1
|
van der Plas E, Darji H, Srivastava K, Schapiro M, Jeffe D, Perkins S, Howell R, Leisenring W, Armstrong GT, Oeffinger K, Krull K, Edelstein K, Hayashi RJ. Risk factors for neurocognitive impairment, emotional distress, and poor quality of life in survivors of pediatric rhabdomyosarcoma: A report from the Childhood Cancer Survivor Study. Cancer 2024; 130:2224-2236. [PMID: 38373075 PMCID: PMC11139574 DOI: 10.1002/cncr.35236] [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: 09/06/2023] [Revised: 01/11/2024] [Accepted: 01/12/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND Prevalence and risk of poor psychological outcomes following rhabdomyosarcoma (RMS) are not well-established. METHODS Participants in this cross-sectional, case-control study (n = 713 survivors, 42.5% female; mean [SD] age, 30.5 [6.6] years; n = 706 siblings, 57.2% female; mean age, 32.8,[7.9] years) completed measures of neurocognition, emotional distress, and health-related quality of life (HRQOL). Multivariable logistic regression models identified treatments, health behaviors, and chronic conditions associated with impairment. RESULTS Relative to siblings, more survivors reported neurocognitive impairment (task efficiency: 21.1% vs. 13.7%, emotional regulation: 16.7% vs. 11.0%, memory: 19.3% vs. 15.1%), elevated emotional distress (somatic distress: 12.9% vs. 4.7%, anxiety: 11.7% vs. 5.9%, depression: 22.8% vs. 16.9%) and poorer HRQOL (physical functioning: 11.1% vs. 2.8%, role functioning due to physical problems: 16.8% vs. 8.2%, pain: 17.5% vs. 10.0%, vitality: 22.3% vs. 13.8%, social functioning: 14.4% vs. 6.8%, emotional functioning: 17.1% vs. 10.6%). Cranial radiation increased risk for impaired task efficiency (odds ratio [OR], 2.30; 95% confidence interval [CI], 1.14-4.63), whereas chest and pelvic radiation predicted increased risk of physical functioning (OR, 2.68; 95% CI, 1.16-6.21 and OR, 3.44; 95% CI, 1.70-6.95, respectively). Smoking was associated with impaired task efficiency (OR, 2.06; 95% CI, 1.14-3.70), memory (OR, 2.23; 95% CI, 1.26-3.95), anxiety (OR, 2.71; 95% CI, 1.36-5.41) and depression (OR, 1.77; 95% CI, 1.01-3.11). Neurologic conditions increased risk of anxiety (OR, 2.30; 95% CI, 1.04-5.10), and hearing conditions increased risk of depression (OR, 1.79; 95% CI, 1.05-3.03). Neurologic and hearing conditions, respectively, were associated with impaired memory (OR, 2.44; 95% CI, 1.20-4.95 and OR, 1.87; 95% CI, 1.05-3.35) and poor health perception (OR, 2.62; 95% CI, 1.62-1.28 and OR, 2.33; 95% CI, 1.34-4.06). CONCLUSIONS RMS survivors are at significant risk for poor psychological outcomes. Advancing therapies for local control, smoking cessation, and managing chronic medical conditions may mitigate poor outcomes following RMS.
Collapse
Affiliation(s)
- Ellen van der Plas
- Arkansas Children’s Hospital, Department of Hematology/Oncology, Little Rock, AR, USA
- University of Arkansas for Medical Sciences, Department of Pediatrics, Little Rock, AR, USA
| | - Himani Darji
- Stanford University, Quantitative Sciences Unit, Department of Medicine, Stanford, CA, USA
- St. Jude Children’s Research Hospital, Biostatistics Department, Memphis, TN, USA
| | - Kumar Srivastava
- St. Jude Children’s Research Hospital, Biostatistics Department, Memphis, TN, USA
| | - Melissa Schapiro
- SSM Health Cardinal Glennon Children’s Hospital-St. Louis University, Department of Pediatrics, St Louis, MO, USA
| | - Donna Jeffe
- Washington University School of Medicine in St Louis, John T. Milliken Department of Medicine, St Louis, MO, USA
| | - Stephanie Perkins
- Washington University in St Louis, Department of Radiation Oncology, St Louis, MO, USA
| | - Rebecca Howell
- MD Anderson Cancer Center, Department of Radiation Physics, Houston, TX, USA
| | - Wendy Leisenring
- Fred Hutch Cancer Center, Clinical Research Division, Seattle, WA, USA
| | - Gregory T. Armstrong
- St. Jude Children’s Research Hospital, Epidemiology and Cancer Control, Memphis, TN, USA
| | | | - Kevin Krull
- St. Jude Children’s Research Hospital, Psychology & Biobehavioral Sciences, Memphis, TN, USA
| | - Kim Edelstein
- Princess Margaret Cancer Center, Department of Supportive Care, Toronto, Canada
| | - Robert J. Hayashi
- Washington University School of Medicine in St Louis, Department of Pediatrics, St Louis Childrens Hospital, Siteman Cancer Center, St Louis, MO, USA
| |
Collapse
|
2
|
Wang Q, Yang X, Liang Y, Wang C, Zhou R. A 16-Year-Old Girl with Sinonasal Cutaneous Fistula Following Excision and Radiotherapy for Rhabdomyosarcoma Requiring Reconstructive Surgery Using an Expanded Forehead Flap. AMERICAN JOURNAL OF CASE REPORTS 2024; 25:e943098. [PMID: 38736220 PMCID: PMC11099548 DOI: 10.12659/ajcr.943098] [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: 11/05/2023] [Revised: 03/27/2024] [Accepted: 03/20/2024] [Indexed: 05/14/2024]
