Contents1. Principles of diagnosis and treatment of head and neck cancer2. Diagnosis principles of head and neck cancer2.1 Image diagnosis2.2 Pathological diagnosis2.3 Staging3. Treatment principles of early and local...Contents1. Principles of diagnosis and treatment of head and neck cancer2. Diagnosis principles of head and neck cancer2.1 Image diagnosis2.2 Pathological diagnosis2.3 Staging3. Treatment principles of early and locally advanced head and neck squamous cell carcinoma3.1 Treatment of oral cancer3.1.1 Treatment of early oral cancer3.1.2 Treatment of locally advanced oral cancer.展开更多
Penpulimab is an anti-programmed cell death-1(PD-1)IgG1 antibody with no Fc gamma receptor(FcγR)binding activity,and thus theoretically reduced immune-related adverse events(irAEs)while maintaining efficacy.This sing...Penpulimab is an anti-programmed cell death-1(PD-1)IgG1 antibody with no Fc gamma receptor(FcγR)binding activity,and thus theoretically reduced immune-related adverse events(irAEs)while maintaining efficacy.This single-arm,phase II trial conducted across 20 tertiary care centers in China enrolled adult patients with metastatic nasopharyngeal carcinoma(NPC)who had failed two or more lines of previous systemic chemotherapy.Patients received 200-mg penpulimab intravenously every 2 weeks(4 weeks per cycle)until disease progression or intolerable toxicities.The primary endpoint was objective response rate(ORR)per RECIST(version 1.1),as assessed by an independent radiological review committee.The secondary endpoints included progression-free survival(PFS)and overall survival(OS).One hundred thirty patients were enrolled and 125 were efficacy evaluable.At the data cutoff date(September 28,2022),1 patient achieved complete response and 34 patients attained partial response.The ORR was 28.0%(95%CI 20.3–36.7%).The response was durable,with 66.8%still in response at 9 months.Thirty-three patients(26.4%)were still on treatment.The median PFS and OS were 3.6 months(95%CI=1.9–7.3 months)and 22.8 months(95%CI=17.1 months to not reached),respectively.Ten(7.6%)patients experienced grade 3 or higher irAEs.Penpulimab has promising anti-tumor activities and acceptable toxicities in heavily pretreated metastatic NPC patients,supporting further clinical development as third-line treatment of metastatic NPC.展开更多
Background:Radiotherapy following primary operation is strongly recommended for salivary gland carcinomas(SGCs)with adverse features.The interval between surgery and the initiation of radiotherapy(SRT)varied and a pro...Background:Radiotherapy following primary operation is strongly recommended for salivary gland carcinomas(SGCs)with adverse features.The interval between surgery and the initiation of radiotherapy(SRT)varied and a prolonged SRT may cause failure of cancer treatment.However,the association of SRT with survival is unclear in major SGCs.Methods:This retrospective study included a total of 346 patients who underwent radiotherapy after the pri-mary operation from Fudan University Shanghai Cancer Center from 2005 to 2020.The best cutoffvalue of the SRT was determined by the maximum log-rank statistic method.The primary endpoint of the study was over-all survival(OS).Correlations between variables and OS were conducted by the univariable analysis using the Log-rank method,and a multivariate Cox proportional hazards regression was performed to identify the indepen-dent prognostic factors associated with OS.The estimated survival rates were captured using the Kaplan-Meier method.Results:With a median follow-up time of 70.31 months,the estimated 5-year OS,LRFS,and DMFS were 83.3%,80.1%,and 75.9%,respectively.The cutoffvalue for SRT was 8.5 weeks,while age,T stage,N stage,perineural invasion(PNI),pathological aggression,chemotherapy,and SRT were associated with OS in the univariable analysis.The Cox regression analysis demonstrated that older age(P<0.001),T3-4 tumors(P=0.007),positive N stage(P<0.001),pathological aggression(P=0.014),and longer SRT(P=0.009)were independent prognostic factors for major SGCs.Using the stratification model,we observed that delay in the SRT was associated with worse OS(P=0.006)in the high-risk group,whereas no significant difference was observed in the low-risk subgroup(P=0.61).Conclusions:The delay in the initiation of postoperative radiotherapy may be a prognostic factor for patients with major SGCs.It was suggested that radiotherapy should be delivered within 8.5 weeks following the operation,especially for patients with≥2 risk factors,including older age,high pathological aggression,T3-4 tumors,and positive N stage.展开更多
文摘Contents1. Principles of diagnosis and treatment of head and neck cancer2. Diagnosis principles of head and neck cancer2.1 Image diagnosis2.2 Pathological diagnosis2.3 Staging3. Treatment principles of early and locally advanced head and neck squamous cell carcinoma3.1 Treatment of oral cancer3.1.1 Treatment of early oral cancer3.1.2 Treatment of locally advanced oral cancer.
