scholarly journals Checkpoint Inhibitor Immunotherapy for Head and Neck Cancer: Incorporating Care Step Pathways for Effective Side-Effect Management

Author(s):  
Casey Fazer, PA-C
2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 6594-6594 ◽  
Author(s):  
Shrujal S. Baxi ◽  
Eric Jeffrey Sherman ◽  
Coral L Atoria ◽  
Nancy Y. Lee ◽  
David G. Pfister ◽  
...  

6594 Background: The benefit of chemoradiation (CTRT) in the treatment of locally advanced head and neck cancer (LAHNC) declines in older and sicker patients. In 2006, the FDA approved cetuximab in LAHNC. Cetuximab with radiation has a perceived lower side effect profile compared to standard chemotherapies used in CTRT. Our objective was to examine the impact of cetuximab on the use of CTRT in elderly patients with LAHNC. Methods: We identified adults aged 66 and older diagnosed with LAHNC between 1999 and 2007 in the Surveillance Epidemiology and End Results (SEER)-Medicare linked database. Treatment was categorized as CTRT or other based on Medicare claims within 6 months of diagnosis. We excluded patients who did not receive definitive treatment. In patients who had CTRT, we identified use of cetuximab based on drug-specific billing codes. We assessed trends in the use of CTRT over the entire study period and in the use of cetuximab since 2006. We examined the influence of age and comorbidity on the likelihood of receiving CTRT before and after 2006 adjusting for clinical and demographic factors. Results: We identified 4,809 patients with LAHNC. One-fourth were ≥80 years and almost a fifth had a Charlson comorbidity score (CCS) of ≥2. Overall more than 20% of patients received CTRT. The use of CTRT more than tripled over time, from 10% of patients diagnosed in 1999 to 38% in 2007 (p<0.0001 for trend). Of the 336 patients who had CTRT since 2006, 45% received cetuximab. Prior to 2006, patients ≥80 years or those with a CCS of ≥2 were significantly less likely to be treated with CTRT compared to younger patients or those with a CCS of 0. In patients diagnosed in 2006 or later, age and comorbidity no longer predicted the likelihood of receiving CTRT. Conclusions: In this population-based cohort of older adults, the use of CTRT increased substantially over time. The availability of cetuximab, with a perceived gentler side effect profile, may have increased the use of CTRT, especially in older and sicker patients. [Table: see text]


2021 ◽  
Vol 11 (7) ◽  
pp. 281-289
Author(s):  
Ujjwala Murkute ◽  
Shaikh Nida Nausheen

Objectives: - To evaluate the effectiveness of informational booklet regarding side effects management in patient undergoing external radiation therapy. Methods: Quasi experimental pre test post test design was used in the study at radiation therapy department in cancer institute. 35 patients of head and neck cancer undergoing external radiation therapy received information booklet regarding side effect management of external radiation therapy in their first week of treatment. Knowledge regarding side effect management of external radiation therapy was assessed one week later. Results: - In pre test there was 51.1% patients with poor knowledge, 48.6% had average knowledge and no one had good knowledge whereas the post test scores are increased by 85.7% with good knowledge, 14.3% had average knowledge and no one had poor knowledge. There is significant difference of knowledge score between pre and post test as P<0.0001 i.e. knowledge score significantly increased after administering information booklet. Sociodemographic variable age, gender, educational status, family income & type of treatment were found to have no association with knowledge score regarding management of side effects. Conclusion: - Radiation therapy is one of the important treatments for cancer but can also cause side effects. These Side effects of radiation therapy are very common and can affect the quality of life of the cancer patients. There was significant impact of information booklet on knowledge regarding side effects management of radiation therapy among head and neck cancer patients. Hence using information booklet as an education material can be helpful in teaching patients self care behaviours, prevent the side effects of radiation therapy and improve the quality of life. Key words: Information booklet, external radiation therapy, head and neck cancer, side effect management.


At JADPRO Live Virtual 2020, Casey Fazer-Posorske, PA-C, provided updates in the management of patients with head and neck cancer, including the types of head and neck cancers, their associated treatments and side-effect management, the role of de-escalation treatment, and the prevalence of HPV infection and role of vaccination in the prevention of head and neck cancer.


2017 ◽  
Vol 25 (11) ◽  
pp. 2440-2451 ◽  
Author(s):  
Amanda Rosewell Shaw ◽  
Caroline E. Porter ◽  
Norihiro Watanabe ◽  
Kiyonori Tanoue ◽  
Andrew Sikora ◽  
...  

2018 ◽  
Vol 8 (2) ◽  
pp. 30-33
Author(s):  
Shajedul Islam ◽  
Md Shahed Rafi Pavel ◽  
Syed Taufiqul Islam ◽  
Nazmus Shalehin ◽  
Shahed Jahan Babu

Head and neck cancer (HNC) is a common malignant tumor, carrying a poor prognosis, and despite advances in oncology, this rate has not improved significantly for decades. It has recently been evaluated that the immunologic checkpoint inhibitors become a novel promising strategic immunotherapy in the treatment of metastatic cancer. Therefore, our current review article will discuss the biological role and impact of the immune checkpoint inhibitor in HNC. Update Dent. Coll. j: 2018; 8 (2): 30-33


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