scholarly journals TO COMPARE THE TOXICITY PROFILE OF ACCELERATED RADIOTHERAPY (SIX FRACTIONS PER WEEK) WITH CONCOMITANT CHEMO-RADIOTHERAPY IN LOCALLY ADVANCED HEAD AND NECK CANCER

2019 ◽  
Vol 3 (11) ◽  
Author(s):  
Vikrant Kaushal ◽  
Amit Rana ◽  
Manoj Gupta ◽  
Rajeev Seam ◽  
Manish Gupta
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Randomized Study ◽  
Locally Advanced ◽  
Medical Science ◽  
Hematological Toxicity ◽  
P Value ◽  
Significant Difference ◽  
The Difference

Background: Head and neck malignancies are common among males in India. The age adjusted incidence rate of head and neck cancer in India in males is 16.4/100,000 and in females it is 8.8/100,000.In All India Institute of Medical Science head and neck cancer represents 25% of all malignancies registered Methods: This prospective randomized study was conducted in the Department of Radiation Therapy & Oncology, Regional Cancer Centre, IGMC, Shimla and patients were enrolled for a period of one year, from July 2012 to July 2013.It included all the eligible, previously untreated patients of squamous cell carcinoma of Head and Neck with histologically confirmed diagnosis and no evidence of distant metastasis. The sites included were oro-pharynx, hypo-pharynx and larynx with stages III, IV A and IV B. Results: Grade 3 and grade 4 skin toxicities were higher in CRT arm but without statistically significant difference from that in ART arm. G3 & G4 mucositis was higher in the Concomitant CRT arm however the difference was not statistically significant. G2 and G3 Laryngeal Toxicities were higher in Concomitant CRT arm as compared to Accelerated arm but the difference was not statistically significant. G2 & G3 haematological toxicities were significantly (combined p value = 0.002) higher in the concomitant CRT arm (32.4%) as compared to Accelerated RT arm (2.9%). Only one patient in accelerated arm had any hematological toxicity. Conclusion: Higher peak incidence of toxicities was seen in concomitant CRT arm as compared to accelerated arm. Keywords: Toxocity, six fraction, chemoradiation, Local control

Radiochemotherapy in the treatment of locally advanced head and neck cancer: results after five years of a randomized study

1999 ◽  
Vol 35 ◽  
pp. S167
Author(s):  
M. Santarelli ◽  
N. Raffetto ◽  
P. Torcia ◽  
V. De Santis ◽  
V. Donato ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Randomized Study ◽  
Locally Advanced ◽  
Advanced Head

scholarly journals The kinetics of γ-H2AX during radiotherapy of head and neck cancer potentially allow for prediction of severe mucositis

2020 ◽  
Vol 54 (1) ◽  
pp. 96-102
Author(s):  
Joanna Kazmierska ◽  
Wojciech Barczak ◽  
Tomasz Winiecki ◽  
Łukasz Łuczewski ◽  
Magdalena Marciniak ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Peripheral Blood Lymphocytes ◽  
Significant Difference ◽  
Radiation Induced ◽  
The Difference ◽  
Kinetics Of ◽  
Severe Mucositis

AbstractBackgroundThe aim of the study was to evaluate the changes in γ-H2AX expression in peripheral blood lymphocytes (PBL) according to severity of radiation-induced mucositis.Patients and methodFifty patients with head and neck cancer treated with radiotherapy (RT) or chemoradiation were included in the study. Blood samples were collected before treatment to measure baseline γ-H2AX levels. Second sample was taken 45 minutes after the first RT fraction and then once a week, 45 min after irradiation. In patients treated with chemoradiation the blood sample was taken the day after chemotherapy. Mucositis was evaluated once a week and reported according to CTCAE v4 and RTOG/EORTC scales. PBL were analyzed with flow cytometry and level of H2AX phosphorylation at every time point was evaluated.ResultsIn 35 patients mild to moderate (grade 1–2) mucositis was observed and 15 patients developed severe (grade 3) mucositis. No cases of grade 4 mucositis were observed. The difference in baseline levels of γ-H2AX between groups with mild and severe mucositis was statistically insignificant (p = 0.25). The statistically significant difference in γ-H2AX level was observed in week 7 of treatment (p = 0.01). No significant differences in γ-H2AX level were found neither between group treated with concomitant chemoradiation or RT alone neither between groups with and without common comorbidities. In the analysis of the kinetics of γ-H2AX during treatment, a statistically significant difference (p = 0.0088) between groups with mild and severe mucositis was observed. After fourth week of treatment levels of γ-H2AX decreased significantly in the group with severe mucositis and increased in patients with mild side effects. The observed difference was not caused by the decrease in peripheral lymphocyte count, which was similar in both groups.ConclusionsPresented results indicate that severity of radiation-induced mucositis does not correlate directly with γ-H2AX levels measured in vivo in PBL. Prediction of mucositis grade based on γ-H2AX level is not yet possible, either before treatment or early during treatment, but preliminary results, indicating significant differences in γ-H2AX kinetics between groups, encourage further studies.

