The treatment of head and neck cancers, especially that of the larynx, causes late effects and can affect negatively the patient's quality of life.
For locally advanced laryngeal cancer, clinical ...response outcomes such as locoregional control and survival were similar in patients treated with concomittent chemoradiotherapy and those treated with total laryngectomy (TL).
The aim of this work was to compare the quality of life of patients treated by concomitant radio-chemotherapy with those treated by total laryngectomy (TL) followed by adjuvant radiotherapy.
Thirty-six patients treated for locally advanced laryngeal cancer (stage III or IV) were included in this study. These patients were treated with concomitant chemoradiotherapy or TL with adjuvant radiotherapy. Patients had to be without evidence of recurrence and have completed treatment at least 3 months before study inclusion.
The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire (QLQ-C30) and Head and Neck (H&N35) questionnaires were used for the assessment of quality of life.
An interrogation took place during the post-therapeutic monitoring consultation during the period from January 1, 2023 to August 1, 2023.
On the baseline questionnaire (QLQ-C30), there was a difference in the overall quality of life score between the 2 groups, with a higher score in the group treated with concomitant chemoradiotherapy meaning a better quality of life in this group.
Analysis of functional subscales revealed a tendency for patients in the surgery followed by radiotherapy group to experience greater difficulty in social functioning compared to the chemoradiotherapy group.
On the QLQ-H&N35, surgical patients reported significantly greater difficulties with sensory disturbances (smell and taste), analgesic use, and cough. On the other hand, patients treated with chemoradiotherapy reported significantly more problems with dry mouth and ageusia.
We found better overall quality of life scores in patients undergoing concomitant chemoradiotherapy for laryngeal preservation compared to patients treated with LT and postoperative radiotherapy for advanced laryngeal cancer. This appears to be primarily caused by better physical health, functioning, and social contact scores and fewer problems with pain, speech, senses, and sleep disturbances in this group.
Nous évaluerons les aspects diagnostiques, thérapeutiques et évolutifs du plasmocytome solitaire osseux dans notre structure. Il s'agit d'une revue rétrospective portant sur 11 patients suivis et ...traités dans le Service de Radiothérapie de l'Institut National d'Oncologie de Rabat pour un plasmocytome solitaire osseux entre janvier 1999 et décembre 2009. L’âge moyen de nos patients était de 53 ans (19-79 ans). La douleur était le signe révélateur le plus fréquent. Le siège des lésions était rachidien dans 4cas, nasosinusien dans 2cas, orbitaire dans 1 cas, costal dans 1 cas, presternal dans 1 cas, sellaire dans 1 cas et sacré dans 1 cas. Tous les malades ont reçu une radiothérapie. Cette irradiation était délivrée seule dans 8 cas (73%) ou associée à la chirurgie (laminectomie) dans 3 cas (27%). La dose moyenne de la radiothérapie était de 44 Gy (30 à 60 Gy) et celle-ci a été délivrée par un appareil de télécobalthérapie ou un accélérateur linéaire. La durée moyenne de suivi était de 78 mois (38-118 mois). Le contrôle local, défini par une stabilité radiologique, a été obtenu chez 7 des 11 malades (87%). Un patient a évolué vers un myélome multiple après un délai de 8 mois. La radiothérapie constitue un traitement efficace du plasmocytome osseux solitaire. Le pronostic est affecté par l’évolution vers le myélome multiple, ce qui justifie une surveillance rigoureuse après traitement et suggère une réflexion sur la place exacte de la chimiothérapie.
Sociability is defined as the set of experiences connecting the individual to other people. It brings together the analysis of five different environments: the friendly environment, the solitary ...environment, the known environment, the unknown environment, and the necessary environment
The aim of this study is to assess the impact of ENT cancer and its treatment on the sociability of spouses.
The collection was carried out via an original questionnaire sent to the patient's spouses. The main outcome criterion used was the spouse's self-assessment of the influence or otherwise of the illness on their daily life.
We included the spouses of patients treated for squamous cell carcinoma of the larynx, hypopharynx, the oropharynx, and the oral cavity between 1er january 2022 and 30 septembre 2023. A informed consent of patients and their spouses has been collected.The spouses of the selected patients were asked to answer the questionnaire assessing their social relationships.
