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Martins BNFL, Palmier NR, Prado-Ribeiro AC, de Goes MF, Lopes MA, Brandão TB, Rivera C, Migliorati CA, Epstein JB, Santos-Silva AR. Awareness of the risk of radiation-related caries in patients with head and neck cancer: A survey of physicians, dentists, and patients. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 132:398-408. [PMID: 34353769 DOI: 10.1016/j.oooo.2021.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 05/27/2021] [Accepted: 06/13/2021] [Indexed: 12/30/2022]
Abstract
OBJECTIVES Radiation-related caries (RRC) is one of the most aggressive complications of radiotherapy (RT) in survivors of head and neck cancer (HNC). Lack of RRC awareness may contribute to the occurrence of this oral cavity complication. RRC may be considered a "forgotten oral complication" by patients with HNC, oncologists, and dentists. The present study aimed to assess the level of awareness of RRC among physicians, dentists, and patients. STUDY DESIGN Physicians (group 1, G1), dentists (group 2, G2), and patients with HNC undergoing RT (group 3, G3) answered questionnaires concerning their awareness of RRC. Physicians (G1) were divided into group 1A (oncological experience) and group 1B (general physicians/other specialties). Dentists (G2) were divided into group 2A (oncological experience) and group 2B (general dentists/other specialties). Personalized questionnaires were designed for each group. RESULTS Recruitment was as follows: physicians (n = 124): 1A (n = 64), 1B (n = 60); dentists: (n = 280), 2A (n = 160), 2B (n = 120). In addition, 58 patients answered the questionnaire. In terms of RRC awareness, 46.77% of physicians, 81.78% of dentists, and 24.13% of patients had some knowledge of the problem. CONCLUSION Patient awareness of RRC was poor. The heterogeneity of answers among physicians and dentists suggests an opportunity to improve patient education and prevention of this serious oral complication of RT.
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Affiliation(s)
| | - Natália Rangel Palmier
- University of Campinas (UNICAMP), Oral Diagnosis Department, Piracicaba Dental School, Piracicaba, SP, Brazil; Instituto do Câncer do Estado de São Paulo (ICESP-FMUSP), Dental Oncology Service, São Paulo, SP, Brazil.
| | - Ana Carolina Prado-Ribeiro
- University of Campinas (UNICAMP), Oral Diagnosis Department, Piracicaba Dental School, Piracicaba, SP, Brazil; Instituto do Câncer do Estado de São Paulo (ICESP-FMUSP), Dental Oncology Service, São Paulo, SP, Brazil
| | - Mario Fernando de Goes
- University of Campinas (UNICAMP), Oral Rehabilitation Department, Piracicaba Dental School, Piracicaba, SP, Brazil
| | - Marcio Ajudarte Lopes
- University of Campinas (UNICAMP), Oral Diagnosis Department, Piracicaba Dental School, Piracicaba, SP, Brazil
| | - Thais Bianca Brandão
- Instituto do Câncer do Estado de São Paulo (ICESP-FMUSP), Dental Oncology Service, São Paulo, SP, Brazil
| | - Cesar Rivera
- Department of Basic Biomedical Sciences, Universidad de Talca, Talca, Chile
| | | | - Joel B Epstein
- Samuel Oschin Comprehensive Cancer Center, Cedars-Sinai Health System, Los Angeles, CA, USA; City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Alan Roger Santos-Silva
- University of Campinas (UNICAMP), Oral Diagnosis Department, Piracicaba Dental School, Piracicaba, SP, Brazil.
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Nedeljak J, Armijo-Olivo S, Hernandez IA, Nayar S, McNeely ML. A Scoping Review of Physiotherapeutic Interventions for Trismus in Head and Neck Cancer: Where Is the Manual Therapy? Physiother Can 2021. [DOI: 10.3138/ptc-2020-0068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: Trismus, or restricted mouth opening, is a common side effect of treatment for head and neck cancer. This scoping review examined the characteristics, extent, and nature of existing research on manual therapy and jaw-mobilizing devices to prevent and manage trismus related to head and neck cancer. Method: Six electronic databases were searched using the terms trismus, head and neck cancer, and physical therapy and the associated MeSH terms. The review focused on the factors related to intervention delivery: timing, adherence, completion rates, and adverse events. Results: Nine studies were included. Eight examined the use of a jaw-mobilizing device, and one explored the benefit of remote telephone support. Two studies involved cancer survivors at risk of trismus, five involved survivors with trismus, and two included survivors both with and at risk of trismus. No studies were found examining physiotherapist provision of manual therapy. Within-group comparisons supported the benefit of using a jaw-mobilizing device to manage trismus, whereas significant between-groups differences were found only in non-randomized controlled trials. Survivor symptoms and intervention burden were reported reasons for poor adherence and completion rates. Conclusions: No benefit was found for the use of jaw-mobilizing devices for the prevention of trismus. Given the potential of manual therapy to enhance outcomes, physical therapist–led research is warranted.
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Affiliation(s)
- Joni Nedeljak
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Susan Armijo-Olivo
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
- Faculty of Business and Social Sciences, University of Applied Sciences, Osnabruck, Germany
| | | | - Suresh Nayar
- Institute for Reconstructive Sciences in Medicine, Edmonton, Alberta, Canada
| | - Margaret L. McNeely
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada
- Department of Oncology, Cross Cancer Institute, Edmonton, Alberta, Canada
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Tawfik GM, Mostafa EM, Alshareef A, Hmeda AB, Khaled S, Abdelwahed KA, Mahran SA, Agage HS, Amer AE, Emara NS, El-Qushayri AE, Ebied A, Huy NT. Association between radiotherapy and obstructive sleep apnea in head and neck cancer patients: A systematic review and meta-analysis. Auris Nasus Larynx 2021; 48:1126-1134. [PMID: 34112558 DOI: 10.1016/j.anl.2021.04.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 03/31/2021] [Accepted: 04/30/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Our aim was to investigate association between OSA and radiotherapy in head and neck cancer patients. METHODS On 9th of September 2018, we have searched 12 electronic databases to retrieve relevant studies. All eligible studies that assessed association between OSA and radiotherapy in head and neck cancer patients were included in our meta-analysis. Quality assessment of included studies was done using the NIH tools for cohort, cross-sectional and case series studies. RESULTS Fourteen studies met our study selection criteria, and six studies were eligible for our meta-analysis. There was no significant association between occurrence of OSA and radiotherapy in head and neck cancer patients (Odds ratio 1.54, 95% CI [0.66-3.60]; P = 0.322). CONCLUSION These findings point to no significant association between OSA risk and radiotherapy in head and neck cancer patients. We suggest more studies to be conducted to investigate any confounders that may influence the effect of radiotherapy on development of OSA in head and neck cancer patients.
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Affiliation(s)
- Gehad Mohamed Tawfik
- Faculty of Medicine, Ain Shams University, Cairo, Egypt; Online Research Club (http://onlineresearchclub.org), Nagasaki 852-8523, Japan
| | - Esraa Mahmoud Mostafa
- Online Research Club (http://onlineresearchclub.org), Nagasaki 852-8523, Japan; Faculty of Medicine, Port Said University, Port Said, Egypt
| | - Abdulmueti Alshareef
- Online Research Club (http://onlineresearchclub.org), Nagasaki 852-8523, Japan; Faculty of Medicine, University of Zawia, Azzawiyah, Libya
| | - Almotsim Ben Hmeda
- Online Research Club (http://onlineresearchclub.org), Nagasaki 852-8523, Japan; Faculty of Medicine, University of Tripoli, Tripoli, Libya
| | - Samar Khaled
- Online Research Club (http://onlineresearchclub.org), Nagasaki 852-8523, Japan; Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Khloud Amr Abdelwahed
- Online Research Club (http://onlineresearchclub.org), Nagasaki 852-8523, Japan; Faculty of Medicine, Misr University for Science and Technology, 6th of October City, Egypt
| | - Saleh Adel Mahran
- Online Research Club (http://onlineresearchclub.org), Nagasaki 852-8523, Japan; Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Hesham Saeed Agage
- Online Research Club (http://onlineresearchclub.org), Nagasaki 852-8523, Japan; Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Ahmed Esmail Amer
- Faculty of Medicine, Ain Shams University, Cairo, Egypt; Online Research Club (http://onlineresearchclub.org), Nagasaki 852-8523, Japan
| | - Nehad Samy Emara
- Online Research Club (http://onlineresearchclub.org), Nagasaki 852-8523, Japan; Faculty of Pharmacy, Zagazig University, Sharkia, Egypt
| | - Amr Ehab El-Qushayri
- Online Research Club (http://onlineresearchclub.org), Nagasaki 852-8523, Japan; Faculty of Medicine, Minia University, Minia, Egypt
| | - Amr Ebied
- Online Research Club (http://onlineresearchclub.org), Nagasaki 852-8523, Japan; Egyptian National Blood Transfusion Services, Cairo, Egypt
| | - Nguyen Tien Huy
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki 852-8523, Japan.
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Fan WL, Yang LY, Hsieh JCH, Lin TC, Lu MYJ, Liao CT. Prognostic Genetic Biomarkers Based on Oncogenic Signaling Pathways for Outcome Prediction in Patients with Oral Cavity Squamous Cell Carcinoma. Cancers (Basel) 2021; 13:cancers13112709. [PMID: 34070941 PMCID: PMC8199274 DOI: 10.3390/cancers13112709] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/22/2021] [Accepted: 05/25/2021] [Indexed: 01/02/2023] Open
Abstract
Simple Summary A comprehensive analysis based on mutational signatures and oncogenic signaling pathways to identify a specific subgroup of patients that had a significantly negative impact on both disease-free and overall survival in oral cavity squamous cell carcinoma (OCSCC) from whole exome-sequencing data. This analysis has revealed a variety of biologically relevant candidate target genes. Thirty percent of 165 tumors had multiple targetable alterations in multiple pathways. This suggests the complex interplay and crosstalk of oncogenic signaling pathways play an important role on the outcome of patients with OCSCC, and the candidate genes and pathways identified may include prognostic genetic biomarkers or therapeutic targets for OCSCC. Abstract Mutational profiling of patients’ tumors has suggested that the development of oral cavity squamous cell carcinoma (OCSCC) is driven by multiple genes in multiple pathways. This study aimed to examine the association between genomic alterations and clinical outcomes in patients with advanced stages OCSCC to facilitate prognostic stratification. We re-analyzed our previous whole-exome sequencing data from 165 long-term follow-ups of stages III and IV patients with OCSCC. Their frequent mutations were mapped to 10 oncogenic signaling pathways. Clinicopathological risk factors, relapse, and survival were analyzed to identify the genetic factors associated with advanced OCSCC. Frequent genetic alterations included point mutations in TP53, FAT1, NOTCH1, CASP8, CDKN2A, HRAS, PIK3CA, KMT2B (also known as MLL4), and LINC00273; amplified segments in CCND1, EGFR, CTTN, and FGFR1; and lost segments in CDKN2A, ADAM3A, and CFHR1/CFHR4. Comprehensive analysis of genetic alterations revealed that subgroups based on mutational signatures had a significant negative impact on disease-free survival (p = 0.0005) and overall survival (p = 0.0024). Several important signaling pathways were identified to be frequently genetically altered in our cohort. A specific subgroup of patients with alterations in NOTCH, RTK/RAS/MAPK, and TGF-beta pathways that had a significantly negative impact on disease-free survival (p = 0.0009). Thirty percent of samples had multiple targetable mutations in multiple pathways, indicating opportunities for novel therapy.
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Affiliation(s)
- Wen-Lang Fan
- Genomic Medicine Core Laboratory, Linkou Chang Gung Memorial Hospital, Taoyuan 33382, Taiwan; (W.-L.F.); (T.-C.L.)
| | - Lan-Yan Yang
- Clinical Trial Center, Biostatistics and Informatics Unit, Linkou Chang Gung Memorial Hospital, Taoyuan 33382, Taiwan;
| | - Jason Chia-Hsun Hsieh
- Department of Internal Medicine, Division of Hematology-Oncology, New Taipei Municipal TuCheng Hospital, New Taipei City 236043, Taiwan;
- Medical Oncology, Linkou Chang Gung Memorial Hospital, Taoyuan 33382, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 33382, Taiwan
| | - Tsung-Chieh Lin
- Genomic Medicine Core Laboratory, Linkou Chang Gung Memorial Hospital, Taoyuan 33382, Taiwan; (W.-L.F.); (T.-C.L.)
| | - Mei-Yeh Jade Lu
- Biodiversity Research Center, Academia Sinica, Taipei 11529, Taiwan;
| | - Chun-Ta Liao
- Department of Otorhinolaryngology, Head and Neck Surgery, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan 33382, Taiwan
- Correspondence:
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155
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De Felice F, Lei M, Oakley R, Lyons A, Fry A, Jeannon JP, Simo R, Guerrero Urbano T. Risk stratified follow up for head and neck cancer patients - An evidence based proposal. Oral Oncol 2021; 119:105365. [PMID: 34058702 DOI: 10.1016/j.oraloncology.2021.105365] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/11/2021] [Accepted: 05/23/2021] [Indexed: 11/29/2022]
Abstract
Head and neck squamous cell carcinoma (HNSCC) has a significant impact on patients' quality of life and treatment can be associated with severe morbidity. Following completion of treatment, patients are followed up in order to detect potentially salvageable recurrences and to manage long-term toxicities. In recent years, a growing interest has been given to risk stratified follow-up interventions to prevent and detect recurrences and manage treatment toxicities in other tumour sites as well as to transfer some of that care to community services. We review the literature for HNSCC and propose a risk stratified follow up protocol to address these issues and assist clinicians in decision making. A shift in patterns of care is suggested in order to provide a basis to improve care for HNSCC patients after complete response to primary treatment.
