Underreporting of mortality from head and neck carcinoma: our experience at a tertiary head and neck cancer unit

2013 ◽  
Vol 38 (1) ◽  
pp. 103-104
Author(s):  
A. Khanna ◽  
S. Mansuri ◽  
S. Mortimore ◽  
M. De ◽  
R. Elliott ◽  
...  
2021 ◽  
Author(s):  
Xingli Li ◽  
Jianjian Wang ◽  
Ting Zhang ◽  
Jiabin Wang ◽  
Zhangcai Zheng ◽  
...  

Abstract Background: Head and neck carcinoma, usually begins in the squamous cells, not only seriously endangers the quality of life, but brings a heavy financial burden for families and countries. Metronomic chemotherapy, a frequent administration of chemotherapeutic agents at a non-toxic dose, gives an alternative low-cost and tolerated approach for patients. We conducted a systematic review to find the effectiveness and safety of metronomic chemotherapy for head and neck cancer.Methods: We searched seven databases and Clinical.gov from the inception to July 14, 2021. The patients diagnosed head and neck cancer and older than 18 were included. Metronomic chemotherapy was defined as intervention. Randomized and non-randomized trials were all included. Quality assessment of included randomized control trials was performed using the Cochrane Risk-of-Bias criteria, cohort studies using The Newcastle-Ottawa Scale (NOS), single arm trials using the checklist recommended by The Agency for Healthcare Research and Quality (AHRQ). Studies were synthetized using a narrative approach. The indicators used for meta-analysis was hazard ratio (HR).Results: 310 Literatures were potentially eligible from 7 databases, finally 13 records were included. Five studies were of high quality, while eight were of moderate quality. The overall effect of HR for death of five trials reported had no statistically significant (HR=0.89, 95%CI 0.71-1.10). Subgroup analysis by different design showed a statistically significant HR (0.73, 95%CI 0.60-0.90) in randomized control trials while no significant difference in subgroup of prospective study design (HR=1.23, 95%CI 0.72-2.10). As for HR for PFS, there was no significant difference in overall effect of four studies. HR for PFS was 0.84 (95%CI 0.55-1.31). Subgroup analysis of study design showed that randomized control trials produced a significant HR (0.54, 95%CI 0.45-0.64), while prospective studies did not (1.25, 95%CI 0.73, 2.14).Conclusions: Metronomic chemotherapy has been an optimistic option for treatment for advanced head and neck cancer, especially in low income and medical resource-restricted regions.


2007 ◽  
Vol 14 (01) ◽  
pp. 111-119
Author(s):  
AHMAD IJAZ MASUD ◽  
QAISER MAHMOOD ◽  
NASREEN SIDDIQUE

Introduction: Cancers of the head and neck are estimated to be the most prevalent cancers in the world. Data from various cancer centers of Pakistan reveal that epithelial head and neck cancer is one of the most frequent cancers varying from 12 to 25% of the total new patients seenannually. Objectives: To see the effect of concomitant chemo-radiotherapy on the survival of patient, to assess the toxicity of different treatment arms and the effect of age, sex and bulk or tumour on survival and compare the literature. Setting: Radiotherapy Department, Nishtar Hospital, Multan. Duration: 2 years. Material and Methods: Sample Size: 200 patients. Results: Out of 130 patients, 83 were males and theremaining 47 were females. The male to female ratio being 1.8:1. The mean age of the patients included in the study was 52 years, range being 22-80 years. The patients of head and neck cancer in the trial had different sites of involvement. In the trial the patients presented with various symptoms such as pain, swelling, ulcer, bleeding, dysphagia, dyspnea, hoarseness of voice and nasal obstruction etc. No patient had early stage disease. All the patients in the trial had the experience of nausea and vomiting, it was more marked in patients having radiotherapy; either alone or in concomitant with chemotherapy. The patients having concomitant chemo-radiotherapy i.e. group-C also had diarrhoea as a side effect. The effect on the liver function test was more pronounced in patients of group-A. The renal function was seen to alter more in patients receiving chemotherapy with cisplatin, whether as induction or as a concomitant to radiotherapy. Conclusion: Concomitant chemo-radiotherapy in locally advanced, unresectable head and neck carcinoma is statistically superior to induction chemotherapy followed by radiotherapy and the standard radiotherapy alone.


Immunotherapy ◽  
2019 ◽  
Vol 11 (14) ◽  
pp. 1193-1203 ◽  
Author(s):  
Johannes Doescher ◽  
Stephanie E Weissinger ◽  
Stefan S Schönsteiner ◽  
Catharina Lisson ◽  
Lars Bullinger ◽  
...  

Aim: In a prospective clinical initiative, we selected heavily pretreated head and neck carcinoma patients and assessed the clinical utility of a protein-based oncopanel for identification of potential targetable markers. Patients & methods: Tumor samples of 45 patients were evaluated using a 12-marker immunohistochemistry panel. The primary end point was the prevalence of potentially actionable markers. Results: At least one expressed marker in each case could be identified. We noted a high prevalence of EGFR (80%, 39/45) and MET (57.4%, 28/45). Three patients received oncopanel-based therapy with variable results. Conclusion: Despite the limited number of treated subjects, oncopanel analysis in end-stage head and neck cancer is operationally and technically feasible. Combination with targeted next generation sequencing might provide additional therapy options.


2017 ◽  
Vol 12 (2) ◽  
pp. 25 ◽  
Author(s):  
Ni Kou ◽  
Hyejoung Cho ◽  
Hye-Eun Kim ◽  
Qiaochu Sun ◽  
Kyuhyeon Ahn ◽  
...  

