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Petersson K, Finizia C, Pauli N, Dotevall H, Tuomi L. A randomized controlled study evaluating the head-lift exercise in head and neck cancer patients with radiation-induced dysphagia: effect on swallowing function and health-related quality of life over 12 months. Eur Arch Otorhinolaryngol 2023; 280:5445-5457. [PMID: 37584752 PMCID: PMC10620310 DOI: 10.1007/s00405-023-08183-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 08/07/2023] [Indexed: 08/17/2023]
Abstract
PURPOSE Dysphagia is common after radiotherapy for head and neck cancer (HNC) and can affect health-related quality of life (HRQL). This randomized controlled trial aimed to evaluate the effect of the head-lift exercise (HLE) over 12 months in HNC patients with radiation-induced dysphagia. METHODS Sixty-one patients with dysphagia were randomized to intervention group (n = 30) and control group (n = 31) at 6-36 months after completion of radiotherapy for HNC. Dysphagia-specific HRQL was measured with the MD Anderson Dysphagia Inventory (MDADI); general and HNC-specific HRQL was measured with the European Organization for Research and Treatment of Cancer Quality of Life questionnaire Core 30 (EORTC QLQ-C30) and QLQ-H&N35. Measurements were made at baseline, and at 8 weeks and 12 months after start of intervention. RESULTS Adherence to the intervention was good throughout the year. When comparing change from baseline reports to each follow-up no statistically significant differences between the groups were found in any of the HRQL instruments. There were some statistically significant changes within groups compared to baseline. The intervention group improved self-rated swallowing function on the MDADI at 8 weeks (emotional domain, p = 0.03; functional domain, p = 0.007; total score, p = 0.01) and the control at twelve months (emotional domain, p = 0.03; functional domain, p = 0.02; physical domain, p = 0.004; total score, p = 0.002). CONCLUSION In this randomized control study, no effect was observed short term or at 12 months on HRQL after use of the HLE as rehabilitation for radiation-induced dysphagia.
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Affiliation(s)
- Kerstin Petersson
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Department of Otorhinolaryngology, Head and Neck Surgery, Sahlgrenska University Hospital, Region Västra Götaland, 41345, Gothenburg, Sweden.
| | - Caterina Finizia
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Otorhinolaryngology, Head and Neck Surgery, Sahlgrenska University Hospital, Region Västra Götaland, 41345, Gothenburg, Sweden
| | - Nina Pauli
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Otorhinolaryngology, Head and Neck Surgery, Sahlgrenska University Hospital, Region Västra Götaland, 41345, Gothenburg, Sweden
| | - Hans Dotevall
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Otorhinolaryngology, Head and Neck Surgery, Sahlgrenska University Hospital, Region Västra Götaland, 41345, Gothenburg, Sweden
| | - Lisa Tuomi
- Department of Otorhinolaryngology, Head and Neck Surgery, Sahlgrenska University Hospital, Region Västra Götaland, 41345, Gothenburg, Sweden
- Institute of Neuroscience and Physiology, Speech and Language Pathology Unit, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Pani SC, Dong CSY, Faulks D. Intersection of the iADH undergraduate curriculum in special care dentistry and the association of Canadian faculties of dentistry competencies framework. SPECIAL CARE IN DENTISTRY 2023; 43:785-794. [PMID: 36617659 DOI: 10.1111/scd.12822] [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: 05/12/2022] [Revised: 05/12/2022] [Accepted: 12/26/2022] [Indexed: 01/10/2023]
Abstract
AIMS To map the International Association of Disability and Oral Health (iADH) curriculum to the Association of Canadian Faculties of Dentistry (ACFD) competencies framework to develop a strategy for teaching special care dentistry (SCD) using the International Classification of Functioning, Disability, and Health (ICF). To review the literature to identify educational methodologies that support teaching SCD competencies. METHODS The 20 subdomains of the ACFD competencies framework were mapped to the 18 subdomains of the iADH competency matrix. A literature review of methods, techniques, or innovations used to teach SCD was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and the Sample, Phenomenon of Interest, Design, Evaluation, and Research Type (SPIDER) tool. RESULTS The iADH curriculum was mapped to the ACFD competencies in the areas of patient care, professionalism, communication and collaboration, practice information management, and health promotion. A total of 176 articles from PubMed and 10 resources from MedEdPortal were identified in the literature search. Eleven articles met the inclusion and exclusion criteria. The overall quantity and quality of studies was low. Experiential learning in either a dental school or hospital-based program seemed to improve knowledge of SCD and to incite greater willingness to treat patients requiring SCD. CONCLUSIONS Case-based learning, computer-based modules, standardized patients, and clinical practice are educational strategies for teaching SCD competencies. The integration of SCD into the undergraduate dental curriculum seems feasible, as most required competencies are transferable to all dental disciplines. Furthermore, the ICF provides a functional model that is a patient-centered approach and is applicable to dentistry beyond SCD.