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Affiliation(s)
- Francesca De Felice
- Department of Clinical Oncology, Guy's and St Thomas' NHS Trust, London, UK; Department of Radiotherapy, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy
| | - Mary Lei
- Department of Clinical Oncology, Guy's and St Thomas' NHS Trust, London, UK
| | - Richard Oakley
- Department of Head and Neck Surgery Guys and St Thomas' NHS Trust, London, UK
| | - Andrew Lyons
- Department of Head and Neck Surgery Guys and St Thomas' NHS Trust, London, UK
| | - Alastair Fry
- Department of Head and Neck Surgery Guys and St Thomas' NHS Trust, London, UK
| | - Jean-Pierre Jeannon
- Department of Head and Neck Surgery Guys and St Thomas' NHS Trust, London, UK; King's College London, UK
| | - Ricard Simo
- Department of Head and Neck Surgery Guys and St Thomas' NHS Trust, London, UK
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156
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Salz T, Ostroff JS, Nightingale CL, Atkinson TM, Davidson EC, Jinna SR, Kriplani A, Lesser GJ, Lynch KA, Mayer DK, Oeffinger KC, Patil S, Salner AL, Weaver KE. The Head and Neck Survivorship Tool (HN-STAR) Trial (WF-1805CD): A protocol for a cluster-randomized, hybrid effectiveness-implementation, pragmatic trial to improve the follow-up care of head and neck cancer survivors. Contemp Clin Trials 2021; 107:106448. [PMID: 34023515 DOI: 10.1016/j.cct.2021.106448] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/26/2021] [Accepted: 05/17/2021] [Indexed: 11/25/2022]
Abstract
Survivors of head and neck cancer (HNC) can have multiple health concerns. To facilitate their care, we developed and pilot-tested a clinical informatics intervention, HN-STAR. HN-STAR elicits concerns online from HNC survivors prior to a routine oncology clinic visit. HN-STAR then presents tailored evidence-based clinical recommendations as a clinical decision support tool to be used during the visit where the oncology clinician and survivor select symptom management strategies and other actions. This generates a survivorship care plan (SCP). Online elicitation of health concerns occurs 3, 6, and 9 months after the clinic visit, generating an updated SCP each time. HN-STAR encompasses important methods of improving survivorship care (e.g., needs assessment, tailored interventions, dissemination of guidelines) and will be evaluated in a pragmatic trial to maximize external validity. This hybrid type 1 implementation-effectiveness trial tests HN-STAR effectiveness while studying barriers and facilitators to implementation in community oncology practices within the National Cancer Institute Community Oncology Research Program. Effectiveness will be measured as differences in key survivorship outcomes between HNC participants who do and do not use HN-STAR over one year after the clinic visit. The primary endpoint is HNC-specific quality of life; other outcomes include patient-centered measures and receipt of guideline-concordant care. Implementation outcomes will be assessed of survivors, providers, and clinic stakeholders. The hybrid design will provide insight into a dose-response relationship between the extent of implementation fidelity and effectiveness outcomes, as well as how to incorporate HN-STAR into standard practice outside the research setting.
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Affiliation(s)
- Talya Salz
- Memorial Sloan Kettering Cancer Center, 1275 York Street, New York, NY 10065, USA.
| | - Jamie S Ostroff
- Memorial Sloan Kettering Cancer Center, 1275 York Street, New York, NY 10065, USA
| | - Chandylen L Nightingale
- Wake Forest School of Medicine, Department of Social Sciences & Health Policy, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Thomas M Atkinson
- Memorial Sloan Kettering Cancer Center, 1275 York Street, New York, NY 10065, USA
| | - Eleanor C Davidson
- Wake Forest School of Medicine, Department of Social Sciences & Health Policy, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Sankeerth R Jinna
- Memorial Sloan Kettering Cancer Center, 1275 York Street, New York, NY 10065, USA
| | - Anuja Kriplani
- Memorial Sloan Kettering Cancer Center, 1275 York Street, New York, NY 10065, USA
| | - Glenn J Lesser
- Wake Forest School of Medicine, Department of Social Sciences & Health Policy, Medical Center Boulevard, Winston-Salem, NC 27157, USA
| | - Kathleen A Lynch
- Memorial Sloan Kettering Cancer Center, 1275 York Street, New York, NY 10065, USA
| | - Deborah K Mayer
- University of North Carolina Lineberger Comprehensive Cancer Center, 450 West Dr, Chapel Hill, NC 27599, USA
| | - Kevin C Oeffinger
- Duke Cancer Institute, 2424 Erwin Dr, Suite 601, Durham, NC 27705, USA
| | - Sujata Patil
- The Cleveland Clinic Foundation, 9500 Euclid Avenue, CA6-160, Cleveland, OH 44195, USA
| | - Andrew L Salner
- Hartford HealthCare Cancer Institute at Hartford Hospital, 79 Retreat Ave, Hartford, CT 06106, USA
| | - Kathryn E Weaver
- Wake Forest School of Medicine, Department of Social Sciences & Health Policy, Medical Center Boulevard, Winston-Salem, NC 27157, USA
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Eskander A, Sahovaler A, Shin J, Deutsch K, Crowson M, Goyal N, Witsell DL, Schulz K, Gross ND, Weber R, Khariwala SS, Cohen S, CyrLee DW, Mehta V. A preliminary assessment of guideline adherence and clinical variation in oral cancer treatment: a MarketScan database study. BMC Oral Health 2021; 21:270. [PMID: 34001080 PMCID: PMC8130137 DOI: 10.1186/s12903-021-01616-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 05/09/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To assess variations in adherence to guideline-recommended processes of care for oral cavity cancer patients. METHODS Retrospective study using a U.S. healthcare research database (MarketScan). Index diagnoses were considered from 2010 to 2012 with follow-up from 2013 to 2014. Diagnostic and procedure codes were utilized to identify oral cavity patients with a defined treatment modality. Compliance with guideline-recommended processes of care, which included pre-treatment imaging, thyroid-function testing (TFTs), multidisciplinary consultation and gastrostomy-tube insertion rates, were assessed. RESULTS A total of 2752 patients were identified. Surgery alone was the most common treatment (60.8%), followed by surgery with adjuvant chemoradiotherapy (20.4%) and surgery with adjuvant radiotherapy (18.8%). Head/neck and chest imaging were obtained in 60% and 62.5% of patients respectively. Significant geographical differences in head and neck imaging were observed between North-central (64%), South (58.4%) and West (56.1%) regions (p = 0.026). Differences in chest imaging were also present between North-east (65%) and West (56.8%; p = 0.007). TFTs were obtained in 54.4% of the patients after radiation treatment, and 18.6% of patients had multidisciplinary consultation during the 6 months before and 3 months after initiation of treatment. During the year after treatment initiation, 21.2% of patients underwent G-tube placement, with significantly higher rates in patients receiving triple modality treatment (58%) when compared to surgery plus radiation (27%) and surgery alone (15%; p < 0.01). CONCLUSION Adherence to evidence-based practices was low based on the database coding. These data suggest a potential to improve adherence and increase the routine use of practices delineated in national clinical practice guidelines. CLINICAL RELEVANCE This study reflects a suboptimal adherence to guidelines based on the database employed. This study should be considered by healthcare providers and efforts should be maximized to follow the processes of care which have proven to impact on patient's outcomes.
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Affiliation(s)
- Antoine Eskander
- Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Centre and the Odette Cancer Centre, University of Toronto, 2075 Bayview Ave., M1-102, Toronto, ON, M4N 3M5, Canada.
| | - Axel Sahovaler
- Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Centre and the Odette Cancer Centre, University of Toronto, 2075 Bayview Ave., M1-102, Toronto, ON, M4N 3M5, Canada
| | - Jennifer Shin
- Department of Otolaryngology, Harvard Medical School, Boston, MA, USA
| | - Konrado Deutsch
- Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Centre and the Odette Cancer Centre, University of Toronto, 2075 Bayview Ave., M1-102, Toronto, ON, M4N 3M5, Canada
| | - Matthew Crowson
- Department of Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Centre and the Odette Cancer Centre, University of Toronto, 2075 Bayview Ave., M1-102, Toronto, ON, M4N 3M5, Canada
| | - Neerav Goyal
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, The Pennsylvania State University, Hershey, PA, USA
| | - David L Witsell
- Department of Head and Neck Surgery & Communication Sciences, Duke University Medical Center, Durham, NC, USA
| | - Kristine Schulz
- Department of Head and Neck Surgery & Communication Sciences, Duke University Medical Center, Durham, NC, USA
| | - Neil D Gross
- Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, USA
| | - Randal Weber
- Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, USA
| | - Samir S Khariwala
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Seth Cohen
- Department of Head and Neck Surgery & Communication Sciences, Duke University Medical Center, Durham, NC, USA
| | - Derek Walter CyrLee
- Department of Head and Neck Surgery & Communication Sciences, Duke University Medical Center, Durham, NC, USA.,Clinical Research Unit, Duke University, Durham, NC, USA
| | - Vikas Mehta
- Department of Otorhinolaryngology-Head and Neck Surgery, Montefiore Medical Center, Bronx, NY, USA
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158
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Examination of a distress screening intervention for rural cancer survivors reveals low uptake of psychosocial referrals. J Cancer Surviv 2021; 16:582-589. [PMID: 33983534 PMCID: PMC8116196 DOI: 10.1007/s11764-021-01052-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 04/26/2021] [Indexed: 12/14/2022]
Abstract
Purpose To determine the impact of a telemedicine-delivered intervention aimed at identifying unmet needs and cancer-related distress (CRD) following the end of active treatment on supportive care referral patterns. Methods We used a quasi-experimental design to compare supportive care referral patterns between a group of rural cancer survivors receiving the intervention and a control group (N = 60). We evaluated the impact of the intervention on the number and type of referrals offered and whether or not the participant accepted the referral. CRD was measured using a modified version of the National Comprehensive Cancer Network Distress Thermometer and Problem List. Results Overall, 30% of participants received a referral for further post-treatment supportive care. Supporting the benefits of the intervention, the odds of being offered a referral were 13 times higher for those who received the intervention than those in the control group. However, even among the intervention group, only 28.6% of participants who were offered a referral for further psychosocial care accepted. Conclusions A nursing telemedicine visit was successful in identifying areas of high distress and increasing referrals. However, referral uptake was low, particularly for psychosocial support. Distance to care and stigma associated with seeking psychosocial care may be factors. Further study to improve referral uptake is warranted. Implications for Cancer Survivors Screening for CRD may be inadequate for cancer survivors unless patients can be successfully referred to further supportive care. Strategies to improve uptake of psychosocial referrals is of high importance for rural survivors, who are at higher risk of CRD. Supplementary Information The online version contains supplementary material available at 10.1007/s11764-021-01052-4.
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159
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Wang J, Huang X, Sun S, Wang K, Qu Y, Chen X, Wu R, Zhang Y, Liu Q, Zhang J, Luo J, Xiao J, Gao L, Xu G, Hu C, Li YX, Yi J. Stage-dependent conditional survival and failure hazard of non-metastatic nasopharyngeal carcinoma after intensity-modulated radiation therapy: Clinical implications for treatment strategies and surveillance. Cancer Med 2021; 10:3613-3621. [PMID: 33960136 PMCID: PMC8178506 DOI: 10.1002/cam4.3917] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 03/28/2021] [Accepted: 03/29/2021] [Indexed: 01/31/2023] Open
Abstract
Purpose Conditional survival (CS) and failure hazard estimations can provide important dynamic prognostic information for clinical decision‐making and surveillance counseling. The current study aimed to investigate the CS and dynamic failure hazard in non‐metastatic nasopharyngeal carcinoma (NPC) treated with intensity‐modulated radiotherapy (IMRT). Methods Conditional overall survival (COS) and progression‐free survival (CPFS) estimates adjusted for age and gender against each AJCC 8th stage were calculated. Multivariable Cox regression (MCR) models were fitted in the entire population at baseline and subsequently separate MCR models were fitted in patients who have maintained event‐free time of 1 to 10 years to generate respective hazard ratio (HR). Annual hazard rates of death and progression over 10 years for each stage were also estimated. Results A total of 1993 patients were eligible for analysis. The estimated 5‐year OS and PFS for entire cohort were 79.0% and 70.7% at initial diagnosis. After 5 years of event‐free follow‐up, additional 5‐year COS and CPFS increased to 85.9% and 85.5%, respectively. Stage I/II maintained dramatically favorable CS and low hazard (< 5%) of death and progression over time. Relative to stage I/II, stage III manifested non‐significantly higher failure hazard for the first 3 years of survivorship and approached to similar level of stage I/II afterwards. Stage IVA presented most impressive improvement in terms of both COS (∆=9.8%) and CPFS (∆ = 16.8%) whereas still drastically inferior to that of stage I‐III across all conditional time points. After 4 years of follow‐up, progression hazard of stage IVA became relatively steady of approximate 6%. Conclusions Survival prospect of non‐metastatic NPC improves over years with distinct dynamic patterns across stages, providing important implications for personalized decision‐making in terms of both clinical management and surveillance counseling. Stage‐dependent and hazard‐adapted clinical management and surveillance are warranted.
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Affiliation(s)
- Jingbo Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaodong Huang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shiran Sun
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Kai Wang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yuan Qu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xuesong Chen
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Runye Wu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ye Zhang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qingfeng Liu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianghu Zhang
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jingwei Luo
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jianping Xiao
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li Gao
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guozhen Xu
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chen Hu
- Division of Biostatistics and Bioinformatics, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ye-Xiong Li
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Junlin Yi
- Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Chen J, Li Q, Wang F, Yang M, Xie L, Zeng X. Biosafety, Nontoxic Nanoparticles for VL-NIR Photothermal Therapy Against Oral Squamous Cell Carcinoma. ACS OMEGA 2021; 6:11240-11247. [PMID: 34056279 PMCID: PMC8153918 DOI: 10.1021/acsomega.1c00101] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 04/06/2021] [Indexed: 02/08/2023]
Abstract
![]()
Semiconductor nanocrystals
with extraordinary physicochemical and
biosafety properties with unique nanostructures have shown tremendous
potential as photothermal therapy (PTT) nanosensitizers. Herein, we
successfully synthesized chiral molybdenum (Cys-MoO3–x) nanoparticles (NPs) for overcoming the general
limitation on electron energy bands and biotoxicity. The obtained
Cys-MoO3–x NPs are selected as
an ideal design for the treatment of oral squamous cell carcinoma
(OSCC) cells through the decoration of cysteine molecules due to excellent
initial photothermal spectral analysis of conductivity and light absorbance.
Notably, NPs possess the ability to act as visible light (VL) and
near-infrared (NIR) double-reactive agents to ablate cancer cells.
By combining photoconductive PTT with hypotoxicity biochemotherapy,
the treatment validity of OSCC cancer cells can be improved in vitro
by up to 89% (808 nm) and get potential PTT effect under VL irradiation,
which intuitively proved that the nontoxic NPs were lethally effective
for cancer cells under laser irradiation. Hence, this work highlights
a powerful and safe NP platform for NIR light-triggered PTT for use
in head and neck cancer (HNC) cells, showing promising application
prospects in oral tumor treatment.
