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Takeshita N, Enokida T, Okano S, Fujisawa T, Wada A, Sato M, Tanaka H, Tanaka N, Onaga R, Hoshi Y, Sakashita S, Ishii G, Tahara M. Weekly paclitaxel, carboplatin and cetuximab (PCE) combination followed by nivolumab for recurrent and/or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN). Oral Oncol 2023; 147:106615. [PMID: 37931493 DOI: 10.1016/j.oraloncology.2023.106615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 10/28/2023] [Accepted: 10/29/2023] [Indexed: 11/08/2023]
Abstract
OBJECTIVES Cetuximab-based chemotherapy is a standard 1st-line treatment for recurrent and/or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN). However, few studies have reported survival data for a treatment sequence consisting of a PCE regimen (paclitaxel + carboplatin + cetuximab) followed by an immune checkpoint inhibitor. MATERIALS AND METHODS We retrospectively assessed 37 patients with R/M SCCHN from the oral cavity, oropharynx, hypopharynx, and larynx who received PCE as 1st-line treatment followed by nivolumab as 2nd-line at the National Cancer Center Hospital East between December 2016 and July 2021. For comparison, we also analyzed 14 patients who did not receive nivolumab after PCE. RESULTS Of the 37 patients who received nivolumab, overall response rate (ORR) by PCE was 48.6%, and median time to response and median progression-free survival (PFS) were 2.1 months (range: 0.8-4.8) and 4.4 months, respectively. In the nivolumab phase, ORR was 10.8%. 23 patients received 3rd-line therapy. Median PFS2, PFS3, and overall survival (OS) were 6.8, 11.6, and 19.5 months, respectively. Subgroup analysis by PD-L1 expression showed no significant difference in OS. Analysis of the comparison group revealed a trend toward improved OS in those who received nivolumab compared to those who did not (HR 0.47, 95%CI [0.19-1.13], p = 0.084). CONCLUSION PCE followed by nivolumab shows a favorable survival outcome, representing the potential for rapid tumor response with PCE and extension of OS by the addition of nivolumab regardless of combined positive score.
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Affiliation(s)
- Naohiro Takeshita
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan; Department of Otorhinolaryngology, Jikei University School of Medicine, Tokyo, Japan
| | - Tomohiro Enokida
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Susumu Okano
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Takao Fujisawa
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Akihisa Wada
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan; Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masanobu Sato
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan; Department of Otorhinolaryngology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hideki Tanaka
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Nobukazu Tanaka
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Ryutaro Onaga
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Yuta Hoshi
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Shingo Sakashita
- Department of Pathology and Laboratory Medicine, National Cancer Center Hospital East, Kashiwa, Japan
| | - Genichiro Ishii
- Department of Pathology and Laboratory Medicine, National Cancer Center Hospital East, Kashiwa, Japan
| | - Makoto Tahara
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan.
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Endo M, Fukuda Y, Okada K, Ogawa K, Nakamura M, Takahashi S, Murakami E, Shibayama C, Kawahara M, Akahane K, Onaga R, Nagatomo T, Kanazawa T, Nishino H, Mori H, Shirai K. Clinical Outcomes of Radiotherapy for Stage 1 Glottic Carcinoma: Comparing Accelerated Hyperfractionation and Once-daily Fractionation. In Vivo 2023; 37:2320-2326. [PMID: 37652523 PMCID: PMC10500519 DOI: 10.21873/invivo.13335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 07/15/2023] [Accepted: 07/17/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND/AIM Accelerated hyperfractionation (AHF) is used in head and neck cancer to improve the local control (LC) rate, but reports of outcomes for early-stage GC are limited. The outcomes of radiotherapy (RT) for stage 1 glottic carcinoma (GC) were retrospectively analyzed, comparing AHF and once-daily fractionation (ODF) using 2.0-2.4 Gy. PATIENTS AND METHODS A total of 102 patients with stage 1 GC underwent RT alone between 2007 and 2021, with 43 in the AHF group and 59 in the ODF group. A p-value less than 0.05 was considered to indicate a significant difference. RESULTS The 5-year LC rate was 98% in the AHF group and 91% in the ODF group (p=0.19). During RT, significantly more patients in the AHF group required opioids due to mucositis than in the ODF group (74% vs. 25%, p<0.001), and the rate of aspiration pneumonia tended to be higher in the AHF group than in the ODF group (7% vs. 0%, p=0.072). CONCLUSION There was no difference in the LC rate between AHF and ODF for stage 1 GC. Moreover, the AHF group required opioids at a higher rate and tended to have a higher risk of developing aspiration pneumonia.
