Comparative analyses of short- and long-term outcomes between endoscopic submucosal dissection and endoscopic laryngo-pharyngeal surgery for superficial pharyngeal carcinomas.

Objectives: Endoscopic treatment of superficial pharyngeal carcinomas includes endoscopic submucosal dissection (ESD; usually performed by endoscopists), and endoscopic laryngo-pharyngeal surgery (ELPS; primarily performed by otolaryngologists). Few studies have compared the efficacy of the two techniques in treating superficial pharyngeal carcinomas. In this study, we compared the outcomes of these two techniques to determine the advantages. Methods: We retrospectively examined the short- and long-term outcomes of 93 consecutive patients with superficial pharyngeal carcinoma who either underwent an ESD or ELPS between August 2008 and December 2021. Results: There were 35 lesions among 29 patients and 93 lesions among 71 patients in the ESD and ELPS groups, respectively. The ELPS group had a significantly shorter procedure time (121.2 ± 97.4 min vs. 54.7 ± 40.2 min, p<0.01), greater procedure speed (0.10 ± 0.06 min/min vs. 0.30 ± 0.23 min/min, p<0.01), and less laryngeal edema than that of the ESD group. There were no significant differences in the 3-year overall, relapse-free, or disease-specific survival rates between the two groups. Intervention with ESD during ELPS was most commonly required when it was difficult to secure the visual field. Conclusions: There were no differences in batch resection rates or long-term prognoses between the two groups; nevertheless, the ELPS group had a shorter treatment time and less laryngeal edema than the ESD group. However, the treatment of narrow areas, such as the esophageal inlet patch, is a technical limitation of ELPS; thus, ELPS should be combined with ESD techniques.

Inhibition of Benzo[a]pyrene-induced DNA Adduct in Buccal Cells of Smokers by Black Raspberry Lozenges.

Using LC-MS/MS analysis we previously showed for the first time (Carcinogenesis 43:746-753, 2022) that levels of DNA damage-induced by benzo[a]pyrene (B[a]P), an oral carcinogen and tobacco smoke (TS) constituent, were significantly higher in buccal cells of smokers than those in non-smokers; these results suggest the potential contribution of B[a]P in the development of oral squamous cell carcinoma (OSCC) in humans. Treating cancers, including OSCC at late stages even with improved targeted therapies, continues to be a major challenge. Thus interception/prevention remains a preferable approach for OSCC management and control. In previous preclinical studies we and others demonstrated the protective effects of black raspberry (BRB) against carcinogen-induced DNA damage and OSCC. Thus, to translate preclinical findings we tested the hypothesis, in a Phase 0 clinical study, that BRB administration reduces DNA damage induced by B[a]P in buccal cells of smokers. After enrolling 27 smokers, baseline buccal cells were collected before the administration of BRB lozenges (5/day for 8 weeks, 1 gm BRB powder/lozenge) at baseline, at the middle and the end of BRB administration. The last samples were collected at four weeks after BRB cessation (washout period). B[a]P-induced DNA damage (BPDE-N2-dG) was evaluated by LC-MS/MS. BRB administration resulted in a significant reduction in DNA damage: 26.3% at the midpoint (p = 0.01506) compared to baseline, 36.1% at the end of BRB administration (p = 0.00355), and 16.6% after BRB cessation (p = 0.007586). Our results suggest the potential benefits of BRB as a chemopreventive agent against the development of TS-initiated OSCC.

A narrative review of the relationship between head and neck cancer and obstructive sleep apnea: Clinical studies and statistical analysis.

