Analysis of loco-regional failures in head and neck cancer after radical radiation therapy

Felice, Francesca De; Thomas, Christopher; Barrington, Sally F.; Pathmanathan, A.; Lei, Mary; Urbano, Teresa Guerrero

doi:10.1016/j.oraloncology.2015.08.004

Cited by 50 publications

(33 citation statements)

References 19 publications

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“…The median overall post-failure survival of patients with loco-regional failure after intensity modulated radiotherapy with/without chemotherapy was 9.37 months (20). Of these patients, a significantly worse prognosis was noted in those unable to undergo salvage surgery (7.4 months vs. 22.6 months; p = 0.003).…”

Section: Discussionmentioning

confidence: 99%

Paclitaxel Plus Cetuximab as 1st Line Chemotherapy in Platinum-Based Chemoradiotherapy-Refractory Patients With Squamous Cell Carcinoma of the Head and Neck

et al. 2018

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Purpose: We sought to evaluate the efficacy and safety of the combination of cetuximab (Cmab) and paclitaxel (PTX) in patients with squamous cell carcinoma of the head and neck (SCCHN) who had unresectable recurrent or metastatic (R/M) disease after platinum-based chemoradiotherapy.Materials and Methods: Data on 23 patients with SCCHN who received paclitaxel and cetuximab (Cmab) for R/M disease no more than 6 months after CRT completion were retrospectively reviewed. PTX and Cmab were given in a 28-day cycle (PTX, 80 mg/m2 on days 1, 8, and 15; Cmab, loading dose 400 mg/m2 followed by a weekly 250 mg/m2). The differences in prognosis between subgroups in different clinical settings were also assessed.Results: CRT had been delivered as definitive treatment in 13 cases (57%) and as adjuvant treatment in 10 (43%). Median time from CRT completion to disease recurrence or metastasis was 73 days (1–152). The best objective response and disease control rates were 52 and 83%, respectively, with 12 partial responses and seven cases of stable disease by Response Evaluation Criteria in Solid Tumors (RECIST). A total of 17 of 23 patients (74%) achieved a degree of tumor shrinkage. Median progression-free survival (PFS) and overall survival (OS) were 7.0 (95% confidence interval [CI]: 3.7–8.4) and 16.3 months (95% CI: 7.8–23.3), respectively. Patients with a longer duration (≥60 d) from CRT completion to disease progression had a statistically significantly longer OS than the others (median OS 22.3 vs. 8.1 months, log-rank test; p = 0.034). Main Grade 3 toxicities included neutropenia (13%), anemia (13%), and hypomagnesemia (13%). No Grade 4 toxicity or treatment-related death was seen.Conclusion: PTX and Cmab is a tolerable and effective option in SCCHN patients with symptomatic CRT-refractory disease. Its favorable effects on tumor shrinkage will help relieve tumor-associated symptoms.

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Section: Discussionmentioning

confidence: 99%

Paclitaxel Plus Cetuximab as 1st Line Chemotherapy in Platinum-Based Chemoradiotherapy-Refractory Patients With Squamous Cell Carcinoma of the Head and Neck

et al. 2018

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“…Another report emphasized the importance of accurate target volume definition for the effectiveness of radiotherapy [15]. Tumor thickness is believed to be an important prognostic factor for 2-year survival, supported by a study of Chen et al [16] where magnetic resonance tomography showing a tumor thickness greater than 26 mm indicated a significantly poorer diseasespecific survival and 2-year survival rates of merely 27% in T4a-staged tongue carcinomas.…”

Section: Key Pointsmentioning

confidence: 95%

Early death among head and neck cancer patients

Farnebo

Malila

Mäkitie

et al. 2016

Current Opinion in Otolaryngology & Head and Neck Surgery

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“…Up to 60% of patients develop loco-regional recurrence and up to 30% will have distant failure. Recurrent or metastatic cancer represents the onset of a highly aggressive disease with dismal survival rates [11, 12]. …”

Section: Introductionmentioning

confidence: 99%

PITX2andPANCRDNA methylation predicts overall survival in patients with head and neck squamous cell carcinoma

et al. 2016

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BackgroundSquamous cell carcinoma of the head and neck region (HNSCC) is a common malignant disease accompanied by a high risk of local or distant recurrence after curative-intent treatment. Biomarkers that allow for the prediction of disease outcome can guide clinicians with respect to treatment and surveillance strategies. Here, the methylation status of PITX2 and an adjacent lncRNA (PANCR) were evaluated for their ability to predict overall survival in HNSCC patients.ResultsPITX2 hypermethylation was associated with a better overall survival (hazard ratio, HR = 0.51, 95%CI: 0.35-0.74, p<0.001), while PANCR hypermethylation was significantly associated with an increased risk of death (HR = 1.64, 95%CI: 1.12-2.39, p=0.010).MethodsQuantitative, methylation-specific real-time PCR assays for PITX2 and PANCR were employed to measure bisulfite-converted DNA from formalin-fixed, paraffin-embedded (FFPE) tissues in a cohort of 399 patients with localized or locally advanced HNSCC who received curative-intent treatment (surgery with optional adjuvant radiochemotherapy or definite radiochemotherapy).ConclusionsPITX2 and PANCR methylation status were shown to be independent predictors for overall survival in HNSCC patients. Tissue-based methylation testing could therefore potentially be employed to identify patients with a high risk for death who might benefit from a more radical or alternative treatment.

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Analysis of loco-regional failures in head and neck cancer after radical radiation therapy

Cited by 50 publications

References 19 publications

Paclitaxel Plus Cetuximab as 1st Line Chemotherapy in Platinum-Based Chemoradiotherapy-Refractory Patients With Squamous Cell Carcinoma of the Head and Neck

Paclitaxel Plus Cetuximab as 1st Line Chemotherapy in Platinum-Based Chemoradiotherapy-Refractory Patients With Squamous Cell Carcinoma of the Head and Neck

Early death among head and neck cancer patients

PITX2andPANCRDNA methylation predicts overall survival in patients with head and neck squamous cell carcinoma

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