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Boguszewicz Ł, Heyda A, Ciszek M, Bieleń A, Skorupa A, Mrochem-Kwarciak J, Składowski K, Sokół M. Metabolite Biomarkers of Prolonged and Intensified Pain and Distress in Head and Neck Cancer Patients Undergoing Radio- or Chemoradiotherapy by Means of NMR-Based Metabolomics-A Preliminary Study. Metabolites 2024; 14:60. [PMID: 38248863 PMCID: PMC10819132 DOI: 10.3390/metabo14010060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 01/09/2024] [Accepted: 01/13/2024] [Indexed: 01/23/2024] Open
Abstract
Treatment of head and neck squamous cell carcinoma (HNSCC) has a detrimental impact on patient quality of life. The rate of recognized distress/depression among HNSCC patients ranges from 9.8% to 83.8%, and the estimated prevalence of depression among patients receiving radiotherapy is 63%. Shorter overall survival also occurs in preexisting depression or depressive conditions. The present study analyzes the nuclear magnetic resonance (NMR) blood serum metabolic profiles during radio-/chemoradiotherapy and correlates the detected alterations with pain and/or distress accumulated with the disease and its treatment. NMR spectra were acquired on a Bruker 400 MHz spectrometer and analyzed using multivariate methods. The results indicate that distress and/or pain primarily affect the serum lipids and metabolites of energy (glutamine, glucose, lactate, acetate) and one-carbon (glycine, choline, betaine, methanol, threonine, serine, histidine, formate) metabolism. Sparse disturbances in the branched-chain amino acids (BCAA) and in the metabolites involved in protein metabolism (lysine, tyrosine, phenylalanine) are also observed. Depending on the treatment modality-radiotherapy or concurrent chemoradiotherapy-there are some differences in the altered metabolites.
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Affiliation(s)
- Łukasz Boguszewicz
- Department of Medical Physics, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland; (M.C.); (A.S.); (M.S.)
| | - Alicja Heyda
- 1st Radiation and Clinical Oncology Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland; (A.H.); (A.B.)
| | - Mateusz Ciszek
- Department of Medical Physics, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland; (M.C.); (A.S.); (M.S.)
| | - Agata Bieleń
- 1st Radiation and Clinical Oncology Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland; (A.H.); (A.B.)
| | - Agnieszka Skorupa
- Department of Medical Physics, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland; (M.C.); (A.S.); (M.S.)
| | - Jolanta Mrochem-Kwarciak
- Analytics and Clinical Biochemistry Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland;
| | - Krzysztof Składowski
- 1st Radiation and Clinical Oncology Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland; (A.H.); (A.B.)
| | - Maria Sokół
- Department of Medical Physics, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland; (M.C.); (A.S.); (M.S.)
- 1st Radiation and Clinical Oncology Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland; (A.H.); (A.B.)
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Boguszewicz Ł, Bieleń A, Ciszek M, Skorupa A, Mrochem-Kwarciak J, Składowski K, Sokół M. Metabolomic Insight into Implications of Induction Chemotherapy Followed by Concomitant Chemoradiotherapy in Locally Advanced Head and Neck Cancer. Int J Mol Sci 2023; 25:188. [PMID: 38203359 PMCID: PMC10779362 DOI: 10.3390/ijms25010188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 12/15/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
The present study compares two groups of locally advanced patients with head and neck squamous cell carcinoma (LA-HNSCC) undergoing concurrent chemoradiotherapy (cCHRT), specifically those for whom it is a first-line treatment and those who have previously received induction chemotherapy (iCHT). The crucial question is whether iCHT is a serious burden during subsequent treatment for LA-HNSCC and how iCHT affects the tolerance to cCHRT. Of the 107 LA-HNSCC patients, 54 received cisplatin-based iCHT prior to cCHRT. The patients were clinically monitored at weekly intervals from the day before until the completion of the cCHRT. The 843 blood samples were collected and divided into two aliquots: for laboratory blood tests and for nuclear magnetic resonance (NMR) spectroscopy (a Bruker 400 MHz spectrometer). The NMR metabolites and the clinical parameters from the laboratory blood tests were analyzed using orthogonal partial least squares analysis (OPLS) and the Mann-Whitney U test (MWU). After iCHT, the patients begin cCHRT with significantly (MWU p-value < 0.05) elevated blood serum lipids, betaine, glycine, phosphocholine, and reticulocyte count, as well as significantly lowered NMR inflammatory markers, serine, hematocrit, neutrophile, monocyte, red blood cells, hemoglobin, and CRP. During cCHRT, a significant increase in albumin and psychological distress was observed, as well as a significant decrease in platelet, N-acetyl-cysteine, tyrosine, and phenylalanine, in patients who received iCHT. Importantly, all clinical symptoms (except the decreased platelets) and most metabolic alterations (except for betaine, serine, tyrosine, glucose, and phosphocholine) resolve until the completion of cCHRT. In conclusion, iCHT results in hematological toxicity, altered lipids, and one-carbon metabolism, as well as downregulated inflammation, as observed at the beginning and during cCHRT. However, these complications are temporary, and most of them resolve at the end of the treatment. This suggests that iCHT prior to cCHRT does not pose a significant burden and should be considered as a safe treatment option for LA-HNSCC.
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Affiliation(s)
- Łukasz Boguszewicz
- Department of Medical Physics, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland; (M.C.); (A.S.); (M.S.)
| | - Agata Bieleń
- 1st Radiation and Clinical Oncology Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland; (A.B.)
| | - Mateusz Ciszek
- Department of Medical Physics, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland; (M.C.); (A.S.); (M.S.)
| | - Agnieszka Skorupa
- Department of Medical Physics, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland; (M.C.); (A.S.); (M.S.)
| | - Jolanta Mrochem-Kwarciak
- Analytics and Clinical Biochemistry Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland;
| | - Krzysztof Składowski
- 1st Radiation and Clinical Oncology Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland; (A.B.)
| | - Maria Sokół
- Department of Medical Physics, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland; (M.C.); (A.S.); (M.S.)
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Heyda A, Księżniak-Baran D, Wygoda A, Składowski K. Low Post-Treatment Quality of Life and the High Incidence of Pain Are Common and Significantly Exacerbated in Depressed Head and Neck Patients Treated with Definitive Accelerated Radiotherapy. Cancers (Basel) 2023; 16:79. [PMID: 38201507 PMCID: PMC10777976 DOI: 10.3390/cancers16010079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/11/2023] [Accepted: 12/18/2023] [Indexed: 01/12/2024] Open
Abstract
(1) Background: The goal of this study is to evaluate psychological tolerance and health-related quality of life (QOL) in head and neck (HN) cancer patients treated with definitive accelerated radiotherapy (DART). (2) Methods: 76 recurrence-free patients eligible for the study, who were treated with DART in the CAIR-2 phase III clinical study (median of follow-up = 47 months), completed EORTC QLQ-C30 with the H&N35 module, Hospital Anxiety and Depression Scale (HADS) and Visual-Analog Scales (VAS) of pain in HN and the neck/arm areas. (3) Results: The most dominant symptoms measured with QLQ-C30 were as follows: fatigue (44/100), sleeplessness (39/100), financial problems (38/100) and pain (32/100). Within the H&N35, the highest scores were reported on the subscales of sticky saliva (60/100), mouth dryness (65/100) and increased intake of painkillers (50/100). Pain (VAS) was reported by 87% (HN area) and 78% (shoulder area) of the patients, with a mean score of 3/10. One-third of the patients reported depressive moods (HADS ≥ 15 points) with an average score of 12.5/42 p. The depressed group, who smoked more as compared to the non-depressed group before DART (96% vs. 78%) and required steroids treatment (85% vs. 58%) during DART, also scored significantly worse on 23 of the 35 subscales of QLQ-C30 and H&N35 and experienced more intense pain (VAS). Women and less-advanced patients scored better in several aspects of quality of life. (4) Conclusions: Patients treated with DART struggle with low quality of life and persistent treatment-related symptoms including constant pain. HNC survivors, especially those who are depressed, may require additional psychosocial, rehabilitation and medical intervention programmes.
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Affiliation(s)
- Alicja Heyda
- 1st Radiation and Clinical Oncology Department, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, 44-102 Gliwice, Poland
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Wierzbicka M, Markowski J, Pietruszewska W, Burduk P, Mikaszewski B, Rogowski M, Składowski K, Milecki P, Fijuth J, Jurkiewicz D, Niemczyk K, Maciejczyk A. Algorithms of follow-up in patients with head and neck cancer in relation to primary location and advancement. Consensus of Polish ENT Society Board and Head Neck Experts. Front Oncol 2023; 13:1298541. [PMID: 38152365 PMCID: PMC10751934 DOI: 10.3389/fonc.2023.1298541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 10/31/2023] [Indexed: 12/29/2023] Open
Abstract
Summary The algorithm of follow-up in patients with head and neck cancer (HNC) has been prepared by a board of Polish Head Neck and Oncology Experts. The aim of this research is to focus on the specificity of HNC monitoring, to review the current trends in follow-up, and to adapt the evidence-based medicine international standards to the capabilities of the local healthcare service. Materials and methods The first methodological step was to categorize HNCs according to the estimated risk of failure after the adequate first-line treatment and according to the possibility of effective salvage treatment, resulting in improved overall survival. The final method used in this work was to prepare an authors' original monitoring algorithm for HNC groups with a high, moderate, and low risk of recurrence in combination with a high or low probability of using an effective salvage. Results Four categories were established: Ia. low risk of recurrence + effective organ preservation feasible; Ib. low risk of recurrence + effective salvage feasible; II. moderate risk of recurrence + effective salvage feasible; III. high risk of recurrence + effective salvage feasible; and IV. high risk of recurrence + no effective salvage feasible. Follow-up visit consisting of 1. ENT examination + neck ultrasound, 2. imaging HN tests, 3. chest imaging, 4. blood tests, and 5. rehabilitation (speech and swallowing) was scheduled with a very different frequency, at the proposed monthly intervals, tailored to the needs of the group. The number of visits for individual groups varies from 1 to 8 in the first 2 years and from 1 to 17 in the entire 5-year monitoring period. Group IV has not been included in regular follow-up, visits on own initiative of the patient if symptomatic, or supportive care needs, having in mind that third-line therapy and immune checkpoint inhibitors are available. Conclusion Universal monitoring algorithm for HNC four groups with a high, moderate, and low risk of recurrence after the adequate treatment in combination with a high or low probability of using an effective salvage is an innovative approach to redeploying system resources and ensuring maximum benefit for patients with HNC.
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Affiliation(s)
- Małgorzata Wierzbicka
- Department of Otolaryngology, Regional Specialist Hospital Wroclaw, Research & Development Centre, Wroclaw, Poland
- Faculty of Medicine, Wroclaw University of Science and Technology, Wroclaw, Poland
- Institute of Human Genetics, Polish Academy of Sciences, Poznan, Poland
| | - Jarosław Markowski
- Department of Laryngology, Faculty of Medical Sciences in Katowice, Medical University of Silesia in Katowice, Katowice, Poland
| | - Wioletta Pietruszewska
- Department of Otolaryngology Head Neck Oncology, Medical University of Lodz, Lodz, Poland
| | - Paweł Burduk
- Department of Otolaryngology Phoniatrics and Audiology, Nicolaus Copernicus University in Toruń, Bydgoszcz, Poland
| | - Bogusław Mikaszewski
- Department of Otolaryngology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Marek Rogowski
- Department of Otolaryngology, Medical University of Bialystok, Bialystok, Poland
| | - Krzysztof Składowski
- Radiation and Clinical Oncology Department, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Piotr Milecki
- Department of Radiotherapy I, The Greater Poland Cancer Centre, Poznan, Poland
| | - Jacek Fijuth
- Department of Radiation Therapy, Oncology Chair, Medical University of Lodz, Lodz, Poland
| | - Dariusz Jurkiewicz
- Department of Otolaryngology and Laryngological Oncology with Clinical Department of Cranio-Maxillofacial Surgery, Military Institute of Medicine - National Research Institute, Warsaw, Poland
| | - Kazimierz Niemczyk
- Department of Otorhinolaryngology Head and Neck Surgery, Medical University of Warsaw, Warsaw, Poland
| | - Adam Maciejczyk
- Department of Oncology, Wroclaw Medical University, Wroclaw, Poland
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Kentnowski M, Cortez AJ, Mazurek AM, Mrochem-Kwarciak J, Hebda A, Kacorzyk U, Drosik-Rutowicz K, Chmielik E, Paul P, Gajda K, Łasińska I, Bobek-Billewicz B, d'Amico A, Składowski K, Śnietura M, Faden DL, Rutkowski TW. Determinants of the level of circulating-tumor HPV16 DNA in patients with HPV-associated oropharyngeal cancer at the time of diagnosis. Sci Rep 2023; 13:21226. [PMID: 38040848 PMCID: PMC10692143 DOI: 10.1038/s41598-023-48506-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 11/27/2023] [Indexed: 12/03/2023] Open
Abstract
Circulating tumor HPV DNA (ctHPV16) assessed in liquid biopsy may be used as a marker of cancer in patients with HPV-associated oropharyngeal cancer (HPV + OPC). Factors influencing the initial ctHPV16 quantity are not well recognized. In this study we aimed to establish what factors are related to the level of ctHPV16 at the time of diagnosis. 51 patients (37 men and 14 women, median age of 57 years old) with HPV + OPC prior to definitive treatment were included. ctHPV16 was measured by qPCR. Tumor and nodal staging were assessed according to AJCC8. Blood derived factors included squamous cell carcinoma antigen (SCC-Ag), serum soluble fragment of cytokeratin 19 (CYFRA 21-1), C-reactive protein (CRP), albumin level (Alb), neutrophils (Neut), thrombocytes (Plt) and lymphocyte (Lym) count, Neut/Lym ratio were assessed. The volumes of the primary tumor (TV) and involved lymph nodes (NV) were calculated using MRI, CT or PET-CT scans. Data were analysed using parametric and nonparametric methods. Variables for multivariable linear regression analysis were chosen based on the results from univariable analysis (correlation, univariable regression and difference). There were 9 (18%), 10 (19%) and 32 (63%) patients who had TV and NV assessed in MRI, CT or PET respectively. Primary tumor neither as T-stage nor TV was related to ctHPV16 level. Significant differences in the ctHPV16 between patients with high vs low pain (P = 0.038), NV (P = 0.023), TV + NV (P = 0.018), CYFRA 21-1 (P = 0.002), CRP (P = 0.019), and N1 vs N3 (P = 0.044) were observed. ctHPV16 was significantly associated with CYFRA 21-1 (P = 0.017), N stage (P = 0.005), NV (P = 0.009), TV + NV (P = 0.002), CRP (P = 0.019), and pain (P = 0.038). In univariable linear regression analysis the same variables predicted ctHPV16 level. In multivariable analyses, CYFRA 21-1 and CRP (both as categorical variables) were predictors of ctHPV16 level even above NV. ctHPV16 at presentation is driven by tumor volume measured mostly by N. CYFRA 21-1 and CRP are additional factors related to ctHPV16 prior to the treatment.
