Browsing by Subject "Oropharyngeal cancer"

Now showing 1 - 7 of 7
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    The Dosimetric Outcome of a Rotational Planning Target Volume in Patients With Oropharyngeal Cancers
    (Springer, 2022-08) Arbab, Mona; Bartlett, Gregory; Dawson, Benjamin; Ge, Jeffrey; Langer, Mark; Radiation Oncology, School of Medicine
    An isotropic expanded Planning Target Volume (PTV) neglects patient's off-axis rotation. This study designs a rotational PTV that is used instead of the standard 3-mm Clinical Target Volume (CTV) expanded PTV in oropharyngeal cancers with the goal to reduce pharyngeal constrictor muscle (PCM) mean dose. 10 patients were retrospectively evaluated. For off-axis rotation, the image was rotated around the longitudinal axis (cervical spinal canal) ± 5 degrees. These new CTVs were combined to form the rotational PTV. The standard and rotational treatment plans were designed with the goal to keep the superior and middle PCM-CTV70 mean dose to less than 50 Gy. There were a 355 cGy reduction in the superior PCM mean dose (form 5332 to 4977 cGy) and a 506 cGy reduction in middle PCM mean dose (from 4185 to 3679 cGy). 60% of patients may have at least a 20% reduction in dysphagia probability based on a Normal Tissue Complication Probability (NTCP) formula. The superior and middle PCM mean dose were reduced to less than 50 Gy in 40 and 20% of cases. There was an association between superior PCM mean dose and overlap volume of PTV70 and superior PCM in both standard (r = 0.92, p = 0.001) and rotational (r = 0.84, p = 0.002) plans. This association was present for middle PCM and PTV70 (r = 0.52, p = 0.02 and r = 0.62, p = 0.006). Rotational PTV can lower the mean dose to superior and middle PCMs, ultimately leading to lower dysphagia rates.
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    High Expression of NFX1-123 in HPV Positive Head and Neck Squamous Cell Carcinomas
    (Wiley, 2022) Chintala, Sreenivasulu; Quist, Kevin M.; Gonzalez-DeWhitt, Patricia A.; Katzenellenbogen, Rachel A.; Pediatrics, School of Medicine
    Background: High-risk human papillomaviruses (HR HPV) cause nearly all cervical cancers and, in the United States, the majority of head and neck cancers (HNSCCs). NFX1-123 is overexpressed in cervical cancers, and NFX1-123 partners with the HR HPV type 16 E6 oncoprotein to affect multiple growth, differentiation, and immune response genes. However, neither the expression of NFX1-123 nor the levels of these genes have been investigated in HPV positive (HPV+) or negative (HPV-) HNSCCs. Methods: The Cancer Genome Atlas Splicing Variants Database and HNSCC cell lines were used to quantify expression of NFX1-123 and cellular genes increased in cervical cancers. Results: NFX1-123 was increased in HPV+ HNSCCs compared to HPV- HNSCCs. LCE1B, KRT16, SPRR2G, and FBN2 were highly expressed in HNSCCs compared to normal tissues. Notch1 and CCNB1IP1 had greater expression in HPV+ HNSCCs compared to HPV- HNSCCs. Conclusion: NFX1-123 and a subset of its known targets were increased in HPV+ HNSCCs.
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    HPV-related oropharyngeal cancer: a review on burden of the disease and opportunities for prevention and early detection
    (Taylor & Francis, 2019-05-07) Timbang, Mary Roz; Sim, Michael W.; Bewley, Arnaud F.; Farwell, D. Gregory; Mantravadi, Avinash; Moore, Michael G.; Otolaryngology -- Head and Neck Surgery, School of Medicine
    The incidence of oropharyngeal cancer (OPC) related to infection with human papillomavirus (HPV) is rising, making it now the most common HPV-related malignancy in the United States. These tumors present differently than traditional mucosal head and neck cancers, and those affected often lack classic risk factors such as tobacco and alcohol use. Currently, there are no approved approaches for prevention and early detection of disease, thus leading many patients to present with advanced cancers requiring intense surgical or nonsurgical therapies resulting in significant side effects and cost to the health-care system. In this review, we outline the evolving epidemiology of HPV-related OPC. We also summarize the available evidence corresponding to HPV-related OPC prevention, including efficacy and safety of the HPV vaccine in preventing oral HPV infections. Finally, we describe emerging techniques for identifying and screening those who may be at high risk for developing these tumors.
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    Human Papillomavirus Oral- and Sero- Positivity in Fanconi Anemia
    (MDPI, 2021-03-18) Sauter, Sharon L.; Zhang, Xue; Romick-Rosendale, Lindsey; Wells, Susanne I.; Myers, Kasiani C.; Brusadelli, Marion G.; Poff, Charles B.; Brown, Darron R.; Panicker, Gitika; Unger, Elizabeth R.; Mehta, Parinda A.; Bleesing, Jack; Davies, Stella M.; Butsch Kovacic, Melinda; Medicine, School of Medicine
    High-risk human papillomavirus (HPV) is prevalent and known to cause 5% of all cancers worldwide. The rare, cancer prone Fanconi anemia (FA) population is characterized by a predisposition to both head and neck squamous cell carcinomas and gynecological cancers, but the role of HPV in these cancers remains unclear. Prompted by a patient-family advocacy organization, oral HPV and HPV serological studies were simultaneously undertaken. Oral DNA samples from 201 individuals with FA, 303 unaffected family members, and 107 unrelated controls were tested for 37 HPV types. Serum samples from 115 individuals with FA and 55 unrelated controls were tested for antibodies against 9 HPV types. Oral HPV prevalence was higher for individuals with FA (20%) versus their parents (13%; p = 0.07), siblings (8%, p = 0.01), and unrelated controls (6%, p ≤ 0.001). A FA diagnosis increased HPV positivity 4.84-fold (95% CI: 1.96-11.93) in adjusted models compared to unrelated controls. Common risk factors associated with HPV in the general population did not predict oral positivity in FA, unlike unrelated controls. Seropositivity and anti-HPV titers did not significantly differ in FA versus unrelated controls regardless of HPV vaccination status. We conclude that individuals with FA are uniquely susceptible to oral HPV independent of conventional risk factors.
