scholarly journals The Effectiveness and Safety of Metronomic Chemotherapy in Patients with Head and Neck Carcinoma: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Xingli Li ◽  
Jianjian Wang ◽  
Ting Zhang ◽  
Jiabin Wang ◽  
Zhangcai Zheng ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Meta Analysis ◽  
Metronomic Chemotherapy ◽  
Head And Neck Carcinoma ◽  
Randomized Control Trials ◽  
Neck Carcinoma ◽  
Significant Difference ◽  
Randomized Control

Abstract Background: Head and neck carcinoma, usually begins in the squamous cells, not only seriously endangers the quality of life, but brings a heavy financial burden for families and countries. Metronomic chemotherapy, a frequent administration of chemotherapeutic agents at a non-toxic dose, gives an alternative low-cost and tolerated approach for patients. We conducted a systematic review to find the effectiveness and safety of metronomic chemotherapy for head and neck cancer.Methods: We searched seven databases and Clinical.gov from the inception to July 14, 2021. The patients diagnosed head and neck cancer and older than 18 were included. Metronomic chemotherapy was defined as intervention. Randomized and non-randomized trials were all included. Quality assessment of included randomized control trials was performed using the Cochrane Risk-of-Bias criteria, cohort studies using The Newcastle-Ottawa Scale (NOS), single arm trials using the checklist recommended by The Agency for Healthcare Research and Quality (AHRQ). Studies were synthetized using a narrative approach. The indicators used for meta-analysis was hazard ratio (HR).Results: 310 Literatures were potentially eligible from 7 databases, finally 13 records were included. Five studies were of high quality, while eight were of moderate quality. The overall effect of HR for death of five trials reported had no statistically significant (HR=0.89, 95%CI 0.71-1.10). Subgroup analysis by different design showed a statistically significant HR (0.73, 95%CI 0.60-0.90) in randomized control trials while no significant difference in subgroup of prospective study design (HR=1.23, 95%CI 0.72-2.10). As for HR for PFS, there was no significant difference in overall effect of four studies. HR for PFS was 0.84 (95%CI 0.55-1.31). Subgroup analysis of study design showed that randomized control trials produced a significant HR (0.54, 95%CI 0.45-0.64), while prospective studies did not (1.25, 95%CI 0.73, 2.14).Conclusions: Metronomic chemotherapy has been an optimistic option for treatment for advanced head and neck cancer, especially in low income and medical resource-restricted regions.

scholarly journals The Association of Cachexia with Head and Neck Cancer Burden and Pathologic Features

2020 ◽  
Vol 3 ◽  
Author(s):  
Marelle Rukes ◽  
Alexander Jones ◽  
Leah Novinger ◽  
Kyle Davis ◽  
Vincent Campiti ◽  
...  
Keyword(s):  
Weight Loss ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Head And Neck Carcinoma ◽  
Depth Of Invasion ◽  
Skeletal Muscle Index ◽  
Pathologic Features ◽  
Significant Difference ◽  
The Impact

Background and Hypothesis: Head and neck cancer (HNC) is frequently associated with cachexia, characterized by involuntary weight loss, sarcopenia, and malnutrition. In HNC patients, dysphagia and anorexia from obstructive aerodigestive tumors propagates cachexia even further. However, the impact of pathologic features and burden of HNC on cachexia has yet to be investigated. We therefore hypothesize that larger, more aggressive tumors impose greater cachexia severity in HNC patients.     Methods: A single-institution, retrospective study of adult patients undergoing surgical resection of head and neck carcinoma from 2014-2017 was performed. Patients without 30-day preoperative abdominal CT imaging for skeletal muscle index (SMI, cm2/m2) measurements were excluded. Patient demographics, comorbidities, nutrition data, and cancer pathology reports were collected. Cachexia was defined as unintentional weight loss >5% over 6 months or >2% with BMI <20 kg/m2. Statistical analyses were performed using 2-sided one-way Welch’s ANOVA or Pearson’s c2 tests. Significance was determined at p <0.05.      Results: The cohort included 125 predominantly white (92.0%), male (75.2%) HNC patients age 59.9 ± 11.5 years. Sixty-seven (53.6%) patients had cachexia, twenty (16.0%) of whom were severe (weight loss ≥15%). Patients with severe cachexia had larger tumors (5.5 ± 2.1 cm, p=0.021) than patients with mild-to-moderate cachexia (weight loss 5-14.9%; 4.9 ± 2.1 cm) or no cachexia (4.1 ± 1.9 cm). Worsening cachexia severity was also associated with lower SMI (p=0.004), BMI (p=0.002), and serum albumin (p=0.011). There was no statistically significant difference between cachexia groups comparing patient age, comorbidities, tumor grade, depth of invasion, nodal metastases, cancer stage, perineural invasion, lymphovascular invasion, or extranodal extension.     Conclusion and Potential Impact: Tumor burden of HNC patients, but not adverse pathologic features, is associated with greater cachexia severity. Identifying pro-cachectic markers produced by larger tumors could provide a molecular target for anti-cachexia therapies and improve cancer patient outcomes. 