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Affiliation(s)
- Marek Kentnowski
- Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Wybrzeże Armii Krajowej 15, 44-101, Gliwice, Poland
| | - Alexander J Cortez
- Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Wybrzeże Armii Krajowej 15, 44-101, Gliwice, Poland
| | - Agnieszka M Mazurek
- Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Wybrzeże Armii Krajowej 15, 44-101, Gliwice, Poland
| | - Jolanta Mrochem-Kwarciak
- Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Wybrzeże Armii Krajowej 15, 44-101, Gliwice, Poland
| | - Anna Hebda
- Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Wybrzeże Armii Krajowej 15, 44-101, Gliwice, Poland
| | - Urszula Kacorzyk
- Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Wybrzeże Armii Krajowej 15, 44-101, Gliwice, Poland
| | - Katarzyna Drosik-Rutowicz
- Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Wybrzeże Armii Krajowej 15, 44-101, Gliwice, Poland
| | - Ewa Chmielik
- Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Wybrzeże Armii Krajowej 15, 44-101, Gliwice, Poland
| | - Piotr Paul
- Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Wybrzeże Armii Krajowej 15, 44-101, Gliwice, Poland
| | - Karolina Gajda
- Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Wybrzeże Armii Krajowej 15, 44-101, Gliwice, Poland
| | - Izabela Łasińska
- Department of Medical and Experimental Oncology, Cancer Institute, Poznań University of Medical Sciences, 16/18 Grunwaldzka Street, 60-786, Poznan, Poland
- Department of Nursing, Institute of Health Sciences, University of Zielona Góra, 2 Energetyków Street, 65-417, Zielona Góra, Poland
| | - Barbara Bobek-Billewicz
- Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Wybrzeże Armii Krajowej 15, 44-101, Gliwice, Poland
| | - Andrea d'Amico
- Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Wybrzeże Armii Krajowej 15, 44-101, Gliwice, Poland
| | - Krzysztof Składowski
- Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Wybrzeże Armii Krajowej 15, 44-101, Gliwice, Poland
| | - Mirosław Śnietura
- Department of Pathomorphology and Molecular Diagnostics, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Daniel L Faden
- Department of Otolaryngology-Head and Neck Surgery Harvard Medical School, Mass Eye and Ear, Mass General Hospital, Broad Institute of MIT and Harvard, Cambridge, USA
| | - Tomasz W Rutkowski
- Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Wybrzeże Armii Krajowej 15, 44-101, Gliwice, Poland.
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Krzywon A, Kotylak A, Cortez AJ, Mrochem-Kwarciak J, Składowski K, Rutkowski T. Influence of nutritional counseling on treatment results in patients with head and neck cancers. Nutrition 2023; 116:112187. [PMID: 37683314 DOI: 10.1016/j.nut.2023.112187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 07/28/2023] [Accepted: 08/05/2023] [Indexed: 09/10/2023]
Abstract
OBJECTIVES Nutritional intervention, including nutritional counseling (NC), plays a significant role in the comprehensive management of patients with head and neck cancer (HNC). The aim of this study was to investigate the effects of NC combined with oral nutritional supplements during radical treatment on weight loss and survival outcomes in patients with HNC. METHODS The study included 310 patients who received radical treatment for HNC. Among these patients, 119 underwent NC along with oral nutritional supplements (NCONS); 191 were supported with oral nutritional supplements only (ONS). The study aimed to investigate the effects of sex, disease stage, treatment modality, and tumor site on weight loss. Additionally, the Kaplan-Meier method assessed the influence of NC on overall survival and disease-free survival. RESULTS The present study suggested that the NC independently prevented weight loss, regardless of sex and disease stage (female: -1.6%, P = 0.001; male: -2.3 %, P = 0.003; T stage (0-2): -1.7%, P = 0.008; T stage (3-4): -2.7%, P = 0.003; N stage (0-1): 2.5%, P = 0,027; N stage (3-4): 2.9%, P < 0.001). The protective effect was most significant in patients with oral cancer and oropharyngeal cancer and in patients treated with chemotherapy (oral: -1.7%, P = 0.03; oropharynx: -3.3%, P < 0.001; radiochemotherapy: -3%, P = 0.028; induction chemotherapy preceded radiochemotherapy: -6%, P < 0.001). Furthermore, the 3-year overall survival rates were 93.4% and 85.4% in the NC along with oral nutritional supplements (NCONS) and oral nutritional supplement (ONS) groups, respectively (P = 0.031). CONCLUSIONS Patients with HNC who received NC during radical treatment experienced reduced weight loss. This effect was particularly pronounced in patients with oral cavity or oropharyngeal cancer and those undergoing chemotherapy. Additionally, NC was associated with improved overall survival in this patient cohort. Nevertheless, further studies are required to validate and support these findings.
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Affiliation(s)
- Aleksandra Krzywon
- Department of Biostatistics and Bioinformatics, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland.
| | - Anna Kotylak
- I Radiation and Clinical Oncology Department, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Alexander Jorge Cortez
- Department of Biostatistics and Bioinformatics, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Jolanta Mrochem-Kwarciak
- Analytics and Clinical Biochemistry Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Krzysztof Składowski
- I Radiation and Clinical Oncology Department, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Tomasz Rutkowski
- Radiotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland.
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Butkiewicz D, Krześniak M, Gdowicz-Kłosok A, Składowski K, Rutkowski T. DNA Double-Strand Break Response and Repair Gene Polymorphisms May Influence Therapy Results and Prognosis in Head and Neck Cancer Patients. Cancers (Basel) 2023; 15:4972. [PMID: 37894339 PMCID: PMC10605140 DOI: 10.3390/cancers15204972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/05/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
Radiotherapy and cisplatin-based chemotherapy belong to the main treatment modalities for head and neck squamous cell carcinoma (HNSCC) and induce cancer cell death by generating DNA damage, including the most severe double-strand breaks (DSBs). Alterations in DSB response and repair genes may affect individual DNA repair capacity and treatment sensitivity, contributing to the therapy resistance and poor prognosis often observed in HNSCC. In this study, we investigated the association of a panel of single-nucleotide polymorphisms (SNPs) in 20 DSB signaling and repair genes with therapy results and prognosis in 505 HNSCC patients treated non-surgically with DNA damage-inducing therapies. In the multivariate analysis, there were a total of 14 variants associated with overall, locoregional recurrence-free or metastasis-free survival. Moreover, we identified 10 of these SNPs as independent predictors of therapy failure and unfavorable prognosis in the whole group or in two treatment subgroups. These were MRE11 rs2155209, XRCC5 rs828907, RAD51 rs1801321, rs12593359, LIG4 rs1805388, CHEK1 rs558351, TP53 rs1042522, ATM rs1801516, XRCC6 rs2267437 and NBN rs2735383. Only CHEK1 rs558351 remained statistically significant after correcting for multiple testing. These results suggest that specific germline variants related to DSB response and repair may be potential genetic modifiers of therapy effects and disease progression in HNSCC treated with radiotherapy and cisplatin-based chemoradiation.
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Affiliation(s)
- Dorota Butkiewicz
- Center for Translational Research and Molecular Biology of Cancer, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland
| | - Małgorzata Krześniak
- Center for Translational Research and Molecular Biology of Cancer, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland
| | - Agnieszka Gdowicz-Kłosok
- Center for Translational Research and Molecular Biology of Cancer, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland
| | - Krzysztof Składowski
- I Radiation and Clinical Oncology Department, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland
| | - Tomasz Rutkowski
- I Radiation and Clinical Oncology Department, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland
- Radiotherapy Department, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland
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Tajstra M, Dyrbuś M, Rutkowski T, Składowski K, Sosnowska‐Pasiarska B, Góźdź S, Radecka B, Staszewski M, Majsnerowska A, Myrda K, Nowowiejska‐Wiewióra A, Skoczylas I, Rymkiewicz I, Niklewski T, Nowak J, Przybyłowski P, Gąsior M, Jarząb M. Sacubitril/valsartan for cardioprotection in breast cancer (MAINSTREAM): design and rationale of the randomized trial. ESC Heart Fail 2023; 10:3174-3183. [PMID: 37449716 PMCID: PMC10567668 DOI: 10.1002/ehf2.14466] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/11/2023] [Accepted: 06/21/2023] [Indexed: 07/18/2023] Open
Abstract
AIMS In recent years, survival in patients with breast cancer has increased. Despite the improvement in outcomes of those patients, the risk of treatment-related cardiotoxicity remains high, and its presence has been associated with a higher risk of treatment termination and thus lower therapeutic efficacy. Prior trials demonstrated that a preventive initiation of heart failure drugs, including the renin-angiotensin-aldosterone inhibitors, might reduce the risk of treatment-related cardiotoxicity. However, to date, no study investigated the efficacy of sacubitril/valsartan, a novel antineurohormonal drug shown to be superior to the previous therapies, in the prevention of cardiotoxicity in patients with early-stage breast cancer, which is the aim of the trial. METHODS AND RESULTS MAINSTREAM is a randomized, placebo-controlled, double-blind, multicentre, clinical trial. After the run-in period, a total of 480 patients with early breast cancer undergoing treatment with anthracyclines and/or anti-human epidermal growth factor receptor 2 drugs will be randomized to the highest tolerated dose of sacubitril/valsartan, being preferably 97/103 mg twice daily or placebo in 1:1 ratio. The patients will be monitored, including routine transthoracic echocardiography (TTE) and laboratory biomarker monitoring, for 24 months. The primary endpoint of the trial will be the occurrence of a decrease in left ventricular ejection fraction by ≥5% in TTE within 24 months. The key secondary endpoints will be the composite endpoint of death from any cause or hospitalization for heart failure, as well as other imaging, laboratory, and clinical outcomes, including the occurrence of the cancer therapy-related cardiac dysfunction resulting in the necessity to initiate treatment. The first patients are expected to be recruited in the coming months, and the estimated completion of the study and publication of the results are expected in December 2027, pending recruitment. CONCLUSIONS The MAINSTREAM trial will determine the efficacy and safety of treatment with sacubitril/valsartan as a prevention of cardiotoxicity in patients with early breast cancer (ClinicalTrials.gov number: NCT05465031).
