Personalized 3D-printed shields protect healthy tissue during radiotherapy

Source: physicsworld.com
Author: Jigar Dubal

Personalized 3D-printed devices for radioprotection of anatomical sites at high risk of radiation toxicity: intra-oral device (A), oesophageal device (B) and rectal device (C) generated from patient CT images. The area for protection is highlighted in red. (Courtesy: CC BY 4.0/Adv. Sci. 10.1002/advs.202100510)

One of the primary goals of radiation therapy is to deliver a large radiation dose to cancer cells whilst minimizing normal tissue toxicity. However, most cancer patients undergoing such treatments are likely to experience some side effects caused by irradiation of healthy tissue. The extent of this damage is dependent on the treatment location, with the most common toxicities involving the oral cavity and gastrointestinal tract.

Materials with a high atomic number (Z), often known as radiation-attenuating materials, can be used to shield normal tissue from radiation. However, integrating such materials into current patient treatment protocols has proven difficult due to the inability to rapidly create personalized shielding devices.

James Byrne and colleagues at Brigham and Women’s Hospital, Dana-Farber Cancer Institute, Massachusetts General Hospital and MIT have addressed this need. The team has developed 3D-printed radiation shields, based on patient CT scans, incorporating radiation-attenuating materials to reduce the toxicity to healthy tissue.

Producing personalized 3D-printed shielding
Before a patient undergoes radiotherapy, they undergo CT scans to provide anatomical information that is used to plan their treatment. Byrne and his colleagues utilize these CT images to design personalized radio-protective devices, which they produce through 3D printing.

To determine the most appropriate shielding materials for the device, the researchers tested various elements and alloys, including liquids, with a high Z number. They characterized these materials by measuring their relative mass attenuation coefficients. From this, the team determined that elemental materials demonstrated greater radiation shielding than alloys or composites, and that mercury largely outperformed all other liquids. They then incorporated the high-Z materials into the personalized 3D-printed devices. The devices were made such that the shielding material could be removed to reduce artefacts during CT imaging and replaced prior to treatment.

To evaluate the device’s ability to shield healthy tissue from radiation, the team treated 14 rats with single-dose irradiation, half with and half without radio-protective devices in place, and examined the incidence of toxicities such as oral mucositis and proctitis.

The group also simulated clinical radiation treatments by modelling the radio-protective devices in the treatment planning software. The dose distributions with and without shielding were compared to evaluate the dosimetric impact of the device. The researchers simulated treatments of prostate and head-and-neck cancer patients, selecting the appropriate positioning of the device based on the regions of increased radiation exposure.

Evaluation of radio-protective devices
Histopathological analysis revealed that only one of seven rats with radio-protective devices in place during treatment suffered ulceration on the surface of the tongue. In contrast, all seven control rats, with no device in place, experienced extensive ulcerations on the tongue surface.

The clinical simulations identified that using radio-protective devices during prostate cancer treatment could reduce the dose to healthy tissue by 15% without reducing the dose delivered to the tumour. For the head-and-neck cancer treatment, the dose absorbed by inner-cheek tissue was reduced by 30%.

The results clearly show that the radio-protective devices may improve patient comfort throughout the course of treatment. “Our results support the feasibility of personalized devices for reduction of radiation dose and associated side effects” claims Byrne.

Future clinical implementation
The benefits of using 3D-printed radio-protective devices in the clinic are clear. “This personalized approach could be applicable to a variety of cancers that respond to radiation therapy,” says Byrne.

The researchers acknowledge that full clinical translation of 3D-printed shielding devices will require further development. “Given the small sample size of our dosimetric studies, further investigation in larger cohorts is needed to validate these approaches,” they say.

The researchers publish their findings in Advanced Science.

New therapy shortens treatment for HPV-related cancers of the tonsils, tongue

Source: medicalxpress.com
Author: From Mayo Clinic News Network, Mayo Clinic News Network

Patients with HPV-related oropharyngeal cancer who undergo surgery and are treated with chemotherapy, may be able to forgo significant radiation therapy without increasing the risk of their cancer spreading, according to the results of a clinical trial led by researchers at Mayo Clinic.

