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

{"title":"Continental Preferences in Reconstruction of Pharyngolaryngectomy Defects: A Multi-National Survey.","authors":"William Karantanis, Andrew R Larson, Ravjit Singh, Daniel G Deschler, Prathamesh S Pai, Thomas E Havas","doi":"10.1002/hed.28078","DOIUrl":"https://doi.org/10.1002/hed.28078","url":null,"abstract":"<p><strong>Objectives: </strong>Reconstruction of total pharyngolaryngectomy defects may restore pharyngeal function and enable tracheoesophageal speech after resection of locoregionally advanced malignancy. Little remains known about variations in the practices and preferences of surgeons across differing global regions.</p><p><strong>Methods: </strong>A survey was sent to reconstructive head and neck surgeons across three continents with responses analyzed to evaluate trends.</p><p><strong>Results: </strong>Of 155 respondents, 79.4% (n = 123) completed the survey including surgeons from North America (USA/Canada), the Indian Subcontinent (India/Bangladesh) and Australia/New Zealand. Among surgeons trained in pedicle flap reconstruction, only 47.5% performed these procedures after completion of training. Pedicle flaps were performed most frequently by surgeons from the Indian subcontinent. The anterolateral thigh flap was most popular among surgeons for free flap reconstruction, 58.5% (n = 72).</p><p><strong>Conclusion: </strong>This study demonstrates significant region-based variation in preferred reconstructive modality, suggesting location of practice and institutional experience influence the reconstructive algorithms of head and neck surgeons.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025709","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":"Survival, Tumor Control, and Safety Outcomes of Proton Therapy in Sinonasal Cancer Population: A Systematic Review and Meta-Analysis","authors":"Srivatsa Surya Vasudevan,&nbsp;Estephania Candelo,&nbsp;Alireza Sharifi,&nbsp;Daniel J. Ma,&nbsp;Samir H. Patel,&nbsp;David M. Routman,&nbsp;Adam L. Holtzman,&nbsp;Homan Mohammadi,&nbsp;Angela M. Donaldson","doi":"10.1002/hed.28082","DOIUrl":"10.1002/hed.28082","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In sinonasal cancer (SNC), treatment with proton therapy (PT) provides excellent local control, especially after gross total resection. Because of the heterogeneity and rarity of this disease site, a comprehensive assessment of toxicity, survival, and control rates is lacking. Our primary objective was to assess the toxicity outcomes of PT in SNC patients, with a secondary aim of assessing survival and tumor control after PT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed, Embase, EBSCO, Scopus, Science Direct, Web of Science, Ovid, Proquest, and Cochrane Library were searched from inception to August 2024 reporting PT acute and late toxicity, survival, and tumor control outcomes in SNC patients. A random-effect meta-analysis was used to assess the pooled safety, survival, and tumor control outcomes. The primary analysis was to report acute and late toxicity. The secondary aims included overall survival (OS), disease-free survival (DFS), local control (LC), regional control (RC), and distant metastasis control (DMC) rate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fourteen studies were included for qualitative analysis. We pooled data from 756 patients who received PT for SNC. Among acute toxicity (AT), there was a 31.9% occurrence rate of grade ≥ 3 events, whereas within late toxicity (LT), grade ≥ 3 events occurred at a rate of 35.3%. Most LT (62.1%) were classified as grade 2, with the most frequent being ocular (24.8%) or neurological (18.4%) toxicities. The most common grade ≥ 3 toxicities were mucositis (15.3%) in AT and ocular toxicity (9.6%) in LT. The pooled 5-year OS, DFS, LC, RC, and DMC were 36.8%, 34.2%, 35.6%, 28.6%, and 54.3%, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our analysis demonstrates that PT-treated SNC patients experience acceptable rates of acute and LT consistent with other published outcomes with highly conformal radiation techniques. PT demonstrates favorable OS and DFS. Further prospective and comparative effectiveness research is needed to better quantify the magnitude of the benefit of PT or other forms of radiation modalities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":"47 4","pages":"1291-1305"},"PeriodicalIF":2.3,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034152","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":"Nuances in the Treatment of Ewing Sarcoma of the Head and Neck in a Low-Middle-Income Country Setting: A Multi-Disciplinary Approach.","authors":"Archana Sasi, Shuvadeep Ganguly, Alok Thakar, Kapil Sikka, Sandeep Agarwala, Deepam Pushpam, Akash Kumar, Bivas Biswas, Rachna Meel, Ahitagni Biswas, Adarsh Barwad, Asit Ranjan Mridha, Sameer Bakhshi","doi":"10.1002/hed.28086","DOIUrl":"https://doi.org/10.1002/hed.28086","url":null,"abstract":"<p><strong>Background: </strong>Ewing sarcoma of the head and neck (ES-HN) is a rare subsite of ES, where therapeutic outcomes need to be explored further.