Chemoradiotherapy for Head and Neck Cancer

D’Onofrio, Ida; Nardone, Valerio; Reginelli, Alfonso; Cappabianca, Salvatore

doi:10.3390/cancers15102820

Cited by 4 publications

(4 citation statements)

References 7 publications

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“…Approximately 3% of patients present with distant metastases at initial diagnosis [10], but 20-30% of patients currently develop distant metastases later in the course of their disease [11][12][13][14]. To summarize, the primary obstacle to further improve OS beyond the current 50% margin at five years [15] is increasingly shifting from failure in locoregional control to metastatic disease.…”

Section: Introductionmentioning

confidence: 99%

Survival, Treatment Outcome, and Safety of Multiple and Repeated Courses of Stereotactic Body Radiotherapy for Pulmonary Oligometastases of Head and Neck Squamous Cell Carcinoma

Vorbach,

Mangesius,

Dejaco

et al. 2023

Cancers

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Current literature regarding survival and treatment outcome of SBRT in patients with pulmonary oligometastatic head and neck squamous cell carcinoma (HNSCC) is limited. Additionally, most of the published studies include metastatic lesions deriving also from primaries with histologies other than SCC when investigating the outcome of SBRT. The aim of the present retrospective study is to explore local control (LC) of treated metastases, progression-free survival (PFS), and overall survival (OS) of exclusively pulmonary oligometastatic HNSCC-patients treated with SBRT. Between 2006 and 2021, a total of 46 patients were treated with SBRT for a maximum of four pulmonary oligometastases (PM) concurrently (mean PM per patient = 2.0; range 1 to 6 PM, total of 92). Of these, 17 patients (37.0%) developed new pulmonary metastases after their first SBRT. Repeated courses of SBRT were required once in 15 patients (88.2%) and twice in 2 patients (11.8%). Median follow-up was 17 months (range, 0–109 months). One year after completion of SBRT, LC rate, PFS, and OS were 98.7%, 37.9%, and 79.5%, respectively. After two years, LC rate, PFS, and OS were 98.7%, 28.7%, and 54.9%; as well as 98.7%, 16.7%, and 31.0% after five years. Radiochemotherapy (HR 2.72, p < 0.001) or radiotherapy as primary treatment (HR 8.60; p = 0.003), as well as reduced patient performance status (HR 48.30, p = 0.002), were associated with lower PFS. Inferior OS correlated with poor performance status (HR 198.51, p < 0.001) and surgery followed by radiochemotherapy (HR 4.18, p = 0.032) as primary treatment, as well as radiotherapy alone (HR 7.11, p = 0.020). Treatment of more than one PM is an independent predictor of impaired OS (HR 3.30, p = 0.016). SBRT of HNSCC-derived PMs results in excellent LC rates and encouraging OS rates of 54.9% at two years along with good tolerability (no more than grade 2 toxicities). Favourable outcome and low toxicity also apply to repeated courses of SBRT of newly emerging PMs.

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Section: Introductionmentioning

confidence: 99%

Survival, Treatment Outcome, and Safety of Multiple and Repeated Courses of Stereotactic Body Radiotherapy for Pulmonary Oligometastases of Head and Neck Squamous Cell Carcinoma

Vorbach,

Mangesius,

Dejaco

et al. 2023

Cancers

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“…Most patients are diagnosed in advanced stages of the disease, which limits therapeutic options and leads to a persistently poor five-year overall survival of approximately 60% [ 2 ]. For locally advanced (LA) HNSCC patients, primary chemoradiation is an established and frequently used therapeutic option, especially in advanced T stages and with other considerations that make surgery less preferable [ 2 , 3 , 4 , 5 , 6 , 7 ]. Here, intensity-modulated radiation therapy (IMRT) is combined with cisplatin, which has been shown to achieve three-year locoregional control rates of 55–80% in large-scale, prospective clinical trials [ 8 , 9 , 10 , 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

“…Here, intensity-modulated radiation therapy (IMRT) is combined with cisplatin, which has been shown to achieve three-year locoregional control rates of 55–80% in large-scale, prospective clinical trials [ 8 , 9 , 10 , 11 , 12 ]. However, the response to therapy is highly heterogeneous [ 5 ] with only a few established predictive biomarkers, including tumor human papillomavirus (HPV) status [ 13 , 14 , 15 ], tobacco consumption [ 13 , 15 ], tumor stage [ 13 ], nodal stage [ 13 ], and tumor hypoxia [ 16 ]. Hence, additional predictive and prognostic biomarkers are urgently needed for a more effective and individualized therapeutic management of LA-HNSCC patients.…”

