HPV-associated oropharyngeal cancer: in search of surrogate biomarkers for early lesions

Oncogene, Год журнала: 2024, Номер 43(8), С. 543 - 554

Опубликована: Янв. 8, 2024

The incidence of oropharyngeal cancer (OPSCC) has escalated in the past few decades; this largely been triggered by high-risk human papillomavirus (HPV). Early screening is needed for timely clinical intervention and may reduce mortality morbidity, but lack knowledge about premalignant lesions OPSCC poses a significant challenge to early detection. Biomarkers that identify individuals at high risk act as surrogate markers precancer these are limited only studies decipher multistep progression from HPV infection development. Here, we summarize current literature describing oral infection, persistence, tumor development oropharynx. We also examine key challenges hinder identification oropharynx discuss potential biomarkers precancer. Finally, evaluate novel strategies improve investigations biological process drives persistence OPSCC, highlighting new developments establishment genetic model + vivo models mimic pathogenesis.

Язык: Английский

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Emerging technologies for cancer therapy using accelerated particles

Progress in Particle and Nuclear Physics, Год журнала: 2023, Номер 131, С. 104046 - 104046

Опубликована: Апрель 8, 2023

Язык: Английский

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Single proton LET characterization with the Timepix detector and artificial intelligence for advanced proton therapy treatment planning

Physics in Medicine and Biology, Год журнала: 2023, Номер 68(10), С. 104001 - 104001

Опубликована: Апрель 3, 2023

Abstract Objective. Protons have advantageous dose distributions and are increasingly used in cancer therapy. At the depth of Bragg peak range, protons produce a mixed radiation field consisting low- high-linear energy transfer (LET) components, latter which is characterized by an increased ionization density on microscopic scale associated with biological effectiveness. Prediction yield LET primary secondary charged particles at certain patient performed Monte Carlo simulations but difficult to verify experimentally. Approach. Here, results measurements Timepix detector produced therapeutic proton beam water presented compared simulations. The unique capability perform high-resolution single particle tracking identification enhanced artificial intelligence allowed resolve type measure deposited each comprising field. Based collected data, biologically important physics parameters, dose-averaged LET, were computed. Main results. An accuracy over 95% was achieved for recognition developed neural network model. For recognized protons, measured spectra generally agree mean difference between values obtained from 17%. We observed broad spectrum ranging fraction keV μ m −1 about 10 most fields. Significance. It has been demonstrated that introduced measurement method provides experimental data validation D or any treatment planning system. simplicity accessibility methodology make it easy be translated into clinical routine therapy facility.

Язык: Английский

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Proton Bragg Peak FLASH Enables Organ Sparing and Ultra-High Dose-Rate Delivery: Proof of Principle in Recurrent Head and Neck Cancer

Cancers, Год журнала: 2023, Номер 15(15), С. 3828 - 3828

Опубликована: Июль 28, 2023

Proton pencil-beam scanning (PBS) Bragg peak FLASH combines ultra-high dose rate delivery and organ-at-risk (OAR) sparing. This proof-of-principle study compared dosimetry coverage between PBS transmission in head neck reirradiation. plans were created via the highest beam single energy, range shifter, compensator, to for 6 GyE/fraction 10 eight recurrent patients originally treated with quad shot reirradiation (14.8/3.7 CGE). The also using conventional-rate intensity-modulated proton therapy techniques. FLASH, conventional OAR sparing, coverage, target coverage. All V40 Gy/s was 90-100% at GyE both modalities. generated volume histograms (DVHs) like those of demonstrated improved sparing over FLASH. modalities had similar CTV can deliver conformal, a two-millisecond minimum MU per spot. dose-sparing, which more pronounced than GyE/fraction. feasibility generates hypotheses benefits developing biological models.

