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Head and Neck cancer
Long-term Survivorship and Non-cancer Competing Mortality in Head and Neck Cancer: A Nationwide Population-Based Study in South Korea
Yuh-Seog Jung, Dahhay Lee, Kyu-Won Jung, Hyunsoon Cho
Cancer Res Treat. 2023;55(1):50-60.   Published online March 4, 2022
DOI: https://doi.org/10.4143/crt.2021.1086
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
As the survival of head and neck cancer (HNC) improves, survivors increasingly confront non-cancer–related deaths. This nationwide population-based study aimed to investigate non-cancer–related deaths in HNC survivors.
Materials and Methods
Data from the Korean Central Cancer Registry were obtained to characterize causes of death, mortality patterns, and survival in patients with HNC between 2006 and 2016 (n=40,890). Non-cancer-related mortality relative to the general population was evaluated using standardized mortality ratios (SMRs). The 5- and 10-year cause-specific competing risks probabilities of death (cumulative incidence function, CIF) and subdistribution hazards ratios (sHR) from the Fine-Gray models were estimated.
Results
Comorbidity-related mortality was frequent in older patients, whereas suicide was predominant in younger patients. The risk of suicide was greater in patients with HNC than in the general population (SMR, 3.1; 95% confidence interval [CI], 2.7 to 3.5). The probability of HNC deaths reached a plateau at 5 years (5-year CIF, 33.9%; 10-year CIF, 39.5%), whereas the probability of non-HNC deaths showed a long-term linear increase (5-year, CIF 5.6%; 10-year CIF, 11.9%). Patients who were male (sHR, 1.56; 95% CI, 1.41 to 1.72), diagnosed with early-stage HNC (localized vs. distant: sHR, 1.86; 95% CI, 1.58 to 2.21) and older age (65-74 vs. 0-44: sHR, 6.20; 95% CI, 4.92 to 7.82; ≥ 75 vs. 0-44: sHR, 9.81; 95% CI, 7.76 to 12.39) had an increased risk of non-cancer mortality.
Conclusion
Non-HNC–related deaths continue increasing. HNC survivors are at increased risk of suicide in the younger and comorbidity-related death in the older. Better population-specific surveillance awareness and survivorship plans for HNC survivors are warranted.

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  • Time‐varying association of second primary malignancy and long‐term survival outcomes in patients with head and neck cancer
    Xiaoke Zhu, Yu Heng, Jian Zhou, Hanqing Lin, Liang Zhou, Ming Zhang, Pengyu Cao, Lei Tao
    International Journal of Cancer.2023; 153(1): 94.     CrossRef
  • 4,993 View
  • 152 Download
  • 1 Web of Science
  • 1 Crossref
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Effect of National Oral Health Screening Program on the Risk of Head and Neck Cancer: A Korean National Population-Based Study
Chan Woo Wee, Hyo-Jung Lee, Jae-Ryun Lee, Hyejin Lee, Min-Jeong Kwoen, Woo-Jin Jeong, Keun-Yong Eom
Cancer Res Treat. 2022;54(3):709-718.   Published online October 22, 2021
DOI: https://doi.org/10.4143/crt.2021.834
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
Poor oral health is associated with head and neck cancer (HNC). We evaluated whether a national oral health screening program (OHSP) could reduce the risk of HNC.
Materials and Methods
Data from 408,247 healthy individuals aged ≥ 40 years from the National Health Insurance System-National Health Screening program during 2003 and 2004 in Korea were analyzed. The risk of HNC was compared between subjects who underwent OHSP (HEALS-Dental+, n=165,292) and routine health check-ups only (HEALS-Dental‒, n=242,955). The impact of individual oral health-related factors on HNC risk was evaluated in HEALS-Dental+.
Results
A total of 1,650 HNC cases were diagnosed. The 10-year HNC-free rate was 99.684% with a median follow-up of 11 years. The risk of all HNC (hazard ratio [HR], 1.16; 95% confidence interval [CI], 1.03 to 1.29; p=0.011) and oropharyngeal cancer (HR, 1.48; 95% CI, 1.13 to 1.94; p=0.005) was significantly higher in HEALS-Dental‒ than in HEALS-Dental+. In HEALS-Dental+, oral cavity cancer was marginally reduced (p=0.085), and missing teeth was a significant factor for HNC (HR, 1.24; 95% CI, 1.02 to 1.50; p=0.032). Toothbrushing was a significant factor in univariate analysis (p=0.028), but not in multivariate analysis (p=0.877).
Conclusion
The National OHSP significantly reduced the long-term HNC risk, particularly the incidence of oropharyngeal cancer. Routine OHSP should be considered at the population level.

