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1. Morimoto H, Hashida H, Honda T, Aibara Y: [An elderly case of cytomegalovirus enterocolitis associated with a malignant tumor]. Nihon Ronen Igakkai Zasshi; 2002 Jan;39(1):97-100
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  • [Title] [An elderly case of cytomegalovirus enterocolitis associated with a malignant tumor].
  • An 83-year-old man was given a diagnosis of left parotid cancer in our hospital in November 1997.
  • He refused to undergo a surgical procedure because of his advanced age.
  • Therefore chemotherapy and radiotherapy were used.
  • Chemotherapy with CAP (Cyclophosphamide, Adriacin, and CDDP) was conducted on 6 occasions between December 1997 to July 2000.
  • As the patient also began to suffer high grade fevers and stomachaches, he was admitted on a diagnosis of acute enterocolitis.
  • Cytomegalovirus enterocolitis is an opportunistic infection, so immunocompromised hosts (such as cancer patients, patients using immunosuppressants, old people) have a greater probability of contracting cytomegalovirus infection.
  • A ganciclovir is an effective treatment.
  • A cytomegalovirus enterocolitis should considered in the differential diagnosis of enterocolitis, when alimentary symptoms like diarrhea or bloody stool are found in immunocompromised hosts.
  • [MeSH-major] Cytomegalovirus Infections / etiology. Enterocolitis / etiology. Immunocompromised Host. Parotid Neoplasms / immunology
  • [MeSH-minor] Aged. Aged, 80 and over. Antiviral Agents / therapeutic use. Ganciclovir / therapeutic use. Humans. Male

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  • (PMID = 11857983.001).
  • [ISSN] 0300-9173
  • [Journal-full-title] Nihon Ronen Igakkai zasshi. Japanese journal of geriatrics
  • [ISO-abbreviation] Nihon Ronen Igakkai Zasshi
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antiviral Agents; P9G3CKZ4P5 / Ganciclovir
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2. Wendt TG, Abbasi-Senger N, Salz H, Pinquart I, Koscielny S, Przetak SM, Wiezorek T: 3D-conformal-intensity modulated radiotherapy with compensators for head and neck cancer: clinical results of normal tissue sparing. Radiat Oncol; 2006;1:18
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  • [Title] 3D-conformal-intensity modulated radiotherapy with compensators for head and neck cancer: clinical results of normal tissue sparing.
  • BACKGROUND: To investigate the potential of parotic gland sparing of intensity modulated radiotherapy (3D-c-IMRT) performed with metallic compensators for head and neck cancer in a clinical series by analysis of dose distributions and clinical measures.
  • MATERIALS AND METHODS: 39 patients with squamous cell cancer of the head and neck irradiated using 3D-c-IMRT were evaluable for dose distribution within PTVs and at one parotid gland and 38 patients for toxicity analysis.
  • 10 patients were treated primarily, 29 postoperatively, 19 received concomitant cis-platin based chemotherapy, 20 3D-c-IMRT alone.
  • Gross tumor/tumor bed (PTV 1) was irradiated up to 60-70 Gy, [5 fractions/week, single fraction dose: 2.0-2.2 (simultaneously integrated boost)], adjuvantly irradiated bilateral cervical lymph nodes (PTV 2) with 48-54 Gy [single dose: 1.5-1.8]).
  • RESULTS: Mean of the median doses at the parotid glands to be spared was 25.9 (16.3-46.8) Gy, for tin granulate 26 Gy, for MCP alloy 24.2 Gy.
  • Tin-granulate compensators resulted in a median parotid dose above 26 Gy in 10/22, MCP 96 alloy in 0/17 patients.
  • During therapy the XQ forms showed (degree 0-2/3): 88%/12%.
  • CONCLUSION: 3D-c-IMRT using metallic compensators along with inverse calculation algorithm achieves sufficient parotid gland sparing in virtually all advanced head and neck cancers.
  • Since the concept of lower single (and total) doses in the adjuvantly treated volumes reduces acute morbidity 3D-c-IMRT nicely meets demands of concurrent chemotherapy protocols.
  • [MeSH-minor] Adult. Aged. Dose-Response Relationship, Radiation. Female. Humans. Male. Middle Aged. Parotid Gland / pathology. Parotid Gland / radiation effects. Radiotherapy Planning, Computer-Assisted / methods. Treatment Outcome. Xerostomia / etiology

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  • (PMID = 16790059.001).
  • [ISSN] 1748-717X
  • [Journal-full-title] Radiation oncology (London, England)
  • [ISO-abbreviation] Radiat Oncol
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC1524966
  • [General-notes] NLM/ Original DateCompleted: 20070618
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3. Piechocki MP, Lonardo F, Ensley JF, Nguyen T, Kim H, Yoo GH: Anticancer activity of docetaxel in murine salivary gland carcinoma. Clin Cancer Res; 2002 Mar;8(3):870-7
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  • [Title] Anticancer activity of docetaxel in murine salivary gland carcinoma.
  • PURPOSE: The purpose of this study was to evaluate the biological mechanisms of docetaxel (TXT) on salivary gland carcinoma.
  • RESULTS: We characterized a spontaneous mouse salivary gland carcinoma (SGC1).
  • SGC1 is a poorly differentiated carcinoma that originated from the parotid gland of a BALB/c mouse.
  • Initially, cells formed tumor nodules in severe combined immunodeficient (SCID) mice.
  • CONCLUSIONS: We have identified several novel targets of TXT that contribute to its antitumor activity in poorly differentiated salivary gland carcinoma.
  • These results suggest that TXT may be appropriate for additional in vivo studies and clinical trials in patients with salivary cancers.
  • [MeSH-major] Adenocarcinoma / drug therapy. Antineoplastic Agents, Phytogenic / therapeutic use. Paclitaxel / analogs & derivatives. Paclitaxel / therapeutic use. Salivary Gland Neoplasms / drug therapy. Taxoids
  • [MeSH-minor] Animals. Antigens, CD95 / metabolism. Apoptosis / drug effects. Blotting, Western. Cell Communication / drug effects. Cell Cycle / drug effects. Cell Division / drug effects. Connexin 43 / metabolism. Female. Flow Cytometry. Fluorescent Antibody Technique. Gap Junctions / drug effects. Immunoenzyme Techniques. Keratins / metabolism. Mice. Mice, Inbred BALB C. Mice, SCID. Precipitin Tests. Proliferating Cell Nuclear Antigen / metabolism. S100 Proteins / metabolism. Tumor Cells, Cultured / drug effects

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  • (PMID = 11895921.001).
  • [ISSN] 1078-0432
  • [Journal-full-title] Clinical cancer research : an official journal of the American Association for Cancer Research
  • [ISO-abbreviation] Clin. Cancer Res.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antigens, CD95; 0 / Antineoplastic Agents, Phytogenic; 0 / Connexin 43; 0 / Proliferating Cell Nuclear Antigen; 0 / S100 Proteins; 0 / S100A1 protein; 0 / Taxoids; 15H5577CQD / docetaxel; 68238-35-7 / Keratins; P88XT4IS4D / Paclitaxel
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4. Harish K, Mangala Gouri SR: Adenoid cystic carcinoma of the parotid metastasizing to liver: case report. BMC Cancer; 2004 Jul 30;4:41
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  • [Title] Adenoid cystic carcinoma of the parotid metastasizing to liver: case report.
  • BACKGROUND: Adenoid cystic carcinoma is a rare malignant parotid tumor.
  • Metastasis can occur even a decade or more after initial treatment of the primary.
  • CASE PRESENTATION: We report a 60 year old female patient who presented with adenoid cystic carcinoma of the parotid gland.
  • While on follow up, patient developed multiple liver metastases which manifested three years later.
  • Palliative chemotherapy can be considered in symptomatic cases while the usefulness of metastasectomy is controversial.
  • [MeSH-major] Carcinoma, Adenoid Cystic / secondary. Liver Neoplasms / secondary. Parotid Neoplasms / radiotherapy. Parotid Neoplasms / surgery

