bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and safety of nab-paclitaxel+cisplatin/nedaplatin + S-1 as an induction chemotherapy regimen for locally advanced hypopharyngeal cancer.
Authors: Jiang Cailing , He Xiaosong , Xu Lieyin , Xu Shengyuan , Mo Yunyan , Kang Mafei , Zhu Lin , Xue Feng 
Published: June 2023

e18050 Background: Targeted therapy and immunotherapy are efficacious treatment options for advanced head and neck cancer. However, the treatment of locally advanced hypopharyngeal carcinoma still consists of surgery, radiotherapy, and chemotherapy. Combining docetaxel, cisplatin (DDP), and 5-fluorouracil as standard induction chemotherapy provided opportunities for further surgical larynx preservation in some patients. This study retrospectively analyzed the short-term efficacy and adverse events of nab-paclitaxel + DDP/nedaplatin (NDP) + S-1 as an induction chemotherapy regimen for locally advanced hypopharyngeal cancer. Methods: The study included 22 patients with locally advanced hypopharyngeal cancer treated via induction chemotherapy at the Affiliated Hospital of Guilin Medical University from December 2020 to July 2022. Among these patients, 11 received nab-paclitaxel (125mg/m2, days 1 and 8) + DDP (35- 40mg/m2, days 1-2) or NDP (65-75mg/m2, day 1) + S-1 (30-40 mg/m2 bid, days 1-14) every 21 days for a total of three cycles. A baseline enhanced magnetic resonance imaging (MRI) of the head and neck was performed for all patients to confirm the presence of suspicious lesions. Another MRI was performed before the third cycle of induction chemotherapy to confirm the efficacy of the treatment regimen. Patients, who were responsive to the induction therapy, were allowed to choose their respective sequential therapy regimen. The response was assessed using RECIST v1.1. Adverse reactions were evaluated according to CTCAE5.0. Results: The response to treatment of the 11 patients was assessed by the investigators. There was one patient with a complete response (9.1%), eight patients with a partial response (72.7%), and two patients with stable disease (18.2%). The objective response rate was 81.8% (9/11), and the disease control rate was 100%. Five of the nine patients with a partial or complete response opted for surgery after three cycles of induction chemotherapy. The pathological complete response rate was 100% (5/5). The most common grade 3 treatment-emergent adverse events (TEAE) were leukopenia (45.5%), neurotoxicity (36.3%), and anemia (18.2%). Grade 4/5 TEAEs were not observed. Conclusions: Based on the results of this retrospective study, the nab-paclitaxel + DDP/ NDP + S-1 was a safe and viable induction chemotherapy regimen for locally advanced hypopharyngeal cancer. It allowed more options for subsequent treatment. Further research is warranted to validate the findings of this study. [Table: see text]
Comparing the role of different treatment modalities in locoregionally advanced olfactory neuroblastoma: The 20-year clinical experience of a single institution.
