Alcohol and cigarette consumption predict mortality in patients with head and neck cancer: a pooled analysis within the International Head and Neck Cancer Epidemiology (INHANCE) Consortium

Giraldi, Luca; Leoncini, Emanuele; Pastorino, Roberta; Wünsch-Filho, Victor; Carvalho, Mocelin de; López, Rossana Mendoza; Cadoni, Gabriella; Arzani, Dario; Petrelli, Livia; Matsuo, Keitaro; Bosetti, Cristina; Vecchia, Carlo La; Garavello, Werner; Polesel, Jerry; Serraino, Diego; Simonato, Lorenzo; Canova, Cristina; Richiardi, Lorenzo; Boffetta, Paolo; Hashibe, Mia; Lee, Y. C.A.; Boccia, Stefania

doi:10.1093/annonc/mdx486

Cited by 105 publications

(89 citation statements)

References 23 publications

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“…In that study, subgroup analysis revealed that the addition of cetuximab led to a trend toward improved outcomes in young patients, those with HPV-negative tumors of the oropharynx or hypopharynx, and the T4 subgroup. [28][29][30][31] National Comprehensive Cancer Network guidelines recommend 3-weekly or weekly cisplatin as standard treatment options. Seventy percent of patients in that study had primary tumors in the oropharynx, and only 27% of these were HPV-negative.…”

Section: Discussionmentioning

confidence: 99%

“…9,24-27 Furthermore, our patients had a high proportion of hypopharyngeal primaries, high rates of tobacco use (86.5%), and almost one-fifth had gross perinodal extension, all of which are recognized adverse prognostic features. [28][29][30][31] National Comprehensive Cancer Network guidelines recommend 3-weekly or weekly cisplatin as standard treatment options. 32 We used weekly cisplatin in this study, and it is used worldwide, especially in head and neck cancer-endemic regions (>85% of centers), at doses from 30 to 40 mg/m 2 .…”

Section: Discussionmentioning

confidence: 99%

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A randomized phase 3 trial comparing nimotuzumab plus cisplatin chemoradiotherapy versus cisplatin chemoradiotherapy alone in locally advanced head and neck cancer

Patil

Noronha

Joshi

et al. 2019

Cancer

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BACKGROUND:Because the addition of nimotuzumab to chemoradiation in patients with locally advanced head and neck cancer improved outcomes in a phase 2 study, the authors conducted a phase 3 study to confirm these findings. METHODS: This openlabel, investigator-initiated, phase 3, randomized trial was conducted from 2012 to 2018. Adult patients with locally advanced head and neck cancer who were fit for radical chemoradiation were randomized 1:1 to receive either radical radiotherapy (66-70 grays) with concurrent weekly cisplatin (30 mg/m 2 ) (CRT) or the same schedule of CRT with weekly nimotuzumab (200 mg) (NCRT). The primary endpoint was progression-free survival (PFS); key secondary endpoints were disease-free survival (DFS), duration of locoregional control (LRC), and overall survival (OS). An intent-to-treat analysis also was performed. RESULTS: In total, 536 patients were allocated equally to both treatment arms. The median follow-up was 39.13 months. The addition of nimotuzumab improved PFS (hazard ratio [HR], 0.69; 95% CI, 0.53-0.89; P = .004), LRC (HR, 0.67; 95% CI, 0.50-0.89; P = .006), and DFS (HR, 0.71; 95% CI, 0.55-0.92; P = .008) and had a trend toward improved OS (HR, 0.84; 95% CI, 0.65-1.08; P = .163). Grade 3 through 5 adverse events were similar between the 2 arms, except for a higher incidence of mucositis in the NCRT arm (66.7% vs 55.8%; P = .01). CONCLUSIONS: The addition of nimotuzumab to concurrent weekly CRT improves PFS, LRC, and DFS. This combination provides a novel alternative therapeutic option to a 3-weekly schedule of 100 mg/m 2 cisplatin in patients with locally advanced head and neck cancer who are treated with radical-intent CRT. Cancer 2019;125:3184-3197.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A randomized phase 3 trial comparing nimotuzumab plus cisplatin chemoradiotherapy versus cisplatin chemoradiotherapy alone in locally advanced head and neck cancer

Patil

Noronha

Joshi

et al. 2019

Cancer

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“…21 On the other side, the possible relation between cancer and glycemic metabolism represents a new field of interest. 21 On the other side, the possible relation between cancer and glycemic metabolism represents a new field of interest.…”

Section: Patient-related Factorsmentioning

confidence: 99%

“…The relationship between alcohol and tobacco with head and neck cancer is well known, with a synergic risk in case that both are abused of. 21 On the other side, the possible relation between cancer and glycemic metabolism represents a new field of interest. Recent studies have pointed out that insulin resistance in patients with head and neck cancer might be an important prognostic indicator.…”