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  • (PMID = 15285782.001).
  • [ISSN] 1471-2407
  • [Journal-full-title] BMC cancer
  • [ISO-abbreviation] BMC Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Other-IDs] NLM/ PMC509249
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5. Boccon-Gibod L, Boman F, Josset P, Landman-Parker J: Mucoepidermoid carcinoma of the parotid gland in a child previously treated for acute lymphoblastic leukemia. Pediatr Blood Cancer; 2005 Jun 15;44(7):673-5
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  • [Title] Mucoepidermoid carcinoma of the parotid gland in a child previously treated for acute lymphoblastic leukemia.
  • Occurrence of second cancers is a major concern for the care of children cured of cancer.
  • Children treated for acute lymphoblastic leukemia (ALL) have an increased risk for developing mucoepidermoid carcinomas (MEC) of the parotid gland.
  • Treatment included multidrug chemotherapy and prophylactic intrathecal injections of methotrexate and prednisolone.
  • Low-grade MEC of the left parotid gland was diagnosed at the age of 7 years, only 1 year after completing treatment.
  • This case report is remarkable for the early diagnosis of second cancer, only 4 years after diagnosis of ALL, and its occurrence in parotid gland without previous head and neck irradiation.
  • It highlights the need for concern about second cancers of the parotid gland in children treated for ALL.
  • [MeSH-major] Carcinoma, Mucoepidermoid / etiology. Neoplasms, Second Primary / etiology. Parotid Neoplasms / etiology. Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / drug therapy. Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Child, Preschool. Humans. Male

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  • [Copyright] Copyright 2004 Wiley-Liss, Inc.
  • (PMID = 15515042.001).
  • [ISSN] 1545-5009
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 17
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6. Bouyon A, Hans S, Durdux C, Housset M: [Postoperative treatment of malignant tumors of the parotid gland: radiotherapy, concomitant chemotherapy and radiation therapy?]. Cancer Radiother; 2007 Dec;11(8):465-75

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  • [Title] [Postoperative treatment of malignant tumors of the parotid gland: radiotherapy, concomitant chemotherapy and radiation therapy?].
  • [Transliterated title] Tumeurs malignes de la parotide: prise en charge multidisciplinaire, rôle de la radiothérapie.
  • The low incidence, the wide histological spectrum and the natural, sometimes slow, evolution of malignant parotid gland tumours do not allow to easily establish the impact of their treatments.
  • We present here the therapeutic highlights of parotid cancers: surgery, with the particular concern of facial nerve preservation; and adjuvant treatment essentially based on radiotherapy.
  • This review focused on adjuvant care explores the indications and the technical aspects of radiation, as well as the role of concurrent chemotherapy.
  • [MeSH-major] Parotid Neoplasms / radiotherapy. Parotid Neoplasms / surgery
  • [MeSH-minor] Combined Modality Therapy. Female. Humans. Incidence. Male. Middle Aged. Neoplasm Staging. Prognosis. Radiotherapy / methods. Retrospective Studies. Survival Analysis

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  • (PMID = 17888707.001).
  • [ISSN] 1278-3218
  • [Journal-full-title] Cancer radiothérapie : journal de la Société française de radiothérapie oncologique
  • [ISO-abbreviation] Cancer Radiother
  • [Language] fre
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] France
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7. Harish K: Management of primary malignant epithelial parotid tumors. Surg Oncol; 2004 Jul;13(1):7-16

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Management of primary malignant epithelial parotid tumors.
  • Parotid cancers are infrequently encountered.
  • Controversies surrounding pre-treatment evaluation by imaging and fine needle aspiration, utility of operative frozen section are partly resolved.
  • Though surgery remains the mainstay of treatment, radiation is being recognized as a useful adjuvant.
  • The role of chemotherapy is still investigational.
  • The prognosis and necessity of elective neck treatment are mainly guided by the tumor grade and stage.
  • [MeSH-major] Neoplasms, Glandular and Epithelial / therapy. Parotid Neoplasms / therapy
  • [MeSH-minor] Humans. Lymph Node Excision. Neoplasm Staging. Prognosis

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  • (PMID = 15145029.001).
  • [ISSN] 0960-7404
  • [Journal-full-title] Surgical oncology
  • [ISO-abbreviation] Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Netherlands
  • [Number-of-references] 81
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8. Chao KS, Low DA, Perez CA, Purdy JA: Intensity-modulated radiation therapy in head and neck cancers: The Mallinckrodt experience. Int J Cancer; 2000 Apr 20;90(2):92-103
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  • [Title] Intensity-modulated radiation therapy in head and neck cancers: The Mallinckrodt experience.
  • The purpose of the study was to investigate the feasibility and the optimization of tomotherapy-based intensity-modulated radiation therapy (IMRT) in patients with head and neck cancer.
  • Treatment planning was performed on a Peacock inverse planning system and prescription optimization was used to achieve the best plan for target coverage and parotid sparing.
  • The treatment planning system process has a dosimetric characteristic of delivering different doses to different target structures simultaneously in each daily treatment; therefore, the biological equivalent dose was implemented using the linear-quadratic model to adjust the total dose to the target volume receiving a daily dose of less than 1.9 Gy.
  • All eight patients with gross disease (six in the nasopharynx, two in the tonsil) and one patient with recurrent nasopharyngeal carcinoma received concurrent cisplatin chemotherapy.
  • All patients completed the prescribed treatment without unexpected interruption.
  • To spare the parotid gland, which is in the proximity of the target, a fraction of the target volume may not receive the prescribed dose.
  • In the best-achievable plan of our studied cohort, only 27% +/- 8% of parotid gland volumes were treated to more than 30 Gy, while an average of 3.3% +/- 0.6% of the target volume received less than 95% of the prescribed dose.
  • This is mainly related to the steep dose gradient in the region where the target abuts the parotid gland.
  • The inverse planning system allowed us the freedom of weighting normal tissue-sparing and target coverage to select the best-achievable plan.
  • Local control was achieved in eight patients with gross tumor; six were treated postoperatively.
  • In summary, a system for patient immobilization, setup verification, and dose optimization for head and neck cancer with parotid sparing without significantly compromising target coverage is being implemented for a tomotherapy-based IMRT plan at the Mallinckrodt Institute of Radiology.
  • The initial clinical experience in tumor control is promising, and no severe adverse acute side effects have been observed.
  • Further refining of delivery technology and the inverse planning system, gaining clinical experience to address target definition and dose inhomogeneity within the targets, and understanding the partial volume effect on normal tissue tolerance are needed for IMRT to excel in the treatment of head and neck cancer. Int. J.
  • Cancer (Radiat. Oncol. Invest.
  • [MeSH-minor] Adult. Aged. Combined Modality Therapy. Humans. Laryngeal Neoplasms / radiotherapy. Magnetic Resonance Imaging. Middle Aged. Nasopharyngeal Neoplasms / radiotherapy. Oropharyngeal Neoplasms / radiotherapy. Radiation Dosage. Tonsillar Neoplasms / radiotherapy. Treatment Outcome

