Multidisciplinary Head and Neck Cancer Symposium

HPV-Positive Oropharyngeal Patients Show Overall Higher Survival Rate Compared to HPV-Negative Patients

Source: eurekalert.orgPublished: February 20, 2014By: Michelle Kirkwood Scottsdale, Ariz., February 20, 2014—A retrospective analysis of oropharyngeal patients with recurrence of disease after primary therapy in the Radiation Therapy Oncology Group (RTOG) studies 0129 or 0522 found that HPV-positive patients had a higher overall survival (OS) rate than HPV-negative patients (at two years post-treatment, 54.6 percent vs. 27.6 percent, respectively), according to research presented today at the 2014 Multidisciplinary Head and Neck Cancer Symposium. The analysis included 181 patients with stage III-IV oropharyngeal squamous cell carcinoma (OPSCC) with known HPV status (HPV-positive = 105; HPV-negative = 76), and cancer progression that was local, regional and/or distant after completion of primary cisplatin-based chemotherapy and radiation therapy (standard vs. accelerated fractionation (AFX)) in RTOG 0129 or cisplatin-AFX with or without cetuximab in RTOG 0522. Tumor status was determined by a surrogate, p16 immunohistochemistry. Median time to progression was virtually the same for HPV-positive and HPV-negative patients (8.2 months vs. 7.3 months, respectively). Increased risk of death in univariate analysis was associated with high tumor stage at diagnosis (T4 vs. T2-T3), fewer on-protocol cisplatin cycles (≤1 vs. 2-3) and distant vs. local/regional recurrent (for all, hazard ratios (HRs) >2.0 and p<0.05). Risk of death after disease progression increased by 1 percent per cigarette pack-year at diagnosis. Rates were estimated by Kaplan-Meier method and compared by log-rank. HRs were estimated by Cox proportional hazards models and stratified by treatment protocol. In addition, HPV-positive and HPV-negative patients who underwent surgery after cancer recurrence also experienced improved OS [...]

Charlotte Parker2014-02-25T18:01:44-07:00February, 2014|Oral Cancer News|

PET/CT Detects Early Recurrence of Head and Neck Cancer

Source: Elsevier Global Medical News Routine use of positron emission tomography/computed tomography scans can detect locoregional recurrences of squamous cell carcinoma of the head and neck before they became clinically apparent, according to a retrospective chart review of 234 patients who had been treated with chemoradiation between 2006 and 2010.  The finding suggests that routine use of positron emission tomography/computed tomography (PET/CT) may improve the outcome of salvage therapy, said Dr. Yasir Rudha, who reported the study at the Multidisciplinary Head and Neck Symposium sponsored by the American Society for Radiation Oncology.  PET/CT was associated with a high false positive rate, which should be considered when ordering radiological exams and biopsies, but a negative post therapy PET scan appears to be an excellent predictor of freedom from future locoregional recurrence, said Dr. Rudha of St. John Hospital/Van Elslander Cancer Center, Grosse Pointe Woods, Mich.  The technology is relatively new, and its use for routine follow-up in patients with head and neck cancer is still controversial, he acknowledged. "Only a few publications have reported the value of PET examination at a fixed time interval after the end of treatment," he said. "PET scan is often ordered in our hospital as a routine surveillance tool following successful completion of treatment."  The review of charts for all 234 patients identified 45 who had achieved clinical no-evidence-of-disease status at the time of post treatment imaging. In this group, PET/CT scanning at 6-9 weeks identified 15 patients with abnormalities that required further evaluation. Of those, eight patients (53%) were [...]

Charlotte Parker2012-02-06T11:45:04-07:00February, 2012|Oral Cancer News|

Jaw Necrosis Common after Radiation for Oral Cancer

Source: MedpageToday.com Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco. Action Points Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal. Explain that osteoradionecrosis of the jaw (ORNJ) occurred more than twice as often as reported in the literature among patients with oral cancer treated with radiation. Point out that factors associated with the risk of ORNJ included female sex, no chemotherapy, and lower Charlson comorbidity index. PHOENIX -- Osteoradionecrosis of the jaw (ORNJ) occurred more than twice as often as reported in the literature, according to a population-based study of patients treated with radiation for oral cancer. A review of national medical records showed that 16.1% of patients had jaw complications or interventions consistent with ORNJ compared with published rates of 5% to 7%. However, when investigators applied the definition of ORNJ to patients who had interventions associated with jaw complications, the rate approximated the published rates, as reported here at the Multidisciplinary Head and Neck Cancer Symposium. "The rates of all jaw complications in the SEER-Medicare database are higher than reported rates from prospective and retrospective institutional reports," said Beth M. Beadle, MD, PhD, of the University of Texas MD Anderson Cancer Center in Houston. "If we limited the definition to interventions, the rates are similar to those of published reports." Radiation therapy has documented efficacy for locoregional [...]

Charlotte Parker2012-02-01T16:34:06-07:00February, 2012|Oral Cancer News|

Newer radiation technology improves head and neck cancer patients’ long-term quality of life

Source: Eurekalert.org Patients treated with IMRT for head and neck cancer report an increasingly better quality of life post-treatment when compared to patients receiving other forms of radiation therapy, according to a study presented at the Multidisciplinary Head and Neck Cancer Symposium, sponsored by AHNS, ASCO, ASTRO and SNM. Intensity modulated radiation therapy, or IMRT, is a highly specialized form of external beam radiation therapy that allows the radiation beam to better target and conform to a tumor. It is a newer treatment that has become widely adopted for treating head and neck cancer. Prior studies have shown that IMRT decreases the probability of radiation therapy related side effects, including dry mouth and chewing and swallowing problems, but no study has been conducted to measure long-term quality of life in head and neck cancer patients treated with various forms of radiation therapy. Investigators from the University of California, Davis, School of Medicine, prospectively administered the University of Washington Quality of Life instrument, a standardized, previously validated questionnaire that patients complete after radiation therapy, to 155 patients undergoing treatment for cancers of the head and neck and analyzed the scores over time. Fifty-four percent of patients were initially treated with IMRT and 46 percent were treated with non-IMRT techniques. The researchers showed that the early quality of life gains associated with IMRT not only are maintained but become more magnified over time. At one-year post-treatment, 51 percent of IMRT patients rated their quality of life as very good or outstanding compared [...]

Charlotte Parker2012-01-27T11:29:03-07:00January, 2012|Oral Cancer News|