Factors Influencing the Development of Pneumonia in Patients With Head and Neck Cancer: A Meta-analysis

2020 ◽  
pp. 019459982093801
Author(s):  
Priyanka D. Reddy ◽  
Flora Yan ◽  
Shaun A. Nguyen ◽  
Cherie-Ann O. Nathan
Keyword(s):  
Risk Factors ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Subdistribution Hazard ◽  
Hazard Ratios ◽  
Independent Risk Factors ◽  
Male Sex

Objective The aim of this study was to identify factors that are associated with the occurrence of pneumonia in patients with head and neck cancer (HNC) after treatment. Data Sources PubMed, Scopus, OVID, and Cochrane Library from inception to November 26, 2019. Review Methods A systematic review in accordance with the PRISMA guidelines and an assessment of bias were performed. Included studies reported on the risk factors of pneumonia development after HNC treatment via odds ratios and subdistribution hazard ratios from regression analysis. Results Fifteen studies were included, comprising 30,962 patients with a mean age of 70 years (range, 19-95 years). Of these, 71.6% are male. The results of our study indicate that the following were independent risk factors contributing to the development of pneumonia: male sex, habitual alcohol consumption, poor oral hygiene before treatment, pretreatment dysphagia, hypopharynx and nasopharynx tumor sites, use of radiotherapy with or without chemotherapy versus surgery alone, addition of chemotherapy to radiotherapy, reirradiation, neck dissection, increased duration of tracheotomy, and use of sedatives for sleeping. Conclusion Multiple patient-, tumor-, and treatment-specific risk factors were identified in predicting pneumonia. Recognition of these risk factors early on may help prevent or at least detect pneumonia in this vulnerable group of patients.

scholarly journals Salivary DNA Methylation as an Epigenetic Biomarker for Head and Neck Cancer. Part I: A Diagnostic Accuracy Meta-Analysis

2021 ◽  
Vol 11 (6) ◽  
pp. 568
Author(s):  
Óscar Rapado-González ◽  
Cristina Martínez-Reglero ◽  
Ángel Salgado-Barreira ◽  
Laura Muinelo-Romay ◽  
Juan Muinelo-Lorenzo ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Head And Neck Cancer ◽  
Diagnostic Accuracy ◽  
Head And Neck ◽  
Likelihood Ratio ◽  
Neck Cancer ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Epigenetic Mechanism ◽  
Cochrane Library

DNA hypermethylation is an important epigenetic mechanism for gene expression inactivation in head and neck cancer (HNC). Saliva has emerged as a novel liquid biopsy representing a potential source of biomarkers. We performed a comprehensive meta-analysis to evaluate the overall diagnostic accuracy of salivary DNA methylation for detecting HNC. PubMed EMBASE, Web of Science, LILACS, and the Cochrane Library were searched. Study quality was assessed by the Quality Assessment for Studies of Diagnostic Accuracy-2, and sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (dOR), and their corresponding 95% confidence intervals (CIs) were calculated using a bivariate random-effect meta-analysis model. Meta-regression and subgroup analyses were performed to assess heterogeneity. Eighty-four study units from 18 articles with 8368 subjects were included. The pooled sensitivity and specificity of salivary DNA methylation were 0.39 and 0.87, respectively, while PLR and NLR were 3.68 and 0.63, respectively. The overall area under the curve (AUC) was 0.81 and the dOR was 8.34. The combination of methylated genes showed higher diagnostic accuracy (AUC, 0.92 and dOR, 36.97) than individual gene analysis (AUC, 0.77 and dOR, 6.02). These findings provide evidence regarding the potential clinical application of salivary DNA methylation for HNC diagnosis.

scholarly journals Risk factors for postoperative delirium in patients undergoing major head and neck cancer surgery: a meta-analysis

2017 ◽  
Vol 47 (6) ◽  
pp. 505-511 ◽  
Author(s):  
Yun Zhu ◽  
Gangpu Wang ◽  
Shengwen Liu ◽  
Shanghui Zhou ◽  
Ying Lian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Postoperative Delirium ◽  
Meta Analysis ◽  
Cancer Surgery