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Affiliation(s)
| | | | - Denise Faulks
- Universite Clermont Auvergne, EA4847, CHU Clermont-Ferrand, Service d'Odontologie, Clermont-Ferrand, France
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3
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Impact of AJCC 8th edition staging system and definitive treatment choice on the prognosis of complete responders with p16+ and p16− oropharyngeal squamous cell carcinomas. Oral Oncol 2022; 128:105861. [PMID: 35436712 PMCID: PMC9624219 DOI: 10.1016/j.oraloncology.2022.105861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 03/31/2022] [Accepted: 04/10/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVES To identify predictors of overall survival (OS) in oropharyngeal squamous cell carcinoma (OPSCC) patients who achieved complete response (CR). METHODS We performed a retrospective study of OPSCC patients who achieved CR from a single academic medical center. Associations between OS, AJCC 8th edition staging system, definitive treatment choice, smoking history, and p16 status were assessed. RESULTS p16+ status was associated with favorable prognosis for CR (p < 0.001) but not non-CR (p = 0.67) patients. For early stage, p16+ OPSCC patients who achieved CR, surgery + adjuvant radiation (RT) treatment was more durable compared to concurrent chemoradiation (CRT), particularly in smokers. CONCLUSIONS Curative intent treatment choice and smoking history has an impact on the long-term OS of the CR p16+ OPSCC cohort. Prospective studies to define the optimal multi-modality treatment option to manage p16+ OPSCC patients is needed.
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4
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Anakapu K, Wilson M, Findlay M, Brown T, Bauer J. Nutritional outcomes in patients undergoing transoral robotic surgery for head and neck cancers compared to conventional open surgery. A systematic review. Head Neck 2021; 44:238-253. [PMID: 34724253 DOI: 10.1002/hed.26913] [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: 02/08/2021] [Revised: 08/26/2021] [Accepted: 10/07/2021] [Indexed: 11/06/2022] Open
Abstract
This systematic review examined nutritional outcomes in patients undergoing transoral robotic surgery (TORS), compared to open surgery (OS) for head and neck cancer. PUBMED, CINAHL, and Web of Science were systematically reviewed. Target nutritional outcomes included: weight, nutritional status, use of enteral feeding, swallowing function/ability, and time to oral diet. Risk of bias was assessed using the risk of bias in non-randomized studies tool, and certainty of evidence was assessed using grading of recommendations, assessment, development, and evaluation (GRADE). Eight studies were included (total n = 608). Compared to OS, TORS probably reduces short- and long-term enteral feeding use or duration (GRADE "moderate" certainty), may reduce time to full swallow ability (GRADE "low" certainty), but it remains uncertain whether TORS reduces long-term patient reported swallowing function or time to oral feeding (GRADE "very-low" certainty). No studies examined nutritional status or weight. There is limited body of evidence examining nutrition outcomes following TORS. Further studies are warranted, which may improve the certainty of evidence and assist in determining the optimal nutrition care for these patients.
