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Radiation Therapy for Head and Neck Cancer
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Radiation Therapy for Head and Neck Cancer

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: closed (30 June 2023) | Viewed by 11140

Special Issue Editors

Dr. Ali Hosni

E-Mail Website
Guest Editor
Department of Radiation Oncology Temerty Faculty of Medicine; University of Toronto, Toronto, ON, Canada
Interests: technology-driven research; novel biomarkers; IGRT; predictive models; personalized RT
Dr. Andrew McPartlin

E-Mail Website
Guest Editor
Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
Interests: technical radiotherapy; MR imaging

Special Issue Information

Dear Colleagues,

Radiation therapy is a standard of care, both in primary and adjuvant settings, in the treatment of head and neck cancer. However, radiotherapy is associated with significant acute and long-term complications. As survival rates of head and neck cancer are improving, the impact of radiation therapy in the long term becomes of utmost importance. The aim of this Special Issue is to present a series of original (pre)clinical trials/translational studies/review articles that will highlight the progress that has been achieved in the management of head and neck cancer.

We look forward to receiving your contributions.

Dr. Ali Hosni
Dr. Andrew McPartlin
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • radiation therapy
  • IMRT/IGRT
  • outcomes
  • head and neck cancer
  • survival

Published Papers (5 papers)

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Research

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12 pages, 2057 KiB  
Article
The Clinical Characteristics and Outcomes of Human Papillomavirus-Positive Nasopharyngeal Carcinoma in a Single-Institution Cohort
by Muhammad Awawda, Saeed Salman and Salem Billan
J. Clin. Med. 2023, 12(13), 4264; https://doi.org/10.3390/jcm12134264 - 25 Jun 2023
Viewed by 1363
Abstract
Background: Nasopharyngeal carcinoma (NPC) is a head and neck cancer more frequent among East Asian populations compared with Western populations. While much is known about human papillomavirus’s (HPV’s) role in oropharyngeal cancer (OPC), little is known about its prevalence and prognostic value in [...] Read more.
Background: Nasopharyngeal carcinoma (NPC) is a head and neck cancer more frequent among East Asian populations compared with Western populations. While much is known about human papillomavirus’s (HPV’s) role in oropharyngeal cancer (OPC), little is known about its prevalence and prognostic value in NPC. The aim of this study is to investigate the role of HPV in NPC treated with definitive radiotherapy at a single institution. Methods: A retrospective cohort analysis of patient’s medical records and HPV status treated for NPC in Rambam Health Care Campus (Rambam HCC). Immunohistochemical staining for p16 was used as a surrogate marker of HPV infection in the tumor cells. All specimens were stained and evaluated by pathologists at the referring center independently. Results: In total, 87 patients diagnosed with NPC were treated at Rambam HCC between 2005 and 2018. Seventy-four patients had accessible data on the disease’s clinical parameters and p16 status. In total, 10/74 (13.5%) had p16-positive staining in tumor cells; 75% were men and over 50% were smokers. The average age of diagnosis for the whole cohort was 48 years, being lower for p16-positive patients compared with p16-negative patients at 43 and 49 years old, respectively. A total of 84% of the patients had advanced disease of stage III and IV at presentation. Only 16% were diagnosed with stage I and II. Unlike the p16-negative group, the p16-positive group did not include any stage I or II disease. In univariate and multivariate analysis of overall survival rates, the age at diagnosis and the nodal spread status were the only statistically significant measures. P16 status was not found to be associated with survival. Conclusions: The HPV prevalence in NPC is nontrivial. p16-positive patients had significantly less nodal spread and tended to be younger. Both age and nodal status were significantly correlated with the survival, but P16 status was not prognostic. Further large-scale trials are needed to elucidate the role of HPV in NPC. Full article
(This article belongs to the Special Issue Radiation Therapy for Head and Neck Cancer)
