Locally advanced squamous cell carcinoma of the head and neck: A systematic review and Bayesian network meta-analysis of the currently available treatment options

Iocca, Oreste; Farcomeni, Alessio; Rocco, Arianna Di; Maio, Pasquale Di; Golusiński, Paweł; López, Simón Pardiñas; Savo, Alfredo; Pellini, Raul; Spriano, Giuseppe

doi:10.1016/j.oraloncology.2018.03.001

Cited by 50 publications

(31 citation statements)

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“…We also reported pattern of safety and recurrence of stage III to IV head and neck cancer patients treated with RT with a daily dose of 2.12 grays (Gy) for 33 fractions . A more recent systematic review and Bayesian network meta‐analysis, including only LAHNC, confirmed the superiority of concurrent chemoradiotherapy compared to RT alone in terms of survival; moreover, altered fractionation resulted not superior to conventional RT in terms of progression‐free survival …”

Section: Introductionmentioning

confidence: 86%

“…12 A more recent systematic review and Bayesian network meta-analysis, including only LAHNC, confirmed the superiority of concurrent chemoradiotherapy compared to RT alone in terms of survival; moreover, altered fractionation resulted not superior to conventional RT in terms of progression-free survival. 13 In the present study, we aimed to analyze and compare two cohorts of LAHNC patients treated in the same institution with two schedules of hypofractionated RT, 33 fractions of 2.12 Gy each versus 30 fractions of 2.2 Gy each, and 5 versus 3 mm CTV (clinical target volume) to PTV (planning target volume) margins.…”

Section: Introductionmentioning

confidence: 99%

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Impact of hypofractionated schemes in radiotherapy for locally advanced head and neck cancer patients

et al. 2019

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Objective To analyze two cohorts of locally advanced head and neck cancer (LAHNC) patients treated with two schedules of hypofractionated radiotherapy and 5 versus 3 mm clinical target volume–planning target volume (CTV‐PTV) margins. Methods 145 patients were included. The patient cohort was divided into two groups. Group A included 97 patients treated with 69.96/54.45 grays (Gy) to the high‐risk and low‐risk volumes, respectively, in 33 fractions, with 5 mm margins. Group B included 48 patients treated with 66/54 Gy in 30 fractions using 3 mm margins. Toxicity was recorded according to the Common Toxicity Criteria version 3. Patient outcomes for locoregional control (LRC), disease‐free survival (DFS), and overall survival (OS) were determined. Results Median follow‐up was 26 months. In terms of toxicity, acute dysphagia worsened significantly (P = 0.003) in group B, whereas acute salivary toxicity tended to significance (P = 0.071). No significant late toxicity differences were recorded. Rates of LRC at 1 and 2 years were 90.1% ± 2.6% and 84.2% ± 3.4%, respectively, with superiority for group A (P = 0.045). The statistical significance remained for the low‐dose level (P = 0.007) but not for high dose (P = 0.110). Rates of DFS at 1 and 2 years were 84.9% ± 3.1% and 76.5% ± 3.9%, respectively, whereas rates of OS were 95.9% ± 1.8% and 91.6% ± 2.7%, respectively. No differences were observed between the two groups in terms of DFS (P = 0.270) and OS (P = 0.152). Conclusion The use of reduced CTV to PTV margins and dose reduction with hypofractionation schedule can improve the pattern of toxicity in LAHNC patients. This approach resulted in an increased rate of locoregional progression, particularly in low‐risk regions. Level of Evidence 4 Laryngoscope, 130:E163–E170, 2020

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Section: Introductionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Impact of hypofractionated schemes in radiotherapy for locally advanced head and neck cancer patients

et al. 2019

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“…Patients with locally-advanced diseases, unresectable tumors, or patients at high risk, post-operation, are often treated with RT [ 9 ]. The concurrent administration of chemotherapy during the RT course has been reported to significantly improve overall, disease-specific, and disease-free survival rates [ 10 , 11 ]. Although the toxicity of combination modality therapy remains higher than that of chemotherapy, RT alone can also lead to significant oral complications and profoundly influence patients’ quality of life [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Differential Pharmacological Activities of Oxygen Numbers on the Sulfoxide Moiety of Wasabi Compound 6-(Methylsulfinyl) Hexyl Isothiocyanate in Human Oral Cancer Cells

