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Choi KY, Patel SD, Lane C, Tucker J, Chan K, Pradhan S, Mahase SS, Tam SH, King TS. Elucidating survival and functional outcomes in patients with primary head and neck malignancies treated in academic versus community settings. Head Neck 2024; 46:398-407. [PMID: 38087455 DOI: 10.1002/hed.27588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 10/19/2023] [Accepted: 11/19/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Differences in treatment outcomes between community or academic centers are incompletely understood. METHODS Retrospective review of head and neck cancer patients between 2010 and 2020 in a rural health region. Kaplan-Meier curves and log-rank tests were used to evaluate survival outcomes, along with bivariate and multivariable Cox proportional hazards models. Linear regression was used for functional outcomes of tracheotomy and gastrostomy tube dependence. RESULTS Two hundred and forty-eight patients treated at an academic center were compared with 94 patients treated in community centers. In multivariable analysis, the risk of death (HR = 0.60, p = 0.019), and risk of recurrence were lower (HR = 0.29, p < 0.001) for patients treated in academic centers. Patients treated in community centers had longer gastrostomy tube dependence (p = 0.002). CONCLUSION Our findings suggest that treatment at an academic center was associated with a lower risk of recurrence and shorter gastrostomy tube dependence compared to treatment in the community.
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Affiliation(s)
- Karen Y Choi
- Department of Otolaryngology-Head and Neck Surgery, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Shivam D Patel
- Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Ciaran Lane
- Department of Otolaryngology, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada
| | - Jacqueline Tucker
- Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Kimberly Chan
- Department of Otolaryngology-Head and Neck Surgery, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Sandeep Pradhan
- Department of Public Health Sciences, Division of Biostatistics and Bioinformatics, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Sean S Mahase
- Department of Radiation Oncology, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
| | - Samantha H Tam
- Department of Otolaryngology-Head and Neck Surgery, Henry Ford Medical Center, Detroit, Michigan, USA
| | - Tonya S King
- Department of Public Health Sciences, Division of Biostatistics and Bioinformatics, The Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
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Olek M, Machorowska-Pieniążek A, Czuba ZP, Cieślar G, Kawczyk-Krupka A. Immunomodulatory Effect of Hypericin-Mediated Photodynamic Therapy on Oral Cancer Cells. Pharmaceutics 2023; 16:42. [PMID: 38258051 PMCID: PMC10819034 DOI: 10.3390/pharmaceutics16010042] [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: 12/07/2023] [Revised: 12/19/2023] [Accepted: 12/25/2023] [Indexed: 01/24/2024] Open
Abstract
In 2020, there were 377,713 new oral and lip cancer diagnoses and 177,757 deaths. Oral cancer is a malignancy of the head and neck region, and 90% of cases are squamous cell carcinomas (OSCCs). One of the alternative methods of treating pre-cancerous lesions and oral cancer is photodynamic therapy (PDT). In addition to the cytotoxic effect, an important mechanism of PDT action is the immunomodulatory effect. This study used the OSCC (SCC-25) cell line and the healthy gingival fibroblast (HGF-1) line. A compound of natural origin-hypericin (HY)-was used as the photosensitizer (PS). The HY concentrations of 0-1 µM were used. After two hours of incubation with PS, the cells were irradiated with light doses of 0-20 J/cm2. The MTT test determined sublethal doses of PDT. Cell supernatants subjected to sublethal PDT were assessed for interleukin 6 (IL-6), soluble IL-6 receptor alpha (sIL-6Ralfa), sIL-6Rbeta, IL-8, IL-10, IL-11 IL-20, IL-32, and Pentraxin-3 using the Bio-Plex ProTM Assay. The phototoxic effect was observed starting with a light dose of 5 J/cm2 and amplified with increasing HY concentration and a light dose. HY-PDT affected the SCC-25 cell secretion of sIL-6Rbeta, IL-20, and Pentraxin-3. HY alone increased IL-8 secretion. In the case of HGF-1, the effect of HY-PDT on the secretion of IL-8 and IL-32 was found.