<p class="MS">The apoptosis resistance restricts the efficacy of traditional therapies of head and neck squamous cell carcinoma (HNSCC). To overcome this problem, <em>Atractylodes macrocephala</em>, a traditional Korean and Chinese herbal medicine, has been used in clinical practice. In the present study, the anticancer effect of <em>A. macrocephala</em> extract was investigated and its underlying mechanisms using head and neck cancer KB cell line. The extract-induced cytotoxicity was mediated by autophagic cell death as well as apoptosis in HNSCC cells though extrinsic apoptotic pathway and the Akt/mTOR autophagic pathway. This study suggests that <em>A. macrocephala</em> extracts can be a potential drug to overcome side effects and susceptibility for head and neck carcinoma by double induction of apoptosis and autophagy.</p><p class="MS"><strong>Video Clip of Methodology</strong>: 6 min 27 sec  <a href="https://www.youtube.com/v/iRpGT4zpfs4">Full Screen</a>    <a href="https://www.youtube.com/watch?v=iRpGT4zpfs4">If Failed</a></p>


2011 ◽  
Vol 10 (1) ◽  
pp. 55-58
Author(s):  
Ye. V. Klisho ◽  
I. V. Kondakova ◽  
Ye. L. Choynzonov ◽  
O. V. Cheremisina ◽  
D. A. Shishkin

The concentrations of matrix metalloproteinases (MMP-2, -3, -9) and their tissue inhibitors (TIMP-1, -2) were studied in blood serum of 193 patients with squamous cell head and neck carcinoma (SCHNC) and in 38 healthy donors using immunoenzymatic assay. The decreased MMP-3 and TIMP-1, -2 levels were found in patients with oral cavity tumors as compared to patients with laryngeal cancer. The serum MMP-9 and TIMP-1 levels were significantly higher in head and neck cancer patients than in healthy subjects. High TIMP-1 and MMP-9 levels in blood serum of patients with SCHNC should be greatly attended for detection of their predictive and prognostic significances.


2020 ◽  
Vol 3 ◽  
Author(s):  
Marelle Rukes ◽  
Alexander Jones ◽  
Leah Novinger ◽  
Kyle Davis ◽  
Vincent Campiti ◽  
...  

Background and Hypothesis: Head and neck cancer (HNC) is frequently associated with cachexia, characterized by involuntary weight loss, sarcopenia, and malnutrition. In HNC patients, dysphagia and anorexia from obstructive aerodigestive tumors propagates cachexia even further. However, the impact of pathologic features and burden of HNC on cachexia has yet to be investigated. We therefore hypothesize that larger, more aggressive tumors impose greater cachexia severity in HNC patients.     Methods: A single-institution, retrospective study of adult patients undergoing surgical resection of head and neck carcinoma from 2014-2017 was performed. Patients without 30-day preoperative abdominal CT imaging for skeletal muscle index (SMI, cm2/m2) measurements were excluded. Patient demographics, comorbidities, nutrition data, and cancer pathology reports were collected. Cachexia was defined as unintentional weight loss >5% over 6 months or >2% with BMI <20 kg/m2. Statistical analyses were performed using 2-sided one-way Welch’s ANOVA or Pearson’s c2 tests. Significance was determined at p <0.05.      Results: The cohort included 125 predominantly white (92.0%), male (75.2%) HNC patients age 59.9 ± 11.5 years. Sixty-seven (53.6%) patients had cachexia, twenty (16.0%) of whom were severe (weight loss ≥15%). Patients with severe cachexia had larger tumors (5.5 ± 2.1 cm, p=0.021) than patients with mild-to-moderate cachexia (weight loss 5-14.9%; 4.9 ± 2.1 cm) or no cachexia (4.1 ± 1.9 cm). Worsening cachexia severity was also associated with lower SMI (p=0.004), BMI (p=0.002), and serum albumin (p=0.011). There was no statistically significant difference between cachexia groups comparing patient age, comorbidities, tumor grade, depth of invasion, nodal metastases, cancer stage, perineural invasion, lymphovascular invasion, or extranodal extension.     Conclusion and Potential Impact: Tumor burden of HNC patients, but not adverse pathologic features, is associated with greater cachexia severity. Identifying pro-cachectic markers produced by larger tumors could provide a molecular target for anti-cachexia therapies and improve cancer patient outcomes. 


2021 ◽  
pp. 79-81
Author(s):  
Swapan Kumar Mallick ◽  
Rinki Saha

Introduction: Head and neck cancer is the commonest malignancy in India. Most of the cases present are at a locally advanced stage. Concurrent chemo radiotherapy is one of the treatment options in locally advanced Head & Neck Cancer patients. Materials & Methods: Locally advanced head and neck cancer patients attending the Out Patient Department of Radiotherapy from May 2018 to February 2020. Patients were treated with concurrent chemoradiation and followed for a minimum period of 9 months. Results: On analysing the pattern of response, it was noted that, in the chemoradiation complete response was seen in 20 patients (66.66%), partial response in 6 patients (20%), stable disease in 2 patients (6.66%) and progressive disease in 1 patient (3.33%). In our study, complete Response in case of Stage III was seen in 18 patients and other form of response was seen in 3 patients . In case of Stage IV A and IV B , Complete Response in 2 patients and other form of response was in 6 patients respectively. Haematological toxicities like neutropenia (3.3%), thrombocytopenia (0%) and anaemia (3.3%) were seen. Acute toxicities like oral mucositis and skin reaction were observed 10% in both the cases. Conclusions: The present study, Concomitant chemoradiotherapy improved overall survival and locoregional control. Preservation of function is a major endpoint of interest.


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