Oral Oncology Reports最新文献_第6页

Assessment of the mean dose of the pharyngeal constrictor muscles (as one organ) as a part of DARS and its effect on dysphagia in IMRT treated head and neck cancer patients

Oral Oncology Reports

Pub Date : 2024-11-19 DOI: 10.1016/j.oor.2024.100689

May Gamal Ashour , Tarek Hamed Shouman , Ashraf Hamed Hassouna , Maha Hassan Mokhtar , Dalia Abdelfatah

Objective

To assess the mean dose the pharyngeal constrictor muscle (PCM) received and its effect on dysphagia and develop a cut-off value for its occurrence.

Methods

116 patients with head and neck cancer who required bilateral neck irradiation treated using the simultaneous integrated boost IMRT technique were retrospectively evaluated. Pharyngeal constrictor (superior, middle, inferior) and cricopharyngeus and esophageal inlet muscles (cricopharyngeal inlet) were considered dysphagia/aspiration-related structures (DARS) and were summated as one organ at risk structure PCM. PlanPCM consists of the sum of one or multiple pharyngeal constrictor muscles away from high-risk volumes.

Results

This study enrolled 116 patients (37 female, 79 male), mean age of 51 years. The mean dose to PCM was 51.37 Gy ± SD (range, 30.08–63.86 Gy). The severity of dysphagia correlated significantly with the dose received by PlanPCM (p < 0.001). The mean dose to PlanPCM in the nasopharyngeal primary was 53.3 Gy (Range 44–63.5 Gy), while it was 45.4 Gy (Range 30.1–56.3 Gy) for laryngeal primaries. Our findings indicated that a dose exceeding 50 Gy to the PlanPCM was more likely associated with high occurrence of dysphagia at one year after the completion of treatment.

Conclusion

We reported that PCM delineation as a single structure with sparing the part outside the high risk volumes is more reproducible and leads to the same outcomes if delineated separately.

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引用次数: 0

Neoadjuvant immunotherapy in advanced oral cancer: Emerging treatment paradigms 晚期口腔癌的新辅助免疫疗法：新兴治疗范例

Oral Oncology Reports

Pub Date : 2024-11-08 DOI: 10.1016/j.oor.2024.100683

Ankit Vishwani, Bipin Thomas Varghese, Shaji Thomas, Ashima Kumar, Japneet Kaur, Anukampa Sharma

Background

Locally advanced borderline resectable oral cancer poses significant treatment challenges due to its infiltrative nature and high relapse rates, leading to poor prognosis. Neoadjuvant immunotherapy may offer a novel therapeutic approach, potentially altering the standard of care for advanced oral cancer.

Case report

Two patients with locally advanced tongue cancer, initially deemed inoperable, were treated with neoadjuvant immunotherapy. The first patient received 4 cycles of taxane, cisplatin, and pembrolizumab, while the second received 12 cycles of nivolumab and methotrexate. Both patients exhibited excellent clinical responses at the primary site and in regional lymph nodes. Following treatment, one patient underwent primary closure, and the other had a nasolabial flap with marginal mandibulectomy. Intraoperative frozen sections indicated tumor-free margins in both cases.

Conclusion

These two cases underscore the potential of neoadjuvant immunotherapy in managing borderline resectable oral squamous cell carcinoma (OSCC), initially deemed inoperable. The favorable outcomes highlight the need for more research and clinical trials to further assess the efficacy of this approach in head and neck cancers. In this review, we explore the scientific rationale, current clinical evidence, and key debated topics, including the evaluation of pathological and radiological responses.

