Preliminary results of CyberKnife stereotactic radiotherapy (SBRT) boost for primary head and neck cancers: is it the future direction?

2015 ◽  
Vol 14 (2) ◽  
pp. 187-193
Author(s):  
Tejinder Kataria ◽  
Trinanjan Basu ◽  
Shikha Goyal ◽  
Ashu Abhishek ◽  
Deepak Gupta ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Stereotactic Radiotherapy ◽  
Phase 1 ◽  
Objective Assessment ◽  
Complete Response ◽  
Tumour Volume ◽  
Head And Neck Cancers ◽  
Preliminary Results

AbstractAimTo analyse the preliminary results of CyberKnife stereotactic radiotherapy (SBRT) boost in primary head and neck cancer patients among Indian population.Methods and materialsA total of nine patients of primary head and neck cancer were treated with CyberKnife SBRT boost after intensity-modulated radiation therapy (IMRT). The median phase 1 IMRT dose was 54 Gy/27 fractions. Histological types included squamous cell carcinoma (n=7) and adenoid cystic carcinoma (n=2). Response was evaluated using positron emission tomography/computed tomography and detailed clinical examination.ResultsAs a preliminary analysis with median follow up of 8 months (range: 6–19 months), phase 2 median tumour volume of 16·3 cc and a median dose of 5 Gy per fraction, eight patients had loco-regionally stable disease and one had distant metastasis. With objective assessment five patients had complete response. Treatment was well tolerated with no grade 3 or more acute toxicities directly related to CyberKnife boost.ConclusionCyberKnife SBRT boost is an attractive option for primary head and neck cancers especially where disease is in close proximity to critical structures hindering radical dose delivery. Future prospective analysis and optimum assessment of total biological effective dose (BED) in a properly selected case might actually benefit the use of CyberKnife SBRT boost.

Hydroxyurea, fluorouracil, and concomitant radiotherapy in poor-prognosis head and neck cancer: a phase I-II study.

1989 ◽  
Vol 7 (6) ◽  
pp. 761-768 ◽  
Author(s):  
E E Vokes ◽  
W R Panje ◽  
R L Schilsky ◽  
R Mick ◽  
A M Awan ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Poor Prognosis ◽  
Local Therapy ◽  
Complete Response ◽  
Synergistic Activity ◽  
Dose Levels ◽  
Concomitant Radiotherapy

Hydroxyurea and fluorouracil (5-FU) are active cytotoxic drugs in head and neck cancer and have shown synergistic activity in vitro. Both drugs also act as radiosensitizers. Therefore, we administered radiotherapy at daily fractions of 180 to 200 cGy with simultaneous continuous infusion 5-FU at 800 mg/m2/d and escalating daily doses of hydroxyurea for five days. Cycles were repeated every other week until completion of radiotherapy. Thirty-nine inoperable patients were treated at six dose levels of hydroxyurea ranging from 500 mg to 3,000 mg orally daily. Little effect of hydroxyurea on the WBC or platelet count was noted in patients receiving less than 2,000 mg daily, whereas both parameters decreased progressively in patients receiving 2,000 mg daily or more. Mucositis occurred at all dose levels, requiring frequent dose reduction of 5-FU; however, in patients receiving a daily hydroxyurea dose of 2,000 mg or less, the median weekly 5-FU dose administered was 1,725 mg/m2 (86% of the intended 5-FU dose), whereas at daily hydroxyurea doses exceeding 2,000 mg, the median weekly 5-FU dose decreased to 1,133 mg/m2 (57%) (P = .001). Of 15 evaluable patients with recurrent disease after prior local therapy only one failed to respond; six had a complete response (CR), and eight a partial response (PR). Of 17 evaluable patients without prior local therapy, 12 had a CR, with no patient developing recurrence in the irradiated field to date; five patients had a PR. We conclude that the recommended dose of hydroxyurea in this regimen is 2,000 mg daily. That dose will cause mild to moderate myelosuppression and will allow for delivery of greater than 80% of the intended 5-FU dose. The activity of this regimen in poor-prognosis head and neck cancer exceeds 90%; its further investigation in previously untreated patients is warranted.