“We found that decreasing the amount of radiation therapy after a minimally invasive robotic surgery improved the quality of life of patients with HPV-related oropharyngeal cancer while delivering excellent cure rates,” says Dr. Eric Moore, a Mayo Clinic otolaryngologist. “In essence, we found exactly the right amount of treatment to deliver without over-treating these patients.”

Dr. Moore and his colleagues compared 79 patients treated at Mayo Clinic for HPV-related tonsil and tongue cancer with surgery and two weeks of radiation therapy to a group of 115 patients with the same cancer who were treated with surgery, and the standard six weeks of radiation therapy and chemotherapy.

Dr. Moore and his colleagues found no decrease in survival or cancer recurrence in the group that received two weeks of radiation therapy, compared to the group that received six weeks of radiation therapy. He says that by decreasing the amount of radiation therapy after minimally invasive robotic surgery, physicians were able to improve the quality of life of patients and achieve excellent cure rates.

“In essence, we found exactly the right amount of treatment to deliver without overtreating,” says Dr. Moore.

Dr. Moore says Mayo Clinic now offers dose de-escalation radiation therapy to appropriately selected patients with HPV-related cancers of the tonsils and tongue.

“This approach shortens the treatment time for these patients by several weeks and reduces side effects without sacrificing the effectiveness of the treatment,” Dr. Moore says.

A new method for fighting ‘cold’ tumors

Source: www.eurekalert.org
Author: news release University of Colorado Anschutz Medical Campus

Not all cancerous tumors are created equal. Some tumors, known as “hot” tumors, show signs of inflammation, which means they are infiltrated with T cells working to fight the cancer. Those tumors are easier to treat, as immunotherapy drugs can then amp up the immune response.

“Cold” tumors, on the other hand, have no T-cell infiltration, which means the immune system is not stepping in to help. With these tumors, immunotherapy is of little use.

It’s the latter type of tumor that researchers Michael Knitz and radiation oncologist and University of Colorado Cancer Center member Sana Karam, MD, PhD, address in new research published this week in the Journal for ImmunoTherapy of Cancer. Working with mouse models in Karam’s specialty area of head and neck cancers, Knitz and Karam studied the role of T cells in tumor treatment.

“What we found is that the cells that normally tell the T cell, ‘Hey, here’s a tumor — come and attack it,’ are being silenced,” Karam says.

She and her team found that regulatory T cells (Tregs), a specialized T cell type that suppresses immune response, are essentially telling the T cells to stop fighting the cancer.

“Tregs normally serve as an important balance in a healthy immune system,” Knitz says. “They prevent autoimmune disease and put the brakes on the T cells when needed. However, in many tumors, Tregs are too numerous or overly suppressive, bringing the T cell response to a halt.”

Using medication that deactivates the Tregs can help boost the immune response in patients with cold tumors, the researchers found, as can radiation treatment that causes enough injury that the immune cells known as dendritic cells work to put the regular T cells into fight mode.

But this is only part of the story. The T cells need to know what to attack. “You need the radiation to create injury and bring in the immune cells so that the tumor can be recognized and targeted,” says Karam, also an associate professor of radiation oncology at the University of Colorado School of Medicine. “That way, the dendritic cells trigger the immune system to produce a lot of T cells, similar to what a vaccine does. Those T cells then go back to the tumor to kill cancer cells. The pieces are already in place; they just need the proper signals. Activating the dendritic cells is a crucial step in allowing radiation to heat up these cold tumors.”

Importantly, Karam and her team, which includes post-doctorate fellow Thomas Bickett, found that the radiation must be administered in a specific way.

“A specific dosing is needed,” Karam says. “You have to pulse it. You can’t just give one dose. You have to give it again and combine it with things that remove the suppression — the Tregs — while simultaneously keeping those antigen-presenting dendritic cells active and on board.”