</p><p><strong>Methods: </strong>This retrospective study includes ES-HN patients registered at our center between 2003 and 2019. Demographic details and treatment outcomes were recorded from the hospital database. Prognostic factors for survival were identified by Cox regression.</p><p><strong>Results: </strong>Eighty-five patients were included. Metastatic disease was seen in nine patients (10.59%). Local therapy included radiotherapy alone (n = 38; 44.7%), surgery plus radiotherapy (n = 15; 17.6%), or surgery alone (n = 8; 9.4%). The median overall survival (OS) was 37.4 months. On multivariable analysis, osseous primary (HR 0.40; p = 0.009) and male sex (HR 0.43; p = 0.023) were associated with superior OS. Leucocytosis (HR 3.46; p = 0.001) was associated with inferior OS.</p><p><strong>Conclusions: </strong>ES-HN has favorable biology with metastases being rare at baseline. However, leucocytosis, extra-osseous disease, and female sex are poor prognostic factors. In resource-challenged settings, difficulties in administering local therapy may contribute to inferior outcomes.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025778","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":"Transoral Robotic Surgery in Chronic Lingual Tonsillitis: An Observational Cohort Study.","authors":"Alexandra G L Toppenberg, Robert E Plaat, Leonora Q Schwandt","doi":"10.1002/hed.28074","DOIUrl":"https://doi.org/10.1002/hed.28074","url":null,"abstract":"<p><strong>Background: </strong>Chronic lingual tonsillitis (CLT) entails persistent inflammation of the lingual tonsils (LT), presenting in recurrent infections, throat discomfort, dyspnea, dysphagia, and LT hypertrophy.</p><p><strong>Methods: </strong>A retrospective observational study at a nonacademic general hospital described outcomes of CLT patients undergoing base of tongue (BOT) reduction via transoral robotic surgery (TORS). Primary outcomes were changes in patient-reported quality of swallowing and life and were assessed at baseline, 3, 6, and 12 months post-TORS. Secondary outcomes were tonsillitis complaints, LT Friedman grade, and postoperative complications.</p><p><strong>Results: </strong>Thirty-three patients were included, 5 patients were lost to follow-up at 6 and 12 months. Improved swallowing experience and enhanced quality of life were observed. Tonsillitis scores decreased significantly (mean 7.8 to 1.65 p < 0.001). LT Friedman grade reduced, with 69.7% achieving grade 0 at 12-months follow-up. Two patients experienced postoperative bleeding.</p><p><strong>Conclusions: </strong>TORS appears effective and safe for treating CLT improving swallowing, and overall quality of life for patients and reducing tonsillitis complaints.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016321","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":"Toxicity and Quality of Life After Locoregional Radiotherapy in Patients With Thyroid Cancer.","authors":"Job W van den End, Eline C Jager, Hans H G Verbeek, Edwin Oldehinkel, Liesbeth Jansen, Adrienne H Brouwers, Wouter T Zandee, Schelto Kruijff, Thera P Links","doi":"10.1002/hed.28076","DOIUrl":"https://doi.org/10.1002/hed.28076","url":null,"abstract":"<p><strong>Background: </strong>Locoregional external beam radiotherapy (EBRT) is selectively used in thyroid cancer patients to induce locoregional control. However, despite technological advances, EBRT remains associated with toxicities. We evaluated thyroid-cancer specific toxicities and long-term Quality of Life (QoL) post-EBRT.</p><p><strong>Methods: </strong>EBRT-treated thyroid cancer patients at Universal Medical Centre Groningen (2007-2023) were retrospectively evaluated (n = 66). Acute (< 6 weeks) and late (≥ 3 months) toxicities and QLQ-H&N35 results, prospectively collected as standard patient care, were analyzed (available in 24/66). Additionally, 17/66 living patients cross-sectionally completed the QLQ-H&N43 [renewed QLQ-H&N35] and SF-36-RAND-36.</p><p><strong>Results: </strong>In 24/66 patients who completed questionnaires during EBRT treatment, most severe acute toxicities occurred around week 6 (91% dermatitis, 74% pain, 70% hoarseness, 65% dysphagia). Late toxicities included persisting acute toxicities and fibrosis. Six months post-treatment, only QLQ-H&N35 domains \"social eating\" (p = 0.031) and \"dry mouth/sticky saliva\" (p = 0.025) were affected, in comparison to pre-radiation. In the 10/17 patients who completed the QLQ-H&N35 6 months post-radiation and the cross-sectionally performed QLQ-H&N43, no long-term mitigation of assessed domains was identified in a longitudinal analysis. The most advanced EBRT technique was associated with better QLQ-H&N43 scores (p = 0.047).