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Cao LM, Zhong NN, Chen Y, Li ZZ, Wang GR, Xiao Y, Liu XH, Jia J, Liu B, Bu LL. Less is more: Exploring neoadjuvant immunotherapy as a de-escalation strategy in head and neck squamous cell carcinoma treatment. Cancer Lett 2024; 598:217095. [PMID: 38964728 DOI: 10.1016/j.canlet.2024.217095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 06/15/2024] [Accepted: 06/28/2024] [Indexed: 07/06/2024]
Abstract
Head and neck squamous cell carcinoma (HNSCC) constitutes a significant global cancer burden, given its high prevalence and associated mortality. Despite substantial progress in survival rates due to the enhanced multidisciplinary approach to treatment, these methods often lead to severe tissue damage, compromised function, and potential toxicity. Thus, there is an imperative need for novel, effective, and minimally damaging treatment modalities. Neoadjuvant treatment, an emerging therapeutic strategy, is designed to reduce tumor size and curtail distant metastasis prior to definitive intervention. Currently, neoadjuvant chemotherapy (NACT) has optimized the treatment approach for a subset of HNSCC patients, yet it has not produced a noticeable enhancement in overall survival (OS). In the contemporary cancer therapeutics landscape, immunotherapy is gaining traction at an accelerated pace. Notably, neoadjuvant immunotherapy (NAIT) has shown promising radiological and pathological responses, coupled with encouraging efficacy in several clinical trials. This potentially paves the way for a myriad of possibilities in treatment de-escalation of HNSCC, which warrants further exploration. This paper reviews the existing strategies and efficacies of neoadjuvant immune checkpoint inhibitors (ICIs), along with potential de-escalation strategies. Furthermore, the challenges encountered in the context of the de-escalation strategies of NAIT are explored. The aim is to inform future research directions that strive to improve the quality of life (QoL) for patients battling HNSCC.
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Affiliation(s)
- Lei-Ming Cao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Somatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
| | - Nian-Nian Zhong
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Somatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
| | - Yang Chen
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Somatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
| | - Zi-Zhan Li
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Somatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
| | - Guang-Rui Wang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Somatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
| | - Yao Xiao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Somatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
| | - Xuan-Hao Liu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Somatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
| | - Jun Jia
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Somatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China; Department of Oral & Maxillofacial Head Neck Oncology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China.
| | - Bing Liu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Somatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China; Department of Oral & Maxillofacial Head Neck Oncology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China.
| | - Lin-Lin Bu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Somatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China; Department of Oral & Maxillofacial Head Neck Oncology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430079, China.
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Sato M, Enokida T, Fujisawa T, Okano S, Takeshita N, Tanaka N, Tanaka H, Motegi A, Zenda S, Shinozaki T, Matsuura K, Hayashi R, Akimoto T, Tahara M. Induction chemotherapy with paclitaxel, carboplatin, and cetuximab (PCE) followed by chemoradiotherapy for unresectable locoregional recurrence after curative surgery in patients with squamous cell carcinoma of the head and neck. Front Oncol 2024; 14:1420860. [PMID: 39011480 PMCID: PMC11246904 DOI: 10.3389/fonc.2024.1420860] [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: 04/21/2024] [Accepted: 06/18/2024] [Indexed: 07/17/2024] Open
Abstract
Background The significance of induction chemotherapy (IC) in the treatment of squamous cell carcinoma of the head and neck (SCCHN) with unresectable locoregional recurrence after curative surgery has not been clarified. The aim of this study was to evaluate the efficacy of IC followed by chemoradiotherapy (CRT) in these patients. Methods Among patients with unresectable locoregional recurrent SCCHN who had not undergone prior irradiation and were eligible for cisplatin, we conducted a retrospective analysis of patients who received CRT following IC with paclitaxel, carboplatin, or cetuximab (IC-PCE group) and those who received CRT without prior IC (CRT group) between June 2013 and August 2021. Result Forty-two patients were included. The CRT group and IC-PCE group consisted of 15 and 27 patients, respectively. Primary site was the oral cavity (n=25), oropharynx (n=3), hypopharynx (n=13) and larynx (n=1). Objective response rate (ORR) with IC-PCE was 55.6%; 24 patients (88.9%) subsequently received CRT. ORR after completion of CRT was significantly better in the IC-PCE group (95.8% in the IC-PCE group vs. 66.7% in the CRT group, p=0.024). Progression-free survival (PFS) of the total population on median follow-up of 2.4 years (range: 0.8-7.3) tended to be better in the IC-PCE group (2-year PFS: 55.6% in the IC-PCE group vs. 33.3% in the CRT group, log-rank p=0.176), especially in oral cancer (2-year PFS: 37.5% in the IC-PCE group vs. 0% in the CRT group, log-rank p=0.015). Conclusion Therapeutic strategies including IC-PCE in patients with unresectable locoregional recurrent SCCHN after curative surgery may contribute to improved prognosis, especially in oral cancer.
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Affiliation(s)
- Masanobu Sato
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
- Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan
- Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tomohiro Enokida
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Takao Fujisawa
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Susumu Okano
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Naohiro Takeshita
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
- Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan
| | - Nobukazu Tanaka
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Hideki Tanaka
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Atsushi Motegi
- Department of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Kashiwa, Japan
| | - Sadamoto Zenda
- Department of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Kashiwa, Japan
| | - Takeshi Shinozaki
- Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Kazuto Matsuura
- Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Ryuichi Hayashi
- Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan
| | - Tetsuo Akimoto
- Department of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Kashiwa, Japan
| | - Makoto Tahara
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
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Jiang JL, Chang JTC, Yeh CH, Chang TY, Huang BS, Sung PS, Lin CY, Fan KH, Wei YC, Liu CH. Incidence of Carotid Blowout Syndrome in Patients with Head and Neck Cancer after Radiation Therapy: A Cohort Study. Diagnostics (Basel) 2024; 14:1222. [PMID: 38928638 PMCID: PMC11202696 DOI: 10.3390/diagnostics14121222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Revised: 06/02/2024] [Accepted: 06/04/2024] [Indexed: 06/28/2024] Open
Abstract
Carotid blowout syndrome (CBS) is a rare yet life-threatening complication that occurs after radiation therapy (RT). This study aimed to determine the incidence of CBS in patients with head and neck cancer (HNC) undergoing contemporary RT and to explore potential discrepancies in the risk of CBS between nasopharyngeal cancer (NPC) and non-NPC patients. A total of 1084 patients with HNC who underwent RT between 2013 and 2023 were included in the study. All patients were under regular follow-ups at the radio-oncology department, and underwent annual contrast-enhanced computed tomography and/or magnetic resonance imaging for cancer recurrence surveillance. Experienced neuroradiologists and vascular neurologists reviewed the recruited patients' images. Patients were further referred to the neurology department for radiation vasculopathy evaluation. The primary outcome of this study was CBS. Patients were categorized into NPC and non-NPC groups and survival analysis was employed to compare the CBS risk between the two groups. A review of the literature on CBS incidence was also conducted. Among the enrolled patients, the incidence of CBS in the HNC, NPC, and non-NPC groups was 0.8%, 0.9%, and 0.7%, respectively. Kaplan-Meier analysis revealed no significant difference between the NPC and non-NPC groups (p = 0.34). Combining the findings for our cohort with those of previous studies revealed that the cumulative incidence of CBS in patients with HNC is 5% (95% CI = 3-7%) after both surgery and RT, 4% (95% CI = 2-6%) after surgery alone, and 5% (95% CI = 3-7%) after RT alone. Our findings indicate a low incidence of CBS in patients with HNC undergoing contemporary RT. Patients with NPC may have a CBS risk close to that of non-NPC patients. However, the low incidence of CBS could be a potentially cause of selection bias and underestimation bias.