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Affiliation(s)
- Kimberley Anakapu
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
| | - Michael Wilson
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia.,Nutrition and Dietetics, Royal Brisbane & Women's Hospital, Brisbane, Queensland, Australia
| | - Merran Findlay
- Cancer Services, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,Chris O'Brien Lifehouse, Sydney, New South Wales, Australia
| | - Teresa Brown
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia.,Nutrition and Dietetics, Royal Brisbane & Women's Hospital, Brisbane, Queensland, Australia
| | - Judith Bauer
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia.,Nutrition and Dietetics, Royal Brisbane & Women's Hospital, Brisbane, Queensland, Australia
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O'Hara J, Warner L, Fox H, Hamilton D, Meikle D, Counter P, Robson A, Goranova R, Iqbal S, Kelly C, Robinson M, Paleri V. Primary transoral robotic surgery +/- adjuvant therapy for oropharyngeal squamous cell carcinoma-A large observational single-centre series from the United Kingdom. Clin Otolaryngol 2021; 46:1005-1012. [PMID: 33754476 DOI: 10.1111/coa.13769] [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: 07/07/2020] [Revised: 02/25/2021] [Accepted: 03/14/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To analyse the oncological outcomes following primary Transoral Robotic Surgery (TORS) for oropharyngeal squamous cell carcinoma (OPSCC). DESIGN Observational case series. SETTING Tertiary centre; first TORS practice to commence in the UK. PARTICIPANTS All consecutive patients undergoing primary TORS with curative intent, with or without adjuvant treatment. MAIN OUTCOME MEASURES Descriptive analysis of patient and tumour pathology variables. Survival outcomes: Overall, Disease-Specific, Progression-Free and Locoregional control. RESULTS The cohort comprised of 120 patients undergoing TORS with minimum 12-month follow-up data and the following characteristics: mean age 58 years, 91 males (76%), 78 tonsil (65%) and 34 base of tongue primaries (28%), 89% HPV-related OPSCC. The surgical pathology revealed 14 (12%) with positive margins, 19 (16%) had close margins <2mm and 31% with extranodal extension. The treatment was as follows: 39 (33%) treated with TORS alone, 50 (42%) received adjuvant radiotherapy and 31 (26%) received adjuvant radiotherapy with chemotherapy. There were 15 recurrences. Estimated survival for all patients at 3 years (95% CI): overall 85% (78-92), disease-specific 90% (85-96), progression-free 86% (79-92) and locoregional control 90% (84-96). The equivalent survival figures for the HPV-related cases alone were as follows: overall 88% (82-94), disease-specific 93% (87-98), progression-free 88% (81-95) and locoregional control 92% (87-98). CONCLUSIONS Whilst TORS has become a common practice in the management of OPSCC in the UK, these are the first reported oncological outcomes. For selected patients, TORS with or without adjuvant therapy is an appropriate treatment modality.
