Factors Affecting the Compliance of Curative Intent Treatment in Patients with Head and Neck Cancer

Abstract Objective: This study aims to investigate the factors that lead to poor compliance in initiating the treatment in patients with newly diagnosed head and neck cancers. Design: Retrospective cohort study Particpants: Data from a total of 271 patients were retrieved and analyzed. After excluding patients with (1) multiple cancers (2) inconclusive diagnoses, (3) rare primary cancer sites, such as the nasal cavity, paranasal sinuses, or salivary glands and (4) primary site unknown, a total of 194 patients were included in this study. Main outcome measures: The variables included in the analysis were age, gender, primary cancer site, T stage, N stage, M stage, overall stage (I-IV), patient’s residential distance, and the impact of COVID-19. Univariate and multivariate analyses were employed to evaluate the significance of these variables in regard to affecting the time to receiving on-time treatment based on the specialist’s suggestion. Results: Upon multivariate analysis, the primary site, stage, and residential distance were significantly associated with initial compliance (P<0.05). The impact of COVID-19 showing a borderline significance (p=0.137). Conclusion: The primary site, overall stage, patient living distance to the healthcare facility, and the impact of COVID-19 might affect the compliance of initiating a curative-intent treatment in patients with newly diagnosed head and neck cancers.

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Diagnosis and treatment delay of head and neck cancers during COVID-19 era in a tertiary care academic hospital: what should we expect?

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-021-06834-1 ◽

2021 ◽

Author(s):

Pietro De Luca ◽

Antonella Bisogno ◽

Vito Colacurcio ◽

Pasquale Marra ◽

Claudia Cassandro ◽

...

Keyword(s):

Retrospective Study ◽

Head And Neck ◽

Retrospective Analysis ◽

Tertiary Care ◽

Diagnostic Delay ◽

Treatment Delay ◽

Head And Neck Cancers ◽

Control Measures ◽

Academic Hospital ◽

The Impact

Abstract Background Since the spreading of SARS-CoV-2 from China, all deferrable medical activities have been suspended, to redirect resources for the management of COVID patients. The goal of this retrospective study was to investigate the impact of COVID-19 on head and neck cancers’ diagnosis in our Academic Hospital. Methods A retrospective analysis of patients treated for head and neck cancers between March 12 and November 1, 2020 was carried out, and we compared these data with the diagnoses of the same periods of the 5 previous years. Results 47 patients were included in this study. We observed a significative reduction in comparison with the same period of the previous 5 years. Conclusions Our findings suggest that the COVID-19 pandemic is associated with a decrease in the number of new H&N cancers diagnoses, and a substantial diagnostic delay can be attributable to COVID-19 control measures.

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Changes in carnitine levels through induction chemotherapy in head and neck cancer patients as a potential cause of therapy-related malaise

BMC Cancer ◽

10.1186/s12885-021-08471-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tatsuya Ito ◽

Kiyoaki Tsukahara ◽

Hiroki Sato ◽

Akira Shimizu ◽

Isaku Okamoto

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Induction Chemotherapy ◽

Neck Cancer ◽

Cancer Site ◽

Primary Cancer ◽

Analog Scale ◽

Before And After ◽

Primary Cancer Site ◽

Total Carnitine

Abstract Background Carnitine is related to malaise, and cisplatin is associated with decreased carnitine. The purpose of this study was to elucidate the effects of one course of induction chemotherapy (IC) for head and neck cancer on blood carnitine levels, focusing on free carnitine (FC). Methods This single-center prospective study investigated 20 patients diagnosed with primary head and neck cancer who underwent IC with cisplatin, docetaxel, and 5-fluorouracil. FC, acylcarnitine (AC), and total carnitine (TC) levels were measured before starting therapy and on Days 7 and 21 after starting IC. In addition, malaise was evaluated before and after therapy using a visual analog scale (VAS). Results All subjects were men and the most common primary cancer site was the hypopharynx (9 patients). FC levels before starting therapy and on Days 7 and 21 were 47.7 ± 2.2 μM/mL, 56.7 ± 2.2 μM/mL, and 41.1 ± 1.9 μM/mL, respectively. Compared with the baseline before starting therapy, FC had significantly decreased on Day 21 (p = 0.007). AC levels before starting therapy and on Days 7 and 21 were 12.5 ± 1.2 μM/mL, 13.6 ± 1.4 μM/mL, and 10.7 ± 0.7 μM/mL, respectively. TC levels before starting therapy and on Days 7 and 21 were 60.2 ± 2.5 μM/mL, 70.2 ± 3.3 μM/mL, and 51.7 ± 2.3 μM/mL, respectively. No significant differences in AC, TC or VAS were seen before the start of therapy and on Day 21. Conclusions After IC, a latent decrease in FC occurred without any absolute deficiency or subjective malaise.

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The impact of routine CT of the chest on the diagnosis and management of newly diagnosed squamous cell carcinoma of the head and neck.

