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Salvestrini V, Caini S, Scricciolo M, Saerens M, Bollen H, Bonomo P, Caparrotti F, Lorini L, Oliva M, Urbanowicz-Nijaki M, Szturz P. Immunotherapy in elderly head and neck cancer patients: a systematic review and meta-analysis. Front Oncol 2024; 14:1395838. [PMID: 38800381 PMCID: PMC11127588 DOI: 10.3389/fonc.2024.1395838] [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: 03/04/2024] [Accepted: 04/23/2024] [Indexed: 05/29/2024] Open
Abstract
Introduction Over the past years, there has been a growing interest in the role of immunotherapy in locally advanced (LA) and recurrent and metastatic head and neck squamous cell carcinoma (R/M HNSCC). High-quality data from prospective trials are lacking for the elderly subpopulation. This systematic review and meta-analysis aims to review the efficacy and safety of immunotherapy in older patients. Methods A systematic literature search was conducted. Randomized clinical trials providing outcome data on a subgroup of elderly (>65 years old) were available for meta-analysis. Primary outcomes of interest were OS and PFS for efficacy analysis. Results Seven studies were included in the systematic review and four in the efficacy analysis. The pooled analysis of OS and PFS showed a consistent benefit (HR 0.78 and 0.91, respectively). Conclusions Immunotherapy may be an effective and well-tolerated treatment option in the elderly population, but more prospective and randomized data are needed. Systematic Review Registration PROSPERO (CRD42022333891).
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Affiliation(s)
- Viola Salvestrini
- Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Saverio Caini
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research Prevention and Clinical Network, Florence, Italy
| | | | - Michael Saerens
- Department of Medical Oncology, Ghent University Hospital, Ghent, Belgium
| | - Heleen Bollen
- Department of Oncology, Laboratory of Experimental Radiotherapy, and Radiation Oncology, UZ Leuven, Leuven, Belgium
| | - Pierluigi Bonomo
- Radiation Oncology Unit, Oncology Department, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Francesca Caparrotti
- Radiation Oncology Department, Clinique Générale Beaulieu - Swiss Medical Network, Geneva, Switzerland
| | - Luigi Lorini
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
| | - Marc Oliva
- Department of Medical Oncology, Institut Català d’Oncologia (ICO) L´Hospitalet, Barcelona, Spain
- Department of Medical Oncology, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
| | | | - Petr Szturz
- Department of Oncology, University of Lausanne (UNIL) and Lausanne University Hospital (CHUV), Lausanne, Switzerland
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Yariv O, Amitai N, Nachalon Y, Moore A, Popovtzer A. Outcome of radiotherapy for the treatment of laryngeal squamous cell carcinoma in the very elderly population. J Laryngol Otol 2024; 138:443-447. [PMID: 36776099 DOI: 10.1017/s002221512300018x] [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] [Indexed: 02/14/2023]
Abstract
BACKGROUND Treatment selection for squamous cell carcinoma patients aged over 84 years is controversial. This retrospective chart review examined and compared characteristics of laryngeal squamous cell carcinoma in very elderly (over 84 years) and younger patients (approximately 65 years). The secondary objective was to further evaluate the outcome of radiotherapy as a treatment modality in this patient population. METHODS Of all 23 very elderly patients with laryngeal squamous cell carcinoma treated with radiotherapy, with or without surgery, in the Davidoff Cancer Center, from 1992 to 2012, 19 had sufficient data for analysis, and comprised the study group. RESULTS Median age at diagnosis was 86 years. Disease stage at diagnosis was I, II, III and IVA in 53 per cent, 21 per cent, 21 per cent and 5 per cent, respectively. Median radiotherapy dose was 60 Gy given in 25 fractions. Three patients had recurrence. No patient discontinued treatment because of toxicity. Median overall survival was 3.6 years (range, 0-10 years). CONCLUSION Very elderly laryngeal squamous cell carcinoma patients may derive a similar survival advantage as younger counterparts. Modern radiotherapy is effective and safe for treating laryngeal squamous cell carcinoma in this study population. Further, large-scale studies are needed.
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Affiliation(s)
- Orly Yariv
- Institute of Oncology, Davidoff Cancer Center, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nimrod Amitai
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Otorhinolaryngology - Head and Neck Surgery, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
| | - Yuval Nachalon
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Otorhinolaryngology - Head and Neck Surgery, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
| | - Assaf Moore
- Institute of Oncology, Davidoff Cancer Center, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Aron Popovtzer
- Institute of Oncology, Davidoff Cancer Center, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Pereira LMB, Ruas HMS, de Freitas Filho W, Alves WSM, Dias GO, Durães CP, Monteiro-Junior RS, Santos SHS, Farias LC, Guimarães ALS, Haikal DSA, Cardoso CM, de Paula AMB. Older adults, appendicular anthropometric measurements, and poor functional performance are predictors of sarcopenia in individuals with head and neck squamous cell carcinoma. Support Care Cancer 2024; 32:82. [PMID: 38175289 DOI: 10.1007/s00520-023-08254-9] [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: 07/19/2022] [Accepted: 12/11/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVE To identify predictors of sarcopenia (demographical, anthropometric measurements, tumor-related clinical characteristics, performance status, and serum C-reactive protein (CRP) and albumin levels in individuals with head and neck squamous cell carcinoma (HNSCC). MATERIAL AND METHODS This cross-sectional study selected diagnosed with HNSCC (n = 125). Sarcopenia was defined as low muscle strength and low physical performance. Association between sarcopenia and anthropometric assessments (weight, height, body mass index, triceps skinfold, mid-upper arm circumference [MUAC], mid-upper arm muscle circumference, mid-upper arm fat area [UFA], mid-upper arm bone free muscle area, calf circumference, and appendicular skeletal muscle mass and index), tumor clinical characteristics (anatomical site, tumor size, and cervical metastasis), performance status scale (Eastern Cooperative Oncology Group Performance Status [ECOG-PS]), and CRP and albumin levels was analyzed using binary logistic regression models. RESULTS The diagnosis of sarcopenia was identified in 28 (22.4%) individuals with HNSCC. Being an older adult increases the odds of association with sarcopenia in individuals with HNSCC (odds ratio [OR] = 1.05). Increments in MUAC measurement reduce the odds of association with sarcopenia (OR = 0.69), while the increase in the UFA measurement increases the odds of association with sarcopenia (OR = 1.33). Poor ECOG-PS scores increase the odds of association with sarcopenia in individuals with HNSCC (OR = 5.54). CONCLUSION Early identification of easy-to-perform, cost-effective predictors of sarcopenia tends to favor the implementation of personalized therapeutic and supportive interventions in individuals with HNSCC.
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Affiliation(s)
- Luciana Mara Barbosa Pereira
- Health Research Laboratories, Programa de Pós-Graduação em Ciências da Saúde, Hospital Universitário Clemente de Faria, Universidade Estadual de Montes Claros (UNIMONTES), Avenida Cula Mangabeira No 562. Bairro Santo Expedito, Montes Claros, Minas Gerais, 39401-001, Brazil
| | - Hérika Maria Silveira Ruas
- Health Research Laboratories, Programa de Pós-Graduação em Ciências da Saúde, Hospital Universitário Clemente de Faria, Universidade Estadual de Montes Claros (UNIMONTES), Avenida Cula Mangabeira No 562. Bairro Santo Expedito, Montes Claros, Minas Gerais, 39401-001, Brazil
| | - Walter de Freitas Filho
- Health Research Laboratories, Programa de Pós-Graduação em Ciências da Saúde, Hospital Universitário Clemente de Faria, Universidade Estadual de Montes Claros (UNIMONTES), Avenida Cula Mangabeira No 562. Bairro Santo Expedito, Montes Claros, Minas Gerais, 39401-001, Brazil
| | - Wislene Sarajane Moreira Alves
- Health Research Laboratories, Programa de Pós-Graduação em Ciências da Saúde, Hospital Universitário Clemente de Faria, Universidade Estadual de Montes Claros (UNIMONTES), Avenida Cula Mangabeira No 562. Bairro Santo Expedito, Montes Claros, Minas Gerais, 39401-001, Brazil
- Head and Neck Surgery and Oncology Center, Fundação de Saúde Hospital Dilson de Quadros Godinho, Montes Claros, Minas Gerais, 39400-292, Brazil
| | - Gabrielle Oliveira Dias
- Health Research Laboratories, Programa de Pós-Graduação em Ciências da Saúde, Hospital Universitário Clemente de Faria, Universidade Estadual de Montes Claros (UNIMONTES), Avenida Cula Mangabeira No 562. Bairro Santo Expedito, Montes Claros, Minas Gerais, 39401-001, Brazil
| | - Cristina Paixão Durães
- Health Research Laboratories, Programa de Pós-Graduação em Ciências da Saúde, Hospital Universitário Clemente de Faria, Universidade Estadual de Montes Claros (UNIMONTES), Avenida Cula Mangabeira No 562. Bairro Santo Expedito, Montes Claros, Minas Gerais, 39401-001, Brazil
- Head and Neck Surgery and Oncology Center, Fundação de Saúde Hospital Dilson de Quadros Godinho, Montes Claros, Minas Gerais, 39400-292, Brazil
| | - Renato Sobral Monteiro-Junior
- Health Research Laboratories, Programa de Pós-Graduação em Ciências da Saúde, Hospital Universitário Clemente de Faria, Universidade Estadual de Montes Claros (UNIMONTES), Avenida Cula Mangabeira No 562. Bairro Santo Expedito, Montes Claros, Minas Gerais, 39401-001, Brazil
- Department of Physical Education, Universidade Estadual de Montes Claros (UNIMONTES), Montes Claros, Minas Gerais, 39401-001, Brazil
| | - Sérgio Henrique Sousa Santos
- Health Research Laboratories, Programa de Pós-Graduação em Ciências da Saúde, Hospital Universitário Clemente de Faria, Universidade Estadual de Montes Claros (UNIMONTES), Avenida Cula Mangabeira No 562. Bairro Santo Expedito, Montes Claros, Minas Gerais, 39401-001, Brazil
- Departament of Food Engineering, Institute of Agricultural Sciences, Universidade Federal de Minas Gerais (UFMG), Montes Claros, Minas Gerais, 39404-547, Brazil
| | - Lucyana Conceição Farias
- Health Research Laboratories, Programa de Pós-Graduação em Ciências da Saúde, Hospital Universitário Clemente de Faria, Universidade Estadual de Montes Claros (UNIMONTES), Avenida Cula Mangabeira No 562. Bairro Santo Expedito, Montes Claros, Minas Gerais, 39401-001, Brazil
- Department of Dentistry, Universidade Estadual de Montes Claros (UNIMONTES), Montes Claros, Minas Gerais, 39401-001, Brazil
| | - André Luiz Sena Guimarães
- Health Research Laboratories, Programa de Pós-Graduação em Ciências da Saúde, Hospital Universitário Clemente de Faria, Universidade Estadual de Montes Claros (UNIMONTES), Avenida Cula Mangabeira No 562. Bairro Santo Expedito, Montes Claros, Minas Gerais, 39401-001, Brazil
- Department of Dentistry, Universidade Estadual de Montes Claros (UNIMONTES), Montes Claros, Minas Gerais, 39401-001, Brazil
| | - Desirée Sant Ana Haikal
- Health Research Laboratories, Programa de Pós-Graduação em Ciências da Saúde, Hospital Universitário Clemente de Faria, Universidade Estadual de Montes Claros (UNIMONTES), Avenida Cula Mangabeira No 562. Bairro Santo Expedito, Montes Claros, Minas Gerais, 39401-001, Brazil
- Department of Dentistry, Universidade Estadual de Montes Claros (UNIMONTES), Montes Claros, Minas Gerais, 39401-001, Brazil
| | - Cláudio Marcelo Cardoso
- Health Research Laboratories, Programa de Pós-Graduação em Ciências da Saúde, Hospital Universitário Clemente de Faria, Universidade Estadual de Montes Claros (UNIMONTES), Avenida Cula Mangabeira No 562. Bairro Santo Expedito, Montes Claros, Minas Gerais, 39401-001, Brazil
- Head and Neck Surgery and Oncology Center, Fundação de Saúde Hospital Dilson de Quadros Godinho, Montes Claros, Minas Gerais, 39400-292, Brazil
| | - Alfredo Mauricio Batista de Paula
- Health Research Laboratories, Programa de Pós-Graduação em Ciências da Saúde, Hospital Universitário Clemente de Faria, Universidade Estadual de Montes Claros (UNIMONTES), Avenida Cula Mangabeira No 562. Bairro Santo Expedito, Montes Claros, Minas Gerais, 39401-001, Brazil.
- Department of Dentistry, Universidade Estadual de Montes Claros (UNIMONTES), Montes Claros, Minas Gerais, 39401-001, Brazil.
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Zhang S, Zheng M, Tian H, Liu W, Feng Z, Xing S, Han F. Are immune checkpoint inhibitors ineffective in treating patients with head and neck squamous cell carcinoma aged 75 years or Older? A Meta-Analysis. Oral Oncol 2024; 148:106632. [PMID: 38039875 DOI: 10.1016/j.oraloncology.2023.106632] [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: 07/17/2023] [Revised: 11/06/2023] [Accepted: 11/15/2023] [Indexed: 12/03/2023]
Abstract
OBJECTIVES The efficacy of immune checkpoint inhibitors (ICIs) is unclear in patients aged ≥ 75 years with head and neck squamous cell carcinoma (HNSCC). We conducted a systematic review and meta-analysis of randomized trials that compared ICIs with standard-of-care (SOC) therapy for recurrent/metastatic HNSCC. MATERIALS AND METHODS PubMed, EMBASE, Web of Science, and ClinicalTrials.gov were searched for eligible trials. We evaluated the overall survival (OS) benefit of ICIs versus SOC according to patient age (<75 versus ≥ 75 years). The OS benefit was evaluated and compared between the age subgroups using hazard ratios (HRs). Data were pooled using a random-effects model. RESULTS Five phase 3 trials involving 3437 patients were included. In patients aged ≥ 75 years (n = 207), ICIs did not improve OS compared to SOC (HR = 1.30, 95 % confidence interval [CI]: 0.93-1.81, P = 0.127). However, an improvement in OS was observed in patients aged < 75 years (n = 3230, HR = 0.90, 95 % CI: 0.83-0.99, P = 0.025). There is a significant difference in OS benefit between patients aged < 75 and ≥ 75 years (ratio of HR = 0.69, 95 % CI: 0.49-0.98, P = 0.036). Subgroup, meta-regression, and sensitivity analyses supported the reliability of the results. CONCLUSIONS Given the small sample size, our findings showing no improvement in OS suggest a lack of evidence to support the use of ICIs in patients with recurrent/metastatic HNSCC aged ≥ 75 years. Therefore, prospective studies are needed to clarify their efficacy among this age group.
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Affiliation(s)
- Siqi Zhang
- Cancer Center, The First Hospital of Jilin University, 71 Xinmin Ave, Changchun, China.
| | - Mengge Zheng
- Cancer Center, The First Hospital of Jilin University, 71 Xinmin Ave, Changchun, China.
| | - Huimin Tian
- Cancer Center, The First Hospital of Jilin University, 71 Xinmin Ave, Changchun, China.
| | - Wenjia Liu
- Cancer Center, The First Hospital of Jilin University, 71 Xinmin Ave, Changchun, China.
| | - Zhenbang Feng
- Cancer Center, The First Hospital of Jilin University, 71 Xinmin Ave, Changchun, China.
| | - Shasha Xing
- Cancer Center, The First Hospital of Jilin University, 71 Xinmin Ave, Changchun, China.
| | - Fujun Han
- Cancer Center, The First Hospital of Jilin University, 71 Xinmin Ave, Changchun, China.
