Predictors of Survival After Head and Neck Squamous Cell Carcinoma in South America: The InterCHANGE Study

PURPOSE Head and neck squamous cell carcinoma (HNSCC) incidence is high in South America, where recent data on survival are sparse. We investigated the main predictors of HNSCC survival in Brazil, Argentina, Uruguay, and Colombia. METHODS Sociodemographic and lifestyle information was obtained from standardized interviews, and clinicopathologic data were extracted from medical records and pathologic reports. The Kaplan-Meier method and Cox regression were used for statistical analyses. RESULTS Of 1,463 patients, 378 had a larynx cancer (LC), 78 hypopharynx cancer (HC), 599 oral cavity cancer (OC), and 408 oropharynx cancer (OPC). Most patients (55.5%) were diagnosed with stage IV disease, ranging from 47.6% for LC to 70.8% for OPC. Three-year survival rates were 56.0% for LC, 54.7% for OC, 48.0% for OPC, and 37.8% for HC. In multivariable models, patients with stage IV disease had approximately 7.6 (LC/HC), 11.7 (OC), and 3.5 (OPC) times higher mortality than patients with stage I disease. Current and former drinkers with LC or HC had approximately 2 times higher mortality than never-drinkers. In addition, older age at diagnosis was independently associated with worse survival for all sites. In a subset analysis of 198 patients with OPC with available human papillomavirus (HPV) type 16 data, those with HPV-unrelated OPC had a significantly worse 3-year survival compared with those with HPV-related OPC (44.6% v 75.6%, respectively), corresponding to a 3.4 times higher mortality. CONCLUSION Late stage at diagnosis was the strongest predictor of lower HNSCC survival. Early cancer detection and reduction of harmful alcohol use are fundamental to decrease the high burden of HNSCC in South America.

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Upfront chemotherapy and accelerated radiotherapy with EGFR inhibition for locally advanced inoperable head and neck cancer

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.6040 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. 6040-6040

Author(s):

C. Mercke ◽

G. Wickart-Johansson ◽

H. Sjödin ◽

G. Adell ◽

J. Nyman ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Oral Cavity ◽

Cell Carcinoma ◽

Head And Neck ◽

Squamous Cell ◽

Locally Advanced ◽

Stage Iv ◽

Resected Specimen ◽

Stage Iv Disease

6040 Background: Concomitant chemoradiotherapy (CT/RT) is the standard treatment for locally advanced head and neck squamous cell carcinoma. However, late toxicity is substantial.This phase II trial explores the feasibility and efficacy of combining neoadjuvant TPF and accelerated RT where the concomitant cytostatic component is replaced with cetuximab (E), a chimeric IgG1 mAb against EGFR. Methods: Patients (pts) had previously untreated stage III/IV M0,WHO 0–1, unresectable squamous cell carcinoma of the oral cavity, oropharynx, larynx, or hypopharynx and were scheduled for 2 cycles of TPF (docetaxel 75 mg/m2 and cisplatin 75 mg/m2 day 1 and 5-FU 1,000 mg/m2 96 hours CI) every 3 weeks followed by RT (68 Gy/4.5 weeks) with E given one week before (400 mg/m2) and weekly during RT (250 mg/m2). A brachytherapy boost of 8 Gy was given to pts with oral cavity or oropharyngeal tumours. Neck dissection was planned for pts with N2–3 and complete response (CR) at the primary tumour. Tumour response was evaluated according to RECIST with CT, MRI or PET/CT after CT and at 6 weeks follow up. Toxicity (CTC 3.0) and quality of life (EORTC QLQ 30) was registered during and after treatment. Results: From 070401 to 081115 68 pts were enrolled, 56 had stage IV disease (T4, n = 14, N3, n = 9). Median age 57, 60 males, 3 oral cavity, 44 oropharynx, 10 larynx, and 11 hypopharynx. 30 pts were followed beyond 6 weeks and evaluated for response and early toxicity: stage IV disease 24 (T4, n = 6, N3, n = 3), median age 60, 25 males, 18 oropharynx, 5 larynx, and 7 hypopharynx. Remissions after TPF/after RT: CR 1/10, PR 15/18, SD 14/1, and PD 1. TPF as prescribed: 28/30 (pat refusal 1, renal insuff 1, dose reduction 0/28); E as prescribed: 22/30 (dermatitis 4, hypersensitivity 3, liver tox 1). Vital tumour in resected specimen 0/13. Alive at follow-up 29/30 (1 local failure). Conclusions: TPF followed by RT concomitant with E is feasible with manageable toxicities. Dermatitis in the irradiated neck, at least with the present accelerated fractionation, is troublesome to some patients but does not interrupt treatment and heals rapidly. To dispose of feeding tubes after disappearance of acute mucosal reactions has not been a problem. Early survival results are promising. Toxicity and survival results will be updated. [Table: see text]