The Association between Metformin and Survival of Head and Neck Cancer: A Systematic Review and Meta-Analysis of 7 Retrospective Cohort Studies

2020 ◽  
Vol 26 (26) ◽  
pp. 3161-3170 ◽  
Author(s):  
Yongbo Wang ◽  
Tao Fu ◽  
Yu Liu ◽  
Guifang Yang ◽  
Chuanhua Yu ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Cohort Studies ◽  
Head And Neck ◽  
Neck Cancer ◽  
Retrospective Cohort ◽  
Cancer Survival ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Cochrane Library ◽  
Retrospective Cohort Studies

Background: Metformin has been associated with improved survival outcomes in various malignancies. However, observational studies in head and neck cancer are inconsistent. Objective: The study aimed to summarize and quantify the relationship between metformin use and the survival of head and neck cancer. Methods: A meta-analysis based on cohort studies was systematically conducted (published up to Jan 18, 2020), identified from PubMed, Embase, Web of Science, Cochrane Library, Google Scholar, and Scopus databases. Summary hazard ratios (HR) and 95% confidence intervals (CI) were calculated using a random-effects model. Results: Seven retrospective cohort studies including 3,285 head and neck cancer patients were included. The association between the use of metformin and cancer survival was not statistically significant: summarized HR of 0.89 (95% CI 0.66-1.18, P=0.413, I2=64.0%) for overall survival, summarized HR of 0.65 (95% CI 0.31-1.35, P=0.246, I2=60.3%) for disease-free survival, and summarized HR of 0.69 (95% CI 0.40-1.20, P=0.191, I2=73.1%) for disease-specific survival. Conclusion: In this meta-analysis of 7 retrospective cohort studies, there was not a statistically significant association between the use of metformin and better survival for head and neck cancer. However, the analysis may have been underpowered. More studies of prospective designs with larger sample sizes are needed to investigate the effect of metformin on the survival of head and neck cancer.

scholarly journals miR-146a C/G polymorphism increased the risk of head and neck cancer, but overall cancer risk: an analysis of 89 studies

2018 ◽  
Vol 38 (1) ◽  
Author(s):  
Dezhong Sun ◽  
Xiaoyan Zhang ◽  
Xiaolei Zhang
Keyword(s):  
Head And Neck Cancer ◽  
Cancer Risk ◽  
Head And Neck ◽  
Neck Cancer ◽  
Large Scale ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Dominant Model ◽  
Case Control Studies ◽  
Stratified Analysis

Several studies have evaluated the association of miR-146a C/G with head and neck cancer (HNC) susceptibility, and overall cancer risk, but with inconclusive outcomes. To drive a more precise estimation, we carried out this meta-analysis. The literature was searched from MEDLINE (mainly PubMed), Embase, the Cochrane Library, and Google Scholar databases to identify eligible studies. A total of 89 studies were included. The results showed that miR-146a C/G was significantly associated with increased HNC risk in dominant model (I2 =15.6%, Pheterogeneity=0.282, odds ratio (OR) =1.088, 95% confidence interval (CI) =1.002–1.182, P=0.044). However, no cancer risk was detected under all genetic models. By further stratified analysis, we found that rs4919510 mutation contributed to the risk of HNC amongst Asians under homozygote model (I2 =0, Pheterogeneity=0.541, OR =1.189, 95% CI =1.025–1.378, P=0.022), and dominant model (I2 =0, Pheterogeneity=0.959, OR =1.155, 95% CI =1.016–1.312, P=0.028). Simultaneously, in the stratified analysis by source of controls, a significantly increased cancer risk amongst population-based studies was found under homozygote model, dominant model, recessive model, and allele comparison model. However, no significant association was found in the stratified analysis by ethnicity and source of control. The results indicated that miR-146a C/G polymorphism may contribute to the increased HNC susceptibility and could be a promising target to forecast cancer risk for clinical practice. However, no significant association was found in subgroup analysis by ethnicity and source of control. To further confirm these results, well-designed large-scale case–control studies are needed in the future.

