Indian clinical practice consensus guidelines for the management of squamous cell carcinoma of head and neck

Prabhash, Kumar; Babu, Govind; Chaturvedi, Pankaj; Kuriakose, Moni Abraham; Birur, Praveen; Anand, Anil Kumar; Kaushal, Ashish; Mahajan, Abhishek; Syiemlieh, Judita; Singhal, Manish; Gairola, Munish; Ramachandra, Prakash; Goyal, Sumit; John, Sheila; Nayyar, Rohit; Patil, Vijay; Rao, Vishal U.S.; Roshan, Vikas; Rath, Goura Kishor

doi:10.4103/0019-509x.278971

Cited by 43 publications

(29 citation statements)

References 15 publications

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“…Head and neck cancer constitutes between 30% and 40% of cancers in India. 9 Oral cavity cancer is the most common cancer in Indian men 10 ; one in every 60 Indians will develop cancer of the oral cavity or pharynx during their lifetime. 11 The causative factors for head and neck squamous cell carcinoma in India include smokeless tobacco, smoking, and alcohol; HPV plays a less important etiologic role.…”

Section: Choosing Wisely: Value-added Head and Neck Cancer Care In Densely Populated And Resource-constrained Regions-the Indian Experienmentioning

confidence: 99%

Making the Best of Limited Resources: Improving Outcomes in Head and Neck Cancer

Fagan

Noronha

Graboyes

2021

American Society of Clinical Oncology Educational Book

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The overwhelming majority of head and neck cancers and related deaths occur in low- and middle-income countries, which have challenges related to burden of disease versus access to care. Yet the additional health care burden of the COVID-19 pandemic has also impacted access to care for patients with head and neck cancer in the United States. This article focuses on challenges and innovation in prioritizing head and neck cancer care in Sub-Saharan Africa, the Indian experience of value-added head and neck cancer care in busy and densely populated regions, and strategies to optimize the management of head and neck cancer in the United States during the COVID-19 pandemic.

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Section: Choosing Wisely: Value-added Head and Neck Cancer Care In Densely Populated And Resource-constrained Regions-the Indian Experienmentioning

confidence: 99%

Making the Best of Limited Resources: Improving Outcomes in Head and Neck Cancer

Fagan

Noronha

Graboyes

2021

American Society of Clinical Oncology Educational Book

View full text Add to dashboard Cite

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“…Moreover, the enormous patient load in high volume referral centers imparts greater logistic difficulties in devoting the time and infrastructure to execute conformal treatment planning for every patient (3)(4)(5). Therefore, 2-dimensional conventional radiotherapy continues to be used for a significant proportion of our patients (6,7).…”

Section: Introductionmentioning

confidence: 99%

Genetic Variants of DNA Repair Genes as Predictors of Radiation-Induced Subcutaneous Fibrosis in Oropharyngeal Carcinoma

