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

{"title":"Evaluating the reduction of elective radiotherapy fields for de novo metastatic nasopharyngeal carcinoma in the immunotherapy era.","authors":"Ting Jin, Pei-Jing Li, Qi-Feng Jin, Yong-Hong Hua, Xiao-Zhong Chen","doi":"10.1002/hed.27931","DOIUrl":"10.1002/hed.27931","url":null,"abstract":"<p><strong>Background: </strong>This study evaluates the outcomes of omitting the high- and low-risk clinical tumor volume (CTV1 and CTV2) radiation in de novo metastatic nasopharyngeal carcinoma (dnm-NPC) patients in the immunotherapy era.</p><p><strong>Methods: </strong>We retrospectively analyzed 45 consecutive dnm-NPC patients receiving chemotherapy and immunotherapy combined with radiotherapy (CIR) from October 9, 2018 to June 1, 2022. Irradiation was only delivered to the primary tumor and retropharyngeal nodes (GTVnx+rn) and gross cervical lymph nodes (GTVnd).</p><p><strong>Results: </strong>The median follow-up was 45 (range, 15-67) months. There was no recurrence in the omitted elective regions. The 36-month LRRFS, PFS, and OS were 95.4%, 44.6%, and 90.8%, respectively. The main grade 3/4 hematologic toxicities were neutropenia (42.2%), anemia (20.0%), and thrombocytopenia (13.3%). The incidence of acute grade 3/4 dermatitis, mucositis, and xerostomia were 4.4%, 8.9%, and 4.4%, respectively.</p><p><strong>Conclusions: </strong>Omitting CTV1 and CTV2 was well-tolerated and provided favorable clinical outcomes in the era of immunotherapy.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":"559-566"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332759","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":"Visual pathology reports for improved collaboration at multidisciplinary head and neck tumor board.","authors":"Carly Fassler, Pratyusha Yalamanchi, Marina Aweeda, Julie Rezk, Barbara Murphy, Natalie A Lockney, Ryan Whitaker, Ryan Rigsby, Joseph Aulino, Emily Hosokawa, Mitra Mehrad, Kim Ely, James S Lewis, Evan Derman, Ed LaHood, Sarah L Rohde, Robert J Sinard, Eben L Rosenthal, Michael C Topf","doi":"10.1002/hed.27926","DOIUrl":"10.1002/hed.27926","url":null,"abstract":"<p><strong>Purpose: </strong>Multidisciplinary tumor boards (TB) are the standard for discussing complex head and neck cancer cases. During TB, imaging and microscopic pathology is reviewed, but there is typically no visualization of the resected cancer.</p><p><strong>Methods: </strong>A pilot study was conducted to investigate the utility of visual pathology reports at weekly TB for 10 consecutive weeks. Faculty-level participants completed a pre-survey and post-survey to assess understanding of resected cancer specimens.</p><p><strong>Results: </strong>Providers (n = 25) across seven medical specialties completed pre-survey and post-survey. Following intervention, providers reported significant improvement in understanding of anatomic orientation of the specimen and sites of margin sampling (mean 47.4-96.1, p < 0.001), ability to locate the site of a positive margin (mean 69.5-91.1, p < 0.001), and confidence in treatment plans created (mean 69.5-89.2, p < 0.001) with the addition of visual pathology reports.</p><p><strong>Conclusions: </strong>Visual pathology reports improve provider understanding of resected cancer specimens at multidisciplinary TB.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":"452-462"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142114949","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}

{"title":"The impact of digital inequities on salivary gland cancer disparities in the United States.","authors":"David M Bruss, David J Fei-Zhang, Helena Kim, Daniel C Chelius, Anthony M Sheyn, John P Maddalozzo, Jeffrey C Rastatter, Jill N D'Souza","doi":"10.1002/hed.27930","DOIUrl":"10.1002/hed.27930","url":null,"abstract":"<p><strong>Introduction: </strong>Technology and internet access have become increasingly integrated into healthcare as the primary platform for health-related information and provider-patient communication. Disparities in access to digital resources exist in the United States and have been shown to impact health outcomes in various head and neck malignancies. Our objective is to evaluate the associations of digital inequity on health outcomes in patients with salivary gland cancer (SGC).