Head & neck
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Multicenter Study
Psychometric properties of 3 patient-reported outcome measures for the assessment of shoulder disability after neck dissection.
Patient-reported outcome measures evaluating shoulder disability after neck dissection have not been sufficiently validated. We assessed the psychometric properties of the Shoulder Disability Questionnaire (SDQ), Neck Dissection Impairment Index (NDII), and the Shoulder Pain and Disability Index (SPADI) in patients after neck dissection. ⋯ The results support the suitability of the SDQ, NDII, and the SPADI for use in neck dissection patients. Combining the SPADI and NDII in a single Rasch scale improves item difficulty distribution but reduces variability and discriminative ability.
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Randomized Controlled Trial Multicenter Study Comparative Study
Randomized phase III study of 2 cisplatin-based chemoradiation regimens in locally advanced head and neck squamous cell carcinoma: impact of changing disease epidemiology on contemporary trial design.
Chemoradiotherapy results in excellent outcomes in locally advanced head and neck squamous cell carcinoma (HNSCC). This trial compared 2 chemoradiotherapy regimens. ⋯ Multiagent was not superior to single-agent chemoradiotherapy. Overrepresentation of HPV/p16+ patients resulted in better than expected outcomes.
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Randomized Controlled Trial Multicenter Study Comparative Study
Phase III randomized study: oral pilocarpine versus submandibular salivary gland transfer protocol for the management of radiation-induced xerostomia.
Xerostomia is a serious morbidity of radiation treatment in head and neck cancer. ⋯ Submandibular SGT procedure is superior to pilocarpine in management of radiation-induced xerostomia.
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Multicenter Study
Taxane-based chemoirradiation for organ preservation with locally advanced head and neck cancer: results of a phase II multi-institutional trial.
The optimal drug schedule and sequencing of chemotherapy and radiation for organ preservation in head and neck cancer has yet to be determined. We undertook a phase II trial of a taxane-based induction chemotherapy (ICT) followed by a taxane-based concurrent chemoradiation (CCR) regimen in patients with resectable stage III or IV disease to determine the feasibility, toxicity, and overall efficacy. ⋯ There were no significant differences in relapse-free survival or organ preservation rates between concurrent regimens. Platinum and paclitaxel-based CCR is feasible after ICT and provides a high rate of organ preservation. Substitution of concurrent cisplatin to weekly carboplatin with paclitaxel and radiation has an improved toxicity profile. The ease of administration and low toxicity make this a regimen that is practical for use in the community setting.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
End results of a prospective trial on elective lateral neck dissection vs type III modified radical neck dissection in the management of supraglottic and transglottic carcinomas.
Either modified type III radical neck dissection (MRND) or lateral neck dissections (LNDs) are considered valid treatments for patients with laryngeal carcinoma with clinically negative neck findings (N0). The object of this prospective study was to compare complications, neck recurrences, and survival results of elective MRND and LND on the management of laryngeal cancer patients. Patients and Methods This prospective randomized study began in 1990, and patient accrual was closed on December 1993. A total of 132 patients was included in the trial. All patients had previously untreated T2-T4 N0 M0 supraglottic or transglottic squamous cell carcinoma. No significant imbalance was found between groups with respect to demographic, clinical, pathologic, and other therapeutic variables. Seventy-one patients were given MRNDs (13 bilateral) and 61 were given LNDs (18 bilateral). ⋯ The rate of false-negative nodes in supraglottic and transglottic carcinomas was 26%, and most positive nodes were at levels II and III. The rates of 5-year overall survival, neck recurrences, and complications were similar in both groups. These results confirm the efficacy of lateral neck dissection in the elective treatment of the neck in patients with supraglottic and transglottic carcinomas.