et al. 2021

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PurposeTo investigate the impact of genetic variants of DNA repair and pro-fibrotic pathway genes on the severity of radiation-induced subcutaneous fibrosis in patients of oropharyngeal carcinoma treated with radical radiotherapy.Materials and MethodsPatients of newly diagnosed squamous cell carcinoma of oropharynx being treated with two-dimensional radical radiotherapy were enrolled in the study. Patients who had undergone surgery or were receiving concurrent chemotherapy were excluded. Patients were followed up at 6 weeks post completion of radiotherapy and every 3 months thereafter for a median of 16 months. Subcutaneous fibrosis was graded according to the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC) grading system and the maximum grade was recorded over the length of the patient’s follow-up. Patients with severe fibrosis (≥G3), were compared to patients with minor (≤G2) fibrotic reactions. Eight single nucleotide polymorphisms of 7 DNA repair genes and 2 polymorphisms of a single pro-fibrotic pathway gene were analyzed by Polymerase Chain Reaction and Restriction Fragment Length Polymorphism and were correlated with the severity of subcutaneous fibrosis.Results179 patients were included in the analysis. Subcutaneous fibrosis was seen in 168 (93.9%) patients. 36 (20.1%) patients had severe (grade 3) fibrosis. On multivariate logistic regression analysis, Homozygous CC genotype of XRCC3 (722C>T, rs861539) (p=0.013*, OR 2.350, 95% CI 1.089-5.382), Homozygous AA genotype of ERCC4 Ex8 (1244G>A, rs1800067) (p=0.001**, OR 11.626, 95% CI 2.490-275.901) and Homozygous TT genotype of XRCC5 (1401G>T, rs828907) (p=0.020*, OR 2.188, 95% CI 1.652-7.334) were found to be predictive of severe subcutaneous fibrosis. On haplotype analysis, the cumulative risk of developing severe fibrosis was observed in patients carrying both haplotypes of variant Homozygous AA genotype of ERCC4 Ex8 (1244G>A, rs1800067) and Homozygous TT genotype of XRCC5 (1401 G>T, rs828907) (p=0.010*, OR 26.340, 95% CI 4.014-76.568).ConclusionWe demonstrated significant associations between single nucleotide polymorphisms of DNA repair genes and radiation-induced subcutaneous fibrosis in patients of oropharyngeal carcinoma treated with radiotherapy. We propose to incorporate these genetic markers into predictive models for identifying patients genetically predisposed to the development of radiation-induced fibrosis, thus guiding personalized treatment protocols.

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“…Head and neck cancers are amongst the most common (30%–40%)[ 1 ] cancers in India, and surgery is the mainstay of treatment. These are long, complex procedures involving primary resection of tumour and reconstruction with free tissue transfer involving microvascular anastomosis.…”

Section: Introductionmentioning

confidence: 99%

Prospective analysis of goal-directed fluid therapy vs conventional fluid therapy in perioperative outcome of composite resections of head and neck malignancy with free tissue transfer

et al. 2021

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Background and Aim: Head and neck cancer surgeries with free tissue transfer are complex procedures, and fluid management can grossly affect the microvascular anastomosis. We hypothesise that intra-operative goal-directed fluid therapy (GDFT) is the key to administer fluid individualised to a patient's requirement. The aim of this study was to observe the role of GDFT in perioperative flap outcome and length of hospital stay. Methods: A randomised prospective controlled study was performed in 106 patients undergoing composite resection of head and neck cancer with free tissue transfer. Patients in Group A received GDFT based on stroke volume variation whereas Group B received conventional fluid therapy intra-operatively. The endpoints of this study were total perioperative fluid, fluid boluses, vasopressor requirement, flap outcome and length of intensive care unit and hospital stay. Statistical analysis was done using Chi-square test. Results: The total intra-operative fluid given to both the groups was comparable but patients in Group A received more boluses and vasopressors compared to Group B during intra-operative period. The amount of fluid given in the first 24 hours post-operatively was significantly less in Group A (1807 + 476 ml) compared to Group B (2205 + 382 ml). Incidence of hypotension with tachycardia was observed in three patients in Group B and none in Group A. Poor flap outcome was observed in one patient in Group A versus four in Group B due to thrombosis. Conclusion: GDFT helps in early detection of fluid deficit and may avoid complications arising due to inadequate microvascular perfusion during the peri-operative period.

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Indian clinical practice consensus guidelines for the management of squamous cell carcinoma of head and neck

Cited by 43 publications

References 15 publications

Making the Best of Limited Resources: Improving Outcomes in Head and Neck Cancer

Making the Best of Limited Resources: Improving Outcomes in Head and Neck Cancer

Genetic Variants of DNA Repair Genes as Predictors of Radiation-Induced Subcutaneous Fibrosis in Oropharyngeal Carcinoma

Prospective analysis of goal-directed fluid therapy vs conventional fluid therapy in perioperative outcome of composite resections of head and neck malignancy with free tissue transfer

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