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Maina G, Crawford-Williams F, Woods C, Ooi EH. A cross-sectional survey assessing clinicians' perspectives towards redesigning the surveillance model for head and neck cancer: can we do better? Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08791-x. [PMID: 38985201 DOI: 10.1007/s00405-024-08791-x] [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: 05/17/2024] [Accepted: 06/14/2024] [Indexed: 07/11/2024]
Abstract
BACKGROUND Service delivery of post-treatment surveillance in head and neck cancer (HNC) varies across institutions in Australia. To better understand current practices and develop protocols that maximize service capacity or incorporate emerging technologies, especially in under-resourced regional and remote communities, it is important to obtain the perspectives of clinicians that regularly manage patients with HNC. DESIGN This cross-sectional study utilized an online survey distributed via email to specialists recruited from HNC-associated networks across Australia. The survey captured information on current practices and explored clinician perspectives towards re-designing the current surveillance model to incorporate telehealth or patient-reported outcome measures (PROMs). Quantitative data was analyzed using descriptive statistics while open-ended survey comments were analyzed using a content analysis approach. RESULTS Forty participants completed the survey (25 surgeons, 9 medical oncologists, 5 radiation oncologists and 1 oral medicine specialist). Most clinicians used either institution-specific guidelines (44%) or National Comprehensive Cancer Network guidelines (39%), with the remaining 17% using surveillance intervals based on patient symptoms. Following treatment, 53% of participants imaged patients only when there was clinical suspicion of recurrence or new symptoms. Planned surveillance imaging was conducted at 6 or 12-monthly intervals based on the HNC subtype. Fifty-seven percent of clinicians were open to redesigning the surveillance model, specifically in low-risk patients who did not require nasoendoscopic examination. Seventy-one percent had concerns regarding the feasibility of telehealth appointments, citing disparities in digital health equity. Additionally, 61% felt PROMs are currently underutilized and were open to incorporating HNC-specific PROMS into surveillance. Open-ended responses indicated that within the current surveillance model, "fragmented service provision" and "administration issues" were significantly impacting on timing of care. CONCLUSION Surveyed HNC clinicians feel that current post-treatment surveillance can be fragmented and potentially lead to delayed care. They are open to incorporating PROMS to assist in surveillance scheduling, especially in low-risk patients.
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Affiliation(s)
- Grace Maina
- Department of Otolaryngology and Head and Neck Surgery, Flinders Medical Centre, Adelaide, Australia.
- ENT Department, The Queen Elizabeth Hospital, Woodville, 5011, Australia.
| | | | - Charmaine Woods
- Department of Otolaryngology and Head and Neck Surgery, Flinders Medical Centre, Adelaide, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Eng H Ooi
- Department of Otolaryngology and Head and Neck Surgery, Flinders Medical Centre, Adelaide, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
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Daniels KJ, Gardner J, Solverson M, Davis K, King D, Rose S, Sunde J, Vural E, Moreno MA. Correlating area deprivation index with initial stage at presentation and with follow up and recurrence within an advanced practice provider-led survivorship clinic. Am J Otolaryngol 2024; 45:104095. [PMID: 38039915 DOI: 10.1016/j.amjoto.2023.104095] [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: 06/02/2023] [Accepted: 10/29/2023] [Indexed: 12/03/2023]
Abstract
INTRODUCTION Living in disadvantaged neighborhoods has been shown to result in worse healthcare outcomes. The Area Deprivation Index (ADI) is a metric that ranks neighborhoods by socioeconomic disadvantage utilizing numerous factors including income, education, employment, and housing quality. METHODS A retrospective review of all patients who underwent surveillance in an APP-led head and neck cancer survivorship clinic from Dec 2016 to Oct 2020 at an academic tertiary care center were included. Tumor characteristics, visit frequency, recurrence, number of missed appointments, loss of follow up, and ADI scores were collected. RESULTS 543 patients were included in the study. A majority were male (69.9 %) and white race (84.9 %) with an average age of 64.6 years old. Average ADI national percentile score was 71.6(range: 17 to 100). ADI national percentile score was not predictive of tumor characteristics at initial presentation: lymphovascular invasion (p = 0.940; OR 1.0 [95 % CI: 0.9 to 1.1]), extranodal extension (p = 0.576; OR 1.0 [95 % CI: 0.9 to 1.2]), positive margins (p = 0.069; OR 0.9 [95 % CI: 0.9 to 1.0]). ADI national percentile score was not significantly correlated with loss to follow up (p = 0.153; OR 1.2 [95 % CI: 0.9 to 1.7] or cancer recurrence (p = 0.594; OR 1.0 [95 % CI: 0.9 to 1.1]). Missing one or more clinic visits was correlated with loss to follow up (p = 0.029; OR 13.1 [95 % CI: 1.3 to 131.7]. CONCLUSION Living in a disadvantaged neighborhood did not correlate with negative tumor characteristics, loss to follow up, or recurrence within an APP-led survivorship head and neck cancer clinic.
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Affiliation(s)
- Kacee J Daniels
- Department of Otolaryngology - Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, United States of America
| | - James Gardner
- Department of Otolaryngology - Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, United States of America
| | - Matt Solverson
- Department of Otolaryngology - Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, United States of America
| | - Kyle Davis
- Department of Otolaryngology - Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, United States of America
| | - Deanne King
- Department of Otolaryngology - Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, United States of America
| | - Samantha Rose
- Department of Otolaryngology - Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, United States of America
| | - Jumin Sunde
- Department of Otolaryngology - Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, United States of America.
| | - Emre Vural
- Department of Otolaryngology - Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, United States of America
| | - Mauricio A Moreno
- Department of Otolaryngology - Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, United States of America
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Goodfellow M, O'Hara J, Kennedy M, Adams J. Novel method to plan and design services. Using software to optimise the head and neck cancer patient's commute to hospital. Br J Oral Maxillofac Surg 2024; 62:150-156. [PMID: 38155067 DOI: 10.1016/j.bjoms.2023.10.016] [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: 07/26/2023] [Revised: 10/11/2023] [Accepted: 10/26/2023] [Indexed: 12/30/2023]
Abstract
Travelling for hospital appointments represents a significant burden to patients. We have developed a computer programme that accurately evaluates patient commutes between their home and treatment hospital in public and private transport. This has been applied to a cohort of Head and Neck Cancer (HNC) patients to plan the locations of satellite hospitals and assess their impact on patients' commutes. Patients diagnosed with HNC were identified from our hospital's database between December 2019 and January 2022. Using Python, commuting distances from patients' postcodes to our tertiary referral hospital were calculated. These commutes incorporated routes along defined roads, traffic data, and were calculated using public and private transport. Patient commutes from their postcodes to four satellite hospitals were also calculated. We identified their closest hospital and compared that journey to the patients' journey to our tertiary centre. We included 709 patients in our analysis. Patients would have a significantly shorter journey distance and time in both public and private transport if satellite hospitals were used for appointments alongside our tertiary centre. Average travel times would reduce by 10 minutes in private and 25 minutes in public transport. Furthermore, 70% of patients required ≥2 forms of public transport to get to our hospital. This would drop to 44.1% of patients if satellite hospitals were included in our service. Our programme would allow the most accessible sites to be identified for establishing outreach clinics at appropriate satellite hospitals, therefore improving patient access to healthcare.
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Affiliation(s)
- Michael Goodfellow
- Department of Otolaryngology, Freeman Hospital, Freeman Rd, High Heaton, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne NE7 7DN, United Kingdom.
| | - James O'Hara
- Department of Otolaryngology, Freeman Hospital, Freeman Rd, High Heaton, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne NE7 7DN, United Kingdom
| | - Matthew Kennedy
- Department of Oral & Maxillofacial Surgery, Royal Victoria Infirmary, Queen Victoria Rd, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, United Kingdom
| | - James Adams
- Department of Oral & Maxillofacial Surgery, Royal Victoria Infirmary, Queen Victoria Rd, Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, United Kingdom
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4
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Wierzbicka M, Markowski J, Pietruszewska W, Burduk P, Mikaszewski B, Rogowski M, Składowski K, Milecki P, Fijuth J, Jurkiewicz D, Niemczyk K, Maciejczyk A. Algorithms of follow-up in patients with head and neck cancer in relation to primary location and advancement. Consensus of Polish ENT Society Board and Head Neck Experts. Front Oncol 2023; 13:1298541. [PMID: 38152365 PMCID: PMC10751934 DOI: 10.3389/fonc.2023.1298541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 10/31/2023] [Indexed: 12/29/2023] Open
Abstract
Summary The algorithm of follow-up in patients with head and neck cancer (HNC) has been prepared by a board of Polish Head Neck and Oncology Experts. The aim of this research is to focus on the specificity of HNC monitoring, to review the current trends in follow-up, and to adapt the evidence-based medicine international standards to the capabilities of the local healthcare service. Materials and methods The first methodological step was to categorize HNCs according to the estimated risk of failure after the adequate first-line treatment and according to the possibility of effective salvage treatment, resulting in improved overall survival. The final method used in this work was to prepare an authors' original monitoring algorithm for HNC groups with a high, moderate, and low risk of recurrence in combination with a high or low probability of using an effective salvage. Results Four categories were established: Ia. low risk of recurrence + effective organ preservation feasible; Ib. low risk of recurrence + effective salvage feasible; II. moderate risk of recurrence + effective salvage feasible; III. high risk of recurrence + effective salvage feasible; and IV. high risk of recurrence + no effective salvage feasible. Follow-up visit consisting of 1. ENT examination + neck ultrasound, 2. imaging HN tests, 3. chest imaging, 4. blood tests, and 5. rehabilitation (speech and swallowing) was scheduled with a very different frequency, at the proposed monthly intervals, tailored to the needs of the group. The number of visits for individual groups varies from 1 to 8 in the first 2 years and from 1 to 17 in the entire 5-year monitoring period. Group IV has not been included in regular follow-up, visits on own initiative of the patient if symptomatic, or supportive care needs, having in mind that third-line therapy and immune checkpoint inhibitors are available. Conclusion Universal monitoring algorithm for HNC four groups with a high, moderate, and low risk of recurrence after the adequate treatment in combination with a high or low probability of using an effective salvage is an innovative approach to redeploying system resources and ensuring maximum benefit for patients with HNC.
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Affiliation(s)
- Małgorzata Wierzbicka
- Department of Otolaryngology, Regional Specialist Hospital Wroclaw, Research & Development Centre, Wroclaw, Poland
- Faculty of Medicine, Wroclaw University of Science and Technology, Wroclaw, Poland
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
| | - Jarosław Markowski
- Department of Laryngology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
| | - Wioletta Pietruszewska
- Department of Otolaryngology Head Neck Oncology, Medical University of Lodz, Lodz, Poland
| | - Paweł Burduk
- Department of Otolaryngology Phoniatrics and Audiology, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Bogusław Mikaszewski
- Department of Otolaryngology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Marek Rogowski
- Department of Otolaryngology, Medical University of Bialystok, Bialystok, Poland
| | - Krzysztof Składowski
- Radiation and Clinical Oncology Department, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Piotr Milecki
- Department of Radiotherapy I, The Greater Poland Cancer Centre, Poznan, Poland
| | - Jacek Fijuth
- Department of Radiation Therapy, Oncology Chair, Medical University of Lodz, Lodz, Poland
| | - Dariusz Jurkiewicz
- Department of Otolaryngology and Laryngological Oncology with Clinical Department of Cranio-Maxillofacial Surgery, Military Institute of Medicine - National Research Institute, Warsaw, Poland
| | - Kazimierz Niemczyk
- Department of Otorhinolaryngology Head and Neck Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Adam Maciejczyk
- Department of Oncology, Wroclaw Medical University, Wroclaw, Poland
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Ho H, Chen M, Lin C, Lo Y, Chuang Y, Hsieh M. Epiberberine suppresses the metastasis of head and neck squamous cell carcinoma cells by regulating the MMP-13 and JNK pathway. J Cell Mol Med 2023; 27:3796-3804. [PMID: 37710409 PMCID: PMC10718148 DOI: 10.1111/jcmm.17954] [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: 05/16/2023] [Revised: 08/29/2023] [Accepted: 09/01/2023] [Indexed: 09/16/2023] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) is one of the most common histological types of head and neck cancer. Epiberberine is a potent antitumour agent for several types of cancer. This study is aimed at investigating the regulatory and molecular mechanism of epiberberine on HNSSC cell metastasis. The results showed that epiberberine inhibited the motility of Ca9-22 and FaDu cell lines at nontoxicity doses. Moreover, the epithelial-mesenchymal transition (EMT)-related proteins, vimentin, snail and slug, were found suppressing after epiberberine treatments. In addition, the JNK signalling cascade and the metalloproteinase 13 (MMP-13) expression were also found downregulated by epiberberine. In conclusion, the present study demonstrates that epiberberine suppresses cell migration and invasion by regulating the JNK pathway and MMP-13. These results suggest that epiberberine could be a potential antimetastatic agent in HNSCC cells.
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Affiliation(s)
- Hsin‐Yu Ho
- Oral Cancer Research CenterChanghua Christian HospitalChanghuaTaiwan
| | - Mu‐Kuan Chen
- Department of Otorhinolaryngology, Head and Neck SurgeryChanghua Christian HospitalChanghuaTaiwan
- Department of Post‐Baccalaureate Medicine, College of MedicineNational Chung Hsing UniversityTaichungTaiwan
| | - Chia‐Chieh Lin
- Oral Cancer Research CenterChanghua Christian HospitalChanghuaTaiwan
| | - Yu‐Sheng Lo
- Oral Cancer Research CenterChanghua Christian HospitalChanghuaTaiwan
| | - Yi‐Ching Chuang
- Oral Cancer Research CenterChanghua Christian HospitalChanghuaTaiwan
| | - Ming‐Ju Hsieh
- Oral Cancer Research CenterChanghua Christian HospitalChanghuaTaiwan
- Doctoral Program in Tissue Engineering and Regenerative Medicine, College of MedicineNational Chung Hsing UniversityTaichungTaiwan
- Graduate Institute of Biomedical SciencesChina Medical UniversityTaichungTaiwan
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6
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Lingl JP, Böhm F, Schuler PJ, Hoffmann TK, Deininger K, Beer M, Beer AJ, Thaiss W. [Value of PET imaging in head and neck cancer]. RADIOLOGIE (HEIDELBERG, GERMANY) 2023; 63:925-936. [PMID: 37938427 DOI: 10.1007/s00117-023-01236-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
The combination of positron-emission tomography (PET) with cross-sectional imaging in particular is becoming increasingly important in the diagnosis of head and neck tumors because, in addition to pure anatomy, the metabolic activity of tissue can be visualized and assessed. The combination of PET and computed tomography (CT) is already an established procedure in head and neck tumor patients in some indications, e.g., for primary tumor detection in cancer of unknown primary (CUP) syndrome or also after completed primary radio(chemo)therapy for evaluation of response, especially also with regard to nodal status. In some cases, salvage neck dissection can thus be avoided in the case of PET-negative findings. In the context of primary diagnosis, PET/CT imaging can be used primarily to evaluate distant metastasis. According to current guidelines, PET-based imaging is not (yet) of value in determining the local extent at initial diagnosis. A challenge is the still limited reimbursement by health insurance companies, which currently allow only certain indications, and the still lack of nationwide coverage.