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Grants
- CMRPG3M0811, CMRPG381503, CMRPG3C0763, CMRPG3G0261, CFRPG3L0011, and BMRPF99 Chang Gung Memorial Hospital
- grants 106-2511-S-182A-002-MY2, 108-2314-B-182A-050-MY3, 111-2314-B-182A-133-MY3, NMRPG3M6231-3, NMRPG3G6411-2, and NMRPG3J6131-3 Ministry of Science and Technology
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Affiliation(s)
- Jian-Lin Jiang
- Stroke Center and Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33333, Taiwan
| | - Joseph Tung-Chieh Chang
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Department of Radiation Oncology, Proton and Radiation Therapy Center, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan 33333, Taiwan
- Taipei Chang Gung Head & Neck Oncology Group, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33333, Taiwan
| | - Chih-Hua Yeh
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Department of Neuroradiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33333, Taiwan
| | - Ting-Yu Chang
- Stroke Center and Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33333, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Bing-Shen Huang
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Department of Radiation Oncology, Proton and Radiation Therapy Center, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan 33333, Taiwan
- Taipei Chang Gung Head & Neck Oncology Group, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33333, Taiwan
| | - Pi-Shan Sung
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
| | - Chien-Yu Lin
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Department of Radiation Oncology, Proton and Radiation Therapy Center, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan 33333, Taiwan
- Taipei Chang Gung Head & Neck Oncology Group, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33333, Taiwan
- Radiation Research Core Laboratory, Chang Gung University, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33333, Taiwan
| | - Kang-Hsing Fan
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Department of Radiation Oncology, Proton and Radiation Therapy Center, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan 33333, Taiwan
- Department of Radiation Oncology, New Taipei Municipal Tu-Cheng Hospital, New Taipei City 236, Taiwan
| | - Yi-Chia Wei
- Department of Neurology, Keelung Chang Gung Memorial Hospital, Keelung 83301, Taiwan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
| | - Chi-Hung Liu
- Stroke Center and Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33333, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei 10055, Taiwan
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Liu CH, Lin CY, Huang BS, Wei YC, Chang TY, Yeh CH, Sung PS, Jiang JL, Lin LY, Chang JTC, Fan KH. Risk of temporal lobe necrosis between proton beam and volumetric modulated arc therapies in patients with different head and neck cancers. Radiat Oncol 2023; 18:155. [PMID: 37735389 PMCID: PMC10512503 DOI: 10.1186/s13014-023-02344-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/05/2023] [Indexed: 09/23/2023] Open
Abstract
BACKGROUND To investigate the frequency of temporal lobe necrosis (TLN) soon after radiotherapy (RT) and identify differences among patients with various types of head and neck cancer (HNC) and between different RT methods. METHODS We retrospectively reviewed 483 patients with HNC who had completed RT in our hospital after January, 2015. These patients were followed-up at the radio-oncology department and received contrast-enhanced magnetic resonance imaging (MRI) or computed tomography (CT) to identify metastases or recurrence of cancer at regular intervals. Meanwhile, the occurrence of TLN, graded according to the Common Terminology Criteria for Adverse Events V5.0, was recorded. We categorized the patients into nasopharyngeal carcinoma (NPC) and non-NPC groups and compared the cumulative occurrence of TLN between the groups using Kaplan-Meier and Cox regression analyses. We further compared the cumulative occurrence of TLN between proton beam therapy (PBT) and volumetric modulated arc therapy (VMAT) in patients with any HNC, NPC, and non-NPC HNC. RESULTS Compared with the non-NPC group, the NPC group had a higher frequency of TLN (5.6% vs. 0.4%, p < 0.01) and were more commonly associated with TLN in the Kaplan-Meier analysis (p < 0.01) and the Cox regression model after covariates were adjusted for (adjusted hazard ratio: 13.35, 95% confidence interval: 1.37-130.61) during the follow-up period. Furthermore, the frequency of TLN was similar between patients receiving PBT and those receiving VMAT (PBT vs. VMAT: 4.7% vs. 6.3%, p = 0.76). Kaplan-Meier analysis revealed that the accumulated risks of TLN were similar between PBT and VMAT in patients with any HNC (p = 0.44), NPC (p = 0.84), and non-NPC HNC (p = 0.70). CONCLUSION Our study demonstrated that patients with NPC are susceptible to TLN during the early period after RT. In addition, PBT may be associated with an equivalent risk of TLN when compared with VMAT in patients with NPC or other HNCs.
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Affiliation(s)
- Chi-Hung Liu
- Stroke Center, Department of Neurology, Linkou Medical Center, Chang Gung Memorial Hospital, Taoyüan, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Taoyüan, Taiwan
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Chien-Yu Lin
- School of Medicine, College of Medicine, Chang Gung University, Taoyüan, Taiwan
- Department of Radiation Oncology, Proton and Radiation Therapy Center, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyüan, Taiwan
- Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital Linkou Medical Center, Taoyüan, Taiwan
- Particle Physics and Beam Delivery Core Laboratory of Institute for Radiological Research, Linkou Medical Center, Chang Gung University/Chang Gung Memorial Hospital, Taoyüan, Taiwan
| | - Bing-Shen Huang
- School of Medicine, College of Medicine, Chang Gung University, Taoyüan, Taiwan
- Department of Radiation Oncology, Proton and Radiation Therapy Center, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyüan, Taiwan
| | - Yi-Chia Wei
- Department of Neurology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
- Community Medicine Research Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Ting-Yu Chang
- Stroke Center, Department of Neurology, Linkou Medical Center, Chang Gung Memorial Hospital, Taoyüan, Taiwan
- School of Medicine, College of Medicine, Chang Gung University, Taoyüan, Taiwan
| | - Chih-Hua Yeh
- School of Medicine, College of Medicine, Chang Gung University, Taoyüan, Taiwan
- Department of Neuroradiology, Linkou Medical Center, Chang Gung Memorial Hospital, Taoyüan, Taiwan
| | - Pi-Shan Sung
- Department of Neurology, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan
| | - Jian-Lin Jiang
- Stroke Center, Department of Neurology, Linkou Medical Center, Chang Gung Memorial Hospital, Taoyüan, Taiwan
| | - Li-Ying Lin
- School of Medicine, College of Medicine, Chang Gung University, Taoyüan, Taiwan
| | - Joseph Tung-Chieh Chang
- School of Medicine, College of Medicine, Chang Gung University, Taoyüan, Taiwan.
- Department of Radiation Oncology, Proton and Radiation Therapy Center, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyüan, Taiwan.
- Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital Linkou Medical Center, Taoyüan, Taiwan.
| | - Kang-Hsing Fan
- School of Medicine, College of Medicine, Chang Gung University, Taoyüan, Taiwan.
- Department of Radiation Oncology, Proton and Radiation Therapy Center, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyüan, Taiwan.
- Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital Linkou Medical Center, Taoyüan, Taiwan.
- Department of Radiation Oncology, New Taipei Municipal Tu-Cheng Hospital, New Taipei City, Taiwan.
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Shi MW, Huang J, Sun Y. Neoadjuvant Immunotherapy for Head and Neck Squamous Cell Carcinoma: Expecting Its Application in Temporal Bone Squamous Cell Carcinoma. Curr Med Sci 2023; 43:213-222. [PMID: 36971976 DOI: 10.1007/s11596-023-2700-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 09/14/2022] [Indexed: 03/29/2023]
Abstract
Temporal bone malignant tumors are characterized by atypical clinical symptoms, and easy recurrence and metastasis. They account for 0.2% of head and neck tumors, and the most common pathological type is squamous cell carcinoma. Patients with squamous cell carcinoma of the temporal bone are often at advanced stages when diagnosed, and lose the chance for surgery. Neoadjuvant immunotherapy has recently been approved as the first-line treatment for refractory recurrent/metastatic squamous cell carcinoma of the head and neck. However, it remains to be determined whether neoadjuvant immunotherapy can be used as the first-line treatment for temporal bone squamous cell carcinoma to reduce the tumor stage before surgery, or as a palliative treatment for patients with unresectable advanced stage carcinoma. The present study reviews the development of immunotherapy and its clinical application in head and neck squamous cell carcinoma, summarizes the treatment of temporal bone squamous cell carcinoma, and prospects the neoadjuvant immunotherapy as the first-line treatment for temporal bone squamous cell carcinoma.
