No abstract

The M. D. Anderson Symptom Inventory-Head and Neck (MDASI-HN) is a reliable and valid instrument to measure head and neck cancer symptom burden, and the interference symptoms cause in the major aspects of a patient's daily life. A subset of specifically distressing symptoms was identified, many of which are not included in commonly used head and neck cancer quality of life instruments.

Purpose To present pilot toxicity and survival outcomes for a prospective trial investigating adaptive radiotherapy (ART) for oropharyngeal squamous cell carcinoma. Methods Twenty-four patients enrolled onto an IRB-approved clinical trial. Twenty-two patients were analyzed. Daily CT-guided setup and deformable image registration permitted serial mapping of CTVs and avoidance structures for ART planning. Primary site was base of tongue in 15 patients, tonsil in 6, and glossopharyngeal sulcus in 1. Twenty (91%) patients had AJCC stage IV disease. T stage distribution was 2 T1, 12 T2, 3 T3, 5 T4 and N stage distribution was 1 N0, 2 N1, 5 N2a, 12 N2b, and 2 N2c. Twenty-one (95%) patients received systemic therapy. Results With 31 month median follow up (range: 13-45), there has been no primary site failure and 1 nodal relapse, yielding 100% local and 95% regional disease control at 2 years. Baseline tumor size correlated with absolute volumetric treatment response (p = 0.018). Parotid volumetric change correlated with duration of feeding tube placement (p = 0.025). Acute toxicity was comparable to conventional IMRT results. Chronic toxicity and functional outcomes beyond 1 year were tabulated. Discussion This is the first prospective evaluation of morbidity and survival outcomes in patients with locally advanced head and neck cancer treated with automated adaptive replanning. ART can provide dosimetric benefit with only 1 or 2 mid-treatment replanning events. Our preliminary clinical outcomes document functional recovery and preservation of disease control at one-year follow-up and beyond.

New treatment approaches to xerostomia from RT for head and neck cancer may result in significant improvement in patient QOL.

Two types of ionic modification approaches (i.e., sulfonation and triethylamination) were applied with the aid of dual‐layer hollow fiber technology in this work to fine tune the pore size and pore size distribution, introduce the electrostatic interaction, and reduce membrane fouling for long‐term high‐performance protein separation. A binary protein mixture comprising bovine serum albumin (BSA) and hemoglobin (Hb) was separated in this work. The sulfonated fiber exhibits an improved BSA/Hb separation factor at pH = 6.8 compared with as‐spun fibers but at the expense of BSA sieving coefficient. On the other hand, the triethylaminated fiber reveals the best and most durable separation performance at pH = 4.8. Its BSA/Hb separation factor is maintained above 80 for 4 days and maximum BSA sieving coefficient reaches 33%. Therefore, this study documents that an intelligent combination of both size‐exclusion and electrostatic interaction can synergistically enhance protein separation performance in both purity and concentration. © 2008 American Institute of Chemical Engineers AIChE J, 2009