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Affiliation(s)
- Julia P Lingl
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89075, Ulm, Deutschland.
- i2SOUL Consortium, Surgical Oncology Ulm, Ulm, Deutschland.
| | - Felix Böhm
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89075, Ulm, Deutschland
- i2SOUL Consortium, Surgical Oncology Ulm, Ulm, Deutschland
| | - Patrick J Schuler
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89075, Ulm, Deutschland
- i2SOUL Consortium, Surgical Oncology Ulm, Ulm, Deutschland
| | - Thomas K Hoffmann
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89075, Ulm, Deutschland
- i2SOUL Consortium, Surgical Oncology Ulm, Ulm, Deutschland
| | - Katharina Deininger
- Klinik für Nuklearmedizin, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland
- i2SOUL Consortium, Surgical Oncology Ulm, Ulm, Deutschland
| | - Meinrad Beer
- Diagnostische und Interventionelle Radiologie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland
- i2SOUL Consortium, Surgical Oncology Ulm, Ulm, Deutschland
| | - Ambros J Beer
- Klinik für Nuklearmedizin, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland
- i2SOUL Consortium, Surgical Oncology Ulm, Ulm, Deutschland
| | - Wolfgang Thaiss
- Klinik für Nuklearmedizin, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland
- Diagnostische und Interventionelle Radiologie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland
- i2SOUL Consortium, Surgical Oncology Ulm, Ulm, Deutschland
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7
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Chen Z, Guan D, Zhu Q, Wang Z, Han F, Zhou W. Biological Roles and Pathogenic Mechanisms of LncRNA MIR4435-2HG in Cancer: A Comprehensive Review. Curr Issues Mol Biol 2023; 45:8864-8881. [PMID: 37998733 PMCID: PMC10670187 DOI: 10.3390/cimb45110556] [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: 10/19/2023] [Revised: 10/30/2023] [Accepted: 11/02/2023] [Indexed: 11/25/2023] Open
Abstract
The long non-coding RNA MIR4435-2HG has been confirmed to play a crucial regulatory role in various types of tumors. As a novel type of non-coding RNA, MIR4435-2HG plays a key role in regulating the expression of tumor-related genes, interfering with cellular signaling pathways, and affecting tumor immune evasion. Its unique structure allows it to regulate the expression of various tumor-related genes through different pathways, participating in the regulation of tumor signaling pathways, such as regulating the expression of oncogenes and tumor suppressor genes, influencing the biological behaviors of proliferation, metastasis, and apoptosis in tumors. Numerous studies have found a high expression of MIR4435-2HG in various tumor tissues, closely related to the clinical pathological characteristics of tumors, such as staging, lymph node metastasis and prognosis. Some studies have discovered that MIR4435-2HG can regulate the sensitivity of tumor cells to chemotherapy drugs, affecting tumor cell drug resistance. This provides new insights into overcoming tumor drug resistance by regulating MIR4435-2HG. Therefore, studying its molecular mechanisms, expression regulation, and its relationship with the clinical features of tumors is of great significance for revealing the mechanisms of tumor occurrence and developing new therapeutic targets.
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Affiliation(s)
- Zhou Chen
- The First Clinical Medical College, Lanzhou University, Lanzhou 730000, China
- The First Hospital of Lanzhou University, Lanzhou 730000, China
| | - Defeng Guan
- The First Clinical Medical College, Lanzhou University, Lanzhou 730000, China
- The First Hospital of Lanzhou University, Lanzhou 730000, China
| | - Qiangping Zhu
- The First Clinical Medical College, Lanzhou University, Lanzhou 730000, China
| | - Zhengfeng Wang
- The First Clinical Medical College, Lanzhou University, Lanzhou 730000, China
- The First Hospital of Lanzhou University, Lanzhou 730000, China
| | - Fangfang Han
- The First Clinical Medical College, Lanzhou University, Lanzhou 730000, China
- The First Hospital of Lanzhou University, Lanzhou 730000, China
| | - Wence Zhou
- The First Clinical Medical College, Lanzhou University, Lanzhou 730000, China
- The Department of General Surgery, Lanzhou University Second Hospital, Lanzhou 730000, China
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8
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Lingl JP, Böhm F, Schuler PJ, Hoffmann TK, Deininger K, Beer M, Beer AJ, Thaiss W. [Value of PET imaging in head and neck cancer]. HNO 2023; 71:681-692. [PMID: 37702793 DOI: 10.1007/s00106-023-01354-2] [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] [Accepted: 08/04/2023] [Indexed: 09/14/2023]
Abstract
The combination of positron-emission tomography (PET) with cross-sectional imaging in particular is becoming increasingly important in the diagnosis of head and neck tumors because, in addition to pure anatomy, the metabolic activity of tissue can be visualized and assessed. The combination of PET and computed tomography (CT) is already an established procedure in head and neck tumor patients in some indications, e.g., for primary tumor detection in cancer of unknown primary (CUP) syndrome or also after completed primary radio(chemo)therapy for evaluation of response, especially also with regard to nodal status. In some cases, salvage neck dissection can thus be avoided in the case of PET-negative findings. In the context of primary diagnosis, PET/CT imaging can be used primarily to evaluate distant metastasis. According to current guidelines, PET-based imaging is not (yet) of value in determining the local extent at initial diagnosis. A challenge is the still limited reimbursement by health insurance companies, which currently allow only certain indications, and the still lack of nationwide coverage.
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Affiliation(s)
- Julia P Lingl
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89075, Ulm, Deutschland.
- i2SOUL Consortium, Surgical Oncology Ulm, Ulm, Deutschland.
| | - Felix Böhm
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89075, Ulm, Deutschland
- i2SOUL Consortium, Surgical Oncology Ulm, Ulm, Deutschland
| | - Patrick J Schuler
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89075, Ulm, Deutschland
- i2SOUL Consortium, Surgical Oncology Ulm, Ulm, Deutschland
| | - Thomas K Hoffmann
- Universitätsklinik für Hals-Nasen-Ohrenheilkunde, Kopf- und Halschirurgie, Universitätsklinikum Ulm, Frauensteige 12, 89075, Ulm, Deutschland
- i2SOUL Consortium, Surgical Oncology Ulm, Ulm, Deutschland
| | - Katharina Deininger
- Klinik für Nuklearmedizin, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland
- i2SOUL Consortium, Surgical Oncology Ulm, Ulm, Deutschland
| | - Meinrad Beer
- Diagnostische und Interventionelle Radiologie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland
- i2SOUL Consortium, Surgical Oncology Ulm, Ulm, Deutschland
| | - Ambros J Beer
- Klinik für Nuklearmedizin, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland
- i2SOUL Consortium, Surgical Oncology Ulm, Ulm, Deutschland
| | - Wolfgang Thaiss
- Klinik für Nuklearmedizin, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland
- Diagnostische und Interventionelle Radiologie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland
- i2SOUL Consortium, Surgical Oncology Ulm, Ulm, Deutschland
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9
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Ramkumar SP, Bhardwaj A, Patel A, Seetharaman K, Christman A, Amondikar N, Abouelella DK, Hussaini AS, Barnes JM, Adjei Boakye E, Watts TL, Osazuwa-Peters N. Differences in Receipt of Immunotherapy Treatment Among Patients With Head and Neck Cancer. JAMA Otolaryngol Head Neck Surg 2023; 149:912-918. [PMID: 37651149 PMCID: PMC10472266 DOI: 10.1001/jamaoto.2023.2420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 07/01/2023] [Indexed: 09/01/2023]
Abstract
Importance The US Food and Drug Administration approved immune checkpoint inhibitors (immunotherapy) for select cases of head and neck squamous cell carcinoma (HNSCC) in 2016. However, it is unclear whether there are clinical or sociodemographic differences among patients receiving immunotherapy as part of their care. Given the known disparities in head and neck cancer care, we hypothesized that there are differences in receipt of immunotherapy among patients with HNSCC based on clinical and nonclinical characteristics. Objective To characterize clinical and nonclinical factors associated with receipt of immunotherapy among older patients with HNSCC. Design, Setting, and Participants This retrospective cohort study included patients 65 years or older diagnosed with HNSCC (n = 4860) in a community oncology care setting. Electronic health records from Navigating Cancer were assessed from January 1, 2017, to April 30, 2022. Main Outcomes and Measures Multivariable logistic regression was used to characterize clinical (tumor stage [localized vs advanced] and anatomical subsite [oropharyngeal vs nonoropharyngeal]) and nonclinical (age, smoking history, race and ethnicity, sex, and marital status) factors associated with receipt of immunotherapy. Results In the study cohort of 4860 patients, 3593 (73.9%) were men; 4230 (87.0%) were White and 630 (13.0%) were of other races. A total of 552 patients (11.4%) had received immunotherapy. After adjusting for covariates, in the final model, White patients with HNSCC had 80% increased odds of receiving immunotherapy (adjusted odds ratio [AOR], 1.80 [95% CI, 1.30-2.48]) compared with patients of other races. There were no statistically significant differences in the odds of receiving immunotherapy based on age, sex, or smoking history. Patients with nonoropharyngeal disease were significantly more likely to receive immunotherapy than those with oropharyngeal cancer (AOR, 1.29 [95% CI, 1.05-1.59]), as were those with advanced compared with local disease (AOR, 2.39 [95% CI, 1.71-3.34]). Conclusions and Relevance The findings of this cohort study suggest that among older patients with HNSCC, White patients may be more likely to receive immunotherapy as part of their care. Equitable access to immunotherapy and other treatment options will reduce cancer-related health disparities and improve survival of patients with HNSCC.
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Affiliation(s)
- Shreya P. Ramkumar
- currently a medical student at Saint Louis University School of Medicine, St Louis, Missouri
| | | | | | | | | | | | - Dina K. Abouelella
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Adnan S. Hussaini
- Department of Otolaryngology–Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Justin M. Barnes
- Department of Radiation Oncology, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Eric Adjei Boakye
- Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan
- Department of Otolaryngology–Head and Neck Surgery, Henry Ford Health System, Detroit, Michigan
| | - Tammara L. Watts
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina
- Duke Cancer Institute, Durham, North Carolina
| | - Nosayaba Osazuwa-Peters
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina
- Duke Cancer Institute, Durham, North Carolina
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
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10
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Agarwal P, Bloom J, Zhou Y, Zhao R, Huang S, Yajima M, Devaiah AK. Socioeconomic disparities in treatment and survival in patients with hypopharyngeal malignancy. Head Neck 2023; 45:2670-2679. [PMID: 37638612 DOI: 10.1002/hed.27492] [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: 03/15/2023] [Revised: 07/26/2023] [Accepted: 08/14/2023] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND This retrospective study utilizes The Surveillance, Epidemiology, and End Results database to investigate socioeconomic factors leading to treatment disparities in hypopharyngeal malignancy. METHODS Treatment was compared to National Cancer Care Network guidelines. Novel analyses, including logistic modeling, allowed survival analysis and identification of socioeconomic variables not previously considered in staging and management guidelines. RESULTS Black and older patients, and residence in low-income areas predict lower likelihood of standard therapy (p < 0.05). Early-stage disease and standard therapy correlate with improved survival (p < 0.001). Medicaid, advanced age, advanced disease, and treatment outside of consensus guidelines correlated with lower survival (p < 0.0001). CONCLUSIONS There are clear socioeconomic factors impacting treatment and survival in hypopharyngeal malignancies. Standard therapy affords superior survival rate. Black, low socioeconomic status, and older patients are less likely to receive standard therapy. Education and language isolation do not predict treatment or survival. Understanding these discrepancies is paramount to palliating disparities in healthcare.
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Affiliation(s)
- Pratima Agarwal
- Department of Otolaryngology - Head and Neck Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA
- Boston University School of Medicine, Boston, Massachusetts, USA
| | - Jacob Bloom
- Department of Otolaryngology - Head and Neck Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA
- Boston University School of Medicine, Boston, Massachusetts, USA
| | | | - Runqi Zhao
- Boston University, Boston, Massachusetts, USA
| | - Simu Huang
- Boston University, Boston, Massachusetts, USA
| | | | - Anand K Devaiah
- Department of Otolaryngology - Head and Neck Surgery, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA
- Boston University School of Medicine, Boston, Massachusetts, USA
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11
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Gordon K, Smyk D, Gulidov I, Golubev K, Fatkhudinov T. An Overview of Head and Neck Tumor Reirradiation: What Has Been Achieved So Far? Cancers (Basel) 2023; 15:4409. [PMID: 37686685 PMCID: PMC10486419 DOI: 10.3390/cancers15174409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 08/27/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
The recurrence rate of head and neck cancers (HNCs) after initial treatment may reach 70%, and poor prognosis is reported in most cases. Curative options for recurrent HNCs mainly depend on the treatment history and the recurrent tumor localization. Reirradiation for HNCs is effective and has been included in most guidelines. However, the option remains clinically challenging due to high incidence of severe toxicity, especially in cases of quick infield recurrence. Recent technical advances in radiation therapy (RT) provide the means for upgrade in reirradiation protocols. While the majority of hospitals stay focused on conventional and widely accessible modulated RTs, the particle therapy options emerge as tolerable and providing further treatment opportunities for recurrent HNCs. Still, the progress is impeded by high heterogeneity of the data and the lack of large-scale prospective studies. This review aimed to summarize the outcomes of reirradiation for HNCs in the clinical perspective.
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Affiliation(s)
- Konstantin Gordon
- A. Tsyb Medical Radiological Research Center, Branch of the National Medical Research Radiological Center of the Ministry of Health of the Russian Federation (A. Tsyb MRRC), 4, Korolev Street, 249036 Obninsk, Russia; (D.S.); (I.G.); (K.G.)
- Medical Institute, Peoples’ Friendship University of Russia (RUDN University), Miklukho-Maklaya Street 8, 117198 Moscow, Russia;
| | - Daniil Smyk
- A. Tsyb Medical Radiological Research Center, Branch of the National Medical Research Radiological Center of the Ministry of Health of the Russian Federation (A. Tsyb MRRC), 4, Korolev Street, 249036 Obninsk, Russia; (D.S.); (I.G.); (K.G.)
