Serumal and Salivary 25(OH)D and 1,25(OH)D Levels of  Head and Neck Cancer Patients

BACKGROUND: Saliva has been suggested as a substitute of serum for the detection of 25 Dihydroxyvitamin D (25(OH)D) in healthy people. However, investigation of salivary 1,25(OH)D has not been clearly reported. Vitamin plays important roles in inhibiting cancer progression. Current study was conducted to investigate serumal and salivary 25(OH)D) and 1,25(OH)D levels of healthy and head and neck cancer (HNC) subjects.METHODS: Research were conducted at Haji Adam Malik Hospital, Medan, Indonesia. Forty HNC and 40 healthy subjects were recruited and selected based on inclusion and exclusion criteria. Medical records were documented, followed by anthropometric evaluation and serum and saliva collection. Laboratory investigation for 25(OH)D and 1,25(OH) was performed using Enzyme-linked immunosorbent assay (ELISA) methods.RESULTS: Significant serumal (p=0.002) and salivary (p=0.016) 25(OH)D mean level differences of HNC and normal groups were obtained. More serumal or salivary 25(OH)D deficient subjects were found in control group than those in HNC group. Meanwhile, serumal and salivary 1,25(OH)D mean levels of HNC group were not significantly different with the ones of control group. There were significant correlations of serumal-salivary 25(OH)D as well as serumal-salivary 1,25(OH)D levels in normal group.CONCLUSION: Serumal and salivary 25(OH)D and 1,25(OH)D levels of HNC group were relatively normal. Salivary 25(OH)D and 1,25(OH)D could be suggested as substitutes for serumal ones.KEYWORDS: vitamin D, 25(OH)D, 1,25(OH)D, head and neck cancer

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Case-control study of oral disease indexes in individuals with head and neck cancer after antineoplastic therapy

Einstein (São Paulo) ◽

10.1590/s1679-45082018ao4245 ◽

2018 ◽

Vol 16 (3) ◽

Author(s):

Reyna Aguilar Quispe ◽

Adrielle Lindolpho Cremonesi ◽

Jeanne Kelly Gonçalves ◽

Cassia Maria Fischer Rubira ◽

Paulo Sérgio da Silva Santos

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Permanent Teeth ◽

Control Group ◽

Study Group ◽

Periodontal Index ◽

Community Periodontal Index ◽

History Of ◽

Antineoplastic Treatment

ABSTRACT Objective To evaluate the oral health of patients with head and neck cancer after antineoplastic treatment, and to compare them with patients with no history of cancer. Methods A total of 75 patients, divided into Study Group, composed of individuals after antineoplastic treatment (n=30), and Control Group, with individuals with no history of cancer (n=45), aged 37 to 79 years. The oral health status was evaluated through the index of decayed, missing or filled permanent teeth (DMFT), community periodontal index and evaluation of the use and need of prosthesis. All of these items were evaluated according to the criteria recommended by the World Health Organization. The statistical analysis was descriptive and used the Pearson’s χ2 test. Results The community periodontal index was higher in the Study Group when compared to the Control Group (p<0.0001). The need for an upper (p<0.001) and lower (p<0.0001) prostheses was higher in the Study Group. Also, the use of upper prosthesis was higher in the Study Group (p<0.002). The missing or filled permanent teeth index between the two groups (p>0.0506) and the use of lower prosthesis (p>0.214) did not present a relevant statistical difference. Conclusion Periodontal disease and edentulism are the most significant changes in individuals who received antineoplastic therapy for head and neck cancer as well as greater need for oral rehabilitation.

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Quantitative Assessment of Serum Magnesium Levels in Head and Neck Cancer: A Tertiary Hospital Based Case Control Study

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2021/v33i2031183 ◽

2021 ◽

pp. 249-257

Author(s):

Surender Kumar ◽

Neha Salaria ◽

Deepak Verma ◽

Uma Garg ◽

Monika Verma

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Case Control Study ◽

Serum Magnesium ◽

Tertiary Care ◽

Case Control ◽

Control Group ◽

Control Study

Background- Head and neck squamous cell carcinomas(HNSCC) are one of the most widespread malignancies worldwide. Trace elements such as magnesium are essential at cellular level, and it has been suggested that magnesium plays a role in carcinogenesis. Methods- A hospital based case control study was conducted in a tertiary care medical college with an aim to determine the levels of serum magnesium in patients with head and neck cancer and to compare the levels of serum magnesium of head and neck cancer patients with healthy matched control group and derive significance if any. Results- HNSCC was mainly found in males of age group 46 to 55 years. The mean serum Mg value of head and neck cancer patients was 0.71± 0.18 mmol/l while that seen in controls was 0.85± 0.09 mmol/l which was significantly lower(p<0.001). Average serum magnesium levels in stages I, II, III and IV were 0.85, 0.849, 0.682 and 0.554 mmol/l respectively, and a statistically significant association was determined between the two. Conclusion- As the stage of cancer progressed, average magnesium levels decreased congruently, hence establishing that magnesium levels were undeniably correlated to onset as well as progression of HNC. These evidences could be utilized to identify role of magnesium asa potential prognostic biomarker to assess progression of disease or clinical response to various modes of therapy in head and neck cancer patients.

