Stereotactic Radiosurgery for Retreatment of Gross Perineural Invasion in Recurrent Cutaneous Squamous Cell Carcinoma of the Head and Neck

Tang, Chad; Fischbein, Nancy J.; Murphy, James D.; Chu, Karen; Bavan, Brindha; Dieterich, Sonja; Hara, Wendy; Kaplan, Michael; Colevas, A. Dimitrios; Le, Quynh Thu

doi:10.1097/coc.0b013e3182468019

Cited by 10 publications

(5 citation statements)

References 18 publications

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“…Our goal was to generate data in skull base cancer survivors who had primary disease treated with curative intent. In our estimation, patients receiving palliative or noncurative therapy for recurrent disease bear a symptom burden that is different, and in many regards more severe, for reasons related to tumor burden and also sequelae of prior therapy . In addition, the treatment regimen in this patient population is not necessarily standardized and may have made interpretation of our results less conclusive.…”

Section: Discussionmentioning

confidence: 84%

Long‐term quality of life after definitive treatment of sinonasal and nasopharyngeal malignancies

et al. 2019

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Objective: To evaluate long-term global and site-specific health-related quality of life (HRQoL) in patients treated for sinonasal and nasopharyngeal malignancies.Study Design: Cross-sectional. Methods: One hundred fourteen patients with sinonasal and nasopharyngeal malignancies received surgery, radiation, systemic chemotherapy, or a combination thereof, with curative intent. Validated global ([EuroQol-5D] Visual Analogue Scale [EQ-5D VAS]) and disease-specific instruments (MD Anderson Symptom Inventory-Head and Neck [MDASI-HN], Anterior Skull Base Questionnaire [ASBQ]) were administered to patients who were both free of disease and had completed treatment at least 12 months previously. Associations between instruments, instrument domains, and specific clinical parameters were analyzed.Results: The median age was 55 years. The mean EQ-5D VAS, MDASI-22 composite score, and ASBQ score were 74 (standard deviation [SD] 21), 48 (SD 36), and 130 (SD 27), respectively. The most frequently reported high-severity items in MDASI-HN were dry mouth and difficulty tasting food. The most frequently reported high-severity items in ASBQ were difficulty with smell and nasal secretions. Advanced Tumor (T) classification was associated with worse overall ASBQ sum score (P = 0.02). ASBQ performance at home and MDASI-HN drowsy symptom items independently predicted worse global HRQoL as measured by the EQ-5D VAS (P < 0.001).Conclusion: Global HRQoL for survivors of sinonasal and nasopharyngeal malignancies after multimodality treatment approximates that of the U.S. population for the same age group. ASBQ and MDASI-HN correlate well with global HRQoL outcomes as measured by EQ-5D VAS. MDASI-HN and ASBQ elicited unique symptoms, highlighting the complex symptom burden experienced by these patients. Further studies should identify patients predisposed to reduced long-term QOL.

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Section: Discussionmentioning

confidence: 84%

Long‐term quality of life after definitive treatment of sinonasal and nasopharyngeal malignancies

et al. 2019

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“…Studies in this review are summarized in Table 1. Several published studies were not included owing to reporting limitations that precluded accurate assessment of the delivered doses and clinical outcomes (19)(20)(21)(22)(23). A PubMed search in April 2015 for the keywords "stereotactic" AND "neck" AND "radiation" resulted in 293 articles.…”

Section: Review Of Outcomes Datamentioning

confidence: 99%

Head and Neck Tumor Control Probability: Radiation Dose–Volume Effects in Stereotactic Body Radiation Therapy for Locally Recurrent Previously-Irradiated Head and Neck Cancer: Report of the AAPM Working Group

Vargo

Moiseenko

Grimm

et al. 2021

International Journal of Radiation Oncology*Biology*Physics

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“…Treatment of the involved nerves ranges from aggressive surgical resection of nerves up to the skull base and occasionally beyond 4,5 to nonsurgical approaches utilizing radiotherapy or chemoradiation. 6,7 These treatments have limited success in disease control and cure. In addition, both approaches lead to significant short and longterm morbidity.…”

Section: Introductionmentioning

confidence: 99%

“…First‐line therapy for most cSCC is surgical resection; however, management of tumors with cPNI is more complicated and tends to be institution‐specific. Treatment of the involved nerves ranges from aggressive surgical resection of nerves up to the skull base and occasionally beyond 4,5 to nonsurgical approaches utilizing radiotherapy or chemoradiation 6,7 . These treatments have limited success in disease control and cure.…”

Section: Introductionmentioning

confidence: 99%

Clinical Perineural Invasion and Immunotherapy for Head and Neck Cutaneous Squamous Cell Carcinoma

Reinshagen

Cunnane

et al. 2021

The Laryngoscope

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Objectives/Hypothesis To describe outcomes of advanced head and neck cutaneous squamous cell carcinoma (cSCC) with clinical perineural invasion (cPNI) treated with immune checkpoint inhibitor (ICI) therapy, and to describe post‐treatment radiographic findings in the context of clinical response to treatment using a new grading system. Study Design Retrospective chart review. Methods Retrospective chart review was performed for 11 patients treated with ICI for head and neck cSCC with cPNI of large named nerves. The primary outcome was response to treatment as defined by radiographic and clinical evidence. Clinical responses were defined as improvement in symptoms of neuropathic pain, hypoesthesia, nerve weakness, or decrease in visible tumor. Imaging studies were graded based on a new classification system for perineural invasion and reviewed by two neuroradiologists since RECISTv1.1 is inadequate to adjudicate response in these patients. Results Nine (82%) patients had radiographic perineural disease control on ICI. Eight patients had improved radiographic perineural disease and one had stable disease. Of these, complete resolution of radiographic evidence of perineural disease was seen in only one patient. Seven (64%) patients had clinical responses, with either improved or stable radiographic disease. Conclusions ICI therapy is a viable treatment option for head and neck cSCC with cPNI. Radiographic and clinical evidence of response correlate well, with improvement in neuropathic pain being the most sensitive clinical marker of response. Even with favorable findings on repeat imaging and stable clinical course, complete resolution of perineural thickening and enhancement is rare. A grading system for classifying changes in perineural disease over time is proposed. Level of Evidence 4 Laryngoscope, 132:1213–1218, 2022

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Stereotactic Radiosurgery for Retreatment of Gross Perineural Invasion in Recurrent Cutaneous Squamous Cell Carcinoma of the Head and Neck

Cited by 10 publications

References 18 publications

Long‐term quality of life after definitive treatment of sinonasal and nasopharyngeal malignancies

Long‐term quality of life after definitive treatment of sinonasal and nasopharyngeal malignancies

Head and Neck Tumor Control Probability: Radiation Dose–Volume Effects in Stereotactic Body Radiation Therapy for Locally Recurrent Previously-Irradiated Head and Neck Cancer: Report of the AAPM Working Group

Clinical Perineural Invasion and Immunotherapy for Head and Neck Cutaneous Squamous Cell Carcinoma

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