Pub Date : 2022-02-14DOI: 10.17650/2222-1468-2021-11-4-97-109
A. Polonskaia, E. Shatokhina, L. Kruglova
Epidermal growth factor receptor inhibitors (EGFR) have a high rate of class-specific dermatologic adverse events. Supportive treatment of dermatologic adverse events decreases their severity, minimizes the need for dose de-escalation / discontinuation of targeted therapy, improves commitment to anticancer treatment and patient’s quality of life. Close interdisciplinary cooperation between oncologists and dermatologists is a key to the successful management of patients treated with EGFR. This article highlights current approaches to classification, concepts of pathogenesis and clinical course of EGFR-associated dermatologic adverse events, current and promising prophylactic and therapeutic strategies to manage these adverse events.
{"title":"Dermatologic adverse events associated with epidermal growth factor receptor inhibitors: current concepts of interdisciplinary problem","authors":"A. Polonskaia, E. Shatokhina, L. Kruglova","doi":"10.17650/2222-1468-2021-11-4-97-109","DOIUrl":"https://doi.org/10.17650/2222-1468-2021-11-4-97-109","url":null,"abstract":"Epidermal growth factor receptor inhibitors (EGFR) have a high rate of class-specific dermatologic adverse events. Supportive treatment of dermatologic adverse events decreases their severity, minimizes the need for dose de-escalation / discontinuation of targeted therapy, improves commitment to anticancer treatment and patient’s quality of life. Close interdisciplinary cooperation between oncologists and dermatologists is a key to the successful management of patients treated with EGFR. This article highlights current approaches to classification, concepts of pathogenesis and clinical course of EGFR-associated dermatologic adverse events, current and promising prophylactic and therapeutic strategies to manage these adverse events.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82218602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-14DOI: 10.17650/2222-1468-2021-11-4-73-80
R. F. Zibirov, S. A. Mozerov, V. Polkin, F. Sevrukov, V. S. Medvedev, A. P. Raykova, M. E. Riss
Introduction. Squamous cell carcinoma of the tongue is the most common oral cancer. The tumor microenvironment has a significant impact on tumor progression; therefore, better understanding of its characteristics is crucial for the treatment strategy, since in some cases it modifies the tumor microenvironment resulting in tumor resistance to therapy.Study objective – to compare the number of CD8+Т-lymphocytes, CD57+NK-cells, and CD20+B-lymphocytes in the microenvironment of tongue squamous cell carcinoma in patients receiving and not receiving neoadjuvant chemoradiotherapy.Materials and methods. We performed immunohistochemical examination of specimens from 67 patients with tongue squamous cell carcinoma who did not receive neoadjuvant chemoradiotherapy. Eleven patients were diagnosed with well differentiated tumors (G1); 21 patients had moderately differentiated tumors (G2); and 35 patients had poorly differentiated tumors (G3). T1 tumors were observed in 11 individuals, T2 tumors – in 26 individuals, T3 tumors – in 26 individuals, and T4 tumors – in 4 individuals. We also examined 30 patients who had undergone neoadjuvant chemoradiotherapy, including external beam radiotherapy (total dose of 60 Gy) and a cycle of polychemotherapy (cisplatin and 5‑fluorouracil). Of them, 6 patients had T1 tumors, 17 patients – T2 tumors, 5 patients – T3 tumors, and 2 patients – T4 tumors. We measured the areas occupied by CD8+T-lymphocytes, CD20+B-lymphocytes, and CD57+NK-cells in the hot spots in the tumor microenvironment.Results. The number of CD8+T-lymphocytes in the tumor microenvironment was higher in patients after neoadjuvant chemoradiotherapy than in those who did not receive it (р = 0.000), whereas the number of CD20+B-lymphocytes was lower after neoadjuvant chemoradiotherapy. The area occupied by CD57+NK-cells in the hot spots of the tumor microenvironment did not differ significantly before and after therapy (p >0.05).Conclusion. Thus, neoadjuvant chemoradiotherapy in patients with tongue squamous cell carcinoma caused an increase in the number of CD8+T-lymphocytes, a decrease in the number of CD20+B-lymphocytes in the tumor microenvironment, and had no effect on the population of CD57+NK-cells.