- Medical Institute, Peoples’ Friendship University of Russia (RUDN University), Miklukho-Maklaya Street 8, 117198 Moscow, Russia;
| | - Igor Gulidov
- A. Tsyb Medical Radiological Research Center, Branch of the National Medical Research Radiological Center of the Ministry of Health of the Russian Federation (A. Tsyb MRRC), 4, Korolev Street, 249036 Obninsk, Russia; (D.S.); (I.G.); (K.G.)
| | - Kirill Golubev
- A. Tsyb Medical Radiological Research Center, Branch of the National Medical Research Radiological Center of the Ministry of Health of the Russian Federation (A. Tsyb MRRC), 4, Korolev Street, 249036 Obninsk, Russia; (D.S.); (I.G.); (K.G.)
| | - Timur Fatkhudinov
- Medical Institute, Peoples’ Friendship University of Russia (RUDN University), Miklukho-Maklaya Street 8, 117198 Moscow, Russia;
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12
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Lu D, Zhou X, Sun H, Zeng B, Fu J, Gong J, Liao G, Liang Y, Yang L. Risk of second primary cancer in patients with head and neck squamous cell carcinoma: a systemic review and meta-analysis. Clin Oral Investig 2023; 27:4897-4910. [PMID: 37540282 DOI: 10.1007/s00784-023-05066-3] [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: 06/06/2022] [Accepted: 05/07/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVES Second primary cancer is a common event in patients with head and neck squamous cell carcinoma. However, the incidence and relevant factors vary by studies. We conducted a systematic review and meta-analysis of observational studies to estimate the incidence and relevant risk factors. MATERIALS AND METHODS PubMed and Web of Science were searched for studies published between January 2000 and December 2020 that reported the incidence of SPC in HNSCC patients. Per 1000-person-year incidence and odds ratios were used to estimate the incidence and potential risk factors. Due to the high heterogeneity, random-effects models were used to estimate the incidence and 95% confidence interval. RESULTS Seven thousand seven hundred thirteen articles were identified from the databases, in which 60 studies were included in this meta-analysis. The pooled incidence of the total, synchronous, and metachronous SPC in patients with HNSCC were 29.116 per 1000-person-year, 6.960 per 1000-person-year, and 26.025 per 1000-person-year, respectively. The head and neck region was the most common area where SPC occurred, followed by the lung (7.472 per 1000-person-year) and upper digestive tract (2.696 per 1000-person-year). Smoking, alcohol consumption, betel quid chewing, primary cancer of T1-2, and N0 were risk factors, while HPV infection (OR 0.47, 95% CI 0.30-0.72) was the protective factor. CONCLUSIONS SPC is frequently observed in HNSCC patients and had great impact on the prognosis. The findings could promote a more individualized follow-up strategy for SPC in HNSCC patients. CLINICAL RELEVANCE This systemic review and meta-analysis provide sufficient evidence for the establishment of the follow-up strategy for head and neck squamous cancer patients.
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Affiliation(s)
- Dongheng Lu
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, 56Th Lingyuanxi Road, Guangzhou, 510055, Guangdong, China
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2Nd Zhongshan Road, Guangzhou, 510080, Guangdong, China
| | - Xinyu Zhou
- Department of Oral & Maxillofacial-Head & Neck Oncology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, No 639, Zhizaoju Rd, Shanghai, 200011, China
| | - Huaxiu Sun
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, 56Th Lingyuanxi Road, Guangzhou, 510055, Guangdong, China
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2Nd Zhongshan Road, Guangzhou, 510080, Guangdong, China
| | - Bin Zeng
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, 56Th Lingyuanxi Road, Guangzhou, 510055, Guangdong, China
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2Nd Zhongshan Road, Guangzhou, 510080, Guangdong, China
| | - Jiarun Fu
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, 56Th Lingyuanxi Road, Guangzhou, 510055, Guangdong, China
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2Nd Zhongshan Road, Guangzhou, 510080, Guangdong, China
| | - Jianbin Gong
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, 56Th Lingyuanxi Road, Guangzhou, 510055, Guangdong, China
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2Nd Zhongshan Road, Guangzhou, 510080, Guangdong, China
| | - Guiqing Liao
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, 56Th Lingyuanxi Road, Guangzhou, 510055, Guangdong, China
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2Nd Zhongshan Road, Guangzhou, 510080, Guangdong, China
| | - Yujie Liang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, 56Th Lingyuanxi Road, Guangzhou, 510055, Guangdong, China.
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2Nd Zhongshan Road, Guangzhou, 510080, Guangdong, China.
| | - Le Yang
- Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, 56Th Lingyuanxi Road, Guangzhou, 510055, Guangdong, China.
- Guangdong Province Key Laboratory of Stomatology, No. 74, 2Nd Zhongshan Road, Guangzhou, 510080, Guangdong, China.
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Rahimy E, Gensheimer MF, Beadle B, Le QT. Lessons and Opportunities for Biomarker-Driven Radiation Personalization in Head and Neck Cancer. Semin Radiat Oncol 2023; 33:336-347. [PMID: 37331788 DOI: 10.1016/j.semradonc.2023.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Head and neck cancer is notoriously challenging to treat in part because it constitutes an anatomically and biologically diverse group of cancers with heterogeneous prognoses. While treatment can be associated with significant late toxicities, recurrence is often difficult to salvage with poor survival rates and functional morbidity.1,2 Thus, achieving tumor control and cure at the initial diagnosis is the highest priority. Given the differing outcome expectations (even within a specific sub-site like oropharyngeal carcinoma), there has been growing interest in personalizing treatment: de-escalation in selected cancers to decrease the risk of late toxicity without compromising oncologic outcomes, and intensification for more aggressive cancers to improve oncologic outcomes without causing undue toxicity. This risk stratification is increasingly accomplished using biomarkers, which can represent molecular, clinicopathologic, and/or radiologic data. In this review, we will focus on biomarker-driven radiotherapy dose personalization with emphasis on oropharyngeal and nasopharyngeal carcinoma. This radiation personalization is largely performed on the population level by identifying patients with good prognosis via traditional clinicopathologic factors, although there are emerging studies supporting inter-tumor and intra-tumor level personalization via imaging and molecular biomarkers.
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Affiliation(s)
- Elham Rahimy
- Department of Radiation Oncology, Stanford University, Stanford, CA.
| | | | - Beth Beadle
- Department of Radiation Oncology, Stanford University, Stanford, CA
| | - Quynh-Thu Le
- Department of Radiation Oncology, Stanford University, Stanford, CA
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Mireștean CC, Iancu RI, Iancu DPT. Image Guided Radiotherapy (IGRT) and Delta (Δ) Radiomics-An Urgent Alliance for the Front Line of the War against Head and Neck Cancers. Diagnostics (Basel) 2023; 13:2045. [PMID: 37370940 DOI: 10.3390/diagnostics13122045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/24/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
The identification of a biomarker that is response predictive could offer a solution for the stratification of the treatment of head and neck cancers (HNC) in the context of high recurrence rates, especially those associated with loco-regional failure. Delta (Δ) radiomics, a concept based on the variation of parameters extracted from medical imaging using artificial intelligence (AI) algorithms, demonstrates its potential as a predictive biomarker of treatment response in HNC. The concept of image-guided radiotherapy (IGRT), including computer tomography simulation (CT) and position control imaging with cone-beam-computed tomography (CBCT), now offers new perspectives for radiomics applied in radiotherapy. The use of Δ features of texture, shape, and size, both from the primary tumor and from the tumor-involved lymph nodes, demonstrates the best predictive accuracy. If, in the case of treatment response, promising Δ radiomics results could be obtained, even after 24 h from the start of treatment, for radiation-induced xerostomia, the evaluation of Δ radiomics in the middle of treatment could be recommended. The fused models (clinical and Δ radiomics) seem to offer benefits, both in comparison to the clinical model and to the radiomic model. The selection of patients who benefit from induction chemotherapy is underestimated in Δ radiomic studies and may be an unexplored territory with major potential. The advantage offered by "in house" simulation CT and CBCT favors the rapid implementation of Δ radiomics studies in radiotherapy departments. Positron emission tomography (PET)-CT Δ radiomics could guide the new concepts of dose escalation on radio-resistant sub-volumes based on radiobiological criteria, but also guide the "next level" of HNC adaptive radiotherapy (ART).
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Affiliation(s)
- Camil Ciprian Mireștean
- Department of Oncology and Radiotherapy, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania
- Department of Surgery, Railways Clinical Hospital Iasi, 700506 Iași, Romania
| | - Roxana Irina Iancu
- Oral Pathology Department, "Gr. T. Popa" Faculty of Dental Medicine, University of Medicine and Pharmacy, 700115 Iași, Romania
- Department of Clinical Laboratory, "St. Spiridon" Emergency Universitary Hospital, 700111 Iași, Romania
| | - Dragoș Petru Teodor Iancu
- Oncology and Radiotherapy Department, Faculty of Medicine, "Gr. T. Popa" University of Medicine and Pharmacy, 700115 Iași, Romania
- Department of Radiation Oncology, Regional Institute of Oncology, 700483 Iași, Romania
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15
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Seo IH, Seo HJ, Na D, Yoo M, Schwint A, Kim SH, Lee J, Jeon SJ, Choi JW, Kim WH, Park K, Yee GT, Kim WK. The therapeutic effects on U87 and SAS cells using Proton Linac based Boron Neutron Capture Therapy in Korea. Appl Radiat Isot 2023; 197:110794. [PMID: 37054663 DOI: 10.1016/j.apradiso.2023.110794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/15/2022] [Accepted: 03/26/2023] [Indexed: 04/05/2023]
Abstract
A proton linac based boron neutron capture therapy system (A-BNCT, 10MeV, 4mA) was successfully developed in Korea. We performed in vitro experiments with U87 and SAS cells and revealed the efficacy of a binary therapy BNCT using epithermal neutrons and boronophenylalanine (BPA). The results revealed that BNCT showed cancer cell selectivity and caused cell death. Further in vitro studies can be a valuable method to characterize an A-BNCT system. We expect BNCT to become a treatment option for cancer patients.
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Affiliation(s)
- Il Hyeok Seo
- A-BNCT center, Dawonmedax, 9, Songdomirae-ro, Yeonsu-gu, Incheon, Republic of Korea
| | - Hyo Jung Seo
- A-BNCT center, Dawonmedax, 9, Songdomirae-ro, Yeonsu-gu, Incheon, Republic of Korea.
| | - Dasom Na
- A-BNCT center, Dawonmedax, 9, Songdomirae-ro, Yeonsu-gu, Incheon, Republic of Korea
| | - Mooyoung Yoo
- A-BNCT center, Dawonmedax, 9, Songdomirae-ro, Yeonsu-gu, Incheon, Republic of Korea
| | - Amanda Schwint
- National Atomic Energy Commission (CNEA), Avenida del Libertador 8250, C1429, Buenos Aires, Argentina
| | - Se Hyun Kim
- A-BNCT center, Dawonmedax, 9, Songdomirae-ro, Yeonsu-gu, Incheon, Republic of Korea
| | - Jeongwoo Lee
- A-BNCT center, Dawonmedax, 9, Songdomirae-ro, Yeonsu-gu, Incheon, Republic of Korea
| | - Sang-June Jeon
- A-BNCT center, Dawonmedax, 9, Songdomirae-ro, Yeonsu-gu, Incheon, Republic of Korea
| | - Jae Won Choi
- A-BNCT center, Dawonmedax, 9, Songdomirae-ro, Yeonsu-gu, Incheon, Republic of Korea
| | - Woo Hyoung Kim
- A-BNCT center, Dawonmedax, 9, Songdomirae-ro, Yeonsu-gu, Incheon, Republic of Korea
| | - Kawngwoo Park
- Department of Neurosurgery, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Gi-Taek Yee
- Department of Neurosurgery, Gachon University Gil Medical Center, Incheon, Republic of Korea
| | - Woo-Kyung Kim
- Department of Neurosurgery, Gachon University Gil Medical Center, Incheon, Republic of Korea
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16
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Tao Y, Sun XS, Pointreau Y, Le Tourneau C, Sire C, Kaminsky MC, Coutte A, Alfonsi M, Calderon B, Boisselier P, Martin L, Miroir J, Ramee JF, Delord JP, Clatot F, Rolland F, Villa J, Magne N, Elicin O, Gherga E, Nguyen F, Lafond C, Bera G, Calugaru V, Geoffrois L, Chauffert B, Damstrup L, Crompton P, Ennaji A, Gollmer K, Nauwelaerts H, Bourhis J. Extended follow-up of a phase 2 trial of xevinapant plus chemoradiotherapy in high-risk locally advanced squamous cell carcinoma of the head and neck: a randomised clinical trial. Eur J Cancer 2023; 183:24-37. [PMID: 36796234 DOI: 10.1016/j.ejca.2022.12.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/14/2022] [Accepted: 12/17/2022] [Indexed: 01/10/2023]
Abstract
INTRODUCTION We report long-term efficacy and overall survival (OS) results from a randomised, double-blind, phase 2 study (NCT02022098) investigating xevinapant plus standard-of-care chemoradiotherapy (CRT) vs. placebo plus CRT in 96 patients with unresected locally advanced squamous cell carcinoma of the head and neck (LA SCCHN). METHODS Patients were randomised 1:1 to xevinapant 200 mg/day (days 1-14 of a 21-day cycle for 3 cycles), or matched placebo, plus CRT (cisplatin 100 mg/m2 every 3 weeks for 3 cycles plus conventional fractionated high-dose intensity-modulated radiotherapy [70 Gy/35 F, 2 Gy/F, 5 days/week for 7 weeks]). Locoregional control, progression-free survival, and duration of response after 3 years, long-term safety, and 5-year OS were assessed. RESULTS The risk of locoregional failure was reduced by 54% for xevinapant plus CRT vs. placebo plus CRT but did not reach statistical significance (adjusted hazard ratio [HR] 0.46; 95% CI, 0.19-1.13; P = .0893). The risk of death or disease progression was reduced by 67% for xevinapant plus CRT (adjusted HR 0.33; 95% CI, 0.17-0.67; P = .0019). The risk of death was approximately halved in the xevinapant arm compared with placebo (adjusted HR 0.47; 95% CI, 0.27-0.84; P = .0101). OS was prolonged with xevinapant plus CRT vs. placebo plus CRT; median OS not reached (95% CI, 40.3-not evaluable) vs. 36.1 months (95% CI, 21.8-46.7). Incidence of late-onset grade ≥3 toxicities was similar across arms. CONCLUSIONS In this randomised phase 2 study of 96 patients, xevinapant plus CRT demonstrated superior efficacy benefits, including markedly improved 5-year survival in patients with unresected LA SCCHN.