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  • Gold Nanoparticles Enhance the Tumor Growth-Suppressing Effects of Cetuximab and Radiotherapy in Head and Neck Cancer In Vitro and In Vivo
    Takumi Sato, Yasumasa Kakei, Takumi Hasegawa, Masahiko Kashin, Shun Teraoka, Akinobu Yamaguchi, Ryohei Sasaki, Masaya Akashi
    Cancers.2023; 15(23): 5697.     CrossRef
  • 6,207 View
  • 138 Download
  • 1 Web of Science
  • 1 Crossref
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Radiation-Induced Ocular Surface Disorders and Retinopathy: Ocular Structures and Radiation Dose-Volume Effect
Ozlem Ozkaya Akagunduz, Suzan Guven Yilmaz, Emin Tavlayan, Mine Esen Baris, Filiz Afrashi, Mustafa Esassolak
Cancer Res Treat. 2022;54(2):417-423.   Published online June 24, 2021
DOI: https://doi.org/10.4143/crt.2021.575
AbstractAbstract PDFPubReaderePub
Purpose
This study aimed to evaluate the radiation-induced adverse effects on ocular structures in head and neck cancer patients and investigate the radiation dose-volume effects on the cornea, lacrimal gland, retina, optic nerve and chiasm.
Materials and Methods
A total of 38 eyes of 19 patients were included in this prospective, cohort study. All patients underwent complete ophthalmological examination in addition to contrast sensitivity, visual field and visual evoked potentials (VEP) tests. Ophthalmological examinations and psychophysical tests were performed in 6th, 12th, 18th, 24th months and in the last visit. The relationship between the ophthalmologic findings, and the radiation doses below and above the cut-off values was evaluated.
Results
Contrast sensitivity decrease and visual field deterioration were observed in 42% of the patients in the last visit (median 26 months) whereas a prolonged latency and decreased amplitude of P100 wave in VEP was observed in 58% and 33% of the eyes, respectively at 24th month. Totally 16 patients (84.2%) developed dry eye disease and eight of them received radiotherapy below tolerance doses and had mild to moderate dry eye findings. Radiation-induced retinopathy was observed in three of the eyes in eight patients who received radiation above tolerance dose.
Conclusion
Head and neck cancers treated with radiotherapy, resulted in various ophthalmic complications. All patients who are treating with radiotherapy should be evaluated by an ophthalmologist in terms of anterior and posterior segment damage, even if the radiation dose is below the tolerance limit.