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Almarzooqi S, Hashim MJ, Awwad A, Sharma C, Saraswathiamma D, Albawardi A. Lower Prevalence of Human Papillomavirus in Head and Neck Squamous Cell Carcinoma in Middle Eastern Population: Clinical Implications for Diagnosis and Prevention. Cureus 2023; 15:e34912. [PMID: 36938175 PMCID: PMC10016730 DOI: 10.7759/cureus.34912] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2023] [Indexed: 02/16/2023] Open
Abstract
Introduction Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide. The prevalence of human papillomavirus (HPV) in HNSCC varies across regions. Objective This study aimed to determine the prevalence of high-risk HPV (hrHPV) among patients with HNSCC in the Middle East region. Methods Samples from patients with oropharyngeal or laryngeal lesions who underwent biopsy or resection at a tertiary care hospital from 2010 to 2015 were collected. Those confirmed as squamous cell carcinoma (SCC) on histopathology were identified as cases (n = 61), whereas benign lesions were used as controls (n = 83). Immunohistochemistry (IHC) for p16, p53, Ki-67, and in situ hybridization (ISH) for hrHPV genotypes 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 66 were performed on all cases. Results A total of 154 cases were studied: 61 squamous cell cancers (cases), 83 benign lesions (control), and 10 dysplasia specimens. Among the cases, only five (8.6%) were positive for hrHPV, whereas only one control specimen tested positive. The SCC group had higher mean age, male sex, and history of cigarette smoking and alcohol usage. Among the hrHPV-positive SCC cases, 80% had a tumor in the oropharyngeal region. All hrHPV-positive cases were positive for p16 and p53 immunostains. Conclusion Among HNSCC cases, hrHPV was detected at a lower rate compared to other regions of the world. This study suggests that hrHPV plays a minor role in the pathogenesis of HNSCC in this region, compared to tobacco use and alcohol consumption.
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Affiliation(s)
- Saeeda Almarzooqi
- Department of Pathology, College of Medicine and Health Sciences, United Arab Emirates University (UAE) University, Al Ain, ARE
| | - Muhammad Jawad Hashim
- Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University (UAE) University, Al Ain, ARE
| | - Aktham Awwad
- Department of Laboratory Medicine, Tawam Hospital, Al Ain, ARE
| | - Charu Sharma
- Department of Internal Medicine, College of Medicine and Health Sciences, United Arab Emirates University (UAE) University, Al Ain, ARE
| | - Dhanya Saraswathiamma
- Department of Pathology, College of Medicine and Health Sciences, United Arab Emirates University (UAE) University, Al Ain, ARE
| | - Alia Albawardi
- Department of Pathology, College of Medicine and Health Sciences, United Arab Emirates University (UAE) University, Al Ain, ARE
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Faiq S, Solis RN, Sekhon HK, Morisada MV, Wilson M, Abouyared M, Bewley AF, Birkeland AC. Predictors of Health Care Utilization Following Major Head and Neck Oncologic Surgery in Older Patients. Otolaryngol Head Neck Surg 2022:1945998221124828. [PMID: 36125882 DOI: 10.1177/01945998221124828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To identify patient factors in older patients associated with making posttreatment visits in the first year after major head and neck oncologic surgery. STUDY DESIGN Retrospective cohort study. SETTING Academic institution. METHODS Patients aged ≥60 years who underwent a neck dissection with or without a free flap reconstruction were retrospectively analyzed. Data collected included patient demographics, comorbidities, social variables, perioperative course, and clinical visits. RESULTS Within a 1-year postoperative period, the 181 patients in our cohort had a mean ± SD 6.37 ± 3.6 postoperative clinic visits; 70% attended at least 4 visits. Multivariable regression analysis showed a significant association with distance closer to the hospital (P = .013): for every 10-mile increase in distance, the number of visits decreased by 0.15 (SE = 0.06). Additionally, receiving adjuvant radiation therapy (P = .0096) demonstrated significant associations: when compared with no adjuvant therapy, radiation therapy had on average 1.5 (SE = 0.56) more visits, and chemoradiation had 0.04 (SE = 0.73) more visits. CONCLUSION Older patients who undergo major head and neck oncology surgery are more likely to attend posttreatment visits in the 1 year following surgery if they are discharged home rather than to a skilled nursing facility, live closer to the hospital, and undergo adjuvant radiation therapy.
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Affiliation(s)
- Samya Faiq
- Department of Otolaryngology-Head and Neck Surgery, University of California-Davis, Sacramento, California, USA
| | - Roberto N Solis
- Department of Otolaryngology-Head and Neck Surgery, University of California-Davis, Sacramento, California, USA
| | - Harveen K Sekhon
- Department of Otolaryngology-Head and Neck Surgery, University of California-Davis, Sacramento, California, USA
| | - Megan V Morisada
- Department of Otolaryngology-Head and Neck Surgery, University of California-Davis, Sacramento, California, USA
| | - Machelle Wilson
- Department of Biostatistics, Epidemiology, and Research Design, Clinical and Translational Science Center, University of California-Davis, Sacramento, California, USA
| | - Marianne Abouyared
- Department of Otolaryngology-Head and Neck Surgery, University of California-Davis, Sacramento, California, USA
| | - Arnaud F Bewley
- Department of Otolaryngology-Head and Neck Surgery, University of California-Davis, Sacramento, California, USA
| | - Andrew C Birkeland
- Department of Otolaryngology-Head and Neck Surgery, University of California-Davis, Sacramento, California, USA
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Savcı A, Buldurun K, Alkış ME, Alan Y, Turan N. Synthesis, characterization, antioxidant and anticancer activities of a new Schiff base and its M(II) complexes derived from 5-fluorouracil. MEDICAL ONCOLOGY (NORTHWOOD, LONDON, ENGLAND) 2022; 39:172. [PMID: 35972705 DOI: 10.1007/s12032-022-01774-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 06/17/2022] [Indexed: 10/15/2022]
Abstract
In this study, Schiff base ligand was obtained from the condensation reaction of benzene-1,2-diamine and 5-fluoropyrimidine-2,4(1H,3H)-dione (5-FU). Metal(II) complexes were synthesized with Fe(II), Co(II) and Ni(II) chloride salts. The synthesized ligand and metal complexes were characterized by FT-IR, UV-vis, 1H-13C NMR, elemental analyses, mass spectroscopy, magnetic moments, molar conductivity and thermogravimetric analysis studies. With the help of different techniques reveal Fe(II), Co(II) and Ni(II) complexes have exhibited tetrahedral and octahedral geometry. Ligand acted as bidentate and it binds metal(II) ions through deprotonated-NH, imine-N atom and carbonyl-O atom, respectively. DPPH, ABTS, FRAP, CUPRAC and total antioxidant activity methods were used to determine the antioxidant properties of ligand and metal complexes. According to the results, the synthesized compounds showed very high antioxidant activity compared to 5-FU. The cytotoxicities of the synthesized compounds were performed on MCF-7 (human breast cancer) and L-929 (fibroblast) cell lines using the MTT assay. In addition, the effect of electroporation (EP) on the cytotoxicity of the compounds was investigated. Our results demonstrated that novel Co(II) and Ni(II) complexes show potential as new anticancer agents and ECT may be a viable treatment option for breast cancer.
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Affiliation(s)
- Ahmet Savcı
- Department of Molecular Biology and Genetics, Faculty of Art and Science, Mus Alparslan University, 49250, Mus, Turkey.
| | - Kenan Buldurun
- Department of Medical Services and Techniques, Health Services Vocational School, Mus Alparslan University, 49250, Mus, Turkey
| | - Mehmet Eşref Alkış
- Department of Occupational Health and Safety, Faculty of Health Sciences, Mus Alparslan University, 49250, Mus, Turkey
| | - Yusuf Alan
- Department of Molecular Biology and Genetics, Faculty of Art and Science, Mus Alparslan University, 49250, Mus, Turkey
| | - Nevin Turan
- Department of Chemistry, Faculty of Arts and Sciences, Mus Alparslan University, 49250, Mus, Turkey
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Janto M, Iurcov R, Daina CM, Neculoiu DC, Venter AC, Badau D, Cotovanu A, Negrau M, Suteu CL, Sabau M, Daina LG. Oral Health among Elderly, Impact on Life Quality, Access of Elderly Patients to Oral Health Services and Methods to Improve Oral Health: A Narrative Review. J Pers Med 2022; 12:372. [PMID: 35330372 PMCID: PMC8950250 DOI: 10.3390/jpm12030372] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/15/2022] [Accepted: 02/23/2022] [Indexed: 12/24/2022] Open
Abstract
Dental health is often neglected among the elderly because of the numerous comorbidities in this population, such as cardiovascular diseases. However, dental health influences general health and quality of life by impacting both the general health and the psychological state of the individual. The present review highlights the main dental comorbidities in the elderly population, their impact on the quality of life, the barriers towards access to dental care in the elderly and methods to improve their dental health. Information related to dental care and its importance must be provided both to older individuals and their caregivers in order to detect dental pathology and treat it adequately. Ensuring dental health involves the whole society of elders, caregivers, dental care providers, the public sector, health policymakers, and the private sector.
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Affiliation(s)
- Michael Janto
- Faculty of Medicine and Pharmacy, Doctoral School, University of Oradea, 1 December Sq., 410081 Oradea, Romania;
| | - Raluca Iurcov
- Dentistry Department, Faculty of Medicine, University of Oradea, 410073 Oradea, Romania;
| | - Cristian Marius Daina
- Psycho-Neurosciences and Recovery Department, Faculty of Medicine and Pharmacy, University of Oradea, 1 December Sq., 410081 Oradea, Romania; (C.M.D.); (C.L.S.); (M.S.); (L.G.D.)
| | | | - Alina Cristiana Venter
- Department of Morphologycal Sciences, Faculty of Medicine and Pharmacy, University of Oradea, 1 December Sq., 410081 Oradea, Romania
| | - Dana Badau
- Faculty of Sciences and Letters, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology, 540142 Targu Mures, Romania;
- Interdisciplinary Doctoral School, Transilvania University, 500068 Brasov, Romania
| | - Adrian Cotovanu
- Faculty of Medicine, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology, 540142 Targu Mures, Romania;
| | - Marcel Negrau
- Department of Surgical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 1 December Sq., 410081 Oradea, Romania;
| | - Corina Lacramioara Suteu
- Psycho-Neurosciences and Recovery Department, Faculty of Medicine and Pharmacy, University of Oradea, 1 December Sq., 410081 Oradea, Romania; (C.M.D.); (C.L.S.); (M.S.); (L.G.D.)
| | - Monica Sabau
- Psycho-Neurosciences and Recovery Department, Faculty of Medicine and Pharmacy, University of Oradea, 1 December Sq., 410081 Oradea, Romania; (C.M.D.); (C.L.S.); (M.S.); (L.G.D.)
| | - Lucia Georgeta Daina
- Psycho-Neurosciences and Recovery Department, Faculty of Medicine and Pharmacy, University of Oradea, 1 December Sq., 410081 Oradea, Romania; (C.M.D.); (C.L.S.); (M.S.); (L.G.D.)
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Haehl E, Rühle A, Spohn S, Sprave T, Gkika E, Zamboglou C, Grosu AL, Nicolay NH. Patterns-of-Care Analysis for Radiotherapy of Elderly Head-and-Neck Cancer Patients: A Trinational Survey in Germany, Austria and Switzerland. Front Oncol 2022; 11:723716. [PMID: 35047384 PMCID: PMC8761738 DOI: 10.3389/fonc.2021.723716] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 12/08/2021] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES The number of elderly head-and-neck squamous cell carcinoma (HNSCC) patients is increasing, and clinical trials defining the standard of care either excluded or underrepresented elderly patients. This leaves physicians with a challenging and highly individual treatment decision largely lacking clinical evidence. METHODS A tri-national patterns-of-care survey was sent to all members of the German (DEGRO), Austrian (ÖGRO), and Swiss (SRO/SSRO) national societies of radiation oncology. The online questionnaire consisted of 27 questions on the treatment of elderly HNSCC patients, including 6 case-based questions. Frequency distributions and subgroup comparisons were calculated using SPSS statistics software. RESULTS A total of 132 answers were collected, including 46(35%) form universities, 52(39%) from non-university-hospitals and 34(26%) from private practices. 83(63%) treat 1-5 and 42(32%) >5 elderly HNSCC patients per month. Target volumes are defined analog current guidelines by 65(50%) of responders and altered based on age/comorbidities or tumor stage by 36(28%) and 28(22%), respectively. Chemotherapy is routinely administered by 108(84%) if indicated, with weekly 40mg/m2 of cisplatin being the favored regimen by 68(53%) in the definitive situation and 60(47%) in the adjuvant setting. Hypofractionation and hyperfractionation/acceleration are used by 26(20%) and 11(9%), respectively. Only 7(5%) clinicians routinely recommend inpatient treatment for elderly HNSCC patients. In a typical definitive patient case, 73(63%) responders recommended chemoradiation with bilateral elective node irradiation analog current guidelines. In an adjuvant example case recommendations regarding elective volume and chemotherapy were heterogeneous. Differences between responders' institutions concern the frequency of PET-CT in staging, preventive port-catheter and PEG implantation, the choice of chemotherapy regimens and the use of alternative fractionations. CONCLUSION Treatment of elderly HNSCC-patients in the German-speaking countries mainly follows guidelines established for younger patients. Algorithms for patient stratification and treatment de-escalation for "unfit" elderly patients are needed.
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Affiliation(s)
- Erik Haehl
- Department of Radiation Oncology, University of Freiburg - Medical Center, Freiburg, Germany.,German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (dkfz), Heidelberg, Germany
| | - Alexander Rühle
- Department of Radiation Oncology, University of Freiburg - Medical Center, Freiburg, Germany.,German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (dkfz), Heidelberg, Germany
| | - Simon Spohn
- Department of Radiation Oncology, University of Freiburg - Medical Center, Freiburg, Germany.,German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (dkfz), Heidelberg, Germany
| | - Tanja Sprave
- Department of Radiation Oncology, University of Freiburg - Medical Center, Freiburg, Germany.,German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (dkfz), Heidelberg, Germany
| | - Eleni Gkika
- Department of Radiation Oncology, University of Freiburg - Medical Center, Freiburg, Germany.,German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (dkfz), Heidelberg, Germany
| | - Constantinos Zamboglou
- Department of Radiation Oncology, University of Freiburg - Medical Center, Freiburg, Germany.,German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (dkfz), Heidelberg, Germany
| | - Anca-Ligia Grosu
- Department of Radiation Oncology, University of Freiburg - Medical Center, Freiburg, Germany.,German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (dkfz), Heidelberg, Germany
| | - Nils H Nicolay
- Department of Radiation Oncology, University of Freiburg - Medical Center, Freiburg, Germany.,German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (dkfz), Heidelberg, Germany
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10
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Fasano M, D’Onofrio I, Belfiore MP, Angrisani A, Caliendo V, Della Corte CM, Pirozzi M, Facchini S, Caterino M, Guida C, Nardone V, Reginelli A, Cappabianca S. Head and Neck Squamous Cell Carcinoma in Elderly Patients: Role of Radiotherapy and Chemotherapy. Cancers (Basel) 2022; 14:472. [PMID: 35158740 PMCID: PMC8833743 DOI: 10.3390/cancers14030472] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/13/2022] [Accepted: 01/13/2022] [Indexed: 01/01/2023] Open
Abstract
Head and neck squamous cell carcinomas (HNSCC) constitute the sixth most common malignancy worldwide, with approximately 25-40% of the diagnosed patients older than 70 years. HNSCC patients are often frail and frequently have multiple comorbidities due to their unhealthy lifestyle, and evidence suggests that older patients may receive less aggressive and suboptimal treatment than younger patients with the same disease status. The aim of this review is to depict and summarize the evidence regarding the different strategies that can be used in the clinical management of elderly HNSCC patients. Key references were derived from a PubMed query. Hand searching and clinicaltrials.gov were also used. This paper contains a narrative report and a critical discussion of clinical approaches in the context of elderly HNSCC.