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Affiliation(s)
- Yungan Tao
- Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France
| | - Xu-Shan Sun
- Department of Radiation Oncology, Nord Franche-Comté de Montbéliard and CHRU de Besançon, Besançon, France
| | - Yoann Pointreau
- Oncologie-Radiothérapie, Institut Inter-Régional de Cancérologie, Centre Jean Bernard, Le Mans, France
| | - Christophe Le Tourneau
- Department of Drug Development and Innovation (D3i), Institut Curie, Paris-Saclay University, Paris, France
| | - Christian Sire
- South Brittany Hospital Center, Hôpital du Scorff Radiothérapie, Lorient, France
| | - Marie-Christine Kaminsky
- Institut Cancérologie de Lorraine - Alexis Vautrin, Oncologie Médicale, Vandoeuvre-lès-Nancy, France
| | | | - Marc Alfonsi
- Institut Sainte Catherine, Radiothérapie, Avignon, France
| | | | - Pierre Boisselier
- Institut du Cancer de Montpellier, Val d'Aurelle, Oncologie-Radiothérapie, Montpellier, France
| | - Laurent Martin
- Centre de Radiothérapie Guillaume le Conquérant, Le Havre, France
| | - Jessica Miroir
- Jean Perrin Center, Radiothérapie, Clermont-Ferrand, France
| | | | - Jean-Pierre Delord
- Medical Oncology Dept, Institut Claudius Regaud, IUCT-Oncopole, Toulouse, France
| | - Florian Clatot
- Henri Becquerel Centre, Service Oncologie Médicale rue d'Amiens, Rouen, France
| | - Frederic Rolland
- Institut de Cancérologie de l'Ouest, Centre René Gauducheau, Saint-Herblain, France
| | - Julie Villa
- CHU Grenoble, Radiothérapie, Pôle de Cancérologie, Grenoble, France
| | - Nicolas Magne
- Institut de Cancérologie Lucien Neuwirth, Radiothérapie, Saint-Priest-en-Jarez, France
| | - Olgun Elicin
- Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Elisabeta Gherga
- Department of Radiation Oncology, Nord Franche-Comté de Montbéliard and CHRU de Besançon, Besançon, France
| | - France Nguyen
- Department of Radiation Oncology, Institut Gustave Roussy, Villejuif, France
| | - Cédrik Lafond
- Oncologie-Radiothérapie, Institut Inter-Régional de Cancérologie, Centre Jean Bernard, Le Mans, France
| | - Guillaume Bera
- South Brittany Hospital Center, Hôpital du Scorff Radiothérapie, Lorient, France
| | - Valentin Calugaru
- Radiotherapy Oncology Department, Institut Curie, Paris-Saclay University, Paris, France
| | - Lionnel Geoffrois
- Institut Cancérologie de Lorraine - Alexis Vautrin, Oncologie Médicale, Vandoeuvre-lès-Nancy, France
| | - Bruno Chauffert
- CHU Amiens Picardie, Oncologie-Radiothérapie, Amiens, France
| | | | | | | | | | | | - Jean Bourhis
- CHUV, Radiation Oncology Department, Bâtiment Hospitalier, Lausanne, Switzerland.
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17
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Denaro N, Succo G, Ostellino O, Airoldi M, Merlano MC, Badellino S, Solinas C, Garrone O, Iorio GC. The oligometastatic setting in HNSCC: A critical review by the Rete Oncologica Piemonte e Valle d'Aosta multidisciplinary team. Crit Rev Oncol Hematol 2023; 185:103968. [PMID: 36965646 DOI: 10.1016/j.critrevonc.2023.103968] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 02/21/2023] [Accepted: 03/22/2023] [Indexed: 03/27/2023] Open
Abstract
INTRODUCTION The oligometastatic disease is a low burden metastatic disease that might still benefit from curable treatment. Squamous cell carcinoma of the head and neck (HNSCC) is a complex group of malignancies, with high rates of loco-regional recurrences. Distant metastases are less frequent, and a single or few deposits are often observed (oligometastatic disease). The optimal management of oligometastatic HNSCC remains to be defined. MATERIALS AND METHODS Key references were derived from a PubMed query. Hand searching and clinicaltrials.gov were also used. RESULTS This paper contains a narrative report and a critical discussion of the available evidence on the management of oligometastatic HNSCC patients, with a focus on metastasis-directed therapy (MDT), particularly stereotactic ablative radiotherapy (SABR). CONCLUSIONS in line with literature data, the multidisciplinary evaluation emerged as the key element in the management of oligometastatic HNSCC patients.
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Affiliation(s)
- Nerina Denaro
- Department of Medical Oncology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy
| | - Giovanni Succo
- Oncology Department, Head & Neck Surgery, University of Turin, Turin, Italy
| | - Oliviero Ostellino
- Oncology Unit 2, Città della Salute e della Scienza di Torino, Turin, Italy
| | - Mario Airoldi
- Oncology Unit 2, Città della Salute e della Scienza di Torino, Turin, Italy
| | - Marco Carlo Merlano
- Scientific Direction, Candiolo Cancer Institute, FPO-IRCCS Candiolo, 10060 Torino, Italy
| | - Serena Badellino
- Department of Oncology, University of Torino, 10125 Torino, Italy
| | - Cinzia Solinas
- Oncology Department AOU Cagliari, Policlinico di Monserrato, Monserrato (CA) Italy
| | - Ornella Garrone
- Department of Medical Oncology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy
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18
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Granda-Díaz R, Manterola L, Hermida-Prado F, Rodríguez R, Santos L, García-de-la-Fuente V, Fernández MT, Corte-Torres MD, Rodrigo JP, Álvarez-Teijeiro S, Lawrie CH, Garcia-Pedrero JM. Targeting oncogenic functions of miR-301a in head and neck squamous cell carcinoma by PI3K/PTEN and MEK/ERK pathways. Biomed Pharmacother 2023; 161:114512. [PMID: 36931033 DOI: 10.1016/j.biopha.2023.114512] [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: 01/27/2023] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 03/18/2023] Open
Abstract
Treatment of head and neck squamous cell carcinomas (HNSCC), the sixth most frequent cancer worldwide, remains challenging. miRNA dysregulation is closely linked to tumorigenesis and tumor progression, thus emerging as suitable targets for cancer treatment. Transcriptomic analysis of TCGA HNSCC dataset revealed that miR-301a expression levels significantly increased in primary tumors, as compared to patient-matched normal tissue. This prompted us to investigate its pathobiological role and potential as new therapeutic target using different preclinical HNSCC models. miR-301a overexpression in HNSCC-derived cell lines led to enhanced proliferation and invasion, whereas miR-301 inhibition reduced these effects. In vivo validation was performed using an orthotopic mouse model. Results concordantly showed that the mitotic counts, the percentage of infiltration depth and Ki67 proliferative index were significantly augmented in the subgroup of mice harboring miR-301a-overexpressing tumors. Further mechanistic characterization revealed PI3K/PTEN/AKT and MEK/ERK pathways as central signaling nodes responsible for mediating the oncogenic activity of miR-301a observed in HNSCC cells. Notably, pharmacological disruption of PI3K and ERK signals with BYL-719 and PD98059, respectively, was effective to completely revert/abolish miR-301a-promoted tumor cell growth and invasion. Altogether, these findings demonstrate that miR-301a dysregulation plays an oncogenic role in HNSCC, thus emerging as a candidate therapeutic target for this disease. Importantly, available PI3K and ERK inhibitors emerge as promising anti-tumor agents to effectively target miR-301a-mediated signal circuit hampering growth-promoting and pro-invasive functions.
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Affiliation(s)
- Rocío Granda-Díaz
- Instituto Universitario de Oncología del Principado de Asturias (IUOPA), University of Oviedo, Oviedo, Spain; Department of Otolaryngology, Hospital Universitario Central de Asturias and Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), University of Oviedo, Oviedo, Spain; CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | - Lorea Manterola
- Molecular Oncology group, Biodonostia Research Institute, San Sebastián, Spain
| | - Francisco Hermida-Prado
- Instituto Universitario de Oncología del Principado de Asturias (IUOPA), University of Oviedo, Oviedo, Spain; Department of Otolaryngology, Hospital Universitario Central de Asturias and Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), University of Oviedo, Oviedo, Spain; CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | - René Rodríguez
- CIBERONC, Instituto de Salud Carlos III, Madrid, Spain; Instituto Universitario de Oncología del Principado de Asturias (IUOPA), University of Oviedo, Oviedo, Spain; Sarcomas and Experimental Therapies, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), University of Oviedo, Oviedo, Spain
| | - Laura Santos
- Instituto Universitario de Oncología del Principado de Asturias (IUOPA), University of Oviedo, Oviedo, Spain; Department of Otolaryngology, Hospital Universitario Central de Asturias and Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), University of Oviedo, Oviedo, Spain
| | - Vanessa García-de-la-Fuente
- Instituto Universitario de Oncología del Principado de Asturias (IUOPA), University of Oviedo, Oviedo, Spain; Department of Otolaryngology, Hospital Universitario Central de Asturias and Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), University of Oviedo, Oviedo, Spain
| | - María Teresa Fernández
- Histopathology Unit, Instituto Universitario de Oncología del Principado de Asturias (IUOPA), University of Oviedo, Oviedo, Spain
| | - M Daniela Corte-Torres
- Biobank of Principado de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
| | - Juan P Rodrigo
- Instituto Universitario de Oncología del Principado de Asturias (IUOPA), University of Oviedo, Oviedo, Spain; Department of Otolaryngology, Hospital Universitario Central de Asturias and Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), University of Oviedo, Oviedo, Spain; CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | - Saúl Álvarez-Teijeiro
- Instituto Universitario de Oncología del Principado de Asturias (IUOPA), University of Oviedo, Oviedo, Spain; Department of Otolaryngology, Hospital Universitario Central de Asturias and Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), University of Oviedo, Oviedo, Spain; CIBERONC, Instituto de Salud Carlos III, Madrid, Spain.
| | - Charles H Lawrie
- Molecular Oncology group, Biodonostia Research Institute, San Sebastián, Spain; IKERBASQUE, Basque Foundation for Science, Bilbao, Spain; Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom; Sino-Swiss Institute of Advanced Technology (SSIAT), Shanghai University, Shanghai, China.
| | - Juana M Garcia-Pedrero
- Instituto Universitario de Oncología del Principado de Asturias (IUOPA), University of Oviedo, Oviedo, Spain; Department of Otolaryngology, Hospital Universitario Central de Asturias and Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), University of Oviedo, Oviedo, Spain; CIBERONC, Instituto de Salud Carlos III, Madrid, Spain.
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19
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Head and Neck Squamous Cell Carcinoma Presenting With Leptomeningeal Carcinomatosis and Myeloradiculopathy via Perineural Growth. J Clin Neuromuscul Dis 2023; 24:164-165. [PMID: 36809206 DOI: 10.1097/cnd.0000000000000425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
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20
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Brands MT, Swinkels IJ, Aarts AMWM, Verbeek ALM, Merkx MAW, Marres HAM, Kaanders JHAM, Melchers WJG, van Engen-van Grunsven I, Takes RP, Geurts SME. Value of routine follow-up in oropharyngeal squamous cell cancer patients treated with curative intent. Head Neck 2023; 45:586-594. [PMID: 36565244 DOI: 10.1002/hed.27269] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 07/28/2022] [Accepted: 11/10/2022] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The major goal of routine follow-up in oropharyngeal squamous cell carcinoma (OPSCC) patients is the asymptomatic detection of new disease in order to improve survival. This study evaluated the effect of routine follow-up on overall survival (OS). METHODS A retrospective cohort of 307 consecutive OPSCC patients treated with curative intent between 2006 and 2012 was analyzed. The effectiveness of routine follow-up was studied by comparing treatment-intent and OS in patients with asymptomatically versus symptomatically detected new disease. RESULTS Three- and five-year risks of new disease were 29% (95% CI: 24-34) and 33% (95% CI: 27-39). Of the 81 patients with locoregional recurrence or second primary head and neck cancer, 8 (10%) were detected asymptomatically with no difference in OS with those detected with symptoms. CONCLUSIONS Asymptomatic detection of new disease during routine visits was not associated with improved OS. The focus of follow-up should be on providing psychosocial care and rehabilitation.
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Affiliation(s)
- Maria T Brands
- Netherlands Comprehensive Cancer Organisation, Eindhoven, The Netherlands
| | - Iris J Swinkels
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anne M W M Aarts
- Radboud Institute for Health Sciences, Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands.,Department of Otorhinolaryngology-Head and Neck Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - André L M Verbeek
- Radboud Institute for Health Sciences, Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Matthias A W Merkx
- Netherlands Comprehensive Cancer Organisation, Eindhoven, The Netherlands.,Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Henri A M Marres
- Department of Otorhinolaryngology-Head and Neck Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Johannes H A M Kaanders
- Department of Radiation Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Willem J G Melchers
- Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Robert P Takes
- Radboud Institute for Health Sciences, Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Sandra M E Geurts
- Radboud Institute for Health Sciences, Department for Health Evidence, Radboud University Medical Centre, Nijmegen, The Netherlands.,Department of Internal Medicine, Division of Medical Oncology, GROW, Maastricht University Medical Center, Maastricht, The Netherlands
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21
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Ferrari C, Santo G, Mammucci P, Rubini D, Sciacqua A, Sardaro A, Pisani AR, Rubini G. [ 18F]FDG PET/CT in head and neck squamous cell carcinoma: a head-to-head between visual point-scales and the added value of multi-modality imaging. BMC Med Imaging 2023; 23:34. [PMID: 36814217 PMCID: PMC9945665 DOI: 10.1186/s12880-023-00989-5] [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: 05/31/2022] [Accepted: 02/09/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Head and neck squamous cell carcinoma (HNSCC) represents the 6th leading cancer worldwide. In most cases, patients present a locally advanced disease at diagnosis and non-surgical curative treatment is considered the standard of care. Nowadays, [18F]FDG PET/CT is a validated tool in post-treatment evaluation, with a high level of evidence. However, to standardize imaging response, several visual scales have been proposed with none of them approved yet. The study's aim is a head-to-head comparison between the diagnostic performance of the Hopkins criteria, the Deauville score, and the new proposed Cuneo score, to establish their prognostic role. Secondly, we investigate the possible value of semiquantitative analysis, evaluating SUVmax and ΔSUVmax of the lymph node with the highest uptake on the restaging PET scan. Moreover, we also considered morphological features using the product of diameters measured on the co-registered CT images to assess the added value of hybrid imaging. METHODS We performed a retrospective analysis on histologically proven HNSCC patients who underwent baseline and response assessment [18F]FDG PET/CT. Post-treatment scans were reviewed according to Hopkins, Deauville, and Cuneo criteria, assigning a score to the primary tumor site and lymph nodes. A per-patient final score for each scale was chosen, corresponding to the highest score between the two sites. Diagnostic performance was then calculated for each score considering any evidence of locoregional progression in the first 3 months as the gold standard. Survival analysis was performed using the Kaplan-Meier method. SUVmax and its delta, as well as the product of diameters of the lymph node with the highest uptake at post-treatment scan, if present, were calculated. RESULTS A total of 43 patients were finally included in the study. Sensitivity, specificity, PPV, NPV, and accuracy were 87%, 86%, 76%, 92%, and 86% for the Hopkins score, whereas 93%, 79%, 70%, 96%, and 84% for the Deauville score, respectively. Conversely, the Cuneo score reached the highest specificity and PPV (93% and 78%, respectively) but the lowest sensitivity (47%), NPV (76%), and accuracy (77%). Each scale significantly correlated with PFS and OS. The ROC analysis of the combination of SUVmax and the product of diameters of the highest lymph node on the restaging PET scan reached an AUC of 0.822. The multivariate analysis revealed the Cuneo criteria and the product of diameters as prognostic factors for PFS. CONCLUSIONS Each visual score statistically correlated with prognosis thus demonstrating the reliability of point-scale criteria in HNSCC. The novel Cuneo score showed the highest specificity, but the lowest sensibility compared to Hopkins and Deauville criteria. Furthermore, the combination of PET data with morphological features could support the evaluation of equivocal cases.
