Proliferative capacity in head and neck cancer

Struikmans, H.; Kal, Henk B.; Hordijk, G. J.; Tweel, Ingeborg van der

doi:10.1002/hed.1064

Cited by 10 publications

(5 citation statements)

References 40 publications

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“…The main cause of failure of locally advanced HNC surgery is local recurrence caused by regrowth of tumor cell residues [14]. Radiotherapy has become an important nonsurgical treatment for different stages of HNC, especially advanced lesions that usually recur in local areas [24]. Most clinical practices also suggest that the main cause of failure by CFRT for malignant tumors is local recurrence.…”

Section: Discussionmentioning

confidence: 99%

Accelerated Hyperfractionated Radiotherapy versus Conventional Fractionation Radiotherapy for Head and Neck Cancer: A Meta-Analysis of Randomized Controlled Trials

Zhu

Kou

Bai

et al. 2019

Journal of Oncology

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Objective The benefits of accelerated hyperfractionated radiotherapy (HART) and conventional fractionation radiotherapy (CFRT) in the treatment of head and neck cancer (HNC) remain controversial. In this study, we analyzed the therapeutic effects of these two treatment regimens to explore whether HART can improve the overall survival (OS) rate and locoregional control (LRC) rate in patients with HNC. Methods The PubMed, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched for eligible studies. The OS rate and LRC rate were considered as the efficacy outcomes. I2 was used to test the heterogeneity among studies with a cutoff value of 50%. Potential publication bias was assessed by funnel plots and Egger's test. We also performed a sensitivity analysis to assess the stability of the results. In this meta-analysis, all analyses were performed using R 3.5.3 software. Results Twelve qualified articles including a total of 2,935 patients were identified. HART had a significant beneficial effect on OS rate (HR = 0.80, 95% CI: 0.65–0.98). Compared with CFRT, HART demonstrated a significantly higher LRC rate (HR = 0.82, 95% CI: 0.71–0.96). Conclusion Our meta-analysis showed that HART can significantly improve OS and LRC compared with CFRT in patients with HNC.

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Section: Discussionmentioning

confidence: 99%

Accelerated Hyperfractionated Radiotherapy versus Conventional Fractionation Radiotherapy for Head and Neck Cancer: A Meta-Analysis of Randomized Controlled Trials

Zhu

Kou

Bai

et al. 2019

Journal of Oncology

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“…Presently, the majority of clinical practices have suggested that the failure of malignant tumor treatment by CF RT is primarily due to local recurrence. Furthermore, Struikmans et al40 have also shown that the accelerated proliferation of living tumor stem cells during RT is a primary cause for failures in the treatment of squamous cell carcinoma of the digestive and upper respiratory tracts. Therefore, inhibition of the accelerated repopulation of the tumor stem cells is a key factor in improving the survival and local control rates.…”

Section: Discussionmentioning

confidence: 99%

Accelerated or hyperfractionated radiotherapy for esophageal carcinoma: a meta-analysis of randomized controlled trials

Liu

Kou

et al. 2017

OTT

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Objective The goal of this study was to evaluate the efficacy and safety of modified (accelerated and/or hyperfractionated) radiotherapy in the treatment of esophageal carcinoma, compared with conventional radiotherapy. Methods Studies published in the PubMed, Cochrane Library, EMBASE, CBM, VIP, CNKI and Wanfang databases in the most recent two decades were searched for use in this meta-analysis. Only randomized controlled trials were included. The heterogeneity analysis and calculation of the pooled odds ratio (OR) were performed using RevMan 5.3 software. The assessment of publication bias and sensitivity analyses was conducted using Stata 13.0 software. Results Twenty trials with a total of 1,742 Chinese patients who met the inclusion criteria were included. The pooled results showed that modified radiotherapy improved the response rate compared with conventional schedules (OR =3.90, 95% confidence interval [CI]: 2.47–6.16, P <0.001). Favorable results were observed for the 1-year (OR =2.58, 95% CI: 2.05–3.26, P <0.001), 3-year (OR =2.30, 95% CI: 1.83–2.89, P <0.001) and 5-year (OR =2.36, 95% CI: 1.74–3.21, P <0.001) overall survival and for the 1-year (OR =2.46, 95% CI: 1.72–3.51, P <0.001), 3-year (OR =2.08, 95% CI: 1.49–2.90, P <0.001) and 5-year (OR =2.15, 95% CI: 1.38–3.34, P <0.001) overall local control rate in the modified fractionation radiotherapy group. However, the altered radiotherapy increased the risk of acute radiation esophagitis (OR =1.70, 95% CI: 1.27–2.28, P <0.001) and acute radiation tracheitis (OR =1.47, 95% CI: 1.09–1.99, P =0.01). No significant differences in the risk of esophageal perforation (OR =1.30, 95% CI: 0.51–3.32, P =0.58) or esophagorrhagia (OR =0.88, 95% CI: 0.41–1.88, P =0.74) were found between the two groups. Conclusion Chinese patients with squamous cell esophagus carcinomas gained a significant benefit in terms of the response rate, survival and local control rates from the modified fractionation radiotherapy, but also had an increased risk of acute radiation reactions. Otherwise, there was no observed statistically significant difference in terms of early adverse reactions.

