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Alexandros Papachristofilou, Madeleine M Hipp, Ute Klinkhardt, Martin Früh, Martin Sebastian, Christian Weiss, Miklos Pless, Richard Cathomas, Wolfgang Hilbe, Georg Pall, Thomas Wehler, Jürgen Alt, Helge Bischoff, Michael Geißler, Frank Griesinger, Karl-Josef Kallen, Mariola Fotin-Mleczek, Andreas Schröder, Birgit Scheel, Anke Muth, Tobias Seibel, Claudia Stosnach, Fatma Doener, Henoch S Hong, Sven D Koch, Ulrike Gnad-Vogt, Alfred Zippelius
BACKGROUND: Preclinical studies demonstrate synergism between cancer immunotherapy and local radiation, enhancing anti-tumor effects and promoting immune responses. BI1361849 (CV9202) is an active cancer immunotherapeutic comprising protamine-formulated, sequence-optimized mRNA encoding six non-small cell lung cancer (NSCLC)-associated antigens (NY-ESO-1, MAGE-C1, MAGE-C2, survivin, 5T4, and MUC-1), intended to induce targeted immune responses. METHODS: We describe a phase Ib clinical trial evaluating treatment with BI1361849 combined with local radiation in 26 stage IV NSCLC patients with partial response (PR)/stable disease (SD) after standard first-line therapy...
February 8, 2019: Journal for Immunotherapy of Cancer
Taoran Cui, Matthew C Ward, Nikhil P Joshi, Neil M Woody, Eric J Murray, John Potter, Andrew A Dorfmeyer, John F Greskovich, Shlomo A Koyfman, Ping Xia
BACKGROUND: To evaluate plan quality using volumetric-modulated arc therapy (VMAT) and step-and-shoot intensity-modulated radiation therapy (SS-IMRT) techniques and for patients treated for oropharyngeal squamous cell carcinoma (OPSCC). METHODS: Treatment plans for patients treated definitively for stages I-IVb, OPSCC between December 2009 and August 2015 were retrospectively reviewed. Dosimetric endpoints of involved organs-at-risk (OARs) were retrieved from clinical plans...
January 31, 2019: Head & Neck
Emma Kristen Charters, Hans Bogaardt, Amy L Freeman-Sanderson, Kirrie J Ballard
BACKGROUND: Technological advances in radiotherapy have allowed investigations into new methods to spare healthy tissue in those treated for head and neck cancer. This systematic review with meta-analysis demonstrates the effect that radiation has on swallowing. METHODS: Selection and analysis of studies examining the effect of radiation to swallowing structures. A fixed effects meta-analysis calculated the pooled proportions for select outcomes of dysphagia, common across many studies...
January 24, 2019: Head & Neck
Keiichi Kimura, Yoshito Hayashi, Keisuke Otani, Yoshiki Tsujii, Hideki Iijima, Fumiaki Isohashi, Kazuhiko Ogawa, Tetsuo Takehara
Only a few cases of esophageal granulocyte-colony-stimulating-factor (G-CSF)-producing esophageal carcinosarcoma are reported, and patients with G-CSF-producing tumors are typically considered to have poor prognosis. An 89-year-old man was examined for low-grade fever and dysphagia. Chest computed tomography revealed a huge 80-mm tumor on the thoracic esophagus without direct invasion to surrounding organs. Esophagogastroduodenoscopy (EGD) showed a huge mass occupying the esophageal lumen with a superficial flat lesion...
January 16, 2019: Clinical Journal of Gastroenterology
Douglas J Van Daele, Susan E Langmore, Gintas P Krisciunas, Cathy L Lazarus, Barbara R Pauloski, Timothy M McCulloch, Gary D Gramigna, Barbara P Messing, Cynthia W Wagner, Sarah L Mott
BACKGROUND: Swallowing dysfunction after radiotherapy (RT) for head and neck cancer can be devastating. A randomized control trial compared swallow exercises versus exercise plus neuromuscular electrical stimulation therapy and found no overall difference in outcomes. METHODS: Quality of life (QOL), diet, and swallowing variables collected at discrete intervals on 117 patients were reanalyzed to test the hypothesis that shorter time between the completion of radiotherapy and beginning of the swallowing therapy program yielded improved outcomes...
January 10, 2019: Head & Neck
Elliana Kirsh, Matthew Naunheim, Allison Holman, Rachel Kammer, Mark Varvares, Tessa Goldsmith
OBJECTIVE: The primary objective of this project was to retrospectively investigate the relationship between patient-reported and physiologic swallowing measures after chemoradiation therapy for head neck cancer (HNC). METHODS: Adult patients who underwent chemoradiation therapy for HNC and presented for videofluoroscopic swallow study were reviewed retrospectively. Surgically treated patients were excluded. Patient perception of swallowing-related outcomes was assessed via the MD Anderson Dysphagia Inventory (MDADI) on the same day that physiologic measures of swallow function were obtained...