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Affiliation(s)
- Cristina Ferrari
- Nuclear Medicine Unit, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Giulia Santo
- Nuclear Medicine Unit, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Paolo Mammucci
- Nuclear Medicine Unit, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Dino Rubini
- Nuclear Medicine Unit, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Alessio Sciacqua
- Nuclear Medicine Unit, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Angela Sardaro
- Section of Radiology and Radiation Oncology, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124, Bari, Italy.
| | - Antonio Rosario Pisani
- Nuclear Medicine Unit, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Giuseppe Rubini
- Nuclear Medicine Unit, Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124, Bari, Italy
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22
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Head and neck cancer patient-derived tumouroid cultures: opportunities and challenges. Br J Cancer 2023; 128:1807-1818. [PMID: 36765173 PMCID: PMC10147637 DOI: 10.1038/s41416-023-02167-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 01/11/2023] [Accepted: 01/16/2023] [Indexed: 02/12/2023] Open
Abstract
Head and neck cancers (HNC) are the seventh most prevalent cancer type globally. Despite their common categorisation, HNCs are a heterogeneous group of malignancies arising in various anatomical sites within the head and neck region. These cancers exhibit different clinical and biological manifestations, and this heterogeneity also contributes to the high rates of treatment failure and mortality. To evaluate patients who will respond to a particular treatment, there is a need to develop in vitro model systems that replicate in vivo tumour status. Among the methods developed, patient-derived cancer organoids, also known as tumouroids, recapitulate in vivo tumour characteristics including tumour architecture. Tumouroids have been used for general disease modelling and genetic instability studies in pan-cancer research. However, a limited number of studies have thus far been conducted using tumouroid-based drug screening. Studies have concluded that tumouroids can play an essential role in bringing precision medicine for highly heterogenous cancer types such as HNC.
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23
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Dong H, Li M, Yang C, Wei W, He X, Cheng G, Wang S. Combination therapy with oncolytic viruses and immune checkpoint inhibitors in head and neck squamous cell carcinomas: an approach of complementary advantages. Cancer Cell Int 2023; 23:1. [PMID: 36604694 PMCID: PMC9814316 DOI: 10.1186/s12935-022-02846-x] [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: 10/11/2022] [Accepted: 12/30/2022] [Indexed: 01/06/2023] Open
Abstract
Squamous cell carcinomas are the most common head and neck malignancies. Significant progress has been made in standard therapeutic methods combining surgery, radiation, and chemotherapy. Nevertheless, the 5-year survival rate remains at 40-50%. Immune checkpoint inhibitors (ICIs) are a new strategy for treating head and neck squamous cell carcinomas (HNSCCs). Still, the overall response and effective rates are poor, as HNSCCs are 'cold' tumors with an immunosuppressive tumor microenvironment (TME), limiting ICI's beneficial effects. In this case, transforming the tumor suppression microenvironment before using ICIs could be helpful. Oncolytic viruses (OVs) can transform cold tumors into hot tumors, improving the situation. Talimogene laherparepvec (T-VEC), oncolytic immunotherapy authorized for advanced melanoma, also showed good safety and antitumor activity in treating head and neck cancer and pancreatic cancer. In combination with pembrolizumab, T-Vec may have more anticancer efficacy than either drug alone. Therefore, understanding the mechanisms underpinning OVs and their potential synergism with ICIs could benefit patients with HNSCC.
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Affiliation(s)
- Hui Dong
- grid.252957.e0000 0001 1484 5512Department of Stomatology, Bengbu Medical College, 2600 Donghai Avenue, Bengbu, 233030 China ,grid.417401.70000 0004 1798 6507Department of Stomatology, Center for Plastic and Reconstructive Surgery, Cancer Center, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, 310014 Zhejiang China
| | - Mengli Li
- grid.252957.e0000 0001 1484 5512Department of Stomatology, Bengbu Medical College, 2600 Donghai Avenue, Bengbu, 233030 China ,grid.417401.70000 0004 1798 6507Department of Stomatology, Center for Plastic and Reconstructive Surgery, Cancer Center, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, 310014 Zhejiang China
| | - Chen Yang
- grid.417401.70000 0004 1798 6507Department of Ultrasound Medicine, Cancer Center, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, 310014 Zhejiang China
| | - Wei Wei
- grid.506977.a0000 0004 1757 7957Postgraduate Training Base of Jinzhou Medical University (Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, 310014 Zhejiang People’s Republic of China
| | - Xianglei He
- grid.417401.70000 0004 1798 6507Department of Pathology, Cancer Center, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, 310014 Zhejiang China
| | - Gang Cheng
- grid.252957.e0000 0001 1484 5512Department of Stomatology, Bengbu Medical College, 2600 Donghai Avenue, Bengbu, 233030 China ,grid.417401.70000 0004 1798 6507Department of Stomatology, Center for Plastic and Reconstructive Surgery, Cancer Center, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, 310014 Zhejiang China
| | - Shibing Wang
- grid.417401.70000 0004 1798 6507Cancer Center, Key Laboratory of Tumor Molecular Diagnosis and Individualized Medicine of Zhejiang Province, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, 310014 Zhejiang China
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24
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Kotevski DP, Smee RI, Vajdic CM, Field M. Machine Learning and Nomogram Prognostic Modeling for 2-Year Head and Neck Cancer-Specific Survival Using Electronic Health Record Data: A Multisite Study. JCO Clin Cancer Inform 2023; 7:e2200128. [PMID: 36596211 DOI: 10.1200/cci.22.00128] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
PURPOSE There is limited knowledge of the prediction of 2-year cancer-specific survival (CSS) in the head and neck cancer (HNC) population. The aim of this study is to develop and validate machine learning models and a nomogram for the prediction of 2-year CSS in patients with HNC using real-world data collected by major teaching and tertiary referral hospitals in New South Wales (NSW), Australia. MATERIALS AND METHODS Data collected in oncology information systems at multiple NSW Cancer Centres were extracted for 2,953 eligible adults diagnosed between 2000 and 2017 with squamous cell carcinoma of the head and neck. Death data were sourced from the National Death Index using record linkage. Machine learning and Cox regression/nomogram models were developed and internally validated in Python and R, respectively. RESULTS Machine learning models demonstrated highest performance (C-index) in the larynx and nasopharynx cohorts (0.82), followed by the oropharynx (0.79) and the hypopharynx and oral cavity cohorts (0.73). In the whole HNC population, C-indexes of 0.79 and 0.70 and Brier scores of 0.10 and 0.27 were reported for the machine learning and nomogram model, respectively. Cox regression analysis identified age, T and N classification, and time-corrected biologic equivalent dose in two gray fractions as independent prognostic factors for 2-year CSS. N classification was the most important feature used for prediction in the machine learning model followed by age. CONCLUSION Machine learning and nomogram analysis predicted 2-year CSS with high performance using routinely collected and complete clinical information extracted from oncology information systems. These models function as visual decision-making tools to guide radiotherapy treatment decisions and provide insight into the prediction of survival outcomes in patients with HNC.
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Affiliation(s)
- Damian P Kotevski
- Department of Radiation Oncology, Prince of Wales Hospital and Community Health Services, Sydney, New South Wales, Australia.,Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Robert I Smee
- Department of Radiation Oncology, Prince of Wales Hospital and Community Health Services, Sydney, New South Wales, Australia.,Prince of Wales Clinical School, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.,Department of Radiation Oncology, Tamworth Base Hospital, Tamworth, New South Wales, Australia
| | - Claire M Vajdic
- Kirby Institute, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Matthew Field
- South Western Sydney Clinical Campus, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia.,South Western Sydney Cancer Services, NSW Health, Sydney, Sydney, New South Wales, Australia.,Ingham Institute for Applied Medical Research, Sydney, New South Wales, Australia
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25
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Pastorino R, Sassano M, Danilo Tiziano F, Giraldi L, Amore R, Arzani D, Abiusi E, Ahrens W, Vilches LA, Canova C, Healy CM, Holcatova I, Lagiou P, Polesel J, Popovic M, Nygård S, Cadoni G, Znaor A, Boffetta P, Matsuo K, Oze I, Brennan P, Boccia S. Plasma miR-151-3p as a Candidate Diagnostic Biomarker for Head and Neck Cancer: A Cross-sectional Study within the INHANCE Consortium. Cancer Epidemiol Biomarkers Prev 2022; 31:2237-2243. [PMID: 36126276 PMCID: PMC9720423 DOI: 10.1158/1055-9965.epi-22-0376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/24/2022] [Accepted: 09/19/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Identification of screening tests for the detection of head and neck cancer (HNC) at an early stage is an important strategy to improving prognosis. Our objective was to identify plasma circulating miRNAs for the diagnosis of HNC (oral and laryngeal subsites), within a multicenter International Head and Neck Cancer Epidemiology consortium. METHODS A high-throughput screening phase with 754 miRNAs was performed in plasma samples of 88 cases and 88 controls, followed by a validation phase of the differentially expressed miRNAs, identified in the screening, in samples of 396 cases and 396 controls. Comparison of the fold changes (FC) was carried out using the Wilcoxon rank-sum test and the Dunn multiple comparison test. RESULTS We identified miR-151-3p (FC = 1.73, P = 0.007) as differentially expressed miRNAs in the screening and validation phase. The miR-151-3p was the only overexpressed miRNA in validation sample of patients with HNC with early stage at diagnosis (FC = 1.81, P = 0.008) and it was confirmed upregulated both in smoker early-stage cases (FC = 3.52, P = 0.024) and in nonsmoker early-stage cases (FC = 1.60, P = 0.025) compared with controls. CONCLUSIONS We identified miR-151-3p as an early marker of HNC. This miRNA was the only upregulated in patients at early stages of the disease, independently of the smoking status. IMPACT The prognosis for HNC is still poor. The discovery of a new diagnostic biomarker could lead to an earlier tumor discovery and therefore to an improvement in patient prognosis.
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Affiliation(s)
- Roberta Pastorino
- Department of Woman and Child Health and Public Health—Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Michele Sassano
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italia
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Francesco Danilo Tiziano
- Department of Life Sciences and Public Health, Section of Genomic Medicine, Università Cattolica del Sacro Cuore, Roma, Italia
- Unit of Medical Genetics, Department of Laboratory Science and Infectious Diseases, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
| | - Luca Giraldi
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Rosarita Amore
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Dario Arzani
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italia
| | - Emanuela Abiusi
- Department of Life Sciences and Public Health, Section of Genomic Medicine, Università Cattolica del Sacro Cuore, Roma, Italia
- Unit of Medical Genetics, Department of Laboratory Science and Infectious Diseases, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology, BIPS, and University of Bremen, Faculty of Mathematics and Computer Science, Institute of Statistics, Bremen, Germany
| | - Laia Alemany Vilches
- Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, L'Hospitalet de Llobregat, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Cristina Canova
- Department of Cardiac Thoracic Vascular Sciences and Public Health, Università di Padova, Padova, Italia
| | | | - Ivana Holcatova
- Institute of Hygiene & Epidemiology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Pagona Lagiou
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Jerry Polesel
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico (CRO) Aviano, IRCCS, Aviano, Italia
| | - Maja Popovic
- Cancer Epidemiology Unit, Department of Medical Sciences, Università di Torino, Torino, Italia
| | | | - Gabriella Cadoni
- Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della Testa-Collo, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
- Dipartimento Patologia Testa Collo e Organi di Senso, Facoltà Medicina e Chirurgia Università Cattolica Sacro Cuore, Roma, Italia
| | - Ariana Znaor
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York
| | - Keitaro Matsuo
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center, Nagoya, Japan
- Division of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Isao Oze
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center, Nagoya, Japan
| | - Paul Brennan
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Stefania Boccia
- Department of Woman and Child Health and Public Health—Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Roma, Italia
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Steger E, Mattson B, Montano M. Notes on Surviving Head and Neck Cancer: Paving the Road Ahead. Adv Biol (Weinh) 2022; 6:e2200306. [PMID: 36522134 DOI: 10.1002/adbi.202200306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Lee HI, Lee J, Lee JH, Wu HG, Kim JH, Kim Y, Eom KY. Evaluation of Optimal Assessment Schedules for Surveillance After Definitive Locoregional Treatment of Locally Advanced Head and Neck Cancer: A Retrospective Cohort Study With Parametric Modeling of Event-Free Survival. JAMA Otolaryngol Head Neck Surg 2022; 148:1059-1067. [PMID: 36173618 PMCID: PMC9523554 DOI: 10.1001/jamaoto.2022.2561] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 07/08/2022] [Indexed: 12/13/2022]
Abstract
Importance In clinical practice, assessment schedules are often arbitrarily determined after definitive treatment of head and neck cancer (HNC), producing heterogeneous and inconsistent surveillance plans. Objective To establish an optimal assessment schedule for patients with definitively treated locally advanced HNC, stratified by the primary subsite and HPV status, using a parametric model of standardized event-free survival curves. Design, Setting, and Participants This was a retrospective study including 2 tertiary referral hospitals and a total of 673 patients with definitive locoregional treatment of locally advanced HNC (227 patients with nasopharyngeal cancer [NPC]; 237 patients with human papillomavirus-positive oropharyngeal cancer [HPV+ OPC]; 47 patients with HPV-negative [HPV-] OPC; 65 patients with hypopharyngeal cancer [HPC]; and 97 patients with laryngeal cancer [LC]). Patients had received primary treatment in 2008 through 2019. The median (range) follow-up duration was 57.8 (6.4-158.1) months. Data analyses were performed from April to October 2021. Main Outcomes and Measures Tumor recurrence and secondary malignant neoplasms. Event-free survival was defined as the period from the end of treatment to occurrence of any event. Event-free survival curves were estimated using a piecewise exponential model and divided into 3 phases of regular follow-up. A 5% event rate criterion determined optimal follow-up time point and interval. Results The median (range) age of the 673 patients at HNC diagnosis was 58 (15-83) years; 555 (82.5%) were men; race and ethnicity were not considered. The event rates of NPC, HPV+ OPC, HPV- OPC, HPC, and LC were 18.9% (43 of 227), 14.8% (35 of 237), 36.2% (17 of 47), 44.6% (29 of 65), and 30.9% (30 of 97), respectively. Parametric modeling demonstrated optimal follow-up intervals for HPC, LC, and NPC, respectively, every 2.1, 3.2, and 6.1 months; 3.7, 5.6, and 10.8 months; and 9.1, 13.8, and 26.5 months until 16.5, 16.5 to 25.0, and 25.0 to 99.0 months posttreatment (open follow-up thereafter). For HPV- OPC, assessment was recommended every 2.7, 4.8, and 11.8 months until 16.5, 16.5 to 25.0, and 25 to 99 months posttreatment, respectively. In contrast, HPV+ OPC optimal intervals were every 7.7, 13.7, and 33.7 months until 16.5, 16.5 to 25.0, and 25 to 99 months posttreatment, respectively. Five, 4, 12, 15, and 10 follow-up visits were recommended for NPC, HPV+ OPC, HPV- OPC, HPC, and LC, respectively. Conclusions and Relevance This retrospective cohort study using parametric modeling suggests that the HNC assessment schedules should be patient tailored and evidence based to consider primary subsites and HPV status. Given limited health care resources and rising detection rates and costs of HNC, the guidelines offered by these findings could benefit patients and health systems and aid in developing future consensus guidelines.
