Treatment of primary mucosal head and neck squamous cell carcinoma using photodynamic therapy: results after 25 treated cases

2003 ◽  
Vol 117 (9) ◽  
pp. 713-717 ◽  
Author(s):  
M. G. Dilkes ◽  
E. Benjamin ◽  
S. Ovaisi ◽  
A. S. Banerjee
Keyword(s):  
Squamous Cell Carcinoma ◽  
Photodynamic Therapy ◽  
Head And Neck ◽  
Squamous Cell ◽  
Complete Response ◽  
Primary Treatment ◽  
Squamous Cell Carcinomas ◽  
Radical Radiotherapy ◽  
Wide Range

The use of photodynamic therapy for the treatment of malignant and non-malignant conditions is increasing. This paper demonstrates the efficacy of a second-generation photosensitizer, Foscan®, in the primary treatment of a wide range of mucosal head and neck squamous cell carcinomas. Tumours ranged in stage from T1 to T3. A complete response to primary treatment was seen in 19/21 patients (90 per cent). In laryngeal cancer recurrent after radical radiotherapy, one out of four patients treated obtained a complete response (25 per cent). Six patients (24 per cent) required surgery after photodynamic therapy, for local recurrence or dysplasia. Mean follow up was for 27.3 months (standard deviation 20.6 months).

scholarly journals Photodynamic Therapy as an Alternative Therapeutic Tool in Functionally Inoperable Oral and Oropharyngeal Carcinoma: A Single Tertiary Center Retrospective Cohort Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Arnaud Lambert ◽  
Lotte Nees ◽  
Sandra Nuyts ◽  
Paul Clement ◽  
Jeroen Meulemans ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Photodynamic Therapy ◽  
Oral Cavity ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Standard Treatment ◽  
Treated Area ◽  
Free Interval

Background: Head and neck cancer is typically treated with surgery, radiotherapy, chemoradiation, or a combination of these treatments. This study aims to retrospectively analyse oncological outcomes, adverse events and toxicity of treatment with temoporfin-mediated photodynamic therapy at a single tertiary referral center. More specifically, in a selected group of patients with otherwise (functionally) inoperable oral or oropharyngeal head and neck squamous cell carcinoma.Methods: Twenty-six consecutive patients who received photodynamic therapy for oral or oropharyngeal squamous cell carcinoma from January 2002 until July 2019 at the University Hospitals Leuven were included. These were (1) patients with an accessible recurrent or new primary tumor in an extensively treated area of the head and neck, not suitable for standard treatment, or (2) patients that were judged medically unfit to undergo standard treatment modalities.Results: Complete tumor response immediately after PDT was obtained in 76.9% of cases. During follow-up, a proportion of CR patients did recur, to reach recurrence-free rates at six months, one year and two years of 60.6%, 48.5% and 32.3%. Local control at the PDT treated area was 42.3% with a median recurrence free interval time of 9 months. Recurrence-free interval was statistically more favorable for oropharyngeal squamous cell carcinoma (with or without oral cavity extension) in comparison to oral cavity squamous cell carcinoma alone (p < 0.001). During a median follow-up period of 27 months, we report new tumor activity in 80.8% of patients. Median overall and disease-specific survival time was 31 and 34 months, respectively. Most reported adverse events were pain after treatment and facial edema. At the end of follow-up, swallowing and upper airway functionality were preserved in 76.9 and 95.7% of patients, respectively.Conclusion: Photodynamic therapy is a valuable treatment option in highly selected patients with oral and/or oropharyngeal (functionally) inoperable head and neck squamous cell carcinoma. Treatment with this alternative modality can induce durable local control in an important fraction of treated patients, with an acceptable toxicity profile.

Follow-up of concomitant treatment with gemcitabine/radiotherapy in locally advanced squamous cell carcinoma of head and neck

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 15537-15537
Author(s):  
F. Bustamante ◽  
R. Villalobos ◽  
E. Castillo ◽  
A. Calva ◽  
F. Gallegos ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Partial Response ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Locally Advanced ◽  
Complete Response ◽  
Concomitant Treatment ◽  
Advanced Squamous Cell Carcinoma