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Affiliation(s)
- Mateusz Tajstra
- 3rd Department of Cardiology, School of Medical Sciences in ZabrzeMedical University of SilesiaKatowicePoland
| | - Maciej Dyrbuś
- 3rd Department of Cardiology, School of Medical Sciences in ZabrzeMedical University of SilesiaKatowicePoland
| | - Tomasz Rutkowski
- Department of Radiation and Clinical OncologyMaria Skłodowska‐Curie National Research Institute of Oncology, Gliwice BranchGliwicePoland
| | - Krzysztof Składowski
- Department of Radiation and Clinical OncologyMaria Skłodowska‐Curie National Research Institute of Oncology, Gliwice BranchGliwicePoland
| | | | | | - Barbara Radecka
- Department of Oncology, Institute of Medical SciencesUniversity of OpoleOpolePoland
- Department of Clinical OncologyTadeusz Koszarowski Cancer Centre in OpoleOpolePoland
| | | | - Aleksandra Majsnerowska
- 3rd Department of Cardiology, School of Medical Sciences in ZabrzeMedical University of SilesiaKatowicePoland
| | - Krzysztof Myrda
- 3rd Department of Cardiology, School of Medical Sciences in ZabrzeMedical University of SilesiaKatowicePoland
| | - Alicja Nowowiejska‐Wiewióra
- 3rd Department of Cardiology, School of Medical Sciences in ZabrzeMedical University of SilesiaKatowicePoland
| | - Ilona Skoczylas
- 3rd Department of Cardiology, School of Medical Sciences in ZabrzeMedical University of SilesiaKatowicePoland
| | | | - Tomasz Niklewski
- Department of Cardiac, Vascular and Endovascular Surgery and TransplantologyMedical University of Silesia, Silesian Centre for Heart DiseasesZabrzePoland
| | - Jolanta Nowak
- 3rd Department of Cardiology, School of Medical Sciences in ZabrzeMedical University of SilesiaKatowicePoland
| | - Piotr Przybyłowski
- Department of Cardiac, Vascular and Endovascular Surgery and TransplantologyMedical University of Silesia, Silesian Centre for Heart DiseasesZabrzePoland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, School of Medical Sciences in ZabrzeMedical University of SilesiaKatowicePoland
| | - Michał Jarząb
- Breast Cancer UnitMaria Skłodowska‐Curie National Research Institute of Oncology, Gliwice BranchGliwicePoland
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9
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Pilśniak A, Szlauer-Stefańska A, Tukiendorf A, Rutkowski T, Składowski K, Kamińska-Winciorek G. Dermoscopy of acute radiation-induced dermatitis in patients with head and neck cancers treated with radiotherapy. Sci Rep 2023; 13:15711. [PMID: 37735505 PMCID: PMC10514312 DOI: 10.1038/s41598-023-42507-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 09/11/2023] [Indexed: 09/23/2023] Open
Abstract
Head and neck cancer (HNC) was the seventh most common cancer in the world in 2018. Treatment of a patient may include surgery, radiotherapy (RT), chemotherapy, targeted therapy, immunotherapy, or a combination of these methods. Ionizing radiation used during RT covers relatively large volumes of healthy tissue surrounding the tumor. The acute form of radiation-induced dermatitis (ARD) are skin lesions that appear usually within 90 days of the start of RT. This is a prospective study which compares 2244 dermoscopy images and 374 clinical photographs of irradiated skin and healthy skin of 26 patients at on average 15 time points. Dermoscopy pictures were evaluated independently by 2 blinded physicians. Vessels in reticular distribution, white, yellow or brown scale in a patchy distribution, perifollicular pigmentation and follicular plugs arranged in rosettes were most often observed. For these dermoscopic features, agreement with macroscopic features was observed. Two independent predictors of severe acute toxicity were identified: gender and concurrent chemotherapy. Knowledge of dermoscopic features could help in the early assessment of acute toxicity and the immediate implementation of appropriate therapeutic strategies. This may increase the tolerance of RT in these groups of patients.
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Affiliation(s)
- Aleksandra Pilśniak
- Department of Internal Medicine, Autoimmune and Metabolic Diseases, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Anastazja Szlauer-Stefańska
- Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie National Research Institute of Oncology (MSCNRIO), Gliwice, Poland
| | | | - Tomasz Rutkowski
- Inpatient Department of Radiation and Clinical Oncology, Maria Sklodowska Curie National Research Institute of Oncology (MSCNRIO), Gliwice, Poland
| | - Krzysztof Składowski
- Inpatient Department of Radiation and Clinical Oncology, Maria Sklodowska Curie National Research Institute of Oncology (MSCNRIO), Gliwice, Poland
| | - Grażyna Kamińska-Winciorek
- Department of Bone Marrow Transplantation and Onco-Hematology, Skin Cancer and Melanoma Team, Maria Sklodowska-Curie National Research Institute of Oncology (MSCNRIO), Wybrzeże Armii Krajowej 15, 44-101, Gliwice, Poland.
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10
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Polanowski P, Nasiek A, Grządziel A, Pietruszka A, Składowski K, Polanowska K. Stereotactic Radiotherapy in Combination with Immunotherapy in Treatment of Advanced Recurrent Squamous Cell Carcinoma of the Larynx. Biomedicines 2023; 11:2067. [PMID: 37509706 PMCID: PMC10377655 DOI: 10.3390/biomedicines11072067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 07/17/2023] [Accepted: 07/21/2023] [Indexed: 07/30/2023] Open
Abstract
Squamous cell carcinoma (SCC) of the larynx in advanced stages is a challenging malignancy to treat with a high recurrence and death rate. An individualized approach to treatment is crucial in such patients. We present a 58-year-old male patient with SCC of the larynx in the T3N0M0 stage who was treated with concurrent radiochemotherapy. A total of 17 months after the radical treatment, the patient underwent a laryngectomy due to recurrence. A total of 11 months after the operation, local failure was diagnosed. In the next order, the patient received six cycles of palliative chemotherapy according to cisplatin 100 mg/m2 and 5-fluorouracil 1000 mg/m2. After three months, due to progression, Nivolumab-based immunotherapy was administered, ensuring disease stabilization. After the 56th cycle of Nivolumab, another progression was documented. The addition of stereotactic radiotherapy (18 Gy in three fractions) to immunotherapy led to significant regression of the disease and enabled the continuation of Nivolumab to the 70th cycle. The presented case demonstrates the usefulness of the combination of stereotactic radiotherapy with immunotherapy in prolonging the local control.
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Affiliation(s)
- Paweł Polanowski
- 1st Radiation and Clinical Oncology Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Wybrzeże Armii Krajowej 15, 44-102 Gliwice, Poland
| | - Aleksandra Nasiek
- 3rd Radiation and Clinical Oncology Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Wybrzeże Armii Krajowej 15, 44-102 Gliwice, Poland
| | - Aleksandra Grządziel
- Radiotherapy Planning Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Wybrzeże Armii Krajowej 15, 44-102 Gliwice, Poland
| | - Agnieszka Pietruszka
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, Garncarska 11, 31-115 Cracow, Poland
| | - Krzysztof Składowski
- 1st Radiation and Clinical Oncology Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Wybrzeże Armii Krajowej 15, 44-102 Gliwice, Poland
| | - Katarzyna Polanowska
- Ophthalmology Department, St. Barbara Provincial Hospital No 5, Plac Medyków 1, 41-200 Sosnowiec, Poland
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11
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Polanowski P, Nasiek A, Grządziel A, Chmielik E, Pietruszka A, Składowski K, Polanowska K. Stereotactic Radiotherapy Boost in Treatment of Persistent Periocular Sebaceous Carcinoma after Surgery. Biomedicines 2023; 11:1538. [PMID: 37371633 DOI: 10.3390/biomedicines11061538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 05/17/2023] [Accepted: 05/24/2023] [Indexed: 06/29/2023] Open
Abstract
Sebaceous carcinoma is a rare malignancy that should be treated with surgical resection. Nonetheless, a dynamic and aggressive course of the disease may disqualify a patient from this treatment. Applying radiotherapy with the escalation dose using a stereotactic boost is worthy of consideration as a radical treatment. In this paper, we present the case study of a young patient with a tumor localized in the periocular area. The patient was treated with operation two times without a satisfactory effect. Conventional radiotherapy, 60 Gy in 30 fractions, combined with chemotherapy based on cisplatin 40 mg/m2 and the addition of a stereotactic radiosurgery boost were administered. The tolerance of this treatment was acceptable. During the 2-year follow-up, local and distant recurrences were not diagnosed. The presented case shows the usefulness of an individualized approach in the radical treatment of sebaceous carcinoma with the use of the stereotactic radiotherapy boost. This is a subsequent example of the implementation of the boost in head and neck carcinoma, which yields a positive result.
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Affiliation(s)
- Paweł Polanowski
- 1st Radiation and Clinical Oncology Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Wybrzeże Armii Krajowej 15, 44-102 Gliwice, Poland
| | - Aleksandra Nasiek
- 3rd Radiation and Clinical Oncology Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Wybrzeże Armii Krajowej 15, 44-102 Gliwice, Poland
| | - Aleksandra Grządziel
- Radiotherapy Planning Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Wybrzeże Armii Krajowej 15, 44-102 Gliwice, Poland
| | - Ewa Chmielik
- Tumor Pathology Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Wybrzeże Armii Krajowej 15, 44-102 Gliwice, Poland
| | - Agnieszka Pietruszka
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, Garncarska 11, 31-115 Cracow, Poland
| | - Krzysztof Składowski
- 1st Radiation and Clinical Oncology Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Wybrzeże Armii Krajowej 15, 44-102 Gliwice, Poland
| | - Katarzyna Polanowska
- Ophthalmology Department, St. Barbara Provincial Hospital No 5, Plac Medyków 1, 41-200 Sosnowiec, Poland
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12
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Heyda A, Bieleń A, Wygoda A, Składowski K. Walking through the valley of the shadow of death-The psychotherapy of the head and neck cancer patient expressing suicidal ideations and impulses. J Clin Psychol 2023; 79:1562-1571. [PMID: 37006196 DOI: 10.1002/jclp.23517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 03/17/2023] [Accepted: 03/20/2023] [Indexed: 04/04/2023]
Abstract
The paper aims to show the multilevel and complex cooperation and the inclusion of the psychotherapist leading the psychotherapy in the medical team at the radiotherapy and clinical oncology clinic. We illustrate these interventions with the case of Stan. This 43-year-old firefighter was diagnosed with advanced head and neck cancer and pre-existing mental health problems meeting the criteria of ICD-10: obsessive-compulsive disorder, post-traumatic stress disorder and psychoactive substance abuse. During the treatment, suicidal thoughts and impulses emerged, triggered at the hospital by electronic noises and the feeling of entrapment without a way out. This situation put the patient at high risk and the whole healthcare team needed an urgent effective response. The patient agreed to stay in the secured room, where he was cared for by doctors, nurses, a dietitian, and a psychotherapist. He actively attended daily sessions with noticeable engagement. Psychotherapy sessions focused on alleviating posttraumatic stress disorder and OCD. Mindfulness and breathwork-based exercises were implemented to increase non-judgemental self-awareness and regulate the over-aroused nervous system. As a result, the patient's mental health has improved and the completion of the cancer treatment was possible. Psychotherapy, good therapeutic alliance, and attentive teamwork effectively managed his mental health and treatment-related symptoms.
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Affiliation(s)
- Alicja Heyda
- Maria Sklodowska-Curie National Research Institute, Gliwice Branch, Poland
| | - Agata Bieleń
- Maria Sklodowska-Curie National Research Institute, Gliwice Branch, Poland
| | - Andrzej Wygoda
- Maria Sklodowska-Curie National Research Institute, Gliwice Branch, Poland
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13
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Tajstra M, Dyrbuś M, Wojtynek E, Wojtaszczyk A, Rutkowski T, Niedziela JT, Błachut A, Jarząb M, Blamek S, Kurek A, Gorol J, Witek M, Składowski K, Gąsior M, Bobek-Bilewicz B. Magnetic resonance imaging in patients with cardiac implantable electronic devices in the cardiooncology center. Kardiol Pol 2023:VM/OJS/J/93769. [PMID: 36999722 DOI: 10.33963/kp.a2023.0080] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 01/18/2023] [Indexed: 04/01/2023]
Affiliation(s)
- Mateusz Tajstra
- 3rd Department of Cardiology, School of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland.
| | - Maciej Dyrbuś
- 3rd Department of Cardiology, School of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Elżbieta Wojtynek
- Department of Cardiology and Intensive Cardiac Care Unit, Regional Specialist Hospital No. 3, Rybnik, Poland
| | - Adam Wojtaszczyk
- Department of Electrocardiology, Medical University of Lodz, Łódź, Poland
| | - Tomasz Rutkowski
- 1st Department of Radiation and Clinical Oncology, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Jacek T Niedziela
- 3rd Department of Cardiology, School of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Aleksandra Błachut
- 3rd Department of Cardiology, School of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Michał Jarząb
- Breast Cancer Unit, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Sławomir Blamek
- Department of Radiotherapy, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Anna Kurek
- 3rd Department of Cardiology, School of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Jarosław Gorol
- 3rd Department of Cardiology, School of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Mateusz Witek
- 3rd Department of Cardiology, School of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Krzysztof Składowski
- 1st Department of Radiation and Clinical Oncology, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Mariusz Gąsior
- 3rd Department of Cardiology, School of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Barbara Bobek-Bilewicz
- Department of Radiology and Imaging Diagnostic, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
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Rutkowski T, Mazurek A, Kacorzyk U, Dębiec K, Kentnowski M, Pietruszka A, Składowski K. P29 Comparison of selected clinical factors and treatment results according to HPV status in patients with oropharyngeal cancer treated with radiotherapy alone or combined with chemotherapy. Oral Oncol 2022. [DOI: 10.1016/j.oraloncology.2022.106160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Wierzbicka M, Fijuth J, Składowski K, Jurkiewicz D, Burduk P, Miłoński J, Niemczyk K, Pietruszewska W, Rogowski M, Stodulski D, Mikaszewski B. Adjuvant radiotherapy in parotid gland pleomorphic adenoma - recommendations. Otolaryngol Pol 2022; 76:1-7. [PMID: 36622124 DOI: 10.5604/01.3001.0015.9818] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
<b>Introduction:</b> Standard treatment for pleomorhic adenoma (PA) of the parotid gland is complete surgical excision. Radiotherapy (RT) as a primary treatment method is controversial and generally is not applied. However, RT might be considered as an adjuvant therapy in some selected cases. </br></br> <b>Aim:</b> The aim of this work was to define recommendations for RT in patients with parotid gland PA after primary surgical treatment.</br></br> <b>Material and methods:</b> Based on the results currently published in the literature and the authors' own experiences from leading Polish laryngological and oncological clinical centers dealing with the treatment of salivary gland tumors, the indications for irradia- tion and its methods in patients with PA of the salivary glands were discussed. </br></br> <b>Results and discussion:</b> Authors recommend personalized treatment based on multidisciplinary panel decisions in each patient. Adjuvant RT should be considered in cases of suboptimal resection of primary PA (close margin, intraoperative tumor spillage, risk of recurrence based on clinical factors and histological features), and in cases of PA recurrence. Doses/ fractions and techniques of irradiation are recommended depending on the clinical extension of the primary or recurrent tumor. </br></br> <b> Conclusions:</b> Adjuvant RT in PA treatment should be a result of a personalized multidisciplinary decision after considering all possible risks of irradiation consequences. Recommendations for this treatment should be taken into consideration.
