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‘Paradoxical’ data show routine imaging lacks benefit for head and neck cancer survivors

Source: www.healio.com Author: Matthew Shinkle Key takeaways: Researchers saw no statistical difference between patient groups with respect to treatment outcomes. Larger studies are needed to further evaluate this study’s findings. Compared with expectant management, imaging-based surveillance did not improve outcomes among patients in remission after completion of primary radiation therapy for head and neck cancer, according to data published in JAMA Network Open. Although imaging “in the context of clinical suspicion” for this specific patient population is common and typically beneficial, according to researchers, the results of this study show that such a practice is not valuable for asymptomatic patients. “The results of the present study, while seemingly paradoxical, are consistent with those of others which have failed to demonstrate a benefit to surveillance imaging among patients who have successfully completed treatment for head and neck cancer,” Allen M. Chen, MD, MBA, professor and chair of the department of radiation oncology at University of California, Irvine, Chao Family Comprehensive Cancer Center, and researchers wrote. Researchers conducted a retrospective, comparative effectiveness review to evaluate the potential benefit of surveillance imaging among asymptomatic patients with head and neck cancer currently in remission following completion of chemoradiation. The study included 340 adults (59% men; 43% white) who had achieved a complete metabolic response to initial treatment for newly diagnosed squamous cell carcinoma of the head and neck between January 2014 and June 2022. Researchers defined surveillance imaging as the acquisition of a PET with CT, MRI or CT of the head and neck [...]

CERN detector could help treat brain tumors with greater precision

Source: www.inceptivemind.com Author: Ashwini Sakharkar Mária Martišíková (left), the project leader from Heidelberg University Hospital and German Cancer Research Center (DKFZ), and DKFZ researcher Laurent Kelleter. Credit: Heidelberg University Hospital / H.Schroeder Scientists are testing a new device that will help them more accurately target cancer cells during ion radiotherapy for head and neck tumors. Scientists from the German National Center for Tumor Diseases (NCT), the German Cancer Research Center (DKFZ), and the Heidelberg Ion Beam Therapy Center (HIT) at Heidelberg University Hospital are currently testing the imaging device on their first patients. The device includes a small Timepix3 pixel detector developed at CERN, which allows head and neck tumors to be closely monitored during ion radiotherapy, making them easier to target and thus helping limit the treatment’s side effects. “One of the most advanced methods for treating head and neck tumors involves irradiation with ion beams. This has one unique feature: it can be precisely tailored to the depth inside the human head where the particles should have the maximal effect”, explains Mária Martišíková, the head of the DKFZ team. Like other forms of irradiation, ion radiation can have drawbacks. While it can be effective in targeting tumors, it can also affect healthy tissue surrounding the tumor. In the case of brain tumors, this can be particularly challenging, as damage to the optic nerve or a patient’s memory is possible. Ideally, the irradiated area around the tumor should be minimized while maximizing the dose to the tumor. [...]

Rhod Gilbert: Doctor reveals how ‘brutal’ therapy tackled comedian’s cancer

Source: www.bbc.com Author: Natalie Grice, BBC News Prof Mererid Evans says Rhod Gilbert "wanted something positive to come out of his experience" "A patient once described it to me as brutal, and it's really stuck with me, because it's difficult to go through." What's so brutal? It's the cancer treatment Prof Mererid Evans routinely prescribes to the people who come to her, hoping she will save their lives, and which she aims to improve with research she is leading. It was the same word used by Welsh comedian Rhod Gilbert when in 2022 he found himself sitting in front of the consultant oncologist after being diagnosed with throat, neck, tongue and tonsil cancer. Rhod Gilbert was a patron of Velindre Cancer Centre for 10 years before his diagnosis Her famous patient suddenly put her consulting room at Velindre Cancer Centre, Cardiff, in the limelight when he made a documentary about his treatment. "Rhod wanted something positive to come out of his experience," said Prof Evans, 54, head and neck specialist at Velindre Cancer Centre in Cardiff, a professor at Cardiff University's cancer and genetics division, and head of the Wales Cancer Research Centre. "We talked about the treatment he'd be receiving and I think he felt it was an opportunity to highlight what it's like going through cancer treatment." The resulting Channel 4 programme, A Pain in the Neck for SU2C, followed Gilbert through diagnosis, treatment and the aftermath. Head and neck cancer is the eighth [...]