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Affiliation(s)
- Morena Fasano
- Department of Precision Medicine, Faculty of Medicine and Surgery, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (M.F.); (M.P.B.); (A.A.); (V.C.); (C.M.D.C.); (M.P.); (S.F.); (M.C.); (A.R.); (S.C.)
| | - Ida D’Onofrio
- Unit of Radiation Oncology, Ospedale del Mare, ASL Napoli 1 Centro, 80147 Naples, Italy; (I.D.); (C.G.)
| | - Maria Paola Belfiore
- Department of Precision Medicine, Faculty of Medicine and Surgery, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (M.F.); (M.P.B.); (A.A.); (V.C.); (C.M.D.C.); (M.P.); (S.F.); (M.C.); (A.R.); (S.C.)
| | - Antonio Angrisani
- Department of Precision Medicine, Faculty of Medicine and Surgery, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (M.F.); (M.P.B.); (A.A.); (V.C.); (C.M.D.C.); (M.P.); (S.F.); (M.C.); (A.R.); (S.C.)
| | - Valentina Caliendo
- Department of Precision Medicine, Faculty of Medicine and Surgery, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (M.F.); (M.P.B.); (A.A.); (V.C.); (C.M.D.C.); (M.P.); (S.F.); (M.C.); (A.R.); (S.C.)
| | - Carminia Maria Della Corte
- Department of Precision Medicine, Faculty of Medicine and Surgery, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (M.F.); (M.P.B.); (A.A.); (V.C.); (C.M.D.C.); (M.P.); (S.F.); (M.C.); (A.R.); (S.C.)
| | - Mario Pirozzi
- Department of Precision Medicine, Faculty of Medicine and Surgery, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (M.F.); (M.P.B.); (A.A.); (V.C.); (C.M.D.C.); (M.P.); (S.F.); (M.C.); (A.R.); (S.C.)
| | - Sergio Facchini
- Department of Precision Medicine, Faculty of Medicine and Surgery, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (M.F.); (M.P.B.); (A.A.); (V.C.); (C.M.D.C.); (M.P.); (S.F.); (M.C.); (A.R.); (S.C.)
| | - Marianna Caterino
- Department of Precision Medicine, Faculty of Medicine and Surgery, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (M.F.); (M.P.B.); (A.A.); (V.C.); (C.M.D.C.); (M.P.); (S.F.); (M.C.); (A.R.); (S.C.)
| | - Cesare Guida
- Unit of Radiation Oncology, Ospedale del Mare, ASL Napoli 1 Centro, 80147 Naples, Italy; (I.D.); (C.G.)
| | - Valerio Nardone
- Department of Precision Medicine, Faculty of Medicine and Surgery, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (M.F.); (M.P.B.); (A.A.); (V.C.); (C.M.D.C.); (M.P.); (S.F.); (M.C.); (A.R.); (S.C.)
| | - Alfonso Reginelli
- Department of Precision Medicine, Faculty of Medicine and Surgery, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (M.F.); (M.P.B.); (A.A.); (V.C.); (C.M.D.C.); (M.P.); (S.F.); (M.C.); (A.R.); (S.C.)
| | - Salvatore Cappabianca
- Department of Precision Medicine, Faculty of Medicine and Surgery, University of Campania “L. Vanvitelli”, 80138 Naples, Italy; (M.F.); (M.P.B.); (A.A.); (V.C.); (C.M.D.C.); (M.P.); (S.F.); (M.C.); (A.R.); (S.C.)
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11
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van der Kamp MF, Halmos GB, Guryev V, Horvatovich PL, Schuuring E, van der Laan BFAM, van der Vegt B, Plaat BEC, Verhoeven CJ. Age-specific oncogenic pathways in head and neck squamous cell carcinoma - are elderly a different subcategory? Cell Oncol (Dordr) 2022; 45:1-18. [PMID: 35015241 DOI: 10.1007/s13402-021-00655-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND In recent clinical practice, an increasing number of elderly patients suffering from head and neck squamous cell carcinoma (HNSCC) of unknown pathophysiology is observed. The majority of HNSCC patients can roughly be divided into three subcategories. First, a small group of young patients who present with variants of genomic aberrations and inheritable diseases like Fanconi anaemia. Second, an increasing population of HPV-related HNSCCs that are regarded as genomic stable tumours with a more favourable prognosis. Though HPV-related tumours used to be more common among younger males, a notable rise in the elderly population is observed. The third subcategory, that of HPV-negative tumours, has been shown to be more heterogeneous with involvement of a variety of oncogenic pathways related to lifestyle factors like smoking and alcohol consumption, often seen in middle-aged males. Some of these pathways could be related to age, such as TP53 alterations, EGFR activation, apoptotic pathway alterations and field cancerization. CONCLUSIONS In this narrative review, we provide an overview of established and newly discovered age-specific pathophysiological mechanisms underlying HNSCC. We propose a fourth subcategory of patients with a suspected different pathophysiology: elderly (HPV-negative) HNSCC patients without a history of tobacco and alcohol consumption. In this subcategory, carcinogenesis seems to be a multi-step process based on genomic instability, immunosenescence, cell cycle disruption and telomere shortening. To conclude, we discuss suggestions for future research to fill the knowledge gap about age-dependent HNSCC carcinogenesis.
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Affiliation(s)
- Martine Froukje van der Kamp
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700RB, Groningen, The Netherlands.
| | - Gyorgy Bela Halmos
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700RB, Groningen, The Netherlands
| | - Victor Guryev
- European Research Institute for the Biology of Ageing, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Peter Laszlo Horvatovich
- Department of Pharmacy, Analytical Biochemistry, University of Groningen, Groningen, The Netherlands
| | - Ed Schuuring
- Department of Pathology & Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Bert van der Vegt
- Department of Pathology & Medical Biology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Boudewijn Evert Christiaan Plaat
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700RB, Groningen, The Netherlands
| | - Cornelia Johanna Verhoeven
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700RB, Groningen, The Netherlands
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12
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McCusker MG, Mehra R, Amr S, Taylor RJ, Cullen KJ, Goloubeva OG. Comparison of efficacy and toxicity of chemoradiation regimens for head and neck squamous cell carcinoma primary treatment. Head Neck 2021; 44:749-759. [PMID: 34931731 DOI: 10.1002/hed.26965] [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: 09/22/2021] [Revised: 11/19/2021] [Accepted: 12/10/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The best chemoradiation regimen to treat locally and regionally advanced head and neck squamous cell carcinoma (HNSCC) is yet to be established. METHODS We compared overall survival (OS) and adverse events following chemoradiation regimens (high-dose [HDC] or low-dose [LDC] cisplatin, or carboplatin [CB]) in HNSCC cases selected from SEER-Medicare linked database. RESULTS Of the 1335 cases who underwent radiotherapy, 264 received HDC, 259 received LDC, and 353 received CB, concurrently. Compared to chemoradiation with HDC, using LDC or CB, or radiotherapy alone were associated with an increasingly worse OS; hazard ratios were 1.33, p = 0.03; 1.35, p = 0.02; and 2.12, p < 0.001; respectively. There were no differences in the rates of adverse events between the three chemoradiation regimens. CONCLUSION Chemoradiation regimen using HDC appears to be the best primary treatment for locally and regionally advanced HNSCC. Nonetheless, prospective large studies are warranted to further determine its absolute benefit.
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Affiliation(s)
- Michael G McCusker
- University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, Maryland, USA
| | - Ranee Mehra
- University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, Maryland, USA
| | - Sania Amr
- University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, Maryland, USA.,Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Rodney J Taylor
- University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, Maryland, USA.,Department of Otorhinolaryngology - Head & Neck Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Kevin J Cullen
- University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, Maryland, USA
| | - Olga G Goloubeva
- University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, Maryland, USA.,Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
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13
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Amr S, Ioffe D, Suzuki I, Mehra R, Cullen K, Goloubeva O. Treatment modalities, adverse events, and survival outcomes in older patients with head and neck squamous cell carcinoma. Head Neck 2021; 43:3935-3945. [PMID: 34632677 DOI: 10.1002/hed.26893] [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: 04/19/2021] [Revised: 07/12/2021] [Accepted: 09/21/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Chemoradiation with curative intent in older adults with locally advanced head and neck squamous cell carcinoma (HNSCC) has been a challenge, because of its potential toxicities. METHODS We selected primary HNSCC cases from the SEER-Medicare linked database, assessed overall survival (OS) and adverse events and their associations with different treatments, across four age groups including the youngest (66-69 years) and the oldest (≥80 years). RESULTS Better OS was associated with chemoradiation compared to radiation alone, not only in all patients (N = 5879) (hazard ratio [HR] = 0.82, p < 0.001), but also in the oldest group (N = 1380) (HR = 0.77, p = 0.006) in whom the adverse events rates were not higher than those in the youngest (N = 1562); more of the latter (26%-30%) than the former (14%-19%) received chemoradiation, regardless of their comorbidity indices. CONCLUSIONS Our findings provide evidence that patients' characteristics, other than chronological age, should be equally considered in selecting the best therapy for older patients with HNSCC.
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Affiliation(s)
- Sania Amr
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, Maryland, USA.,Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Dina Ioffe
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Ikumi Suzuki
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Ranee Mehra
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Kevin Cullen
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Olga Goloubeva
- Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, Maryland, USA.,Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, Maryland, USA
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14
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The role of age in treatment decisions for oral cavity squamous cell carcinoma: Analysis of the National Cancer Database. Oral Oncol 2021; 118:105330. [PMID: 33991757 DOI: 10.1016/j.oraloncology.2021.105330] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/08/2021] [Accepted: 04/27/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND The number of elderly patients with oral squamous cell carcinoma (OCSCC) is increasing as the elderly population increases. Unfortunately, evidence to guide the management of these patients is lacking. METHODS Patients with OCSCC identified from the National Cancer Database (NCDB) were stratified into age-based cohorts. Demographics, comorbidities, and treatment patterns were analyzed. Patients were stratified into early stage (Stage I/II) and advanced stage (Stage III/IV) disease. The likelihood of receiving multimodality therapy by age was calculated using multinomial logistic regression for each stratum while controlling for potential confounders. Cox proportional hazard regression was used to calculate 5-year mortality risk while controlling for potential confounders. RESULTS Surgery alone or palliative options were offered to older patients more frequently. After controlling for confounders, older patients were less likely to receive multimodality therapy for both early stage and advanced stage disease. Patients with advanced disease across all age cohorts had improved 5-year survival with surgery and adjuvant therapy. CONCLUSION Our analyses suggest that elderly patients have unique demographic and pathologic features. They frequently receive less treatment than similarly staged younger patients, yet they benefit from multimodality therapy when feasible. These data suggest an urgent need to critically appraise the care of elderly OCSCC patients within the broader context of their individual comorbidity burden, functional status, and treatment goals.
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15
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Rühle A, Haehl E, Kalckreuth T, Stoian R, Spohn SKB, Sprave T, Zamboglou C, Gkika E, Knopf A, Grosu AL, Nicolay NH. Surviving Elderly Patients with Head-and-Neck Squamous Cell Carcinoma-What Is the Long-Term Quality of Life after Curative Radiotherapy? Cancers (Basel) 2021; 13:cancers13061275. [PMID: 33805662 PMCID: PMC7999122 DOI: 10.3390/cancers13061275] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/08/2021] [Accepted: 03/10/2021] [Indexed: 01/05/2023] Open
Abstract
The effects of radiotherapy on the long-term quality of life (QoL) of surviving elderly HNSCC patients are not well understood, therefore, we analyzed QoL in this population. A cross-sectional analysis was performed at a tertiary cancer center to assess long-term QoL in elderly HNSCC patients. Eligible patients were ≥65 years at the time of treatment who had to be alive for ≥1 year after radiotherapy and without current anti-cancer treatment. QoL and patient satisfaction were assessed using the EORTC QLQ-C30, QLQ-H&N35 and ZUF-8 questionnaires, respectively, and treatment-related toxicities were graded according to CTCAE (Common Terminology Criteria of Adverse Effects) v.5.0. Seventy-four patients met the inclusion criteria, of which 50 consented to participate. Median time between radiotherapy and QoL assessment was 32 months (range 12-113). The QLQ-C30 global QoL median amounted to 66.7 points (interquartile range (IQR) 50.0-83.3), which was comparable to the age- and gender-adjusted German population (median 65.3). Median global QoL was similar between patients undergoing definitive (75.0, IQR 50.0-83.3) and adjuvant (chemo)radiotherapy (66.7, IQR 41.7-83.3, p = 0.219). HPV-positive HNSCC patients had superior global QoL after radiotherapy than their HPV-negative counterparts (p < 0.05), and concomitant chemotherapy did not influence the long-term QoL (p = 0.966). Median global QoL did not correspond with physician-assessed highest-graded chronic toxicities (p = 0.640). The ZUF-8 ranged at 29 points in median (IQR 27-31), showing high patient satisfaction. Surviving elderly HNSCC patients treated by radiotherapy exhibit a relatively high long-term global QoL which is a relevant information for clinicians treating elderly HNSCC patients.
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Affiliation(s)
- Alexander Rühle
- Department of Radiation Oncology, University of Freiburg—University Medical Center Freiburg, Robert-Koch-Str. 3, 79106 Freiburg, Germany; (A.R.); (E.H.); (T.K.); (R.S.); (S.K.B.S.); (T.S.); (C.Z.); (E.G.); (A.-L.G.)
- German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (dkfz), Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Erik Haehl
- Department of Radiation Oncology, University of Freiburg—University Medical Center Freiburg, Robert-Koch-Str. 3, 79106 Freiburg, Germany; (A.R.); (E.H.); (T.K.); (R.S.); (S.K.B.S.); (T.S.); (C.Z.); (E.G.); (A.-L.G.)
- German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (dkfz), Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Tobias Kalckreuth
- Department of Radiation Oncology, University of Freiburg—University Medical Center Freiburg, Robert-Koch-Str. 3, 79106 Freiburg, Germany; (A.R.); (E.H.); (T.K.); (R.S.); (S.K.B.S.); (T.S.); (C.Z.); (E.G.); (A.-L.G.)
- German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (dkfz), Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Raluca Stoian
- Department of Radiation Oncology, University of Freiburg—University Medical Center Freiburg, Robert-Koch-Str. 3, 79106 Freiburg, Germany; (A.R.); (E.H.); (T.K.); (R.S.); (S.K.B.S.); (T.S.); (C.Z.); (E.G.); (A.-L.G.)
- German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (dkfz), Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Simon K. B. Spohn
- Department of Radiation Oncology, University of Freiburg—University Medical Center Freiburg, Robert-Koch-Str. 3, 79106 Freiburg, Germany; (A.R.); (E.H.); (T.K.); (R.S.); (S.K.B.S.); (T.S.); (C.Z.); (E.G.); (A.-L.G.)
- German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (dkfz), Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Tanja Sprave
- Department of Radiation Oncology, University of Freiburg—University Medical Center Freiburg, Robert-Koch-Str. 3, 79106 Freiburg, Germany; (A.R.); (E.H.); (T.K.); (R.S.); (S.K.B.S.); (T.S.); (C.Z.); (E.G.); (A.-L.G.)
