Abstract
Oral cancer is often preceded by precancerous lesions, the most common of which is leukoplakia. Several treatment modalities are available: elimination of the possible cause, cold knife, laser, or cryosurgery, and topical application of bleomycin and 5-fluorouracil. In research, oral leukoplakia is used as a model to study the value of chemoprevention as a strategy to prevent cancer, because its effect is directly visible and material for analysis is easily obtainable from the mouth. In several studies and chemoprevention trials the efficacy of retinoids, retinol and/or beta-carotene on oral leukoplakia has been demonstrated. Second primary tumors occur in 10–30% of head and neck cancer patients and 10% of lung cancer patients. Chemoprevention offers an attractive approach to combat this threast to such patients, which is bound to cast a shadow over their lives. In the last 10–15 years several chemoprevention studies with vitamin A, retinoids or agents working through other mechanisms (antioxidants) have been launched. The largest chemoprevention study in curatively treated early-stage oral cancer, laryngeal cancer and lung cancer (N=2595) is EUROSCAN, an EORTC study initiated in 1988. End-points are second tumors, local/regional recurrence and distant metastases, and long-term survival rates. Preminary results will be available in 1998.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
Similar content being viewed by others
References
Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group (1994) The effect of vitamin E and beta carotene on the incidence of lung cancer and other cancers in male smokers. N Engl J Med 330:1029–1035.
Axell T, Pindborg JJ, Smith CJ, van der Waal I and an International Collaborative Group on Oral White Lesions (1996) Oral white lesions with special reference to precancerous and tobacco-related lesions: conclusion of a international symposium held in Uppsala, Sweden. J Oral Pathol Med 25:49–54.
Benner SE, Pajak TF, Lippman SM, Earley C, Hong WK (1994) Prevention of second primary tumors with isotretinoin in patients with squamous cell carcinoma of the head and neck: long term follow-up. J Natl Cancer Inst 86:140–141.
Bolla M, Lefus R, Ton Van J et al. (1994) Prevention of second primary tumors with etretinate in squamous cell carcinoma of oral cavity and oropharynx. Results of a multicentric double-blind randomized study. Cancer Res 54:854–856.
Boone CW, Steele VE, Kelloff GJ (1992) Screening for chemopreventive (anticarcinogenic) compounds in rodents. Mutat Res 267:251–255.
Cesarone CF, Scarabelli L, Orenesu M, Bagnasco M, De Flora S (1987) Effects of aminothiols in 2-acetylaminofluorone-treated rats. I. Damage and repair of liver DNA, hyperplastic foci, and Zymbal gland tumors. In Vivo 1:85–91.
Chiesa F, Tradati N, Sala L et al. (1990) Follow-up of oral leukoplakia after carbon dioide laser surgery. Arch Otolaryngol Head Neck Surg 116:177–181.
Chiesa F, Tradati N, Marazzi M et al. (1992) Prevention of local relapses and new localizations of oral leukoplakias with the synthetic retinoid fenretinide (4-HPR). Preliminary results. Oral Oncol Eur J Cancer 24B:97–102.
Chiesa F, Tradati N, Rossi N et al. (1993) Fenretinide (4-HPR) in chemoprevention of oral leukoplakia. J Cell Biochem Suppl 17F:255–261.
Copper MP, Braakhuis BJM, de Vries N, van Dongen GAMS, Nauta JP, Snow GB (1993) A panel of biomarkers of carcinogenesis of the upper aerodigestive tract as potential intermediate end points in chemoprevention trials. Cancer 71:825–830.
Cordero AA, Allevato MAJ, Barclay CA et al. (1981) Retinoids: advances in basis research and therapy. Springer, Berlin Heidelberg New York, p 273.
De Flora S, Astengo M, Serra D, Benicelli C (1986) Prevention of induced lung tumors in mice by dietary N-acetylcysteine. Cancer Lett 32:235–241.
De Vries N (1990) The magnitude of the problem. In: de Vries N, Gluckman JL (eds) Multiple primary tumors in the head and neck. Thieme, Stuttgart, pp 1–25.
De Vries N, Oldekalter P, Snow GB (1986) Multiple primary tumors in patients with laryngeal squamous cell hyperplasia. Arch Otorhinolaryngol 243:143–145.
De Vries N, van Zandwijk N, Pastorino U (1991) The EUROSCAN Trial (Guest Editorial). Br J Cancer 64:985–989.
Garewal Hs, Meyskens FL, Killen D, Reeves D, Kiersch TA, Elletson H, Strosberg A, King D, Streinbronn K (1990) Response of oral leukoplakia to beta-carotene. J Clin Oncol 8:1715–1720.
Hennekens CH, Buring JE, Manson JE, Stampher M, Rosner B, Cook NR et al. (1996) Lack of effect of long term supplementation with beta carotene on the incidence of malignant neoplasms and cardiovascular disease. N Engl J Med 334:1145–1149.
Hogewind WFC, van der Waal I (1988) Prevalence study of oral leukoplakia in a selected population of 1000 patients from the Netherlands. Community Dent Epidemiol 16:302–305.
Hong WK, Endicott J, Itri L (1986) 13-cis retinoic acid in the treatment of oral leukoplakia. N Engl J Med 315:1501–1505.
Hong WK, Lippman SM, Itri LM, Karp DD, Lee JS, Byers RM, Schantz SP, Kramer AM, Lotan R, Peters LJ, Dimery IW, Brown BW, Goepfert H (1990) Prevention of second tumors with isotretinoin in squamous-cell carcinoma of the head and neck. N Engl J Med 323:795–801.
Issing WJ, Struck R, Naumann A (1997) Positive impact of retinyl palmitate in leukoplakia of the larynx. Eur Arch Otorhinolaryngol 254:105–109.
