Head And Neck
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2021 ◽  
Vol 26 (Sup10) ◽  
pp. S6-S15
Amanda Pigott ◽  
Bena Brown ◽  
Megan Trevethan ◽  
Sandra Porceddu ◽  
Andrew McCann ◽  

Management of secondary head and neck lymphoedema has undergone little research investigation. Its treatment is time and labour intensive and involves multiple therapeutic modalities without a clear understanding of which is most effective. This study aimed to determine the feasibility of a randomised controlled trial comparing two therapeutic modalities to manage head and neck lymphoedema. The secondary objective was to evaluate the clinical effects of these treatments. Participants were randomised to receive treatment with manual lymphatic drainage or compression over 6 weeks, with the primary outcome—percentage tissue water—measured 12 weeks after treatment. Six participants were recruited until the study was ceased due to restrictions imposed by the COVID-19 pandemic. Some 86% of required attendances were completed. Percentage tissue water increased in all participants at 12 weeks. No consistent trends were identified between internal and external lymphoedema. The small number of people recruited to this study informs its feasibility outcomes but limits any conclusions about clinical implications.

2021 ◽  
Vol 12 ◽  
Xin Fan ◽  
YangShaobo Ou ◽  
Huijie Liu ◽  
Liangzhen Zhan ◽  
Xingrong Zhu ◽  

Background: Due to the lack of accurate guidance of biomarkers, the treatment of head and neck squamous cell carcinoma (HNSCC) has not been ideal. Ferroptosis plays an important role in tumor suppression and treatment of patients. However, tumor protein p53 (TP53) mutation may promote tumor progression through ferroptosis. Therefore, it is particularly important to mine prognostic-related differentially expressed ferroptosis-related genes (PR-DE-FRGs) in HNSCC to construct a prognostic model for accurately guiding clinical treatment.Methods: First, the HNSCC data obtained from The Cancer Genome Atlas (TCGA) was used to identify PR-DE-FRGs for screening candidate genes to construct a prognostic model. We not only used a variety of methods to verify the accuracy of the model for predicting prognosis but also explored the role of ferroptosis in the development of HNSCC from the perspective of the immune microenvironment and mutation. Finally, we explored the correlation between the prognostic model and clinical treatment and drew a high-precision nomogram to predict the prognosis.Results: Seventeen of the 29 PR-DE-FRGs were selected to construct a prognostic model with good predictive performance. Patients in the low-risk group were found to have a greater number of CD8 + T cells, follicular helper T cells, regulatory T cells, mast cells, T-cell costimulations, and type II interferon responses. A higher tumor mutation burden (TMB) was observed in the low-risk group and was associated with a better prognosis. A higher risk score was found in the TP53 mutation group and was associated with a worse prognosis. The risk score is closely related to the expression of immune checkpoint inhibitors (ICIs)-related genes such as PD-L1 and the IC50 of six chemotherapeutic drugs. The nomogram we constructed performs well in predicting prognosis.Conclusion: Ferroptosis may participate in the progression of HNSCC through the immune microenvironment and TP53 mutation. The model we built can be used as an effective predictor of immunotherapy and chemotherapy effects and prognosis of HNSCC patients.

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257735
Seok Woo Hong ◽  
Ki Tae Park ◽  
Yoon-Sok Chung ◽  
Yong Jun Choi ◽  
Jeong-Hyun Kang

The purpose of the present study was to reveal the relationship between degenerative changes in the cervical spine, head and neck postures, neck pain, and bone mineral density (BMD) of the total hip, femoral neck, and lumbar spine in post-menopausal females. In total, 116 females (mean age 60.4 ± 7.1 years; age range 50–80 years) were included. Participants were classified into three groups based on the T-score criteria of the total hip, femoral neck, and lumbar spine set by World Health Organization, respectively. The degree of neck pain was assessed using self-administered questionnaire, the Neck Disability Index. Cervical spine degeneration and head and neck postures were identified using the lateral cephalograms. Grading system for cervical degeneration included three categories of the radiographic alterations including disc height loss, osteophyte formation, and diffuse sclerosis. The areal BMD of the total hip, femoral neck, and lumbar spine were determined using dual-energy x-ray absorptiometry. Females with lower BMD exhibited lesser degree of neck pain and forward head posture (FHP) compared to those with normal BMD. Higher BMD seemed to be associated with more notable loss of the disc height at the level of C4-5. More prominent degenerative changes in the cervical spine were associated with higher areal BMD of the hip, femoral neck, and lumbar spine, altered head posture, and development of neck pain.

