Evaluation of tumor oxygenation by color duplex sonography: A new approach

2005 ◽  
Vol 132 (5) ◽  
pp. 765-769 ◽  
Author(s):  
Ercole F.N. Di Martino ◽  
Bernd Gagel ◽  
Oliver Schramm ◽  
Payam Maneschi ◽  
Martin Westhofen
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Medical Center ◽  
Academic Medical Center ◽  
Duplex Sonography ◽  
Tumor Oxygenation ◽  
Controlled Study ◽  
Color Duplex Sonography ◽  
New Approach

OBJECTIVE: Description of a new noninvasive method for the evaluation of tissue oxygenation in head and neck cancer. STUDY DESIGN AND SETTING: Prospective nonrandomized controlled study in an academic medical center on 20 patients with neck metastases of head and neck cancer. Metastases were investigated using color duplex sonography and pO2 histography. The vascularization in sonography was quantitatively evaluated by color pixel density and compared to the pO2 values of the same nodes. RESULTS: The correlation between vascularization and flow velocity was 0.71. For the mean/median pO2-values and for the pO2 readings < 10.0 mmHg correlations were r = 0.65/0.76 and 0.71. CONCLUSION: This sonographic method allows a safe and reliable evaluation of oxygenation in metastases of head and neck cancer. SIGNIFICANCE: The new approach is an alternative to pO2 histography and may play a future role in the planning of radiotherapy in the neck. (Otolaryngol Head Neck Surg 2005;132:765-9.)

scholarly journals Times to Diagnosis, Staging, and Treatment of Head and Neck Cancer Before and During COVID-19

OTO Open ◽  
2021 ◽  
Vol 5 (4) ◽  
pp. 2473974X2110594
Author(s):  
Peter Yao ◽  
Victoria Cooley ◽  
William Kuhel ◽  
Andrew Tassler ◽  
Victoria Banuchi ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Medical Center ◽  
Academic Medical Center ◽  
Head And Neck Cancers ◽  
Newly Diagnosed ◽  
Time To Treatment ◽  
Time To Diagnosis ◽  
The Times

Objective The coronavirus disease 2019 (COVID-19) pandemic has reduced the demand for, and supply of, head and neck cancer services. This study compares the times to diagnosis, staging, and treatment of head and neck cancers before and during the COVID-19 pandemic. Study Design Retrospective cohort study. Setting Tertiary academic medical center in New York City (NYC). Methods The times to diagnosis, staging, and treatment of head and neck cancer for patients presenting to the clinics of 4 head and neck oncology surgeons with newly diagnosed head and neck cancers were compared between pre–COVID-19 and COVID-19 periods. Results Sixty-eight patients in the pre–COVID-19 period and 26 patients in the COVID-19 period presented with newly diagnosed head and neck cancer. Patients in the COVID-19 group had a significantly longer time to diagnosis than the pre–COVID-19 group after adjustment for age and cancer diagnosis ( P = .02; hazard ratio [HR], 0.54; 95% CI, 0.32-0.92). Patients in the pre–COVID-19 and COVID-19 groups had no statistically significant differences in time to staging ( P > .9; HR, 1.01; 95% CI, 0.58-1.74) or time to treatment ( P = .12; HR, 1.55; 95% CI, 0.89-2.72). Conclusion This study found that time to diagnosis for head and neck cancers was delayed during a COVID-19 period compared to a pre–COVID-19 period. However, there was no evidence of delays in time to staging and time to treatment during the COVID-19 period. Our results prompt further investigations into the factors contributing to diagnostic delays but provide reassurance that despite COVID-19, patients were receiving timely staging and treatment for head and neck cancers.