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Affiliation(s)
- Jinhuan Chen
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, P. R. China
| | - Qionghua Li
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, P. R. China
| | - Fei Wang
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, P. R. China
| | - Ming Yang
- School of Optoelectronic Science and Engineering, University of Electronic Science and Technology of China, Chengdu 610054, P. R. China
| | - Liang Xie
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, P. R. China
| | - Xin Zeng
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Chinese Academy of Medical Sciences Research Unit of Oral Carcinogenesis and Management, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, P. R. China
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161
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Wurcel V, Chirovsky D, Borse R, Altuna JI, Carabajal F, Gandhi J. Cost-Effectiveness of Pembrolizumab Regimens for the First-Line Treatment of Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma in Argentina. Adv Ther 2021; 38:2613-2630. [PMID: 33855690 PMCID: PMC8107151 DOI: 10.1007/s12325-021-01656-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 02/04/2021] [Indexed: 10/26/2022]
Abstract
INTRODUCTION The phase III KEYNOTE-048 trial showed that the programmed death receptor 1 (PD-1) inhibitor pembrolizumab, in the combined positive score (CPS) ≥ 1 population and combined with platinum + 5-fluorouracil in the total population, improves survival over cetuximab + platinum + 5-fluorouracil in recurrent or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC). We evaluated the cost-effectiveness of pembrolizumab as monotherapy in the CPS ≥ 1 population or combined with platinum + 5-fluorouracil in the total population versus cetuximab + platinum + 5-fluorouracil from the social security perspective in Argentina. METHODS A partitioned survival model projected costs and outcomes over 20 years with 3% annual discounting. Health state occupancy was modeled using KEYNOTE-048 Kaplan-Meier curves until the final analysis data cutoff, followed by parametric extrapolations guided by statistical criteria. Costs for initial and subsequent treatments, disease and adverse events management, and terminal care were included (AR $74.00 = 1 USD). Time-on-treatment and EuroQol five-dimension scores were taken from KEYNOTE-048. Utilities were derived using an Argentina-specific algorithm. RESULTS With pembrolizumab monotherapy, patients accrued 1.1040 additional life-years and 0.8768 additional quality-adjusted life-years (QALYs), for incremental cost-effectiveness ratios (ICERs) of AR $135,801/life-year and AR $170,985/QALY gained over cetuximab + platinum + 5-fluorouracil. Additional life-years and QALYs gained with pembrolizumab combination therapy versus cetuximab + platinum + 5-fluorouracil were 1.3296 and 1.0536, respectively (ICERs of AR $680,143/life-year and AR $858,306/QALY). Considering a threshold of AR $1,676,122/QALY gained, pembrolizumab monotherapy and combination therapy had an 88.0% and a 77.1% probability of being cost-effective, respectively. CONCLUSION Pembrolizumab either as monotherapy or in combination with chemotherapy offers substantial survival gains for patients with R/M HNSCC at small additional costs, making it a cost-effective treatment versus cetuximab + platinum + 5-FU in Argentina.
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Gharzai LA, Burger N, Li P, Jaworski EM, Henderson C, Spector M, Rosko A, Chen MM, Prince ME, Bradford CR, Malloy KM, Stucken CL, Swiecicki P, Worden F, Schipper MJ, Schonewolf CA, Shah J, Jagsi R, Chinn S, Shuman A, Casper K, Mierzwa ML. Patient Burden with Current Surveillance Paradigm and Factors Associated with Interest in Altered Surveillance for Early Stage HPV-Related Oropharyngeal Cancer. Oncologist 2021; 26:676-684. [PMID: 33823077 DOI: 10.1002/onco.13784] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 03/26/2021] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Optimal surveillance paradigms for survivors of early stage human papillomavirus (HPV)-related oropharyngeal cancer are not well defined. This study aimed to characterize patient interest in and factors associated with an altered surveillance paradigm. MATERIALS AND METHODS We surveyed patients with Stage I or II HPV-related oropharyngeal cancer treated at a tertiary care institution from 2016 to 2019. Primary outcomes were descriptive assessment of patient knowledge, interest in altered surveillance, burdens of in-person appointments, and priorities for surveillance visits. Ordinal regression was used to identify correlates of interest in altered surveillance. RESULTS Sixty-seven patients completed surveys from February to April 2020 at a median of 21 months since completing definitive treatment. A majority (61%) of patients were interested in a surveillance approach that decreased in-person clinic visits. Patients who self-identified as medical maximizers, had higher worry of cancer recurrence, or were in long-term relationships were less likely to be interested. Patients reported significant burdens associated with surveillance visits, including driving distance, time off work, and nonmedical costs. Patients were most concerned with discussing cancer recurrence (76%), physical quality of life (70%), mortality (61%), and mental quality of life (52%) with their providers at follow-up visits. CONCLUSION Patients with early stage HPV-related oropharyngeal cancers are interested in altered surveillance approaches, experience significant burdens related to surveillance visits, and have concerns that are not well addressed with current surveillance approaches, including physical and mental quality of life. Optimized surveillance approaches should incorporate patient priorities and minimize associated burdens. IMPLICATIONS FOR PRACTICE The number of patients with HPV-related oropharyngeal cancers is increasing, and numerous clinical trials are investigating novel approaches to treating these good-prognosis patients. There has been limited work assessing optimal surveillance paradigms in these patients. Patients experience significant appointment-related burdens and have concerns such as physical and mental quality of life. Additionally, patients with early stage HPV-related oropharyngeal cancers express interest in altered surveillance approaches that decrease in-person clinic visits. Optimization of surveillance paradigms to promote broader survivorship care in clinical practice is needed.
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Affiliation(s)
- Laila A Gharzai
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA.,Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Nicholas Burger
- Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA
| | - Pin Li
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
| | - Elizabeth M Jaworski
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Caitlin Henderson
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Matthew Spector
- Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA
| | - Andy Rosko
- Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA
| | - Michelle M Chen
- Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA
| | - Mark E Prince
- Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA
| | - Carol R Bradford
- Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA
| | - Kelly M Malloy
- Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA
| | - Chaz L Stucken
- Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA
| | - Paul Swiecicki
- Department of Medical Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Francis Worden
- Department of Medical Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Matthew J Schipper
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
| | - Caitlin A Schonewolf
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Jennifer Shah
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA
| | - Reshma Jagsi
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA.,Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Steve Chinn
- Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA
| | - Andrew Shuman
- Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA
| | - Keith Casper
- Department of Otolaryngology, University of Michigan, Ann Arbor, Michigan, USA
| | - Michelle L Mierzwa
- Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA
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163
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Leach CR, Alfano CM, Potts J, Gallicchio L, Yabroff KR, Oeffinger KC, Hahn EE, Shulman LN, Hudson SV. Personalized Cancer Follow-Up Care Pathways: A Delphi Consensus of Research Priorities. J Natl Cancer Inst 2021; 112:1183-1189. [PMID: 32333765 DOI: 10.1093/jnci/djaa053] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 03/26/2020] [Accepted: 04/02/2020] [Indexed: 12/24/2022] Open
Abstract
Development of personalized, stratified follow-up care pathways where care intensity and setting vary with needs could improve cancer survivor outcomes and efficiency of health-care delivery. Advancing such an approach in the United States requires identification and prioritization of the most pressing research and data needed to create and implement personalized care pathway models. Cancer survivorship research and care experts (n = 39) participated in an in-person workshop on this topic in 2018. Using a modified Delphi technique-a structured, validated system for identifying consensus-an expert panel identified critical research questions related to operationalizing personalized, stratified follow-up care pathways for individuals diagnosed with cancer. Consensus for the top priority research questions was achieved iteratively through 3 rounds: item generation, item consolidation, and selection of the final list of priority research questions. From the 28 research questions that were generated, 11 research priority questions were identified. The questions were categorized into 4 priority themes: determining outcome measures for new care pathways, developing and evaluating new care pathways, incentivizing new care pathway delivery, and providing technology and infrastructure to support self-management. Existing data sources to begin answering questions were also identified. Although existing data sources, including cancer registry, electronic medical record, and health insurance claims data, can be enhanced to begin addressing some questions, additional research resources are needed to address these priority questions.
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Affiliation(s)
- Corinne R Leach
- Behavioral and Epidemiology Research Group, American Cancer Society, Inc, Atlanta, GA, USA
| | | | - Jessica Potts
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lisa Gallicchio
- Epidemiology and Genomics Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA
| | - K Robin Yabroff
- Surveillance and Health Services Research, American Cancer Society, Inc, Atlanta, GA, USA; 6Duke Cancer Institute, Duke University, Durham, NC, USA
| | - Kevin C Oeffinger
- Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Erin E Hahn
- Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Lawrence N Shulman
- Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, USA
| | - Shawna V Hudson
- Rutgers Robert Wood Johnson Medical School and Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
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164
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Effectiveness of physical activity interventions in improving objective and patient-reported outcomes in head and neck cancer survivors: A systematic review. Oral Oncol 2021; 117:105253. [PMID: 33901767 DOI: 10.1016/j.oraloncology.2021.105253] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 02/06/2021] [Accepted: 02/24/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To assess the effectiveness of physical activity interventions in improving objective and patient-reported outcomes in HNC survivors. INTRODUCTION Multiple guidelines recommend that head and neck cancer (HNC) survivors participate in regular physical activity. Physical activity is associated with improved outcomes and mortality in healthy individuals as well as in certain cancer populations. However, the effectiveness of physical activity interventions in HNC survivors is inadequately understood. METHODS AND RESULTS Our literature search through December 2018 identified 2,392 articles. After de-duplication, title and abstract review, full-text review and bibliographic search, 20 studies met all inclusion criteria. Inclusion criteria included any full-body physical activity intervention in HNC survivors that did not target discrete organ sites or functions (e.g. swallowing). Study cohorts included 749 predominantly male participants with a mean age range of 48-63 years. At their conclusion, physical activity interventions were associated with at least one significant improvement in an objective or patient-reported outcome in 75% of studies. Aerobic capacity and fatigue were the most commonly improved outcomes. None of the included studies evaluated associations with survival or recurrence. Although traditional aerobic and resistance interventions were more common, a greater proportion of alternative physical activity (yoga and Tai Chi) interventions demonstrated improved objective and patient-reported outcomes. CONCLUSION Physical activity interventions in HNC survivors often conferred some improvement in objective and patient-reported outcomes. Additional highly-powered, randomized controlled studies are needed to establish the optimal type, intensity, and timing of physical activity interventions as well as their impact on oncologic outcomes.
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165
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Wang Z, Goto Y, Allevato MM, Wu VH, Saddawi-Konefka R, Gilardi M, Alvarado D, Yung BS, O'Farrell A, Molinolo AA, Duvvuri U, Grandis JR, Califano JA, Cohen EEW, Gutkind JS. Disruption of the HER3-PI3K-mTOR oncogenic signaling axis and PD-1 blockade as a multimodal precision immunotherapy in head and neck cancer. Nat Commun 2021; 12:2383. [PMID: 33888713 PMCID: PMC8062674 DOI: 10.1038/s41467-021-22619-w] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 03/16/2021] [Indexed: 12/31/2022] Open
Abstract
Immune checkpoint blockade (ICB) therapy has revolutionized head and neck squamous cell carcinoma (HNSCC) treatment, but <20% of patients achieve durable responses. Persistent activation of the PI3K/AKT/mTOR signaling circuitry represents a key oncogenic driver in HNSCC; however, the potential immunosuppressive effects of PI3K/AKT/mTOR inhibitors may limit the benefit of their combination with ICB. Here we employ an unbiased kinome-wide siRNA screen to reveal that HER3, is essential for the proliferation of most HNSCC cells that do not harbor PIK3CA mutations. Indeed, we find that persistent tyrosine phosphorylation of HER3 and PI3K recruitment underlies aberrant PI3K/AKT/mTOR signaling in PIK3CA wild type HNSCCs. Remarkably, antibody-mediated HER3 blockade exerts a potent anti-tumor effect by suppressing HER3-PI3K-AKT-mTOR oncogenic signaling and concomitantly reversing the immune suppressive tumor microenvironment. Ultimately, we show that HER3 inhibition and PD-1 blockade may provide a multimodal precision immunotherapeutic approach for PIK3CA wild type HNSCC, aimed at achieving durable cancer remission.
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Affiliation(s)
- Zhiyong Wang
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - Yusuke Goto
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - Michael M Allevato
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
- Department of Pharmacology, University of California San Diego, La Jolla, CA, USA
| | - Victoria H Wu
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
- Department of Pharmacology, University of California San Diego, La Jolla, CA, USA
| | - Robert Saddawi-Konefka
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA.
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, UC San Diego School of Medicine, San Diego, CA, USA.
| | - Mara Gilardi
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | | | - Bryan S Yung
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
- Department of Pharmacology, University of California San Diego, La Jolla, CA, USA
| | - Aoife O'Farrell
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - Alfredo A Molinolo
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - Umamaheswar Duvvuri
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jennifer R Grandis
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Joseph A Califano
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
- Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, UC San Diego School of Medicine, San Diego, CA, USA
| | - Ezra E W Cohen
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - J Silvio Gutkind
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA.
- Department of Pharmacology, University of California San Diego, La Jolla, CA, USA.
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166
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Pannu JS, Simpson MC, Adjei Boakye E, Massa ST, Cass LM, Challapalli SD, Rohde RL, Osazuwa-Peters N. Survival outcomes for head and neck patients with Medicaid: A health insurance paradox. Head Neck 2021; 43:2136-2147. [PMID: 33780066 DOI: 10.1002/hed.26682] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 01/11/2021] [Accepted: 03/12/2021] [Indexed: 11/05/2022] Open
Abstract
PURPOSE Privately insured patients with head and neck cancer (HNC) typically have better outcomes; however, differential outcome among Medicaid versus the uninsured is unclear. We aimed to describe outcome disparities among HNC patients uninsured versus on Medicaid. METHODS A cohort of 18-64-year-old adults (n = 57 920) with index HNC from the Surveillance, Epidemiology, and End Results 18 database (2007-2015) was analyzed using Fine and Gray multivariable competing risks proportional hazards models for HNC-specific mortality. RESULTS Medicaid (sdHR = 1.65, 95% CI 1.58, 1.72) and uninsured patients (sdHR = 1.55, 95% CI 1.46, 1.65) had significantly greater mortality hazard than non-Medicaid patients. Medicaid patients had increased HNC mortality hazard than those uninsured. CONCLUSION Compared with those uninsured, HNC patients on Medicaid did not have superior survival, suggesting that there may be underlying mechanisms/factors inherent in this patient population that could undermine access to care benefits from being on Medicaid.
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Affiliation(s)
- Jaibir S Pannu
- Saint Louis University School of Medicine, Saint Louis, Missouri, USA
| | - Matthew C Simpson
- Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, USA
| | - Eric Adjei Boakye
- Department of Population Science and Policy, Southern Illinois University School of Medicine, Springfield, Illinois, USA.,Simmons Cancer Center, Southern Illinois University School of Medicine, Springfield, Illinois, USA
| | - Sean T Massa
- Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, USA
| | - Lauren M Cass
- Department of Otolaryngology-Head and Neck Surgery, Saint Louis University School of Medicine, Saint Louis, Missouri, USA
| | - Sai D Challapalli
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, Texas, USA
| | - Rebecca L Rohde
- Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Nosayaba Osazuwa-Peters
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, North Carolina, USA.,Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA.,Duke Cancer Center, Duke University School of Medicine, Durham, North Carolina, USA
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167
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Chan RJ, Agbejule OA, Yates PM, Emery J, Jefford M, Koczwara B, Hart NH, Crichton M, Nekhlyudov L. Outcomes of cancer survivorship education and training for primary care providers: a systematic review. J Cancer Surviv 2021; 16:279-302. [PMID: 33763806 PMCID: PMC7990618 DOI: 10.1007/s11764-021-01018-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 03/05/2021] [Indexed: 12/30/2022]
Abstract
Purpose To identify published literature regarding cancer survivorship education programs for primary care providers (PCPs) and assess their outcomes. Methods PubMed, Embase, and CINAHL databases were searched between January 2005 and September 2020. The Quality of Cancer Survivorship Care Framework and Kirkpatrick’s 4-level evaluation model were used to summarize program content and outcomes, respectively. Data extraction and critical appraisal were conducted by two authors. Results Twenty-one studies were included, describing self-directed online courses (n=4), presentations (n=2), workshops and training sessions (n=6), placement programs (n=3), a live webinar, a fellowship program, a referral program, a survivorship conference, a dual in-person workshop and webinar, and an in-person seminar and online webinar series. Eight studies described the use of a learner framework or theory to guide program development. All 21 programs were generally beneficial to PCP learners (e.g., increased confidence, knowledge, behavior change); however, methodological bias suggests caution in accepting claims. Three studies reported positive outcomes at the patient level (i.e., satisfaction with care) and organizational level (i.e., increased screening referrals, changes to institution practice standards). Conclusions A range of cancer survivorship PCP education programs exist. Evidence for clinical effectiveness was rarely reported. Future educational programs should be tailored to PCPs, utilize an evidence-based survivorship framework, and evaluate patient- and system-level outcomes. Implications for Cancer Survivors PCPs have an important role in addressing the diverse health care needs of cancer survivors. Improving the content, approach, and evaluation of PCP-focused cancer survivorship education programs could have a positive impact on health outcomes among cancer survivors. Supplementary Information The online version contains supplementary material available at 10.1007/s11764-021-01018-6.