scholarly journals Pretreatment prognostic nutritional index as a prognostic marker in head and neck cancer: a systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chih-Wei Luan ◽  
Yao-Te Tsai ◽  
Hsin-Yi Yang ◽  
Kuan-Yin Chen ◽  
Po-Hsien Chen ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Predictive Value ◽  
Meta Analysis ◽  
Prognostic Nutritional Index ◽  
Cochrane Library ◽  
Cancer Site ◽  
Free Survival ◽  
Nutritional Index

AbstractThe predictive value of the pretreatment prognostic nutritional index (PNI) for head and neck cancer (HNC) remains controversial. We conducted a meta-analysis to assess the predictive value of PNI in HNC patients. A systematic search through internet databases including PubMed, Embase, and Cochrane Library for qualified studies estimating the association of PNI with HNC patient survival was performed. Overall survival (OS), progression-free survival (PFS), disease-specific survival (DSS), disease-free survival (DFS) and distant metastasis-free survival (DMFS) data were collected and evaluated. A random-effects model was used to calculate the pooled hazard ratios (pHRs) and corresponding 95% confidence intervals (CIs). A total of 7815 HNC patients from 14 eligible studies were involved. Pooled analysis showed that low pretreatment PNI was correlated with poor OS (pHR: 1.93, 95% CI 1.62–2.30, p < 0.001), PFS (pHR: 1.51, 95% CI 1.19–1.92, p = 0.008), DSS (pHR: 1.98, 95% CI 1.12–3.50, p < 0.001), DFS (pHR: 2.20, 95% CI 1.66–2.91, p < 0.001) and DMFS (pHR: 2.04, 95% CI 1.74–2.38, p < 0.001). Furthermore, low pretreatment PNI was correlated with poor OS despite variations in the cancer site, sample size, PNI cut-off value, analysis method (multivariate analysis or univariate analysis) and treatment modality in subgroup analysis. Elevated pretreatment PNI is correlated with a superior prognosis in HNC patients and could be used as a biomarker in clinical practice for prognosis prediction and treatment stratification.

scholarly journals Association between PD-L1 expression and head and neck cancer prognosis: a meta-analysis

2019 ◽  
Author(s):  
Zhisen Shen ◽  
Linrong Wu ◽  
Xianlei Cai ◽  
Dong Ye ◽  
Gangjun Zhao
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Meta Analysis ◽  
Head And Neck Tumors ◽  
Cancer Prognosis ◽  
Cochrane Library ◽  
Prognostic Impact ◽  
Poor Prognostic Factor ◽  
Neck Tumors

Abstract Background: Programmed cell death ligand 1（PD-L1) plays an important role in tumor cell immune escape, and it has been extensively studied in head and neck cancer. However, its prognostic impact on patients with head and neck cancer remains controversial, so we sought to investigate this issue through a comprehensive meta-analysis. Methods: To assess the significance of PD-L1 on the survival of patients with head and neck cancer, we collected articles reported in PubMed, EMBASE, and Cochrane Library, until January 31, 2019. We also used the Newcastle Ottawa Scale (NOS) for literature quality evaluation. Results: The study included a total of 4551 patients affected by 6 different types of head and neck cancer reported in 26 articles. Our study found that the association between the expression of PD-L1 and the prognosis of head and neck tumors was highly heterogeneous (P < 0.00001, I2 = 80.0%); therefore, the random effects model was applied to combine the effect sizes. Based on the combined hazard ratios (HR)of 1.15 (95% CI: 0.88 to 1.50, P = 0.32), the expression of PD-L1 in head and neck tumors may not be a factor associated with poor prognosis. Conclusions: Our results suggest that PD-L1 expression cannot predict the overall survival of patients with oral, nasopharyngeal, or esophageal cancer. Through subgroup analysis, we found that the expression of PD-L1 may be a poor prognostic factor for some head and neck cancers.