Authors: Chai Yue , Wei Yu-Ce , Zhang Di , Dong Mei 
Published: June 2023

e18055 Background: There are few studies on different treatment modalities, especially systemic chemotherapy (CT) for locoregionally advanced olfactory neuroblastoma (LA ONB) with only a few small-sample studies reported. We retrospectively analyzed the treatment patterns and explored the factors affecting the prognosis of patients with LA ONB at our center over the past 20 years in the present study. Methods: LA ONB patients from 2000 to 2020 at our center were collected retrospectively. The entire cohort was divided into combined systemic and local therapy (CSLT) vs. local therapy (LT) groups (grouping method 1), and the same cohort was divided into neoadjuvant chemotherapy (NAC) vs. non-NAC groups (grouping method 2). CSLT group included patients treated with CT + LT. LT group included patients treated with surgery (SG), radiotherapy (RT), concurrent chemoradiotherapy (CCRT), or any combination of the above methods. LT group was further divided into mono-modality local therapy (MOLT) group and multi-modality local therapy (MULT) group. MOLT group included patients treated with RT alone or SG alone. MULT group included patients treated with SG + RT/CCRT, or CCRT alone. NAC group included patients treated with NAC + LT ± adjuvant chemotherapy (ADC). Non-NAC group included patients who received LT ± ADC. Results: A total of 111 patients with LA ONB were included. The median age was 40 (range, 10–82) years old. The median follow-up duration for the entire cohort was 80.2 (range, 2.1-254.9) months, while 88.5 (range, 4.0-240.7) months for the CSLT group, 77.2 (range, 2.1-254.9) months for the LT group, 86.0 (range, 4.0-240.7) months for the NAC group, and 78.7 (range, 2.1-254.9) months for the non-NAC group. Thirty-five patients (31.5%) died, among which 30 patients died of tumor progression, 3 patients died of other diseases, and 2 patients’ causes of death were not available. The estimated 5-year overall survival (OS), progression-free survival (PFS), local recurrence-free survival (LRFS) and distant metastasis-free survival (DMFS) rates for the entire cohort (n = 111) were 70.2%, 53.1%, 73.6%, and 74.1%, respectively. The estimated 10-year OS, PFS, LRFS, and DMFS rates were 61.3%, 37.7%, 60.1%, and 68.0%, respectively. In univariate analysis, patients treated with NAC (n = 43) had significantly better overall survival (OS) compared with those without NAC (n = 68) ( P = 0.041). Patients in MULT group (n = 45) had significantly improved OS ( P = 0.004) and PFS ( P = 0.003) compared with those in MOLT group (n = 15). Multivariate analysis identified NAC and CSLT (n = 51) were independent prognostic factors for superior OS ( P = 0.020; P = 0.046). Conclusions: Our study suggested that CSLT, especially a combination of NAC and LT, improved the survival of patients with LA ONB. Multiple treatment modalities yielded better PFS and OS compared to single modality treatment.
Neoadjuvant camrelizumab plus chemotherapy in patients with locoregionally advanced nasopharyngeal carcinoma: A single-arm, phase II trial.
Authors: Gao Jin , Qian Liting , Zhou Lingran , Sun Bin , He Jian , Wang Ru , Zhang Yangyang , Yang Liping , Zhou Yan , Yang Jing 
Published: June 2023

e18057 Background: Anti-programmed death receptor-1 (PD-1) agents improve survival in patients with recurrent or metastatic nasopharyngeal carcinoma (NPC), but have not been studied well in patients with locoregionally advanced NPC. In this study, we investigated the efficacy and safety of the PD-1 inhibitor camrelizumab combined with gemcitabine and cisplatin as neoadjuvant therapy in patients with locoregionally advanced NPC. Methods: This was a single-arm, single-center, phase II trial done at the First Affiliated Hospital of University of Science and Technology of China. Patients with previously untreated, stage III-IVB (except T3N0-1; AJCC 8th) NPC, aged 18-70 years without severe comorbidities were enrolled. Eligible patients received neoadjuvant therapy with camrelizumab 200 mg on day 1, cisplatin 80 mg/m2 on day 1, and gemcitabine 1,000 mg/m2 on days 1 and 8 of each 21-day cycle for three cycles. The primary endpoints were overall response rate(ORR) per RECIST version 1.1 and safety. Biomarker analysis included programmed death-ligand 1 (PD-L1) expression using the tumor proportion score (TPS) and combined positive score (CPS; Dako 22C3 pharmDx assay). Results: Between January 2022 and January 2023, 14 patients were enrolled and treated. The median age was 55 years (range, 33-68), and 11 (78.6%) patients were males. Thirteen (92.9%) patients had baseline PD-L1 data: TPS ranged from 2% to 80% and CPS ranged from 5 to 90. Eight patients (61.5%) had PD-L1 TPS of higher than 20% and seven patients (53.8%) had PD-L1 CPS of higher than 50. The ORR was 92.9% (13 of 14), including one (7.14%) patient with complete response and 12 (85.7%) patients with partial response. The most common grade 3 treatment-related adverse events (TRAEs; Common Terminology Criteria for Adverse Events, version 5.0) during neoadjuvant treatment were anorexia (two of 14;16.7%) and nausea (two, 9.5%), and no grade 4 or 5 TRAEs occurred. The most common immune-related AEs were endocrinopathies (all grade 1; 50%). Conclusions: Neoadjuvant camrelizumab plus chemotherapy showed promising activity with a manageable safety profile for patients with locoregionally advanced NPC. Longer follow-up and larger studies are needed to further confirm the efficacy of this combination in this population. This trial was approved by the Ethics Office of the First Affiliated Hospital of the University of Science and Technology of China (2021 no98), and registered in the Chinese Clinical Trial Registry. Clinical trial information: ChiCTR2200057745 .
