Head and neck cancer is the 6th most common cancer worldwide, accounting for 5 to 6% of all cancer cases. Surgical resection and/or radiotherapy have long been regarded as the standard treatment, while chemotherapy can be added as an adjunct. However, conventional chemotherapy has certain drawbacks like nonspecific distribution, short circulation time, and tumor resistance. Recently, targeted therapeutics with nanoparticles have emerged as promising alternatives to overcome these drawbacks of conventional approaches and among the diverse classes of nanomaterials, carbon nanotubes (CNTs), due to their unique physicochemical properties, have become a popular tool in cancer diagnosis and therapy. Carbon nanotubes are tubular materials with nanometer-sized diameters and axial symmetry, with unique properties, such as ease of cellular uptake, high drug loading, and thermal ablation, which render them useful for cancer therapy. The important biomedical applications of CNTs include their contribution in the field of drug delivery, thermal therapy, photodynamic therapy, gene delivery, biological detection, and imaging. More recently, they have also been used as vehicles for antigen delivery, a novel immunization strategy against infectious diseases and cancer. These multifunctional and multiplex nanoparticles are now being actively investigated and are on the horizon as the next generation of nanoparticles, facilitating personalized and tailored cancer treatment. However, concerns over certain issues, such as biocompatibility and toxicity have been raised and warrant extensive research in this field.
Oral cancer is an alarming health problem globally, with 300,000 cases being newly diagnosed annually. Despite research being aimed to improve treatment with conventional methods such as surgery, radiotherapy, and chemotherapy; there is severe morbidity associated with this malignancy. This presents an emerging need to develop advanced treatment options. Recent advances in molecular biology and technology have provided us with unique possibilities for studying aberrations at the genetic level and hence provided the basis for possible treatments such as gene therapy. The definition of gene therapy hence is given as the "alteration or insertion of genetic material into an organism to replace or repair a defect to correct or prevent disease." Employing human tumor suppressor p53 as the target of gene therapy demonstrates great potential in curing squamous cell carcinomas. The functions of tumor suppressor genes can be reinstated with the incorporation of the therapeutic p53 gene into tumor cells. The treatment results are also greatly improved when it is administered with various vectors, most commonly adenoviral delivery. Combination therapy with p53 and chemotherapy provides a synergistic benefit toward the tumor growth suppression and apoptosis and also emphasizes the superiority of intra-arterial administration of this combination as compared to other routes. Thus, the purpose of this article is to review and emphasize the use and purpose of intra-arterial infusion of chemotherapeutics in combination with p53 gene therapy.
Tissue hypoxia is a biological condition characterized by oxygen deficiency at the tissue level. Hypoxia has been seen to play a crucial role in tumor recurrence in head and neck cancer patients. The detection and assessment of tumor hypoxia plays a critical role in both validation and development of hypoxia modification therapies. Hypoxic cancers being more resistant to radiotherapy and chemotherapy, attempts have been made to improve the response of hypoxic cancers to radiotherapy through the use of radiosensitizers such as carbogen and others. Several techniques to assess the status of tumor oxygenation have been developed in the past, among which functional imaging techniques remain the most validated. Blood-oxygen-leveldependent magnetic resonance imaging (BOLD MRI) is a non-invasive functional imaging technique that can recognize hypoxic cancers which will respond to accelerated radiotherapeutic treatment with radiosensitizers. BOLD MRI employs a T-sensitive sequence which can detect a transient rise in signal during oxygen inhalation. This increase in signal intensity is caused by the reduced paramagnetic effect due to a decrease in the blood deoxyhaemoglobin level within cancer. Hence, BOLD MRI can detect reduced hypoxia in the malignant solid tumors and may pave the path for more conservative treatment approach for hypoxic head and neck cancers in future.
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