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Affiliation(s)
- Meng-Wen Shi
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Jing Huang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
| | - Yu Sun
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
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Li R, Ye L, Zhu Y, Ding H, Wang S, Ying H, Wu C, Zhou L, Wang X, Tian S. Induction chemotherapy of modified docetaxel, cisplatin, 5-fluorouracil for laryngeal preservation in locally advanced hypopharyngeal squamous cell carcinoma. Head Neck 2022; 44:2018-2029. [PMID: 35915867 DOI: 10.1002/hed.27119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/22/2022] [Accepted: 05/24/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Previous studies have investigated the value of induction chemotherapy (IC) in organ preservation strategies for head and neck cancers. This study evaluated the effectiveness of sequential IC with radiotherapy as a laryngeal preservation strategy for locally advanced hypopharyngeal carcinoma (LAHSCC). METHODS One hundred and forty-two consecutive patients with LAHSCC were retrospectively analyzed who received three IC regimens from 2015 to 2019. RESULTS In the TP (docetaxel plus cisplatin), TPF (TP plus 5-fluorouracil), and TPX (TP plus capecitabine) IC groups, there were 51, 29, and 62 patients, respectively. The primary tumor objective response rates were 51%, 55.2%, and 71%, and the 3-year survival rates with preserved larynx were 36.6%, 31.8%, and 51.2%, respectively (p = 0.03). There was no difference in overall survival and the adverse events were tolerable. CONCLUSIONS The TPX regimen displayed good efficacy and safety, indicating its potential as a therapeutic IC regimen for LAHSCC.
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Affiliation(s)
- Ruichen Li
- Department of Radiation Oncology, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Lulu Ye
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Yi Zhu
- Department of Radiation Oncology, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Hao Ding
- Department of Radiation Oncology, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Shengzi Wang
- Department of Radiation Oncology, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Hongmei Ying
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Chunping Wu
- Shanghai Key Clinical Disciplines of Otorhinolaryngology, Department of Otolaryngology, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Liang Zhou
- Shanghai Key Clinical Disciplines of Otorhinolaryngology, Department of Otolaryngology, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Xiaoshen Wang
- Department of Radiation Oncology, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
| | - Shu Tian
- Department of Radiation Oncology, Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China
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Liu CH, Huang BS, Lin CY, Yeh CH, Lee TH, Wu HC, Chang CH, Chang TY, Huang KL, Jiang JL, Chang JTC, Chang YJ. Head and Neck Cancer Types and Risks of Cervical-Cranial Vascular Complications within 5 Years after Radiation Therapy. J Pers Med 2022; 12:jpm12071060. [PMID: 35887557 PMCID: PMC9317699 DOI: 10.3390/jpm12071060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 11/24/2022] Open
Abstract
Background and purpose: to investigate the frequency of cervical−cranial vascular complications soon after radiation therapy (RT) and identify differences among patients with various types of head and neck cancer (HNC). Methods: We enrolled 496 patients with HNC who had received their final RT dose in our hospital. These patients underwent carotid duplex ultrasound (CDU) for monitoring significant carotid artery stenosis (CAS). Brain imaging were reviewed to detect vertebral, intracranial artery stenosis, or preexisted CAS before RT. Primary outcome was significant CAS at the internal or common carotid artery within first 5 years after RT. We categorized the patients into nasopharyngeal carcinoma (NPC) and non-NPC groups and compared the cumulative occurrence of significant CAS between the groups using Kaplan−Meier and Cox-regression analyses. Results: Compared to the NPC group, the non-NPC group had a higher frequency of significant CAS (12.7% vs. 2.0%) and were more commonly associated with significant CAS after adjusting the covariates (Adjusted hazard ratio: 0.17, 95% confident interval: 0.05−0.57) during the follow-up period. All the non-NPC subtypes (oral cancer/oropharyngeal, hypopharyngeal, and laryngeal cancers) were associated with higher risks of significant CAS than the NPC group (p < 0.001 respectively). Conclusion: Significant CAS was more frequently noted within 5 years of RT among the patients with non-NPC HNC than among the patients with NPC. Scheduled carotid artery surveillance and vascular risk monitoring should be commenced earlier for patients with non-NPC HNC. By contrast, vascular surveillance could be deferred to 5 years after RT completion in NPC patients.
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Affiliation(s)
- Chi-Hung Liu
- Stroke Center, Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33333, Taiwan; (C.-H.L.); (T.-H.L.); (H.-C.W.); (C.-H.C.); (T.-Y.C.); (K.-L.H.); (J.-L.J.)
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 33333, Taiwan; (B.-S.H.); (C.-Y.L.); (C.-H.Y.)
| | - Bing-Shen Huang
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 33333, Taiwan; (B.-S.H.); (C.-Y.L.); (C.-H.Y.)
- Department of Radiation Oncology, Proton and Radiation Therapy Center, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan 33333, Taiwan
| | - Chien-Yu Lin
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 33333, Taiwan; (B.-S.H.); (C.-Y.L.); (C.-H.Y.)
- Department of Radiation Oncology, Proton and Radiation Therapy Center, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan 33333, Taiwan
- Taipei Chang Gung Head & Neck Oncology Group, Chang Gung Memorial Hospital Linkou Medical Center, Taoyuan 33333, Taiwan
- Particle Physics and Beam Delivery Core Laboratory of Institute for Radiological Research, Chang Gung Memorial Hospital, Chang Gung University, Linkou Medical Center, Taoyuan 33333, Taiwan
| | - Chih-Hua Yeh
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 33333, Taiwan; (B.-S.H.); (C.-Y.L.); (C.-H.Y.)
- Department of Neuroradiology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33333, Taiwan
| | - Tsong-Hai Lee
- Stroke Center, Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33333, Taiwan; (C.-H.L.); (T.-H.L.); (H.-C.W.); (C.-H.C.); (T.-Y.C.); (K.-L.H.); (J.-L.J.)
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 33333, Taiwan; (B.-S.H.); (C.-Y.L.); (C.-H.Y.)
| | - Hsiu-Chuan Wu
- Stroke Center, Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33333, Taiwan; (C.-H.L.); (T.-H.L.); (H.-C.W.); (C.-H.C.); (T.-Y.C.); (K.-L.H.); (J.-L.J.)
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 33333, Taiwan; (B.-S.H.); (C.-Y.L.); (C.-H.Y.)
| | - Chien-Hung Chang
- Stroke Center, Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33333, Taiwan; (C.-H.L.); (T.-H.L.); (H.-C.W.); (C.-H.C.); (T.-Y.C.); (K.-L.H.); (J.-L.J.)
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 33333, Taiwan; (B.-S.H.); (C.-Y.L.); (C.-H.Y.)
| | - Ting-Yu Chang
- Stroke Center, Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33333, Taiwan; (C.-H.L.); (T.-H.L.); (H.-C.W.); (C.-H.C.); (T.-Y.C.); (K.-L.H.); (J.-L.J.)
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 33333, Taiwan; (B.-S.H.); (C.-Y.L.); (C.-H.Y.)
| | - Kuo-Lun Huang
- Stroke Center, Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33333, Taiwan; (C.-H.L.); (T.-H.L.); (H.-C.W.); (C.-H.C.); (T.-Y.C.); (K.-L.H.); (J.-L.J.)
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 33333, Taiwan; (B.-S.H.); (C.-Y.L.); (C.-H.Y.)
| | - Jian-Lin Jiang
- Stroke Center, Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33333, Taiwan; (C.-H.L.); (T.-H.L.); (H.-C.W.); (C.-H.C.); (T.-Y.C.); (K.-L.H.); (J.-L.J.)
| | - Joseph Tung-Chieh Chang
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 33333, Taiwan; (B.-S.H.); (C.-Y.L.); (C.-H.Y.)
