State of Rehabilitation Research in the Head and Neck Cancer Population: Functional Impact vs. Impairment-Focused Outcomes

Parke, Sara; Langelier, David; Cheng, Jessica Tse; Kline‐Quiroz, Cristina; Stubblefield, Michael D.

doi:10.1007/s11912-022-01227-x

Cited by 19 publications

(25 citation statements)

References 207 publications

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“…Like radiation brosis syndrome (RFS), lymphedema is a progressive process associated with protein deposition, brosis and sclerosis. 5,8,24 Unlike RFS, the protein deposition and brosis resulting from lymphedema may be mitigated, at least to some degree, by effective lymphedema therapies such as MLD, compression and APCD utilization. [25][26][27][28][29] This raises the possibility that not identifying and addressing HNL may contribute to progression of brosis-related issues by superimposing lymphedema-related brosis on top of radiation-related brosis.…”

Section: Discussionmentioning

confidence: 99%

“…3 Improved treatment outcomes coupled with this changing epidemiology will result in many more HNC survivors destined to live their lives, often from a relatively young age, with the late effects of HNC and its treatment. 4,5 Lymphedema is characterized by several pathophysiological events, including lymph stasis, lymphatic vessel remodeling and dysfunction, in ammation, adipose tissue deposition, and ultimately brosis. 6 Head and neck lymphedema (HNL), a common complication of HNC, results from treatments such as neck dissection and/or radiation.…”

Section: Introductionmentioning

confidence: 99%

“…5,8,14,16−19 Progression of HNL and brosis is associated with increasing symptom burden, functional impairment, and reduced quality of life. 5,17 There is growing evidence in the breast cancer literature that early recognition and effective treatment of breast cancer-related lymphedema improves outcomes. 20,21 Though less robust, evidence also suggests that the early identi cation and effective treatment of HNL may improve functional outcomes including dyspnea, pain, and dysphagia in HNC survivors.…”

Section: Introductionmentioning

confidence: 99%

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Under recognition and treatment of lymphedema in head and neck cancer survivors – a database study

Stubblefield

Weycker

2023

Support Care Cancer

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Purpose: Head and neck cancer (HNC) will be diagnosed in approximately 54,000 Americans in 2022 with more than 11,000 dying as a result. The treatment of HNC often involves aggressive multimodal therapy including surgery, radiotherapy, and systemic therapy. HNC and its treatments are associated with multiple painful and function-limiting neuromusculoskeletal and visceral long-term and late effects. Among these is head and neck lymphedema (HNL), the abnormal accumulation of protein rich uid, in as many as 90% of survivors. Though HNL is common and potentially contributory to other function-limiting issues in this population, it is notoriously understudied, underrecognized, underdiagnosed, and undertreated. This study seeks to determine the incidence of HNC-related lymphedema diagnosis and treatment in a large US healthcare claims repository database. Methods: A retrospective observational cohort design and data from an integrated US healthcare claims repository-the IBM MarketScan Commercial Claims and Encounters (CCAE) and Medicare Supplemental and Coordination of Bene ts (MDCR) Databases spanning the period April 1, 2012 through March 31, 2020.Results: Of the 16,654 HNC patients eligible for evaluation, 1,082 (6.5%) with a diagnosis of lymphedema were identi ed based on eligibility criteria. Of the 521 HNC patients evaluated for lymphedema treatment, 417 (80.0%) patients received 1.5 courses of MLD, 71 (13.6%) patients were prescribed compression garments, and 45 (8.6%) patients received an advanced pneumatic compression device. Conclusion: HNL in this population of HNC survivors was underdiagnosed and treated compared with contemporary assessments HNL incidence.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Under recognition and treatment of lymphedema in head and neck cancer survivors – a database study

Stubblefield

Weycker

2023

Support Care Cancer

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“…Additionally, a significant number of survivors also had cardiovascular (70%), pulmonary (44%), endocrine (63%), gastrointestinal (29%), and other visceral late effects. A recent review of the functional issues facing HNC survivors addresses dysphagia, xerostomia, dysgeusia, dysosmia, odynophagia, trismus, first bite syndrome, dysarthria, dysphonia, lymphedema, shoulder syndrome, cervicalgia, cervical dystonia and dropped head syndrome, deconditioning, and fatigue [ 4 •]. A more medically focused review listed loss of saliva, osteoradionecrosis, radiation recall myositis, pharyngoesophageal stenosis, dental caries, oral cavity necrosis, fibrosis, impaired wound healing, skin changes and skin cancer, lymphedema, hypothyroidism, hyperparathyroidism, lightheadedness, dizziness and headaches, secondary cancer, and eye, ear, neurological, and neck structure damage as late effects [ 5 ].…”

