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Pannunzio S, Di Bello A, Occhipinti D, Scala A, Messina G, Valente G, Quirino M, Di Salvatore M, Tortora G, Cassano A. Multimodality treatment in recurrent/metastatic squamous cell carcinoma of head and neck: current therapy, challenges, and future perspectives. Front Oncol 2024; 13:1288695. [PMID: 38239635 PMCID: PMC10794486 DOI: 10.3389/fonc.2023.1288695] [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: 09/04/2023] [Accepted: 12/05/2023] [Indexed: 01/22/2024] Open
Abstract
Squamous cell carcinoma of the head and neck is a complex group of diseases that presents a challenge to the clinician. The prognosis in the recurrent/metastatic disease is particularly dismal, with a median survival of approximately 12 months. Recently, the personalized and multimodal approach has increased prognosis by integrating locoregional strategies (salvage surgery and stereotactic radiotherapy) and systemic treatments (chemotherapy, immunotherapy, and target therapy). Malnutrition is a significant clinical problem that interferes with dose intensity, and thus, feeding supplementation is critical not only to increase the quality of life but also to improve overall survival. With this review, we want to emphasize the importance of the multidisciplinary approach, quality of life, and nutritional supportive care and to integrate the latest updates of predictive biomarkers for immunotherapy and future therapeutic strategies.
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Affiliation(s)
- Sergio Pannunzio
- Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Roma, Italy
| | - Armando Di Bello
- Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Roma, Italy
| | - Denis Occhipinti
- Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Roma, Italy
| | - Alessandro Scala
- Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Roma, Italy
| | - Gloria Messina
- Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Roma, Italy
| | - Giustina Valente
- Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Roma, Italy
| | - Michela Quirino
- Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Roma, Italy
| | - Mariantonietta Di Salvatore
- Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Roma, Italy
| | - Giampaolo Tortora
- Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Roma, Italy
- Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
| | - Alessandra Cassano
- Oncologia Medica, Fondazione Policlinico Universitario Agostino Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Roma, Italy
- Comprehensive Cancer Center, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
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Yokota T, Mukaigawa T, Yasunaga Y, Ogawa H, Onoe T, Yurikusa T, Yamashita A. Multidisciplinary tumor board for head and neck cancer from the perspective of medical oncologists-optimizing its effectiveness. Front Oncol 2023; 13:1257853. [PMID: 37711197 PMCID: PMC10498916 DOI: 10.3389/fonc.2023.1257853] [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: 07/13/2023] [Accepted: 08/14/2023] [Indexed: 09/16/2023] Open
Abstract
Head and neck cancer (HNC) treatment is becoming increasingly multidisciplinary, and patient characteristics vary. Therefore, a multidisciplinary tumor board (MTB) is essential in clinical practice. This review provides insights into the benefits and tips for improving head and neck MTB from the perspective of medical oncologists. The MTB is a platform to discuss the optimal application of the standard of care to each case, reach a consensus, and establish a recommendation to support patients' decision-making. A productive and educational MTB also provides an opportunity to share information on ongoing clinical trials with physicians. Case presentations should be systematic to discuss all new and challenging cases before, during, and after the treatment. Human resource development, particularly of head and neck medical oncologists, is crucial. The type of multidisciplinary network between medical staff and the extent of patient intervention differs among MTB teams. Subsequently, a virtual MTB can establish a medical network between institutions that will contribute to the equalization and centralization of head and neck oncologic care.
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Affiliation(s)
- Tomoya Yokota
- Division of Gastrointestinal Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Takashi Mukaigawa
- Division of Head and Neck Surgery, Shizuoka Cancer Center, Shizuoka, Japan
| | - Yoshichika Yasunaga
- Division of Plastic and Reconstructive Surgery, Shizuoka Cancer Center, Shizuoka, Japan
| | - Hirofumi Ogawa
- Division of Radiation Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Tsuyoshi Onoe
- Division of Radiation Oncology, Shizuoka Cancer Center, Shizuoka, Japan
| | - Takashi Yurikusa
- Division of Dentistry and Oral Surgery, Shizuoka Cancer Center, Shizuoka, Japan
| | - Aiko Yamashita
- Division of Nutrition, Shizuoka Cancer Center, Shizuoka, Japan
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Koyama S, Ehara H, Donishi R, Morisaki T, Ogura T, Taira K, Fukuhara T, Fujiwara K. Photoimmunotherapy with surgical navigation and computed tomography guidance for recurrent maxillary sinus carcinoma. Auris Nasus Larynx 2022:S0385-8146(22)00204-8. [PMID: 36123249 DOI: 10.1016/j.anl.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 08/16/2022] [Accepted: 09/01/2022] [Indexed: 12/24/2022]
Abstract
Photoimmunotherapy (PIT) using lasers to target treatment areas is effective for unresectable locally advanced or unresectable locoregionally recurrent head and neck cancer; however, there are only two devices to target the treatment area. One illuminates tumour tissue through a needle, and the other illuminates tumour tissue superficially. Treating lesions surrounded by bone, such as in maxillary sinus cancer, is difficult. We report the first case of PIT for unresectable recurrent maxillary sinus cancer employing surgical navigation and computed tomography guidance in a 56-year-old man. Although he underwent concurrent chemoradiotherapy for cT4bN0M0 maxillary sinus cancer, the tumour recurred at the primary site 6 months post treatment. Chemotherapy was performed for approximately 1 year; however, the tumour progressed. The tumour involved the anterior wall of the maxillary sinus and caused bone destruction; thus, we believed that PIT with a needle device was possible if the puncture was carefully performed. We used a surgical navigation system for neurosurgery and computed tomography guidance to ensure that intraoperative punctures were accurately performed. The operation time was 1 h 52 min and the treatment was completed as planned. Tumour necrosis and volume reduction were obtained with no severe adverse events, which reduced the patient's pain.
