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A novel therapeutic approach appears to dramatically increase cancer-free survival in patients with advanced head and neck cancer, according to a recent article published in the

Journal of Clinical Oncology.

The term head and neck cancer is used to refer to a number of cancers that may occur in the head and/or neck. These may include cancers of the tongue, mouth, salivary glands, pharynx, larynx, sinus, and other sites located in the head and neck area. Treatment options may include surgery, radiation therapy, biological therapy and/or chemotherapy, depending on the specific type, location, and stage (extent of disease at diagnosis) of the cancer. Locally advanced head and neck cancer refers to cancer that has spread from its site of origin to nearby sites in the body, including lymph nodes. Although many patients with locally advanced head and neck cancer achieve a complete disappearance of their cancer following initial treatment, cure rates are largely hindered by local cancer recurrences. Additionally, a large percentage of patients are not able to undergo optimal treatment dosages of chemotherapy and/or radiation due to the associated side effects. This has prompted research efforts to investigate novel therapeutic approaches to improve outcomes and minimize side effects for patients with this disease.

Recently, researchers from the M.D. Anderson Cancer Center, Vanderbilt University, and the University of Pittsburgh Cancer Institute conducted a clinical trial evaluating a novel biological combination to prevent cancer recurrences in locally advanced head and neck cancer. This trial involved 42 patients who had locally advanced head and neck cancer with spread to the lymph nodes upon diagnosis. All patients received prior surgery and/or radiation for the treatment of their cancer and had a complete disappearance of their cancer upon initiation of treatment in the trial. Treatment in the trial consisted of 12 months of the combination of interferon-alpha, a natural substance produced by the body to stimulate the immune system, 13 cis-retinoic acid, a vitamin A derivative, and alpha-tocopherol, a vitamin E derivative. Overall survival at one year following the initiation of this treatment was 98% and at two years following treatment was 91%. Cancer-free survival at one year following treatment was 91% and two years following treatment was 84%. This treatment regimen was well tolerated, with only 4 patients not able to complete the 12 months of treatment due to side effects. The average duration of survival has not yet been reached.

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These results are very encouraging for the prevention of cancer recurrences in patients with locally advanced head and neck cancer, which may ultimately improve cure rates. Future clinical trials will determine the optimal role of this novel treatment combination for patients with this disease. Persons who have locally advanced cancer of the head or neck may wish to talk with their doctor about the risks and benefits of participating in a clinical trial further evaluating this treatment strategy or other new therapies. (

Journal of Clinical Oncology, Vol 19, No 12, pp 3010-3017, 2001)

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