allopurinol and Head-and-Neck-Neoplasms

The aim of this systematic review was to analyze the available literature and define clinical practice guidelines for the use of the following agents for the prevention and treatment of oral mucositis (OM): allopurinol, midline mucosa-sparing radiation blocks, payayor, pentoxifylline, timing of radiation therapy (RT) (morning versus late afternoon), pilocarpine, bethanechol, chewing gum, propantheline, and tetrachlorodecaoxide.. A systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society for Oral Oncology (MASCC/ISOO). The body of evidence for each intervention, in each cancer treatment setting, was assigned an evidence level. Based on the evidence level, one of the following three guideline determinations was possible: recommendation, suggestion, no guideline possible.. A total of 32 papers across 10 interventions were examined. New suggestions were developed against the use of systemic pilocarpine administered orally for prevention of OM during RT in head and neck cancer patients and in patients receiving high-dose chemotherapy, with or without total body irradiation, prior to hematopoietic stem cell transplantation. A suggestion was also made against the use of systemic pentoxifylline administered orally for the prevention of OM in patients undergoing bone marrow transplantation. No guideline was possible for any other agent reviewed due to inadequate and/or conflicting evidence.. None of the agents reviewed was determined to be effective for the prevention or treatment of OM. Two agents, pilocarpine and pentoxifylline, were determined to be ineffective, in the populations listed above. Additional well-designed research is needed on other interventions.

Topics: Allopurinol; Antimetabolites; Chemoradiotherapy; Chewing Gum; Head and Neck Neoplasms; Humans; Muscarinic Agonists; Practice Guidelines as Topic; Radiation-Protective Agents; Stomatitis

We describe the effect of multiagent chemotherapy for malignant chordoma. Previous reports of other patients with malignant chordoma treated with chemotherapy as well as other therapeutic interventions are reviewed.. We describe a 19-month-old girl with unresectable cervical chordoma metastatic to the lungs at diagnosis treated with multiagent systemic chemotherapy. CNS disease was diagnosed after one course of therapy, and intrathecal chemotherapy was then administered.. Ifosfamide and doxorubicin were efficacious in a patient with advanced metastatic disease, producing significant disease regression. The addition of intrathecal or intraventricular therapy with hydrocortisone, ARA-C, and methotrexate was effective in controlling CNS disease due to chordoma. There was no apparent benefit from the use of actinomycin-D, cyclophosphamide and vincristine nor the combination of cisplatin and 5-fluorouracil or high-dose methotrexate.

Topics: Adult; Allopurinol; Antineoplastic Combined Chemotherapy Protocols; Child, Preschool; Chordoma; Dexamethasone; Doxorubicin; Female; Head and Neck Neoplasms; Humans; Ifosfamide; Male

Topics: Allopurinol; Antineoplastic Combined Chemotherapy Protocols; Fluorouracil; Head and Neck Neoplasms; Humans; Hydroxyurea; Immunologic Factors; Interferons; Leucovorin; Methotrexate

Head and neck cancer (HNC) is one of the most common malignancies in the world. HNC is a group of cancers that starts in the mouth, nose, throat, larynx, sinuses, or salivary glands. According to this section of the body parts; induction of cancer can be associated with CO

Topics: Aryldialkylphosphatase; Biomarkers, Tumor; Carbon Dioxide; Carbonic Anhydrases; Catalase; Female; Head and Neck Neoplasms; Healthy Volunteers; Humans; Male; Middle Aged; Oxidative Stress; Xanthine Oxidase

Clinical and epidemiological findings have provided evidence supporting a role of free radicals in the etiology of cancer. Scavengers and inhibitors of free radical processes have been demonstrated to prevent or delay the neoplastic process.. Adenosine deaminase, xanthine oxidase, superoxide dismutase, and glutathione peroxidase activities and malondialdehyde levels were measured in the sera of 35 patients with head and neck cancers and were compared to those of healthy control subjects.. Serum adenosine deaminase activity was found to be significantly increased in the patient group (p<0.001). Compared to the control group, glutathione peroxidase and xanthine oxidase activities and malondialdehyde levels were slightly higher and serum superoxide dismutase activity was slightly lower in the patient group, with none reaching statistical significance.. The results indicate that serum adenosine deaminase activity may be helpful in the diagnosis and follow-up of head and neck cancers. Further studies with a larger cohort of patients are needed to clarify the exact mechanism of adenosine deaminase elevation.

