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Combining radiotherapy and systemic therapies in oropharyngeal cancer: A comprehensive review of recent developments 口咽癌放疗与全身治疗的结合:最新进展综述
Pub Date : 2024-09-19 DOI: 10.1016/j.oor.2024.100659
Madhan Krishnan, Shyamaladevi Babu
Oropharyngeal cancer (OPC) has seen significant advancements in treatment modalities, particularly with the integration of radiotherapy and systemic therapies. This review comprehensively examines recent developments in combining these treatments, focusing on their synergistic potential, clinical outcomes, and future prospects. Advances in radiotherapy, including intensity-modulated radiotherapy (IMRT), proton beam therapy (PBT), and stereotactic body radiotherapy (SBRT), have improved targeting and reduced toxicity. Concurrent chemoradiotherapy (CCRT) remains a cornerstone, while the onset of immunotherapy, especially immune checkpoint inhibitors, has transformed systemic treatment. Combining radiotherapy with immunotherapy shows promise in enhancing treatment efficacy. Targeted therapies, such as those targeting the epidermal growth factor receptor (EGFR), are also explored for their potential in OPC management. The review underscores the importance of personalized treatment approaches and highlights ongoing research into novel therapeutic combinations and advanced technologies like artificial intelligence and machine learning. These advancements aim to optimize treatment strategies, improve survival rates, and minimize treatment-related toxicity, heralding a new era in OPC management.
口咽癌(OPC)的治疗方法有了长足的进步,尤其是放射治疗和全身治疗的结合。本综述全面探讨了这些治疗方法结合的最新进展,重点关注其协同潜力、临床疗效和未来前景。包括调强放射治疗(IMRT)、质子束治疗(PBT)和立体定向体放射治疗(SBRT)在内的放射治疗技术的进步提高了靶向性并降低了毒性。同期化放疗(CCRT)仍然是基石,而免疫疗法,尤其是免疫检查点抑制剂的出现,改变了全身治疗。放疗与免疫疗法的结合有望提高疗效。针对表皮生长因子受体 (EGFR) 等靶向疗法也在探索其在 OPC 治疗中的潜力。综述强调了个性化治疗方法的重要性,并重点介绍了正在进行的新型治疗组合研究以及人工智能和机器学习等先进技术。这些进展旨在优化治疗策略、提高生存率并最大限度地减少治疗相关毒性,从而预示着 OPC 治疗进入了一个新时代。
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引用次数: 0
Current advances in immunotherapy for cancer 癌症免疫疗法的最新进展
Pub Date : 2024-09-18 DOI: 10.1016/j.oor.2024.100652
Indrajit Desai , Saee Thakur , Pradeep Pagariya
Recent advances in cancer immunotherapy, including immune checkpoint inhibitors (ICIs) and chimeric antigen receptor (CAR) T-cell therapy, have significantly improved the clinical management of various cancers. ICIs, such as PD-1/PD-L1 and CTLA-4 inhibitors, enhance the body's immune response against tumors, offering substantial benefits in cancers like melanoma, non-small-cell lung cancer, and lymphoma. CAR-T cell therapy has demonstrated remarkable efficacy in hematologic malignancies, particularly B-cell leukemias and lymphomas, through the genetic modification of T-cells to target tumor-specific antigens.Despite these successes, several challenges remain, particularly in the treatment of solid tumors. The heterogeneity of tumor antigens, the presence of physical barriers that impede CAR-T cell infiltration, and the immunosuppressive tumor microenvironment limit the effectiveness of these therapies. To address these issues, ongoing research is exploring combination therapies that integrate ICIs with CAR-T cell therapy, improved CAR-T cell engineering, and strategies to modulate the tumor microenvironment to enhance immune cell infiltration and function.
癌症免疫疗法的最新进展,包括免疫检查点抑制剂(ICIs)和嵌合抗原受体(CAR)T 细胞疗法,大大改善了各种癌症的临床治疗。PD-1/PD-L1和CTLA-4抑制剂等ICIs能增强机体对肿瘤的免疫反应,对黑色素瘤、非小细胞肺癌和淋巴瘤等癌症大有裨益。CAR-T 细胞疗法通过对 T 细胞进行基因改造,使其针对肿瘤特异性抗原,在血液系统恶性肿瘤,尤其是 B 细胞白血病和淋巴瘤方面取得了显著疗效。肿瘤抗原的异质性、阻碍 CAR-T 细胞浸润的物理屏障的存在以及免疫抑制性肿瘤微环境限制了这些疗法的有效性。为了解决这些问题,目前的研究正在探索将 ICIs 与 CAR-T 细胞疗法相结合的联合疗法、改进的 CAR-T 细胞工程以及调节肿瘤微环境以增强免疫细胞浸润和功能的策略。
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引用次数: 0
Emerging immune checkpoint inhibitors for the treatment of oropharyngeal squamous cell carcinoma 治疗口咽鳞癌的新兴免疫检查点抑制剂
Pub Date : 2024-09-12 DOI: 10.1016/j.oor.2024.100650
Pandiselvi Ravi , Shyamaladevi Babu