Underreporting of mortality from head and neck carcinoma: our experience at a tertiary head and neck cancer unit

2013 ◽  
Vol 38 (1) ◽  
pp. 103-104
Author(s):  
A. Khanna ◽  
S. Mansuri ◽  
S. Mortimore ◽  
M. De ◽  
R. Elliott ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Head And Neck Carcinoma ◽  
Neck Carcinoma

scholarly journals UNRESECTABLE HEAD AND NECK CARCINOMAS

2007 ◽  
Vol 14 (01) ◽  
pp. 111-119
Author(s):  
AHMAD IJAZ MASUD ◽  
QAISER MAHMOOD ◽  
NASREEN SIDDIQUE
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Early Stage ◽  
Locally Advanced ◽  
Head And Neck Carcinoma ◽  
Ulcer Bleeding ◽  
Early Stage Disease ◽  
Female Ratio ◽  
Neck Carcinoma

Introduction: Cancers of the head and neck are estimated to be the most prevalent cancers in the world. Data from various cancer centers of Pakistan reveal that epithelial head and neck cancer is one of the most frequent cancers varying from 12 to 25% of the total new patients seenannually. Objectives: To see the effect of concomitant chemo-radiotherapy on the survival of patient, to assess the toxicity of different treatment arms and the effect of age, sex and bulk or tumour on survival and compare the literature. Setting: Radiotherapy Department, Nishtar Hospital, Multan. Duration: 2 years. Material and Methods: Sample Size: 200 patients. Results: Out of 130 patients, 83 were males and theremaining 47 were females. The male to female ratio being 1.8:1. The mean age of the patients included in the study was 52 years, range being 22-80 years. The patients of head and neck cancer in the trial had different sites of involvement. In the trial the patients presented with various symptoms such as pain, swelling, ulcer, bleeding, dysphagia, dyspnea, hoarseness of voice and nasal obstruction etc. No patient had early stage disease. All the patients in the trial had the experience of nausea and vomiting, it was more marked in patients having radiotherapy; either alone or in concomitant with chemotherapy. The patients having concomitant chemo-radiotherapy i.e. group-C also had diarrhoea as a side effect. The effect on the liver function test was more pronounced in patients of group-A. The renal function was seen to alter more in patients receiving chemotherapy with cisplatin, whether as induction or as a concomitant to radiotherapy. Conclusion: Concomitant chemo-radiotherapy in locally advanced, unresectable head and neck carcinoma is statistically superior to induction chemotherapy followed by radiotherapy and the standard radiotherapy alone.

Clinical utility of a protein-based oncopanel in patients with end-stage head and neck cancer

Immunotherapy ◽  
2019 ◽  
Vol 11 (14) ◽  
pp. 1193-1203 ◽  
Author(s):  
Johannes Doescher ◽  
Stephanie E Weissinger ◽  
Stefan S Schönsteiner ◽  
Catharina Lisson ◽  
Lars Bullinger ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Clinical Utility ◽  
Head And Neck Carcinoma ◽  
Targeted Next Generation Sequencing ◽  
Neck Carcinoma ◽  
High Prevalence ◽  
Heavily Pretreated ◽  
End Stage

Aim: In a prospective clinical initiative, we selected heavily pretreated head and neck carcinoma patients and assessed the clinical utility of a protein-based oncopanel for identification of potential targetable markers. Patients & methods: Tumor samples of 45 patients were evaluated using a 12-marker immunohistochemistry panel. The primary end point was the prevalence of potentially actionable markers. Results: At least one expressed marker in each case could be identified. We noted a high prevalence of EGFR (80%, 39/45) and MET (57.4%, 28/45). Three patients received oncopanel-based therapy with variable results. Conclusion: Despite the limited number of treated subjects, oncopanel analysis in end-stage head and neck cancer is operationally and technically feasible. Combination with targeted next generation sequencing might provide additional therapy options.

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