</p><p><strong>Methods: </strong>The Digital Inequity Index (DII) was developed using 17 census-tract level variables obtained from the American Community Survey and Federal Communications Commission. Variables were categorized as digital infrastructure or sociodemographic (e.g., non-digital) and scored based on relative rankings across all US counties. Scores were assigned to patients from the Surveillance-Epidemiology-End Results (SEER) database diagnosed with SGC between 2013 and 2017 based on county-of-residence. Regressions were performed between DII score and outcomes of surveillance time, survival time, tumor stage at time of diagnosis, and treatment modality.</p><p><strong>Results: </strong>Among 9306 SGC-patients, increased digital inequity was associated with advanced-staging at presentation (OR: 1.04, 95% CI: 1.01-1.07, p = 0.033), increased odds of chemotherapy receipt (OR: 1.05, CI: 1.01-1.10, p = 0.010), and decreased odds of surgical intervention (OR: 0.94, 95% CI: 0.91-0.98, p = 0.003) after accounting for traditional sociodemographic factors. Increased digital inequity was also associated with decreased surveillance time and survival periods.</p><p><strong>Conclusions: </strong>Digital inequity significantly and independently associates with negative health and treatment outcomes in SGC patients, highlighting the importance of directed efforts to address these seldom-investigated drivers of health disparities.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":"538-548"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142332761","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}

{"title":"The Benefits of Silicone Laryngectomy Tubes at the Time of Laryngectomy-A Case Series Spanning 17 Years.","authors":"Ann Kearney, Idris Samad, Michael A Belsky, Philip C Doyle, Edward J Damrose","doi":"10.1002/hed.27967","DOIUrl":"10.1002/hed.27967","url":null,"abstract":"<p><strong>Objectives: </strong>Although total laryngectomy (TL) is a well-established surgical procedure with clear functional or oncologic indications, the peri- and postoperative care for those undergoing TL is variable, particularly regarding postlaryngectomy tracheostoma management. This study examined TL outcomes from a single institution with the immediate perioperative use of soft silicone laryngectomy tubes. More specifically, we explored potential complications associated with immediate perioperative use of a flexible laryngectomy tube (LaryTube and StomaSoft) and the use of heat and moisture exchange (HME) devices in association with peri- and postoperative care.</p><p><strong>Methods: </strong>A case series including all patients undergoing TL by one primary surgeon at a tertiary care hospital between 2006 and 2023 were assessed. Variables of interest included hospital average length of stay (LOS) in hospital, use of laryngectomy tube and an HME, primary tracheoesophageal puncture voice restoration at time of TL, discharge feeding, stoma-related complications, and overall complications.</p><p><strong>Results: </strong>Seventy-two patients were included over the study period, and all utilized a laryngectomy tube and HME in the perioperative period without complications. Fifty-six patients (77.7%) had concurrent neck dissections and nine (15%) underwent total laryngopharyngectomy. Sixty-two patients (86%) underwent TL for squamous cell carcinoma of the larynx or hypopharynx and 35 of these (56%) were salvage surgeries. Mean LOS was 8.4 (3-45) days, and 63 patients (88%) were discharged with nasal gastric tube feeding. Of the six patients (8%) who were readmitted for complications, zero (0%) were related to the laryngectomy tube or to stoma-related complications (e.g., dehiscence, infection, mucous plugging). No patient who utilized a laryngectomy tube and HME device in the perioperative period experienced stomal stenosis.</p><p><strong>Conclusions: </strong>Laryngectomy tubes combined with an HME can be employed safely and successfully in a high percentage of laryngectomy patients placed perioperative. No instances of postlaryngectomy tracheostoma stenosis occurred in association with perioperative laryngectomy tube with HME use. These collective data support the use of a laryngectomy tube with HME in the immediate perioperative period, with low risk of complications.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":"720-725"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481359","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}