Efficacy and safety of induction chemotherapy with docetaxel + cisplatin in selected groups of patients with HNSCC.
Authors: Kutukova Svetlana , Ivaskova Julia V. , Belyak Natalia P. , Varankina Anna , Androsova Alexandra , Razumova Alexandra 
Published: June 2023

e18059 Background: We investigated the efficacy and safety of docetaxel + cisplatin (DC) induction chemotherapy vs TPF in patients with locally advanced HNSCC. Methods: Under our observation there were 22 patients in HNSCC (63,6% men and 36,4% women, aged 43 to 74 years (58.7±9.4 (95% CI 55.0-62.4)). The control group consisted of 18 patients (72,2% men and 27,8% women, aged 43 to 73 years (53.9±8.8 (95% CI 49.6-58.3). Both groups were comparable in terms of location, stage (III-IVA) and tumor differentiation. The patients of group 1 received DC (docetaxel 75 mg/m2 + cisplatin 75 mg/m2; q3w) as induction chemotherapy (ICT), while patients in the control group received TPF. Results: The planned number of ICT cycles (No. 3) in group 1 was received by 100% pts. and in the control group - 77.78% pts. (p = 0.02). At the control assessment according to RECIST 1.1, PR was registered in 77.3% pts. of group 1 vs 55.5% pts. in control group (p = 0.14), SD - in 22.7% vs 33.3: (p = 0.45), PD was registered only in patients of the control group - in 11.2% (p = 0.11). The frequency of registration of AEs: diarrhea gr.1-3 - 9.1% pts. group 1 vs 33.3% of pts. the control group (p = 0.06), nausea gr.1 -2 - 9.1% vs 22.2% (p= 0.25), asthenia gr. 1-2 - 4.5% versus 16.7% (p = 0.20), anemia gr. 1-2 - 9.1% vs. 16.7% (p = 0.47), neutropenia gr. 3-4– 4.5% versus 16.7% (p = 0.20). Reduction of doses of cytostatic up to 50% was performed in 4.5% pts. in group 1 and 16.7% pts. in the control group (p = 0.20). Conclusions: Induction chemotherapy in DC mode may be an effective and safe regimen in certain groups of patients with HNCH (for example, in patients with contraindications to 5-FU infusions, as well as in patients with high-risk HHNH for alternative surgical treatment or concurrent CRT as initial treatment of localized and locally advanced HNSCC.
A retrospective analysis of tislelizumab and GP regimen neoadjuvant therapy followed by concurrent chemoradiotherapy plus nimotuzumab in patients with high-risk nasopharyngeal carcinoma.