</p><p><strong>Conclusions: </strong>EBRT causes acute and late toxicities in most thyroid cancer patients and may be associated with a decreased QoL. As these patients generally survive for multiple years, there is a compelling need to minimize toxicities with more refined radiation techniques, such as proton therapy.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016315","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":"Superior Regional Control and Laryngeal Function Preservation With Radiotherapy Versus Partial Laryngectomy: A Propensity Score-Matched Analysis of 562 Early Glottic Cancer Patients.","authors":"Shaoqiu Zhang, Ruichen Li, Yang Zhao, Liting Zhu, Ming Guo, Xiaoshen Wang, Yi Zhu","doi":"10.1002/hed.28080","DOIUrl":"https://doi.org/10.1002/hed.28080","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to compare the outcomes of patients with T1-T2N0M0 glottic squamous cell carcinoma who underwent either partial laryngectomy (PL) or radiotherapy (RT).</p><p><strong>Methods: </strong>A retrospective analysis of 562 patients treated with RT (n = 151) or PL (n = 411) was conducted. The Kaplan-Meier method was used to estimate outcomes. The risk factors were identified using univariate and multivariate Cox regression analyses. Propensity score matching (PSM) was used to adjust for baseline variations.</p><p><strong>Results: </strong>Post-PSM, the 5-year overall survival (89.4% vs. 88.4%, p = 0.879), 5-year cancer-specific survival (91.9% vs. 90.1%, p = 0.554), and 5-year local relapse-free survival (87.2% vs. 89.3%, p = 0.487) rates did not differ significantly between the two groups. However, the 5-year regional relapse-free survival rate was significantly higher in the RT group than that in the PL group (99.3% vs. 93.3%, p = 0.009). Recurrence was most likely to occur in the lymph nodes at levels II and III. Supraglottic engagement has emerged as an independent prognostic factor for regional relapse in T2 stage diagnosed PL. The RT group demonstrated significantly superior speech function (mean: 6.065) compared to the PL group (mean: 10.650, p < 0.0001).</p><p><strong>Conclusions: </strong>RT yielded survival rates, local control, and laryngeal preservation comparable to PL. RT is associated with a higher regional control rate in T2 patients. Supraglottic involvement is an independent risk factor for regional relapse in patients with T2 disease after PL. The RT group exhibited extremely low complication rates and significantly improved speech function.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016314","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":"Morbidity of the Free Fibular Flap in Reconstructive Surgery.","authors":"Carolin Goetz, Fabian Dietz, Oliver Bissinger, Klaus-Dietrich Wolff, Philipp Ehrmann, Jochen Weitz","doi":"10.1002/hed.28064","DOIUrl":"https://doi.org/10.1002/hed.28064","url":null,"abstract":"<p><strong>Background: </strong>Our study evaluated long-term morbidities in patients and compared subjective morbidities to those measurable objectively.</p><p><strong>Methods: </strong>Patients completed a questionnaire regarding long-term morbidity, filled out the Pain Sensitivity Questionnaire by Ruscheweyh et al. and were examined physically.</p><p><strong>Results: </strong>Eighty-two patients were included in the study, 31 patients returned to the clinic for further evaluation and testing. The most common morbidities were weakened dorsiflexion of the great toe (34 patients), reduced ambulatory status (33), and muscle weakness (31). A significant correlation (p < 0.01) was found between higher pain intensity and high pain sensitivity scores. However, donor-site morbidities were not significantly associated with pre-existing comorbidities like smoking, diabetes, or age over 70. Subjective morbidities were reported 2.3 times more frequently than objectively measured ones.</p><p><strong>Conclusions: </strong>Our findings suggest a notable discrepancy between subjective and objective morbidities, highlighting the importance of considering patients' subjective experiences when assessing postoperative outcomes and rehabilitation progress.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016037","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":"Female Representation Among Head and Neck Surgical Oncology Publications.","authors":"Monica S Trent, Madelyn Frank, Leo L T Meller, Daniella Chan, Cynthia Tsang, Waheda Tokhi, Tjoson Tjoa, Yarah M Haidar","doi":"10.1002/hed.28066","DOIUrl":"https://doi.org/10.1002/hed.28066","url":null,"abstract":"<p><strong>Background: </strong>There is lower female representation within academic medicine. We aimed to investigate female authorship (FA) and female-held chair or program director (PD) positions within head and neck oncology (HNO).</p><p><strong>Methods: </strong>Articles authored by females about microvascular and reconstructive surgery (MRS) and transoral robotic surgery (TORS) were identified. A sub-analysis was performed by investigating the gender of HNO fellows, PDs, and chairpersons. These were collected, and FA reported.