Karam says the next step in her research is clinical trials she hopes will eventually change the treatment paradigm from surgery and weeks of chemotherapy and radiation to just three sessions of radiation and immunotherapy, then surgery. She is driven to change the standard of care for cold tumors, she explains, because of the horrendous effects they have on patients.

“These tumors resemble those in patients who are heavy smokers,” she says. “They’re very destructive to bone and muscle, infiltrating the tongue, jaw, gum, and lymph nodes. It’s horrible. We have very high failure rates with them, and the treatment often involves removing the tongue and weeks of radiation and chemotherapy, only for the patient to fail. I’m confident that we can do better for our patients.”

Patients with oral cancer may get relief from dry mouth through MU research

Source: www.columbiamissourian.com
Author: Tia Alphonse

Gary Rackers bit his tongue one night, and it began to bleed. Thinking it wasn’t serious, he waited a couple of weeks, but something still didn’t feel right.

So, he asked his wife to take a look. She was shocked, Rackers said. His tongue was black.

After seeing his family physician and a local ear, nose and throat doctor in Jefferson City, Rackers was referred to Ellis Fischel Cancer Center. There, he connected with a physician who specialized in surgical treatment for patients with head and neck cancers. He was diagnosed with squamous cell carcinoma — a common oral cancer. The doctor ended up surgically removing half of Rackers’s tongue and nearly all of his teeth, and he began radiation and chemotherapy treatments.

Since then, Rackers said he‘s had 33 radiation treatments and three rounds of chemotherapy. He is pleased and proud of the work his physician did, he said. Because of her, he’s in the recovery phase: “I’m doing good…and I’m feeling good.”

Many head and neck cancer patients like Rackers lose their ability to produce saliva after radiation treatment. He said it doesn’t affect him much during the day, but his mouth gets quite dry at night. Dry mouth frequently disturbs his sleep, he said, causing him to often fetch water or juice for relief.

“If I could get through the night,” he said, the days are easy.

MU researcher and former dentist Olga Baker hopes to help patients like Rackers by dedicating her efforts to something most of us take for granted — saliva. Through her research, she hopes to find better solutions to combat dry mouth, particularly among cancer patients whose glands have been destroyed by radiation therapy.

When she practiced dentistry, Baker said she encountered many patients who struggled with dry mouth. Although the condition is often viewed as insignificant, those who underproduce saliva often develop mouth sores, cavities and a host of other issues. Baker said she has even worked with patients who have trouble talking because their inner cheeks stick to their teeth without natural lubrication from saliva. She has also treated patients who feel as if they are choking at night without the fluid to keep their airways moist.

Multiple groups of people suffer from chronic dry mouth. Patients who undergo radiation treatment for neck and head cancer are among a common group that often loses the function of salivary glands. After treatment, many of these glands stop working and can no longer naturally produce saliva, Baker said. She has seen patients who suffer from Sjögren’s syndrome, an autoimmune disease that causes inflammation that destroys the salivary glands. Other patients are born without functioning salivary glands at all.

“For these patients, there is no cure,” Baker said. “So, we’re working on different options.”

In the past, she worked to produce artificial saliva from plant-based resources and researched resolvins, lipids derived from the Omega-3 fatty acids commonly found in fish oil. This can be a potential treatment for dry mouth in Sjögren’s syndrome patients. These kind of solutions provide temporary relief, working as a spray that can be applied throughout the day to mimic the effects of saliva lubrication.

Baker’s current research into saliva production is dedicated to finding a more long-term solution to dry mouth, specifically for patients whose glands have been destroyed by radiation therapy. The therapy Baker is researching uses a specialized hydrogel that targets the affected glands. She has zeroed in on a protein called laminin-111, which is important to the embryonic process and has long been associated with regenerative properties. Baker said her previous research found that the protein helped restore salivary gland function when only single molecules were used.

She looked at recent studies on the way trimers, a combination of three molecules of a given protein, could give greater results than single molecules. She became interested in testing trimers of laminin-111 on salivary glands to see whether the protein could further restore salivary function in mice.

