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Background: No gold standard has been developed for the therapy of intracanalicular vestibular schwannomas (IVS). Options for treatment include a conservative approach, microsurgery, or radiosurgery. Although the efficacy of these treatment has been well-documented, little is known about the determinants of outcome in IVSs following radiosurgery. Therefore, we examined the results in relation to age, gender, tumor volume, distance to fundus, microcyst existence, and radiosensitivity in this group. In addition, we investigated possible predictors of facial nerve function and hearing preservation. Methods: Ninety-four patients with unilateral IVS were included in the evaluation (52 women and 42 males). The patients were separated into younger and older age groups based on their median age (55 years). The median IVS volume was 138 mm3, microcysts were identified in 16 tumors, and 63 tumors were adjacent to the fundus. The data were analyzed using Statistica software package ver. 13.3. Results: At final follow-up, a statistically significant decrease in tumor volume and no statistically significant decline in hearing were noted, but no differences between age groups were found. The sex had no effect on overall tumor growth control, facial nerve preservation, or hearing preservation. Localization of IVS close to the fundus and the presence of tumor microcysts had no effect on the control of tumor growth, preservation of hearing, and sparing of facial nerve following radiosurgery. Cochlear dose had no influence on hearing preservation. Higher tumor volume was associated with its pseudoprogression during early follow-up and a greater risk of hearing loss. Conclusions: Age, sex, tumor volume, proximity to the fundus, and the existence of a microcyst were not predictive of radiosensitivity nor preservation of facial nerve function and hearing, based on the findings. There was no effect of cochlear dose on hearing. Initial greater tumor volume was associated with an increased probability of tumor pseudoprogression. [ABSTRACT FROM AUTHOR]

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Superior vena cava syndrome (SVCS) often occurs in advanced malignant disease. SVCS is recognized as an oncologic emergency. It encompasses the set of symptoms resulting from obstruction of superior vena cava (SVC): edema of the head and neck and upper part of the chest, cyanosis and thoracic and neck vein distention. Themost commonmalignant cause of SVCS is lung cancer. Management of the SVC syndrome associated with malignant disease includes both treatment of the cancer and relief of the symptoms of obstruction. We reviewed the etiology, patophysiology, clinical evaluation and therapeutic modalities including chemotherapy, radiotherapy and supportive care. [ABSTRACT FROM AUTHOR]

Patients with head and neck squamous cell carcinoma (HNSCC) who have progressed following primary treatment (PT) have a poor prognosis. In this group, nivolumab has been demonstrated to significantly improve outcomes. This study presents the efficacy of nivolumab in Polish patients with recurrent and/or metastatic (R/M) HNSCC using real-world data. The analyzed group consisted of 324 adult patients with R/M HNSCC following platinum-based therapy. Patients were divided into 3 groups based on the time from completion of PT to nivolumab initiation (tPT-N): within 6 months (refractory), between 6 and 24 months (sensitive, tPT-N ≤24), and beyond 24 months (sensitive, tPT-N >24). Survival analysis and the Cox proportional hazards model were performed to evaluate how various risk factors affect patient outcomes. The 1-year and 2-year overall survival (OS) was 19.1%, 6.1%, 30.7%, 9.4%, and 45.7%, 29.1% in refractory, sensitive tPT-N ≤24, sensitive tPT-N >24 patients, respectively and was higher for both sensitivity groups vs. refractory (p = .004) and for sensitive tPT-N >24 versus refractory and sensitive tPT-N ≤24 (p <.001). Patients with nasopharyngeal cancer had OS significantly higher than patients with other primary tumor localization. The multivariate Cox analysis showed a significant favorable effect of tPT-N >24 (HR = 0.53, p = .001) and nasopharyngeal cancer on OS (HR = 0.20, p = .008). Conversely, female sex was identified as an unfavorable factor for OS (HR = 1.48, p = .020). In our study, we established that the benefit of nivolumab increases with the increasing tPT-N. The probability of death is significantly lower in male patients and patients with nasopharyngeal cancer regardless of tPT-N., (© 2024 The Author(s). International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.)

