Squamous Cell Carcinoma of the Head and Neck: Dramatic Response to Chemoradiotherapy (original) (raw)
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Patients with Squamous Cell Carcinoma of the Head and Neck
This study assessed the radiation dosimetry of 99m Tc-labeled ethylene dicysteine (EC) C225 (EC-C225), a promising radioligand for functional tumor imaging. Methods: Whole-body scanning was performed on 6 patients with head and neck squamous cell carcinoma up to 24 h after administration of 99m Tc-EC-C225. Alternate patients who had been randomized to receive C225 in a phase III trial received 99m Tc-EC-C225 before their 20-mg test dose or after their 400 mg/m 2 loading dose of unlabeled C225 (patients 1/3/5 and 2/4/6, respectively). Radiation dosimetry was assessed using the MIRD method. Results: The critical organ was the kidney, with an average radiationabsorbed dose for all 6 patients of 0.0274 mGy/MBq. The average total-body absorbed dose was 0.0022 mGy/MBq (0.243 cGy/1,110 MBq). Conclusion: The new radiopharmaceutical 99m Tc-EC-C225 appears to have reasonable dosimetric properties for a diagnostic nuclear medicine agent. Correlation of the imaging results with clinical findings is the next step.
Squamous cell skin carcinoma of the head and neck: results of treatment for advanced disease
Clinical & Translational Oncology, 2004
Introduction Advanced squamous cell skin carcinoma of the head & neck represents a therapeutic challenge and the purpose of the present study was to identify factors related to disease recurrence and survival. Material and methods Clinical case records of 104 patients were reviewed. Results Tumours were located in scalp (28%), nose (23%), cheek (19%), ear (17%) and eyelids (12%). Of the tumours, 57% were >2cm and lymph node metastases were present in 12%. Treatment administered was surgery (46%), radiotherapy (35%). Surgery + radiotherapy (16%) and chemo-radiotherapy (3%). Most relapses were local (23%). Positive margin was associated with lower recurrence (7% vs 37%; p=0.047). Mortality was associated with tumour size >4 cm (p=0.020); scalp, cheek and ear location (p=0.025); deep penetration (p=0.005); single-modality of treatment (p=0.021). Conclusions Patients with large tumours (>4 cm) located in scalp, cheek and ear together with deep penetration and with positive margins need to be treated aggressively. Introducción El carcinoma cutáneo avanzado de células escamosas en la cabeza y el cuello representa un problema terapéutico. El objetivo de este estudio es identificar factores asociados con recaída y supervivencia. Material y métodos Se revisaron los registros clínicos de 104 pacientes. Resultados El tumor estuvo localizado en el cuero cabelludo (28%), nariz (23%), mejilla (19%), pabellón auricular (17%) y párpados (12%). De los tumores 57% eran>2 cm y metástasis ganglionares estaban presentes en 12%. El tratamiento primario fue cirugía en 46%, radioterapia en 35%, cirugía más radioterapia en 16% y quimiorradioterapia en 3%. La mayoría de las recaídas fueron locales (23%). Los márgenes positivos se asociaron a menor recaída (7% frente a 37%, p=0,047). La mortalidad se asoció con el tamano tumoral>4 cm (p=0,020), localización en el cuero cabelludo, mejilla o pabellón auricular (p=0,025), penetración profunda (p=0,005) y una sola modalidad de tratamiento (p=0.021). Conclusiones Los pacientes con tumores>4 cm localizados en el cuero cabelludo, mejilla o pabellón auricular y con penetración profunda o márgenes positivos deben ser tratados en forma agresiva.