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  • [Copyright] Copyright 2000 Wiley-Liss, Inc.
  • (PMID = 10814959.001).
  • [ISSN] 0020-7136
  • [Journal-full-title] International journal of cancer
  • [ISO-abbreviation] Int. J. Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] UNITED STATES
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9. Markowski J, Gierek T, Zielińska-Pajak E, Witkowska M, Wodołazski A, Pajak J, Paluch J: [Distant metastases to the parotid gland--review of the literature and report of own two cases]. Otolaryngol Pol; 2005;59(4):547-52
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  • [Title] [Distant metastases to the parotid gland--review of the literature and report of own two cases].
  • Metastatic tumors to the parotid gland are very uncommon and it accounts for 8% of all cancers of parotid gland.
  • The parotid gland and its lymph nodes are possible sites of metastases from head and neck cancers.
  • However, metastasis from distant primary neoplasm below clavicle is possible, too.
  • The authors presented the two cases of distant metastases to the parotid gland.
  • The women with breast cancer and metastases to the parotid gland 11 years after surgery, radio- and chemotherapy of breast cancer.
  • She died 7 months after parotid surgery of systemically advanced disease.
  • The man with metastasis of malignant melanoma of unknown primary site.
  • He underwent total parotid surgery with the tumor and lymph nodes.
  • The authors described pathophysiology of distant metastases to the parotid gland with special attention to possibilities of treatment and survival.
  • [MeSH-major] Breast Neoplasms / pathology. Melanoma / pathology. Neoplasms, Unknown Primary / genetics. Neoplasms, Unknown Primary / pathology. Parotid Neoplasms / secondary

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  • (PMID = 16273860.001).
  • [ISSN] 0030-6657
  • [Journal-full-title] Otolaryngologia polska = The Polish otolaryngology
  • [ISO-abbreviation] Otolaryngol Pol
  • [Language] pol
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Poland
  • [Number-of-references] 15
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10. Anand AK, Jain J, Negi PS, Chaudhoory AR, Sinha SN, Choudhury PS, Kumar R, Munjal RK: Can dose reduction to one parotid gland prevent xerostomia?--A feasibility study for locally advanced head and neck cancer patients treated with intensity-modulated radiotherapy. Clin Oncol (R Coll Radiol); 2006 Aug;18(6):497-504
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  • [Title] Can dose reduction to one parotid gland prevent xerostomia?--A feasibility study for locally advanced head and neck cancer patients treated with intensity-modulated radiotherapy.
  • AIMS: Dryness of the mouth is one of the most distressing chronic toxicities of radiation therapy in head and neck cancers.
  • In this study, parotid function was assessed in patients with locally advanced head and neck cancers undergoing intensity-modulated radiotherapy (IMRT) with or without chemotherapy.
  • Parotid function was assessed with the help of a questionnaire and parotid scintigraphy, especially with regards to unilateral sparing of the parotid gland.
  • The dose to the clinical target volume ranged between 66 and 70 Gy in 30-35 fractions to 95% of the isodose volume.
  • Ipsilateral high-risk neck nodes received an average dose of 60 Gy and the contralateral low-risk neck received a dose of 54-56 Gy.
  • Eight of 19 patients also received concomitant chemotherapy.
  • RESULTS: Subjective toxicity to the parotid glands was assessed with the help of a questionnaire at 0, 3 and 6 months and objective toxicity was assessed with parotid scintigraphy at 0 and 3 months.
  • The mean dose to the ipsilateral parotid gland ranged from 19.5 to 52.8 Gy (mean 33.14 Gy) and the mean dose to the contralateral gland was 11.1-46.6 Gy (mean 26.85 Gy).
  • At a median follow-up of 13 months, 9/19 patients had no symptoms of dryness of the mouth (grade I), 8/19 had mild dryness of the mouth (grade II) and only 2/19 had grade III xerostomia, although the parotid gland could only be spared on one side in most of the patients.
  • CONCLUSIONS: Minimising the radiation dose to one of the parotid glands with the help of IMRT in patients with advanced head and neck cancers can prevent xerostomia in most patients and parotid scintigraphy is a useful method of documenting xerostomia.
  • [MeSH-major] Head and Neck Neoplasms / radiotherapy. Parotid Gland / radiation effects. Radiotherapy, Intensity-Modulated / adverse effects. Xerostomia / prevention & control
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Combined Modality Therapy. Disease Progression. Dose-Response Relationship, Radiation. Feasibility Studies. Follow-Up Studies. Humans. Magnetic Resonance Imaging / methods. Neoplasm Recurrence, Local. Neoplasm Staging. Radionuclide Imaging. Radiotherapy Dosage. Sensitivity and Specificity. Surveys and Questionnaires. Tomography, X-Ray Computed / methods. Treatment Outcome

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  • (PMID = 16909975.001).
  • [ISSN] 0936-6555
  • [Journal-full-title] Clinical oncology (Royal College of Radiologists (Great Britain))
  • [ISO-abbreviation] Clin Oncol (R Coll Radiol)
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] England
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11. Soldevilla HF, Molina RM, Navarra SV: Breast lymphoma in Sjögren's syndrome complicated by acute monocular blindness. Int J Rheum Dis; 2010 May;13(2):164-70
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  • A 69-year-old hypertensive woman presented with eye and mouth dryness, bilateral parotid gland enlargement, associated with anasarca and proteinuria.
  • Family history was notable for malignancies including breast, nasopharyngeal and colon cancers.
  • Physical exam disclosed hypertension, bilaterally enlarged, firm, non-tender parotid glands, fine bibasilar crackles and bipedal edema.
  • Anti Ro/Sjögren's syndrome antigen A antibody was positive, with negative tests for anti La/Sjögren's syndrome antigen B and anti-nuclear antibody (ANA).
  • She underwent modified radical mastectomy of the right breast, and pathologic report revealed diffuse, small cell, non-Hodgkin's lymphoma of the breast; axillary lymph nodes were negative for tumor.
  • She opted for alternative therapy and did not return to the clinic until 7 months later when she developed sudden monocular blindness in the right eye with no other systemic manifestations.
  • She received pulse methylprednisolone therapy (1 g/day for 3 days) with partial recovery of vision.
  • She is scheduled for lymphoma chemotherapy to include rituximab.
  • [MeSH-minor] Aged. Combined Modality Therapy. Diagnosis, Differential. Female. Humans. Mastectomy, Radical. Methylprednisolone / therapeutic use. Neoplasm Metastasis / diagnosis. Neuromyelitis Optica / diagnosis. Prednisone / therapeutic use. Radiography, Thoracic

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  • (PMID = 20536602.001).
  • [ISSN] 1756-185X
  • [Journal-full-title] International journal of rheumatic diseases
  • [ISO-abbreviation] Int J Rheum Dis
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] VB0R961HZT / Prednisone; X4W7ZR7023 / Methylprednisolone
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12. Zackrisson B, Mercke C, Strander H, Wennerberg J, Cavallin-Ståhl E: A systematic overview of radiation therapy effects in head and neck cancer. Acta Oncol; 2003;42(5-6):443-61
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  • [Title] A systematic overview of radiation therapy effects in head and neck cancer.
  • A systematic review of radiation therapy trials in several tumour types was performed by The Swedish Council of Technology Assessment in Health Care (SBU).
  • This synthesis of the literature on radiation therapy for head and neck cancer is based on data from 39 randomized trials and 1 meta-analysis.
  • Substantial evidence indicates that the tumour effect of radiotherapy can be increased by the concomitant administration of chemotherapeutic agents, particularly cisplatin and 5-fluorouracil.
  • There is moderate evidence of a survival benefit of radiation combined with concomitant chemotherapy compared to radiation alone.
  • There is substantial evidence in published studies for an increased frequency of severe acute side effects as a result of concomitant chemotherapy and radiotherapy.
  • There is strong evidence that larynx preservation is possible in 50% of the patients surviving for 5 years with hypopharyngeal cancers when treated with neoadjuvant chemotherapy and radical radiotherapy There is a non-significant trend for the overall survival being lower in non-surgically treated patients than in those treated with primary surgery and postoperative radiotherapy Nasopharynx.
  • There is moderate evidence that patients with nasopharyngeal carcinomas of the endemic type benefit from therapy with a combination of chemotherapy and radical radiotherapy.
  • There is some evidence that certain schedules of altered fractionation improve tumour control without increasing severe late side effects.
  • There is some evidence that nervous tissues are more susceptible to damage by altered fractionation.
  • There is moderate evidence that accelerated hyperfractionation may reduce the frequency of serious late side effects while retaining a similar tumour effect as conventional radiotherapy Hypoxic cell sensitizers.
  • Most reported trials reject the usefulness of nitroimidazole derivatives for sensitization of hypoxic tumour cells.
  • Prophylactic treatment of side effects.
  • There is insufficient evidence that radioprotective agents offer clinically significant protection of parotid glands (one study in two publications).
  • There is insufficient evidence that radioprotective agents do not spare tumour tissue.
  • Both methods are well established and have independently proved to be effective in the treatment of certain head and neck cancers.
  • [MeSH-minor] Adult. Aged. Dose Fractionation. Female. Humans. Male. Middle Aged. Neoplasm Staging. Prognosis. Radiation Injuries. Radiotherapy Dosage. Radiotherapy, Adjuvant. Randomized Controlled Trials as Topic. Risk Assessment. Survival Analysis. Sweden. Treatment Outcome

