P-40 Radiotherapy with curative intent in head and neck cancer – Experience from a tertiary care center

Background: The occurrence of the head and neck cancers (HNC) is increasing day by day. These have been associated with multiple etiological factors, and early diagnosis has a prime role in the patient's prognosis and overall survival. Prognostic evaluation in head and neck cancer patients utilizing clinical incidence and imaging outcomes.Methods: The study sample included 217 confirmed HNC patients’ data obtained from the tertiary cancer care centre were analysed to assess the prognosis and be subjected to statistical analysis.Results: Out of all HNC, cancer pertaining to the lip and oral cavity was the most common variety with 65.89% and most of the HNC occurred in men of about 97%, suggesting a strong association with adverse oral habits.Conclusions: We conclude that the current scenario of HNC’s progression and treatment modalities in Andhra Pradesh were in comparison to the World Health Organization (WHO) data suggests an increase in the awareness of the etiological factors and the disease progression. Though various advanced imaging and treatment modalities are available, the patients' prognosis is untethered due to low socio-economic status in this region.

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The Impact of Smoking, Alcohol Use, Recurrent Disease, and Age on the Development of Neck Fibrosis in Head and Neck Cancer Patients Following Radiation Therapy

Frontiers in Oncology ◽

10.3389/fonc.2021.707418 ◽

2021 ◽

Vol 11 ◽

Author(s):

Connor L. Pratson ◽

Michael C. Larkins ◽

Brandon H. Karimian ◽

Caitrin M. Curtis ◽

Pamela A. Lepera ◽

...

Keyword(s):

Head And Neck Cancer ◽

Alcohol Use ◽

Head And Neck ◽

Neck Cancer ◽

Recurrent Disease ◽

Care Center ◽

Univariate Analysis ◽

Tertiary Care ◽

Factors Associated ◽

The Impact

There is a paucity of information regarding the demographic factors associated with the development of neck fibrosis in head and neck cancer (HNC) patients following radiotherapy. A retrospective review of all patients being treated for HNC at a tertiary care center between 2013 and 2017 was performed. Chi-squared and Mann-Whitney U tests were used to identify differences in incidence and grade of fibrosis, respectively, between populations. A total of 90 patients aged 19 to 99 years were included. Factors associated with an increased incidence of fibrosis included smoking during radiotherapy (p < 0.001), alcohol use (p = 0.026), recurrent disease (p = 0.042), and age less than 60 (p < 0.001) on univariate analysis. Factors associated with increased grade of fibrosis in HNC patients included recurrent HNC (p = 0.033), alcohol use (p = 0.013), patient age younger than 60 years (p = 0.018), smoking during radiotherapy (p < 0.001), and non-Caucasian race (p = 0.012). Identification and intervention directed at patients that possess risk factors associated with fibrosis prior to treatment has the potential to improve the long-term quality of life for HNC patients.

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Perioperative Deep Vein Thrombosis Risk Stratification: A Comparative Analysis of Free and Pedicled Flap Patients

Otolaryngology ◽

10.1177/0194599816667399 ◽

2016 ◽

Vol 156 (1) ◽

pp. 118-121 ◽

Cited By ~ 4

Author(s):

Sumi Sinha ◽

Sidharth V. Puram ◽

Rosh K. V. Sethi ◽

Neerav Goyal ◽

Kevin S. Emerick ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Care Center ◽

Tertiary Care ◽

Pedicled Flap ◽

Vein Thrombosis ◽

Thrombosis Risk ◽

Reconstructive Operations ◽

Deep Vein

Patients with head and neck cancer who undergo reconstructive surgery are at risk for deep venous thrombosis (DVT), but the risk profile for patients undergoing major flap reconstruction is highly variable. Herein, we report our findings from a retrospective analysis of head and neck cancer patients (n = 517) who underwent free (n = 384) or pedicled (n = 133) flap reconstructive operations at a major tertiary care center from 2011 to 2014. DVTs developed perioperatively in 9 (1.7%) patients. Compared with pedicled flap patients, free flap patients had a longer mean operative time (421.4 ± 4.4 vs 332.7 ± 10.7 min, P < .0001), but the DVT incidence did not differ significantly between free and pedicled flap patients (1.6% vs 2.2%, respectively, P = .28). These data suggest that perioperative DVT risk in head and neck oncology patients may be largely similar regardless of the reconstructive strategy pursued.