Obstructive sleep apnea (OSA) is an underestimated and overlooked comorbidity in head and neck cancer (HNC) care. Refining HNC-OSA management requires an improved grasp of the HNC-OSA relationship. Thus, this paper reviews the current course of HNC therapy, causal and associative relationships before and after treatment, and statistical methods quantifying HNC-OSA interactions. This evaluation serves a dual purpose: to support oncologists and sleep physicians in improving the treatment outcomes of patients undergoing HNC treatment by considering OSA as a comorbidity and to assist researchers in selecting suitable analytical models for investigating the correlation between OSA and HNC. The investigation confirms a positive correlation between the apnea-hypopnea index (AHI) and primary tumor size, consistent with prior findings. Case studies also reported new evidence of lipoma and head-neck tumors triggering OSA, and sleep apnea surgery prompting tumor development. This paper provides an overview of existing statistical models and offers suggestions for model selection and a framework for designing experiments that delve into research questions surrounding the link between OSA and HNC across various stages of cancer treatment. Despite progress, understanding the HNC-OSA interplay remains incomplete due to limited histological, molecular, and clinical data. Future studies with longitudinal data are crucial for comprehensive insights.

CTA and DSA findings in carotid blowout syndrome: An overview and approach to imaging diagnosis.

Carotid blowout syndrome (CBS) is a potentially life-threatening complication in patients suffering head and neck cancer, in which rupture of the carotid artery and/or its branches can rapidly lead to life-threatening hemorrhage, shock, and death. CBS is categorized into three subtypes, which are characterized by extent of disease as evidenced by clinical presentation, physical exam findings, and imaging characteristics. Given the high morbidity and mortality associated with CBS, prompt recognition and treatment remains pivotal, as early intervention is associated with longer survival and lower complication rates. In turn, we present an overview of the hallmark imaging findings of CBS through a retrospective review of our institution's findings of these characteristic imaging findings in all patients who underwent evaluation and management of CBS at our facility across a 10-year period.

Volumetric measurement to evaluate treatment response to induction chemotherapy on MRI outperformed RECIST guideline in outcome prediction in advanced nasopharyngeal carcinoma.

BACKGROUND: Treatment response evaluated by tumour size change is an important indicator for outcome prediction. Advanced nasopharyngeal carcinoma (adNPC) grows irregularly, and so the unidimensional measurement may not be accurately applied to adNPC for outcome prediction. This study aimed to evaluate values of unidimensional and volumetric measurements for treatment response to induction chemotherapy (IC) for outcome prediction in adNPC and compared the values with that of RECIST 1.1 guideline. MATERIALS AND METHODS: Pre-treatment and post-IC magnetic resonance images (MRIs) from 124 patients with stage III-IVA NPC were retrospectively reviewed. Sums of the maximum unidimensional diameters (D) and volumes of the targeted tumours (primary tumour and two largest metastatic lymph nodes) on the pre- (Dpre and Vpre) and post-IC MRIs (Dpost-IC and Vpost-IC) and percentage changes in D (Δ D%) and V (ΔV%) between two scans were calculated and correlated with disease-free survival (DFS), locoregional recurrence-free survival (LRRFS), and distant metastases-free survival (DMFS) using Cox regression analysis. Area under the curves (AUCs) of independent measurements and RECIST groups (RECIST response and non-response groups) for predicting disease recurrence, locoregional recurrence, and distant metastases, respectively, were calculated and compared using the DeLong test. RESULTS: Univariable analysis showed correlations between high Dpost-IC with poor DFS and DMFS (P < 0.05), but not with LRRFS (P = 0.07); high Vpost-IC and low ΔV% (less decrease in volume on post-IC) with poor DFS, LRRFS, and DMFS (P < 0.05); and no correlations between Dpre, ΔD%, and Vpre and the outcomes (P > 0.05). Multivariable analysis showed that ΔV% was the only independent measurement for outcomes (P < 0.05). Compared with RECIST groups, ΔV% of 47.9% (median value) showed a higher AUC for disease recurrence (0.682 versus 0.526, P < 0.01) and for locoregional recurrence (0.782 versus 0.585, P < 0.01), but not for distant metastases (0.593 versus 0.518, P = 0.26). CONCLUSIONS: Volumetric measurement to evaluate treatment response to IC outperformed unidimensional measurement and RECIST guideline in outcome prediction in adNPC.