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The Development and Treatment of Lymphatic Dysfunction in Cancer Patients and Survivors

Cancers ◽

10.3390/cancers12082280 ◽

2020 ◽

Vol 12 (8) ◽

pp. 2280

Author(s):

Melissa B. Aldrich ◽

John C. Rasmussen ◽

Caroline E. Fife ◽

Simona F. Shaitelman ◽

Eva M. Sevick-Muraca

Keyword(s):

Breast Cancer ◽

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Patients ◽

Cancer Progression ◽

Neck Cancer ◽

Cancer Metastasis ◽

Near Infrared ◽

Critical Role ◽

Lymphatic Function

Breast-cancer-acquired lymphedema is routinely diagnosed from the appearance of irreversible swelling that occurs as a result of lymphatic dysfunction. Yet in head and neck cancer survivors, lymphatic dysfunction may not always result in clinically overt swelling, but instead contribute to debilitating functional outcomes. In this review, we describe how cancer metastasis, lymph node dissection, and radiation therapy alter lymphatic function, as visualized by near-infrared fluorescence lymphatic imaging. Using custom gallium arsenide (GaAs)-intensified systems capable of detecting trace amounts of indocyanine green administered repeatedly as lymphatic contrast for longitudinal clinical imaging, we show that lymphatic dysfunction occurs with cancer progression and treatment and is an early, sub-clinical indicator of cancer-acquired lymphedema. We show that early treatment of lymphedema can restore lymphatic function in breast cancer and head and neck cancer patients and survivors. The compilation of these studies provides insights to the critical role that the lymphatics and the immune system play in the etiology of lymphedema and associated co-morbidities.

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113 The angled down radiotherapy technique for head and neck cancer: progression from a 2D compensator based to a 3D aperture based approach

Radiotherapy and Oncology ◽

10.1016/s0167-8140(03)80489-9 ◽

2003 ◽

Vol 69 ◽

pp. S28

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Cancer Progression ◽

Neck Cancer

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STAT3 Modulation of Regulatory T Cells in Response to Radiation Therapy in Head and Neck Cancer

JNCI Journal of the National Cancer Institute ◽

10.1093/jnci/djz036 ◽

2019 ◽

Vol 111 (12) ◽

pp. 1339-1349 ◽

Cited By ~ 17

Author(s):

Ayman J Oweida ◽

Laurel Darragh ◽

Andy Phan ◽

David Binder ◽

Shilpa Bhatia ◽

...

Keyword(s):

T Cells ◽

Head And Neck Cancer ◽

Regulatory T Cells ◽

Head And Neck ◽

Neck Cancer ◽

Single Agent ◽

Effector T Cells ◽

Enzyme Linked Immunosorbent Assay ◽

Tumor Control ◽

Stat3 Inhibition

Abstract Background Radioresistance represents a major problem in the treatment of head and neck cancer (HNC) patients. To improve response, understanding tumor microenvironmental factors that contribute to radiation resistance is important. Regulatory T cells (Tregs) are enriched in numerous cancers and can dampen the response to radiation by creating an immune-inhibitory microenvironment. The purpose of this study was to investigate mechanisms of Treg modulation by radiation in HNC. Methods We utilized an orthotopic mouse model of HNC. Anti-CD25 was used for Treg depletion. Image-guided radiation was delivered to a dose of 10 Gy. Flow cytometry was used to analyze abundance and function of intratumoral immune cells. Enzyme-linked immunosorbent assay was performed to assess secreted factors. For immune-modulating therapies, anti–PD-L1, anti-CTLA-4, and STAT3 antisense oligonucleotide (ASO) were used. All statistical tests were two-sided. Results Treatment with anti-CD25 and radiation led to tumor eradication (57.1%, n = 4 of 7 mice), enhanced T-cell cytotoxicity compared with RT alone (CD4 effector T cells [Teff]: RT group mean = 5.37 [ 0.58] vs RT + αCD25 group mean =10.71 [0.67], P = .005; CD8 Teff: RT group mean = 9.98 [0.81] vs RT + αCD25 group mean =16.88 [2.49], P = .01) and induced tumor antigen-specific memory response (100.0%, n = 4 mice). In contrast, radiation alone or when combined with anti-CTLA4 did not lead to durable tumor control (0.0%, n = 7 mice). STAT3 inhibition in combination with radiation, but not as a single agent, improved tumor growth delay, decreased Tregs, myeloid-derived suppressor cells, and M2 macrophages and enhanced effector T cells and M1 macrophages. Experiments in nude mice inhibited the benefit of STAT3 ASO and radiation. Conclusion We propose that STAT3 inhibition is a viable and potent therapeutic target against Tregs. Our data support the design of clinical trials integrating STAT3 ASO in the standard of care for cancer patients receiving radiation.