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The Impact of COVID-19 on Head and Neck Cancer Treatment: Before and During the Pandemic

OTO Open ◽

10.1177/2473974x211068075 ◽

2021 ◽

Vol 5 (4) ◽

pp. 2473974X2110680

Author(s):

Roberto N. Solis ◽

Mehrnaz Mehrzad ◽

Samya Faiq ◽

Roberto P. Frusciante ◽

Harveen K. Sekhon ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Care Center ◽

Tertiary Care ◽

Distant Metastases ◽

Newly Diagnosed ◽

Duration Of Symptoms ◽

Time To Diagnosis ◽

The Impact

Objectives To describe the impact that the coronavirus disease 2019 (COVID-19) pandemic had on the presentation of patients with head and neck cancer in a single tertiary care center. Study Design Retrospective cohort study. Setting Academic institution. Methods We performed a retrospective review of patients with newly diagnosed head and neck squamous cell carcinoma (HNSCC) who presented as new patients between September 10, 2019, and September 11, 2020. Patients presenting during the 6 months leading up to the announcement of the pandemic (pre–COVID-19 period) on March 11, 2020, were compared to those presenting during the first 6 months of the pandemic (COVID-19 period). Demographics, time to diagnosis and treatment, and tumor characteristics were analyzed. Results There were a total of 137 patients analyzed with newly diagnosed malignancies. There were 22% fewer patients evaluated during the COVID-19 timeframe. The groups were similar in demographics, duration of symptoms, time to diagnosis, time to surgery, extent of surgery, and adjuvant therapy. There was a larger proportion of tumors classified as T3/T4 (61.7%) in the COVID-19 period vs the pre–COVID-19 period (40.3%) ( P = .024), as well as a larger median tumor size during the COVID-19 period ( P = .0002). There were no differences between nodal disease burden ( P = .48) and distant metastases ( P = .42). Conclusion Despite similar characteristics, time to diagnosis, and surgery, our findings suggest that there was an increase in primary tumor burden in patients with HNSCC during the early COVID-19 pandemic.

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OPERATING ON HEAD AND NECK CANCERS DURING COVID-19 PANDEMIC: OUR EXPERIENCE IN A TERTIARY CARE SURGICAL ONCOLOGY CENTER IN CENTRAL INDIA

10.36106/ijsr/3536439 ◽

2020 ◽

pp. 72-73

Author(s):

Sandeep Ghosh ◽

Bonny Joseph ◽

Vinod Dhakad ◽

Sanjay Desai

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Care Center ◽

Tertiary Care ◽

Central India ◽

Surgical Oncology ◽

Cancer Management ◽

Global Pandemic

WHO declared the COVID-19 outbreak to be a global pandemic on March 11, 2020. We hereby present the ongoing challenges, and the protocol and algorithms followed by us right from diagnosis, surgery and follow up of 50 head and neck cancer patients during the time of covid-19 pandemic at a tertiary care center in central India. Of the 50 head and neck cancer patients operated we had 16(32%) Ca buccal mucosa cases, 13(26%) cases of ca lower alveolus, 9 (18%) ca tongue cases, 5 (10%) ca maxilla, 3 (6%) ca larynx, 2 (4%) ca lip and 2 (4%) ca thyroid cases. It is prudent to consider every patient as covid carrier as community spread has already occurred in our country and take necessary precautions while examining all patients. Cancer Management is semi-emergency. The precautions taken by us are considered to be standard and have allowed us to perform head and neck cancer surgeries safely in this Covid-19 pandemic.