2021 ◽  
shanchun hou ◽  
Qi Li ◽  
Wulong Jin ◽  
You Peng ◽  
Sujuan Niu ◽  

Abstract Background: Metformin is the first-line drug for type II diabetes, and recent studies indicate that metformin plays an inhibitory role in multiple cancers. Metformin can also enhance the effect of chemotherapy. Although head and neck squamous cell carcinoma cells are sensitive to metformin, the mechanisms related to the metformin response and the chemosensitization effect have not been fully studied. Results: In this study, we aimed to elucidate the molecular mechanisms of metformin in HNSCC by transcriptome analysis and to reveal the underlying mechanisms of the sensitizing effects of metformin by combined online dataset analysis. mRNA sequencing and functional analysis of HNSCC samples after metformin treatment and functional analysis of mRNAs with opposite metformin-induced effects in chemosensitive versus chemoresistant cells revealed the molecular pathways, mainly the base excision repair pathway, by which this small molecule drug sensitizes HNSCC cells to treatment. Conclusions: These findings indicate that metformin exerts a hypersensitization effect by regulating the BER pathway in tumour cells, reducing their self-repair capacity after chemotherapy-induced DNA damage. In addition, the genes identified by transcriptome analysis are candidates for further investigation into the effector targets of metformin in the inhibition of HNSCC and could be applied to improve the treatment in HNSCC patients who develop resistance after advanced chemotherapy.

2021 ◽  
Renata Camilla Favarin Froes ◽  
Mariana Inri Carvalho² ◽  
Raquel Rosa Rodrigues³ ◽  
Paulo Sérgio dos Santos Silva ◽  
Giédre Berretin-Felix

Abstract Head and neck cancer damages the oral health and chewing performance, impairing the nutritional status and quality of life even after treatment completion. Objective: This study investigated the effect of treatment on the chewing function, the influence on oral health in chewing function and the relationships between chewing, nutritional status and quality of life in individuals after treatment of head and neck cancer. Methods: The study was conducted on twenty individuals who were evaluated by surface electromyography; nutritional status; evaluation of oral health and quality of life. Results: The results of electromyography showed an asymmetric pattern, with predominance of activity on the working side. The correlations evidenced that the greater the use of upper dentures and caries activity, the greater the asymmetry of muscle activity, while the greater need of lower denture led to more chewing cycles. The lower the body fat percentage, the greater the symmetry of muscle activity; and the lower the recruitment of temporalis muscles, the greater the physical limitation. Conclusions: It was concluded that, in individuals after treatment of head and neck cancer, there was relationship between the correlated variables.

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.

2021 ◽  
Haoyue Xu ◽  
Xiangpu Wang ◽  
Zhien Feng ◽  
Renji Chen ◽  
Zhengxue Han

Abstract Background: Currently, no systematic analysis has been conducted to assess the potential of multiple autophagy-related long non-coding RNAs (lncRNA) to predict the prognosis of head and neck squamous cell carcinoma (HNSCC). we investigated the prognostic potential of autophagy-related long non-coding RNAs (lncRNA) in HNSCC patients. Methods: Patient information and Autophagy-associated genes were obtained from The Cancer Genome Atlas (TCGA) and Human Autophagy data resource. Autophagy-related lncRNAs were determined through Lasso and Cox regression analyses. Then, on the basis of autophagy- related lncRNAs, a risk score and a nomogram were constructed for estimation of prognostic outcomes for HNSCC patients. These models were verified internally using the TCGA and. Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) were used for gene functional analyses. Results: Three autophagy-related lncRNAs (AC002401.4, AC245041.2 and TMEM44-AS1) that are associated with HNSCC were identified. Univariate and multivariate Cox regression analyses revealed that the risk score is an independent prognostic indicator (p ≤ 0.001), with its ability to predict prognosis being higher than that of other clinicopathological indicators (AUC=0.732). Concordance index of the nomogram was 0.712, and AUC values for one-year, three-year and five-year survival rates were 0.730, 0.745 and 0.728, respectively. Internal verifications revealed that this nomogram had a good ability to predict prognosis. Functional analysis showed that the genes were mostly enriched in autophagy and tumor-related cascades. Conclusion: The autophagy-related lncRNAs model can predict the prognosis of patients with HNSCC.Trial registration: Prospective, Observational, Real-world Oral Malignant Tumors Study (POROMS), NCT02395367. Registered 23 March 2015, https://clinicaltrials.gov/ct2/show/NCT02395367

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