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Hendrickx JJ, Mennega T, Uppelschoten JM, Leemans CR. Changes in multidisciplinary team decisions in a high volume head and neck oncological center following those made in its preferred partner. Front Oncol 2023; 13:1205224. [PMID: 37727212 PMCID: PMC10505803 DOI: 10.3389/fonc.2023.1205224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 07/24/2023] [Indexed: 09/21/2023] Open
Abstract
Objective Head and neck cancer care is highly complex, and multidisciplinary team meetings (MDTs) are vital for improved outcomes. In the Netherlands, head and neck cancer care is practiced in eight high-volume head and neck oncologic centers (HNOC) and six affiliated hospitals preferred partner (PP) centers. Patients treated in the PP are presented and discussed in the HNOC. To evaluate the importance of these mandatory and decisive steps in decision making, we have assessed the changes in treatment. Materials and methods Retrospective evaluation of head and neck cancer patients referred between January 2011 and October 2018 for a MDT evaluation to the HNOC was conducted. The differences in MDT recommendation were classified with regards to major and minor changes. Results Management recommendation(MR) changed after 113 of 515 MDT discussions within the PP (487 patients; 22%), of which 86 cases (16%) were major changes. In 67 cases (59.3%), escalation of management was recommended, while in 43 cases (38.1%) de-escalation was recommended. Conclusion There was a high rate of change of MRs, when comparing the PP recommendations with the HNOC recommendations. Since patient and tumor characteristics seem unable to predict these changes, we recommend all patients be seen for a clinical presentation, revision of diagnostics, and MDT discussion in a high volume HNOC.
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Affiliation(s)
- Jan-Jaap Hendrickx
- Department of Otolaryngology-Head and Neck Surgery, Amsterdam University Medical Center-location VUmc, Amsterdam, Netherlands
| | - Tommy Mennega
- Department of Otolaryngology-Head and Neck Surgery, Amsterdam University Medical Center-location VUmc, Amsterdam, Netherlands
| | | | - C. René Leemans
- Department of Otolaryngology-Head and Neck Surgery, Amsterdam University Medical Center-location VUmc, Amsterdam, Netherlands
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Mlak R, Powrózek T, Brzozowska A, Homa-Mlak I, Mazurek M, Małecka-Massalska T. RRM1 gene expression evaluated in the liquid biopsy (blood cfRNA) as a non-invasive, predictive factor for radiotherapy-induced oral mucositis and potential prognostic biomarker in head and neck cancer patients. Cancer Biomark 2018; 22:657-667. [DOI: 10.3233/cbm-171082] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Radosław Mlak
- Department of Human Physiology, Medical University of Lublin, Lublin, Poland
| | - Tomasz Powrózek
- Department of Human Physiology, Medical University of Lublin, Lublin, Poland
| | - Anna Brzozowska
- Department of Oncology, Medical University of Lublin, Lublin, Poland
| | - Iwona Homa-Mlak
- Department of Human Physiology, Medical University of Lublin, Lublin, Poland
| | - Marcin Mazurek
- Department of Human Physiology, Medical University of Lublin, Lublin, Poland
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Mañós M, Giralt J, Rueda A, Cabrera J, Martinez-Trufero J, Marruecos J, Lopez-Pousa A, Rodrigo J, Castelo B, Martínez-Galán J, Arias F, Chaves M, Herranz J, Arrazubi V, Baste N, Castro A, Mesía R. Multidisciplinary management of head and neck cancer: First expert consensus using Delphi methodology from the Spanish Society for Head and Neck Cancer (part 1). Oral Oncol 2017; 70:58-64. [DOI: 10.1016/j.oraloncology.2017.04.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Revised: 03/31/2017] [Accepted: 04/08/2017] [Indexed: 01/15/2023]
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Nutritional changes in patients with locally advanced head and neck cancer during treatment. Oral Oncol 2017; 71:67-74. [PMID: 28688694 DOI: 10.1016/j.oraloncology.2017.06.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 06/01/2017] [Accepted: 06/04/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The purpose of the study is to evaluate changes in body composition and nutritional status that occur throughout the oncological treatment in head and neck cancer patients. METHODS A prospective cohort observational study in patients diagnosed with head and neck squamous cell carcinoma (HNSCC) that underwent treatment with induction chemotherapy (iCT) followed by chemoradiotherapy or bioradiotherapy were invited to participate. All patients had dietetic counseling from the diagnosis and a close monitoring throughout the treatment implementing nutritional support as needed. RESULTS From June 2011 until October 2012, 20 patients were included. Nutritional and anthropometric parameters were collected at diagnosis, post iCT, after radiotherapy, 1 