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14 pages, 1685 KiB  
Article
The Prognostic and Diagnostic Value of [18F]FDG PET/CT in Untreated Laryngeal Carcinoma
by Akram Al-Ibraheem, Ahmed Saad Abdlkadir, Dhuha Al-Adhami, Taher Abu Hejleh, Asem Mansour, Issa Mohamad, Malik E. Juweid, Ula Al-Rasheed, Nabeela Al-Hajaj, Dima Abu Laban, Enrique Estrada-Lobato and Omar Saraireh
J. Clin. Med. 2023, 12(10), 3514; https://doi.org/10.3390/jcm12103514 - 17 May 2023
Cited by 4 | Viewed by 1860
Abstract
This study aims to determine the diagnostic accuracy of staging PET/CT and neck MRI in patients with laryngeal carcinoma and to assess the value of PET/CT in predicting progression-free survival (PFS) and overall survival (OS). Sixty-eight patients who had both modalities performed before [...] Read more.
This study aims to determine the diagnostic accuracy of staging PET/CT and neck MRI in patients with laryngeal carcinoma and to assess the value of PET/CT in predicting progression-free survival (PFS) and overall survival (OS). Sixty-eight patients who had both modalities performed before treatment between 2014 and 2021 were included in this study. The sensitivity and specificity of PET/CT and MRI were evaluated. PET/CT had 93.8% sensitivity, 58.3% specificity, and 75% accuracy for nodal metastasis, whereas MRI had 68.8%, 61.1%, and 64.7% accuracy, respectively. At a median follow-up of 51 months, 23 patients had developed disease progression and 17 patients had died. Univariate-survival analysis revealed all utilized PET parameters as significant prognostic factors for OS and PFS (p-value < 0.03 each). In multivariate analysis, metabolic-tumor volume (MTV) and total lesion glycolysis (TLG) predicted better PFS (p-value < 0.05 each). In conclusion, PET/CT improves the accuracy of nodal staging in laryngeal carcinoma over neck MRI and adds to the prognostication of survival outcomes through the use of several PET metrics. Full article
(This article belongs to the Special Issue Radiation Therapy for Head and Neck Cancer)
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12 pages, 1262 KiB  
Article
Re-Irradiation for Recurrent Head and Neck Cancer: Freedom from Cancer Recurrence Rate
by Issa Mohamad, Taher Abu Hejleh, Sania Abdelqader, Lina Wahbeh, Ayat Taqash, Abdelatif Almousa, Ebrahim Mayta, Akram Al-Ibraheem, Fawzi Abuhijla, Ramiz Abu-Hijlih, Tariq Hussein, Wisam Al-Gargaz, Hamza Ghatasheh and Ali Hosni
J. Clin. Med. 2023, 12(8), 2979; https://doi.org/10.3390/jcm12082979 - 19 Apr 2023
Cited by 2 | Viewed by 1912
Abstract
Salvage re-irradiation (rRT) for patients with locoregionally recurrent head and neck cancer (rHNC) remains challenging. A retrospective analysis was performed on 49 patients who received rRT between 2011 and 2018. The co-primary endpoint of the study was 2-year freedom from cancer recurrence rate [...] Read more.
Salvage re-irradiation (rRT) for patients with locoregionally recurrent head and neck cancer (rHNC) remains challenging. A retrospective analysis was performed on 49 patients who received rRT between 2011 and 2018. The co-primary endpoint of the study was 2-year freedom from cancer recurrence rate (FCRR) and overall survival (OS), and secondary endpoints were 2-year disease-free survival (DFS), local failure (LF), regional failure (RF), distant metastases (DM), and RTOG grade 3 ≥ late toxicities. Adjuvant and definitive rRT were delivered to 22 and 27 patients, respectively. A total of 91% of patients were managed with conventional re-RT and 71% of patients received concurrent chemotherapy. The median follow-up after rRT was 30 months. The 2-year FCRR, OS, DFS, LF, RF, and DM were 64%, 51%, 28%, 32%, 9%, and 39% respectively. MVA showed that poor performance status (PS: 1–2 vs. 0) and age > 52 years were predictive of worse OS. In comparison, poor PS (1–2 vs. 0) and total dose of rRT < 60 Gy were predictive of worse DFS. Late RTOG toxicity of grade 3 ≥ was reported in nine (18.3%) patients. FCRR at 2 years after salvage rRT for rHNC was higher than other traditional endpoints and could be an important endpoint to be included in future rRT studies. rRT for rHNC at our cohort was relatively successful, with a manageable level of late severe toxicity. Replacing this approach in other developing countries is a viable option. Full article
(This article belongs to the Special Issue Radiation Therapy for Head and Neck Cancer)
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Review

