Michael Hinni | Mayo Clinic (original) (raw)

Papers by Michael Hinni

International Journal of Radiation Oncology Biology Physics, Mar 1, 2016

International Journal of Radiation Oncology Biology Physics, Apr 1, 2018

Annals of Otology, Rhinology, and Laryngology, Jan 5, 2017

Oral Oncology, Nov 1, 2020

International Journal of Radiation Oncology Biology Physics, Nov 1, 2012

Advances in Radiation Oncology

International Journal of Radiation Oncology*Biology*Physics

International Journal of Radiation Oncology*Biology*Physics

International Journal of Radiation Oncology*Biology*Physics, 2020

International journal of radiation oncology, biology, physics, 2020

PURPOSE/OBJECTIVE(S) De-escalated treatment for HPV+ Oropharynx squamous cell carcinoma (OPSCC) h... more PURPOSE/OBJECTIVE(S) De-escalated treatment for HPV+ Oropharynx squamous cell carcinoma (OPSCC) has shown promising initial results. Healthcare policy is increasingly focusing on high value care. This analysis compares the cost of care for HPV+ OPSCC treated with definitive chemoradiation (CRT), surgery and adjuvant radiation (RT), and surgery and de-escalated CRT on ***. MATERIALS/METHODS *** is a prospective phase II study evaluating adjuvant CRT to 30-36 Gy plus docetaxel for HPV+ OPSCC after surgery for high-risk patients. Matched standard of care control groups were retrospectively identified for patients treated with definitive CRT or adjuvant RT. Standardized costs were evaluated in pre-radiation, treatment (during RT), short-term (6-month), and long-term (7-24 month) follow-up periods. RESULTS A total 56 definitive CRT, 101 adjuvant RT, and 66 *** patients were included. The CRT arm had more T3-4 disease (63% vs 17-21%) and higher N2c-N3 disease (52% vs 20-24%). Total treatm...

International Journal of Radiation Oncology*Biology*Physics, 2021

International Journal of Radiation Oncology*Biology*Physics, 2021

PURPOSE/OBJECTIVE(S) We previously reported the two-year results of MC1273, a phase II trial eval... more PURPOSE/OBJECTIVE(S) We previously reported the two-year results of MC1273, a phase II trial evaluating 30-36 Gy of adjuvant radiation therapy (RT) for selected patients (pts) with HPV+ OPSCC. Herein we report the long-term disease control and toxicity rates for this de-escalated regimen. MATERIALS/METHODS Details for the MC1273 regimen have previously been published. All pts received surgery & neck dissection for a margin negative resection. Eligibility criteria included pts with HPV+OPSCC, ≤10 pack-year smoking history, and negative margins. Cohort A (≥T3, ≥N2, lymphovascular invasion, or perineural invasion) received 30 Gy delivered in 1.5 Gy b.i.d. over 12 days along with weekly docetaxel (15 mg/m2, days 1 & 8). Pts with +ECE were enrolled in Cohort B and received the same treatment plus a simultaneous integrated boost to nodal levels with ECE to 36 Gy in 1.8 Gy b.i.d. The primary endpoint was local/regional control (LRC) at 2 years with each cohort powered to detect a 10% locoregional failure rate with 85% confidence. Secondary endpoints included 2-yr progression free survival (PFS), overall survival (OS), toxicity, swallow function, and pt reported QOL. Follow-up was q3 mos for the first 2 years, q6 mo for year 3, and yearly until year 5. Based upon the 2-year MC1273 data, pts with pT4 disease were excluded from MC1675, the follow-up phase III trial randomizing pts to the 30-36 Gy regimen versus a standard 60 Gy regimen. RESULTS Accrual was from September 2013 to June 2016 (n = 80, 1 ineligible, Cohort A: 37, Cohort B: 43, median (range) age 61 years (25 - 77), male n = 71 (89.9%). Median follow-up for alive pts as of 2/22/21 was 52 mos (30 - 67). Late grade 2 or higher toxicity rates at 2, 3, and 5 years were 6.7%, 6.8%, and 5.0%, respectively, with the most common being dry mouth (1.7%, 3.4%, and 0.0% at years 2, 3, and 5) and dysphagia (3.3%, 0.0%, and 5.0% at years 2, 3, and 5). Grade 3 rates were 0.0%, 0.0%, and 1.2% at years 2, 3, and 5, respectively, with one pt who developed a malignant peripheral nerve sheath tumor in the brachial plexus at the edge of the neck volume 51 mo after RT. The 2, 3, and 5 year disease metrics for the entire study population, Cohort A, and Cohort B can be found in the Table, along with an unplanned subset analysis for pts qualifying for MC1675 (n = 72). CONCLUSION MC1273 maintained excellent long-term disease control rates comparable to historical controls, particularly in the intermediate risk cohort and pts qualifying for MC1675. Toxicity rates remained low long-term.