High-Risk Cutaneous Squamous Cell Carcinoma of the Head and Neck: A Clinical Review
Annals of Surgical Oncology, 2021
BACKGROUND. Most patients with cutaneous squamous cell carcinoma (cSCC) of the head and neck (HN) are at low-risk (Ͻ 5%) of developing metastatic SCC to regional lymph nodes. However, patients with unfavorable clinicopathologic factors often are under appreciated by clinicians but remain at higher risk for developing metastatic lymph node disease and dying. METHODS. Patients were identified who had metastatic cSCC to lymph nodes (parotid and cervical) of the HN and who were treated within the context of a multidisciplinary HN cancer service between 1980 and 2005 at Westmead Hospital (Sydney, Australia). Relevant patient details and data from primary lesions were analyzed and reported. RESULTS. In total, 266 patients were treated with curative intent. The median patient age was 69 years among 219 males and 47 females. The majority of metastatic lymph nodes (162 of 266 lymph nodes; 61%) were located in the parotid with or without cervical lymph node involvement. The median tumor thickness was 6 mm (range, 0.5-28 mm), and the median tumor size was 15 mm (range, 3-70 mm). Most tumors (65%) that measured Ն5 mm in thickness, and 30% of patients had lesions that measured Ն2 cm in greatest dimension. Recurrent cSCC was present in 15% of patients, and most lesions were located within the lymphatic drainage of the parotid on the temple/forehead (28%), on or around the ear (20%), or on the cheek (12%). Forty-six percent of patients had moderately or poorly differentiated cSCC, and 5% of patients were immunosuppressed. A minority of patients (27%) did not have an identifiable index lesion. CONCLUSIONS. Data from this large, prospective data base, in concordance with other series, suggested that a patient with thick cSCC (Ͼ4-5 mm) located in proximity to the parotid gland can be considered at high-risk. Increasing lesion size and recurrence contribute to this risk.
Metastatic cutaneous squamous cell carcinoma of the head and neck
Cancer, 2009
The authors propose a prognostic score model using a prospective study of patients with regional metastatic cutaneous squamous cell carcinoma of the head and neck. METHODS: Two-hundred fifty patients were analyzed using a competing risks model to identify risk factors for survival. A risk score was obtained using the significant coefficients from the regression model, and cutoff points were determined that separated the score into 3 risk groups (low risk, moderate risk, and high risk). RESULTS: At a median follow-up of 54 months (range, 1.3-212 months) 70 of 250 patients (28%) developed recurrent disease: Most were regional recurrences (51 of 70 patients; 73%) in the treated lymph node basin. After regional recurrence, a majority (73%) died of disease. The following 4 variables were associated significantly with survival: immunosuppression (hazard ratio [HR], 3.13; 95% confidence interval [CI], 1.39-7.05), treatment (HR, 0.32; 95% CI, 0.16-0.66), extranodal spread (HR, 9.92; 95% CI, 1.28-77.09), and margin status (HR, 1.85; 95% CI, 1.85-3.369); and those 4 variables (immuosuppression, treatment, extranodal spread, and margin status) were used to calculate the ITEM score. The 5-year risk of dying from disease for patients with high-risk (>3.0), moderate-risk (>2.6-3.0), and low-risk ( 2.6) ITEM scores were 56%, 24%, and 6%, respectively. Fifty-six of 250 patients (22%) died from another cause. CONCLUSIONS: Patients who underwent surgery and received adjuvant radiotherapy had a better outcome compared with patients who underwent surgery alone. Patients who had moderate-or high-risk ITEM scores, usually because of extranodal spread and involved excision margins, had a poor outcome. The authors recommend considering these patients for inclusion in adjuvant chemoradiotherapy trials.
Head and Neck Squamous Cell Carcinoma: A Review Article
Post-Graduate Medical Journal of NAMS, 2020
Head and Neck Squamous Cell Cancer (HNSCC) is one of the major health related burdens worldwide, causing high morbidities and significant number of mortalities, accounting for more than 800,000 new cases every year. HNSCC usually develops in males in the 6th and 7th decade. Major risk factors of HNSCC are the consumption of tobacco and alcohol and infection with high-risk types of human papillomavirus. HNSCC often develops from preexisting dysplastic lesions. Particular chromosomal alterations appear to be associated with distinct stages of tumor progression. Management of head and neck cancers is complex and involves multiple modalities therefore a multidisciplinary approach is mandatory. Surgery, radiation and chemotherapy are the backbones of the treatment. Majorities of the patients present in the locoregionally advanced disease. Similarly, almost 10% of newly diagnosed patients present with distant metastatic disease. Almost 60% of these patients even after aggressive, site-specific multimodality therapy, fail locally and up to a 30% develop distant metastases. Targeted therapy and Immunotherapy are recent advances in the management of refractory HNSCC to conventional treatments.