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20 pages, 1523 KiB  
Review
Review of Osteoradionecrosis of the Jaw: Radiotherapy Modality, Technique, and Dose as Risk Factors
by Erkan Topkan, Ahmet Kucuk, Efsun Somay, Busra Yilmaz, Berrin Pehlivan and Ugur Selek
J. Clin. Med. 2023, 12(8), 3025; https://doi.org/10.3390/jcm12083025 - 21 Apr 2023
Cited by 15 | Viewed by 2412
Abstract
Radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) is the cornerstone of organ-sparing or adjuvant therapy for nearly all head and neck cancers. Unfortunately, aggressive RT or CCRT can result in severe late toxicities, such as osteoradionecrosis of the jaws (ORNJ). The incidence of ORNJ [...] Read more.
Radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) is the cornerstone of organ-sparing or adjuvant therapy for nearly all head and neck cancers. Unfortunately, aggressive RT or CCRT can result in severe late toxicities, such as osteoradionecrosis of the jaws (ORNJ). The incidence of ORNJ is currently less than 5–6% due to advances in dental preventive care programs, RT planning systems, and RT techniques. Although numerous patient-, tumor-, and treatment-related factors may influence the incidence rates of ORNJ, RT modality (equipment), technique, and dose-volume-related factors are three of the most influential factors. This is mainly because different RT equipment and techniques have different levels of success at delivering the prescribed dose to the focal volume of the treatment while keeping the “organ at risk” safe. ORNJ risk is ultimately determined by mandibular dose, despite the RT technique and method being known predictors. Regardless of the photon delivery method, the radiobiological effects will be identical if the total dose, dose per fraction, and dose distribution within the tissue remain constant. Therefore, contemporary RT procedures mitigate this risk by reducing mandibular dosages rather than altering the ionizing radiation behavior in irradiated tissues. In light of the paucity of studies that have examined the impact of RT modality, technique, and dose-volume-related parameters, as well as their radiobiological bases, the present review aims to provide a comprehensive overview of the published literature on these specific issues to establish a common language among related disciplines and provide a more reliable comparison of research results. Full article
(This article belongs to the Special Issue Radiation Therapy for Head and Neck Cancer)
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Other

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12 pages, 271 KiB  
Hypothesis
Simultaneous Integrated Boost (SIB) vs. Sequential Boost in Head and Neck Cancer (HNC) Radiotherapy: A Radiomics-Based Decision Proof of Concept
by Camil Ciprian Mireștean, Roxana Irina Iancu and Dragoș Petru Teodor Iancu
J. Clin. Med. 2023, 12(6), 2413; https://doi.org/10.3390/jcm12062413 - 21 Mar 2023
Cited by 2 | Viewed by 3044
Abstract
Artificial intelligence (AI) and in particular radiomics has opened new horizons by extracting data from medical imaging that could be used not only to improve diagnostic accuracy, but also to be included in predictive models contributing to treatment stratification of cancer. Head and [...] Read more.
Artificial intelligence (AI) and in particular radiomics has opened new horizons by extracting data from medical imaging that could be used not only to improve diagnostic accuracy, but also to be included in predictive models contributing to treatment stratification of cancer. Head and neck cancers (HNC) are associated with higher recurrence rates, especially in advanced stages of disease. It is considered that approximately 50% of cases will evolve with loco-regional recurrence, even if they will benefit from a current standard treatment consisting of definitive chemo-radiotherapy. Radiotherapy, the cornerstone treatment in locally advanced HNC, could be delivered either by the simultaneous integrated boost (SIB) technique or by the sequential boost technique, the decision often being a subjective one. The principles of radiobiology could be the basis of an optimal decision between the two methods of radiation dose delivery, but the heterogeneity of HNC radio-sensitivity makes this approach difficult. Radiomics has demonstrated the ability to non-invasively predict radio-sensitivity and the risk of relapse in HNC. Tumor heterogeneity evaluated with radiomics, the inclusion of coarseness, entropy and other first order features extracted from gross tumor volume (GTV) in multivariate models could identify pre-treatment cases that will benefit from one of the approaches (SIB or sequential boost radio-chemotherapy) considered the current standard of care for locally advanced HNC. Computer tomography (CT) simulation and daily cone beam CT (CBCT) could be chosen as imaging source for radiomic analysis. Full article
(This article belongs to the Special Issue Radiation Therapy for Head and Neck Cancer)
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