背景局部晚期边缘可切除口腔癌因其浸润性和高复发率导致预后不良，给治疗带来了巨大挑战。病例报告两名局部晚期舌癌患者最初被认为无法手术，他们接受了新辅助免疫疗法治疗。第一位患者接受了 4 个周期的紫杉类药物、顺铂和 pembrolizumab 治疗，第二位患者接受了 12 个周期的 nivolumab 和甲氨蝶呤治疗。两名患者的原发部位和区域淋巴结都出现了极佳的临床反应。治疗后，一名患者进行了原发灶闭合术，另一名患者进行了鼻唇皮瓣和下颌骨边缘切除术。结论这两例病例强调了新辅助免疫疗法在治疗最初被认为无法手术的边缘可切除口腔鳞状细胞癌（OSCC）方面的潜力。良好的疗效凸显了进行更多研究和临床试验的必要性，以进一步评估这种方法在头颈部癌症中的疗效。在这篇综述中，我们将探讨这种方法的科学原理、目前的临床证据和主要争论点，包括病理和放射学反应的评估。

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引用次数: 0

Epigenetic alterations in oral cancer: Mechanisms, biomarkers, and therapeutic targets 口腔癌的表观遗传学改变：机制、生物标记物和治疗目标

Oral Oncology Reports

Pub Date : 2024-10-31 DOI: 10.1016/j.oor.2024.100681

Madhan Krishnan , Sharan Basappa , Shyamaladevi Babu

Epigenetic alterations play an important aspect in the pathogenesis of oral cancer, affecting gene regulation occurs without altering the DNA sequence itself. These alterations include processes like DNA methylation, histone modification, and the regulation mediated by non-coding RNAs (ncRNAs), contribute to the initiation, progression, and metastasis of oral squamous cell carcinoma (OSCC). This review comprehensively examines the major epigenetic mechanisms implicated in oral cancer, elucidates potential biomarkers for early detection and prognosis, and explores emerging epigenetic therapies with significant potential for targeted treatment. The reversible characteristics of epigenetic modifications render them promising therapeutic targets and offers hope for improved clinical outcomes. We also discuss the current limitations in research and suggest future directions for developing effective epigenetic-based diagnostic and therapeutic strategies.

表观遗传学改变在口腔癌的发病机制中起着重要作用，它在不改变 DNA 序列本身的情况下影响基因调控。这些改变包括 DNA 甲基化、组蛋白修饰和非编码 RNA（ncRNA）介导的调控等过程，有助于口腔鳞状细胞癌（OSCC）的发生、发展和转移。这篇综述全面探讨了与口腔癌有关的主要表观遗传机制，阐明了用于早期检测和预后判断的潜在生物标志物，并探索了具有显著靶向治疗潜力的新兴表观遗传疗法。表观遗传修饰的可逆性使其成为有前景的治疗目标，并为改善临床结果带来了希望。我们还讨论了当前研究的局限性，并提出了开发基于表观遗传的有效诊断和治疗策略的未来方向。

引用次数: 0

Head and neck cancer treatment delays in 2021: Estimating distributional effects by site, surgery, and p16-positivity 2021 年头颈癌治疗延迟：按部位、手术和 p16 阳性率估算分布效应

Oral Oncology Reports

Pub Date : 2024-10-30 DOI: 10.1016/j.oor.2024.100682

Jason Semprini , Kiran Marla

Background

Following decades of policies increasing access to high-quality cancer treatment, the COVID-19 pandemic upended the U.S. healthcare system. The pandemic's disruption likely affected an often-overlooked dimension of quality cancer treatment: timely initiation. Timely treatment initiation is especially critical for head and neck cancer (HNC). We aimed to assess how the treatment interval (diagnosis to treatment initiation) changed in 2021 for different types of HNCs and treatment modalities.

Methodology

We analyzed Surveillance, Epidemiological, End Results (SEER) case data for years 2007–2021. Using ICD site codes, cancers were restricted to oropharynx, oral cavity, other pharynx, larynx. Oropharynx cancers were stratified by Human Papillomavirus (HPV) subtype based on p16-positivity codes. The outcome of interest was a variable measuring the number of days from diagnosis to treatment initiation. Cases were stratified by site and whether they received surgery as first course of treatment. To overcome validity threats from skewed treatment interval data and unobserved heterogeneity, we constructed an unconditional quantile regression model to estimate the effect of treatment in 2021 across the distribution of the treatment interval.

Results

155,273 patients in SEER initiated HNC treatment between 2007 and 2021. The median treatment interval was 29 days (Interquartile Range = 2–48). Among patients not receiving surgery, 2021 was associated with delayed treatment for all sites except oral cavity. For patients receiving surgery, 2021 was only associated with delayed treatment for p16+ Oropharynx cancer.