Authors: Zhang Qinhua , Lai Mingfen , Li Fangming , Chen Jiarong , Chang Mingzhang , Yang Peixin , Chen Guojian 
Published: June 2023

e18060 Background: Efficacy of nasopharyngeal carcinoma (NPC) with T4 or N3 remains unsatisfactory due to high-risk of distant metastasis or recurrence, indicating the need of more comprehensive treatment. We aim to analysis the efficacy and safety of tislelizumab and GP regimen in combination with neoadjuvant therapy and concurrent chemoradiotherapy (CCRT) plus nimotuzumab in patients with high-risk NPC. Methods: Our team conducted a retrospective analysis of 44 adult patients with high-risk locally advanced (T4 or N3; M0) nasopharyngeal carcinoma between March 2021 and January 2022, the median follow-up time was 599 days. The patients had received neoadjuvant chemotherapy (gemcitabine,1000 mg/m2, days 1 and 8, cisplatin,80 mg/m2, day 1), and tislelizumab (200mg) on day 1 every 3 weeks for 4 cycles followed by chemoradiotherapy including intensity modulated radiotherapy (IMRT), lobaplatin and nimotuzumab. Lobaplatin was intravenously administered at a dose of 30 mg/m2 on days 1 and 22. Nimotuzumab was intravenously administered at a dose of 200 mg on day 1 every week for 6 weeks. All patients underwent response assessments during neoadjuvant therapy, chemoradiotherapy and follow-up at regular intervals. Results: 44 patients were identified with the median age being 50y(24y-70y). At neoadjuvant treatment period, 44 patients completed 170 cycles of the combination of tislelizumab and GP regimen. During concurrent chemo-radiotherapy period, 42 (95.45%) of 44 patients completed 6 weeks of nimotuzumab treatment and 41 (93.18%) of 44 patients completed 2 cycles of lobaplatin treatment. Overall, 20 patients (45.5%) had a complete response, and 24 (54.5%) had a partial response after neoadjuvant therapy before the start of chemoradiotherapy. At 3 months and 6 months after radiotherapy, 90.9% (40 of 44) and 97.7% (43 of 44) of the patients had a complete response. 42 of the 44 patients were alive (95.5%). 3 events of recurrence(1) or death(2) were recorded. 19 (43.2%) of 44 patients had grade 3-4 treatment-related adverse events, and grade 3-4 immune-related adverse events(irAE) was recorded in 3 patients (6.8%) in the entire treatment. Grade 3-4 irAEs were rash(2) and hypothyroidism(1). Conclusions: Neoadjuvant therapy with tislelizumab and GP regimen followed by concurrent chemoradiotherapy plus nimotuzumab seems to have promising efficacy, lower toxic effects and better treatment compliance, which is a new treatment strategy for high-risk NPC.
The association of body mass index with overall survival, progression free survival and locoregional control in head and neck cancer treated with curative-intent definitive chemoradiation.
Authors: Chatterjee Udit , Ma Sung Jun , Khan Michael , Santhosh Sharon , Hashmi Mahnoor , Gill Jasmin , Yu Brian , Iovoli Austin , Farrugia Mark , Yu Han , Singh Anurag K. 
Published: June 2023

e18062 Background: The prevalence of obesity is anticipated to increase with nearly 1 in 2 adults having obesity by 2030. Previous meta-analysis and prospective studies showed that both obesity and overweight BMI were associated with worse all-cause mortality, cancer-related mortality, and the incidence of multiple types of cancer. Combined modality therapy, such as chemoradiation, often results in significant morbidity among patients with head and neck cancer (HNC). The association of BMI with treatment response, tumor recurrence, and survival outcomes among HNC patients remains unclear. Methods: Our study included a total of 445 patients with non-metastatic head and neck cancer who underwent curative-intent definitive chemoradiation at the Roswell Park Comprehensive Cancer Center from 01/2005 to 01/2021. We evaluated overall survival (OS), progression-free survival (PFS), locoregional failure (LRF), and distant failure (DF). BMI was stratified by normal weight (18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2), and obese (30 kg/m2 or higher). Evaluation was performed using Kaplan-Meier method, log-rank tests, Cox proportional hazard multivariable (MVA) analyses. Results: A total of 445 patients (373 male [83.8%], median [interquartile range] age, 61 [55-66] years; n = 107 with normal, n = 179 with overweight, and n = 159 with obese) were included for analysis. Median follow up was 48.1 months (interquartile range 24.7-74.9). On Cox MVA, only overweight was associated with improved OS (adjusted hazards ratio [aHR] 0.59, 95% confidence interval [CI] 0.39-0.91, p = 0.02) and PFS (aHR 0.51, 95% CI 0.34-0.75, p < 0.001). On logistic MVA, overweight (adjusted odds ratio [aOR] 0.86, 95% CI 0.80-0.93, p < 0.001) and obese (aOR 0.89, 95% CI 0.81-0.96, p = 0.005) were associated with complete metabolic response on follow-up PET-CT after treatments. On Fine-Gray MVA overweight was associated with reduction in LRF (aHR 0.30, 95% CI 0.12-0.71, p = 0.007), but not DF (aHR 0.92, 95% CI 0.47-1.77, p = 0.79). Being obese was not associated with both LRF (aHR0.63, 95% CI 0.29-1.37, p = 0.24) and DF (aHR 0.70, 95% CI 0.35-1.38, p = 0.30). Conclusions: When compared to normal BMI, overweight BMI was an independent, favorable prognostic factor for complete response after treatments, OS, PFS and a reduction in LRF. Further investigations are warranted to improve our understanding on the role of BMI among patients with HNC.
