Background: Head and Neck (H and N) cancers include malignant tumors of the nasal cavity, pharynx, paranasal sinuses, oral cavity, larynx and salivary glands. Opium use might be related to these cancers. The aim of this study was to investigate the relation between Opium and its Derivatives (O and D) use and the incidence of H and N cancers. Methods: In this case-control study conducted in Kerman, 140 patients with H and N cancers and 280 healthy controls (matched for age, gender, and place of residence) were included. Information about their use of O and D, cigarette smoking, alcohol and diet were collected using a structured questionnaire. Conditional logistic regression was used to investigate the relation between variables. Results: The use of opioids was associated with an increased risk of HandN cancers (Adjusted OR: 8.13; CI: 4.08-16.2). A significant dose-response relation between O and D use was observed, with high use Adjusted OR=8.91; 95% CI: 4.03-19.65 and low use Adjusted OR=6.52; 95% CI: 3.18-13.36. This dose-response association was stronger in patients with laryngeal cancer and opioids use, with high use Adjusted OR = 11.17; 95% CI=4.48-28.09 and low use Adjusted OR = 9.46; 95% CI= 3.97-22.52. Conclusion: The results show that opium use can be considered as an important risk factor for H and N cancers. Also in Iran, opium seems to play a more important role than cigarette smoking.

No abstract

Background: In recent years, lung cancer (LC) incidence has increased in Iran. The use of opium and its derivatives (O&D) has increased as well. The aim of this study was to investigate the association between the use of O&D and LC incidence. Methods: In this case-control study conducted in Kerman, Iran; 140 patients with lung cancer and 284 healthy controls matched by age, sex, and place of residence were included. Data including O&D use, cigarette smoking, alcohol use, and diet were collected using a structured questionnaire. The relation between the use of O&D and LC was evaluated using conditional logistic regression test. Results: The use of opium was associated with an increased risk of LC (Adjusted Odds Ratio (AOR) = 7.95, 95% CI: 3.78 -16.73). A significant dose-response relation between the use of opium and its derivatives was observed (low use AOR = 7.47, 95% CI: 2.33-23.98 and high use AOR = 11.57, 95% CI: 2.25-59.49). Also, there was a relation between starting to use O&D at lower ages and an increased risk of LC (AOR = 5.78, 95 % CI: 2.36 - 14.14). Conclusion: The results of this study support that opium use could be considered as a strong risk factor for LC. Thus, it is highly suggested that tailored policies to be applied in order to reduce use of opium.

Sequential chemotherapy with docetaxel, cisplatin and 5-flurouracil followed by radiation may be an alternative to a laryngectomy in patients with advanced laryngeal cancer.

Background: In recent years, lung cancer (LC) incidence has increased in Iran. The use of opium and its derivatives (O&D) has increased as well. This study aimed to investigate the association between the use of O&D and LC incidence. Methods: In this case-control study conducted in Kerman, Iran; 140 patients with lung cancer and 280 healthy controls matched by age, sex, and place of residence were included. Data, including O&D use, cigarette smoking, alcohol use, and diet, were collected using a structured questionnaire. The relation between the use of O&D and LC was evaluated using conditional logistic regression adjusted for tobacco smoking, education, daily intake of fruit, vegetables, red meat, and hydrogenated fats. Results: Opium ever-use was associated with an increased risk of LC (Adjusted Odds Ratio (AOR) =5.95, 95% CI: 1.87-18.92). Participants were divided into low and high use groups based on the median of opium use in the control group. A significant dose-response relation was observed between the amount of daily O&D use and LC; and the relation was stronger in high users (AOR low users = 3.81% CI: 1.13-12.77 and OR high users = 9.36, 95% CI: 2.05-42.72). Also, LC was higher among participants starting the use of O&D at younger ages (≤ 41 years old vs never users AOR = 8.64, 95% CI: 1.90-39.18) compared to those who started at an older age (> 41 years old vs never users, AOR = 4.71, 95% CI: 1.38-16.08). The association between opium, and lung cancer among non-smokers was OR: 6.50 (95% CI: 2.89 to 14.64). Conclusion: The results of this study show that opium use is probably a dose related risk factor for lung cancer.

Opium use was recently classified as a human carcinogen for lung cancer by the International Agency for Research on Cancer. We conducted a large, multicenter case‐control study evaluating the association between opium use and the risk of lung cancer. We recruited 627 cases and 3477 controls from May 2017 to July 2020. We used unconditional logistic regression analyses to estimate the odds ratios (OR) and 95% confidence intervals (CI) and measured the association between opium use and the risk of lung cancer. The ORs were adjusted for the residential place, age, gender, socioeconomic status, cigarettes, and water pipe smoking. We found a 3.6‐fold risk of lung cancer for regular opium users compared to never users (95% CI: 2.9, 4.6). There was a strong dose‐response association between a cumulative count of opium use and lung cancer risk. The OR for regular opium use was higher for small cell carcinoma than in other histology (8.3, 95% CI: 4.8, 14.4). The OR of developing lung cancer among opium users was higher in females (7.4, 95% CI: 3.8, 14.5) than in males (3.3, 95% CI: 2.6, 4.2). The OR for users of both opium and tobacco was 13.4 (95% CI: 10.2, 17.7) compared to nonusers of anything. The risk of developing lung cancer is higher in regular opium users, and these results strengthen the conclusions on the carcinogenicity of opium. The association is stronger for small cell carcinoma cases than in other histology.

No abstract

Objective: In loco regionally advanced head and neck cancer, the superiority of concomitant cetuximab with radiation over radiation alone has been proven previously. But comparison between chemo radiation and bioradiation has not been well studied. Methods: Between October 2013 and August 2017, 38 patients with locoregionally advanced laryngeal cancer and more than 50% response to 3 cycles of induction chemotherapy (docetaxel and cisplatin: both with a dose of 75 mg/m 2 on the first day and 5-flurouracil: 750 mg/m 2 during days 1to 3; repeated every 21 days) were selected to receive either carboplatin (18 patients, AUC 1.5 , weekly) or cetuximab (20 patients, with loading dose of 400 mg/m 2 and weekly dose of 250 mg/m2) with radiation. A Kaplan–Meier analysis was used to calculate progression free survival and overall survival rates. The log–rank test was used to compare overall survival between treatment groups. Results: The median follow up time was 36 months. The 2-year organ preservation rate of 78.9% was achieved. The 3- year progression-free survival rates of 65.2%, 72.7% and 58.2% were observed for all patients, carboplatin group and cetuximab group, respectively (p=0.4). The 3-year estimates of overall survival were 67.8%, 69.2 %, and 66.3 % for all patients, carboplatin group and cetuximab group, respectively (p=0.47). Concomitant carboplatin was discontinued in 3 patients due to toxicity Conclusion: Concomitant cetuximab is a reasonable alternative to concomitant chemotherapy. But the difference in treatment outcome between bioradiation and chemoradiation remains to be defined.