Head and Neck-Journal for the Sciences and Specialties of the Head and Neck最新文献

{"title":"Neoadjuvant Anlotinib Plus Paclitaxel-Cisplatin for Technically Resectable Locally Advanced Head and Neck Squamous Cell Carcinoma: A Prospective Single-Arm Phase II Study.","authors":"Ran Xu, Meng-Jie Huang, Zhen-Hua Jiang, Lei Liu, Li-Jun Zhang, Shuang Zhang, Ji-Fang Luo, Jing Yuan","doi":"10.1002/hed.70501","DOIUrl":"https://doi.org/10.1002/hed.70501","url":null,"abstract":"<p><strong>Background: </strong>Technically resectable locally advanced head and neck squamous cell carcinoma may require highly morbid surgery. We evaluated short-course neoadjuvant anlotinib plus paclitaxel-cisplatin as a signal-generating strategy.</p><p><strong>Methods: </strong>Twenty-one patients received two 21-day cycles in a prospective, single-arm Phase II study. The primary endpoint was RECIST 1.1 objective response rate; pathological response and surgical extent were exploratory.</p><p><strong>Results: </strong>Objective response rate was 66.7% (14/21; 95% CI, 43.0%-85.4%), meeting the prespecified activity criterion. Eight patients underwent surgery; all achieved R0 resection, 5/8 achieved major pathological response, and 4/8 underwent less extensive resection than initially planned. Documented adverse events were mainly Grade 1, including one Grade 1 hypertension controlled with levamlodipine and one Grade 2 primary-tumor bleeding event; proteinuria was not systematically captured.</p><p><strong>Conclusions: </strong>The regimen generated antitumor activity and surgical feasibility signals but does not establish anlotinib benefit beyond TP or functional preservation.</p><p><strong>Trial registration: </strong>Chinese Clinical Trial Registry: ChiCTR2100046440.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149118870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time to Rethink Pathology Reporting in Adenoid Cystic Carcinoma.","authors":"Luigi Lorini, Emily Governini, Armando Di Bello, Silvia Uccella, Martina Iuzzolino, Carlo Resteghini, Paolo Bossi","doi":"10.1002/hed.70493","DOIUrl":"https://doi.org/10.1002/hed.70493","url":null,"abstract":"<p><strong>Purpose: </strong>To propose a practical, biologically informed pathology reporting framework for adenoid cystic carcinoma (AdCC) that integrates conventional morphology with selective biomarker assessment.</p><p><strong>Methods: </strong>A narrative review of current pathological reporting standards, emerging proteogenomic evidence, and clinically relevant biomarkers was performed. Based on available evidence, a stepwise reporting strategy was developed in which routine histopathological evaluation remains the foundation, while additional immunohistochemical and molecular analyses are selectively recommended for high-risk or clinically relevant cases.</p><p><strong>Findings: </strong>Conventional morphology accurately establishes the diagnosis but does not fully capture the biological heterogeneity and complexity of AdCC. A selective biological addendum including MYC, p63, B7-H4, TROP2, Nectin-4, and selected molecular analyses may improve biological stratification, optimize tissue stewardship, and identify patients eligible for biomarker-driven therapeutic trials.</p><p><strong>Conclusion: </strong>Morphology should remain the cornerstone of AdCC pathology reporting while guiding selective biological characterization to support precision oncology and future clinical trial enrollment.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thin Thoracodorsal Artery Perforator Free Flap for Scalp Resurfacing After Malignant Skin Tumor Excision.","authors":"Daihun Kang, Suein Lee, Seung Eun Hong, Youn Hwan Kim","doi":"10.1002/hed.70490","DOIUrl":"https://doi.org/10.1002/hed.70490","url":null,"abstract":"<p><strong>Background: </strong>Scalp defects after malignant tumor excision often require free tissue transfer for durable coverage. The thoracodorsal artery perforator (TDAP) flap remains underused despite its suitability for thin elevation.</p><p><strong>Methods: </strong>Fourteen patients (6 men, 8 women; mean age 62 years) treated with a thin TDAP free flap for scalp resurfacing after malignant tumor excision between 2016 and 2026 were retrospectively reviewed. All flaps were performed by a single surgeon at two institutions.</p><p><strong>Results: </strong>TDAP elevation was completed in 14 of 16 attempts (87.5%); in 2 patients no reliable perforator was found at exploration and a latissimus dorsi flap was raised instead. Diagnoses included squamous cell carcinoma (6), basal cell carcinoma (3), basosquamous carcinoma (2), and single cases of eccrine porocarcinoma, angiosarcoma, and melanoma. Mean flap area was 97 cm² and pedicle length 9.7 cm; superficial temporal vessels served as recipients, with single-artery, single-vein anastomosis per flap. Mean operative time, including excision, was 134 min. One venous thrombosis was salvaged by re-exploration, one flap showed transient venous congestion that resolved spontaneously, and all 14 flaps survived. Over a mean follow-up of 17 months, one patient with angiosarcoma developed regional and distant recurrence without local recurrence at the reconstructed site.