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Affiliation(s)
- Raymond J Chan
- Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Brisbane, QLD, Australia. .,School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia. .,Division of Cancer Services, Princess Alexandra Hospital, Brisbane, QLD, Australia.
| | - Oluwaseyifunmi Andi Agbejule
- Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Brisbane, QLD, Australia.,School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Patsy M Yates
- Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Brisbane, QLD, Australia.,School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.,Division of Cancer Services, Princess Alexandra Hospital, Brisbane, QLD, Australia
| | - Jon Emery
- Centre for Cancer Research and Department of General Practice, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Michael Jefford
- Centre for Cancer Research and Department of General Practice, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, VIC, Australia.,Australian Cancer Survivorship Centre, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Bogda Koczwara
- Flinders Center for Innovation in Cancer and Flinders Medical Centre, Flinders University, Adelaide, SA, Australia
| | - Nicolas H Hart
- Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Brisbane, QLD, Australia.,School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.,School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia.,Institute for Health Research, University of Notre Dame Australia, Perth, WA, Australia
| | - Megan Crichton
- Cancer and Palliative Care Outcomes Centre, Queensland University of Technology, Brisbane, QLD, Australia.,School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
| | - Larissa Nekhlyudov
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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168
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Saeidzadeh S, Gilbertson-White S, Cherwin CH, Reisinger HS, Kendell N, Pagedar NA, Seaman AT. Post-treatment head and neck cancer survivors' approaches to self-management: A qualitative study. Eur J Oncol Nurs 2021; 52:101944. [PMID: 33774374 DOI: 10.1016/j.ejon.2021.101944] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 02/08/2021] [Accepted: 03/12/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Post-treatment head and neck cancer (HNC) survivors contend with distinct, long-term challenges related to cancer treatments that impact their day-to-day lives. Alongside follow-up cancer care, they also must be responsible for the daily management of often intrusive physical and psychological symptoms, as well as maintaining their health and a lifestyle to promote their well-being. The purpose of this study was to identify HNC survivors' approaches toward engagement in self-management activities. METHODS Post-treatment HNC survivors (N=22) participated in the study through purposeful sampling. Participants were eligible if they 1) had a history of upper aerodigestive tract cancer; 2) completed their most recent primary treatment (i.e. chemotherapy, radiation, and surgery) more than eighteen months prior and had no evidence of HNC, and 3) could speak in English. A semi-structured interview was used. Data was analyzed using content analysis. RESULTS We identified three approaches that survivors took towards self-management activities: taking charge, living with it, and engaging as needed. Our results showed that taking charge is when survivors take an active role in evaluating their health and taking action subsequently; as needed represents engaging in self-management as necessary; and living with it reflects adapting to the symptoms and side effects without managing them. CONCLUSIONS We propose self-management approaches as a novel mechanism to understand the relationship between survivors' characteristics and health preferences and their self-management. It is important for clinicians to highlight the variation in individuals 'self-management approaches as they work to identify tailored patient-centered strategies that compliment specific patient needs.
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Affiliation(s)
| | | | | | - Heather Schacht Reisinger
- Institute for Clinical and Translational Research, Iowa City, IA, USA; Department of Internal Medicine, College of Medicine, University of Iowa, Iowa City, IA, USA
| | | | - Nitin A Pagedar
- Department of Otolaryngology, College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Aaron T Seaman
- Institute for Clinical and Translational Research, Iowa City, IA, USA; Department of Internal Medicine, College of Medicine, University of Iowa, Iowa City, IA, USA
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Ebersole B, McCarroll L, Ridge JA, Liu JC, Bauman J, Donnelly S, Galloway TJ. Identification and management of late dysfunction in survivors of head and neck cancer: Implementation and outcomes of an interdisciplinary quality of life (IQOL) clinic. Head Neck 2021; 43:2124-2135. [PMID: 33749012 DOI: 10.1002/hed.26681] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 02/27/2021] [Accepted: 03/09/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Identifying and treating late dysfunction in survivors of head and neck cancer (HNC) is important; however, an effective way to do so is not established. METHODS A quality improvement initiative altering our HNC survivorship clinic to include surveillance by rehabilitation providers was undertaken. The nature of dysfunction identified, along with the number and type of referrals to ancillary/support services were collected and compared to baseline. RESULTS The baseline, single-provider, clinic evaluated 61 patients and referred 2 (3%) to ancillary/support services. Fifty-seven patients were evaluated in the interdisciplinary clinic, with 36 (63%) referred to at least one ancillary/support service for new/progressive dysfunction. Of 59 referrals made, 22 (37%) were for dysphagia, 17(29%) were for neck/shoulder dysfunction, and 28 (47%) were attended by the patient. CONCLUSION Many HNC survivors exhibit late dysfunction appropriate for referral to ancillary/support services. A survivorship clinic including surveillance by rehabilitation specialists may optimize identification of dysfunction.
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Affiliation(s)
- Barbara Ebersole
- Department of Otolaryngology-Head & Neck Surgery, Temple University School of Medicine, Philadelphia, Pennsylvania, USA.,Department of Speech Pathology, Fox Chase Cancer Center, Temple Head and Neck Institute, Temple University Health System, Philadelphia, Pennsylvania, USA.,Department of Surgical Oncology, Fox Chase Cancer Center, Temple Head and Neck Institute, Temple University Health System, Philadelphia, Pennsylvania, USA
| | - Liane McCarroll
- Department of Otolaryngology-Head & Neck Surgery, Temple University School of Medicine, Philadelphia, Pennsylvania, USA.,Department of Speech Pathology, Fox Chase Cancer Center, Temple Head and Neck Institute, Temple University Health System, Philadelphia, Pennsylvania, USA.,Department of Surgical Oncology, Fox Chase Cancer Center, Temple Head and Neck Institute, Temple University Health System, Philadelphia, Pennsylvania, USA
| | - John A Ridge
- Department of Otolaryngology-Head & Neck Surgery, Temple University School of Medicine, Philadelphia, Pennsylvania, USA.,Department of Surgical Oncology, Fox Chase Cancer Center, Temple Head and Neck Institute, Temple University Health System, Philadelphia, Pennsylvania, USA
| | - Jeffrey C Liu
- Department of Otolaryngology-Head & Neck Surgery, Temple University School of Medicine, Philadelphia, Pennsylvania, USA.,Department of Surgical Oncology, Fox Chase Cancer Center, Temple Head and Neck Institute, Temple University Health System, Philadelphia, Pennsylvania, USA
| | - Jessica Bauman
- Department of Hematology Oncology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, Pennsylvania, USA
| | - Steven Donnelly
- Department of Surgical Oncology, Fox Chase Cancer Center, Temple Head and Neck Institute, Temple University Health System, Philadelphia, Pennsylvania, USA
| | - Thomas J Galloway
- Department of Radiation Oncology, Fox Chase Cancer Center, Temple University Health System, Philadelphia, Pennsylvania, USA
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170
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Sense of coherence as a mediator between perceived stress and depression in newly diagnosed breast cancer patients: a cross-sectional study. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01496-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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171
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Genetic Drivers of Head and Neck Squamous Cell Carcinoma: Aberrant Splicing Events, Mutational Burden, HPV Infection and Future Targets. Genes (Basel) 2021; 12:genes12030422. [PMID: 33804181 PMCID: PMC7998272 DOI: 10.3390/genes12030422] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/16/2021] [Accepted: 03/11/2021] [Indexed: 12/15/2022] Open
Abstract
Head and neck cancers include cancers that originate from a variety of locations. These include the mouth, nasal cavity, throat, sinuses, and salivary glands. These cancers are the sixth most diagnosed cancers worldwide. Due to the tissues they arise from, they are collectively named head and neck squamous cell carcinomas (HNSCC). The most important risk factors for head and neck cancers are infection with human papillomavirus (HPV), tobacco use and alcohol consumption. The genetic basis behind the development and progression of HNSCC includes aberrant non-coding RNA levels. However, one of the most important differences between healthy tissue and HNSCC tissue is changes in the alternative splicing of genes that play a vital role in processes that can be described as the hallmarks of cancer. These changes in the expression profile of alternately spliced mRNA give rise to various protein isoforms. These protein isoforms, alternate methylation of proteins, and changes in the transcription of non-coding RNAs (ncRNA) can be used as diagnostic or prognostic markers and as targets for the development of new therapeutic agents. This review aims to describe changes in alternative splicing and ncRNA patterns that contribute to the development and progression of HNSCC. It will also review the use of the changes in gene expression as biomarkers or as the basis for the development of new therapies.
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172
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Stout NL, Santa Mina D, Lyons KD, Robb K, Silver JK. A systematic review of rehabilitation and exercise recommendations in oncology guidelines. CA Cancer J Clin 2021; 71:149-175. [PMID: 33107982 PMCID: PMC7988887 DOI: 10.3322/caac.21639] [Citation(s) in RCA: 86] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/06/2020] [Accepted: 08/06/2020] [Indexed: 12/18/2022] Open
Abstract
Guidelines promote high quality cancer care. Rehabilitation recommendations in oncology guidelines have not been characterized and may provide insight to improve integration of rehabilitation into oncology care. This report was developed as a part of the World Health Organization (WHO) Rehabilitation 2030 initiative to identify rehabilitation-specific recommendations in guidelines for oncology care. A systematic review of guidelines was conducted. Only guidelines published in English, for adults with cancer, providing recommendations for rehabilitation referral and assessment or interventions between 2009 and 2019 were included. 13840 articles were identified. After duplicates and applied filters, 4897 articles were screened. 69 guidelines were identified with rehabilitation-specific recommendations. Thirty-seven of the 69 guidelines endorsed referral to rehabilitation services but provided no specific recommendations regarding assessment or interventions. Thirty-two of the 69 guidelines met the full inclusion criteria and were assessed using the AGREE II tool. Twenty-one of these guidelines achieved an AGREE II quality score of ≥ 45 and were fully extracted. Guidelines exclusive to pharmacologic interventions and complementary and alternative interventions were excluded. Findings identify guidelines that recommend rehabilitation services across many cancer types and for various consequences of cancer treatment signifying that rehabilitation is a recognized component of oncology care. However, these findings are at odds with clinical reports of low rehabilitation utilization rates suggesting that guideline recommendations may be overlooked. Considering that functional morbidity negatively affects a majority of cancer survivors, improving guideline concordant rehabilitative care could have substantial impact on function and quality of life among cancer survivors.
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Affiliation(s)
- Nicole L Stout
- Department of Hematology/Oncology Cancer Prevention and Control, West Virginia University Cancer Institute, Morgantown, West Virginia
- Rehabilitation Medicine Department, National Institutes of Health, Bethesda, Maryland
| | - Daniel Santa Mina
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
- Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Kathleen D Lyons
- Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
- Norris Cotton Cancer Center, Geisel School of Medicine, Hanover, New Hampshire
| | - Karen Robb
- North East London Cancer Alliance, London, United Kingdom
- Transforming Cancer Services Team for London, Healthy London Partnership, London, United Kingdom
| | - Julie K Silver
- Department of Physical Medicine & Rehabilitation, Harvard Medical School, Boston, Massachusetts
- Massachusetts General Hospital, Boston, Massachusetts
- Brigham and Women's Hospital, Boston, Massachusetts
- Spaulding Rehabilitation Hospital, Boston, Massachusetts
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173
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Ng JY, Dogadova E. The Presence of Complementary and Alternative Medicine Recommendations in Head and Neck Cancer Guidelines: Systematic Review and Quality Assessment. Curr Oncol Rep 2021; 23:32. [PMID: 33587206 DOI: 10.1007/s11912-021-01024-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE OF REVIEW A high proportion of head and neck cancer (HNC) patients use complementary and alternative medicine (CAM), however, healthcare professionals generally have little knowledge about the safety and efficacy of these therapies. The purpose of this study was to determine the quantity and assess the quality of CAM recommendations across clinical practice guidelines (CPGs) for the treatment and/or management of HNC. RECENT FINDINGS MEDLINE, EMBASE, and CINAHL were systematically searched for HNC CPGs published between 2009 and April 2020; the Guidelines International Network and the National Center for Complementary and Integrative Health websites were also were searched. Eligible CPGs containing CAM recommendations were assessed twice with the Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument, once for the overall CPG and once for the CAM sections. Of 305 unique search results, 7 CPGs mentioned CAM and 4 CPGs made CAM recommendations. The overall CPG scored higher than the CAM section for 4 of 6 domains (overall, CAM): scope and purpose (93.8%, 93.8%), clarity of presentation (88.2%, 64.6%), stakeholder involvement (68.8%, 39.6%), rigor of development (58.3%, 34.6%), editorial independence (42.7%, 42.7%), and applicability (51.6%, 19.8%). Quality varied within and between CPGs. Highly scoring CPGs serve as evidence-based resources that clinicians can use to inform their patients about safe and effective CAM use; CPGs achieving variable or lower scores could be improved in future updates based on currently available guideline development/implementation tools. Future research should identify CAM therapies supported by sufficient evidence to be included as part of HNC CPGs.
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Affiliation(s)
- Jeremy Y Ng
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Michael G. DeGroote Centre for Learning and Discovery, Room 2112, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada.
| | - Ekaterina Dogadova
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Michael G. DeGroote Centre for Learning and Discovery, Room 2112, 1280 Main Street West, Hamilton, ON, L8S 4K1, Canada
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Bai AV, Agostini F, Bernetti A, Mangone M, Fidenzi G, D'Urzo R, Ruggiero M, Murgia M, Santilli V, Paoloni M, Ruoppolo G, Masiero S. State of the evidence about rehabilitation interventions in patients with dysphagia. Eur J Phys Rehabil Med 2021; 57:900-911. [PMID: 33541045 DOI: 10.23736/s1973-9087.21.06716-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Rather than a separate nosological entity, dysphagia must be considered as a symptom of other pathological conditions, which afflicts patients admitted to numerous medical departments (rehabilitation, neurology, geriatrics, internal medicine, etc.) These disorders share the need for timely access to quality care and multidisciplinary treatment, including rehabilitation. The purpose of this study was to conduct a review of the current guidelines' recommendations in the literature and provide recommendations on the rehabilitative management of the patient with dysphagia. EVIDENCE ACQUISITION The search was carried out through the main databases (Medline, PEDro, Cochrane Database and Google Scholar). All the articles concerning rehabilitation management of dysphagia, published in the last 10 years, have been included. EVIDENCE SYNTHESIS Bibliographic research has provided thirteen guidelines. The literature analysed focuses mainly on the screening, the evaluation and the planning of multidisciplinary treatment. The literature agrees in recommending as cornerstones in the treatment of the dysphagic patient dietary changes, rehabilitation training (particularly muscle strengthening exercises and coordination) and early use of alternative nutrition in patients severely compromised. CONCLUSIONS The dysphagic patient requires the deployment of a range of skills by a multiprofessional and multi-disciplinary team. Speech and language pathologists in cooperation with specialists of rehabilitation have the task of managing the various stages, ranging from the early identification of the symptom to the setting of the treatment plan. Due to the lack of standardized protocols, it is necessary to implement the research path, especially regarding rehabilitation intervention.
