Systemic therapies for squamous cell carcinoma of the head and neck

Psychosocial adjustment and its influencing factors among head and neck cancer survivors after radiotherapy: A cross-sectional study

PURPOSE

Psychosocial adjustment is an important issue in patients' long-term survival. Understanding psychosocial adjustment and its influencing factors in head and neck cancer survivors after radiotherapy is essential to help them return to society and lead a normal life. The purpose of this study was to describe the level of psychosocial adjustment and explore its influencing factors in head and neck cancer patients.

METHODS

Between May 2019 and May 2022, 253 head and neck cancer survivors at a tertiary hospital in northeast China were enrolled in a cross-sectional study. The research instruments comprised the Demographic and Clinical Characteristics Questionnaire, the Self-report Psychosocial Adjustment to Illness Scale (PAIS-SR), the General Self-efficacy Scale (GSES), the Social Support Rating Scale (SSRS) and the M.D. Anderson Symptom Survey-head and neck Questionnaire (MDASI-H&N).

RESULTS

The mean PAIS-SR score was 42.31 ± 16.70 (moderate). The multiple regression model revealed that 73.2% of the variance in psychosocial adjustment was explained by marital status (β = -0.114, P = 0.005), return to work or not (β = -0.275, P < 0.01), self-efficacy (β = -0.327, P < 0.01), subjective support (β = -0.106, P = 0.043), utilization of support (β = -0.172, P < 0.01), and trouble with symptoms in daily life (β = 0.138, P = 0.021).

CONCLUSION

The psychosocial adjustment of head and neck cancer survivors after radiotherapy is an issue that needs to be addressed, and medical staff should develop effective, individualized interventions to improve their psychosocial adjustment by increasing their social support, improving their self-efficacy and strengthening symptom management according to their actual situation.

Transcatheter arterial chemoembolization is safe and effective for patients with late-stage or recurrent oral carcinoma

OBJECTIVE

We reported the long-term outcomes of transcatheter chemoembolization (TACE) for patients with late-stage or recurrent oral carcinoma.

METHODS

This retrospective study enrolled 18 patients with late-stage or recurrent oral carcinoma between December 2015 and April 2021. The tumor-feeding artery was catheterized, and cisplatin/oxaliplatin and 5-FU/raltitrexed were infused with embolization using polyvinyl alcohol or gelatin sponge. Computed tomography was performed at about 1, 3, and 6 months after the procedure, and every 6 months after that. During the procedure and follow-up, procedure outcomes, complications, treatment efficacy, and overall survival were analyzed.

RESULTS

A total of 31 sessions of TACE were performed, with a technical success rate of 100%. Of 12 patients combined with oral hemorrhage, two patients showed rebleeding 35 and 37 days later, with a clinical efficiency of hemostasis of 88.9%. Mild complications were observed in 11 patients (61.1%). Severe complications or procedure-related deaths were not observed during or after the procedure. The objective response rate and disease control rate were 20.0% and 86.7%, 38.5% and 61.5%, and 25.0% and 50.0% at 1, 3, and 6 months later, respectively. Seventeen patients (94.4%) were followed up, with a median duration of 37.8 months (IQR 22.3-56.8). Nine patients died of tumor progression, one died of massive rebleeding, and one died of severe lung infection. The median overall survival was 23.8 months.

CONCLUSION

TACE is a safe and effective procedure with minimal invasiveness for treating late-stage or recurrent oral carcinoma. TACE can be recommended as a palliative treatment, particularly for patients with oral hemorrhage.

Efficacy of nimotuzumab combined with docetaxel-cisplatin-fluorouracil regimen in treatment of advanced oral carcinoma

The present study aimed to evaluate efficacy and adverse effects of Nimotuzumab combined with docetaxel-cisplatin-fluorouracil regimen in the treatment of advanced oral carcinoma. Nine patients with advanced oral carcinoma were treated with Nimotuzumab combined with docetaxel-cisplatin-fluorouracil regimen (test group). The treatment was given as follows: Nimotuzumab 200 mg, given as intravenous infusion once a week for 6 weeks; docetaxel and cisplatin, 75 mg/m(2) each, on day 1 only; 5-fluorouracil, 750 mg/m(2) infused continually for 8 h, used from day 1 to 5; the total cycle was for 21 days. Another eight patients comprised control group (docetaxel-cisplatin-fluorouracil regimen alone). Study patients from both groups were evaluated for objective response. The response rate was significantly (p = 0.044) higher in test group (88.9 vs. 37.5 % in control group). The disease control rate also tended to be higher in test group (100 vs. 62.5 % in control group; p = 0.083). The major adverse effects were bone marrow suppression, nausea, vomiting, and alopecia. The incidence of adverse effects was similar between both study groups. In conclusion, Nimotuzumab combined with docetaxel-cisplatin-fluorouracil regimen is effective and safe in the treatment of advanced oral carcinoma.

Carrier-based intralymphatic cisplatin chemotherapy for the treatment of metastatic squamous cell carcinoma of the head & neck

BACKGROUND

Since head and neck squamous cell carcinoma (HNSCC) preferentially metastasizes to the locoregional lymphatics, treatment of the tumor-draining cervical lymph nodes is paramount.

RESULTS

We developed a hyaluronan-cisplatin (HA-Pt) nanoconjugate with prolonged lymphatic retention and greatly improved tumor tissue deposition for the treatment of metastatic HNSCC. We also developed an orthotopic metastatic xenograft model of HNSCC to examine the efficacy of the nanoconjugate. HNSCC (1/week x 3 weeks) were completely cured for 57% of the female mice in the HA-Pt treatment group, which demonstrated greatly hindered HNSCC progression compared with the standard cisplatin therapy (p < 0.05).

CONCLUSION

With this insight, we will be able to optimize the carriers for better uptake, penetration and retention within cancer cells.