{"title":"Characteristics of composition a lymphoid infiltrate in the tongue squamous cell carcinoma","authors":"R. F. Zibirov, S. A. Mozerov, V. Polkin, F. Sevrukov, V. S. Medvedev, A. P. Raykova, M. E. Riss","doi":"10.17650/2222-1468-2021-11-4-73-80","DOIUrl":"https://doi.org/10.17650/2222-1468-2021-11-4-73-80","url":null,"abstract":"Introduction. Squamous cell carcinoma of the tongue is the most common oral cancer. The tumor microenvironment has a significant impact on tumor progression; therefore, better understanding of its characteristics is crucial for the treatment strategy, since in some cases it modifies the tumor microenvironment resulting in tumor resistance to therapy.Study objective – to compare the number of CD8+Т-lymphocytes, CD57+NK-cells, and CD20+B-lymphocytes in the microenvironment of tongue squamous cell carcinoma in patients receiving and not receiving neoadjuvant chemoradiotherapy.Materials and methods. We performed immunohistochemical examination of specimens from 67 patients with tongue squamous cell carcinoma who did not receive neoadjuvant chemoradiotherapy. Eleven patients were diagnosed with well differentiated tumors (G1); 21 patients had moderately differentiated tumors (G2); and 35 patients had poorly differentiated tumors (G3). T1 tumors were observed in 11 individuals, T2 tumors – in 26 individuals, T3 tumors – in 26 individuals, and T4 tumors – in 4 individuals. We also examined 30 patients who had undergone neoadjuvant chemoradiotherapy, including external beam radiotherapy (total dose of 60 Gy) and a cycle of polychemotherapy (cisplatin and 5‑fluorouracil). Of them, 6 patients had T1 tumors, 17 patients – T2 tumors, 5 patients – T3 tumors, and 2 patients – T4 tumors. We measured the areas occupied by CD8+T-lymphocytes, CD20+B-lymphocytes, and CD57+NK-cells in the hot spots in the tumor microenvironment.Results. The number of CD8+T-lymphocytes in the tumor microenvironment was higher in patients after neoadjuvant chemoradiotherapy than in those who did not receive it (р = 0.000), whereas the number of CD20+B-lymphocytes was lower after neoadjuvant chemoradiotherapy. The area occupied by CD57+NK-cells in the hot spots of the tumor microenvironment did not differ significantly before and after therapy (p >0.05).Conclusion. Thus, neoadjuvant chemoradiotherapy in patients with tongue squamous cell carcinoma caused an increase in the number of CD8+T-lymphocytes, a decrease in the number of CD20+B-lymphocytes in the tumor microenvironment, and had no effect on the population of CD57+NK-cells.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85168713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-14DOI: 10.17650/2222-1468-2021-11-4-81-85
A. O. Sekretnaya, I. Zaderenko, S. Ivanov, S. Alieva, A. Dymnikov, R. R. Kaledin, H. Alsayed Hachem
Introduction. Oral mucositis is one of the earliest and most frequent complications of radiation therapy or chemotherapy in patients diagnosed with oropharyngeal cancer. Because of this pathology, therapeutic interventions are most often used, thereby poor treatment is considered an etiological factor of oral mucositis. Now, this issue is being actively studied in the world, but a unified algorithm for treatment and prevention of oral mucositis has not been formed.The study objective – is to evaluate the effect of titanium glycerosolvate aquacomplex in reducing the intensity of radiation induced reactions and reducing the frequency of interruptions.Materials and methods. 52 patients diagnosed with oropharyngeal cancer were included in this study, treated with radiotherapy or chemotherapy. For prophylaxis of severe stages of oral mucositis, 32 patients underwent standard symptomatic therapy (group 1, control group); 20 patients took titanium glycerosolvate aquacomplex in accordance with symptomatic therapy (group 2).Results. In the group 1 only 61.7 % of patients completed treatment. In the group 2 80 % of patients completely underwent antitumor therapy. At the same time, they developed oral mucositis of the I–II degree. Also, in the group of the studied drug, in 100 % of cases, therapy was performed without interruptions.Conclusion. Using titanium glycerosolvate aquacomplex for the prophylaxis of severe stages of oral mucositis during radiotherapy or chemotherapy of oropharyngeal cancer is effective and safe. It is also convenient from the medical and economic side, thanks to the ability to use it on an outpatient basis.
