Induction chemotherapy followed by concurrent chemoradiotherapy versus CCRT for locally
advanced hypopharynx and base of tongue cancer

Lim, Sung Hee; Sun, Jong‐Mu; Hong, Jung Hee; Oh, Dongryul; Ahn, Yong Chan; Chung, Man Ki; Jeong, Han‐Sin; Son, Young‐Ik; Ahn, Myung‐Ju; Baek, Chung‐Hwan; Park, Keunchil

doi:10.3904/kjim.2019.161

Cited by 9 publications

(7 citation statements)

References 14 publications

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“…The observation in the bottom left corner of the regression model figure belongs to the Lim et al. ( 49 ) trial, which, due to its relatively small size, did not have a meaningful influence on the model.…”

Section: Resultsmentioning

confidence: 99%

Correlation Between Early Time-to-Event Outcomes and Overall Survival in Patients With Locally Advanced Head and Neck Squamous Cell Carcinoma Receiving Definitive Chemoradiation Therapy: Systematic Review and Meta-Analysis

Black

Keeping²,

Mojebi³

et al. 2022

Front. Oncol.

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BackgroundOverall survival (OS) is the most patient-relevant outcome in oncology; however, in early cancers, large sample sizes and extended follow-up durations are needed to detect statistically significant differences in OS between interventions. Use of early time-to-event outcomes as surrogates for OS can help facilitate faster approval of cancer therapies. In locally advanced head and neck squamous cell carcinoma (LA-HNSCC), event-free survival (EFS) was previously evaluated as a surrogate outcome (Michiels 2009) and demonstrated a strong correlation with OS. The current study aimed to further assess the correlation between EFS and OS in LA-HNSCC using an updated systematic literature review (SLR) focusing on patients receiving definitive chemoradiation therapy (CRT).MethodsAn SLR was conducted on May 27, 2021 to identify randomized controlled trials assessing radiotherapy alone or CRT in the target population. Studies assessing CRT and reporting hazard ratios (HRs) or Kaplan-Meier data for OS and EFS were eligible for the analysis. CRT included any systemic treatments administered concurrently or sequentially with radiation therapy. Trial-level EFS/OS correlations were assessed using regression models, and the relationship strength was measured with Pearson correlation coefficient (R). Correlations were assessed across all CRT trials and in trial subsets assessing concurrent CRT, sequential CRT, RT+cisplatin, targeted therapies and intensity-modulated RT. Subgroup analysis was conducted among trials with similar EFS definitions (i.e. EFS including disease progression and/or death as events) and longer length of follow-up (i.e.≥ 5 years).ResultsThe SLR identified 149 trials of which 31 were included in the analysis. A strong correlation between EFS and OS was observed in the overall analysis of all CRT trials (R=0.85, 95% confidence interval: 0.72-0.93). Similar results were obtained in the sensitivity analyses of trials assessing concurrent CRT (R=0.88), sequential CRT (R=0.83), RT+cisplatin (R=0.82), targeted therapies (R=0.83) and intensity-modulated RT (R=0.86), as well as in trials with similar EFS definitions (R=0.87), with longer follow-up (R=0.81).ConclusionEFS was strongly correlated with OS in this trial-level analysis. Future research using individual patient-level data can further investigate if EFS could be considered a suitable early clinical endpoint for evaluation of CRT regimens in LA-HNSCC patients receiving definitive CRT.

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Section: Resultsmentioning

confidence: 99%

Correlation Between Early Time-to-Event Outcomes and Overall Survival in Patients With Locally Advanced Head and Neck Squamous Cell Carcinoma Receiving Definitive Chemoradiation Therapy: Systematic Review and Meta-Analysis

Black

Keeping²,

Mojebi³

et al. 2022

Front. Oncol.

