View clinical trials related to Head and Neck Neoplasms.
Filter by:PROTOCOL FOR PREVENTIVE ADMINISTRATION OF GLUTAMINE TO AVOID RADIATE SIDE EFFECTS IN PATIENTS UNDER RADIOTHERAPY IN THE CHEST AND HEAD & NECK PURPOSE OF THE STUDY The purpose of the protocol is to study the acute and distant toxicity of the mucosa of the oral cavity and esophagus after radiotherapy for head-neck and tumors of the chest. Radiation therapy in all cases is a three-dimensional conformal technique with a linear accelerator. INCLUSION CRITERIA Patients undergoing radiotherapy with or without concomitant chemotherapy for Ca nasopharynx, hypopharynx, palate, tonsils, mouth base, parotid, tongue, cervix and esophagus as well as mediastinal and lung cancer. EXCLUSION CRITERIA Patients with psychiatric problems and inability to cooperate, as well as patients with gluten intolerance, as well as patients with hepatic encephalopathy or hyperammonemia, are excluded from the study. METHODS Oral glutamine administration starting 4 days before the start of radiotherapy and for a total of 3 months. The preparation is dissolved in water and taken orally 4 hours before radiotherapy and 4 hours before dinner. FOLLOW UP Immediately after completion of radiotherapy at 3, 6 and 12 months, orthoscopy (on symptoms) and oral mucosal examination will be performed on patients who have undergone cervical and mediastinal radiotherapy and their evaluation based on the EORTC-RTOG scale. REFERENCES 1. Anderson PM, Schroeder G, Skubitz KM. "Oral glutamine reduces the duration and severity of stomatitis after cytotoxic cancer chemotherapy". Cancer: 1998; 83: 1433-1439. 2. Cerchietti LC, Navigante AH, Lutteral MA, Castro MA, Kirchuk R, Bonomi M et al. "Double-blinded, placebo-controlled trial on intravenous L-alanyl-L-glutamine in the incidence of oral mucosis following chemotherapy in patients with head-and-neck cancer. Int J Radiat Oncol Biol Phys. 2006 Aug 1; 65 (5): 1330-7. 3. Peterson DE, Jones JB, Petit RG 2nd. "Randomized, placebo-controlled trial of Saforis for prevention and treatment of oral mucositis in breast cancer patients receiving anthracycline-based chemotherapy. Cancer. 2007 Jan 15; 109(2): 322-31. 4. Kozelsky TF, Meyers GE, Sloan JA, Shanahan TG, Dick SJ et al; North Central Cancer Treatment Group. Mayo Clinic "Phase III double-blind study of glutamine versus placebo for the prevention of acute diarrhea in patients receiving pelvic radiation therapy". J Clin Oncol 2003 May 1; 21 (9):1669-74. 5. Topkan E, Yavuz MN, et al "Prevention of acute radiation-induced esophagitis with glutamine in non-small cell lung cancer patients treated with radiotherapy: Evaluation of clinical and dosimetric parameters". Lung Cancer, 2008 August 6. 6. Ismael Membrive Conejo, Ana Reig Castillejo, Nuria Rodriguez de Dios, Palmira Foro Arnalot, Javier Sanz Latiesas, et al: "Prevention of acute radiation enteritis: efficacy and tolerance of glutamine". Clinical and Translational Oncology. Vol 13, Number 10 (2011), 760-763, DOI: 10.1007/st 2094-011-0729-3. 7. Yoshida S, Kaibara A, Ishibashi N, Shirouzu K. "Glutamine supplementation in cancer patients" Nutrition. 2001: 17:766-768. 8. Klimberg SV, McClellan Jl. "Glutamine, cancer and its therapy. Am J Surg. 1996;172: 172:418-424. 9. Rouse K, Nwokedi E, Woodliff JE, Epstein J, Klimberg VS. "Glutamine enhances selectivity of chemotherapy through changes in glutathione metabolism. Ann Surg. 1995; 221:420-426. 10. Baxevanis CN, Reclos GJ, Grittapis AD et al "Elevated PGE2 production by monocytes is responsible for the depressed levels of NK&LAK cell function in patients with breast cancer" Cancer. 1993; 12:491-501. 11. Erdem NZ, Yasti AC, Atli M, et al. "The effects of perioperative oral enteral support with glutamine added elemental formulas in patients with gastrointestinal cancers: a prospective randomized clinical study. Nutr Res.2002:22:977-988. 12. Berk L, James J, Schwartz A, Hug E, Mahadevan A, Samuels M et al. "A randomized, double-blind, placebo-controlled trial of a beta hydroxyl beta-methyl butyrate, glutamine, and arginine mixture for the treatment of cancer cachexia". Support Care Cancer. 2008 Oct; 16 (10): 1179-88. Epub 2008 Feb 22.
Nutritional deficiency and subsequent weight loss in patients with head and neck cancer is a common problem and a negative predictor of treatment outcomes and mortality, as well as quality of life. Nutritional support for patients is a prerequisite for the successful management of cancer patients. Sensory changes can be side effects of chemotherapy or ionizing radiation, which damages sensory receptors in the area of radiation, disrupts the function of the salivary glands, leading to hyposalivation and a decrease in taste. Individual choice of nutrition based on sensory sensations can significantly improve the quality of life of patients and ensure timely correction of their eating behavior.
