Marco A Mascarella, Keith Richardson, Alex Mlynarek, Michael P Hier, Derin Caglar, Livia Florianova, Marc Philippe Pusztaszeri, Khalil Sultanem, Nader Sadeghi, Nathaniel Bouganim, Khashayar Esfahani
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Accessing timely care remains challenging in public health care systems, potentially resulting in disease progression before treatment initiation.</p><p><strong>Study design: </strong>A prospective cohort of patients receiving neoadjuvant capecitabine (NC) was compared to stage-matched patients undergoing standard of care (SC).</p><p><strong>Setting: </strong>This study was performed at 2 academic centers in Montreal, Canada.</p><p><strong>Methods: </strong>To ascertain the effect of 2 cycles of NC in operable HPV-negative HNSCC patients on clinical-to-pathologic stage migration. Comparison to an SC group was performed to site and TNM stage matched patients. Pathologic treatment response was measured using the modified Ryan score.</p><p><strong>Results: </strong>We compared 16 NC patients (11 oral cavity, 3 skin, 2 larynx) with 32 SC patients. Ten NC patients exhibited a pathologic response (1 complete, 3 major, 6 minor). Clinical-to-pathologic stage migration differed significantly between NC and SC groups: downstage (6 vs 1), upstage (3 vs 14), no change (7 vs 17, P = .0047). There was no severe treatment toxicity related to capecitabine. All patients in the NC group underwent surgery.</p><p><strong>Conclusion: </strong>NC followed by surgery demonstrates measurable pathologic response in HPV-negative HNSCC, suggesting potential utility in resource-limited health care settings.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1773-1779"},"PeriodicalIF":2.6000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605015/pdf/","citationCount":"0","resultStr":"{\"title\":\"Neoadjuvant Capecitabine in Operable HPV-Negative Head and Neck Cancer: Fortuitous Findings in a Resource Constrained Setting.\",\"authors\":\"Marco A Mascarella, Keith Richardson, Alex Mlynarek, Michael P Hier, Derin Caglar, Livia Florianova, Marc Philippe Pusztaszeri, Khalil Sultanem, Nader Sadeghi, Nathaniel Bouganim, Khashayar Esfahani\",\"doi\":\"10.1002/ohn.1003\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Limited progress has occurred in treating operable human papillomavirus (HPV)-negative head and neck squamous cell carcinoma (HNSCC). Accessing timely care remains challenging in public health care systems, potentially resulting in disease progression before treatment initiation.</p><p><strong>Study design: </strong>A prospective cohort of patients receiving neoadjuvant capecitabine (NC) was compared to stage-matched patients undergoing standard of care (SC).</p><p><strong>Setting: </strong>This study was performed at 2 academic centers in Montreal, Canada.</p><p><strong>Methods: </strong>To ascertain the effect of 2 cycles of NC in operable HPV-negative HNSCC patients on clinical-to-pathologic stage migration. Comparison to an SC group was performed to site and TNM stage matched patients. Pathologic treatment response was measured using the modified Ryan score.</p><p><strong>Results: </strong>We compared 16 NC patients (11 oral cavity, 3 skin, 2 larynx) with 32 SC patients. Ten NC patients exhibited a pathologic response (1 complete, 3 major, 6 minor). Clinical-to-pathologic stage migration differed significantly between NC and SC groups: downstage (6 vs 1), upstage (3 vs 14), no change (7 vs 17, P = .0047). There was no severe treatment toxicity related to capecitabine. 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引用次数: 0
摘要
目的：可手术的人乳头瘤病毒（HPV）阴性头颈部鳞状细胞癌（HNSCC）的治疗进展有限。在公共医疗系统中，及时获得治疗仍是一项挑战，这可能导致疾病在开始治疗前就已恶化：研究设计：将接受新辅助卡培他滨（NC）治疗的前瞻性队列患者与接受标准治疗（SC）的分期匹配患者进行比较：研究在加拿大蒙特利尔的两个学术中心进行：方法：确定可手术的HPV阴性HNSCC患者接受2个周期NC治疗对临床到病理分期迁移的影响。对部位和TNM分期相匹配的患者与SC组进行比较。病理治疗反应采用改良瑞安评分法进行测量：我们将 16 例 NC 患者（11 例口腔癌、3 例皮肤癌、2 例喉癌）与 32 例 SC 患者进行了比较。10例NC患者出现了病理反应（1例完全反应，3例大反应，6例小反应）。NC组和SC组的临床到病理分期迁移有显著差异：下期（6 vs 1）、上期（3 vs 14）、无变化（7 vs 17，P = .0047）。卡培他滨没有引起严重的治疗毒性。NC组所有患者均接受了手术治疗：结论：对HPV阴性的HNSCC患者进行NC治疗后再进行手术可获得可测量的病理反应，这表明该疗法在资源有限的医疗环境中具有潜在的实用性。
Neoadjuvant Capecitabine in Operable HPV-Negative Head and Neck Cancer: Fortuitous Findings in a Resource Constrained Setting.
Objective: Limited progress has occurred in treating operable human papillomavirus (HPV)-negative head and neck squamous cell carcinoma (HNSCC). Accessing timely care remains challenging in public health care systems, potentially resulting in disease progression before treatment initiation.
Study design: A prospective cohort of patients receiving neoadjuvant capecitabine (NC) was compared to stage-matched patients undergoing standard of care (SC).
Setting: This study was performed at 2 academic centers in Montreal, Canada.
Methods: To ascertain the effect of 2 cycles of NC in operable HPV-negative HNSCC patients on clinical-to-pathologic stage migration. Comparison to an SC group was performed to site and TNM stage matched patients. Pathologic treatment response was measured using the modified Ryan score.
Results: We compared 16 NC patients (11 oral cavity, 3 skin, 2 larynx) with 32 SC patients. Ten NC patients exhibited a pathologic response (1 complete, 3 major, 6 minor). Clinical-to-pathologic stage migration differed significantly between NC and SC groups: downstage (6 vs 1), upstage (3 vs 14), no change (7 vs 17, P = .0047). There was no severe treatment toxicity related to capecitabine. All patients in the NC group underwent surgery.
Conclusion: NC followed by surgery demonstrates measurable pathologic response in HPV-negative HNSCC, suggesting potential utility in resource-limited health care settings.
期刊介绍：
Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.
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