Section: Patient-related Factorsmentioning

confidence: 99%

Factors of local recurrence and organ preservation with transoral laser microsurgery in laryngeal carcinomas; CHAID decision‐tree analysis

et al. 2018

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Background Indications of transoral laser microsurgery (TLM) are conditioned by the risk of local relapse. Objective To evaluate prognostic factors of local relapse and local control with TLM (LC‐TLM). Methods Local relapse and LC‐TLM were evaluated in 1119 patients. Logistic regression and CHAID decision tree analysis were performed. Results Local relapse correlated to previous radiotherapy failure (8.45, CI 95%: 2.64‐27.03; P < .001), paraglottic involvement (2.42, CI: 1.41‐4.15; P = .001), anterior commissure involvement (2.12, CI: 1.43‐3.14; P < .001), grade of differentiation (1.74, CI: 1.18‐2.57; P = .005), and alcohol consumption (1.4, CI: 0.99‐1.98; P = .057). Local relapse tended to inversely correlate with experience (0.73, CI: 0.51‐1.03; P = .078). The most important factors for local relapse were previous radiotherapy failure and anterior commissure involvement. LC‐TLM inversely correlated with previous radiotherapy failure (0.09, CI: 0.03‐0.28; P < .001), paraglottic involvement (0.25, CI: 0.14‐0.43; P < .001), anterior commissure involvement (0.49, CI: 0.32‐0.77; P = .007), margins (0.56, CI: 0.30‐1.04; P = .068), and differentiation (0.68, CI: 0.44‐1.05; P = .087). LC‐TLM correlated with experience (1.71, CI: 1.13‐2.55; P = .010). The most important factors for LC‐TLM were previous radiotherapy failure and paraglottic involvement. Conclusion Previous radiotherapy failure is the most important factor for local relapse and LC‐TLM. In primary treatments, anterior commissure involvement and paraglottic involvement are the most important factors for local relapse and LC‐TLM, respectively.

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“…Prediagnosis cigarette smoking can be a prognostic factor for overall survival (OS) in OSCC patients (4). Therapeutic options for early stage OSCC include both surgery and radiotherapy as single treatment modality, while those for advanced stage include surgery, chemoradiation and chemotherapy (5,6).…”

mentioning

confidence: 99%

Relationship Between p16 Expression and Prognosis in Patients with Oropharyngeal Cancer Undergoing Surgery

Kida

Terada

Uwa

et al. 2018

In Vivo

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Abstract. Background Among head and neck squamous cell carcinomas (HNSCCs), the incidence of oropharyngeal SCC (OSCC) is increasing compared with carcinomas of other origins, thereby attracting public attention (1, 2). Like other malignancies in the upper gastrointestinal tract, OSCC is attributed to the carcinogenic effects of tobacco and alcohol (3). Prediagnosis cigarette smoking can be a prognostic factor for overall survival (OS) in OSCC patients (4). Therapeutic options for early stage OSCC include both surgery and radiotherapy as single treatment modality, while those for advanced stage include surgery, chemoradiation and chemotherapy (5, 6).On the other hand, in recent years, human papillomavirus (HPV) is known to be involved, in addition to drinking and smoking, in oropharyngeal carcinogenesis (1, 7-10). HPV is the most common sexually transmitted disease. However, the overwhelming majority of patients with HPV clear the infection. A small percentage of patients with HPV develop oncogenic HPV types, especially HPV-16, and consequently, SCCs can develop in such patients. HPV causes more than 5% of malignancies worldwide (1, 7-10). Over 70% of OSCCs are currently thought to be linked to oncogenic HPV infection. Immunohistochemistry for p16 protein is often used as a surrogate marker for oncogenic HPV in the oropharyngeal tissues (11, 12). The clinical profile of patients with HPV-related OSCC differs quite notably from that of non-HPV-related OSCC, and the clinical outcome for HPV-related OSCC is reported to be significantly better due to high sensitivity for radiation therapy (2,7,8).Numerous clinical studies have examined the role of transoral surgical resection (SR) for the treatment of oropharyngeal malignancies and have shown similar clinical outcomes and improved functional outcomes compared with chemoradiation therapies (5, 13). However, the relationship between p16 expression and prognosis in OSCC patients undergoing surgery has not been fully examined. Thus, there is urgent need for elucidating these issues. The aims of this study are therefore to clarify the relationship between p16 expression and prognosis in patients with OSCC undergoing surgery. 927

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Alcohol and cigarette consumption predict mortality in patients with head and neck cancer: a pooled analysis within the International Head and Neck Cancer Epidemiology (INHANCE) Consortium

Cited by 105 publications

References 23 publications

A randomized phase 3 trial comparing nimotuzumab plus cisplatin chemoradiotherapy versus cisplatin chemoradiotherapy alone in locally advanced head and neck cancer

A randomized phase 3 trial comparing nimotuzumab plus cisplatin chemoradiotherapy versus cisplatin chemoradiotherapy alone in locally advanced head and neck cancer

Factors of local recurrence and organ preservation with transoral laser microsurgery in laryngeal carcinomas; CHAID decision‐tree analysis

Relationship Between p16 Expression and Prognosis in Patients with Oropharyngeal Cancer Undergoing Surgery

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