Racial and ethnic disparities in treatment refusal for head and neck cutaneous malignancies.

Racial and ethnic minorities with skin cancer experience disproportionately worse prognoses and adverse outcomes compared to non-Hispanic, White patients. We analyzed patients diagnosed with any cutaneous malignancies of the head and neck between 2010 to 2021 using the data from the National Cancer Database to quantify disparities. The primary outcome variable was treatment refusal, and secondary variables included days from diagnosis to treatment, tumor depth, and mortality. Among the 151,733 patients analyzed, most were non-Hispanic White (99%) and male (71%). Black patients had the greatest odds of treatment refusal (4.166, 95% CI: 2.054-8.452, p < 0.001) across all cutaneous malignancies of the head and neck. Black and Hispanic patients also had increased times from diagnosis to treatment (p < 0.001). Black patients had higher odds of 90-day mortality compared to non-Hispanic White patients (p < 0.001). This coincided with greater tumor depth in Black and Hispanic patients compared to that of non-Hispanic White patients (p < 0.001). Black patients were more likely to refuse treatment for head and neck cutaneous malignancies. Moreover, Black and Hispanic patients experienced more treatment delays. These findings may relate to the increased 90-day mortality among Black patients and increased tumor depth in Black and Hispanic patients. Further investigation into the quality of life and functional impairment is warranted alongside interventions to reduce these disparities.

Pattern of Fine Needle Aspiration Cytology of Head and Neck Swelling in Patients Attending a Tertiary Health Care Center: A Descriptive Cross-sectional Study.

INTRODUCTION: Fine needle aspiration cytology is a simple, rapid, cost-effective method in diagnosis of head and neck swelling with minimal risk of complications. Head and neck swellings include a broad spectrum of diseases with different management for each. Fine needle aspiration cytology is a suitable and useful method for assessment of these swelling. This study was done with the objective to study the frequency and distribution of various head and neck lesions detected by fine needle aspiration cytology. METHODS: A descriptive cross-sectional study was conducted at the Department of Pathology in a tertiary care center from February 1 to July 31, 2023 after obtaining ethical approval from Institutional Review Committee (Reference number: IRC-PA-191/2078-79). All the patients presenting with head and neck swelling during the study period were included in this study. Total sampling was done. Fine needle aspiration was done and cytological diagnosis was made. Descriptive analysis was done where frequency and percentage were calculated. RESULTS: Out of 112 cases included in the study, 43 (38.40%) were of lymph nodes, 36 (32.14%) of thyroid, 22 (19.64%) of skin and soft tissue and 11 (9.82%) of salivary glands. Among the lymph nodes cases, there were 11 (25.57%) metastases. In thyroid lesions, beingn lesions were seen in 24 (66.68%). CONCLUSIONS: This study found that lymph nodes were the most common site for head and neck swellings, frequently involving metastatic lesions.

Nuclear TOP1MT Confers Cisplatin Resistance via Pseudogene in HNSCC.

Cisplatin resistance is one of the major causes of treatment failure in head and neck squamous cell carcinoma (HNSCC). There is an urgent need to uncover the underlying mechanism for developing effective treatment strategies. A quantitative proteomics assay was used to identify differential proteins in cisplatin-resistant cells. Mitochondrial topoisomerase I (TOP1MT) localization was determined using laser confocal microscopy and nucleocytoplasmic separation assay. Chromatin immunoprecipitation sequencing, dual-luciferase reporter assay, and RNA immunoprecipitation were used to identify the interaction between pseudogenes, miRNAs, and real genes. In vivo experiments verified the interaction between TOP1MT and pseudogenes on cisplatin resistance. TOP1MT was identified as a driving factor of cisplatin resistance in vitro, in vivo, and in HNSCC patients. Moreover, TOP1MT exceptionally translocated to the nucleus in cisplatin-resistant HNSCC cells in a signal peptide-dependent manner. Nuclear TOP1MT (nTOP1MT) transcriptionally regulated the mitochondrial functional pseudogene MTATP6P1, which bound to miR-137 and miR-491-5p as a competing endogenous RNA (ceRNA) and promoted the expression of MTATP6. An increase in MTATP6 enhanced mitochondrial oxidative phosphorylation (OXPHOS), which conferred cisplatin resistance in HNSCC. Our findings revealed that nTOP1MT transcriptionally activated MTAPT6P1 and increased MTATP6 expression via ceRNA, which facilitated OXPHOS and cisplatin resistance. These results provide novel insight for overcoming cisplatin resistance in HNSCC.