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Antitumor Efficacy of Liposome-Encapsulated NVP-BEZ235 Combined with Irreversible Electroporation for Head and Neck Cancer

Molecules ◽

10.3390/molecules24193560 ◽

2019 ◽

Vol 24 (19) ◽

pp. 3560

Author(s):

Li Tian ◽

Lucas Wang ◽

Yang Qiao ◽

Linfeng Lu ◽

Patrick Lee ◽

...

Keyword(s):

Growth Rate ◽

Head And Neck Cancer ◽

Head And Neck ◽

Tumor Cells ◽

Neck Cancer ◽

Irreversible Electroporation ◽

Antitumor Efficacy ◽

Treatment Center ◽

Control Group ◽

Tumor Mass

Irreversible electroporation (IRE) kills tumor cells by the delivery of short pulses of strong electric fields. However, the field strength decreases with distance from the treatment center. When IRE cannot eradicate the entire tumor mass, the surviving tumor cells can regrow. NVP-BEZ235 is a dual PI3K/mTOR inhibitor that has been administered orally in clinical trials. However, its hydrophobicity and poor water solubility make NVP-BEZ235 difficult to deliver to target areas. To improve its pharmacokinetics and therapeutic efficacy, we have encapsulated NVP-BEZ235 in a liposome (termed as L-BEZ). Our current study focuses on the long-term antitumor efficacy of IRE and intratumoral injection of L-BEZ in HN5 head and neck cancer xenografts in nude mice. We compared in vitro efficacy, as well as the effect on tumor size and growth rate in vivo, between IRE alone, IRE + oral BEZ, and IRE + L-BEZ over the course of two months. All animals in the control group were sacrificed by day 36, due to excess tumor burden. Tumors treated with IRE alone grew faster and larger than those in the control group. IRE + oral BEZ suppressed tumor growth, but the growth rate increased to that of the controls toward the end of 21 days. Only IRE + L-BEZ eradicated the tumor masses, with no palpable or extractable tumor mass observed after two months. The combination of IRE and L-BEZ could effectively eradicate tumors and prevent recurrence.

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Impact of antiviral prophylaxis in HSV positive patients treated with concurrent chemoradiotherapy for head and neck cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.15_suppl.6078 ◽

2019 ◽

Vol 37 (15_suppl) ◽

pp. 6078-6078

Author(s):

Nathalie Letarte ◽

Vincent-T. Taillefer ◽

Céline Marty ◽

Louise Lambert ◽

Francine Aubin ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Concurrent Chemoradiotherapy ◽

Locally Advanced ◽

Control Group ◽

Antiviral Prophylaxis ◽

Grade 3 ◽

Simplex Virus ◽

The Impact

6078 Background: Chemoradiotherapy used for the treatment of locally advanced head and neck cancer (HNC) causes a high incidence of mucositis that may be accentuated by a reactivation of herpes simplex virus (HSV). To date, no study has evaluated the impact of antivirals used as prophylaxis to prevent mucositis or their severity. Methods: This is a retrospective observational study including patients who received at least one cycle of concurrent chemoradiotherapy for the treatment of head and neck cancer between January 2014 and June 2017 at the Centre hospitalier de l’Université de Montréal (CHUM). HSV negative patients were excluded. After approval by the IRB, we compared the incidence and severity of mucositis in HSV positive patients who started an antiviral prophylaxis before cycle 1 or 2 (prophylaxis group) to HSV+/unknown HSV patients who did not receive antiviral prophylaxis (control group). Emergency visits and hospitalizations related to mucositis were collected. Mucositis were assessed regularly by radiation oncologists during the treatment. Results: Of 482 patients who received concurrent chemoradiotherapy for HNC, 75 were HSV negative and 407 were included in this study. In the group with (n = 94) and without prophylaxis (n = 313), patients received carboplatin and 5-FU (77% vs 62%) and cisplatin (23% vs 38%) with concurrent radiation respectively. The rate of all grade mucositis in patients with and without prophylaxis (99% vs 96%; p = 0.19) was not statistically significant. The rate of grade 3 and 4 mucositis (42% vs 49%; p = 0.29), the rate of emergency visit (29% vs 28%; p = 0.91) and hospitalization (9% vs 8%; p = 0.80) were not statistically significant between each group. However, in a subgroup of patient receiving carboplatin and 5-FU, antiviral prophylaxis seems to decrease significantly the rate of grade 3 (49% vs 63%; p = 0.04). Conclusions: The addition of antiviral prophylaxis in HSV positive in patients undergoing concurrent chemoradiotherapy for locally advanced HNC didn’t decrease the rate of all grade mucositis. In the subgroup of patients receiving carboplatin and 5-FU mainly of oropharynx origin, HSV prophylaxis decreased the severity of mucositis.

