectively. This study shows a significant higher survival rate of extra-oral implants placed during ablative surgery compared to implants in a later stage (p =0.044), thereby stressing the importance of installing extra-oral implants during the ablative surgical session. [Copyright &y& Elsevier]

Summary: To evaluate galectin-1, -3 and -7 serum levels as diagnostic and/or prognostic markers for head and neck squamous cell carcinomas (HNSCCs). ELISA was employed to test sera from 102 patients with HNSCCs and from 38 healthy control volunteers for galectin-1, -3 and -7 serum levels. Serum galectin levels were assayed by ELISA and the levels of galectin expression in HNSCCs were determined by means of immunohistochemistry. HNSCCs display significant immunohistochemical amounts of galectin-7, but this galectin cannot be detected in the blood of HNSCC patients. Galectin-3 levels differ significantly (p =0.03) in healthy volunteers and HNSCC patients. Using a threshold value of 4.3ng/ml, galectin-3 serum level enabled a significant level of discrimination (p =0.03) to be established between the cancer patients and the healthy volunteers, with 90% level of specificity and 36% level of sensitivity. The discrimination was even better when using a threshold value of 13.5ng/ml for galectin-1 (p =0.001), with 100% level of specificity and 22% level of sensitivity. A subgroup of stage IV HNSCC patients displayed significantly reduced levels of circulating galectin-1 (p =0.003) and galectin-3 (p =0.001) after treatment as opposed to before. Galectin-3 concentrations in sera from the patients with a metastatic disease were significantly (p =0.01) higher than in sera from the patients with localized tumors. The determination of circulating levels of galectin-1 and -3 could be used to monitor the progression of their disease or their response to therapy. [Copyright &y& Elsevier]

Intensity-modulated radiation therapy (IMRT), an advent of three-dimensional conformal radiotherapy (3D CRT), has excited the profession of radiation oncology more than any other new invention since the introduction of the linear accelerator. Approximately 1000 articles have been published on this topic to date, more than 200 of which focus on head and neck cancer. IMRT is based on computer-optimized treatment planning and a computer-controlled treatment delivery system. The computer-driven technology generates dose distributions that sharply conform to the tumor target while minimizing the dose delivered to the surrounding normal tissues. The high dose volume that tailors to the 3D configuration of the tumor along with the ability to spare the nearby normal tissues allows the option of tumor dose escalation. The head and neck region is an ideal target for this new technology for several reasons. First, IMRT offers the potential for improved tumor control through delivery of high doses to the target volume. Second, because of sharp dose gradients, IMRT results in the relative sparing of normal structures, such as the parotid glands, in the head and neck region. Third, organ motion is virtually absent in the head and neck region so, with proper immobilization, treatment can be accurately delivered. Although this is a relatively new technology, single-institution retrospective studies show better dosimetric profiles compared with conventional radiation techniques, as well as excellent clinical results. Salivary gland sparing using IMRT has also resulted in reduced incidence and severity of xerostomia, and this has been tested in a randomized trial against conventional radiotherapy for early-stage nasopharyngeal cancer. The results do confirm that IMRT does decrease xerostomia compared with conventional radiotherapy. © 2005 Wiley Periodicals, Inc. Head Neck27: XXX–XXX, 2005 [ABSTRACT FROM AUTHOR]

Objective To e-amine whether screening chest radiographs lead to significantly longer life span in patients found to have pulmonary lesions than in those in whom lung cancer was detected after symptoms developed. Study Design A retrospective study. Material and Methods Charts of 1086 patients with squamous cell cancer of the head and neck treated for cure from January 1, 1974, to December 31, 1998, were analyzed. Results Pulmonary cancer developed in 62 patients. In 41 patients pulmonary malignancy was found because of patient symptoms. In 21 patients lung cancer was detected by routine annual chest radiography. Seventy-five percent of lung cancers were detected within 3 years of initial treatment of the head and neck cancer. Conclusion Chest radiography is a poor screening tool, because it failed to find pulmonary lesions in more than 65% (41/62) of patients who were later found to have pulmonary cancer. Survival rate did not differ between patients in whom pulmonary cancer was found by screening chest radiography and those in whom symptoms prompted evaluation ( P = .48). Using current treatment protocols, routine yearly chest radiography did not improve survival in patients with head and neck cancer. However, there maybe new therapeutic regimens under investigation that would benefit these patients if their lung cancers were found in early stages of disease. Future directives must include the establishment of an effective follow-up protocol for the early detection of lung malignancies in these patients. [ABSTRACT FROM AUTHOR]