- Department of Radiation Oncology, Proton and Radiation Therapy Center, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan 33333, Taiwan
- Taipei Chang Gung Head & Neck Oncology Group, Chang Gung Memorial Hospital Linkou Medical Center, Taoyuan 33333, Taiwan
- Correspondence: (J.T.-C.C.); (Y.-J.C.)
| | - Yeu-Jhy Chang
- Stroke Center, Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 33333, Taiwan; (C.-H.L.); (T.-H.L.); (H.-C.W.); (C.-H.C.); (T.-Y.C.); (K.-L.H.); (J.-L.J.)
- Department of Medicine, College of Medicine, Chang Gung University, Taoyuan 33333, Taiwan; (B.-S.H.); (C.-Y.L.); (C.-H.Y.)
- Chang Gung Medical Education Research Centre, Taoyuan 33333, Taiwan
- Correspondence: (J.T.-C.C.); (Y.-J.C.)
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Current Updates on Cancer-Causing Types of Human Papillomaviruses (HPVs) in East, Southeast, and South Asia. Cancers (Basel) 2021; 13:cancers13112691. [PMID: 34070706 PMCID: PMC8198295 DOI: 10.3390/cancers13112691] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/23/2021] [Accepted: 05/25/2021] [Indexed: 12/13/2022] Open
Abstract
Simple Summary Among the over 200 human papillomavirus (HPV) genotypes identified, approximately 15 of them can cause human cancers. In this review, we provided an updated overview of the distribution of cancer-causing HPV genotypes by countries in East, Southeast and South Asia. Besides the standard screening and treatment methods employed in these regions, we unravel HPV detection methods and therapeutics utilised in certain countries that differ from other part of the world. The discrepancies may be partly due to health infrastructure, socio-economy and cultural diversities. Additionally, we highlighted the area lack of study, particularly on the oncogenicity of HPV genotype variants of high prevalence in these regions. Abstract Human papillomavirus (HPV) infection remains one of the most prominent cancer-causing DNA viruses, contributing to approximately 5% of human cancers. While association between HPV and cervical cancers has been well-established, evidence on the attribution of head and neck cancers (HNC) to HPV have been increasing in recent years. Among the cancer-causing HPV genotypes, HPV16 and 18 remain the major contributors to cancers across the globe. Nonetheless, the distribution of HPV genotypes in ethnically, geographically, and socio-economically diverse East, Southeast, and South Asia may differ from other parts of the world. In this review, we garner and provide updated insight into various aspects of HPV reported in recent years (2015–2021) in these regions. We included: (i) the HPV genotypes detected in normal cancers of the uterine cervix and head and neck, as well as the distribution of the HPV genotypes by geography and age groups; (ii) the laboratory diagnostic methods and treatment regimens used within these regions; and (iii) the oncogenic properties of HPV prototypes and their variants contributing to carcinogenesis. More importantly, we also unveil the similarities and discrepancies between these aspects, the areas lacking study, and the challenges faced in HPV studies.
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9
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Lee TL, Wei PY, Yang MH, Chang PMH, Wang LW, Tai SK. Tongue conservation treatment for oral tongue squamous cell carcinoma with induction chemotherapy, surgery, and risk-adapted adjuvant therapy: A phase II trial. Cancer Rep (Hoboken) 2021; 5:e1456. [PMID: 34051137 PMCID: PMC8842695 DOI: 10.1002/cnr2.1456] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/29/2021] [Accepted: 04/28/2021] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND To assess the feasibility of tongue conservation treatment with induction chemotherapy (ICT), tongue conservation surgery, and risk-adapted postoperative adjuvant therapy in oral tongue squamous cell carcinoma (OTSCC). METHODS Patients with newly diagnosed OTSCC cT2-4 N0-2 M0 were recruited. The ICT with a regimen of docetaxel, cisplatin, and oral tegafur/uracil (DCU) was administrated every 21 days. After the first cycle of ICT (DCU1), patients with a more than 30% decrease in the longest diameter of primary tumor underwent a second cycle of ICT (DCU2). Tongue conservation surgery was performed after ICT, and risk-adapted adjuvant therapy was organized based on pathological features. RESULTS From July 2011 to December 2015, a total of 23 patients were enrolled, 87% of whom were classified as stage III-IV. Clinical responders to DCU1 and DCU2 were determined in 90.5% (19/21) and 88.2% (15/17) of patients. Tongue conservation surgery was performed in 16 responders to ICT. Only one patient had a positive margin (6.3%), and a complete pathologic response was achieved in eight patients (50%). Only one patient developed local recurrence after a median follow-up of 58.6 months (range, 7.9-105.2). The 5-year overall survival (0% vs. 87.5%, P = 0.001) and disease-specific survival (0% vs. 93.3%, P = 0.000) were significantly different between the DCU1 nonresponders and responders. CONCLUSION Tongue conservation treatment with ICT, followed by conservation surgery and risk-adapted adjuvant therapy, is feasible for patients with OTSCC who are good responders to ICT. However, the outcomes of nonresponders are dismal. Further study in a larger patient population is warranted.
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Affiliation(s)
- Tsung-Lun Lee
- Department of Otolaryngology, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Pei-Yin Wei
- Department of Otolaryngology, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Otolaryngology, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Muh-Hwa Yang
- Infection and Immunity Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Oncology, Division of Medical Oncology, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Peter Mu-Hsin Chang
- Oncology, Division of Medical Oncology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ling-Wei Wang
- Oncology, Division of Radiation Oncology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shyh-Kuan Tai
- Department of Otolaryngology, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Otolaryngology, Taipei Veterans General Hospital, Taipei, Taiwan.,Infection and Immunity Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
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10
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Liu CH, Chang JTC, Lee TH, Chang PY, Chang CH, Wu HC, Chang TY, Huang KL, Lin CY, Fan KH, Chu CL, Chang YJ. Total plaque score helps to determine follow-up strategy for carotid artery stenosis progression in head and neck cancer patients after radiation therapy. PLoS One 2021; 16:e0246684. [PMID: 33577590 PMCID: PMC7880459 DOI: 10.1371/journal.pone.0246684] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 01/22/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND To identify predictors of carotid artery stenosis (CAS) progression in head and neck cancer (HNC) patients after radiation therapy (RT). METHODS We included 217 stroke-naïve HNC patients with mild carotid artery stenosis after RT in our hospital. These patients underwent annual carotid duplex ultrasound (CDU) studies to monitor CAS progression. CAS progression was defined as the presence of ≥50% stenosis of the internal/common carotid artery on follow-up CDU. We recorded total plaque score (TPS) and determined the cut-off TPS to predict CAS progression. We categorized patients into high (HP) and low plaque (LP) score groups based on their TPS at enrolment. We analyzed the cumulative events of CAS progression in the two groups. RESULTS The TPS of the CDU study at enrolment was a significant predictor for CAS progression (adjusted odds ratio [aOR] = 1.69, p = 0.002). The cut-off TPS was 7 (area under the curve: 0.800), and a TPS ≥ 7 strongly predicted upcoming CAS progression (aOR = 41.106, p = 0.002). The HP group had a higher risk of CAS progression during follow-up (adjusted hazard ratio = 6.15; 95% confident interval: 2.29-16.53) in multivariable Cox analysis, and also a higher trend of upcoming ischemic stroke (HP vs. LP: 8.3% vs. 2.2%, p = 0.09). CONCLUSIONS HNC patients with a TPS ≥ 7 in any CDU study after RT are susceptible to CAS progression and should receive close monitoring within the following 2 years.