Evaluation of the head and neck cancer patient population and the incidence of hospitalization at an academic medical center

2017 ◽  
Vol 25 (2) ◽  
pp. 333-338 ◽  
Author(s):  
Lindsay A Hazelden ◽  
Matthew J Newman ◽  
Stephanie Shuey ◽  
Julie M Waldfogel ◽  
Victoria T Brown
Keyword(s):  
Logistic Regression ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Medical Center ◽  
Academic Medical Center ◽  
Factors Associated ◽  
Chemotherapy Agent ◽  
Academic Medical ◽  
The Impact

Purpose Patients with head and neck cancer are at risk for disease- and treatment-related toxicities that may be severe enough to require hospitalization. The risk factors associated with hospitalization in these patients are not well defined. Methods We conducted a single-center, retrospective observational study of patients with head and neck cancer receiving chemotherapy at an academic medical center infusion clinic in a one-year period. The primary objective was to characterize the head and neck cancer population at an academic medical center. Secondary objectives included describing the clinical and social factors associated with hospitalization. Results There were 109 patients with head and neck cancer included in the analysis. Of these patients, 38 (35%) were hospitalized. The factors that were significantly associated with hospitalization on univariable logistic regression were former alcohol abuse, being on a nonstandard of care chemotherapy regimen, and having a chemotherapy agent discontinued. On multivariable logistic regression, the factor that was significantly associated with hospitalization was having a chemotherapy agent discontinued. The most common reasons for hospitalization included shortness of breath/respiratory failure, fever/neutropenic fever, and infection. The most common new supportive care medications prescribed at discharge were stool softeners or laxatives and opioids. Conclusion This study identified several factors which may be useful to identify patients as high risk for hospitalization and the next steps will be to determine and study the role of the pharmacist in preventing hospitalization of these patients. Further studies are needed to assess the impact of adding a pharmacist to the head and neck cancer multidisciplinary team.

scholarly journals Follow-Up Phone Interviews and Attendance Motivation From A Free Head and Neck Cancer Screening

2020 ◽  
pp. 014556132094086
Author(s):  
Zachary D. Urdang ◽  
David H. Rosales ◽  
QiLiang Chen ◽  
Ryan J. Li ◽  
Peter E. Andersen ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Medical Center ◽  
Academic Medical Center ◽  
Significant Proportion ◽  
Community Outreach ◽  
Cancer Center ◽  
Screening Programs

Introduction: Head and Neck Cancer Awareness and Screening Programs (HNCASP) are popular community outreach events hosted by academic and community otolaryngology departments. However, long-term follow-up of participants is lacking. Patients and Methods: Participants of a HNCASP held at an academic cancer center prospectively filled out demographic and risk factor surveys followed by HNC screening examination. A phone interview was conducted for participants between 2012 and 2016 with suspicious findings to assess outcomes. Results: Participants were largely Caucasian, female, and had health insurance, reflecting the setting at an academic medical center. Despite this, there were 156 (16.8%) positive screenings; 47 of these completed follow up interviews. Twelve (1.1% of all participants) cancer cases were confirmed. Discussion: A significant proportion of HNCASP participants benefited from this screening opportunity. Education regarding HNC is the primary benefit and motivational factor for attendance of HNCASPs, although a significant subset of patients was identified that needed follow-up, and several cancers were detected.

Update and external validation of a multivariable prediction model for tube feeding dependency for at least four weeks during chemoradiotherapy for head and neck cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 6040-6040
Author(s):  
Anna C. H. Willemsen ◽  
Annemieke Kok ◽  
Laura W.J. Baijens ◽  
J. P. De Boer ◽  
Remco de Bree ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Radiation Dose ◽  
The Netherlands ◽  
Prediction Model ◽  
Head And Neck ◽  
Neck Cancer ◽  
Predictive Value ◽  
Medical Center ◽  
External Validation ◽  
Tube Feeding

