Cancers of the head & neck最新文献

{"title":"Venous thromboembolism in head and neck cancer surgery.","authors":"Faisal I Ahmad,&nbsp;Daniel R Clayburgh","doi":"10.1186/s41199-016-0014-9","DOIUrl":"https://doi.org/10.1186/s41199-016-0014-9","url":null,"abstract":"<p><strong>Background: </strong>Venous thromboembolism (VTE) is a major cause of perioperative morbidity and mortality. Historically, otolaryngology surgery has been seen as very low risk of VTE, given the relatively short procedures and healthy patient population. However, head and neck surgery patients have multiple additional risk factors for VTE compared to general otolaryngology patients, and only recently has research been directed at examining this population of patients regarding VTE risk.</p><p><strong>Review: </strong>VTE has long been recognized as a major issue in other surgical specialties, with VTE rates of 15-60 % in some specialties in the absence of prophylaxis with either mechanical compression or anticoagulation. Multiple large-scale retrospective studies have shown that the incidence of VTE in otolaryngology patients is quite low, ranging between 0.1 and 1.6 %. However, these studies indicated that head and neck cancer patients may have an increased risk of VTE. Further retrospective studies focusing on head and neck cancer patients found a VTE rate of approximately 2 %, but one study also found a suspected VTE rate of 5.6 % based on clinical symptoms, indicating that retrospective studies may underreport the true incidence. A single prospective study found a 13 % risk of VTE after major head and neck surgery. Furthermore, risk stratification using the Caprini risk assessment model demonstrates that the highest risk patients may have a VTE risk of 18.3 %, although this may be lowered (but not eliminated) through the use of appropriate prophylactic anticoagulation.</p><p><strong>Conclusion: </strong>VTE is likely a more significant concern in head and neck surgery patients than previously realized. Appropriate prophylaxis with mechanical compression and anticoagulation is essential; risk stratification may serve as a useful tool to identify head and neck cancer patients at highest risk for VTE.</p>","PeriodicalId":72518,"journal":{"name":"Cancers of the head & neck","volume":"1 ","pages":"13"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41199-016-0014-9","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37243811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral and dental health in head and neck cancer survivors.","authors":"Firoozeh Samim, Joel B Epstein, Zachary S Zumsteg, Allen S Ho, Andrei Barasch","doi":"10.1186/s41199-016-0015-8","DOIUrl":"10.1186/s41199-016-0015-8","url":null,"abstract":"<p><p>Therapeutic improvements and epidemiologic changes in head and neck cancer (HNC) over the last three decades have led to increased numbers of survivors, resulting in greater need for continuing management of oral and dental health in this population. Generally, the HNC patient oral health needs are complex, requiring multidisciplinary collaboration among oncologists and dental professionals with special knowledge and training in the field of oral oncology. In this review, we focus on the impact of cancer treatment on oral health, and the oral care protocols recommended prior to, during and after cancer therapy. The management of oral complications such as mucositis, pain, infection, salivary function, taste and dental needs are briefly reviewed. Other complications and their management, including osteonecrosis of the jaw and recurrent/new primary malignancies are also described. This review offers clinical protocols and information for medical providers to assist in understanding oral complications and their management in HNC patients and survivors, and their oral and dental health care needs. Oral and dental care is impacted by the patient's initial oral and dental status, as well as the specific cancer location, type, and its treatment; thus, close communication between the dental professional and the oncology team is required for appropriate therapy.</p>","PeriodicalId":72518,"journal":{"name":"Cancers of the head & neck","volume":"1 ","pages":"14"},"PeriodicalIF":0.0,"publicationDate":"2016-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6460838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37243812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Costimulatory and coinhibitory immune checkpoint receptors in head and neck cancer: unleashing immune responses through therapeutic combinations.","authors":"Ruth J Davis, Robert L Ferris, Nicole C Schmitt","doi":"10.1186/s41199-016-0013-x","DOIUrl":"10.1186/s41199-016-0013-x","url":null,"abstract":"<p><p>Head and neck squamous cell carcinoma (HNSCC) represents a model of escape from anti-tumor immunity. The high frequency of p53 tumor suppressor loss in HNSCC leads to genomic instability and immune stimulation through the generation of neoantigens. However, the aggressive nature of HNSCC tumors and significant rates of resistance to conventional therapies highlights the ability of HNSCC to evade this immune response. Advances in understanding the role of co-stimulatory and immune checkpoint receptors in HNSCC-mediated immunosuppression lay the foundation for development of novel therapeutic approaches. This article provides an overview of these co-stimulatory and immune checkpoint pathways, as well as a review of preclinical and clinical evidence supporting the modulation of these pathways in HNSCC. Finally, the synergistic potential of combining these approaches is discussed, along with an update of current clinical trials evaluating combinations of immune-based therapies in HNSCC patients.