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“…Given the assumption that both treatment and technique help performance, and medical research can sometimes require a high degree of abstraction ( 22 ); studies so far were not able to show a significant improvement of the survival rates and local control using various regimens of induction chemotherapy in comparison to the concurrent CRT, the last one remains the standard of care in organ conservation for advanced hypopharyngeal cancer ( 16 ).…”

Section: Discussionmentioning

confidence: 99%

“…No complaints or complications involving the tracheostomy were observed. The clinical trials that support the use of induction chemotherapy for hypopharyngeal cancer are not consistent as they have failed to exhibit a significant improvement and as a result, CCRT is used as a therapeutic option for a greater local and regional control ( 16 , 17 ).…”

Section: Case Reportmentioning

confidence: 99%

Quality of life and tracheostomy influence in successfully treated hypopharyngeal cancer: A case report

Cordunianu

Ganea²,

Cordunianu

et al. 2022

Exp Ther Med

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Squamous cell carcinoma (SCC) of the hypopharynx is associated with the worst prognosis of all squamous cell cancer types of the head and neck, with a rich submucosal lymphatic network and a significant inferior extent. Generally, cancers of the head and neck have a big impact on the quality of life (QoL) in patients, both before and after treatment, due to the fact that most cases are diagnosed in advanced stages, with lymph node metastases and have an aggressive pattern associated with low survival rates. The present case report aimed to see the evolution of a patient successfully treated for hypopharyngeal cancer with conservation therapies from the QoL perspective and the influence made by the presence of tracheostomy. Variables, including clinical parameters (sex, age, TNM classification, performance status, histological type and tumor subsite), local control, QoL, Adult Comorbidity Evaluation-27 score and overall survival were assessed, according to the American Joint Committee on Cancer 8th edition, for a 58-year-old patient treated with conservation therapies and tracheostomy in a tertiary center. Subjective features measured through the QoL questionnaire had scores with lowering tendencies during the treatment period. The patient was provided with early training for tracheostomy care and early discharge education. The following objective features of treatment response were exhibited: Hemoglobin levels, leukocyte count, tumor size, imagistic evaluations and local control to confirm treatment response. It is essential when planning the treatment of aggressive and rare pathologies, such as hypopharyngeal cancer, to consider the QoL and patient choice for better adherence. Overall, the results demonstrated that the initial requirement for emergency tracheostomy was not associated with any ulterior complications and did not influence the end result of the treatment.

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“…There may be some tendency to show higher severe myelosuppression rate in triweekly cisplatin treated group. However, most reports demonstrated only the rate of severe myelosuppression and median/mean age of participants [ 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 ], which made it difficult to clearly evaluate the effects of triweekly/weekly cisplatin for older patients ( Table 2 ). It seems that the use of chemotherapy for the elderly will increase more and more in near future.…”

Section: Cisplatin-associated Toxicitiesmentioning

confidence: 99%

Nonsurgical Treatment Strategies for Elderly Head and Neck Cancer Patients: An Emerging Subject Worldwide

Okuda

Shibata

Watanabe

et al. 2022

Cancers

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Consistent with the increasing rate of head and neck cancers among elderly adults, there has been an increase in the rate of those receiving nonsurgical treatments to maintain their function and quality of life. However, various problems, such as poor tolerance to chemoradiotherapy-related toxicity, are of greater concern in elderly adults than in younger individuals. In this review, we describe adverse events that should be particularly noted in elderly patients and provide an overview of countermeasures in nonsurgical treatments. We mainly focus on cisplatin-based chemoradiotherapy—the primary treatment for head and neck squamous cell carcinoma (HNSCC). Furthermore, we review the molecular targeted drugs and immune checkpoint inhibitors for elderly patients with HNSCC. Although the number of older patients is increasing worldwide, clinical trials aimed at determining the standard of care typically enroll younger or well-conditioned elderly patients. There is still very little evidence for treating elderly HNSCC older patients, and the question of optimal treatment needs to be explored.

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Induction chemotherapy followed by concurrent chemoradiotherapy versus CCRT for locally advanced hypopharynx and base of tongue cancer

Cited by 9 publications

References 14 publications

Correlation Between Early Time-to-Event Outcomes and Overall Survival in Patients With Locally Advanced Head and Neck Squamous Cell Carcinoma Receiving Definitive Chemoradiation Therapy: Systematic Review and Meta-Analysis

Correlation Between Early Time-to-Event Outcomes and Overall Survival in Patients With Locally Advanced Head and Neck Squamous Cell Carcinoma Receiving Definitive Chemoradiation Therapy: Systematic Review and Meta-Analysis

Quality of life and tracheostomy influence in successfully treated hypopharyngeal cancer: A case report

Nonsurgical Treatment Strategies for Elderly Head and Neck Cancer Patients: An Emerging Subject Worldwide

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