Язык: Английский

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Interdisciplinary Collaboration in Head and Neck Cancer Care: Optimizing Oral Health Management for Patients Undergoing Radiation Therapy

Current Oncology, Год журнала: 2024, Номер 31(4), С. 2092 - 2108

Опубликована: Апрель 7, 2024

Radiation therapy (RT) plays a crucial role in the treatment of head and neck cancers (HNCs). This paper emphasizes importance effective communication collaboration between radiation oncologists dental specialists HNC care pathway. It also provides an overview RT illustrates interdisciplinary these teams to optimize patient care, expedite treatment, prevent post-treatment oral complications. The methods utilized include thorough analysis existing research articles, case reports, clinical guidelines, with terms such as ‘dental management’, ‘oral oncology’, ‘head cancer’, ‘radiotherapy’ included for this review. findings underscore significance early involvement planning phase assess prepare patients RT, including strategies prophylactic tooth extraction mitigate potential Furthermore, health follow-up management by are minimizing incidence severity RT-induced sequelae. In conclusion, proactive measures help minimize complications before, during, after treatment.

Язык: Английский

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Efficacy and safety of proton therapy versus intensity‐modulated radiation therapy in the treatment of head and neck tumors: A systematic review and meta‐analysis

Head & Neck, Год журнала: 2024, Номер 46(10), С. 2616 - 2631

Опубликована: Июль 15, 2024

Abstract To comprehensively evaluate the therapeutic efficacy and safety when utilizing proton therapy (PT) versus intensity‐modulated radiation (IMRT) in head neck cancer patients. Pubmed, ScienceDirect, Embase, Scopus, Web of Science were systematically searched for studies on comparative PT IMRT outcomes. We performed a random effect model meta‐analysis to estimate hazard ratio (HR) odds (OR) outcome variables between IMRT. From 641 identified articles, 11 met inclusion criteria, comprising 3087 patients (606 treated with 2481 IMRT). On toxicity analysis, is associated decreased acute grade 1 nausea (OR = 0.34, 95% CI: 0.13–0.84, p 0.02) compared In 2 toxicity, showed significant advantages over mucositis 0.44, < 0.0001), dysgeusia 0.35, 0.02), dysphagia 0.36, fatigue 0.29, 0.001), pain 0.01), weight loss 0.54, 0.02). Proton also exhibited increased 3 incidence 0.0001) demonstrated improved overall survival (OS) across multiple time points: 1‐year OS (HR 0.43, 2‐year 5‐year 0.78, 0.004). terms disease‐free (DFS), outcomes at DFS 0.65, 0.03) 0.81, 0.03). superior (OS), better local control rate (LCR) The data patients, particularly involving events.

Язык: Английский

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A systematic review of salivary gland hypofunction and/or xerostomia induced by non-surgical cancer therapies: prevention strategies

Supportive Care in Cancer, Год журнала: 2025, Номер 33(2)

Опубликована: Янв. 10, 2025

Abstract Purpose This systematic review aimed to assess the updated literature for prevention of salivary gland hypofunction and xerostomia induced by non-surgical cancer therapies. Methods Electronic databases MEDLINE/PubMed, EMBASE, Cochrane Library were searched randomized controlled trials (RCT) that investigated interventions prevent and/or xerostomia. Literature search began from 2010 publications Multinational Association Supportive Care in Cancer/International Society Oral Oncology (MASCC/ISOO) up February 2024. Two independent reviewers extracted information regarding study design, population, treatment modality, interventions, outcome measures, methods, results, risk bias (RoB version 2), conclusions each article. Results A total 51 addressing preventive included. Eight RCTs on tissue-sparing radiation modalities included showing significant lower prevalence xerostomia, with unclear effect hypofunction. Three acupuncture showed reduced but not muscarinic agonist stimulation bethanechol suggested a saliva flow rate patients undergoing head neck or radioactive iodine therapy. studies submandibular transfer higher rates compared pilocarpine no active intervention. There is insufficient evidence effectiveness vitamin E, amifostine, photobiomodulation, miscellaneous interventions. Conclusion continues support potential tecniques intensity-modulated therapy (IMRT) preserve function cancer, limited other strategies, including bethanecol. Preventive focus should be optimized new approaches developed further reduce dose parotid, submandibular, minor glands. As these glands are major contributors moistening oral cavity, limiting through various has demonstrated reduction severity remains checkpoint inhibitors biologicals due lack RCTs.