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Extent of neck dissection required after concurrent chemoradiation for stage IV head and neck squamous cell carcinoma

Yearbook of Otolaryngology-Head and Neck Surgery ◽

10.1016/j.yoto.2010.12.032 ◽

2011 ◽

Vol 2011 ◽

pp. 28-29

Author(s):

M. Gapany

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Head And Neck ◽

Neck Dissection ◽

Squamous Cell ◽

Stage Iv ◽

Neck Squamous Cell Carcinoma ◽

Concurrent Chemoradiation

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A clinical study of stage IV head and neck squamous cell carcinoma. Prognostic factors for long-term survival.

Japanese jornal of Head and Neck Cancer ◽

10.5981/jjhnc1974.24.90 ◽

1998 ◽

Vol 24 (1) ◽

pp. 90-96

Author(s):

Madoka FURUKAWA ◽

Akira KUBOTA ◽

Yuuji TANIGAKI ◽

Kousuke YAMASITA ◽

Masato SUGIYAMA ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Prognostic Factors ◽

Clinical Study ◽

Cell Carcinoma ◽

Head And Neck ◽

Squamous Cell ◽

Stage Iv ◽

Neck Squamous Cell Carcinoma ◽

Term Survival

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A comparative study of survival rates after treatment with induction chemotherapy or concurrent chemoradiotherapy in locoregionally advanced head and neck squamous cell carcinoma

Toukeibu Gan ◽

10.5981/jjhnc.38.368 ◽

2012 ◽

Vol 38 (3) ◽

pp. 368-373

Author(s):

Yukihiro Hiraga ◽

Junichi Kou

Keyword(s):

Squamous Cell Carcinoma ◽

Comparative Study ◽

Cell Carcinoma ◽

Head And Neck ◽

Induction Chemotherapy ◽

Squamous Cell ◽

Concurrent Chemoradiotherapy ◽

Survival Rates ◽

Neck Squamous Cell Carcinoma ◽

Advanced Head

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Significance of mammalian target of rapamycin in patients with locally advanced stage IV head and neck squamous cell carcinoma receiving induction chemotherapy with docetaxel, cisplatin, and fluorouracil

Head & Neck ◽

10.1002/hed.24111 ◽

2015 ◽

Vol 38 (S1) ◽

pp. E844-E852 ◽

Cited By ~ 12

Author(s):

Shau-Hsuan Li ◽

Wei-Che Lin ◽

Tai-Lin Huang ◽

Chang-Han Chen ◽

Tai-Jan Chiu ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Head And Neck ◽

Induction Chemotherapy ◽

Squamous Cell ◽

Locally Advanced ◽

Mammalian Target Of Rapamycin ◽

Stage Iv ◽

Neck Squamous Cell Carcinoma ◽

Advanced Stage

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Cancer Stem Cell Markers in Head and Neck Squamous Cell Carcinoma

Stem Cells International ◽

10.1155/2013/319489 ◽

2013 ◽

Vol 2013 ◽

pp. 1-13 ◽

Cited By ~ 49

Author(s):

Aidan G. Major ◽

Luke P. Pitty ◽

Camile S. Farah

Keyword(s):

Squamous Cell Carcinoma ◽

Stem Cell ◽

Cell Carcinoma ◽

Head And Neck ◽

Squamous Cell ◽

Survival Rates ◽

Neck Squamous Cell Carcinoma ◽

Treatment Modalities ◽

Stem Cell Markers ◽

Cancer Stem Cell Markers

Head and neck squamous cell carcinoma (HNSCC) is one of the world’s top ten most common cancers. Current survival rates are poor with only 50% of patients expected to survive five years after diagnosis. The poor survival rate of HNSCC is partly attributable to the tendency for diagnosis at the late stage of the disease. One of the reasons for treatment failure is thought to be related to the presence of a subpopulation of cells within the tumour called cancer stem cells (CSCs). CSCs display stem cell-like characteristics that impart resistance to conventional treatment modalities and promote tumour initiation, progression, and metastasis. Specific markers for this population have been investigated in the hope of developing a deeper understanding of their role in the pathogenesis of HNSCC and elucidating novel therapeutic strategies.

