Objective:The aim of this retrospective study is to evaluate the safety and efficacy of tislelizumab in patients with recurrent/metastatic head and neck squamous cell carcinoma. Methods:Six patients with recurrent/metastatic head and neck squamous cell carcinoma who received tislelizumab monotherapy in our hospital from 2018 to 2020 were retrospectively analyzed. The information of sex, age, TNM stage, efficacy, and adverse reactions were collected. All patients were recruited from the RATIONALE 102 study. The primary end point was the objective response rate, and other end points included progression-free survival and overall survival. We performed tumor immune-related gene sequencing and transcriptome sequencing analysis on the tumor tissues of the patient, and used bioinformatics methods to enrich immune cells and analyze signaling pathways. All analyses were performed using R 4.1. 0 software, SPSS Statistics 24.0 software and GraphPad Prism 8. Results:As of May 31, 2020, the median follow-up time was 26.35 months. The objective response rate with tislelizumab was 50.0%, the median progression-free survival was 6.44 months, and the estimated median survival was 20.07 months. The incidence of grade 3 or higher adverse reactions was 66.7%, including hyponatremia, hypokalemia, hypercalcemia, etc. The expression of macrophage, Treg and neutrophil-related genes are higher in immune-sensitive patients, and the signaling pathways of the intestinal immune network for IgA production, graft versus host disease and autoimmune thyroid disease are significantly activated. Conclusion:Tislelizumab was found to be controllable and tolerable in patients with recurrent/metastatic head and neck squamous cell carcinoma. The response to tislelizumab is related to immune cell infiltration and activation of immune-related signaling pathways.
Humans ; Squamous Cell Carcinoma of Head and Neck/etiology* ; Retrospective Studies ; Carcinoma, Squamous Cell/pathology* ; Neoplasm Recurrence, Local/pathology* ; Head and Neck Neoplasms ; Antineoplastic Combined Chemotherapy Protocols

Oral squamous cell carcinoma (OSCC) is the most frequent tumour in head and neck malignant. The current treatment is mainly based on surgery therapy, radiation therapy and chemical therapy. Meanwhile, there are many a defect in the treatment. For example, there are many defects in radiotherapy. Radioactive salivatitis is the most common. In addition, there are a series of changes such as dry mouth, oral mucositis, rampant dental caries, and radioactive osteomyelitis of jaw, which cause swallowing, chewing problems, and taste dysfunction. Currently, the research on radioactive salivatitis is progressing rapidly, but its mechanism is more complication. This paper review aims to summarize the research progress in this field.
Carcinoma, Squamous Cell ; Dental Caries ; Head and Neck Neoplasms/radiotherapy* ; Humans ; Mouth Neoplasms ; Radiation Injuries ; Salivary Glands ; Xerostomia/etiology*

Objective:To evaluate the clinical significance of neoadjuvant immunotherapy combined with chemotherapy in the treatment of larynx preservation in locally advanced hypopharyngeal squamous cell carcinoma. Methods:Patients with locally advanced HPSCC（cT3-T4aN0-N3M0） were eligible. All received 2 cycles of pembrolizumab combined with docetaxel and platinum neoadjuvant induction therapy. After two cycles, the efficacy was evaluated, followed by radical chemoradiotherapy or surgery and adjuvant chemoradiotherapy according to the efficacy. The primary endpoints were objective response rate（ORR） ，larynx-preservation（LP） rate at 3 months post-treatment and the adverse reactions during neoadjuvant therapy. Results:From December 2021 to December 2022, 10 patients with locally advanced HPSCC（cT3-T4aN0-N3M0） were enrolled. After 2 cycles of the neoadjuvant therapy, 2 patients achieved complete response（CR）, 7 patients achieved partial response（PR）, 1 patient was stable disease（SD）, objective response rate（ORR） was 90%, and disease control rate（DCR） was 100%. 5 patients received radical chemoradiotherapy, 5 patients received surgery and adjuvant chemoradiotherapy, four of them received partial laryngectomy and partial hypopharyngeal resection surgery, and one of them received total laryngectomy and partial hypopharyngeal resection surgery. All patients were able to withstand adverse reactions of neoadjuvant therapy and successfully completed the whole treatment of HPSCC without grade 3-4 treatment-related adverse reactions. There was no recurrence or metastasis during 3-18 months of follow-up. 1 patient died of severe pneumonia 3 months after the completion of radical chemoradiotherapy. At 3 months after treatment, the larynx-preservation rate was 80%. Conclusion:Neoadjuvant immunotherapy combined with chemotherapy has good short-term efficacy and the adverse reactions were tolerable. It can improve the larynx-preservation rate of patients with locally advanced HPSCC, thus improving the prognosis and quality of life of patients.
Humans ; Squamous Cell Carcinoma of Head and Neck/etiology* ; Neoadjuvant Therapy ; Quality of Life ; Cisplatin ; Treatment Outcome ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Larynx ; Head and Neck Neoplasms ; Immunotherapy