December 24, 2018: Laryngoscope
Agata Gawryszuk, Hendrik P Bijl, Monique Holwerda, Gyorgy B Halmos, Jan Wedman, Max J H Witjes, Anton M van der Vliet, Bart Dorgelo, Johannes A Langendijk
BACKGROUND AND PURPOSE: In a separate article (PART 1), a rationale and explanation of the physiology-and-anatomy-based concept of Functional Swallowing Units (FSUs) was presented. FSUs are swallowing muscles not included in the set of commonly defined swallowing organs at risk (SWOARs). They are involved in three crucial swallowing components: hyolaryngeal elevation (HLE), tongue base retraction (TBR) and tongue motion. This paper is a continuation of PART 1 and it provides detailed computed tomography (CT)-based delineation guidelines for FSUs, which presumably are also at risk of radiation-induced dysphagia...
December 11, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
R D van der Bogt, B D Vermeulen, A N Reijm, P D Siersema, M C W Spaander
Palliation of dysphagia is the cornerstone of palliative treatment in patients with incurable oesophageal cancer. Available palliative options for dysphagia are oesophageal stent placement and radiotherapy. In general, oesophageal stent placement is the preferred therapeutic option in patients with a relatively poor prognosis because of its rapid relief of dysphagia. Regardless of ongoing technical developments, recurrence of dysphagia and stent-related complications are still occurring. For patients with a relatively good prognosis, intra-luminal brachytherapy is advised because of its sustained palliation of dysphagia...
October 2018: Best Practice & Research. Clinical Gastroenterology
Shearwood McClelland, Janna Z Andrews, Huma Chaudhry, Sewit Teckie, Anuj Goenka
Although chemoradiotherapy (CRT) has improved disease outcomes in advanced head and neck cancer (aHNC), toxicity remains a major concern. Treatment interruptions and decreased quality of life (QOL) can occur due to malnutrition, secondary to mucositis, dysphagia and odynophagia. Gastrostomy tubes are used in many patients to improve nutrition during CRT. The optimal timing of PEG placement in patients with aHNC undergoing CRT remains controversial. Using the PubMed database, we performed a systematic review of published CRT series in aHNC to guide decision-making regarding optimal timing of percutaneous endoscopic gastrostomy (PEG) placement...
December 2018: Oral Oncology
N Patrik Brodin, Rafi Kabarriti, Mark Pankuch, Clyde B Schechter, Vinai Gondi, Shalom Kalnicki, Chandan Guha, Madhur K Garg, Wolfgang A Tomé
PURPOSE: Developing a quantitative decision-support strategy estimating the impact of normal tissue complications from definitive radiation therapy (RT) for head and neck cancer (HNC). We developed this strategy to identify oropharyngeal HNC patients that may benefit most from receiving proton RT. METHODS AND MATERIALS: Recent normal tissue complication probability (NTCP) models for dysphagia, esophagitis, hypothyroidism, xerostomia and oral mucositis were used to estimate NTCP for 33 oropharyngeal HNC patients previously treated with photon IMRT...
November 26, 2018: International Journal of Radiation Oncology, Biology, Physics
Erin Kamarunas, Seng Mun Wong, Christy L Ludlow
Previously, vibratory stimulation increased spontaneous swallowing rates in healthy volunteers indicating that sensory stimulation excited the neural control of swallowing. Here, we studied patients with severe chronic dysphagia following brain injury or radiation for head and neck cancer to determine if sensory stimulation could excite an impaired swallowing system. We examined (1) if laryngeal vibratory stimulation increased spontaneous swallowing rates over sham (no stimulation); (2) the optimal rate of vibration, device contact pressure, and vibratory mode for increasing swallowing rates; and (3) if vibration altered participants' urge to swallow, neck comfort, and swallow initiation latency...
November 28, 2018: Dysphagia
Satish Srinivas Kondaveeti, Divyambika C V, Christopher John, Manickavasagam M, Rajendiran S
Background: A troublesome and usually unavoidable consequence of Head and Neck chemo radiation is oral mucositis which decreases patients’ compliance and negatively influences the outcome of therapy by increasing overall treatment time. Currently, no single effective recommended treatment exists for this problem and a variety of supportive care measures have been practiced with limited benefits. This study was done to evaluate the therapeutic benefit of Placentrex in the management of oral mucositis seen in oral cancer patients undergoing treatment with concurrent chemoradiation...
November 29, 2018: Asian Pacific Journal of Cancer Prevention: APJCP
Rajendra Bhalavat, Vibhay Pareek, Manish Chandra, Lalitha Nellore, Karishma George, Dipalee Borade, Ketan Kalariya, Zaiba Moosa, Amrita Srivastava, Navaneeth Reddy, Ankita Kapoor, Darshana Kawale, Nandakumar P, Pratibha Bauskar
Purpose: High-dose-rate (HDR) interstitial brachytherapy has an established role in head and neck malignancies and offers good survival rates; however, there is scant data on improved local control (LC) and treatment-related complications in recurrent cases. We present our results in patients with recurrent head and neck cancers treated with HDR interstitial brachytherapy. Material and methods: Twenty-five patients with recurrent head and neck cancers were treated with HDR interstitial brachytherapy using Iridium 192 between 2009 and 2016...
