Head and neck squamous cell carcinoma is the fifth most common cancer type worldwide. Even though it is known that the most important environmental aetiological factors for head and neck cancer (HNC) development are tobacco and alcohol, genetic susceptibility is also thought to be important. The use of biomarkers of chromosomal damage due to genetic instability in order to predict risk of cancer as well as to identify high-risk individuals is imperative. We have investigated genetic damage in patients having HNC (n = 59) and their first-degree relatives (FDRs) (n = 34) with a biomarker in two different tissues; the micronucleus (MN) test in peripheral blood lymphocytes and in exfoliated buccal cells. The mean (standard deviation) levels of MN frequencies (‰) in lymphocytes of patients, relatives and controls were 27.10 (9.52), 14.09 (5.13) and 9.00 (6.87), respectively. The mean (standard deviation) levels of MN frequencies (‰) in exfoliated buccal cells of patients, relatives and controls were 2.87 (1.16), 1.38 (0.85) and 1.23 (0.93), respectively. Our results indicated that spontaneous genetic damage in lymphocytes of patients having HNC was significantly higher than that of controls (P < 0.01) and thus genetic instability appeared to exist in lymphocytes of cancer patients. Similar findings were obtained for exfoliated buccal cell MN frequencies of cancer patients (P < 0.01). We observed that the FDRs of patients having HNC showed significantly higher chromosomal damage in terms of MN frequencies in lymphocytes when compared with those of controls (P < 0.05), thus reflecting an increased susceptibility to HNC in FDRs. However, for buccal cell MN frequencies, we could not demonstrate enhanced genetic instability in the FDRs of patients having HNC.

A retrospective and prospective analysis is reported of epidemiological, clinical, and therapeutic aspects of 33 children with nasopharyngeal carcinoma who were treated in a single institution over a period of 10 years. Twenty-three male and 10 female children ranging from 9 to 17 years were referred to our center. Histopathology was WHO type 3 carcinoma in 21, WHO type 2 in 8, WHO type 1 in 1, and unclassified in 3 patients. Disease extent was T2a (n = 15), T2b (n = 2), T3 (n = 11), and T4 (n = 5); N1 (n = 5), N2 (n = 12), and N3a (n = 16). Five patients had base of skull invasion. Four patients had M1 disease on admission. Four patients were treated with irradiation only. Three patients received neoadjuvant, 4 patients received adjuvant, and 22 patients received neoadjuvant + adjuvant chemotherapy in addition to radiotherapy. Patients received 50-72 Gy to the primary tumor and involved nodes and 45-50 Gy to uninvolved regions. Chemotherapy consisted of combinations of cisplatin, fluorouracil or Adriamycin, vincristine, and cyclophosphamide. Twenty-nine patients (88%) attained locoregional control. Overall, 10 patients died with progressive disease or infectious complications, and 2 patients are still receiving therapy. Three patients are still living with multiple metastases and stable disease. Eight patients were lost to follow-up. Twelve patients are alive without relapse 3 and 63 months from diagnosis. Seven patients had 6 relapses at distant and 1 relapse at local site. The median time for first relapse was 8 months. Overall, the 5-year survival rate was 63% and disease-free survival rate was 53%. Although the locoregional control rate is high, long-term survival rates will be the real test of the impact of chemotherapy. Further studies are needed to confirm the optimal combination of effective chemotherapeutic agents and radiotherapy.

Bu çalışmada, ekstraplevral pnömonektomi yapılamayan ve kemoterapi altında progrese olan malign plevral mezotelyomalı (MPM) hastalara verilen palyatif hemitoraks radyoterapisinin (RT) etkinliği ve toksisitesi değerlendirilmiştir. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Kliniğimize Haziran 2010 ile Aralık 2011 tarihleri arasında başvuran ve görüntü rehberliğinde yoğunluk ayarlı hemitoraks RT'si uygulanan 4 hasta prospektif olarak incelenmiştir. Yaygın plevral tutulumu olan timoma tanılı bir hasta dışında, diğerleri ileri evre MPM tanılı idi. Hastaların tümünde 6-15 kür değişik kemoterapi (KT) protokolleri uygulanırken, progresyon gelişmiş ve ağrı palyasyonu amaçlı kliniğimize yönlendirilmişti. Pozitron emisyon tomografisi ile eşleştirme yapılarak elde edilen hedef hacimlere, helikal tomoterapi cihazı ile günlük 2 Gy fraksiyonlarla, 48-54 Gy (ortanca 52 Gy) hemitoraks RT'si uygulandı. B Bu ul lg gu ul la ar r: : Hastaların tümünde 6-14 ay arasında devam eden kalıcı ağrı palyasyonu elde edildi. RT'ye bağlı mortalite olmadı ve genelde tedavi iyi tolere edildi. Radyoterapi esnasında iki hastada grade 1, iki hastada grade 2 özefajit ve iki hastada grade 1, iki hastada grade 2 dermatit gelişti. Bir hastamızda radyoterapiden 3 ay sonra gelişen ve steroid tedavisi ile hızla iyileşen grade 3 radyasyon pnömonisi izlendi. S So on nu uç ç: : İleri evre malign plevral mezotelyomanın küratif tedavisi günümüz teknik ve olanakları ile olası görünmemektedir, ancak ağrı palyasyonunda hemitoraks RT'si bir seçenek olarak yer alabilir.

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