A case for radiation enhancement in head and neck cancer

Source: www.medscape.com Author: M. Alexander Otto, PA, MMS Two new exploratory studies of radioenhancers used in combination with radiation therapy in the treatment of head and neck cancers showed that these agents can boost the effectiveness of radiotherapy in these cancers. The two phase 2 studies, presented at the 2024 American Society for Radiation Oncology (ASTRO) Head and Neck Cancer Symposium on March 1, 2024, found an increase in 1-year local control rate, progression-free survival, and overall survival. In one study, which explored the use of the hedgehog pathway inhibitor vismodegib alongside radiation therapy, researchers found that all but one patient with locally advanced, unresectable basal cell carcinoma (BCC) demonstrated 1-year local control — a significantly better rate than that expected from radiation alone — and 83% were alive at 5 years. The second, which explored the use of hafnium oxide nanoparticles (NBTXR3) prior to radiation therapy, also reported promising results. Patients with T3/4 locally advanced head and neck squamous cell carcinoma of the oropharynx or oral cavity who were ineligible for chemoradiation demonstrated a median overall survival of 18.1 months vs 12 months, the life expectancy with radiation alone. Although small, both studies suggest a role for radioenhancers in head and neck cancer, Jonathan Schoenfeld, MD, a head and neck cancer radiation oncologist at the Dana Farber Cancer Institute, in Boston, Massachusetts, told Medscape Medical News.

Prognostic factors linked with poor locoregional control in tongue cancer

Source: www.cancernetwork.com Author: Gina Mauro Depth of invasion, lymphovascular space invasion, and positive glossectomy specimen margins were all found to be linked with inferior locoregional control (LRC) in patients with pT1-2N0 oral tongue squamous cell carcinoma who were treated with partial glossectomy and elective neck dissection alone. The retrospective findings, which were presented during the 2024 ASTRO Multidisciplinary Head and Neck Cancers Symposium, were seen even with final negative tumor bed margins. Results showed that, at a median follow-up of 45.6 months, the 3-year LRC and overall survival (OS) rates were 88.0% and 92.5%, respectively, in the all-comer patient population. In patients with pT1 disease, these rates were 92.0% and 95.2%, respectively; they were 85.0% and 90.5% in those with pT2 disease. However, upon the multivariate analysis, those with positive glossectomy margins had worse LRC (HR, 6.66; 95% CI, 1.60-27.78; P = .009). Lymphovascular space invasion (HR, 6.90; 95% CI, 1.42-33.65; P = .02) and depth of invasion (HR, 1.31; 95% CI, 1.06-1.63; P = .01) were also associated with inferior LRC. “Patients with these risk factors may be considered for adjuvant radiotherapy to optimize disease control,” lead study author Michael Modzelewski, MD, of Kaiser Permanente Bernard J. Tyson School of Medicine, in Pasadena, California, and coinvestigators wrote in a poster presented at the meeting. Patients who have early-stage tongue squamous cell carcinoma do not typically receive adjuvant radiation because they are often at low risk for recurrence. Following surgery, the status of main glossectomy specimen margin has been shown [...]

Novel therapy promising for radiation-induced oral mucositis

Source: www.medpagetoday.com Author: Mike Bassett, Staff Writer, MedPage Today The first-in-class uridine phosphorylase inhibitor TK-90 almost completely eliminated severe oral mucositis (SOM) in patients with non-metastatic squamous cell carcinoma of the head and neck who underwent radiation therapy, a small randomized study showed. None of the 12 patients treated with TK-90 developed SOM by the end of treatment at week 7, compared with six of 12 treated with placebo (0% vs 50%, P=0.14), reported Nabil F. Saba, MD, of the Winship Cancer Institute of Emory University in Atlanta. At week 9 follow-up after the end of dosing, just one patient treated with TK-90 had developed SOM compared with nine in the placebo group (8.3% vs 75%, P=0.003). The duration of SOM in the patient treated with TK-90 was 12 days compared with a mean duration of 35 days in patients who developed SOM in the placebo arm (P=0.026). "Parenteral administration of TK-90 appears to be an effective strategy for preventing radiation-induced mucositis," Saba said during a session at the Multidisciplinary Head and Neck Cancers Symposiumopens in a new tab or window in Phoenix. "These results merit additional validation in larger trials." Mucositis is a debilitating complication of radiotherapy or chemotherapy, leading to weight loss, mouth ulcers, abdominal pain, vomiting, diarrhea, and potentially fatal infections. "Uridine is essential to the preservation of the health of the normal mucosa," Saba explained. "By inhibiting uridine phosphorylase, uridine levels are restored in the mucosa, basically reducing the leakage in the mitochondria and, by doing [...]

Case Western Reserve University-led research team discovers new method to test for oral cancer

Source: thedaily.case.edu Author: staff Oral cancers and precancerous mouth lesions are considered especially difficult to diagnose early and accurately. For one, biopsies are expensive, invasive, stressful for the patient and can lead to complications. They’re also not feasible if repeated screenings of the same lesion are required. But a team of researchers, led by a clinician scientist at Case Western Reserve University School of Dental Medicine, has discovered a noninvasive, low-cost test to detect oral cancer, monitor precancerous lesions and determine when a biopsy is warranted. Their findings, published online March 4 in the journal Cell Reports Medicine are based on a scoring system linked to the levels of two proteins in cells brushed from suspicious oral lesions of patients at dental clinics or the ear, nose and throat department at University Hospitals (UH). One of the proteins (human beta defensin 3 or hBD-3) is expressed at high levels in early-stage oral cancer, while the second (hBD-2) is low or unchanged. The ratio of hBD-3 to hBD-2 in the lesion site—over the ratio of the two proteins on the opposite, normal site—generates a score, called the beta defensin index (BDI). A score above a predetermined threshold implies cancer; anything below does not. Determining the levels of the proteins and quantifying the BDI is done routinely in a lab. The BDI was independently validated using identical protocols at CWRU/UH, University of Cincinnati Medical Center and West Virginia University School of Dentistry. Aaron Weinberg “When we first discovered hBD-3, we saw it [...]

