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Immunologic screening in the head and neck cancer population - its usefulness
IMMUNOLOGIC SCREENING IN THE (22) HEAD AND NECK CANCER POPULATION - ITS USEFULNESS Paul Chan, M.D., Harvey A. Gilbert, M.D., A.Robert Kagan, M.D., Herman Nussbaum, M.D., Hohn Miles, M.D., Luis Flores, M.D. Departments of Radiation Therapy and Otolaryngology, Southern California Permanente Medical Group, 1510 N. Edgemont Street, Los Angeles, California 90027
One hundred primary head and neck cancer patients treated for cure with radiation alone or radiation plus surgery were systematically screened with sensitizing and challenge doses of dinitrochlorogenzene (DNCB) to measure their immunocompetence. The rationale for this study was based on the experience of Morton and others; that prognosis in patients with squamous cell cancer was related to DNCB reactivity and that among DNCB nonreactors most patients failed treatment. Absolute lymphocyte counts were also determined and analyzed. The results of these tests were related to original stage and site of tumor. Clearly in our results the two years NED rate for any individual patient cannot be predicted by DNCB skin reactivity. This holds true for all sites of tumor and clinical stages of disease. The most disappointing finding was that many patients with early favorable tumors and positive DNCB's failed treatment quite early in their course. Conversely, many patients with advanced tumors and negative DNCB's had excellent disease free survival. The absolute lymphocyte count also did not correlate with prognosis. Therefore, neither test helped to predict treatment failure or success.
(23) THE PRESENT STATUS OF OUR LOW-DOSE RATE IRRADIATION OF ADVANDED HEAD AND NECK CANCERS 9. Pierquin 1, W. Mueller2, and F. Baillet 'Chef du Service de Car inologie Radiothdrapique de l!Hopital Henri Mondor 8M&ecin Assistant 2 titre &ranger 'edecin Adjoint du Service de Carcinologie Radiothgrapique de 1'Hopital Henri Mondor
46 patients with advanced epidermoid carcinomas of the head and neck have been treated with semicontinuous low dose rate cobalt teletherapy with curative intent. The dose rate was 90 to 130 rads per hour, the patients were treated 6 to 8 hours per day, and they received total doses of 6500 to 7000 rads in either single or split course. 34 of these patients have minimum one year followup and form the basis of this report. While the survival of these patients was poor (22% at 3 years), the local control rate The immediate tolerance of the mucosa was frequently of 58% was encouraging. Furthermore, there was a high necrosis exceeded in single course treatment. rate, but skin reactions remained characteristically mild. Split course treatment succeeded in reducing mucosal reactions to a tolerable level, but 38
One hundred primary head and neck cancer patients treated for cure with radiation alone or radiation plus surgery were systematically screened with sensitizing and challenge doses of dinitrochlorogenzene (DNCB) to measure their immunocompetence. The rationale for this study was based on the experience of Morton and others; that prognosis in patients with squamous cell cancer was related to DNCB reactivity and that among DNCB nonreactors most patients failed treatment. Absolute lymphocyte counts were also determined and analyzed. The results of these tests were related to original stage and site of tumor. Clearly in our results the two years NED rate for any individual patient cannot be predicted by DNCB skin reactivity. This holds true for all sites of tumor and clinical stages of disease. The most disappointing finding was that many patients with early favorable tumors and positive DNCB's failed treatment quite early in their course. Conversely, many patients with advanced tumors and negative DNCB's had excellent disease free survival. The absolute lymphocyte count also did not correlate with prognosis. Therefore, neither test helped to predict treatment failure or success.
(23) THE PRESENT STATUS OF OUR LOW-DOSE RATE IRRADIATION OF ADVANDED HEAD AND NECK CANCERS 9. Pierquin 1, W. Mueller2, and F. Baillet 'Chef du Service de Car inologie Radiothdrapique de l!Hopital Henri Mondor 8M&ecin Assistant 2 titre &ranger 'edecin Adjoint du Service de Carcinologie Radiothgrapique de 1'Hopital Henri Mondor
46 patients with advanced epidermoid carcinomas of the head and neck have been treated with semicontinuous low dose rate cobalt teletherapy with curative intent. The dose rate was 90 to 130 rads per hour, the patients were treated 6 to 8 hours per day, and they received total doses of 6500 to 7000 rads in either single or split course. 34 of these patients have minimum one year followup and form the basis of this report. While the survival of these patients was poor (22% at 3 years), the local control rate The immediate tolerance of the mucosa was frequently of 58% was encouraging. Furthermore, there was a high necrosis exceeded in single course treatment. rate, but skin reactions remained characteristically mild. Split course treatment succeeded in reducing mucosal reactions to a tolerable level, but 38