International Journal of Radiation Oncology*Biology*Physics, 2021

PURPOSE/OBJECTIVE(S) Salivary duct carcinomas (SDC) make up < 2% of salivary duct tumors but a... more PURPOSE/OBJECTIVE(S) Salivary duct carcinomas (SDC) make up < 2% of salivary duct tumors but are very aggressive with a low 5-year survival rate of 35%. This series reports long term outcomes of patients with SDC treated at a single institution. MATERIALS/METHODS Patients ≥18 years with histological confirmation of SDC treated with curative intent from 1961-2018 were included in this analysis. Patients were excluded if treatment was palliative intent (N = 14), and if staging (N = 4) or locoregional control (LRC) status (N = 7) was not recorded. 89 patients (74% male) met criteria for inclusion. Median age was 66 years (range: 32 - 89). AJCC 8 staging of patients were as follows: 13% (I), 6% (II), 12% (III), 62% (IVa), and 7% (IVb). 67% of patients were lymph node positive. Kaplan Meier analyses were used to estimate LRC and OS rates. Bivariate regression analyses using disease and treatment characteristics (i.e., perineural invasion (PNI), extracapsular extension (EE), vascular invasion (VI), CN VII sacrifice, extraparenchymal involvement (EI)) for prediction of LRC and OS were performed. RESULTS Median follow-up was 48.5 months (0.4-343 mo). Most patients were treated with combined modality therapy; 82% (n = 73) undergoing curative surgery followed by adjuvant radiotherapy (RT) with (26%, n = 23) or without (56%, n = 50) concurrent chemo while 4.5% (n = 4) were treated with definitive RT; 2.3% (n = 2) receiving concurrent chemo. 13.5% (n = 12) were treated with surgery alone. Crude post-treatment LRC after surgery alone, surgery followed by adjuvant RT, and definitive RT alone were 66.7, 78.1 and 0% (P = 0.002), respectively. The odds of achieving LRC were diminished with incidence of VI (odds ratio (OR) = 0.07, P = 0.02), EI (OR = 0.3, P = 0.03), and T3/T4 staging (OR = 0.3, P = 0.03). Chemotherapy did not influence LRC. The occurrence of distant metastases was associated with PNI (OR = 5, P = 0.003) and EI (OR = 2.6, P = 0.03). EI status was also associated with a shorter time to recurrence (26 vs 17.3 mo, P = 0.04). Median overall survival (OS) was 55.3 months (41.7-81.7 95% CI) with 82% surviving at 2 years, 47% at 5 years, and 28% at 10 years. Failure to achieve LRC (81.7 vs 36 mo, P < 0.001), distant metastases (108.5 vs 41.7 mo, P < 0.001), VI (86.2 vs 46.8 mo, P = 0.046), T3/T4 staging (125.8 vs 48.8 mo, P = 0.02), PNI (88.1 vs 48.8 mo, P = 0.03), and EI (108.5 vs 47.3 mo, P = 0.004) were found to significantly reduce median OS. CONCLUSION SDC is an aggressive tumor that requires a multimodality treatment approach. Patients analyzed here had a 5-year survival greater than what is typically reported for SDC (47 vs. 35%). Definitive radiotherapy was less likely to control gross disease and should be reserved for the adjuvant setting if surgery is an option. We identified incidence of extraparenchymal involvement, perineural and vascular invasion as negative prognostic indicators of disease control and survival.

Head & Neck, 2020

Aggressive dose de‐escalated adjuvant radiation therapy (RT) in patients with human papillomaviru... more Aggressive dose de‐escalated adjuvant radiation therapy (RT) in patients with human papillomavirus–associated oropharyngeal squamous cell carcinoma (HPV(+)OPSCC).