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Affiliation(s)
- Małgorzata Wierzbicka
- Klinika Otolaryngologii i Onkologii Laryngologicznej, Uniwersytet Medyczny w Poznaniu
| | - Jacek Fijuth
- Zakład Radioterapii, Uniwersytet Medyczny w Łodzi Zakład Teleradioterapii, Regionalny Ośrodek Onkologiczny, Szpital im. Mikołaja Kopernika w Łodzi
| | - Krzysztof Składowski
- I Klinika Radioterapii i Onkologii Klinicznej, Narodowy Instytut Onkologii im. Marii Skłodowskiej-Curie w Gliwicach
| | - Dariusz Jurkiewicz
- Department of Otolaryngology, Military Institute of Medicine in Warsaw, Poland
| | - Paweł Burduk
- Klinika Otolaryngologii, Onkologii Laryngologicznej i Chirurgii Szczękowo-Twarzowej, Collegium Medicum w Bydgoszczy
| | - Jarosław Miłoński
- Klinika Otolaryngologii, Onkologii Laryngologicznej, Audiologii i Foniatrii, II Katedry Otolaryngologii Uniwersytetu Medycznego w Łodzi
| | - Kazimierz Niemczyk
- Chair and Clinic of Otorhinolaryngology, Head and Neck Surgery at the Medical University of Warsaw, Poland
| | - Wioletta Pietruszewska
- I Katedra Otolaryngologii, Klinika Otolaryngologii i Laryngologii Onkologicznej, Uniwersytet Medyczny w Łodzi
| | - Marek Rogowski
- Klinika Otolaryngologii, Uniwersytet Medyczny w Białymstoku
| | - Dominik Stodulski
- Klinika Otolaryngologii, Wydział Lekarski, Gdański Uniwersytet Medyczny
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Słowińska M, Dudzisz – Śledź M, Sobczuk P, Łasińska I, Pieruszka A, Cybulska – Stopa B, Kowalczyk A, Świtaj T, Czarnecka I, Koseła‐Paterczyk H, Rogala P, Paluchowska E, Składowski K, Mackiewicz J, Rutkowski P, Owczarek W. Analysis of efficacy and safety of vismodegib therapy in patients with advanced basal cell carcinoma ‐ real world multicenter cohort study. J Eur Acad Dermatol Venereol 2022; 36:1219-1228. [PMID: 35279879 PMCID: PMC9541446 DOI: 10.1111/jdv.18070] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 02/09/2022] [Indexed: 11/30/2022]
Affiliation(s)
- M. Słowińska
- Department of Dermatology Military Institute of Medicine Warsaw Poland
| | - M. Dudzisz – Śledź
- Department of Soft Tissue/Bone Sarcoma and Melanoma Maria Skłodowska‐Curie National Research Institute of Oncology Warsaw Poland
| | - P. Sobczuk
- Department of Soft Tissue/Bone Sarcoma and Melanoma Maria Skłodowska‐Curie National Research Institute of Oncology Warsaw Poland
- Department of Experimental and Clinical Physiology Laboratory of Centre for Preclinical Research Medical University of Warsaw Warsaw Poland
| | - I. Łasińska
- Department of Medical and Experimental Oncology Heliodor Święcicki Clinical Hospital Poznań University of Medical Sciences Poznań Poland
- Department of Nursing Faculty of Medicine and Health Sciences Collegium Medicum University of Zielona Góra Zielona Góra Poland
| | - A. Pieruszka
- 1st Radiation and Clinical Oncology Department Maria Skłodowska‐Curie National Research Institute of Oncology Gliwice Branch Gliwice Poland
| | - B. Cybulska – Stopa
- Clinical Oncology Department Maria Skłodowska‐Curie National Research Institute of Oncology Cracow Branch Cracow Poland
| | - A. Kowalczyk
- Department of Oncology and Radiotherapy Medical University of Gdańsk Gdańsk Poland
| | - T. Świtaj
- Department of Soft Tissue/Bone Sarcoma and Melanoma Maria Skłodowska‐Curie National Research Institute of Oncology Warsaw Poland
| | - I. Czarnecka
- Department of Dermatology Military Institute of Medicine Warsaw Poland
| | - H Koseła‐Paterczyk
- Department of Soft Tissue/Bone Sarcoma and Melanoma Maria Skłodowska‐Curie National Research Institute of Oncology Warsaw Poland
| | - P. Rogala
- Department of Soft Tissue/Bone Sarcoma and Melanoma Maria Skłodowska‐Curie National Research Institute of Oncology Warsaw Poland
| | - E. Paluchowska
- Department of Dermatology Military Institute of Medicine Warsaw Poland
| | - K. Składowski
- 1st Radiation and Clinical Oncology Department Maria Skłodowska‐Curie National Research Institute of Oncology Gliwice Branch Gliwice Poland
| | - J. Mackiewicz
- Department of Medical and Experimental Oncology Heliodor Święcicki Clinical Hospital Poznań University of Medical Sciences Poznań Poland
- Department of Diagnostics and Cancer Immunology Greater Poland Cancer Centre Poznań Poland
| | - P. Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma Maria Skłodowska‐Curie National Research Institute of Oncology Warsaw Poland
| | - W. Owczarek
- Department of Dermatology Military Institute of Medicine Warsaw Poland
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Boguszewicz L, Bieleń A, Jarczewski J, Ciszek M, Skorupa A, Składowski K, Sokół M. 885P Molecular response to induction chemotherapy and its correlation with treatment outcome in head and neck cancer patients by means of NMR-based metabolomics. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Mrochem-Kwarciak J, Wygoda A, Rutkowski T, Chmura A, Deja R, Mazurek A, Składowski K. P-12 Prognostic value of inflammatory markers in HPV-positive and HPV-negative patients with oropharyngeal cancer (OPC). Oral Oncol 2021. [DOI: 10.1016/s1368-8375(21)00301-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Mrochem-Kwarciak J, Wygoda A, Deja R, Rutkowski T, Polanowski P, Składowski K. P-11 Assessment of clinical utility of angiogenesis and hypoxia markers in patients with head and neck cancer (HNC). Oral Oncol 2021. [DOI: 10.1016/s1368-8375(21)00300-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Mrochem-Kwarciak J, Wygoda A, Rutkowski T, Chmura A, Deja R, Składowski K. P-45 Assessment of clinical utility of angiogenesis and hypoxia markers in patients with head and neck cancer (HNC). Oral Oncol 2021. [DOI: 10.1016/s1368-8375(21)00333-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Golen M, Miszczyk L, Składowski K, dAmico A, Kołosza Z. P-37 Use of dynamic scintigraphy for objective quantitative estimation of the risk of salivary gland xerostomia after radiotherapy. Oral Oncol 2021. [DOI: 10.1016/s1368-8375(21)00325-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Brewczyński A, Jabłońska B, Mazurek AM, Mrochem-Kwarciak J, Mrowiec S, Śnietura M, Kentnowski M, Kołosza Z, Składowski K, Rutkowski T. Comparison of Selected Immune and Hematological Parameters and Their Impact on Survival in Patients with HPV-Related and HPV-Unrelated Oropharyngeal Cancer. Cancers (Basel) 2021; 13:cancers13133256. [PMID: 34209764 PMCID: PMC8268778 DOI: 10.3390/cancers13133256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 06/20/2021] [Accepted: 06/25/2021] [Indexed: 01/21/2023] Open
Abstract
Simple Summary This is a research article on oropharyngeal cancer (OPC). The aim of the study was to assess and compare basic immune parameters and ratios in patients with Human Papilloma Virus (HPV)+ and HPV− OPC, before and after radiotherapy (RT) or chemoradiotherapy (CRT), and to investigate their impact on overall survival (OS) and disease-free survival (DFS). The higher neutrophil-lymphocyte ratio (NLR) and systemic immune inflammation (SII) are significant adverse prognostic factors for HPV+ OPC patients, because they are significantly associated with both inferior OS and DFS in this group, whereas the higher platelet cells (PLT) count is significant adverse prognostic factor for HPV− OPC patients, because it is significantly associated with inferior OS and DFS in this group. This study confirmed that determination of HPV etiology as well as analysis of various hematological and immune parameters should be a standard management in OPC patients in order to properly treat them for improved prognosis. Abstract Several immune and hematological parameters are associated with survival in patients with oropharyngeal cancer (OPC). The aim of the study was to analyze selected immune and hematological parameters of patients with HPV-related (HPV+) and HPV-unrelated (HPV−) OPC, before and after radiotherapy/chemoradiotherapy (RT/CRT) and to assess the impact of these parameters on survival. One hundred twenty seven patients with HPV+ and HPV− OPC, treated with RT alone or concurrent chemoradiotherapy (CRT), were included. Patients were divided according to HPV status. Confirmation of HPV etiology was obtained from FFPE (Formalin-Fixed, Paraffin-Embedded) tissue samples and/or extracellular circulating HPV DNA was determined. The pre-treatment and post-treatment laboratory blood parameters were compared in both groups. The neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), and systemic immune inflammation (SII) index were calculated. The impact of these parameters on overall (OS) and disease-free (DFS) survival was analyzed. In HPV+ patients, a high pre-treatment white blood cells (WBC) count (>8.33 /mm3), NLR (>2.13), SII (>448.60) significantly correlated with reduced OS, whereas high NLR (>2.29), SII (>462.58) significantly correlated with reduced DFS. A higher pre-treatment NLR and SII were significant poor prognostic factors for both OS and DFS in the HPV+ group. These associations were not apparent in HPV− patients. There are different pre-treatment and post-treatment immune and hematological prognostic factors for OS and DFS in HPV+ and HPV− patients. The immune ratios could be considered valuable biomarkers for risk stratification and differentiation for HPV− and HPV+ OPC patients.
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Affiliation(s)
- Adam Brewczyński
- I Radiation and Clinical Oncology Department of Maria Skłodowska-Curie National Research Institute of Oncology, 44-102 Gliwice Branch, Poland; (A.B.); (M.K.); (K.S.); (T.R.)
| | - Beata Jabłońska
- Department of Digestive Tract Surgery, Medical University of Silesia, 40-752 Katowice, Poland;
- Correspondence:
| | - Agnieszka Maria Mazurek
- Centre for Translational Research and Molecular Biology of Cancer of Maria Skłodowska-Curie National Research Institute of Oncology, 44-102 Gliwice Branch, Poland;
| | - Jolanta Mrochem-Kwarciak
- The Analytics and Clinical Biochemistry Department of Maria Skłodowska-Curie National Research Institute of Oncology, 44-102 Gliwice Branch, Poland;
| | - Sławomir Mrowiec
- Department of Digestive Tract Surgery, Medical University of Silesia, 40-752 Katowice, Poland;
| | - Mirosław Śnietura
- Tumor Pathology Department of Maria Skłodowska-Curie National Research Institute of Oncology, 44-102 Gliwice Branch, Poland;
| | - Marek Kentnowski
- I Radiation and Clinical Oncology Department of Maria Skłodowska-Curie National Research Institute of Oncology, 44-102 Gliwice Branch, Poland; (A.B.); (M.K.); (K.S.); (T.R.)
| | - Zofia Kołosza
- Department of Biostatistics and Bioinformatics of Maria Skłodowska-Curie National Research Institute of Oncology, 44-102 Gliwice Branch, Poland;
| | - Krzysztof Składowski
- I Radiation and Clinical Oncology Department of Maria Skłodowska-Curie National Research Institute of Oncology, 44-102 Gliwice Branch, Poland; (A.B.); (M.K.); (K.S.); (T.R.)
| | - Tomasz Rutkowski
- I Radiation and Clinical Oncology Department of Maria Skłodowska-Curie National Research Institute of Oncology, 44-102 Gliwice Branch, Poland; (A.B.); (M.K.); (K.S.); (T.R.)
