Charles J. Krause

In Vitro Radiation Resistance Among Cell Lines Established From Patients With Squamous Cell Carcinoma of the Head and Neck

Twenty‐five squamous cell carcinoma (SCC) cell lines from 20 patients with head and neck cancer were assessed for radiosensitivity in vitro using a 96‐well plate assay. Four non‐SCC lines were also tested. Radiation sensitivity of individual cell lines was compared using the area under the survival curve (AUC) as a measure of the mean inactivation dose. Tumor lines were tested with either a cobalt‐60 (60Co) γ‐irradiator having a dose rate of 100 cGy/minute or with a 4‐meV photon beam having a dose rate of 200 cGy/minute. The mean AUC of the 25 SCC cell lines was 188 ± 7 (SEM) cGy (range, 100 to 250 cGy) whereas the four non‐SCC lines had a mean AUC of 225 ± 9 cGy. The SCC cell lines with mean inactivation dose values greater than 188 cGy were classified as relatively radioresistant whereas those with values less than 188 cGy were considered relatively radiosensitive. In seven cases SCC cell lines were derived from patients who had already received radiation therapy. In four of these cases the tumor cell lines were radioresistant (AUC, 210 to 250) but in the other three cases the tumor lines were radiosensitive (AUC, 160 to 180). Thus, failure of a tumor to respond to radiation did not always select for radioresistant cells. The mean of the AUC for cell lines from previously irradiated patients (197 ± 11 cGy) did not differ significantly from that of the cell lines from patients who received no prior radiation therapy (182 ± 9 cGy). However, among radiation‐resistant lines those from the four previously irradiated patients were significantly more resistant (mean AUC = 235 ± 9) than seven other radioresistant lines from nonirradiated patients (mean AUC, 208 ± 4) (P = 0.0194). In four cases more than one cell line was derived from different tumor specimens in the same patient. In each of these cases the lines from the same patients were similar to one another in their degree of radioresistance. Based on these observations the authors conclude that the degree of in vitro radiation resistance is an inherent property of some squamous cell tumors.

Acinic cell carcinoma: A clinicopathologic study of thirty-five cases

A clinicopathologic study of 35 cases of acinic cell carcinomas is presented. Complete follow-up information was available on 31 patients (average period, 7-5 years). The malignant potential of these neoplasms is affirmed by observations that metastases (local and distant) occurred in nine patients and that eight patients died as a consequence of their carcinoma. Retrospective classification of the carcinomas into high and low grade lesions correlated well with ultimate biologic behavior but is unlikely to be successful in an intra-operative (frozen section) mode. This limitation is due to: (a) sampling limitations at the time of primary surgery and (b) the malignant behavior of the occasional low grade carcinoma. Histologic features characterizing high grade carcinomas are local aggressive infiltration and areas of the tumor that appear analogous to the embryonic and post-embryonic terminal tubules and intercalated ducts. The best opportunity for cure of these neoplasms lies in their complete surgical removal at the time of initial treatment. For this, a total parotidectomy is the procedure of choice. Enucleation and local excision is to be condemned.

Antibodies to human squamous cell carcinoma.

We are studying membrane antigens of human squamous cell cancer with the use of naturally occurring autologous antibodies from patients’ sera, along with a set of other serologic reagents and monoclonal antibodies raised against cultured squamous cell lines. Twenty-eight squamous cell carcinoma cell lines have been established in our laboratory from tissues obtained from 23 patients. Antibody reactivity has been found against the autologous tumor cell line in 13 of 23 patients. One of these is of sufficient titer for detailed analysis. Four cell lines are available from this patient. UM-SCC-17A is derived from the primary laryngeal carcinoma, and UM-SCC-17B is derived from a lymph node metastasis removed during the same surgical procedure. Fibroblasts have been cultured from normal mucosa, and a B-lymphoblastoid line has been developed by Epstein-Barr virus transformation of the patients peripheral blood lymphocytes. Antibody from this patient reacts with the UM-SCC-17A and -17B tumor cell lines but does not react with the normal fibroblasts (UM-NF-17).

Reconstruction Of The Oral Cavity With A Free Flap

Free groin flaps were used successfully within the oral cavity in 4 patients after ablative operations for cancer. Preoperative or postoperative radiation (cobalt therapy) had no apparent detrimental effect on the survival of these free flaps.

Cutaneous basosquamous carcinoma of the head and neck: a comparative analysis.

Considerable debate has taken place concerning cutaneous basosquamous carcinomas. Some authors believe they are merely a variant of basal cell carcinoma, based on the apparent rare occurrence of metastases. This comparative study of 33 cases of basosquamous, 1, 7% cases of basal cell, and 736 cases of squamous carcinomas arising in the head and neck demonstrates that the basosquamous lesion has the potential to recur and to metastasize, which is similar to squamous cell lesions. An aggressive primary treatment program is recommended.

Carcinoma of the pyriform sinus a comparison of treatment modalities.

One hundred four patients with epidermoid carcinoma of the pyriform fossa were reviewed retrospectively. Survival, local recurrence and metastatic rates were all compiled for the purpose of comparing the efficacy of combined therapy with radiation therapy and surgery alone in treating such lesions. Combined therapy consisted of 4500 rad Cobalt60 therapy at 200 rads per day preoperatively. All lesions were staged according to AJC classification. There was a similar stage distribution of patients in each therapeutic category.

Fractures of the orbital floor.

The charts of 324 patients treated for 363 orbital floor fractures between 1965 and 1973 were reviewed retrospectively. Of these, 38 (11 percent) were isolated floor fractures, 27 (8 percent) were rim and floor fractures, 168 (46 percent) were trimalar fractures and 130 (35 percent) were associated with complex facial fractures.

Ultrasonic Analysis of Head and Neck Neoplasms Correlation with Surgical Findings

Ultrasonography of head and neck neoplasms is useful in the preoperative evaluation of patients. Inflammatory masses demonstrate high reflectivity in a homogeneous pattern and have diffuse borders. Similarly, lipomas show medium to high reflectivity and have a homogeneous pattern, but are well outlined. Mixed tumors of the major salivary glands have a characteristic heterogeneous pattern and are well outlined. Malignant lesions demonstrate low reflectivity in a homogeneous or heterogeneous pattern and have poorly outlined or diffuse borders. Cysts of the head and neck are well outlined and devoid of interior echoes.

Factors Affecting the Growth of Head and Neck Squamous Carcinoma Cell Lines

Cell plating density influences the growth pattern of human squamous cell carcinoma (SCC) cell lines in culture. SCC lines were used to study factors responsible for these effects. Experiments in which the medium was changed daily or in which conditioned medium was used showed that the growth-supporting factors were not found in the media. However, when cells were plated in dishes in which the same cell line had been grown to confluence and removed by scraping, logarithmic growth began immediately. The effect was not seen on areas of the plate that had been covered with coverslips or in dishes where fibroblasts had been cultured. Antibodies to fibronectin, laminin, and a variety of epidermal cell antigens were used to determine the nature of the growth-stimulating substances remaining on the dish following cell removal. Results indicate that an extracellular matrix with similarities to basement membranes was present on the conditioned dishes.

Extended Transantral Approach to Pterygomaxillary Tumors

A review of 14 patients treated between 1975 and 1979 is reported. The lesions were quite extensive in most of the patients, having extended beyond the nasopharynx in all but one. An extended transantral approach was utilized in nine of the patients to facilitate removal of lateral and superior extensions of tumor. Two of the patients (14%) developed recurrent tumor, one six months and one nine months following treatment. The extended transantral approach appears to be an effective method of approaching the pterygomaxillary extension of the tumor.