American Journal of Otolaryngology, 2021

PURPOSE Determine rates of intra-parotid and neck nodal metastasis, identify risk factors for rec... more PURPOSE Determine rates of intra-parotid and neck nodal metastasis, identify risk factors for recurrence, and report outcomes in patients with primary high-grade parotid malignancy who undergo total parotidectomy and neck dissection. MATERIALS & METHODS Retrospective review of patients undergoing total parotidectomy and neck dissection for high-grade parotid malignancy between 2005 and 2015. The presence and number of parotid lymph nodes, superficial and deep, as well as cervical lymph nodes involved with metastatic disease were assessed. Risk factors associated with metastatic spread to the parotid deep lobe were identified and recurrence rates reported. RESULTS 75 patients with median follow-up time of 47 months. 35 patients (46.7%) had parotid lymph node metastasis. Seven patients (9.3%) had deep lobe nodal metastasis without metastasis to the superficial lobe nodes. Nine patients (12%) had positive intra-parotid nodes without positive cervical nodes. Cervical nodal disease was identified in 49.3% patients (37/75). Local, parotid-bed recurrence rate was 5.3% (4/75). Regional lymph node recurrence rate was also 5.3% (4/75). Rate of distant metastasis was 30.6% (23/75). The overall disease free survival rate for all patients at 2 and 5 years were 71% and 60% respectively. CONCLUSION Parotid lymph node metastasis occurred at a similar rate to cervical lymph node metastasis (46.7% and 49.3%, respectively). Deep lobe parotid nodal metastasis occurred in nearly a quarter of patients and can occur without superficial parotid nodal metastasis. Rate of recurrence in the parotid bed, which may represent local or regional recurrence, was similar to regional cervical lymph node recurrence. Total parotidectomy and neck dissection should be considered high-grade parotid malignancy regardless of clinical nodal status.

International Journal of Radiation Oncology*Biology*Physics, 2018

International Journal of Radiation Oncology*Biology*Physics, 2020

Journal of Clinical Oncology, 2019

International Journal of Radiation Oncology Biology Physics, Mar 1, 2016

International Journal of Radiation Oncology Biology Physics, Apr 1, 2018

Annals of Otology, Rhinology, and Laryngology, Jan 5, 2017

Oral Oncology, Nov 1, 2020

International Journal of Radiation Oncology Biology Physics, Nov 1, 2012

Advances in Radiation Oncology

International Journal of Radiation Oncology*Biology*Physics

International Journal of Radiation Oncology*Biology*Physics

International Journal of Radiation Oncology*Biology*Physics, 2020

International journal of radiation oncology, biology, physics, 2020

PURPOSE/OBJECTIVE(S) De-escalated treatment for HPV+ Oropharynx squamous cell carcinoma (OPSCC) h... more PURPOSE/OBJECTIVE(S) De-escalated treatment for HPV+ Oropharynx squamous cell carcinoma (OPSCC) has shown promising initial results. Healthcare policy is increasingly focusing on high value care. This analysis compares the cost of care for HPV+ OPSCC treated with definitive chemoradiation (CRT), surgery and adjuvant radiation (RT), and surgery and de-escalated CRT on ***. MATERIALS/METHODS *** is a prospective phase II study evaluating adjuvant CRT to 30-36 Gy plus docetaxel for HPV+ OPSCC after surgery for high-risk patients. Matched standard of care control groups were retrospectively identified for patients treated with definitive CRT or adjuvant RT. Standardized costs were evaluated in pre-radiation, treatment (during RT), short-term (6-month), and long-term (7-24 month) follow-up periods. RESULTS A total 56 definitive CRT, 101 adjuvant RT, and 66 *** patients were included. The CRT arm had more T3-4 disease (63% vs 17-21%) and higher N2c-N3 disease (52% vs 20-24%). Total treatm...