Can a digital tool improve the understanding of treatment option for patients with head/neck cancer and increase providers' self-perceived ability to communicate with patients?: Shortened Running Title: Digital tool for head/neck cancer treatment understanding.

PURPOSE: A digital visual communication tool was recently developed by MyCareGorithm which incorporates explanations of treatments and procedures for cancer patients. This study will evaluate if this novel tool can enhance both patient and provider satisfaction. METHODS: In an IRB approved, prospective, pilot study, patients and caregivers at a single institution receiving head and neck cancer radiation underwent an initial consult using this digital tool and completed a survey of 6 questions to evaluate their understanding of their disease. Providers completed a 7-question survey to rate their satisfaction. Patients and caregivers with 4 or more "Yes" answers and providers with 5 or more "Yes" answers were defined as "Satisfied". In order to obtain 90% power to detect that the proportion of "Satisfied" patients (assumed 75%) is greater than 50% with a significance level 5% using a one-sided Z test, we planned to enroll 30 patients. RESULTS: Thirty patients enrolled and completed all surveys. Most patients were male (66%), white (60%) and spoke English as a primary language (93%). Patients most commonly had oropharyngeal cancer (23%). Overall, 27 out of 30 of patients (90%; one sided 95%CI: 76.1%) were satisfied (z = 4.38, p < 0.05), 16 of the 17 caregivers (94%; one sided 95% CI: 74.8%) were satisfied and 100% of providers were satisfied with the digital tool. Most patients (90%) and caregivers (94%) felt that the tool improved their understanding of the disease. One male answered "No" for all 6 questions commenting that it was only marginally helpful. One female also answered "No" for all questions commenting that she did not find it helpful on its own without the provider explanation. Out of the 30 patients, 26 (87%) stayed at our institution to receive treatment. CONCLUSIONS: These findings showed high rates of patient, caregiver and provider satisfaction with their initial consult when incorporating a digital visual tool. Its routine use in clinical practice should be strongly considered.

Usefulness of using the superficial temporal pedicle as the recipient site for microvascular anastomosis in facial reconstruction: a retrospective study of 94 cases.

In cranio-cervico-facial reconstructive surgery, it is accepted that the use of free flaps is the treatment of choice. The multiple antecedents can place the surgeon in situations of vascular deserts. The aim of our study is to report and analyse our experience of the use of temporal vessels in primary and secondary reconstructive surgery. A retrospective study was conducted between 01/01/2010 and 31/03/2023. Patients who underwent cranio-cervico-facial reconstruction using free flaps, with use of the superficial temporal pedicle as the recipient site for the vascular anastomosis were included. Early and late complication and failure rates were analysed according to type of reconstruction, location and risk factors for free flap failure. A total of 94 patients underwent craniocervical-facial reconstruction using a free flap anastomosed to the superficial temporal pedicle (in primary or secondary situations). Ten patients underwent reconstruction of the upper third, 58 the middle third and 26 the lower third. With an overall complication rate of 28.7% (21.3% minor complications and 7.4% major complications). Our study proves the reliability of the superficial temporal pedicle, both in the primary situation (with a success rate of 93.9%) and in the secondary situation (with a success rate of 89.3%), as well as its versatility whatever the cranio-cervico-facial level to be reconstructed. This study demonstrates the value of preserving the superficial temporal pedicle in craniofacial reconstruction surgery. This is because it is a preferred recipient site for reconstructions of the upper and middle thirds in the primary situation or in the event of recourse.

