scholarly journals Guidelines update: Post-treatment follow-up of adult head and neck squamous cell carcinoma: Screening for metastasis and metachronous esophageal and bronchial locations

2015 ◽  
Vol 132 (4) ◽  
pp. 217-221 ◽  
Author(s):  
D. Blanchard ◽  
B. Barry ◽  
D. De Raucourt ◽  
O. Choussy ◽  
B. Dessard-Diana ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Post Treatment ◽  
Neck Squamous Cell Carcinoma ◽  
Adult Head

scholarly journals Effect of coronavirus disease 2019 on recurrences and follow up of head and neck squamous cell carcinoma

2021 ◽  
pp. 1-4
Author(s):  
E Kytö ◽  
E Haapio ◽  
I Kinnunen ◽  
H Irjala
Keyword(s):  
Squamous Cell Carcinoma ◽  
Prospective Study ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Neck Squamous Cell Carcinoma ◽  
One Year ◽  
Diagnostic Delays

Abstract Objective This prospective study aimed to evaluate possible diagnostic delays in head and neck squamous cell carcinoma recurrences due to the changed follow-up protocol during the coronavirus disease 2019 pandemic. Methods The follow-up appointments of head and neck squamous cell carcinoma patients treated more than one year prior to the pandemic were changed to telephone appointments in order to reduce physical visits to the hospital. All contacts, reasons for contact and recurrent cancers were recorded. Results There were 17 recurrences during a seven-month study period among 178 patients treated in the previous year (10 per cent); 14 of these recurrences occurred in patients whose treatment had ended less than one year previously and 3 occurred more than one year after treatment had ended. There was no delay in diagnoses of recurrent tumours or treatment despite reduced visits because of the coronavirus disease 2019 pandemic. Conclusion According to our analyses, no delay was caused in the diagnoses of recurrent diseases. Follow up by telephone or telemedicine can be considered as part of the follow-up protocol one year after the treatment of head and neck squamous cell carcinoma when necessary.

P-47 Head and neck squamous cell carcinoma: a stratified follow-up program

Oral Oncology ◽  
2021 ◽  
Vol 118 ◽  
pp. 5
Author(s):  
Francesca de Felice ◽  
Mary Lei ◽  
Richard Oakley ◽  
Andrew Lyons ◽  
Alastair Fry ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Neck Squamous Cell Carcinoma

EGFRv3 and PTEN as prognostic markers in head and neck squamous cell carcinoma patients treated with cetuximab.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e17032-e17032
Author(s):  
Alexandre Andre Balieiro Anastacio da Costa ◽  
Adriana Regina G. Ribeiro ◽  
Andrea Paiva Guimaraes ◽  
Ludmilla Thome Chinen ◽  
Clovis Pinto ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Objective Response ◽  
Locally Advanced ◽  
Population Characteristics ◽  
Neck Squamous Cell Carcinoma ◽  
Phase Iii

e17032 Background: Cetuximab (CTx) is used in treatment of locally advanced (LAD) head and neck squamous cell carcinoma (HNSCC) in combination with radiotherapy (RT) or in metastatic disease (MD). There is no comparison between CTx plus RT and cisplatin plus RT. Patients treated with CTx in daily clinical practice are frequently different from the selected population treated in clinical trials. There are no biomarkers for efficacy of CTx in HNSCC. EGFR variant 3 mutation (EGFRv3), an extracellular domain mutation of EGFR, has been reported in different frequencies in HNSCC in the last years and its association with prognosis and CTx efficacy is still unknown. Methods: Retrospective review of data from patients with HNSCC treated with CTx at a single institution from 2007 to 2010. We evaluated CTx efficacy and expression of EGFRv3, EGFR, PTEN, CD44 and CD44v6 and their impact in objective response rate (ORR), progression free survival (PFS) and overall survival (OS). Biomarkers were analyzed by immunohistochemistry in tissue microarray. Results: For a median follow-up time of 13 months, 61 patients with LAD treated with RT plus CTx had a median OS of 22.7 months, and a median PFS of 8.0 months. Age adjusted Charlson Comorbidity Index (AA-CCI) and ECOG performance status were the most important predictors of poor prognosis in this population. For a median follow-up time of 10.9 months, 44 patients with MD had a median OS of 13.0 months and a median PFS of 7.0 months, for an ORR of 53.7%. EGFRv3 was expressed in 27.1% of tumor samples and was not associated with any clinical outcome. EGFR positivity was associated to higher ORR in LAD and PTEN negativity was associated with shorter OS in the MD setting. Conclusions: In a non selected population with LAD treatment results with CTx in combination with radiotherapy were worse than expected by the phase III study, median OS 22.7 months vs 49.0 months. This difference may be attributed to different population characteristics with higher ECOG and AA-CCI in our study and warrants an adequate proof of efficacy of CTx in this population. EGFRv3 is present in HNSCC but does not impact prognosis. PTEN and EGFR expression emerged as potential biomarkers in HNSCC patients treated with CTx.