</p><p><strong>Conclusions: </strong>The thin TDAP free flap is a reliable, efficient, and versatile option for oncologic scalp reconstruction.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgery After Thermal Ablation of Thyroid Nodules: A Systematic Review of Surgical Risk, Strategy and Pathological Findings.","authors":"Francesco Brucchi, Federica Poli, Beatrice Sperotto, Carla Colombo, Laura Fugazzola, Gianlorenzo Dionigi","doi":"10.1002/hed.70487","DOIUrl":"https://doi.org/10.1002/hed.70487","url":null,"abstract":"<p><strong>Background: </strong>Thermal ablation is increasingly used for selected thyroid nodules, but some patients subsequently require thyroidectomy. The effect of prior ablation on surgical risk, operative strategy, and histopathology remains unclear.</p><p><strong>Methods: </strong>PubMed/MEDLINE, EMBASE, and the Cochrane Library were searched from inception to May 2026 for studies reporting surgical and/or histopathological outcomes of thyroidectomy after radiofrequency, laser, or microwave ablation. Cohort studies and case series with at least two patients were included. Data were synthesized descriptively and stratified by ablation indication: benign/indeterminate nodules versus primary papillary thyroid carcinoma.</p><p><strong>Results: </strong>Nine retrospective studies including 150 patients were included: six on benign/indeterminate nodules (n = 105) and three on primary papillary thyroid carcinoma (n = 45). In benign/indeterminate cases, transient recurrent laryngeal nerve palsy ranged from 0% to 9.7%, transient hypoparathyroidism from 0% to 6.5%, and hematoma requiring reoperation from 0% to 6.5%; no permanent recurrent laryngeal nerve palsy or hypoparathyroidism was reported. Controlled studies showed longer operative times, higher thyroidectomy difficulty scores, and more severe adhesions after ablation, although overall complication rates did not differ significantly. Histopathology showed fibrosis, hyalinization, coagulative necrosis, and treatment-related atypia, potentially complicating assessment of follicular-patterned neoplasms; no carcinoma arising within the ablated zone was identified. In the papillary thyroid carcinoma group, surgical specimens frequently revealed residual tumor and lymph node metastases after ablation used as primary treatment, while oncological follow-up was largely absent. Reporting of surgical strategy and intraoperative adjuncts was inconsistent.</p><p><strong>Conclusions: </strong>Thyroidectomy after thermal ablation appears feasible in experienced endocrine surgery centers, with low reported permanent morbidity, but may be technically more complex than primary surgery. Current evidence is limited to small, heterogeneous retrospective series and cannot define the true incremental surgical risk, optimal operative strategy, or long-term oncological impact of prior ablation. Prospective multicenter comparative studies with standardized reporting are needed.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cold Exposure to the Recurrent Laryngeal Nerve: A Porcine Continuous Intraoperative Neuromonitoring Model Study.","authors":"Tzu-Yen Huang, Hsin-Yi Tseng, Yi-Chu Lin, Gregory W Randolph, Marika Russell, Amr H Abdelhamid Ahmed, I-Cheng Lu, Chih-Hung Lin, Cheng-Hsun Chuang, Jia Joanna Wang, Leong-Perng Chan, Feng-Yu Chiang, Li-Ren Yeh, Che-Wei Wu","doi":"10.1002/hed.70489","DOIUrl":"https://doi.org/10.1002/hed.70489","url":null,"abstract":"<p><strong>Background: </strong>Tissue exposure to cold temperatures is common in clinical practice, yet the safety of exposing the recurrent laryngeal nerve (RLN) to cold remains unclear. This study evaluated temperature-dependent effects of cold exposure on RLN function.</p><p><strong>Methods: </strong>A porcine continuous intraoperative neuromonitoring (C-IONM) model was used to assess electromyographic (EMG) changes in 16 RLNs exposed to four temperature conditions: room temperature water, cold water, ice water, and ice block. Each exposure lasted 1 min, followed by 20 min of EMG monitoring.</p><p><strong>Results: </strong>Room temperature and cold water caused no or only mild EMG changes with complete recovery. Ice water induced moderate to severe disturbances with partial reversibility. Ice block exposure produced the most severe effects, including transient loss of signal and incomplete recovery in some nerves.</p><p><strong>Conclusions: </strong>Cold exposure below 3°C can induce significant RLN dysfunction. These findings provide evidence that near-freezing temperatures, presumed to be neuroprotective, instead carry a distinct risk of iatrogenic neural injury, underscoring the need for caution in clinical applications.