{"title":"The use of a titanium-containing drug for the prevention of severe degrees of radiation mucositis in patients with metal structures in the oral cavity","authors":"A. O. Sekretnaya, I. Zaderenko, S. Ivanov, S. Alieva, A. Dymnikov, R. R. Kaledin, H. Alsayed Hachem","doi":"10.17650/2222-1468-2021-11-4-81-85","DOIUrl":"https://doi.org/10.17650/2222-1468-2021-11-4-81-85","url":null,"abstract":"Introduction. Oral mucositis is one of the earliest and most frequent complications of radiation therapy or chemotherapy in patients diagnosed with oropharyngeal cancer. Because of this pathology, therapeutic interventions are most often used, thereby poor treatment is considered an etiological factor of oral mucositis. Now, this issue is being actively studied in the world, but a unified algorithm for treatment and prevention of oral mucositis has not been formed.The study objective – is to evaluate the effect of titanium glycerosolvate aquacomplex in reducing the intensity of radiation induced reactions and reducing the frequency of interruptions.Materials and methods. 52 patients diagnosed with oropharyngeal cancer were included in this study, treated with radiotherapy or chemotherapy. For prophylaxis of severe stages of oral mucositis, 32 patients underwent standard symptomatic therapy (group 1, control group); 20 patients took titanium glycerosolvate aquacomplex in accordance with symptomatic therapy (group 2).Results. In the group 1 only 61.7 % of patients completed treatment. In the group 2 80 % of patients completely underwent antitumor therapy. At the same time, they developed oral mucositis of the I–II degree. Also, in the group of the studied drug, in 100 % of cases, therapy was performed without interruptions.Conclusion. Using titanium glycerosolvate aquacomplex for the prophylaxis of severe stages of oral mucositis during radiotherapy or chemotherapy of oropharyngeal cancer is effective and safe. It is also convenient from the medical and economic side, thanks to the ability to use it on an outpatient basis.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"31 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78740182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-14DOI: 10.17650/2222-1468-2021-11-4-110-118
T. I. Deshkina, L. Bolotina, A. Gevorkov, A. Boyko, V. S. Surkova, M. Sedova, A. Polyakov, A. Kornietskaya, A. Fedenko
Malignant tumors of the sinuses and nasal cavity are rare diseases. Squamous cell carcinoma is the most common histological type (55–70 % of tumors of the sinuses and nasal cavity). The frequency of neuroendocrine tumors reaches 5 %. Currently, there is no generally accepted standard for the treatment of neuroendocrine tumors of sinonasal localization. If surgical treatment is associated with a significant deterioration of the quality of life or poor outcomes, chemoradiotherapy can be recommended. This article describes a clinical case of combined treatment of neuroendocrine cancer of the maxillary sinus and brief review of the literature on malignant tumors of the paranasal sinuses and the nasal cavity.
{"title":"Neuroendocrine cancer of maxillary sinus: case report and literature review","authors":"T. I. Deshkina, L. Bolotina, A. Gevorkov, A. Boyko, V. S. Surkova, M. Sedova, A. Polyakov, A. Kornietskaya, A. Fedenko","doi":"10.17650/2222-1468-2021-11-4-110-118","DOIUrl":"https://doi.org/10.17650/2222-1468-2021-11-4-110-118","url":null,"abstract":"Malignant tumors of the sinuses and nasal cavity are rare diseases. Squamous cell carcinoma is the most common histological type (55–70 % of tumors of the sinuses and nasal cavity). The frequency of neuroendocrine tumors reaches 5 %. Currently, there is no generally accepted standard for the treatment of neuroendocrine tumors of sinonasal localization. If surgical treatment is associated with a significant deterioration of the quality of life or poor outcomes, chemoradiotherapy can be recommended. This article describes a clinical case of combined treatment of neuroendocrine cancer of the maxillary sinus and brief review of the literature on malignant tumors of the paranasal sinuses and the nasal cavity.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"78 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74127787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-14DOI: 10.17650/2222-1468-2021-11-4-86-96
S. Gvetadze, E. Roshchina, A. Mudunov, A. Karseladze, J. Sun, M. Lv, X. Yang, N. N. Ayzikova, K. D. Ilkaev
A review of accumulated international clinical experience and prognostic significance calculations of metastatic involvement of the lingual lymph nodes is given. Anatomical terminology of lingual lymph nodes and its contradictive aspects are discussed. It is shown that metastatic lesions of the lingual lymph nodes posses high prognostic value, therein a topographic anatomic classification of the lingual lymph nodes is needed to increase the efficiency of diagnosis and augmenting of the oncologic treatment results. This classification should be unified to avoid misunderstanding between researchers.