October 2018: Journal of Contemporary Brachytherapy
Stephan Maring, Khaled Elsayad, Markus Stenner, Claudia Rudack, Uwe Haverkamp, Jan Rehkämper, Eva Wardelmann, Hans T Eich
BACKGROUND: Cisplatin-based chemotherapy (CTX) is commonly used concurrently with radiotherapy for head and neck cancer. The value of CTX regimens other than cisplatin for locally advanced squamous cell carcinoma of head and neck (LASCCHN) has not been well established. Here we compare the outcome of patients treated with different platinum-based chemotherapy regimens. METHODS: Medical records from 104 patients with LASCCHN treated with radiochemotherapy (RCTX) between February 2013 and August 2016 were analyzed...
2018: Oncology Research and Treatment
Dorothy M Gujral, Christopher M Nutting
Intensity modulated radiotherapy (IMRT) in head and neck cancer allows sculpting of radiation dose to conform closely to target volumes and spare organs at risk. However, this may be offset by an increased risk of a geographical miss and reduction in survival outcomes. We reviewed the data from 5 prospective randomized controlled trials, one prospective phase II trial and 10 retrospective comparative series in terms of patterns of failure, treatment outcomes and late toxicities to determine any compromise in survival outcomes in favour of reduced late toxicity...
November 2018: Oral Oncology
Dan P Zandberg, Kevin Cullen, Soren M Bentzen, Olga G Goloubeva
OBJECTIVE: To evaluate OS and toxicity after definitive radiation with concurrent cetuximab (CTX-RT) compared to radiation with concurrent cytotoxic chemotherapy (CRT) in older HNSCC patients via the SEER-Medicare linked database. MATERIALS AND METHODS: We used the SEER-Medicare linked database to evaluate OS in HNSCC patients (Oropharynx, Larynx, Hypopharynx, Nasopharynx) diagnosed over 2005-2011, following FDA approval of cetuximab in combination with radiation therapy (RT) in March 2006...
November 2018: Oral Oncology
Li Jiang, Chenhui Huang, Yixiu Gan, Tong Wu, Xiaobi Tang, Yiru Wang, Rensheng Wang, Yong Zhang
Dysphagia is a side effect of nasopharyngeal carcinoma chemo-radiotherapy (CRT) which greatly influences the quality of life of the patients. We analyzed late dysphagia in 134 patients with nasopharyngeal cancer undergoing radical radiotherapy (RT), and correlated these findings with dose-volume histogram (DVH) parameters of the swallowing organs at risk (SWOARs). DVH parameters of SWOARs were correlated with late dysphagia, and with RTOG/EORTC scale score and the M. D. Anderson dysphagia inventory (MDADI) score...
November 6, 2018: Scientific Reports
K M Saeed, S Khattak, A A Syed, M A Yusuf
Benign oesophageal strictures can arise in the treatment of oesophageal cancer as a result of radiation therapy, or at anastomotic sites, post-oesophagectomy. Data on the benefit of stenting of these types of stricture is limited. We analyzed the effects of oesophageal stents on such benign esophageal strictures. In this retrospective study, data was obtained from consecutive patients, 18 years and above from January 2000 to May 2016. Inclusion criteria comprised of oesophageal stenting in post-radiation strictures and anastomotic strictures, without any malignant residual disease...
July 2018: Acta Gastro-enterologica Belgica
Ozlem Ozkaya Akagunduz, Sibel Eyigor, Esra Kirakli, Emin Tavlayan, Zeynep Erdogan Cetin, Gulsen Kara, Mustafa Esassolak
Purpose We aimed to restore dose-volume parameters of swallowing-related structures (SRSs) by evaluating long-term swallowing dysfunctions after radiotherapy (RT) in head and neck cancer patients (HNCPs). Materials and Methods Head and neck cancer patients whose pharyngeal region was involved in RT portal and treated with definitive RT/chemoradiotherapy (CRT) were included in the analyses. Patients underwent objective swallowing assessment by flexible endoscopic evaluation of swallowing (FEES). Volumes of SRSs that received 55 Gy (V55 ) (mean dose [Dmean]) were evaluated according to the dose-volume histograms of each patient...
October 20, 2018: Annals of Otology, Rhinology, and Laryngology
Thomas E Stinchcombe, Wen Fan, Steven E Schild, Everett E Vokes, Jeff Bogart, Quynh-Thu Le, Charles R Thomas, Martin J Edelman, Leora Horn, Ritsuko Komaki, Harvey J Cohen, Apar Kishor Ganti, Herbert Pang, Xiaofei Wang
BACKGROUND: Platinum and etoposide with thoracic radiation followed by prophylactic cranial irradiation constitute the standard treatment for limited-stage small cell lung cancer (LS-SCLC). Many patients with LS-SCLC are elderly with comorbidities. METHODS: Individual patient data were collected from 11 phase 2 or 3 trials for LS-SCLC conducted by the National Clinical Trials Network and activated from 1990 to 2010. The primary endpoint was overall survival (OS); the secondary endpoints were progression-free survival (PFS), the rate of severe adverse events, and off-treatment reasons...
October 21, 2018: Cancer
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