The Current Indications for Non-Surgical Treatment of Hypopharyngeal Cancer.

The Current Indications for Non-Surgical Treatment of Hypopharyngeal Cancer. Adv Otorhinolaryngol. 2019;83:76-89 Authors: de Bree R Abstract The management of hypopharyngeal cancer is challenging because of poor patient survival and the potential effects of treatment on breathing, voice and swallowing. In general, early stage hypopharyngeal cancer can be primarily treated by radiotherapy or conservative transoral or open surgery, whereas advanced stage hypopharyngeal cancer can be treated by non-surgical protocols if the patient has no loss of functions (dysfunctional larynx) and/or cartilage invasion (T4a). Factors to determine individualized patient treatment include resectability, tumour volume, distant metastases, comorbidity, age, patient's preference, functional imaging parameters, response on induction chemotherapy and employing functional imaging parameters performed in the pre-treatment phase and repeated in the early treatment phase when employing a non-surgical treatment strategy. PMID: 30754041 [PubMed - in process]
Source: Advances in Oto-Rhino-Laryngology - Category: ENT & OMF Tags: Adv Otorhinolaryngol Source Type: research

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ConclusionsA single-cycle induction chemotherapy for HNSCC enables surgery plus adjuvant therapy as well as chemoradiotherapy. The long-term local and distant disease control was good but varied between tumors in the larynx and mesopharynx/tongue vs. hypopharynx.
Source: European Archives of Oto-Rhino-Laryngology - Category: ENT & OMF Source Type: research
ConclusionsThese preliminary results suggest a promising response to single cycle induction treatment with cisplatin/ docetaxel plus durvalumab/ tremelimumab in unselected HNSCC patients. Furthermore, they show an induction of an immune response in both in the tumor tissue and the peripheral blood.Clinical trial identificationNCT03426657.Legal entity responsible for the studyThe authors.FundingAstraZeneca.DisclosureM. Hecht: Research grant / Funding (institution): AstraZeneca; Advisory / Consultancy, Research grant / Funding (institution), Travel / Accommodation / Expenses: MSD. A. Gostian: Advisory / Consultancy: test. M....
Source: Annals of Oncology - Category: Cancer & Oncology Source Type: research
AbstractBackgroundThe presence of high levels of tumor immune infiltrate has been recognized to be associated with better prognosis in Head and Neck cancer (H&N). The consensus Immunoscore quantifies the densities of CD3 and CD8 in the center of the tumour (CT) and the invasive margin (IM) and stratifies patients into 3 Immunoscore categories (Low, Intermediate and High). Table: 1115PDCutpointSensitivitySpecificityN (prevalence)ORR, %Odds Ratio (CI)PFS HR (CI)OS HR (CI)TPS ≥50%0.470.7765 (0.27)26.23.83 (1.31, 11.15)0.59 (0.40, 0.87)0.54 (0.36, 0.82)TPS ≥20%0.560.6494 (0.39)21.31.84 (0.83, 4.11)0.72 (0.52, 0.99)0.66 (...
Source: Annals of Oncology - Category: Cancer & Oncology Source Type: research
Conclusions: HART represents an attractive approach for patients with HNSCC where treatment intensification is indicated. PMID: 31519130 [PubMed - as supplied by publisher]
Source: Acta Oncologica - Category: Cancer & Oncology Authors: Tags: Acta Oncol Source Type: research
CONCLUSIONS: Definitive carboplatin-based chemoRT was equivalent to cisplatin-based therapy and superior to RT alone and RT with concurrent cetuximab. In light of recent results of the RTOG 1016 and De-ESCALaTE trials, our findings suggest that carboplatin-based regimens warrant prospective investigation as an alternative to cisplatin for patients who are not cisplatin candidates. PMID: 31487677 [PubMed - in process]
Source: Journal of the National Comprehensive Cancer Network : JNCCN - Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research
Authors: Tangsriwong K, Jitreetat T Abstract PURPOSE: To determine factors affecting laryngeal preservation rate in laryngeal and hypopharyngeal cancer patientstreated with organ preservation. MATERIAL AND METHODS: Retrospective study examining stage III to IV laryngeal andhypopharyngeal cancer patients who have been treated with organ preservation. Conventional radiation must be appliedin all patients with minimum dose of 45 Gray. Weekly or triweekly chemotherapy can be adding during radiation. Salvagesurgery should be considered in residual disease or local recurrence. Kaplan-Meier was used for survival analy...
Source: Asian Pacific Journal of Cancer Prevention - Category: Cancer & Oncology Tags: Asian Pac J Cancer Prev Source Type: research
Nature Reviews Clinical Oncology, Published online: 12 June 2019; doi:10.1038/s41571-019-0227-zThe authors of this Review discuss treatments currently available for patients with head and neck squamous cell carcinomas (focusing in those of the oral cavity, oropharynx, hypopharynx and larynx). Advances in surgical and non-surgical approaches (mainly combinations of radiotherapy and chemotherapy) are discussed, including the first immunotherapeutic agents approved for these malignancies.
Source: Nature Reviews Clinical Oncology - Category: Cancer & Oncology Authors: Source Type: research
AbstractPurposeThe present work aims at evaluating intensity-modulated radiation therapy with simultaneous integrated boost (IMRT-SIB) in squamous cell carcinomas (SCC) of the larynx and hypopharynx.Methods/patientsWe performed a single institutional retrospective analysis on 116 pharyngo (29%)-laryngeal (71%) SCC patients (93% male) treated with IMRT-SIB to 66 –69.96 Gy in 33 fractions between 2008 and 2016. Those who underwent surgery (54%) received adjuvant radiation of 66 Gy at 2 Gy/fraction to the surgical bed. 16 patients (14%) were treated for a local recurrence after prior surgery. High-risk ly...
Source: Clinical and Translational Oncology - Category: Cancer & Oncology Source Type: research
CONCLUSIONS: These data suggest that HPV status may be a prognostic factor in patients with T4a LSCC. Further, it supports further investigation into the usefulness of HPV status as a selection factor for larynx preservation with CRT in these patients. PMID: 31174105 [PubMed - as supplied by publisher]
Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology - Category: Radiology Authors: Tags: Radiother Oncol Source Type: research
For long, the treatment of locoregionally laryngeal and hypopharyngeal squamous cell cancer consisted of either total laryngectomy (TL) or radical radiotherapy (RT). The appearance of induction cisplatin/5fluorouracil (PF) and the correlation between chemo and radiosensitivity in previously untreated patients opened a new era of treatment aiming at larynx preservation (LP). The concept was to select patients to either TL or RT according to the tumour response to induction PF. The first two trials (VALGSG for larynx SCC and EORTC 24891 for hypopharynx SCC) concluded that such an approach could preserve nearly 60 % of lar...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
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