and 3months post radiotherapy. According to Patient Generated Subjective Global Assessment, 30% of patients were malnourished at diagnosis. After iCT there was an increase in weight, body mass index (BMI) and fat free mass (FFM) with almost complete improvement in dysphagia and odynophagia. Nevertheless a significant nutritional deterioration (p=0.0022) occurred at the end of radiotherapy with 95% of patients becoming severe or moderate malnourished. Nutritional parameters such as weight, BMI and hand grip strength also decrease significantly during treatment. CONCLUSIONS Despite an intensive nutritional support from the diagnosis throughout the oncological treatment in advanced HNSCC cancer patients, nutritional status deteriorates during radiotherapy. Our findings suggest that iCT may help improve nutritional status by ameliorating the symptoms that limit the oral intake. This improvement in the nutritional status could contribute to minimize further deterioration. Further investigations are needed involving novel approaches to avoid nutritional deterioration.
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Françoso A, Simioni PU. Immunotherapy for the treatment of colorectal tumors: focus on approved and in-clinical-trial monoclonal antibodies. DRUG DESIGN DEVELOPMENT AND THERAPY 2017; 11:177-184. [PMID: 28138221 PMCID: PMC5241129 DOI: 10.2147/dddt.s119036] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Colorectal cancer is considered a disease of the elderly population. Since the number of geriatric patients continues to rise, monoclonal antibody therapy is the most promising therapy in the recent research. Presently, the monoclonal antibodies most frequently used in the treatment of colorectal tumors are bevacizumab, cetuximab, panitumumab, and ramucirumab. Bevacizumab is a monoclonal antibody that acts on VEGF. Cetuximab and panitumumab act on EGFR. Ramucirumab binds directly to the ligand-binding pocket of VEGFR-2 to block the binding of VEGF-A, VEGF-C, and VEGF-D. These monoclonal antibodies, alone or in association with radiotherapy or chemotherapy, are presenting good results and are increasing patient survival, despite the side effects. Due to the limited number of molecules available, several studies are trying to develop new monoclonal antibodies for the treatment of colorectal tumors. Among those being studied, some recent molecules are in phase I and/or II trials and are yielding advantageous results, such as anti-DR5, anti-Fn14, anti-IGF-1R, anti-EGFR, anti-NRP1, and anti-A33 antibodies. This has been successful in reducing side effects and in treating nonresponsive patients.
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Affiliation(s)
- Alex Françoso
- Department of Biomedical Science, Faculty of Americana, Americana
| | - Patricia Ucelli Simioni
- Department of Biomedical Science, Faculty of Americana, Americana; Department of Genetics, Evolution and Bioagents, Institute of Biology, University of Campinas, Campinas; Department of Biochemistry and Microbiology, Institute of Biosciences, Universidade Estadual Paulista, Rio Claro, São Paulo, Brazil
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6
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Gobbo M, Bullo F, Perinetti G, Gatto A, Ottaviani G, Biasotto M, Tirelli G. Diagnostic and therapeutic features associated with modification of quality-of-life's outcomes between one and six months after major surgery for head and neck cancer. Braz J Otorhinolaryngol 2016; 82:548-57. [PMID: 26878840 PMCID: PMC9444670 DOI: 10.1016/j.bjorl.2015.10.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 10/02/2015] [Indexed: 12/13/2022] Open
Abstract
Introduction Treatments used in head and neck cancer greatly impact the physical, psychological and functional state of patients. Evaluation of quality of life has become an integral part of the treatment. Objective This retrospective study evaluates features involved in changes in quality of life after major surgery for head and neck cancer within six months, according to self-reported outcomes. Methods One hundred and thirty patients completed the University of Washington Quality of Life questionnaire one and six months after major surgery for head and neck cancer. A multivariate model was used to evaluate which diagnostic and therapeutic features were related to improvement of quality of life within a six-month period. Results Significant improvement in most features related to quality of life was already recognizable at six months. Patients submitted to more invasive treatment had the biggest improvement in quality of life between time-points, as well as those patients with bigger tumors. Conclusion After major surgery, patients may undergo fast recovery, with overall quality of life likely to improve in the short-term. Clinicians must be aware of the importance of dealing with treatment-related issues immediately after surgery, with hopeful possibility of on-the-upgrade results.