International Journal of Radiation Oncology*Biology*Physics, 2021

International Journal of Radiation Oncology*Biology*Physics, 2021

PURPOSE/OBJECTIVE(S) We previously reported the two-year results of MC1273, a phase II trial eval... more PURPOSE/OBJECTIVE(S) We previously reported the two-year results of MC1273, a phase II trial evaluating 30-36 Gy of adjuvant radiation therapy (RT) for selected patients (pts) with HPV+ OPSCC. Herein we report the long-term disease control and toxicity rates for this de-escalated regimen. MATERIALS/METHODS Details for the MC1273 regimen have previously been published. All pts received surgery & neck dissection for a margin negative resection. Eligibility criteria included pts with HPV+OPSCC, ≤10 pack-year smoking history, and negative margins. Cohort A (≥T3, ≥N2, lymphovascular invasion, or perineural invasion) received 30 Gy delivered in 1.5 Gy b.i.d. over 12 days along with weekly docetaxel (15 mg/m2, days 1 & 8). Pts with +ECE were enrolled in Cohort B and received the same treatment plus a simultaneous integrated boost to nodal levels with ECE to 36 Gy in 1.8 Gy b.i.d. The primary endpoint was local/regional control (LRC) at 2 years with each cohort powered to detect a 10% locoregional failure rate with 85% confidence. Secondary endpoints included 2-yr progression free survival (PFS), overall survival (OS), toxicity, swallow function, and pt reported QOL. Follow-up was q3 mos for the first 2 years, q6 mo for year 3, and yearly until year 5. Based upon the 2-year MC1273 data, pts with pT4 disease were excluded from MC1675, the follow-up phase III trial randomizing pts to the 30-36 Gy regimen versus a standard 60 Gy regimen. RESULTS Accrual was from September 2013 to June 2016 (n = 80, 1 ineligible, Cohort A: 37, Cohort B: 43, median (range) age 61 years (25 - 77), male n = 71 (89.9%). Median follow-up for alive pts as of 2/22/21 was 52 mos (30 - 67). Late grade 2 or higher toxicity rates at 2, 3, and 5 years were 6.7%, 6.8%, and 5.0%, respectively, with the most common being dry mouth (1.7%, 3.4%, and 0.0% at years 2, 3, and 5) and dysphagia (3.3%, 0.0%, and 5.0% at years 2, 3, and 5). Grade 3 rates were 0.0%, 0.0%, and 1.2% at years 2, 3, and 5, respectively, with one pt who developed a malignant peripheral nerve sheath tumor in the brachial plexus at the edge of the neck volume 51 mo after RT. The 2, 3, and 5 year disease metrics for the entire study population, Cohort A, and Cohort B can be found in the Table, along with an unplanned subset analysis for pts qualifying for MC1675 (n = 72). CONCLUSION MC1273 maintained excellent long-term disease control rates comparable to historical controls, particularly in the intermediate risk cohort and pts qualifying for MC1675. Toxicity rates remained low long-term.