Discussion

HNC patients overall, but HPV+ Oropharynx cancer patients especially, experienced treatment delays in 2021. These delays, and their consequences, warrant policymaking attention.

背景几十年来，美国一直在制定相关政策以提高癌症治疗的质量，但 COVID-19 大流行却颠覆了美国的医疗保健系统。大流行的破坏很可能影响了优质癌症治疗中经常被忽视的一个方面：及时开始治疗。及时开始治疗对于头颈癌（HNC）尤为重要。我们旨在评估 2021 年不同类型 HNC 和治疗方式的治疗间隔（从诊断到开始治疗）发生了哪些变化。根据 ICD 病变部位代码，癌症仅限于口咽、口腔、其他咽部和喉部。口咽部癌症根据 p16 阳性代码按人乳头瘤病毒 (HPV) 亚型进行分层。相关结果是衡量从诊断到开始治疗的天数的变量。病例按部位和是否接受手术作为第一疗程进行分层。为了克服偏斜的治疗间隔数据和未观察到的异质性对有效性的威胁，我们构建了一个无条件的量子回归模型，以估计 2021 年治疗间隔分布对治疗的影响。治疗间隔中位数为 29 天（四分位距 = 2-48）。在未接受手术的患者中，除口腔外，2021 年与所有部位的治疗延迟有关。在接受手术的患者中，2021 年只与 p16+ 口咽癌的治疗延迟有关。这些延误及其后果值得政策制定者关注。

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引用次数: 0

Comparative evaluation of DNA synthesis for qPCR analysis from oral squamous cell carcinoma tissues - A rapid and robust isolation technique for gene expression studies 用于口腔鳞状细胞癌组织 qPCR 分析的 DNA 合成比较评估 - 一种用于基因表达研究的快速、稳健的分离技术

Oral Oncology Reports

Pub Date : 2024-10-24 DOI: 10.1016/j.oor.2024.100677

Ramya Mahalingam , Vivek Narayanan , Magesh Karuppur Thiagarajan , T. Jayaprakash , K.V. Leela

Background

DNA isolation from biological materials is the initial step in several bioanalytical processes, including the polymerase chain reaction (PCR). This procedure works best with pure DNA devoid of potential amplification reaction inhibitors. Since the quantity and quality of biological samples are limited, it is essential to extract as much DNA as possible from the original sample. The solid-phase extraction technique is frequently used to purify DNA. In this process, the DNA is adsorbed onto a solid support, any contaminants from the reaction are eliminated by washing, and the purified DNA is then eluted from the support. The quality and concentration of DNA have a direct effect on the gene analysis procedure. Therefore, before interpreting the results of PCR-based diagnostic assays, it is imperative to confirm the DNA preparation and integrity, particularly if no pathogenic DNA is identified.

Methods

A comparative study was carried out using two standardized protocols for DNA synthesis in comparison with a test protocol incorporating carrier RNA and proteinase K from a viral detection kit. The quality and quantity of the synthesized DNA are assessed by qPCR analysis for gene amplification of metastasis suppressor genes NDRG1, RhoGDI, and KISS 1.

Results and conclusion

The test protocol showed higher yields of DNA in comparison to the standard protocol. The concentration of DNA obtained was validated by the concentration of gene expressed from q PCR analysis. The gene expression was significantly higher when the test protocol method was followed for DNA synthesis. Thus the study validates the potential of nucleic acid carrier RNA molecules to improve DNA extraction processes used in tissue samples for gene analysis procedures.