Long-term toxicity following radiation therapy for head and neck squamous cell carcinoma: A retrospective study analyzing the effect of concurrent chemotherapy and advanced t-stage on late treatment-induced toxicities.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e17560-e17560
Author(s):  
William Barrett ◽  
Christine Cassidy
Keyword(s):  
Squamous Cell Carcinoma ◽  
Radiation Therapy ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Late Effects ◽  
Neck Squamous Cell Carcinoma ◽  
Definitive Chemoradiation

e17560 Background: There are approximately 436,000 survivors of head and neck squamous cell carcinoma (HNSCC) in the U.S. Toxicities related to definitive chemoradiation or radiation therapy can persist for many years, with some toxicities not presenting clinically until five or more years after definitive treatment. Long-term management of late radiotherapy effects is thus warranted. Methods: This retrospective chart review has three aims: (1) comprehensively assess overall late effects of definitive radiation and chemoradiation; (2) compare treatment-related toxicities between definitive radiation and chemoradiation; and (3) compare treatment-related toxicities between patients with TNM stage T1/T2 tumors to T3/T4 tumors. Late term effects were assessed using 17 toxicity categories including xerostomia, dysphagia, and neck fibrosis. HNSCC patients included in the study were those seen by a single practitioner for follow-up of definitive radiation or chemoradiation, without a history of surgical intervention to the primary site, between June 2017 and June 2018 (N = 49). Results: The median time from the end of treatment to the most recent follow-up was 8.53 years (1.17-24.08 years). In the total cohort, the most common late effect was xerostomia (78%, N = 38), followed by dysphagia (43%, N = 21), and neck fibrosis (27%, N = 13). For the majority of toxicity categories (11 of 17), the cohort that received definitive chemoradiation had higher rates of toxicity than the cohort that received definitive radiation alone. Additionally, for the majority of toxicity categories (10 of 17), the cohort of T3/T4 tumors had higher rates of long-term toxicity than the cohort of T1/T2 tumors. Conclusions: Although the patient population in this study has excellent locoregional control after definitive radiation or chemoradiation, the majority of patients suffer from long-term treatment-related toxicities. Long-term follow up care is needed to manage the late effects of radiotherapy that can develop and persist for years after treatment completion.

Incidence of hypothyroidism in head and neck squamous cell carcinoma patients receiving radiotherapy with and without immune checkpoint inhibitors.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e18551-e18551
Author(s):  
Jennifer Leddon ◽  
Martina Chirra ◽  
Arushi Agrawal ◽  
Logan Roof ◽  
Danny Trotier ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Risk Factor ◽  
Oral Cavity ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Primary Tumor ◽  
Thyroid Dysfunction ◽  
Neck Squamous Cell Carcinoma

e18551 Background: Treatment for locally advanced head and neck squamous cell carcinoma (HNSCC) involves a combination of surgery, chemotherapy, and radiotherapy (RT). RT for HNSCC is a known risk factor for the development of hypothyroidism. Recently, anti-PD1 therapies have been approved for recurrent and metastatic HNSCC and are moving to the forefront of HNSCC care. Similarly, thyroid dysfunction is a common immune-related adverse event following anti-PD1 therapy. Whether the addition of anti-PD1 to RT increases the likelihood of developing hypothyroidism remains unknown. Methods: The rate of hypothyroidism in HNSCC patients receiving RT (+/- chemotherapy and surgery) was compared to HNSCC patients receiving RT + anti-PD1 therapy either concurrently or after RT. Exclusion criteria were preexisting thyroid dysfunction, RT dose < 45 Gy and patients with incomplete treatment records. We defined clinical hypothyroidism as an elevation of TSH with low T3, T4 or elevation of TSH with symptoms requiring levothyroxine initiation. Hypothyroidism incidence was compared using Fisher’s exact test. Results: 153 patients were evaluated. In the RT group (N = 103), patients received RT +/- surgery or chemotherapy. 82/103 (80%) were male, median age was 57 and primary tumor groups included oropharynx 62/103 (60%), larynx 29/103 (28%), oral cavity 9/103 (9%) and other 3/103 (3%). In the RT + anti-PD1 group (N = 50), 36/50 (72%) were males, median age was 57 and primary tumor groups included oral cavity 19/50 (38%), oropharynx 17/50 (34%), larynx 8/50 (16%), and other 6/50 (12%). In the RT group, median follow up after RT was 801 days. In the RT+ anti-PD1 group, median follow up was 595 days from RT and 388 days from anti-PD1. The rate of hypothyroidism was significantly higher in the RT group 22.3% (23/103) versus 6% (3/50)after anti-PD1 therapy (p = 0.011). Multinomial logistical regression found no significant difference in hypothyroidism based on age, sex, or BMI. Larynx as primary tumor location was an independent risk factor for development of hypothyroidism (OR 4.74, p = 0.002). Conclusions: The addition of anti-PD1 therapy to standard HNSCC treatments does not significantly increase the risk of developing hypothyroidism. In fact, this study finds a lower incidence of hypothyroidism in HNSCC patient receiving RT + PD1 therapy which may be due to shorter duration of follow up and lower proportion of laryngeal cancer patients who are at relatively higher risk for surgical hypothyroidism.

