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Shearwood McClelland, Janna Z Andrews, Huma Chaudhry, Sewit Teckie, Anuj Goenka
Although chemoradiotherapy (CRT) has improved disease outcomes in advanced head and neck cancer (aHNC), toxicity remains a major concern. Treatment interruptions and decreased quality of life (QOL) can occur due to malnutrition, secondary to mucositis, dysphagia and odynophagia. Gastrostomy tubes are used in many patients to improve nutrition during CRT. The optimal timing of PEG placement in patients with aHNC undergoing CRT remains controversial. Using the PubMed database, we performed a systematic review of published CRT series in aHNC to guide decision-making regarding optimal timing of percutaneous endoscopic gastrostomy (PEG) placement...
December 2018: Oral Oncology
N Patrik Brodin, Rafi Kabarriti, Mark Pankuch, Clyde B Schechter, Vinai Gondi, Shalom Kalnicki, Chandan Guha, Madhur K Garg, Wolfgang A Tomé
PURPOSE: Developing a quantitative decision-support strategy estimating the impact of normal tissue complications from definitive radiation therapy (RT) for head and neck cancer (HNC). We developed this strategy to identify oropharyngeal HNC patients that may benefit most from receiving proton RT. METHODS AND MATERIALS: Recent normal tissue complication probability (NTCP) models for dysphagia, esophagitis, hypothyroidism, xerostomia and oral mucositis were used to estimate NTCP for 33 oropharyngeal HNC patients previously treated with photon IMRT...
November 26, 2018: International Journal of Radiation Oncology, Biology, Physics
Erin Kamarunas, Seng Mun Wong, Christy L Ludlow
Previously, vibratory stimulation increased spontaneous swallowing rates in healthy volunteers indicating that sensory stimulation excited the neural control of swallowing. Here, we studied patients with severe chronic dysphagia following brain injury or radiation for head and neck cancer to determine if sensory stimulation could excite an impaired swallowing system. We examined (1) if laryngeal vibratory stimulation increased spontaneous swallowing rates over sham (no stimulation); (2) the optimal rate of vibration, device contact pressure, and vibratory mode for increasing swallowing rates; and (3) if vibration altered participants' urge to swallow, neck comfort, and swallow initiation latency...
November 28, 2018: Dysphagia
Satish Srinivas Kondaveeti, Divyambika C V, Christopher John, Manickavasagam M, Rajendiran S
Background: A troublesome and usually unavoidable consequence of Head and Neck chemo radiation is oral mucositis which decreases patients’ compliance and negatively influences the outcome of therapy by increasing overall treatment time. Currently, no single effective recommended treatment exists for this problem and a variety of supportive care measures have been practiced with limited benefits. This study was done to evaluate the therapeutic benefit of Placentrex in the management of oral mucositis seen in oral cancer patients undergoing treatment with concurrent chemoradiation...
November 29, 2018: Asian Pacific Journal of Cancer Prevention: APJCP
Rajendra Bhalavat, Vibhay Pareek, Manish Chandra, Lalitha Nellore, Karishma George, Dipalee Borade, Ketan Kalariya, Zaiba Moosa, Amrita Srivastava, Navaneeth Reddy, Ankita Kapoor, Darshana Kawale, Nandakumar P, Pratibha Bauskar
Purpose: High-dose-rate (HDR) interstitial brachytherapy has an established role in head and neck malignancies and offers good survival rates; however, there is scant data on improved local control (LC) and treatment-related complications in recurrent cases. We present our results in patients with recurrent head and neck cancers treated with HDR interstitial brachytherapy. Material and methods: Twenty-five patients with recurrent head and neck cancers were treated with HDR interstitial brachytherapy using Iridium 192 between 2009 and 2016...
October 2018: Journal of Contemporary Brachytherapy
Stephan Maring, Khaled Elsayad, Markus Stenner, Claudia Rudack, Uwe Haverkamp, Jan Rehkämper, Eva Wardelmann, Hans T Eich
BACKGROUND: Cisplatin-based chemotherapy (CTX) is commonly used concurrently with radiotherapy for head and neck cancer. The value of CTX regimens other than cisplatin for locally advanced squamous cell carcinoma of head and neck (LASCCHN) has not been well established. Here we compare the outcome of patients treated with different platinum-based chemotherapy regimens. METHODS: Medical records from 104 patients with LASCCHN treated with radiochemotherapy (RCTX) between February 2013 and August 2016 were analyzed...