Acute kidney injury in head and neck cancer patients treated with chemoradiation with cisplatin: A single-center cohort study.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e17559-e17559
Author(s):  
Esther Van Meerten ◽  
Catherine Owusuaa ◽  
Ewout Hoorn ◽  
Esther Oomen De Hoop
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Univariate Analysis ◽  
Kidney Injury ◽  
Tertiary Center ◽  
Kdigo Guidelines ◽  
Independent Risk Factors

e17559 Background: Patients with advanced head and neck cancer (HNC) are commonly treated with chemoradiation with concomitant cisplatin. Acute kidney injury (AKI) is considered a dose-limiting toxicity of cisplatin. We aim to describe the incidence and risk factors of AKI. Methods: In our tertiary center, we retrospectively identified 261 patients with advanced HNC and adequate renal function who were treated curatively from 2008 to 2015 using radiotherapy and concurrent three-weekly cisplatin. Outcome was the first AKI episode, defined according to the Kidney Disease Improving Global Outcomes (KDIGO) guidelines as a ≥50% rise in serum creatinine compared to baseline. Several potential predictors were investigated by means of logistic regression analyses. Results: In our cohort (mean age 58 ± 8 years, 74.3% male), a total of 102 (39.1%) patients developed AKI. Factors significantly associated with AKI in the univariate analysis were: age, alcohol consumption, excessive smoking, diabetes, hypertension, diuretic use, renin-angiotensin-aldosterone-system blockers, and administration of furosemide when indicated during first cisplatin cycle. In the multivariable model smoking 6-25 and > 25 cigarettes per day (OR 1.85; 95% CI 1.01-3.39 and OR 3.22; 95% CI 1.34-7.70, respectively), diabetes (OR 2.58; 95% CI, 1.01-6.61), furosemide (OR 2.39; 95% CI, 1.36-4.18) , and hypertension (OR 2.79; 95% CI, 1.52-5.12) remained independent risk factors for AKI. Conclusions: The identified risk factors smoking, diabetes, and hypertension may have caused pre-existing kidney damage and therefore have predisposed to AKI. Co-administration of furosemide with cisplatin is a potentially reversible risk factor for AKI.

Risk of chronic opioid use after radiation for head and neck cancer: A systematic review and meta-analysis.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 6579-6579
Author(s):  
Sondos Zayed ◽  
Cindy Lin ◽  
Gabriel Boldt ◽  
Nancy Read ◽  
Lucas Mendez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Meta Analysis ◽  
Primary Tumour ◽  
Opioid Use ◽  
History Of ◽  
Chronic Opioid Use ◽  
Current Alcohol

6579 Background: Opioid overuse is a major international public health concern. The prevalence and risk factors for chronic opioid use (COU) in radiation-induced head and neck pain are poorly understood. The aim of this study was to estimate the rates of COU and to identify risk factors for COU in head and neck cancer (HNC) patients undergoing curative-intent radiotherapy (RT) or chemoradiotherapy (CRT). Methods: We performed a systematic review and meta-analysis based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, using the PubMed (Medline), EMBASE, and Cochrane library databases, queried from dates of inception until present. COU was defined as persistent opioid use ≥3 months after treatment completion. Studies in the English language that reported on COU in HNC patients who received RT/CRT were included. Meta-analyses were performed using random effects models. Heterogeneity was assessed using the I2 value. Results: A total of 134 studies were identified, with 7 retrospective studies (reporting on 1841 patients) meeting inclusion criteria. Median age was 59.4 years (range 56.0-62.0) with 1343 (72.9%) men and 498 (27.1%) women. Primary tumour locations included oropharynx (891, 48.4%), oral cavity (533, 29.0%), larynx (93, 5.1%), hypopharynx (32, 1.7%), and nasopharynx (29, 1.6%). 846 (46.0%) patients had stage I/II disease and 926 (50.3%) had stage III-IV disease. 301 (16.3%) patients had RT alone, 738 (40.1%) received CRT, and 594 (32.3%) underwent surgery followed by adjuvant RT/CRT. The proportion of HNC patients who received radiotherapy and developed COU was 40.7% at 3 months (95% CI 22.6%-61.7%, I2= 97.1%), 15.5% at 6 months (95% CI 7.3%-29.7%, I2= 94.3%) and 7.0% at 1 year. There were significant differences in COU based on primary tumor sites (P < 0.0001), with the highest rate (46.6%) in oropharyngeal malignancies. Other factors associated with COU included history of psychiatric disorder (61.7%), former/current alcohol abuse (53.9%), and start of opioids prior to radiation treatment (51.6%). There was no significant difference in the proportion of COU by gender (P = 0.683), disease stage (I/II vs III/IV; P = 0.443), or treatment received (RT, CRT, or adjuvant RT/CRT; P = 0.711). Conclusions: A significant proportion of patients who undergo radiotherapy for head and neck cancer suffer from COU. High-risk factors for COU include an oropharyngeal primary tumour, history of psychiatric disorder, former/current alcohol abuse, and pre-treatment opioid use. New strategies to mitigate opioid use are needed.