{"title":"On terminology and topographic classification of the lingual lymph nodes","authors":"S. Gvetadze, E. Roshchina, A. Mudunov, A. Karseladze, J. Sun, M. Lv, X. Yang, N. N. Ayzikova, K. D. Ilkaev","doi":"10.17650/2222-1468-2021-11-4-86-96","DOIUrl":"https://doi.org/10.17650/2222-1468-2021-11-4-86-96","url":null,"abstract":"A review of accumulated international clinical experience and prognostic significance calculations of metastatic involvement of the lingual lymph nodes is given. Anatomical terminology of lingual lymph nodes and its contradictive aspects are discussed. It is shown that metastatic lesions of the lingual lymph nodes posses high prognostic value, therein a topographic anatomic classification of the lingual lymph nodes is needed to increase the efficiency of diagnosis and augmenting of the oncologic treatment results. This classification should be unified to avoid misunderstanding between researchers.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76812651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-14DOI: 10.17650/2222-1468-2021-11-4-58-63
A. Mudunov
KEYNOTE-048 study results became basis for changing standard of care in the 1st line treatment of patients with recurrent / metastatic squamous cell cancer of the head and neck (SCCHN). However, there were no significant improvement in the progression free survival for patients receiving pemrolizumab as a monotherapy or in combination with chemotherapy in both group of patients, with PD-L expression (CPS >1) and without it (CPS <1). The latter lead to reassess existing treatment options for patients with progressive recurrent / metastatic SCCHN.TPExtreme study started in 2014 as an open multicenter randomized II phase trial to assess efficacy of a new chemotherapy regimen for the treatment of inoperable recurrent / metastatic SCCHN. Patients in the experimental arm received TPEx regimen: docetaxel 75 mg / m2, cysplatimun 75 mg / m2 and cetuximab 400 mg / m2 on the 1st day (further 250 mg / m2 weekly). Four cycles of TPEx were planned totally with further cetuximab maintenance every 2 week (500 mg / m2) until progression or unfit toxicity. Control arm received EXTREME regimen. Therapeutical effect assessed every 8 weeks. 541 patients were enrolled in study totally (271 patients TPEx arm and 270 patients ETREME arm). Median follow-up were 34.4 months in the TPEx arm and 30.2 months in the ETREME arm, overall survival 14.5 months (95 % confidence interval (CI) 12.5–15.7) and 13.4 months (95 % CI 12.2–15.4) respectively (hazard ratio (HR) 0.89, 95 % CI 0.74–1.08; p = 0,23). Progression-free survival didn’t differ significantly in both groups (HR 0.9, 95 % CI 0.75–1.07). There was no significant difference in objective response rate in both treatment groups. TPEx regimen had favorable safety profile. Quality of life was better in experimental arm also. Authors made conclusion that TPEx regimen could provide an alternative to standard of care with the EXTREME regimen in the first-line treatment of patients with recurrent or metastatic SCCHN, especially for those who might not be good candidates for up-front pembrolizumab treatment. According to KEYNOTE-048 study results, the rate of progression was much higher in patients who received pembrolizumab as a monotherapy (total population) compared to patients received EXTREME (41 % vs 12 %). As a result, the latter led to worsening of progression-free survival in pembrolizumab arm. Pembrolizumab as a monotherapy gives positive effect only in patients with certain level of PD-L expression (CPS >20) in total population. Post-hoc analysis of TPExtreme study demonstrated the most benefit results until now for patients who received consequently cetuximab contained chemotherapy regimens as a first line followed by immunotherapy for the second line in this patients group (overall survival 19.4 months for EXTREME arm and 21.9 months for TPEx arm).Thus TPExtreme study results demonstrates opportunity for better disease control in patients receiving cetuximab in first line and immunotherapy as second line treatment i
{"title":"Choice of optimal therapeutic sequence in treatment of patients with progressive / metastatic squamous cell cancer of the head and neck in the light of TPEx study results","authors":"A. Mudunov","doi":"10.17650/2222-1468-2021-11-4-58-63","DOIUrl":"https://doi.org/10.17650/2222-1468-2021-11-4-58-63","url":null,"abstract":"KEYNOTE-048 study results became basis for changing standard of care in the 1st line treatment of patients with recurrent / metastatic squamous cell cancer of the head and neck (SCCHN). However, there were no significant improvement in the progression free survival for patients receiving pemrolizumab as a monotherapy or in combination with chemotherapy in both group of patients, with PD-L expression (CPS >1) and without it (CPS <1). The latter lead to reassess existing treatment options for patients with progressive recurrent / metastatic SCCHN.TPExtreme study started in 2014 as an open multicenter randomized II phase trial to assess efficacy of a new chemotherapy regimen for the treatment of inoperable recurrent / metastatic SCCHN. Patients in the experimental arm received TPEx regimen: docetaxel 75 mg / m2, cysplatimun 75 mg / m2 and cetuximab 400 mg / m2 on the 1st day (further 250 mg / m2 weekly). Four cycles of TPEx were planned totally with further cetuximab maintenance every 2 week (500 mg / m2) until progression or unfit toxicity. Control arm received EXTREME regimen. Therapeutical effect assessed every 8 weeks. 