scholarly journals Multidisciplinary Service Utilization Pattern by Advanced Head and Neck Cancer Patients: A Single Institution Study

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Jacqueline C. Junn ◽  
Irene A. Kim ◽  
Marianna L. Zahurak ◽  
Marietta Tan ◽  
Katherine Y. Fan ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Head And Neck Cancer ◽  
Social Work ◽  
Marital Status ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Stage Iv ◽  
Female Gender ◽  
Stage Iv Disease

Purpose. To analyze the patterns and associations of adjunctive service visits by head and neck cancer patients receiving primary, concurrent chemoradiation therapy.Methods. Retrospective chart review of patients receiving adjunctive support during a uniform chemoradiation regimen for stages III-IV head and neck squamous cell carcinoma. Univariate and multivariate models for each outcome were obtained from simple and multivariate linear regression analyses.Results. Fifty-two consecutive patients were assessed. Female gender, single marital status, and nonprivate insurance were factors associated with an increased number of social work visits. In a multivariate analysis, female gender and marital status were related to increased social work services. Female gender and stage IV disease were significant for increased nursing visits. In a multivariate analysis for nursing visits, living greater than 20 miles between home and hospital was a negative predictive factor.Conclusion. Treatment of advanced stage head and neck cancer with concurrent chemoradiation warrants a multidisciplinary approach. Female gender, single marital status, and stage IV disease were correlated with increased utilization of social work and nursing services. Distance over 20 miles from the center was a negative factor. This information may help guide the treatment team to allocate resources for the comprehensive care of patients.

Predicitve factors of cisplatin (CDDP) discontinuation in concurrent chemoradiotherapy (CCRT) to locally advanced head and neck cancer patients.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e17006-e17006
Author(s):  
Kenji Nakano ◽  
Yasuyoshi Sato ◽  
Yukiko Sato ◽  
Takashi Toshiyasu ◽  
Takao Asari ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Renal Dysfunction ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Odds Ratio ◽  
Locally Advanced ◽  
Stage Iv ◽  
High Dose ◽  
Advanced Head

e17006 Background: CCRT is a standard therapy for locally advanced head and neck cancer patients, but some patients have intolerance to high dose density of CDDP. Predictive factors for CDDP discontinuation need to be investigated for making appropriate treatment decisions. Methods: We retrospectively analyzed nonmetastatic head and neck cancer patients treated with CCRT with CDDP (80 mg/m2 per 3 weeks) from November 2005 to April 2012 in our institute. Radiation therapy was performed as three-dimensional radiotherapy or intensity-modified radiotherapy (IMRT). Results: A total of 164 patients received CCRT, of which 89 (54 %) were Stage IV;. Primary sites were as follows; oral cavity 7, oropharynx 52, hypopharynx 53, larynx 14, nasopharynx 30, paranasal sinus/nasal cavity 3, and unknown primary 5. IMRT was performed to 54 (33 %) patients. Median follow-up time was 19 months (range 1-69 months); 1-year overall survival (OS) and progression free survival (PFS) were 90 % and 78 %. Non-Stage IV; and high creatinine clearance (>70 ml/min) were associated with longer OS in Cox proportional hazard model. As for CDDP treatment, 75 (46 %) patients completed 3 cycles of CDDP, 69 (42 %) patients received 2 cycles, and 20 (12 %) patients received only 1 cycle. The main reasons for CDDP discontinuation were infection (24 patients) and renal dysfunction (18 patients). In logistic regression analysis, male sex, younger age (< 61 years) and high body mass index (BMI) (>25) were associated with 3 cycles completion of CDDP statistically significantly (p = .002, odds ratio 6.622; p = .006, odds ratio 2.602; p = .035, odds ratio 2.655, respectively). Conclusions: In CCRT to head and neck cancer patients, infection and renal dysfunction were the main reasons for CDDP discontinuation. Sex, age and BMI could be predictive of CDDP completion/discontinuation.

scholarly journals Pretreatment Health Behaviors Predict Survival Among Patients With Head and Neck Squamous Cell Carcinoma

2009 ◽  
Vol 27 (12) ◽  
pp. 1969-1975 ◽  
Author(s):  
Sonia A. Duffy ◽  
David L. Ronis ◽  
Scott McLean ◽  
Karen E. Fowler ◽  
Stephen B. Gruber ◽  
...  
Keyword(s):  
Physical Activity ◽  
Multivariate Analysis ◽  
Head And Neck Cancer ◽  
Health Behaviors ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Univariate Analysis ◽  
Fruit Intake ◽  
The Relationship

Purpose Our prior work has shown that the health behaviors of head and neck cancer patients are interrelated and are associated with quality of life; however, other than smoking, the relationship between health behaviors and survival is unclear. Patients and Methods A prospective cohort study was conducted to determine the relationship between five pretreatment health behaviors (smoking, alcohol, diet, physical activity, and sleep) and all-cause survival among 504 head and neck cancer patients. Results Smoking status was the strongest predictor of survival, with both current smokers (hazard ratio [HR] = 2.4; 95% CI, 1.3 to 4.4) and former smokers (HR = 2.0; 95% CI, 1.2 to 3.5) showing significant associations with poor survival. Problem drinking was associated with survival in the univariate analysis (HR = 1.4; 95% CI, 1.0 to 2.0) but lost significance when controlling for other factors. Low fruit intake was negatively associated with survival in the univariate analysis only (HR = 1.6; 95% CI, 1.1 to 2.1), whereas vegetable intake was not significant in either univariate or multivariate analyses. Although physical activity was associated with survival in the univariate analysis (HR = 0.95; 95% CI, 0.93 to 0.97), it was not significant in the multivariate model. Sleep was not significantly associated with survival in either univariate or multivariate analysis. Control variables that were also independently associated with survival in the multivariate analysis were age, education, tumor site, cancer stage, and surgical treatment. Conclusion Variation in selected pretreatment health behaviors (eg, smoking, fruit intake, and physical activity) in this population is associated with variation in survival.