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Affiliation(s)
- James O'Hara
- Consultant Otolaryngologist, The Freeman Hospital, Newcastle-upon-Tyne, UK.,Honorary Senior Clinical Lecturer, Newcastle University, UK
| | - Laura Warner
- Consultant Otolaryngologist, The Freeman Hospital, Newcastle-upon-Tyne, UK
| | - Hannah Fox
- Consultant Otolaryngologist, The Freeman Hospital, Newcastle-upon-Tyne, UK
| | - David Hamilton
- Consultant Otolaryngologist, The Freeman Hospital, Newcastle-upon-Tyne, UK.,Honorary Senior Clinical Lecturer, Newcastle University, UK
| | - David Meikle
- Consultant Otolaryngologist, The Freeman Hospital, Newcastle-upon-Tyne, UK
| | - Paul Counter
- Consultant Otolaryngologist, Cumberland Infirmary, Carlisle, UK
| | - Andrew Robson
- Consultant Otolaryngologist, Cumberland Infirmary, Carlisle, UK
| | - Rebecca Goranova
- Consultant Clinical Oncologist, University Hospitals, Plymouth, UK
| | - Shahid Iqbal
- Consultant Clinical Oncologist, The Freeman Hospital, Newcastle-upon-Tyne, UK
| | - Charles Kelly
- Consultant Clinical Oncologist, The Freeman Hospital, Newcastle-upon-Tyne, UK
| | - Max Robinson
- Consultant Cellular Pathologist, The Royal Victoria Infirmary, Newcastle-upon-Tyne, UK
| | - Vinidh Paleri
- Consultant Otolaryngologist, The Royal Marsden Hospitals, London, UK
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Lin DJ, Altamimi J, Pearce K, Wilson JA, Patterson JM. Psychometric Properties of the MDADI-A Preliminary Study of Whether Less is Truly More? Dysphagia 2021; 37:323-332. [PMID: 33709289 PMCID: PMC8948102 DOI: 10.1007/s00455-021-10281-9] [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: 03/28/2020] [Accepted: 02/27/2021] [Indexed: 11/28/2022]
Abstract
The MD Anderson Dysphagia Inventory (MDADI) is a 20-item dysphagia-specific QOL questionnaire with four subscales: global, emotional, functional, and physical. It is widely used in clinical practice and in research; however, its psychometric properties have been under-researched. We aim to evaluate the organisation of the MDADI subscales and identify any redundant items. The MDADI is a routinely collected outcome measure at two centres in northeast England. Questionnaires completed at three months following treatment were extracted from these existing databases. Factor analysis was carried out with the aim of reducing redundancy among the set of questionnaire items. Cases with missing values were excluded. A total of 196 complete patient questionnaires were used in factor analysis. A one-factor model accounted for around 50% of the total variance in item responses. The top five endorsed items (abbreviated by the questionnaire item keywords: Excluded, Irritate, Esteem, Social, and Why) in this one factor appeared in three (emotional, functional, and physical) of the four supposed MDADI subscales, i.e. global, emotional, functional, and physical. Our results suggest an overlap of three MDADI subscales across the top five endorsed items. The content of the top five questions all appear related to the psychosocial aspects of swallowing. This implies some redundancy of the items in the original subscales of the questionnaire. Using the most endorsed items, it appears feasible to abbreviate the 20-item MDADI questionnaire to a 5-item “MiniDADI” questionnaire, which is likely to have greater utility in routine clinical practice outside of research settings.
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Affiliation(s)
- Daniel J Lin
- Translational and Clinical Research Institute, Newcastle University, 3rd Floor, William Leech Building, Medical School, Framlington Place, Newcastle Upon Tyne, NE2 4HH, UK. .,Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.
| | - Jenan Altamimi
- Faculty of Medical Sciences Graduate School, Newcastle University, Newcastle upon Tyne, UK
| | - Kim Pearce
- Faculty of Medical Sciences Graduate School, Newcastle University, Newcastle upon Tyne, UK
| | - Janet A Wilson
- Freeman Hospital, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.,Institute of Health & Society, Newcastle University, Newcastle Upon Tyne, UK
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7
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Rickert D, Steinhart H, Lendlein A. Functional requirements for polymeric implant materials in head and neck surgery. Clin Hemorheol Microcirc 2020; 76:179-189. [PMID: 32925016 DOI: 10.3233/ch-209212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The pharyngeal reconstruction is a challenging aspect after pharyngeal tumor resection. The pharyngeal passage has to be restored to enable oral alimentation and speech rehabilitation. Several techniques like local transposition of skin, mucosa and/or muscle, regional flaps and free vascularized flaps have been developed to reconstruct pharyngeal defects following surgery, in order to restore function and aesthetics. The reconstruction of the pharynx by degradable, multifunctional polymeric materials would be a novel therapeutical option in head and neck surgery. MATERIALS AND METHODS Samples of an ethylene-oxide sterilized polymer (diameter 10 mm, 200μm thick) were implanted for the reconstruction of a standardized defect of the gastric wall in rats in a prospective study. The stomach is a model for a "worst case" application site to test the stability of the implant material under extreme chemical, enzymatical, bacterial, and mechanical load. RESULTS Fundamental parameters investigated in this animal model were a local tight closure between the polymer and surrounding tissues, histological findings of tissue regeneration and systemic responses to inflammation. A tight anastomosis between the polymer and the adjacent stomach wall was found in all animals after polymer implantation (n = 42). Histologically, a regeneration with glandular epithelium was found in the polymer group. No differences in the systemic responses to inflammation were found between the polymer group (n = 42) and the control group (n = 21) with primary wound closure of the defect of the gastric wall. CONCLUSIONS A sufficient stability of the polymeric material is a requirement for the pharyngeal reconstruction with implant materials.