Citations

Citations to this article as recorded by  
  • Neurological complications of modern radiotherapy for head and neck cancer
    James C.H. Chow, Jason C.S. Ho, Ka Man Cheung, David Johnson, Bonaventure Y.M. Ip, Jonathan J. Beitler, Primož Strojan, Antti A. Mäkitie, Avraham Eisbruch, Sweet Ping Ng, Sandra Nuyts, William M. Mendenhall, Silvia Babighian, Alfio Ferlito
    Radiotherapy and Oncology.2024; 194: 110200.     CrossRef
  • Efficacy of Intravitreal Injections Anti-Vascular Endothelial Growth Factor Treatment for Radiation Retinopathy: A Systematic Review and Meta-analysis
    Jiayuan Zhuang, Yang Yang, Yuexia Liao, Chenghao Li, Wen-an Wang, Xiangxia Luo, Heng Zhou
    American Journal of Ophthalmology.2024; 263: 141.     CrossRef
  • Personalized treatment for patients with lacrimal sac squamous cell carcinoma
    Jie Wang, Qi Zhang, Xiuqian Yi, Tianci Tang, Tian Wang, Xinmao Song
    Canadian Journal of Ophthalmology.2024; 59(6): e768.     CrossRef
  • Biomaterials-mediated radiation-induced diseases treatment and radiation protection
    Jianping Man, Yanhua Shen, Yujie Song, Kai Yang, Pei Pei, Lin Hu
    Journal of Controlled Release.2024; 370: 318.     CrossRef
  • Retinopatía por radiación vs. síndrome isquémico ocular: ¿cómo llegar al diagnóstico?
    A. Aramburu-González, J. Zarrabeitia Carrandi, C.B. Robles Elejalde, A. Quilez Larragan
    Archivos de la Sociedad Española de Oftalmología.2024; 99(8): 352.     CrossRef
  • Orbital cavernous venous malformation shrinkage during fractionated stereotactic radiotherapy contributing to the development of radiation retinopathy
    Laura Hughes, Amy C Cohn, Neda Haghighi, Alan A McNab
    European Journal of Ophthalmology.2024; 34(5): NP53.     CrossRef
  • Radiation retinopathy vs. ocular ischemic syndrome: how to reach the diagnosis?
    A. Aramburu-González, J. Zarrabeitia Carrandi, C.B. Robles Elejalde, A. Quilez Larragan
    Archivos de la Sociedad Española de Oftalmología (English Edition).2024; 99(8): 352.     CrossRef
  • Ocular surface changes in patients who have undergone head and neck radiation therapy
    H Sujithra, Kannisha N Shah, R Anoop, Pushpaja K Ullattil, Gopal S Pillai, Greeshma C Ravindran, Jayesh Vazirani
    Indian Journal of Ophthalmology.2024;[Epub]     CrossRef
  • New Frontiers in the Treatment of Patients with HER2+ Cancer and Brain Metastases: Is Radiotherapy Always Useful?
    Giuseppa Scandurra, Valentina Lombardo, Giuseppe Scibilia, Daniela Sambataro, Vittorio Gebbia, Paolo Scollo, Basilio Pecorino, Maria Rosaria Valerio
    Cancers.2024; 16(13): 2466.     CrossRef
  • Radiation-Induced Retinopathy and Optic Neuropathy after Radiation Therapy for Brain, Head, and Neck Tumors: A Systematic Review
    Buket Kinaci-Tas, Tanja Alderliesten, Frank D. Verbraak, Coen R. N. Rasch
    Cancers.2023; 15(7): 1999.     CrossRef
  • Radiation Retinopathy
    Kaylie Chen, Andrew W. Browne
    Current Ophthalmology Reports.2023; 11(3): 49.     CrossRef
  • Case Report: Optical coherence tomography angiography findings in radiation retinopathy
    Wafa Ammari, Asma Zaghdoudi, Olfa Berriche, Riadh Messaoud
    F1000Research.2023; 11: 968.     CrossRef
  • Case Report: Optical coherence tomography angiography findings in radiation retinopathy
    Wafa Ammari, Asma Zaghdoudi, Olfa Berriche, Riadh Messaoud
    F1000Research.2023; 11: 968.     CrossRef