Antitumor regimens with gemcitabine are safe for tumor patients with COVID-19.
Authors: Wu Yuanqiang , Quan Weini , Ma Jinan , Li Zhenjiang 
Published: June 2023

e18064 Background: COVID-19 infection is a worldwide health threatening disease, especially for malignant tumor patients. Systemic antitumor therapies may slower the body to clear virus, which results in delayed recovery from COVID-19. Thus, present guidelines or expert consensuses recommend to postpone antictumor therapies, which would unquestionablely retard treatment cycle and reduce therapeutic effect.Gemcitabine is a nucleoside analogue, which has shown antiviral activity as well as anticancer effect. Therefore, we assume that antitumor regimens with gemcitabine are also able to control COVID-19 reproduction. Such “kill two birds with one stone” regimen aims to not delay both anticancer treatment and COVID-19 turning negative. Methods: Four newly pathologically diagnosed advanced tumor patients from Department of Oncology, Second Xiangya Hospital, Central South University were collected, including three nasopharyngeal carcinoma (NPC) patients and one non-small cell lung cancer (NSCLC) patient. All of them were asymptomaticly infected with COVID-19 recently. Anticancer regimens with gemcitabine were adopted as initial treatment for these patiens. Three patients with NPC received gemcitabine combined with cisplatin (gemcitabine 1g/㎡ on day 1 and 8, cisplatin 25mg/㎡ from day 1 to 3).The patient with NSCLC accepted gemcitabine and PD-1 inhibitor (gemcitabine 1g/㎡ on day 1 and 8,tislelizumab 100mg on day 1 and 8). Throat swabs were performed to test the COVID-19 nucleic acid on day 1, 5, 9 and 21 during treatment. Results: Four patients are all middle-aged males of 43-59 years old. Their COVID-19 nucleic acid tests were positive on day 1 before infusing any drugs.The cycle count threshold (CT) of nucleic acid did not go down but gradually went up during antitumor treatment.Patients showed no COVID-19 related symptom during the whole treatment cycle. There were no greater than or equal to grade 3 adverse evens (AEs). Treatment related AEs included one patient with grade 2 leukopenia, and one patient with grade 2 fever. All patients normally finished the first anticancer cycle and successfully went to the second cycle. Conclusions: Antitumor regimens with gemcitabine is safe for patients both with manignancy and COVID-19. Cancer patients with COVID-19 can accept gemcitabine-related therapy as soon as possible intead of waiting until COVID-19 nucleic acid becoming negative.
Characteristics of local extension based on tumor distribution in nasopharyngeal carcinoma and proposed clinical target volume delineation.