“CLINICALASSESSMENT OF TREATMENT RELATED TOXICITY AND RESPONSE BY CONCOMITANT CHEMORADIATION THERAPY IN LOCALLY ADVANCED HEAD AND NECK CARCINOMA”

2021 ◽  
pp. 79-81
Author(s):  
Swapan Kumar Mallick ◽  
Rinki Saha
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Treatment Options ◽  
Locally Advanced ◽  
Stage Iv ◽  
Head And Neck Carcinoma ◽  
Complete Response ◽  
Advanced Head

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.

Weekly paclitaxel for platin-resistant stage IV head and neck cancer patients

2009 ◽  
Vol 129 (11) ◽  
pp. 1294-1299 ◽  
Author(s):  
Juan josé Grau ◽  
Miguel Caballero ◽  
Eugenia Verger ◽  
Mariano Monzó ◽  
Jose luís Blanch
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Stage Iv ◽  
Weekly Paclitaxel

Weekly paclitaxel for platin-resistant stage IV head and neck cancer patients

2008 ◽  
pp. 1-6 ◽  
Author(s):  
Juan jose Grau ◽  
Miguel Caballero ◽  
Eugenia Verger ◽  
Mariano Monzo ◽  
Jose luis Blanch
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Stage Iv ◽  
Weekly Paclitaxel

scholarly journals Immunoscore Combining CD8, FoxP3 and CD68 Expression and Distribution Predicts the Prognosis of Head and Neck Cancer Patients

2021 ◽  
Author(s):  
Sonia Furgiuele ◽  
Géraldine Descamps ◽  
Jérôme R. Lechien ◽  
Didier Dequanter ◽  
Fabrice Journe ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Immune Cell ◽  
Cox Regression ◽  
Histological Grade ◽  
Univariate Analysis ◽  
Kaplan Meier

Abstract Purpose: The objective of this study was to assess immune cell infiltrates to develop an immunoscore for prognosis and to investigate its correlation with clinical data of patients with head and neck squamous cell carcinomaMethods: CD8, FoxP3 and CD68 were evaluated by immunohistochemistry in 258 carcinoma samples and counted in stromal and intra-tumoral compartments. Optimal cut-offs were assessed to divide population regarding to survival while the prognostic value was established by using Kaplan-Meier curves and Cox regression models for each immune marker alone and in combination.Results: We found with univariate analysis that infiltration of immune cells in both compartments was predictive for RFS and OS. Multivariate analysis revealed that CD8+ number influenced independently patient prognosis. Additionally, the combination of CD8, FoxP3 and CD68 in an immunoscore provided a significant association with OS (p=0.002, HR=9.87). Such immunoscore stayed significant (p=0.018, HR=11.17) in a multivariate analysis in comparison to tumour stage and histological grade which had lower prognostic values.Conclusion: Altogether, our analysis indicated that an immunoscore including CD8, FoxP3 and CD68 immunostaining was a strong, independent, and significant prognostic marker which could be introduced into the landscape of current tools to improve the clinical management of head and neck cancer patients.

Accelerated Bifractionated Radiation with Concurrent Cisplatin Administration in Locally Advanced Head and Neck Cancer: A Feasibility Study

1997 ◽  
Vol 83 (4) ◽  
pp. 735-739 ◽  
Author(s):  
George Fountzilas ◽  
Athanassios Athanassiadis ◽  
Angelos Nikolaou ◽  
Anna Kalogera-Fountzila ◽  
John Tzitzikas ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Performance Status ◽  
Locally Advanced ◽  
Stage Iv ◽  
Complete Response ◽  
Advanced Head ◽  
Concurrent Administration ◽  
Stage Iv Disease

Aims and Background To test the feasibility of accelerated interrupted twice-daily radiation and concurrent cisplatin administration in patients with locally advanced head and neck cancer. Patients and Methods Nineteen patients with locally advanced head and neck cancer were treated with accelerated bifractionated radiation with concurrent administration of cisplatin. There were 18 men and 1 female with a median age of 60 years (range, 17–71) and median performance status of 90 (-range, 80–100). Sixteen patients (85%) presented with stage IV disease. Primary site included the nasopharynx (n = 7), oropharynx (n = 5), hypopharynx (n = 1) and larynx (n = 6). Radiation consisted of two fractions of 1.6 Gy each daily, five times weekly to a total dose of 64 Gy. Cisplatin was administered at a dose of 100 mg/m2 on days 2 and 28 of the treatment period. Results Nine patients achieved a complete response (47%; 95% CI, 25%–70%) and 5 a partial response (26%; 95% CI, 7%–46%). Grade III–IV toxicity included leukopenia (16%), mucositis (26%), dry mouth (5%), weight loss (16%) and infection (5%). After a median follow-up of 27.11 months (range, 1–33+), 9 patients have died. Median time to progression was 11 months (range, 1–32+) and median survival 25 months (range, 1–32+). Conclusions Accelerated twice-daily radiation with concurrent cisplatin is effective in locally advanced head and neck cancer and can be safely given with manageable toxicity.

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