Epidemiologic factors in patients with advanced head and neck cancer treated with radiation therapy

Treister, Nathaniel S.; Sollecito, Thomas P.; Schmidt, Brian L.; Patton, Lauren L.; Yang, Yi; Lin, Alexander; Elting, Linda S.; Hodges, James S.; Lalla, Rajesh V.

doi:10.1002/hed.26468

Cited by 12 publications

(7 citation statements)

References 20 publications

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“…Regarding periodontal disease and dental caries status, our sub-cohort is similar to that of the larger OraRad cohort ( Table 1 and Brennan et al, 2021 ). A study identified by LitSuggest, reviewing findings pertaining to oral HPV infection in relation to periodontitis, suggests periodontal pockets may act as a reservoir for HPV and that oral HPV prevalence may be associated with periodontitis ( Shigeishi et al, 2021a ).…”

Section: Discussionsupporting

confidence: 58%

“…Demographics and clinical information of our HNC patient cohort ( N = 30 patients, sub-cohort of OraRad study) are presented in Table 1 . Clinical information, including caries and periodontal disease status for OraRad HNC patient cohort, associated with HPV status ( N = 559 of 572 total patients) has been published elsewhere ( Brennan et al, 2021 ). While no significant differences were noted in age and ethnicity, the male population was over-represented in the HNC patient set in OraRad and this study, as anticipated for oral SCC in general and for HPV-associated oropharyngeal cancers ( Fakhry et al, 2018 ; Mahal et al, 2019 ).…”

Section: Resultsmentioning

confidence: 99%

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Haemophilus pittmaniae and Leptotrichia spp. Constitute a Multi-Marker Signature in a Cohort of Human Papillomavirus-Positive Head and Neck Cancer Patients

et al. 2022

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ObjectivesHuman papillomavirus (HPV) is a known etiological factor of oropharyngeal head and neck cancer (HNC). HPV positivity and periodontal disease have been associated with higher HNC risk, suggesting a role for oral bacterial species. Our objective was to determine oral microbiome profiles in HNC patients (HPV-positive and HPV-negative) and in healthy controls (HC).MethodsSaliva samples and swabs of buccal mucosa, supragingival plaque, and tongue were collected from HNC patients (N = 23 patients, n = 92 samples) before cancer therapy. Next-generation sequencing (16S-rRNA gene V3–V4 region) was used to determine bacterial taxa relative abundance (RA). β-Diversities of HNC HPV+ (N = 16 patients, n = 64 samples) and HNC HPV– (N = 7 patients, n = 28 samples) groups were compared using PERMANOVA (pMonte Carlo < 0.05). LEfSe discriminant analysis was performed to identify differentiating taxa (Log LDA > 2.0). RA differences were analyzed by Mann–Whitney U-test (α = 0.05). CombiROC program was used to determine multi-marker bacterial signatures. The Microbial Interaction Network Database (MIND) and LitSuggest online tools were used for complementary analyses.ResultsHNC vs. HC and HNC HPV+ vs. HNC HPV– β-diversities differed significantly (pMonte Carlo < 0.05). Streptococcus was the most abundant genus for HNC and HC groups, while Rothia mucilaginosa and Haemophilus parainfluenzae were the most abundant species in HNC and HC patients, respectively, regardless of antibiotics treatment. LEfSe analysis identified 43 and 44 distinctive species for HNC HPV+ and HNC HPV– groups, respectively. In HNC HPV+ group, 26 periodontal disease-associated species identified by LefSe had a higher average RA compared to HNC HPV– group. The significant species included Alloprevotella tannerae, Fusobacterium periodonticum, Haemophilus pittmaniae, Lachnoanaerobaulum orale, and Leptotrichia spp. (Mann–Whitney U-test, p < 0.05). Of 43 LEfSe-identified species in HPV+ group, 31 had a higher RA compared to HPV– group (Mann–Whitney U-test, p < 0.05). MIND analysis confirmed interactions between Haemophilus and Leptotrichia spp., representing a multi-marker signature per CombiROC analysis [area under the curve (AUC) > 0.9]. LitSuggest correctly classified 15 articles relevant to oral microbiome and HPV status.ConclusionOral microbiome profiles of HNC HPV+ and HNC HPV– patients differed significantly regarding periodontal-associated species. Our results suggest that oral bacterial species (e.g., Leptotrichia spp.), possessing unique niches and invasive properties, coexist with HPV within HPV-induced oral lesions in HNC patients. Further investigation into host–microbe interactions in HPV-positive HNC patients may shed light into cancer development.