International Journal of Radiation Oncology*Biology*Physics, 2021

PURPOSE/OBJECTIVE(S) Salivary duct carcinomas (SDC) make up < 2% of salivary duct tumors but a... more PURPOSE/OBJECTIVE(S) Salivary duct carcinomas (SDC) make up < 2% of salivary duct tumors but are very aggressive with a low 5-year survival rate of 35%. This series reports long term outcomes of patients with SDC treated at a single institution. MATERIALS/METHODS Patients ≥18 years with histological confirmation of SDC treated with curative intent from 1961-2018 were included in this analysis. Patients were excluded if treatment was palliative intent (N = 14), and if staging (N = 4) or locoregional control (LRC) status (N = 7) was not recorded. 89 patients (74% male) met criteria for inclusion. Median age was 66 years (range: 32 - 89). AJCC 8 staging of patients were as follows: 13% (I), 6% (II), 12% (III), 62% (IVa), and 7% (IVb). 67% of patients were lymph node positive. Kaplan Meier analyses were used to estimate LRC and OS rates. Bivariate regression analyses using disease and treatment characteristics (i.e., perineural invasion (PNI), extracapsular extension (EE), vascular invasion (VI), CN VII sacrifice, extraparenchymal involvement (EI)) for prediction of LRC and OS were performed. RESULTS Median follow-up was 48.5 months (0.4-343 mo). Most patients were treated with combined modality therapy; 82% (n = 73) undergoing curative surgery followed by adjuvant radiotherapy (RT) with (26%, n = 23) or without (56%, n = 50) concurrent chemo while 4.5% (n = 4) were treated with definitive RT; 2.3% (n = 2) receiving concurrent chemo. 13.5% (n = 12) were treated with surgery alone. Crude post-treatment LRC after surgery alone, surgery followed by adjuvant RT, and definitive RT alone were 66.7, 78.1 and 0% (P = 0.002), respectively. The odds of achieving LRC were diminished with incidence of VI (odds ratio (OR) = 0.07, P = 0.02), EI (OR = 0.3, P = 0.03), and T3/T4 staging (OR = 0.3, P = 0.03). Chemotherapy did not influence LRC. The occurrence of distant metastases was associated with PNI (OR = 5, P = 0.003) and EI (OR = 2.6, P = 0.03). EI status was also associated with a shorter time to recurrence (26 vs 17.3 mo, P = 0.04). Median overall survival (OS) was 55.3 months (41.7-81.7 95% CI) with 82% surviving at 2 years, 47% at 5 years, and 28% at 10 years. Failure to achieve LRC (81.7 vs 36 mo, P < 0.001), distant metastases (108.5 vs 41.7 mo, P < 0.001), VI (86.2 vs 46.8 mo, P = 0.046), T3/T4 staging (125.8 vs 48.8 mo, P = 0.02), PNI (88.1 vs 48.8 mo, P = 0.03), and EI (108.5 vs 47.3 mo, P = 0.004) were found to significantly reduce median OS. CONCLUSION SDC is an aggressive tumor that requires a multimodality treatment approach. Patients analyzed here had a 5-year survival greater than what is typically reported for SDC (47 vs. 35%). Definitive radiotherapy was less likely to control gross disease and should be reserved for the adjuvant setting if surgery is an option. We identified incidence of extraparenchymal involvement, perineural and vascular invasion as negative prognostic indicators of disease control and survival.

Head & Neck, 2020

Aggressive dose de‐escalated adjuvant radiation therapy (RT) in patients with human papillomaviru... more Aggressive dose de‐escalated adjuvant radiation therapy (RT) in patients with human papillomavirus–associated oropharyngeal squamous cell carcinoma (HPV(+)OPSCC).

American Journal of Otolaryngology, 2021

PURPOSE Determine rates of intra-parotid and neck nodal metastasis, identify risk factors for rec... more PURPOSE Determine rates of intra-parotid and neck nodal metastasis, identify risk factors for recurrence, and report outcomes in patients with primary high-grade parotid malignancy who undergo total parotidectomy and neck dissection. MATERIALS & METHODS Retrospective review of patients undergoing total parotidectomy and neck dissection for high-grade parotid malignancy between 2005 and 2015. The presence and number of parotid lymph nodes, superficial and deep, as well as cervical lymph nodes involved with metastatic disease were assessed. Risk factors associated with metastatic spread to the parotid deep lobe were identified and recurrence rates reported. RESULTS 75 patients with median follow-up time of 47 months. 35 patients (46.7%) had parotid lymph node metastasis. Seven patients (9.3%) had deep lobe nodal metastasis without metastasis to the superficial lobe nodes. Nine patients (12%) had positive intra-parotid nodes without positive cervical nodes. Cervical nodal disease was identified in 49.3% patients (37/75). Local, parotid-bed recurrence rate was 5.3% (4/75). Regional lymph node recurrence rate was also 5.3% (4/75). Rate of distant metastasis was 30.6% (23/75). The overall disease free survival rate for all patients at 2 and 5 years were 71% and 60% respectively. CONCLUSION Parotid lymph node metastasis occurred at a similar rate to cervical lymph node metastasis (46.7% and 49.3%, respectively). Deep lobe parotid nodal metastasis occurred in nearly a quarter of patients and can occur without superficial parotid nodal metastasis. Rate of recurrence in the parotid bed, which may represent local or regional recurrence, was similar to regional cervical lymph node recurrence. Total parotidectomy and neck dissection should be considered high-grade parotid malignancy regardless of clinical nodal status.

International Journal of Radiation Oncology*Biology*Physics, 2018

International Journal of Radiation Oncology*Biology*Physics, 2020

Journal of Clinical Oncology, 2019