15537 Background: The stages of the locally advanced head and neck cancer have a negative prognosis, therefore, new treatments are continuously explored. One of these treatments consists of the use of Gemcitabine concomitant with radiotherapy. We previously evaluated the rate of response and the toxicity profile of this treatment in 15 patients and now we are reporting the follow up of such study. Methods: Fifteen patients, with histological report of locally advanced squamous cell carcinoma of head and neck, initiated treatment of Gemcitabine at intravenously doses of 50 mg\m2 per application weekly concomitant with radiotherapy. The radiotherapy consisted of an initial photons dose of 3960 cGy in 22 fractions of 180 cGy to the primary site and regional lymph with posterior increments of 2880 cGy in 16 fractions of 180 cGy excluding the spinal cord and electrons increments if necessary. Results: In 9 of the 15 patients complete response was obtained, achieving organ preservation. Four of the 15 patients presented a partial response and two presented progression. The principal severe toxicity presented was mucositis. The mean follow-up is 23 months with a range of 19–27 months. From the 9 patients that presented a complete response, one presented bone recurrence 13 months after achieving the total response; another one of them died because an infectious process without evidence of tumoral activity. The rest 7 patients are to the present date without evidence of tumoral activity. One of the patients with partial response is still alive with tumoral activity in central nervous system. The remaining patients died due to tumoral activity. Conclusions: In our study with 15 patients an overall response of 87% was obtained. With a follow up to 23 months only one recurrence has been presented. We concluded that the treatment is feasible and it could have an impact in the overall survival but studies with a greater number of patients and a larger follow up are needed. No significant financial relationships to disclose.

A phase I-II trial of induction chemotherapy with carboplatin and fluorouracil in locally advanced head and neck squamous cell carcinoma: a report from the UCL-Oncology Group, Belgium.

1991 ◽  
Vol 9 (8) ◽  
pp. 1385-1392 ◽  
Author(s):  
V Grégoire ◽  
M Beauduin ◽  
Y Humblet ◽  
M Hamoir ◽  
J Longueville ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Induction Chemotherapy ◽  
Squamous Cell ◽  
Primary Tumor ◽  
Complete Response ◽  
Neck Squamous Cell Carcinoma ◽  
Radiotherapy Alone

Eighty-three patients (median age, 56 years and Karnofsky performance status greater than or equal to 70) were treated with carboplatin (Carbo) and fluorouracil (5Fu) for stage III and IV head and neck squamous cell carcinoma (HNSCC). 5Fu (1 g/m2/d) was administered from day 1 to 4 by continuous infusion. Carbo was given on day 1 and, in order to evaluate its maximum-tolerated dose (MTD), the dose level was progressively increased from 250 mg/m2 to 450 mg/m2. The effectiveness of this association and its potential role in local control were also evaluated. Three patients received Carbo at a dose of 250 mg/m2, 13 received 300 mg/m2, one received 330 mg/m2, 12 received 350 mg/m2, six received 375 mg/m2, 26 received 400 mg/m2, 18 received 420 mg/m2, and four received 450 mg/m2. Two (13 of 83) or three courses (64 of 83), repeated every 4 weeks, were administered. The overall (primary tumor and node) response and complete response (CR) rates were 33% and 14%, respectively. For primary tumor, the response rate (RR) was 57% with 32% CR and 18% pathologic complete response (PCR); the RR was higher for patients with oropharyngeal tumor (76%, P = .037) and for patients treated with Carbo greater than or equal to 350 mg/m2 (65%, P = .02); the tumor size (T1 + T2 v T3 + T4) was a good prognostic factor for RR (90% v 46%, P = .001), CR (65% v 20%, P less than .001), and PCR (45% v 8%, P less than .001). For nodes, the RR was 33% with 11% CR. Grade 3-4 neutropenia and thrombocytopenia were experienced by 17% and 28% of the patients treated with 420 mg/m2 of Carbo and by 50% of the patients treated with 450 mg/m2. The MTD can be fixed at 420 mg/m2 and the proposed dose at 400 mg/m2. Thirty-eight patients were treated with surgery plus radiotherapy, 33 with radiotherapy alone, and seven with surgery alone. The median follow-up is 12 months. The 18-month disease-free survival (DFS) is 78% for overall complete responders and 39% for the others (P = .04). There is no primary tumor recurrence among the 12 patients with a primary tumor PCR treated by radiotherapy alone for tumor control (median follow-up, 17.3 months). The association of Carbo-5Fu is a safe induction chemotherapy regimen for HNSCC. The proposed dose of Carbo for future treatment is 400 mg/m2.(ABSTRACT TRUNCATED AT 400 WORDS)

scholarly journals A comparative study of radical radiotherapy with weekly paclitaxel versus radical radiotherapy with weekly cisplatin in the management of locally advanced squamous cell carcinomas of head and neck

2017 ◽  
Vol 5 (2) ◽  
pp. 473
Author(s):  
Ram Madhavan ◽  
Bhaskar P.K ◽  
Antonoitte Mary Nithiya ◽  
Janarthina Kani ◽  
Madhu Mathi ◽  
...  
Keyword(s):  
Partial Response ◽  
Head And Neck ◽  
Squamous Cell ◽  
Locally Advanced ◽  
Complete Response ◽  
Squamous Cell Carcinomas ◽  
Weekly Paclitaxel ◽  
Radiation Dermatitis ◽  
Radical Radiotherapy ◽  
Weekly Cisplatin