Oropharyngeal Squamous Cell Carcinoma (OPSCC) is a challenging subtype of head and neck cancer that traditionally has been associated with poor prognosis and high morbidity due to the limitations of conventional treatments such as surgery, radiation, and chemotherapy. Immune checkpoint inhibitors have revolutionized OPSCC and other cancer therapies. ICIs that target the PD-1 and PD-L1 axis and CTLA-4 have altered cancer action by improving the immune system capacity to detect and kill cancer cells. This paper discusses the significant impact of ICIs like Pembrolizumab and Nivolumab, which have been approved for use in recurrent or metastatic OPSCC and have demonstrated remarkable efficacy in clinical trials. The integration of these therapies into clinical practice has been facilitated by the identification of biomarkers such as PD-L1 expression, which guides personalized treatment strategies. Moreover, ongoing research into combination therapies involving ICIs and other treatment modalities is poised which, leads for further improvement in patient outcomes. Despite the successes, challenges such as immune-related adverse events and resistance mechanisms remain, underscoring the need for continued innovation and exploration in the field. This review highlights the pivotal role of ICIs in redefining OPSCC treatment, offering new hope for sustained survival and improved quality of life.

口咽鳞状细胞癌(OPSCC)是一种具有挑战性的头颈部癌症亚型,由于手术、放疗和化疗等传统治疗方法的局限性,该病传统上预后差、发病率高。免疫检查点抑制剂彻底改变了 OPSCC 和其他癌症疗法。以 PD-1 和 PD-L1 轴以及 CTLA-4 为靶点的 ICIs 通过提高免疫系统检测和杀死癌细胞的能力,改变了癌症的作用。本文讨论了 Pembrolizumab 和 Nivolumab 等 ICIs 的重大影响,这些药物已被批准用于复发性或转移性 OPSCC,并在临床试验中显示出显著疗效。PD-L1表达等生物标志物的确定促进了这些疗法与临床实践的结合,为个性化治疗策略提供了指导。此外,对 ICIs 和其他治疗方式的联合疗法的研究也在进行中,这将进一步改善患者的治疗效果。尽管取得了成功,但免疫相关不良事件和耐药机制等挑战依然存在,这凸显了该领域继续创新和探索的必要性。本综述强调了 ICIs 在重新定义 OPSCC 治疗中的关键作用,为患者带来了持续生存和改善生活质量的新希望。
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引用次数: 0
Letter to the editor, “Incidental dose to the oropharynx with involved neck only radiotherapy in squamous cell cancer of unknown primary of the head and neck.” 致编辑的信,"头颈部原发灶不明的鳞状细胞癌仅采用颈部受累放疗时口咽部的偶发剂量"。
Pub Date : 2024-09-10 DOI: 10.1016/j.oor.2024.100648
Gnanaprakash Jeyaraj
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引用次数: 0
Advances in image-guided radiotherapy (IGRT): Reducing toxicity while increasing efficacy in oral cancer 图像引导放射治疗 (IGRT) 的进展:在提高口腔癌疗效的同时降低毒性
Pub Date : 2024-09-01 DOI: 10.1016/j.oor.2024.100623
Shyamaladevi Babu, Pandiselvi Ravi
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引用次数: 0
Comment on “Prognostic significance of neutrophil to lymphocyte ratio (NLR) in oral squamous cell carcinoma” 关于 "中性粒细胞与淋巴细胞比值(NLR)在口腔鳞状细胞癌中的预后意义 "的评论
Pub Date : 2024-09-01 DOI: 10.1016/j.oor.2024.100643
Elumalai perumal, Jospin Sindya
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引用次数: 0
Role of obturator in restoring quality of life and function in maxillary oncological defect cases- A systematic review 钝器在恢复上颌骨肿瘤缺损病例的生活质量和功能方面的作用--系统性综述
Pub Date : 2024-09-01 DOI: 10.1016/j.oor.2024.100636
Neelima Manoj, Ahila Singaravel Chidambaranathan, MuthuKumar Balasubramanium, Ganesh RamKumar Rajapandi

Statement of problem

Whether prosthetic rehabilitation significantly affects quality of life and functions of post maxillectomy patients.