Automated tumor localization and segmentation through hybrid neural network in head and neck cancer.

PURPOSE: Head and Neck (H&N) cancer accounts for 3% of cancer cases in the United States. Precise tumor segmentation in H&N is of utmost importance for treatment planning and administering personalized treatment dose. We aimed to develop an automatic tumor localization and segmentation method in enhancing the clinical efficiency and ultimately improving treatment outcomes. APPROACH: In this study, a hybrid neural network (HNN) was developed by integrating object localization and segmentation into a unified framework. It consists of 4 stages: preprocessing, HNN training, object localization and segmentation, and postprocessing. We utilized a dataset consisting of PET and CT images for 48 patients and designed a Hybrid Neural Network (HNN) which consists of YOLOv4 object detection model + U-Net model for image segmentation. YOLOv4 was used to identify regions of interests (ROI), while the U-Net was employed for the precise image segmentation. In our experiments we considered 2 object detection architectures to identify possible tumor regions, namely YOLOv4 and Faster-RCNN. The evaluation metrics for both were evaluated and compared. RESULTS: We evaluated the performance of 3 model combinations: YOLOv4 + U-Net, Faster-RCNN + U-Net, and U-Net alone. The models were evaluated based on Sensitivity, Specificity, F-Score, and Intersection over Union (IoU). YOLOv4 + U-Net achieved the best values with Sensitivity of 0.89, Specificity of 0.99, F-Score of 0.84, and IoU of 0.72. CONCLUSION: A new hybrid neural network (HNN) for fully automatic tumor localization and segmentation was developed and the experimental results. showcased the HNN's impressive performance, indicating its potential to be a valuable H&N tumor segmentation tool.

Reirradiation of squamous cell carcinoma of the head and neck with external photons: A practical review of the literature.

The modalities of management by reirradiation for recurrence or a second localization of head and neck squamous cell carcinoma (HNSCC) in previously irradiated terrain is challenging due to the great heterogeneity of data in the literature, mainly retrospective data reporting non-negligible risks of serious late toxicity events. With the recent development of more precise and conformal radiotherapy techniques such as intensity modulated radiotherapy (IMRT), volumetric modulated arc therapy (VMAT), stereotactic radiotherapy (SBRT), the benefit-to-risk ratio of reirradiation has evolved in recent years with encouraging results, but patient selection is crucial. The aim of this review is to discuss the role of HNSCC reirradiation in terms of patient selection and external photon radiotherapy techniques for definitive tumor reirradiation and postoperative reirradiation.

Clinical validation of a tissue-agnostic genome-wide methylome enrichment molecular residual disease assay for head and neck malignancies.

BACKGROUND: Outcomes for patients with locally advanced head and neck cancer (HNC) treated with curative intent remain disappointing, with 5-year survival rates at 50%. Most recurrences occur within the first 2 years after treatment, providing a window of opportunity to identify patients with molecular residual disease (MRD). A tissue-agnostic test for MRD detection in patients with human papillomavirus (HPV) positive and negative HNC, where tissue is often scarce, is needed. PATIENTS AND METHODS: Patients with stage I-IVB HNC, including patients positive and negative for HPV, were enrolled and peripheral blood plasma was collected longitudinally at diagnosis and ∼3, 12, and 24 months after curative intent treatment. The full cohort includes 325 patients with 1155 samples. Samples were split into distinct sets to train and validate a classifier capable of identifying MRD using a tissue-agnostic genome-wide methylome enrichment platform. The primary endpoint was recurrence-free survival (RFS). RESULTS: With a median follow-up of 60 months, patients in the blinded validation set with MRD positivity experienced significantly worse RFS with a hazard ratio (HR) of 35.7 [95% confidence interval (CI) 10.8-117.8; P < 0.0001]. For patients with HPV negativity, HR was 42.3 (95% CI 9.8-182.3; P < 0.0001); for patients with HPV-positive oropharyngeal cancer, HR was 24.1 (95% CI 3.0-196.8; P < 0.0001). Moreover, the lead time between MRD positivity and clinical recurrence was up to 14.9 months, with a mean lead time of 4.1 months. Surveillance sensitivity was 91% (95% CI 77% to 97%) and specificity was 88% (95% CI 80% to 93%). CONCLUSIONS: Here we validate the clinical performance characteristics of a tissue-agnostic genome-wide methylome enrichment assay for MRD detection in patients with HNC. The MRD detection test showed high sensitivity for identifying recurrence at high specificity across different anatomical sites, HPV status, and treatment regimens, highlighting the broad applicability for MRD detection in patients with HNC.