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“…In clinical practice, local recurrence is the important cause of treatment failure of esophageal squamous cell carcinoma. Research has suggested that accelerated repopulation of the tumor during radiotherapy is one of the major reasons for treatment failure in squamous cell carcinoma of the upper respiratory and digestive tracts 22 . In order to improve the local control and survival, one goal of treatment is to limit the extent of esophageal carcinoma cell regeneration that occurs during RT.…”

Section: Discussionmentioning

confidence: 99%

“…Research has suggested that accelerated repopulation of the tumor during radiotherapy is one of the major reasons for treatment failure in squamous cell carcinoma of the upper respiratory and digestive tracts. 22 In order to improve the local control and survival, one goal of treatment is to limit the extent of esophageal carcinoma cell regeneration that occurs during RT. Reports show that accelerated repopulation usually begins 3-5 weeks after the start of RT.…”

Section: Discussionmentioning

confidence: 99%

Long-term outcomes of late course accelerated hyper-fractionated radiotherapy for localized esophageal carcinoma in Mainland China: a meta-analysis

Zhang

Chen

Bai

et al. 2011

Diseases of the Esophagus

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Published data on the long-term survival results of patients with localized esophageal carcinoma receiving late course accelerated hyper-fractionated radiotherapy (LCAF RT) versus conventional fractionated radiotherapy (CF RT) are inconclusive. In order to derive a more precise estimation of the both treatment-regimes, a meta-analysis based on systematic review of published articles was performed. A meta-analysis was performed using trials identified through Pubmed and Chinese national knowledge infrastructure. Results in 5-year survival and 5-year local control were collected from randomized trials comparing LCAF RT with CF RT. Review Manager (The Cochrane Collaboration, Oxford, England) and Stata software (Stata Corporation, College Station, TX, USA) were used for data management. A total of 11 trials were involved in this analysis with 572 cases and 567 controls. Our results showed that LCAF RT, compared with CF RT, significantly improved the 5-year survival (odds ratio [OR]= 2.93, 95% confidence interval [CI]: 2.15-4.00, P < 0.00001) and 5-year local control (OR = 3.96, 95% CI: 2.91-5.38, P < 0.00001). LCAF RT was more therapeutically beneficial than CF RT in the localized esophageal carcinoma.

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Proliferative capacity in head and neck cancer

Abstract: (1) In general, no significant differences in proliferation parameters were observed with respect to site of origin. (2) Aneuploid head and neck tumors have a higher proliferative capacity than diploid ones, they might benefit most from accelerated irradiation.

Cited by 10 publications

References 40 publications

Accelerated Hyperfractionated Radiotherapy versus Conventional Fractionation Radiotherapy for Head and Neck Cancer: A Meta-Analysis of Randomized Controlled Trials

Accelerated Hyperfractionated Radiotherapy versus Conventional Fractionation Radiotherapy for Head and Neck Cancer: A Meta-Analysis of Randomized Controlled Trials

Accelerated or hyperfractionated radiotherapy for esophageal carcinoma: a meta-analysis of randomized controlled trials

Long-term outcomes of late course accelerated hyper-fractionated radiotherapy for localized esophageal carcinoma in Mainland China: a meta-analysis

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