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Affiliation(s)
- Masashi Endo
- Department of Radiology, Jichi Medical University Hospital, Shimotsuke, Japan;
| | - Yukiko Fukuda
- Department of Radiology, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Kohei Okada
- Department of Radiology, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Kazunari Ogawa
- Department of Radiology, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Michiko Nakamura
- Department of Radiology, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Satoru Takahashi
- Department of Radiology, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Eri Murakami
- Department of Radiology, Jichi Medical University Hospital, Shimotsuke, Japan
- Department of Radiology, National Hospital Organization Tochigi Medical Center, Utsunomiya, Japan
| | - Chiaki Shibayama
- Department of Radiology, Jichi Medical University Hospital, Shimotsuke, Japan
- Department of Radiology, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan
| | - Masahiro Kawahara
- Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Keiko Akahane
- Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Ryutaro Onaga
- Department of Otolaryngology-Head and Neck Surgery, Jichi Medical University Hospital, Shimotsuke, Japan
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Takafumi Nagatomo
- Department of Otolaryngology-Head and Neck Surgery, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Takeharu Kanazawa
- Department of Otolaryngology-Head and Neck Surgery, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Hiroshi Nishino
- Department of Otolaryngology-Head and Neck Surgery, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Harushi Mori
- Department of Radiology, Jichi Medical University Hospital, Shimotsuke, Japan
| | - Katsuyuki Shirai
- Department of Radiology, Jichi Medical University Hospital, Shimotsuke, Japan
- Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama, Japan
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Onaga R, Enokida T, Ito K, Ueda Y, Okano S, Fujisawa T, Wada A, Sato M, Tanaka H, Takeshita N, Tanaka N, Hoshi Y, Tahara M. Combination chemotherapy with taxane and platinum in patients with salivary gland carcinoma: a retrospective study of docetaxel plus cisplatin and paclitaxel plus carboplatin. Front Oncol 2023; 13:1185198. [PMID: 37397398 PMCID: PMC10311248 DOI: 10.3389/fonc.2023.1185198] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/09/2023] [Indexed: 07/04/2023] Open
Abstract
Background Despite advances in precision medicine, most patients with recurrent or metastatic salivary gland carcinoma still need conventional chemotherapies, such as the combination of taxane and platinum. However, evidence for these standardized regimens is limited. Methods We retrospectively reviewed patients with salivary gland carcinoma treated with a taxane and platinum, which contained docetaxel at a dose of 60 mg/m2 plus cisplatin at a dose of 70 mg/m2 on day 1, or paclitaxel at a dose of 100 mg/m2 plus carboplatin at a dose of area under the plasma concentration-time curve = 2.5 on days 1 and 8 (both on 21-day cycles), between January 2000 and September 2021. Result Forty patients with ten adenoid cystic carcinomas and thirty other pathologies were identified. Of these, 29 patients were treated with docetaxel plus cisplatin and 11 with paclitaxel plus carboplatin. For the total population, the objective response rate (ORR) and median progression-free survival (mPFS) were 37.5% and 5.4 months (95% confidence interval: 3.6-7.4 months), respectively. On subgroup analysis, docetaxel plus cisplatin provided favorable efficacy compared with paclitaxel plus carboplatin (ORR: 46.5% vs. 20.0%, mPFS: 7.2 vs. 2.8 months), and the findings were well retained in patients with adenoid cystic carcinoma (ORR: 60.0% vs. 0%, mPFS: 17.7 vs. 2.8 months). Grade 3/4 neutropenia was relatively frequent in the docetaxel plus cisplatin (59% vs.27%), although febrile neutropenia was uncommon (3%) in the cohort. No treatment-related death was seen in any case. Conclusion The combination of taxane and platinum is generally effective and well-tolerated for recurrent or metastatic salivary gland carcinoma. In contrast, paclitaxel plus carboplatin appears unfavorable in terms of efficacy in certain patients, such as those with adenoid cystic carcinoma.