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Boguszewicz Ł, Bieleń A, Jarczewski JD, Ciszek M, Skorupa A, Składowski K, Sokół M. Molecular response to induction chemotherapy and its correlation with treatment outcome in head and neck cancer patients by means of NMR-based metabolomics. BMC Cancer 2021; 21:410. [PMID: 33858370 PMCID: PMC8048324 DOI: 10.1186/s12885-021-08137-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 04/02/2021] [Indexed: 12/16/2022] Open
Abstract
Background The aim of this prospective study is to identify the biomarkers associated with the effects of induction chemotherapy (iCHT) in terms of the favorable/weaker response to the treatment in locally advanced head and neck squamous cells carcinomas (LA-HNSCC). Methods The studied group consisted of 53 LA-HNSCC patients treated with iCHT. The treatment tolerance was measured by the Common Terminology Criteria for Adverse Events (CTCAE). The response to the treatment was evaluated by the clinical, fiberoptic and radiological examinations made before and after iCHT (the TNM Classification of Malignant Tumors was used for classifying the extent of cancer spread). Proton nuclear magnetic resonance (1H NMR) serum spectra of the samples collected before and after iCHT were acquired with a 400 MHz spectrometer and analyzed using the multivariate and univariate statistical methods. Results The molecular response to iCHT involves an increase of the serum lipids which is accompanied by the simultaneous decrease of alanine, glucose and N-acetyl-glycoprotein (NAG). Furthermore, in males, the iCHT induced changes in the lipid signals and NAG significantly correlate with the regression of the primary tumor. The OPLS-DA multivariate model identified two subgroups of the patients with a weaker metabolic and clinical response. The first one consisted of the patients with a significantly lower initial nodal stage, the second one showed no differences in the initial clinical and metabolic statuses. Conclusions The NMR-based metabolomic study of the serum spectra revealed that iCHT induces the marked changes in the LA-HNSCC patients’ metabolic profiles and makes it possible to stratify the patients according to their response to iCHT. These effects are sex dependent. Further studies on a larger scale accounting for sex and the clinical and metabolic factors are warranted. Supplementary Information The online version contains supplementary material available at 10.1186/s12885-021-08137-4.
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Affiliation(s)
- Łukasz Boguszewicz
- Department of Medical Physics, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Warszawa, Poland.
| | - Agata Bieleń
- 1st Radiation and Clinical Oncology Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Warszawa, Poland
| | - Jarosław Dawid Jarczewski
- Radiology and Diagnostic Imaging Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Warszawa, Poland
| | - Mateusz Ciszek
- Department of Medical Physics, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Warszawa, Poland
| | - Agnieszka Skorupa
- Department of Medical Physics, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Warszawa, Poland
| | - Krzysztof Składowski
- 1st Radiation and Clinical Oncology Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Warszawa, Poland
| | - Maria Sokół
- Department of Medical Physics, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Warszawa, Poland
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Polanowski P, Księżniak-Baran D, Grządziel A, Pietruszka A, Chmielik E, Pilecki B, Amrogowicz N, Gajda K, Składowski K. Successful Treatment of Adenoid Cystic Carcinoma with the Application of a High-Dose Stereotactic Body Radiotherapy Boost. Case Rep Oncol 2021; 14:371-377. [PMID: 33776731 PMCID: PMC7983606 DOI: 10.1159/000512069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 10/05/2020] [Indexed: 12/04/2022] Open
Abstract
Background Adenoid cystic carcinoma (ACC) should be treated with a surgical procedure. Unfortunately, in some cases, such procedures are impossible to perform. In that event, radiotherapy can be used as a form of radical treatment, although ACC is established as a radio- and chemoresistant tumour. Therefore, unconventional fractionated radiotherapy needs to be considered. Case presentation Here, we present a case study of a patient with an unresectable tumour of the choanae and nasopharynx treated with a stereotactic radiotherapy boost in combination with conventional radiotherapy. We achieved complete clinical regression after application of a 1 × 18 Gy boost followed by conventional radiotherapy at 50 Gy in 25 fractions. The early and late tolerance of this treatment were positive. During the 2-year follow-up, local and distant recurrence were not detected. Conclusions This case represents an individualized, modern and safe approach to unresectable ACC. This is one of the first cases to show the use of a combination of stereotactic and conventional radiotherapy in radical, conservative cancer treatment.
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Affiliation(s)
- Paweł Polanowski
- 1st Radiation and Clinical Oncology Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Dorota Księżniak-Baran
- 1st Radiation and Clinical Oncology Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Aleksandra Grządziel
- Radiotherapy Planning Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Agnieszka Pietruszka
- 1st Radiation and Clinical Oncology Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Ewa Chmielik
- Tumor Pathology Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Bolesław Pilecki
- 1st Radiation and Clinical Oncology Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Natalia Amrogowicz
- 1st Radiation and Clinical Oncology Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Karolina Gajda
- Tumor Pathology Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland
| | - Krzysztof Składowski
- 1st Radiation and Clinical Oncology Department, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice, Poland
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Wozniak G, Misiołek M, Idasiak A, Dębosz-Suwińska I, Jaworska M, Bal W, Maciejewski B, Miszczyk L, Składowski K, Suwinski R. Randomised clinical trial on 7-days-a-week postoperative radiotherapy vs. concurrent postoperative radio-chemotherapy in locally advanced cancer of the oral cavity/oropharynx. Br J Radiol 2020; 93:20200288. [PMID: 32960662 DOI: 10.1259/bjr.20200288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To compare the efficacy and tolerance of 7-days-a-week accelerated postoperative radiotherapy (p-CAIR) vs postoperative radio-chemotherapy (p-RTCT). METHODS Between September 2007 and October 2013, 111 patients were enrolled and randomly assigned to receive 63 Gy in 1.8 Gy fractions 7-days-a-week (n = 57, p-CAIR) or 63 Gy in 1.8 Gy fractions 5-days-a-week with concurrent cisplatin 80-100 mg per square meter of body-surface area on days 1, 22 and 43 of the radiotherapy course (p-RTCT). It represents approximately 40% of the intended trial size, that was closed prematurely due to slowing accrual. Only high-risk patients with squamous cell cancer of the oropharynx/oral cavity, considered fit for concurrent treatment were enrolled. RESULTS The rate of locoregional control (LRC) did not differ significantly between treatment arms (p = 0.18, HR = 0.56), 5 year LRC tended, however, to favour p-RTCT (81%) vs p-CAIR (62%). There was no difference in overall survival between treatment arms (p = 0.90, HR = 1.03).The incidence and severity of acute mucosal reactions and late reactions did not differ significantly between treatment arms. Haematological toxicity of p-RTCT was, however, considerably increased compared to p-CAIR. CONCLUSION Concurrent postoperative RTCT tended to improve locoregional control rate as compared to p-CAIR. This, however, did not transferred into improved overall survival. Postoperative RTCT was associated with a substantial increase in haematological toxicity that negatively affected treatment compliance in this arm. ADVANCES IN KNOWLEDGE To our knowledge, this is the first trial that compares accelerated radiotherapy and radio-chemotherapy in postoperative treatment for oralcavity/oropharyngeal cancer.
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Affiliation(s)
- Grzegorz Wozniak
- Department of Radiation Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Poland
| | - Maciej Misiołek
- Department of Laryngology, Silesian Medical University, Katowice, Poland
| | - Adam Idasiak
- Radiotherapy Clinic and Teaching Hospital, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Poland
| | - Iwona Dębosz-Suwińska
- Department of Radiation Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Poland
| | - Magdalena Jaworska
- Department of Pathology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Poland
| | - Wieslaw Bal
- Department of Chemotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Poland
| | - Boguslaw Maciejewski
- Department of Radiation Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Poland
| | - Leszek Miszczyk
- Department of Radiation Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Poland
| | - Krzysztof Składowski
- Radiotherapy Clinic and Teaching Hospital, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Poland
| | - Rafal Suwinski
- Radiotherapy Clinic and Teaching Hospital, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Poland
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Polanowski P, Wydmański J, Tukiendorf A, Składowski K. The analysis of absorbed dose by pancreas during gastric cancer radiotherapy. Radiother Oncol 2020; 151:20-23. [PMID: 32679311 DOI: 10.1016/j.radonc.2020.07.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 06/29/2020] [Accepted: 07/04/2020] [Indexed: 12/19/2022]
Abstract
INTRODUCTION The toxicity of radiotherapy is a very important issue in the everyday work of radiation oncologist. The tolerance to certain doses of radiotherapy in organs at risk determines the safety of radiotherapy. Despite the increasing number of publications concerning the injury of the pancreas after radiotherapy, this organ does not have common directives. We decided to reanalyse our previously published data in terms of the dose of radiation absorbed by the pancreas to determine a dose-effect relationship with the use of radiation-induced hypoamylasaemia and hypolipasaemia. MATERIALS AND METHODS We reanalysed a group of 127 gastric cancer patients after preoperative or postoperative chemoradiotherapy who were treated with a total dose of 45 Gy administered in 25 fractions. To identify the absorbed doses, the pancreas was contoured based on the CT scans used for radiotherapy planning and divided into anatomical parts: the head, the body and the tail. RESULTS We found that 80% of the whole pancreatic volume absorbed at least 44.5 Gy. The body, tail and head absorbed 100%, 90% and 70% of the abovementioned dose, respectively. The mean dose absorbed by the whole pancreas ranged from 32 to 48 Gy, with a mean of 44 Gy. A total dose of 45 Gy administered to gastric cancer patients can lead to subclinical insufficiency of the pancreas (hypolipasaemia and hypoamylasaemia). This dose is not able to cause symptomatic damage to the pancreas.
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Affiliation(s)
- Paweł Polanowski
- 1st Radiation and Clinical Oncology Department, Maria Sklodowska-Curie National Research Institute of Oncology, Poland.
| | - Jerzy Wydmański
- Department of Radiotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Poland
| | - Andrzej Tukiendorf
- Department of Public Health, Wrocław Medical University, Wrocław, Poland
| | - Krzysztof Składowski
- 1st Radiation and Clinical Oncology Department, Maria Sklodowska-Curie National Research Institute of Oncology, Poland.
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Butkiewicz D, Gdowicz-Kłosok A, Krześniak M, Rutkowski T, Krzywon A, Cortez AJ, Domińczyk I, Składowski K. Association of Genetic Variants in ANGPT/TEK and VEGF/VEGFR with Progression and Survival in Head and Neck Squamous Cell Carcinoma Treated with Radiotherapy or Radiochemotherapy. Cancers (Basel) 2020; 12:cancers12061506. [PMID: 32526933 PMCID: PMC7352333 DOI: 10.3390/cancers12061506] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/28/2020] [Accepted: 06/07/2020] [Indexed: 12/12/2022] Open
Abstract
Angiogenesis is essential for growth, progression, and metastasis of solid tumors. Vascular endothelial growth factor (VEGF)/VEGF receptor (VEGFR) and angiopoietin (ANGPT)/ tyrosine kinase endothelial (TEK) signaling plays an important role in regulating angiogenesis. Very little is known about the effects of single-nucleotide polymorphisms (SNPs) in angiogenesis-related genes on treatment outcome in head and neck squamous cell carcinoma (HNSCC). Therefore, we evaluated the association between SNPs in ANGPT1, ANGPT2, TEK, VEGF, VEGFR1, and VEGFR2 genes and five clinical endpoints in 422 HNSCC patients receiving radiotherapy alone or combined with chemotherapy. Multivariate analysis showed an association of ANGPT2 rs3739391, rs3020221 and TEK rs639225 with overall survival, and VEGF rs2010963 with overall and metastasis-free survival. VEGFR2 rs1870377 and VEGF rs699947 affected local recurrence-free survival in all patients. In the combination treatment subgroup, rs699947 predicted local, nodal, and loco-regional recurrence-free survival, whereas VEGFR2 rs2071559 showed an association with nodal recurrence-free survival. However, these associations were not statistically significant after multiple testing correction. Moreover, a strong cumulative effect of SNPs was observed that survived this adjustment. These SNPs and their combinations were independent risk factors for specific endpoints. Our data suggest that certain germline variants in ANGPT2/TEK and VEGF/VEGFR2 axes may have predictive and prognostic potential in HNSCC treated with radiation or chemoradiation.
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Affiliation(s)
- Dorota Butkiewicz
- Center for Translational Research and Molecular Biology of Cancer, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland; (A.G.-K.); (M.K.); (I.D.)
- Correspondence:
| | - Agnieszka Gdowicz-Kłosok
- Center for Translational Research and Molecular Biology of Cancer, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland; (A.G.-K.); (M.K.); (I.D.)
| | - Małgorzata Krześniak
- Center for Translational Research and Molecular Biology of Cancer, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland; (A.G.-K.); (M.K.); (I.D.)
| | - Tomasz Rutkowski
- I Radiation and Clinical Oncology Department, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland; (T.R.); (K.S.)
| | - Aleksandra Krzywon
- Department of Biostatistics and Bioinformatics, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland; (A.K.); (A.J.C.)
| | - Alexander Jorge Cortez
- Department of Biostatistics and Bioinformatics, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland; (A.K.); (A.J.C.)
| | - Iwona Domińczyk
- Center for Translational Research and Molecular Biology of Cancer, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland; (A.G.-K.); (M.K.); (I.D.)
| | - Krzysztof Składowski
- I Radiation and Clinical Oncology Department, Maria Skłodowska-Curie National Research Institute of Oncology, Gliwice Branch, 44-102 Gliwice, Poland; (T.R.); (K.S.)