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Affiliation(s)
- Satoshi Koyama
- Department of Otolaryngology Head and Neck Surgery, Tottori University Faculty of Medicine, Yonago, 683-8504, Japan.
| | - Hiroaki Ehara
- Department of Otolaryngology Head and Neck Surgery, Tottori University Faculty of Medicine, Yonago, 683-8504, Japan
| | - Ryohei Donishi
- Department of Otolaryngology Head and Neck Surgery, Tottori University Faculty of Medicine, Yonago, 683-8504, Japan
| | - Tsuyoshi Morisaki
- Department of Otolaryngology Head and Neck Surgery, Tottori University Faculty of Medicine, Yonago, 683-8504, Japan
| | - Takafumi Ogura
- Division of Neurosurgery, Department of Brain and Neuroscience, Tottori University Faculty of Medicine, Yonago, 683-8504, Japan
| | - Kenkichiro Taira
- Department of Otolaryngology Head and Neck Surgery, Tottori University Faculty of Medicine, Yonago, 683-8504, Japan
| | - Takahiro Fukuhara
- Department of Otolaryngology Head and Neck Surgery, Tottori University Faculty of Medicine, Yonago, 683-8504, Japan
| | - Kazunori Fujiwara
- Department of Otolaryngology Head and Neck Surgery, Tottori University Faculty of Medicine, Yonago, 683-8504, Japan
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The impact of patient preference in the treatment algorithm for recurrent/metastatic head and neck squamous cell carcinoma. Radiol Med 2022; 127:866-871. [PMID: 35752659 PMCID: PMC9349154 DOI: 10.1007/s11547-022-01509-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 05/30/2022] [Indexed: 12/24/2022]
Abstract
The advent of immune checkpoint inhibitors for recurrent/metastatic head and neck squamous cell carcinoma (RM-HNSCC) has revolutionized the standard of care approach in first-line treatment. The heterogeneity of disease presentation and treatment-related toxicities can be associated with suboptimal patient compliance to oncologic care. Hence, prioritizing quality of life and well-being are crucial aspects to be considered in tailoring the best treatment choice. The aim of our work is to present a short report on the topic of the patient’s preference in regard to treatment and its consequences on quality of life in the recurrent/metastatic setting. According to the literature, there’s an unmet need on how to assess patient attitude in respect to the choice of treatment. In view of the availability of different therapeutic strategies in first-line management of RM-HNSCC, increasing emphasis should be put on integrating patient preferences into the medical decision-making.
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Klinghammer K, Lorini L, Nevens D, Simon C, Machiels JP, Bossi P. Treatment Stratification in First-Line Recurrent or Metastatic Head and Neck Cancer, on Behalf of the EORTC Young Investigator Head and Neck Cancer Group. Front Oncol 2022; 12:730785. [PMID: 35155222 PMCID: PMC8830482 DOI: 10.3389/fonc.2022.730785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 01/05/2022] [Indexed: 11/13/2022] Open
Abstract
Multiple factors differentially influence treatment decisions in the first line treatment of recurrent/metastatic HNSCC. The EORTC Young investigator group launched a survey among treating physicians to explore the main influencing factors for treatment stratification. The questionnaire was posted as a web-survey link from May to August 2020. Next to defining the factors that mostly influence therapeutic decision the survey was complemented by a clinical case discussion of five patient cases. A total of 118 responses from 19 countries were collected. The key factors identified to guide treatment decision were performance status, PD-L1 Expression, time from last systemic treatment above or below 6 months, and disease burden. Prospective evaluation of patient characteristics and additional potential predictive biomarkers for novel treatment options remains an important question to stratify personalized treatment for RM HNSCC.