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Affiliation(s)
- Dorothee Rickert
- Institute of Biomaterial Science and Berlin-Brandenburg Center for Regenerative Therapies, Helmholtz-Zentrum Geesthacht, Teltow, Germany.,ENT-clinic, Department of Head and Neck Surgery, Marienhospital Stuttgart, Stuttgart, Germany
| | - Helmut Steinhart
- ENT-clinic, Department of Head and Neck Surgery, Marienhospital Stuttgart, Stuttgart, Germany
| | - Andreas Lendlein
- Institute of Biomaterial Science and Berlin-Brandenburg Center for Regenerative Therapies, Helmholtz-Zentrum Geesthacht, Teltow, Germany.,Institute of Chemistry, University of Potsdam, Potsdam, Germany
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8
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Martinez-Monedero R, Danielian A, Angajala V, Dinalo JE, Kezirian EJ. Methodological Quality of Systematic Reviews and Meta-analyses Published in High-Impact Otolaryngology Journals. Otolaryngol Head Neck Surg 2020; 163:892-905. [PMID: 32450783 DOI: 10.1177/0194599820924621] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To assess the methodological quality of intervention-focused systematic reviews (SRs) and meta-analyses (MAs) published in high-impact otolaryngology journals. DATA SOURCES Ovid Medline, Embase, and Cochrane Library. REVIEW METHODS A comprehensive search was performed for SR and MA citations from 2012 to 2017 in the 10 highest impact factor otolaryngology journals. Abstracts were screened to identify published manuscripts in which the authors indicated clearly that they were performing an SR or MA. Applying a modified typology of reviews, 4 reviewers characterized the review type as SR, MA, or another review type. A simplified version of the AMSTAR 2 (A MeaSurement Tool to Assess systematic Reviews 2) tool was used to assess the reporting and methodological quality of the SRs and MAs that were focused on interventions. RESULTS Search and abstract screening generated 499 manuscripts that identified themselves as performing an SR or MA. A substantial number (85/499, 17%) were review types other than SRs or MAs, including 34 (7%) that were literature reviews. In total, 236 SRs and MAs focused on interventions. Over 50% of these SRs and MAs had weaknesses in at least 3 of the 16 items in the AMSTAR 2, and over 40% had weaknesses in at least 2 of the 7 critical domains. Ninety-nine percent of SRs and MAs provided critically low confidence in the results of the reviews. CONCLUSION Intervention-focused SRs and MAs published in high-impact otolaryngology journals have important methodological limitations that diminish confidence in the results of these reviews.