Objective

Systematically analyze the effects of different types of obturators on post-maxillectomy patients focusing on quality of life and function.

Materials and methods

An electronic search was conducted across four databases PubMed, Google Scholar, Cochrane Library, and ScienceDirect in English language from January 1995 June 2024 using the key terms maxillectomy OR hemi-maxillectomy OR palatomaxillary defect OR Aramany OR Brown OR Okay AND obturator OR denture OR prosthetic AND flap OR surgery OR prosthetic rehabilitation. Additionally, a hand search was performed in the institutional library on Journal of Prosthetic Dentistry, Journal of Indian Prosthodontic Society, Journal of Prosthodontics, International Journal of Prosthodontics and Indian Journal of Prosthodontic Research.

Results

Seven articles were included in this systematic review. Patient scores from quality-of-life questionnaires and functional ability evaluations were compared across a total of 251 patients, including those with and without obturators. The evaluation included 3 prospective studies, 2 retrospective studies, 1 clinical study, and 1 randomized controlled trial. The results demonstrated a statistically significant improvement in both speech and quality of life for patients using maxillary obturators.

Conclusion

Obturator prostheses are not only improved the health-related quality of life (HRQOL) but also enhance overall function of the patient rehabilitated with maxillary oncological defects. They play a crucial role in orofacial rehabilitation by addressing functional and aesthetic challenges faced by individuals with such defects. This positive impact is likely due to the prostheses' ability to restore oral and facial functions, improve speech, and enhance self-esteem and social interactions.

问题陈述假体康复是否会明显影响上颌骨切除术后患者的生活质量和功能。目的系统分析不同类型的闭孔器对上颌骨切除术后患者的影响,重点关注生活质量和功能。材料和方法使用关键术语上颌骨切除术或半上颌骨切除术或腭颌缺损或阿拉曼尼或布朗或Okay AND obturator OR denture OR prosthetic AND flap OR surgery OR prosthetic rehabilitation,对1995年1月至2024年6月期间的四个英文数据库PubMed、Google Scholar、Cochrane Library和ScienceDirect进行了电子检索。此外,还在机构图书馆对《口腔修复学杂志》、《印度口腔修复学会杂志》、《口腔修复学杂志》、《国际口腔修复学杂志》和《印度口腔修复研究杂志》进行了人工检索。对总共 251 名患者的生活质量问卷和功能能力评估结果进行了比较,其中包括使用和未使用顺铂的患者。评估包括 3 项前瞻性研究、2 项回顾性研究、1 项临床研究和 1 项随机对照试验。结果表明,使用上颌钝器的患者在言语和生活质量方面都有显著的统计学改善。它们在口面部康复中发挥着至关重要的作用,解决了此类缺损患者所面临的功能和美学挑战。这种积极影响可能是由于假体能够恢复口腔和面部功能、改善言语、增强自尊和社会交往。
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引用次数: 0
A review based study on emotional distress and physical pain in oral and head and neck cancer patients pre- and post-chemotherapy 基于综述的口腔癌和头颈癌患者化疗前后情绪困扰和身体疼痛研究
Pub Date : 2024-09-01 DOI: 10.1016/j.oor.2024.100637
Sanya Mehndiratta , Ravindra Singh , Saanjli Bhandari , Mansha Dadhich