The experiment tested mice that had undergone radiation treatment and lost salivary function. Proteins from the treatment are put into hydrogels to make a more efficient delivery system. The gel was applied to the mice, and their saliva secretion was monitored. The treatment has proved effective in mice that lose salivary gland function due to radiation. Baker said the next step is to expand her research into larger animals and ultimately do clinical trials on human patients.

Meanwhile, Rackers is adjusting to his recovery. He said he no longer eats spicy foods, and he can’t stand the tanginess of condiments like barbecue and mustard. He can, however, still enjoy most foods.

“Tonight, I’m making smoked sausage, fried potatoes and steamed vegetables,” he said. “And I can eat that.”

2021-02-04T20:59:31-07:00February, 2021|Oral Cancer News|

University of Cincinnati research unveils possible new combo therapy for head and neck cancer

Source: www.eurekalert.org
Author: Research News, University of Cincinnati

Head and neck cancer is the sixth most common cancer worldwide, and while effective treatments exist, sadly, the cancer often returns.

Researchers at the University of Cincinnati have tested a new combination therapy in animal models to see if they could find a way to make an already effective treatment even better.

Since they’re using a Food and Drug Administration-approved drug to do it, this could help humans sooner than later.

These findings are published in the journal Cancer Letters.

Christina Wicker, PhD, a postdoctoral fellow in the lab of Vinita Takiar, MD, PhD, led this research which she says will hopefully extend the lives of patients one day.

“Head and neck cancer, like any cancer, is truly life-altering,” she says. “Head and neck cancer could impact your throat, tongue or nose, and patients often can’t swallow, talk or eat; it truly takes away some of the most social, enjoyable parts of life.”

Researchers in this study combined radiation therapy with a drug (telaglenastat) that stops a key enzyme in a cell pathway that becomes altered in cancer cells, causing those cells to grow rapidly and resist treatment. Wicker says this drug has already been studied in multiple clinical trials to see if it could improve treatment of various cancers.

“Until now, no one has examined if this drug has the potential to improve radiation treatment in head and neck cancer. Most importantly, this drug compound has been well tolerated by patients and causes minimal side effects,” she says.

Using animal models, researchers found that the drug alone reduced the growth of head and neck cancer cells up to 90%, and it also increased the efficacy of radiation in animals with head and neck tumors by 40%.

“With these results, and especially with previous clinical trials showing that the drug is well tolerated by patients, there is the potential to move more rapidly into head and neck cancer clinical trials,” Wicker says. “In the future, we hope this drug will be used to make radiation treatments for head and neck cancer even more effective.”

Currently, the most common treatment for that cancer is radiation therapy, but the cancer eventually returns in up to half of patients, Wicker says, and often it doesn’t respond as positively to treatment the second time around.

“When [traditional] drugs are less effective, cancer growth becomes difficult to control, which can lead to the cancer quickly spreading to other organs,” she says. “It is very important that scientists and clinicians develop new cancer treatments to improve treatment of this type of cancer, and hopefully our findings will provide one more option to help patients.”

UK Innovators target nanoparticles at inoperable cancers

Source: www.politicshome.com
Author: from Medicines Discovery Catapult

At a point of critical clinical need for improved treatments for pancreatic and head and neck cancers, a partnership of healthcare innovators set out to revolutionise radiotherapy for inoperable, and the most difficult to treat tumours.

With the aim of achieving a higher quality of life for those with unfavourable prognoses, this project, funded by Innovate UK, the UK’s innovation agency, brings together partners with a wealth of experience and specialist know-how in the areas of nanoparticle development, drug delivery and bioimaging.

The pioneering work being conducted will target cancerous cells more selectively, enabling a reduced dose of radiation, which would lower the toxic effects a patient receives as a result.

This targeted approach will employ Xerion Healthcare’s non-toxic radiosensitiser – this heightens the cells’ sensitivity to radiotherapy, increasing the likelihood of successful treatment while reducing the often devastating side effects.

