Importance of Treatment Institution in Head and Neck Cancer Radiotherapy

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.

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Time-Course of Salivary Metabolomic Profiles during Radiation Therapy for Head and Neck Cancer

Journal of Clinical Medicine ◽

10.3390/jcm10122631 ◽

2021 ◽

Vol 10 (12) ◽

pp. 2631

Author(s):

Wakako Yatsuoka ◽

Takao Ueno ◽

Kanako Miyano ◽

Ayame Enomoto ◽

Sana Ota ◽

...

Keyword(s):

Radiation Therapy ◽

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Time Course ◽

Low Grade ◽

High Grade ◽

Gamma Aminobutyric Acid ◽

Least Squares Regression ◽

Significant Difference

Oral mucositis (OM) is one of the most frequently observed adverse oral events in radiation therapy for patients with head and neck cancer. Thus, objective evaluation of OM severity is needed for early and timely intervention. Here, we analyzed the time-course of salivary metabolomic profiles during the radiation therapy. The severity of OM (National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events v3.0) of nine patients with head and neck cancer was evaluated. Partial least squares regression-discriminant analysis, using samples collected before radiation therapy, showed that histidine and tyrosine highly discriminated high-grade OM from low-grade OM before the start of radiation therapy (significant difference, p = 0.048 for both metabolites). Further, the pretreatment concentrations of gamma-aminobutyric acid and 2-aminobutyric acids were higher in the high-grade OM group. Although further validations are still necessary, this study showed potentially associated metabolites with worse radiotherapy-related OM among patients with head and neck cancer.

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Polymorphism in glutathione S-transferases: Susceptibility and treatment outcome for head and neck cancer

Xenobiotica ◽

10.3109/00498254.2011.614020 ◽

2011 ◽

Vol 41 (12) ◽

pp. 1122-1130 ◽

Cited By ~ 16

Author(s):

Munindra Ruwali ◽

Madhu Singh ◽

Mohan C. Pant ◽

Devendra Parmar

Keyword(s):

Head And Neck Cancer ◽

Treatment Outcome ◽

Head And Neck ◽

Neck Cancer ◽

Glutathione S Transferases

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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.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.6040 ◽

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.

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Head and neck cancer: how imaging predicts treatment outcome

Cancer Imaging ◽

10.1102/1470-7330.2006.9028 ◽

2006 ◽

Vol 6 (Special Issue A) ◽

pp. S145-S153 ◽

Cited By ~ 20

Author(s):

Robert Hermans

Keyword(s):

Head And Neck Cancer ◽

Treatment Outcome ◽

Head And Neck ◽

Neck Cancer

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Evaluation of the prevalence and severity of xerophthalmia in head and neck cancers patients undergoing curative radiotherapy

Asian Journal of Ophthalmology ◽

10.35119/asjoo.v14i4.149 ◽

2016 ◽

Vol 14 (4) ◽

Author(s):

Sowmya V ◽

Dipika Jayachander ◽

Vijna Kamath ◽

Mithun SK Rao ◽

Mohammed Raees Tonse ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Keratoconjunctivitis Sicca ◽

Study Objective ◽

Cancer Group ◽

Curative Radiotherapy ◽

Significant Difference ◽

Rectal Cancers

Background: The study objective was to assess the development of xerophthalmia [dry eye syndrome (DES) or keratoconjunctivitis sicca] in head and neck cancer patients undergoing radiotherapy.Methods: Twenty two head and neck cancer patients requiring more than 60 Gy of curative radiotherapy/chemoradiotherapy and ten patients requiring radiotherapy/ chemoradiotherapy for treating cancers in the non head and neck regions (like breast, oesophagus, prostate, cervix and rectal cancers) were also enrolled in the study. The development of DES was studied at the beginning (day 0, before the start of radiotherapy) at day 21 (after completion of 30 Gy) and on completion of the treatment (> 60 Gy). As a comparative cohort, people with non head and neck cancer needing curative radiotherapy were also evaluated for comparison.Results: There was no difference in degree of DES between the Head and Neck cancer cohorts and non head and neck group at the beginning of treatment. However there was a statistically significant difference (p < 0.001) between the two groups at both mid and end of RT time point. Inter comparison between the various time points in the head and neck cancer group showed that the incidence of DES increased with the radiation exposure and was significant (pre to mid p < 0.001; and mid to end p < 0.005). A negative (r = -0.262) correlation was seen between DES and distance.Conclusions: The study showed that lesser the distance from the epicenter of the radiation to the orbital rim more was the severity of DES.

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

OTO Open ◽

10.1177/2473974x211059429 ◽

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.

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