- German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (dkfz), Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Constantinos Zamboglou
- Department of Radiation Oncology, University of Freiburg—University Medical Center Freiburg, Robert-Koch-Str. 3, 79106 Freiburg, Germany; (A.R.); (E.H.); (T.K.); (R.S.); (S.K.B.S.); (T.S.); (C.Z.); (E.G.); (A.-L.G.)
- German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (dkfz), Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Eleni Gkika
- Department of Radiation Oncology, University of Freiburg—University Medical Center Freiburg, Robert-Koch-Str. 3, 79106 Freiburg, Germany; (A.R.); (E.H.); (T.K.); (R.S.); (S.K.B.S.); (T.S.); (C.Z.); (E.G.); (A.-L.G.)
- German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (dkfz), Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Andreas Knopf
- Department of Otorhinolaryngology, University of Freiburg—University Medical Center Freiburg, Killianstr. 5, 79106 Freiburg, Germany;
| | - Anca-Ligia Grosu
- Department of Radiation Oncology, University of Freiburg—University Medical Center Freiburg, Robert-Koch-Str. 3, 79106 Freiburg, Germany; (A.R.); (E.H.); (T.K.); (R.S.); (S.K.B.S.); (T.S.); (C.Z.); (E.G.); (A.-L.G.)
- German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (dkfz), Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - Nils H. Nicolay
- Department of Radiation Oncology, University of Freiburg—University Medical Center Freiburg, Robert-Koch-Str. 3, 79106 Freiburg, Germany; (A.R.); (E.H.); (T.K.); (R.S.); (S.K.B.S.); (T.S.); (C.Z.); (E.G.); (A.-L.G.)
- German Cancer Consortium (DKTK) Partner Site Freiburg, German Cancer Research Center (dkfz), Neuenheimer Feld 280, 69120 Heidelberg, Germany
- Correspondence: ; Tel.: +49-761-270-94010
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16
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Strojan P, Grošelj A, Serša G, Plaschke CC, Vermorken JB, Nuyts S, de Bree R, Eisbruch A, Mendenhall WM, Smee R, Ferlito A. Electrochemotherapy in Mucosal Cancer of the Head and Neck: A Systematic Review. Cancers (Basel) 2021; 13:cancers13061254. [PMID: 33809141 PMCID: PMC7999968 DOI: 10.3390/cancers13061254] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 03/07/2021] [Accepted: 03/09/2021] [Indexed: 12/24/2022] Open
Abstract
Electrochemotherapy (ECT) is a local ablative treatment that is based on the reversible electroporation and intracellular accumulation of hydrophilic drug molecules, which greatly increases their cytotoxicity. In mucosal head and neck cancer (HNC), experience with ECT is limited due to the poor accessibility of tumors. In order to review the experience with ECT in mucosal HNC, we undertook a systematic review of the literature. In 22 articles, published between 1998 and 2020, 16 studies with 164 patients were described. Curative and palliative intent treatment were given to 36 (22%) and 128 patients (78%), respectively. The majority of tumors were squamous cell carcinomas (79.3%) and located in the oral cavity (62.8%). In the curative intent group, complete response after one ECT treatment was achieved in 80.5% of the patients, and in the palliative intent group, the objective (complete and partial) response rate was 73.1% (31.2% and 41.9%). No serious adverse events were reported during or soon after ECT and late effects were rare (19 events in 17 patients). The quality-of-life assessments did not show a significant deterioration at 12 months post-ECT. Provided these preliminary data are confirmed in randomized controlled trials, ECT may be an interesting treatment option in selected patients with HNC not amenable to standard local treatment.
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Affiliation(s)
- Primož Strojan
- Department of Radiation Oncology, Institute of Oncology Ljubljana and Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
- Correspondence: ; Tel.: +386-1-5879290
| | - Aleš Grošelj
- Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Centre Ljubljana and Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia;
| | - Gregor Serša
- Department of Experimental Oncology, Institute of Oncology Ljubljana and Faculty of Health Sciences, University of Primorska, Izola and Faculty of Health Sciences, University of Ljubljana, 1000 Ljubljana, Slovenia;
| | - Christina Caroline Plaschke
- Department of Otorhinolaryngology, Head & Neck Surgery and Audiology, Copenhagen University Hospital Rigshospitalet, 2100 Copenhagen, Denmark;
| | - Jan B. Vermorken
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, and Department of Medical Oncology, Antwerp University Hospital, 2650 Edegem, Belgium;
| | - Sandra Nuyts
- Department of Oncology, KU Leuven, University of Leuven and Department of Radiation Oncology, UZ Leuven, 3000 Leuven, Belgium;
| | - Remco de Bree
- Department of Head and Neck Surgical Oncology, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht University, 3584 Utrecht, The Netherlands;
| | - Avraham Eisbruch
- Department of Radiation Oncology, University of Michigan, Ann Arbor, MI 48109-5010, USA;
| | - William M. Mendenhall
- Department of Radiation Oncology, University of Florida, Gainesville, FL 32610-0385, USA;
| | - Robert Smee
- Department of Radiation Oncology, The Prince of Wales Cancer Centre, Sydney, NSW 2031, Australia;
| | - Alfio Ferlito
- Coordinator of the International Head and Neck Scientific Group, 35100 Padua, Italy;
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Viani GA, Faustino AC, Danelichen AFB, Matsuura FK, Neves LVF, Fernandes MH, Fernandes JP. Radiotherapy for locally advanced head and neck cancer in elderly patients: results and prognostic factors a single cohort. ACTA ACUST UNITED AC 2021; 26:12-19. [PMID: 33948297 DOI: 10.5603/rpor.a2021.0002] [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: 06/27/2020] [Accepted: 12/09/2020] [Indexed: 12/24/2022]
Abstract
Background The objective of this study was to assess the treatment outcomes and prognostic factors of elderly patients with locally advanced head and neck cancer (LAHNC) undergoing radiotherapy (RT). Materials and methods A retrospective cohort from a single institution, from 2000 to 2015, including patients older than 65 years old with LAHNC (stage III-IVa) treated by RT combined or not with chemotherapy (CRT). Univariate and multivariate analysis (MVA) were performed to identify prognostic factors associated with overall survival (OS), cancer-specific survival (CS), and locoregional control (LRC). A p-value < 0.05 was considered significant. Results 220 patients with LAHNC and > 65 years of age were identified. The median follow-up was 3.8 years, the 3/5 years estimated OS, CS, and LRC rate was 40%/30%, 49%/34%, 76%/45%, respectively. In the univariate analysis, clinical stage (III vs. IVa/b, p = 0.01), tumor stage (T1/2 vs. T3/4, p = 0.035), Karnofsky performance status (KPS, 60-70, p = 0.03) and tumor site (other than vs. hypopharynx, p = 0.0001) were associated with lower OS. Patients with clinical stage (III vs. IVa/b, p = 0.01), tumor stage (T1/2 vs. T3/4, p = 0.015), N stage (N0/1 vs. N2/3, p = 0.04), (KPS 60-70, p = 0.04) and tumor site (other than vs. hypopharynx, p = 0.0001) had worst CS. For the LRC, clinical stage (III vs. IVa/b, p = 0.02), tumor stage (T1/2 vs. T3/4, p = 0.02), treatment type (CRT vs. RT, p = 0.02), RT technique (IMRT vs. 2DRT/3DRT, p = 0.0001), and tumor site (other than vs. hypopharynx, p = 0.02) were significant. In the MVA, KPS maintained significant for OS and CS. For LRC, clinical stage (Iva/b, p = 0.007), tumor stage (T3/4, p = 0.047) and radiotherapy technique other than IMRT (p = 0.0001) were significant. Conclusion The OS, CS, and LRC were associated with several prognostic factors. The clinical performance was the main marker of OS and CS. Chemoradiation should be offered to selected elderly patients using IMRT to improve LRC.
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Affiliation(s)
- Gustavo Arruda Viani
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil
| | - Alexandre Ciufi Faustino
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil
| | | | - Fernando Kojo Matsuura
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil
| | - Leonardo Vicente Fay Neves
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil
| | - Marco Henrique Fernandes
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, São Paulo, Brazil
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18
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Yamada S, Misawa K, Mima M, Imai A, Mochizuki D, Yamada T, Shinmura D, Kita J, Ishikawa R, Yamaguchi Y, Misawa Y, Kawasaki H, Mineta H. Telomere shortening in head and neck cancer: association between DNA demethylation and survival. J Cancer 2021; 12:2165-2172. [PMID: 33758594 PMCID: PMC7974875 DOI: 10.7150/jca.54760] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 01/28/2021] [Indexed: 12/11/2022] Open
Abstract
A growing body of evidence indicates that telomere dysfunction is a biological marker of progression in several types of cancer. However, the association between head and neck squamous cell carcinoma (HNSCC) and telomere length (TL) remains unknown. We measured the absolute TL levels in a well-characterised dataset of 211 tumoral vs normal tissues obtained from the same patients by quantitative polymerase chain reaction assay. Normalised TL levels were significantly lower in tumour samples than in normal tissue (P < 0.001) and there was a positive correlation between tumour tissue and normal mucosal tissue (R2 = 0.176, P < 0.001). We were able to distinguish two classes, one with a tumour/normal TL ratio ≤ 0.3 (38.4%), which showed clear telomere erosion, and the other with a tumour/normal TL ratio > 0.3 (61.6%), in which the TL was slightly shorter or longer than that in normal tissue. Notably, the tumour/normal TL ratio was correlated with the likelihood of disease recurrence (P = 0.002), the 5-hydroxymethylcytosine level (P = 0.043), and expression of the ten-eleven translocation (TET) gene (P = 0.043). Our findings show that TL shortening and subsequent low levels of 5-hydroxymethylcytosine and TET expression may contribute to development of HNSCC.
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Affiliation(s)
- Satoshi Yamada
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Kiyoshi Misawa
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Masato Mima
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Atsushi Imai
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Daiki Mochizuki
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Taiki Yamada
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Daichi Shinmura
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Junya Kita
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Ryuji Ishikawa
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yuki Yamaguchi
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yuki Misawa
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hideya Kawasaki
- Preeminent Medical Photonics Education and Research Center Institute for NanoSuit Research, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Hiroyuki Mineta
- Department of Otolaryngology/Head and Neck Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan
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19
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Lyu Y, Ni M, Zhai R, Kong F, Du C, Hu C, Ying H. Clinical characteristics and prognosis of elderly nasopharyngeal carcinoma patients receiving intensity-modulated radiotherapy. Eur Arch Otorhinolaryngol 2020; 278:2549-2557. [PMID: 33021689 PMCID: PMC8165069 DOI: 10.1007/s00405-020-06399-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 09/23/2020] [Indexed: 01/22/2023]
Abstract
Purpose To evaluate the clinical characteristics and prognosis of elderly nasopharyngeal carcinoma (NPC) patients receiving intensity-modulated radiotherapy (IMRT). Methods From June 2008 to October 2014, 148 newly diagnosed non-metastatic elderly NPC patients (aged ≥ 70 years) receiving IMRT were recruited. Comorbid condition was evaluated using the age-adjusted Charlson Comorbidity Index (ACCI). Kaplan–Meier method was used to estimate survival rates and the differences were compared using log-rank test. Hazard ratio (HR) and the associated 95% confidence interval (CI) were calculated using Cox proportional hazard model by means of multivariate analysis. Results The median follow-up time was 66.35 months. Estimated OS rate at 5 years for the entire group was 61.8% (95% confidence interval [CI] 0.542–0.703). The 5-year OS rate of RT alone group was 58.4% (95% [CI] 0.490–0.696) compared with 65.2% (95% [CI] 0.534–0.796) in CRT group (p = 0.45). In patients receiving IMRT only, ACCI score equal to 3 was correlated with superior 5-year OS rate in comparison with higher ACCI score 62.1% (95% [CI] 0.510–0.766) to 48.5% (95% [CI] 0.341–0.689), respectively; p = 0.024). A 5-year OS rate of 63.1% (95% [CI] 0.537–0.741) was observed in patients younger than 75 years old compared with 57.5% (95% [CI] 0.457–0.723) in patients older (p = 0.026). Patients with early-stage disease (I–II) showed better prognosis than patients with advanced-stage (III–IV) disease (5-year OS, 72.3–55.4%, respectively; p = 0.0073). The Cox proportional hazards model suggested that age independently predicted poorer OS (HR, 1.07; 95%CI 1.00–1.15, p = 0.04). Conclusion The survival outcome of patients aged ≥ 70 years receiving IMRT only was similar to chemoradiotherapy with significantly less acute toxicities. Among the population, age is significantly prognostic for survival outcomes.
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Affiliation(s)
- Yingchen Lyu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, 270 Dong'an Road, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Mengshan Ni
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, 270 Dong'an Road, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Ruiping Zhai
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, 270 Dong'an Road, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Fangfang Kong
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, 270 Dong'an Road, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Chengrun Du
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, 270 Dong'an Road, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Chaosu Hu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, 270 Dong'an Road, Shanghai, 200032, China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Hongmei Ying
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, 270 Dong'an Road, Shanghai, 200032, China. .,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China.
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20
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Kedves A, Tóth Z, Emri M, Fábián K, Sipos D, Freihat O, Tollár J, Cselik Z, Lakosi F, Bajzik G, Repa I, Kovács Á. Predictive Value of Diffusion, Glucose Metabolism Parameters of PET/MR in Patients With Head and Neck Squamous Cell Carcinoma Treated With Chemoradiotherapy. Front Oncol 2020; 10:1484. [PMID: 32983984 PMCID: PMC7492555 DOI: 10.3389/fonc.2020.01484] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 07/13/2020] [Indexed: 12/15/2022] Open
Abstract
Purpose: This study aims to evaluate the predictive value of the pretreatment, metabolic, and diffusion parameters of a primary tumor assessed with PET/MR on patient clinical outcomes. Methods: Retrospective evaluation was performed using PET/MR image data sets acquired using the single tracer injection dual imaging of 68 histologically proven head and neck cancer patients 4 weeks before receiving definitive chemoradiotherapy (CRT). PET/MR was performed before the CRT and 12 weeks after the CRT for response evaluation. Image data (PET and MRI diffusion-weighted imaging [DWI]) was used to specify the maximum standard uptake value, the peak lean body mass corrected, SUVmax, the metabolic tumor volume, the total lesion glycolysis (SUVmax, SULpeak, MTV, and TLG), and the mean apparent diffusion coefficient (ADCmean) of the primary tumor. Based on the results of the therapeutic response evaluation, two patient subgroups were created: one with a viable tumor and another without. Metabolic and diffusion data, from the pretreatment PET/MR and the therapeutic response, were correlated using Spearman's correlation coefficient and Wilcoxon's test. Results: After completing the CRT, a viable residual tumor was detected in 36/68 (53%) cases, and 32/68 (47%) patients showed complete remission. However, no significant correlation was found between the pretreatment parameter, ADCmean (p = 0.88), and the therapeutic success. The PET parameters, SUVmax and SULpeak, MTV, and TLG (p = 0.032, p = 0.01, p < 0.0001, p = 0.0004) were statistically significantly different between the two patient subgroups. Conclusion: This study found that MRI-based (ADCmean) data from FDG PET/MR pretreatment could not be used to predict therapeutic response although the PET parameters SUVmax, SULpeak, MTV, and TLG proved to be more useful; thus, their inclusion in risk stratification may also be of additional value.