  • Efficacy and Safety of Radiotherapy Combined with Pyrotinib in the Treatment of HER2-Positive Breast Cancer with Brain Metastases
    Jie Huang, Wenqiang Zhu, Qiangzhi Duan, Chaomang Zhu, Xueling Shi, Hongyu Zhao, Peng Cai, Duojie Li
    Breast Cancer: Targets and Therapy.2023; Volume 15: 841.     CrossRef
  • Comparable meibomian gland changes in patients with and without ocular graft-versus-host disease after hematopoietic stem cell transplantation
    Wenxin Zhao, Jing Yang, Yinglin Liao, Hubert Yuenhei Lao, Quanbin Huang, Ling Jin, Jing Sun, Fen Huang, Lingyi Liang
    The Ocular Surface.2022; 25: 1.     CrossRef
  • Case Report: Optical coherence tomography angiography findings in radiation retinopathy
    Wafa Ammari, Asma Zaghdoudi, Olfa Berriche, Riadh Messaoud
    F1000Research.2022; 11: 968.     CrossRef
  • Corneal Epithelial Stem Cells–Physiology, Pathophysiology and Therapeutic Options
    Yue Ruan, Subao Jiang, Aytan Musayeva, Norbert Pfeiffer, Adrian Gericke
    Cells.2021; 10(9): 2302.     CrossRef
  • 7,299 View
  • 384 Download
  • 11 Web of Science
  • 17 Crossref
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Head and Neck Cancer
Outcomes and Biomarkers of Immune Checkpoint Inhibitor Therapy in Patients with Refractory Head and Neck Squamous Cell Carcinoma: KCSG HN18-12
Yun-Gyoo Lee, Hyun Chang, Bhumsuk Keam, Sang Hoon Chun, Jihyun Park, Keon Uk Park, Seong Hoon Shin, Ho Jung An, Kyoung Eun Lee, Keun-Wook Lee, Hye Ryun Kim, Sung-Bae Kim, Myung-Ju Ahn, In Gyu Hwang
Cancer Res Treat. 2021;53(3):671-677.   Published online December 7, 2020
DOI: https://doi.org/10.4143/crt.2020.824
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Purpose
This study was conducted to determine the effectiveness of immune checkpoint inhibitors (ICIs) in recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC) after platinum-containing chemotherapy. We also identified clinical biomarkers which may be predictive of patient prognosis.
Materials and Methods
We analyzed 125 patients with R/M HNSCC who received ICIs, retrospectively. Overall response rate (ORR) was the primary study outcome. Overall survival (OS) and progression-free survival (PFS) were the secondary study outcomes.
Results
The patients received anti–programmed cell death protein-1 (PD-1) (n=73, 58%), anti–programmed death-ligand 1 (PD-L1) (n=24, 19%), or a combination of anti–PD-1/PD-L1 and anti–cytotoxic T-lymphocyte antigen 4 (n=28, 22%). The median age was 57 years (range, 37 to 87). The location of the primary tumor was in the oral cavity in 28% of the cases, followed by oropharynx (27%), hypopharynx (20%), and larynx (12%). The ORR was 15% (19/125). With 12.3 months of median follow-up, median PFS was 2.7 months. Median OS was 10.8 months. A neutrophil-to-lymphocyte ratio (NLR) > 4 was significantly associated with poor response to ICIs (odds ratio, 0.30; p=0.022). A sum of the target lesions > 40 mm (hazard ratio [HR], 1.53; p=0.046] and a NLR > 4 (HR, 1.75; p=0.009) were considered to be predictive markers of short PFS. A poor performance status (HR, 4.79; p < 0.001), a sum of target lesions > 40 mm (HR, 1.93; p=0.025), and an NLR > 4 (HR, 3.36; p < 0.001) were the significant predictors for poor survival.
Conclusion
ICIs exhibited favorable antitumor activity in R/M HNSCC. Clinically, our findings can be used to recognize patients benefit from receiving ICI.