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Affiliation(s)
- Rodrigo Martinez-Monedero
- USC Caruso Department of Otolaryngology-Head & Neck Surgery, Keck School of Medicine of USC, California, USA
| | - Arman Danielian
- Department of Head and Neck Surgery, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Varun Angajala
- Keck School of Medicine of USC, Los Angeles, California, USA
| | - Jennifer E Dinalo
- Health Sciences Libraries, Keck School of Medicine of USC, Los Angeles, California, USA
| | - Eric J Kezirian
- USC Caruso Department of Otolaryngology-Head & Neck Surgery, Keck School of Medicine of USC, California, USA
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Choosing surgery or radiotherapy for oropharyngeal squamous cell carcinoma: is the issue definitely settled? Lancet Oncol 2019; 20:1328-1329. [PMID: 31416686 DOI: 10.1016/s1470-2045(19)30495-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 06/21/2019] [Accepted: 07/02/2019] [Indexed: 11/23/2022]
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10
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You EL, Henry M, Zeitouni AG. Human papillomavirus-associated oropharyngeal cancer: review of current evidence and management. ACTA ACUST UNITED AC 2019; 26:119-123. [PMID: 31043814 DOI: 10.3747/co.26.4819] [Citation(s) in RCA: 76] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Oropharyngeal cancer (opc) has become the leading site for human papillomavirus (hpv)-associated cancers in humans. It is an epidemic that remains relatively unfamiliar to most physicians, potentially delaying diagnosis and treatment. Traditionally, cancers involving the head and neck have occurred in smokers and in those with a significant alcohol history. Typically, hpv-positive opc presents in a younger, healthier population with a different set of risk factors and good prognosis for survival. However, many head-and-neck cancer patients, including those with hpv-positive disease, develop lifelong disabilities because of the morbid nature of their treatments, and those patients have the highest level of unmet needs in studies spanning cancer sites. Knowledge of this epidemic, a high index of suspicion, and an understanding of how the tumours present in clinical practice can help physicians to make an early diagnosis, thus sparing the patient significant morbidity from treatments associated with more advanced disease stages. Furthermore, recognizing that these patients have distinct psychosocial needs and implementing a collaborative team approach is critical to providing optimal care and improving quality of life in the survivorship period.
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Affiliation(s)
- E L You
- McGill University, Montreal, QC
| | - M Henry
- McGill University, Montreal, QC.,McGill Department of Otolaryngology- Head and Neck Surgery, Montreal, QC
| | - A G Zeitouni
- McGill University, Montreal, QC.,McGill Department of Otolaryngology- Head and Neck Surgery, Montreal, QC
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11
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Rock K, O’Sullivan B, Chen ZJ, Xu ZY, Li JS, Huang SH. Surgery- vs Radiation-Based Therapy for p16+/HPV-Related Oropharyngeal Cancers. CURRENT OTORHINOLARYNGOLOGY REPORTS 2018. [DOI: 10.1007/s40136-018-0214-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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12
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Moroney LB, Helios J, Ward EC, Crombie J, Pelecanos A, Burns CL, Spurgin AL, Blake C, Kenny L, Chua B, Hughes BGM. Helical intensity-modulated radiotherapy with concurrent chemotherapy for oropharyngeal squamous cell carcinoma: A prospective investigation of acute swallowing and toxicity patterns. Head Neck 2018; 40:1955-1966. [DOI: 10.1002/hed.25182] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Revised: 01/01/2018] [Accepted: 02/20/2018] [Indexed: 12/14/2022] Open
Affiliation(s)
- Laura B. Moroney
- Department of Speech Pathology and Audiology; Royal Brisbane and Women's Hospital; Brisbane Australia
- The University of Queensland; School of Health and Rehabilitation Sciences; Brisbane Australia
| | - Jennifer Helios
- Department of Speech Pathology and Audiology; Royal Brisbane and Women's Hospital; Brisbane Australia