Section: Clinical Complexitymentioning

confidence: 99%

Embracing Complexity—the Role of Cancer Rehabilitation in Restoring and Maintaining Function and Quality of Life in Cancer Survivors with Radiation Fibrosis Syndrome

Stubblefield

Tortorella

Alfano

2023

Curr Phys Med Rehabil Rep

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Purpose of Review Despite more than 6 decades of growth and transformation, the field of cancer rehabilitation has considerable room to evolve if it is to live up to its full potential. This article will discuss the importance of this evolution in the context of radiation late effects and serve as a call for the clinical and operational expansion of the field so that it can become a key component of comprehensive cancer care. Recent Findings The clinical and operational challenges inherent in cancer survivors with radiation late effects necessitate different thinking with respect to how rehabilitation professionals evaluate and manage patients as well as how our institutions equip these professionals to practice at the highest possible level. Summary To achieve its promise, the field of cancer rehabilitation must evolve to embrace fully the scope, scale, and complexity of issues faced by cancer survivors with radiation late effects. Better engagement and coordination of the care team are needed to deliver this care and ensure our programs are robust, sustainable, and flexible.

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“…Despite improvements in imaging technologies, surgical methods, radiation treatment, and chemotherapy, there has been no significant improvement in the 5-year survival rate of OSCC patients ( Kumar et al, 2016 ; Zanoni et al, 2019 ). Worse still, many OSCC patients still battle with the terrible side effects even after receiving treatment, including depression, nutritional deficiencies and damage of the patient’s appearance and ability to complete daily activities ( Parke et al, 2022 ). Currently, histological characteristics are the basis for vast majority of the clinical prediction signatures.…”

Section: Introductionmentioning

confidence: 99%

Multi-omics analysis reveals prognostic and therapeutic value of cuproptosis-related lncRNAs in oral squamous cell carcinoma

Zhou

Zhu

et al. 2022

Front. Genet.

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Background: Extensive research revealed copper and lncRNA can regulate tumor progression. Additionally, cuproptosis has been proven can cause cell death that may affect the development of tumor. However, there is little research focused on the potential prognostic and therapeutic role of cuproptosis-related lncRNA in OSCC patients.Methods: Data used were for bioinformatics analyses were downloaded from both the TCGA database and GEO database. The R software were used for statistical analysis. Mapping was done using the tool of FigureYa.Results: The signature consist of 7 cuproptosis-related lncRNA was identified through lasso and Cox regression analysis and a nomogram was developed. In addition, we performed genomic analyses including pathway enrichment analysis and mutation analysis between two groups. It was found that OSCC patients were prone to TP53, TTN, FAT1 and NOTCH1 mutations and a difference of mutation analysis between the two groups was significant. Results of TIDE analysis indicating that patients in low risk group were more susceptible to immunotherapy. Accordingly, results of subclass mapping analysis confirmed our findings, which revealed that patients with low riskscore were more likely to respond to immunotherapy.Conclusion: We have successfully identified and validated a novel prognostic signature with a strong independent predictive capacity. And we have found that patients with low riskscore were more susceptible to immunotherapy, especially PD-1 inhibitor therapy.

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State of Rehabilitation Research in the Head and Neck Cancer Population: Functional Impact vs. Impairment-Focused Outcomes

Cited by 19 publications

References 207 publications

Under recognition and treatment of lymphedema in head and neck cancer survivors – a database study

Under recognition and treatment of lymphedema in head and neck cancer survivors – a database study

Embracing Complexity—the Role of Cancer Rehabilitation in Restoring and Maintaining Function and Quality of Life in Cancer Survivors with Radiation Fibrosis Syndrome

Multi-omics analysis reveals prognostic and therapeutic value of cuproptosis-related lncRNAs in oral squamous cell carcinoma

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