Abstract
BACKGROUND Sinonasal rhabdomyosarcoma (RMS) is a rare malignancy in children and adolescents. It is aggressive and locally invasive, and can require local postoperative radiotherapy. This report presents the case of a 16-year-old girl with a sinonasal-cutaneous fistula following excision and radiotherapy for rhabdomyosarcoma, which required reconstructive surgery using an expanded forehead flap. CASE REPORT We report the case of a16-year-old girl who was referred to our clinic with sinonasal-cutaneous fistula. Prior to presentation at our department, she presented with bilateral intermittent nasal congestion 3 years ago. At a local hospital, orbital computed tomography and nasal endoscopic biopsy revealed an embryonal rhabdomyosarcoma (ERMS). One month later, skull base tumor resection, nasal cavity and sinus tumor resection, and low-temperature plasma ablation were performed at a local hospital. Two weeks after the operation, the patient received intensity-modulated radiation therapy for a total of 50 Gy. Chemotherapy started 15 days after radiotherapy, using a vincristine, dactinomycin, and cyclophosphamide (VAC) regimen. Approximately 1 month later, an ulcer appeared at the nasal root and the lesion gradually expanded. The patient was referred to our hospital due to the defect. Firstly, a tissue expander was implanted at the forehead for 7 months. Then, the skin around the defect was trimmed and forehead flap was separated to repair the lining and external skin. The flap survived well 1-year after the operation. CONCLUSIONS This report highlights the challenges of post-radiation reconstructive surgery and describes how an expanded forehead flap can achieve an acceptable cosmetic outcome in a patient with a sinonasal-cutaneous fistula.
Collapse
Affiliation(s)
| | | | | | - Chen Wang
- Corresponding Authors: Chen Wang, e-mail: , Renpeng Zhou, e-mail:
| | - Renpeng Zhou
- Corresponding Authors: Chen Wang, e-mail: , Renpeng Zhou, e-mail:
| |
Collapse
|
3
|
Zhao D, Zhou F, Liu W, Huang Z, Xu X, Zheng B, Liu C, Bai C, Liu J, Sun Y, Wang W, Xiao S. Adult head and neck rhabdomyosarcoma: radiotherapy- based treatment, outcomes, and predictors of survival. BMC Cancer 2024; 24:340. [PMID: 38486204 PMCID: PMC10938762 DOI: 10.1186/s12885-024-12079-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 03/04/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Adult head and neck rhabdomyosarcoma (HNRMS) is an exceptionally rare malignancy, and there is a paucity of data and research dedicated to understanding its characteristics and management in adult populations. This study aimed to assess the outcomes and identify survival predictors in adult HNRMS. METHODS We retrospectively evaluated 42 adult patients (> 16 years) with HNRMS who received radiotherapy (RT)-based treatment at our institute between 2008 and 2022. We analysed the clinical characteristics and prognosis of these patients, including the locoregional recurrence-free survival (LRFS), progression-free survival (PFS), and overall survival (OS), using the Kaplan-Meier method. The chi-square and Fisher's exact tests were used to analyse differences between groups for dichotomous and categorical variables, respectively. Survival rates were calculated using the Kaplan-Meier method. Prognostic variables were assessed through univariate Cox analyses. RESULTS The median patient age was 28 years (range, 16-82 years). Alveolar RMS was the most common histological type, observed in 21 patients (50.0%), followed by embryonal in 16 patients (38.1%). The anatomic sites of origin were orbital in one (2.4%), parameningeal in 26 (61.9%), and non-orbital/non-parameningeal in 15 (35.7%) patients. Nineteen patients (45.2%) had regional lymph node metastasis, and five patients (11.9%) presented with distant metastatic disease. Distant metastasis (n = 17) was the primary cause of treatment failure. At a median follow-up of 47.0 months, the 5-year LRFS, PFS, and OS rates were 69.0%, 39.7%, and 41.0%, respectively. Univariate analysis revealed that tumour size, lymph node involvement, and the local treatment pattern (surgery and RT vs. RT alone) were significant predictors of survival. CONCLUSIONS The main failure pattern in patients with HNRMS receiving RT-based treatment was distant metastasis. Tumour size > 5 cm and lymph node involvement were predictors of worse LRFS. Multimodality local treatment, combining surgery and RT, is effective and provides survival benefits.