American Journal of Roentgenology ◽

10.2214/ajr.169.3.9275874 ◽

1997 ◽

Vol 169 (3) ◽

pp. 667-671 ◽

Cited By ~ 36

Author(s):

B Reiner ◽

E Siegel ◽

R Sawyer ◽

R M Brocato ◽

M Maroney ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Cell Carcinoma ◽

Head And Neck ◽

Squamous Cell ◽

Newly Diagnosed ◽

Diagnosis And Management ◽

The Impact

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Times to Diagnosis, Staging, and Treatment of Head and Neck Cancer Before and During COVID-19

OTO Open ◽

10.1177/2473974x211059429 ◽

2021 ◽

Vol 5 (4) ◽

pp. 2473974X2110594

Author(s):

Peter Yao ◽

Victoria Cooley ◽

William Kuhel ◽

Andrew Tassler ◽

Victoria Banuchi ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Medical Center ◽

Academic Medical Center ◽

Head And Neck Cancers ◽

Newly Diagnosed ◽

Time To Treatment ◽

Time To Diagnosis ◽

The Times

Objective The coronavirus disease 2019 (COVID-19) pandemic has reduced the demand for, and supply of, head and neck cancer services. This study compares the times to diagnosis, staging, and treatment of head and neck cancers before and during the COVID-19 pandemic. Study Design Retrospective cohort study. Setting Tertiary academic medical center in New York City (NYC). Methods The times to diagnosis, staging, and treatment of head and neck cancer for patients presenting to the clinics of 4 head and neck oncology surgeons with newly diagnosed head and neck cancers were compared between pre–COVID-19 and COVID-19 periods. Results Sixty-eight patients in the pre–COVID-19 period and 26 patients in the COVID-19 period presented with newly diagnosed head and neck cancer. Patients in the COVID-19 group had a significantly longer time to diagnosis than the pre–COVID-19 group after adjustment for age and cancer diagnosis ( P = .02; hazard ratio [HR], 0.54; 95% CI, 0.32-0.92). Patients in the pre–COVID-19 and COVID-19 groups had no statistically significant differences in time to staging ( P > .9; HR, 1.01; 95% CI, 0.58-1.74) or time to treatment ( P = .12; HR, 1.55; 95% CI, 0.89-2.72). Conclusion This study found that time to diagnosis for head and neck cancers was delayed during a COVID-19 period compared to a pre–COVID-19 period. However, there was no evidence of delays in time to staging and time to treatment during the COVID-19 period. Our results prompt further investigations into the factors contributing to diagnostic delays but provide reassurance that despite COVID-19, patients were receiving timely staging and treatment for head and neck cancers.

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The impact of the MR-Linac field length on head and neck cancers patient selection

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2019.11.240 ◽

2020 ◽

Vol 106 (5) ◽

pp. 1156-1157

Author(s):

B. Ng-Cheng-Hin ◽

D. Mcquaid ◽

C.M. Nutting ◽

S. Bhide ◽

K.H. Wong ◽

...

Keyword(s):

Head And Neck ◽

Patient Selection ◽

Head And Neck Cancers ◽

The Impact

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Survival-Associated Metabolic Genes in Human Papillomavirus-Positive Head and Neck Cancers

Cancers ◽

10.3390/cancers12010253 ◽

2020 ◽

Vol 12 (1) ◽

pp. 253 ◽

Cited By ~ 6

Author(s):

Martin A. Prusinkiewicz ◽

Steven F. Gameiro ◽

Farhad Ghasemi ◽

Mackenzie J. Dodge ◽

Peter Y. F. Zeng ◽

...

Keyword(s):

Human Papillomavirus ◽

Head And Neck ◽

Patient Survival ◽

Tricarboxylic Acid Cycle ◽

Predictive Biomarkers ◽

Head And Neck Cancers ◽

The Cancer Genome Atlas ◽

Metabolic Genes ◽

Hpv Status ◽

The Impact

Human papillomavirus (HPV) causes an increasing number of head and neck squamous cell carcinomas (HNSCCs). Altered metabolism contributes to patient prognosis, but the impact of HPV status on HNSCC metabolism remains relatively uncharacterized. We hypothesize that metabolism-related gene expression differences unique to HPV-positive HNSCC influences patient survival. The Cancer Genome Atlas RNA-seq data from primary HNSCC patient samples were categorized as 73 HPV-positive, 442 HPV-negative, and 43 normal-adjacent control tissues. We analyzed 229 metabolic genes and identified numerous differentially expressed genes between HPV-positive and negative HNSCC patients. HPV-positive carcinomas exhibited lower expression levels of genes involved in glycolysis and higher levels of genes involved in the tricarboxylic acid cycle, oxidative phosphorylation, and β-oxidation than the HPV-negative carcinomas. Importantly, reduced expression of the metabolism-related genes SDHC, COX7A1, COX16, COX17, ELOVL6, GOT2, and SLC16A2 were correlated with improved patient survival only in the HPV-positive group. This work suggests that specific transcriptional alterations in metabolic genes may serve as predictive biomarkers of patient outcome and identifies potential targets for novel therapeutic intervention in HPV-positive head and neck cancers.

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