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  • (PMID = 14596506.001).
  • [ISSN] 0284-186X
  • [Journal-full-title] Acta oncologica (Stockholm, Sweden)
  • [ISO-abbreviation] Acta Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Norway
  • [Number-of-references] 43
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13. Chao KS, Deasy JO, Markman J, Haynie J, Perez CA, Purdy JA, Low DA: A prospective study of salivary function sparing in patients with head-and-neck cancers receiving intensity-modulated or three-dimensional radiation therapy: initial results. Int J Radiat Oncol Biol Phys; 2001 Mar 15;49(4):907-16
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  • [Title] A prospective study of salivary function sparing in patients with head-and-neck cancers receiving intensity-modulated or three-dimensional radiation therapy: initial results.
  • OBJECTIVES: In a prospective clinical study, we tested the hypothesis that sparing the parotid glands may result in significant objective and subjective improvement of xerostomia in patients with head-and-neck cancers.
  • The functional outcome 6 months after the completion of radiation therapy is presented.
  • METHODS AND MATERIALS: From February 1997 to February 1999, 41 patients with head-and-neck cancers were enrolled in a prospective salivary function study.
  • Inverse-planning intensity-modulated radiation therapy (IMRT) was used to treat 27 patients, and forward-planning three-dimensional radiation therapy in 14.
  • To avoid potential bias in data interpretation, only patients whose submandibular glands received greater than 50 Gy were eligible.
  • Attempts were made to spare the superficial lobe of the parotid glands to avoid underdosing tumor targets in the parapharyngeal space; however, the entire parotid volume was used to compute dose-volume histograms (DVHs) for this analysis.
  • DVHs were computed for each gland separately.
  • Parotid function was assessed objectively by measuring stimulated and unstimulated saliva flow before and 6 months after the completion of radiation therapy.
  • Measurements were converted to flow rate (mL/min) and normalized relative to that before treatment.
  • RESULTS: We observed a correlation between parotid mean dose and the fractional reduction of stimulated saliva output at 6 months after the completion of radiation therapy.
  • The first model assumed that each parotid gland is comprised of multiple independent parallel functional subunits (corresponding to computed tomography voxels) and that each gland contributes equally to overall flow, and that saliva output decreases exponentially as a quadratic function of irradiation dose to each voxel.
  • The second approach uses the equivalent uniform dose (EUD) metrics, which assumes loss of salivary function with increase in EUD for each parotid gland independently.
  • The analysis suggested that the mean dose to each parotid gland is a reasonable indicator for the functional outcome of each gland.
  • The corresponding exponential coefficient was 0.0428/Gy (95% confidence interval: 0.01, 0.09).
  • In a multivariate analysis, a toxicity score derived from the model based on radiation dose to the parotid gland was found to be the sole significant predictive factor for xerostomia.
  • Neither radiation technique (IMRT vs. non-IMRT) nor chemotherapy (yes or no) independently influenced the functional outcome of the salivary glands.
  • CONCLUSION: Sparing of the parotid glands translates into objective and subjective improvement of both xerostomia and QOL scores in patients with head-and-neck cancers receiving radiation therapy.
  • Modeling results suggest an exponential relationship between saliva flow reduction and mean parotid dose for each gland.
  • We found that the stimulated saliva flow at 6 months after treatment is reduced exponentially, for each gland independently, at a rate of approximately 4% per Gy of mean parotid dose.
  • [MeSH-major] Carcinoma, Adenosquamous / radiotherapy. Carcinoma, Squamous Cell / radiotherapy. Head and Neck Neoplasms / radiotherapy. Parotid Gland / physiology. Quality of Life. Radiotherapy, Conformal / methods. Xerostomia / prevention & control

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  • (PMID = 11240231.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / CA85181
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
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14. Pollard JD, Hanasono MM, Mikulec AA, Le QT, Terris DJ: Head and neck cancer in cardiothoracic transplant recipients. Laryngoscope; 2000 Aug;110(8):1257-61
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  • [Title] Head and neck cancer in cardiothoracic transplant recipients.
  • INTRODUCTION: There is an increased incidence of cancer in patients after organ transplantation.
  • Demographic data, risk factors, and disease course were evaluated in patients who developed cancer.
  • RESULTS: One hundred twenty patients (11.2%) developed 547 non-lymphomatous malignancies.
  • The mean number of malignancies per cancer patient was 4.6.
  • The average time from transplantation to development of cancer was 63.1 months.
  • Noncutaneous malignancies involved the oral cavity (5), thyroid (4), and parotid (1).
  • Thirteen percent of cutaneous head and neck cancers behaved aggressively, requiring extensive management including radical surgery, radiation, and/or chemotherapy.
  • A total of 34.2% of cancer patients developed metastases and 54.9% of cancer patients died as a direct result of cancer.
  • A total of 68% of cancer patients were smokers and 23.8% had significant alcohol use.
  • CONCLUSION: Transplant recipients have an increased incidence of cancer presenting in the head and neck.
  • Recognition of this aggressive biological behavior and heightened cancer surveillance should result in improved outcomes.


15. Laskawi R, Ellies M: The role of botulinum toxin in the management of head and neck cancer patients. Curr Opin Otolaryngol Head Neck Surg; 2007 Apr;15(2):112-6
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The role of botulinum toxin in the management of head and neck cancer patients.
  • PURPOSE OF REVIEW: In this review article different relevant applications of botulinum toxin type A are demonstrated in patients with head and neck cancer.
  • RECENT FINDINGS: Patients with head and neck cancers of different etiologies often suffer from disorders concerning their musculature (for example, synkinesis in mimic muscles) or gland secretion in the head and neck region.
  • The application of botulinum toxin type A can improve movement disorders like synkinesis following reconstructive surgery in patients with cancers of the parotid gland, spasms of the pharyngo-esophageal musculature following laryngectomies and disorders of the autonomous nerve system like hypersalivation, hyperlacrimation and pathological sweating.
  • SUMMARY: The application of botulinum toxin type A is a helpful and minimally invasive treatment option in different functional disorders improving the quality of life in patients with head and neck cancers of different etiologies.
  • [MeSH-major] Botulinum Toxins, Type A / therapeutic use. Head and Neck Neoplasms / complications. Neuromuscular Agents / therapeutic use
  • [MeSH-minor] Dyskinesias / drug therapy. Dyskinesias / etiology. Facial Nerve Injuries / complications. Facial Nerve Injuries / etiology. Facial Paralysis / drug therapy. Facial Paralysis / etiology. Humans. Lacrimal Apparatus Diseases / drug therapy. Lacrimal Apparatus Diseases / etiology. Laryngectomy / adverse effects. Muscle Spasticity / complications. Muscle Spasticity / drug therapy. Muscle Spasticity / etiology. Sialorrhea / drug therapy. Sialorrhea / etiology. Speech Disorders / drug therapy. Speech Disorders / etiology. Sweating, Gustatory / drug therapy. Sweating, Gustatory / etiology