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Affiliation(s)
- Arianna V Bai
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - Francesco Agostini
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy -
| | - Andrea Bernetti
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - Massimiliano Mangone
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - Gabriele Fidenzi
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - Rossella D'Urzo
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - Marco Ruggiero
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - Massimiliano Murgia
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - Valter Santilli
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - Marco Paoloni
- Department of Anatomical and Histological Sciences, Legal Medicine and Orthopedics, Sapienza University of Rome, Rome, Italy
| | - Giovanni Ruoppolo
- Department of Sensorial Organs, Sapienza University of Rome, Rome, Italy
| | - Stefano Masiero
- Department of Neuroscience, University of Padua, Padua, Italy
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175
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Bhandari S, Soni BW, Ghoshal S. Impact of non-compliance with oral care on radiation caries in head and neck cancer survivors. Support Care Cancer 2021; 29:4783-4790. [PMID: 33527227 DOI: 10.1007/s00520-021-06033-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 01/26/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE A cross-sectional study was performed to quantify radiation caries (RC); explore the possible influence of various covariates like elapsed time since radiotherapy, cancer site and stage, treatment modality(ies), grades of xerostomia (GOX), and inter-incisal mouth opening on RC; and also to estimate the unmet treatment needs in head and neck cancer (HNC) survivors, where personal and professional oral care was neglected before and after completion of the treatment. METHODOLOGY Clinical status of the dentition was recorded using decayed missing filled surface/decayed missing filled teeth (DMFS/DMFT) index. Patients were grouped according to the respective covariates, and relevant statistical analysis was performed considering p value ≤ 0.05 as statistically significant. RESULTS Eighty nine patients, 72 males and 17 females, with a mean age of 52.37±11.19 (range 18-70) years were included in this study. Overall, 85% (76/89) and 78% (29/37), 87.5% (35/40), and 100% (12/12) of patients reporting within 1, 1-3, and 3-5 years after RT, respectively, were affected with RC. The mean DMFS/DMFT score, range, and standard deviation in the included patients up to 5 years post-RT were 61.12/15.99, 0-128/0-28, and 36.608/8.66, respectively. Unmet treatment needs concerning dental decay were 97%. A statistically significant difference was found between the mean DMFS with elapsed time since radiotherapy and different GOX, respectively. CONCLUSION Oral health will be worse, treatment needs will be high, and limitations to performing desirable treatment will be numerous in HNC patients, where the oral care component of their treatment is ignored. Future studies are required to identify the true relationship between various risk factors and the development and progression of RC.
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Affiliation(s)
- Sudhir Bhandari
- Unit of Prosthodontics, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
| | - Bhavita Wadhwa Soni
- Unit of Prosthodontics, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sushmita Ghoshal
- Department of Radiotherapy, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Effects of Exercise in Patients Undergoing Chemotherapy for Head and Neck Cancer: A Pilot Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031291. [PMID: 33535507 PMCID: PMC7908197 DOI: 10.3390/ijerph18031291] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/22/2021] [Accepted: 01/25/2021] [Indexed: 11/17/2022]
Abstract
Background: Cisplatin administration may induce muscle atrophy, thereby reducing the fitness level of patients with head and neck cancer (HNC). To date, only animal studies have been conducted to test the effectiveness of exercise interventions in diminishing side effects of cisplatin. Aim: To determine whether exercise training improves physical fitness and health-related quality of life (HRQoL) in patients receiving chemotherapy for Head & Neck (H&N). Material and methods: This pilot-randomized controlled trial was conducted on 57 participants receiving chemotherapy for HNC. The participants were randomized into an exercise group and a control group. The exercise group received moderate-intensity combined aerobic, resistance and flexibility exercises three times a week for eight weeks during chemotherapy. The control group received no specific information regarding exercise. The outcome measures including body composition, muscle strength, balance, flexibility, cardiovascular fitness and health-related quality of life (HRQoL) were assessed at baseline and eight weeks following baseline. Results: The body composition (body fat percentage, p = 0.002; skeletal muscle percentage, p = 0.008), dynamic balance (p = 0.01), muscle strength (upper extremity, p = 0.037; lower extremity, p = 0.025) and HRQoL (p = 0.001) showed a significant difference between the exercise group and the control group eight weeks following baseline. Significant deteriorations were noted in flexibility, muscle strength, cardiovascular fitness and several domains of HRQoL scale in the control group at eight weeks following baseline. Conclusions: This study found that a combined aerobic, resistance and flexibility exercise program during chemotherapy may improve physical fitness (i.e., muscle strength, balance, flexibility and body composition) and HRQoL and alleviate the deterioration of cardiovascular fitness in patients with HNC. Further research studies with large sample sizes are warranted to investigate the long-term effects of exercise in this population.
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177
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Gaudioso P, Borsetto D, Tirelli G, Tofanelli M, Cragnolini F, Menegaldo A, Fabbris C, Molteni G, Marchioni D, Nicolai P, Bossi P, Ciorba A, Pelucchi S, Bianchini C, Mauramati S, Benazzo M, Giacomarra V, Di Carlo R, Sethi M, Polesel J, Fussey J, Boscolo-Rizzo P. Advanced lung cancer inflammation index and its prognostic value in HPV-negative head and neck squamous cell carcinoma: a multicentre study. Support Care Cancer 2021; 29:4683-4691. [PMID: 33515105 PMCID: PMC8236476 DOI: 10.1007/s00520-020-05979-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 12/29/2020] [Indexed: 12/13/2022]
Abstract
Purpose The aim of this study is to evaluate the prognostic value of pre-treatment advanced lung cancer inflammation index (ALI) in patients with HPV-negative HNSCC undergoing up-front surgical treatment. Methods The present multi-centre, retrospective study was performed in a consecutive cohort of patients who underwent upfront surgery with or without adjuvant (chemo)-radiotherapy for head and neck squamous cell carcinoma (HNSCC). Patients were stratified by ALI, and survival outcomes were compared between groups. In addition, the prognostic value of ALI was compared with two other indices, the prognostic nutritional index (PNI) and systemic inflammatory index (SIM). Results Two hundred twenty-three patients met the inclusion criteria (151 male and 72 female). Overall and progression-free survival were significantly predicted by ALI < 20.4 (HR 3.23, CI 1.51–6.90 for PFS and HR 3.41, CI 1.47–7.91 for OS). Similarly, PNI < 40.5 (HR = 2.43, 95% CI: 1.31–4.51 for PFS and HR = 2.40, 95% CI: 1.19–4.82 for OS) and SIM > 2.5 (HR = 2.51, 95% CI: 1.23–5.10 for PFS and HR = 2.60, 95% CI: 1.19–5.67 for OS) were found to be significant predictors. Among the three indices, ALI < 20.4 identified the patients with the worst 5-year outcomes. Moreover, patients with a combination of low PNI and low ALI resulted to be a better predictor of progression (HR = 5.26, 95% CI: 2.01–13.73) and death (HR = 5.68, 95% CI: 1.92–16.79) than low ALI and low PNI considered alone. Conclusions Our results support the use of pre-treatment ALI, an easily measurable inflammatory/nutritional index, in daily clinical practice to improve prognostic stratification in surgically treated HPV-negative HNSCC.
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Affiliation(s)
- Piergiorgio Gaudioso
- Department of Neurosciences, Section of Otolaryngology, University of Padova, Treviso, Italy
| | - Daniele Borsetto
- Department of ENT, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Giancarlo Tirelli
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - Margherita Tofanelli
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - Fiordaliso Cragnolini
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - Anna Menegaldo
- Department of Neurosciences, Section of Otolaryngology, University of Padova, Treviso, Italy
| | - Cristoforo Fabbris
- Section of Ear Nose and Throat (ENT), Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - Gabriele Molteni
- Section of Ear Nose and Throat (ENT), Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - Daniele Marchioni
- Section of Ear Nose and Throat (ENT), Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - Piero Nicolai
- Department of Otorhinolaryngology-Head Neck Surgery, University of Brescia, Brescia, Italy
| | - Paolo Bossi
- Medical Oncology Unit, Department of Medical Oncology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Andrea Ciorba
- ENT Department, University Hospital of Ferrara, Ferrara, Italy
| | | | | | - Simone Mauramati
- Department of Otorhinolaryngology, University of Pavia, IRCCS Policlinico "San Matteo" Foundation, Pavia, Italy
| | - Marco Benazzo
- Department of Otorhinolaryngology, University of Pavia, IRCCS Policlinico "San Matteo" Foundation, Pavia, Italy
| | - Vittorio Giacomarra
- Unit of Otolaryngology, Azienda Ospedaliera "S. Maria degli Angeli", Pordenone, Italy
| | - Roberto Di Carlo
- Department of Neurosciences, Section of Otolaryngology, University of Padova, Padova, Italy
| | - Mantegh Sethi
- Department of Otolaryngology, Leeds University Hospital, Leeds, UK
| | - Jerry Polesel
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Jonathan Fussey
- Department of ENT/Head and Neck Surgery, Queen Elizabeth University Hospital Birmingham, Birmingham, UK
| | - Paolo Boscolo-Rizzo
- Department of Neurosciences, Section of Otolaryngology, University of Padova, Treviso, Italy. .,Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy.
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Differences in perceived intra-oral dryness in various dry-mouth patients as determined using the Regional Oral Dryness Inventory. Clin Oral Investig 2021; 25:4031-4043. [PMID: 33496869 PMCID: PMC8137633 DOI: 10.1007/s00784-020-03734-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 12/04/2020] [Indexed: 01/20/2023]
Abstract
Objectives Recently, it was shown that the Regional Oral Dryness Inventory (RODI) could determine differences in dry-mouth perception at different intra-oral locations. The main aim of this study was to determine whether the RODI might help to discriminate between various causes of oral dryness in dry-mouth patients. The second aim was to ascertain whether the RODI could become an additional diagnostic tool in dry-mouth patients. Materials and methods Data were collected retrospectively from patients who visited a specialized saliva clinic. Salivary flow rates, Xerostomia Inventory scores, and RODI scores were extracted from the medical records. Patients were stratified into subgroups according to their health status. Results Five hundred twenty-eight patients participated in this study (mean age of 59.6 ± 16.0 years; 68.4% female). Specific patient groups differed with regard to the region of the mouth they experienced as the most and least dry. The posterior palate was the area perceived as most dry by controls and Sjögren patients. In patients using limited or multiple medications, it was the anterior tongue. RODI scores also differed significantly among dry-mouth patient groups: whereas controls and patients using limited medication had the lowest RODI scores and experienced less intra-oral dryness, Sjögren patients had the highest RODI scores. Conclusion Our use of the RODI questionnaire showed that perceived intra-oral dryness differed between the various dry-mouth patients. Clinical relevance The RODI can be a valuable clinical diagnostic tool in dry-mouth diagnostics, in which it can be used to discriminate between the various causes of oral dryness in patients.
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Hammermüller C, Hinz A, Dietz A, Wichmann G, Pirlich M, Berger T, Zimmermann K, Neumuth T, Mehnert-Theuerkauf A, Wiegand S, Zebralla V. Depression, anxiety, fatigue, and quality of life in a large sample of patients suffering from head and neck cancer in comparison with the general population. BMC Cancer 2021; 21:94. [PMID: 33482771 PMCID: PMC7825198 DOI: 10.1186/s12885-020-07773-6] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 12/26/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Treatment of head and neck cancer (HNC) often leads to visible and severe functional impairments. In addition, patients often suffer from a variety of psychosocial problems, significantly associated with a decreased quality of life. We aimed to compare depression, anxiety, fatigue and quality of life (QoL) between HNC patients and a large sample of the general population in Germany and to examine the impact of sociodemographic, behavioral and clinical factors on these symptoms. METHODS We assessed data of HNC patients during the aftercare consultation at the Leipzig University Medical Center with a patient reported outcome (PRO) tool named "OncoFunction". Depression, anxiety, fatigue and QoL were assessed using validated outcome measures including the PHQ-9, the GAD-2, and the EORTC QLQ-C30 questionnaire. RESULTS A total of 817 HNC patients were included in our study and compared to a sample of 5018 individuals of the general German population. HNC patients showed significantly higher levels of impairment in all dimensions assessed. Examination of association between depression, anxiety, fatigue and QoL and clinical as well as sociodemographic variables showed significant relationships between occupational status, ECOG-state, body mass index and time since diagnosis. CONCLUSIONS HNC patients suffer significantly from psychological distress. The used questionnaires are suitable for the use in daily routine practice and can be helpful to increase the detection of depression, anxiety and fatigue and therefore can improve HNC aftercare.
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Affiliation(s)
- C Hammermüller
- Clinic of Otolaryngology, Head and Neck Surgery, University of Leipzig, Leipzig, Germany
| | - A Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - A Dietz
- Clinic of Otolaryngology, Head and Neck Surgery, University of Leipzig, Leipzig, Germany
| | - G Wichmann
- Clinic of Otolaryngology, Head and Neck Surgery, University of Leipzig, Leipzig, Germany
| | - M Pirlich
- Clinic of Otolaryngology, Head and Neck Surgery, University of Leipzig, Leipzig, Germany
| | - T Berger
- Clinic of Otolaryngology, Head and Neck Surgery, University of Leipzig, Leipzig, Germany
| | - K Zimmermann
- Clinic of Otolaryngology, Head and Neck Surgery, University of Leipzig, Leipzig, Germany
| | - T Neumuth
- Innovation Center Computer Assisted Surgery (ICCAS), University of Leipzig, Leipzig, Germany
| | - A Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - S Wiegand
- Clinic of Otolaryngology, Head and Neck Surgery, University of Leipzig, Leipzig, Germany
| | - V Zebralla
- Clinic of Otolaryngology, Head and Neck Surgery, University of Leipzig, Leipzig, Germany.