Second malignancy post-chemoradiation in head and neck cancer patients.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e18525-e18525
Author(s):  
Gunjesh Kumar Singh ◽  
Rohit Swami ◽  
Vijay Maruti Patil ◽  
Vanita Noronha ◽  
Amit Joshi ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Locally Advanced ◽  
Rank Test ◽  
P Value ◽  
Second Malignancy ◽  
Continuous Variables ◽  
Early Stage Disease

e18525 Background: There is limited data available in the literature regarding incidence and treatment of second malignancy post-chemo-radiation (CTRT) in head and neck cancer patients. Hence we planned this analysis to address this lacuna in the current literature. Methods: We have already published a randomized study of 536 head and neck cancer patients, comparing radical CTRT with weekly cisplatin with or without nimotuzumab. The database of this study was used for the current analysis. Data regarding occurrence, site, stage, treatment details and outcomes were extracted from the database. Continuous variables were expressed in terms of the median with range, while non-continuous variables were reported in percentage. Kaplan Meier method was used for estimating the overall survival (OS). Results: Out of 536 patients, 18 (3.35%) patients developed second malignancy. The most common site was head and neck (44.44%) followed by lung (27.77%), prostate, ovary, breast, gallbladder and thyroid. 16/18 (88.88%) patients developed metachronous, while 2/18 (11.11%) had synchronous second malignancy. Most of the patients (55.55%) presented with locally advanced and metastatic disease, while 44.44% of patients had early-stage disease. 8/18 (44.44%) patients received palliative treatment. Of these, 6/18 (33.33%) patients received best supportive care and 2/18 (11.11%) patients were given palliative chemotherapy and palliative radiotherapy. 10/18 (55.55%) patients received radical treatment in the form of radical surgery (22.22%), CTRT (11.11%) and radical radiotherapy (5.55%), while 16.66% patients were kept under observation only. The median OS after the diagnosis of second malignancy was 451 days (95% CI, 301.45-600.59). It was seen that median OS the diagnosis of second malignancy in the aerodigestive and non-aerodigestive system was 446 days (95% CI, 39.10 - 852.89) and 840 days (95% CI, 278.46 - 1401.53), log-rank test P-value = 0.24. Conclusions: Second malignancy is not an uncommon phenomenon in head and neck cancer patients after CTRT and if properly taken care of, the improved outcome can be expected.

Young adults with squamous cell head and neck cancer: Ten years of a single institution’s experience (1999-2008).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 5567-5567
Author(s):  
Marcos Pantarotto Alves ◽  
Ana Filipa Martins Ferreira Castro ◽  
Liliana Lombo ◽  
Helena Rodrigues ◽  
Jose D. Silva ◽  
...  
Keyword(s):  
Young Adults ◽  
Head And Neck Cancer ◽  
Alcohol Consumption ◽  
Head And Neck ◽  
Neck Cancer ◽  
Squamous Cell ◽  
Locally Advanced ◽  
Histopathological Diagnosis ◽  
Significant Difference

5567 Background: Head and neck cancer of squamous cell type (SCHNC) is characterised by its aggressiveness and strong relationship with smoking and drinking habits. It is generally diagnosed in locally advanced stages, mainly in middle-aged men. People younger than 35yo are rarely affected by this disease, and little is known about its behaviour among young Portuguese adults. Our aim was to describe the clinical and epidemiological features of young adults with diagnosis of SCHNC in a single oncological centre in Portugal. Methods: Retrospective cohort including clinical registries’ databases for patients (pts) with diagnosis of SCHNC, with 3391 eligible pts from 1999 to 2008. Pts aged ≧18yo and ≤35yo at diagnosis with histopathological diagnosis in our Institution were included. Pts admitted to radiation therapy with no follow-up information were excluded. 39 pts fulfilled the criteria described, comprising the study population. Statistical analysis was carried out using SPSS v19.0 for Mac (IBM, 2010, EUA), with values of p<0,05 considered significant. Results: Male sex predominance (82%) was observed. The median age of presentation was 33 yo [22; 35], with 90% smokers with a median of 18,5 package-years [1; 48]. Alcohol consumption was mild to moderate (n=9; 23%) or heavy (n=15; 38%). The median of follow-up time was of 24 months [1;151]. Locally advanced diseased was present at diagnosis in 24 pts, where localised disease was commonest among women (57%) than in men (29%). Median overall survival (OS) was not reached on this population, although K-M graphs seems to show a significant difference in survival between sexes. Alcohol consumption was the most significant variable to influence the survival (p<0,01). Conclusions: SCHNC in young people is a rare condition, with distinct epidemiological and clinical features. Women seems to have greater survival rates, which may be explained by other risk factors already reported for this gender, namely HPV infection. The finding of an apparent relationship between alcohol consumption and OS, and the high prevalence of alcoholic intake habits on this parcel of the population, urge the need of development of public health programs addressed to this specific age group.

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