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Affiliation(s)
- Chi-Hung Liu
- Stroke Center and Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center and College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Joseph Tung-Chieh Chang
- Department of Radiation Oncology, Proton and Radiation Therapy Center, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Taipei Chang Gung Head & Neck Oncology Group, Chang Gung Memorial Hospital Linkou Medical Center, Taoyuan, Taiwan.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Tsong-Hai Lee
- Stroke Center and Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center and College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Pi-Yueh Chang
- Department of Laboratory Medicine, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan.,Department of Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan, Taiwan
| | - Chien-Hung Chang
- Stroke Center and Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center and College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hsiu-Chuan Wu
- Stroke Center and Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center and College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ting-Yu Chang
- Stroke Center and Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center and College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Kuo-Lun Huang
- Stroke Center and Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center and College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chien-Yu Lin
- Department of Radiation Oncology, Proton and Radiation Therapy Center, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Taipei Chang Gung Head & Neck Oncology Group, Chang Gung Memorial Hospital Linkou Medical Center, Taoyuan, Taiwan.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Particle Physics and Beam Delivery Core Laboratory of Institute for Radiological Research, Chang Gung University/Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | - Kang-Hsing Fan
- Department of Radiation Oncology, Proton and Radiation Therapy Center, Chang Gung Medical Foundation, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Taipei Chang Gung Head & Neck Oncology Group, Chang Gung Memorial Hospital Linkou Medical Center, Taoyuan, Taiwan.,Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chan-Lin Chu
- Stroke Center and Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center and College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yeu-Jhy Chang
- Stroke Center and Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center and College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Chang Gung Medical Education Research Centre, Taoyuan, Taiwan
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11
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Hypothyroidism and risks of cerebrovascular complications among patients with head and neck cancer after radiotherapy. BMC Neurol 2021; 21:30. [PMID: 33468088 PMCID: PMC7814701 DOI: 10.1186/s12883-021-02047-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 01/04/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Hypothyroidism (HT) and carotid artery stenosis (CAS) are complications of radiotherapy (RT) in patients with head and neck cancer (HNC). The impact of post-RT HT on CAS progression remains unclear. METHODS Between 2013 and 2014, HNC patients who had ever received RT and were under regular follow-up in our hospital were initially screened. Patients were categorized into euthyroid (EU) and HT groups. Details of RT and HNC were recorded. Total plaque scores and degrees of CAS were measured during annual extracranial duplex follow-up. Patients were monitored for CAS progression to > 50 % stenosis or ischemic stroke (IS). Cumulative time to CAS progression and IS between the 2 groups were compared. Data were further analyzed based on the use or nonuse of thyroxine of the HT group. RESULTS 333 HNC patients with RT history were screened. Finally, 216 patients were recruited (94 and 122 patients in the EU and HT groups). Patients of the HT group received higher mean RT doses (HT vs. EU; 7021.55 ± 401.67 vs. 6869.69 ± 425.32 centi-grays, p = 0.02). Multivariate Cox models showed comparable CAS progression (p = 0.24) and IS occurrence (p = 0.51) between the 2 groups. Moreover, no significant difference was observed in time to CAS progression (p = 0.49) or IS (p = 0.31) among patients with EU and HT using and not using thyroxine supplement. CONCLUSIONS Our results did not demonstrate significant effects of HT and thyroxine supplementation on CAS progression and IS incidence in patients with HNC after RT.
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12
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Esfahani RE, Zahedi P, Zarghami R. 5-Fluorouracil-loaded poly(vinyl alcohol)/chitosan blend nanofibers: morphology, drug release and cell culture studies. IRANIAN POLYMER JOURNAL 2020. [DOI: 10.1007/s13726-020-00882-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Taira K, Fujiwara K, Fukuhara T, Koyama S, Takeuchi H. The effect of Hangeshashinto on Oral Mucositis Caused by Induction Chemotherapy in Patients with Head and Neck Cancer. Yonago Acta Med 2020; 63:183-187. [PMID: 32884437 DOI: 10.33160/yam.2020.08.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 07/06/2020] [Indexed: 01/09/2023]
Abstract
Background Oral mucositis (OM) is a side effect of chemotherapy in head and neck cancer. Severe OM often has a large impact on quality of life. Therefore, the treatment of OM during chemotherapy is very important. It was recently reported that Hangeshashinto (TJ-14), a Japanese traditional medicine (Kampo), is effective for OM caused by fluorinated pyrimidine-based agents used in colon cancer. We investigated the efficacy of TJ-14 for OM. Methods We enrolled patients with head and neck cancer who were treated with induction chemotherapy between September 2014 and March 2016. In this double-blind trial, patients were randomly assigned to the TJ-14 group or placebo group. Patients were instructed to dissolve 2.5 g of TJ-14 or placebo in 100 ml of drinking water, rinse their mouths with the solution for 30 s and then spit it out. They were not allowed to eat anything for 30 minutes before or after using the mouthwash. Results The incidence of ≥ grade 2 OM was 37.5% (three patients) in the TJ-14 group and 50.0% (four patients) in the placebo group, with no significant difference between the two groups. The mean day of onset was 9.7 in the TJ-14 group and 6.7 in the placebo group. The mean duration of ≥ grade 2 OM was 1.3 days in the TJ-14 group and 3.7 days in the placebo group. Thus TJ-14 significantly reduced the duration of ≥ grade 2 OM. Conclusion Treatment of OM with TJ-14 was associated with a statistically significant reduction in the duration of ≥ grade 2 OM compared to placebo. Gargling with TJ-14 is a safe and effective method of administering the drug to patients with head and neck cancer.
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Affiliation(s)
- Kenkichiro Taira
- Division of Otolaryngology, Head and Neck Surgery, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Kazunori Fujiwara
- Division of Otolaryngology, Head and Neck Surgery, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Takahiro Fukuhara
- Division of Otolaryngology, Head and Neck Surgery, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Satoshi Koyama
- Division of Otolaryngology, Head and Neck Surgery, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Hiromi Takeuchi
- Division of Otolaryngology, Head and Neck Surgery, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
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14
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Hsieh CY, Lein MY, Yang SN, Wang YC, Lin YJ, Lin CY, Hua CH, Tsai MH, Lin CC. Dose-dense TPF induction chemotherapy for locally advanced head and neck cancer: a phase II study. BMC Cancer 2020; 20:832. [PMID: 32873270 PMCID: PMC7465725 DOI: 10.1186/s12885-020-07347-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 08/26/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Phase 3 studies suggest that induction chemotherapy (ICT) of cisplatin and 5-fluorouracil plus docetaxel (TPF) is effective but toxic for patients with squamous-cell carcinoma of the head and neck (SCCHN). Dose-dense chemotherapy may yield favorable outcomes compared with standard-dose chemotherapy, yet the optimal induction regimen remains undefined. We assessed the efficacy and tolerability of biweekly dose-dense TPF ICT in patients with SCCHN. METHODS In this prospective phase II study, We enrolled patients with stage III/IV (AJCC 7th edition) unresectable squamous cell carcinoma of head and neck cancer. Patients received dose-dense TPF (ddTPF) with cisplatin and docetaxel 50 mg/m2 on day 1, leucovorin 250 mg/m2 on day1, followed by 48-h continuous infusion of 2500 mg/m2 of 5-fluorouracil on day 1 and 2, every 2 weeks for 6 cycles followed by radiotherapy. The primary endpoint was the response rate (RR) after ICT. RESULTS Fifty-eight patients were enrolled from June 2014 to September 2015. Overall RR after ICT was 89.6% [complete response (CR), 31%; partial response (PR), 58.6%]. Grade 3/4 neutropenia, mucositis, and diarrhea incidences were 25.9, 1.7, and 1.7%, respectively. 94.8% of patients completed all treatment courses of ICT without dose reduction. The 3-year overall survival (OS) was 54.3% (95%CI: 39.7 to 66.8%) and progression-free survival (PFS) was 34.3% (95%CI: 22.0 to 46.9%). Multivariate analysis showed that CR after ICT is an independent prognostic factor for OS and PFS. CONCLUSIONS Six cycles of ddTPF is an active, well-tolerated induction regimen for patients with SCCHN. The presence of CR after ICT predicted long-term survival. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04397341 , May 21, 2020, retrospectively registered.