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Yao CMKL, Fu S, Tam S, Kiong KL, Guo T, Zhao H, Giordano SH, Sturgis EM, Lewis CM. Impact of provider type and number of providers on surveillance testing among survivors of head and neck cancers. Cancer 2021; 127:1699-1711. [PMID: 33471396 DOI: 10.1002/cncr.33402] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 11/10/2020] [Accepted: 11/30/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Guidelines for follow-up after head and neck cancer (HNC) treatment recommend frequent clinical examinations and surveillance testing. Here, the authors describe real-world follow-up care for HNC survivors and variations in surveillance testing. METHODS Using Surveillance, Epidemiology, and End Results (SEER)-Medicare data, this study examined a population-based cohort of HNC survivors between 2001 and 2011 Usage of cross-sectional head and neck imaging (CHNI), chest imaging (CI), positron emission tomography (PET), fiberoptic nasopharyngolaryngoscopy (FNPL), and, in irradiated patients, thyroid function testing (TFT) was captured over 2 consecutive surveillance years. Multivariate modeling with logistic regression analyses was used to assess variations by clinical factors, nonclinical factors, number and types of providers seen and their evolution over time. RESULTS Among 13,836 HNC survivors, the majority saw a medical, radiation, or surgical oncologist and a primary care provider (PCP; 81.7%) in their first year of surveillance. However, only 58.1% underwent either PET or CHNI, 47.8% underwent CHNI, 64.1% underwent CI, 32.5% underwent PET scans, 55.0% underwent FNPL, and 55.9% underwent TFT. In multivariate analyses, patients who followed up with more providers and those who followed up with both a PCP and an oncologist were more likely to undergo surveillance testing (P < .007). However, adjusting for providers seen did not explain the variations in surveillance testing rates based on age, race, education, income level, and place of residence. Over time, there was a gradual increase in the use of PET scans and TFT during surveillance years. CONCLUSIONS In this large SEER-Medicare data study, only half of HNC survivors received the recommended testing, and greater compliance was seen in those who followed up with both an oncologist and a PCP. More attention is needed to minimize variations in surveillance testing across sociodemographic groups.
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Affiliation(s)
- Christopher M K L Yao
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Shuangshuang Fu
- Department of Health Services Research, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Samantha Tam
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Kimberley L Kiong
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Theresa Guo
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Hui Zhao
- Department of Health Services Research, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sharon H Giordano
- Department of Health Services Research, Division of Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Erich M Sturgis
- Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas
| | - Carol M Lewis
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
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Saeidzadeh S, Gilbertson-White S, Babaieasl F, DeBerg J, Seaman AT. An Integrative Review of Self-Management Interventions for Treatment Sequelae in Adult Survivors. Oncol Nurs Forum 2021; 48:94-111. [PMID: 33337439 DOI: 10.1188/21.onf.94-111] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PROBLEM IDENTIFICATION Self-management interventions support cancer survivors in addressing the consequences of treatment. With post-treatment survivors living longer, it is critical to know how research responds to their changing needs. LITERATURE SEARCH A comprehensive search of the CINAHL®, PsycINFO®, and PubMed® databases was performed. Articles were included if the self-management intervention was conducted on cancer-free adult survivors after completing primary treatment. DATA EVALUATION Each study was evaluated using the Critical Appraisal Skills Programme checklist. SYNTHESIS 38 articles were included. The majority of the interventions were designed for short-term survivors, with limited interventions found to support the self-management of long-term cancer survivors. When implementing self-management support, there is a need to use theoretical frameworks that can respond to the changing needs of cancer survivors over time. IMPLICATIONS FOR PRACTICE Future research should provide support for long-term survivors. Oncology nurses can use the results of this review to identify gaps in the self-management education provided to cancer survivors.
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Hu S, Huang B, Pu Y, Xia C, Zhang Q, Guo S, Wang Y, Huang X. A thermally activated delayed fluorescence photosensitizer for photodynamic therapy of oral squamous cell carcinoma under low laser intensity. J Mater Chem B 2021; 9:5645-5655. [PMID: 34190310 DOI: 10.1039/d1tb00719j] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
In this report, a new thermally activated delayed fluorescence (TADF) molecule [2-(4-triphenylvinyl-phenyl)-anthraquinone (TPE-AQ)] was synthesized. This nanomaterial has satisfactory photostability. Through In vitro analysis, it was found that these TADF nanoparticles (NPs) targeted lysosomes in oral cancer cells. ROS were released under irradiation with a 450-nm laser, and the growth of xenograft tumors in mouse models was inhibited in vivo. More interestingly, radiation exposure caused little damage to normal tissues due to the low irradiation intensity (mA) used in the photodynamic therapy (PDT) treatment of oral cancer. Therefore, these TADF NPs provide new possibilities for the development of new PDT drugs for biomedical applications. In future work, possible functional modifications of TADF NPs for increased potency in clinical applications will be addressed.
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Affiliation(s)
- Shiqi Hu
- Department of Oral Pathology, Nanjing Stomatology Hospital, Medical School of Nanjing University, Nanjing, China.
| | - Bin Huang
- College of Life Sciences and Chemistry, Jiangsu Key Laboratory of Biofunctional Molecule, Jiangsu Second Normal University, Nanjing, China
| | - Yumei Pu
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatology Hospital, Medical School of Nanjing University, Nanjing, China.
| | - Chengwan Xia
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatology Hospital, Medical School of Nanjing University, Nanjing, China.
| | - Qian Zhang
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatology Hospital, Medical School of Nanjing University, Nanjing, China.
| | - Sulong Guo
- College of Life Sciences and Chemistry, Jiangsu Key Laboratory of Biofunctional Molecule, Jiangsu Second Normal University, Nanjing, China
| | - Yuxin Wang
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatology Hospital, Medical School of Nanjing University, Nanjing, China.
| | - Xiaofeng Huang
- Department of Oral Pathology, Nanjing Stomatology Hospital, Medical School of Nanjing University, Nanjing, China.
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Chee S, Byrnes YM, Chorath KT, Rajasekaran K, Deng J. Interventions for Trismus in Head and Neck Cancer Patients: A Systematic Review of Randomized Controlled Trials. Integr Cancer Ther 2021; 20:15347354211006474. [PMID: 34014116 PMCID: PMC8145608 DOI: 10.1177/15347354211006474] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 02/19/2021] [Accepted: 03/11/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Current treatment for head and neck cancers (HNCs) have led to an improved survival. However, the sequelae of cancer treatment often result in trismus, or reduced mouth opening. The purpose of this report is to identify interventional studies for trismus management in HNC patients. METHODS A search of PubMed, Embase, Cumulated Index to Nursing and Allied Health Literature, and the Cochrane Library was conducted in March 2020 for randomized controlled trials (RCTs) involving interventions for trismus for head and neck cancer within 10 years. Intervention could involve the use of an exercise regime, jaw rehabilitation device, technological device, medication or massage therapy. The primary outcome was the measurement of mouth opening. RESULTS Eleven RCTs involving a total of 685 patients with HNC were included. Six RCTs evaluated the effectiveness of a jaw mobilization device with exercises; there was no significant benefit of an exercise regime with a jaw mobilization device either initiated before, during or after treatment compared to no exercise. Two RCTs compared 2 intervention groups that involved exercises only, with 1 study assessing the benefit of weekly supervised physical therapy with gum chewing and another evaluating the benefit of immediate (1-2 days) versus delayed (7-10 days) initiation of exercise post-surgery; there was no significant difference between groups in either study. One RCT that recruited only patients with trismus demonstrated that an exercise regime in combination with low-level laser therapy or low-intensity ultrasound had superior results in mouth opening measurements compared to exercise alone. Two RCTs compared intervention groups with and without follow-up reminders; both studies showed a significant improvement in mouth opening measurements in groups with follow-up reminders. CONCLUSION This systematic review did not convey a clear consensus as to optimal intervention for trismus in HNC patients. A variety of exercise regimens and jaw rehabilitation devices appear to have comparable effectiveness. However, efforts focused on increasing adherence to a particular intervention protocol may positively impact mouth opening measures in head and neck cancer patients. Also, low-level laser therapy and low-intensity ultrasound coupled with exercise may be beneficial for patients with trismus.
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Affiliation(s)
- Shuzhen Chee
- University of Pennsylvania,
Philadelphia, PA, USA
| | | | | | | | - Jie Deng
- University of Pennsylvania,
Philadelphia, PA, USA
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HNC0014, a Multi-Targeted Small-Molecule, Inhibits Head and Neck Squamous Cell Carcinoma by Suppressing c-Met/STAT3/CD44/PD-L1 Oncoimmune Signature and Eliciting Antitumor Immune Responses. Cancers (Basel) 2020; 12:cancers12123759. [PMID: 33327484 PMCID: PMC7764918 DOI: 10.3390/cancers12123759] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/10/2020] [Accepted: 12/11/2020] [Indexed: 12/12/2022] Open
Abstract
Simple Summary Cancer stem cells (CSCs) in head and neck squamous cell carcinoma (HNSCC) possess unlimited self-renewal capacity, resist treatments and induce tumor repopulation after interventions. Here, we observed HNSCC CSCs secreted exosomes containing c-Met, STAT3 (also the phosphorylated form of c-Met and STAT3), CD44, and PD-L1 oncogenic signaling molecules. CSC-derived exosomes, in part, transform fibroblasts (NFs) into cancer-associated fibroblasts (CAFs), establish drug resistance, and an immune-evasive tumor microenvironment (TME). We demonstrated HNC0014, a novel small-molecule drug, suppresses HNSCC tumorigenesis, CSC generation and prevents CAF transformation by decreasing the aforementioned oncogenic signaling molecules’ expression in both HNSCC cells and CSC-derived exosomes. Abstract Despite advancements in diagnostic and standard treatment modalities, including surgery, radiotherapy, and chemotherapy, overall survival rates of advanced-stage head and neck squamous cell carcinoma (HNSCC) patients have remained stagnant for over three decades. Failure of these treatment modalities, coupled with post-therapy complications, underscores the need for alternative interventions and an in-depth understanding of the complex signaling networks involved in developing treatment resistance. Using bioinformatics tools, we identified an increased expression of c-Met, STAT3, and CD44 corresponding to a poor prognosis and malignant phenotype of HNSCC. Subsequently, we showed that tumorsphere-derived exosomes promoted cisplatin (CDDP) resistance and colony and tumorsphere formation in parental HNSCC cells, accompanied by an increased level of oncogenic/immune evasive markers, namely, c-Met, STAT3, CD44, and PD-L1. We then evaluated the therapeutic potential of a new small molecule, HNC0014. The molecular docking analysis suggested strong interactions between HNC0014 and oncogenic molecules; c-Met, STAT3, CD44, and PD-L1. Subsequently, we demonstrated that HNC0014 treatment suppressed HNSCC tumorigenic and expression of stemness markers; HNC0014 also reduced cancer-associated fibroblast (CAF) transformation by Exosp- and CAF-induced tumorigenic properties. HNC0014 treatment alone suppressed tumor growth in a cisplatin-resistant (SAS tumorspheres) mouse xenograft model and with higher inhibitory efficacy when combined with CDDP. More importantly, HNC0014 treatment significantly delayed tumor growth in a syngeneic mouse HNSCC model, elicited an antitumor immune profile, and reduced the total c-Met, STAT3, and their phosphorylated forms, PD-L1 and CD44, contents in serum exosomes. Collectively, our findings provide supports for HNC0014 as a multi-targeted immunotherapeutic lead compound for further development.
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185
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Geramita EM, Parker IR, Brufsky JW, Diergaarde B, van Londen GJ. Primary Care Providers' Knowledge, Attitudes, Beliefs, and Practices Regarding Their Preparedness to Provide Cancer Survivorship Care. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2020; 35:1219-1226. [PMID: 31388974 PMCID: PMC8266289 DOI: 10.1007/s13187-019-01585-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Recent cancer care delivery models and clinical practice guidelines have expanded the role of primary care providers (PCPs) in routine follow-up of cancer survivors. We conducted a cross-sectional survey of PCPs affiliated with a large healthcare system to (1) examine practices, attitudes, and beliefs regarding preparedness to provide survivorship care and (2) explore predictors of confidence managing cancer survivors. We distributed a self-administered online survey to 1069 clinical affiliates providing primary care services within the University of Pittsburgh Medical Center system. Associations between PCPs' professional characteristics and attitudes and preparedness were evaluated. Multiple logistic regression explored predictors of confidence monitoring common cancer treatment-related symptoms. One hundred twenty-seven eligible PCPs responded. The sample was split between academic and community practice (48.0% vs. 52.0%, respectively), predominantly comprised of physicians (81.8%), and 64.6% had > 15 years direct patient care experience. The majority agreed that PCPs play a valuable role in surveillance and adverse event monitoring in survivors, though less than 25% felt their professional training prepared them to perform each of these domains. Physicians were significantly more likely than advanced practice providers to be among the 65% of PCPs who were confident monitoring ≥ 1 symptom in each of the 5 evaluated symptom clusters (OR 3.6, 95% CI 1.2-10.8). PCPs appear willing to assume an enhanced role in cancer survivorship care but feel unprepared to do so. Enhanced training and dissemination of clinical practice guidelines are needed to facilitate effective implementation of PCP-delivered survivorship care.
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Affiliation(s)
- Emily M Geramita
- Division of General Internal Medicine, Magee Womens' Hospital, University of Pittsburgh Medical Center, 300 Halket Street, Room 3526, Pittsburgh, PA, USA.
| | | | - Jill W Brufsky
- Division of Hematology/Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Brenda Diergaarde
- Graduate School of Public Health, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA
| | - G J van Londen
- Division of Hematology/Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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186
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Graboyes EM, Maurer S, Park Y, Marsh CH, McElligott JT, Day TA, Hornig JD, Sterba KR. Evaluation of a novel telemedicine-based intervention to manage body image disturbance in head and neck cancer survivors. Psychooncology 2020; 29:1988-1994. [PMID: 32350999 PMCID: PMC7606304 DOI: 10.1002/pon.5399] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 04/06/2020] [Accepted: 04/20/2020] [Indexed: 01/10/2023]
Abstract
OBJECTIVES The study aimed to evaluate the feasibility, acceptability, and preliminary clinical impact of BRIGHT (Building a Renewed ImaGe after Head & neck cancer Treatment), a novel telemedicine-based cognitive-behavioral intervention to manage body image disturbance (BID) in head and neck cancer (HNC) survivors. METHODS Head and neck cancer survivors with BID were enrolled into a single-arm pilot trial. Participants completed study measures at baseline, 1- and 3-months post-BRIGHT to assess its acceptability and clinical impact. Participants completed semi-structured interviews to evaluate the feasibility and acceptability of BRIGHT and refine the intervention. RESULTS Ten HNC survivors with BID were enrolled into the trial of tablet-based BRIGHT. BRIGHT was feasible, as judged by low dropout (n = 1), high session completion rates (100%; 45/45) and low rates of technical issues with the tablet-based delivery (11% minor; 0% major). Ninety percent of participants were highly likely to recommend BRIGHT, reflecting its acceptability. BRIGHT was associated with a 34.5% reduction in mean Body Image Scale scores at 1-month post-BRIGHT (mean difference from baseline = 4.56; 95% CI 1.55, 7.56), an effect that was durable at 3-months post-BRIGHT (mean decrease from baseline = 3.56; 95% CI 1.15-5.96). Program evaluation revealed high levels of satisfaction with BRIGHT, particularly the delivery platform. During the qualitative evaluation, participants highlighted that BRIGHT improved image-related coping behavior. CONCLUSIONS BRIGHT is feasible, acceptable to HNC survivors, and has significant potential as a novel approach to manage BID in HNC survivors. Additional research is necessary to refine BRIGHT and evaluate its clinical efficacy and scalability.