Although newer combined modality approaches, including neoadjuvant cytotoxic chemotherapy, for patients with squamous cell carcinoma (SCCA) of the head and neck have produced high initial complete response rates, they have not improved overall survival for patients with advanced disease. Vitamin A plays an essential role in the normal differentiation of epithelial tissues. Retinoids, analogs of vitamin A, are active in certain premalignant and malignant disorders including SCCA. Six studies, including one recently reported placebo-controlled randomized trial, have demonstrated the efficacy of retinoids in oral leukoplakia. Two studies (totalling 48 patients) have shown significant retinoid activity (67% overall complete response rate) in patients with aggressive, recurrent laryngeal papillomatosis. Two trials (including a randomized phase II trial) of isotretinoin in advanced, refractory SCCA of the head and neck have produced an objective response rate of 16%, which is comparable to that reported in single-agent studies with cytotoxic drugs. There is a need for further study of retinoids in head and neck cancer. The high initial response rates with current therapy and the high subsequent risks of local recurrence and of developing second primary tumors in head and neck cancer patients offer an excellent opportunity to investigate the use of retinoids as adjuvant therapy for this malignancy.

The use of cytokines in head and neck cancer is increasingly under investigation. Clinical trials have tested the interferons, interleukin-2 and other cytokines as single agents and in various combinations. The addition of interferon to the cisplatin and 5-fluorouracil (5-FU) regimens (with and without leucovorin) has been explored. A randomized international trial comparing cisplatin and 5-FU with cisplatin, 5-FU and interferon-alpha 2b is in progress. [ABSTRACT FROM AUTHOR]

A patient receiving maintenance treatment with methadone (MTM) was treated with parenteral methadone for intense pain crises in cancer of the tongue with severe mucositis and dysphagia. Authors like Manfredi et al describe good results in the use of methadone as an analgesic in patients with MTM. The difficulties which arise with parenteral use derive from the drug itself and from those to whom the treatment is administered: serious side effects like malignant arrhythmias and respiratory depression and the complex nature of these patients, addicted to opiates with a terminal illness and pain which is difficult to treat. It should be administered by experts in palliative care in a healthcare unit where it can be successfully monitored., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.)

Using magnetic resonance imaging (MRI) as the sole imaging modality for patient modeling in radiation therapy (RT) is a challenging task due to the need to derive electron density information from MRI and construct a so-called pseudo-computed tomography (pCT) image. We have previously published a new method to derive pCT images from head T1-weighted (T1-w) MR images using a single-atlas propagation scheme followed by a post hoc correction of the mapped CT numbers using local intensity information. The purpose of this study was to investigate the performance of our method with head zero echo time (ZTE) MR images. To evaluate results, the mean absolute error in bins of 20 HU was calculated with respect to the true planning CT scan of the patient. We demonstrated that applying our method using ZTE MR images instead of T1-w improved the correctness of the pCT in case of bone resection surgery prior to RT (that is, an example of large anatomical difference between the atlas and the patient)., (Copyright © 2017. Published by Elsevier Ltd.)

Basal-cell canceris a slow growing, rarely metastasizes, locally malignant skin cancer. Patients with this neoplasm usually have excellent prognosis. Potentially, in some cases, a good prognosis cause a delay in therapy. Delay or withdrawal from treatment might lead to higher local extension of tumour with the destruction of the surrounding tissue. In this article we are presenting two patients with extensive basal cell cancer. The first patient underwent plastic surgery for extensive basal-cell carcinoma located in the parietal and temporal area. The second patient was observed due to recurrence of extensive basal cell carcinoma in the parietal region. Local advancement of the primary tumor could be a reason for the lack of radicality of surgery. Such advancement is rarely seen nowadays. The cases demonstrate the need for awareness about the possible severe course of the disease., (© 2016 MEDPRESS.)