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Affiliation(s)
- Konrad Klinghammer
- Department of Hematology, Oncology and Cancer Immunology, Charité-Universitätsmedizin, Berlin, Germany.,Charité Comprehensive Cancer Center, Berlin, Germany
| | - Luigi Lorini
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy
| | - Daan Nevens
- Iridium Netwerk, Radiation Oncology Department, University of Antwerp, Antwerp, Belgium
| | - Christian Simon
- Department of Otolaryngology, Head and Neck Surgery, University of Lausanne, CHUV, Lausanne, Switzerland
| | - Jean-Pascal Machiels
- Institut Roi Albert II, Department of Medical Oncology, Cliniques Universitaires Saint-Luc and Institut de Recherche Clinique et Expérimentale (Pole MIRO), UC Louvain, Brussels, Belgium
| | - Paolo Bossi
- Medical Oncology Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, ASST Spedali Civili of Brescia, University of Brescia, Brescia, Italy
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Gonçalves KKN, de Araújo ESM, Barbirato DS, do Lago CAP, do Egito Vasconcelos BC. Head and neck cancer associated with myiasis. Int J Oral Maxillofac Surg 2021; 51:847-853. [PMID: 34602319 DOI: 10.1016/j.ijom.2021.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/21/2021] [Accepted: 08/13/2021] [Indexed: 11/28/2022]
Abstract
Head and neck cancer patients represent a risk group for the development of fly larvae infestation in neoplastic wounds. This condition can accelerate the disease progression and increase its lethality due to local or systemic complications. The aim of this study was to conduct a scoping review on head and neck cancer associated with myiasis in order to answer the focal question: what are the occurrence, diagnosis, aetiology, treatment and outcomes of head and neck cancer associated with myiasis? This paper was structured based on the five-steps methodology proposed by Arksey and O'Malley (Int J Soc Res Methodol 2005;1:19-32), and followed the PRISMA Extension for Scoping Reviews (PRISMA-ScR), OSF Registries protocol. The electronic search was performed in the MEDLINE/PubMed, Embase and SciELO.org databases for articles published up to 28 February 2021. In total, 38 articles and 56 patients were included. Most patients were male (66%), and the mean age was 66.63 years. Cases were predominantly associated with squamous or basal cell cancer. The most affected anatomical sites were the eyes, scalp, ears and oral cavity, and the most frequent type of larva was Crisomyia (13%). Manual removal of the larvae was considered the standard treatment, associated or not with antibiotics, analgesics and antiparasitic drugs.
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Affiliation(s)
- K K N Gonçalves
- Department of Oral and Maxillofacial Surgery, University of Pernambuco, Recife-PE, Brazil
| | - E S M de Araújo
- Faculty of Dentistry of Pernambuco, University of Pernambuco, Recife-PE, Brazil
| | - D S Barbirato
- Department of Oral and Maxillofacial Surgery, University of Pernambuco, Recife-PE, Brazil
| | - C A P do Lago
- Maxillofacial Surgery and Traumatology Service, Hospital da Restauração, Recife-PE, Brazil
| | - B C do Egito Vasconcelos
- Department of Oral and Maxillofacial Surgery, University of Pernambuco, Recife-PE, Brazil; Department of Oral and Maxillofacial Surgery, Hospital da Restauração, Pernambuco, Brazil.
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Dos Santos ES, Wagner VP, Cabral Ramos J, Lambert DW, Castilho RM, Paes Leme AF. Epigenetic modulation of the tumor microenvironment in head and neck cancer: Challenges and opportunities. Crit Rev Oncol Hematol 2021; 164:103397. [PMID: 34146679 DOI: 10.1016/j.critrevonc.2021.103397] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/31/2021] [Accepted: 06/07/2021] [Indexed: 12/22/2022] Open
Abstract
Head and neck cancer is globally challenging due to the resistance to therapy and aggressive behavior leading to high rates of mortality. Recent findings show that the tumor microenvironment plays a role in the maintenance and progression of many solid tumors, including head and neck cancer. The mechanisms involved in the modulation and regulation of the tumor microenvironment remain poorly understood. Increasing evidence suggests that epigenetic events can modulate the crosstalk between neoplastic and non-neoplastic cells during tumor progression. In this review, we explore the current understanding of the involvement of epigenetic events in the modulation of the tumor microenvironment and its impact on head and neck cancer behavior. We also explore the latest therapeutic strategies that use epigenetic-modulating drugs to manage tumor growth and progression.
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Affiliation(s)
| | - Vivian Petersen Wagner
- The University of Sheffield Faculty of Medicine Dentistry and Health, 152607, Sheffield, United Kingdom of Great Britain and Northern Ireland
| | - Joab Cabral Ramos
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Daniel W Lambert
- The University of Sheffield Faculty of Medicine Dentistry and Health, 152607, Sheffield, United Kingdom of Great Britain and Northern Ireland
| | - Rogerio Moraes Castilho
- Laboratory of Epithelial Biology, Department of Periodontics and Oral Medicine, Division of Oral Pathology, Radiology and Medicine, University of Michigan School of Dentistry. Ann Arbor, 48109-1078, MI, USA; Rogel Cancer Center, University of Michigan, Ann Arbor, 48109, MI, USA
| | - Adriana Franco Paes Leme
- The Brazilian Bioscience National Laboratory, Center for Research in Energy and Materials, Campinas, Brazil
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