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Rutkowski TW, Mazurek AM, Śnietura M, Hejduk B, Jędrzejewska M, Bobek-Billewicz B, d'Amico A, Pigłowski W, Wygoda A, Składowski K, Kołosza Z, Widłak P. Circulating HPV16 DNA may complement imaging assessment of early treatment efficacy in patients with HPV-positive oropharyngeal cancer. J Transl Med 2020; 18:167. [PMID: 32293457 PMCID: PMC7158033 DOI: 10.1186/s12967-020-02330-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 04/03/2020] [Indexed: 01/29/2023] Open
Abstract
Background Early detection of treatment failure may improve clinical outcome and overall survival in patients with head and neck cancer after first-line treatment. Circulating cell-free HPV16 DNA (cfHPV16 DNA) was evaluated as a possible complementary marker to radiological assessment of early response in patients with HPV-related oropharyngeal cancer (OPC) after radiotherapy alone or combined with chemotherapy. Methods The study included 66 patients with HPV-related OPC receiving radical radiotherapy alone or in combination with chemotherapy. cfHPV16 DNA was assessed in the blood of all patients before treatment using TaqMan-based qPCR. Subsequent analysis of cfHPV16 DNA was performed 12 weeks after treatment completion, along with radiological assessment of early treatment results. Results Complete (CRR) and incomplete radiological response (IRR) was found in 43 (65%) and 23 (35%) patients respectively. cfHPV16 DNA was present in 5 (28%) patients with IRR, while only in 1 (4%) with CRR. Three of five patients with IRR that were positive for cfHPV16 DNA exhibited histopathologically confirmed local or regional treatment failure, and other two developed distant metastases. None of the patients with negative cfHPV16 DNA presented disease failure. Conclusion The post-treatment assessment of cfHPV16 DNA in patients with HPV-related OPC may be used as a complementary biomarker to conventional imaging-based examinations for early identification of treatment failure.
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Affiliation(s)
- Tomasz W Rutkowski
- I Radiotherapy and Chemotherapy Clinic, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-101, Gliwice, Poland.
| | - Agnieszka M Mazurek
- Center for Translational Research and Molecular Biology of Cancer, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-101, Gliwice, Poland
| | - Mirosław Śnietura
- Tumor Pathology Department, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-101, Gliwice, Poland
| | - Beata Hejduk
- Department of Radiology and Diagnostic Imaging, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-101, Gliwice, Poland
| | - Maja Jędrzejewska
- Department of Radiology and Diagnostic Imaging, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-101, Gliwice, Poland
| | - Barbara Bobek-Billewicz
- Department of Radiology and Diagnostic Imaging, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-101, Gliwice, Poland
| | - Andrea d'Amico
- Department of PET Diagnostic, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-101, Gliwice, Poland
| | - Wojciech Pigłowski
- Tumor Pathology Department, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-101, Gliwice, Poland
| | - Andrzej Wygoda
- I Radiotherapy and Chemotherapy Clinic, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-101, Gliwice, Poland
| | - Krzysztof Składowski
- I Radiotherapy and Chemotherapy Clinic, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-101, Gliwice, Poland
| | - Zofia Kołosza
- Department of Biostatistic, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-101, Gliwice, Poland
| | - Piotr Widłak
- Center for Translational Research and Molecular Biology of Cancer, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-101, Gliwice, Poland
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Tajstra M, Blamek S, Niedziela JT, Gadula-Gacek E, Przybylski A, Blicharz J, Oręziak A, Miszczyk L, Gepner K, Fijuth J, Składowski K, Leszek P, Kempa M, Kowalski O, Sterliński M. Patients with cardiac implantable electronic devices undergoing radiotherapy in Poland. Expert opinion of the Heart Rhythm Section of the Polish Cardiac Society and the Polish Society of Radiation Oncology. Kardiol Pol 2019; 77:1106-1116. [PMID: 31741466 DOI: 10.33963/kp.15063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Older age and high morbidity of the society contribute to a growing number of patients with cardiac implantable electronic devices (CIEDs) requiring effective cancer treatment, including radiotherapy (RT). The effect of RT on a CIED may vary depending on the type and physical parameters of radiation, location of the treated lesion, indications for electrotherapy, and the type of CIED. In the most dramatic scenarios, it may cause an irreversible damage to the CIED, with serious clinical consequences. The lack of precise guidelines may limit the access to RT for many patients with CIEDs who would otherwise benefit from the therapy or may lead to a therapy without taking the necessary precautions, which may worsen the prognosis. Therefore, clear and unequivocal recommendations for assessing patient eligibility for RT are aimed at ensuring that adequate precautions are taken as well as at providing patients with concomitant cardiovascular and oncologic diseases with access to safe and effective RT.
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Affiliation(s)
- Mateusz Tajstra
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland.
| | - Sławomir Blamek
- Department of Radiotherapy, Maria Sklodowska-Curie Institute — Oncology Center, Gliwice Branch, Gliwice, Poland
| | - Jacek T Niedziela
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Elżbieta Gadula-Gacek
- 3rd Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | | | - Jarosław Blicharz
- Department of Cardiology, St.Luke’s Voivoideship Hospital,Tarnów, Poland
| | - Artur Oręziak
- Department of Arrhythmia, Institute of Cardiology, Warsaw, Poland
| | - Leszek Miszczyk
- Department of Radiotherapy, Maria Sklodowska-Curie Institute — Oncology Center, Gliwice Branch, Gliwice, Poland
| | - Katarzyna Gepner
- Department of Oncology Diagnostics, Cardiooncology and Palliative Medicine, Maria Sklodowska-Curie Institute — Oncology Center, Warsaw, Poland
| | - Jacek Fijuth
- Department of Radiotherapy, Medical University ofLodz, Łódź, Poland,Department of Teleradiotherapy, Regional Cancer Center, Copernicus Memorial Hospital of Łódź, Poland
| | - Krzysztof Składowski
- 1st Department of Radiotherapy and Chemotherapy, Maria Sklodowska-Curie Institute — Oncology Center, Gliwice Branch, Gliwice, Poland
| | - Przemysław Leszek
- Department of HeartFailure and Transplantology, Institute of Cardiology, Warsaw, Poland
| | - Maciej Kempa
- Department of Cardiology and Electrotherapy, Medical University of Gdańsk, Gdańsk, Poland
| | - Oskar Kowalski
- Department of Cardiology, Congenital Heart Diseases and Electrotherapy, Silesian Center for Heart Diseases, Zabrze, Poland,Department of Dietetics, School of Public Health in Bytom, Medical University of Silesia, Katowice, Poland
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Mazurek AM, Wygoda A, Rutkowski T, Olbryt M, Pietrowska M, Celejewska A, Składowski K, Widłak P. Prognostic significance of Epstein-Barr virus viral load in patients with T1-T2 nasopharyngeal cancer. J Med Virol 2019; 92:348-355. [PMID: 31608452 DOI: 10.1002/jmv.25606] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 10/08/2019] [Indexed: 11/06/2022]
Abstract
Nasopharyngeal cancer (NPC) is highly prevalent in southern Chinese populations but it is rare in most parts of the world. A few studies were performed in nonendemic regions of the world, and suggested the prognostic value of Epstein-Barr virus (EBV) DNA load in blood. In this study, EBV DNA presence and viral load (VL) level in the blood of patients with NPC in Polish population were presented. In addition, its prognostic value for locoregional control among other clinicopathological features was evaluated. Patients with carcinoma of the nasopharynx treated definitively with radiotherapy or radiochemotherapy were included in the study. Real-time polymerase chain reaction was performed for quantitating of EBV DNA in plasma. Among patients with NPC, 51% (22 of 43) were classified as EBV-positive with the mean of the VL of 4934 ± 8693 copies/mL. Multiple regression analysis between log EBV DNA VL and clinical parameters revealed that the most important factors increasing the VLs were advanced N disease together with no-smoking status and advanced T tumors. Multivariate Cox regression analysis revealed that T3-T4 tumors were an independent prognostic factor for poor locoregional control. Analysis for the subgroup of patients with T1-T2 tumors showed that T1-T2 EBV-negative patients had better locoregional control compared with T1-T2 EBV-positive, though without statistical significance. In conclusion, it seems that EBV DNA determination may have an important role in diagnostics of patients with NPC with T1-T2 tumors indicating a subgroup with poorer prognosis, though it needs to be proven on a larger cohort.
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Affiliation(s)
- Agnieszka M Mazurek
- Center for Translational Research and Molecular Biology of Cancer, Maria Sklodowska-Curie Institute-Oncology Center Gliwice Branch, Gliwice, Poland
| | - Andrzej Wygoda
- I Radiotherapy and Chemotherapy Clinic, Maria Sklodowska-Curie Institute-Oncology Center Gliwice Branch, Gliwice, Poland
| | - Tomasz Rutkowski
- I Radiotherapy and Chemotherapy Clinic, Maria Sklodowska-Curie Institute-Oncology Center Gliwice Branch, Gliwice, Poland
| | - Magdalena Olbryt
- Center for Translational Research and Molecular Biology of Cancer, Maria Sklodowska-Curie Institute-Oncology Center Gliwice Branch, Gliwice, Poland
| | - Monika Pietrowska
- Center for Translational Research and Molecular Biology of Cancer, Maria Sklodowska-Curie Institute-Oncology Center Gliwice Branch, Gliwice, Poland
| | - Agata Celejewska
- Department of Radiotherapy, Maria Sklodowska-Curie Institute-Oncology Center Gliwice Branch, Gliwice, Poland
| | - Krzysztof Składowski
- I Radiotherapy and Chemotherapy Clinic, Maria Sklodowska-Curie Institute-Oncology Center Gliwice Branch, Gliwice, Poland
| | - Piotr Widłak
- Center for Translational Research and Molecular Biology of Cancer, Maria Sklodowska-Curie Institute-Oncology Center Gliwice Branch, Gliwice, Poland
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Boguszewicz Ł, Bieleń A, Mrochem-Kwarciak J, Skorupa A, Ciszek M, Heyda A, Wygoda A, Kotylak A, Składowski K, Sokół M. NMR-based metabolomics in real-time monitoring of treatment induced toxicity and cachexia in head and neck cancer: a method for early detection of high risk patients. Metabolomics 2019; 15:110. [PMID: 31420744 PMCID: PMC6697714 DOI: 10.1007/s11306-019-1576-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 08/09/2019] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Nutritional treatment in head and neck squamous cell carcinoma cancer (HNSCC) patients undergoing radio-/chemo-radiotherapy (RT/CHRT) is complex and requires a multidisciplinary approach. In this study the real-time dynamic changes in serum metabolome during RT/CHRT in HNSCC patients were monitored using NMR-based metabolomics. OBJECTIVES The main goal was to find the metabolic markers that could help prevent of acute radiation sequelae (ARS) escalation. METHODS 170 HNSCC patients were treated radically with RT/CHRT. Blood samples were collected weekly, starting from the day before the treatment and stopping within the week after the RT/CHRT completion, resulting in a total number of 1328 samples. 1H NMR spectra were acquired on Bruker 400 MHz spectrometer at 310 K and analyzed using principal component analysis (PCA) and orthogonal partial least squares discriminant analysis (OPLS-DA). Additional statistical analyses were performed on the quantified metabolites. RESULTS PCA has detected a group of distinct outliers corresponding to ketone bodies (3HB, Ace, AceAce). These outliers were found to identify the individuals at high risk of weight loss, mainly by the 3HB changes, which was confirmed by the patients' medical data. In the OPLS-DA models a transition from the lowest to the highest weight loss is seen, defining the metabolic time trajectories for the patients from the studied groups during RT/CHRT. 3HB is a relatively sensitive marker that allows earlier identification of the patients at higher risk of > 10% weight loss. CONCLUSION Our findings indicate that metabolic alterations, characteristic for malnutrition or cachexia, can be detected already at the beginning of the treatment, making it possible to monitor the patients with a higher risk of weight loss.