Citations

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  • Impact of PIK3CA and cell cycle pathway genetic alterations on durvalumab efficacy in patients with head and neck squamous cell carcinoma: Post hoc analysis of TRIUMPH study
    Dong Hyun Kim, Seung Taek Lim, Hye Ryun Kim, Eun Joo Kang, Hee Kyung Ahn, Yun-Gyoo Lee, Der Sheng Sun, Jung Hye Kwon, Sang-Cheol Lee, Hyun Woo Lee, Min Kyoung Kim, Bhumsuk Keam, Keon-Uk Park, Seong-Hoon Shin, Hwan Jung Yun
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    Scientific Reports.2024;[Epub]     CrossRef
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    Quan Wang, Xiangzhi Yin, Shengxia Wang, Haijun Lu
    Frontiers in Oncology.2024;[Epub]     CrossRef
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    Dong Hyun Kim, Seo Yoon Jang, Bhumsuk Keam
    Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology.2024;[Epub]     CrossRef
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    Journal of Cancer Research and Clinical Oncology.2023; 149(20): 18215.     CrossRef
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    Oral Oncology.2022; 126: 105729.     CrossRef
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    Yukinori Takenaka, Ryohei Oya, Norihiko Takemoto, Hidenori Inohara
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  • Safety and Efficacy of Influenza Vaccination in Patients Receiving Immune Checkpoint Inhibitors. Systematic Review with Meta-Analysis
    Maria A. Lopez-Olivo, Valeria Valerio, Aliza R. Karpes Matusevich, Marianela Brizio, Michelle Kwok, Yimin Geng, Maria E. Suarez-Almazor, Ines Colmegna
    Vaccines.2022; 10(8): 1195.     CrossRef
  • Identification of Immune-Related LncRNA Pairs for Predicting Prognosis and Immunotherapeutic Response in Head and Neck Squamous Cell Carcinoma
    Xueying Wang, Kui Cao, Erliang Guo, Xionghui Mao, Lunhua Guo, Cong Zhang, Junnan Guo, Gang Wang, Xianguang Yang, Ji Sun, Susheng Miao
    Frontiers in Immunology.2021;[Epub]     CrossRef
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    Xing-xing Huo, Shu-jie Wang, Hang Song, Ming-de Li, Hua Yu, Meng Wang, Hong-xiao Gong, Xiao-ting Qiu, Yong-fu Zhu, Jian-ye Zhang
    Frontiers in Pharmacology.2021;[Epub]     CrossRef
  • 7,190 View
  • 225 Download
  • 15 Web of Science
  • 16 Crossref
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Prediction of Lymph Node Metastasis by Tumor Dimension Versus Tumor Biological Properties in Head and Neck Squamous Cell Carcinomas
Jeon Yeob Jang, Min Ji Kim, Gwanghui Ryu, Nayeon Choi, Young-Hyeh Ko, Han-Sin Jeong
Cancer Res Treat. 2016;48(1):54-62.   Published online March 6, 2015
DOI: https://doi.org/10.4143/crt.2014.332
AbstractAbstract PDFPubReaderePub
Purpose
Lymph node metastasis (LNM) is a strong prognostic factor in many solid cancers, including head and neck squamous cell carcinomas (HNSCC), and LNM can be dependent upon primary tumor biology, as well as tumor dimension. Here, we investigate the relative risk of LNM in accordance to tumor dimension and biology in HNSCC subsites.
Materials and Methods
Medical data of 295 HNSCC patients who had undergone the initial curative surgery (oral tongue 174, oropharynx 75, hypopharynx 46) were analyzed to identify the significant predictive factor for LNM. Tumor volume and thickness were set as tumor dimensional variables, and biological variables included lymphovascular, perineural invasion, and tumor differentiation. Statistical analyses were conducted to assess the predictability of LNM from variables, and subgroup analyses according to the tumor subsites. In addition, we evaluated the impacts of tumor dimension and biological variables on the treatment outcomes and survival in HNSCC subsites.
Results
The overall tumor dimension and biological variables had a similar impact on the prediction of LNM in HNSCC (area under curve, 0.7682 and 0.7717). The prediction sensitivity of LNM in oral tongue cancer was mainly dependent on tumor dimension, while LNM in oro- and hypo-pharynx cancers was more influenced by biological factors. Survival analyses also confirmed that biological factor was more powerful in estimating disease-free survival of hypopharyngeal cancer patients, while tumor dimension was more significant in that of oral cancer patients.
Conclusion
Tumor dimension and biology have a significant, tumor subsite-dependent impact on the occurrence of LNM and disease-free survival in HNSCC.

