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Chemoradiation head and neck cancer

Toshifumi Yamaguchi, Ken Kato, Kengo Nagashima, Satoru Iwasa, Yoshitaka Honma, Atsuo Takashima, Tetsuya Hamaguchi, Yoshinori Ito, Jun Itami, Narikazu Boku, Kazuhide Higuchi
BACKGROUND: While the standard treatment for stage II-III (non-T4) esophageal squamous cell carcinoma (ESCC) is neoadjuvant therapy followed by esophagectomy, definitive chemoradiation therapy (dCRT) is an option to treat ESCC patients who reject or may not tolerate surgical treatment. Second primary malignancy (SPM) is a problem for long-term survivors after achieving complete response (CR) by dCRT. METHODS: The source of the subjects in this study was the patients with stage II/III (excluding T4 disease) ESCC (UICC6th) who underwent dCRT from 2000 to 2011 at the National Cancer Center Hospital, Japan...
March 8, 2018: International Journal of Clinical Oncology
R Rangarajan, K Jayaraman
BACKGROUND: The WHO defines adherence as the extent to which a patient's behavior coincides with recommendations from a health-care provider. Nonadherence to cancer treatment has a major impact on the therapeutic outcome. AIM OF THE STUDY: To assess the prevalence of nonadherence to radiation regimen and to analyze the factors that affect adherence to cancer treatment. MATERIALS AND METHODS: Patients receiving radiation treatment in our hospital were screened for adherence to appointment keeping and to the prescribed radiation regimen and patients who had unplanned treatment breaks during treatment were interviewed...
April 2017: Indian Journal of Cancer
V Noronha, V Sharma, A Joshi, V M Patil, S G Laskar, K Prabhash
BACKGROUND: Cisplatin-based chemoradiation (CTRT) is the standard of care in locally advanced head and neck cancers. Limited treatment options are available in patients unfit for cisplatin. AIMS: This audit was carried out to study the toxicities, tolerance, and outcomes of carboplatin-based CTRT in patients who are not eligible for cisplatin. MATERIALS AND METHODS: A total of 63 locally advanced head and neck cancer patients treated between January 2011 and October 2015 were administered carboplatin-based CTRT...
April 2017: Indian Journal of Cancer
Feifei Teng, Madhava Aryal, Jae Lee, Choonik Lee, Xioajin Shen, Peter Hawkins, Michelle Mierzwa, Avraham Eisbruch, Yue Cao
PURPOSE: Positron emission tomography with18 F-deoxyglucose (FDG), dynamic contrast-enhanced magnetic resonance imaging (MRI), and diffusion-weighted MRI each identify unique risk factors for treatment outcomes in head and neck cancer (HNC). Clinical trials in HNC largely rely on a single imaging modality to define targets for boosting. This study aimed to investigate the spatial correspondence of FDG uptake, perfusion, and the apparent diffusion coefficient (ADC) in HNC and their response to chemoradiation therapy (CRT) and to determine the implications of this overlap or lack thereof for adaptive boosting...
December 21, 2017: International Journal of Radiation Oncology, Biology, Physics
Mickaël Burgy, Julie Leblanc, Christian Borel
The issue of induction chemotherapy (ICT) interest in locoregionally advanced squamous cell cancer of the head and neck is a real epic that has been carried out over four phase III studies: PARADIGM, DECIDE, NCT01086826 and lastly the conclusive GORTEC 2007-02. With no significant benefit in overall survival of ICT, followed by concurrent chemoradiation over the standard chemoradiotherapy alone, in three of these studies, and a significant number of treatment-related deaths with the standard regimen docetaxel, cisplatin, and fluorouracil, ICT is no longer a hot topic...
April 2018: Anti-cancer Drugs
Rebecca Hoesli, Andrew C Birkeland, Andrew J Rosko, Mohamad Issa, Kelsey L Chow, Nicole L Michmerhuizen, Jacqueline E Mann, Steven B Chinn, Andrew G Shuman, Mark E Prince, Gregory T Wolf, Carol R Bradford, Jonathan B McHugh, J Chad Brenner, Matthew E Spector
Tumor infiltrating lymphocytes (TILs) have been shown to be an important prognostic factor in patients with previously untreated head and neck cancer. After organ preservation therapy for laryngeal cancer and subsequent persistence/recurrence, the prognostic value of TILs is unknown. Our goal was to determine if TILs have value as a prognostic biomarker in patients with surgically salvageable persistent/recurrent laryngeal squamous cell carcinoma. Levels of TILs were quantified on tissue microarrays from 183 patients undergoing salvage total laryngectomy for persistent/recurrent laryngeal cancer after radiation or chemoradiation between 1997 and 2014...