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Affiliation(s)
- Ł Boguszewicz
- Department of Medical Physics, Maria Sklodowska-Curie Institute - Oncology Center Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-101, Gliwice, Poland.
| | - A Bieleń
- I Radiation And Clinical Oncology Department, Maria Sklodowska-Curie Institute - Oncology Center Gliwice Branch, Wybrzeze Armii Krajowej 15, Gliwice, 44-101, Poland
| | - J Mrochem-Kwarciak
- Analytics and Clinical Biochemistry Department, Maria Sklodowska-Curie Institute - Oncology Center Gliwice Branch, Wybrzeze Armii Krajowej 15, Gliwice, 44-101, Poland
| | - A Skorupa
- Department of Medical Physics, Maria Sklodowska-Curie Institute - Oncology Center Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-101, Gliwice, Poland
| | - M Ciszek
- Department of Medical Physics, Maria Sklodowska-Curie Institute - Oncology Center Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-101, Gliwice, Poland
| | - A Heyda
- I Radiation And Clinical Oncology Department, Maria Sklodowska-Curie Institute - Oncology Center Gliwice Branch, Wybrzeze Armii Krajowej 15, Gliwice, 44-101, Poland
| | - A Wygoda
- I Radiation And Clinical Oncology Department, Maria Sklodowska-Curie Institute - Oncology Center Gliwice Branch, Wybrzeze Armii Krajowej 15, Gliwice, 44-101, Poland
| | - A Kotylak
- I Radiation And Clinical Oncology Department, Maria Sklodowska-Curie Institute - Oncology Center Gliwice Branch, Wybrzeze Armii Krajowej 15, Gliwice, 44-101, Poland
| | - K Składowski
- I Radiation And Clinical Oncology Department, Maria Sklodowska-Curie Institute - Oncology Center Gliwice Branch, Wybrzeze Armii Krajowej 15, Gliwice, 44-101, Poland
| | - M Sokół
- Department of Medical Physics, Maria Sklodowska-Curie Institute - Oncology Center Gliwice Branch, Wybrzeze Armii Krajowej 15, 44-101, Gliwice, Poland
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Mrochem-Kwaciak J, Wygoda A, Deja R, Chmura A, Kentnowski M, Łukasz B, Rutkowski T, Składowski K. Prognostic value of erythropoietin (EPO), soluble erythropoietin receptor (SEPOR) and hematological parameters in patients with head and neck cancer treated (HNC) with radio- or radio-chemotherapy. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Huszno J, Kołosza Z, Mrochem Kwarciak J, Rutkowski T, Składowski K. Abstract P2-08-49: The role of neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR) andmonocyte – lymphocyte ratio (MLR) in prognosis of breast cancer patients. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-08-49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Breast cancer (BC) is common malignancies in women.Biomarkers such as neutrophils, lymphocyte, neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), monocyte – lymphocyte ratio (MLR) and PLT have been demonstrated to be closely related to poor prognosis in several solid tumors. The objective of this study was to evaluate the blood PLR, NLR andMLR for its prognostic value in patients with breast cancer.Material and Methods: We retrospectively reviewed 436 breast cancer patients (all woman) diagnosed and treated in MSC Memorial Cancer and Institute of Oncology, Gliwice Branch in years 2005 - 2018. The median age of patients was 52.5 years (range from 25 to 78). We assessed the prognostic value (overall survival) of pretreatment PLR, NLR and MLRbased on univariate and multivariate analysis. The cut-off value of NLR was 'elevated' as >2.65, MLR value was 'elevated'as >0.28 and PLR cut-off value was 'elevated' as >190.9.Results: Median follow-up was 71 months (range, from 3 to 165 months). The 5-year and 10-year OS rates were 88.1% and 80.2%, respectively. The 5-year OS was lower in NLR > 2.65 in comparison to NLR<=2.65 (82.5% vs.89.6%, p=0.053), especially in subgroup of triple negative breast cancer (TNBC) (70.3% vs. 89.3%, p=0.034) and in patients with estrogen receptor negative status tumors (66.6% vs. 83.6%, p=0.018).Similarly, the 5-year OS was lower in patients with PLR > 190.9 in comparison to PLR<=190.9 (78.7% vs. 89.4%; p=0.020). The worse OS rate was also observed in subgroup with TNBC and PLR > 190.9 (68.2% vs. 88.5%, p=0.032) or in subgroup with ER negative steroid receptor status tumors with 'elevated' PLR (57.7% vs. 83.6%, p=0.002).The 'elevated' value of MLR (>0.28) was not associated with overall survival time in our group of patients (p=0.830), also in TNBC (p=0.219) and ER (-) (p=0.453) subgroups of patients. Multivariate analysis has showed that NLR and PLR were insignificantly negative prognostic factors in all analyzed group. However the analysis in subgroup of patients with ER (-) negative tumors has showed that higher NLR (p=0.013; HR=2.40; 95%CI 1.20-4.80) and higher PLR (p=0.012; HR=2.51; 95%CI 1.23-5.14) were an independent factors for lower OS together with metastatic lymph nodes (p=0.0001). Conclusion: Elevated pre-treatment NLR (>2.65) and PLR (>190.9) are associated with lower OS in breast cancer patients. In ER (-) subgroups of patients elevated NLR and PLR were significant independent prognostic factors. MLR did not affect overall survival.
Citation Format: Huszno J, Kołosza Z, Mrochem Kwarciak J, Rutkowski T, Składowski K. The role of neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR) andmonocyte – lymphocyte ratio (MLR) in prognosis of breast cancer patients [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-08-49.
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Affiliation(s)
- J Huszno
- MSC Memorial Cancer Centere and Institute of Oncology, Gliwice, Silesia, Poland; MSC Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Silesia, Poland
| | - Z Kołosza
- MSC Memorial Cancer Centere and Institute of Oncology, Gliwice, Silesia, Poland; MSC Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Silesia, Poland
| | - J Mrochem Kwarciak
- MSC Memorial Cancer Centere and Institute of Oncology, Gliwice, Silesia, Poland; MSC Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Silesia, Poland
| | - T Rutkowski
- MSC Memorial Cancer Centere and Institute of Oncology, Gliwice, Silesia, Poland; MSC Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Silesia, Poland
| | - K Składowski
- MSC Memorial Cancer Centere and Institute of Oncology, Gliwice, Silesia, Poland; MSC Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Silesia, Poland
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Mazurek AM, Rutkowski T, Śnietura M, Pigłowski W, Suwiński R, Składowski K. Detection of circulating HPV16 DNA as a biomarker in the blood of patients with human papillomavirus-positive oropharyngeal squamous cell carcinoma. Head Neck 2018; 41:632-641. [PMID: 30566259 DOI: 10.1002/hed.25368] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 04/13/2018] [Accepted: 05/21/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Development of biomarker analysis using the circulating cell-free DNA (cfDNA) methodology is a challenge for noninvasive cancer diagnosis. In this study, a comparison between the plasma and tumor tissue HPV16 DNA viral loads (VLs) has been presented. METHODS Real-time polymerase chain reaction was performed for quantitating of HPV16 DNA in the plasma and tumor samples of patients with oropharyngeal cancer. RESULTS Among the tissues, HPV16-positive patients with oropharyngeal squamous cell carcinoma, nonsmoking patients, displayed significantly higher HPV16 DNA VLs in their tissue. No smoking and advanced N disease were the most important predictors for cHPV16 DNA (circulating HPV16 DNA) detection. The cHPV16-positive women displayed significantly higher VLs in their tumor tissues compared to the men, although without notable impact on the blood detection. CONCLUSIONS Many factors were responsible for human papillomavirus DNA circulation in blood. As a result of the small size of the analyzed group, some observed discrepancies need to be proven on a larger cohort.
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Affiliation(s)
- Agnieszka M Mazurek
- Center for Translational Research and Molecular Biology of Cancer, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland
| | - Tomasz Rutkowski
- I Radiotherapy and Chemotherapy Clinic, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Mirosław Śnietura
- Tumor Pathology Department, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Wojciech Pigłowski
- Tumor Pathology Department, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Rafał Suwiński
- II Radiotherapy and Chemotherapy Clinic, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - Krzysztof Składowski
- I Radiotherapy and Chemotherapy Clinic, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland
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Janiszewska M, Raczkowski M, Walczak J, Składowski K, Maciejczyk A. The Physical and Clinical Aspects of Radiation Therapy in Skin Cancer and Subcutaneous Tissue Neoplasm. Health (London) 2018. [DOI: 10.4236/health.2018.106056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Grégoire V, Evans M, Le QT, Bourhis J, Budach V, Chen A, Eisbruch A, Feng M, Giralt J, Gupta T, Hamoir M, Helito JK, Hu C, Hunter K, Johansen J, Kaanders J, Laskar SG, Lee A, Maingon P, Mäkitie A, Micciche' F, Nicolai P, O'Sullivan B, Poitevin A, Porceddu S, Składowski K, Tribius S, Waldron J, Wee J, Yao M, Yom SS, Zimmermann F, Grau C. Delineation of the primary tumour Clinical Target Volumes (CTV-P) in laryngeal, hypopharyngeal, oropharyngeal and oral cavity squamous cell carcinoma: AIRO, CACA, DAHANCA, EORTC, GEORCC, GORTEC, HKNPCSG, HNCIG, IAG-KHT, LPRHHT, NCIC CTG, NCRI, NRG Oncology, PHNS, SBRT, SOMERA, SRO, SSHNO, TROG consensus guidelines. Radiother Oncol 2017; 126:3-24. [PMID: 29180076 DOI: 10.1016/j.radonc.2017.10.016] [Citation(s) in RCA: 216] [Impact Index Per Article: 30.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 10/15/2017] [Accepted: 10/15/2017] [Indexed: 02/01/2023]
Abstract
PURPOSE Few studies have reported large inter-observer variations in target volume selection and delineation in patients treated with radiotherapy for head and neck squamous cell carcinoma. Consensus guidelines have been published for the neck nodes (see Grégoire et al., 2003, 2014), but such recommendations are lacking for primary tumour delineation. For the latter, two main schools of thoughts are prevailing, one based on geometric expansion of the Gross Tumour Volume (GTV) as promoted by DAHANCA, and the other one based on anatomical expansion of the GTV using compartmentalization of head and neck anatomy. METHOD For each anatomic location within the larynx, hypopharynx, oropharynx and oral cavity, and for each T-stage, the DAHANCA proposal has been comprehensively reviewed and edited to include anatomic knowledge into the geometric Clinical Target Volume (CTV) delineation concept. A first proposal was put forward by the leading authors of this publication (VG and CG) and discussed with opinion leaders in head and neck radiation oncology from Europe, Asia, Australia/New Zealand, North America and South America to reach a worldwide consensus. RESULTS This consensus proposes two CTVs for the primary tumour, the so called CTV-P1 and CVT-P2, corresponding to a high and lower tumour burden, and which should be associated with a high and a lower dose prescription, respectively. CONCLUSION Implementation of these guidelines in the daily practice of radiation oncology should contribute to reduce treatment variations from clinicians to clinicians, facilitate the conduct of multi-institutional clinical trials, and contribute to improved care of patients with head and neck carcinoma.
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Affiliation(s)
- Vincent Grégoire
- Université catholique de Louvain, St-Luc University Hospital, Department of Radiation Oncology, Brussels, Belgium.
| | - Mererid Evans
- Velindre Cancer Centre, Department of Radiation Oncology, Wales, UK
| | - Quynh-Thu Le
- Stanford University School of Medicine, Department of Radiation Oncology, USA
| | - Jean Bourhis
- CHUV and University of Lausanne, Department of Radiation Oncology, Switzerland
| | - Volker Budach
- Charité University Hospital, Department of Radio-oncology and Radiotherapy, Berlin, Germany
| | - Amy Chen
- Sun Yat-Sen University, Cancer Centre, Department of Radiation Oncology, Guangzhou, China
| | - Abraham Eisbruch
- University of Michigan Health System, Department of Radiation Oncology, Ann Arbor, USA
| | - Mei Feng
- Department of Radiation Oncology, Sichuan Cancer Hospital, Chengdu, China
| | - Jordi Giralt
- Vall d'Hebron University Hospital, Radiation Oncology Service, Barcelona, Spain
| | - Tejpal Gupta
- Tata Memorial Hospital, Department of Radiation Oncology, Mumbai, India
| | - Marc Hamoir
- Université catholique de Louvain, St-Luc University Hospital, Department of Head and Neck Surgery, Brussels, Belgium
| | - Juliana K Helito
- Hospital Israelita Albert Einstein, Department of Radiation Oncology, Sao Paulo, Brazil
| | - Chaosu Hu
- Fudan University Shanghai Cancer Center, Department of Radiation Oncology, China
| | - Keith Hunter
- University of Sheffield, School of Clinical Dentistry, Unit of Oral and Maxillofacial Pathology, UK
| | | | - Johannes Kaanders
- Radboud University Medical Centre, Department of Radiation Oncology, Nijmegen, The Netherlands
| | | | - Anne Lee
- University of Hong Kong and University of Hong Kong Shenzhen Hospital, Department of Clinical Oncology, Hong Kong, China
| | - Philippe Maingon
- Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Department of Radiation Oncology, Paris, France
| | - Antti Mäkitie
- University of Helsinki and Helsinki University Hospital, Department of Otorhinolaryngology - Head & Neck Surgery, Finland
| | - Francesco Micciche'
- Universita' Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli, Polo Scienze Oncologiche ed Ematologiche, Rome, Italy
| | - Piero Nicolai
- University of Brescia, Divisions of Otorhinolaryngology - Head and Neck Surgery, Italy
| | - Brian O'Sullivan
- University of Toronto, The Princess Margaret Hospital, Department of Radiation Oncology, Canada
| | | | - Sandro Porceddu
- Princess Alexander Hospital, Department of Radiation Oncology, Brisbane, Australia
| | | | - Silke Tribius
- Asklepios St. Georg Hospital, Hermann-Holthusen Institute for Radiotherapy, Hamburg, Germany
| | - John Waldron
- University of Toronto, The Princess Margaret Hospital, Department of Radiation Oncology, Canada
| | - Joseph Wee
- National Cancer Centre Singapore, Division of Radiation Oncology, Singapore
| | - Min Yao
- Case Western Reserve University Hospital, Department of Radiation Oncology, Cleveland, USA
| | - Sue S Yom
- University of California-San Francisco, Department of Radiation Oncology, USA
| | - Frank Zimmermann
- University Hospital Basel, Clinic of Radiotherapy and Radiation Oncology, Switzerland
| | - Cai Grau
- Aarhus University Hospital, Department of Oncology, Denmark
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Wygoda A, Rutkowski T, Szcześniak-Kłusek B, Mrochem-Kwarciak J, Jędrzejewska M, Składowski K. Primary squamous-cell thyroid carcinoma - a successful treatment with five-year follow-up. Endokrynol Pol 2017; 68:592-596. [PMID: 28879652 DOI: 10.5603/ep.a2017.0048] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 10/03/2016] [Accepted: 10/04/2016] [Indexed: 11/25/2022]
Abstract
Squamous cell carcinoma is an extremely rare neoplasm of the thyroid (SCTC) that represents no more than 1% of all primary thyroid malignancies. We report a case of a 42-year-old woman with rapidly growing mass in the right lower neck, primarily diagnosed in fineneedle aspiration cytology as a low-differentiated carcinoma. After the surgery, exclusion of all the other possible primary tumour locations, and immunohistochemistry tests, the diagnosis of primary squamous cell carcinoma of the thyroid gland was established. Because of close surgical margins and metastatic neck node, the patient was referred to adjuvant postoperative irradiation. With five-year follow-up the patient is free of disease and still in very good condition.