Prevalence and assessment of sleep-disordered breathing in head and neck cancer patients: a systematic review.

STUDY OBJECTIVES: Sleep-disordered breathing (SDB) is a very common and underdiagnosed condition in head and neck cancers (HNC) patients. If untreated, SDB can lead to negative health consequences. The identification of SDB in HNC patients is crucial to ensure appropriate treatment and to improve outcomes. The purpose of the study was to investigate the incidence of coexisting SDB in HNC patients and to evaluate methods of assessing SDB in the population. METHODS: A systematic search of PubMed, Embase, CINAHL, Cochrane Database, the Web of Science, and Scopus was performed for studies related to SDB in HNC patients. In total, 1713 articles were identified. 19 articles were selected for qualitative synthesis. The studies involved 584 subjects. RESULTS: The prevalence of SDB ranged from 57 to 90% before cancer treatment and from 12 to 96% after. When using an apnea-hypopnea index (AHI) cut-off ≥ 5/h to diagnosis SDB, the prevalence of SDB was 57-90% before cancer treatment and 12-94% after treatment. Sleep studies using polysomnography are the most commonly used assessment tools, but thresholds for diagnosis have been inconsistent. CONCLUSIONS: There is a high prevalence of SDB in HNC patients. However, the diagnostic and thresholds methods used for detecting SDB vary widely. To determine the accurate prevalence of SDB, prospective, systematic studies of SDB in unselected cohorts of HNC participants are required.

Depth of invasion and extranodal extension: the influential factors to predict survival rate of patients with oral tongue squamous cell carcinoma.

BACKGROUND: Cancer staging is essential in determining patients' prognoses and designing the appropriate treatment strategy. American Joint Committee on Cancer has released the latest version of the staging system for tongue SCC. However, it is interesting to know whether this change in staging and the addition of depth of invasion (DOI) and the extra-nodal extension (ENE) have any influence on patients' prognosis. METHODS: In this retrospective cohort study, the pathology records of patients with tongue SCC who underwent surgery at the Pathology Department of Cancer Institute Hospital, 2017-2021, were collected by referring to the hospital information system. Then the rate of change of pT, pN, and overall stage were assessed based on American Joint Committee on Cancer 7th and 8th editions. RESULTS: The records of 204 patients were included in the final analysis. Significant changes in the staging system 2021 resulted in upstaging 64 patients (31.4%) in the overall stage, 91 patients (44.6%) in pT, and 30 patients (14.7%) in pN. The survival of upstaged patients was inferior compared to those without upstaging. However, this was not statistically significant for tumor and overall upstaging in the univariate analysis, while those with upstaged pN had significantly shorter survival. In the multivariate analysis, pT upstage also significantly impacted survival. CONCLUSION: This study showed the importance of pathology reports based on the latest edition of the American Joint Committee on Cancer, the accuracy in examining factors such as depth of invasion and extra-nodal extension.

Relationships Between Family Resilience, Individual Resilience, and Quality of Life in Patients with Head and Neck Cancer: A Cross-Sectional Study.