Citations

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  • Extra-Capsular Spread of Lymph Node Metastasis in Oral, Oropharyngeal and Hypopharyngeal Cancer: A Comparative Subsite Analysis
    Yung Jee Kang, Goeun Park, Sung Yool Park, Taehwan Kim, Eunhye Kim, Yujin Heo, Changhee Lee, Han-Sin Jeong
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    Bok‐Soon Lee, Jeon Yeob Jang, Chorong Seo, Chul‐Ho Kim
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    Christoph Klingelhöffer, Andreas Gründlinger, Gerrit Spanier, Stephan Schreml, Maximilian Gottsauner, Steffen Mueller, Johannes K. Meier, Torsten E. Reichert, Tobias Ettl
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    Xu Qian, Branko Sinikovic, Frank Schreiber, Sebastian Ochsenreither, Konrad Klinghammer, Barbara Wollenberg, Andreas M. Kaufmann, Andreas E. Albers
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    Jeung Hui Pyo, Sun-Ju Byeon, Hyuk Lee, Yang Won Min, Byung-Hoon Min, Jun Haeng Lee, Kyoung-Mee Kim, Hyeon Seon Ahn, Kyunga Kim, Yoon-Ho Choi, Jae J. Kim
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    Jeon Yeob Jang
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    Susanne Jung, Sonja Sielker, Nikolai Purcz, Christoph Sproll, Yahya Acil, Johannes Kleinheinz
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  • 13,335 View
  • 130 Download
  • 15 Web of Science
  • 15 Crossref
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Concurrent Chemoradiation with Low-Dose Weekly Cisplatin in Locally Advanced Stage IV Head and Neck Squamous Cell Carcinoma
Myoung Hee Kang, Jung Hun Kang, Haa-Na Song, Bae Kwon Jeong, Gyu Young Chai, Kimun Kang, Seung Hoon Woo, Jung Je Park, Jin Pyeong Kim
Cancer Res Treat. 2015;47(3):441-447.   Published online December 2, 2014
DOI: https://doi.org/10.4143/crt.2013.219
AbstractAbstract PDFPubReaderePub
Purpose
Concurrent chemoradiation (CRT) with 3-weekly doses of cisplatin is a standard treatment for loco-regionally advanced head and neck squamous cell carcinoma (HNSCC). However, treatment with 3-weekly doses of cisplatin is often associated with several adverse events. Therefore, we conducted this retrospective analysis to determine the efficacy and tolerance of CRT with a low weekly dose of cisplatin in stage IV HNSCC patients.
Materials and Methods
Medical records of patients who were diagnosed with stage IV HNSCC and received concurrent CRT were analyzed. All patients were treated weekly with cisplatin at 20-30 mg/m2 until radiotherapy was completed.
Results
A total of 35 patients were reviewed. Median follow up was 10.7 months (range, 1.7 to 90.5 months), the median radiation dose was 7,040 cGy, and the median dose of cisplatin received was 157 mg/m2. Eleven patients received docetaxel combination chemotherapy. Overall, 25 patients (71.4%) achieved complete response (CR), eight (22.9%) showed partial response. The median overall survival was 42.7 months, the 3-year survival rate was 51.2% and the 3 year disease-free survival rate was 72.8%. Overall survival was improved in patients who achieved CR relative to others (59.7 months vs. 13.4 months; p=0.008). There were significant differences in survival between patients who received docetaxel combination and cisplatin alone (51.8 months vs. 7.9 months; p=0.009). Grade 3-4 adverse events included stomatitis (82.9%), dermatitis (22.9%), infection (11.4%), dysphagia (8.6%), and neutropenia (5.7%).
Conclusion
CRT with low dose weekly cisplatin is likely effective and tolerable, even in patients with locally advanced-stage IV HNSCC.

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Analysis of the Prognostic Factors for Distant Metastasis after Induction Chemotherapy Followed by Concurrent Chemoradiotherapy for Head and Neck Cancer
Dong Hyun Kim, Won Taek Kim, Joo Hye Lee, Yong Kan Ki, Ji Ho Nam, Byung Joo Lee, Jin Choon Lee, Young Jin Choi, Young Mi Seol, Dong Won Kim
Cancer Res Treat. 2015;47(1):46-54.   Published online August 25, 2014
DOI: https://doi.org/10.4143/crt.2013.212
AbstractAbstract PDFPubReaderePub
Purpose
The aim of this study is to identify the prognostic factors of distant metastasis (DM) after induction chemotherapy (IC) followed by concurrent chemoradiotherapy (CRT) for locoregionally advanced head and neck cancer (HNC). Materials and Methods A total of 321 patients with HNC who underwent IC followed by CRT treated between January 2005 and December 2010 were analyzed retrospectively. IC consisted of three courses of docetaxel (70 mg/m2) and cisplatin (75 mg/m2) every three weeks, followed by radiotherapy of 66-70 Gy/2 Gy per fraction/5 fractions per week concurrent with weekly cisplatin (40 mg/m2). Tumor/nodal stage, primary site, tumor differentiation, lower neck node involvement (level IV, VB, and supraclavicular regions), number of concurrent chemotherapy cycles, overall duration of radiotherapy, and response to IC were assessed as potential prognostic factors influencing DM and survival outcome. Results The five-year loco-regional recurrence and DM rates were 23.6% and 18.2%. N stage, overall duration of radiotherapy, lower neck node involvement, and response to IC were significant factors for DM. With a median follow-up period of 52 months (range, 4 to 83 months), the 5-year progression-free, DM-free, and overall survival rates were 41.2%, 50.7%, and 55.1%, respectively. Lower neck node involvement (p=0.008) and poor response to IC (p < 0.001) showed an association with significantly inferior DM-free survival. Conclusion Even with the addition of IC, the DM rate and survival outcome were poor when metastatic lower neck lymph nodes were present or when patients failed to respond after receiving IC.