文摘Penpulimab is an anti-programmed cell death-1(PD-1)IgG1 antibody with no Fc gamma receptor(FcγR)binding activity,and thus theoretically reduced immune-related adverse events(irAEs)while maintaining efficacy.This single-arm,phase II trial conducted across 20 tertiary care centers in China enrolled adult patients with metastatic nasopharyngeal carcinoma(NPC)who had failed two or more lines of previous systemic chemotherapy.Patients received 200-mg penpulimab intravenously every 2 weeks(4 weeks per cycle)until disease progression or intolerable toxicities.The primary endpoint was objective response rate(ORR)per RECIST(version 1.1),as assessed by an independent radiological review committee.The secondary endpoints included progression-free survival(PFS)and overall survival(OS).One hundred thirty patients were enrolled and 125 were efficacy evaluable.At the data cutoff date(September 28,2022),1 patient achieved complete response and 34 patients attained partial response.The ORR was 28.0%(95%CI 20.3–36.7%).The response was durable,with 66.8%still in response at 9 months.Thirty-three patients(26.4%)were still on treatment.The median PFS and OS were 3.6 months(95%CI=1.9–7.3 months)and 22.8 months(95%CI=17.1 months to not reached),respectively.Ten(7.6%)patients experienced grade 3 or higher irAEs.Penpulimab has promising anti-tumor activities and acceptable toxicities in heavily pretreated metastatic NPC patients,supporting further clinical development as third-line treatment of metastatic NPC.
文摘Background:Radiotherapy following primary operation is strongly recommended for salivary gland carcinomas(SGCs)with adverse features.The interval between surgery and the initiation of radiotherapy(SRT)varied and a prolonged SRT may cause failure of cancer treatment.However,the association of SRT with survival is unclear in major SGCs.Methods:This retrospective study included a total of 346 patients who underwent radiotherapy after the pri-mary operation from Fudan University Shanghai Cancer Center from 2005 to 2020.The best cutoffvalue of the SRT was determined by the maximum log-rank statistic method.The primary endpoint of the study was over-all survival(OS).Correlations between variables and OS were conducted by the univariable analysis using the Log-rank method,and a multivariate Cox proportional hazards regression was performed to identify the indepen-dent prognostic factors associated with OS.The estimated survival rates were captured using the Kaplan-Meier method.Results:With a median follow-up time of 70.31 months,the estimated 5-year OS,LRFS,and DMFS were 83.3%,80.1%,and 75.9%,respectively.The cutoffvalue for SRT was 8.5 weeks,while age,T stage,N stage,perineural invasion(PNI),pathological aggression,chemotherapy,and SRT were associated with OS in the univariable analysis.The Cox regression analysis demonstrated that older age(P<0.001),T3-4 tumors(P=0.007),positive N stage(P<0.001),pathological aggression(P=0.014),and longer SRT(P=0.009)were independent prognostic factors for major SGCs.Using the stratification model,we observed that delay in the SRT was associated with worse OS(P=0.006)in the high-risk group,whereas no significant difference was observed in the low-risk subgroup(P=0.61).Conclusions:The delay in the initiation of postoperative radiotherapy may be a prognostic factor for patients with major SGCs.It was suggested that radiotherapy should be delivered within 8.5 weeks following the operation,especially for patients with≥2 risk factors,including older age,high pathological aggression,T3-4 tumors,and positive N stage.