Topics: Adenosine Deaminase; Adult; Aged; Aged, 80 and over; Biomarkers, Tumor; Carcinoma, Squamous Cell; Case-Control Studies; Female; Glutathione Peroxidase; Head and Neck Neoplasms; Humans; Male; Malondialdehyde; Middle Aged; Predictive Value of Tests; Superoxide Dismutase; Xanthine Oxidase

In attempts to increase fluorouracil (FU) activity by pharmacomodulation, most attention has been paid to FU activation pathways without consideration of the presence and possible role of FU catabolism in the target tumoral cell itself. The first step in the catabolism of FU is hydrogenation by the enzyme dihydropyrimidine dehydrogenase (DPD). The purpose of the present study was to test the DPD-inhibitory effects of several agents whose use as FU biomodulators has been clinically established: cisplatin, hydroxyurea, dipyridamole, and allopurino. Five cancer cell lines of human origin were used. Dipyridamole and hydroxyurea were the only modulators for which an augmentation in FU cell-growth inhibition (MTT test) was clearly evident for the whole panel of cell lines investigated (P<1.10(-4) and P=0.005, respectively). With dipyridamole the efficacy of FU was multiplied by a factor of around 5. Allopurinol and cisplatin had no obvious effect on cellular DPD activity (biochemical method). For dipyridomole and hydroxyurea, DPD activity showed a more or less marked concentration-related inhibition according to the cell line tested. Only dipyridamole produced reductions in FU IC50 values (50% growth-inhibitory concentrations), i.e., potentiation of FU cytotoxicity, that were significantly related to inhibition of cellular DPD activity. This DPD-mediated interaction between dipyridamole and FU is a new finding that could be important for a better understanding of FU-dipyridamole combination chemotherapy.

Topics: Allopurinol; Antimetabolites, Antineoplastic; Antineoplastic Agents; Breast Neoplasms; Carcinoma; Cell Division; Cisplatin; Dihydrouracil Dehydrogenase (NADP); Dipyridamole; Dose-Response Relationship, Drug; Drug Interactions; Female; Fluorouracil; Head and Neck Neoplasms; Humans; Hydroxyurea; Oxidoreductases; Pancreatic Neoplasms; Platelet Aggregation Inhibitors; Tumor Cells, Cultured

The combination of cisplatin (100 mg/m2) and 5-fluorouracil (5-FU) by continuous infusion (1 g/m2/day for 5 days) has been reported to produce a high response rate as neoadjuvant therapy for advanced squamous cell head and neck cancer. We sought to improve the response rate by increasing the dose of 5-FU to 1.5 g/m2/day and 2.0 g/m2/day with allopurinol modulation to reduce toxicity. The overall response rate in the 30 patients who received three courses of chemotherapy was 100% with a 50% complete response (CR) rate. A 50% CR rate was observed in patients with T3 (six of 12) and N3 (four of eight) disease. Six patients (four with CR) did not complete subsequent treatment as planned. Seven of 11 (63.6%) chemotherapy complete responders and three of 12 (25%) partial responders (one lost to follow-up) who received all planned treatment are free of disease. The major toxicity encountered was stomatitis (severe in 32%) followed by leukopenia. The maximum tolerated dose of 5-FU in this combination with allopurinol protection was 1.5 g/m2/day. Cisplatin plus high dose 5-FU does not appear to be associated with a higher CR rate than that reported with conventional doses of 5-FU and is more toxic.

Topics: Adult; Aged; Allopurinol; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Squamous Cell; Cisplatin; Combined Modality Therapy; Drug Evaluation; Fluorouracil; Head and Neck Neoplasms; Humans; Middle Aged; Neoplasm Staging