541 patients were enrolled in study totally (271 patients TPEx arm and 270 patients ETREME arm). Median follow-up were 34.4 months in the TPEx arm and 30.2 months in the ETREME arm, overall survival 14.5 months (95 % confidence interval (CI) 12.5–15.7) and 13.4 months (95 % CI 12.2–15.4) respectively (hazard ratio (HR) 0.89, 95 % CI 0.74–1.08; p = 0,23). Progression-free survival didn’t differ significantly in both groups (HR 0.9, 95 % CI 0.75–1.07). There was no significant difference in objective response rate in both treatment groups. TPEx regimen had favorable safety profile. Quality of life was better in experimental arm also. Authors made conclusion that TPEx regimen could provide an alternative to standard of care with the EXTREME regimen in the first-line treatment of patients with recurrent or metastatic SCCHN, especially for those who might not be good candidates for up-front pembrolizumab treatment. According to KEYNOTE-048 study results, the rate of progression was much higher in patients who received pembrolizumab as a monotherapy (total population) compared to patients received EXTREME (41 % vs 12 %). As a result, the latter led to worsening of progression-free survival in pembrolizumab arm. Pembrolizumab as a monotherapy gives positive effect only in patients with certain level of PD-L expression (CPS >20) in total population. Post-hoc analysis of TPExtreme study demonstrated the most benefit results until now for patients who received consequently cetuximab contained chemotherapy regimens as a first line followed by immunotherapy for the second line in this patients group (overall survival 19.4 months for EXTREME arm and 21.9 months for TPEx arm).Thus TPExtreme study results demonstrates opportunity for better disease control in patients receiving cetuximab in first line and immunotherapy as second line treatment i","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"75 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85721188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-13DOI: 10.17650/2222-1468-2021-11-4-29-34
Z. Radzhabova, M. Kotov, M. Girshovich, O. Ponomareva, E. Kostromina, M. A. Radzhabova, A. Mitrofanov, V. Klimenko, E. Levchenko
The study objective – to analyze the treatment results and prognostic factors of survival in patients with locally advanced laryngeal cancer who received surgical treatment and chemoradiotherapy.Materials and methods. The retrospective study included patients with locally advanced laryngeal cancer treated at the N. N. Petrov National medical Research Center of Oncology, Ministry of Health of Russia in the period from 2009 to 2018. The patients included in the study were divided into 2 equal groups (74 patients were included in each group) depending of treatment: surgery with postoperative radiation therapy combined with chemotherapy (group 1) and concurrent chemoradiation therapy and subsequent surgical treatment in case of incomplete response to treatment or disease progression (group 2). The endpoints of the study were general and relapse-free survival.Results. One hundred and forty-eight patients were included in the study: 74 patients in group 1 and 74 patients in the group 2. The median overall survival in the surgical treatment group was 45 months, in the chemoradiotherapy group – 44.6 months, and the overall 5-year survival for the group 1 and the group 2 were 39.3 (95 % confidence interval (CI) 26.1–59.2), and 59.2 % (95 % CI 45.3–77.2), respectively. The relapse-free 5-year survival rate for the surgical treatment group and the chemoradiotherapy group was 36.8 (95 % CI 25.1–53.8), and 53.9 % (95 % CI 40.7–71.4), respectively.Conclusion. There were no significant differences in overall and relapse-free survival. Metastatic lesion of the neck lymph nodes (N2–3), invasion of laryngeal cartilage, invasion of the thyroid gland and the spread of the tumor to the larynx are statistically significantly associated with lower overall and relapse-free survival.
本研究的目的是分析局部晚期喉癌患者手术加放化疗的治疗效果及影响生存的预后因素。材料和方法。回顾性研究纳入2009 - 2018年在俄罗斯卫生部n.n.彼得罗夫国家肿瘤医学研究中心接受治疗的局部晚期喉癌患者。根据治疗方法将纳入研究的患者分为两组(每组74例患者):手术后放射治疗联合化疗(1组)和在治疗不完全缓解或疾病进展的情况下同时进行放化疗并随后进行手术治疗(2组)。研究的终点是一般和无复发生存。148例患者纳入研究:组1 74例，组2 74例。手术治疗组的中位总生存期为45个月，放化疗组的中位总生存期为44.6个月，1组和2组的总5年生存期分别为39.3(95%可信区间(CI) 26.1-59.2)和59.2% (95% CI 45.3-77.2)。手术治疗组和放化疗组的5年无复发生存率分别为36.8% (95% CI 25.1 ~ 53.8)和53.9% (95% CI 40.7 ~ 71.4)。总生存率和无复发生存率无显著差异。颈部淋巴结转移灶(N2-3)、喉软骨浸润、甲状腺浸润和肿瘤向喉部扩散与总生存率和无复发生存率较低有统计学意义。
{"title":"Analysis results of surgical treatment and chemoradiotherapy with assessment of prognostic factors in localy advanced laryngeal cancer","authors":"Z. Radzhabova, M. Kotov, M. Girshovich, O. Ponomareva, E. Kostromina, M. A. Radzhabova, A. Mitrofanov, V. Klimenko, E. Levchenko","doi":"10.17650/2222-1468-2021-11-4-29-34","DOIUrl":"https://doi.org/10.17650/2222-1468-2021-11-4-29-34","url":null,"abstract":"The study objective – to analyze the treatment results and prognostic factors of survival in patients with locally advanced laryngeal cancer who received surgical treatment and chemoradiotherapy.Materials and methods. The retrospective study included patients with locally advanced laryngeal cancer treated at the N. N. Petrov National medical Research Center of Oncology, Ministry of Health of Russia in the period from 2009 to 2018. The patients included in the study were divided into 2 equal groups (74 patients were included in each group) depending of treatment: surgery with postoperative radiation therapy combined with chemotherapy (group 1) and concurrent