背景从生物材料中分离 DNA 是包括聚合酶链反应 (PCR) 在内的多个生物分析过程的第一步。这一过程的最佳条件是DNA纯净，没有潜在的扩增反应抑制剂。由于生物样本的数量和质量有限，因此必须从原始样本中提取尽可能多的 DNA。固相萃取技术常用于纯化 DNA。在这一过程中，DNA 被吸附在固体支持物上，通过洗涤去除反应中的污染物，然后从支持物中洗脱出纯化的 DNA。DNA 的质量和浓度对基因分析程序有直接影响。因此，在解释基于 PCR 的诊断检测结果之前，必须确认 DNA 的制备和完整性，尤其是在未鉴定出病原体 DNA 的情况下。方法：我们使用两种标准化的 DNA 合成方案与使用病毒检测试剂盒中的载体 RNA 和蛋白酶 K 的测试方案进行了比较研究。通过对转移抑制基因 NDRG1、RhoGDI 和 KISS 1 的基因扩增进行 qPCR 分析，评估合成 DNA 的质量和数量。通过 q PCR 分析得出的基因表达浓度验证了 DNA 的浓度。采用测试方案合成 DNA 时，基因表达量明显更高。因此，这项研究验证了核酸载体 RNA 分子在改进用于基因分析程序的组织样本 DNA 提取过程方面的潜力。

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引用次数: 0

Immune checkpoint inhibition in NPC: A comprehensive review of PD-L1 overexpression and treatment responses 鼻咽癌的免疫检查点抑制：PD-L1过表达和治疗反应综述

Oral Oncology Reports

Pub Date : 2024-10-23 DOI: 10.1016/j.oor.2024.100680

Madhan Krishnan , Sharan Basappa , M.V. Vinaya Kumar , Gayathri Sekar

Nasopharyngeal carcinoma (NPC) is a distinct type of cancer that affects the head and neck region, and it is notably linked to infection with the Epstein-Barr Virus (EBV), particularly in endemic regions such as Southeast Asia and Southern China. Despite advances in the conventional care for NPC, including radiation and chemotherapy, the prognosis remains poor for individuals with relapsed or metastatic stages of the disease. Immune checkpoint inhibitors (ICIs), particularly those targeting the PD-1/PD-L1 axis, have emerged as an optimistic therapeutic option. PD-L1 overexpression in NPC contributes to immune avoidance and correlates in relation to these immunotherapies. This review comprehensively explores PD-L1 expression in NPC and its role in tumor immune escape, along with a detailed analysis of clinical trials investigating PD-1/PD-L1 blockade. While PD-L1 overexpression is associated with better responses to ICIs, resistance mechanisms and the complex tumor microenvironment (TME) limit their overall efficacy. We will address these barriers and highlight future directions for improving outcomes, including combination therapies, novel biomarkers, and personalized approaches to treatment. With ongoing research and clinical trials, immune checkpoint inhibition holds great potential to revolutionize NPC therapy, offering hope for improved sustained survival rates and overall well-being for individuals.

鼻咽癌（NPC）是一种影响头颈部的独特癌症，与感染爱泼斯坦-巴氏病毒（EBV）密切相关，尤其是在东南亚和中国南方等流行地区。尽管包括放疗和化疗在内的鼻咽癌常规治疗方法取得了进展，但复发或转移期鼻咽癌患者的预后仍然很差。免疫检查点抑制剂（ICIs），尤其是针对PD-1/PD-L1轴的抑制剂，已成为一种乐观的治疗选择。鼻咽癌中的PD-L1过表达有助于免疫回避，并与这些免疫疗法相关。本综述全面探讨了 PD-L1 在鼻咽癌中的表达及其在肿瘤免疫逃避中的作用，并详细分析了研究 PD-1/PD-L1 阻断疗法的临床试验。虽然 PD-L1 的过度表达与对 ICIs 更好的反应有关，但耐药机制和复杂的肿瘤微环境 (TME) 限制了 ICIs 的总体疗效。我们将讨论这些障碍，并强调改善疗效的未来方向，包括联合疗法、新型生物标记物和个性化治疗方法。随着研究和临床试验的不断深入，免疫检查点抑制剂具有彻底改变鼻咽癌治疗的巨大潜力，为提高鼻咽癌患者的持续生存率和整体健康带来了希望。

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引用次数: 0

Digitally made nasal prosthesis: A new frontier in facial reconstruction - Case report 数字化鼻假体：面部重建的新领域 - 病例报告

Oral Oncology Reports

Pub Date : 2024-10-23 DOI: 10.1016/j.oor.2024.100679

Angel Rose Amalraj, Muthukumar Balasubramanium, Vishal Reddy, Ahila Singaravel Chidambaranathan, Peter John

Background

Worldwide, millions of people experience sickness, trauma, or birth defects that negatively impact their social interactions, career, finances, mental health, and overall quality of life. When anatomical portions where plastic surgery is not appropriate or too expensive are given new functions and aesthetics, prostheses improve the quality of life for most affected individuals. The production of prosthesis items could benefit from 3D printing as a viable method to address the drawbacks of traditional construction, including lack of attachment, function, robustness, aesthetics, and cost. But prosthetic material 3D printing is still in its infancy and faces several obstacles, including low mechanical strength in printed parts, printability problems, restricted 3D printing of appropriate prosthesis materials, and flaws.