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Affiliation(s)
- Hye In Lee
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Jongjin Lee
- Department of Statistics, Seoul National University, Seoul, Korea
| | - Joo Ho Lee
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hong-Gyun Wu
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
- Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jin Ho Kim
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea
| | - Yongdai Kim
- Department of Statistics, Seoul National University, Seoul, Korea
| | - Keun-Yong Eom
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
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Taziki M, Rajaei S, Firouzei G, Hashemzadeh F, Rajabalian M, Mansoury M, Sedaghat S, Ghahraman F, Ghasemi-Kebria F, Weiderpass E, Roshandel G. Five-year relative survival and determinants of excess mortality in patients with head and neck and thyroid cancers: A population-based study from Golestan province, Northern Iran. Cancer Epidemiol 2022; 80:102247. [PMID: 36081275 DOI: 10.1016/j.canep.2022.102247] [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: 03/31/2022] [Revised: 07/28/2022] [Accepted: 08/29/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND We aimed to assess relative survival (RS) and determinants of excess mortality rate in patients with head and neck squamous cell carcinomas (HNSCC) and thyroid cancer in Golestan province, Northern Iran. METHODS We recruited new primary HNSCC and thyroid cancer cases from Golestan, 2006-2016. Five-year age-standardized RS with their 95% confidence intervals (CIs) were calculated. The relationships between different variables with excess mortality rates were assessed by estimating adjusted excess hazard ratios (aEHRs) with their 95% CIs. RESULTS Overall, 718 cases of HNSCC and 386 thyroid cancer cases were enrolled. Five-year age-standardized RS (95% CI) were 36% (31-41) and 61% (52-69) in HNSCC and thyroid cancer patients, respectively. There were significant relationship between excess mortality rates in HNSCC patients with metastasis (aEHR= 3.31; 95%CI: 2.26-4.84), treatment type (4.19; 2.54-6.91, for no treatment as compared to receiving both surgery and chemoradiotherapy), age (2.16; 1.57-2.96, for older age group) and smoking (2.00; 1.45-2.75, for smokers as compared to non-smokers). Determinant of the excess mortality in thyroid cancer patients included metastasis (19.65; 8.08-47.79), tumor morphology (12.27; 4.62-32.58, for anaplastic cancer as compared to papillary cancer), treatment type (8.95, 4.13-19.4, for no treatment as compared to receiving both surgery and iodine therapy) and age (2.31; 1.17-4.54, for older age group). CONCLUSION Our findings suggested low RS for thyroid cancer in our population, while the estimates for HNSCC were comparable with other population. Metastasis, treatment type and age were determinants of mortality both in thyroid and HNSCC patients.
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Affiliation(s)
| | - Siamak Rajaei
- Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Golare Firouzei
- Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | | | - Mahdis Rajabalian
- Cancer Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mohsen Mansoury
- Department of Statistics and Information Technology, Golestan University of Medical Sciences, Gorgan, Iran
| | - SeyedMehdi Sedaghat
- Deputy of Public Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Fahimeh Ghahraman
- Deputy of Public Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Fatemeh Ghasemi-Kebria
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran.
| | - Elisabete Weiderpass
- Office of the Director, International Agency for Research on Cancer (IARC), Lyon, France
| | - Gholamreza Roshandel
- Golestan Research Center of Gastroenterology and Hepatology, Golestan University of Medical Sciences, Gorgan, Iran; Omid Cancer Research Center, Omid Preventive Medicine and Heath Promotion Center, Golestan University of Medical Sciences, Gorgan, Iran.
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Ooms M, Puladi B, Winnand P, Heitzer M, Steiner T, Bickenbach J, Hölzle F, Modabber A. Perfusion of microvascular free flaps in head and neck reconstruction after prior neck dissection and irradiation. Int J Oral Maxillofac Surg 2022; 52:640-647. [PMID: 36253245 DOI: 10.1016/j.ijom.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 10/05/2022] [Accepted: 10/07/2022] [Indexed: 12/24/2022]
Abstract
Microvascular free flaps are frequently used for head and neck reconstruction after prior neck dissection (ND) and neck irradiation (RTX). The aim of this study was to investigate the influence of ND and RTX on flap perfusion as a critical factor for flap success. Overall, 392 patients reconstructed with a microvascular fasciocutaneous flap (FF) or perforator flap (PF) in the head and neck region between 2011 and 2020 were analysed retrospectively. Flap perfusion measured intraoperatively and postoperatively with the O2C tissue oxygen analysis system was compared between patients who had received neither ND nor RTX (controls), patients who had received ND but no RTX (ND group), and patients who had received both ND and RTX (ND+RTX group). Intraoperative and postoperative flap blood flow was decreased in FFs in ND group patients compared to controls (median 66.3 AU vs 86.0 AU, P = 0.023; median 73.5 AU vs 93.8 AU, P = 0.045, respectively). In the multivariable analysis, these differences showed a tendency to persist (P = 0.052 and P = 0.056). Flap success rates were similar in control patients, ND patients, and ND+RTX patients (98.7%, 94.0%, and 97.6%, respectively). Flap perfusion is not reduced in FFs and PFs in patients who have undergone ND or ND and RTX. This indicates that neck dissection and neck irradiation should not be contraindications for microvascular free flap reconstruction.
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Dietz M, Jain S, Monnett S, Deipolyi A. Transarterial Embolization-Assisted Necrosis of a Facial Tumor. Cureus 2022; 14:e29119. [PMID: 36147865 PMCID: PMC9482801 DOI: 10.7759/cureus.29119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2022] [Indexed: 11/05/2022] Open
Abstract
The treatment and prognosis of non-operable high-risk head and neck squamous cell carcinoma (SCC) are poor. There is no definitive model for therapy in these cases to date, but strategies that have been utilized include radiation therapy (RT) with or without chemotherapy. Here, we report the effectiveness of arterial embolization with subsequent chemoradiation with cisplatin in a case of advanced oropharyngeal SCC. These interventions resulted in a remarkable tumor burden reduction of a stage IV SCC of the head and neck that had been deemed nonresectable.
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Tsai YL, Chen SW, Kao CH, Cheng DC. Neck Lymph Node Recurrence in HNC Patients Might Be Predicted before Radiotherapy Using Radiomics Extracted from CT Images and XGBoost Algorithm. J Pers Med 2022; 12:jpm12091377. [PMID: 36143163 PMCID: PMC9503811 DOI: 10.3390/jpm12091377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 08/20/2022] [Accepted: 08/23/2022] [Indexed: 12/24/2022] Open
Abstract
The five-year overall survival rate of patients without neck lymph node recurrence is over 50% higher than those with lymph node metastasis. This study aims to investigate the prognostic impact of computed tomogram (CT)-based radiomics on the outcome of metastatic neck lymph nodes in patients with head and neck cancer (HNC) receiving definitive radiotherapy or chemoradiotherapy for organ preservation. The pretreatment 18F-FDG PET/CT of 79 HNC patients was retrospectively analyzed with radiomics extractors. The imbalanced data was processed using two techniques: over-sampling and under-sampling, after which the prediction model was established with a machine learning model using the XGBoost algorithm. The imbalanced dataset strategies slightly decreased the specificity but greatly improved the sensitivity. To have a higher chance of predicting neck cancer recurrence, however, clinical data combined with CT-based radiomics provides the best prediction effect. The original dataset performed was as follows: accuracy = 0.76 ± 0.07, sensitivity = 0.44 ± 0.22, specificity = 0.88 ± 0.06. After we used the over-sampling technique, the accuracy, sensitivity, and specificity values were 0.80 ± 0.05, 0.67 ± 0.11, and 0.84 ± 0.05, respectively. Furthermore, after using the under-sampling technique, the accuracy, sensitivity, and specificity values were 0.71 ± 0.09, 0.73 ± 0.13, and 0.70 ± 0.13, respectively. The outcome of metastatic neck lymph nodes in patients with HNC receiving radiotherapy for organ preservation can be predicted based on the results of machine learning. This way, patients can be treated alternatively. A further external validation study is required to verify our findings.
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Affiliation(s)
- Yi-Lun Tsai
- The Ph.D Program for Medical Engineering and Rehabilitation Science, College of Biomedical Engineering, China Medical University, Taichung 404333, Taiwan
| | - Shang-Wen Chen
- Department of Radiation Oncology, China Medical University Hospital, Taichung 404327, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung 404333, Taiwan
- School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
- Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung 404327, Taiwan
| | - Chia-Hung Kao
- Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung 404327, Taiwan
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung 404327, Taiwan
- Graduate Institute of Biomedical Sciences, School of Medicine, College of Medicine, Elite Campus, China Medical University, Taichung 404333, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, Taichung 41354, Taiwan
| | - Da-Chuan Cheng
- Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung 404327, Taiwan
- Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung 404333, Taiwan
- Correspondence: ; Tel.: +886-932-030-392
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Clinical Characteristics and Predictive Outcomes of Recurrent Nasopharyngeal Carcinoma-A Lingering Pitfall of the Long Latency. Cancers (Basel) 2022; 14:cancers14153795. [PMID: 35954458 PMCID: PMC9367553 DOI: 10.3390/cancers14153795] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/28/2022] [Accepted: 08/01/2022] [Indexed: 12/28/2022] Open
Abstract
Purpose: To investigate the clinical characteristics, risk factors, and clinical outcomes of long-latent recurrence (>five years) of nasopharyngeal carcinoma (NPC). Methods: This retrospective study enrolled newly diagnosed NPC patients from the Chang Gung Research Database between January 2007 and December 2019. We analyzed the patients’ characteristics and survival outcomes after recurrence. Results: A total of 2599 NPC patients were enrolled. The overall recurrence rate was 20.5%, while 8.1% of patients had long-latent recurrence (>five years). These patients had a higher percentage of initial AJCC (The American Joint Committee on Cancer) stage I/II (60.5%, p = 0.001) and local recurrence (46.5%, p < 0.001). Unresectable rT3 and rT4 were found in 60% of patients when recurrence and 30% of local recurrence occurred in the skull base, which could not be detected by the regular endoscopy. The five-year overall survival rate of long-latent recurrence was 19.7%. Alive patients tended to be asymptomatic but have regular follow-ups with the interval less than six months. Multivariate analysis showed age and initial advanced AJCC stages were independent risk factors of death after recurrence. In contrast, patients with recurrence between two and five years, salvage surgeries, and regional recurrence had favorable survival outcomes. Conclusion: Long-latent NPC recurrence is not rare, and the survival outcome is poor. Regular follow-up for early detection of NPC recurrence is necessary even after five years of disease-free period.
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Zirakchian Zadeh M, Asadollahi S, Kaghazchi F, Raynor WY, Mehdizadeh Seraj S, Werner TJ, Seierstad T, Korostoff J, Swisher-McClure S, Alavi A, Revheim ME. Prognostic significance of conventional and volumetric PET parameters with and without partial volume correction in the assessment of head and neck squamous cell carcinoma. Nucl Med Commun 2022; 43:800-806. [PMID: 35552334 DOI: 10.1097/mnm.0000000000001573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND The optimal quantification of PET in assessment of head and neck squamous cell carcinoma (HNSCC) is still under development. The effect of partial volume correction (PVC) on the evaluation of survival in the HNSCC patients has not been investigated yet. METHODOLOGY Pretreatment 18F-FDG-PET/CT scans of a selected group of 57 patients with advanced stage HNSCC were collected. Conventional (SUVmean and SUVmax) and volumetric [total lesion glycolysis (TLG) and metabolic tumor volume (MTV)] PET metrics were calculated. The ROVER software (ABX GmbH, Radeberg, Germany) automatically applied PVC to the PET metrics. Cox proportional hazards regression model calculated hazard ratio (HR) for assessment of predictive parameters of progression-free survival (PFS). RESULTS In multivariate Cox regression analysis, including age, gender, race, human papillomavirus status, and stage, the only significant predictors of PFS were the volumetric PET parameters (TLG: HR, 1.003; 95% CI, 1.001-1.005; P = 0.02), pvcTLG (HR, 1.002; 95% CI, 1.001-1.004; P = 0.01) and MTV (HR, 1.050; 95% CI, 1.024-1.077; P < 0.01). The partial volume-corrected values were significantly higher than the noncorrected values (Wilcoxon sign test; P < 0.05). However, there was not a statistically significant difference between the nonpartial volume corrected and partial volume-corrected PET metrics for assessment of PFS. CONCLUSION Volumetric PET metrics were predictors of PFS in Cox regression analysis. Applying PVC could not significantly improve the accuracy of PET metrics for assessment of PFS.
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Affiliation(s)
| | - Shadi Asadollahi
- Johns Hopkins Medicine and The Russell H. Morgan Department of Radiology and Radiological Sciences at Johns Hopkins Medicine, Baltimore, Maryland
| | | | - William Y Raynor
- Department of Radiology, Hospital of the University of Pennsylvania
- Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Siavash Mehdizadeh Seraj
- Department of Radiology & Biomedical Imaging, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Thomas J Werner
- Department of Radiology, Hospital of the University of Pennsylvania
| | | | - Jonathan Korostoff
- Division for Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | | | - Abass Alavi
- Department of Radiology, Hospital of the University of Pennsylvania
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Lorenc A, Wells M, Fulton-Lieuw T, Nankivell P, Mehanna H, Jepson M. Clinicians' Views of Patient-initiated Follow-up in Head and Neck Cancer: a Qualitative Study to Inform the PETNECK2 Trial. Clin Oncol (R Coll Radiol) 2022; 34:230-240. [PMID: 34862101 PMCID: PMC8950325 DOI: 10.1016/j.clon.2021.11.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/13/2021] [Accepted: 11/12/2021] [Indexed: 12/23/2022]
Abstract
AIMS Current follow-up for head and neck cancer (HNC) is ineffective, expensive and fails to address patients' needs. The PETNECK2 trial will compare a new model of patient-initiated follow-up (PIFU) with routine scheduled follow-up. This article reports UK clinicians' views about HNC follow-up and PIFU, to inform the trial design. MATERIALS AND METHODS Online focus groups with surgeons (ear, nose and throat/maxillofacial), oncologists, clinical nurse specialists and allied health professionals. Clinicians were recruited from professional bodies, mailing lists and personal contacts. Focus groups explored views on current follow-up and acceptability of the proposed PIFU intervention and randomised controlled trial design (presented by the study co-chief investigator), preferences, margins of equipoise, potential organisational barriers and thoughts about the content and format of PIFU. Data were interpreted using inductive thematic analysis. RESULTS Eight focus groups with 34 clinicians were conducted. Clinicians highlighted already known limitations with HNC follow-up - lack of flexibility to address the wide-ranging needs of HNC patients, expense and lack of evidence - and agreed that follow-up needs to change. They were enthusiastic about the PETNECK2 trial to develop and evaluate PIFU but had concerns that PIFU may not suit disengaged patients and may aggravate patient anxiety/fear of recurrence and delay detection of recurrence. Anticipated issues with implementation included ensuring a reliable route back to clinic and workload burden on nurses and allied health professionals. CONCLUSIONS Clinicians supported the evaluation of PIFU but voiced concerns about barriers to help-seeking. An emphasis on patient engagement, psychosocial issues, symptom reporting and reliable, quick routes back to clinic will be important. Certain patient groups may be less suited to PIFU, which will be evaluated in the trial. Early, meaningful, ongoing engagement with clinical teams and managers around the trial rationale and recruitment process will be important to discourage selective recruitment and address risk-averse behaviour and potential workload burden.