Collapse
Affiliation(s)
- Dan Zhao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China
| | - Fang Zhou
- Department of Radiotherapy, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Shandong, P.R. China
| | - Weixin Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China
| | - Zhou Huang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China
| | - Xiaolong Xu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China
| | - Baomin Zheng
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China
| | - Changqing Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China
| | - Chujie Bai
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Bone and Soft Tissue Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China
| | - Jiayong Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Bone and Soft Tissue Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China
| | - Yan Sun
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China
| | - Weihu Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China.
| | - Shaowen Xiao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China.
| |
Collapse
|
4
|
Li Q, Chen W, Li Q, Mao J, Chen X. A novel neutrophil extracellular trap signature to predict prognosis and immunotherapy response in head and neck squamous cell carcinoma. Front Immunol 2022; 13:1019967. [PMID: 36225931 PMCID: PMC9549764 DOI: 10.3389/fimmu.2022.1019967] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 09/06/2022] [Indexed: 12/02/2022] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) is one of the most common malignant cancers, and patients with HNSCC possess early metastases and poor prognosis. Systematic therapies (including chemotherapy, targeted therapy, and immunotherapy) are generally applied in the advanced/late stages of HNSCC, but primary and acquired resistance eventually occurs. At present, reliable biomarkers to predict the prognosis of HNSCC have not been completely identified. Recent studies have shown that neutrophil extracellular traps (NETs) are implicated in cancer progression, metastasis and cancer immune response, and NET-related gene signatures are associated with the prognosis of patients with several human cancers. To explore whether NET-related genes play crucial roles in HNSCC, we have performed systematic analysis and reported several findings in the current study. Firstly, we identified seven novel NET-related genes and developed a NET-score signature, which was highly associated with the clinicopathological and immune traits of the HNSCC patients. Then, we, for the first time, found that NIFK was significantly upregulated in HNSCC patient samples, and its levels were significantly linked to tumor malignancy and immune status. Moreover, functional experiments confirmed that NIFK was required for HNSCC cell proliferation and metastasis. Altogether, this study has identified a novel NET-score signature based on seven novel NET-related genes to predict the prognosis of HNSCC and NIFK has also explored a new method for personalized chemo-/immuno-therapy of HNSCC.
Collapse
Affiliation(s)
- Qilin Li
- Department of Stomatology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Weimin Chen
- Department of Stomatology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
| | - Qiuhui Li
- State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory for Oral Biomedicine of Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
- *Correspondence: Xin Chen, ; Qiuhui Li, ; Jing Mao,
| | - Jing Mao
- Department of Stomatology, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- School of Stomatology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Hubei Province Key Laboratory of Oral and Maxillofacial Development and Regeneration, Wuhan, China
- *Correspondence: Xin Chen, ; Qiuhui Li, ; Jing Mao,
| | - Xin Chen
- Department of Oncology, Tongji Hospital, Tongji Medical School, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Xin Chen, ; Qiuhui Li, ; Jing Mao,
| |
Collapse
|
5
|
C-Phycoycanin-Doxorubicin Nanoparticles for Chemo-Photodynamic Cancer Therapy. Macromol Res 2022. [DOI: 10.1007/s13233-022-0057-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
6
|
Shen Q, Liu X, Li W, Zhao X, Li T, Zhou K, Zhou J. Emerging Role and Mechanism of circRNAs in Pediatric Malignant Solid Tumors. Front Genet 2022; 12:820936. [PMID: 35116058 PMCID: PMC8804321 DOI: 10.3389/fgene.2021.820936] [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: 11/23/2021] [Accepted: 12/21/2021] [Indexed: 11/24/2022] Open
Abstract
Circular RNAs (circRNAs) are non-coding RNAs with covalent closed-loop structures and are widely distributed in eukaryotes, conserved and stable as well as tissue-specific. Malignant solid tumors pose a serious health risk to children and are one of the leading causes of pediatric mortality. Studies have shown that circRNAs play an important regulatory role in the development of childhood malignant solid tumors, hence are potential biomarkers and therapeutic targets for tumors. This paper reviews the biological characteristics and functions of circRNAs as well as the research progress related to childhood malignant solid tumors.
Collapse
Affiliation(s)
- Qiyang Shen
- Department of Pediatric Surgery, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Xingyu Liu
- Department of Pediatric Surgery, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Wei Li
- Department of ENT, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Xu Zhao
- Department of Pediatric Surgery, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Tao Li
- Department of Pediatric Surgery, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Kai Zhou
- Department of Pediatric Surgery, First Affiliated Hospital of Bengbu Medical College, Bengbu, China
- *Correspondence: Jianfeng Zhou, ; Kai Zhou,
| | - Jianfeng Zhou
- Department of Pediatric Surgery, Children’s Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Jianfeng Zhou, ; Kai Zhou,
| |
Collapse
|