Head and Neck

Research on carotenoids and cardiovascular disease (CVD) stems from the discovery that the etiology of this disease involves oxidative processes that may be slowed by exogenous antioxidants. One of the best understood processes contributing to development of CVD is the oxidation of low-density lipoprotein (LDL). When LDL becomes oxidized, it is readily taken up by foam cells in the vascular endothelium where it contributes to the development of atherosclerotic lesion. Enhancement of the oxidative stability of LDL may also prevent other oxidative steps involved in clinical expression of coronary disease (e.g., myocardial infarction) and possibly steps not related to LDL oxidation. There is optimism about the potential role of P-carotene in prevention of CVD 

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A clinical trial to evaluate misoprostol as a protector of normal tissue during a course of XRT in cancer patients suggests a reduction in acute normal tissue injury (215). A randomized, prospective, double-blind study indicates that topical misoprostol, administered as an oral rinse 15-20 min before irradiation using conventional 2-Gy (200 rad) fractions, five days a week over 6—7 weeks, significantly protects the oral mucosa from radiomucositis, a frequently observed normal tissue complication during XRT for head and neck cancer (215). 

The retinoid isotretinoin (68) has been found to reduce the incidence of secondary malignancies in patients treated for head and neck cancer. In addition, the use of trans-m m.oic acid in patients having M3 leukemia has been reported to induce complete, although temporary, remissions (32). 

Common-sense guidelines can be deduced from the requirements for building operations and works of engineering construction summarized in Table 13.11. In special situations, e.g. for firefighting or protection against toxic chemicals, hoods and suits cover the head and neck and many incorporate protection. 

Cetuximab Anti-EGFR Colorectal cancer, Head and Neck cancers... 

Currently, 13-cis-retinoic acid is the most studied chemopreventive agent that decreases the incidence of second primary tumors in patients with head-and-neck cancer, reverses premalignant lesions, and reduces appearance of nonmelanoma skin cancer in patients with xeroderma pigmentosum. Unfortunately, this vitamin A derivative has a significant clinical toxicity, which limits its utility in a practice setting. 

Molecular epidemiological studies to assess the risk associated with metabolic polymoiphisms for cancers of head-and-neck and the lung have shown that the overall... 

Cetuximab specifically binds the extracellular domain of EGFR. It has been approved in colorectal and head and neck cancer. However, unlike for trastuzu-mab, no clear correlation has been demonstrated between EGFR expression in cancer cell and efficacy of cetuximab. 

ADCC. Cetuximab is approved for treatment of metastatic colorectal cancer (CRC) and squamous cell carcinoma of the head and neck (SCCHN). Interestingly, an adverse event, acneiform rash seems to correlate with a better response to cetuximab, while there is no such correlation with expression levels of EGFR assessed by immunohistochemistry. Further side effects are rare infusion reactions and hypomagnesia. Two other anti-EGFR antibodies approved for clinical use are the fully human antibody panitumumab (Vectibix)... 

The amount of contrast material required for CTA is comparable to that used for conventional contrast-enhanced CT imaging. The amount of scanning time required for a CTA examination of the head and neck, such as is usually performed for acute... 

B. Cerebrovascular imaging (using one of the following modahties) CT based CTA head and neck... 

BCL-1 or PRAD1 Codes for cyclin D1, a cell cycle clock stimulator Breast, head and neck cancers... 

Docetaxel, another taxane, binds to tubulin to promote microtubule assembly. The pharmacokinetics of docetaxel are best described by a three-compartment model, with an a half-life of 0.08 hours, a 3 half-life of 1.6 to 1.8 hours, and a terminal half-life of 65 to 73 hours.14 Docetaxel has activity in the treatment of breast, non-small cell lung, prostate, bladder, esophageal, stomach, ovary, and head and neck cancers. Dexamethasone, 8 mg twice daily for 3 days starting the day before treatment, is used to prevent the fluid retention syndrome associated with docetaxel and possible hypersensitivity reactions. The fluid... 

The pharmacokinetics of bevacizumab demonstrate a terminal half-life of 21 days, with a volume of distribution consistent with limited extravascular distribution.34 Bevacizumab has shown clinical activity in the treatment of colorectal, kidney, lung, breast, and head and neck cancer. Patients may develop hypertension requiring chronic medication during therapy. Impaired wound healing, thrombolembolic events, proteinuria, bleeding, and perforation are serious side effects. 

CNS leukemia (IT) Breast cancer NHL Osteosarcoma Head and neck cancer Bladder cancer Rheumatoid arthritis... 

In patients with SCC, metastatic spread to the lymph nodes occurs in less than 5%.32 The lymph nodes of the head and neck are the most common sites of metastasis. Patients are still curable with this stage of the disease, but they are at high risk of experiencing regional relapse and distant metastasis to the bones and lungs. As may be expected, survival is decreased compared with patients who do not present with nodal involvement. Factors that may be useful in... 

Radiation is not standard therapy for the treatment of skin cancer however, there are circumstances in which radiation may be preferred. It is used as adjunctive therapy after surgical resection for patients with head and neck MM with metastasis to regional lymph nodes.40 Radiation is also indicated for patients with unresectable metastases or brain metastases or for palliation of symptoms from metastases.40 Older patients or patients who are poor candidates for surgery may be offered radiation as an option.40 Radiation offers good cosmetic results,... 

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