Aim of the Study: Oral mucositis is a common side effect of the oral mucosa due to anticancer therapy, especially for head and neck cancer. Caphosol is indicated for dryness of the mouth and oropharynx and treatment of mucositis due to irradiation or high-dose chemotherapy. The aim of the study was to evaluate the efficacy of Caphosol in preventing and alleviating mucositis due to radiotherapy in the head and neck region., Material and Methods: Caphosol was used from the beginning of the irradiation and for two weeks more after the treatment was completed. Mucositis, xerostomia, and dysphagia were scored by radiotherapists. Subjective evaluation was made by patients. Caphosol was assessed in a non-blinded, matched clinical study. Each treatment arm consisted of 50 patients. The groups were similar. The only difference in the management protocol between the treatment arms was the use of Caphosol in the experimental arm., Results: A statistically significant difference in mean severity of early irradiation-induced side effects between the studied groups was observed with respect to: mucositis in the clinical target volume (CTV) area, mucositis in the increased dose (boost) area, dysphagia and xerostomia ( p < 0.001 for all reactions). In the group of patients who used Caphosol, the mucositis was less intense, both in the CTV and in the boost area., Conclusions: The use of Caphosol reduces the severity of acute mucositis, dysphagia and xerostomia, exerting a positive effect on comfort in the oral cavity in patients irradiated for head and neck tumors., Competing Interests: The authors declare no conflict of interest.

Unlabelled: Concomitant radiochemotherapy become the treatment of choice for locally advanced SCHNC. This strategy of treatment has a limitation, which is an acute and late toxicity. The IMRT technique provides the possibility of better sparing of healthy tissue. Radiobiological and clinical data also suggest that accelerated fractionation and higher dose per fraction given in GTV may produce better locoregional control. Therefore it might be expected that concomitant chemotherapy and SIB-IMRT radiotherapy could increase locoregional control and reduce acute and late radiation reactions. The evaluation of early results and toxicity of this treatment modality is presented., Aim of Study: The evaluation of the early results and toxicity of SIB-IMRT radiotherapy given concomitantly with cisplatin for locally advanced squamous cell head and neck cancer (SCHNC)., Methods: SIB-IMRT technique was applied. The boost volume was limited to the GTV + 3mm margin (macroscopic tumor extension was defined on the basis of CT and/or MRI examinations). Dose per fraction given to this volume was 2.25 Gy up to 67.5 Gy of total dose. The PTV-CTV + 3mm - was defined as an area of increased risk of microscopic spread. Dose per fraction given to this volume was 2 Gy up to 60 Gy. The PTV1-ETV+ 3mm (electively irradiated volume) received dose per fraction -1.8 Gy up to 54-56 Gy. Overall treatment time was 6 weeks (5 fractions per week, 30 fractions). Concomitant chemotherapy consisted of cisplatin in daily dose100mg/m2 given two times during irradiation (1 and 22 day of treatment). The evaluation of early tolerance was performed once weekly during the treatment than during the follow up every 2 months. The early reactions were scored according to the EORTC/RTOG scale., Material: Between June 2006 and December 2009 99 patients diagnosed with III and IV clinical stage of SCHNC were treated with this method. 65 patients were diagnosed with oropharyngeal cancer, 18 with laryngeal cancer and 16 with hypopharyngeal cancer. PEG was performed at 65 patients before treatment for better alimentation during radiochemotherapy., Results: No severe life risking complications were observed a no concequentional late effects were observed. Extended mucositis grade III according RTOG/EORTC scale were observed only in boost region in 80% patients just after treatment was completed. In 2 patients ulceration were observed in tumour side which have healed up spontaneously within two months after treatment. 55% patients were suffering for III xerostomia and 41% for middle after the treatment. Majority of side effects were cured within 4 months after irradiation. The PEG was removing in 92% patients 2 months after treatment. The median follow-up time is 28 months (ranged from 14 m to 58 m). Actuarial 2-years overall survival and disease-free survival is respectively 90% and 82%, probability of locoregional recurrence at 2-years is 14% and 5-years estimated is 17,5%., Conclusions: At the present moment it might be concluded that accelerated radiotherapy with SIB-IMRT given concomitantly with cisplatin produce excellent local control in patients treated of III-IV stage SCHNC without increasing toxicity., (Copyright © 2011 Polish Otolaryngology Society. Published by Elsevier Urban & Partner (Poland). All rights reserved.)