chemoradiation therapy and subsequent surgical treatment in case of incomplete response to treatment or disease progression (group 2). The endpoints of the study were general and relapse-free survival.Results. One hundred and forty-eight patients were included in the study: 74 patients in group 1 and 74 patients in the group 2. The median overall survival in the surgical treatment group was 45 months, in the chemoradiotherapy group – 44.6 months, and the overall 5-year survival for the group 1 and the group 2 were 39.3 (95 % confidence interval (CI) 26.1–59.2), and 59.2 % (95 % CI 45.3–77.2), respectively. The relapse-free 5-year survival rate for the surgical treatment group and the chemoradiotherapy group was 36.8 (95 % CI 25.1–53.8), and 53.9 % (95 % CI 40.7–71.4), respectively.Conclusion. There were no significant differences in overall and relapse-free survival. Metastatic lesion of the neck lymph nodes (N2–3), invasion of laryngeal cartilage, invasion of the thyroid gland and the spread of the tumor to the larynx are statistically significantly associated with lower overall and relapse-free survival.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87522040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-13DOI: 10.17650/2222-1468-2021-11-4-50-57
E. Galeeva, A. Stepanova, A. Kostin
Introduction. Nutritional support is an important component of multimodal cancer therapy. It is well known that proper nutrition supplemented by necessary nutrients can support muscles and their function, reduce the incidence and severity of complications associated with cancer therapy, and facilitate recovery. Proper nutritional support is planned according to patient’s need for energy (30 kcal / kg body weight per day), protein (1.5 g protein / kg body weight per day), and eicosapentaenoic acid (2 g per day).Materials and methods. We analyzed the dynamics of nutritional status of 632 cancer patients treated in P.A. Herzen Moscow Oncology Research Institute – a branch of the National Medical Radiology Research Center, Ministry of Health of Russia between 2019 and 2021. Study participants were divided into two groups: experimental (n = 316) and control (n = 316). Patients in the experimental group received proper nutritional support. This study included patients with confirmed gastrointestinal cancers (esophageal and gastric), colon cancer, head and neck cancer, and lung cancer.Results. Nutritional therapy in the process of drug antitumor treatment has improved the trophological status of patients with tumors of the head and neck, lungs, upper gastrointestinal tract. As a result of the work, there was a tendency to increase the body weight of patients in these subgroups, whereas in the control group there was a statistically significant decrease in body weight compared to the initial indicators by 9.4; 9.5; 5.3 and 9.6 kg, respectively. Also, full clinical nutrition contributed to an increase in the level of total protein in patients with cancer of the upper gastrointestinal tract and colon and rectum by 4.0 and 3.7 g/l, respectively, at the level of statistical trend. The level of albumin significantly increased (by 6.6 g/l) only in patients with lung cancer.Improved nutritional status of patients during their systemic therapy ensured a 6 % reduction in the frequency of intercycle periods, a 0.2–3.4 % reduction in the need for dosage correction, and a 2.9–11.1 % increase in the completeness of cancer therapy stages (trend).Conclusion. Our findings suggest that additional specialized (oral or enteral) nutritional support during chemotherapy stabilizes body weight and its index, resulting, first of all, in improved tolerability of treatment.
{"title":"Effects of nutritional support in cancer patients receiving chemotherapy","authors":"E. Galeeva, A. Stepanova, A. Kostin","doi":"10.17650/2222-1468-2021-11-4-50-57","DOIUrl":"https://doi.org/10.17650/2222-1468-2021-11-4-50-57","url":null,"abstract":"Introduction. Nutritional support is an important component of multimodal cancer therapy. It is well known that proper nutrition supplemented by necessary nutrients can support muscles and their function, reduce the incidence and severity of complications associated with cancer therapy, and facilitate recovery. Proper nutritional support is planned according to patient’s need for energy (30 kcal / kg body weight per day), protein (1.5 g protein / kg body weight per day), and eicosapentaenoic acid (2 g per day).Materials and methods. We analyzed the dynamics of nutritional status of 632 cancer patients treated in P.A. Herzen Moscow Oncology Research Institute – a branch of the National Medical Radiology Research Center, Ministry of Health of Russia between 2019 and 2021. Study participants were divided into two groups: experimental (n = 316) and control (n = 316). Patients in the experimental group received proper nutritional support. This study included patients with confirmed gastrointestinal cancers (esophageal and gastric), colon cancer, head and neck cancer, and lung cancer.Results. Nutritional therapy in the process of drug antitumor treatment has improved the trophological status of patients with tumors of the head and neck, lungs, upper gastrointestinal tract. As a result of the work, there was a tendency to increase the body weight of patients in these subgroups, whereas in the control group there was a statistically significant decrease in body weight compared to the initial indicators by 9.4; 9.5; 5.3 and 9.6 kg, respectively. Also, full clinical nutrition contributed to an increase in the level of total protein in patients with cancer of the upper gastrointestinal tract and colon and rectum by 4.0 and 3.7 g/l, respectively, at the level of statistical trend. The level of albumin significantly increased (by 6.6 g/l) only in patients with lung cancer.Improved nutritional status of patients during their systemic therapy ensured a 6 % reduction in the frequency of intercycle periods, a 0.2–3.4 % reduction in the need for dosage correction, and a 2.9–11.1 % increase in the completeness of cancer therapy stages (trend).Conclusion. Our findings suggest that additional specialized (oral or enteral) nutritional support during chemotherapy stabilizes body weight and its index, resulting, first of all, in improved tolerability of treatment.