Authors: Wu Zheng , Lin fei-Fei , Zhang Lin , He Qian , Li Feiping , Wang Hui , Han Yaqian , Yin wen-Jing , Qi Bin 
Published: June 2023

e18068 Background: to summarize the characteristics of local extension of the eccentric and central nasopharyngeal carcinoma (NPC) by magnetic resonance imaging (MRI) and to improve clinical target volume (CTV) delineation. Methods: MRIs of 870 newly diagnosed NPC patients were reviewed. According to the tumor distribution feature, the NPCs were divided into eccentric and central lesions. Results: All local invasions presented as continuous invasion from gross lesions and structures adjacent to the nasopharynx are more likely to be invaded. There were 240 (27.6%) and 630 (72.4%) cases with central and eccentric lesions, respectively. The spread of eccentric lesions centered on the ipsilateral Rosenmüller’s fossa; and most anatomic sites had significantly higher invasion rates in ipsilateral side than the contralateral side ( P < 0.05); however, they were at low risk of concurrent bilateral tumor invasion ( < 10%) except the prevertebral muscle (15.4%) and nasal cavity (13.8%). The extension of central NPCs centered on the nasopharyngeal superior-posterior wall and was more common in superior-posterior direction; furthermore, the bilateral tumor invasion into the anatomical sites was common. Conclusions: Local invasion of NPC was characterized by continuous invasion from proximal to distal sites. The eccentric and central lesions showed different invasion features. Individual CTV delineation should be based on the distribution characteristics of tumors. The eccentric lesion had very low probability of invasion into the contralateral tissue, thus routine prophylactic radiation of contralateral parapharyngeal space and skull base foramina may not be necessary.
Real-world survival of older adults with LA SCCHN using SEER-Medicare.
Authors: Zhou Summera Qiheng , Ng Carmen , Wang Rongrong , Gasior Greg , Schrader Dustin , Baliga Sujith , Fox David 
Published: June 2023

e18071 Background: Squamous cell carcinomas of the head and neck (SCCHN) account for around 4% of all types of malignant neoplasms. Roughly 50-67% of patients with SCCHN present with locally advanced (LA) disease and 65% of them relapse after primary therapy. The standard of care for LA SCCHN is definitive therapy (DT), a combination of surgery and or radiation therapy (RT), with or without platinum-based chemotherapy/cetuximab (chemo), that has been shown to optimize long term disease control. Advances in surgery/RT have led to improved outcomes, but there have been no FDA approved therapeutic agents for LA SCCHN since cetuximab in 2006. Our objective was to characterize the real-world overall survival (OS) of older adults with LA SCCHN in the US. Methods: We used the Surveillance, Epidemiology, and End Results (SEER)-Medicare database, a linkage of cancer registry and claims data, to identify patients diagnosed with LA SCCHN (first and only cancer) from 2010 to 2017 who initiated a relevant treatment (treatment initiation date defined as index date) and were continuously enrolled in Medicare Parts A, B, and D from 12 months pre-index until death or 12 months post-index. We categorized DT as: no DT, non-surgical DT (concurrent chemo + RT (cCRT) or chemo followed by RT/cCRT), or surgical DT (surgery then RT/cCRT with or without prior chemo) using Medicare claims. Median OS (mOS) estimates and 95% confidence intervals (CI) were estimated using the Kaplan-Meier method starting from index date. Results: We identified 1052 older adults with LA SCCHN (median age 73 years, 37% female, and 81% non-Hispanic white). Overall, median follow up was 26.4 months and primary tumor sites were 52.6% oropharynx, 44.7% oral cavity, and 2.8% hypopharynx. LA patients overall had a mOS of 39.2 months. mOS was lowest in patients with SCCHN of the hypopharynx. Around 58% of patients received a DT regimen and mOS was lower for patients treated with non-DT vs DT regimens (21.8 vs 60.9 months, respectively). mOS differed between DT regimens (Table). Conclusions: In this descriptive analysis, we found that OS differed by site and receipt of DT and that a large proportion (42%) of patients received non-DT regimens. mOS was lower in patients who received non-DT vs DT. Despite available treatment options, there remains a need for novel therapies that can improve outcomes in LA SCCHN. Future analyses should explore differences in OS between subgroups while adjusting for patient demographic and clinical characteristics. [Table: see text]