The Expanding Role of Systemic Therapy in Head and Neck Cancer

2004 ◽  
Vol 22 (9) ◽  
pp. 1743-1752 ◽  
Author(s):  
Ezra E.W. Cohen ◽  
Mark W. Lingen ◽  
Everett E. Vokes
Keyword(s):  
Quality Of Life ◽  
Squamous Cell Carcinoma ◽  
Head And Neck ◽  
Randomized Trials ◽  
Locally Advanced ◽  
Standards Of Care ◽  
Current Therapy ◽  
Future Research

Treatment of squamous cell carcinoma of the head and neck (SCCHN) has evolved greatly in the last two decades, owing to the integration of chemotherapy, advances in radiotherapeutic techniques, and organ-preserving surgery. Several randomized trials have established new standards of care that should be adopted. Current efforts are building on these earlier trials in order to improve survival and quality of life. Coincident with this, investigators are developing molecularly targeted approaches that hold promise for the future. This review will focus on current therapy for locally advanced, recurrent, and metastatic SCCHN and discuss controversies and directions for future research.

scholarly journals RETROSPECTIVE ANALYSIS OF NIMOTUZUMAB VS CHEMOTHERAPY IN LOCALLY ADVANCED HEAD AND NECK SQUAMOUS CELL CARCINOMA PATIENTS RECEIVING CONCURRENT RADIOTHERAPY

2021 ◽  
Vol 5 (6) ◽  
Author(s):  
Rakesh Sharma ◽  
Suresh Attili ◽  
Mallik Singaraju ◽  
Dattatreya Palanki
Keyword(s):  
Quality Of Life ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Locally Advanced ◽  
Neck Squamous Cell Carcinoma ◽  
Retrospective Data ◽  
Standard Format

Background: In advanced malignancies, it is important to ensure that the quality of life is not comprised, when treating the disease. Therfore there is immense need for the data on the QOL parameters for the newer agents/indications. In view of the paucity of data for the Nimotuzumab, we thought of conducting a retrospective data analysis in patients with head and neck squamous cell carcinoma Methods: This is a multi institutional, two arm retrospective data collection exercise done in subjects with head and neck cancer stage III or less receiving radical radiotherapy(IMRT) with either nimotuzumab or chemotherapy (weekly cisplatin) between 2015-2018 with three years follow up.  Standard format for the QOL (a part of dissertation thesis by PG) was used for analysis along with demographics and outcome in terms of clinical data and survival. Results: During the study period a total of 84 subjects were meeting the criteria for the study and the case records were retrived with 1:1 case/control (matched population) for stage, age and other variables. Response rate was higher in the Nimotuzumab arm (86% versus 81%; P=NS).. No differences were observed in median progression-free survival and overall survival. Nimotuzimab had better TWIST score of 653+238vs 508+173 (Mean+ SD) days and better overall QOL score improvement 4.6+1.5 vs 3.1+1.3 points(Mean+ SD)compared to the cisplatin arm Conclusions: The results indicate that, though more expensive, the Nimotuzumab scores over the conventional cisplatin (weekly) in terms of better response rates, Quality of life TWIST score and ease of administration. However retrospective nature of the data nd the subject selection bias remain a major challenge for this study, which can be addressed in future prospective trials. Keywords: concurrent, nimotuzumab, chemotherapy , head and neck caners

scholarly journals Proton therapy for non-squamous cell carcinoma of the head and neck: planning comparison and toxicity

2019 ◽  
Vol 60 (5) ◽  
pp. 612-621 ◽  
Author(s):  
Hiromitsu Iwata ◽  
Toshiyuki Toshito ◽  
Kensuke Hayashi ◽  
Maho Yamada ◽  
Chihiro Omachi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Proton Therapy ◽  
Patient Specific ◽  
Dose Distributions