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Affiliation(s)
- Ching-Yun Hsieh
- Division of Hematology and Oncology, Department of internal medicine, China Medical University Hospital, China Medical University, 2 Yude Rd, North District, Taichung, 404, Taiwan
| | - Ming-Yuh Lein
- Division of Hematology and Oncology, Department of internal medicine, China Medical University Hospital, China Medical University, 2 Yude Rd, North District, Taichung, 404, Taiwan
| | - Shih-Neng Yang
- Division of Radiation Oncology, China Medical University Hospital, China Medical University, Taichung, 404, Taiwan
| | - Yao-Ching Wang
- Division of Radiation Oncology, China Medical University Hospital, China Medical University, Taichung, 404, Taiwan
| | - Yin-Jun Lin
- Division of Radiation Oncology, China Medical University Hospital, China Medical University, Taichung, 404, Taiwan
| | - Chen-Yuan Lin
- Division of Hematology and Oncology, Department of internal medicine, China Medical University Hospital, China Medical University, 2 Yude Rd, North District, Taichung, 404, Taiwan
| | - Chun-Hung Hua
- Department of Otorhinolaryngology, China Medical University Hospital, China Medical University, Taichung, 404, Taiwan
| | - Ming-Hsul Tsai
- Department of Otorhinolaryngology, China Medical University Hospital, China Medical University, Taichung, 404, Taiwan
| | - Ching-Chan Lin
- Division of Hematology and Oncology, Department of internal medicine, China Medical University Hospital, China Medical University, 2 Yude Rd, North District, Taichung, 404, Taiwan. .,Graduate Institute of Biomedical Sciences, China Medical University, Taichung, 404, Taiwan.
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Nouman M, Haider G, Bukhari N, Yousuf A, Nouman R, Shaikh MR, Hussain S, Pavan B, Rahool R, Memon P, Zahoor S, Mehar K, Sami A. Response Rate of Cisplatin Plus Docetaxel as Primary Treatment in Locally Advanced Head and Neck Carcinoma (Squamous Cell Types). Asian Pac J Cancer Prev 2020; 21:825-830. [PMID: 32212813 PMCID: PMC7437326 DOI: 10.31557/apjcp.2020.21.3.825] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Indexed: 12/09/2022] Open
Abstract
OBJECTIVE To evaluate the response rate of Cisplatin plus Docetaxel in the treatment of locally advanced head and neck squamous cell carcinomas (HNSCC) at a tertiary care hospital in Karachi, Pakistan. MATERIALS AND METHODS It was a longitudinal study, conducted at the Department of Medical Oncology, Jinnah Postgraduate Medical Center, Karachi, Pakistan from December 2018 to June 2019. One hundred patients of age 14-66 years of age of either gender with histologically proven Squamous Cell Carcinoma of Head and Neck, Stage III and IV (locally advanced) with no distant metastases were included in the study. Patients who were declared unresectable by the otolaryngologist and those with delayed appointment for radiation were given 3 cycles of Induction Chemotherapy with Cisplatin and Docetaxel, both at a dose of 75mg/m2 3 weekly. After 3 cycles, CT scan was repeated to assess the clinical response. Those patients who had partial or complete response as per RECIST criteria were re-assessed by the otolaryngologist and were planned for surgery if disease became resectable while other patients were referred for Concurrent Chemo-Radiation Therapy (CCRT). SPSS version 23 was used to analyze data. RESULTS The partial response was achieved in majority of the patients after Induction Chemotherapy with Docetaxel and Cisplatin (62%) with a complete response in 12 %. However, 22% showed progression of the disease, and 4% showed stable disease. The most frequent side effects observed were diarrhea (62%) and neutropenia (57%). CONCLUSION Induction chemotherapy with Cisplatin and Docetaxel is a promising regimen with good response and favorable toxicity profile and can be considered as a potentially effective outpatient regimen for locally advanced squamous cell carcinoma of head and neck.
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Affiliation(s)
- Maryum Nouman
- Department of Medical Oncology, Jinnah Postgraduate Medical Center, Karachi, Pakistan
| | - Ghulam Haider
- Department of Medical Oncology, Jinnah Postgraduate Medical Center, Karachi, Pakistan
| | - Neelma Bukhari
- Department of Medical Oncology, Jinnah Postgraduate Medical Center, Karachi, Pakistan
| | - Aveen Yousuf
- Department of Medical Oncology, Jinnah Postgraduate Medical Center, Karachi, Pakistan
| | - Rabeea Nouman
- Department of Medical Oncology, Jinnah Postgraduate Medical Center, Karachi, Pakistan
| | - Mehwish Roshan Shaikh
- Department of Medical Oncology, Jinnah Postgraduate Medical Center, Karachi, Pakistan
| | - Shahid Hussain
- Department of Medical Oncology, Jinnah Postgraduate Medical Center, Karachi, Pakistan
| | - Bhunisha Pavan
- Department of Medical Oncology, Jinnah Postgraduate Medical Center, Karachi, Pakistan
| | - Raja Rahool
- Department of Medical Oncology, Jinnah Postgraduate Medical Center, Karachi, Pakistan
| | - Paras Memon
- Department of Medical Oncology, Jinnah Postgraduate Medical Center, Karachi, Pakistan
| | - Saima Zahoor
- Department of Medical Oncology, Jinnah Postgraduate Medical Center, Karachi, Pakistan
| | - Khalil Mehar
- Department of Medical Oncology, Jinnah Postgraduate Medical Center, Karachi, Pakistan
| | - Abdus Sami
- Department of Medical Oncology, Jinnah Postgraduate Medical Center, Karachi, Pakistan
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Sun Y, Guo W, Bai Y, Ge M, Hu C, Wu S, Hao J, Gao M, Pan J, Dong P, Wu Y, Liang H, Wei Q, Zhong M, Lu T. Neoadjuvant dose-modified docetaxel in squamous cell carcinoma of the head and neck: A phase 3 study. Oral Dis 2020; 26:285-294. [PMID: 31830347 DOI: 10.1111/odi.13252] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 10/28/2019] [Accepted: 11/12/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To evaluate the efficacy and safety of dose-modified docetaxel plus cisplatin and 5-fluorouracil (TPF) in Chinese patients with squamous cell carcinoma of the head and neck (SCCHN). MATERIALS AND METHODS This Phase III, open-label, multi-center study included Chinese adults with previously untreated TNM Stage III or IV SCCHN (NCT00995293). Patients were randomized (1:1) to induction chemotherapy with TPF (docetaxel 60 mg/m2 and cisplatin 60 mg/m2 on day 1 and 5-FU 750 mg/m2 per day continuous IV infusion on days 1-5) or PF (cisplatin 75 mg/m2 on day 1 and 5-FU 750 mg/m2 per day on days 1-5) every 3 weeks for 3-4 cycles. The primary endpoint was progression-free survival (PFS). RESULTS Median PFS in the TPF (n = 108) and PF (n = 111) groups was 400 days and 342 days (HR = 0.75; 95% CI, 0.53─1.06; p = .227), respectively. Overall response rate was higher for TPF versus PF (76.3% vs. 52.9%; p = .001), although this equalized following radiotherapy (75.0% vs. 73.9%). In the TPF and PF groups, ≥1 treatment-emergent adverse event was experienced by 104 (94.5%) and 110 (93.2%) patients, respectively. CONCLUSION Adding dose-modified docetaxel to PF did not significantly improve PFS but may increase anti-tumor activity in Chinese patients with locally advanced SCCHN.