Case report

53 years old male reported with a complaint of a missing nose. The nasal defect was postsurgical following total rhinectomy for squamous cell carcinoma. The patient was treated for Grade 2 squamous cell carcinoma. Patient underwent total rhinectomy and rehabilitated with forehead rotation flap and split thickness graft cover. Then the defect was rehabilitated through digital procedure for creating nasal prosthesis.

Conclusion

Digital technology is changing prosthetic design and manufacture by combining precision, personalisation, and efficiency, providing new hope and a higher quality of life for individuals who have had their noses surgically removed.

背景世界上有数百万人经历过疾病、创伤或先天缺陷，对他们的社会交往、事业、经济、心理健康和整体生活质量造成了负面影响。当整形手术不合适或过于昂贵的解剖部位被赋予新的功能和美感时，假肢就能改善大多数受影响者的生活质量。3D打印作为一种可行的方法，可以解决传统结构的缺点，包括缺乏附着性、功能、坚固性、美观性和成本等，从而使假肢的生产受益匪浅。但假体材料 3D 打印仍处于起步阶段，面临着一些障碍，包括打印部件机械强度低、可打印性问题、适当假体材料的 3D 打印受限以及缺陷等。鼻缺损是鳞状细胞癌全鼻切除术后造成的。患者曾接受过 2 级鳞状细胞癌治疗。患者接受了全鼻切除术，并用前额旋转皮瓣和分层厚度移植覆盖物进行了修复。结论数字技术集精确性、个性化和高效性于一身，正在改变假体的设计和制造，为手术切除鼻子的患者带来新的希望和更高的生活质量。

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引用次数: 0

Oral cancer: Recent breakthroughs in pathology and therapeutic approaches 口腔癌：病理学和治疗方法的最新突破

Oral Oncology Reports

Pub Date : 2024-10-22 DOI: 10.1016/j.oor.2024.100678

Surekha Ramachandran

Oral cancer, primarily oral squamous cell carcinoma (OSCC), continues to be a major global health challenge. Despite improvements in early detection and treatment, the prognosis for patients, particularly those diagnosed at advanced stages, remains unfavorable. However, recent progress in understanding the molecular mechanisms of oral carcinogenesis and the development of innovative treatment approaches offer new hope for enhancing patient outcomes. This review highlights the latest discoveries in oral cancer pathology, key molecular drivers of disease progression, early detection strategies, and cutting-edge treatment options, including immunotherapy and targeted treatments. Additionally, it explores next-generation treatments incorporating artificial intelligence and machine learning.

口腔癌，主要是口腔鳞状细胞癌（OSCC），仍然是全球健康面临的一大挑战。尽管在早期检测和治疗方面有所改进，但患者的预后，尤其是确诊为晚期的患者的预后仍然不容乐观。然而，最近在了解口腔癌发生的分子机制和开发创新治疗方法方面取得的进展为改善患者预后带来了新的希望。本综述重点介绍了口腔癌病理学的最新发现、疾病进展的关键分子驱动因素、早期检测策略以及包括免疫疗法和靶向治疗在内的前沿治疗方案。此外，它还探讨了结合人工智能和机器学习的下一代治疗方法。