Exposure to secondhand smoke during chemotherapy makes treatment less effective, study finds

Source: medicalxpress.com Author: staff, University of Oklahoma People who are diagnosed with head and neck cancer often receive a standard type of chemotherapy as part of their treatment. If they are exposed to secondhand smoke during chemotherapy—even if they have never smoked themselves—the treatment may be far less effective at killing cancer cells. That finding, considered the first of its kind, was revealed in a study recently published by researchers at the University of Oklahoma Health Sciences. Tobacco use is a well-established risk factor for cancer and a signal of poor outcomes, especially if a person continues to smoke during treatment. However, researchers have understood much less about the effects of secondhand smoke on cancer treatment. Lurdes Queimado, M.D., Ph.D., a professor of otolaryngology at the OU College of Medicine, led the investigation into secondhand smoke exposure, which was published in the International Journal of Molecular Sciences. Her findings have major implications for cancer patients and the physicians who treat them. "Head and neck cancer is the sixth most common cancer worldwide and is prevalent in Oklahoma, where we also have a high rate of smoking. This is the first time that researchers have examined the impact of secondhand smoke exposure on cancer patients and the mechanism of why it is happening." "Our studies will continue, but we think it is important to raise awareness now that people who are exposed to secondhand smoke during treatment will likely have a worse prognosis," said Queimado, who also directs the Tobacco Regulatory [...]

2024-02-28T08:44:27-07:00February, 2024|Oral Cancer News|

Squamous cell carcinoma survivor thankful he chose proton therapy

Source: www.mdanderson.org Author: Valerie Jones A routine dentist visit prompted a series of tests that led to Jay Rusovich’s squamous cell carcinoma diagnosis in early 2023. “My dentist was cleaning my teeth when he saw something in my throat,” says Jay. “He told me to get it checked out.” Jay visited his primary care doctor and took a multi-cancer early detection blood test. While awaiting the results, Jay visited an ear, nose and throat (ENT) specialist. The ENT didn’t find anything, but Jay’s primary care doctor called him with the results of his blood test. “He said the test showed that there was cancer in my bloodstream coming from my throat,” says Jay, who was 67 at the time. He went back to his ENT and had a biopsy. It showed Jay had HPV-related squamous cell carcinoma. It was early-stage and located on his left tonsil. Jay hadn’t had any symptoms before his diagnosis. He had been going to the gym six days a week and eating organic foods. He didn’t drink or smoke. After the initial shock of his cancer diagnosis, Jay focused on getting treated. He lived in Houston and knew of MD Anderson’s reputation as a leader in cancer care. So, he requested an appointment. Determined to find the best squamous cell carcinoma treatment Jay first visited MD Anderson West Houston to learn about treatment options. After hearing about traditional radiation therapy and chemotherapy, Jay was hesitant about the possible side effects. After speaking to oral oncologist [...]

2024-02-26T14:32:26-07:00February, 2024|Oral Cancer News|

Gadget that shines bright red LEDs to mend cancer scars now being used to treat debilitating scarring and swelling in the mouth caused by radiotherapy

Source: www.dailymail.co.uk Author: Beth Kennedy A 'Lollipop' gadget that emits red light is being used to treat debilitating scarring and swelling in the mouth caused by radiotherapy cancer treatment. The device's light-emitting diodes (LEDs) can repair damaged tissue, calm the body's response to injury and reduce inflammation – and patients simply need to pop it in their mouth for a few minutes to feel the benefits. It is believed that the wavelength of light being produced, called near-infrared, is absorbed by damaged cells and helps to repair them. The therapy – known as photobiomodulation – is being offered to NHS patients in Nottingham, where experts claim it has proved remarkably successful. But there are now hopes it could be rolled out more widely in a bid to improve the lives of cancer survivors across the UK. Radiotherapy most often involves shooting high-energy X-ray beams into the body to destroy tumours. The treatment is highly effective, but there can be collateral damage to healthy surrounding tissue, which causes scarring to develop both on the skin and internally. Also known as fibrosis, this affects one in ten patients who undergo radiotherapy, and the problem can occur months or even years after initial treatment. It can cause discomfort and leads to difficulty in moving the affected areas. In the case of head and neck cancers, patients may be left unable to turn their head fully or, in the worst scenarios, powerless to chew or speak properly. The LED treatment is already approved by [...]

2024-02-25T14:26:01-07:00February, 2024|Oral Cancer News|
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