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  • (PMID = 17413413.001).
  • [ISSN] 1068-9508
  • [Journal-full-title] Current opinion in otolaryngology & head and neck surgery
  • [ISO-abbreviation] Curr Opin Otolaryngol Head Neck Surg
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Neuromuscular Agents; EC 3.4.24.69 / Botulinum Toxins, Type A
  • [Number-of-references] 20
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16. Cheuk DK, Shek TW, Chan GC, Lau YL, Ha SY, Chiang AK: Parotid acinar cell carcinoma in a long-term survivor of childhood acute lymphoblastic leukemia. Pediatr Blood Cancer; 2008 Mar;50(3):636-9
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  • [Title] Parotid acinar cell carcinoma in a long-term survivor of childhood acute lymphoblastic leukemia.
  • Secondary malignancies are an important cause of morbidity and mortality in childhood cancer survivors.
  • Salivary gland tumors account for about 6% of the second cancers.
  • The majority of these are mucoepidermoid carcinomas (MEC) of the parotid gland.
  • We report the clinical and pathological features of a rarer histological type, acinic cell carcinoma (ACC), in a childhood acute lymphoblastic leukemia (ALL) survivor.
  • The behavior of secondary ACC appears similar to primary tumor and similar treatment may be adopted.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / adverse effects. Carcinoma, Acinar Cell / etiology. Neoplasms, Radiation-Induced / etiology. Neoplasms, Second Primary / etiology. Parotid Neoplasms / etiology. Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / drug therapy. Whole-Body Irradiation / adverse effects
  • [MeSH-minor] 6-Mercaptopurine / administration & dosage. 6-Mercaptopurine / adverse effects. Adenoma, Sweat Gland / etiology. Adenoma, Sweat Gland / surgery. Asparaginase / administration & dosage. Asparaginase / adverse effects. Child, Preschool. Combined Modality Therapy / adverse effects. Cyclophosphamide / administration & dosage. Cyclophosphamide / adverse effects. Cytarabine / administration & dosage. Cytarabine / adverse effects. Daunorubicin / administration & dosage. Daunorubicin / adverse effects. Epirubicin / administration & dosage. Epirubicin / adverse effects. Etoposide / administration & dosage. Etoposide / adverse effects. Follow-Up Studies. Humans. Male. Methotrexate / administration & dosage. Methotrexate / adverse effects. Prednisolone / administration & dosage. Prednisolone / adverse effects. Recurrence. Remission Induction. Survivors. Sweat Gland Neoplasms / etiology. Sweat Gland Neoplasms / surgery. Vincristine / administration & dosage. Vincristine / adverse effects

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  • [Copyright] (c) 2007 Wiley-Liss, Inc.
  • (PMID = 16865683.001).
  • [ISSN] 1545-5017
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 04079A1RDZ / Cytarabine; 3Z8479ZZ5X / Epirubicin; 5J49Q6B70F / Vincristine; 6PLQ3CP4P3 / Etoposide; 8N3DW7272P / Cyclophosphamide; 9PHQ9Y1OLM / Prednisolone; E7WED276I5 / 6-Mercaptopurine; EC 3.5.1.1 / Asparaginase; YL5FZ2Y5U1 / Methotrexate; ZS7284E0ZP / Daunorubicin; UKALL X protocol
  • [Number-of-references] 17
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17. Chambers MS, Garden AS, Kies MS, Martin JW: Radiation-induced xerostomia in patients with head and neck cancer: pathogenesis, impact on quality of life, and management. Head Neck; 2004 Sep;26(9):796-807
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Radiation-induced xerostomia in patients with head and neck cancer: pathogenesis, impact on quality of life, and management.
  • BACKGROUND: Xerostomia is a common, debilitating complication of radiation therapy (RT) for head and neck cancer.
  • This article reviews the pathogenesis of radiation-induced xerostomia, its impact on quality of life (QOL), and treatment options.
  • METHODS: Virtually all patients undergoing RT for head and neck cancers have xerostomia, which causes oral discomfort and pain, increased dental caries and oral infection, and difficulty speaking and swallowing.
  • This significantly impairs QOL and can compromise nutritional intake and continuity of cancer therapy.
  • The literature describing pathogenesis, impact on QOL of radiation-induced xerostomia, and preventive and interventional therapies was reviewed.
  • RESULTS: Current management strategies include stringent dental and oral hygiene; parotid-sparing radiation techniques to prevent or minimize xerostomia; and pharmacotherapies, such as salivary substitutes and sialogogues.
  • Future strategies may include advanced three-dimensional intensity-modulated RT techniques, salivary gland transfer, newer sialogogues, and gene therapy.
  • CONCLUSIONS: New treatment approaches to xerostomia from RT for head and neck cancer may result in significant improvement in patient QOL.
  • [MeSH-major] Quality of Life. Radiotherapy / adverse effects. Xerostomia / etiology. Xerostomia / therapy

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  • [Copyright] Copyright 2004 Wiley Periodicals, Inc.
  • (PMID = 15350026.001).
  • [ISSN] 1043-3074
  • [Journal-full-title] Head & neck
  • [ISO-abbreviation] Head Neck
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Number-of-references] 73
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18. Pamuk GE, Turgut B, Vural O, Demir M, Tek M, Altaner S: Metastatic squamous cell carcinoma of the skin in chronic myeloid leukaemia: complication of hydroxyurea therapy. Clin Lab Haematol; 2003 Oct;25(5):329-31
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  • [Title] Metastatic squamous cell carcinoma of the skin in chronic myeloid leukaemia: complication of hydroxyurea therapy.
  • Hydroxyurea is a ribonucleotide diphosphate reductase inhibitor used in the treatment of patients with myeloproliferative disorders.
  • However, in addition to the appearance of various skin lesions and cutaneous squamous cell carcinoma after 3 years of therapy, he was found to have a metastatic squamous cell carcinoma after 4 years.
  • We present this case to draw attention to the association between hydroxyurea and secondary skin cancers and to emphasize the need for dermatological examination before and during the course of hydroxyurea therapy.
  • [MeSH-major] Antineoplastic Agents / adverse effects. Carcinoma, Squamous Cell / chemically induced. Hydroxyurea / adverse effects. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Skin Neoplasms / chemically induced
  • [MeSH-minor] Aged. Humans. Male. Neoplasm Metastasis. Parotid Neoplasms / secondary

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  • (PMID = 12974726.001).
  • [ISSN] 0141-9854
  • [Journal-full-title] Clinical and laboratory haematology
  • [ISO-abbreviation] Clin Lab Haematol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents; X6Q56QN5QC / Hydroxyurea
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19. Shields JA, Shields CL, Brotman HK, Carvalho C, Perez N, Eagle RC Jr: Cancer metastatic to the orbit: the 2000 Robert M. Curts Lecture. Ophthal Plast Reconstr Surg; 2001 Sep;17(5):346-54
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  • [Title] Cancer metastatic to the orbit: the 2000 Robert M. Curts Lecture.
  • RESULTS: Of 100 patients, the primary tumor site was breast in 53 (53%), prostate gland in 12 (12%), lung in 8 (8%), skin (melanoma) in 6 (6%), kidney in 5 (5%), gastrointestinal tract in 5 (5%), choroid (melanoma) in 2 (2%), parotid gland in 1 (1%), and adrenal gland (neuroblastoma) in 1 (1%).
  • Of patients in whom a detailed history was available, there was no history of cancer at the time of presentation in 19%.
  • In 10%, the primary tumor remained undetected despite systemic evaluation.
  • There were 36 male patients and 64 female patients whose mean age at diagnosis was 62 years (median 60 years, range 5 to 91 years).
  • Treatment included chemotherapy, hormone therapy, irradiation, surgical excision, or observation, depending on clinical circumstances.
  • Among patients with sufficient follow-up, 95% died of metastasis, with overall mean survival of 15 months (median 15 months; range 3 to 96 months) after orbital diagnosis.
  • CONCLUSIONS: The most common primary cancers that metastasize to the orbit are breast, prostate gland, and lung cancer.
  • In 19%, there is no history of cancer when the patient presents with ophthalmic symptoms and in 10% the primary site remains obscure despite systemic evaluation.
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Child. Child, Preschool. Female. Humans. Male. Middle Aged. Prognosis. Retrospective Studies. Tomography, X-Ray Computed


