Benefit from surgery with additional radiotherapy in N1 head and neck cancer at the time of IMRT: A population-based study on recent developments

Evers, Christoph; Ostheimer, C.; Sieker, Frank; Vordermark, Dirk; Medenwald, Daniel

doi:10.1371/journal.pone.0229266

Cited by 8 publications

(7 citation statements)

References 41 publications

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“…When treating head and neck cancers, radiotherapy is often employed, either alone or in combination with surgery [ 5 , 6 , 7 , 8 ]. In order to reduce normal tissue toxicity, the use of intensity-modulated radiotherapy has been implemented [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Cytokines Explored in Saliva and Tears from Radiated Cancer Patients Correlate with Clinical Manifestations, Influencing Important Immunoregulatory Cellular Pathways

Aqrawi

Chen

Hynne

et al. 2020

Cells

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Although radiotherapy is a common form of treatment for head and neck cancer, it may lead to tissue damage in the salivary and lacrimal glands, possibly affecting cytokine expression in the gland fluid of treated individuals. Cytokine profiles in saliva and tear fluid of 29 radiated head and neck cancer patients and 20 controls were screened using a multiplex assay. Correlations between cytokine expression and clinical oral and ocular manifestations were examined, and cellular pathways influenced by these cytokines were assessed using the Functional Enrichment Analysis Tool. Significantly elevated cytokines identified in patient saliva were CCL21, IL-4, CX3CL1, CCL2, CXCL1 and CCL15. Many of these cytokines correlated positively with objective signs of oral dryness, and reduced saliva production in the patients. Although CCL21 and IL-4 levels were significantly lower in patient tear fluid, they correlated with subjective ocular symptoms. These increased salivary cytokines affected pro-inflammatory and apoptotic cellular pathways, including T cell signalling, several interleukin signalling pathways, TNF and TGF-β receptor signalling, and the apoptotic p53 pathway. In conclusion, the upregulated salivary cytokines identified suggest an interplay between innate and adaptive immunity, affecting immunoregulatory cellular pathways. Whether this is due to late effects of radiotherapy or tissue repair remains to be investigated.

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Section: Introductionmentioning

confidence: 99%

Cytokines Explored in Saliva and Tears from Radiated Cancer Patients Correlate with Clinical Manifestations, Influencing Important Immunoregulatory Cellular Pathways

Aqrawi

Chen

Hynne

et al. 2020

Cells

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“…Head and neck tumours occur with an incidence of 4-5 cases per 100,000 population and affect twice as many males as females (1). Over 90% of these are tumours of epithelial origin, the rest made up of tumours of mesenchymal and neuroectodermal origin (2).…”

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confidence: 99%

A Comparison of ¹⁸F-FDG-PET/MRI and ¹⁸F-FDG-PET/CT in the Cancer Staging of Locoregional Lymph Nodes

Slouka

Krcal

Kostlivy

et al. 2020

In Vivo

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Aim: The aim of the study was to evaluate the yields of 2-deoxy-2-[ 18 F]-fluoro-D-glucose positronemission tomography/magnetic resonance imaging (18 F-FDG-PET/MRI) and 18 F-FDG-PET/computed tomography (CT) for the detection of metastatic involvement of locoregional neck nodes in patients with head and neck malignancy. Patients and Methods: A total of 90 patients (66 men and 24 women) met the inclusion criteria. Preoperative staging was performed: 53 examinations using PET/CT and 37 using PET/MRI. Results: For PET/MRI, the study demonstrated a sensitivity of 89%, specificity of 64%, positive predictive value of 85%, and negative predictive value of 70%; PET/CT had a sensitivity of 95%, specificity 47%, positive predictive value of 82%, and negative predictive value of 78%. Conclusion: Both methods have a high yield in N-clinical staging with statistically insignificant differences. We assume PET/MRI to be the first-choice method in organ-targeted examinations, for pediatric patients and repeat examinations. In cases of MRI contraindication, PET/CT can be used with no impact on the quality of care.

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“…We also aimed to explore the difference in survival time and toxicity according to the radiation method. The advantage of IMRT and VMAT lies in the fact that a higher radiation dose can be delivered to the tumor while surrounding normal tissue can be better spared when compared to 3D-conformal techniques [ 2 , 14 ]. Moreover, toxic side effects such as xerostomia can be reduced [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Prognostic factors in radiotherapy of anaplastic thyroid carcinoma: a single center study over 31 years

et al. 2023

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Background Anaplastic thyroid carcinoma has a very poor prognosis. We analyzed the effect of surgery, radiotherapy and chemotherapy on survival time and side effects in patients with ATC. Methods We retrospectively analyzed all patients (n = 63) with histologically confirmed ATC who presented at our clinic between 1989 and 2020. We analyzed the survival with Kaplan–Meier curves and cox proportional hazard models and acute toxicities with logistic regression models. Results Out of 63 patients, 62 received radiotherapy, 74% underwent surgery and 24% received combined chemotherapy. A median radiation dose of 49 Gy (range 4–66 Gy) was applied. In 32% of the cases opposing-field technique was used, in 18% 3D-conformal, in 27% a combination of opposing field and 3D-conformal technique and 21% obtained IMRT (intensity modulated radiotherapy) or VMAT (volumetric modulated arc radiotherapy). Median overall survival (OS) was 6 months. We identified five predictive factors relevant for survival: absence of distant metastases at the time of diagnosis (OS 8 months), surgery (OS 9.8 months), resection status R0 (OS 14 months), radiation dose of 50 Gy or higher (OS 13 months) and multimodal therapy (surgery, radiotherapy and chemotherapy) with a median OS of 9.7 months. Conclusion In spite of the dismal outcome, longer survival can be achieved in some patients with ATC using surgery and radiotherapy with a high radiation dose. Compared to our previous study, there are no significant advantages in overall survival. Trial registration Retrospectively registered.

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Benefit from surgery with additional radiotherapy in N1 head and neck cancer at the time of IMRT: A population-based study on recent developments

Cited by 8 publications

References 41 publications

Cytokines Explored in Saliva and Tears from Radiated Cancer Patients Correlate with Clinical Manifestations, Influencing Important Immunoregulatory Cellular Pathways

Cytokines Explored in Saliva and Tears from Radiated Cancer Patients Correlate with Clinical Manifestations, Influencing Important Immunoregulatory Cellular Pathways

A Comparison of ¹⁸F-FDG-PET/MRI and ¹⁸F-FDG-PET/CT in the Cancer Staging of Locoregional Lymph Nodes

Prognostic factors in radiotherapy of anaplastic thyroid carcinoma: a single center study over 31 years

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Benefit from surgery with additional radiotherapy in N1 head and neck cancer at the time of IMRT: A population-based study on recent developments

Cited by 8 publications

References 41 publications

Cytokines Explored in Saliva and Tears from Radiated Cancer Patients Correlate with Clinical Manifestations, Influencing Important Immunoregulatory Cellular Pathways

Cytokines Explored in Saliva and Tears from Radiated Cancer Patients Correlate with Clinical Manifestations, Influencing Important Immunoregulatory Cellular Pathways

A Comparison of 18F-FDG-PET/MRI and 18F-FDG-PET/CT in the Cancer Staging of Locoregional Lymph Nodes

Prognostic factors in radiotherapy of anaplastic thyroid carcinoma: a single center study over 31 years

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A Comparison of ¹⁸F-FDG-PET/MRI and ¹⁸F-FDG-PET/CT in the Cancer Staging of Locoregional Lymph Nodes