</p>","PeriodicalId":72518,"journal":{"name":"Cancers of the head & neck","volume":"1 ","pages":"12"},"PeriodicalIF":0.0,"publicationDate":"2016-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6460794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37243810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cylindromatosis (<i>CYLD</i>) gene and head and neck tumorigenesis.","authors":"Krista Roberta Verhoeft,&nbsp;Hoi Lam Ngan,&nbsp;Vivian Wai Yan Lui","doi":"10.1186/s41199-016-0012-y","DOIUrl":"https://doi.org/10.1186/s41199-016-0012-y","url":null,"abstract":"<p><p>Germline <i>CYLD</i> mutation is associated with the development of a rare inheritable syndrome, called the <i>CYLD</i> cutaneous syndrome. Patients with this syndrome are distinctly presented with multiple tumors in the head and neck region, which can grow in size and number over time. Some of these benign head and neck tumors can turn into malignancies in some individuals. <i>CYLD</i> has been identified to be the only tumor suppressor gene reported to be associated with this syndrome thus far. Here, we summarize all reported <i>CYLD</i> germline mutations associated with this syndrome, as well as the reported paired somatic <i>CYLD</i> mutations of the developed tumors. Interestingly, whole-exome sequencing (WES) studies of multiple cancer types also revealed <i>CYLD</i> mutations in many human malignancies, including head and neck cancers and several epithelial cancers. Currently, the role of <i>CYLD</i> mutations in head and neck carcinogenesis and other cancers is poorly defined. We hope that this timely review of recent findings on <i>CYLD</i> genetics and animal models for oncogenesis can provide important insights into the mechanism of head and neck tumorigenesis.</p>","PeriodicalId":72518,"journal":{"name":"Cancers of the head & neck","volume":"1 ","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2016-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41199-016-0012-y","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37242441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic therapy for recurrent or metastatic salivary gland malignancies.","authors":"Ashish V Chintakuntlawar,&nbsp;Scott H Okuno,&nbsp;Katharine A Price","doi":"10.1186/s41199-016-0011-z","DOIUrl":"10.1186/s41199-016-0011-z","url":null,"abstract":"<p><p>Salivary gland carcinomas are notoriously resistant to therapy and no standard of care exists. Due to the rarity of these malignancies, various histologies, and wide ranging clinical behavior it has been difficult to standardize systemic therapy. We have reviewed clinical prospective studies in the last 15 years with salivary gland malignancies involving cytotoxic chemotherapy and biologic agents including targeted therapies such as anti-HER-2, anti-EGFR therapies, and therapies directed at c-kit. Although the results of most trials are modest at best, there has been an increase in studies for salivary cancer in recent years and there are several promising treatment approaches in evolution. Every effort should be made to treat salivary gland malignancies under a clinical protocol and/or at a large multidisciplinary practice with clinicians experienced in treating these malignancies.</p>","PeriodicalId":72518,"journal":{"name":"Cancers of the head & neck","volume":"1 ","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2016-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41199-016-0011-z","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37243809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A review of weight loss and sarcopenia in patients with head and neck cancer treated with chemoradiation.","authors":"Shrujal S Baxi,&nbsp;Emily Schwitzer,&nbsp;Lee W Jones","doi":"10.1186/s41199-016-0010-0","DOIUrl":"https://doi.org/10.1186/s41199-016-0010-0","url":null,"abstract":"<p><strong>Background: </strong>Concurrent chemotherapy and radiation (CTRT) improves disease-free survival in locally advanced head and neck cancer but is associated with numerous acute and chronic toxicities resulting in substantial alterations in body mass and composition. We aim to summarize the current evidence on body composition changes experienced by patients undergoing CTRT, examine the impact of these changes on clinical outcomes and address potential interventions aimed at mitigating the loss.