Jyothirmayi R, Ramadas K, Varghese C, Jacob R, Nair MK, Sankaranarayanan R (1996) Efficacy of vitamin A in the prevention of loco-regional recurrence and second primaries in head and neck cancer. Oral Oncol Eur J Cancer 6:373–376.
Kleinsasser O (1988) Precancerous lesions. In: Kleinsasser O (ed) Tumors of the larynx and hypopharynx. Thieme, Stuttgart, pp 61–69.
Koch HF (1978) Biochemical treatment of precancerous oral lesions: the effectiveness of various analogues of retinoic acid. J Maxillofac Surg 6:59–63.
Koch HF (1981) Advances in basic research and therapy. Springer, Berlin Heidelberg New York, pp 307–312.
Lind PO (1987) Malignant transformation in oral leukoplakia. Scand Dent Res 95:449–455.
Lippman SM, Lee JS, Lotan R, Hittelman W, Wargovich MJ, Hong WK (1990) Biomarkers as intermediate endpoints in chemoprevention trials. J Natl Cancer Inst 82:555–560.
Lippman SM, Batsakis, Toth BB et al. (1993) Comparison of low-dose isotretinoin with beta-carotene to prevent oral carcinogenesis. N Engl J Med 328:15–20.
Lundgren J, Olofsson J (1987) Malignant tumours in patients with non-invasive squamous cell lesions of the vocal cords. Clin Otolaryngol 12:39–43.
Omenn GS, Goodman GE, Thornquist MD, Balmes J, Cullen Mr, Glass A et al. (1996) Effects of a combination of beta carotene and vitamin A on lung cancer and cardiovascular disease in asbestos-exposed workers and in smokers. N Engl J Med 334:1150–1155.
Pastorino U, Soresi E, Clerici M, Chiesa G, Belloni PA, Ongari M, Valente M, Ravasi G (1988) Lung cancer chemoprevention with Retinol Palmitate. Acta Oncol 27:1–10.
Pastorino U, Chiesa G, Infante M, Soresi E, Clerici M, Valente M, Belloni PA, Ravasi G (1991) Safety of high dose vitamin A. Oncology 48:131–137.
Pastorino U, Infante M, Maioli M, Chiesa G, Buyse M, Firket P, Rosmentz N, Clerici M, Soresi E, Valente M, Belloni PA, Ravasi G (1993) Adjuvant treatment of stage I lung cancer with high dose vitamin A. J Clin Oncol 11:1216–1222.
Raque CJ, Biondo RV, Keeran MG et al. (1975) Snuff dippers’ keratosis (snuff-induced leukoplakia). South Med 68:565–568.
Rothstein JB, Slaga TJ (1988) Effect of exogenous glutathione on tumour progression in the murine skin multistage carcinogenesis model. Carcinogenesis 9:1547–1551.
Schepman KP, van der Meij EH, Smeele LF, van der Waal I (1996) Prevalence study or oral white lesions with special reference to a new definition of oral leukoplakia. Oral Oncol Eur J Cancer 32B:416–419.
Shah JP, Strong EW, DeCosse JJ (1983) Effect of retinoids on oral leukoplakia. Am J Surg 146:466–470.
Silverman S, Renstrup G, Pindborg JJ (1963) Studies in oral leukoplakias. Acta Odontol Scand 21:271–292.
Stich HF, Rosin MP (1984) Micronuclei in exfoliated human cells as a tool for studies in cancer risk and cancer intervention. Cancer Lett 22:241–253.
Stich HF, Stich W, Parida BB (1982) Elevated frequency of micronucleated cells in the buccal mucosa of individuals at high risk for oral cancer: betel quid chewers. Cancer Lett 17:125–134.
Stich HF, Stich W, Rosin MP, Vallejera MO (1984) Use of the micronucleus test to monitor the effect of vitamin A, beta-carotene and canthaxanthin on the buccal mucosa of betel nut/tobacco chewers. Int J Cancer 34:745–750.
Stich HF, Hornby AP, Dunn BP (1986) A pilot beta-carotene intervention trial in patients using smokeless tobacco. Int J Cancer 36:321–327.
Stich HF, Hornby Ad, Mathew B (1988) Response of oral leukoplakias to the administration of vitamin A. Cancer Lett 40:93–101.
Torna S, Albanese M, DeLorenzi G et al. (1990) Beta-carotene in the treatment of oral leukoplakia. Proc Am Soc Clin Oncol 9:179.
Torna S, Mangiante PE, Margariano G, Nicolo G, Palumbo R (1992) Progressive 13-ds-reti-noic acid dosage in the treatment of oral leukoplakia. Oral Oncol J Cancer 24 B121–123.
Wilpart M, Speder A, Roberfroid M (1986) Anti-initiation activity of N-acetyl-cysteine in experimental colonic carcinogenesis. Cancer Lett 31:319–324.
World Health Organization Collaborating Centre for Oral Precancerous Lesions (1978) Definition of leukoplakia and related lesions: an aid to studies on oral precancer. Oral Surg 46:518–539.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1999 Springer-Verlag Berlin · Heidelberg
About this paper
Cite this paper
de Vries, N., van Zandwijk, N., Pastorino, U. (1999). Chemoprevention of Head and Neck and Lung (Pre)Cancer. In: Senn, HJ., Costa, A., Jordan, V.C. (eds) Chemoprevention of Cancer. Recent Results in Cancer Research, vol 151. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-59945-3_2
Download citation
DOI: https://doi.org/10.1007/978-3-642-59945-3_2
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-64192-3
Online ISBN: 978-3-642-59945-3
eBook Packages: Springer Book Archive