To ensure the nanoparticles carrying the therapeutic agent reaches deep inside the tumour, Active Needle Technology’s unique delivery system conveys the treatment to the cancerous cells with the assistance of ultrasonic vibrations, which not only allow accurate placement, but also enables an optimal distribution throughout the tumour and limits damage of healthy cells in the process.

Medicines Discovery Catapult’s (MDC) advanced pre-clinical imaging suite and state-of-the-art expertise in complex medicines validation will undertake in-life imaging of the nanoparticle distribution, allowing the partners to validate its biodistribution in tumour and across other tissues and organs.

Ian Quirk, CEO of Active Needle Technology said:

“For patients suffering from a range of late stage cancers, treatment options can be limited. The effectivity and accuracy of Active Needles delivery of Xerion Healthcare’s ground-breaking new anti-cancer treatment is poised to revolutionise radiotherapy, and offer the hope of recovery for vast numbers of patients. We’re delighted to be working with Medicines Discovery Catapult to take the technology one step closer to the clinic.”

Dr Gareth Wakefield, Chief Technology Officer from Xerion Healthcare said:

“Effective direct tumoural delivery of anti-cancer agents is a key stepping stone to getting our nanoparticle products into clinical trials and into treatment programs for patients with inoperable tumours. Partnering with Active Needles unique ultrasonic delivery system and MDC’s real time imaging allows us to optimise the delivery system for maximum efficacy.

“Late presenting inoperable tumours require very high dose radiotherapy for successful treatment. This can often have very severe side effects or simply not be possible due to nearby sensitive organs. This project gives us a way to boost the effectiveness of the treatment without increasing the whole body dose.”

Professor Peter Simpson, Chief Scientific Officer at Medicines Discovery Catapult (MDC) said:

“MDC is pleased to be providing our state of the art imaging facilities and complex medicines expertise in this exciting collaboration with Active Needle Technology and Xerion Healthcare – to assess the biodistribution and efficacy of this nanoparticle approach.

“Complex medicines have the potential to address patients’ problems which conventionally administered small molecules and monoclonal antibodies cannot. This project is a very encouraging example of exploring how using an advanced drug delivery technology could improve drug biodistribution, and so improve the targeting and efficacy of potentially toxic therapeutics.”

Although great progress has been made in the treatment of some common cancers, there remain many indications where there has been little improvement in care over decades. Pancreatic cancer is on course to become the second leading cause of cancer mortality by 2030 with head and neck cancer currently seeing a 50% mortality rate. It has never been more timely or pertinent for research in this space to be undertaken.

2020-12-19T08:18:56-07:00December, 2020|Oral Cancer News|

FDA clears IND application for cell therapy to treat radiotherapy-induced dry mouth

Source: www.healio.com
Author: staff

The FDA cleared an investigational new drug application for a mesenchymal stromal cell therapy to treat radiotherapy-induced xerostomia, also known as dry mouth.

Researchers at University of Wisconsin Carbone Cancer Center developed the therapy, which uses the patient’s interferon-gamma activated marrow stromal cells.

Xerostomia is a one of the most common adverse effects of radiation therapy for head and neck cancers and may cause difficulties eating, speaking and sleeping, in addition to oral health complications.

“There is a critical need for improved treatments for this condition,” Randy Kimple, MD, PhD, associate professor of human oncology at University of Wisconsin School of Medicine, said in a press release. “For most patients, the best care we can provide currently is to encourage them to eat specially prepared food, suck on hard sugar-free candies and carry a water bottle with them all day.”

Kimple told Healio the therapy process involves the patient undergoing a bone marrow biopsy to harvest mesenchymal stromal cells.

Kimple — who will lead the forthcoming phase 1 trial for the therapy — said the cells will be prepared by the Program for Advanced Cell Therapy’s lab at UW Health’s University Hospital. Patients will receive the therapy via injection into the submandibular gland after completion of radiation therapy.