Background: Concurrent chemo radiation is standard of care in locally advanced squamous cell carcinomas of head and neck. Single agent Cisplatin either weekly or three weekly is commonly used concurrently with radiation. The present study aims to evaluate the response rate and toxicity of radical radiotherapy with weekly paclitaxel and cisplatin in head and neck cancers.Methods: This is a prospective double arm study in which sixty patients with histologically proved squamous cell carcinomas registered in our department were accrued into the study with thirty patients in each arm. All patients were treated using Theratron phoenix 780 cobalt unit with a dose of 66 Gy in 33 fractions. The patients were randomized to receive 40 mg/m2 of weekly cisplatin or 40 mg/m2 of weekly Paclitaxel concurrently with radiation. The response to the therapy was assessed six weeks after completion of treatment. The statistical analysis was done using SPSS software.Results: In cisplatin group 18 patients achieved complete response and 12 patients achieved partial response whereas in Paclitaxel group 21 patients achieved complete response and 9 patients achieved partial response. However in paclitaxel arm the incidence of radiation dermatitis, mucositis, dysphagia and laryngitis are slightly higher compared to cisplatin group.Conclusions: The weekly paclitaxel concurrent with radiation is a feasible alternative to weekly cisplatin in locally advanced squamous cell carcinomas of head and neck.

Long-Term Follow-up on an Intensified Treatment Regimen for Advanced Resectable Head and Neck Squamous Cell Carcinomas

2001 ◽  
Vol 19 (2) ◽  
pp. 127-136 ◽  
Author(s):  
John C. Grecula ◽  
David E. Schuller ◽  
Roy Smith ◽  
Chris A. Rhoades ◽  
Subir Nag ◽  
...  
Keyword(s):  
Head And Neck ◽  
Treatment Regimen ◽  
Squamous Cell ◽  
Squamous Cell Carcinomas ◽  
Long Term Follow Up

scholarly journals Interim 4′-[methyl-11C]-thiothymidine PET for predicting the chemoradiotherapeutic response in head and neck squamous cell carcinoma: comparison with [18F]FDG PET

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Katsuya Mitamura ◽  
Takashi Norikane ◽  
Yuka Yamamoto ◽  
Kengo Fujimoto ◽  
Yasukage Takami ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Fdg Pet ◽  
Tumor Volume ◽  
Standardized Uptake Value ◽  
Complete Response ◽  
Neck Squamous Cell Carcinoma ◽  
Pet Ct

Abstract Purpose We investigated the potential of interim 4′-[methyl-11C]thiothymidine ([11C]4DST) PET for predicting the chemoradiotherapeutic response for head and neck squamous cell carcinoma (HNSCC), in comparison with 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) PET. Methods A total of 32 patients with HNSCC who underwent both [11C]4DST and [18F]FDG PET/CT before therapy (baseline) and at approximately 40 Gy point during chemoradiotherapy (interim) were available for a retrospective analysis of prospectively collected data. The baseline was treatment-naïve PET/CT scan as part of staging. The maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV) from [18F]FDG PET or proliferative tumor volume (PTV) from [11C]4DST PET, and total lesion glycolysis (TLG) from [18F]FDG PET or total lesion proliferation (TLP) from [11C]4DST PET were measured. MTV or PTV was defined as the volume with an SUVmax greater than 2.5. The differences in SUVmax (ΔSUVmax), MTV (ΔMTV) or PTV (ΔPTV) and TLG (ΔTLG) or TLP (ΔTLP) from baseline to interim PET scans were calculated. Patients without or with evidence of residual or recurrent disease at 3 months after completion of chemoradiotherapy were classified as showing a complete response (CR) and non-CR, respectively. Results All patients showed increased uptake in primary tumor on baseline [11C]4DST and [18F]FDG PET studies. All patients showed increased uptake on interim [18F]FDG PET, whereas 18 patients showed no increased uptake on interim [11C]4DST PET. After chemoradiotherapy, 25 patients were found to be in CR group and 7 to be in non-CR group. [11C]4DST ΔSUVmax, ΔPTV, and ΔTLP for CR group showed significantly greater reductions than the corresponding values for non-CR group (P = 0.044, < 0.001, < 0.001, respectively). However, there were no significant differences in [18F]FDG ΔSUVmax, ΔMTV, or ΔTLG between CR group and non-CR group. [11C]4DST ΔMTV of -90 was the best cutoff value for the early identification of patients with non-CR. Conclusion These preliminary results suggest that interim [11C]4DST PET might be useful for predicting the chemoradiotherapeutic response in patients with HNSCC, in comparison with [18F]FDG PET.