引用次数: 0

Journey of Exosomes in Oral Squamous Cell Carcinoma (OSCC) 口腔鳞状细胞癌（OSCC）中的外泌体之旅

Oral Oncology Reports

Pub Date : 2024-10-19 DOI: 10.1016/j.oor.2024.100674

Raman Dineja, R. Ashwini

“EXOSOMES” are one of the most important varieties of extracellular vesicles. They help in communication within the cell. The end version of exosomes involves in immune-modulation, stromal adaptation, and multiple biological events. Oral squamous cell carcinoma (OSCC) is considered as second most common cancer in the world. Detection of oral carcinoma happens only during the end stage which makes very poor prognosis of the condition. Now a days multiple research projects are conducted to detect and diagnose the oral squamous cell carcinoma during its early stage. In these researches exosomes play a vital role in detecting the OSCC. A PubMed search was performed for English-language, full-text available papers published from January 2005 to March 2024, focusing on exosomes role in Oral squamous cell carcinoma (OSCC). This review is done to understand the timely research where exosomes are used in various aspect in terms of OSCC. This review help to recall the yearly achievement in the diagnosis, treatment planning, prognosis of OSCC by utilising the exosomes.

"细胞外囊泡 "是细胞外囊泡中最重要的种类之一。它们有助于细胞内的交流。外泌体的末端参与免疫调节、基质适应和多种生物事件。口腔鳞状细胞癌（OSCC）被认为是世界上第二常见的癌症。口腔癌只有在晚期才会被发现，因此预后很差。如今，许多研究项目都在进行口腔鳞状细胞癌的早期检测和诊断。在这些研究中，外泌体在检测口腔鳞状细胞癌方面发挥着至关重要的作用。我们在PubMed上搜索了2005年1月至2024年3月期间发表的有关外泌体在口腔鳞状细胞癌（OSCC）中作用的英文全文论文。本综述旨在及时了解外泌体在OSCC各方面的应用研究。这篇综述有助于回顾每年利用外泌体在OSCC的诊断、治疗计划和预后方面取得的成就。

引用次数: 0

Delta Radiomics — Potential role in Head Neck Cancer 德尔塔放射组学--在头颈部癌症中的潜在作用

Oral Oncology Reports

Pub Date : 2024-10-19 DOI: 10.1016/j.oor.2024.100676

Shrikant B. Mali

Introduction

Delta radiomics is a tool used to assess the response of oncologic patients undergoing immunotherapy. It extracts high-dimensional quantitative features from medical images, providing information about cancer's phenotype, genotype, and tumoral microenvironment. This analysis could help avoid invasive procedures and help choose the most suitable therapeutic in multiple therapeutic options. Radiomics has gained interest as an imaging biomarker for predicting response to various immunotherapies. Delta radiomics assesses feature variations from one time point to another based on subsequent images, offering higher value for treatment-outcome prediction or patient stratification into risk categories. It has potential benefits for clinical endpoints in oncology, such as differential diagnosis, prognosis, treatment response prediction, and evaluation of side effects. Further research with prospective and multicentre studies is needed for clinical validation of delta radiomics approaches.

Statement of clinical significance

In head and neck oncology, delta radiomics can be used to enhance the precision of diagnosis, assess tumor response, forecast normal tissue toxicity, predict clinical outcome, and pinpoint characteristics for treatment modification. Patients' quality of life may be enhanced by it. It can support post-treatment surveillance. Additionally, it can support the delivery of individualized care based on a patient's reaction to medication and radiation.

简介：Delta 放射组学是一种用于评估接受免疫疗法的肿瘤患者反应的工具。它从医学影像中提取高维定量特征，提供有关癌症表型、基因型和肿瘤微环境的信息。这种分析有助于避免侵入性手术，并帮助在多种治疗方案中选择最合适的疗法。放射组学作为预测对各种免疫疗法反应的成像生物标志物，已经引起了人们的兴趣。德尔塔放射组学根据后续图像评估从一个时间点到另一个时间点的特征变化，为治疗结果预测或患者风险分层提供更高的价值。它对肿瘤学的临床终点，如鉴别诊断、预后、治疗反应预测和副作用评估，都有潜在的益处。临床意义在头颈部肿瘤学中，δ放射组学可用于提高诊断的精确度、评估肿瘤反应、预测正常组织毒性、预测临床结果，以及准确定位治疗调整的特征。患者的生活质量也会因此得到提高。它可以支持治疗后监测。此外，它还可以根据病人对药物和放射治疗的反应提供个性化护理。

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引用次数: 0