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73899228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-13DOI: 10.17650/2222-1468-2021-11-4-41-49
S. Musin, A. V. Sultanbayev, K. Menshikov, F. F. Mufazalov, A. Nasretdinov, O. Goncharova, S. Osokin, M. M. Zamilov, K. E. Timin
Introduction. Unresectable oral cancer is an urgent and complex problem in modern oncology. Annually, the proportion of patients with stage III–IV is 35 %, and the one-year mortality rate for this pathology reaches 32 %. Patients with advanced oral tumors usually have a negative prognosis and treatment tactics are limited to radiation therapy (RT), chemoradiation therapy, or sequential therapy, including induction chemotherapy (CT). Polymodal therapy for oral cancer is of particular interest in the treatment of pathology in this area.The study objective – to analyze the results of sequential treatment, including induction CT followed by RT and induction CT followed by surgery and RT in patients with unresectable oral cancer (T3–4bN0–3M0).Materials and methods. This retrospective study included 30 patients (11 women and 19 men) with primary non-resectable squamous cell carcinoma of the oral cavity (T3–4bN0–3M0) who received 2–3 courses of induction chemotherapy (CT) with DCF (docetaxel, cisplatin, 5-fluorouracil). Mean patients’ age was 61.2 years. The first treatment stage included induction CT according to the following scheme: docetaxel (75 mg/m2 /day on day 1) + cisplatin (75 mg/m2 /day on day 1) + 5-fluorouracil (1000 mg/m2 /day on days 1–4) repeated every 21 days. Study participants were divided into 2 groups according to their objective response to CT. Patients with resectable residual tumors have undergone surgery (after induction CT) followed by radical radiation therapy (RT) (induction CT + surgery + RT). Patients with non-resectable residual tumors/no objective response/no complete response after induction CT have undergone radical RT (induction CT + RT).Results. The objective response rate (ORR) to induction CT was 66.6 % (20 / 30). Five out of thirty patients (16.7 %) received no subsequent therapy: 3 individuals developed grade III–IV adverse events, while 2 individuals had progressive disease. One-third of patients (10 / 30; 33.3 %) had surgery followed by RT. Half of patients (15 / 30; 50 %) received RT after induction CT. The two-year relapse-free survival rates in the groups of induction CT + surgery + RT and induction CT + RT was 14 and 16 %, respectively (p = 0.49). The two-year overall survival rates in the same groups were 44 and 38 %, respectively (р = 0.74).Conclusion. Resectability was achieved in 33.3 % (10 / 30) of patients with initially unresectable oral cancer after induction CT. A sequential therapy regimen, including a surgical stage after induction CT, did not demonstrate a statistically significant increase in overall and disease-free survival rates. Sequential multimodal treatment of common oral cancers has some potential, but requires further study to assess its significance.
{"title":"Surgical stage in sequential therapy of unresectable oral cancer T3-4bN0-3M0: evaluation of treatment results","authors":"S. Musin, A. V. Sultanbayev, K. Menshikov, F. F. Mufazalov, A. Nasretdinov, O. Goncharova, S. Osokin, M. M. Zamilov, K. E. Timin","doi":"10.17650/2222-1468-2021-11-4-41-49","DOIUrl":"https://doi.org/10.17650/2222-1468-2021-11-4-41-49","url":null,"abstract":"Introduction. Unresectable oral cancer is an urgent and complex problem in modern oncology. Annually, the proportion of patients with stage III–IV is 35 %, and the one-year mortality rate for this pathology reaches 32 %. Patients with advanced oral tumors usually have a negative prognosis and treatment tactics are limited to radiation therapy (RT), chemoradiation therapy, or sequential therapy, including induction chemotherapy (CT). Polymodal therapy for oral cancer is of particular interest in the treatment of pathology in this area.The study objective – to analyze the results of sequential treatment, including induction CT followed by RT and induction CT followed by surgery and RT in patients with unresectable oral cancer (T3–4bN0–3M0).Materials and methods. This retrospective study included 30 patients (11 women and 19 men) with primary non-resectable squamous cell carcinoma of the oral cavity (T3–4bN0–3M0) who received 2–3 courses of induction chemotherapy (CT) with DCF (docetaxel, cisplatin, 5-fluorouracil). Mean patients’ age was 61.2 years. The first treatment stage included induction CT according to the following scheme: docetaxel (75 mg/m2 /day on day 1) + cisplatin (75 mg/m2 /day on day 1) + 5-fluorouracil (1000 mg/m2 /day on days 1–4) repeated every 21 days. Study participants were divided into 2 groups according to their objective