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Impact of a tobacco treatment program on abstinence and survival rates among current smokers with head and neck squamous cell carcinoma

Head & Neck ◽

10.1002/hed.26268 ◽

2020 ◽

Vol 42 (9) ◽

pp. 2440-2452

Author(s):

Andrew T. Day ◽

Kristina R. Dahlstrom ◽

Rebecca Lee ◽

Maher Karam‐Hage ◽

Erich M. Sturgis

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Head And Neck ◽

Squamous Cell ◽

Treatment Program ◽

Survival Rates ◽

Neck Squamous Cell Carcinoma ◽

Tobacco Treatment

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The radiobiology of HPV-positive and HPV-negative head and neck squamous cell carcinoma

Expert Reviews in Molecular Medicine ◽

10.1017/erm.2020.4 ◽

2020 ◽

Vol 22 ◽

Author(s):

Chumin Zhou ◽

Jason L. Parsons

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Head And Neck ◽

Squamous Cell ◽

Survival Rates ◽

Cell Cycle Checkpoint ◽

Neck Squamous Cell Carcinoma ◽

Hpv Status ◽

Hnscc Cell

Abstract Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide, with reported incidences of ~800 000 cases each year. One of the critical determinants in patient response to radiotherapy, particularly for oropharyngeal cancers, is human papillomavirus (HPV) status where HPV-positive patients display improved survival rates and outcomes particularly because of increased responsiveness to radiotherapy. The increased radiosensitivity of HPV-positive HNSCC has been largely linked with defects in the signalling and repair of DNA double-strand breaks. Therefore, strategies to further radiosensitise HPV-positive HNSCC, but also radioresistant HPV-negative HNSCC, have focussed on targeting key DNA repair proteins including PARP, DNA-Pk, ATM and ATR. However, inhibitors against CHK1 and WEE1 involved in cell-cycle checkpoint activation have also been investigated as targets for radiosensitisation in HNSCC. These studies, largely conducted using established HNSCC cell lines in vitro, have demonstrated variability in the response dependent on the specific inhibitors and cell models utilised. However, promising results are evident targeting specifically PARP, DNA-Pk, ATR and CHK1 in synergising with radiation in HNSCC cell killing. Nevertheless, these preclinical studies require further expansion and investigation for translational opportunities for the effective treatment of HNSCC in combination with radiotherapy.

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Pre-Therapeutic VEGF Level in Plasma Is a Prognostic Bio-Marker in Head and Neck Squamous Cell Carcinoma (HNSCC)

Cancers ◽

10.3390/cancers13153781 ◽

2021 ◽

Vol 13 (15) ◽

pp. 3781

Author(s):

Julia Siemert ◽

Theresa Wald ◽

Marlen Kolb ◽

Isolde Pettinella ◽

Ulrike Böhm ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Head And Neck ◽

Squamous Cell ◽

Cox Regression ◽

Neck Squamous Cell Carcinoma ◽

Operating Characteristics ◽

Event Free Survival ◽

Free Survival ◽

Study Protocols

Vascular endothelial growth factor (VEGF) is centrally involved in cancer angiogenesis. We hypothesized that pre-therapeutic VEGF levels in serum and plasma differ in their potential as biomarkers for outcomes in head and neck squamous cell carcinoma (HNSCC) patients. As prospectively defined in the study protocols of TRANSCAN-DietINT and NICEI-CIH, we measured VEGF in pretreatment serum and plasma of 75 HNSCC test cohort (TC) patients. We analyzed the prognostic value of VEGF concentrations in serum (VEGFSerum) and plasma (VEGFPlasma) for event-free survival (EFS) utilizing receiver-operating characteristics (ROC). Mean VEGF concentrations in plasma (34.6, 95% CI 26.0–43.3 ng/L) were significantly lower (p = 3.35 × 10−18) than in serum (214.8, 95% CI 179.6–250.0 ng/L) but, based on ROC (area under the curve, AUCPlasma = 0.707, 95% CI 0.573–0.840; p = 0.006 versus AUCSerum = 0.665, 95% CI 0.528–0.801; p = 0.030), superiorly correlated with event-free survival (EFS) of TC patients. Youden indices revealed optimum binary classification with VEGFPlasma 26 ng/L and VEGFSerum 264 ng/L. Kaplan–Meier plots demonstrated superiority of VEGFPlasma in discriminating patients regarding outcome. Patients with VEGFPlasma < 26 ng/L had superior nodal (NC), local (LC) and loco-regional control (LRC) leading to significant prolonged progression-free survival (PFS) and EFS. We successfully validated VEGFPlasma according the cut-off <26 ng/L as predictive for superior outcome in an independent validation cohort (iVC) of 104 HNSCC patients from the studies DeLOS-II and LIFE and found better outcomes including prolonged tumor-specific (TSS) and overall survival (OS). Outcomes in TC and iVC combined again was related to VEGFPlasma, and multivariate Cox regression revealed that VEGFPlasma was an independent outcome predictor. In HNSCC, pre-therapeutic VEGFPlasma is prognostic for outcomes.

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