Unlabelled: The most frequent malignant tumor of the head and neck region is a squamous cell cancer of the larynx. Squamous cell cancer of the hypopharynx is diagnosed rarely, but it has poorer prognosis than laryngeal cancer. The surgical treatment, especially in advanced disease, is a laryngectomy with the definitive tracheostomy, what negatively influenced the quality of life. Therefore, oncologists have been interested in new alternative methods of conservative treatment from many years., The Aim of the Study: The evaluation of efficacy and toxicity of the organ preservation treatment in patients with locally advanced laryngeal and hypopharyngeal cancer., Material and Methods: The patients with diagnosed squamous cell laryngeal and hypopharyngeal cancer in III and IVa clinical status were treated with concomitant radiochemotherapy with intention of the organ preservation. Conformal 3D radiotherapy and SIB-IMRT technique was applied in all cases. Concomitant chemotherapy consisted of cisplatin in daily dose100mg/m(2) given two times during irradiation (1 and 22 day of treatment) or once weekly in dose 40mg/m(2). Between January 2004 and November 2008 146 patients were treated with this method. There were 83 patients diagnosed with laryngeal cancer and 62 patients with hypopharyngeal cancer in this group., Results: The median follow up is 42 months. Five years overall survival is 75% and disease free survivak is 63%. Three years laryngectomy free survival (LFS) is 82% and 5-years LFS is 76%. This group of patients is alive with larynx preservations. In 17.3% patients local recurrence was observed (4.5% regional recurrence and 1.8% locoregional). Those patients underwent salvage surgery or were treated with palliative chemotherapy. No severe life risking early and late complications were observed. Only 7% of patients have required temporary tracheostomy because of difficulties in breathing due to larynx edema., Conclusion: We can conclude that organ preservation treatment is a valuable alternative to surgical procedure in patients diagnosed with laryngeal and hypopharyngeal cancer in III and IVa clinical status., (Copyright © 2011 Polish Otolaryngology Society. Published by Elsevier Urban & Partner (Poland). All rights reserved.)

Unlabelled: The results of combined treatment patients with olfactory neuroblastoma in material of Cancer Center in Warsaw, Aim: The analysis of the results of combined treatment patients with olfactory neuroblastoma in material of Cancer Center in Warsaw., Material: Authors present material of 27 cases olfactory neuroblastoma treated in Cancer Center of Warsaw from 1965 to 2008. The median age was 44 years (range 10-74). The median observation was 72 months (range 2-235).The tumors were seen in 15 women and 12 men. According to Kadish staging there were one A, eight B, and seventeen C stage tumor. The patients in stage A and B was treated by surgery and radiotherapy (mean dose in whole material was 57.15 Gy range 44-70). Five patients in stage C was treated by surgery, radiotherapy and adjuvant chemotherapy. Five patients were treated by neoadjuvant chemotherapy and radiotherapy. Six patients underwent surgery and radiotherapy. One patient was died during adjuvant chemotherapy. One patient in stage B had local recurrence, one local recurrence and metastases and one had only metastases. In stage C 4 patients was died because of metastases, one had local recurrence and, 3 was died because of other reasons. Patients who was failed, underwent surgery, chemotherapy or radiotherapy, it was dependent of clinical situation., Results: A complete regression was seen in 100% patients in early stages (A and B) and 82% patients in stage C. The 5-year local progression-free survival rate was 91% in early stages and 60% in stage C. The LPFS in whole group was 66.7%. The 5-year disease-free survival rate was 91% in early stages, 46% in stage C. The DSF rate in whole group was 44.4%. The 5-year overall survival rate was 80% in stages A and B, 41.2% in stage C. The OS in whole group was 55.6%. The 5-year survival rate was 20% for patients who had recurrence and/or metastases., Conclusion: A combination of surgery and radiotherapy appears to be adequate treatment for early stages (A and B) olfactory neuroblastoma. There are still no clear protocols of treatment patients in stage C., (Copyright © 2011 Polish Otolaryngology Society. Published by Elsevier Urban & Partner (Poland). All rights reserved.)