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Section: Discussionsupporting

confidence: 58%

Section: Resultsmentioning

confidence: 99%

Haemophilus pittmaniae and Leptotrichia spp. Constitute a Multi-Marker Signature in a Cohort of Human Papillomavirus-Positive Head and Neck Cancer Patients

et al. 2022

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“…Previous studies describe the epidemiological profile of head and neck cancer (HNC) patients in different parts of the world. Age, sex, race, socioeconomic status, marital status, and primary tumor location are factors commonly reported (Lebo et al,2019;Brennan et al,2021). The present study identified the following data: sex, age, occupation, alcohol and tobacco use, tumor location, treatment type, and possible adverse effects of oral cavity treatments, allowing the comparison of findings from two regions of Brazil.…”

Section: Discussionmentioning

confidence: 99%

Head and neck cancer: epidemiological aspects of two large Brazilian medical centers

Cardoso Amorim,

Lúcia Coutinho Silva,

Félix Souza

et al. 2024

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Objective: To compare clinical and epidemiological aspects of Head and neck cancers (HNC) patients treated in hospitals in northeast and southeast regions of Brazil. Methodology: The study cross-sectional retrospective analyzed 519 medical records of patients treated between 2016 and 2021. The factors evaluated for HNC prevalence included demographic data, predisposing factors, tumor location, treatment type, and related oral manifestations. Qualitative variables were expressed in absolute and relative frequencies. The chi-square test assessed potential associations between these variables (p< 0.05). Results: 54.1% of patients were men and 45.9% were women. Hospitals significantly differed regarding sex, age, and tobacco use (p< 0.05). The accumulated percentage indicated that adults under 60 years old were the most affected (62.6%). The larynx/hypopharynx was the most prevalent location (51.8%), followed by the oral cavity (25.8%). The tongue was the most affected anatomical region in the oral cavity (11.0%). Conclusion: Patient profile showed possible changes, with both sexes being similarly affected in increasingly younger patients. Demographic and lifestyle factors suggest an association with HNC, representing information for consideration when screening more susceptible patients and tracking early-stage lesions.

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“…Primary RT sites of larynx/ hypopharynx or oral cavity were associated with worsening DMFS over time compared to both the oropharynx and salivary glands. OraRad patients with human papillomavirus (HPV)positive oropharyngeal cancers (47% of the current cohort) differed in many ways from those with all other HNCs (Brennan et al 2021). Patients with HPV-positive oropharyngeal cancer had higher socioeconomic status (more education, increased likelihood of private medical and dental insurance, decreased likelihood of Medicaid, or receipt of public assistance), were more likely to be white and married, used tobacco less but used alcohol more frequently, and had less dental disease burden with more teeth at baseline and less periodontal disease.…”

Section: Discussionmentioning

confidence: 99%

Dental Caries Postradiotherapy in Head and Neck Cancer

Treister

Sollecito

Schmidt

et al. 2022

JDR Clinical & Translational Research

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Background: Treatment for head and neck cancer (HNC) such as radiotherapy (RT) can lead to numerous acute and chronic head and neck sequelae, including dental caries. The goal of the present study was to measure 2-y changes in dental caries after radiotherapy in patients with HNC and test risk factors for caries increment. Methods: Cancer and dental disease characteristics, demographics, and oral health practices were documented before and 6, 12, 18, and 24 mo after the start of RT for 572 adult patients with HNC. Patients were eligible if they were age 18 y or older, diagnosed with HNC, and planned to receive RT for treatment of HNC. Caries prevalence was measured as decayed, missing, and filled surfaces (DMFS). The association between change in DMFS and risk factors was evaluated using linear mixed models. Results: On average, DMFS increased from baseline to each follow-up visit: 6 mo, +1.11; 12 mo, +2.47; 18 mo, +3.43; and 24 mo, +4.29 (P < 0.0001). The increase in DMFS during follow-up was significantly smaller for the following patient characteristics: compliant with daily fluoride use (P = 0.0004) and daily oral hygiene (brushing twice daily and flossing daily; P = 0.015), dental insurance (P = 0.004), and greater than high school education (P = 0.001). DMFS change was not significantly associated with average or maximum RT dose to the parotids (P > 0.6) or salivary flow (P > 0.1). In the subset of patients who had salivary hypofunction at baseline (n = 164), lower salivary flow at follow-up visits was associated with increased DMFS. Conclusion: Increased caries is a complication soon after RT in HNC. Fluoride, oral hygiene, dental insurance, and education level had the strongest association with caries increment after radiotherapy to the head and neck region. Thus, intensive oral hygiene measures, including fluoride and greater accessibility of dental care, may contribute to reducing the caries burden after RT in HNC. Knowledge Transfer Statement: The results of this study can be used by clinicians when deciding how to minimize oral complications related to cancer therapy for patients with head and neck cancer. Identification of modifiable factors (e.g., oral hygiene and prescription fluoride compliance) associated with increased caries risk can minimize radiation caries burden.

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Epidemiologic factors in patients with advanced head and neck cancer treated with radiation therapy

Cited by 12 publications

References 20 publications

Haemophilus pittmaniae and Leptotrichia spp. Constitute a Multi-Marker Signature in a Cohort of Human Papillomavirus-Positive Head and Neck Cancer Patients

Haemophilus pittmaniae and Leptotrichia spp. Constitute a Multi-Marker Signature in a Cohort of Human Papillomavirus-Positive Head and Neck Cancer Patients

Head and neck cancer: epidemiological aspects of two large Brazilian medical centers

Dental Caries Postradiotherapy in Head and Neck Cancer

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