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Affiliation(s)
- Margherita Gobbo
- Dental Science Department, Division of Oral Medicine and Pathology, Trieste, Italy.
| | - Federica Bullo
- University of Trieste, Hospital of Cattinara, ENT Clinic, Head and Neck Department, Trieste, Italy
| | - Giuseppe Perinetti
- Dental Science Department, Division of Oral Medicine and Pathology, Trieste, Italy
| | - Annalisa Gatto
- University of Trieste, Hospital of Cattinara, ENT Clinic, Head and Neck Department, Trieste, Italy
| | - Giulia Ottaviani
- Dental Science Department, Division of Oral Medicine and Pathology, Trieste, Italy
| | - Matteo Biasotto
- Dental Science Department, Division of Oral Medicine and Pathology, Trieste, Italy
| | - Giancarlo Tirelli
- University of Trieste, Hospital of Cattinara, ENT Clinic, Head and Neck Department, Trieste, Italy
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Licitra L, Keilholz U, Tahara M, Lin JC, Chomette P, Ceruse P, Harrington K, Mesia R. Evaluation of the benefit and use of multidisciplinary teams in the treatment of head and neck cancer. Oral Oncol 2016; 59:73-79. [DOI: 10.1016/j.oraloncology.2016.06.002] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Accepted: 06/03/2016] [Indexed: 10/21/2022]
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Gallegos Hernández JF. ¿Cuál es el mejor esquema de quimioterapia asociado a radioterapia en el cáncer epidermoide localmente avanzado de cabeza y cuello? Reflexiones sobre una sesión académica. GACETA MEXICANA DE ONCOLOGÍA 2015. [DOI: 10.1016/j.gamo.2015.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Prise en charge globale des carcinomes épidermoïdes de la tête et du cou (CETEC) en 2015. ONCOLOGIE 2015. [DOI: 10.1007/s10269-015-2516-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Lanzer M, Bachna-Rotter S, Graupp M, Bredell M, Rücker M, Huber G, Reinisch S, Schumann P. Unknown primary of the head and neck: A long-term follow-up. J Craniomaxillofac Surg 2015; 43:574-9. [DOI: 10.1016/j.jcms.2015.03.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 02/27/2015] [Accepted: 03/02/2015] [Indexed: 12/20/2022] Open
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Gobbo M, Ottaviani G, Perinetti G, Ciriello F, Beorchia A, Giacca M, Di Lenarda R, Rupel K, Tirelli G, Zacchigna S, Biasotto M. Evaluation of nutritional status in head and neck radio-treated patients affected by oral mucositis: efficacy of class IV laser therapy. Support Care Cancer 2014; 22:1851-6. [DOI: 10.1007/s00520-014-2155-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Accepted: 01/28/2014] [Indexed: 01/09/2023]
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Cruz-Hernández JJ, Rodríguez CA. SEOM guidelines 2013: a response to the needs of Spanish oncologists. Clin Transl Oncol 2013; 15:975-6. [PMID: 23925725 DOI: 10.1007/s12094-013-1097-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 07/28/2013] [Indexed: 11/29/2022]
Affiliation(s)
- J J Cruz-Hernández
- Spanish Society of Medical Oncology, Servicio de Oncología Médica, Hospital Clínico Universitario, Po San Vicente, 58-182, 37007, Salamanca, Spain
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