Oncologists and scientists in the field of head and neck cancer exchanged their research findings and clinical experiences in the Sino-USA Symposium on Head and Neck Cancer, which was held January 6-7, 2012 in Guangzhou, China. The symposium was jointly organized by Sun Yat-sen University Cancer Center (SYSUCC) and the University of Texas MD Anderson Cancer Center (MDACC). The Guangdong Provincial Anti-Cancer Association and the Chinese Journal of Cancer also helped in organizing the conference. Speakers were from China (SYSUCC, the Chinese University of Hong Kong, Tianjin Medical University Cancer Institute and Hospital, and Fudan University Shanghai Cancer Center) and the United States (MDACC). The presentations covered most kinds of head and neck cancers and included both basic and clinical research progress. In particular, NPC was discussed in depth. The symposium explored the reality that cancer is complex and numerous questions remain to be answered, even though there has already been an enormous effort into research. International exchanges of experience and in-depth cooperation are definitely needed to improve our capability of caring for cancer patients. In this article, we provide highlights of the presentations.
Carcinoma, Squamous Cell ; genetics ; Combined Modality Therapy ; Drug Delivery Systems ; Head and Neck Neoplasms ; drug therapy ; etiology ; genetics ; pathology ; surgery ; Humans ; Nasopharyngeal Neoplasms ; genetics ; pathology ; therapy ; Thyroid Neoplasms ; epidemiology

OBJECTIVETo study the association between polymorphism of DNA repair gene XRCC3 Thr 241 Met and the risks of developing laryngeal and hypopharyngeal carcinomas.

METHODSOne hundred and seventy five patients with laryngeal or hypopharyngeal carcinoma and 525 cancer-free controls were genotyped for the polymorphism by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using unconditional logistic regression model.

RESULTSThe XRCC3 241 Met allele increased the risk of developing laryngeal carcinoma and hypopharyngeal carcinoma. Comparing with subjects having the XRCC3 241 Thr/Thr genotype, the subjects at least having one XRCC3 241 Met allele had OR of 2. 26 (95% CI 1.33 -3.82). Respectively analyzing the risks of laryngeal carcinoma and hypopharyngeal carcinoma, The allele XRCC3 241 Met increased the risks of developing both laryngeal and hypopharyngeal carcinoma. Comparing with the subjects having the XRCC3 241 Thr/Thr genotype, the subjects with laryngeal carcinoma at least having one XRCC3 241 Met genotype had OR of 2.27 (95% CI 1.26 - 4.09); the subjects with hypopharyngeal carcinoma at least having one XRCC3 241 Met genotype had OR of 2. 99 (95% CI 1.27 - 7.04). Smoking may increase the risk of developing laryngeal carcinoma and hypopharyngeal carcinoma. The interaction of smoking and XRCC3 Thr241 Met increased risk of laryngeal carcinoma and hypopharyngeal carcinoma in a super-multiplicative manner. The subjects with heavy smoking and at least having one XRCC3 241Met allele had OR of 19.09 (95% CI 7.38 -49.40) comparing with those having the XRCC3 241 Thr/ Thr genotype and no smoking, which was greater than the multiplication of ORs both of subjects at least having one 241 Met allele meanwhile without smoking (OR, 0.91; 95% CI, 0.20 - 4.21) and of subjects having XRCC3 241 Thr/Thr genotype meanwhile with smoking (OR, 4.13; 95% CI, 2.38 - 7.17).