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Affiliation(s)
- András Kedves
- Doctoral School of Health Sciences, University of Pécs, Pécs, Hungary.,Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, Pécs, Hungary.,Dr. József Baka Diagnostic, Radiation Oncology, Research and Teaching Center, "Moritz Kaposi" Teaching Hospital, Kaposvár, Hungary
| | - Zoltán Tóth
- Doctoral School of Health Sciences, University of Pécs, Pécs, Hungary.,MEDICOPUS Healthcare Provider and Public Nonprofit Ltd., Somogy County Moritz Kaposi Teaching Hospital, Kaposvár, Hungary
| | - Miklós Emri
- Dr. József Baka Diagnostic, Radiation Oncology, Research and Teaching Center, "Moritz Kaposi" Teaching Hospital, Kaposvár, Hungary.,Department of Medical Imaging, Faculty of Health Sciences, University of Debrecen, Debrecen, Hungary
| | - Krisztián Fábián
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, Pécs, Hungary
| | - Dávid Sipos
- Doctoral School of Health Sciences, University of Pécs, Pécs, Hungary.,Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, Pécs, Hungary.,Dr. József Baka Diagnostic, Radiation Oncology, Research and Teaching Center, "Moritz Kaposi" Teaching Hospital, Kaposvár, Hungary
| | - Omar Freihat
- Doctoral School of Health Sciences, University of Pécs, Pécs, Hungary
| | - József Tollár
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, Pécs, Hungary.,Dr. József Baka Diagnostic, Radiation Oncology, Research and Teaching Center, "Moritz Kaposi" Teaching Hospital, Kaposvár, Hungary
| | - Zsolt Cselik
- Oncoradiology, Csolnoky Ferenc County Hospital, Veszprém, Hungary
| | - Ferenc Lakosi
- Dr. József Baka Diagnostic, Radiation Oncology, Research and Teaching Center, "Moritz Kaposi" Teaching Hospital, Kaposvár, Hungary
| | - Gábor Bajzik
- Dr. József Baka Diagnostic, Radiation Oncology, Research and Teaching Center, "Moritz Kaposi" Teaching Hospital, Kaposvár, Hungary
| | - Imre Repa
- Dr. József Baka Diagnostic, Radiation Oncology, Research and Teaching Center, "Moritz Kaposi" Teaching Hospital, Kaposvár, Hungary
| | - Árpád Kovács
- Doctoral School of Health Sciences, University of Pécs, Pécs, Hungary.,Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, Pécs, Hungary.,Department of Oncoradiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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21
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Wang S, Igawa K, Ogawara R, Suda M, Hamano T, Ibaragi S, Hanafusa T, Ichikawa Y, Sasaki A. The accelerator-based boron neutron capture reaction evaluation system for head and neck cancer. Appl Radiat Isot 2020; 165:109271. [PMID: 32771869 DOI: 10.1016/j.apradiso.2020.109271] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 05/26/2020] [Accepted: 06/04/2020] [Indexed: 12/01/2022]
Abstract
The purpose of this study is to assess accelerator-based boron neutron capture reaction (BNCR) in human tumor cell lines by colony formation assay and modified high density survival assay (HDS assay). The results of post irradiation survival rate in human oral squamous cell carcinoma and osteosarcoma using both assays were similar. Therefore, HDS assay would be efficient to evaluate BNCR in not only tumor cells but also in normal cells as BNCT screening.
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Affiliation(s)
- Shou Wang
- Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata Kita-ku Okayama, 700-855, Japan
| | - Kazuyo Igawa
- Neutron Therapy Research Center, Okayama University, 2-5-1 Shikata Kita-ku Okayama, 700-855, Japan.
| | - Ryo Ogawara
- Advanced Research Center for Beam Science, Institute for Chemical Research, Kyoto University, Gokasho, Uji, Kyoto 611-0011, Japan; National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
| | - Mitsuru Suda
- National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
| | - Tsuyoshi Hamano
- National Institutes for Quantum and Radiological Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
| | - Soichiro Ibaragi
- Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata Kita-ku Okayama, 700-855, Japan
| | - Tadashi Hanafusa
- Neutron Therapy Research Center, Okayama University, 2-5-1 Shikata Kita-ku Okayama, 700-855, Japan
| | - Yasuaki Ichikawa
- Neutron Therapy Research Center, Okayama University, 2-5-1 Shikata Kita-ku Okayama, 700-855, Japan
| | - Akira Sasaki
- Department of Oral and Maxillofacial Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata Kita-ku Okayama, 700-855, Japan
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22
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Gogineni E, Rana Z, Vempati P, Karten J, Sharma A, Taylor P, Pereira L, Frank D, Paul D, Seetharamu N, Ghaly M. Stereotactic body radiotherapy as primary treatment for elderly and medically inoperable patients with head and neck cancer. Head Neck 2020; 42:2880-2886. [PMID: 32691496 DOI: 10.1002/hed.26342] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 04/23/2020] [Accepted: 05/30/2020] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Patients with head and neck cancer (HNC) who are not candidates for definitive treatment represent an increasing challenge, with limited data to guide management. Conventional local therapies such as surgery and chemoradiation can significantly impact quality of life (QoL). There has been limited data published using stereotactic body radiotherapy (SBRT) as primary treatment in previously unirradiated patients. We hypothesize that SBRT provides high rates of control while limiting toxicity. METHODS A total of 66 medically unfit previously unirradiated patients with HNC were treated with SBRT, consisting of 35-40 Gy to gross tumor volume and 30 Gy to clinical target volume in five fractions. RESULTS Median age was 80 years. Local control (LC) and overall survival (OS) at 1 year were 73% and 64%. Two patients experienced grade 3 toxicity. CONCLUSION SBRT shows acceptable outcomes with relatively low toxicity in previously unirradiated patients with HNC who are medically unfit for conventional treatment. SBRT may provide an aggressive local therapy with high rates of LC and OS while maintaining QoL.
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Affiliation(s)
- Emile Gogineni
- Department of Radiation Medicine, Northwell Health, Lake Success, New York, USA
| | - Zaker Rana
- Department of Radiation Medicine, Northwell Health, Lake Success, New York, USA
| | - Prashant Vempati
- Department of Radiation Medicine, Northwell Health, Lake Success, New York, USA
| | - Jessie Karten
- Department of Radiation Medicine, Northwell Health, Lake Success, New York, USA
| | - Anurag Sharma
- Department of Radiation Medicine, Northwell Health, Lake Success, New York, USA
| | - Peter Taylor
- Department of Radiation Medicine, Northwell Health, Lake Success, New York, USA
| | - Lucio Pereira
- Department of Otolaryngology, Northwell Health, Lake Success, New York, USA
| | - Douglas Frank
- Department of Otolaryngology, Northwell Health, Lake Success, New York, USA
| | - Doru Paul
- Department of Medical Oncology, Northwell Health, Lake Success, New York, USA
| | | | - Maged Ghaly
- Department of Radiation Medicine, Northwell Health, Lake Success, New York, USA
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23
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The Value of Laboratory Parameters for Anemia, Renal Function, Systemic Inflammation and Nutritional Status as Predictors for Outcome in Elderly Patients with Head-and-Neck Cancers. Cancers (Basel) 2020; 12:cancers12061698. [PMID: 32604773 PMCID: PMC7352755 DOI: 10.3390/cancers12061698] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/05/2020] [Accepted: 06/23/2020] [Indexed: 12/13/2022] Open
Abstract
The purpose of this study was to evaluate the value of routine blood markers regarding their predictive potential for treatment outcomes of elderly head-and-neck squamous cell carcinoma (HNSCC) patients. In total, 246 elderly HNSCC patients (≥65 years) undergoing (chemo)radiotherapy from 2010 to 2018 were analyzed for treatment outcomes, depending on their hemoglobin, glomerular filtration rate (GFR), C-reactive protein (CRP) and albumin values, representing anemia, kidney function, inflammation and nutrition status, respectively. Local/locoregional control, progression-free and overall survival (OS) were calculated using the Kaplan–Meier method. Cox analyses were performed to examine the influence of blood parameters on oncological outcomes. In the univariate Cox regression analysis, hemoglobin ≤ 12 g/dL (HR = 1.536, p < 0.05), a GFR ≤ 60 mL/min/1.73 m2 (HR = 1.537, p < 0.05), a CRP concentration > 5 mg/L (HR = 1.991, p < 0.001) and albumin levels ≤ 4.2 g/dL (HR = 2.916, p < 0.001) were significant risk factors for OS. In the multivariate analysis including clinical risk factors, only performance status (HR = 2.460, p < 0.05) and baseline albumin (HR = 2.305, p < 0.05) remained significant prognosticators. Additionally, baseline anemia correlated with the prevalence of higher-grade chronic toxicities. We could show for the first time that laboratory parameters for anemia (and at least partly, tumor oxygenation), decreased renal function, inflammation and reduced nutrition status are associated with impaired survival in elderly HNSCC patients undergoing (chemo)radiotherapy.
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24
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[Head and neck cancer in the elderly-current aspects]. HNO 2020; 68:184-190. [PMID: 31912168 DOI: 10.1007/s00106-019-00792-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
BACKGROUND The treatment of head and neck cancer is dominated by surgery and radiochemotherapy, which is in part associated with high morbidity. In elderly patients, however, the otorhinolaryngologist often has to question the rationality of invasive treatment. Although the proportion of geriatric patients with head and neck tumors is increasing, the paucity of data means that there are few consistent standards and recommendations in the literature and guidelines. OBJECTIVE The aim of this paper is to provide concrete clinical recommendations for geriatric patients with head and neck tumors based on a systematic literature search. MATERIALS AND METHODS A keyword-based literature search was performed to present the current level of evidence and provide a clinical algorithm. RESULTS In addition to age, the pretreatment dispositional evaluation of geriatric patients should include psychosocial, functional, and medical (patient history) comorbidities. For pretreatment risk stratification, an algorithm was created on the basis of these data for individual evaluation of the patient's pretreatment risk. CONCLUSION Pretreatment risk stratification of geriatric patients with head and neck malignancies is of high relevance for the individual decision for or against invasive treatment, but the currently available evidence is limited. This paper is based on a systematic literature review and provides a clinical algorithm for otorhinolaryngologists and head and neck surgeons.
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Dhahbi J, Nunez Lopez YO, Schneider A, Victoria B, Saccon T, Bharat K, McClatchey T, Atamna H, Scierski W, Golusinski P, Golusinski W, Masternak MM. Profiling of tRNA Halves and YRNA Fragments in Serum and Tissue From Oral Squamous Cell Carcinoma Patients Identify Key Role of 5' tRNA-Val-CAC-2-1 Half. Front Oncol 2019; 9:959. [PMID: 31616639 PMCID: PMC6775249 DOI: 10.3389/fonc.2019.00959] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 09/10/2019] [Indexed: 12/12/2022] Open
Abstract
Oral squamous cell carcinoma (OSCC) is the most common type of head and neck cancer and, as indicated by The Oral Cancer Foundation, kills at an alarming rate of roughly one person per hour. With this study, we aimed at better understanding disease mechanisms and identifying minimally invasive disease biomarkers by profiling novel small non-coding RNAs (specifically, tRNA halves and YRNA fragments) in both serum and tumor tissue from humans. Small RNA-Sequencing identified multiple 5' tRNA halves and 5' YRNA fragments that displayed significant differential expression levels in circulation and/or tumor tissue, as compared to control counterparts. In addition, by implementing a modification of weighted gene coexpression network analysis, we identified an upregulated genetic module comprised of 5' tRNA halves and miRNAs (miRNAs were described in previous study using the same samples) with significant association with the cancer trait. By consequently implementing miRNA-overtargeting network analysis, the biological function of the module (and by "guilt by association," the function of the 5' tRNA-Val-CAC-2-1 half) was found to involve the transcriptional targeting of specific genes involved in the negative regulation of the G1/S transition of the mitotic cell cycle. These findings suggest that 5' tRNA-Val-CAC-2-1 half (reduced in serum of OSCC patients and elevated in the tumor tissue) could potentially serve as an OSCC circulating biomarker and/or target for novel anticancer therapies. To our knowledge, this is the first time that the specific molecular function of a 5'-tRNA half is specifically pinpointed in OSCC.
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Affiliation(s)
- Joseph Dhahbi
- Department of Medical Education, School of Medicine, California University of Science & Medicine, San Bernardino, CA, United States
| | - Yury O. Nunez Lopez
- Translational Research Institute for Metabolism and Diabetes, AdventHealth, Orlando, FL, United States
| | - Augusto Schneider
- Faculdade de Nutrição, Universidade Federal de Pelotas, Pelotas, Brazil
| | - Berta Victoria
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL, United States
| | - Tatiana Saccon
- Faculdade de Nutrição, Universidade Federal de Pelotas, Pelotas, Brazil
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL, United States
| | - Krish Bharat
- Department of Medical Education, School of Medicine, California University of Science & Medicine, San Bernardino, CA, United States
| | - Thaddeus McClatchey
- Department of Medical Education, School of Medicine, California University of Science & Medicine, San Bernardino, CA, United States
| | - Hani Atamna
- Department of Medical Education, School of Medicine, California University of Science & Medicine, San Bernardino, CA, United States
| | - Wojciech Scierski
- Department of Otorhinolaryngology and Laryngological Oncology in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Pawel Golusinski
- Department of Otolaryngology and Maxillofacial Surgery, University of Zielona Gora, Zielona Gora, Poland
- Department of Biology and Environmental Studies, Poznan University of Medical Sciences, Poznań, Poland
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznań, Poland
| | - Wojciech Golusinski
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznań, Poland
| | - Michal M. Masternak
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, Orlando, FL, United States
- Department of Biology and Environmental Studies, Poznan University of Medical Sciences, Poznań, Poland
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznań, Poland
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Hosokawa S, Takahashi G, Okamura J, Imai A, Mochizuki D, Ishikawa R, Takizawa Y, Yamatodani T, Misawa K, Mineta H. Management of elderly patients with head and neck carcinoma: analysis of outcomes for radical versus palliative treatment. Int J Clin Oncol 2019; 25:432-438. [DOI: 10.1007/s10147-019-01531-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Accepted: 08/16/2019] [Indexed: 10/26/2022]
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Saba NF, Blumenschein G, Guigay J, Licitra L, Fayette J, Harrington KJ, Kiyota N, Gillison ML, Ferris RL, Jayaprakash V, Li L, Brossart P. Nivolumab versus investigator's choice in patients with recurrent or metastatic squamous cell carcinoma of the head and neck: Efficacy and safety in CheckMate 141 by age. Oral Oncol 2019; 96:7-14. [PMID: 31422216 PMCID: PMC7723820 DOI: 10.1016/j.oraloncology.2019.06.017] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 06/03/2019] [Accepted: 06/13/2019] [Indexed: 01/17/2023]
Abstract
OBJECTIVES Many patients with squamous cell carcinoma of the head and neck (SCCHN) are ≥65 years old; comorbidities and other age-related factors may affect their ability to tolerate traditional chemotherapy. Nivolumab is the only immunotherapy to significantly improve overall survival (OS) versus investigator's choice (IC) of single-agent chemotherapy at primary analysis in a phase 3 trial (CheckMate 141) in patients with recurrent/metastatic SCCHN post-platinum therapy. In this post hoc analysis, we report efficacy and safety by age. PATIENTS AND METHODS Eligible patients were randomized 2:1 to nivolumab 3 mg/kg every 2 weeks (n = 240) or IC (methotrexate, docetaxel, or cetuximab n = 121). The primary endpoint of the trial was OS. For this analysis, outcomes were analyzed by age < 65 and ≥65 years. The data cut-off date was September 2017 (minimum follow-up 24.2 months). RESULTS At baseline, 68 patients (28.3%) receiving nivolumab and 45 patients (37.2%) receiving IC were ≥65 years. Baseline characteristics were generally similar across age groups. OS and tumor response benefits with nivolumab versus IC were maintained regardless of age. The 30-month OS rates of 11.2% (<65 years) and 13.0% (≥65 years) with nivolumab were more than tripled versus corresponding IC rates of 1.4% and 3.3%, respectively. The nivolumab arm had a lower rate of treatment-related adverse events versus IC regardless of age, consistent with the overall patient population. CONCLUSION In CheckMate 141, nivolumab resulted in a higher survival versus IC in patients <65 and ≥65 years, with a manageable safety profile in both age groups. ClinicalTrials.gov: NCT02105636.