6040 Background: Patients who receive chemoradiation or bioradiation (CRT/BRT) for locally advanced head and neck squamous cell carcinoma (LAHNSCC) often experience high toxicity rates, which may interfere with oral intake, leading to (temporary) tube feeding (TF) dependency. International guidelines recommend gastrostomy insertion when the expected use of TF exceeds four weeks. In this study we aimed to update and externally validate a prediction model to identify patients in need for TF for at least four weeks, meeting the international criteria for prophylactic gastrostomy insertion. Methods: This retrospective multicenter cohort study was performed in four tertiary referral head and neck cancer centers in the Netherlands. The prediction model was developed using data from the University Medical Center Utrecht and the Netherlands Cancer Institute. The model was externally validated in patients from the Maastricht University Medical Center and Radboud University Medical Center. The primary endpoint was TF, initiated during or within 30 days after completion of CRT/BRT, and administered for at least four weeks. Potential predictors were retrieved from patient medical records and radiotherapy dose-volume parameters were calculated. Results: The developmental and validation cohort included 409 and 334 patients respectively. Multivariable analysis showed significant predictive value (p < 0.05) for adjusted diet at start of CRT/BRT, percentage weight change prior to treatment initiation, WHO performance status, tumor-site, nodal stage, mean radiation dose to the contralateral parotid gland, and mean radiation dose to the oral cavity. The area under the receiver operating characteristics curve for the updated model was 0.73 and after external validation 0.64. Positive and negative predictive value at 90% cut off were 80.0% and 48.2% respectively. Conclusions: This externally validated prediction model to estimate TF-dependency for at least four weeks in LAHNSCC patients performs well. This model, which will be presented, can be used in clinical practice to guide personalized decision making on prophylactic gastrostomy insertion.

Importance of Treatment Institution in Head and Neck Cancer Radiotherapy

2009 ◽  
Vol 141 (2) ◽  
pp. 172-176 ◽  
Author(s):  
Gregory J. Kubicek ◽  
Fen Wang ◽  
Eashwar Reddy ◽  
Yelizaveta Shnayder ◽  
Cristina E. Cabrera ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Treatment Outcome ◽  
Head And Neck ◽  
Neck Cancer ◽  
Time Course ◽  
Medical Center ◽  
Recurrence Rates ◽  
Historical Cohort ◽  
Initial Surgery ◽  
Significant Difference

OBJECTIVE: The treatment for head and neck cancer (HNC) often involves radiotherapy. Many HNC patients are treated at the academic center (AC) where the initial surgery or diagnosis was made. Because of the lengthy time course for radiotherapy, some patients are treated at community radiation facilities (non-AC) rather than the AC despite potential AC advantages in terms of experience and technology. Our goal is to determine if these potential AC advantages correspond to a difference in treatment outcome. STUDY DESIGN: Historical cohort study. SETTING: University of Kansas Medical Center, Kansas City, Kansas. SUBJECTS AND METHODS: Review of records of patients with HNC cancers evaluated at the otolaryngology (ENT) department of an AC. Each patient's information and treatment characteristics were recorded, including radiotherapy treatment venue and treatment outcome. RESULTS: Three hundred seventy-four patients were analyzed, 263 were treated at an AC and 101 at a non-AC. Patients treated at a non-AC were more likely to present with earlier stage tumors, be treated with radiation alone rather than chemoradiotherapy, and be treated with adjuvant rather than primary radiotherapy. There was no difference in overall survival or recurrence rates between AC and non-AC. CONCLUSION: Patients treated at an AC are more likely to have advanced stage tumors and receive chemoradiotherapy as their primary treatment. In analyses of matching patient subsets, there was no significant difference in patient outcomes. Patients can be treated at a non-AC without affecting outcome compared with treatment at an AC.

Predictive Value of the Tumor Oxygenation by Means of pO2 Histography in Patients with Advanced Head and Neck Cancer

2001 ◽  
Vol 177 (9) ◽  
pp. 462-468 ◽  
Author(s):  
Volker Rudat ◽  
Peter Stadler ◽  
Axel Becker ◽  
Bernhard Vanselow ◽  
Andreas Dietz ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Predictive Value ◽  
Tumor Oxygenation ◽  
Advanced Head
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