BACKGROUND: Patients with head and neck cancer (HNC) have to cope with a multitude of treatment-related adverse effects that impact their quality of life (QoL) post-treatment completion. The presence of family resilience could potentially foster individual resilience and might contribute to patients' QoL. However, this interconnection has not been confirmed. OBJECTIVE: To explore the relationships between family resilience, individual resilience, and QoL in patients with HNC and to determine whether individual resilience in HNC patients functions as a mediator between family resilience and QoL. METHODS: From September 2022 to June 2023, a cross-sectional survey was conducted among 185 patients with HNC recruited through convenience sampling from a tertiary care hospital in Jiangsu Province, China. Self-report measures of family resilience, individual resilience, and QoL were assessed. Relationships were examined by Pearson's correlations. Structural equation models were used to assess whether individual resilience played a mediating role between family resilience and QoL. RESULTS: There were significant positive correlations between QoL and both family resilience (r = 0.43, P < .01) and individual resilience (r = 0.59, P < .01). Moreover, family resilience had an indirect influence on QoL through its effect on individual resilience (ß = 0.319, 95% CI: 0.336-0.815). CONCLUSION: Family resilience emerges as a significant positive factor capable of enhancing QoL for patients with HNC by bolstering their resilience. To mitigate the detrimental effects of inadequate individual resilience on QoL of patients with HNC, it is advised to implement interventions focused on enhancing family resilience. CHINA CLINICAL TRIALS REGISTRY NUMBER: ChiCTR2300067612.

Phase I trials of single-agent new drugs in head and neck cancer: a scoping review.

BACKGROUND: The conventional method of drug development in oncology typically progresses through phase I, phase II and randomized phase III trials. Nevertheless, some recent drug approvals for head and neck cancer (HNC) relied on findings from single-arm phase II trials. This underscores the significance of disease-specific phase I trials as a crucial step in exploring new drugs for HNC patients. The purpose of this review is to present the currently available data of phase I clinical trials conducted in HNC and to provide an overview of ongoing therapeutic trends in HNC. METHODS: We performed a scoping review of phase I trials evaluating single-agent treatments specifically designed for HNC patients. The PubMed database was searched using "(phase I) AND (head and neck)". To ensure exhaustiveness, we also performed a search from the American Society of Clinical Oncology, European Society for Medical Oncology and American Association for Cancer Research websites. RESULTS: We screened 1,134 articles and selected 29 trials that met eligibility criteria, published between 1994 and 2023, for a total of 741 patients. Twenty-one trials comprised patients with different sites of HNSCC and only 8 trials (27%) focused on a specified subsite of head and neck. Most of trials investigated treatments in recurrent/metastatic (R/M) settings (86%). Immunotherapeutic agents were the most examined followed by targeted agents, cytotoxic drugs and "others" including a nanoparticle, a therapeutic gene, a fusion protein and a modulator of gene expression. Among trials reporting activity for R/M head and neck patients (n=23), the global median overall response rate (ORR) was 12% and four trials (17%) did not report any response. The incidence of grade 3/4 treatment-related adverse events (TRAEs) was low (7%). However, in seven trials safety results are not clearly assessable from the published data. CONCLUSIONS: Phase I trials of single agents designed for head and neck patients were generally safe but with a low ORR. Future development of new drugs dedicated for HNC patients that can more accurately reflect the heterogeneity of HNC and provide more detailed subgroup analyses is warranted.

[Clinical analysis and literature review of 7 cases of plasmacytoma first diagnosed with head and neck symptoms].