February 2018: Oral Oncology
Karlijn van den Bovenkamp, Bart Dorgelo, Maartje G Noordhuis, Bernard F A M van der Laan, Bert van der Vegt, Hendrik P Bijl, Jan L Roodenburg, Boukje A C van Dijk, Sjoukje F Oosting, Ed M D Schuuring, Johannes A Langendijk, Gyorgy B Halmos, Boudewijn E C Plaat
OBJECTIVES: To identify predictive factors for the presence of viable tumor and outcome in head and neck cancer patients who undergo therapeutic salvage neck dissections. MATERIALS AND METHODS: Retrospective analysis of 76 salvage neck dissections after radiotherapy alone (n = 22), radiotherapy in combination with carboplatin/5-fluorouracil (n = 42) or with cetuximab (n = 12). RESULTS: Viable tumor was detected in 41% of all neck dissections...
February 2018: Oral Oncology
Lauren A Zimmaro, Sandra E Sephton, Chelsea J Siwik, Kala M Phillips, Whitney N Rebholz, Helena C Kraemer, Janine Giese-Davis, Liz Wilson, Jeffrey M Bumpous, Elizabeth D Cash
BACKGROUND: Head and neck cancers are associated with high rates of depression, which may increase the risk for poorer immediate and long-term outcomes. Here it was hypothesized that greater depressive symptoms would predict earlier mortality, and behavioral (treatment interruption) and biological (treatment response) mediators were examined. METHODS: Patients (n = 134) reported depressive symptomatology at treatment planning. Clinical data were reviewed at the 2-year follow-up...
January 22, 2018: Cancer
Hamid Abdollahi, Shayan Mostafaei, Susan Cheraghi, Isaac Shiri, Seied Rabi Mahdavi, Anoshirvan Kazemnejad
OBJECTIVES: Immediately or after head-and-neck (H&N) cancer chemoradiotherapy (CRT), patients may undergone significant sensorineural hearing loss (SNHL) which could affect their quality of life. Radiomic feature analysis is proposed to predict SNHL induced by CRT. MATERIAL AND METHODS: 490 image features of 94 cochlea from 47 patients treated with three dimensional conformal RT (3DCRT) for different H&N cancers were extracted from CT images. Different machine learning (ML) algorithms and also least absolute shrinkage and selection operator (LASSO) penalized logistic regression were implemented on radiomic features for feature selection, classification and prediction...
January 9, 2018: Physica Medica: PM
Stephen T Sonis, Alessandro Villa
Oral mucositis is a significant unmet clinical need for many cancer patients. The biological complexity of mucositis' pathogenesis provides a number of mechanistic targets suitable as pharmacologic targets. The diversity of targets has stimulated drug development in search of an effective intervention. In this paper, we review a range of agents that are currently being evaluated. Areas covered: Drugs for management of oral mucositis vary in formulation, route of administration and biological target. Most propose to interrupt the initiation of injury by suppressing activation of the innate immune response or countering oxidative stress, or minimizing downstream inflammatory responses...
January 11, 2018: Expert Opinion on Investigational Drugs
June R Greaves
The National Institutes of Health National Cancer Institute estimates that over 13,000 new cases of head and neck cancer (HNC) will be diagnosed in 2017. Patients with HNC often require enteral nutrition (EN) via gastrostomy tube to provide nutrition support and hydration because of tumor obstruction of the oropharynx and/or cumulative effects of chemoradiation therapy. The percutaneous endoscopic gastrostomy (PEG) tube has become the preferred technique for EN access because placement is considered a minimally invasive procedure...
January 11, 2018: Nutrition in Clinical Practice
Peter A Benedict, Ryan Ruiz, Avanti Verma, Gregory R Dion, Philmo Oh, Binhuan Wang, Omar H Ahmed, Nao Hiwatashi, Renjie Bing, Kristen Victor, Kenneth S Hu, Aaron Johnson, Ryan C Branski, Milan R Amin
OBJECTIVES/HYPOTHESIS: To develop a clinically relevant model of oropharyngeal concurrent chemoradiation therapy (CCRT) in order to quantify the effects of CCRT on tongue function and structure. CCRT for advanced oropharyngeal cancer commonly leads to tongue base dysfunction and dysphagia. However, no preclinical models currently exist to study the pathophysiology of CCRT-related morbidity, thereby inhibiting the development of targeted therapeutics. STUDY DESIGN: Animal model...
December 27, 2017: Laryngoscope
Teresa Magnes, Alexander Egle, Richard Greil, Thomas Melchardt
At the annual ASCO meeting clinically relevant data concerning the management of advanced head and neck cancer that will influence clinical practice in the future were presented. Chemoradiation with high-dose cisplatin remains the mainstay of treatment for patients with locally advanced squamous cell head and neck cancer. Adjuvant therapy with afatinib following chemoradiation failed to show clinical benefit. The combination of bevacizumab with platinum-based chemotherapy improved progression-free survival but did not lead to a significant difference in overall survival compared to chemotherapy alone...
2017: Memo
John V Hegde, Narek Shaverdian, Carol Felix, Pin-Chieh Wang, Darlene Veruttipong, Sophia Hsu, Jonathan W Riess, Shyam D Rao, Megan E Daly, Allen M Chen
PURPOSE: To analyze functional outcomes for patients treated on a phase 2 trial of de-escalated chemoradiation therapy for human papillomavirus-positive oropharyngeal cancer. METHODS AND MATERIALS: Patient eligibility included p16-positive, stage III or IV oropharyngeal squamous cell carcinoma and a Zubrod performance status of 0 to 1. Treatment was induction chemotherapy with paclitaxel, 175 mg/m2 , and carboplatin, area under the curve (AUC) of 6 mg/ml/min, for 2 cycles every 21 days, followed by concurrent paclitaxel, 30 mg/m2 , every 7 days with dose-reduced radiation therapy of 54 or 60 Gy...