| | - Elizabeth C. Ward
- The University of Queensland; School of Health and Rehabilitation Sciences; Brisbane Australia
- Centre for Functioning and Health Research; Metro South Hospital and Health Service; Brisbane Australia
| | - Jane Crombie
- Department of Speech Pathology and Audiology; Royal Brisbane and Women's Hospital; Brisbane Australia
| | - Anita Pelecanos
- QIMR Berghofer Medical Research Institute; Brisbane Australia
| | - Clare L. Burns
- Department of Speech Pathology and Audiology; Royal Brisbane and Women's Hospital; Brisbane Australia
- The University of Queensland; School of Health and Rehabilitation Sciences; Brisbane Australia
| | - Ann-Louise Spurgin
- Department of Speech Pathology and Audiology; Royal Brisbane and Women's Hospital; Brisbane Australia
| | - Claire Blake
- Department of Nutrition and Dietetics; Royal Brisbane and Women's Hospital; Brisbane Australia
| | - Lizbeth Kenny
- Department of Speech Pathology and Audiology; Royal Brisbane and Women's Hospital; Brisbane Australia
- Department of Nutrition and Dietetics; Royal Brisbane and Women's Hospital; Brisbane Australia
- The University of Queensland, School of Medicine; Brisbane Australia
| | - Benjamin Chua
- Department of Speech Pathology and Audiology; Royal Brisbane and Women's Hospital; Brisbane Australia
- Department of Nutrition and Dietetics; Royal Brisbane and Women's Hospital; Brisbane Australia
- The University of Queensland, School of Medicine; Brisbane Australia
| | - Brett G. M. Hughes
- Department of Speech Pathology and Audiology; Royal Brisbane and Women's Hospital; Brisbane Australia
- Department of Nutrition and Dietetics; Royal Brisbane and Women's Hospital; Brisbane Australia
- The University of Queensland, School of Medicine; Brisbane Australia
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13
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Swallowing after transoral surgery for oropharyngeal cancer: comparison with primary chemoradiotherapy outcomes. Curr Opin Otolaryngol Head Neck Surg 2018; 25:101-107. [PMID: 28106661 DOI: 10.1097/moo.0000000000000340] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE OF REVIEW Survival equipoise is recognized between the contemporary surgical and oncological approaches to oropharyngeal squamous cell carcinoma treatment. Primary transoral surgery (TOS) options have emerged that utilize either laser or robotic techniques. Our review presents an overview of the evidence available for swallowing outcomes following TOS approaches and compares these with outcomes following primary oncological management. RECENT FINDINGS Meta-analysis of swallow outcomes following TOS or (chemo)radiotherapy is not possible given the heterogeneity of the available data. There are suggestions of less swallowing impairment following primary TOS, but the favourable selection of patients to these case series must be considered. SUMMARY Minimizing swallowing impairment following oropharyngeal squamous cell carcinoma treatment, while ensuring oncological efficacy, should be a priority for head and neck healthcare providers. Primary TOS may offer an advantage to patients, but only through a team approach that considers how adjuvant oncological therapy could be tailored to individuals. High-quality clinical trials are in progress that will inform future practice.
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14
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Quality of life in survivors of oropharyngeal cancer: A systematic review and meta-analysis of 1366 patients. Eur J Cancer 2017; 78:91-102. [DOI: 10.1016/j.ejca.2017.03.006] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2016] [Revised: 12/24/2016] [Accepted: 03/06/2017] [Indexed: 01/13/2023]
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15
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Meulemans J, Vanclooster C, Vauterin T, D'heygere E, Nuyts S, Clement PM, Hermans R, Delaere P, Vander Poorten V. Up-front and Salvage Transoral Robotic Surgery for Head and Neck Cancer: A Belgian Multicenter Retrospective Case Series. Front Oncol 2017; 7:15. [PMID: 28232904 PMCID: PMC5298968 DOI: 10.3389/fonc.2017.00015] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Accepted: 01/23/2017] [Indexed: 01/04/2023] Open