20. Krishnan RS, Clark DP, Donnelly HB: The use of botulinum toxin in the treatment of a parotid duct injury during Mohs surgery and review of management options. Dermatol Surg; 2009 Jun;35(6):941-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The use of botulinum toxin in the treatment of a parotid duct injury during Mohs surgery and review of management options.
  • BACKGROUND: Aggressive skin cancers on the cheeks may involve the parotid duct.
  • For such tumors to be successfully removed, at least part of the parotid duct must be excised as well.
  • Failure to properly address parotid duct injuries that result from Mohs micrographic surgery exposes the patient to a variety of adverse sequelae.
  • OBJECTIVE: To discuss the various diagnostic and treatment options that should be considered when managing parotid duct injuries that result from skin cancer extirpation.
  • MATERIALS AND METHODS: We describe a patient who sustained a parotid duct injury after Mohs micrographic surgery for treatment of squamous cell carcinoma.
  • RESULTS: Two weeks after treatment of the injury with botulinum toxin, the patient reported complete resolution of his symptoms.
  • CONCLUSION: If a parotid duct injury is diagnosed at the time of tumor extirpation, then surgical repair of the duct should be attempted, but if surgical repair is not possible or if an injury remains unrecognized until well after tumor extirpation, then surgery is not necessary.
  • In such cases, conservative, nonsurgical measures, such as treatment with botulinum toxin, will provide excellent results.
  • [MeSH-major] Botulinum Toxins, Type A / administration & dosage. Carcinoma, Squamous Cell / surgery. Mohs Surgery / adverse effects. Neuromuscular Agents / administration & dosage. Parotid Diseases / drug therapy. Parotid Gland / injuries. Skin Neoplasms / surgery

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  • (PMID = 19397665.001).
  • [ISSN] 1524-4725
  • [Journal-full-title] Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.]
  • [ISO-abbreviation] Dermatol Surg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Neuromuscular Agents; EC 3.4.24.69 / Botulinum Toxins, Type A
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21. Kiprian D: [Strategy of combined treatment in patient with cancer of paranasal sinuses]. Otolaryngol Pol; 2007;61(4):527-30

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  • [Title] [Strategy of combined treatment in patient with cancer of paranasal sinuses].
  • Cancers of pranasal sinuses are rare neoplasms in humans.
  • Squamous cell cancer is the most frequent one in this region.
  • Other types of cancer in this region are adenocarcinoma (about 30%), carcinoma adenoides cysticum or neoplasms such as rhabdosarcoma, chondrosarcoma, lymphoma or melanoma malignum.
  • There is a very rare neoplasm as a olfactory neuroblastoma in this localization.
  • Cancer of the paranasal sinuses infiltrates only locoregionally.
  • Metastases to the lymph nodes are seldom--below 30%; this is why elective lymphangiectomy or irradiation are not obligatory treatment in this case.
  • The treatment of cancers of paranasal sinuses is always surgery with adjuvant irradiation.
  • The modern radiotherapy techniques provide the possibility to spare healthy tissues and organs at risk.
  • The organs at risk in this localization are optical nerves and chiasm, and parotid glands.
  • In case of the tumour being of complex shape and located in the vicinity of the organs at risk the IMRT technique is used.
  • The radiation treatment combined with chemotherapy is applied in cases of not radical surgery in the region of ethmoides sinuses.
  • [MeSH-major] Paranasal Sinus Neoplasms / diagnosis. Paranasal Sinus Neoplasms / therapy
  • [MeSH-minor] Combined Modality Therapy. Humans. Incidence. Neoplasm Staging. Radiotherapy, Conformal. Treatment Outcome

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  • (PMID = 18260245.001).
  • [ISSN] 0030-6657
  • [Journal-full-title] Otolaryngologia polska = The Polish otolaryngology
  • [ISO-abbreviation] Otolaryngol Pol
  • [Language] pol
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Poland
  • [Number-of-references] 5
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22. Veness MJ, Porceddu S, Palme CE, Morgan GJ: Cutaneous head and neck squamous cell carcinoma metastatic to parotid and cervical lymph nodes. Head Neck; 2007 Jul;29(7):621-31
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Cutaneous head and neck squamous cell carcinoma metastatic to parotid and cervical lymph nodes.
  • Nonmelanoma skin cancers occur at an epidemic rate in Australia and are increasing in incidence worldwide.
  • In most patients, local treatment is curative.
  • The parotid and upper cervical nodes are common sites for the development of metastases arising from ear, anterior scalp, temple/forehead, or scalp SCC.
  • Research aimed at improving outcome such as a randomized trial incorporating the addition of chemotherapy to adjuvant radiotherapy is currently in progress in Australia and New Zealand.
  • [MeSH-minor] Biomarkers, Tumor / metabolism. Humans. Immunocompromised Host. Lymphatic Metastasis. Neoplasm Invasiveness. Neoplasm Staging. Parotid Gland / pathology. Parotid Gland / surgery. Prognosis. Radiotherapy, Adjuvant. Sentinel Lymph Node Biopsy


23. Kubota A, Furukawa M, Kawano T, Komatsu M: [Nedaplatin for recurrent cancer of the head and neck]. Nihon Jibiinkoka Gakkai Kaiho; 2004 May;107(5):475-82
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  • [Title] [Nedaplatin for recurrent cancer of the head and neck].
  • This study was undertaken to evaluate the clinical efficacy and toxicity of Nedaplatin (254-S) alone or combined for UFT for recurrent head and neck cancers in an outpatient setting.
  • The primary site was identified in the oropharynx in 8 patients, oral cavity in 7, larynx in 5, nasopharynx in 4, hypopharynx in 3, sinuses in one, parotid in one, and unknown primary in one patient.
  • Treatment with 254-S alone or combined UFT-E could be conducted in an outpatient setting and was able to improve the overall survival rate for recurrent head and neck cancer.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Head and Neck Neoplasms / drug therapy. Organoplatinum Compounds / therapeutic use
  • [MeSH-minor] Adenocarcinoma / drug therapy. Adult. Aged. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Carcinoma, Adenoid Cystic / drug therapy. Carcinoma, Squamous Cell / drug therapy. Female. Humans. Male. Middle Aged. Survival Rate. Tegafur / administration & dosage. Uracil / administration & dosage

