Current research - general information
Since 1994, The Norwegian Radium Hospital (NRH) has co-operated with The Danish Head and Neck Cancer Study Group through the DAHANCA protocols. This co-operation has given good results and, as in Denmark, our treatment policy is now to give the radiosensitizer nimorazole 11/2 hours before radiation and to give six fractions weekly, in line with the results from the DAHANCA studies.
For the time being we are participating in the following DAHANCA protocols:
The prognosis for patients with head and neck cancer, whose disease recurs, is very poor and the patients are often highly symptomatic. The main unmet medical need for these patients is for a treatment that gives improved survival benefit and symptom control over methotrexate/ best supportive care. For this reason we are participating in the
Squamous cell carcinomas in the head and neck region usually develop from leukoplakia. At NRH it has been found that the DNA content can be used to predict the risk for oral cancer in a wide range of oral precancerous lesions. Thus while 87% of patient with aneuploid lesions developed a carcinoma, only 1% of patients with diploid lesions did. Further on, in a series of 150 patients with dysplastic oral leukoplakia, including diploid, tetraploid as well as aneuploid lesions, only patients with aneuploid lesions died. It seems that aneuploid leukoplakia lesions already have acquired biological characteristics that define their progression to clinically aggressive oral cancer. There is little evidence that such cancers can be controlled by the prevention measure of resecting precursor lesions or by treatment with surgery and postoperative radiotherapy. Since preclinical models of human cancer, including head and neck cancer, have demonstrated the anti-tumor effects of targeting EGFR and COX-2, this strategy will be examined in the following
Photodynamic therapy (PDT) is a treatment modality based upon the use of a photosensitizer and light of appropriate wavelength to induce selective cell and tissue damage. PDT has been applied for different pre-cancerous and cancerous skin lesions on an experimental basis for decades, and during the past few years as an approved therapy using METVIX® (methyl-aminolevulinat) as sensitizer.
The oral cavity is like the skin covered by squamous cell epithelium, which implies that superficial diseases in the skin and the oral cavity are of similar character. It has been shown that application of aminolevulinat, either topically or systemically, has a selective uptake in cancerous and dysplastic cells, including the oral cavity. To further explore the potential of this treatment principle, patients with superficial lesions in the oral cavity is now treated according to
For the time being we are participating in the following DAHANCA protocols:
- DAHANCA 10: Study of the importance of Novel Erythropoiesis Stimulating Protein (Aranesp R) for the effect of Radiotherapy in Patients with Primary Head and Neck Cancer.
- DAHANCA 14: Combined cisplatin and radiotherapy for nasoparyngeal cancer. Guidelines for concomittant radiochemotherapy of nasopharyngeal cancer.
The prognosis for patients with head and neck cancer, whose disease recurs, is very poor and the patients are often highly symptomatic. The main unmet medical need for these patients is for a treatment that gives improved survival benefit and symptom control over methotrexate/ best supportive care. For this reason we are participating in the
- IMEX study: A phase III randomised, stratified, parallel-group, multi-centre, comparative study of ZD1839 (IRESSAR) 250 mg and 500 mg versus methotrexate for previously treated patients with squamous cell carcinoma of head and neck.
Squamous cell carcinomas in the head and neck region usually develop from leukoplakia. At NRH it has been found that the DNA content can be used to predict the risk for oral cancer in a wide range of oral precancerous lesions. Thus while 87% of patient with aneuploid lesions developed a carcinoma, only 1% of patients with diploid lesions did. Further on, in a series of 150 patients with dysplastic oral leukoplakia, including diploid, tetraploid as well as aneuploid lesions, only patients with aneuploid lesions died. It seems that aneuploid leukoplakia lesions already have acquired biological characteristics that define their progression to clinically aggressive oral cancer. There is little evidence that such cancers can be controlled by the prevention measure of resecting precursor lesions or by treatment with surgery and postoperative radiotherapy. Since preclinical models of human cancer, including head and neck cancer, have demonstrated the anti-tumor effects of targeting EGFR and COX-2, this strategy will be examined in the following
- PROTOCOL: Prospective Randomised Trial on preventing Oral Carcinoma from Oral Leukoplakia
Photodynamic therapy (PDT) is a treatment modality based upon the use of a photosensitizer and light of appropriate wavelength to induce selective cell and tissue damage. PDT has been applied for different pre-cancerous and cancerous skin lesions on an experimental basis for decades, and during the past few years as an approved therapy using METVIX® (methyl-aminolevulinat) as sensitizer.
The oral cavity is like the skin covered by squamous cell epithelium, which implies that superficial diseases in the skin and the oral cavity are of similar character. It has been shown that application of aminolevulinat, either topically or systemically, has a selective uptake in cancerous and dysplastic cells, including the oral cavity. To further explore the potential of this treatment principle, patients with superficial lesions in the oral cavity is now treated according to
- Protocol no.: DNR PDT 01-2: Photodynamic treatment of oral superficial squamous cell carcinoma, oral dysplasia and oral lichen planus