Paclitaxel and Carboplatin in Neo-Adjuvant and Concomitant Chemoradiotherapy in Locally Advanced Head and Neck Squamous Cell Carcinoma

2002 ◽  
Vol 88 (6) ◽  
pp. 489-494 ◽  
Author(s):  
Gianni Fornari ◽  
Elisa Artusio ◽  
Lorenza Mairone ◽  
Mario Airoldi ◽  
Guido Bongioannini ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Locally Advanced ◽  
Neck Squamous Cell Carcinoma ◽  
Node Involvement ◽  
Ecog Ps ◽  
Local Regional Control

Aim and background To evaluate feasibility of neoadjuvant chemotherapy (NA-CT) followed by CT + radiotherapy (RT) in locally advanced or unresectable head and neck squamous cell carcinoma (HNSCC). Methods 22 HNSCC patients were enrolled (18 males, 4 females; median age, 59.5 years; median ECOG PS, 1). Sites of disease: oral cavity, 18.2%; oropharynx, 40.9%; hypopharynx, 18.2%; larynx, 4.6%, multiple sites, 18.2%. T (tumor) category: T2, 13.6%; T3, 31.8%;T4, 54.5%. N (nodes) category: N0, 9.1%; N1, 18.1%; N2, 40.9%; N3, 31.8%. Stage: III, 4.6%; IVA, 63.6%; IVB, 31.8%. Induction carboplatin (AUC = 6) and paclitaxel (200 mg/m2) × 3 cycles (q21 days) were given. Responders received definitive radiotherapy with concurrent carboplatin (35 mg/m2/day from days 1 to 5 in weeks 1, 3, 5 and 7) and paclitaxel (50 mg/m2 on days 10, 24 and 38). Patients with node involvement were suggested to undergo postradiotherapy neck dissection. Results NA-CT. 97% of planned chemotherapy cycles were administered. Prevalent toxicity was hematologic: 50% G4 neutropenia and 31.8% G3, one neutropenic fever. All patients had alopecia. Complete responses in T and N were 4 (18.2%) and 3 (15%), respectively. Partial responses were 13 (59%) and 9 (45%). There was 1 progressive disease. CT + RT. 79.9% of planned cycles of CT were administered. In 19 patients (86.4%) more than 50% of planned cycles of CT were completed. Median dose of RT was 70.2 Gy on T/N+ and 54 Gy on N0. Limiting toxicity was mucositis in 77.3%, followed by neutropenia (59.1% G3–G4). Median weight loss was 4.9%. 18.2% of patients required hospitalization. Complete responses in T and N were 15 (68.1%) and 8 (40%), respectively. Partial responses were 5 (22.7%) and 7 (35%). Conclusions The preliminary results of this study are encouraging, despite the toxicity. Adequate follow-up is required to evaluate efficacy in terms of local-regional control and overall survival.

scholarly journals Circulating tumour cell and cell-free DNA kinetics during radiotherapy in patients with intact head and neck squamous cell carcinoma

2020 ◽  
Author(s):  
Sweet Ping Ng ◽  
Carolyn S Hall ◽  
Salyna Meas ◽  
Vanessa N Sarli ◽  
Houda Bahig ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Treatment Response ◽  
Squamous Cell ◽  
Clinical Findings ◽  
Post Treatment ◽  
Neck Squamous Cell Carcinoma ◽  
Circulating Tumour Cell ◽  
Pre Treatment