Cancers of pranasal sinuses are rare neoplasms in humans. In 2003, in Poland there were 132 new patients diagnosed for this disease. Squamous cell cancer is the most frequent one in this region. Other types of cancer in this region are adenocarcinoma (about 30%), carcinoma adenoides cysticum or neoplasms such as rhabdosarcoma, chondrosarcoma, lymphoma or melanoma malignum. There is a very rare neoplasm as a olfactory neuroblastoma in this localization. Cancer of the paranasal sinuses infiltrates only locoregionally. Metastases to the lymph nodes are seldom--below 30%; this is why elective lymphangiectomy or irradiation are not obligatory treatment in this case. The most important is histopathological verification performed by biopsy. For clinical staging it is obligatory to perform endoscopy, CT or MR examination. The treatment of cancers of paranasal sinuses is always surgery with adjuvant irradiation. The modern radiotherapy techniques provide the possibility to spare healthy tissues and organs at risk. The organs at risk in this localization are optical nerves and chiasm, and parotid glands. The conformal radiotherapy is used most frequently. In case of the tumour being of complex shape and located in the vicinity of the organs at risk the IMRT technique is used. The radiation treatment combined with chemotherapy is applied in cases of not radical surgery in the region of ethmoides sinuses.

Introduction: Recently, concomitant radiochemotherapy became a method of choice in patients with poorly differentiated nasopharyngeal cancer. The aim of this study is to estimate tolerance and early results of the concomitant radiochemotherapy followed by adjuvant chemotherapy (modified US Head and Neck Intergroup protocol)., Methods and Material: Analysing protocol consist of conventionally fractionated radiotherapy (TD = 70 Gy) given concomitantly with cisplatin (30 mg/m2 daily during 3 days every 3 weeks). This part of treatment was followed by 3 courses of PF (cisplatin + 5-fluorouracil) chemotherapy. Between August 1998 and September 2003 thirty six patients (27 male and 9 female) were qualified to treatment. Median age was 33 years., Results: Tolerance of concomitant radiochemotherapy was acceptable. Intensive mucosal acute reactions (>G2) were observed in 67% patients. Life threatening complications (sepsis + DIC) was observed in single case. All patients received radiotherapy in planned total dose. Eighty six percent of patients received cisplatin in planned cumulated doses. Tolerance of the adjuvant chemotherapy was worse. Only 44% patients received all three courses of PF chemotherapy. The reasons of incomplete chemotherapy were neutropenia, infections, prolongated acute reactions or performance status decreasing. Complete regression was obtained in 86% patients. Two years overall and disease free survival rates were 83% and 72%, respectively., Conclusions: Our results confirm high activity of the concomitant radiochemotherapy followed by chemotherapy in patients with poorly differentiated nasopharyngeal cancer. Those results confirm also high toxicity of this regimen, what suggest very careful patients qualification to treatment.

The authors report the case of 68 year old male operated upon for the branchial cyst of the neck. Histopathological examination showed carcinoma in the wall of the cyst. Ipsilateral tonsillectomy was done and pathology revealed primary focus in the palatine tonsil. Diagnosis of the branchiogenic cancer should be made only when all the criteria defined by Martin in 1950 are met. Patients with carcinoma cells found in branchial cyst should be diagnosed and treated as metastasis from Waldeyer's ring to the lymph nodes of the neck. Ipsilateral tonsillectomy is indicated as blind biopsy. When histopathological examination of the tonsil is negative the patients should be treated as metastasis to the neck from unknown primary focus.