{"title":"Determining Factors Which Limit Resectability in Advanced Hypopharyngeal Malignancy.","authors":"Justin M Hintze, Eoin Cleere, Isobel O'Riordan, Conrad Timon, John Kinsella, Paul Lennon, Conall W R Fitzgerald","doi":"10.1002/hed.27980","DOIUrl":"10.1002/hed.27980","url":null,"abstract":"<p><strong>Background: </strong>Preoperative radiological findings of hypopharyngeal cancers are used to determine suitability for surgical resection. We sought to examine preoperative imaging characteristics to determine how well imaging findings predicted surgical resectability.</p><p><strong>Methods: </strong>A retrospective case-control study of patients undergoing a pharyngolaryngectomy in a tertiary referral center over a 2-year period was completed. Demographic details, previous treatment, subsite, TNM staging, imaging characteristics, and operative characteristics were collected.</p><p><strong>Results: </strong>A total of 78 patients met initial inclusion criteria, of which 71 patients ultimately underwent successful surgical resection (91.1%). Preoperative images identified suspicion of prevertebral fascia invasion in 24 (30.7%) cases and carotid artery involvement in 14 (17.9%) cases. In cases of suspicion of prevertebral fascia invasion (24), 19 cases (79.2%) were resectable, and in those with carotid artery involvement (14), 11 (78.6%) were resectable. Concern for prevertebral fascia invasion on radiology led to a higher likelihood of a close margin (42% vs. 17%) in those without concerning features (p = 0.088).</p><p><strong>Conclusions: </strong>The present study demonstrated a high rate of resectability of hypopharyngeal and upper esophageal cancers despite imaging findings suspicious for factors that could limit resectability. In patients with advanced hypopharyngeal, especially in the salvage setting, surgery should be considered.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":"726-732"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717975/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513314","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}

{"title":"Unsuspected Malignant Mimicry From Topical Vitamin E and Micro Spike Roller.","authors":"Jacob Hauser, Traeden Wilson, Chelsea Huang, Paul Walker","doi":"10.1002/hed.27996","DOIUrl":"10.1002/hed.27996","url":null,"abstract":"<p><strong>Background: </strong>Topical vitamin E is commonly used for its antioxidant properties in a rapidly expanding anti-aging market. Cutaneous reaction to vitamin E is rare and can present a difficult diagnosis.</p><p><strong>Methods: </strong>We report a unique case of a 46-year-old female who developed a severe cutaneous inflammatory chin lesion after topical use of vitamin E oil with a micro-spike roller. Clinical examination found a friable and fungating mass which prompted biopsy due to suspected malignancy. Pathology ruled out malignancy and revealed chronic inflammation with xanthogranulomatous-like features.</p><p><strong>Results: </strong>The lesion was significantly improved with Kenalog injection treatment over 18 months. A scar excision procedure further enhanced the lesion cosmetically.</p><p><strong>Conclusions: </strong>This case highlights the rarity and clinical diversity of vitamin E skin reactions, and their potential to mimic malignancies.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":"E28-E31"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689734","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":"Chemoradiotherapy plus immunotherapy for locoregionally advanced nasopharyngeal carcinoma: A cost-effectiveness analysis.","authors":"Kun Liu, Youwen Zhu, Shan Li, Hong Zhu","doi":"10.1002/hed.27932","DOIUrl":"10.1002/hed.27932","url":null,"abstract":"<p><strong>Background: </strong>Research focused on the addition of immune checkpoint inhibitors (ICIs) to radiotherapeutic regimens in patients with cancer has become increasingly common, revealing promising improvements in efficacy outcomes. In patients with locoregionally advanced nasopharyngeal carcinoma (NPC), combining immunotherapy with chemoradiotherapy can facilitate the significant prolongation of survival, emphasizing the need for pharmacoeconomic studies focused on the clinical uptake of these innovative treatment regimens.</p><p><strong>Methods: </strong>A three-state Markov model was developed based on clinical data from the randomized phase 3 CONTINUUM trial and used to compare the cost-effectiveness of chemoradiotherapy plus sintilimab (sintilimab group) to chemoradiotherapy alone (standard group), analyzing outcomes including incremental cost-effectiveness ratio (ICER), incremental net monetary benefit (INMB), and incremental net-health benefit (INHB) values at a willingness-to-pay (WTP) threshold corresponding to three times the Chinese GDP per capita ($37 035 per quality-adjusted life year [QALY]).</p><p><strong>Results: </strong>The total costs for patients in the sintilimab and standard groups (QALYs [LYs]) were $92 116 (6.68 [10.03]) and $53 255 (3.75 [5.55]), respectively, for an ICER of $13 230/QALY ($8672/LY), an INMB of $70 021 with INHB of 1.89 QALYs. Using the selected WTP threshold. On the standard WTP threshold, the prevalence of sintilimab group as the primary treatment was 90.55% in China. The establishment of the model is stable.