Oral cancer (including the lip) alone, with 300.373 cases worldwide in 2012, is the predominant head and neck squamous cell carcinoma. With an incidence of 6.5 cases per 100.000, south - east asia has the highest incidence worldwide. Many of these cases do present at a locally advanced stage, which often requires combined modality treatment that includes extensive surgery to the primary site and neck and flap reconstruction. This is often followed by either adjuvant radiation or chemo-radiotherapy. This treatment can come with a significant morbidity affecting the self-care ability of the patients as well as impact the quality of life(QOL) (3,4).At the SingHealth Duke - NUS Head and Neck Centre 340 complex cases of head and neck cancer (HNC) involving flap reconstructions and extensive resections have been operated in 2014 alone. Almost all of these patients need further adjuvant treatment (radiotherapy and/or chemotherapy). Side-effects following such treatments, Significant number of patients underwent subsequent adjuvant treatment. The adjuvant treatment and surgery may render these patients weakness of the shoulder and neck muscles, numbness and reduced sensation around the neck and shoulder region and a general impact on the patient's fitness. While survival remains the most important outcome in oncologic treatment, recovery of treatment related morbidity and return to pre-treatment QOL for patients after cancer treatment is equally important. The aims of this study is to evaluate the impact of surgical and adjuvant treatment on physical functions and QOL of the patients. By measuring the impact of extensive treatments for head and neck malignancies on the fitness and QOL of these patients, the team aims to identify the risk factors that necessitate a more aggressive rehabilitation. This is to date the first prospective study investigating the impact of multimodality treatment on fitness and QOL in HNC patients in a structured and predefined manner. Ultrasound (US) elastography will be used to assess muscle and soft tissue stiffness and elasticity and correlate these with functional outcome measurements. Elastography has been previously described as a useful tool to assess stiffness of the neck soft tissues and muscles, however no study thus far has correlated these findings with functional measurements. Hence this trial aims to establish the following: 1. Due to the limited available data: to quantify and qualify the impact of surgery as well as adjuvant treatment on the fitness, physical function of the neck and shoulder & QOL of HNC patients 2. To establish a workflow and assessment protocol for a subsequent larger prospective clinical trial 3. To identify performance markers in these patients, that allow a more targeted rehabilitation process 4. Many patients post head and neck treatment are economically compromised since they are unable to return to mainstream work and there exists a significant unemployment rate. The understanding we gain through objective analysis apart from targeted treatment for every individual patient, in the future this study hopes to address and improve the economic impact to the individual and probably reduce the health care burden.
Informal caregivers to patients with head and neck cancer report that they are unprepared for caregiving, that they experience a high caregiver burden and a deteriorated health. The aim is to develop an internet based intervention for informal caregivers of individuals with head and neck cancer and evaluate the feasibility and acceptability of the intervention. The internet based intervention (Carer eSupport) will be based on scientific evidence, established theoretical frameworks and focus groups with caregivers and health care professionals. The feasibility and acceptability of Carer eSupport will be evaluated by 30 caregivers who will have access to Carer eSupport during one months. The feasibility and acceptability of Carer eSupport will be evaluated with quantitative and qualitative data.
This study aims to assess the survival rate of oral squamous cell carcinoma (OSCC) patients following immediate mandibular reconstruction with vascularized fibula flap (VFF) and to identify risk factors influencing the overall survival rate and postoperative outcomes.
An intratumoral alpha particle based approach for cancer treatment using diffusion alpha-emitting radiation therapy (DaRT)
This study aims to develop and evaluate a low-cost, portable, flexible nasopharyngeal scope (FNS) used to assess head and neck cancers (HNC) in low resource settings. The FNS will be compared to an endoscope that is used as standard of care (SOC) in terms of ease of use, image quality, and perceived pain. The ultimate goal is to compare the ease of use between the FNS to what is used in SOC.
This is a multicenter, open-label, single-arm, phase Ib study to evaluate the safety and efficacy of Mitoxantrone Hydrochloride Liposome in subjects with recurrent/metastatic Head and Neck Cancers
This phase I trial studies the side effects of image-guided hyper-fractioned proton therapy in treating patients with head and neck cancer that has spread to nearby tissue or lymph nodes (locally advanced) and cannot be removed by surgery (unresectable). Radiation therapy uses high energy protons to kill tumor cells and shrink tumors. The change in dose radiation frequency and dose investigated in this study may help to better control the tumor and prevent it from coming back or growing. The goal of this study is to test a new radiation schedule that administers more radiation to the tumor tissue using image guided proton therapy for patients that have a high risk of having a tumor recurrence (the tumor comes back after treatment).
Treatment personalization could ensure better outcome than standard procedures. It is particularly important in intensive care units where patients received many drugs and procedures. Their health status can change very fast. The oncologic patients treated in intensive care units are a special group of patients. Factors related to cancer influence extra their health status. The aim of this study is population pharmacokinetic-pharmacodynamic analysis drugs that are routinely used during an analgosedation in ICU oncologic patients. Analgosedation is monitored by drugs plasma concentration, the depth of sedation (bispectral index) and vital parameters like: systolic and diastolic blood pressure, mean arterial pressure, heart rate. Moreover, the TNM Staging System, biochemical parameters, The American Society of Anesthesiologists (ASA) physical status classification will be checked like potential factors influencing on pharmacokinetics and pharmacodynamics drugs used in the study.