November 13, 2018: Oncology Research and Treatment
Dorothy M Gujral, Christopher M Nutting
Intensity modulated radiotherapy (IMRT) in head and neck cancer allows sculpting of radiation dose to conform closely to target volumes and spare organs at risk. However, this may be offset by an increased risk of a geographical miss and reduction in survival outcomes. We reviewed the data from 5 prospective randomized controlled trials, one prospective phase II trial and 10 retrospective comparative series in terms of patterns of failure, treatment outcomes and late toxicities to determine any compromise in survival outcomes in favour of reduced late toxicity...
November 2018: Oral Oncology
Dan P Zandberg, Kevin Cullen, Soren M Bentzen, Olga G Goloubeva
OBJECTIVE: To evaluate OS and toxicity after definitive radiation with concurrent cetuximab (CTX-RT) compared to radiation with concurrent cytotoxic chemotherapy (CRT) in older HNSCC patients via the SEER-Medicare linked database. MATERIALS AND METHODS: We used the SEER-Medicare linked database to evaluate OS in HNSCC patients (Oropharynx, Larynx, Hypopharynx, Nasopharynx) diagnosed over 2005-2011, following FDA approval of cetuximab in combination with radiation therapy (RT) in March 2006...
November 2018: Oral Oncology
Li Jiang, Chenhui Huang, Yixiu Gan, Tong Wu, Xiaobi Tang, Yiru Wang, Rensheng Wang, Yong Zhang
Dysphagia is a side effect of nasopharyngeal carcinoma chemo-radiotherapy (CRT) which greatly influences the quality of life of the patients. We analyzed late dysphagia in 134 patients with nasopharyngeal cancer undergoing radical radiotherapy (RT), and correlated these findings with dose-volume histogram (DVH) parameters of the swallowing organs at risk (SWOARs). DVH parameters of SWOARs were correlated with late dysphagia, and with RTOG/EORTC scale score and the M. D. Anderson dysphagia inventory (MDADI) score...
November 6, 2018: Scientific Reports
K M Saeed, S Khattak, A A Syed, M A Yusuf
Benign oesophageal strictures can arise in the treatment of oesophageal cancer as a result of radiation therapy, or at anastomotic sites, post-oesophagectomy. Data on the benefit of stenting of these types of stricture is limited. We analyzed the effects of oesophageal stents on such benign esophageal strictures. In this retrospective study, data was obtained from consecutive patients, 18 years and above from January 2000 to May 2016. Inclusion criteria comprised of oesophageal stenting in post-radiation strictures and anastomotic strictures, without any malignant residual disease...
July 2018: Acta Gastro-enterologica Belgica
Ozlem Ozkaya Akagunduz, Sibel Eyigor, Esra Kirakli, Emin Tavlayan, Zeynep Erdogan Cetin, Gulsen Kara, Mustafa Esassolak
Purpose We aimed to restore dose-volume parameters of swallowing-related structures (SRSs) by evaluating long-term swallowing dysfunctions after radiotherapy (RT) in head and neck cancer patients (HNCPs). Materials and Methods Head and neck cancer patients whose pharyngeal region was involved in RT portal and treated with definitive RT/chemoradiotherapy (CRT) were included in the analyses. Patients underwent objective swallowing assessment by flexible endoscopic evaluation of swallowing (FEES). Volumes of SRSs that received 55 Gy (V55 ) (mean dose [Dmean]) were evaluated according to the dose-volume histograms of each patient...
October 20, 2018: Annals of Otology, Rhinology, and Laryngology
Thomas E Stinchcombe, Wen Fan, Steven E Schild, Everett E Vokes, Jeff Bogart, Quynh-Thu Le, Charles R Thomas, Martin J Edelman, Leora Horn, Ritsuko Komaki, Harvey J Cohen, Apar Kishor Ganti, Herbert Pang, Xiaofei Wang
BACKGROUND: Platinum and etoposide with thoracic radiation followed by prophylactic cranial irradiation constitute the standard treatment for limited-stage small cell lung cancer (LS-SCLC). Many patients with LS-SCLC are elderly with comorbidities. METHODS: Individual patient data were collected from 11 phase 2 or 3 trials for LS-SCLC conducted by the National Clinical Trials Network and activated from 1990 to 2010. The primary endpoint was overall survival (OS); the secondary endpoints were progression-free survival (PFS), the rate of severe adverse events, and off-treatment reasons...
October 21, 2018: Cancer
Michael Xiang, F Christopher Holsinger, A Dimitrios Colevas, Michelle M Chen, Quynh-Thu Le, Beth M Beadle
BACKGROUND: Cisplatin and cetuximab are both systemic therapies commonly used in combination with radiation (RT) for the definitive treatment of head and neck cancers, but their comparative efficacy is unclear. METHODS: Patients with locoregionally advanced (American Joint Committee on Cancer stage III-IVB) squamous cell carcinomas of the oropharynx, larynx, or hypopharynx were identified in the Surveillance, Epidemiology, and End Results-Medicare database. Patients received either cisplatin or cetuximab concurrent with RT, as determined by Medicare claims...