response to CT. Patients with resectable residual tumors have undergone surgery (after induction CT) followed by radical radiation therapy (RT) (induction CT + surgery + RT). Patients with non-resectable residual tumors/no objective response/no complete response after induction CT have undergone radical RT (induction CT + RT).Results. The objective response rate (ORR) to induction CT was 66.6 % (20 / 30). Five out of thirty patients (16.7 %) received no subsequent therapy: 3 individuals developed grade III–IV adverse events, while 2 individuals had progressive disease. One-third of patients (10 / 30; 33.3 %) had surgery followed by RT. Half of patients (15 / 30; 50 %) received RT after induction CT. The two-year relapse-free survival rates in the groups of induction CT + surgery + RT and induction CT + RT was 14 and 16 %, respectively (p = 0.49). The two-year overall survival rates in the same groups were 44 and 38 %, respectively (р = 0.74).Conclusion. Resectability was achieved in 33.3 % (10 / 30) of patients with initially unresectable oral cancer after induction CT. A sequential therapy regimen, including a surgical stage after induction CT, did not demonstrate a statistically significant increase in overall and disease-free survival rates. Sequential multimodal treatment of common oral cancers has some potential, but requires further study to assess its significance.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80974999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-13DOI: 10.17650/2222-1468-2021-11-4-22-28
M. Kropotov, V. Sobolevsky, L. Yakovleva, A. V. Khodos, O. A. Saprina, D. Safarov
Introduction. Surgery at the first stage has always been the gold-standard treatment for locally advanced head cancer of almost all locations. Such patients often have significant postoperative defects that cause serious functional and aesthetic disorders. This requires simultaneous defect repair. The technique of defect repair should be chosen carefully with the consideration of its benefits and potential consequences.Objective – to evaluate the efficacy of revascularized radial flaps for defect repair after combination extensive surgical excisions of head and neck tumors.Materials and methods. This study included 67 patients with head and neck cancers of different locations who had undergone surgical tumor excision followed by defect repair using a radial flap.Results. All patients had their defects repaired using radial autologous grafts. Since this study included primarily patients with oral and oropharyngeal tumors (53 patients), we also analyzed the survival in this cohort. patients were followed-up for 2 to 7 years. fourteen patients (26.4 %) developed progressive disease during this time, including 8 individuals with recurrent primary tumor and 6 individuals with regional metastases. The mean time to nasoesophageal probe removal and restored swallowing was 12.2 days; mean length of hospital stay was 13.5 days.Conclusion. Thus, radial flap is a reliable and multifunctional material that can be used to repair complex and combination defects in patients with head and neck tumors. In some cases, it is the method of choice, since it helps to achieve satisfactory quality of life. Repair of tongue defects with radial flaps ensures good functional results.
{"title":"Utility of radial flaps for defect repair after surgical excision of head and neck tumors","authors":"M. Kropotov, V. Sobolevsky, L. Yakovleva, A. V. Khodos, O. A. Saprina, D. Safarov","doi":"10.17650/2222-1468-2021-11-4-22-28","DOIUrl":"https://doi.org/10.17650/2222-1468-2021-11-4-22-28","url":null,"abstract":"Introduction. Surgery at the first stage has always been the gold-standard treatment for locally advanced head cancer of almost all locations. Such patients often have significant postoperative defects that cause serious functional and aesthetic disorders. This requires simultaneous defect repair. The technique of defect repair should be chosen carefully with the consideration of its benefits and potential consequences.Objective – to evaluate the efficacy of revascularized radial flaps for defect repair after combination extensive surgical excisions of head and neck tumors.Materials and methods. This study included 67 patients with head and neck cancers of different locations who had undergone surgical tumor excision followed by defect repair using a radial flap.Results. All patients had their defects repaired using radial autologous grafts. Since this study included primarily patients with oral and oropharyngeal tumors (53 patients), we also analyzed the survival in this cohort. patients were followed-up for 2 to 7 years. fourteen patients (26.4 %) developed progressive disease during this time, including 8 individuals with recurrent primary tumor and 6 individuals with regional metastases. The mean time to nasoesophageal probe removal and restored swallowing was 12.2 days; mean length of hospital stay was 13.5 days.Conclusion. Thus, radial flap is a reliable and multifunctional material that can be used to repair complex and combination defects in patients with head and neck tumors. In some cases, it is the method of choice, since it helps to achieve satisfactory quality of life. Repair of tongue defects with radial flaps ensures good functional results.","PeriodicalId":12937,"journal":{"name":"Head and neck tumors (HNT)","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75574674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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