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Affiliation(s)
- Ryutaro Onaga
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Tomohiro Enokida
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Kazue Ito
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
- Department of Head and Neck Oncology, Miyagi Cancer Center, Natori, Japan
| | - Yuri Ueda
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
- Department of Otorhinolaryngology-Head and Neck Surgery, Tokyo Medical University, Shinjuku, Japan
| | - Susumu Okano
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Takao Fujisawa
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Akihisa Wada
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
- Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masanobu Sato
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Hideki Tanaka
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Naohiro Takeshita
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Nobukazu Tanaka
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Yuta Hoshi
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Makoto Tahara
- Department of Head and Neck Medical Oncology, National Cancer Center Hospital East, Kashiwa, Japan
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Takahashi S, Endo M, Nagatomo T, Onaga R, Yamaguchi H, Yamamoto R, Fukuda Y, Ogawa K, Nakamura M, Okada K, Akahane K, Kawahara M, Nishino H, Kanazawa T, Mori H, Shirai K. Successful Preoperative QUAD SHOT for Bulky Parotid Carcinoma: Potential Preoperative Ultra-Hypofractionated Radiotherapy for Conversion Surgery. Case Rep Oncol 2023; 16:218-226. [PMID: 37069898 PMCID: PMC10105323 DOI: 10.1159/000529829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 02/16/2023] [Indexed: 04/19/2023] Open
Abstract
QUAD SHOT is an ultra-hypofractionated radiotherapy (RT) technique that prescribes 14.0-14.8 Gy over 2 days. Although this technique has already gained some status as an effective palliative treatment for inoperable head and neck cancer (HNC), its application in other situations has not been given much consideration. Herein, we report a case of a 62-year-old woman who received preoperative QUAD SHOT therapy for poorly differentiated parotid carcinoma. In this case, after two courses of QUAD SHOT plus a standard chemotherapy regimen with pembrolizumab, the patient's inoperable, bulky tumor shrank dramatically and became operable. Best of all, while adequate therapeutic effects were achieved, the patient's time commitment and physical exertion were limited. RT during this period consisted of only eight fractions over 4 days. According to previous reports, the response rate for QUAD SHOT is sufficiently high, and the rate of serious adverse events is quite low. This case asks the question of whether the indications for QUAD SHOT irradiation can be expanded as one of the preoperative interventions undertaken by HNC surgeons to achieve conversion surgery.