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Affiliation(s)
- Andrzej Wygoda
- Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology Gliwice Branch.
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Brewczyński A, Rutkowski T, Mazurek A, Snietura M, Kołosza Z, Wygoda A, Składowski K, Celejewska A, Małusecka E, Fiszer-Kierzkowska A, Bojko U, Pigłowski W, Hajduk A, Polanowski P, Dworzecka U, Gawron I, Kentnowski M, Pilecki B, Stępień T, Domińczyk I, Nadolska E, Tatar A, Widłak P. EP-1083: HPV as an etiological and prognostic factor for the Polish patients with HNC. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31519-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Dworzecka U, Wygoda A, Rutkowski T, Pilecki B, Składowski K. PO-123: Hypothyroidism after radiotherapy of head and neck – incidence and risk factors. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)30257-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Roś-Mazurczyk M, Wojakowska A, Marczak Ł, Polański K, Pietrowska M, Jelonek K, Domińczyk I, Hajduk A, Rutkowski T, Składowski K, Widłak P. Ionizing radiation affects profile of serum metabolites: increased level of 3-hydroxybutyric acid in serum of cancer patients treated with radiotherapy. Acta Biochim Pol 2016; 64:189-193. [PMID: 27815965 DOI: 10.18388/abp.2016_1301] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 05/06/2016] [Accepted: 07/14/2016] [Indexed: 11/10/2022]
Abstract
Radiotherapy causes molecular changes observed at the level of body fluids, which are potential biomarker candidates for assessment of radiation exposure. Here we analyzed radiotherapy-induced changes in a profile of small metabolites detected in sera of head and neck cancer patients using the gas chromatography coupled with mass spectrometry approach. There were about 20 compounds, including carboxylic acids, sugars, amines and amino acids, whose levels significantly differed between pre-treatment and post-treatment samples. Among metabolites upregulated by radiotherapy there was 3-hydroxybutyric acid, whose level increased about three times in post-treatment samples. Moreover, compounds affected by irradiation were associated with several metabolic pathways, including protein biosynthesis and amino acid metabolism.
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Affiliation(s)
| | - Anna Wojakowska
- Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland
| | - Łukasz Marczak
- Institute of Bioorganic Chemistry Polish Academy of Sciences, Poznań, Poland
| | - Krzysztof Polański
- Warwick Systems Biology Centre, University of Warwick, Warwick, United Kingdom
| | - Monika Pietrowska
- Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland
| | - Karol Jelonek
- Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland
| | - Iwona Domińczyk
- Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland
| | - Agata Hajduk
- Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland
| | - Tomasz Rutkowski
- Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland
| | - Krzysztof Składowski
- Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland
| | - Piotr Widłak
- Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice, Poland
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Widlak P, Jelonek K, Wojakowska A, Pietrowska M, Polanska J, Marczak Ł, Miszczyk L, Składowski K. Serum Proteome Signature of Radiation Response: Upregulation of Inflammation-Related Factors and Downregulation of Apolipoproteins and Coagulation Factors in Cancer Patients Treated With Radiation Therapy—A Pilot Study. Int J Radiat Oncol Biol Phys 2015; 92:1108-1115. [DOI: 10.1016/j.ijrobp.2015.03.040] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 03/26/2015] [Accepted: 03/30/2015] [Indexed: 01/03/2023]
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Celejewska A, Tukiendorf A, Miszczyk L, Składowski K, Wydmański J, Trela-Janus K. Stereotactic radiotherapy in epithelial ovarian cancer brain metastases patients. J Ovarian Res 2014; 7:79. [PMID: 25298327 PMCID: PMC4147185 DOI: 10.1186/s13048-014-0079-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 07/31/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In this report we present the results of the retrospective (survival and classification) analyses of possible prognostic factors prolonging survival in epithelial ovarian cancer brain metastases patients after stereotactic radiotherapy. We focus on a wide range of available predictors to establish survival in patients with a good health status and no more than three lesions. METHODS Two parallel statistical methods in survival analysis were used: classical and Bayesian methods to verify statistical results. To display the predicted and posterior survivals, classification trees were built. RESULTS From the initial set of prognostic factors, only four were established as statistically significant in multivariate regression. They were: survival to metastases to brain after epithelial ovarian cancer diagnosis, number of metastases at diagnosis, central nervous system radiotherapy prior to stereotactic radiotherapy, and interval to stereotactic radiotherapy after metastases diagnosis. CONCLUSIONS When considering evidence-based standards of treatment of patients suffering from epithelial ovarian cancer brain metastases, the established clinical factors are suggested to be prognostic.
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Mazurek AM, Fiszer-Kierzkowska A, Rutkowski T, Składowski K, Pierzyna M, Ścieglińska D, Woźniak G, Głowacki G, Kawczyński R, Małusecka E. Optimization of circulating cell-free DNA recovery for KRAS mutation and HPV detection in plasma. Cancer Biomark 2013; 13:385-94. [DOI: 10.3233/cbm-130371] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Agnieszka M. Mazurek
- Center for Translational Research and Molecular Biology of Cancer, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - A. Fiszer-Kierzkowska
- Center for Translational Research and Molecular Biology of Cancer, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - T. Rutkowski
- I Radiotherapy Clinic, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - K. Składowski
- I Radiotherapy Clinic, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - M. Pierzyna
- Center for Translational Research and Molecular Biology of Cancer, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - D. Ścieglińska
- Center for Translational Research and Molecular Biology of Cancer, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - G. Woźniak
- Department of Radiotherapy, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - G. Głowacki
- Department of Radiotherapy, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - R. Kawczyński
- Department of Radiotherapy, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland
| | - E. Małusecka
- Center for Translational Research and Molecular Biology of Cancer, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland
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Widłak P, Pietrowska M, Polańska J, Rutkowski T, Jelonek K, Kalinowska-Herok M, Gdowicz-Kłosok A, Wygoda A, Tarnawski R, Składowski K. Radiotherapy-related changes in serum proteome patterns of head and neck cancer patients; the effect of low and medium doses of radiation delivered to large volumes of normal tissue. J Transl Med 2013; 11:299. [PMID: 24304975 PMCID: PMC4235198 DOI: 10.1186/1479-5876-11-299] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 11/25/2013] [Indexed: 11/30/2022] Open
Abstract
Background Conformal intensity-modulated radiation therapy (IMRT) involves irradiation of large volume of normal tissue with low and medium doses, biological relevance of which is not clear yet. Serum proteome features were used here to study the dose-volume effects in patients irradiated with IMRT due to head and neck cancer. Methods Blood samples were collected before and during RT, and also about one month and one year after the end of RT in a group of 72 patients who received definitive treatment. Serum proteome profiles were analyzed using MALDI-ToF mass spectrometry in 800–14,000 Da range. Results Major changes in serum proteome profiles were observed between pre-treatment samples and samples collected one month after RT. Radiation-related changes in serum proteome features were affected by low-to-medium doses delivered to a large fraction of body mass. Proteome changes were associated with intensity of acute radiation toxicity, indicating collectively that RT-related features of serum proteome reflected general response of patient’s organism to irradiation. However, short-term dose-related changes in serum proteome features were not associated significantly with the long-term efficacy of the treatment. Conclusions The effects of low and medium doses of radiation have been documented at the level of serum proteome, which is a reflection of the patient’s whole body response.
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Affiliation(s)
- Piotr Widłak
- Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Gliwice, Poland.
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Rutkowski T, Wygoda A, Składowski K, Hejduk B, Rutkowski R, Kołosza Z, Maciejewski B. Prognostic role of tumor volume for radiotherapy outcome in patient with T2 laryngeal cancer. Strahlenther Onkol 2013; 189:861-6. [DOI: 10.1007/s00066-013-0411-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Accepted: 06/17/2013] [Indexed: 11/24/2022]
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Wygoda A, Rutkowski T, Ponikiewska D, Hejduk B, Składowski K. Ewing’s sarcoma of the larynx. Strahlenther Onkol 2013; 189:586-9. [PMID: 23732462 DOI: 10.1007/s00066-013-0356-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2013] [Accepted: 03/25/2013] [Indexed: 10/26/2022]
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Wygoda A, Rutkowski T, Hutnik M, Składowski K, Goleń M, Pilecki B. Acute mucosal reactions in patients with head and neck cancer. Strahlenther Onkol 2013; 189:547-51. [DOI: 10.1007/s00066-013-0311-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Accepted: 01/16/2013] [Indexed: 11/30/2022]
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Czecior E, Orecka B, Pawlas P, Mrówka-Kata K, Namysłowski G, Składowski K, Sowa P. Comparative assessment of the voice in patients treated for early glottis cancer by laser cordectomy or radiotherapy. Otolaryngol Pol 2012. [DOI: 10.1016/j.otpol.2012.06.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Rutkowski T, Mrochem-Kwarciak J, Masłyk B, Hajduk A, Wygoda A, Lukaszczyk-Wideł B, Hejduk B, Hutnik M, Goleń M, Składowski K. The Role of Biochemical Markers in Prediction of Radiation Therapy Failure for Patients With Head-and-Neck Cancer. Int J Radiat Oncol Biol Phys 2012. [DOI: 10.1016/j.ijrobp.2012.07.1901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Wygoda A, Składowski K, Rutkowski T, Hutnik M, Goleń M, Pilecki B, Przeorek W, Lukaszczyk-Wideł B. Acute mucosal radiation reactions in patients with head and neck cancer. Patterns of mucosal healing on the basis of daily examinations. Strahlenther Onkol 2012; 188:686-91. [PMID: 22729281 DOI: 10.1007/s00066-012-0146-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Accepted: 04/23/2012] [Indexed: 11/26/2022]
Abstract
PURPOSE The goal of this research was to evaluate the healing processes of acute mucosal radiation reactions (AMRR) in patients with head and neck cancer. MATERIALS AND METHODS In 46 patients with oral and oropharyngeal cancer patients irradiated with conventional (n = 25) and accelerated (n = 21) dose fractionation AMRR was evaluated daily during and after radiotherapy. Complex of morphological and functional symptoms according to the Dische score were collected daily until complete healing. RESULTS Duration of healing after the end of radiotherapy ranged widely (12-70 days). It was on the average 8 days longer for accelerated than for conventional radiotherapy (p = 0.016). Duration of dysphagia was also longer for accelerated irradiation (11 days, p = 0.027). Three types of morphological symptoms were observed as the last symptom at the end of AMRR healing: spotted and confluent mucositis, erythema, and edema. Only a slight correlation between healing duration and area of irradiation fields (r = 0.23) was noted. In patients with confluent mucositis, two morphological forms of mucosal healing were observed, i.e., marginal and spotted. The spotted form was noted in 71% of patients undergoing conventional radiotherapy and in 38% of patients undergoing accelerated radiotherapy. The symptoms of mucosal healing were observed in 40% patients during radiotherapy. CONCLUSION The wide range of AMRR healing reflects individual potential of mucosa recovery with longer duration for accelerated radiotherapy. Two morphological forms of confluent mucositis healing were present: marginal and spotted. Healing of AMRR during radiotherapy can be observed in a significant proportion of patients.
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Affiliation(s)
- A Wygoda
- 1st Department of Radiation Oncology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Ul. Wybrzeże Armii Krajowej 15, 44-101, Gliwice, Poland.
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