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Affiliation(s)
- A Lorenc
- QuinteT Research Group, Bristol Medical School, University of Bristol, Bristol, UK.
| | - M Wells
- Nursing Directorate, Imperial College Healthcare, NHS Trust / Department of Surgery and Oncology, Imperial College, London, London, UK
| | - T Fulton-Lieuw
- Institute of Head and Neck Studies and Education (InHANSE), Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - P Nankivell
- Institute of Head and Neck Studies and Education (InHANSE), Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK; University Hospitals, Birmingham NHS Foundation Trust, Birmingham, UK
| | - H Mehanna
- Institute of Head and Neck Studies and Education (InHANSE), Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK; University Hospitals, Birmingham NHS Foundation Trust, Birmingham, UK
| | - M Jepson
- QuinteT Research Group, Bristol Medical School, University of Bristol, Bristol, UK
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Hui TCH, Lim MY, Karandikar AA, Loke SC, Pua U. A Technical Guide to Palliative Ablation of Recurrent Cancers in the Deep Spaces of the Suprahyoid Neck. Semin Intervent Radiol 2022; 39:184-191. [PMID: 35782002 DOI: 10.1055/s-0042-1745764] [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: 10/17/2022]
Abstract
Treatment options for patients with recurrent head and neck cancer, whether locoregional recurrence of previously treated head and neck cancer or secondary primary malignancy, are limited. Percutaneous ablation is a minimally invasive procedure that can be used with palliative intent in the head and neck to achieve symptomatic relief and local tumor control, potentially fulfilling treatment gaps of current standard of care options. Image guidance is key when navigating the deep spaces of the neck with special attention paid to critical structures within the carotid sheath. This review article provides an overview and highlights the important nuances of performing percutaneous ablations in the head and neck. It covers general principles, ablative modalities, image guidance, procedural technique, expected outcomes, and possible complications.
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Affiliation(s)
| | - Ming Yann Lim
- Department of Otorhinolaryngology, Tan Tock Seng Hospital, Singapore, Singapore
| | | | - Siu Cheng Loke
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore, Singapore
| | - Uei Pua
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore, Singapore
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Sheikhbahaei S, Subramaniam RM, Solnes LB. 2-Deoxy-2-[18F] Fluoro-d-Glucose PET/Computed Tomography. PET Clin 2022; 17:307-317. [DOI: 10.1016/j.cpet.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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PET/Computed Tomography. PET Clin 2022; 17:319-326. [DOI: 10.1016/j.cpet.2021.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Szalkowski G, Karakas Z, Cengiz M, Schreiber E, Das S, Yazici G, Ozyigit G, Mavroidis P. Stereotactic body radiotherapy optimization to reduce the risk of carotid blowout syndrome using normal tissue complication probability objectives. J Appl Clin Med Phys 2022; 23:e13563. [PMID: 35194924 PMCID: PMC9121056 DOI: 10.1002/acm2.13563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 01/14/2022] [Accepted: 02/02/2022] [Indexed: 12/24/2022] Open
Abstract
Purpose To determine the possibility of further improving clinical stereotactic body radiotherapy (SBRT) plans using normal tissue complication probability (NTCP) objectives in order to minimize the risk for carotid blowout syndrome (CBOS). Methods 10 patients with inoperable locally recurrent head and neck cancer, who underwent SBRT using CyberKnife were analyzed. For each patient, three treatment plans were examined: (1) cone‐based without delineation of the ipsilateral internal carotid (clinical plan used to treat the patients); (2) cone‐based with the carotid retrospectively delineated and spared; and (3) Iris‐based with carotid sparing. The dose–volume histograms of the target and primary organs at risk were calculated. The three sets of plans were compared based on dosimetric and TCP/NTCP (tumor control and normal tissue complication probabilities) metrics. For the NTCP values of carotid, the relative seriality model was used with the following parameters: D50 = 40 Gy, γ = 0.75, and s = 1.0. Results Across the 10 patient plans, the average TCP did not significantly change when the plans were re‐optimized to spare the carotid. The estimated risk of CBOS was significantly decreased in the re‐optimized plans, by 14.9% ± 7.4% for the cone‐based plans and 17.7% ± 7.1% for the iris‐based plans (p = 0.002 for both). The iris‐based plans had significant (p = 0.02) reduced CBOS risk and delivery time (20.1% ± 7.4% time reduction, p = 0.002) compared to the cone‐based plans. Conclusion A significant improvement in the quality of the clinical plans could be achieved through the delineation of the internal carotids and the use of more modern treatment delivery modalities. In this way, for the same target coverage, a significant reduction in the risk of CBOS could be achieved. The range of risk reduction varied depending on the proximity of carotid artery to the target.
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Affiliation(s)
- Gregory Szalkowski
- Department of Radiation Oncology, University of North Carolina, North Carolina, Chapel Hill, USA
| | - Zeynep Karakas
- Department of Radiation Oncology, University of North Carolina, North Carolina, Chapel Hill, USA
| | - Mustafa Cengiz
- Faculty of Medicine, Department of Radiation Oncology, Hacettepe University, Sihhiye, Ankara, Turkey
| | - Eric Schreiber
- Department of Radiation Oncology, University of North Carolina, North Carolina, Chapel Hill, USA
| | - Shiva Das
- Department of Radiation Oncology, University of North Carolina, North Carolina, Chapel Hill, USA
| | - Gozde Yazici
- Faculty of Medicine, Department of Radiation Oncology, Hacettepe University, Sihhiye, Ankara, Turkey
| | - Gokhan Ozyigit
- Faculty of Medicine, Department of Radiation Oncology, Hacettepe University, Sihhiye, Ankara, Turkey
| | - Panayiotis Mavroidis
- Department of Radiation Oncology, University of North Carolina, North Carolina, Chapel Hill, USA
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Silva-Nash J, Davis KP, Gardner JR, Sunde J, Vural E, Rose S, Moreno MA. Model of an Advanced Practice Provider-Led Head and Neck Cancer Survivorship Clinic: Evaluation of a 4-Year Experience. Otolaryngol Head Neck Surg 2022; 167:699-704. [PMID: 35077258 DOI: 10.1177/01945998221075004] [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 report the efficacy and safety of an advanced practice provider-led head and neck cancer survivorship clinic. STUDY DESIGN Retrospective chart review. SETTING Tertiary academic medical center. METHODS Patients were enrolled into the survivorship clinic after undergoing 1-year follow-up with the primary head and neck surgeon. Those enrolled between December 2016 and October 2020 were retrospectively reviewed for diagnosis, staging, pattern of recurrence, visit frequency, and compliance. Surgical respectability of recurrent disease was used as a surrogate for timely diagnosis. RESULTS An overall 570 patients were followed within the survivorship clinic. The mean length of follow-up was 13.6 months. Mucosal primaries represented 72.6% of patients. A majority of the primary malignancies were squamous cell carcinoma (77.7%). The most common primary subsites were the oropharynx (26.7%), oral cavity (25.1%), cutaneous (17.0%), and larynx (15.3%). Recurrence was detected in 50 patients (8.8%): 26 local, 12 regional, and 14 distant. Two patients had multiple synchronous recurrences. Twelve (2.1%) second primary cancers were detected. Of the 36 cases of locoregional recurrence, 32 (88.9%) were deemed amenable to salvage surgical intervention, with or without adjuvant therapy. Negative margins were obtained in 21 of the 23 (91.3%) local recurrences that underwent salvage resection. CONCLUSION Advanced practice provider-based surveillance of head and neck cancer, without risk stratification, appears to be a sound model but needs further prospective evaluation. Consistent with literature, 88.9% of patients with locoregional recurrence were candidates for curative-intent salvage surgery, emphasizing that recurrences are identified in a timely fashion.
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Affiliation(s)
| | - Kyle P Davis
- Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - James Reed Gardner
- Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Jumin Sunde
- Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Emre Vural
- Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Samantha Rose
- Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Mauricio Alejandro Moreno
- Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
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CDK7 Predicts Worse Outcome in Head and Neck Squamous-Cell Cancer. Cancers (Basel) 2022; 14:cancers14030492. [PMID: 35158760 PMCID: PMC8833595 DOI: 10.3390/cancers14030492] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/03/2022] [Accepted: 01/17/2022] [Indexed: 02/04/2023] Open
Abstract
HNSCC is the sixth most common cancer worldwide and the prognosis is still poor. Here, we investigated the prognostic implications of CDK7 and pMED1. Both proteins affect transcription, and their expression is altered throughout different tumor entities. pMED1 is phosphorylated by CDK7. Importantly, CDK7 and MED1 have been ascribed prognostic implications by various studies. However, their prognostic value in head and neck squamous-cell cancer (HNSCC) remains elusive. We applied immunohistochemical staining of CDK7 and pMED1 on our large and clinically well-characterized HNSCC tissue cohort comprising 419 patients. Software-aided quantification of staining intensity was performed as a measure of protein expression. The following results were linked to the clinicopathological features of our cohort and correlated in different tissue types (primary tumor, lymph node metastasis, distant metastasis, recurrence). Upregulation CDK7 was associated with worse 5-year overall survival as well as disease-free survival in HNSCC while being independent of other known prognostic factors such as p16-status. Also, CDK7 expression was significantly elevated in immune cell infiltrated tumors. In HNSCC CDK7 might serve as a novel prognostic marker to indicate the prognosis of patients. Furthermore, in vitro studies proved the feasibility of CDK7 inhibition with attenuating effects on cell proliferation underlining its remarkable translational potential for future therapeutic regimes.
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Punnoose J, Nachman H, Ashkenazi S. Oxygen Imaging for Non-Invasive Metastasis Detection. SENSORS (BASEL, SWITZERLAND) 2021; 22:s22010237. [PMID: 35009780 PMCID: PMC8749708 DOI: 10.3390/s22010237] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/21/2021] [Accepted: 12/24/2021] [Indexed: 05/16/2023]
Abstract
Sentinel lymph node (SLN) biopsy is an integral part of treatment planning for a variety of cancers as it evaluates whether a tumor has metastasized, an event that significantly reduces survival probability. However, this invasive procedure is associated with patient morbidity, and misses small metastatic deposits, resulting in the removal of additional nodes for tumors with high metastatic probability despite a negative SLN biopsy. To prevent this over-treatment and its associated morbidities for patients that were truly negative, we propose a tissue oxygen imaging method called Photoacoustic Lifetime Imaging (PALI) as an alternative or supplementary tool for SLN biopsy. As the hyper-metabolic state of cancer cells significantly depresses tissue oxygenation compared to normal tissue even for small metastatic deposits, we hypothesize that PALI can sensitively and specifically detect metastases. Before this hypothesis is tested, however, PALI's maximum imaging depth must be evaluated to determine the cancer types for which it is best suited. To evaluate imaging depth, we developed and simulated a phantom composed of tubing in a tissue-mimicking, optically scattering liquid. Our simulation and experimental results both show that PALI's maximum imaging depth is 16 mm. As most lymph nodes are deeper than 16 mm, ways to improve imaging depth, such as directly delivering light to the node using penetrating optical fibers, must be explored.
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Affiliation(s)
- Joshua Punnoose
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN 55455, USA;
| | - Henry Nachman
- Department of Physics and Astronomy, University of North Carolina, Chapel Hill, NC 27599, USA;
| | - Shai Ashkenazi
- Department of Biomedical Engineering, University of Minnesota, Minneapolis, MN 55455, USA;
- Correspondence:
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Chen M, Xu WM, Wang GY, Hou YX, Tian TT, Li YQ, Qi HJ, Zhou M, Kong WJ, Lu MX. Genetic variants of cell cycle pathway genes are associated with head and neck squamous cell carcinoma in the Chinese population. Carcinogenesis 2021; 42:1337-1346. [PMID: 34643214 DOI: 10.1093/carcin/bgab094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 10/01/2021] [Accepted: 10/11/2021] [Indexed: 12/24/2022] Open
Abstract
Genetic alterations in the cell cycle pathway are common in head and neck squamous cell carcinoma (HNSCC). We identified four novel HNSCC susceptibility loci (CDKN1C rs452338, CDK4 rs2072052, E2F2 rs3820028 and E2F2 rs2075993) through a two-stage matched case-control study. There was a combined effect among the four single nucleotide polymorphisms (SNPs), as the number of risk genotypes increased, the risk of HNSCC displayed an increasing trend (Ptrend < 0.001). And there were multiplicative interactions between rs452338 and rs2072052, rs2072052 and rs3820028, rs2072052 and rs2075993. Functional bioinformatics analysis and dual-luciferase reporter assay revealed that E2F2 rs2075993 T>C reduced the stability of E2F2 3'-UTR secondary structure and affected the binding of E2F2 to miR-940, which was up-regulated in HNSCC tumor tissues (P = 2.9e-8) and was correlated with poor overall survival of HNSCC (HR = 1.39, 95% CI = 1.02-1.90). In vitro assays, we discovered that the expression of miR-940 was regulated by METTL3, and miR-940 promoted the proliferation, migration and invasion, and inhibited the senescence and autophagy of tumor cells. In terms of mechanism, compared with rs2075993 allele T, we found that the protective variant rs2075993 allele C interfered with the translational inhibition of E2F2 by miR-940, resulting in increased expression of E2F2 protein, which further reduced the proliferation, migration, invasion, and increased the senescence of tumor cells.
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Affiliation(s)
- Mo Chen
- Department of Epidemiology and Biostatistics, and The Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Wen-Mao Xu
- Department of Epidemiology and Biostatistics, and The Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.,Department of Public Health, Wuhan No. 1 Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Gui-Yang Wang
- Department of Epidemiology and Biostatistics, and The Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.,Wuhan Pulmonary Hospital, Tuberculosis Control and Management Office, Wuhan Institute for Tuberculosis Control, Wuhan 430030, China
| | - Ya-Xuan Hou
- Department of Epidemiology and Biostatistics, and The Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Ting-Ting Tian
- Department of Epidemiology and Biostatistics, and The Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.,National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206,China
| | - Yu-Qing Li
- Department of Epidemiology and Biostatistics, and The Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.,Department of Medical Insurance Office, Qingdao Municipal Hospital, Qingdao 266000, China
| | - Hong-Jiao Qi
- Department of Epidemiology and Biostatistics, and The Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Meng Zhou
- Department of Epidemiology and Biostatistics, and The Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Wei-Jia Kong
- Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Mei-Xia Lu
- Department of Epidemiology and Biostatistics, and The Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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Alwani T, Shehan JN, LeClair J, Mahoney TF, Agarwal P, Chaudhry ST, Wang JJ, Noordzij JP, Tracy LF, Edwards HA, Grillone G, Salama AR, Jalisi SM, Devaiah AK. Geographic Barriers Affect Follow-Up Care in Head and Neck Cancer. Laryngoscope 2021; 132:1022-1028. [PMID: 34762300 PMCID: PMC9007826 DOI: 10.1002/lary.29934] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/26/2021] [Accepted: 10/12/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES/HYPOTHESIS Follow-up care in head and neck cancers (HNC) is critical in managing patient health. However, social determinants of health (SDOH) can create difficulties in maintaining follow-up care. The study goal is to explore how SDOH impacts maintenance of HNC follow-up care appointments. METHODS A systematic retrospective chart review of 877 HNC patients diagnosed in the past 10 years a safety-net tertiary care hospital with systems to help reduce care disparities. Cohort groups were identified and compared against protocols for follow-up. Data were analyzed using analysis of variance, chi-square tests, Fisher's exact tests, two-sample t-tests, and simple linear regression. RESULTS The average length of follow-up time in months and average total number of follow-ups over 5 years were 32.96 (34.60) and 9.24 (7.87), respectively. There was no significant difference in follow-up care between United States (US) versus non-US born and English versus non-English speaking patients. Race/ethnicity, county median household income, insurance status, and county educational attainment were not associated with differences in follow-up. However, living a greater distance from the hospital was associated with lower follow-up length and less frequency in follow-up (P < .0001). CONCLUSION While income, primary language, country of birth, race/ethnicity, insurance status, and markers of educational attainment do not appear to impact HNC follow-up at our safety-net, tertiary care institution, and distance from hospital remains an important contributor to disparities in care. This study shows that many barriers to care can be addressed in a model that addresses SDOH, but there are barriers that still require additional systems and resources. Laryngoscope, 2021.