</p><p><strong>Conclusions: </strong>Adding sintilimab to chemoradiotherapeutic regimens represents an innovative and cost-effective means for patients with locoregionally advanced NPC management in China.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":"485-494"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156666","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":"Integrating lymph node ratio into personalized radiotherapy for oral cavity squamous cell carcinoma.","authors":"Linmei Zhang, Enzhao Zhu, Shaokang Cao, Zisheng Ai, Jiansheng Su","doi":"10.1002/hed.27938","DOIUrl":"10.1002/hed.27938","url":null,"abstract":"<p><strong>Purpose: </strong>The use of postoperative radiotherapy (PORT) in patients with oral squamous cell carcinoma (OCSCC) lacks clear boundaries due to the non-negligible toxicity accompanying its remarkable cancer-killing effect. This study aims at validating the ability of deep learning models to develop individualized PORT recommendations for patients with OCSCC and quantifying the impact of patient characteristics on treatment selection.</p><p><strong>Methods: </strong>Participants were categorized into two groups based on alignment between model-recommended and actual treatment regimens, with their overall survival compared. Inverse probability treatment weighting was used to reduce bias, and a mixed-effects multivariate linear regression illustrated how baseline characteristics influenced PORT selection.</p><p><strong>Results: </strong>4990 patients with OCSCC met the inclusion criteria. Deep Survival regression with Mixture Effects (DSME) demonstrated the best performance among all the models and National Comprehensive Cancer Network guidelines. The efficacy of PORT is enhanced as the lymph node ratio (LNR) increases. Similar enhancements in efficacy are observed in patients with advanced age, large tumors, multiple positive lymph nodes, tongue involvement, and stage IVA. Early-stage (stage 0-II) OCSCC may safely omit PORT.</p><p><strong>Conclusions: </strong>This is the first study to incorporate LNR as a tumor character to make personalized recommendations for patients. DSME can effectively identify potential beneficiaries of PORT and provide quantifiable survival benefits.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":"517-528"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301403","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":"Expression analysis of SOX2 and SOX9 in patients with oral squamous cell carcinoma.","authors":"Sonja Steen, Dominik Horn, Christa Flechtenmacher, Jürgen Hoffmann, Kolja Freier, Oliver Ristow, Jochen Hess, Julius Moratin","doi":"10.1002/hed.27925","DOIUrl":"10.1002/hed.27925","url":null,"abstract":"<p><strong>Background: </strong>Lately SOX2 and SOX9, transcription factors associated with stemness-like phenotypes of cancer cells, have been linked to tumor growth, metastasis, and resistance to therapy.</p><p><strong>Methods: </strong>This study aimed on evaluating the expression of SOX2 and SOX9 in a large cohort of patients with OSCC including primary and recurrent tumors and corresponding lymph node metastases. Semiautomatic digital pathology scoring was used to determine protein expression and survival analysis was performed to evaluate its prognostic significance.</p><p><strong>Results: </strong>We found a significant downregulation of SOX9 from primary disease to lymph node metastases (p < 0.001). SOX9 expression and the subgroup SOX2^lowSOX9^high were significantly correlated with worse overall survival (p < 0.05). Additionally, SOX2^lowSOX9^high expression pattern was confirmed as independent prognosticator for overall survival.</p><p><strong>Conclusions: </strong>These results indicate the relevant role of SOX2 and SOX9 in patients with OSCC and show the clinical relevance for further investigation on the molecular mechanisms underlying SOX-related gene expression.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":"437-451"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11717967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047511","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}

{"title":"Aspirin Use and Head and Neck Cancer.","authors":"Shih-Wei Lai","doi":"10.1002/hed.27984","DOIUrl":"10.1002/hed.27984","url":null,"abstract":"","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":"783-784"},"PeriodicalIF":2.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549031","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}