Lee¹,

Tseng

Lai

et al. 2018

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6-(methylsulfinyl) hexyl isothiocyanate (6-MITC) is a naturally occurring compound isolated from Wasabia japonica (wasabi). The synthetic derivatives, 6-(methylsulfenyl) hexyl isothiocyanate (I7447) and 6-(methylsulfonyl) hexyl isothiocyanate (I7557), were derived from 6-MITC with the deletion and addition of oxygen, respectively. We aimed to evaluate the effect of these synthetic compounds on human oral cancer cells, SAS and OECM-1. All three compounds (I7447, 6-MITC, and I7557) inhibited the viability of SAS and OECM-1 cells using MTT assay. Morphological observations showed various proportions of mitotic arrest and apoptosis in cells treated with these compounds. Cell cycle analysis revealed relatively abundant G2/M arrest in 6-MITC and I7557-treated cells, whereas sub-G1 accumulation was found in I7447-treated cells. In using phosphorylated histone H3 as a marker for mitosis, the addition of 6-MITC and I7557 (excluding I7447) could be shown to arrest cells during mitosis. In contrast, I7447 induced more prominent apoptosis than the 6-MITC or I7557 compounds. The down-regulated expression of the phosphorylated form of CHK1 and Cdc25c was noted in 6-MITC and I7557-treated cells. I7557 could sensitize SAS cells to death by radiation. The wasabi compound, 6-MITC, and its chemical derivatives with different numbers of oxygen may have differential pharmacological effects on human oral cancer cells.

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“…As a radioenhancer, cetuximab provides survival benefit when combined with radiation, 35 and was once thought to have comparable but not increasing toxicities. 12 Although no infusion-associated death was reported in our patients, approximately half of them experienced SAEs with mostly dermatological-or mucosal-associated complications.…”

Section: Discussionmentioning

confidence: 99%

Sequential therapy of neoadjuvant biochemotherapy with cetuximab, paclitaxel, and cisplatin followed by cetuximab‐based concurrent bioradiotherapy in high‐risk locally advanced oral squamous cell carcinoma: Final analysis of a phase 2 clinical trial

et al. 2019

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Background The prognosis of advanced oral squamous cell carcinoma is poor. We investigated the effect of cetuximab‐based sequential therapy as a primary treatment. Methods Forty‐seven treatment‐naive patients with advanced tumors originating from the oral cavity or oropharynx were enrolled. Neoadjuvant cetuximab, paclitaxel, and cisplatin were administered, followed by cetuximab‐based radiotherapy. Immunohistochemical staining was applied to study the tissues. Results The best overall response rate was 70.2%, including 4 patients with a complete response and 29 with a partial response. The median progression‐free and overall survival rates were 10.3 and 15.2 months, respectively. Patients with more than 50% tumor reduction with neoadjuvant therapy had better survival outcomes. Twenty‐two patients had severe adverse events with mostly dermatological complications. Of the 16 patients who received operations, 9 had increased PD‐L1 staining compared to pretreatment biopsy in the post hoc study. Conclusion The regimen was effective in selected patients. Increased PD‐L1 suggested altered tumor features.

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Locally advanced squamous cell carcinoma of the head and neck: A systematic review and Bayesian network meta-analysis of the currently available treatment options

Cited by 50 publications

References 59 publications

Impact of hypofractionated schemes in radiotherapy for locally advanced head and neck cancer patients

Impact of hypofractionated schemes in radiotherapy for locally advanced head and neck cancer patients

Differential Pharmacological Activities of Oxygen Numbers on the Sulfoxide Moiety of Wasabi Compound 6-(Methylsulfinyl) Hexyl Isothiocyanate in Human Oral Cancer Cells

Sequential therapy of neoadjuvant biochemotherapy with cetuximab, paclitaxel, and cisplatin followed by cetuximab‐based concurrent bioradiotherapy in high‐risk locally advanced oral squamous cell carcinoma: Final analysis of a phase 2 clinical trial

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