Predictors of Patient-Reported Dysphagia Following IMRT Plus Chemotherapy in Oropharyngeal Cancer

AbstractThe aim of this cross-sectional study is to evaluate the factors associated with patient-reported dysphagia in patients affected by locally advanced oropharyngeal cancer (OPC) treated with definitive intensity-modulated radiation therapy (IMRT) and concurrent chemotherapy (CHT), with or without induction CHT. We evaluated 148 OPC patients treated with IMRT and concurrent CHT, without evidence of disease and who had completed their treatment since at least 6  months. At their planned follow-up visit, patients underwent clinical evaluation and completed the M.D. Anderson dysphagia inventory (MDADI) questionnaire. The association between questionnaire composite score (MDADI-CS) and different patients’ and tumor’s characteristics and treatments (covar iates) was investigated by univariable and multivariable analyses, the latter including only covariates significant at univariable analysis. With a median time from treatment end of 30 months [range 6–74 months, interquartile range (IQR) 16–50 months], the median (IQR) MDADI-CS was 72 (63–8 4). The majority of patients (82.4%) had a MDADI-CS ≥ 60. At multivariable analysis, female gender, human papilloma virus (HPV)-negative status, and moderate and severe clinician-rated xerostomia were significantly associated with lower MDADI-CS. Patient-perceived dysphagia was satisfactory or acceptable in the majority of patients. HPV status and xerostomia were confirmed...
Source: Dysphagia - Category: Speech-Language Pathology Source Type: research

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It is currently recognized that in addition to the major impact of human papillomavirus (HPV) infection in females, HPV causes considerable disease in men at the genitals, anal canal, and oropharynx. Specifically, genital HPV infections may progress to genital warts and penile carcinoma. Although studies concerning the natural history of HPV infections and associated neoplasias have mainly focused on women, during the last 2 decades considerable attention has been given in further understanding these infections in men. The HIM (HPV infection in men) Study, the only prospective multicenter study of male HPV natural history,...
Source: Acta Cytologica - Category: Cytology Source Type: research
Sexual intercourse is regarded as the primary route of human papillomavirus (HPV) transmission. Reported rates of the genotype-specific genital concordance of HPV infection among heterosexual partners vary. Most studies have evaluated only male/female genital transmission, but lately, the oral region has gained interest because of a rising trend of HPV-associated oropharyngeal cancer. Risk factors for type-specific concordance have been reported as an increasing number of younger couples, persistent HPV infection, higher frequency of sexual intercourse, rising number of spouse ’s lifetime sexual partners, and sexual ...
Source: Acta Cytologica - Category: Cytology Source Type: research
Publication date: 21 February 2019Source: Cell, Volume 176, Issue 5Author(s): Shashi Gujar, John Bell, Jean-Simon DialloOncolytic viruses (OVs) preferentially infect and kill cancer cells without harming normal cells. OVs can revert cancer-associated immune suppression and initiate clinically meaningful antitumor immune responses. OVs and their resultant immunological events can act at both primary and metastatic sites. Thus, OVs can be exploited for cancer gene therapies and immunotherapies alone or in combination with other interventions, including immune checkpoint blockade.
Source: Cell - Category: Cytology Source Type: research
Publication date: 21 February 2019Source: Cell, Volume 176, Issue 5Author(s): Ting Fu, Sally Coulter, Eiji Yoshihara, Tae Gyu Oh, Sungsoon Fang, Fritz Cayabyab, Qiyun Zhu, Tong Zhang, Mathias Leblanc, Sihao Liu, Mingxiao He, Wanda Waizenegger, Emanuel Gasser, Bernd Schnabl, Annette R. Atkins, Ruth T. Yu, Rob Knight, Christopher Liddle, Michael Downes, Ronald M. EvansSummaryIncreased levels of intestinal bile acids (BAs) are a risk factor for colorectal cancer (CRC). Here, we show that the convergence of dietary factors (high-fat diet) and dysregulated WNT signaling (APC mutation) alters BA profiles to drive malignant trans...
Source: Cell - Category: Cytology Source Type: research
Journal Name: Clinical Chemistry and Laboratory Medicine (CCLM) Issue: Ahead of print
Source: Clinical Chemistry and Laboratory Medicine - Category: Laboratory Medicine Source Type: research
CANCER symptoms vary depending on which part of the body is affected by a tumour. You could be at risk of deadly tumour signs if you notice this feeling in your teeth. It could be a warning sign of deadly mouth cancer. Should you see a doctor?
Source: Daily Express - Health - Category: Consumer Health News Source Type: news
In the modern era, favorable oncologic and survival outcomes are achieved for many patients with head and neck squamous cell carcinoma (HNSCC) treated with curative-intent radiotherapy (RT) [1 –3], particularly for those with human papilloma virus (HPV) associated disease [4,5]. Consequently, there is now substantial emphasis on reduction of late radiation toxicities for the ever increasing numbers of long-term survivors [5]. As burden of xerostomia is partially mitigated by the use of more conformal treatment techniques such as intensity modulated radiotherapy (IMRT) and proton therapy [6–8], dysphagia has ove...
Source: Radiotherapy and Oncology - Category: Radiology Authors: Tags: Original article Source Type: research
CONCLUSIONS: The role of endoscopic head and neck surgery in the management of OPSCC is clearly expanding as evidenced by its more overt incorporation into the current National Comprehensive Cancer Network guidelines. Data are mounting regarding its outcomes both in terms of survival and lower morbidity. As confidence increases, it is being used in the management of more advanced OPSCC.Based on this review, there is currently no high-quality evidence from randomised controlled trials regarding clinical outcomes for patients with oropharyngeal cancer receiving endoscopic head and neck surgery compared with primary chemoradi...
Source: Cochrane Database of Systematic Reviews - Category: Journals (General) Authors: Tags: Cochrane Database Syst Rev Source Type: research
ObjectivesTo analyse survival and toxicity outcomes in patients treated with primary intensity‐modulated radiotherapy (IMRT) for oropharyngeal squamous cell carcinoma (OPSCC) in the era of routine human papilloma virus (HPV) testing. DesignSingle‐institution case series. SettingTertiary Head and Neck Cancer Unit. ParticipantsA total of 186 patients received IMRT (+/− chemotherapy) for radical primary treatment of OPSCC between March 2010 and December 2013. HPV status was available for 88% of cases. Median radiation dose was 65 Gy in 30 daily fractions. 90% of stage III/IV patients received concurrent chemotherapy...
Source: Clinical Otolaryngology - Category: ENT & OMF Authors: Tags: Original Article Source Type: research
Abstract ObjectivesTo analyze survival and toxicity outcomes in patients treated with primary intensity‐modulated radiotherapy (IMRT) for oropharyngeal squamous cell carcinoma (OPSCC) in the era of routine human papilloma virus (HPV) testing. DesignSingle institution case series. SettingTertiary Head and Neck Cancer Unit Participants186 patients who received IMRT (+/‐ chemotherapy) for radical primary treatment of OPSCC between March 2010 and December 2013. HPV status was available for 88% of cases. Median radiation dose was 65Gy in 30 daily fractions. 90% of stage III/IV patients received concurrent chemotherapy or ce...
Source: Clinical Otolaryngology - Category: ENT & OMF Authors: Tags: Original Article Source Type: research
More News: Cancer | Cancer & Oncology | Chemotherapy | Human Papillomavirus (HPV) | Intensity-Modulated Radiation Therapy | Oropharyngeal Cancer | Radiation Therapy | Speech-Language Pathology | Study | Xerostomia