Squamous cell carcinomas of the head and neck: descriptive analysis of 1293 cases
The Journal of Laryngology & Otology, 1997
Medical reports of 1293 patients with squamous cell carcinoma (SCC) of the head and neck were retrospectively evaluated. The patients were classified according to their age, sex, primary tumour localization and tumoral stage. There were 1181 males (91.3 per cent) and 112 females (8.7 per cent), with a male to female ratio of 10.5:1. The peak incidences for all primary tumour localizations were observed in the fifth decade. Most common primary tumour localizations were the larynx (71.1 per cent), the nasopharynx (10.1 per cent) and the oral cavity (8.8 per cent). Of all patients in whom staging was complete, 43.1 per cent presented at early and 56.9 per cent at advanced stages. The proportion of patients presenting with metastatic neck nodes was 34.4 per cent and the incidence of metastatic neck nodes increased with increasing T stage. The supraglottic region was the most common primary site among all laryngeal SCC, with a supraglottic to glottic SCC ratio of 1.5:1. Glottic SCC presented at earlier stages compared to supraglottic SCC. The incidence of nodal metastases increased with increasing T stage for SCC of the larynx, the oral cavity and the oropharynx.
Objective: To determine the risk of factors involved in order to promote the education of the community for better prevention of the disease. Material and Methods: This study was conducted at AIMS hospital and the duration of this study was from July 2019 to March 2020. 98 patients were the participants of this study. The mean age of patients is 51±9.31 years the enrolled 55% of patients were male and 45% females. Among the patients enrolled for the study, 66% were from urban areas and 34% belonged to rural areas. Conclusion: Head and Neck squamous carcinoma is the most common form of tumor in Head and Neck region. The most common site is hypopharynx and the most important risk factor is smoking. The highest incidence of the disease in 5 th decade. Head and Neck tumor comprises Neoplastic growth of the oral cavity including Nasal cavity, Pharyngeal cavity, salivary glands, lips and Paranasal sinuses. HNC (head and neck carcinoma) comprises 6% of total tumors of the world. 110,000 patients are diagnosed with HNC in Europe/year.
Head and neck squamous cell carcinoma : Mansoura 10 years experience
2005
Head and neck (H&N) cancers are the sixth most prevalent cancers in the world with squamous cell carcinoma (SCC) constituting around 90% of it. One hundred and eighty eight patients with H&N SCC were treated at Mansoura University Hospital in the period from January 1990 to December 1999 inclusive. For those 188 cases we analyzed their clinicoepidemiologic data, survival, prognostic factors, patterns of failure and toxicity of therapy. Unfortunately 75.5% of the cases presented in advanced stages. The median eventfree survival duration was 14 months, while the median overall survival duration was 22 months. The 5-year eventfree survival and overall survival were 45% and 53%, respectively. On multivariate analysis for event-free survival, only performance status and grade were significant (p ≤0.05). On the other hand multivariate analysis for overall survival found only performance status and stage to be significant (p ≤0.05). Local failure exceeded in incidence both nodal and distan...
High-risk cutaneous squamous cell carcinoma of the head and neck
Cancer, 2006
BACKGROUND. Most patients with cutaneous squamous cell carcinoma (cSCC) of the head and neck (HN) are at low-risk (Ͻ 5%) of developing metastatic SCC to regional lymph nodes. However, patients with unfavorable clinicopathologic factors often are under appreciated by clinicians but remain at higher risk for developing metastatic lymph node disease and dying.