The phase 1 trial soon will begin enrolling up to 30 patients and will be conducted by University of Wisconsin School of Medicine and Public Health as a single-center study of patients treated at Carbone Cancer Center.

Study participants will be monitored for safety and development of adverse effects after receiving the cell therapy injection.

“Patients will also provide samples of their saliva and complete quality-of-life questionnaires to help determine if the treatment is effective,” Kimple said.

Researchers hope to complete the first phase of the trial within a year, according to Kimple.

2020-09-12T10:26:52-07:00September, 2020|Oral Cancer News|

UCM computer science professor researches use of AI in cancer treatment

Source: www.dailystarjournal.com
Author: Sara Lawson

New research by a University of Central Missouri faculty member uses an innovative Artificial Intelligence (AI) technique to allow physicians to predict which patients are at low risk of distant metastasis in order to help minimize severe side effects from radiation treatment. The research conducted by Zhiguo Zhou, assistant professor of computer science, is titled “Multifaceted radiomics for distant metastasis prediction in head-and-neck cancer.” Zhou’s research was published in the journal, Physics in Medicine and Biology, and subsequently reported in the July 2020 issue of Physics World.

Zhou, who has explored AI in medicine for 10 years, joined the UCM faculty in 2019. He began working on this recently published study more than three years ago while serving in the Department of Radiation in oncology at the University of Texas Southwestern Medical Center in Dallas. One of his UT colleagues, Jing Wang, served as co-author on the journal article.

Zhou said the research proposes a novel model for predicting metastasis in head-and-neck cancer after radiotherapy with “outstanding results.” It is a study he believes could provide a general framework which could be extended to predict treatment outcomes for primary cancers in other parts of the human body. While the research now undergoes a validation process that involves a multi-institutional prospective study, Zhou is hopeful that it can be applied in clinical settings within the next two to three years.

“Nowadays, radiotherapy has become one of the most important treatment methods in cancer therapy,” Zhou said. “The basic principal is to use radiation to kill the (primary) tumor and minimally deliver the dose (of radiation) to the surrounding normal organs. However, radiation is also harmful to the human body and it is very difficult to achieve this ideal situation.”

In fighting cancer, one of the challenges doctors face is how to effectively use radiotherapy to control the metastasis or spread of the disease without harming the patient in other ways. Physicians working with cancer patients must weigh different outcomes to address an optimal treatment plan, Zhou said.

“We think the solution is, if we can accurately predict the treatment outcome or response before radiotherapy, we can optimally make the treatment plan,” Zhou said. “This is the basic idea of why we need to do this research.”

As noted in the Physics World article, “As with cancers elsewhere in the body, early-stage cancers of the head and neck are treated using radiotherapy with increasing success. When treatment fails, it is often down to the growth of new tumors far from the site of the initial disease.

Predicting which patients are most likely to develop distant metastasis is vital so that low-risk patients can be spared the severe side effects that accompany the systemic treatments used to control cancer proliferation.”

In seeking to develop a reliable model to predict distant metastasis, Zhou and his research collaborators utilized PET and CT diagnostic and treatment planning images of 188 patients with head-and-neck cancer that were obtained from different institutions. These patients had received follow-up consultations with their care providers and the images were already seen by physicians. The researchers were able to extract from each patient 257 features that included intensity, geometric and textural characteristics in addition to other data related to patient age, gender and progression of the disease.

Zhou said since 2012 a prediction model called radiomics has existed, which uses a characterization algorithm to extract data to help further understanding of a patient’s likelihood of experiencing the spread of cancer from the initial tumor to other organs or lymph nodes. His research, called “M-radiomics,” takes a multifaceted approach to radiomics in order to produce a more reliable and accurate prediction model. Three different algorithms are used in this process to help address challenges related to the integration of data from multiple imaging modalities, sensitivity-specificity optimization and use of multiple data machine learning classifiers simultaneously.

“In M-radiomics we can integrate these three challenges into one framework,” Zhou said. “The results are very promising for distant metastasis prediction in head-and-neck cancer.”