Sixty spouses responded to the questionnaire with a clear predominance of female spouses (51F/9M). Their daily activities were influenced by the disease in 85% of cases.
The friendly environment was considered to have deteriorated in % 51,7%. The number of solitary activities increased in 66,7% of cases. The unfamiliar environment was judged altered in 70% of cases. Social activities linked to the known external environment decreased among 63,3% of spouses. The necessary environment including relationships within the couple was judged to be altered in 48,3% of spouses.
The quality of life of spouses of patients with head and neck cancer is known to be deteriorated. Our study explored more specifically the sociability of spouses showing a real deterioration in all its areas, which underlines the importance of psychologically supporting spouses.
The aim of this study is to assess the impact of tracheostomy on radiotherapy in patients with laryngeal cancer.
This is a prospective qualitative study conducted in the year 2022, including 49 ...patients undergoing radiotherapy for laryngeal cancer. Patients were interviewed using a questionnaire with several items during their weekly follow-up consultations. They were required to rate each step of radiotherapy (in the supine position, the application and maintenance of the thermoformed mask, positioning, dosimetric CT scan, and the treatment session) on a scale from 0 to 10, with 0 representing no discomfort and 10 representing extreme discomfort. Patients were also asked to report their level of anxiety during each step. Correlations were explored using the Pearson coefficient.
The age of patients ranged from 42 to 84 years with a median of 63 years. The most common histological type was squamous cell carcinoma. Tracheostomy was performed urgently in 34 patients, accounting for 69.38%, and scheduled in 15 patients, accounting for 30.61%.
According to our surveyed patients, the application and maintenance of the thermoformed mask were the most unpleasant moments, with an average discomfort rating of 8.5/10 and an average anxiety level of 9/10. The averages for other items varied between 3/10 and 8/10. In response to the question “What do you fear the most during the session?”, 11 patients, or 22.44%, believed that the thermoformed mask could cause them asphyxiation. No significant correlations were found.
To ensure the smooth progress of radiotherapy in tracheostomized patients, it is essential to provide prior explanations for all stages of radiotherapy, its benefits, and its side effects. Adequate management of specific situations and a trusting relationship between medical personnel and the patient are also necessary.
Treatment of nasopharyngeal cancer is based on radiotherapy associated to chemotherapy.
The standard for patients with locoregionally advanced carcinoma is induction chemotherapy associated to ...concurrent chemoradiotherapy.
The aim of our study is to determine the recurrence free survival and overall survival.
Our study focused on non metastatic patients with locoregionally advanced nasopharyngeal carcinoma: T3-T4 with positive nodes.
Treated by induction chemotherapy and concurrent chemoradiotherapy between 2018 and 2021.
For the induction chemotherapy, patients received cisplatin associated to gemcitabine for three cycles.
In concurrent chemoradiotherapy, total dose was 69,96-70 Gray in 33-35 fractions 5 days a week using Volumetric Modulated Arc Therapy (VMAT) plus cisplatin weekly at a dose of 40 mg per square meter of body surface.
Treatment, side effects, loco-regional and distant control and overall survival were collected.
A total of 153 patients were included in the study, patients with metastatic disease were excluded.
We had 61,4% of men vs 38,6% of women with a median age of 49 years old.
13,7% of patients had arterial hypertension or diabetes.
A total of 83,1% of the patients received three cycles of induction chemotherapy.
81,6% received the full dose of radiotherapy, the others interrupted the treatment for side effects.
52,3% of the patients received seven cycles of concurrent chemotherapy.
Side effects were reported in 41,8% of the patients with a higher incidence of neutropenia, anemia, nausea-vomiting, renal toxicity and mucositis.
Grade 3 or 4 toxic side effects were reported in 19,6% of the patients.
At a median follow-up of 44 months, the 2-year recurrence-free survival was 73,2%.
Overall survival at 2 years was 89.4%.
The results of our study are similar to literature's results; the induction chemotherapy followed by concurrent chemoradiotherapy in the locoregionally advanced nasopharyngeal carcinoma promotes distant control and increases overall survival.
Sides effects are unavoidable so they must be recognized and treated early to avoid grade 3 and 4.