Section: Introductionmentioning

confidence: 99%

Expression of 3q Oncogene SEC62 Predicts Survival in Head and Neck Squamous Cell Carcinoma Patients Treated with Primary Chemoradiation

Linxweiler,

Schneider,

Körner

et al. 2023

Cancers

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Primary chemoradiotherapy (CRT) is an established treatment option for locally advanced head and neck squamous cell carcinomas (HNSCC) usually combining intensity modified radiotherapy with concurrent platinum-based chemotherapy. Though the majority of patients can be cured with this regimen, treatment response is highly heterogeneous and can hardly be predicted. SEC62 represents a metastasis stimulating oncogene that is frequently overexpressed in various cancer entities and is associated with poor outcome. Its role in HNSCC patients undergoing CRT has not been investigated so far. A total of 127 HNSCC patients treated with primary CRT were included in this study. The median follow-up was 5.4 years. Pretherapeutic tissue samples of the primary tumors were used for immunohistochemistry targeting SEC62. SEC62 expression, clinical and histopathological parameters, as well as patient outcome, were correlated in univariate and multivariate survival analyses. High SEC62 expression correlated with a significantly shorter overall survival (p = 0.015) and advanced lymph node metastases (p = 0.024). Further significant predictors of poor overall and progression-free survival included response to therapy (RECIST1.1), nodal status, distant metastases, tobacco consumption, recurrence of disease, and UICC stage. In a multivariate Cox hazard proportional regression analysis, only SEC62 expression (p = 0.046) and response to therapy (p < 0.0001) maintained statistical significance as independent predictors of the patients’ overall survival. This study identified SEC62 as an independent prognostic biomarker in HNSCC patients treated with primary CRT. The role of SEC62 as a potential therapeutic target and its interaction with radiation-induced molecular alterations in head and neck cancer cells should further be investigated.

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“…Due to the high complexity and heterogeneity of HNSCC, the response to treatment methods is highly variable, in addition to having a range of clinicopathological risk factors. The heterogeneity of HNSCC consists of several factors, including mutations in the genetic materials, the presence of the tumor microenvironment and the associated immune response [ 3 ]. Anatomically, the four main areas involved in HNC are the oral cavity, pharynx, nasal cavity and larynx.…”

Section: Introductionmentioning

confidence: 99%

New Propargyloxy Derivatives of Galangin, Kaempferol and Fisetin—Synthesis, Spectroscopic Analysis and In Vitro Anticancer Activity on Head and Neck Cancer Cells

Kubina,

Krzykawski,

Sokal

et al. 2023

Cells

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Head and neck cancer (HNC) therapy is limited; therefore, new solutions are increasingly being sought among flavonoids, which exhibit numerous biological properties, including potential anticancer activity. However, because they are mostly insoluble in water, are unstable and have low bioavailability, they are subjected to chemical modification to obtain new derivatives with better properties. This study aimed to synthesize and analyze new propargyloxy derivatives of galangin, kaempferol and fisetin, and to evaluate their anticancer activity against selected HNC cell lines. The obtained derivatives were assessed by spectroscopic analysis; next, their anticancer activity was evaluated using a flow cytometer and real-time cell analysis. The results showed that only the fisetin derivative was suitable for further analysis, due to the lack of crystal formation of the compound. The fisetin derivative statistically significantly increases the number of cells in the G2/M phase (p < 0.05) and increases cyclin B1 levels. A statistically significant increase in the number of apoptotic cells after being exposed to the tested compound was also observed (p < 0.05). The data indicate that the obtained fisetin derivative exhibits anticancer activity by affecting the cell cycle and increasing apoptosis in selected HNC lines, which suggests its potential use as a new medicinal agent in the future.

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Chemoradiotherapy for Head and Neck Cancer

Abstract: Head and neck squamous cell carcinoma (HNSCC) is a highly challenging cancer [...]

Cited by 4 publications

References 7 publications

Survival, Treatment Outcome, and Safety of Multiple and Repeated Courses of Stereotactic Body Radiotherapy for Pulmonary Oligometastases of Head and Neck Squamous Cell Carcinoma

Survival, Treatment Outcome, and Safety of Multiple and Repeated Courses of Stereotactic Body Radiotherapy for Pulmonary Oligometastases of Head and Neck Squamous Cell Carcinoma

Expression of 3q Oncogene SEC62 Predicts Survival in Head and Neck Squamous Cell Carcinoma Patients Treated with Primary Chemoradiation

New Propargyloxy Derivatives of Galangin, Kaempferol and Fisetin—Synthesis, Spectroscopic Analysis and In Vitro Anticancer Activity on Head and Neck Cancer Cells

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