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Affiliation(s)
- Evan M. Graboyes
- Department of Otolaryngology – Head & Neck Surgery, Medical University of South Carolina (MUSC), Charleston, SC
- Hollings Cancer Center, MUSC
| | - Stacey Maurer
- Hollings Cancer Center, MUSC
- Department of Psychiatry and Behavioral Sciences, MUSC
| | - Yeonhee Park
- Hollings Cancer Center, MUSC
- Department of Public Health Sciences, MUSC
| | - Courtney H. Marsh
- Department of Otolaryngology – Head & Neck Surgery, Medical University of South Carolina (MUSC), Charleston, SC
| | | | - Terry A. Day
- Department of Otolaryngology – Head & Neck Surgery, Medical University of South Carolina (MUSC), Charleston, SC
| | - Joshua D. Hornig
- Department of Otolaryngology – Head & Neck Surgery, Medical University of South Carolina (MUSC), Charleston, SC
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Zebralla V, Müller J, Wald T, Boehm A, Wichmann G, Berger T, Birnbaum K, Heuermann K, Oeltze-Jafra S, Neumuth T, Singer S, Büttner M, Dietz A, Wiegand S. Obtaining Patient-Reported Outcomes Electronically With "OncoFunction" in Head and Neck Cancer Patients During Aftercare. Front Oncol 2020; 10:549915. [PMID: 33324544 PMCID: PMC7724103 DOI: 10.3389/fonc.2020.549915] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 10/19/2020] [Indexed: 11/14/2022] Open
Abstract
The disease and treatment of patients with head and neck cancer can lead to multiple late and long-term sequelae. Especially pain, psychosocial problems, and voice issues can have a high impact on patients' health-related quality of life. The aim was to show the feasibility of implementing an electronic Patient-Reported Outcome Measure (PROM) in patients with head and neck cancer (HNC). Driven by our department's intention to assess Patient-Reported Outcomes (PRO) based on the International Classification of Functioning during tumor aftercare, the program "OncoFunction" has been implemented and continuously refined in everyday practice. The new version of "OncoFunction" was evaluated by 20 head and neck surgeons and radiation oncologists in an interview. From 7/2013 until 7/2017, 846 patients completed the PROM during 2,833 of 3,610 total visits (78.5%). The latest software version implemented newly developed add-ins and increased the already high approval ratings in the evaluation as the number of errors and the time required decreased (6 vs. 0 errors, 1.35 vs. 0.95 min; p<0.01). Notably, patients had different requests using PRO in homecare use. An additional examination shows that only 59% of HNC patients use the world wide web. Using OncoFunction for online-recording and interpretation of PROM improved data acquisition in daily HNC patients' follow-up. An accessory timeline grants access to former consultations and their visualization supported and simplified structured examinations. This provides an easy-to-use representation of the patient's functional outcome supporting comprehensive aftercare, considering all aspects of the patient's life.
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Affiliation(s)
- Veit Zebralla
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre, Leipzig, Germany
| | - Juliane Müller
- Innovation Center Computer Assisted Surgery, University of Leipzig, Leipzig, Germany
| | - Theresa Wald
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre, Leipzig, Germany
| | - Andreas Boehm
- Department of Otorhinolaryngology, Clinic St. Georg Leipzig, Leipzig, Germany
| | - Gunnar Wichmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre, Leipzig, Germany
| | - Thomas Berger
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre, Leipzig, Germany
| | - Klemens Birnbaum
- Fraunhofer-Institute for Photonic Microsystems, Dresden, Germany
| | - Katharina Heuermann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre, Leipzig, Germany
| | - Steffen Oeltze-Jafra
- Innovation Center Computer Assisted Surgery, University of Leipzig, Leipzig, Germany
| | - Thomas Neumuth
- Innovation Center Computer Assisted Surgery, University of Leipzig, Leipzig, Germany
| | - Susanne Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz, Mainz, Germany
| | - Matthias Büttner
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center Mainz, Mainz, Germany
| | - Andreas Dietz
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre, Leipzig, Germany
| | - Susanne Wiegand
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Centre, Leipzig, Germany
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Xu B, Mei J, Ji W, Bian Z, Jiao J, Sun J, Shao J. LncRNA SNHG3, a potential oncogene in human cancers. Cancer Cell Int 2020; 20:536. [PMID: 33292213 PMCID: PMC7640707 DOI: 10.1186/s12935-020-01608-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 10/15/2020] [Indexed: 02/06/2023] Open
Abstract
Long noncoding RNAs (lncRNAs) are composed of > 200 nucleotides; they lack the ability to encode proteins but play important roles in a variety of human tumors. A large number of studies have shown that dysregulated expression of lncRNAs is related to tumor oncogenesis and progression. Emerging evidence shows that SNHG3 is a novel oncogenic lncRNA that is abnormally expressed in various tumors, including osteosarcoma, liver cancer, lung cancer, etc. SNHG3 primarily competes as a competitive endogenous RNA (ceRNA) that targets tumor suppressor microRNAs (miRNAs) and ceRNA mechanisms that regulate biological processes of tumors. In addition, abnormal expression of SNHG3 is significantly correlated with patient clinical features. Upregulation of SNHG3 contributes to biological functions, including tumor cell proliferation, migration, invasion and EMT. Therefore, SNHG3 may represent a potential diagnostic and prognostic biomarker, as well as a novel therapeutic target.
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Affiliation(s)
- Bin Xu
- Department of Neurosurgery, Wuxi People's Hospital Affiliated to Nanjing Medical University, No. 299 Qing Yang Road, Wuxi, 214023, Jiangsu, China
| | - Jie Mei
- Department of Oncology, Wuxi People's Hospital Affiliated to Nanjing Medical University, Wuxi, P. R. China
| | - Wei Ji
- Department of Neurosurgery, Wuxi People's Hospital Affiliated to Nanjing Medical University, No. 299 Qing Yang Road, Wuxi, 214023, Jiangsu, China
| | - Zheng Bian
- Department of Neurosurgery, Wuxi People's Hospital Affiliated to Nanjing Medical University, No. 299 Qing Yang Road, Wuxi, 214023, Jiangsu, China
| | - Jiantong Jiao
- Department of Neurosurgery, Wuxi People's Hospital Affiliated to Nanjing Medical University, No. 299 Qing Yang Road, Wuxi, 214023, Jiangsu, China
| | - Jun Sun
- Department of Neurosurgery, Wuxi People's Hospital Affiliated to Nanjing Medical University, No. 299 Qing Yang Road, Wuxi, 214023, Jiangsu, China.
| | - Junfei Shao
- Department of Neurosurgery, Wuxi People's Hospital Affiliated to Nanjing Medical University, No. 299 Qing Yang Road, Wuxi, 214023, Jiangsu, China.
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Pagedar NA, Seaman AT. Rebuilding survivorship care during Covid-19. Ann Otol Rhinol Laryngol 2020; 130:545-546. [PMID: 33084352 DOI: 10.1177/0003489420966588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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190
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Nilsen ML, Belsky MA, Scheff N, Johnson JT, Zandberg DP, Skinner H, Ferris R. Late and Long-Term Treatment-Related Effects and Survivorship for Head and Neck Cancer Patients. Curr Treat Options Oncol 2020; 21:92. [DOI: 10.1007/s11864-020-00797-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/29/2020] [Indexed: 12/26/2022]
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Palmier NR, Leme AFP, De Rossi T, Telles GP, Morais-Faria K, Kowalski LP, Marta GN, Brandão TB, Arany PR, Migliorati CA, Santos-Silva AR, Prado-Ribeiro AC. Salivary alpha-1-antitrypsin and macrophage migration inhibitory factor may be potential prognostic biomarkers for oncologic treatment-induced severe oral mucositis. Support Care Cancer 2020; 29:2939-2946. [PMID: 33009579 DOI: 10.1007/s00520-020-05805-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 09/28/2020] [Indexed: 11/30/2022]
Abstract
AIMS Evaluate the abundance of the selected targets, alpha-1-antitrypsin (A1AT) and macrophage migration inhibitory factor (MIF), and correlate these findings with the risk of developing severe oral mucositis (OM). MATERIALS AND METHODS Head and neck squamous cell carcinoma (HNSCC) patients submitted to radiotherapy (RT) or chemoradiotherapy (CRT) were assessed. OM grade and pain were evaluated daily during treatment. Two protein targets, A1AT and MIF, were evaluated, using selected reaction monitoring-mass spectrometry (SRM-MS), in whole saliva, collected prior to oncologic treatment. The results obtained from the targeted proteomic analysis were correlated with OM clinical outcomes. RESULTS A total of 27 patients were included, of whom 21 (77.8%) had locally advanced disease (clinical stage III or IV). Most patients (70.4%) received CRT. OM grades 2 (40.8%) and 3 (33.3%) were the most prevalent during RT with a mean highest reported OM-related pain of 3.22 through the visual analogue scale (VAS). The abundance of A1AT and MIF correlated significantly with severe (grades 3 or 4, p < 0.02) compared with moderate-low (grades 1 or 2, p < 0.04) OM grade. CONCLUSIONS There is a correlation between the abundance of salivary A1AT and MIF and oncologic treatment-induced OM. The correlation of MIF expression with severe OM appears to be compatible with its physiological pro-inflammatory role. These results open up great possibilities for the use of salivary MIF and A1AT levels as prognostic markers for effective therapeutic interventions, such as photobiomodulation therapy, patient-controlled analgesia, or personalized medicaments.
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Affiliation(s)
| | | | - Tatiane De Rossi
- Brazilian Biosciences National Laboratory, LNBio, CNPEM, Campinas, Brazil
| | | | - Karina Morais-Faria
- Dental Oncology Service, Instituto do Câncer do Estado de São Paulo, ICESP-FMUSP, São Paulo, Brazil
| | - Luiz Paulo Kowalski
- Central Institute, Hospital das Clínicas of the University of São Paulo Medical School (FMUSP), São Paulo, Brazil
| | - Gustavo Nader Marta
- Department of Radiation Oncology, Hospital Sírio-Libanês, Sao Paulo, Brazil.,Department of Radiology and Oncology, Division of Radiation Oncology, Instituto do Câncer do Estado de São Paulo, ICESP-FMUSP, Sao Paulo, Brazil
| | - Thaís Bianca Brandão
- Dental Oncology Service, Instituto do Câncer do Estado de São Paulo, ICESP-FMUSP, São Paulo, Brazil.,Oral Medicine Department, Hospital Sírio-Libanês, Sao Paulo, Brazil
| | - Praveen R Arany
- Oral Biology and Biomedical Engineering, University at Buffalo, Buffalo, NY, USA
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192
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Jeans C, Ward EC, Brown B, Vertigan AE, Pigott AE, Nixon JL, Wratten C, Boggess M. Association between external and internal lymphedema and chronic dysphagia following head and neck cancer treatment. Head Neck 2020; 43:255-267. [PMID: 33001529 DOI: 10.1002/hed.26484] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 06/26/2020] [Accepted: 09/21/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND To examine the relationship between chronic external and internal head and neck lymphedema (HNL) and swallowing function in patients following head and neck cancer (HNC) treatment. METHODS Seventy-nine participants, 1-3 years post treatment were assessed for external HNL using the MD Anderson Cancer Centre Lymphedema Rating Scale, and internal HNL using Patterson's Radiotherapy Edema Rating Scale. Swallowing was assessed via instrumental, clinical and patient-reported outcome measures. RESULTS HNL presented as internal only (68%), combined external/internal (29%), and external only (1%). Laryngeal penetration/aspiration was confirmed in 20%. Stepwise multivariable regression models, that accounted for primary site, revealed that a higher severity of external HNL and internal HNL was associated with more severe penetration/aspiration (P < .004 and P = .006, respectively), diet modification (P < .001 both), and poorer patient-reported outcomes (P = .037 and P = .014, respectively). CONCLUSION Increased swallowing issues can be expected in patients presenting with more severe external HNL and/or internal HNL following HNC treatment.
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Affiliation(s)
- Claire Jeans
- Division of Speech Pathology, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia.,Speech Pathology Department, Calvary Mater Newcastle, Waratah, New South Wales, Australia
| | - Elizabeth C Ward
- Division of Speech Pathology, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia.,Centre for Functioning and Health Research, Metro South Health Services District, Queensland Health, Buranda, Queensland, Australia
| | - Bena Brown
- Division of Speech Pathology, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia.,Centre for Functioning and Health Research, Metro South Health Services District, Queensland Health, Buranda, Queensland, Australia.,Speech Pathology Department, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Anne E Vertigan
- Speech Pathology Department, John Hunter Hospital and Belmont Hospital, New Lambton Heights, New South Wales, Australia.,School of Medicine and Public Health, The University of Newcastle, Callaghan, New South Wales, Australia.,Centre for Asthma and Respiratory Disease, Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Amanda E Pigott
- Centre for Functioning and Health Research, Metro South Health Services District, Queensland Health, Buranda, Queensland, Australia.,Division of Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia.,Occupational Therapy Department, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Jodie L Nixon
- Division of Occupational Therapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia.,Occupational Therapy Department, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
| | - Chris Wratten
- Radiation Oncology Department, Calvary Mater Newcastle, Waratah, New South Wales, Australia
| | - May Boggess
- School of Mathematical and Statistical Sciences, Arizona State University, Tempe, Arizona, USA
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193
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Pathological and Virological Studies of p16-Positive Oropharyngeal Carcinoma with a Good Response to Neoadjuvant Chemotherapy. Microorganisms 2020; 8:microorganisms8101497. [PMID: 33003369 PMCID: PMC7600755 DOI: 10.3390/microorganisms8101497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/25/2020] [Accepted: 09/27/2020] [Indexed: 11/17/2022] Open
Abstract
Human papillomavirus (HPV)-related, p16-positive oropharyngeal carcinoma is considered to be sensitive to anticancer drugs, and the standard treatment is therefore chemoradiotherapy, rather than surgery, especially for aggressive disease. However, with this higher sensitivity, chemotherapy alone may achieve a pathological complete response (CR), making radiation therapy unnecessary. A 46-year-old man with p16-positive squamous cell carcinoma (SCC) of the lateral oropharynx (palatine tonsil) underwent neoadjuvant chemotherapy. This achieved clinically significant tumor shrinkage and therefore surgery was performed for subsequent definitive treatment. Clinical and CT findings indicated a good effect of neoadjuvant chemotherapy on the tumor. A biopsy prior to chemotherapy revealed SCC, which demonstrated p16 immunoreactivity and positive signals for high-risk HPV by RNA in situ hybridization. The post-chemotherapy surgical specimen showed pathological CR and no p16 positive cells nor positive signals for high-risk HPV those were detected in the pre-chemotherapy specimen. There are some reports of chemotherapy alone achieving pathological CR in cases of p16-positive oropharyngeal carcinoma, but none have included high-risk HPV RNA findings. This is the first report of the disappearance of cancer cells as well as p16 staining and a positive signal for high-risk HPV. Achieving pathological CR confirmed by immunohistochemistry and high-risk HPV RNA in situ hybridization in a solid tumor with chemotherapy alone suggests that chemotherapy may have both an antitumor effect and an antiviral effect. Forgoing subsequent radiotherapy and undergoing surgery might be unnecessary and follow-up instead might be sufficient in such cases. Into the future, in an optimal tailored treatment approach, the option of neoadjuvant chemotherapy should be considered for management of p16-positive oropharyngeal carcinoma. Other options such as tumor immunotherapy are also expected to be effective.