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Affiliation(s)
- Nabil F Saba
- Winship Cancer Institute of Emory University, 1365-C Clifton Road NE, Atlanta, GA 30322, USA.
| | | | - Joel Guigay
- Centre Antoine Lacassagne, FHU OncoAge, Université Côte d'Azur, 33 Avenue de Valombrose, Nice 06189, France.
| | - Lisa Licitra
- Fondazione IRCCS Istituto Nazionale dei Tumori and University of Milan, via Venezian 1, Milan 20133, Italy.
| | - Jerome Fayette
- Centre Leon Berard, 28 Prom. Léa et Napoléon Bullukian, Lyon 69008, France.
| | - Kevin J Harrington
- Royal Marsden NHS Foundation Trust/The Institute of Cancer Research, Fulham Road, London SW3 6JJ, UK.
| | - Naomi Kiyota
- Kobe University Hospital Cancer Center, 7 Chome-5-2 Kusunokicho, Chuo Ward, Kobe 650-0017, Japan.
| | - Maura L Gillison
- MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA.
| | - Robert L Ferris
- University of Pittsburgh Medical Center Hillman Cancer Center, 5115 Centre Ave., Pittsburgh, PA 15232, USA.
| | | | - Li Li
- Bristol-Myers Squibb, 3401 Princeton Pike, Lawrenceville 08648, NJ, USA.
| | - Peter Brossart
- University Hospital of Bonn, Sigmund-Freud-Straße 25, Bonn 53127, Germany.
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Otsuki N, Furukawa T, Avinçsal MO, Teshima M, Shinomiya H, Oshikiri T, Nakamura T, Nomura T, Hashikawa K, Nibu KI. Results of free flap reconstruction for patients aged 80 years or older with head and neck cancer. Auris Nasus Larynx 2019; 47:123-127. [PMID: 31060883 DOI: 10.1016/j.anl.2019.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 04/12/2019] [Accepted: 04/17/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Free flap reconstruction in elderly patients is one of the most challenging surgeries in the treatment of head and neck cancers. The aim of this study was to examine the oncological and functional outcomes of free flap reconstruction for elderly patients with head and neck cancer. METHODS We retrospectively reviewed elderly patients who underwent free flap reconstruction for the treatment of head and neck cancers. All patients were 80 years or older. Clinicopathologic features, surgical procedures, oncological and functional outcomes were obtained from medical records. RESULTS Free flap reconstructions were performed in 13 patients (3 female, 10 male). The mean age was 82.6 ± 3.4 years (range: 80-91). The mean follow-up period was 23.3 months (range 4-41 months). The mean disease-free survival was 49 ± 6 months (range 4-60 months). All patients had been alive more than one year after surgery. Reconstruction was performed using free jejunum in 10 patients and radial forearm flap in 3 patients. Graft necrosis occurred in 2 patients. Other two patients experienced major postoperative medical complications. CONCLUSION Free flap reconstruction in well-selected older adults is safe and effective. Advanced age should not preclude consideration of free flap reconstruction in those patients.
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Affiliation(s)
- Naoki Otsuki
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tatsuya Furukawa
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Mehmet Ozgur Avinçsal
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masanori Teshima
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hirotaka Shinomiya
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Taro Oshikiri
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tetsu Nakamura
- Division of Gastrointestinal Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Tadashi Nomura
- Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Kazunobu Hashikawa
- Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Ken-Ichi Nibu
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
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Kishimoto Y, Harada H, Funakoshi M, Miyamoto SI, Suehiro A, Kitamura M, Muto M, Tateya I, Omori K. Endoscopic laryngo-pharyngeal surgery for elderly patients. Auris Nasus Larynx 2019; 46:279-284. [DOI: 10.1016/j.anl.2018.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 08/08/2018] [Accepted: 08/13/2018] [Indexed: 12/24/2022]
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Wang P, Xu L, Li L, Ren S, Tang J, Zhang M, Xu M. The microRNA-375 as a potentially promising biomarker to predict the prognosis of patients with head and neck or esophageal squamous cell carcinoma: a meta-analysis. Eur Arch Otorhinolaryngol 2019; 276:957-968. [PMID: 30747316 DOI: 10.1007/s00405-019-05325-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 01/31/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND The prognostic value of microRNA-375 (miR-375) expression in squamous cell carcinoma (SCC) had been reported in the previous studies; however, the results remain inconsistent. This study was performed to investigate the prognostic significance of miR-375 expression in SCC based on all eligible evidences. METHODS Relevant studies were identified by searching PubMed, Embace, Medline, Cochrane Library, and China Biology Medicine disk. Survival outcome including overall survival (OS) and other survival outcomes were used as the primary endpoint to evaluate the prognostic outcome of patients with SCC. All statistical analyses were performed in RevMan software version 5.3 and STATA software version 14.1. Furthermore, the quality of included studies was assessed by The Newcastle-Ottawa Scale. RESULTS In total, 13 studies, including 1340 patients, met the inclusion criteria for our meta-analysis. The pooled analysis results indicated that downregulation of miR-375 significantly predicted poor OS (HR 1.58, 95% CI 1.34-1.88, P < 0.001). Downregulated miR-375 was also correlated with the other survival outcomes. Subgroup analysis based on tumor type found that lower expression of miR-375 was significantly related with poor OS in patients with esophageal squamous cell carcinoma (ESCC) (HR 1.58, 95% CI 1.29-1.94, P < 0.001) and head and neck squamous cell carcinoma (HNSCC) (HR 1.59, 95% CI 1.16-2.18, P = 0.004). CONCLUSIONS This meta-analysis demonstrated that the downexpression of miR-375 was significantly correlated with poor OS in patients with SCCs and indicated the potential clinical use of miR-375 as a molecular biomarker, particularly in assessing prognosis for patients with ESCC and HNSCC.
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Affiliation(s)
- Peng Wang
- Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - LiangLiang Xu
- Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Lian Li
- Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - ShengSheng Ren
- Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - JianWei Tang
- Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Ming Zhang
- Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China. .,Department of General Surgery, Mianzhu Hospital of West China Hospital, Sichuan University, Mianzhu, Sichuan, China.
| | - MingQing Xu
- Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
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Jang IJH, Skanthakumar T, Tan HK, Tan NC, Soo KC, Iyer NG. Elderly Patients with Advanced Head and Neck Carcinoma: Does Aggressive Treatment Result in Better Outcomes? Otolaryngol Head Neck Surg 2018; 160:642-650. [PMID: 30558490 DOI: 10.1177/0194599818815065] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE There are no well-defined treatment recommendations for elderly patients with advanced head and neck squamous cell carcinoma. This study aimed to investigate whether aggressive treatment among the elderly translated into better survival outcomes. STUDY DESIGN Retrospective cohort study. SETTING Single tertiary institution. SUBJECTS AND METHODS Elderly patients (≥60 years) with advanced-stage head and neck squamous cell carcinoma (stage III and IV) treated between January 1991 and May 2014 were reviewed. According to current National Comprehensive Cancer Network guidelines, they were classified to have received standard or substandard treatment. Overall survival (OS), locoregional recurrence-free survival, and distant recurrence-free survival were evaluated. RESULTS A total of 355 patients were treated curatively: 194 with up-front surgery and 161 with radiotherapy or concurrent chemotherapy and radiotherapy. Median OS was higher among patients who received standard treatment (42.0 vs 16.0 months, P < .001). On multivariate analysis, standard treatment showed superior OS ( P < .001). Use of substandard treatment showed a hazard ratio of 2.09 (95% CI, 1.59-2.74) for poorer OS. CONCLUSION Aggressive standard treatment protocols should be advocated for elderly patients, where comorbidities permit, as they confer better outcomes.
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Parsemain A, Philouze P, Pradat P, Ceruse P, Fuchsmann C. Free flap head and neck reconstruction: Feasibility in older patients. J Geriatr Oncol 2018; 10:577-583. [PMID: 30497979 DOI: 10.1016/j.jgo.2018.11.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 09/02/2018] [Accepted: 11/08/2018] [Indexed: 01/15/2023]
Abstract
OBJECTIVES The main purpose of this study was to evaluate the perioperative morbidity of free flap head and neck reconstructive surgery in patients aged 70 years and over (Group A) by comparison with a cohort of younger patients (Group B). Secondary objectives included assessment of survival rates and functional outcomes in these older patients, likewise by comparison with a cohort of younger patients. METHODS A retrospective study was conducted on all patients aged 70 years and over who underwent free flap reconstruction between 2012 and 2017. They were compared to a control group of younger patients to investigate hospital length of stay, postoperative complications and survival rates, and functional outcomes. RESULTS No significant difference was observed between the two groups in terms of variables such as hospital length of stay and medical/surgical complications. In multivariate analysis, comorbidity was the only predictive factor for postoperative medical complications, and pharyngolaryngeal location the only significant predictive factor for surgical complications. Factors significantly associated with hospital length of stay were older age, active smoking, pharyngolaryngeal location and the Charlson Comorbidity Index (CCI). Overall survival was the only factor that was substantially lower in the over 70 group, while disease-specific and relapse-free survival were comparable in both groups. CONCLUSION Old age per se should not be considered a contraindication to major surgery combined with free flap reconstruction in older patients.
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Affiliation(s)
- Aurélie Parsemain
- Department of Otolaryngology-Head and Neck Surgery, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Pierre Philouze
- Department of Otolaryngology-Head and Neck Surgery, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Pierre Pradat
- Clinical Research Center, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France; Cancer Research Center of Lyon, UMR Inserm U1052, CNRS 5286, Lyon, France; Claude Bernard University, Lyon 1, France
| | - Philippe Ceruse
- Department of Otolaryngology-Head and Neck Surgery, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France; Claude Bernard University, Lyon 1, France
| | - Carine Fuchsmann
- Department of Otolaryngology-Head and Neck Surgery, Croix Rousse Hospital, Hospices Civils de Lyon, Lyon, France.
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Malik A, Mishra A, Chopda P, Singhvi H, Nair S, Nair D, Laskar SG, Prabhash K, Agarwal JP, Chaturvedi P. Impact of age on elderly patients with oral cancer. Eur Arch Otorhinolaryngol 2018; 276:223-231. [PMID: 30402794 DOI: 10.1007/s00405-018-5191-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 10/30/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION In this study we have tried to analyze the impact of age on various clinico-pathological parameters, treatment completion and subsequent survival in older patients. MATERIALS AND METHODS This is a retrospective analysis of 140 elderly (> 65 years) patients of oral cancer operated between January 2012 and December 2013. The patients were divided into two groups based upon their age that ≤ 70 years and > 70 years.Association of distribution of various clinico-pathological factors between different groups was assessed by using Chi-square test. Survival analysis was done using Kaplan Meir analysis. Univariate and multivariate analysis were performed. RESULTS The two groups had similar distribution of various clinico-pathological factors. Disease free survival for the group ≤ 70 and > 70 years was 37.6 months and 36.4 months (p < 0.594). 13.5% and 7.8% patients > 70 years and ≤ 70 years were either advised or received sub-optimal adjuvant therapy (p < 0.002). CONCLUSION There is no difference distribution of various clinico-pathological factors and survival in patients of oral cancer ≤ 70 and > 70 years of age. Age did not affect survival. Majority of patients could complete the adjuvant therapy advised. Still, significantly more number of patients > 70 years could not receive/complete appropriate adjuvant therapy. Thus treatment needs to be tailored keeping in mind the individual's performance status and the co-morbidities.
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Affiliation(s)
- Akshat Malik
- Department of Head and Neck Oncology, Tata Memorial Centre, Mumbai, India
| | - Aseem Mishra
- Department of Head and Neck Oncology, Tata Memorial Centre, Mumbai, India
| | - Prashant Chopda
- Department of Head and Neck Oncology, Tata Memorial Centre, Mumbai, India
| | - Hitesh Singhvi
- Department of Head and Neck Oncology, Tata Memorial Centre, Mumbai, India
| | - Sudhir Nair
- Department of Head and Neck Oncology, Tata Memorial Centre, Mumbai, India
| | - Deepa Nair
- Department of Head and Neck Oncology, Tata Memorial Centre, Mumbai, India
| | | | - Kumar Prabhash
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, India
| | | | - Pankaj Chaturvedi
- Department of Head and Neck Oncology, Tata Memorial Centre, Mumbai, India.
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Massa ST, Cass LM, Challapalli S, Zahirsha Z, Simpson M, Ward G, Osazuwa-Peters N. Demographic predictors of head and neck cancer survival differ in the elderly. Laryngoscope 2018; 129:146-153. [DOI: 10.1002/lary.27289] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Sean T. Massa
- Department of Otolaryngology-Head and Neck Surgery; Saint Louis University; St. Louis Missouri U.S.A
| | - Lauren M. Cass
- Department of Otolaryngology-Head and Neck Surgery; Saint Louis University; St. Louis Missouri U.S.A
| | - Sai Challapalli
- Department of Otolaryngology-Head and Neck Surgery; Saint Louis University; St. Louis Missouri U.S.A
| | - Zisansha Zahirsha
- Department of Otolaryngology-Head and Neck Surgery; Saint Louis University; St. Louis Missouri U.S.A
| | - Matt Simpson
- Department of Otolaryngology-Head and Neck Surgery; Saint Louis University; St. Louis Missouri U.S.A
| | - Gregory Ward
- Department of Otolaryngology-Head and Neck Surgery; Saint Louis University; St. Louis Missouri U.S.A
| | - Nosayaba Osazuwa-Peters
- Department of Otolaryngology-Head and Neck Surgery; Saint Louis University; St. Louis Missouri U.S.A
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Hararah MK, Stokes WA, Jones BL, Oweida A, Ding D, McDermott J, Goddard J, Karam SD. Nomogram for preoperative prediction of nodal extracapsular extension or positive surgical margins in oropharyngeal squamous cell carcinoma. Oral Oncol 2018; 83:73-80. [PMID: 30098782 DOI: 10.1016/j.oraloncology.2018.06.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 05/28/2018] [Accepted: 06/03/2018] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Extracapsular extension (ECE) in regional lymph nodes and positive surgical margins (PSM) are considered high-risk adverse pathologic features in patients with oropharyngeal squamous cell carcinoma (OPSCC) that each constitute an indication for postoperative adjuvant chemoradiation. We identify pre-operative clinical factors that can predict post-operative ECE and/or PSM and create a nomogram to help clinical decision making. METHODS Adult patients with non-metastatic OPSCC with initial surgical treatment and confirmed HPV status diagnosed between 2010 and 2014 were selected from the National Cancer Database. Clinical staging was modified to American Joint Committee on Cancer 8th edition parameters. Logistic regression was used for multivariate analysis to identify predictors of pathologic ECE and/or PSM. RESULTS 5065 patients were included. 47.5% of the 3336 HPV-positive (HPV+) patients had ECE/PSM. 40.4% of the 1729 HPV-negative (HPV-) patients with had ECE/PSM. A model was built that included age, clinical ECE, tumor grade, and clinical T and N staging for HPV+ patients. Increasing N-classification was highly predictive of pathologic ECE and/or PSM (N1 OR = 3.6, N2 OR = 7.0, N3 OR = 11.2, p < 0.01). Clinical ECE (OR = 4.1, p < 0.01), tumor grade (ORs 2.2-4.4 with p < 0.05), and increasing clinical T-classification (ORs 1.2-1.8, p < 0.05) were also associated with ECE and/or PSM. A similar model was built for HPV- with similar predictive capability. Two internally validated nomograms were designed that demonstrated good discrimination (HPV+ AUC = 0.66, 95% CI: 0.64-0.68, and HPV- AUC = 0.70, 95% CI: 0.67-0.72) and good calibration (goodness-of-fit statistic of HPV+ 6.32, p = 0.61 and HPV- 11.66, p = 0.17). CONCLUSIONS These are the first nomograms designed to help predict ECE or PSM for both HPV+ and HPV- OPSCC. The nomograms can facilitate shared decision-making between clinicians and patients as they consider upfront treatment selection for OPSCC.