Abstract
INTRODUCTION/AIM We analyzed the functional and oncologic outcomes of primary and salvage transoral robotic surgery (TORS) procedures, performed in three Belgian institutions with a similar philosophy. PATIENTS AND METHODS A total of 86 patients who underwent TORS between 24-12-2009 and 25-09-2015 were retrospectively reviewed. Descriptive statistics, overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS; Kaplan-Meier), and the variation of these outcomes according to whether patients had primary or salvage TORS were evaluated (univariate log-rank analysis). RESULTS Of 86 patients, 56 (65.1%) underwent TORS as a primary treatment and 30 (34.9%) as a salvage procedure for recurrent or second primary cancer. Tumor location was mainly oropharynx (N = 63; 73.3%) followed by supraglottic larynx (N = 11; 12.8%), hypopharynx (N = 11; 12.8%), and glottic larynx (N = 1; 1.2%). In the up-front TORS group, most tumors were classified as cT1 (N = 23; 41.1%)/pT1 (N = 24; 42.9%) or cT2 (N = 27; 48.2%)/pT2 (N = 27; 48.2%) and cN0 (N = 18; 32.1%), cN1 (N = 13; 23.2%), or cN2 (N = 25; 44.6%). In the salvage TORS group, most tumors were cT1-rT1 (N = 18; 60.0%)/pT1-rpT1 (N = 18; 60.0%) or cT2-rT2 (N = 12; 40.0%)/pT2-rpT2 (N = 7; 23.3%) and cN0 (N = 25; 83.3%). Neck dissection was performed in 87.5% of primary cases and 30.0% of salvage cases. In the up-front TORS group, patients were postoperatively submitted to follow-up (N = 13; 23.2%) or received adjuvant radiotherapy, either as single modality (N = 26; 46.4%) or with concomitant cisplatin (N = 15; 26.8%). On the other hand, most salvage TORS patients did not receive any adjuvant therapy (N = 19; 63.3%). Mean and median follow-up was 23.1 and 21.2 months, respectively. Functional results were excellent (no definitive tracheostomy, long-term tube feeding in 1.8% of primary cases, and 20% of salvage cases). In the up-front TORS group, estimated 2-year OS was 88.5% (SE = 5.0%), 2-year DSS was 91.8% (SE = 4.6%) and 2-year DFS was 86.1% (SE = 5.3%). In the salvage TORS group, estimated 2-year OS was 73.5% (SE = 10.9%), 2-year DSS was 93.3% (SE = 6.4%), and 2-year DFS was 75.8% (SE = 9.7%). Comparing outcome of primarily treated patients to salvage patients, a non-statistically significant trend toward better OS (p = 0.262) and DFS (p = 0.139) was observed. CONCLUSION This retrospective study confirms favorable oncologic and functional outcomes of TORS for selected head and neck malignancies, both in the primary and in the salvage setting.
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Affiliation(s)
- Jeroen Meulemans
- Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium
| | - Christophe Vanclooster
- Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium; Otorhinolaryngology-Head and Neck Surgery, AZ Sint-Lucas, Ghent, Belgium
| | - Tom Vauterin
- Otorhinolaryngology-Head and Neck Surgery, AZ Sint-Jan , Bruges , Belgium
| | - Emmanuel D'heygere
- Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium; Otorhinolaryngology-Head and Neck Surgery, AZ Sint-Jan, Bruges, Belgium
| | - Sandra Nuyts
- Radiation Oncology, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, Section Experimental Radiotherapy, KU Leuven, Leuven, Belgium
| | - Paul M Clement
- Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium; Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Robert Hermans
- Department of Radiology, University Hospitals Leuven , Leuven , Belgium
| | - Pierre Delaere
- Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven , Leuven , Belgium
| | - Vincent Vander Poorten
- Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven, Belgium
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Rubek N, Channir HI, Charabi BW, Lajer CB, Kiss K, Nielsen HU, Bentzen J, Friborg J, von Buchwald C. Primary transoral robotic surgery with concurrent neck dissection for early stage oropharyngeal squamous cell carcinoma implemented at a Danish head and neck cancer center: a phase II trial on feasibility and tumour margin status. Eur Arch Otorhinolaryngol 2017; 274:2229-2237. [DOI: 10.1007/s00405-016-4433-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 12/16/2016] [Indexed: 12/18/2022]
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