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S17. Patient-related factors associated with poor outcomes
Abstracts / Oral Oncology 47 (2011) S15–S27
S15. Treatment approach for head and neck cancers with HIV infection Gerald Paris Head and Neck Clinic, Tygerberg Hospital, University of Stellenbosch, South Africa Introduction: Tygerberg hospital is one of two academic centers serving the Western Cape Province in South Africa. About 400 head and neck cancer patients pass through the center annually; the majority at an advanced stage. All have HIV screens done routinely before referral to our unit although we generally do not factor this in unless there is an unexpected development or unusual decision; in the majority of cases their general condition and the cancer stage is the major determining factor in the management decisions. Discussion: The approach to dealing with the pattern of diseases we face is complicated by an extremely high rate of TB, an erratic supply of anti-retrovirals and extreme pressure on our logistics. Despite all the above problems, a good and sensible palliation is achieved by treatment and reasonable holistic support. There remains an enormous potential for further development, both clinical and academic and we look forward to a multi-national activities to this end in the future.
S19
widely available as it should be and expertise in treatment techniques and use of advanced technologies needs to be developed. AFROG, whose membership comprises of Radiation Oncologists, Medical Physicists and Radiation Therapy Technicians from all over the African continent is one of the available platforms for educational activities and the development of partnerships to combat cancer in the African continent through the various oncology centres in the region. The organization recognizes the multidisciplinary approach to cancer management and so aims to broaden the its activities to include other disciplines. Through IAEA sponsored regional training courses, the treatment of head and neck cancers has been addressed to some extent but there is still an need for this group of cancers to be highlighted especially with the changing epidemiology of these cancers in the era of the human immunodeficiency virus (HIV) epidemic that has affected the greater part of Africa. Discussion: Africa had limited resources to manage cancers in general. Head and neck cancers are a significant burden to cancer these overburdened treatment facilities in the region. This necessitates special consideration of the management of these cancers which are now easily curable in other regions where early presentation is a feature but are still a major cause of cancer fatalities in Africa. Collaboration within the continent and externally would have a big a role to play in the control of these cancers.
doi:10.1016/j.oraloncology.2011.06.079 doi:10.1016/j.oraloncology.2011.06.080 S16. Role of AFROG in improving the management of head and neck cancers in Africa Ntokozo Ndlovu
Sponsored Symposium #6:
Department of Radiology, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
S17. Patient-related factors associated with poor outcomes André Lopes Carvalho
Introduction: The African continent has a wide variety of head and neck cancers according to the subregions. While in North Africa most of these cancers are as a result of smoking and are commonly the classical squamous cell carcinomas, in Central and Southern Africa the HIV epidemic has changed the cancer scenario and head and neck cancers have not bee spared. Manifestations of Kaposi’s sarcoma and non-Hodgkins lymphoma in the head and neck region is a common feature in the cancer treatment clinic. The region has a limited cancer treatment capacity in general due to limited human and economic resources. Methods: The African Radiation Oncology Group (AFROG) is an organization that aims to promote Radiation Oncology and other health practices relevant to the management of cancer within African countries through exchange of knowledge and technology between African countries, continued education, provision of technical expertise, supporting of prevention, early detection and treatment facilities, promotion of radiation safety and research. There is in particular, a recognition of the burden of head and neck cancers in the African region and the need for strategies to combat this group of cancers. The organization also aims at forming liaisons with other organizations of similar interest internationally to achieve its goals. Results: The major collaborator for AFROG is the International Atomic Energy Agency (IAEA) through its Technical Cooperation Department, the Division of Human Health and the Programme of Action for Cancer Therapy (PACT). Radiation therapy is an important part of the treatment of head and neck cancer. In Africa, patients needing this form of treatment could are likely to constitute a higher proportion that in other parts of the world, this being as a consequence of late presentation when surgery is no longer feasible. Unfortunately this treatment is not as
Department of Head and Neck Surgery, Barretos Cancer Hospital, Barretos, Brazil Brazilian Society of Head and Neck Surgery (BSHNS) Advanced oral cancer per se is related to a poor prognosis. However, the literature has shown that factors related to the patient can influence the outcome and stratify prognostic groups within these patients. The main factors related to the patient that can be associated with prognosis are age, race, education, socioeconomic status, comorbid conditions, performance status, symptom distress, among others. The relationship of those factors and prognosis can be due mainly on how they influence access to a proper treatment, the possibility of performing the standard treatment, besides how physicians are influenced in not delivering the standard treatment. We need to discuss how patient-related factors are associated with outcome in advanced oral cancer patients and mainly what are the possibilities for reverting this scenario in selected cases. doi:10.1016/j.oraloncology.2011.06.081
S18. Treatment of patients with advanced (N2–N3) metastatic lymph nodes Fernando Walder ENT and Head and Neck Surgery Department, The University Federal of São Paulo, Brazil Despite the use of aggressive single or multimodality treatment protocols, patients with advanced cervical metastases, N2 and N3,
S15. Treatment approach for head and neck cancers with HIV infection Gerald Paris Head and Neck Clinic, Tygerberg Hospital, University of Stellenbosch, South Africa Introduction: Tygerberg hospital is one of two academic centers serving the Western Cape Province in South Africa. About 400 head and neck cancer patients pass through the center annually; the majority at an advanced stage. All have HIV screens done routinely before referral to our unit although we generally do not factor this in unless there is an unexpected development or unusual decision; in the majority of cases their general condition and the cancer stage is the major determining factor in the management decisions. Discussion: The approach to dealing with the pattern of diseases we face is complicated by an extremely high rate of TB, an erratic supply of anti-retrovirals and extreme pressure on our logistics. Despite all the above problems, a good and sensible palliation is achieved by treatment and reasonable holistic support. There remains an enormous potential for further development, both clinical and academic and we look forward to a multi-national activities to this end in the future.