</p><p><strong>Results: </strong>There were 1227 publications, 656 on MRS and 567 on TORS. Females authored 299 (24%) publications, 139 (23%) about MRS and 160 (30%) about TORS. There was no significant increase in FA or fellowship trends over time (p > 0.05). In our sub-analysis, we identified four HNO chairwomen (3%), and eight (6%) female HNO PDs. HNO chairwomen authored an average of 97 publications, PDs authored 37.</p><p><strong>Conclusion: </strong>FA in MRS and TORS remained stable between 2001 and 2022. Although few HNO females hold program chair or PD positions they perform quality research and serve as senior authors on a large proportion of publications.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016929","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 Clinically Node-Negative Salivary Gland Cancer: Observation, Neck Dissection, or Neck Irradiation?","authors":"Evelyn O Ilori, Neil M Woody, Bryan B Hair, Lisa Rybicki, Eric D Lamarre, Jamie Ahn Ku, Brandon Prendes, Joseph Scharpf, Brian B Burkey, Shlomo A Koyfman, Shauna R Campbell","doi":"10.1002/hed.28079","DOIUrl":"https://doi.org/10.1002/hed.28079","url":null,"abstract":"<p><strong>Introduction: </strong>Salivary gland malignancies are heterogeneous tumors with highly variable outcomes. Elective neck management options include observation, neck dissection (ND), and neck irradiation (NI). We sought to compare outcomes of cN0 salivary gland cancer by elective neck management.</p><p><strong>Methods: </strong>An IRB-approved registry was queried for cN0 salivary gland cancers and categorized based on neck management into observation, ND, NI, and ND + NI groups. cN0 included no evidence of clinical or radiographic metastatic lymphadenopathy.</p><p><strong>Results: </strong>A total of 445 patients were included with 203 in observation, 83 ND, 71 NI, and 88 ND + NI. Median follow-up was 60.8 months (range 0.4-258). There were 47% clinical T1 tumors, 29% T2, and 12% of each T3 and T4. Exactly 90% were cN0 and 10% with borderline lymph node(s). The major salivary gland was the most common site (74%) and the most common histologies included 28% mucoepidermoid and 20% adenoid cystic. Risk factors associated with regional recurrence include age, borderline lymph node features, pathologic T and N stage, poorly differentiated, positive margin, lymphovascular space invasion, and extranodal extension (all p < 0.05). There was no significant difference in local (9.9%-16.7%, p = 0.6) or regional (3.9%-9.4%, p = 0.76) recurrence between all four groups. Five-year distant recurrence was significantly different at 7% for observation, 16% in ND, 25% in NI, and 37% in ND + NI (p < 0.001). Ten-year OS estimates were 78% for observation, 66% for ND, 69% for NI, and 52% in ND + NI (p < 0.001).</p><p><strong>Conclusion: </strong>For patients with cN0 salivary gland cancer, ND and NI yield similar regional control in appropriately selected patients. In high-risk patients with several adverse risk features ND + NI results in favorable regional control but distant metastasis is a driving factor affecting overall survival.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015649","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":"Risk Factors for Progressive Disease After Immune Checkpoint Inhibitor Therapy in Head and Neck Squamous Cell Carcinoma.","authors":"Seo Yoon Jang, Yun-Gyoo Lee, Sang Hoon Chun, Ji Hyun Park, Keon Uk Park, Hyun Chang, Keun-Wook Lee, Hye Ryun Kim, Seong Hoon Shin, Ho Jung An, Kyoung Eun Lee, In Gyu Hwang, Myung-Ju Ahn, Sung-Bae Kim, Bhumsuk Keam","doi":"10.1002/hed.28071","DOIUrl":"https://doi.org/10.1002/hed.28071","url":null,"abstract":"<p><strong>Background: </strong>This study analyzed the clinical features of patients with recurrent or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC), who developed progressive disease (PD) after immune checkpoint inhibitor (ICI) therapy.</p><p><strong>Methods: </strong>We retrospectively analyzed 256 patients with R/M HNSCC treated with ICIs at 11 medical centers. Associations between the treatment outcomes-best response, overall survival, and progression-free survival-and various clinical factors were analyzed.</p><p><strong>Results: </strong>The objective response rate was 19.5% and PD was observed in 50.4% of the patients. A high neutrophil-to-lymphocyte ratio (NLR > 4; HR, 2.20 [1.28-3.78]) and large tumor size (sum of the target lesions > 40 mm; HR, 1.74 [1.03-2.94]) were significant risk factors for PD. High NLR (HR, 2.00 [1.42-2.82]), poor performance status (ECOG PS 2-3; HR, 3.51 [2.04-6.05]), and large tumor size (HR. 1.63 [1.19-2.24]) were independently associated with poor overall survival.</p><p><strong>Conclusions: </strong>Patients with high NLR and large tumor size are at higher risk of PD during ICI therapy.</p>","PeriodicalId":55072,"journal":{"name":"Head and Neck-Journal for the Sciences and Specialties of the Head and Neck","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016003","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}