Abstract To investigate optimal treatment planning using proton beams for non-squamous cell carcinoma of the head and neck (NSCHN), the dose distributions of plans involving pencil beam scanning (PBS) with or without a patient-specific aperture system (PSAS), passive-scattering proton therapy (PSPT) and X-ray intensity-modulated radiotherapy (IMRT) were compared. As clinical results, toxicities of PBS with PSAS, including changes in quality of life, were reported. Between April 2014 and August 2016, a total of 30 patients were treated using PBS with PSAS. In 20 patients selected at random, the dose distributions of PBS with or without the PSAS, PSPT and IMRT plans were compared. Neutron exposure by proton therapy was calculated using a Monte Carlo simulation. Toxicities were scored according to CTCAE ver. 4.0. Patients completed EORTC quality of life survey forms (QLQ-C30 and QLQ-HN35) before and 0–12 months after proton therapy. The 95% conformity number of PBS with the PSAS plan was the best, and significant differences were detected among the four plans (P < 0.05, Bonferroni tests). Neutron generation by PSAS was ~1.1-fold higher, but was within an acceptable level. No grade 3 or higher acute dermatitis was observed. Pain, appetite loss and increased weight loss were more likely at the end of treatment, but recovered by the 3 month follow-up and returned to the pretreatment level at the 12 month follow-up. PBS with PSAS reduced the penumbra and improved dose conformity in the planning target volume. PBS with PSAS was tolerated well for NSCHN.

scholarly journals Quality of Life With Pembrolizumab for Recurrent and/or Metastatic Head and Neck Squamous Cell Carcinoma: KEYNOTE-040

2020 ◽  
Author(s):  
Kevin J Harrington ◽  
Denis Soulières ◽  
Christophe Le Tourneau ◽  
Jose Dinis ◽  
Lisa F Licitra ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Standard Of Care ◽  
Neck Squamous Cell Carcinoma ◽  
Related Quality ◽  
Health Related

Abstract Background Head and neck squamous cell carcinoma (HNSCC) affects health-related quality of life (HRQoL); few treatments have demonstrated clinically meaningful HRQoL benefit. KEYNOTE-040 evaluated pembrolizumab vs standard of care (SOC) in patients with recurrent and/or metastatic HNSCC whose disease recurred or progressed after platinum-containing regimen. Methods Patients received pembrolizumab 200 mg or SOC (methotrexate, docetaxel, or cetuximab). Exploratory HRQoL analyses used European Organisation for Research and Treatment of Cancer (EORTC) 30 quality-of-life, EORTC 35-question quality-of-life head and neck cancer-specific module, and EuroQoL 5-dimensions questionnaires. Results The HRQoL population comprised 469 patients (pembrolizumab = 241, SOC = 228). HRQoL compliance for patients in the study at week 15 was 75.3% (116 of 154) for pembrolizumab and 74.6% (85 of 114) for SOC. The median time to deterioration in global health status (GHS) and QoL scores were 4.8 months with pembrolizumab and 2.8 months with SOC (hazard ratio = 0.79, 95% confidence interval [CI] = 0.59 to 1.05). At week 15, GHS / QoL scores were stable for pembrolizumab (least squares mean [LSM] = 0.39, 95% CI = –3.00 to 3.78) but worsened for SOC (LSM = −5.86, 95% CI = −9.68 to −2.04); the LSM between-group difference was 6.25 points (95% CI = 1.32 to 11.18; nominal 2-sided P = .01). A greater difference in the LSM for GHS / QoL score occurred with pembrolizumab vs docetaxel (10.23, 95% CI = 3.15 to 17.30) compared with pembrolizumab vs methotrexate (6.21, 95% CI = −4.57 to 16.99) or pembrolizumab vs cetuximab (−1.44, 95% CI = −11.43 to 8.56). Pembrolizumab-treated patients had stable functioning and symptoms at week 15, with no notable differences from SOC. Conclusions GHS / QoL scores were stable with pembrolizumab but declined with SOC in patients at week 15, supporting the clinically meaningful benefit of pembrolizumab in recurrent and/or metastatic HNSCC.

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