</p><p><strong>Main body: </strong>Loss of 20 % of pre-CTRT weight predicts poorer treatment tolerance and 30-day mortality. While clinical practice focuses on body weight, emerging data indicates that CTRT causes profound adverse changes in lean body mass (sarcopenia). Higher prevalence of sarcopenia predicts poorer disease-free survival as well as overall survival, lower quality of life and functional performance. The magnitude of CTRT-induced sarcopenia is the equivalent to that observed in a decade of aging in a healthy adult. Alterations in body composition are only explained, in part, by decreased caloric intake; other significant predictors include body mass index, stage, and dysphagia. Lifestyle interventions aimed at preventing loss of whole-body and especially lean mass include nutritional counseling, nutritional supplements, dietary supplements and exercise training. Personalized nutritional counseling has been associated with improvement in quality of life, while the benefits of feeding tube placement are inconsistent. There are inconsistently reported benefits of resistance training in this population.</p><p><strong>Conclusion: </strong>Patients with head and neck cancer undergoing CTRT therapy experience dramatic shifts in body composition, including sarcopenia, which can negatively impact clinical outcomes. Efforts to understand the magnitude, clinical importance and mechanisms of sarcopenia are needed to inform a more personalized approach to mitigating the body composition changes associated with CTRT.</p>","PeriodicalId":72518,"journal":{"name":"Cancers of the head & neck","volume":"1 ","pages":"9"},"PeriodicalIF":0.0,"publicationDate":"2016-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41199-016-0010-0","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37242440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The rationale for including immune checkpoint inhibition into multimodal primary treatment concepts of head and neck cancer.","authors":"Ingeborg Tinhofer,&nbsp;Volker Budach,&nbsp;Korinna Jöhrens,&nbsp;Ulrich Keilholz","doi":"10.1186/s41199-016-0009-6","DOIUrl":"https://doi.org/10.1186/s41199-016-0009-6","url":null,"abstract":"<p><strong>Background: </strong>Treatment of locally advanced squamous cell carcinomas of the head and neck (SCCHN) remains unsatisfactory. Although the addition of concurrent radiochemotherapy (RCT) or the combination of radiotherapy with blockade of the epidermal growth factor receptor (EGFR) have improved outcomes over radiotherapy alone, further optimization is urgently needed. The introduction of immune checkpoint inhibitors is currently revolutionizing cancer treatment. Clinical evidence has recently been provided in melanoma that immune checkpoint blockade may cooperate with radiation. Therefore, we searched in the literature for the evidence of combining immune checkpoint inhibitors with radiotherapy in primary treatment of SCCHN.</p><p><strong>Discussion: </strong>A substantial amount of previous studies has dissected the molecular mechanisms of immune evasion in SCCHN. The biological effects of radio- and chemotherapy in tumor cells and the immune cell microenvironment were characterized in detail, revealing significant interference of both types of treatment with anti-tumor immunity. This extensive review of the literature revealed considerable amount of evidence that addition of immune checkpoint inhibitors might boost the immunomodulatory potential of radiotherapy and RCT regimens in SCCHN.</p><p><strong>Summary: </strong>Promising activity of immune checkpoint inhibitors has already been reported for metastatic/recurrent SCCHN. Given the immunogenic effect of radiotherapy and its enhancement by chemotherapy, combination of radiotherapy or RCT with this new type of immunotherapy might represent a valuable option for improvement of curative treatment modalities in SCCHN.</p>","PeriodicalId":72518,"journal":{"name":"Cancers of the head & neck","volume":"1 ","pages":"8"},"PeriodicalIF":0.0,"publicationDate":"2016-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41199-016-0009-6","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37242439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Considerations in surgical versus non-surgical management of HPV positive oropharyngeal cancer.","authors":"Christopher E Fundakowski,&nbsp;Miriam Lango","doi":"10.1186/s41199-016-0007-8","DOIUrl":"https://doi.org/10.1186/s41199-016-0007-8","url":null,"abstract":"<p><p>Given the marked difference in clinical presentation and treatment response based on human papilloma virus (HPV) status, HPV-associated oropharyngeal squamous cell carcinoma is now viewed as a distinct biologic and clinical entity. HPV-associated oropharyngeal squamous cell carcinoma has increased by nearly 7.5 % per year, from approximately 16 % in the early 1980's to nearly 70 % today, and is believed will continue to increase dramatically in the coming years. Currently, a myriad of treatment options exist for these patients as many active clinical trials are underway which aim to identify the most appropriate interventions for this unique group of patients. This review aims to provide considerations between surgical and non-surgical management for HPV-associated oropharyngeal squamous cell carcinoma.