Emotional distress is a psychological response that occurs in the form of mental suffering to an experience that arises from the any negative event or condition. It commonly occurs in patients who suffer from cancer-related physical pain throughout the treatments. Cancer patients face a lot of exhaustion which makes them physically and mentally dysfunctional in their daily lives. However, the Head and Neck Cancer (HNC) patients face some serious issues due to the site of tumour or surgery itself. The current study aims to describe how chemotherapy and physical pain cause emotional distress in HNC patients. Furthermore, the study aims to determine the association between all three factors (Emotional distress, pain, and chemotherapy) and highlight the relevance of care and remediation needs for HNC patients. The literature related to the concerned topic was investigated including empirical research papers, review papers. In total, the authors identified and reviewed 42 articles related to the above-mentioned variables. These articles were obtained from different databases, such as Google Scholar, PubMed, JSTOR and Research Gate. The authors then assessed the full texts of the selected articles for eligibility and extracted data from them. The study revealed that cancer patients who have tolerated physical pain and witnessed the long-term treatment of the process of chemotherapy experience extremely high emotional distress throughout the course. It was also observed that psychological distress is more common in HNC patients than in patients with cancer in other body parts. The main findings of the result indicated that emotional distress was much higher in females. Psychosocial support and palliative care should be integrated to encourage and improve the abilities of cancer-affected patients.

情绪困扰是一种心理反应,是对任何负面事件或状况所引起的经历的一种精神痛苦。它通常发生在那些在整个治疗过程中饱受与癌症相关的身体疼痛折磨的患者身上。癌症患者面临着大量的疲惫,这使他们在日常生活中身心失调。然而,由于肿瘤部位或手术本身的原因,头颈癌(HNC)患者面临着一些严重的问题。本研究旨在描述化疗和身体疼痛如何导致 HNC 患者的情绪困扰。此外,本研究还旨在确定所有三个因素(情绪困扰、疼痛和化疗)之间的关联,并强调 HNC 患者护理和补救需求的相关性。研究人员调查了与相关主题有关的文献,包括实证研究论文和综述论文。作者总共确定并审查了 42 篇与上述变量相关的文章。这些文章来自不同的数据库,如 Google Scholar、PubMed、JSTOR 和 Research Gate。然后,作者对所选文章的全文进行了资格评估,并从中提取了数据。研究显示,癌症患者在整个化疗过程中,忍受了身体上的痛苦,目睹了化疗的长期治疗过程,会经历极高的情绪困扰。研究还发现,与身体其他部位的癌症患者相比,HNC 患者的心理困扰更为常见。主要研究结果表明,女性患者的情绪困扰程度更高。应将社会心理支持和姑息治疗结合起来,以鼓励和提高癌症患者的能力。
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引用次数: 0
Comparative evaluation of lymph node level IIA & IIB IN N-0 neck of oral squamous cell carcinoma 口腔鳞状细胞癌 N-0 颈部 IIA 和 IIB 级淋巴结的比较评估
Pub Date : 2024-09-01 DOI: 10.1016/j.oor.2024.100639
Mohd Aswad Khan , Ghulam Sarwar Hashmi , Sajjad Abdur Rahman , Roobina Khan , Mehtab Ahmad , Tabishur Rahman
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引用次数: 0
Low grade mucoepidermoid carcinoma arising from glandular odontogenic cyst: A case report with a brief literature review 腺性牙源性囊肿引发的低级别粘液表皮样癌:病例报告与文献综述
Pub Date : 2024-09-01 DOI: 10.1016/j.oor.2024.100644
Spoorti Kulkarni , Adarsh Kudva , G. Srikanth , Vyshak Mohan , Mugdha Francis , Sunitha Carnelio

Low-grade mucoepidermoid carcinoma (MEC) is a salivary gland tumor arising rarely within the jaw bones. It poses a diagnostic challenge due to its considerable overlap of the histopathological features with Glandular odontogenic cyst (GOC). Various theories have been put forward to explain the origin of central low-grade MEC, one of the potential being MEC arising from the lining of GOC. In the present paper we report a case of a multilocular lesion in a 54-year-old female in the mandibular anterior region, which clinically and microscopically had a resemblance to the glandular odontogenic cyst, but the final diagnosis of low-grade MEC was confirmed based on the immunohistochemical appraisal.

低级别粘液表皮样癌(MEC)是一种很少发生在颌骨内的唾液腺肿瘤。由于其组织病理学特征与牙源性腺囊肿(GOC)有相当多的重叠,因此给诊断带来了挑战。人们提出了各种理论来解释中枢性低级别 MEC 的起源,其中一种可能的理论是 MEC 源于 GOC 的内膜。本文报告了一例 54 岁女性的下颌前区多形性病变,该病变在临床和显微镜下与腺性牙源性囊肿相似,但根据免疫组化鉴定最终确诊为低级别 MEC。
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引用次数: 0
期刊
Oral Oncology Reports
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