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Affiliation(s)
- Mohammad K Hararah
- Departments of Otolaryngology, University of Colorado School of Medicine, Aurora, CO, United States
| | - William A Stokes
- Radiation Oncology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Bernard L Jones
- Radiation Oncology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Ayman Oweida
- Radiation Oncology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Ding Ding
- Radiation Oncology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Jessica McDermott
- Medical Oncology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Julie Goddard
- Departments of Otolaryngology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Sana D Karam
- Radiation Oncology, University of Colorado School of Medicine, Aurora, CO, United States.
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Kolenda T, Przybyła W, Kapałczyńska M, Teresiak A, Zajączkowska M, Bliźniak R, Lamperska KM. Tumor microenvironment - Unknown niche with powerful therapeutic potential. Rep Pract Oncol Radiother 2018; 23:143-153. [PMID: 29760589 PMCID: PMC5948324 DOI: 10.1016/j.rpor.2018.01.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 11/20/2017] [Accepted: 01/20/2018] [Indexed: 12/25/2022] Open
Abstract
Head and neck squamous cell carcinomas (HNSCC) are in a group of cancers that are the most resistant to treatment. The survival rate of HNSCC patients has been still very low since last 20 years. The existence of relationship between oncogenic and surrounding cells is probably the reason for a poor response to treatment. Fibroblasts are an important element of tumor stroma which increases tumor cells ability to proliferate. Another highly resistance, tumorigenic and metastatic cell population in tumor microenvironment are cancer initiating cells (CICs). The population of cancer initiating cells can be found regardless of differentiation status of cancer and they seem to be crucial for HNSCC development. In this review, we describe the current state of knowledge about HNSCC biological and physiological tumor microenvironment.
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Affiliation(s)
- Tomasz Kolenda
- Laboratory of Cancer Genetic, Greater Poland Cancer Centre, Poznan, Poland
- Postgraduate School of Molecular Medicine, Medical University of Warsaw, Poland
- Department of Cancer Immunology, Chair of Medical Biotechnology, Poznan University of Medical Sciences, Poznan, Poland
| | - Weronika Przybyła
- Laboratory of Cancer Genetic, Greater Poland Cancer Centre, Poznan, Poland
- Department of Pediatric Research, Division of Pediatric and Adolescent Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway
| | - Marta Kapałczyńska
- Laboratory of Cancer Genetic, Greater Poland Cancer Centre, Poznan, Poland
- Department of Gastroenterology and Hepatology, Charite University Medicine Berlin, Berlin, Germany
- Department of Molecular Biology, Max Planck Institute for Infection Biology, Berlin, Germany
| | - Anna Teresiak
- Laboratory of Cancer Genetic, Greater Poland Cancer Centre, Poznan, Poland
| | - Maria Zajączkowska
- Laboratory of Cancer Genetic, Greater Poland Cancer Centre, Poznan, Poland
- Department of Cancer Immunology, Chair of Medical Biotechnology, Poznan University of Medical Sciences, Poznan, Poland
| | - Renata Bliźniak
- Laboratory of Cancer Genetic, Greater Poland Cancer Centre, Poznan, Poland
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Verma V, Surkar SM, Moreno AC, Lin C, Simone CB. Practice patterns and outcomes of chemoradiotherapy versus radiotherapy alone for older patients with nasopharyngeal cancer. Cancer Med 2018; 7:1604-1611. [PMID: 29603669 PMCID: PMC5943491 DOI: 10.1002/cam4.1290] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 11/20/2017] [Accepted: 11/21/2017] [Indexed: 01/23/2023] Open
Abstract
Older patients are at increased risk of toxicities from aggressive oncologic therapy and of nononcologic death. A meta‐analysis of non‐nasopharyngeal head and neck cancers showed no statistical benefit in adding chemotherapy to radiotherapy (RT) in older patients; another meta‐analysis of RT versus chemoradiotherapy (CRT) in NPC found advantages to CRT, but vastly under‐represented patients ≥70 years old. This is the largest study to date evaluating outcomes of CRT versus RT alone in this population. The National Cancer Data Base (NCDB) was queried for primary nasopharyngeal cancer cases (2004–2013) in patients ≥70 years old receiving RT alone or CRT. Patients with unknown RT/chemotherapy and T1N0 or M1 disease were excluded. Logistic regression analysis ascertained factors associated with CRT delivery. Kaplan–Meier analysis evaluated overall survival (OS) between both cohorts. Cox proportional hazards modeling determined variables associated with OS. In total, 930 patients were analyzed (n = 713 (77%) CRT, n = 217 (23%) RT). Groups were relatively balanced; CRT was less frequently delivered in patients with advancing age, lower nodal burden, and females (P < 0.05 for all). Median OS in the CRT and RT groups were 35.3 versus 20.0 months, respectively (P = 0.002). On multivariate analysis, independent predictors of OS included age, comorbidities, income and insurance status, tumor grade, and stage (P < 0.05 for all). Notably, receipt of chemotherapy independently predicted for improved OS (P = 0.036). CRT, compared to RT alone, was independently associated with improved survival in NPC patients ≥70 years old. CRT appears to be a promising approach in this population, but treatment‐related toxicity risks should continue to be weighed against potential oncologic benefits.
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Affiliation(s)
- Vivek Verma
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Swati M Surkar
- Department of Physical Therapy, Washington University School of Medicine, St. Louis, Missouri
| | - Amy C Moreno
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Chi Lin
- Department of Radiation Oncology, University of Nebraska Medical Center, Omaha, Nebraska
| | - Charles B Simone
- Department of Radiation Oncology, University of Maryland Medical Center, Baltimore, Maryland
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Magnano M, Bertone F, Andreis M, Boffano P, Machetta G. Management of head and neck cancer in older patients. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 125:369-375. [PMID: 29501356 DOI: 10.1016/j.oooo.2018.01.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 12/21/2017] [Accepted: 01/20/2018] [Indexed: 10/18/2022]
Abstract
OBJECTIVE A progressive increase in the number of older patients with head and neck cancer has been observed in the last few years. The aim of this study was to assess our experience in the management of older patients with head and neck cancer (HNC) in comparison with younger patients. STUDY DESIGN A retrospective review was conducted for all patients admitted and treated for newly diagnosed HNC between January 2008 and December 2012. The clinical characteristics, management approaches, and outcome data were recorded. RESULTS In total, 316 patients with HNC (232 males, 84 females) were enrolled: 203 (64%) were in the young group, whereas 113 patients (36%) were in the older group. Comorbidities (P < .000005) and stage IV tumors (P < .0005) were more frequently observed in the older group. Treatment options were uniformly distributed within the 2 groups; only radiotherapy alone was more frequently administered in older patients (P < .0005). CONCLUSIONS Chronologic age should not be a reason to deny appropriate treatments that could prevent death in older patients. A careful pretreatment assessment should always be performed.
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Affiliation(s)
- Mauro Magnano
- Division of Otolaryngology, Pinerolo and Rivoli Hospitals, ASL TO3, Pinerolo, Italy
| | - Fabio Bertone
- Division of Otolaryngology, Pinerolo and Rivoli Hospitals, ASL TO3, Pinerolo, Italy
| | - Marco Andreis
- Division of Otolaryngology, Pinerolo and Rivoli Hospitals, ASL TO3, Pinerolo, Italy
| | - Paolo Boffano
- Division of Otolaryngology, Pinerolo and Rivoli Hospitals, ASL TO3, Pinerolo, Italy.
| | - Giacomo Machetta
- Division of Otolaryngology, Pinerolo and Rivoli Hospitals, ASL TO3, Pinerolo, Italy
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Schneider A, Victoria B, Lopez YN, Suchorska W, Barczak W, Sobecka A, Golusinski W, Masternak MM, Golusinski P. Tissue and serum microRNA profile of oral squamous cell carcinoma patients. Sci Rep 2018; 8:675. [PMID: 29330429 PMCID: PMC5766573 DOI: 10.1038/s41598-017-18945-z] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 12/18/2017] [Indexed: 12/11/2022] Open
Abstract
Head and neck cancer is characterized by malignant tumors arising from the epithelium covering the upper aerodigestive tract, and the majority of these epithelial malignancies are squamous cell carcinomas (SCCs) of the oral cavity (OSCCs). The aim of the current work was to identify miRNAs regulated in OSCC cancerous tissue when compared to a healthy adjacent tissue and to verify the presence of the same miRNAs in the circulation of these patients. For that serum samples and biopsies of healthy and tumor tissues were collected from five patients diagnosed with OSCC of the oral cavity, RNA was extracted from these samples and microRNAs libraries were prepared and sequenced. A total 255 miRNAs were identified in tissue and 381 different miRNAs were identified in serum samples. When comparing the miRNA expression between tumor and healthy tissue we identified 48 miRNAs (25 down- and 23 up-regulated) that were differentially expressed (FDR < 0.05). From these 48 differentially expressed miRNAs in tissue, 30 miRNAs were also found in the serum of the same patients. hsa-miR-32-5p was up-regulated in tumor compared to healthy tissue in our study, and was previously shown to be up-regulated in the serum of OSCC patients. Therefore, this suggests that miRNAs can be used as potential non-invasive biomarkers of OSCC.
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Affiliation(s)
- Augusto Schneider
- Faculdade de Nutrição, Universidade Federal de Pelotas, Pelotas, RS, Brazil
- College of Medicine, Burnett School of Biomedical Sciences, University of Central Florida, Orlando, Florida, 32827, USA
| | - Berta Victoria
- College of Medicine, Burnett School of Biomedical Sciences, University of Central Florida, Orlando, Florida, 32827, USA
| | - Yury Nunez Lopez
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, FL, USA
| | - Wiktoria Suchorska
- Radiobiology Lab, Department of Medical Physics, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznan, Poland
| | - Wojciech Barczak
- Radiobiology Lab, Department of Medical Physics, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznan, Poland
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznan, Poland
| | - Agnieszka Sobecka
- Radiobiology Lab, Department of Medical Physics, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznan, Poland
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznan, Poland
| | - Wojciech Golusinski
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznan, Poland
| | - Michal M Masternak
- College of Medicine, Burnett School of Biomedical Sciences, University of Central Florida, Orlando, Florida, 32827, USA
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznan, Poland
| | - Pawel Golusinski
- College of Medicine, Burnett School of Biomedical Sciences, University of Central Florida, Orlando, Florida, 32827, USA.
- Department of Head and Neck Surgery, Poznan University of Medical Sciences, The Greater Poland Cancer Centre, Poznan, Poland.
- Department of Biology and Environmental Studies, Poznan University of Medical Sciences, Poznan, Poland.
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Carvalho KM, Sawant PR, Dhupar A, Spadigam A. A Case of Oral Squamous Cell Carcinoma in a Nontobacco Habitué. Int J Appl Basic Med Res 2018; 7:278-280. [PMID: 29308372 PMCID: PMC5752819 DOI: 10.4103/ijabmr.ijabmr_417_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
India is considered to be the oral cancer capital of the world. Oral squamous cell carcinoma is a multifactorial disease with tobacco and alcohol being considered major risk factors. However, there is a growing incidence of nonhabit (i.e., the absence of tobacco or alcohol) associated oral cancer. Difference is noted in demographics, site predilection, grade, and stage while comparing habit associated and nonhabit associated oral carcinoma. This warrants a need for a greater understanding of carcinogenesis without a known carcinogen. This case adds to the sparse existing scientific literature on oral cancer in nonhabitués and reviews the possible etiopathogenic mechanisms underlying the disease process.
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Affiliation(s)
- Karla Maria Carvalho
- Department of Oral and Maxillofacial Pathology, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Poonam Ramnath Sawant
- Department of Oral and Maxillofacial Pathology, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Anita Dhupar
- Department of Oral and Maxillofacial Pathology, Goa Dental College and Hospital, Bambolim, Goa, India
| | - Anita Spadigam
- Department of Oral and Maxillofacial Pathology, Goa Dental College and Hospital, Bambolim, Goa, India
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Nunez Lopez YO, Victoria B, Golusinski P, Golusinski W, Masternak MM. Characteristic miRNA expression signature and random forest survival analysis identify potential cancer-driving miRNAs in a broad range of head and neck squamous cell carcinoma subtypes. Rep Pract Oncol Radiother 2018; 23:6-20. [PMID: 29187807 PMCID: PMC5698002 DOI: 10.1016/j.rpor.2017.10.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 08/27/2017] [Accepted: 10/22/2017] [Indexed: 12/13/2022] Open
Abstract
AIM To characterize the miRNA expression profile in head and neck squamous cell carcinoma (HNSSC) accounting for a broad range of cancer subtypes and consequently identify an optimal miRNA signature with prognostic value. BACKGROUND HNSCC is consistently among the most common cancers worldwide. Its mortality rate is about 50% because of the characteristic aggressive behavior of these cancers and the prevalent late diagnosis. The heterogeneity of the disease has hampered the development of robust prognostic tools with broad clinical utility. MATERIALS AND METHODS The Cancer Genome Atlas HNSC dataset was used to analyze level 3 miRNA-Seq data from 497 HNSCC patients. Differential expression (DE) analysis was implemented using the limma package and multivariate linear model that adjusted for the confounding effects of age at diagnosis, gender, race, alcohol history, anatomic neoplasm subdivision, pathologic stage, T and N stages, and vital status. Random forest (RF) for survival analysis was implemented using the randomForestSRC package. RESULTS A characteristic DE miRNA signature of HNSCC, comprised of 11 upregulated (i.e., miR-196b-5p, miR-1269a, miR-196a-5p, miR-4652-3p, miR-210-3p, miR-1293, miR-615-3p, miR-503-5p, miR-455-3p, miR-205-5p, and miR-21-5p) and 9 downregulated (miR-376c-3p, miR-378c, miR-29c-3p, miR-101-3p, miR-195-5p, miR-299-5p, miR-139-5p, miR-6510-3p, miR-375) miRNAs was identified. An optimal RF survival model was built from seven variables including age at diagnosis, miR-378c, miR-6510-3p, stage N, pathologic stage, gender, and race (listed in order of variable importance). CONCLUSIONS The joint differential miRNA expression and survival analysis controlling for multiple confounding covariates implemented in this study allowed for the identification of a previously undetected prognostic miRNA signature characteristic of a broad range of HNSCC.