scholarly journals Effect of Physical Therapy Modalities on Quality of Life of Head and Neck Cancer Survivors: A Systematic Review with Meta-Analysis

2021 ◽  
Vol 10 (20) ◽  
pp. 4696
Author(s):  
Barbara Burgos-Mansilla ◽  
Noelia Galiano-Castillo ◽  
Mario Lozano-Lozano ◽  
Carolina Fernández-Lao ◽  
Maria Lopez-Garzon ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Head And Neck Cancer ◽  
Physical Therapy ◽  
Head And Neck ◽  
Neck Cancer ◽  
Meta Analysis ◽  
Physical Therapy Modalities ◽  
Whole Body ◽  
Cochrane Library

The objective was to describe the effectiveness of different physical therapy modalities to improve Quality of Life (QoL) in Head and Neck Cancer (HNC) survivors. PubMed, Scopus, Web of Science, CINAHL and Cochrane Library were searched for randomized clinical controlled trials published until 30 April 2020. Risk of bias assessment and meta-analysis were conducted using the Cochrane tools. A total of 251 records were retrieved, and 10 met the inclusion criteria. Interventions whose parameters focus on a 12-week exercise programs of aerobic activity (walking) or Progressive Resistance Training (PRT) for the whole body are effective and safe modalities improving QoL in HNC survivors. Electrophysical agents did not show significant results between groups. As for the assessment of methodological quality, 4 of the 10 articles included had a high risk of overall bias. Only five articles provided sufficient information to conduct a meta-analysis for exercise program intervention on QoL, showing a tendency in favor of intervention group, even when the global results did not show statistically significant improvements (pooled Cohen’s d 0.15; 95% CI: −0.25 to 0.54; I2 45.87%; p heterogeneity = 0.10). The present review and meta-analysis identified meaningful benefits of exercise on QoL of HNC survivors; this has been confirmed in a meta-analysis. This review adds evidence supporting exercise interventions on Head and Neck Cancer population whose opportunities for successful recovery after medical treatment are more limited.

scholarly journals Head and neck cancer risk factors in India: protocol for systematic review and meta-analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e020014 ◽  
Author(s):  
Aayush Poddar ◽  
Ritchlynn Ronald Aranha ◽  
Gothandam K Muthukaliannan ◽  
Ramesh Nachimuthu ◽  
Rama Jayaraj
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Risk Factor ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Meta Analysis ◽  
Ethical Review ◽  
Indian States ◽  
Increased Risk

IntroductionDemographic, behavioural and environmental factors have been associated with increased risk of head and neck cancer (HNC). We will review published reports and explore connections between risk factors and HNC incidence. This protocol aims to provide strategies for a systematic review and meta-analysis of HNC risk factor analysis in India. It also provides guidelines in order to visualise obtained HNC risk factor data in the form of a heat-map highlighting variations across gender, age and geographical location.Methods and analysisWe will identify well-established HNC risk factors and perform a comprehensive systematic review and meta-analysis to quantify each risk factor’s impact on HNC incidence. A systematic search will be performed to identify the studies and published reports of HNC risk factors in India. Meta-analysis will be conducted to estimate the proportional contribution of the most prevalent risk factor in HNC on a city-wide basis in Indian states and territories.Ethics and disseminationThe review protocol draws on publicly available anonymised data without directly involving human participants and therefore requires neither formal human ethical review nor approval by a human research ethics committee. We published an outline of the protocol in the International Prospective Register of Systematic Reviews (PROSPERO) in 2017. The results will provide an updated analysis of HNC risk factor prevalence in India, and we will discuss the applicability of rehabilitation care. We plan to disseminate the findings of this systematic review through publication in a peer-reviewed journal and presentation at relevant conference proceedings.PROSPERO registration numberCRD42017077758.

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