December 1, 2018: Cancer
Ilya Likhterov, Meng Ru, Cindy Ganz, Mark L Urken, Raymond Chai, Devin Okay, Jerry Liu, Robert Stewart, Bruce Culliney, Daisy Palacios, Cathy L Lazarus
OBJECTIVES/HYPOTHESIS: This study examined saliva weight over time and its association with diet and patient-rated swallowing, dry mouth, sticky saliva, and dysgeusia quality of life in head and neck cancer (HNCA) patients treated with surgery plus adjuvant chemoradiotherapy (CRT), or primary CRT. STUDY DESIGN: Prospective cohort study in an outpatient HNCA center setting. METHODS: Patients were seen pretreatment, and 1, 3, 6, 12, 24, and 36 + months post-treatment...
October 16, 2018: Laryngoscope
So Kato, Mario Ganau, Michael G Fehlings
Surgery is the only effective treatment option for advanced degenerative cervical myelopathy. Decompression may be achieved via either an anterior or posterior approach. They are both well-established techniques that are used to achieve optimal clinical results with each approach having its own pros and cons. Generally, the approach is dictated by preoperative imaging features with the aim of directly addressing the sources of spinal cord compression. However, there are frequently multiple sources of compression and several other factors should be also considered...
December 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Jessica M Clark, Emma M Holmes, Daniel A O'Connell, Jeffrey Harris, Hadi Seikaly, Vincent L Biron
BACKGROUND: There is a paucity of studies reporting long-term survival outcomes for HPV/p16 positive oropharyngeal squamous cell carcinoma (OPSCC). This study aims to compare long-term outcomes of advanced stage p16 positive and negative OPSCCs, treated by surgical and non-surgical modalities. METHODS: OPSCC patients from 1998 to 2012 were identified through a prospectively collected cancer registry. P16 immunohistochemistry was used as a surrogate marker for HPV-OPSCC...
September 26, 2018: Papillomavirus Research
Danielle F Eytan, Amanda L Blackford, David W Eisele, Carole Fakhry
Objective The aim of this study was to evaluate the prevalence of comorbidities among patients with head and neck squamous cell carcinoma (HNSCC) at the time of their cancer diagnosis and during their survivorship trajectory. The second aim was to evaluate the differences in comorbidities developed according to treatment type received. Study Design Retrospective cross-sectional. Setting SEER (Surveillance, Epidemiology, and End Results)-Medicare linked database. Subjects and Methods Individuals with a first-incident primary diagnosis of HNSCC from 2004 to 2011 per the SEER-Medicare database were included in analysis...
September 25, 2018: Otolaryngology—Head and Neck Surgery
Apostolos Analatos, Mats Lindblad, Ioannis Rouvelas, Peter Elbe, Lars Lundell, Magnus Nilsson, Andrianos Tsekrekos, Jon A Tsai
BACKGROUND: Primary antireflux surgery has high success rates but 5 to 20% of patients undergoing antireflux operations can experience recurrent reflux and dysphagia, requiring reoperation. Different surgical approaches after failed fundoplication have been described in the literature. The aim of this study was to evaluate resection of the gastroesophageal junction with jejunal interposition (Merendino procedure) as a rescue procedure after failed fundoplication. METHODS: All patients who underwent a Merendino procedure at the Karolinska University Hospital between 2004 and 2012 after a failed antireflux fundoplication were identified...
August 30, 2018: BMC Surgery
Michael Thomsen, Luis Vitetta
BACKGROUND: Chemoradiotherapy-associated mucositis can manifest as pain, inflammation, dysphagia, diarrhea, weight loss, rectal bleeding, and infection. Mucositis is a major dose-limiting side effect of chemotherapy, affecting nutritional intake and oral and intestinal function. Despite several interventions being available, there is a need for safe and effective preventative and treatment options for treatment-induced mucositis. The goals of this review are to discuss interventions based on foods and natural products and present the research to date...
December 2018: Integrative Cancer Therapies
Gustavo Nader Marta, Eduardo Weltman, Robson Ferrigno
BACKGROUND: A cost-effectiveness analysis of IMRT compared to 3D-CRT for head and neck cancer patients (HNCPs) was conducted in the Brazilian Public Health System. METHODS: A Markov model was used to simulate radiation therapy-induced dysphagia and xerostomia in HNCPs. Data from the PARSPORT trial and the quality-of-life study were used as parameters. The incremental cost-effectiveness ratio (ICER) and cost per quality-adjusted life-year (QALY) gained were calculated...
April 2018: Revista da Associação Médica Brasileira
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