March 1, 2018: International Journal of Radiation Oncology, Biology, Physics
Vanita Noronha, Amit Joshi, Vijay Maruti Patil, Jaiprakash Agarwal, Sarbani Ghosh-Laskar, Ashwini Budrukkar, Vedang Murthy, Tejpal Gupta, Anil K D'Cruz, Shripad Banavali, Prathamesh S Pai, Pankaj Chaturvedi, Devendra Chaukar, Nikhil Pande, Arun Chandrasekharan, Vikas Talreja, Dilip Harindran Vallathol, Vijayalakshmi Mathrudev, Aparna Manjrekar, Kamesh Maske, Arati Sanjay Bhelekar, Kavita Nawale, Sadhana Kannan, Vikram Gota, Atanu Bhattacharjee, Shubhada Kane, Shashikant L Juvekar, Kumar Prabhash
Purpose Chemoradiation with cisplatin 100 mg/m2 given once every 3 weeks is the standard of care in locally advanced head and neck squamous cell cancer (LAHNSCC). Increasingly, low-dose once-a-week cisplatin is substituted because of perceived lower toxicity and convenience. However, there is no level 1 evidence of comparable efficacy to cisplatin once every 3 weeks. Patients and Methods In this phase III randomized trial, we assessed the noninferiority of cisplatin 30 mg/m2 given once a week compared with cisplatin 100 mg/m2 given once every 3 weeks, both administered concurrently with curative intent radiotherapy in patients with LAHNSCC...
December 8, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Victoria Kuta, Blair Williams, Matthew Rigby, Robert Hart, Jonathan Trites, Colin MacKay, S Mark Taylor
OBJECTIVES/HYPOTHESIS: The unknown primary of the neck is commonly encountered by the head and neck surgeon. Despite the exhaustive diagnostic tools employed in traditional detection protocols, many unknown primaries are not found, and the patient is subjected to wide-field radiation and chemotherapy during treatment. Localizing the primary tumor has demonstrated therapeutic benefits, improved quality of life, and overall survival. The authors' objective was to determine the efficacy of a new management protocol for unknown primaries of the head and neck...
December 7, 2017: Laryngoscope
L Pujari, S Padhi, P Meher, A Tripathy
CONTEXT: Strict adherence and timely completion of the external beam radiation therapy (EBRT) schedule is an important prognostic factor in the survival of head and neck cancer patients. However, many patients are unable to complete the radiation treatment due to various reasons resulting in a poor outcome. AIMS: This study aims to study the pattern and various possible causes of defaults for possible intervention. SETTINGS AND DESIGN: A retrospective epidemiological analysis...
January 2017: Indian Journal of Cancer
Ricky W McCullough
Approximate oncology-wide incidence, duration, costs and deaths associated with mucositis and identify health economic benefits of antimucositis therapies. Review the literature relevant to the clinical experience of mucositis by pathophysiology, incidence, duration, costs and deaths. Use US insurance actuarial and epidemiology on cancer to generalize an oncology-wide impact of toxic mucositis. Toxic mucositis causes oropharyngoesophageal ulcerations, chemo-induced nausea, vomiting and diarrhea. Acutely, it lasts 102 days/six cycles of chemotherapy, 60 days in human stem-cell transplantation patients and 70-84 days in head and neck cancer patients at annual costs of US$13...
December 2017: Future Oncology
Angela Cao, Sarah Khayat, Elizabeth Cash, Christopher Nickel, John Gettelfinger, Paul Tennant, Jeffrey Bumpous
PURPOSE: To determine whether inclusion of chemoradiation history increases estimated risk for complications following total laryngectomy using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) Surgical Risk Calculator. MATERIALS AND METHODS: A retrospective review of 96 patients with laryngeal cancer, approximately half of who had received prior chemoradiation, who underwent laryngectomy between January 2010 and December 2014...
November 13, 2017: American Journal of Otolaryngology
Arlene A Forastiere, Nofisat Ismaila, Jan S Lewin, Cherie Ann Nathan, David J Adelstein, Avraham Eisbruch, Gail Fass, Susan G Fisher, Scott A Laurie, Quynh-Thu Le, Bernard O'Malley, William M Mendenhall, Snehal Patel, David G Pfister, Anthony F Provenzano, Randy Weber, Gregory S Weinstein, Gregory T Wolf
Purpose To update the guideline recommendations on the use of larynx-preservation strategies in the treatment of laryngeal cancer. Methods An Expert Panel updated the systematic review of the literature for the period from January 2005 to May 2017. Results The panel confirmed that the use of a larynx-preservation approach for appropriately selected patients does not compromise survival. No larynx-preservation approach offered a survival advantage compared with total laryngectomy and adjuvant therapy as indicated...
November 27, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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