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Affiliation(s)
- Marcin Olek
- Doctoral School of Medical University of Silesia, 40-055 Katowice, Poland
- Department of Orthodontics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland;
| | | | - Zenon P. Czuba
- Department of Microbiology and Immunology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland;
| | - Grzegorz Cieślar
- Department of Internal Diseases, Angiology and Physical Medicine, Center for Laser Diagnostics and Therapy, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland;
| | - Aleksandra Kawczyk-Krupka
- Department of Internal Diseases, Angiology and Physical Medicine, Center for Laser Diagnostics and Therapy, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland;
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Sullivan CB, Al-Qurayshi Z, Anderson CM, Seaman AT, Pagedar NA. Factors Associated With the Choice of Radiation Therapy Treatment Facility in Head and Neck Cancer. Laryngoscope 2020; 131:1019-1025. [PMID: 32846018 DOI: 10.1002/lary.29033] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/15/2020] [Accepted: 07/29/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To analyze the clinicodemographic characteristics and treatment outcomes of patients receiving postoperative radiation therapy (PORT) at a different treatment facility rather than the initial surgical facility for head and neck cancer. STUDY DESIGN Retrospective cohort analysis. METHODS Utilizing the National Cancer Data Base, 2004 to 2015, patients with a diagnosis of oral cavity/oropharyngeal, hypopharyngeal, and laryngeal squamous cell carcinoma were studied. Multivariate analysis was completed with multivariate regression and Cox proportional hazard model, and survival outcomes were examined using Kaplan-Meier analysis. RESULTS A total of 15,181 patients who had surgery for a head and neck cancer at an academic/research center were included in the study population. Of the study population, 4,890 (32.2%) patients completed PORT at a different treatment facility. Treatment at a different facility was more common among patients who were ≥65 years old, white, Medicare recipients, those with a greater distance between residence and surgical treatment facility, and with lower income within area of residence (each P < .05). Overall survival was worse in patients completing PORT at a different treatment facility versus at the institution where surgery was completed (61.9% vs. 66.4%; P = .002). CONCLUSIONS PORT at a different facility was more common in older individuals, Medicare recipients, those with greater distance to travel, and lower-income individuals. Completing PORT outside the hospital where surgery was performed was associated with inferior survival outcomes among head and neck cancer patients. LEVEL OF EVIDENCE 3 Laryngoscope, 131:1019-1025, 2021.
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Affiliation(s)
- Christopher B Sullivan
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.A
| | - Zaid Al-Qurayshi
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.A
| | - Carryn M Anderson
- Department of Radiation Oncology, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.A
| | - Aaron T Seaman
- Department of Internal Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.A
| | - Nitin A Pagedar
- Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, U.S.A
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Wei M, Wu Y, Liu H, Xie C. Genipin Induces Autophagy and Suppresses Cell Growth of Oral Squamous Cell Carcinoma via PI3K/AKT/MTOR Pathway. DRUG DESIGN DEVELOPMENT AND THERAPY 2020; 14:395-405. [PMID: 32099325 PMCID: PMC6996293 DOI: 10.2147/dddt.s222694] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 12/30/2019] [Indexed: 12/25/2022]
Abstract
Background Oral squamous cell carcinoma (OSCC) is a common malignant tumor of the head and neck, and it accounts for more than 90% of oral cancer. Due to high mortality, limitations of traditional treatment and many complications, new treatment methods are urgently needed. This study aimed to look into the effect of new potential anti-tumor drug, genipin, on OSCC treatment. Methods In vitro, CCK-8, colony formation, and flow cytometry were used to detect the effect of genipin on SCC-9 and SCC-15 cell lines. Immunofluorescence, real-time PCR, and Western blotting were used to investigate its mechanism. Xenograft tumor model was used to explore the role of genipin in vivo. Results We found that genipin suppressed cell growth and induced apoptosis in vitro. In addition, the expression of p62 was down-regulated while Beclin1 and LC3II were up-regulated in SCC-25 and SCC-9 cells. 3-methyladenine (3-MA) significantly decreased LC3 (LC3II)+ puncta, but genipin rescuect 3d this reduction. Furthermore, genipin also reduced the expression of p-PI3K, p-AKT, and p-mTOR. In vivo experiment showed that genipin significantly curbed the tumor size and weight. The positive expression of Ki67 protein and number of apoptotic cells were increased. Conclusion Conclusively, this study implicated that genipin suppresses cell proliferation and stimulated apoptosis, and is the first exploration showing that genipin induces OSCC cell autophagy via PI3K/AKT/mTOR pathway inhibition.