Zhou is continuing his research in M-radiomics, in addition to pursuing other interests related to artificial intelligence in medicine. His work at UCM also involves teaching an undergraduate introduction to biomedical informatics course and a graduate-level course on artificial intelligence. Supportive of student research, Zhou mentors and instructs five graduate students who work with him on research, each of whom is also doing their own research project. He said he is looking forward to getting more undergraduate students involved in research as his career as UCM progresses.

2020-09-06T06:44:52-07:00September, 2020|Oral Cancer News|

Common causes of dysphagia in seniors may differ by sex, study finds

Source: www.mcknights.com
Author: Alicia Lasek

Common causes of swallowing problems may differ significantly between older men and women, according to physician researchers.

In a two-year swallowing clinic study, neuromuscular and esophageal problems were the most frequent causes of dysphagia among 109 study participants, reported Jeremy Applebaum, M.D., from Johns Hopkins University. Many patients (16%) had either diverticula (a soft pouch in the esophagus that can collect food particles), reflux (14%) or scarring caused by radiation treatment (8%). These problems also were associated with significant quality-of-life burden, the researchers added.

Causal differences were also found between the sexes. Men were more likely to have oropharyngeal dysphagia, a difficulty with initiating swallowing as food is introduced to the pharynx and esophagus from the mouth. In contrast, women were more likely to present with esophageal dysphagia, which can have several causes and is typically associated with the sensation of food sticking in the throat or chest after starting to swallow.

Higher rates of smoking and head and neck cancer may explain the prevalence of oropharyngeal problems found in male participants, whereas the esophageal problems in women likely were due to the high prevalence of reflux disease among that cohort, the authors surmised. They did not find significant differences in cause between older age cohorts.

Up to 33% of people age 65 and older are known to have swallowing problems due to physical changes, yet dysphasia also may be the result of underlying disease, the investigators said.

“A complaint of dysphagia in older adults should therefore be regarded as pathologic, especially given the wide spectrum of neuromuscular and structural disorders that increase in prevalence with age,” wrote Applebaum and colleagues. “We hope to inform more nuanced, patient-based approaches to this increasingly important topic,” they concluded.

The study was published in OTO Open: The Official Open Access Journal of the American Academy of Otolaryngology–Head and Neck Surgery Foundation.

Surgery, radiation yield similar efficacy for early squamous cell carcinoma of lip

Source: www.healio.com
Author: Earl Holland Jr.

Both surgery and radiation therapy were beneficial methods of treating early-stage lip squamous cell carcinoma, according to findings presented at the American Academy of Dermatology virtual meeting.

Kevin Phan, MD, of the dermatology department at Liverpool Hospital, Sydney, Australia, and Mahmoud Dibas, MD, of Sulaiman Al Rajhi Colleges, College of Medicine, Saudi Arabia, sought to examine the survival rates in low-stage lip squamous cell carcinoma (SCC) between patients who had surgery alone and patients who had radiation therapy alone.

“Squamous cell carcinoma of the lip composes 25% to 30% of all oral cancers,” the authors wrote. “Lip SCC is often detected at an early stage, due to the highly visible location and slow growth pattern.”

Results from the Surveillance, Epidemiology, and End Results database between 2010 and 2014 were analyzed. Overall survival and cancer-specific survival were measured.

The researchers identified 900 patients with early-stage lip SCC who had received either radiation alone (36 patients) or surgery alone (864 patients).

Patients who underwent surgical procedures had better overall survival and cancer-specific survival rates compared with patients who had radiation alone, the study found. The treatment modality did not have a significant effect on either survival rate; the radiation-alone group had an adjusted hazard ratio of 1.94 (95% CI; 0.83-4.53), while the surgery-alone group had an adjusted hazard ratio of 1.04 (95% CI; 0.07-15.55).

“Our results support the notion that surgery and [radiation therapy] appear to be equally effective in treating early-stage lip SCC,” the researchers wrote.

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