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Adjuvant Postoperative Radiotherapy with or without Chemotherapy for Locally Advanced Squamous Cell Carcinoma of the Head and Neck: The Importance of Patient Selection for the Postoperative Chemoradiotherapy
Jong Hoon Lee, Jin Ho Song, Sang Nam Lee, Jin Hyoung Kang, Min Sik Kim, Dong Il Sun, Yeon-Sil Kim
Cancer Res Treat. 2013;45(1):31-39.   Published online March 31, 2013
DOI: https://doi.org/10.4143/crt.2013.45.1.31
AbstractAbstract PDFPubReaderePub
PURPOSE
We wanted to evaluate the role of postoperative chemoradiotherapy (CRT) for patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN).
MATERIALS AND METHODS
From March 1993 to July 2008, 101 patients with advanced SCCHN and who had undergone macroscopically complete resection were enrolled. Survival and the cumulative incidence of local or regional relapse, metastasis, and acute toxicity were analyzed.
RESULTS
There was a marginally significant difference of disease-free survival at five years in favor of the CRT arm (51.3% vs. 41.8%, respectively; p=0.10). However, there was no significant difference in overall survival between the two treatment arms (p=0.20). The rate of locoregional failure only for the radiotherapy arm was significantly higher than that for the CRT arm (23.2% vs. 4.4%, respectively; p=0.01). The incidence of grade 3 or 4 hematologic toxicity was significantly higher in the CRT arm than that in the radiotherapy arm (37.7% vs. 1.7%, respectively; p=0.01). In CRT arm, early mortality group within 1 year had low performance status and old age over sixty compared with those of the others.
CONCLUSION
After curative-intent surgery, adjuvant CRT is more effective in locoregional tumor control than radiotherapy alone for patients with advanced SCCHN. However, compared with radiotherapy alone, this combined modality treatment had no survival benefit, and was significantly associated with increased toxicity. Thus, patients with low performance status and old age must be cautious in selection of toxic trimodality treatment.

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Clinical Factors Related to Suspected Second Primary Lung Cancer Development in Patients with Head and Neck Cancer
Eui Bae Kim, Yong Park, Seh Jong Park, Dae Sik Kim, Jee Won Kim, Hee Yun Seo, Hwa Jung Sung, In Keun Choi, Kyong Hwa Park, Sang Cheul Oh, Chul Won Choi, Byung Soo Kim, Yeul Hong Kim, Jun Suk Kim, Sang Won Shin, Chul Yong Kim, Kwang-Yoon Jung
Cancer Res Treat. 2008;40(4):178-183.   Published online December 31, 2008
DOI: https://doi.org/10.4143/crt.2008.40.4.178
AbstractAbstract PDFPubReaderePub
Purpose

The rate of second primary lung cancer development for patients with head and neck cancer (HNC) has been noted. The aim of our study was to evaluate the incidence and clinical features of suspected second primary lung cancer that developed in patients with primary HNC.

Materials and Methods

We conducted a retrospective study of 469 patients who were newly diagnosed with HNC at the Korea University Medical Center between January 2000 and December 2006.

Results

A total of 469 patients were included (389 men and 80 women). Eighteen patients (3.8%) had suspected second primary lung cancers. Statistically significant clinical variables for lung cancer development included the origin site for the primary HNC (oro-hypopharynx and larynx) (p=0.048), abnormal chest x-ray findings (p=0.027) and the histological HNC type (squamous cell carcinoma) (p=0.032). When the second primary lung cancers were combined with HNCs, the adjusted overall survival of patients with a second primary lung cancer was 16 months (p<0.001).

Conclusions

Considering the relative risk factors for a second primary lung cancer developing in patients with HNC, advanced diagnostic tools, such as chest CT or PET CT scan, should be applied for the early detection of a second primary lung cancer.