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Affiliation(s)
- MingBo Wei
- Department of Stomatology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, People's Republic of China
| | - YanLi Wu
- Department of Pharmacy, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, People's Republic of China
| | - Hui Liu
- Department of Stomatology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, People's Republic of China
| | - Chun Xie
- Stomatology Center, Affiliated Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, People's Republic of China
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Orbital outcomes after orbit-sparing surgery and free flap reconstruction. Oral Oncol 2019; 98:78-84. [DOI: 10.1016/j.oraloncology.2019.09.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 08/07/2019] [Accepted: 09/22/2019] [Indexed: 10/25/2022]
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Olek M, Kasperski J, Skaba D, Wiench R, Cieślar G, Kawczyk-Krupka A. Photodynamic therapy for the treatment of oral squamous carcinoma—Clinical implications resulting from in vitro research. Photodiagnosis Photodyn Ther 2019; 27:255-267. [DOI: 10.1016/j.pdpdt.2019.06.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 06/16/2019] [Accepted: 06/17/2019] [Indexed: 12/27/2022]
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Lee NCJ, Kelly JR, An Y, Park HS, Judson BL, Burtness BA, Husain ZA. Radiation therapy treatment facility and overall survival in the adjuvant setting for locally advanced head and neck squamous cell carcinoma. Cancer 2019; 125:2018-2026. [PMID: 30748002 DOI: 10.1002/cncr.32001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 01/09/2019] [Accepted: 01/14/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Treatment at high-volume surgical facilities (HVSFs) provides a survival benefit for patients with head and neck squamous cell carcinomas (HNSCCs); however, it is unknown what role postoperative radiation therapy (PORT) plays in achieving the improved outcomes. METHODS From the National Cancer Database, 6844 patients with locally advanced invasive HNSCCs of the oral cavity, oropharynx, larynx, and hypopharynx who underwent definitive surgery with PORT between 2004 and 2013 were identified. HVSFs were those in the top percentile for annual case volume during this period. RESULTS The median follow-up was 54 months. Compared with a lower volume surgical facility (LVSF), an HVSF improved 5-year overall survival (OS; 57.7% at HVSFs vs 52.5% at LVSFs; P = .0003). Overall, 31.6% of the patients changed their radiation therapy (RT) facility after surgery, with this being more common at HVSFs (39.1% vs 28.9% at LVSFs; P < .001). Among those patients undergoing surgery at an HVSF, remaining at the same facility for RT improved 5-year OS (63.1% vs 49.3% with a facility change; P < .0001). A propensity score-matched cohort of patients treated at HVSFs confirmed the improved 5-year OS when patients remained at the treating HVSF for RT (59.2% vs 50.7% with a facility change; P = .005). In a multivariate analysis, treatment at an HVSF and remaining there for RT resulted in a reduced hazard of death (hazard ratio, 0.81; 95% confidence interval, 0.69-0.94; P = .006). CONCLUSIONS The survival benefit associated with HVSFs persists only when patients remain at the facility for RT, and this suggests that facility specialization and/or high-volume PORT may assist in driving the OS improvement.
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Affiliation(s)
- Nicholas C J Lee
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut
| | - Jacqueline R Kelly
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut
| | - Yi An
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut
| | - Henry S Park
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut
| | - Benjamin L Judson
- Division of Otolaryngology, Department of Surgery, Yale School of Medicine, New Haven, Connecticut
| | - Barbara A Burtness
- Division of Medical Oncology, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Zain A Husain
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut.,Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
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