</p>","PeriodicalId":72518,"journal":{"name":"Cancers of the head & neck","volume":"1 ","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2016-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41199-016-0007-8","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37242437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pretreatment predictors of adjuvant chemoradiation in patients receiving transoral robotic surgery for squamous cell carcinoma of the oropharynx: a case control study.","authors":"Harry E Subramanian,&nbsp;Henry S Park,&nbsp;Andrea Barbieri,&nbsp;Amit Mahajan,&nbsp;Benjamin L Judson,&nbsp;Saral Mehra,&nbsp;Wendell G Yarbrough,&nbsp;Barbara A Burtness,&nbsp;Zain A Husain","doi":"10.1186/s41199-016-0008-7","DOIUrl":"https://doi.org/10.1186/s41199-016-0008-7","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to identify preoperative patient characteristics associated with the incidence of positive surgical margins or lymph node extracapsular extension (ECE), which necessitate adjuvant chemoradiation after transoral robotic surgery (TORS).</p><p><strong>Methods: </strong>We conducted a single institution retrospective study of 34 consecutive patients with primary oropharyngeal cancer who underwent TORS. All imaging was reviewed by a single neuroradiologist. Surgical margins and ECE status were determined by a single head and neck pathologist. Associations of preoperative patient characteristics with positive surgical margins and lymph node ECE were examined using univariate analysis. Independent predictors of these outcomes were determined using logistic regression.</p><p><strong>Results: </strong>Preoperatively, the majority of patients had early-stage disease (7 cT1 and 21 cT2; 10 cN0). Positive margins occurred in 4 (12 %) patients. A clinically positive lymph node was seen in 23 (68 %) patients. Neck dissection was performed in 29 (85 %) patients, among whom 19 had a pathologically positive lymph node and 15 had nodal ECE. Logistic regression showed that larger preoperative lymph node size was an independent predictor of ECE (odds ratio, 13.32 [95 % CI, 1.46-121.43]). Among the 21 patients with a clinically positive lymph node who underwent neck dissection, ECE was present more often in patients with a preoperative node size ≥ 3.0 vs. < 3.0 cm (92 % vs. 44 %, <i>P</i> = 0.046). There was no patient characteristic associated with positive margins.</p><p><strong>Conclusions: </strong>Patients with a larger preoperative lymph node appear more likely to have ECE, and thus be treated with chemoradiation after TORS, with a potentially higher rate of toxicity. Lymph node size should be taken into account when deciding upon treatment approaches. Further research is needed to validate these results.</p>","PeriodicalId":72518,"journal":{"name":"Cancers of the head & neck","volume":"1 ","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2016-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41199-016-0008-7","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37242438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in radiation therapy delivery: current evidence and future directions in head and neck cancer.","authors":"Henry S Park,&nbsp;Roy H Decker","doi":"10.1186/s41199-016-0005-x","DOIUrl":"https://doi.org/10.1186/s41199-016-0005-x","url":null,"abstract":"<p><strong>Background: </strong>Though treatments for head and neck cancer have improved in recent years, significant variation persists in the delivery of surgery, radiation therapy, and systemic therapy to patients throughout the United States.</p><p><strong>Body: </strong>In this review, we explore the current evidence regarding radiation therapy utilization inequities across the spectra of race, socioeconomic status, and age. We also discuss hypothesized mechanisms for how non-clinical factors may influence shared clinical decisions between patients and providers. Finally, we suggest future directions for research in treatment disparities.</p><p><strong>Conclusions: </strong>Radiation therapy continues to be delivered inequitably among certain subpopulations with head and neck cancer and other cancers. More research into the drivers of these disparities and interventions designed to address them are necessary.</p>","PeriodicalId":72518,"journal":{"name":"Cancers of the head & neck","volume":"1 ","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2016-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s41199-016-0005-x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37242436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}