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    Yusra F. Shao, Seongho Kim, John D. Cramer, Dina Farhat, Jeffrey Hotaling, Syed Naweed Raza, George Yoo, Ho‐sheng Lin, Harold Kim, Ammar Sukari, Misako Nagasaka
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The Efficacy of an Induction Chemotherapy Combination with Docetaxel, Cisplatin, and 5-FU Followed by Concurrent Chemoradiotherapy in Advanced Head and Neck Cancer
Jae-Sook Ahn, Sang-Hee Cho, Ok-Ki Kim, Joon-Kyoo Lee, Deok-Hwan Yang, Yeo-Kyeoung Kim, Je-Jung Lee, Sang-Chul Lim, Hyeoung-Joon Kim, Woong-Ki Chung, Ik-Joo Chung
Cancer Res Treat. 2007;39(3):93-98.   Published online September 30, 2007
DOI: https://doi.org/10.4143/crt.2007.39.3.93
AbstractAbstract PDFPubReaderePub
Purpose

This study was performed to determine the feasibility and safety of the use of induction chemotherapy combined with docetaxel, cisplatin, and 5-fluorouracil (TPF) followed by concurrent chemoradiation therapy for locally advanced squamous cell carcinoma of the head and neck (SCCHN).

Materials and Methods

The patients, that were initially not treated for locally advanced SCCHN, underwent three cycles of induction chemotherapy every 3 weeks at a dose of 70 mg/m2 docetaxel D1, 75 mg/m2 cisplatin D1, 1000 mg/m2 5-FU D1-4, and subsequently received concurrent chemoradiation therapy.

Results

Forty-nine patients were enrolled in this study and forty-three of the patients completed the treatment. The median duration of follow-up was 18 months (range, 6~39 months). All of the patients had stage III (26.5%) or IV (73.5%) squamous cell carcinoma. After sequential therapy, a complete response and partial response was seen in 28 (65.2%) and 13 (30.2%) patients, respectively. The overall response rate was 95.4%. Overall survival and progression-free survival (PFS) at 2 years were 88.7% and 69.7%, respectively. Grade 3~4 neutropenia occurred in 42.2% of the patients and grade 4 thrombocytopenia in 1 cycle (0.7%). Two patients (4.1%) died during the induction chemotherapy due to pneumonia and a subdural hemorrhage, respectively. The group of patients over 65 years of age showed a significant lower dose intensity than that of patients under 65 years of age, but PFS was not significantly different between two groups (p=0.105).

Conclusion

TPF induction chemotherapy followed by concurrent chemoradiotherapy showed a high level of CR and moderate treatment-induced toxicity. Adequate dose modification in elderly patients should be considered to maintain efficacy and avoid treatment-related toxicity.

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Combination Chemotherapy with 5-Fluorouracil and Carboplatin for Advanced Head and Neck Cancer
Eun Kyung Cho, Won Sup Lee, Chul Won Jung, Keun Seok Lee, Won Seog Kim, Ki Hyeong Lee, Dae Seog Heo, Yung Jue Bang, Kwang Hyun Kim, Charn II Park, Noe Kyeong Kim
J Korean Cancer Assoc. 1996;28(1):94-104.
AbstractAbstract PDF
Twenty-nine patients with previously untreated, locally advanced head and neck cancer were treated with two or three cycles of combination chemotherapy consisting of 5- fluorouracil infusion and carboplatin, followed by surgery and/or curative radiotherapy. Nine patients with recurrent head and neck cancer were treated with the same combination chemotherapy. The results were as follows; 1) Among 28 evaluable patients, response rate was 71.4%(partial response) after neoadjuvant chemotherapy. Following local modality(surgery and/or radiotherapy), response rate was 79%(complete response 51.4%, and partial response 25%). 2) One year survival rate in neoadjuvant group was 83% and one year progression-free survival rate, 68.8%. The progression-free survival of responders was significantly prolonged in comparison with that of non-responders(p<0.05). 3) In palliative treatment group, one partial response(11%) was observed among nine patients. Median time to progression was 6.8 weeks and median survival was 17.7 weeks; there was no significant difference between responders and non-responders. 4) Nausea and vomiting were frequently observed but easily controlled. Hematologic toxicities-leukopenia and thrombocytopenia were observed but were reversible. In conclusion, combination chemotherapy with carboplatin and 5-FU was effective for locally advanced head and neck cancer in neoadjuvant setting, but it had limited benefits for recurrent diseases. Toxicities were tolerable and neurotoxicity, ototoxicity, and nephrotoxicity were not observed.
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Cancer Res Treat : Cancer Research and Treatment
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