The local control rate of nasopharyngeal carcinomas has increasingly increased since the routine use of intensity-modulated conformal radiotherapy. The treatment of local recurrences is essentially ...based on reirradiation; but it is limited by the doses previously received by the organs at risk in series. Evaluate the Efficacy and Toxicity of Reirradiation of Local Relapses of Nasopharyngeal Carcinoma
This is a retrospective study, including 12 patients re-irradiated at the National Institute of Oncology in Rabat for a local or locoregional relapse between 2015 and 2020.
Among 600 irradiated patients, 12 patients had a local or locoregional recurrence for which they received intensity-modulated reirradiation. The average age of patients at the time of initial diagnosis was 40.8 years (range 22 to 52 years). The tumor was initially classified according to the AJCC 2017 classification stage II, stage III and stage IV in 2 cases (16%), 4 cases (34%) and 6 cases (50%) respectively. Initial treatment was based on neoadjuvant chemotherapy followed by concomitant chemoradiotherapy in 9 patients (75%) and concomitant chemoradiotherapy alone in 3 patients (30%). Initial irradiation was using a conventional three-dimensional technique having delivered a total dose of 70 Gy at a rate of 2 Gy per session. All patients were in complete remission. The average time to local relapse was 7 years (range: 3 years – 10 years). The diagnosis was confirmed by a pathological study in all patients. Recurrence was classified stage II, stage III and stage IV respectively in 3 cases (25%), 5 cases (41%) and 4 cases (33%). Therapeutically, 5 patients (50%) received neoadjuvant chemotherapy followed by concomitant chemoradiotherapy; 6 patients (90%) received radiochemotherapy concomitant therapy alone and one patient received exclusive radiotherapy. The reirradiation was with intensity modulation by Arc Therapy, having delivered a total dose of 60 Gy in all patients at a rate of 2Gy per fraction. After a mean follow-up of 19 months (range: 10 months – 34 months), seven patients were in complete remission; two died of the disease after an average follow-up of 10 months and three patients were lost to follow-up. The late toxicity of reirradiation was an increase in hearing toxicity (grade 3 becoming grade 4) in 4 patients, trismus in two patients and cervical fibrosis in two patients.
Reirradiation is the only salvage treatment for recurrences of nasopharyngeal carcinomas, precisely conformal radiotherapy with intensity modulation which makes it possible to deliver sufficient doses to the tumor volume while sparing the organs at risk already irradiated; however, given the associated toxicity, patients must be rigorously selected.
Nasopharyngeal cancer is one of the most common aero-digestive cancers in Morocco. His treatment is essentially based on radiotherapy combined with chemotherapy (1,2).
In addition to investigating ...disease characteristics and pattern of treatment, the main objective of this study is to evaluate locoregional, distant control and 2 years overall survival in patients with non-metastatic nasopharyngeal carcinoma.
This is a retrospective study involving 254 patients collected in the National Institute of Oncology (INO) in Morocco. The study period extends from January 1, 2018 to December 31, 2021.
For this study, we included patients suffering from nasopharyngeal cancer based on histological and radiological evidence. We collected data through hospital records and during patient follow-up consultations.
The statistical analysis was carried out using SPSS software version 18.0.
During the four years of the study, we identified a total of 254 patients. The series finds 154 men and 100 women. Sex-ratio was 1,54. The median age was 47,07 years with extremes of 12 and 86 years. Undifferenciated Carcinoma of Nasopharyngeal type (UCNT) was the most represented histological type, i.e 82,22 % of the population. Squamous cell carcinoma was found in 17,78%.
We had 5 stages I patients, 35 stages II patients, 81 stage III patients, 133 stage IVa patients.
In the majority of our patients therapeutic approach was based on concomitant chemoradiation (205 patients); 157 of these patients underwent neoadjuvant chemotherapy. Doxorubicin combined with cisplatin was the most frequently used protocol (35.66%) as neoadjuvant chemotherapy.
All patients received weekly cisplatin during concomitant chemoradiation.
Overall survival at 2 years was 84,56% for stage I and II patients and 62,03% for stage III and IVA patients.
In view of our data and those of the literature, cisplatin-based chemotherapy and head and neck radiotherapy at curative doses, as well as neoadjuvant chemotherapy with concomitant radio-chemotherapy, allowed local control of overall survival at two years. However, certain toxicities can interfere with the successful completion of treatment.Future trials should therefore offer less toxic molecules for therapeutic purposes.
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