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Baude J, Guigou C, Thibouw D, Vulquin N, Folia M, Constantin G, Boustani J, Duvillard C, Ladoire S, Truc G, Bertaut A, Chevalier C. Definitive radio(chemo)therapy versus upfront surgery in the treatment of HPV-related localized or locally advanced oropharyngeal squamous cell carcinoma. PLoS One 2024; 19:e0307658. [PMID: 39052674 PMCID: PMC11271858 DOI: 10.1371/journal.pone.0307658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 07/09/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND The treatment of stage I-III HPV+ oropharyngeal squamous cell carcinoma (HPV-OPSCC) is based on either surgery ± adjuvant therapy or exclusive radio±chemotherapy. We sought to compare these two therapeutic strategies in terms of efficacy, tolerance and quality of life (QoL). METHODS Patients treated for stage I-III HPV-OPSCC from 2010 to 2021 in 3 academic centers were included and sorted according to the treatment strategy: surgery or exclusive radio±chemotherapy. Efficacy and tolerance were retrospectively assessed, and a transversal exploratory QoL assessment was performed using QoL instruments. RESULTS A total of 83 patients were included, with 21 undergoing non-minimally invasive surgery and 62 receiving definitive radio-±chemotherapy. 2-year progression-free survival (PFS) and overall survival (OS) were respectively 80% and 86% in the surgical group and 92% and 95% in the non-surgical group, with no significant difference. At the end of treatment, 64.5% of patients presented with a grade III toxicity, without significant difference between the two groups. No patient had late grade III toxicity at 24 months. Forty-five patients (11 in the surgical group, 34 in the non-surgical group) participated in an exploratory quality-of-life analysis. Patients reported significantly more fatigue and loss of appetite after surgery, whereas patients in the radio±chemotherapy group described significantly more salivary and oral problems and difficulty swallowing, but the median time between treatment completion and the response to the questionnaires. CONCLUSION There was no significant difference in efficacy, physician-reported toxicity and overall patient-reported quality of life was found between non-minimally invasive surgery and radio±chemotherapy in the treatment of stage I-III HPV-OPSCC.
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Affiliation(s)
- Jérémy Baude
- Department of Radiotherapy, Georges-François Leclerc Cancer Center, UNICANCER, Dijon, Burgundy, France
| | - Caroline Guigou
- Department of Otolaryngology and Head and Neck Surgery, Dijon University Hospital, Dijon, Burgundy, France
| | - David Thibouw
- Department of Radiotherapy, Georges-François Leclerc Cancer Center, UNICANCER, Dijon, Burgundy, France
- Department of Radiation Oncology, Besançon University Hospital, Besançon, Burgundy, France
| | - Noémie Vulquin
- Department of Radiotherapy, Georges-François Leclerc Cancer Center, UNICANCER, Dijon, Burgundy, France
- Department of Radiation Oncology, Besançon University Hospital, Besançon, Burgundy, France
| | - Mireille Folia
- Department of Otolaryngology and Head and Neck Surgery, Dijon University Hospital, Dijon, Burgundy, France
| | - Guillaume Constantin
- Department of Epidemiology and Biostatistics, Georges-François Leclerc Cancer Center, Dijon, Burgundy, France
| | - Jihane Boustani
- Department of Radiation Oncology, Besançon University Hospital, Besançon, Burgundy, France
| | - Christian Duvillard
- Department of Otolaryngology and Head and Neck Surgery, Dijon University Hospital, Dijon, Burgundy, France
| | - Sylvain Ladoire
- Department of Medical Oncology, Georges-François Leclerc Cancer Center, Dijon, Burgundy, France
- Cancer Biology Transfer Platform, Georges-François Leclerc Cancer Center, Dijon, Burgundy, France
- INSERM LNC-UMR1231, Dijon, France
- Genetic and Immunology Medical Institute, Dijon, Burgundy, France
| | - Gilles Truc
- Department of Radiation Oncology, Besançon University Hospital, Besançon, Burgundy, France
| | - Aurélie Bertaut
- Department of Epidemiology and Biostatistics, Georges-François Leclerc Cancer Center, Dijon, Burgundy, France
| | - Cédric Chevalier
- Department of Radiotherapy, Georges-François Leclerc Cancer Center, UNICANCER, Dijon, Burgundy, France
- Department of Radiation Oncology, Besançon University Hospital, Besançon, Burgundy, France
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Unmet needs, quality of life and psychological distress: insights regarding head and neck cancer patients in a rural setting. J Laryngol Otol 2023; 137:89-95. [PMID: 36128616 DOI: 10.1017/s0022215121001699] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE This study aimed to evaluate the perceived quality of life, unmet needs and psychological distress in patients with head and neck cancer in a rural setting in New Zealand. METHOD Patients presenting with head and neck cancer in Northland, New Zealand, were asked to complete questionnaires on quality of life, unmet needs, and anxiety or depression together with a free-text option. RESULTS About one quarter of respondents (27 per cent) scored high in the anxiety and depression scale, with corresponding diminished quality of life scores and increased needs. Over half of respondents (54 per cent) found it challenging to travel for treatment. Financial difficulties were encountered more frequently with indigenous patients. Rurality alone does not lead to significant differences in quality of life or needs. CONCLUSION After treatment for head and neck cancer, it is important to monitor and manage patients' psychological distress and ease of access to health services to improve quality of life.