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Affiliation(s)
- Satoru Takahashi
- Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan
| | - Masashi Endo
- Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan
| | - Takafumi Nagatomo
- Department of Otolaryngology, Jichi Medical University Hospital, Tochigi, Japan
| | - Ryutaro Onaga
- Department of Otolaryngology, Jichi Medical University Hospital, Tochigi, Japan
| | - Hironori Yamaguchi
- Department of Clinical Oncology, Jichi Medical University Hospital, Tochigi, Japan
| | - Rie Yamamoto
- Department of Clinical Oncology, Jichi Medical University Hospital, Tochigi, Japan
| | - Yukiko Fukuda
- Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan
| | - Kazunari Ogawa
- Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan
| | - Michiko Nakamura
- Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan
| | - Kohei Okada
- Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan
| | - Keiko Akahane
- Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Masahiro Kawahara
- Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Hiroshi Nishino
- Department of Otolaryngology, Jichi Medical University Hospital, Tochigi, Japan
| | - Takeharu Kanazawa
- Department of Otolaryngology, Jichi Medical University Hospital, Tochigi, Japan
| | - Harushi Mori
- Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan
| | - Katsuyuki Shirai
- Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan
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Takahashi S, Endo M, Fukuda Y, Ogawa K, Nakamura M, Okada K, Kawahara M, Akahane K, Nagatomo T, Onaga R, Nishino H, Mori H, Shirai K. Nintedanib-Induced Delayed Mucosal Healing after Adjuvant Radiation in a Case of Oropharyngeal Carcinoma. Case Rep Oncol 2022; 15:776-782. [PMID: 36157698 PMCID: PMC9459593 DOI: 10.1159/000526077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 07/11/2022] [Indexed: 11/19/2022] Open
Abstract
Since the launch of imatinib in 2001, tyrosine kinase inhibitors are being used in chemotherapy for a wide range of malignant tumors. Drugs that inactivate multiple molecular mechanisms are called multikinase inhibitors (MKIs). Nintedanib is a type of MKI that inhibits downstream cascades in three systems: vascular endothelial growth factor receptor, fibroblast growth factor receptor, and platelet-derived growth factor receptor inhibitions. It was initially developed as an anticancer drug for non-small-cell lung carcinoma; however, it was also found to inhibit the proliferation of fibroblasts associated with chronic inflammation in the lungs. Therefore, it is being more widely used to treat idiopathic pulmonary fibrosis, a benign disease, than as an antineoplastic agent. Several studies have reported adverse events associated with the concurrent use of MKIs with surgery or radiotherapy. Specifically, there has been a report cautioning against delayed wound healing associated with the use of nintedanib in patients undergoing surgery. However, there is no specific mention of its concurrent use during irradiation. We describe a case of a 72-year-old man with severely delayed recovery from radiation mucositis when nintedanib was being administered for benign disease.
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Affiliation(s)
- Satoru Takahashi
- Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan
| | - Masashi Endo
- Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan
| | - Yukiko Fukuda
- Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan
| | - Kazunari Ogawa
- Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan
| | - Michiko Nakamura
- Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan
| | - Kohei Okada
- Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan
| | - Masahiro Kawahara
- Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Keiko Akahane
- Department of Radiology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Takafumi Nagatomo
- Department of Otolaryngology, Jichi Medical University Hospital, Tochigi, Japan
| | - Ryutaro Onaga
- Department of Otolaryngology, Jichi Medical University Hospital, Tochigi, Japan
| | - Hiroshi Nishino
- Department of Otolaryngology, Jichi Medical University Hospital, Tochigi, Japan
| | - Harushi Mori
- Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan
| | - Katsuyuki Shirai
- Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan
- *Katsuyuki Shirai,
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Sasaki T, Onaga R, Koshu R. Case of delayed presentation of Pendred syndrome with a large goitre causing a life-threatening airway obstruction. BMJ Case Rep 2022; 15:15/6/e250990. [DOI: 10.1136/bcr-2022-250990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Onaga R, Sasaki T, Yamauchi T, Namba K, Higaki A, Gomi A, Nishino H. Successful treatment of ruptured extracranial carotid artery aneurysm and fistula associated with neurofibromatosis type1: Report of two cases. Acta Oto-Laryngologica Case Reports 2022. [DOI: 10.1080/23772484.2022.2043751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Ryutaro Onaga
- Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Jichi Medical University, Tochigi-ken, Japan
| | - Toru Sasaki
- Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Jichi Medical University, Tochigi-ken, Japan
| | - Tomohiko Yamauchi
- Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Jichi Medical University, Tochigi-ken, Japan
| | - Katsunari Namba
- Division of Neuroendovascular Surgery, Center for Endovascular Therapy, Jichi Medical University, Tochigi, Japan
| | - Ayuho Higaki
- Division of Neuroendovascular Surgery, Center for Endovascular Therapy, Jichi Medical University, Tochigi, Japan
| | - Akira Gomi
- Department of Neurosurgery, Jichi Medical University, Tochigi, Japan
| | - Hiroshi Nishino
- Department of Otolaryngology, Head and Neck Surgery, School of Medicine, Jichi Medical University, Tochigi-ken, Japan
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