scholarly journals Perioperative mortality of head and neck cancers

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yannan Wang ◽  
Mengxue Wang ◽  
Yan Tang ◽  
Bincan Sun ◽  
Kai Wang ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Cardiopulmonary Arrest ◽  
Clinical Stage ◽  
Maxillofacial Surgery ◽  
Head And Neck Cancers ◽  
Oral And Maxillofacial Surgery ◽  
Perioperative Mortality ◽  
Advanced Clinical Stage

Abstract Background Head and neck cancers are aggressive cancers, most clinical studies focused on the prognosis of patients with head and neck cancer. However, perioperative mortality was rarely mentioned. Methods A retrospective analysis was performed using all head and neck cancer patients admitting in the Department of Oral and Maxillofacial Surgery of the Second Xiangya Hospital, Central South University from January 2010 to December 2019. The analysis of overall survival and progression-free survival were performed using the Kaplan–Meier method, and cross tabulation with chi-squared testing was applied to analyze the difference in parameters between groups. Results From January 2010 to December 2019, a total of 6576 patients with head and neck cancers were admitted to our department and 7 died in the hospital, all of whom were middle-aged and elderly patients including 6 males and 1 female. The perioperative mortality rate (POMR) was about 1‰. The causes of death included acute heart failure, rupture of large blood vessels in the neck, hypoxic ischemic encephalopathy due to asphyxia, respiratory failure and cardiopulmonary arrest. Conclusion Preoperative radiotherapy, previous chemotherapy, hypertension, diabetes, advanced clinical stage and postoperative infection are risk factors for perioperative mortality of head and neck cancer.

scholarly journals Postoperative Radiotherapy in Head and Neck Cancer

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.

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.

scholarly journals Filipino head and neck cancer patients and their quality of life

2020 ◽  
Vol 6 (3) ◽  
pp. 439
Author(s):  
Frederic Ivan L. Ting ◽  
Aylmer Rex B. Hernandez ◽  
Reno Eufemon P. Cereno ◽  
Irisyl B. Orolfo-Real ◽  
Corazon A. Ngelangel
Keyword(s):  
Quality Of Life ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
The Philippines ◽  
Head And Neck Cancers ◽  
The Social ◽  
The University

<p class="abstract"><strong><span lang="EN-US">Background: </span></strong>In the management of head and neck cancer (HNC), assessment of quality of life (QoL) is imperative because of the potentially debilitating effect of treatment toxicities. Currently, there are no published data assessing the QoL in Filipino HNC patients, thus this study.</p><p class="abstract"><strong><span lang="EN-US">Methods: </span></strong>This cross-sectional study utilized the University of the Philippines - Department of Health Quality of Life scale. Patients with head and neck cancers at the University of the Philippines - Philippine General Hospital from February to September 2019 were invited to participate.  </p><p class="abstract"><strong><span lang="EN-US">Results: </span></strong>A total of 418 patients were included in the study with a mean age of 42 years old (range 18 to 73 years old). In general, Filipino head and neck cancer patients had moderate QoL (mean score of 4.59±0.79). All of the QoL domains (physical, emotional, cognitive, and related functions) had a score of 3-5 (moderate), except for the social status domain which had a mean score of 5.51±0.83 (high). Among socio-demographic factors, patients who are employed and with additional funding sources on top of their income have better global QoL (p&lt;0.01). Clinically, patients with higher stages of disease, fungating tumors, post-laryngectomy, have a feeding tube, with a tracheostomy, and had chemotherapy have lower global QoL (p&lt;0.01).</p><p class="abstract"><strong><span lang="EN-US">Conclusions: </span></strong>Filipino patients with head and neck cancers have an overall moderate quality of life, with high scores in the social domain. Patients with higher tumor burdens and have been exposed to chemotherapy have lower QoL scores, while patients with financial stability and aid have better QoL scores.</p><p class="abstract"><span lang="EN-US"> </span></p>

Feasibility of Robot-Assisted Neck Dissections via a Transaxillary and Retroauricular (“TARA”) Approach in Head and Neck Cancer: Preliminary Results

2011 ◽  
Vol 19 (3) ◽  
pp. 1009-1017 ◽  
Author(s):  
Won Shik Kim ◽  
Hyoung Shin Lee ◽  
Sung Mi Kang ◽  
Hyun Jun Hong ◽  
Yoon Woo Koh ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Robot Assisted ◽  
Preliminary Results
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