scholarly journals Effect of coronavirus disease 2019 on recurrences and follow up of head and neck squamous cell carcinoma

2021 ◽  
pp. 1-4
Author(s):  
E Kytö ◽  
E Haapio ◽  
I Kinnunen ◽  
H Irjala
Keyword(s):  
Squamous Cell Carcinoma ◽  
Prospective Study ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Neck Squamous Cell Carcinoma ◽  
One Year ◽  
Diagnostic Delays

Abstract Objective This prospective study aimed to evaluate possible diagnostic delays in head and neck squamous cell carcinoma recurrences due to the changed follow-up protocol during the coronavirus disease 2019 pandemic. Methods The follow-up appointments of head and neck squamous cell carcinoma patients treated more than one year prior to the pandemic were changed to telephone appointments in order to reduce physical visits to the hospital. All contacts, reasons for contact and recurrent cancers were recorded. Results There were 17 recurrences during a seven-month study period among 178 patients treated in the previous year (10 per cent); 14 of these recurrences occurred in patients whose treatment had ended less than one year previously and 3 occurred more than one year after treatment had ended. There was no delay in diagnoses of recurrent tumours or treatment despite reduced visits because of the coronavirus disease 2019 pandemic. Conclusion According to our analyses, no delay was caused in the diagnoses of recurrent diseases. Follow up by telephone or telemedicine can be considered as part of the follow-up protocol one year after the treatment of head and neck squamous cell carcinoma when necessary.

P-47 Head and neck squamous cell carcinoma: a stratified follow-up program

Oral Oncology ◽  
2021 ◽  
Vol 118 ◽  
pp. 5
Author(s):  
Francesca de Felice ◽  
Mary Lei ◽  
Richard Oakley ◽  
Andrew Lyons ◽  
Alastair Fry ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Neck Squamous Cell Carcinoma

Follow-up strategies in head and neck cancer other than upper aerodigestive tract squamous cell carcinoma

2012 ◽  
Vol 270 (7) ◽  
pp. 1981-1989 ◽  
Author(s):  
Antoine Digonnet ◽  
Marc Hamoir ◽  
Guy Andry ◽  
Vincent Vander Poorten ◽  
Missak Haigentz ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Head And Neck Cancer ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Neck Cancer ◽  
Squamous Cell ◽  
Aerodigestive Tract ◽  
Upper Aerodigestive Tract

scholarly journals Comparison of altered fractionation schedule with concurrent chemo-radiation for squamous cell carcinoma of head and neck

2020 ◽  
Vol 8 (8) ◽  
pp. 2834
Author(s):  
Mathew Varghese K. ◽  
Geeta S. Narayanan ◽  
Bhaskar Vishwanathan ◽  
Shashidhar V. Karpurmath ◽  
Soumya Narayanan
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Performance Status ◽  
Locally Advanced ◽  
Complete Response ◽  
Altered Fractionation ◽  
Fractionation Schedule ◽  
Nodal Burden

Background: Aim of the study was to compare the response of altered fractionation schedule with concurrent chemo-radiation in patients with primary and the nodal disease.Methods: Total of 40 patients (20 in each arm) with stage 1- 4 squamous cell carcinoma of the head and neck with a performance status of 0-2 (ECOG) were included in the study. Arm A was altered fractionation schedule where in patients received 6 fractions per week to a total dose of 6600 cGy in 33 fractions. In Arm B, patients received conventional radiotherapy with concurrent chemotherapy three weekly Inj. of cisplatin (100 mg/m2). Patients were evaluated for acute toxicity every week using the Acute Radiation Morbidity Scoring Criteria. The response was assessed after 6 weeks and 12 weeks post treatment using the RECIST criteria. Data was statistically analyzed.Results: Seventeen patients in Arm A and 18 patients in Arm B completed the treatment. At the end of three months, In Arm A, 7 patients had complete response and in Arm B, 9 patients had complete response of the primary (p>0.05).  When the complete nodal response was compared in both the arms, there was no difference (2 vs 4 in Arm A vs Arm B resp.). But there were more partial nodal responders in Arm B (p = 0.016). The acute toxicities were comparable in both the arms.Conclusions: Altered fraction radiotherapy can be used in early lesions with minimal nodal burden but with locally advanced disease or large nodal burden addition of chemotherapy should not be avoided.

Sign in / Sign up

Export Citation Format

Share Document