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Affiliation(s)
- Yan Sun
- Department of Radiotherapy, Peking University Cancer Hospital & Institute, Beijing, China
| | - Wei Guo
- Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuxian Bai
- Department of Medicine, Affiliated Tumor Hospital of Harbin Medical University, Harbin, China
| | - Minghua Ge
- Department of Head and Neck Surgery, Zhejiang Cancer Hospital, Hangzhou, China
| | - Chaosu Hu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Shaoxiong Wu
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Junfang Hao
- Department of Radiology, Shandong Tumor Hospital & Institute, Jinan, China
| | - Ming Gao
- Department of Head and Neck Tumor, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China
| | - Jianji Pan
- Department of Radiation Oncology, Fujian Provincial Cancer Hospital, Fuzhou, China
| | - Pin Dong
- Department of Otolaryngology, Head and Neck Surgery, Shanghai Jiao Tong University Affiliated to Shanghai First People's Hospital, Shanghai, China
| | - Yunong Wu
- Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Houjie Liang
- Department of Oncology and Southwest Cancer Center, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Qichun Wei
- Department of Radiation Oncology, The Second Affiliated Hospital, Cancer Institute, Zhejiang University School of Medicine, Hangzhou, China
| | - Meizuo Zhong
- Department of Oncology, Xiangya Hospital, Central South University, Changsha, China
| | - Taixiang Lu
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China
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17
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Bano N, Najam R. Histopathological and biochemical assessment of liver damage in albino Wistar rats treated with cytotoxic platinum compounds in combination with 5-fluorouracil. Arch Med Sci 2019; 15:1092-1103. [PMID: 31360204 PMCID: PMC6657249 DOI: 10.5114/aoms.2019.86064] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2016] [Accepted: 04/20/2017] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Chemotherapy-induced hepatotoxicity in cancer patients often results in cessation of therapy and prevents completion of the treatment plan. The entire pathological description and comparison of hepatic damage induced by oxaliplatin or cisplatin in combination with 5-fluorouracil (5-FU) is not adequately reported. This study reports histopathological assessment of hepatotoxicity of a non-tumor bearing organ in rats treated with 5-FU, oxaliplatin and cisplatin (CDDP). MATERIAL AND METHODS Changes in hepatic biochemical profile of 36 albino Wistar rats equally divided into different treatment groups with cisplatin, oxaliplatin, 5-FU, cisplatin plus 5-FU and oxaliplatin plus 5-FU were compared with a group of rats treated with normal saline (control group). At the end of treatments, hepatic tissues were taken for blinded histopathological assessment by light microscopy. RESULTS Serum glutamate pyruvate transaminase and serum glutamic-oxaloacetic transaminase levels were disrupted in rats treated with 5-FU alone and in combination with cisplatin or oxaliplatin. Hepatocellular injuries, e.g. sinusoidal dilatation, venular fibrosis and centrilobular vein injury induced by oxaliplatin were intensified in treatment groups also receiving 5-FU, manifested as massive architectural distortion, periportal fibrosis, hepatic cord degeneration and cystic lesions with demarcated margins. Hepatocellular degenerative sequence and abnormally dilated central hepatic vein was shown in the cisplatin plus 5-FU treatment group with hemorrhage and blood filled sinusoids. CONCLUSIONS Oxaliplatin-associated cystic lesions were intensified in rats treated with a combination of 5-FU and oxaliplatin.
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Affiliation(s)
- Nusrat Bano
- Department of Pharmacology, King Saud Bin Abdulaziz University For Health Sciences, Jeddah, Saudi Arabia
| | - Rahila Najam
- Department of Pharmacology, University of Karachi, Karachi, Saudi Arabia
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18
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Khalil A, Jameson MJ. Downregulation of IGF1R Expression Inhibits Growth and Enhances Cisplatin Sensitivity of Head and Neck Squamous Cell Carcinoma Cells In Vitro. Discov Oncol 2018; 10:11-23. [PMID: 30350263 DOI: 10.1007/s12672-018-0352-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 10/03/2018] [Indexed: 01/07/2023] Open
Abstract
A lentivirus-mediated doxycycline-inducible pTRIPZ shRNAmir plasmid targeting IGF1R transcript was transfected into two head and neck squamous cell carcinoma (HNSCC) cell lines to silence IGF1R expression and to assess the effect of its downregulation on cisplatin sensitivity in vitro. In Cal27-regIGF1R and SCC25-regIGF1R cell lines, IGF1R protein expression was reduced by more than 90% after 72 h of incubation with doxycycline. Both basal and IGF-stimulated pIGF1R, pAKT, and pERK were significantly reduced, without influence on total AKT and ERK expression. Downregulation of the IGF1R was associated with decreased proliferation and cell viability in both cell lines. Reduced IGF1R expression was also associated with increased sub-G0/G1-phase and G0/G1-phase populations and decreased S-phase and G2/M-phase populations. IGF1R downregulation enhanced sensitivity to cisplatin with decrease of cisplatin IC50 from 15 to 7.1 in Cal27-regIGF1R cells and from 11 to 6.3 in SCC25-regIGF1R cells. Cisplatin exhibited increased pro-apoptotic activity by annexin V staining and PARP cleavage in both cells lines when cultured in doxycycline. Thus, in two HNSCC cell lines in vitro, reduced IGF1R expression results in reduced growth rate and increased sensitivity to cisplatin. Thus, IGF1R downregulation and/or inhibition may serve as a useful adjunct to platinum-based cytotoxic chemotherapy.
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Affiliation(s)
- Ashraf Khalil
- Department of Otolaryngology - Head and Neck Surgery, Division of Head and Neck Oncologic and Microvascular Surgery, University of Virginia Health System, Charlottesville, VA, USA. .,Department of Biochemistry and Molecular Diagnostics, National Liver Institute, Menoufiya University, Shebin El Kom, Egypt.
| | - Mark J Jameson
- Department of Otolaryngology - Head and Neck Surgery, Division of Head and Neck Oncologic and Microvascular Surgery, University of Virginia Health System, Charlottesville, VA, USA
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19
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Matuschek C, Haussmann J, Bölke E, Gripp S, Schuler PJ, Tamaskovics B, Gerber PA, Djiepmo-Njanang FJ, Kammers K, Plettenberg C, Anooshahr B, Orth K, Budach W. Accelerated vs. conventionally fractionated adjuvant radiotherapy in high-risk head and neck cancer: a meta-analysis. Radiat Oncol 2018; 13:195. [PMID: 30286777 PMCID: PMC6172789 DOI: 10.1186/s13014-018-1133-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 09/14/2018] [Indexed: 12/16/2022] Open
Abstract
Background Adjuvant radiotherapy in advanced head and neck squamous cell cancer (HNSCC) reduces the risk of local-regional failure and most likely increases the survival rate. Patients at high risk for tumor recurrence may benefit from more aggressive altered fractionation schedules in order to reduce the overall time from surgery to completion of radiotherapy. Here, we reviewed the results of six randomized trials addressing the above hypothesis. Methods In the six trials of interest, a total of 988 patients with locally advanced HNSCC were randomly assigned to receive either accelerated or conventionally fractionated adjuvant radiotherapy. Hazard ratios (HR) were extracted from available publications for local-regional control, distant metastasis as well as overall-, cancer specific- and disease-free survival. Meta-analysis of the effect sizes was performed using fixed and random effect models. Acute and late side effects were categorized and summarized for comparison. Results Accelerated radiotherapy did not improve the loco-regional control (n = 988, HR = 0.740, CI = 0.48–1.13, p = 0.162), progression-free survival (HR = 0.89, CI = 0.76–1.04, p = 0.132) or overall survival (HR = 0.88, CI = 0.75–1.04, p = 0.148) significantly. Acute confluent mucositis occurred with significant higher frequency with accelerated radiotherapy. Late side effects did not differ significantly in either group. Conclusion Accelerated radiotherapy does not result in a significant improvement of loco-regional control or overall survival in high-risk patients. Acute but not late radiation toxicity were more frequent with the accelerated RT technique. In clinical practice accelerated postoperative radiation therapy might be a suitable option only for a subset of patients.
