scholarly journals An Updated Review on Head and Neck Cancer Treatment with Radiation Therapy

Cancers ◽  
2021 ◽  
Vol 13 (19) ◽  
pp. 4912
Author(s):  
Garrett Anderson ◽  
Maryam Ebadi ◽  
Kim Vo ◽  
Jennifer Novak ◽  
Ameish Govindarajan ◽  
...  

The complexity of head and neck cancers (HNC) mandates a multidisciplinary approach and radiation therapy (RT) plays a critical role in the optimal management of patients with HNC, either as frontline or adjuvant treatment postoperatively. The advent of both definitive and post-operative RT has significantly improved the outcomes of patients with HNC. Herein, we discuss the role of postoperative RT in different subtypes of HNC, its side effects, and the importance of surveillance. The treatment regions discussed in this paper are the oral cavity, nasopharynx, paranasal sinus cavity, oropharynx, larynx and hypopharynx. Multiple studies that demonstrate the importance of definitive and/or postoperative RT, which led to an improved outlook of survival for HNC patients will be discussed.

2019 ◽  
Vol 128 (5) ◽  
pp. 441-446 ◽  
Author(s):  
Blake S. Raggio ◽  
Ryan D. Winters

Objective: The aim of this study was to summarize the effectiveness of steroids in the prevention of osteoradionecrosis of the head and neck. Data Sources: PubMED, MEDLINE, Embase, Google Scholar, and Cochrane trial registries. Methods: A systematic review of these data sources was performed through September 2018 using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Included were English-language studies evaluating patients of all age groups diagnosed with head and neck cancer who underwent radiation therapy while receiving peritreatment steroids compared with those who did not receive steroids. Results: Two retrospective cohort studies were identified for qualitative review. On the basis of analysis of 25 328 participants (36-82 years of age) with head and neck cancer who underwent radiation therapy, the use of peritreatment steroids was associated with a significantly lower risk for osteoradionecrosis in both studies, with a hazard ratio of 0.74 (95% confidence interval, 0.59-0.94; P = .012) and a relative risk of 0.04 (95% confidence interval, 0.003-0.560; P = .017). Meta-analysis was precluded by clinical and statistical heterogeneity. Overall, the studies were of limited quality with high risk for bias and poor methodology. Conclusions: Limited retrospective data suggest that steroids are predictive of a reduced risk for osteoradionecrosis; however, no definitive conclusions can be made given the poor quality of the available literature. Well-designed, comparison-controlled trials are needed to clarify the promising role of steroids in the prevention of osteoradionecrosis of the head and neck.


2021 ◽  
Vol 11 (7) ◽  
pp. 281-289
Author(s):  
Ujjwala Murkute ◽  
Shaikh Nida Nausheen

Objectives: - To evaluate the effectiveness of informational booklet regarding side effects management in patient undergoing external radiation therapy. Methods: Quasi experimental pre test post test design was used in the study at radiation therapy department in cancer institute. 35 patients of head and neck cancer undergoing external radiation therapy received information booklet regarding side effect management of external radiation therapy in their first week of treatment. Knowledge regarding side effect management of external radiation therapy was assessed one week later. Results: - In pre test there was 51.1% patients with poor knowledge, 48.6% had average knowledge and no one had good knowledge whereas the post test scores are increased by 85.7% with good knowledge, 14.3% had average knowledge and no one had poor knowledge. There is significant difference of knowledge score between pre and post test as P<0.0001 i.e. knowledge score significantly increased after administering information booklet. Sociodemographic variable age, gender, educational status, family income & type of treatment were found to have no association with knowledge score regarding management of side effects. Conclusion: - Radiation therapy is one of the important treatments for cancer but can also cause side effects. These Side effects of radiation therapy are very common and can affect the quality of life of the cancer patients. There was significant impact of information booklet on knowledge regarding side effects management of radiation therapy among head and neck cancer patients. Hence using information booklet as an education material can be helpful in teaching patients self care behaviours, prevent the side effects of radiation therapy and improve the quality of life. Key words: Information booklet, external radiation therapy, head and neck cancer, side effect management.


Author(s):  
Sandhya Yadav ◽  
Deepak Pant ◽  
Atul Samaiya ◽  
Neetu Kalra ◽  
Sanjay Gupta ◽  
...  

Aberrant alternative splicing is recognized to promote cancer pathogenesis, but the underlying mechanism is yet to be clear. Here, in this study, we report the frequent upregulation of SRSF10 (serine and arginine-rich splicing factor 10), a member of an expanded family of SR splicing factors, in the head and neck cancer (HNC) patients sample in comparison to paired normal tissues. We observed that SRSF10 plays a crucial role in HNC tumorigenesis by affecting the pro-death, pro-survical splice variants of BCL2L1 (BCL2 Like 1: BCLx: Apoptosis Regulator) and the two splice variants of PKM (Pyruvate kinase M), PKM1 normal isoform to PKM2 cancer-specific isoform. SRSF10 is a unique splicing factor with a similar domain organization to that of SR proteins but functions differently as it acts as a sequence-specific splicing activator in its phosphorylated form. Although a body of research studied the role of SRSF10 in the splicing process, the regulatory mechanisms underlying SRSF10 upregulation in the tumor are not very clear. In this study, we aim to dissect the pathway that regulates the SRSF10 upregulation in HNC. Our results uncover the role of transcription factor EGR1 (Early Growth Response1) in elevating the SRSF10 expression; EGR1 binds to the promoter of SRSF10 and promotes TET1 binding leading to the CpG demethylation (hydroxymethylation) in the adjacent position of the EGR1 binding motif, which thereby instigate SRSF10 expression in HNC. Interestingly we also observed that the EGR1 level is in the sink with the ERK1/2 pathway, and therefore, inhibition of the ERK1/2 pathway leads to the decreased EGR1 and SRSF10 expression level. Together, this is the first report to the best of our knowledge where we characterize the ERK 1/2-EGR1-SRSF10 axis regulating the cancer-specific splicing, which plays a critical role in HNC and could be a therapeutic target for better management of HNC patients.


At JADPRO Live Virtual 2020, Casey Fazer-Posorske, PA-C, provided updates in the management of patients with head and neck cancer, including the types of head and neck cancers, their associated treatments and side-effect management, the role of de-escalation treatment, and the prevalence of HPV infection and role of vaccination in the prevention of head and neck cancer.


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