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  • (PMID = 15198007.001).
  • [ISSN] 0030-6622
  • [Journal-full-title] Nihon Jibiinkoka Gakkai kaiho
  • [ISO-abbreviation] Nippon Jibiinkoka Gakkai Kaiho
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Organoplatinum Compounds; 1548R74NSZ / Tegafur; 56HH86ZVCT / Uracil; 8UQ3W6JXAN / nedaplatin; 1-UFT protocol
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24. Kano H, Niranjan A, Kondziolka D, Flickinger JC, Lunsford LD: The role of palliative radiosurgery when cancer invades the cavernous sinus. Int J Radiat Oncol Biol Phys; 2009 Mar 1;73(3):709-15
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  • [Title] The role of palliative radiosurgery when cancer invades the cavernous sinus.
  • PURPOSE: Involvement of the cavernous sinus by direct invasion from skull base cancer or from metastatic spread of cancers is a challenging problem.
  • We evaluated the role of stereotactic radiosurgery (SRS) in the treatment of patients who developed cavernous sinus metastases or direct invasion.
  • METHODS AND MATERIALS: We retrospectively reviewed the data from 37 patients who had cavernous sinus metastases or had cavernous sinus invasion from adjacent skull base cancers and who underwent SRS between 1992 and 2006 at the University of Pittsburgh Medical Center.
  • Previous adjuvant management included fractionated radiotherapy in 8, chemotherapy in 16, and both radiotherapy and chemotherapy in 5.
  • The primary sites of metastases or invasion were nasopharyngeal carcinoma (n = 7), parotid gland carcinoma (n = 7), and metastases from systemic cancer (n = 23).
  • The median target volume was 6.3 cm(3) (range, 0.3-33.6), and the median margin dose was 14 Gy (range, 12-20).
  • SRS early after diagnosis was significantly associated with improvement of cranial nerve dysfunction.
  • CONCLUSION: SRS is a minimally invasive palliative option for patients whose cancer has invaded the cavernous sinus.
  • [MeSH-minor] Adult. Aged. Analysis of Variance. Cranial Nerve Diseases / etiology. Disease-Free Survival. Female. Humans. Male. Middle Aged. Neoplasm Invasiveness. Palliative Care. Radiotherapy Dosage. Retrospective Studies. Skull Base Neoplasms / secondary

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  • (PMID = 18692328.001).
  • [ISSN] 1879-355X
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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25. Rosenthal DI, Chambers MS, Weber RS, Eisbruch A: A phase II study to assess the efficacy of amifostine for submandibular/sublingual salivary sparing during the treatment of head and neck cancer with intensity modulated radiation therapy for parotid salivary sparing. Semin Oncol; 2004 Dec;31(6 Suppl 18):25-8
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  • [Title] A phase II study to assess the efficacy of amifostine for submandibular/sublingual salivary sparing during the treatment of head and neck cancer with intensity modulated radiation therapy for parotid salivary sparing.
  • Intensity modulated radiation therapy (IMRT) allows for relative parotid salivary gland sparing for patients undergoing treatment for head and neck squamous cell cancer, but is less reliable for sparing the submandibular glands.
  • Cytoprotection with amifostine (Ethyol; Medimmune Inc, Gaithersburg, MD) has been shown to decrease rates of acute and late xerostomia in patients undergoing radiation therapy for head and neck squamous cell cancer.
  • The addition of amifostine to IMRT may augment parotid salivary sparing, and add submandibular/sublingual, and minor salivary gland sparing resulting in greater salivary flow rates and a more physiologic saliva.
  • Eligible patients include those slated to receive definitive IMRT for early oropharynx cancer or postoperative RT, both without chemotherapy, for more advanced cancers.
  • These include T1, T2 and favorable T3 (favorable, exophytic), N0-2b (small volume) M0 oropharynx cancers who are to receive bilateral neck RT.
  • Clinical target volume (CTV) 1 will receive 60 to 66 Gy, CTV2 will receive 60 Gy, and CTV3 will receive 54 to 57 Gy.
  • The mean dose goal for the parotid gland is 25 Gy.
  • Whole mouth and individual major salivary gland stimulated and unstimulated saliva will be collected before and after therapy at 6 weeks, 6 and 12 months.
  • The results of this study will give an indication of the objective and subjective benefit of combined IMRT physical parotid salivary sparing and amifostine chemical cytoprotection for combined salivary gland sparing and reduction in the rate of xerostomia in patients undergoing IMRT for head and neck squamous cell cancer.
  • [MeSH-major] Amifostine / therapeutic use. Carcinoma, Squamous Cell / drug therapy. Carcinoma, Squamous Cell / radiotherapy. Head and Neck Neoplasms / drug therapy. Head and Neck Neoplasms / radiotherapy. Parotid Gland / radiation effects. Radiation-Protective Agents / therapeutic use. Submandibular Gland / radiation effects

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  • (PMID = 15726519.001).
  • [ISSN] 0093-7754
  • [Journal-full-title] Seminars in oncology
  • [ISO-abbreviation] Semin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Radiation-Protective Agents; M487QF2F4V / Amifostine
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26. Cozzi L, Fogliata A, Bolsi A, Nicolini G, Bernier J: Three-dimensional conformal vs. intensity-modulated radiotherapy in head-and-neck cancer patients: comparative analysis of dosimetric and technical parameters. Int J Radiat Oncol Biol Phys; 2004 Feb 1;58(2):617-24
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  • [Title] Three-dimensional conformal vs. intensity-modulated radiotherapy in head-and-neck cancer patients: comparative analysis of dosimetric and technical parameters.
  • BACKGROUND AND PURPOSE: The use of intensity-modulated radiotherapy (IMRT) is now widely advocated for the treatment of head-and-neck cancers, to increase the therapeutic ratio of radiotherapy used as sole modality of treatment or in combination with chemotherapy.
  • This report aims to summarize the technical and dosimetric factors to be taken into consideration to assess the respective advantages of the various high conformality treatments in radiotherapy, especially in the framework of quality assurance procedures.
  • MATERIALS AND METHODS: Twenty-six head-and-neck cancer patients were irradiated following a feasibility internal protocol with IMRT.
  • Treatments were performed with either the static step-and-shoot (20) or the dynamic sliding window (6) techniques on a 6 MV Varian Clinac equipped with a multileaf collimator with 80 leaves.
  • Dose plans were computed using commercial treatment planning systems: MDS-Nordion Helax-TMS for static cases and Varian Eclipse for dynamic cases.
  • Each IMRT plan was also compared to a reference 3D conformal therapy plan (3DCRT).
  • In the static mode, 264 +/- 56 MU per Gy were erogated, whereas in the dynamic mode, 387 +/- 126 MU per Gy were erogated, to be compared to 147 +/- 20 computed for reference 3DCRT plans.
  • V(95) increased from 85% to 93% with p < 0.001, or equivalent uniform dose normalized to prescribed dose increased from 0.86 to 0.96 with p = 0.002).
  • Irradiation of parotid glands or spinal cord improved, as well: For parotids, D(2/3V) reduced from 59 Gy to 41 Gy (p < 0.001).
  • For spinal cord, D(max) reduced from about 40 Gy to about 30 Gy (p < 0.001).

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  • (PMID = 14751535.001).
  • [ISSN] 0360-3016
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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27. Tao Y, Daly-Schveitzer N, Lusinchi A, Bourhis J: Advances in radiotherapy of head and neck cancers. Curr Opin Oncol; 2010 May;22(3):194-9
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  • [Title] Advances in radiotherapy of head and neck cancers.
  • PURPOSE OF REVIEW: Radiation therapy plays a key role in the management of head and neck cancers (HNCs).
  • We reviewed the recent advances in radiotherapy of HNCs and the role of imaging in treatment planning.
  • RECENT FINDINGS: As shown in a recent update of meta-analysis of chemotherapy in head and neck cancer (MACH-NC), concurrent chemoradiotherapy was confirmed to be a standard of care in the management of locally advanced HNCs.
  • Two recent large-scale randomized trials [Groupe d'Oncologie Radiothérapie Tête et Cou (GORTEC) and Radiation Therapy Oncology Group (RTOG)] failed to show additional benefit when combining accelerated radiotherapy with concurrent chemoradiotherapy.
  • Taxane-platinum-fluorouracil-based induction chemotherapy has been established as a reference induction regimen and has been explored as a possible part of the treatment of locally advanced HNCs, which was particularly successful in larynx preservation.
  • The superiority of intensity-modulated radiation therapy compared with conventional radiotherapy for parotid protection has been shown in a prospective phase III trial.
  • PET-based treatment planning is still to be validated in the HNCs.
  • SUMMARY: Concurrent chemoradiotherapy could still be considered as a standard of care; several new treatment combinations and new radiation technologies have been recently successfully evaluated in clinical trials.
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Clinical Trials as Topic. Combined Modality Therapy. Humans. Meta-Analysis as Topic