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Affiliation(s)
- Christiane Matuschek
- Department of Radiotherapy and Radiooncology, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Jan Haussmann
- Department of Radiotherapy and Radiooncology, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Edwin Bölke
- Department of Radiotherapy and Radiooncology, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225, Dusseldorf, Germany.
| | - Stephan Gripp
- Department of Radiotherapy and Radiooncology, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Patrick J Schuler
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Ulm University Medical Center, Ulm, Germany
| | - Bálint Tamaskovics
- Department of Radiotherapy and Radiooncology, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Peter Arne Gerber
- Department of Dermatology, Medical Faculty Heinrich Heine University Dusseldorf, Dusseldorf, Germany
| | - Freddy-Joel Djiepmo-Njanang
- Department of Radiotherapy and Radiooncology, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Kai Kammers
- Division of Biostatistics and Bioinformatics, Department of Oncology, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Christian Plettenberg
- Department of Oto-Rhino-Laryngology, Head and Neck Surgery, Heinrich Heine University Dusseldorf, Dusseldorf, Germany
| | | | - Klaus Orth
- Department of Radiotherapy and Radiooncology, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225, Dusseldorf, Germany
| | - Wilfried Budach
- Department of Radiotherapy and Radiooncology, Medical Faculty, Heinrich Heine University, Moorenstr. 5, 40225, Dusseldorf, Germany
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20
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Bai C, Ichinose M, Lee SH, Lee KH, Jöns O, Bothner U, Zhao Y, Buhl R. Lung function and long-term safety of tiotropium/olodaterol in East Asian patients with chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis 2017; 12:3329-3339. [PMID: 29200840 PMCID: PMC5701005 DOI: 10.2147/copd.s137719] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND PURPOSE While the efficacy and safety of combined tiotropium and olodaterol in patients with COPD was established in a large clinical trial program, it is important to assess whether clinical data can be applied to geographic patient groups, particularly for East Asian patients who may have a different phenotypic profile to the global trial population. This study aimed to compare the lung function and safety profiles of tiotropium/olodaterol and monocomponents in East Asian and global populations from the TONADO® trials. MATERIALS AND METHODS In the replicate, double-blind, parallel-group, active-controlled, randomized, 52-week, Phase III TONADO studies, patients received tiotropium/olodaterol, tiotropium, or olodaterol. We assessed the forced expiratory volume in 1 second (FEV1) area under the curve from 0 to 3 hours (AUC0-3) response and trough FEV1 response at 24 weeks for the approved doses, tiotropium/olodaterol 5/5 μg, tiotropium 5 μg, and olodaterol 5 μg. Treatment-emergent adverse events were recorded throughout treatment and ≤21 days after study medication. RESULTS In the East Asian population, 1,152 patients were randomized (5,163 overall). After 24 weeks, FEV1 AUC0-3 and trough FEV1 responses were greater (P<0.0001) with tiotropium/olodaterol 5/5 μg in both populations versus tiotropium or olodaterol. The East Asian population showed slightly greater trough FEV1 treatment differences between tiotropium/olodaterol 5/5 μg and tiotropium compared to the overall population. Generally, no increase in adverse events was seen with tiotropium/olodaterol 5/5 μg compared to tiotropium and olodaterol in either population. CONCLUSION The efficacy and safety profile of tiotropium/olodaterol 5/5 μg has been demonstrated for both East Asian and global populations.
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Affiliation(s)
- Chunxue Bai
- Department of Pulmonary Medicine, Shanghai Respiratory Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Masakazu Ichinose
- Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Sang Haak Lee
- Department of Internal Medicine, St Paul’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Kwan Ho Lee
- Department of Internal Medicine, Yeungnam University Medical Center, Daegu, South Korea
| | - Olaf Jöns
- Department of Medicine TA Respiratory Diseases
| | - Ulrich Bothner
- Department of Pharmacovigilance, Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim, Germany
| | - Yihua Zhao
- Department of Biostatistics and Data Sciences, Boehringer Ingelheim Pharmaceuticals, Inc., Ridgefield, CT, USA
| | - Roland Buhl
- Pulmonary Department, Mainz University Hospital, Mainz, Germany
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21
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Kanagalingam J, Chopra A, Hong MH, Ibrahim W, Villalon A, Lin JC. Povidone-iodine for the management of oral mucositis during cancer therapy. Oncol Rev 2017; 11:341. [PMID: 28959380 PMCID: PMC5607850 DOI: 10.4081/oncol.2017.341] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 08/21/2017] [Indexed: 12/27/2022] Open
Abstract
Oral mucositis (OM) is a common and often dose-limiting side effect of cancer therapy. Povidone iodine (PVP-I) formulations have been shown to decrease the incidence and severity of OM, but the relevance of these findings remains unclear. The objective of the present study was to review evidence for the use of PVP-I for OM management. An algorithm identified relevant articles published online, and a panel of experts with experience in the management of OM reviewed the findings. Six studies fulfilled the criteria for full review. Two studies provided evidence of moderate quality. Two of the studies with negative findings were confounded by the use of PVP-I concentrations that are too low to be efficacious. The remaining two studies were found to have design flaws. There exists reasonable evidence to support a recommendation for the use of PVP-I in the management of cancer therapy-related OM.
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Affiliation(s)
- Jeeve Kanagalingam
- Lee Kong Chian School of Medicine, Johns Hopkins Singapore IMC and Tan Tock Seng Hospital, The ENT Clinic, Mount Elizabeth Novena Hospital, Singapore
| | - Akhil Chopra
- OncoCare, Mount Elizabeth Medical Centre, Mount Elizabeth, Singapore
| | - Min Hee Hong
- Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Severance Hospital, Yonsei University Health System, Seoul, Korea
| | - Wisam Ibrahim
- Ibn Nafees Medical Center, Abu Dhabi, United Arab Emirates
| | | | - Jin-Ching Lin
- Department of Radiation Oncology, Taichung Veterans General Hospital, Taichung, Taiwan
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22
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Xue F, Hu C, He X. Induction chemotherapy followed by intensity-modulated radiotherapy with reduced gross tumor volume delineation for stage T3-4 nasopharyngeal carcinoma. Onco Targets Ther 2017; 10:3329-3336. [PMID: 28740408 PMCID: PMC5505602 DOI: 10.2147/ott.s140420] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose A common problem in stage T3–4 nasopharyngeal carcinoma (NPC) is the narrow gap between the primary tumor and neurological structures, which makes dose optimization difficult. Considering that significant tumor shrinkage may occur during induction chemotherapy (IC), this study explored the efficacy of intensity-modulated radiotherapy (IMRT) using reduced gross tumor volume (GTV) in the treatment of T3–4 NPC. Patients and methods Between January 2009 and April 2014, 103 patients with non-metastatic stage T3–4 NPC were prospectively recruited. They were assigned to accept IC, followed by reduced-volume IMRT and adjuvant chemotherapy. GTV was based on the post-IC volume of intracavity tumors and lymph nodes, and the pre-IC volume of the remaining involved structures. Results For all treated patients, the 3-year local failure-free survival (LFFS) was 91.9%. After IC, 91 (88.3%) patients achieved local objective response (OR), and their 3-year LFFS rates were significantly better than in patients who failed to achieve local OR (94.1% vs 75.0%, P=0.023). A multivariate analysis demonstrated the prognostic value of tumor response to IC for LFFS. Dosimetric analysis showed good homogeneity, and the dose constraints were stringent. Asymptomatic temporal lobe necrosis in the ipsilateral side of tumor occurred in one patient. Conclusion IMRT using a reduced GTV delineation delivered satisfactory doses to the target volumes and avoided overdosing of critical neurological structures. Results showed satisfactory survival outcomes with few treatment-related toxicities. Tumor response to IC could facilitate selection of patients with stage T3–4 NPC eligible for treatment with this method.
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Affiliation(s)
- Fen Xue
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Chaosu Hu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Xiayun He
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
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