Язык: Английский

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Adjuvant Proton Radiation Following Transoral Robotic Surgery for HPV‐Positive Oropharyngeal Squamous Cell Carcinoma

Otolaryngology, Год журнала: 2025, Номер unknown

Опубликована: Янв. 31, 2025

Advances in the treatment of human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) include transoral robotic surgery (TORS) and proton beam therapy (PBT). This study aims to improve understanding toxicities associated with adjuvant PBT following TORS for OPSCC. A retrospective review. An academic tertiary care center Baltimore, Maryland. Patients undergoing followed by from 2017 2023 were reviewed. Forty-seven patients HPV-associated OPSCC underwent PBT. Forty-one (87.2%) male. The median age at first radiation fraction was 61.7 years. identified as white 6 (12.8%) African American. Most had T1 (23 [48.9%]) or T2 (22 [46.8%]), N1 (41 [87.2%]) disease. majority (98.3%) acute grade 1 2, only (2.1%) patient developing 3 toxicities. Three (6.4%) required a feeding tube nutrition during treatment. who tubes also postoperative nasogastric 16 days, compared days all other (Mann-Whitney U, P = .02). most common chronic included xerostomia, dysphagia, dysgeusia, lymphedema, which decreased over time. treated demonstrated favorable toxicity profile mostly 2 Feeding requirement low 6.4%. Many appeared decrease frequency time radiation, although further is required.

Язык: Английский

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Toxicity and Oncologic Outcomes of Proton Radiotherapy for Oropharyngeal Cancer: A Systematic Review and Meta-Analysis

Cureus, Год журнала: 2025, Номер unknown

Опубликована: Фев. 11, 2025

Intensity-modulated radiotherapy (IMRT) for oropharyngeal cancer (OPC) is associated with acute and late toxicities that impact patient quality of life. Proton (PRT) can reduce exposure to surrounding tissues, but the clinical magnitude this advantage unclear. A systematic review meta-analysis was performed in accordance Preferred Reporting Items Systematic Reviews Meta-Analyses (PRISMA) guidelines. Included studies reported toxicity or oncologic outcomes from patients treated PRT OPC. Pooled were estimated using random-effects models. Comparisons between IMRT log odds ratios. Primary pooled rates adverse events, overall survival (OS), progression-free (PFS). total 18 (16 retrospective, two prospective) consisting 956 identified. grade 3+ as follows: dermatitis 19%, mucositis 32%, xerostomia 1.3%, dysphagia 13%, weight loss 1.4%. The rate hospitalizations 10%. Among reporting toxicities, 1.1% 1.6%, respectively. Compared IMRT, lower feeding tube use (21% versus 31%; P = 0.0012), not long-term (1.4% 2.7%; 0.24). After PRT, OS at three years 98% 96%, while PFS 93% 86%. OPC favorable outcomes. While randomized trials are ongoing, these data provide additional evidence regarding efficacy upfront treatment

Язык: Английский

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Assessing proton plans with 3 different beam lines vs photon plans for early-stage lung cancer

Medical dosimetry, Год журнала: 2025, Номер unknown

Опубликована: Фев. 1, 2025

To compare proton plans (IMPT) to VMAT and intercompare using 3 different spot sizes with robustness: cyclotron-generated beams (CPB) (σ: 2.7-7.0 mm), linear accelerator (LPB) 2.9-5.5 mini (LPMB) 0.9-3.9 mm) for the treatment of early-stage lung cancer. Twenty-two lesions from a total twenty patients cancer, originally treated SBRT, were replanned CPBs, LPBs, LPMBs, same planning system dose calculation algorithm. The average intensity projected CTs (AIP-CT) used 3D robust optimization was all plans. Conformity index (CI), homogeneity (HI), R50, V20 Gy, mean compared among plan types Set-up uncertainties ±5 mm ±3.5% range uncertainty included in IMPT evaluation, V100%Rx > 98% ITV. Wilcoxon signed-rank test evaluate statistical differences between types. When plans, generally show improvement CI, HI, Lung Mean dose, R50. LPMB showed most Comparison CPB significance (p < 0.05). R50 CPB, LPB 3.6 ± 0.9, 3.1 0.8 2.6 0.6; 2.2 1.1 1.9 1 Gy 1.6 0.9 respectively 4.1 0.4 3.8 2 respectively. (%) improved across when those evaluated robustness worst-case scenario at ITV 98%, coverage 98.6 0.3%, 0.6%, 98.9 0.6% achieved With decreased size, are excellent alternatives reduced normal tissue quality cancer treatments.

Язык: Английский

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