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  • (PMID = 20401975.001).
  • [ISSN] 1531-703X
  • [Journal-full-title] Current opinion in oncology
  • [ISO-abbreviation] Curr Opin Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 58
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28. Kempf VA, Petzold H, Autenrieth IB: Cat scratch disease due to Bartonella henselae infection mimicking parotid malignancy. Eur J Clin Microbiol Infect Dis; 2001 Oct;20(10):732-3
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  • [Title] Cat scratch disease due to Bartonella henselae infection mimicking parotid malignancy.
  • An unusual Bartonella henselae infection presenting clinically as a putative parotid cancer was diagnosed based on serological tests, histomorphology and amplification of a 16S-rDNA sequence of Bartonella henselae.
  • The patient improved greatly upon antibiotic treatment and did not require surgery.
  • Although uncommon, infection with Bartonella spp., particularly Bartonella henselae, should be included in the differential diagnosis of parotid tumors.
  • [MeSH-major] Bartonella henselae / isolation & purification. Cat-Scratch Disease / pathology. Parotid Neoplasms / pathology
  • [MeSH-minor] Anti-Bacterial Agents. Biopsy, Needle. Blotting, Western. Diagnosis, Differential. Drug Therapy, Combination / therapeutic use. Female. Follow-Up Studies. Humans. Magnetic Resonance Imaging. Middle Aged

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  • (PMID = 11757975.001).
  • [ISSN] 0934-9723
  • [Journal-full-title] European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology
  • [ISO-abbreviation] Eur. J. Clin. Microbiol. Infect. Dis.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0 / Anti-Bacterial Agents
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29. Hocwald E, Korkmaz H, Yoo GH, Adsay V, Shibuya TY, Abrams J, Jacobs JR: Prognostic factors in major salivary gland cancer. Laryngoscope; 2001 Aug;111(8):1434-9
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  • [Title] Prognostic factors in major salivary gland cancer.
  • OBJECTIVE: To identify features of major salivary gland cancers that are prognostic for disease-free survival.
  • STUDY DESIGN: A retrospective study of 78 patients with major salivary gland cancer (64 parotid and 14 submandibular gland) who underwent surgery for definitive treatment from 1976 to 1996.
  • A select group of patients also received adjuvant radiation (56%) and/or chemotherapy (13%).
  • Age, gender, tumor site, T-stage, facial paralysis, histologic neck involvement, perineural invasion, and cancer grade were analyzed with respect to disease-free survival.
  • The role of adjuvant treatment in terms of clinical outcome was also investigated.
  • Examining clinical and histologic features one at a time, we found poorer prognosis was associated with submandibular tumors compared with parotid (P =.02), higher T-stage (P =.001), positive cervical nodes (P <.001), perineural invasion (P =.002), and high-grade or adenoid cystic tumors (P =.002).
  • Receipt of both adjuvant radiation and cisplatin-based chemotherapy (P =.05) was an independent predictor of longer disease-free survival.
  • Our limited data also suggest that adjuvant chemotherapy and radiation therapy may improve disease-free survival.
  • [MeSH-major] Parotid Neoplasms / mortality. Submandibular Gland Neoplasms / mortality
  • [MeSH-minor] Adolescent. Adult. Aged. Aged, 80 and over. Chemotherapy, Adjuvant. Child. Disease-Free Survival. Female. Humans. Male. Middle Aged. Neoplasm Invasiveness. Prognosis. Proportional Hazards Models. Radiotherapy, Adjuvant. Retrospective Studies

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  • (PMID = 11568581.001).
  • [ISSN] 0023-852X
  • [Journal-full-title] The Laryngoscope
  • [ISO-abbreviation] Laryngoscope
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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30. Atabo A, Bradley PJ: Management principles of head and neck cancers during pregnancy: a review and case series. Oral Oncol; 2008 Mar;44(3):236-41
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  • [Title] Management principles of head and neck cancers during pregnancy: a review and case series.
  • Head and neck cancers during pregnancy are rising in incidence.
  • This paper is a review of the literature of head and neck cancers during pregnancy with a short case series of six non-thyroid pregnancy-associated cancers treated by a head and neck oncology surgeon.
  • Tumour types include carcinoma of the tongue, nasopharynx, maxillary sinus, parotid gland, subglottic region, and the neck.
  • Five patients were treated surgically and four were treated with either chemotherapy or radiotherapy.
  • Managing head and neck cancers during pregnancy requires the addition of a pregnancy-related layer of understanding to the armoury of existing specialist knowledge, encompassing a triad of effects, (i) the aetiological effect of pregnancy on cancer, (ii) the direct and indirect effects of cancer on pregnancy, and (iii) the effect of diagnostic and treatment modalities on pregnancy.
  • Consideration must also be given to the ethical dilemmas of decision making.
  • [MeSH-major] Carcinoma, Squamous Cell / therapy. Head and Neck Neoplasms / therapy. Pregnancy Complications, Neoplastic / therapy

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  • (PMID = 17475540.001).
  • [ISSN] 1368-8375
  • [Journal-full-title] Oral oncology
  • [ISO-abbreviation] Oral Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] England
  • [Number-of-references] 46
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31. Portaluri M, Fucilli FI, Castagna R, Bambace S, Pili G, Tramacere F, Russo D, Francavilla MC: Three-dimensional conformal radiotherapy for locally advanced (Stage II and worse) head-and-neck cancer: dosimetric and clinical evaluation. Int J Radiat Oncol Biol Phys; 2006 Nov 15;66(4):1036-43
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  • [Title] Three-dimensional conformal radiotherapy for locally advanced (Stage II and worse) head-and-neck cancer: dosimetric and clinical evaluation.
  • METHODS AND MATERIALS: A total of 49 patients with histologically proven squamous cell cancer of the head and neck were consecutively treated with 3D-CRT using a one-point setup technique; 17 had larynx cancer, 12 oropharynx, 12 oral cavity, and 6 nasopharynx cancer; 2 had other sites of cancer.
  • Of the 49 patients, 41 received postoperative RT and 8 definitive treatment.
  • Also, 13 were treated with cisplatin-based chemotherapy before and during RT; in 6 cases, 5-fluorouracil was added.
  • The follow-up time was 484-567 days (median, 530 days).
  • The mean dose to the primary planning target volume was 49.54 +/- 4.82 Gy (51.53 +/- 5.47 Gy for larynx cases).
  • The average dose to the contralateral parotid gland was approximately 38 Gy (30 Gy for larynx cases).
  • The maximal dose to the spinal cord was 46 Gy.
  • A Grade 0 Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer xerostomia score corresponded to a mean dose of 30 Gy to one parotid gland.
  • A lower xerostomia score with a lower mean parotid dose and longer follow-up seemed to give rise to a sort of functional recovery phenomenon.
  • CONCLUSION: Three dimensional-CRT in head-and-neck cancers permits good coverage of the planning target volume with about 10-11 segments and one isocenter.
  • With a mean dose of approximately 30 Gy to the contralateral parotid, we observed no or mild xerostomia.
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Body Burden. Female. Humans. Male. Middle Aged. Radiotherapy Dosage. Relative Biological Effectiveness. Treatment Outcome

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  • (PMID = 16750321.001).
  • [ISSN] 1879-355X
  • [Journal-full-title] International journal of radiation oncology, biology, physics
  • [ISO-abbreviation] Int. J. Radiat. Oncol. Biol. Phys.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article
  • [Publication-country] United States
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