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Affiliation(s)
- Yury O. Nunez Lopez
- Translational Research Institute for Metabolism & Diabetes, Florida Hospital, 301 East Princeton St., Orlando, FL 32804, USA
| | - Berta Victoria
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, 6900 Lake Nona Blvd., Orlando, FL 32827, USA
| | - Pawel Golusinski
- Department of Head and Neck Surgery, The Greater Poland Cancer Centre, 15 Garbary St., 61-866 Poznan, Poland
| | - Wojciech Golusinski
- Department of Head and Neck Surgery, The Greater Poland Cancer Centre, 15 Garbary St., 61-866 Poznan, Poland
| | - Michal M. Masternak
- Burnett School of Biomedical Sciences, College of Medicine, University of Central Florida, 6900 Lake Nona Blvd., Orlando, FL 32827, USA
- Department of Head and Neck Surgery, The Greater Poland Cancer Centre, 15 Garbary St., 61-866 Poznan, Poland
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Bonomo P, Desideri I, Loi M, Lo Russo M, Olmetto E, Maragna V, Francolini G, Delli Paoli C, Grassi R, Pezzulla D, Greto D, Meattini I, Livi L. Elderly patients affected by head and neck squamous cell carcinoma unfit for standard curative treatment: Is de-intensified, hypofractionated radiotherapy a feasible strategy? Oral Oncol 2017; 74:142-147. [DOI: 10.1016/j.oraloncology.2017.10.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 10/01/2017] [Accepted: 10/04/2017] [Indexed: 12/22/2022]
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Sommers LW, Steenbakkers RJ, Bijl HP, Vemer-van den Hoek JG, Roodenburg JL, Oosting SF, Halmos GB, de Rooij SE, Langendijk JA. Survival Patterns in Elderly Head and Neck Squamous Cell Carcinoma Patients Treated With Definitive Radiation Therapy. Int J Radiat Oncol Biol Phys 2017; 98:793-801. [DOI: 10.1016/j.ijrobp.2017.02.214] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 02/22/2017] [Accepted: 02/23/2017] [Indexed: 11/29/2022]
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Wang T, Hu P, Li B, Zhang JP, Cheng YF, Liang YM. Role of Nrf2 signaling pathway in the radiation tolerance of patients with head and neck squamous cell carcinoma: an in vivo and in vitro study. Onco Targets Ther 2017; 10:1809-1819. [PMID: 28367064 PMCID: PMC5370066 DOI: 10.2147/ott.s122803] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
We aimed to investigate the relationship between the nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway and the radiation tolerance of patients with head and neck squamous cell carcinoma (HNSCC). From January 2015 to January 2016, 117 patients with HNSCC were enrolled in our study and assigned into the sensitive and tolerance groups based on curative effect. Immunohistochemistry (IHC) was conducted to measure protein expressions of Nrf2, heme oxygenase-1 (HO1), NADPH quinine oxidoreductase 1 (NQO1) and glutathione S-transferase (GST). Human squamous cell carcinoma cell line, HSC-4, was induced by radiation to construct the HSC-4-radiation resistance (RR) cell line. HSC-4 and HSC-4-RR were also assigned into the blank, negative control (NC) and Nrf2 siRNA groups. Cell Counting Kit-8 (CCK-8), quantitative real-time polymerase chain reaction (qRT-PCR) and Western blotting were employed to detect cell viability, mRNA expression and protein expression, respectively, of Nrf2, HO1, NQO1 and GST. A total of 40 nude mice were equally assigned into the untreated, Nrf2 siRNA, radiation therapy (RT) and RT + Nrf2 siRNA groups. Compared with the sensitive group, patients in the tolerance group had upregulated Nrf2, HO1, NQO1 and GST expressions. HSC-4-RR cell line had improved cell viability and higher protein and mRNA expressions of Nrf2, HO1, NQO1 and GST compared with HSC-4 cell line. Compared with the HSC-4-NC and HSC-4-blank groups, the HSC-4-Nrf2 siRNA group had downregulated cell viability. Compared with the HSC-4-RR-NC and HSC-4-RR-blank groups, the HSC-4-RR-Nrf2 siRNA group had lower cell viability. However, the HSC-4-RR-Nrf2 siRNA group had elevated cell viability than the HSC-4-Nrf2 siRNA group. Tumor volume and tumor weight in the RT and RT + Nrf2 siRNA groups decreased evidently. The RT + Nrf2 siRNA group exhibited decreased tumor volume and tumor weight in comparison with the RT group. Our data demonstrated that downregulation of HO1, NQO1 and GST via inhibiting Nrf2 signaling pathway reduces the radiation tolerance of patients with HNSCC.
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Affiliation(s)
- Tao Wang
- Department of Radiotherapy, Qilu Hospital of Shandong University, Jinan, People's Republic of China
| | - Peng Hu
- Department of Radiotherapy, Qilu Hospital of Shandong University, Jinan, People's Republic of China
| | - Bo Li
- Department of Radiotherapy, Qilu Hospital of Shandong University, Jinan, People's Republic of China
| | - Jun-Peng Zhang
- Department of Radiotherapy, Qilu Hospital of Shandong University, Jinan, People's Republic of China
| | - Yu-Feng Cheng
- Department of Radiotherapy, Qilu Hospital of Shandong University, Jinan, People's Republic of China
| | - Ye-Min Liang
- Department of Radiotherapy, Qilu Hospital of Shandong University, Jinan, People's Republic of China
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Neve M, Jameson MB, Govender S, Hartopeanu C. Impact of geriatric assessment on the management of older adults with head and neck cancer: A pilot study. J Geriatr Oncol 2016; 7:457-462. [DOI: 10.1016/j.jgo.2016.05.006] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 04/28/2016] [Accepted: 05/27/2016] [Indexed: 12/16/2022]
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Meucci S, Keilholz U, Tinhofer I, Ebner OA. Mutational load and mutational patterns in relation to age in head and neck cancer. Oncotarget 2016; 7:69188-69199. [PMID: 27596625 PMCID: PMC5342469 DOI: 10.18632/oncotarget.11312] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 07/23/2016] [Indexed: 11/25/2022] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) is a cancer with well-defined tumor causes such as HPV infection, smoking and drinking. Using The Cancer Genome Atlas (TCGA) HNSCC cohort we systematically studied the mutational load as well as patterns related to patient age in HNSCC. To obtain a homogenous set we excluded all patients with HPV infection as well as wild type TP53. We found that the overall mutational load is higher in patients of old age. Through unsupervised hierarchical clustering, we detected distinct mutational clusters in very young as well as very old patients. In the group of old patients, we identified four enriched pathways ("Axon Guidance", "ECM-Receptor Interaction", "Focal Adhesion" and "Notch Signaling") that are only sporadically mutated in the other age groups. Our findings indicate that the four pathways regulate cell motility, tumor invasion and angiogenesis supposedly leading to less aggressive tumors in older age patients. Importantly, we did not see a strict pattern of genes always mutated in older age but rather an accumulation of mutations in the same pathways. Our study provides indications of age-dependent differences in mutational backgrounds of tumors that might be relevant for treatment approaches of HNSCCs patients.
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Affiliation(s)
- Stefano Meucci
- Charité Comprehensive Cancer Center, Charité University Hospital, Charitéplatz, Berlin, Germany
| | - Ulrich Keilholz
- Charité Comprehensive Cancer Center, Charité University Hospital, Charitéplatz, Berlin, Germany
| | - Ingeborg Tinhofer
- Department of Radiation Oncology and Radiotherapy, Charité University Hospital Berlin, Translational Radiation Oncology Research Laboratory, Charitéplatz, Berlin, Germany
| | - Oliva A. Ebner
- Charité Comprehensive Cancer Center, Charité University Hospital, Charitéplatz, Berlin, Germany
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Concurrent Radiotherapy and Triweekly Carboplatin for the Definitive Treatment of Locally Advanced Laryngeal Carcinoma. Am J Clin Oncol 2016; 41:595-600. [PMID: 27635621 DOI: 10.1097/coc.0000000000000330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF THE STUDY In 2003, our institution adopted triweekly carboplatin (tCb) area under the curve (AUC) 5 as an alternative to high-dose cisplatin (100 mg/m) for select patients receiving definitive concurrent chemoradiation for locally advanced laryngeal carcinoma (LALC). Here, we present our experience and outcomes with this definitive concurrent chemoradiation regimen. METHODS From January 2003 through December 2013, 53 patients with stage III (60%) or IVA (40%) LALC were treated with tCb AUC 5 and concurrent radiotherapy to 70 Gy without neoadjuvant chemotherapy. Reasons for using carboplatin instead of cisplatin in these patients were: age 70 and older (21%), poor renal function (6%), presence of 1 or more major comorbid condition(s) (36%), and per discretion of the treating medical oncologist (38%). Primary disease site was glottis in 22 (42%) patients and supraglottis in 31 (58%) patients. RESULTS Median follow-up time was 63 months for surviving patients. Out of the 53 patients, 43 (81%) received all 3 cycles of carboplatin and all patients received their intended dose of radiotherapy. Although 17 (32%) patients required a feeding tube during treatment, only 2 (4%) required it long term. There were no acute treatment-related grade 4 or 5 hematologic toxicities. On last follow-up, 14 (26%) patients had died of intercurrent disease. For the subgroup of "RTOG 9111 eligible" patients in our cohort (n=46), 5-year estimates of overall survival, disease-free survival, laryngectomy-free survival, larynx preservation, and locoregional control were: 49%, 42%, 39%, 80%, and 63%, respectively. CONCLUSIONS In patients with LALC who are suboptimal candidates for high-dose cisplatin, our experience suggests that tCb AUC 5 with concurrent radiotherapy provides acceptable outcomes with tolerable toxicity.
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Szturz P, Vermorken JB. Treatment of Elderly Patients with Squamous Cell Carcinoma of the Head and Neck. Front Oncol 2016; 6:199. [PMID: 27630826 PMCID: PMC5006317 DOI: 10.3389/fonc.2016.00199] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 08/23/2016] [Indexed: 12/27/2022] Open
Abstract
The demographics of squamous cell carcinoma of the head and neck (SCCHN) is marked by a growing number of patients aged 65 and over, which is in line with global projections for other cancer types. In developed countries, more than half of new SCCHN cases are diagnosed in older people, and in 15 years from now, the proportion is expected to rise by more than 10%. Still, a high-level evidence-based consensus to guide the clinical decision process is strikingly lacking. The available data from retrospective studies and subset analyses of prospective trials suffer from a considerable underrepresentation of senior participants. The situation is even more challenging in the recurrent and/or metastatic setting, where usually only palliative measures are employed. Nevertheless, it is becoming clear that, if treated irrespective of chronological age, fit elderly patients in a good general condition and with a low burden of comorbidities may derive a similar survival advantage as their younger counterparts. Despite that, undertreatment represents a widespread phenomenon and, together with competing non-cancer mortality, is suggested to be an important cause of the worse treatment outcomes observed in this population. Due to physiological changes in drug metabolism occurring with advancing age, the major concerns relate to chemotherapy administration. In locally advanced SCCHN, concurrent chemoradiotherapy in patients over 70 years remains a point of controversy owing to its possibly higher toxicity and questionable benefit. However, accumulating evidence suggests that it should, indeed, be considered in selected cases when biological age is taken into account. Results from a randomized trial conducted in lung cancer showed that treatment selection based on a comprehensive geriatric assessment (CGA) significantly reduced toxicity. However, a CGA is time-consuming and not necessary for all patients. To overcome this hurdle, geriatric screening tools have been introduced to decide who needs such a full evaluation. Among the various screening instruments, G8 and Flemish version of the Triage Risk Screening Tool were prospectively verified and found to have prognostic value. We, therefore, conclude that also in SCCHN, the application of elderly specific prospective trials and integration of clinical practice-oriented assessment tools and predictive models should be promoted.
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Affiliation(s)
- Petr Szturz
- Department of Internal Medicine, Hematology, and Oncology, University Hospital Brno, Brno, Czech Republic
- School of Medicine, Masaryk University, Brno, Czech Republic
| | - Jan B. Vermorken
- Department of Medical Oncology, Antwerp University Hospital, Edegem, Belgium
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Zanoletti E, Marioni G, Franchella S, Munari S, Pareschi R, Mazzoni A, Martini A. Temporal bone carcinoma: Classical prognostic variables revisited and modern clinico-pathological evidence. Rep Pract Oncol Radiother 2016; 21:386-90. [PMID: 27330424 PMCID: PMC4899418 DOI: 10.1016/j.rpor.2015.07.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Revised: 06/10/2015] [Accepted: 07/23/2015] [Indexed: 11/25/2022] Open
Abstract
AIM Prognostic factors, rational management, and the ongoing investigations regarding temporal bone squamous cell carcinoma (TBSCC) have been critically reviewed. BACKGROUND TBSCC is an uncommon, aggressive malignancy. Although some progress has been made in treating this aggressive tumor, the prognosis in advanced cases remains poor. MATERIALS AND METHODS A systematic search of the literature for articles published between 2009 and October 2014 was performed using the PubMed (http://www.pubmed.gov) electronic database. RESULTS Given the particular anatomical site of TBSCC, its prognosis is significantly influenced by any direct involvement of nearby structures. The extent of the primary tumor is generally considered one of the most important prognostic factors and it is frequently related to prognosis even more strongly than N stage. For TBSCC, biomarker investigations in surgical specimens are only just beginning to appear in the oncological literature. CONCLUSION Given the particular features of TBSCC, the sub-specialty of otologic oncology seems to be emerging as a defined area of practice involving multidisciplinary team comprising oto-neurosurgeons, head and neck surgeons, plastic surgeons, oncologists, radiotherapists, dedicated radiologists, and pathologists.
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Affiliation(s)
- Elisabetta Zanoletti
- Department of Neurosciences, Otolaryngology Section, Padova University, Padova, Italy
| | - Gino Marioni
- Department of Neurosciences, Otolaryngology Section, Padova University, Padova, Italy
| | - Sebastiano Franchella
- Department of Neurosciences, Otolaryngology Section, Padova University, Padova, Italy
| | - Sara Munari
- Department of Neurosciences, Otolaryngology Section, Padova University, Padova, Italy
| | | | - Antonio Mazzoni
- Department of Neurosciences, Otolaryngology Section, Padova University, Padova, Italy
| | - Alessandro Martini
- Department of Neurosciences, Otolaryngology Section, Padova University, Padova, Italy
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Gorenc M, Kozjek NR, Strojan P. Malnutrition and cachexia in patients with head and neck cancer treated with (chemo)radiotherapy. Rep Pract Oncol Radiother 2015; 20:249-58. [PMID: 26109912 DOI: 10.1016/j.rpor.2015.03.001] [Citation(s) in RCA: 110] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 12/26/2014] [Accepted: 03/02/2015] [Indexed: 12/18/2022] Open
Abstract
AIM To highlight the problems associated with nutrition that occur in patients with squamous cell carcinoma of the head and neck (SCCHN). BACKGROUND SCCHN is associated with weight loss before, during and after radiotherapy or concurrent chemoradiotherapy. Because of serious consequences of malnutrition and cachexia on treatment outcome, mortality, morbidity, and quality of life, it is important to identify SCCHN patients with increased risk for the development of malnutrition and cachexia. MATERIALS AND METHODS Critical review of the literature. RESULTS This review describes pathogenesis, diagnosis and treatment of malnutrition and cancer cachexia. Treatment of malnutrition and cancer cachexia includes nutritional interventions and pharmacological therapy. Advantages and disadvantages of different nutritional interventions and their effect on the nutritional status, quality of life and specific oncological treatment are presented. CONCLUSIONS Nutritional management is an essential part of care of these patients, including early screening, assessment of nutritional status and appropriate intervention.
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Affiliation(s)
- Mojca Gorenc
- Department of Radiation Oncology, Institute of Oncology Ljubljana, Zaloška 2, SI-1000 Ljubljana, Slovenia
| | - Nada Rotovnik Kozjek
- Clinical Nutrition Unit, Institute of Oncology Ljubljana, Zaloška 2, SI-1000 Ljubljana, Slovenia
| | - Primož Strojan
- Department of Radiation Oncology, Institute of Oncology Ljubljana, Zaloška 2, SI-1000 Ljubljana, Slovenia
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