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194
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Manthri S, Geraci SA, Chakraborty K. Overview of Cancer Survivorship Care for Primary Care Providers. Cureus 2020; 12:e10210. [PMID: 33033685 PMCID: PMC7532880 DOI: 10.7759/cureus.10210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 09/02/2020] [Indexed: 11/08/2022] Open
Abstract
Survivorship care for a patient with cancer is often complex and requires a multidisciplinary approach. Cancer and its treatment can have late and long-term physical and psychosocial effects. After the acute and intense period of treatment and surveillance administered by oncology teams, cancer survivors slowly transition care to primary providers. Cancer survivors then enter into an extended phase of survivorship whether they are cancer-free, in remission, or living with cancer. In this phase, symptoms related to cancer and its treatment may vary over time. Developing a care plan can facilitate the transition of care between all providers taking care of cancer patients.
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Affiliation(s)
- Sukesh Manthri
- Oncology, East Tennessee State University, Johnson City, USA
| | - Stephen A Geraci
- Internal Medicine and Medical Education, East Tennessee State University, Johnson City, USA
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195
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Jung K, Narwal M, Min SY, Keam B, Kang H. Squamous cell carcinoma of head and neck: what internists should know. Korean J Intern Med 2020; 35:1031-1044. [PMID: 32663913 PMCID: PMC7487309 DOI: 10.3904/kjim.2020.078] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 05/14/2020] [Indexed: 12/17/2022] Open
Abstract
Squamous cell carcinoma of head and neck (SCCHN) is a group of cancer arising from mucosal surfaces of the head and neck. Optimal management of SCCHN requires a multidisciplinary team of surgical oncologists, radiation oncologists, medical oncologists, nutritionist, and speech-language pathologists, due to the complexity of anatomical structure and importance of functional outcome. Human papilloma virus (HPV)-related SCCHN represents a distinct subset from HPV negative SCCHN which is associated with carcinogen exposure such as cigarette smoking, betel nut use and alcohol. HPV related SCCHN responds better to concurrent chemoradiation and has better overall prognosis, compared to HPV negative SCCHN. Radiation therapy has been introduced to the treatment of SCCHN, administered concurrently with systemic chemotherapy for locoregional SCCHN, as well as a palliative measure for recurrent and/or metastatic (R/M) SCCHN. Recently, immune checkpoint inhibitors have been shown to improve overall survival in R/M-SCCHN and have been incorporated into the standard of care. Combination approaches with immune therapy and targeted therapy for biomarker enriched population based on genomics are being actively investigated and will shape the future of SCCHN treatment.
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Affiliation(s)
- Kyungsuk Jung
- Department of Medicine, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Manpreet Narwal
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Seon Young Min
- Department of Oral and Maxillofacial Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Bhumsuk Keam
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Hyunseok Kang
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
- Correspondence to Hyunseok Kang, M.D. Department of Medicine, University of California San Francisco, 550 16th Street, San Francisco, CA 94158, USA Tel: +1-4158857356 Fax: +1-4153337984 E-mail:
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196
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Gilardi M, Wang Z, Proietto M, Chillà A, Calleja-Valera JL, Goto Y, Vanoni M, Janes MR, Mikulski Z, Gualberto A, Molinolo AA, Ferrara N, Gutkind JS, Burrows F. Tipifarnib as a Precision Therapy for HRAS-Mutant Head and Neck Squamous Cell Carcinomas. Mol Cancer Ther 2020; 19:1784-1796. [PMID: 32727882 PMCID: PMC7484242 DOI: 10.1158/1535-7163.mct-19-0958] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 04/06/2020] [Accepted: 06/16/2020] [Indexed: 11/16/2022]
Abstract
Tipifarnib is a potent and highly selective inhibitor of farnesyltransferase (FTase). FTase catalyzes the posttranslational attachment of farnesyl groups to signaling proteins that are required for localization to cell membranes. Although all RAS isoforms are FTase substrates, only HRAS is exclusively dependent upon farnesylation, raising the possibility that HRAS-mutant tumors might be susceptible to tipifarnib-mediated inhibition of FTase. Here, we report the characterization of tipifarnib activity in a wide panel of HRAS-mutant and wild-type head and neck squamous cell carcinoma (HNSCC) xenograft models. Tipifarnib treatment displaced both mutant and wild-type HRAS from membranes but only inhibited proliferation, survival, and spheroid formation of HRAS-mutant cells. In vivo, tipifarnib treatment induced tumor stasis or regression in all six HRAS-mutant xenografts tested but displayed no activity in six HRAS wild-type patient-derived xenograft (PDX) models. Mechanistically, drug treatment resulted in the reduction of MAPK pathway signaling, inhibition of proliferation, induction of apoptosis, and robust abrogation of neovascularization, apparently via effects on both tumor cells and endothelial cells. Bioinformatics and quantitative image analysis further revealed that FTase inhibition induces progressive squamous cell differentiation in tipifarnib-treated HNSCC PDXs. These preclinical findings support that HRAS represents a druggable oncogene in HNSCC through FTase inhibition by tipifarnib, thereby identifying a precision therapeutic option for HNSCCs harboring HRAS mutations.
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Affiliation(s)
- Mara Gilardi
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - Zhiyong Wang
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - Marco Proietto
- Section of Molecular Biology, Division of Biological Sciences, University of California San Diego, La Jolla, CA, USA
| | - Anastasia Chillà
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | | | - Yusuke Goto
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - Marco Vanoni
- Dept of Biotechnology and Biosciences, and SYSBIO Centre of Systems Biology, University Milano-Bicocca, Milan, Italy
| | | | - Zbigniew Mikulski
- La Jolla Institute for Allergy and Immunology, Division of Inflammation Biology, La Jolla, CA
| | | | | | - Napoleone Ferrara
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA
| | - J. Silvio Gutkind
- Moores Cancer Center, University of California San Diego, La Jolla, CA, USA,Corresponding authors: To whom correspondence should be addressed at: J. Silvio Gutkind, Moores Cancer Center, University of California San Diego, 3855 Health Sciences Drive, La Jolla, CA 92093-0803, USA; Phone: 858-534-5980; and to Francis Burrows, Kura Oncology, Inc., San Diego, California.
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197
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Schuch LF, Silveira FM, Wagner VP, Borgato GB, Rocha GZ, Castilho RM, Vargas PA, Martins MD. Head and neck cancer patient-derived xenograft models - A systematic review. Crit Rev Oncol Hematol 2020; 155:103087. [PMID: 32992152 DOI: 10.1016/j.critrevonc.2020.103087] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 08/12/2020] [Accepted: 08/14/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Patient-derived xenograft (PDX) involve the direct surgical transfer of fresh human tumor samples to immunodeficient mice. This systematic review aimed to identify publications of head and neck cancer PDX (HNC-PDX) models, describing the main methodological characteristics and outcomes. METHODS An electronic search was undertaken in four databases, including publications having used HNC-PDX. Data were analyzed descriptively. RESULTS 63 articles were yielded. The nude mouse was one most commonly animal model used (38.8 %), and squamous cell carcinoma accounted for the majority of HNC-PDX (80.6 %). Tumors were mostly implanted in the flank (86.3 %), and the latency period ranged from 30 to 401 days. The successful rate ranged from 17 % to 100 %. Different drugs and pathways were identified. CONCLUSION HNC-PDX appears to significantly recapitulate the morphology of the original HNC and represents a valuable method in translational research for the assessment of the in vivo effect of novel therapies for HNC.
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Affiliation(s)
- Lauren F Schuch
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade de Campinas, Piracicaba, SP, Brazil
| | - Felipe M Silveira
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade de Campinas, Piracicaba, SP, Brazil
| | - Vivian P Wagner
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade de Campinas, Piracicaba, SP, Brazil
| | - Gabriell B Borgato
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade de Campinas, Piracicaba, SP, Brazil
| | - Guilherme Z Rocha
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade de Campinas, Piracicaba, SP, Brazil
| | - Rogerio M Castilho
- Laboratory of Epithelial Biology, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, 48109-1078, United States; Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI, 48109, United States
| | - Pablo A Vargas
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade de Campinas, Piracicaba, SP, Brazil
| | - Manoela D Martins
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade de Campinas, Piracicaba, SP, Brazil; Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
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198
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Chen S, Dee EC, Muralidhar V, Nguyen PL, Amin MR, Givi B. Disparities in Mortality from Larynx Cancer: Implications for Reducing Racial Differences. Laryngoscope 2020; 131:E1147-E1155. [PMID: 32869893 DOI: 10.1002/lary.29046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 07/14/2020] [Accepted: 07/27/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Race predicts overall mortality (OM) of laryngeal squamous cell carcinoma (LSCC) in the United States (US). We assessed whether racial disparities affect cancer-specific mortality (CSM) using the Surveillance, Epidemiology, and End Results (SEER) database. METHODS Adults with LSCC from 2004 to 2015 were selected. Univariable and multivariable Cox proportional hazards and Fine-Gray competing-risks regression analysis adjusted for clinicodemographic factors defined hazard ratios (aHR). RESULTS We identified 14,506 patients. The median age was 63 years. Most were male (11,725, 80.8%) and white (11,653, 80.3%), followed by Black (2294, 15.8%). Most had early-stage disease (7544, 52.0%) and received radiotherapy only (4107, 28.3%), followed by chemoradiation (3748, 25.8%). With median follow-up of 60 months, overall 3- and 5-year OM were 34.0% and 43.2%; CSM were 16.0% and 18.9%, respectively. Black patients had higher OM than white patients on univariable (HR 1.35, 95% CI, 1.26-1.44, P < .001) and multivariable (aHR 1.10, 95% CI, 1.02-1.18, P = .011) analyses. Black patients had higher CSM on univariable analysis (HR 1.22, 95% CI, 1.09-1.35, P < .001) but not on multivariable CSM analysis (aHR 1.01, 95% CI, 0.90-1.13, P = .864). On multivariable analysis, year of diagnosis, age, disease site, stage, treatment, nodal metastasis, marital status, education, and geography significantly predicted CSM. CONCLUSION On multivariable analyses controlling for sociodemographic, clinical, and treatment characteristics, Black and white patients differed in OM but not in CSM. However, Black patients presented with greater proportions of higher stage cancers and sociodemographic factors such as income and marital status that were associated with worse outcomes. Efforts to target sociodemographic disparities may contribute to the mitigation of racial disparities in LSCC. LEVEL OF EVIDENCE 4 Laryngoscope, 131:E1147-E1155, 2021.
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Affiliation(s)
- Sophia Chen
- Department of Otolaryngology-Head & Neck Surgery, New York University School of Medicine, New York, New York, U.S.A
| | - Edward Christopher Dee
- Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A.,Department of Radiation Oncology, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Vinayak Muralidhar
- Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Paul L Nguyen
- Department of Radiation Oncology, Dana-Farber Cancer Institute/Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Milan R Amin
- Department of Otolaryngology-Head & Neck Surgery, New York University Langone Health, New York, New York, U.S.A
| | - Babak Givi
- Department of Otolaryngology-Head & Neck Surgery, New York University Langone Health, New York, New York, U.S.A
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199
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Manne S, Hudson S, Frederick S, Mitarotondo A, Baredes S, Kalyoussef E, Ohman‐Strickland P, Kashy DA. e‐Health
self‐management intervention for oral and oropharyngeal cancer survivors: design and single‐arm pilot study of empowered survivor. Head Neck 2020; 42:3375-3388. [DOI: 10.1002/hed.26403] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 06/23/2020] [Accepted: 07/14/2020] [Indexed: 12/24/2022] Open
Affiliation(s)
- Sharon Manne
- Behavioral Science Rutgers Cancer Institute of New Jersey New Brunswick NJ USA
| | - Shawna Hudson
- Department of Family Medicine Rutgers Cancer Institute of New Jersey New Brunswick NJ USA
| | - Sara Frederick
- Behavioral Science Rutgers Cancer Institute of New Jersey New Brunswick NJ USA
| | - Anna Mitarotondo
- Behavioral Science Rutgers Cancer Institute of New Jersey New Brunswick NJ USA
| | - Soly Baredes
- Otolaryngology Rutgers New Jersey Medical School Newark NJ USA
| | - Evelyne Kalyoussef
- Department of Otolaryngology Rutgers New Jersey Medical School Newark NJ USA
| | - Pamela Ohman‐Strickland
- Department of Biostatistics and Epidemiology Rutgers School of Public Health Piscataway NJ USA
| | - Deborah A. Kashy
- Department of Psychology Michigan State University East Lansing Michigan USA
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200
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Sanft T, Denlinger CS, Armenian S, Baker KS, Broderick G, Demark-Wahnefried W, Friedman DL, Goldman M, Hudson M, Khakpour N, Koura D, Lally RM, Langbaum TS, McDonough AL, Melisko M, Mooney K, Moore HCF, Moslehi JJ, O'Connor T, Overholser L, Paskett ED, Peterson L, Pirl W, Rodriguez MA, Ruddy KJ, Smith S, Syrjala KL, Tevaarwerk A, Urba SG, Zee P, McMillian NR, Freedman-Cass DA. NCCN Guidelines Insights: Survivorship, Version 2.2019. J Natl Compr Canc Netw 2020; 17:784-794. [PMID: 31319383 DOI: 10.6004/jnccn.2019.0034] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The NCCN Guidelines for Survivorship provide screening, evaluation, and treatment recommendations for consequences of cancer and cancer treatment to aid healthcare professionals who work with survivors of adult-onset cancer. Guidance is also provided to help promote physical activity, weight management, and proper immunizations in survivors and to facilitate care coordination to ensure that all needs are addressed. These NCCN Insights summarize some of the topics discussed by the NCCN Survivorship Panel during the 2019 update of the guidelines, including the survivorship population addressed, ways to improve care coordination, and pain management.
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Affiliation(s)
- Tara Sanft
- Yale Cancer Center/Smilow Cancer Hospital
| | | | | | - K Scott Baker
- Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance
| | | | | | | | - Mindy Goldman
- UCSF Helen Diller Family Comprehensive Cancer Center
| | - Melissa Hudson
- St. Jude Children's Research Hospital/The University of Tennessee Health Science Center
| | | | | | | | | | | | | | - Kathi Mooney
- Huntsman Cancer Institute at the University of Utah
| | - Halle C F Moore
- Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute
| | | | | | | | - Electra D Paskett
- The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute
| | - Lindsay Peterson
- Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine
| | | | | | | | | | - Karen L Syrjala
- Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance
| | | | | | - Phyllis Zee
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University; and
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