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Affiliation(s)
- Tooba Alwani
- Department of Otolaryngology – Head and Neck Surgery, Boston Medical Center, Boston, MA
| | | | - Jessica LeClair
- Department of Biostatistics, Boston University School of Public Health, Boston MA
| | - Taylor F. Mahoney
- Department of Biostatistics, Boston University School of Public Health, Boston MA
| | - Pratima Agarwal
- Department of Otolaryngology – Head and Neck Surgery, Boston Medical Center, Boston, MA
| | | | - Judy J. Wang
- Boston University School of Medicine, Boston, MA
| | - J. Pieter Noordzij
- Department of Otolaryngology – Head and Neck Surgery, Boston Medical Center, Boston, MA
- Boston University School of Medicine, Boston, MA
| | - Lauren F. Tracy
- Department of Otolaryngology – Head and Neck Surgery, Boston Medical Center, Boston, MA
- Boston University School of Medicine, Boston, MA
| | - Heather A. Edwards
- Department of Otolaryngology – Head and Neck Surgery, Boston Medical Center, Boston, MA
- Boston University School of Medicine, Boston, MA
| | - Gregory Grillone
- Department of Otolaryngology – Head and Neck Surgery, Boston Medical Center, Boston, MA
- Boston University School of Medicine, Boston, MA
| | - Andrew R. Salama
- Department of Oral Maxillofacial Surgery Boston, Medical Center, Boston MA
| | - Scharukh M. Jalisi
- Department of Otolaryngology – Head and Neck Surgery, Beth Israel Deaconess, Boston, MA
| | - Anand K. Devaiah
- Department of Otolaryngology – Head and Neck Surgery, Boston Medical Center, Boston, MA
- Boston University School of Medicine, Boston, MA
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Bancu A, Cowan R, Chaturvedi A. PD-L1 testing and immunotherapy selection - early laboratory experience and its potential role in head and neck cancer management. Arch Clin Cases 2021; 8:14-18. [PMID: 34754934 PMCID: PMC8565705 DOI: 10.22551/2021.30.0801.10179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Anti-programmed cell death protein-1 (PD-1) therapy has been relatively recently approved in a defined context by NICE in adults in the management of recurrent and metastatic head and neck squamous cell carcinomas (HNSCC). In this context, companion diagnostic programmed cell death ligand-1 (PD-L1) testing, previously established at our center for lung and bladder tumors, was undertaken in a few head and neck cancer cases. The scope of this study was to audit the relevant PD-L1 data and integrate the findings in our current clinical practice, with a view to promote improved routine laboratory biomarkers in HNSCC. Histopathology reports documenting tumor type, PD-L1 result and type of clone/assay were included in this study. Over a 5-year period, PD-L1 testing was undertaken in 199 cancer cases, including 3 with head and neck squamous carcinoma with low focal positive staining. Immunotherapy treatment in HNSCC demonstrates a discreet but still significant improvement in the overall survival of PD-L1 positive subjects.
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Affiliation(s)
- Andrei Bancu
- Department of Histopathology and Molecular Pathology, St James's University Hospital, Leeds, UK
| | - Richard Cowan
- Department of Clinical Oncology, The Christie Hospital, Manchester, UK
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45
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Bulbul MG, Genovese TJ, Hagan K, Rege S, Qureshi A, Varvares MA. Salvage surgery for recurrent squamous cell carcinoma of the head and neck: Systematic review and meta-analysis. Head Neck 2021; 44:275-285. [PMID: 34729845 DOI: 10.1002/hed.26898] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 09/05/2021] [Accepted: 10/15/2021] [Indexed: 12/24/2022] Open
Abstract
The present study aims to estimate a pooled hazard ratio (HR) comparing overall survival (OS) for salvage surgery compared to nonsurgical management of recurrent head and neck squamous cell carcinoma (HNSCC). PubMed/MEDLINE and Embase-Ovid were searched on March 5, 2020, for English-language articles reporting survival for salvage surgery and nonsurgical management of recurrent HNSCC. Meta-analysis of HR estimates using random effects model was performed. Fifteen studies reported survival for salvage surgery and nonsurgical management of recurrence. Five-year OS ranged from 26% to 67% for the salvage surgery groups, compared to 0% to 32% for the nonsurgical management groups. Six studies reported HRs comparing salvage surgery to nonsurgical management; the pooled HR was 0.25 (95% CI [0.16, 0.38]; p < 0.0001). Selection for salvage surgery was associated with one quarter of the mortality rate associated with nonsurgical management in light of confounding factors including subsite and treatment intent.
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Affiliation(s)
- Mustafa G Bulbul
- Department of Otolaryngology-Head and Neck Surgery, West Virginia University School of Medicine, Morgantown, West Virginia, USA.,Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Timothy J Genovese
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.,The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Kobina Hagan
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.,Center for Outcomes Research, Houston Methodist Academic Institute, Houston, Texas, USA
| | - Soham Rege
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.,Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Ahad Qureshi
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.,Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA
| | - Mark A Varvares
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.,Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts, USA
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Prediction of oral squamous cell carcinoma based on machine learning of breath samples: a prospective controlled study. BMC Oral Health 2021; 21:500. [PMID: 34615514 PMCID: PMC8496028 DOI: 10.1186/s12903-021-01862-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 09/24/2021] [Indexed: 12/30/2022] Open
Abstract
Background The aim of this study was to evaluate the possibility of breath testing as a method of cancer detection in patients with oral squamous cell carcinoma (OSCC). Methods Breath analysis was performed in 35 OSCC patients prior to surgery. In 22 patients, a subsequent breath test was carried out after surgery. Fifty healthy subjects were evaluated in the control group. Breath sampling was standardized regarding location and patient preparation. All analyses were performed using gas chromatography coupled with ion mobility spectrometry and machine learning. Results Differences in imaging as well as in pre- and postoperative findings of OSCC patients and healthy participants were observed. Specific volatile organic compound signatures were found in OSCC patients. Samples from patients and healthy individuals could be correctly assigned using machine learning with an average accuracy of 86–90%. Conclusions Breath analysis to determine OSCC in patients is promising, and the identification of patterns and the implementation of machine learning require further assessment and optimization. Larger prospective studies are required to use the full potential of machine learning to identify disease signatures in breath volatiles. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01862-z.
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Alvi MIUR, Eagles EJ, Hamilton DW. A retrospective review of cancer surveillance in 100 head and neck cancer patients: Is there scope for a more tailored approach? Clin Otolaryngol 2021; 47:207-211. [PMID: 34543513 DOI: 10.1111/coa.13862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 07/05/2021] [Accepted: 08/28/2021] [Indexed: 12/01/2022]
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48
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Hoxhaj I, Vukovic V, Boccia S, Pastorino R. Single nucleotide polymorphisms and the risk of developing a second primary cancer among head and neck cancer patients: a systematic literature review and meta-analysis. BMC Cancer 2021; 21:660. [PMID: 34078296 PMCID: PMC8173958 DOI: 10.1186/s12885-021-08335-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 05/10/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Head and Neck Cancer (HNC) survivors are at increased risk of developing a second primary cancer (SPC). Along with the environmental risk factors, genetic factors have been associated with a potential increased susceptibility to SPC development. We aim to identify the Single Nucleotide Polymorphisms (SNPs) that contribute to SPC development among HNC survivors through a systematic review and meta-analysis. METHODS We searched PubMed, Scopus and ISI Web of Science for eligible studies published in English until January 31st, 2020. We included studies reporting primary data that evaluated the association between SNPs and SPC risk in HNC patients. Data were pooled in a random-effect meta-analyses, when at least two studies on the same SNP evaluated the same genotype model. Heterogeneity was assessed using the χ2-based Q-statistics and the I2 statistics. Quality of the included studies was assessed using the Q-Genie tool. RESULTS Twenty-one studies, of moderate to good quality, were included in the systematic review. Fifty-one genes were reported across the included studies to have significant associations with an increased SPC risk. Overall, 81 out of 122 investigated SNPs were significantly associated with the SPC risk. Seven studies were included in the meta-analysis, which showed five SNPs associated with an increased risk of SPC: p21C70T, CT + TT (HR = 1.76; 95% CI: 1.28-2.43); FASLG -844C > T, CT + TT (HR = 1.82; 95% CI: 1.35-2.46), P21 C98A, CA + AA (HR = 1.75; 95% CI: 1.28-2.38); FAS -670A > G (HR = 1.84; 95% CI: 1.28-2.66) and GST-M1, Null genotype (HR = 1.54; 95% CI: 1.13-2.10). CONCLUSIONS The identified SNPs in our systematic review and meta-analysis might serve as potential markers for identification of patients at high risk of developing SPC after primary HNC. PROSPERO REGISTRATION NUMBER CRD42019135612 .
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Affiliation(s)
- Ilda Hoxhaj
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Woman and Child Health and Public Health - Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Vladimir Vukovic
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Center for Disease Control and Prevention, Institute of Public Health of Vojvodina, Novi Sad, Serbia
| | - Stefania Boccia
- Section of Hygiene, University Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.
- Department of Woman and Child Health and Public Health - Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
| | - Roberta Pastorino
- Department of Woman and Child Health and Public Health - Public Health Area, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Jiang H, Tan Q, He F, Yang W, Liu J, Zhou F, Zhang M. Ultrasound in patients with treated head and neck carcinomas: A retrospective analysis for effectiveness of follow-up care. Medicine (Baltimore) 2021; 100:e25496. [PMID: 33879682 PMCID: PMC8078385 DOI: 10.1097/md.0000000000025496] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 03/15/2021] [Indexed: 02/05/2023] Open
Abstract
Correct follow-up is necessary to avoid under- or overtreatment in the care of patients with treated carcinomas of head and neck. Ultrasound is a cost-effective, harmless, easy, and feasible method. It can be applied in the outpatient clinic in follow-up but the United Kingdom National Multidisciplinary guidelines are recommended computed tomography or magnetic resonance imaging for the detection of metastasis for head and neck carcinomas in the follow-up period. The purpose of the study was to state that neck ultrasound would be the method of choice on follow-up care of Chinese patients who received primary treatment for carcinoma of head and neck.Patients who received primary treatment for carcinoma of the head and neck were examined for 5-years in follow-up through physical, clinical, and neck ultrasound (n = 198). If patients had no evidence of disease after 60 months of definitive therapy considered as a cure. If patients had no evidence of disease after 36 months of salvage therapy considered as a cure of recurrence.Irrespective of definitive treatment used, the study was monitored through neck ultrasound during 5 years of a follow-up visit and was reported cure in 126 (64%) patients and recurrence in 72 (36%; distant metastasis: 33 [17%], local recurrence: 24 [12%], and regional recurrence: 15 [7%]) patients. Primary tumor stage IV, III, II, and I had 63% (15/24), 51% (21/41), 32% (18/56), and 23% (18/77) recurrence, respectively. The time to detect regional recurrence was shorter than that for local recurrence (P < .0001, q = 15.059) and distant recurrence (P < .0001, q = 7.958). Local recurrence and stage I primary tumor had the highest percentage cure for recurrence.Neck ultrasound in the follow-up period is reported to be effective for the detection of recurrence of patients who received primary treatment for carcinoma of head and neck especially regional recurrence and primary tumor stage I.Level of Evidence: III.
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Affiliation(s)
- Hongying Jiang
- Department of Rehabilitation Medicine Center, West China Hospital, Sichuan University
- Key Laboratory of Rehabilitation Medicine in Sichuan Province
- West China School of Nursing, West China Hospital, Sichuan University
| | - Qiling Tan
- West China School of Nursing, West China Hospital, Sichuan University
| | - Fawei He
- Department of Ultrasound, Sichuan Cancer Hospital
| | - Wei Yang
- Department of Ultrasound, Sichuan Cancer Hospital
| | - Jifeng Liu
- Department of Otorhinolaryngology-Head and Neck Surgery, West China Hospital of Sichuan University, Chengdu
| | - Fang Zhou
- Department of Oncology, Gong’an County People's Hospital, Gong’an, Hubei, China
| | - Mingxia Zhang
- Department of Oncology, Gong’an County People's Hospital, Gong’an, Hubei, China
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50
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Sequential chemotherapy regimen of induction with panitumumab and paclitaxel followed by radiotherapy and panitumumab in patients with locally advanced head and neck cancer unfit for platinum derivatives. The phase II, PANTERA/TTCC-2010-06 study. Clin Transl Oncol 2021; 23:1666-1677. [PMID: 33876416 DOI: 10.1007/s12094-021-02567-z] [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: 11/07/2020] [Accepted: 02/02/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Sequential treatment of Panitumumab (Pb) plus Paclitaxel (Px) as induction treatment (IT) followed by concurrent bioradiotherapy (Bio-RT) with Pb may be an alternative for locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN) in patients ineligible for high-dose cisplatin therapy. METHODS Phase II, single-arm, multicentre study, with two-stage design, in patients ≥ 18 years with stage III-IVa-b LA-SCCHN unfit for platinum. Patients received Px + Pb (9 weeks) as IT followed by Bio-RT + Pb. Primary endpoint: overall response rate (ORR) after IT, defined as: more than 70% of patients achieving complete response (CR) or partial response (PR) to IT. Secondary end-points: progression-free survival, organ preservation rate, safety profile. RESULTS Study ended prematurely (51 patients) due to slow recruitment. ORR: 66.7% (95% CI: 53.7-79.6), 8 (15.7%) CR and 26 (51.0%) PR. 39 patients (76%) completed radiotherapy (RT). Pb and/or Px-related adverse events (AEs) grade 3-4: 56.9% during IT and 63.4% during the concomitant phase, of which most common were skin toxicity (33.3%). Five deaths occurred during treatment, two of them (3.9%) were Pb and/or Px-related. CONCLUSIONS Although underpowered, ORR was higher than the pre-specified boundary for considering the treatment active. Although Px + Pb as IT provides some benefit, the safety profile is worse than expected. To consider Pb + Px as IT as an alternative for platinum-unsuitable LA-SCCHN, further research/investigation would be needed.
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