S19
widely available as it should be and expertise in treatment techniques and use of advanced technologies needs to be developed. AFROG, whose membership comprises of Radiation Oncologists, Medical Physicists and Radiation Therapy Technicians from all over the African continent is one of the available platforms for educational activities and the development of partnerships to combat cancer in the African continent through the various oncology centres in the region. The organization recognizes the multidisciplinary approach to cancer management and so aims to broaden the its activities to include other disciplines. Through IAEA sponsored regional training courses, the treatment of head and neck cancers has been addressed to some extent but there is still an need for this group of cancers to be highlighted especially with the changing epidemiology of these cancers in the era of the human immunodeficiency virus (HIV) epidemic that has affected the greater part of Africa. Discussion: Africa had limited resources to manage cancers in general. Head and neck cancers are a significant burden to cancer these overburdened treatment facilities in the region. This necessitates special consideration of the management of these cancers which are now easily curable in other regions where early presentation is a feature but are still a major cause of cancer fatalities in Africa. Collaboration within the continent and externally would have a big a role to play in the control of these cancers.
doi:10.1016/j.oraloncology.2011.06.079 doi:10.1016/j.oraloncology.2011.06.080 S16. Role of AFROG in improving the management of head and neck cancers in Africa Ntokozo Ndlovu
Sponsored Symposium #6:
Department of Radiology, University of Zimbabwe College of Health Sciences, Harare, Zimbabwe
S17. Patient-related factors associated with poor outcomes André Lopes Carvalho
Introduction: The African continent has a wide variety of head and neck cancers according to the subregions. While in North Africa most of these cancers are as a result of smoking and are commonly the classical squamous cell carcinomas, in Central and Southern Africa the HIV epidemic has changed the cancer scenario and head and neck cancers have not bee spared. Manifestations of Kaposi’s sarcoma and non-Hodgkins lymphoma in the head and neck region is a common feature in the cancer treatment clinic. The region has a limited cancer treatment capacity in general due to limited human and economic resources. Methods: The African Radiation Oncology Group (AFROG) is an organization that aims to promote Radiation Oncology and other health practices relevant to the management of cancer within African countries through exchange of knowledge and technology between African countries, continued education, provision of technical expertise, supporting of prevention, early detection and treatment facilities, promotion of radiation safety and research. There is in particular, a recognition of the burden of head and neck cancers in the African region and the need for strategies to combat this group of cancers. The organization also aims at forming liaisons with other organizations of similar interest internationally to achieve its goals. Results: The major collaborator for AFROG is the International Atomic Energy Agency (IAEA) through its Technical Cooperation Department, the Division of Human Health and the Programme of Action for Cancer Therapy (PACT). Radiation therapy is an important part of the treatment of head and neck cancer. In Africa, patients needing this form of treatment could are likely to constitute a higher proportion that in other parts of the world, this being as a consequence of late presentation when surgery is no longer feasible. Unfortunately this treatment is not as
Department of Head and Neck Surgery, Barretos Cancer Hospital, Barretos, Brazil Brazilian Society of Head and Neck Surgery (BSHNS) Advanced oral cancer per se is related to a poor prognosis. However, the literature has shown that factors related to the patient can influence the outcome and stratify prognostic groups within these patients. The main factors related to the patient that can be associated with prognosis are age, race, education, socioeconomic status, comorbid conditions, performance status, symptom distress, among others. The relationship of those factors and prognosis can be due mainly on how they influence access to a proper treatment, the possibility of performing the standard treatment, besides how physicians are influenced in not delivering the standard treatment. We need to discuss how patient-related factors are associated with outcome in advanced oral cancer patients and mainly what are the possibilities for reverting this scenario in selected cases. doi:10.1016/j.oraloncology.2011.06.081
S18. Treatment of patients with advanced (N2–N3) metastatic lymph nodes Fernando Walder ENT and Head and Neck Surgery Department, The University Federal of São Paulo, Brazil Despite the use of aggressive single or multimodality treatment protocols, patients with advanced cervical metastases, N2 and N3,