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Oral Cancer From Precursor Lesions: The Case for a Standardized Framework of Analysis to Improve Prediction Modeling.","authors":"Michael E Troka, James C Gates","doi":"10.1002/hed.70465","DOIUrl":"https://doi.org/10.1002/hed.70465","url":null,"abstract":"<p><p>Oral Cancer often occurs from the transformation of precursor lesions, and this offers an opportunity for early detection. Current methods to assess risk of precursor lesion progression to oral cancer incompletely predict risk. A multimodal framework that leverages machine learning is needed to improve prediction. In this manuscript, we propose more standardization in the study of OPMD across sites and propose a framework aligned to the principles of the NCI's Human Tissue Atlas Network (HTAN). We explore whole exome sequencing for genomic risk, methylation array for environmental genetic regulation, RNA sequencing for transcriptional control of cellular programs with spatial transcriptomics to fulfill the spatial requirements of HTAN. Moreover, we propose a machine learning (ML) analysis whereby a learned image-molecular association is created by integrating H&E histology and sequencing results. Once these associations are learned, a \"Teacher-Student\" model can be created whereby the Student model can be deployed to infer the \"molecular associations\" from H&E and patient covariates alone. Such a framework integrating multiomic data across multiple different biologic processes and time points can help to better understand and potentially even predict the biologic events that underlie oral cancer initiation.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149042173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of the Association Between ILIB and Photobiomodulation in Oral Mucositis Among Oncology Patients: A Prospective Study","authors":"Clébia Roberta Eufrazio do Nascimento,&nbsp;Fernanda Suely Barros Dantas,&nbsp;Tácio Fragoso Pereira,&nbsp;Myllenne dos Santos Abreu,&nbsp;Katarina Haluli Jano da Veiga Pessoa,&nbsp;Jair Carneiro Leão,&nbsp;Alessandra de Albuquerque Tavares Carvalho","doi":"10.1002/hed.70285","DOIUrl":"10.1002/hed.70285","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Purpose</h3>\u0000 \u0000 <p>Oral mucositis is one of the most frequent and debilitating adverse effects of antineoplastic therapy, significantly impairing treatment adherence and patients' quality of life. This study aimed to evaluate the effectiveness of Intravenous Laser Irradiation of Blood (ILIB), applied alone or combined with low-level laser therapy, in reducing oral mucositis and improving the quality of life of oncology patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This quasi-experimental prospective study with parallel groups was conducted between 2023 and 2024 at the Memorial Hospital of Arcoverde (PE), involving 76 patients equally allocated into four groups (<i>n</i> = 19): ILIB alone (A and C) and ILIB combined with laser therapy (B and D), applied therapeutically or preventively over weeks. Oral mucositis grade (WHO scale) and quality of life (OHIP-14) were assessed before and after the interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No baseline differences were observed between groups (<i>p</i> &gt; 0.05). After the intervention, the combined therapy groups showed greater reductions in mucositis (B: −1.60; −55.2% and D: −1.70; −60.7%) compared with ILIB alone (A: −0.70; −25.0% and C: −0.70; −25.9%) (<i>p</i> &lt; 0.05). Improvements in quality of life were also more pronounced in the combined groups (B: −9.00; −31.0% and D: −10.40; −36.0%) compared with ILIB alone (A: −4.50; −15.8% and C: −4.30; −15.5%) (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The ILIB + laser therapy association was more effective than ILIB alone in reducing oral mucositis and improving quality of life, both in prevention and treatment contexts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":"48 10","pages":"2685-2692"},"PeriodicalIF":2.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147718946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Swab-Derived Viral Load as a Biomarker of Tumor Biology in HPV-Associated Oropharyngeal Squamous Cell Carcinoma","authors":"Ella P. Jackert,&nbsp;Michelle Koh,&nbsp;Swar Vimawala,&nbsp;Liyang Tang,&nbsp;Daniel Kwon,&nbsp;Niels Kokot,&nbsp;Maie St. John,&nbsp;Yang Chai,&nbsp;Uttam Sinha,&nbsp;Albert Y. Han","doi":"10.1002/hed.70296","DOIUrl":"10.1002/hed.70296","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Site-specific identification of human papillomavirus (HPV)-driven oropharyngeal squamous cell carcinoma (HPV+ OPSCC) remains a major diagnostic challenge. We developed a site-directed mucosal swab assay designed to detect and quantify tumor-derived HPV DNA shed into the oropharyngeal surface overlying HPV-associated tumors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with biopsy-proven HPV+ OPSCC or oral cavity SCC as controls were enrolled after providing informed consent. Swabs of the tumor site as well as the contralateral normal mucosa were collected. Swab-derived DNA was extracted and analyzed by quantitative PCR targeting HPV16 and HPV genotyping with Sanger sequencing. Multivariable linear regression models were used to evaluate associations between swab-based viral load and clinicopathologic features.