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Surveillance of Patients with Head and Neck Cancer with an Intensive Clinical and Radiologic Follow-up

Otolaryngology ◽

10.1177/0194599819860808 ◽

2019 ◽

Vol 161 (4) ◽

pp. 635-642 ◽

Cited By ~ 6

Author(s):

Martina Imbimbo ◽

Salvatore Alfieri ◽

Laura Botta ◽

Cristiana Bergamini ◽

Annunziata Gloghini ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Care Center ◽

Tertiary Care ◽

Cancer Recurrence ◽

Second Primary ◽

Upper Aerodigestive Tract ◽

Second Primary Cancers

Objective There is no consensus on the follow-up modalities in patients with head and neck cancer. This study aims to describe the pattern and survival outcomes of recurrences/second primary cancers in patients undergoing an intensive radiologic and clinical follow-up. Study Design Retrospective analysis. Setting Single academic tertiary care center. Subjects and Methods All patients with stage III-IV head and neck cancer treated with chemoradiotherapy at our institution between 1998 and 2010 were retrospectively reviewed. Persistent/recurrent disease within 6 months since the curative treatment and second primary cancers outside the upper aerodigestive tract were excluded. Data were analyzed by descriptive statistics. Surveillance was planned every 3 months in the first year, then with increasing intervals till the fifth year. Results A total of 326 patients were included. Out of all detected cancer recurrences (n = 106, 32%), 38 (36%) were locoregional, 44 (41%) were distant, and 24 (23%) were second primary cancers. Approximately 70% of recurrences were clinically and/or radiologically discovered, while 30% were diagnosed due to the patients’ symptoms. Of all clinically and/or radiologically discovered recurrences/second primary cancers (n = 74), 26 (35%) were curatively treated, with respect to 9 of the 32 (28%) diagnosed by symptoms. Median overall survival of recurrent curable cases did not significantly differ according to the detection modality (89 months by clinical/radiologic examination vs 85 by symptoms). Conclusions Clinical and radiologic follow-up identified more recurrences/second primary cancers than the symptom-driven monitoring, but the curability of cancer recurrence was similar regardless of detection modality. Prospective trials are needed to define the most effective follow-up strategy in head and neck cancer.

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Tumor-Infiltrating Lymphocytes in Patients With Advanced Laryngeal Cancer Undergoing Bioselection

Otolaryngology ◽

10.1177/01945998211013765 ◽

2021 ◽

pp. 019459982110137

Author(s):

Molly E. Heft Neal ◽

Joshua D. Smith ◽

Andrew C. Birkeland ◽

Catherine T. Haring ◽

Steven B. Chinn ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Induction Chemotherapy ◽

Neck Cancer ◽

Tertiary Care ◽

Tumor Infiltrating Lymphocytes ◽

Care Hospital ◽

Disease Specific Survival ◽

Infiltrating Lymphocytes ◽

Disease Specific

Objective Bioselection to assess tumor response after induction chemotherapy has been introduced as an alternative treatment strategy to total laryngectomy for patients with advanced larynx squamous cell carcinoma (LSCC). Tumor-infiltrating lymphocytes (TILs) have proven to serve as prognostic biomarkers in head and neck cancer but have not been evaluated as a way to select patients for treatment paradigms. The aim of this study is to evaluate the role of pretreatment TILs in patients with advanced LSCC undergoing the bioselection paradigm. Study Design Retrospective study. Setting Tertiary care hospital. Methods Patients with advanced LSCC treated with bioselection and available tissue were included (N = 76). Patients were stratified into CD8-low and CD8-high cohorts by using the median TIL count. Kaplan-Meier survival analysis and multivariate cox regression were performed with SPSS version 26 (IBM). Results After controlling for tobacco use, tumor site, and stage, a high CD8 TIL count was an independent predictor of improved 5-year disease-specific survival (hazard ratio, 0.17 [95% CI, 0.03-0.84]; P = .03). CD8 TIL counts did not predict response to induction chemotherapy; however, subgroup analysis of patients treated with chemoradiation therapy revealed that CD8 TIL count was significantly associated with degree of response ( P = .012). Conclusion These findings support prior data published by our group showing that TILs are predictive of disease-specific survival in patients with head and neck cancer. CD8 TIL counts were significantly associated with degree of clinical response after induction chemotherapy. These results suggest that pretreatment assessment of tumor-infiltrating CD8 cells could be useful in selecting patients.

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