AbstractHead and neck squamous cell carcinoma (HNSCC) treatment response relies heavily on macroscopic clinical findings. Blood monitoring of circulating markers during treatment may improve earlier detection of responders versus non-responders during radiotherapy. In this study, patients with intact tumour of HNSCC were enrolled in the prospective PREDICT-HN study. Pre-, after first treatment, weekly, and post-treatment blood samples were collected. CTC was enumerated using the CellSearch system. cfDNA was quantified from cfNA isolated at pre-, mid- and post-treatment timepoints. Blood samples were collected from 45 patients. Of the 339 samples analysed for CTC, 31% had detectable CTCs. Nine patients had detectable CTCs (1-3/7.5ml blood) in pre-treatment samples. After 1 fraction, 16 patients had CTCs detected, with 12 who had no pre-treatment CTC. Sixteen (36%) patients had detectable CTC in final week of treatment. There was no correlation between cancer stage, nodal status and tumour burden with CTC. cfDNA levels increased during treatment, with its highest level in the final week and lowest at post-treatment. Our results showed in HNSCC that CTCs can be detected during radiotherapy, suggesting mobilization into circulation during treatment, with as-yet-unknown viability. cfDNA kinetics during treatment correlated with CTC release, and may indicate apoptotic change.Simple SummaryHead and neck squamous cell carcinoma (HNSCC) treatment response relies heavily on macroscopic clinical findings. Blood monitoring of circulating markers such as circulating tumour cell (CTC) and cell-free DNA (cfDNA) during treatment may improve earlier detection of responders versus non-responders during definitive radiotherapy. Although the detection of CTCs and cfDNA in patients with HNSCC has been described, there is minimal data on the kinetics of CTC counts and cfDNA levels during radiotherapy in patients with HNSCC. Here, our study prospectively describes the changes in CTC and cfDNA enumeration during radiotherapy in patients with HNSCC. Our results showed, for the first time to our knowledge, in HNSCC, that CTCs can be detected during radiotherapy, suggesting mobilization into peripheral circulation during treatment, with as-yet-unknown viability. cfDNA kinetics during treatment correlated with CTC release, may indicate apoptotic change during radiotherapy. Combined cfDNA-CTC as an early marker of treatment response should be investigated further.

scholarly journals A survey on pulmonary screening practices among otolaryngology-head & neck surgeons across Saudi Arabia in the post treatment surveillance of head and neck squamous cell carcinoma: Cross sectional study . (Preprint)

2020 ◽  
Author(s):  
Majed Alnefaie ◽  
Asalh Saeedi ◽  
Abdullah Alamri ◽  
Yousuf Alqurashi ◽  
Hani Marzouki ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Saudi Arabia ◽  
Head And Neck Cancer ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Neck Cancer ◽  
Post Treatment ◽  
Neck Squamous Cell Carcinoma ◽  
Lung Screening

BACKGROUND In head and neck squamous cell carcinoma patients (HNSCC), post treatment surveillance for distant disease is mostly focusing on the lungs, as HNSCC distant metastasis occurs in this organ in 90% of the cases and a high rate of primary of the lungs can be expected due to field cancerization of the entire upper aero digestive tract. OBJECTIVE The survey aimed to evaluate the current beliefs and pulmonary screening practices among otolaryngology-head & neck surgeons across Saudi Arabia in the post treatment surveillance of head and neck squamous cell carcinoma. METHODS This is a nation-wide cross sectional survey was conducted among Head and Neck surgeon members of the Saudi Society of Otolaryngology. Data Collected During The Period From 1– 30 July , 2020. Predesigned questionnaire including all the relevant questions to fulfill the study objectives. Questions inquired about characteristics of routine lung screening during the post treatment follow-up of head and neck cancer. The questionnaire distributed on all head and neck surgeon of the Saudi Society of Otolaryngology, of Saudi Arabia. RESULTS As regards the methods of routine lung screening during the post treatment follow-up of head and neck cancer, our study found that the majority 40% 9 out of 22 participants used lung radiography followed by 31% 7 out of 22 participants used low dose CT and 27 % 6 out of 22 participants used PET/CT. Regarding to duration of lung screening in head and neck cancer during follow up in physician's practice, the majority 77 % 17 out of 22 participants reported 5 years, 13% 3 out of 22 participants 10 years and only 9 % 2 out of 22 participants performed lung screening lifelong. As regards frequency of lung screening; 77 % 17 out of 22 participants reported annually screening,18% 4 out of 22 participants half-yearly and 4% 1 out of 22 participants biennially. According to believed effectiveness of the screening procedures listed in question 1 in reducing lung cancer mortality during the follow-up of head and neck cancer; 6% 8 out of 22 participants believed to be very effective or somewhat effective, 18% 4 out of 22 participants don’t know and only 9% 2 out of 22believed that it was not effective. CONCLUSIONS The majority used lung radiography, low dose CT and PET/CT as a routine lung screening during the post treatment follow-up of head and neck cancer for mainly 5 years, 10 years and only small percent performed lung screening lifelong. lung screening was mostly annually or half-yearly. The screening believed to be very effective or somewhat effective.

Sign in / Sign up

Export Citation Format

Share Document