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Hunter M, Kellett J, Toohey K, D’Cunha NM, Isbel S, Naumovski N. Toxicities Caused by Head and Neck Cancer Treatments and Their Influence on the Development of Malnutrition: Review of the Literature. Eur J Investig Health Psychol Educ 2020; 10:935-949. [PMID: 34542427 PMCID: PMC8314324 DOI: 10.3390/ejihpe10040066] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/14/2020] [Accepted: 09/30/2020] [Indexed: 02/06/2023] Open
Abstract
Malnutrition poses a significant problem for oncology patients, resulting in fatalities within this population. Patients with head and neck cancer (HNC) are at high risk, with up to 90% developing malnutrition. Common treatments used for HNC can often lead to adverse side effects, including oral health conditions, gastrointestinal upsets, and several metabolic changes. Consequently, treatments can cause inadequate nutritional intake, resulting in a reduction in energy consumption, and alterations in energy utilization, contributing to the development of malnutrition. Furthermore, the presence of these treatment toxicities, and the related malnutrition can lead to reduced quality of life, weight loss, and psychological distress. There are interventions available (nutritional, medicinal, and physical therapies) that have demonstrated potential effectiveness in reducing the severity of symptomatic toxicities, reducing the risk of malnutrition, and improving survival outcomes of patients with HNC. Based on the findings of this review, there is an urgent need for the implementation or continuation of multi-disciplinary strategies, as well as updated and improved guidelines to assist in the prevention and treatment of malnutrition caused by treatment-related toxicities in patients with HNC.
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Affiliation(s)
- Maddison Hunter
- Faculty of Health, University of Canberra, Bruce, 2617 ACT, Australia; (M.H.); (J.K.); (K.T.); (S.I.)
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, 2617 ACT, Australia
| | - Jane Kellett
- Faculty of Health, University of Canberra, Bruce, 2617 ACT, Australia; (M.H.); (J.K.); (K.T.); (S.I.)
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, 2617 ACT, Australia
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, 2617 ACT, Australia
| | - Kellie Toohey
- Faculty of Health, University of Canberra, Bruce, 2617 ACT, Australia; (M.H.); (J.K.); (K.T.); (S.I.)
- Prehabilitation, Activity, Cancer, Exercise and Survivorship (PACES) Research Group, University of Canberra, Bruce, 2617 ACT, Australia
| | - Nathan M. D’Cunha
- Faculty of Health, University of Canberra, Bruce, 2617 ACT, Australia; (M.H.); (J.K.); (K.T.); (S.I.)
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, 2617 ACT, Australia
| | - Stephen Isbel
- Faculty of Health, University of Canberra, Bruce, 2617 ACT, Australia; (M.H.); (J.K.); (K.T.); (S.I.)
| | - Nenad Naumovski
- Faculty of Health, University of Canberra, Bruce, 2617 ACT, Australia; (M.H.); (J.K.); (K.T.); (S.I.)
- Functional Foods and Nutrition Research (FFNR) Laboratory, University of Canberra, Bruce, 2617 ACT, Australia
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17676 Athens, Greece
- Correspondence: ; Tel.: +61 (0)2-6206-8719
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