Objective:In order to better understand the condition and provide the groundwork for early detection and treatment of plasmacytomas, it is important to examine the clinical characteristics, therapeutic options, and effectiveness of plasmacytomas that are initially identified with head and neck symptoms. Methods:Retrospective analysis, evaluation, and discussion of the clinical data of 7 patients with plasmacytoma initially diagnosed with head and neck symptoms and admitted to the Affiliated Hospital of Qingdao University during the period of June 2013 to November 2022 was done in combination with pertinent literature. Results:All seven patients were diagnosed with plasmacytoma by histopathology, with lesions located in the nasopharyngeal oropharynx in 4 cases, nasal sinuses in 2 cases, and ventricular zone in 1 case. Clinical manifestations and imaging were atypical, with localized manifestations, of which 2 cases were accompanied by multiple skeletal lesions throughout the body, and 4 cases had lymph node metastasis. Surgery was preferred for all patients, and individualized treatment was recommended after surgery. Of the 7 patients, 3 patients underwent surgery and chemotherapy, 2 patients underwent surgery and radiotherapy and chemotherapy, 1 patient underwent surgery and radiotherapy, and 1 case was treated with surgery only. The follow-up period was 3-60 months, with a 100% follow-up rate. 5 cases were alive and 2 cases died of multiple myeloma after 4-5 years Conclusion:Plasmacytomas first diagnosed with head and neck symptoms are rare, and extramedullary plasmacytomas have a better prognosis, while more advanced multiple myeloma has a poorer prognosis; Therefore, enhancing the quality of survival as well as the duration of survival for patients with plasmacytomas requires early diagnosis and individualized treatment.

Germinal center B-cell subgroups in the tumor microenvironment cannot be overlooked: Their involvement in prognosis, immunotherapy response, and treatment resistance in head and neck squamous carcinoma.

Background: More than 60 % of patients with head and neck squamous carcinoma (HNSCC) are diagnosed at advanced stages and miss radical treatment. This has prompted the need to find new biomarkers to achieve early diagnosis and predict early recurrence and metastasis of tumors. Methods: Single-cell RNA sequencing (scRNA-seq) data from HNSCC tissues and peripheral blood samples were obtained through the Gene Expression Omnibus (GEO) database (GSE164690) to characterize the B-cell subgroups, differentiation trajectories, and intercellular communication networks in HNSCC and to construct a prognostic model of the associated risks. In addition, this study analyzed the differences in clinical features, immune cell infiltration, functional enrichment, tumor mutational burden (TMB), and drug sensitivity between the high- and low-risk groups. Results: Using scRNA-seq of HNSCC, we classified B and plasma cells into a total of four subgroups: naive B cells (NBs), germinal center B cells (GCBs), memory B cells (MBs), and plasma cells (PCs). Pseudotemporal trajectory analysis revealed that NBs and GCBs were at the early stage of B cell differentiation, while MBs and PCs were at the end. Cellular communication revealed that GCBs acted on tumor cells through the CD99 and SEMA4 signaling pathways. The independent prognostic value, immune cell infiltration, TMB and drug sensitivity assays were validated for the MEF2B+ GCB score groups. Conclusions: We identified GCBs as B cell-specific prognostic biomarkers for the first time. The MEF2B+ GCB score fills the research gap in the genetic prognostic prediction model of HNSCC and is expected to provide a theoretical basis for finding new therapeutic targets for HNSCC.

A Novel Split-Course High-Dose Palliative Radiotherapy Regimen for Locally Advanced Sinonasal Cancer: A Case Report.

Sinonasal malignancies (SNMs) are rare heterogeneous malignancies that frequently present with locally advanced disease. The prognosis is poor when the disease is considered extensive and unresectable. In such cases, a high-dose palliative radiotherapy regimen is often required, but the ideal dose and fractionation have not been established. We detail a 33-year-old male who initially presented with a progressively growing mass over the right cheek. A biopsy of the lesion revealed squamous cell carcinoma (SCC). Imaging revealed a very advanced and unresectable disease with the involvement of several head and neck subsites. He progressed further after receiving induction chemotherapy from an outside institution. The patient requested prompt tumor and symptom control to travel back to his home country. We offered him high-dose split-course palliative radiotherapy in the form of a quad Shot of 14.80 Gy in four fractions twice daily, followed by 30 Gy in five fractions every other day with a 2-week interval. Treatment resulted in excellent clinical response with symptomatic relief in a short time, and the patient could travel back home safely.