CONCLUSIONSXRCC3 Thr 241 Met plays an important role in the development of laryngeal and hypopharyngeal carcinoma.

Carcinoma ; etiology ; genetics ; Carcinoma, Squamous Cell ; Case-Control Studies ; DNA Repair ; DNA-Binding Proteins ; genetics ; Female ; Genetic Predisposition to Disease ; Genotype ; Head and Neck Neoplasms ; etiology ; genetics ; Humans ; Hypopharyngeal Neoplasms ; etiology ; genetics ; Laryngeal Neoplasms ; etiology ; genetics ; Male ; Middle Aged ; Neoplasms, Squamous Cell ; etiology ; genetics ; Polymorphism, Genetic ; Risk Factors ; Smoking

The management of cervical lymph node metastases of squamous cell carcinoma from an unknown primary site is still a therapeutic challenge. We report here our experience in treating these patients with chemoradiotherapy as a curative approach. Data from 40 patients were reviewed. In total, 20 (50%) patients underwent excisional biopsy. All patients underwent radiotherapy, which was delivered to both sides of the neck and pharyngeal mucosa (extensive field), and concurrent chemotherapy consisting of weekly cisplatin at a dose of 40 mg/m(2). The clinical stage of the cervical nodes at presentation was N1 in 25%, N2 in 60%, and N3 in 15%. Most patients (75%) developed at least grade 3 mucositis. Eight patients (20%) had grade 3 xerostomia and 18 patients (45%) required esophageal dilation for stricture. The 5-year overall survival(OS) rate of all patients was 67.5%. The 5-year OS rates of patients with N1, N2, and N3 lesions were 100%, 67%, and 41%, respectively (P = 0.046). The 5-year progression-free survival rate was 62.5%. In multivariate analysis, only N stage significantly affected OS(P = 0.022). Emergence of the occult primary was very limited (1 patient only). Our results suggest that extensive irradiation of both sides of the neck and pharyngeal mucosa with concurrent chemotherapy results in a lower emergence of primary tumor. Because the survival of patients with unknown primary is comparable to that of patients with known primary, an attempt at cure should always be made.
Adult ; Aged ; Antineoplastic Agents ; therapeutic use ; Carcinoma, Squamous Cell ; pathology ; secondary ; therapy ; Chemoradiotherapy ; Cisplatin ; therapeutic use ; Disease-Free Survival ; Esophagitis ; etiology ; Female ; Follow-Up Studies ; Head and Neck Neoplasms ; pathology ; secondary ; therapy ; Humans ; Lymph Nodes ; radiation effects ; surgery ; Male ; Middle Aged ; Mucositis ; etiology ; Neck ; pathology ; Neck Dissection ; Neoplasms, Unknown Primary ; pathology ; therapy ; Pharynx ; pathology ; Survival Rate ; Xerostomia ; etiology ; Young Adult

Recurrent syncope as a complication of recurrent neck malignancy is an uncommon but well documented association. The syncope is presumed to occur when a tumor mass invades the baroreceptor within the carotid sinus or when it disrupts the afferent nerve fibers of the glossopharyngeal nerve. A 59-year-old man presented with recurrent syncope and headache. He had a wide local excision including tonsillectomy and modified left radical neck dissection for tonsilar cancer 4 years ago. A computed tomography scan revealed ill-defined lesions in left parapharyngeal, carotid space and right upper jugular region. After clinical evaluation, cardiac pacemaker was placed, but he still suffered from the syncope. Then, he received the chemotherapy with docetaxel and cisplatin. The last hypotension event occurred on day 10 of the chemotherapy. Six months after 3 cycles of chemotherapy, he remained in complete remission and resolution of syncope. We report a case in which syncope was associated with a recurrence of tonsilar cancer and successfully treated with chemotherapy.
Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; Carcinoma, Squamous Cell/*complications/drug therapy/radiography ; Cisplatin/*therapeutic use ; Head and Neck Neoplasms/*complications/drug therapy/radiography ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local/*complications/drug therapy ; *Pacemaker, Artificial ; Syncope/*drug therapy/etiology ; Taxoids/*therapeutic use ; Tonsillar Neoplasms/*complications/drug therapy/radiography