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Serious illness communication among patients with head and neck cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.31_suppl.2 ◽

2019 ◽

Vol 37 (31_suppl) ◽

pp. 2-2

Author(s):

Floyd Buen ◽

Emily J Martin ◽

Neil Wenger ◽

Kirsten Buen ◽

Anne M. Walling

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Retrospective Analysis ◽

Neck Cancer ◽

Medical Records ◽

Primary Care Providers ◽

Treatment Preferences ◽

Care Providers ◽

Goals Of Care ◽

Serious Illness

2 Background: Head and neck cancer is associated with significant morbidity and mortality, yet little is known about the frequency and content of discussions addressing patients’ values, goals of care, and treatment preferences. Methods: Using an institutional cancer registry, we conducted a retrospective analysis of 70 decedents who underwent surgical treatment for squamous cell carcinoma of the head and neck. We abstracted patients’ medical records using a standardized template. An independent reviewer re-abstracted 20% of the records. For abstracted data pertaining to documented values, goals of care, and/or treatment preferences our inter-rater reliability was greater than 93%. Results: The mean age at diagnosis was 66 years and 69% were male. An enduring advance directive, a completed Physician Order for Life Sustaining Treatment form, and a serious illness conversation documented in the medical record were noted in 27%, 4%, and 49% of the medical records, respectively. Half of the documented goals of care discussions were held in the inpatient setting, over 50% were held in the last month of life, and 25% were held in the last week of life. These conversations involved specialist palliative care providers (47%), hematologist/oncologists (41%), hospitalists (32%), head and neck surgeons (21%), radiation oncologists (19%), and intensivists (18%). None of these discussions involved patients’ primary care providers. Of those with a known location of death, 58% died in the hospital and 4 out of 5 of these patients died during attempted cardiopulmonary resuscitation. Conclusions: In this retrospective analysis, serious illness communication was documented in the minority of patients who died of head and neck cancer. These discussions occurred late in the trajectory of illness. The continuity relationships of teams treating head and neck cancer patients (e.g., head and neck surgeon, radiation/oncologist and hematologist/oncologist) situate these clinicians in the best position to enact serious illness conversations. These data suggest that opportunities to have these discussions upstream are often missed.

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Swallowing and Tongue Function Following Treatment for Oral and Oropharyngeal Cancer

Journal of Speech Language and Hearing Research ◽

10.1044/jslhr.4304.1011 ◽

2000 ◽

Vol 43 (4) ◽

pp. 1011-1023 ◽

Cited By ~ 143

Author(s):

Cathy L. Lazarus ◽

Jeri A. Logemann ◽

Barbara Roa Pauloski ◽

Alfred W. Rademaker ◽

Charles R. Larson ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Oropharyngeal Cancer ◽

Control Group ◽

Tongue Strength ◽

Oral Performance ◽

Control Subjects ◽

Oral And Oropharyngeal Cancer ◽

Primary Radiotherapy

This study examined tongue function and its relation to swallowing in 13 subjects with oral or oropharyngeal cancer treated with primary radiotherapy ± chemotherapy and 13 age- and sex-matched control subjects. Measures of swallowing and tongue function were obtained using videofluoroscopy, pretreatment and 2 months posttreatment. Maximum isometric strength and endurance at 50% of maximum strength were obtained with the Iowa Oral Performance Instrument (IOPI). Control subjects were tested once. All subjects with head and neck cancer were evaluated pretreatment and 2 months posttreatment. No significant differences were found for the tongue function measures pre- and 2 months posttreatment in the group with head and neck cancer. Significantly higher tongue strength was observed in the control than in the group with head and neck cancer both pre- and posttreatment. No significant differences were found for the 2 groups for tongue endurance measures. Significant correlations of tongue strength and endurance and some swallow measures were found pre- and posttreatment for the group with head and neck cancer and for the control group. These correlations included oral and pharyngeal temporal swallow measures and oropharyngeal swallow efficiency. Pretreatment differences between the 2 groups in tongue strength were likely related to tumor bulk, pain, and soreness. Two-month posttreatment differences were likely related to radiation ± chemotherapy changes to the oral and pharyngeal mucosa. This study provides support for the hypothesis that tongue strength plays a role in oropharyngeal swallowing, particularly related to the oral phase of the swallow.

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