High rates of postoperative radiotherapy delay in head and neck cancer before and after Medicaid expansion

INTRODUCTION: Head and neck cancer patients are frequently malnourished at the time of diagnosis and prior to the beginning of treatment. Deterioration of the nutritional status results in an increase in chemo radiotherapy related toxicity and this may increase the prolonged treatment time, which has been associated with poor clinical outcome. The present study aims to do nutritional assessment before and after chemo radiotherapy in head and neck cancer patients. MATERIAL AND METHODS: The present study was undertaken at the Department of Radiation Oncology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly. In this study, 50 patients of Head and neck tumours were enrolled and their nutrition was assessed before and after chemoradiotherapy. Nutrition assessment was done using different laboratory parameters like haemoglobin, total leukocyte count, blood urea, serum creatinine and serum bilirubin. Anthropometric parameters used are Body mass index, Skin fold thickness, and Mid-arm circumference. Nutritional risk indicator and PG-SGA score is measured before and after chemoradiotherapy. All the parameters were assessed and analysed using different statistical tests- Chi-square test, Fisher Exact test and paired t test.RESULTS: Haemoglobin decrease was statistically significant during treatment (p less than 0.001) and the decrease in total leukocyte count during treatment was showing trend towards significance (p value-0.056). There was deterioration in other parameters like blood urea, serum creatinine and serum bilirubin but was not statistically significant. Anthropometric parameters- Body mass index, mid-arm circumference and skin fold thickness and percent body fat showed a significant change (p less than 0.00001). Nutritional risk indicator and PG-SGA class has decreased for majority of patients during treatment, the change is statistically significant (p less than 0.00001 and p=0.0251) respectively.CONCLUSION: The nutrition has important role to play in the management of head and neck cancers by chemo radiotherapy. It helps to reduce the complications and improve the tolerance of chemo radiotherapy, thus avoiding treatment breaks which may lead to failure of treatment.

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Changes in carnitine levels through induction chemotherapy in head and neck cancer patients as a potential cause of therapy-related malaise

BMC Cancer ◽

10.1186/s12885-021-08471-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tatsuya Ito ◽

Kiyoaki Tsukahara ◽

Hiroki Sato ◽

Akira Shimizu ◽

Isaku Okamoto

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Induction Chemotherapy ◽

Neck Cancer ◽

Cancer Site ◽

Primary Cancer ◽

Analog Scale ◽

Before And After ◽

Primary Cancer Site ◽

Total Carnitine

Abstract Background Carnitine is related to malaise, and cisplatin is associated with decreased carnitine. The purpose of this study was to elucidate the effects of one course of induction chemotherapy (IC) for head and neck cancer on blood carnitine levels, focusing on free carnitine (FC). Methods This single-center prospective study investigated 20 patients diagnosed with primary head and neck cancer who underwent IC with cisplatin, docetaxel, and 5-fluorouracil. FC, acylcarnitine (AC), and total carnitine (TC) levels were measured before starting therapy and on Days 7 and 21 after starting IC. In addition, malaise was evaluated before and after therapy using a visual analog scale (VAS). Results All subjects were men and the most common primary cancer site was the hypopharynx (9 patients). FC levels before starting therapy and on Days 7 and 21 were 47.7 ± 2.2 μM/mL, 56.7 ± 2.2 μM/mL, and 41.1 ± 1.9 μM/mL, respectively. Compared with the baseline before starting therapy, FC had significantly decreased on Day 21 (p = 0.007). AC levels before starting therapy and on Days 7 and 21 were 12.5 ± 1.2 μM/mL, 13.6 ± 1.4 μM/mL, and 10.7 ± 0.7 μM/mL, respectively. TC levels before starting therapy and on Days 7 and 21 were 60.2 ± 2.5 μM/mL, 70.2 ± 3.3 μM/mL, and 51.7 ± 2.3 μM/mL, respectively. No significant differences in AC, TC or VAS were seen before the start of therapy and on Day 21. Conclusions After IC, a latent decrease in FC occurred without any absolute deficiency or subjective malaise.

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351 Oral Accelerated versus conventional fractionated postoperative radiotherapy for advanced head and neck cancer: preliminary results of a multicenter phase III study

Radiotherapy and Oncology ◽

10.1016/s0167-8140(02)82666-4 ◽

2002 ◽

Vol 64 ◽

pp. S118-S119

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Postoperative Radiotherapy ◽

Phase Iii ◽

Advanced Head ◽

Preliminary Results ◽

Multicenter Phase ◽

Phase Iii Study

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Distinct Imaging Modalities in Head and Neck Cancer: Benefits and Drawbacks

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11ispl4.4554 ◽

2020 ◽

Vol 11 (SPL4) ◽

pp. 2777-2784

Author(s):

Dana Merin ◽

Roshni P R

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Imaging Techniques ◽

Precise Determination ◽

Imaging Biomarkers ◽

Selection Strategies ◽

Positron Emission ◽

Before And After ◽

Oncological Imaging

This review mainly focuses on the distinct imaging techniques in for head and neck cancer (HNC), its altered techniques used in diagnosis and its applications. It also depicts the upcoming imaging methods present in the field of HNC causing areas. It explains precise determination regarding the degree and extends of neoplasm. We mainly look on to the MRI(Magnetic resonance imaging), PET(Positron emission tomography), CT (computed tomography)imaging biomarkers for the management of HNC. It plays an important role in the therapy selection strategies and also enhances the therapeutic ratio in the management of HNC. The role of imaging techniques become increasingly more crucial in the management process in locally progressed head and neck squamous cell carcinoma(HNSCC). In this structure, PET allows non-invasive assessment of a range of tumour biomarkers such as metabolism, hypoxia and proliferation. MRI techniques such as can characterize different tissues by probing into their microstructure, providing a novel methodology in oncological imaging. CT, MRI, and PET/CT are widely used to determine the presence and extent of the tumours before and after treatment. This review depicts a synopsis of the most recent imaging strategies and imaging recommendations for every one of the different strides along the clinical way of patients with head and neck malignant growth.

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Postoperative Radiotherapy in Head and Neck Cancer

Otorhinolaryngology Clinics - An International Journal ◽

10.5005/jp-journals-10003-1016 ◽

2010 ◽

Vol 2 (1) ◽

pp. 43-51

Author(s):

Vedang Murthy ◽

Sayan Kundu ◽

Tanweer Shahid ◽

Ashwini Budrukkar ◽

Tejpal Gupta ◽

...

Keyword(s):

Head And Neck Cancer ◽

Targeted Therapy ◽

Head And Neck ◽

Neck Cancer ◽

Early Stage ◽

Postoperative Radiotherapy ◽

Locally Advanced ◽

Head And Neck Cancers ◽

Advanced Head ◽

Locoregional Failure

Abstract Though early stage head and neck cancers can be cured either by surgery or radiation, patients with locally advanced disease continues to pose a therapeutic challenge. Locoregional failure is the major cause of death in head and neck cancers. As the outcome of locally advanced head and neck cancer is less than promising, a combined modality approach is generally undertaken in this group of patients. The combination of surgery, radiation and more recently, chemotherapy and targeted therapy can improve outcomes in locally advanced head and neck cancer patients. This overview discusses the rationale and role of postoperative radiotherapy (PORT) in advanced head and neck cancers, the radiotherapy technique in brief and methods of enhancing the efficacy of postoperative RT by altering the fractionation schedules and adding chemotherapy and targeted therapy.

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