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    Oral human papillomavirus is common in individuals with Fanconi anemia
    (American Association for Cancer Research, 2015-05) Sauter, Sharon L.; Wells, Susanne I.; Zhang, Xue; Hoskins, Elizabeth E.; Davies, Stella M.; Myers, Kasiani C.; Mueller, Robin; Panicker, Gitika; Unger, Elizabeth R.; Sivaprasad, Umasundari; Brown, Darron R.; Mehta, Parinda A.; Kovacic, Melinda Butsch; Department of Microbiology & Immunology, IU School of Medicine
    Fanconi anemia is a rare genetic disorder resulting in a loss of function of the Fanconi anemia-related DNA repair pathway. Individuals with Fanconi anemia are predisposed to some cancers, including oropharyngeal and gynecologic cancers, with known associations with human papillomavirus (HPV) in the general population. As individuals with Fanconi anemia respond poorly to chemotherapy and radiation, prevention of cancer is critical. METHODS: To determine whether individuals with Fanconi anemia are particularly susceptible to oral HPV infection, we analyzed survey-based risk factor data and tested DNA isolated from oral rinses from 126 individuals with Fanconi anemia and 162 unaffected first-degree family members for 37 HPV types. RESULTS: Fourteen individuals (11.1%) with Fanconi anemia tested positive, significantly more (P = 0.003) than family members (2.5%). While HPV prevalence was even higher for sexually active individuals with Fanconi anemia (17.7% vs. 2.4% in family; P = 0.003), HPV positivity also tended to be higher in the sexually inactive (8.7% in Fanconi anemia vs. 2.9% in siblings). Indeed, having Fanconi anemia increased HPV positivity 4.9-fold (95% CI, 1.6-15.4) considering age and sexual experience, but did not differ by other potential risk factors. CONCLUSION: Our studies suggest that oral HPV is more common in individuals with Fanconi anemia. It will be essential to continue to explore associations between risk factors and immune dysfunction on HPV incidence and persistence over time. IMPACT: HPV vaccination should be emphasized in those with Fanconi anemia as a first step to prevent oropharyngeal cancers, although additional studies are needed to determine whether the level of protection it offers in this population is adequate.
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    Otolaryngologists and their role in vaccination for prevention of HPV associated head & neck cancer
    (Taylor & Francis, 2019) Shew, Matthew; Shew, Marcia L.; Bur, Andrés M.; Pediatrics, School of Medicine
    As Otolaryngologists we have witnessed a rise in a new disease with human papilloma virus (HPV) associated oropharyngeal squamous cell carcinoma (OPSCC). As of 2018, HPV associated OPSCC has surpassed the incidence of HPV associated cervical cancer within the United States. Non-HPV related head and neck cancer is largely a preventable disease through avoidance of various environmental factors, and we have seen a significant decline in cancer rates through anti-tobacco campaigns and other public health efforts. Given the success of HPV vaccination campaigns and reduction in HPV associated cervical and other anogenital cancers, some would argue HPV OPSCC is largely a preventable disease through vaccination as well. The question remains is how do we as otolaryngologist, non-primary care providers yet surgeons for this disease, help to promote public health efforts to reduce HPV related OPSCC. Within this article, we discuss preliminary data that supports HPV vaccination with HPV related OPSCC and the ongoing needs by our profession to help support public efforts in reducing the burden of this HPV related cancer.
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    There's Much Yet to be Done: Diverse Perspectives on HPV Vaccination
    (Taylor & Francis, 2019) Zimet, Gregory D.; Osazuwa-Peters, Nosayaba; Pediatrics, School of Medicine
    It has been over 10 y since the first HPV vaccines were licensed and introduced in a number of countries around the world. As only the second vaccine (after hepatitis B) that prevents an infection that can lead to the development of cancer, HPV vaccine occupies an important position in our armamentarium of vaccines yet remains underutilized. The number of national HPV vaccination programs has increased steadily; as of June 2017, 91 countries had introduced national HPV vaccination programs,1 with that number now over 100. Over the past 10+ y, several modifications have been made to the vaccination regimen (e.g., moving from three to two doses if the first dose is administered before age 15 y), in the type of vaccine available (e.g., introduction of the 9-valent vaccine), and in the target of vaccination (e.g., many countries have shifted from female-only to gender-neutral vaccination). There is great variability across the globe in terms of HPV vaccination policies and accompanying barriers to the implementation and/or sustainability of programs. It is well known, for instance, that Japan’s initial success with vaccination was undermined by several factors, leading to a precipitous drop in vaccination rates, with little subsequent recovery.2 Other countries, such as the U.S.,3 have struggled to achieve vaccination goals, and still others have faced setbacks but with good recovery (e.g., Denmark and Ireland).4,5 At the same time, many countries, including China,6 still have not implemented national vaccination programs, with the cost of vaccines presenting a significant obstacle, particularly for those countries that are not eligible for reduced pricing through Global Alliance for Vaccines and Immunisation (GAVI) or other mechanisms. Other countries, such as Malaysia, Rwanda, Australia, and the U.K., have achieved sustained high levels of vaccination.7–10 Unwarranted fears about HPV vaccine and the proliferation of misinformation, particularly via social media, have proven to be significant and widespread obstacles to achieving and maintaining high vaccination rates