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In a prospective cohort of 30 patients with HPV+ OPSCC, tumor-side swabs detected HPV DNA in 30 of 30 cases. Swabs obtained from the contralateral mucosa showed substantially lower HPV DNA levels, demonstrating strong spatial specificity for the tumor-bearing region. The assay limit of detection was determined to be ~10 HPV16 copies per reaction (1 viral genome per 500 diploid cells). All negative control patients with oral cavity SCC had negative results. Regression models revealed node-positive status to be independently associated with low quantitative HPV16 viral load (fold change = 0.013, 95% CI: 0.001–0.178).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>By enabling minimally invasive, anatomically targeted detection of HPV-driven cancer at the primary site, this swab-based assay has the potential to shorten the diagnostic pathway for HPV+ OPSCC while providing quantitative viral load measurements that may serve as a surrogate biomarker for intratumoral biology in HPV+ OPSCC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":"48 10","pages":"2782-2791"},"PeriodicalIF":2.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of the Clinically Node-Negative Neck in Intermediate-Grade Mucoepidermoid Carcinoma of the Head and Neck: A Single-Institution Retrospective Study","authors":"Min-Chuan Lin,&nbsp;Xu Jiang,&nbsp;Zi-Chen Qiu,&nbsp;Xiong Zhou,&nbsp;Ya-Lan Tao","doi":"10.1002/hed.70304","DOIUrl":"10.1002/hed.70304","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Management of the clinically node-negative (cN0) neck in intermediate-grade mucoepidermoid carcinoma (MEC) of the head and neck remains controversial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reviewed patients with cN0 intermediate-grade MEC treated between 2008 and 2025. Patients underwent observation or elective neck treatment, including elective neck dissection and/or radiotherapy. Survival outcomes were analyzed using Kaplan–Meier methods and Cox proportional hazards models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty patients were included (27 observation, 33 elective treatment). After a median follow-up of 53 months, regional recurrence occurred in three patients in the observation group and in none receiving elective treatment. Five-year regional recurrence-free survival, disease-free survival, and disease-specific survival were high in both groups, without significant differences. Perineural invasion was associated with worse disease-free survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In cN0 intermediate-grade MEC, regional control outcomes were favorable, and a statistically significant benefit of elective neck treatment was not demonstrated in this cohort. For carefully selected patients without adverse clinicopathologic features, close observation of the neck may be a reasonable strategy. These findings should be interpreted cautiously given the limited sample size and low event rate.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":"48 10","pages":"2773-2781"},"PeriodicalIF":2.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predominance of In-Field Recurrence After Radiotherapy for Sinonasal Cancer: A Single-Center Retrospective Study","authors":"M. de Ridder,&nbsp;L. J. van de Velde,&nbsp;T. de Bie,&nbsp;R. van Noortwijk,&nbsp;C. P. J. Raaijmakers,&nbsp;E. H. Voormolen,&nbsp;W. W. Braunius,&nbsp;R. de Bree,&nbsp;G. E. Breimer,&nbsp;L. A. Devriese,&nbsp;E. J. Smid,&nbsp;J. A. Rijken","doi":"10.1002/hed.70287","DOIUrl":"10.1002/hed.70287","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sinonasal malignancies (SNM) are rare, heterogeneous tumors with poor prognosis. There is an unmet need to improve treatment outcomes. Despite advances in imaging and molecular classification, optimal curative radiotherapy (RT) strategies remain undefined. We analyzed the pattern of failure after RT, focusing in depth on local recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study included 104 SNM patients treated with curative-intent RT (either primary or after endoscopic surgery) at a tertiary center between 2010 and 2022. Local recurrences were delineated on follow-up imaging and registered to pretreatment plans. Recurrence location was classified as in-field, marginal, or out-of-field based on dose at the center of mass.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Local recurrence rate was 25%. Most local recurrences (81%) occurred in-field in the high-dose region (&gt; 95% of prescribed dose), with a median dose of 65 Gy. Perineural spread accounted for most out-of-field failures. Local recurrence significantly impaired disease-specific survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Local failures after RT for SNM predominantly arise in-field within adequately irradiated volumes, suggesting biological radioresistance. These findings support the need for histology-driven, biologically tailored treatment strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":"48 10","pages":"2704-2712"},"PeriodicalIF":2.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hed.70287","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}