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Objectives: Preventing malnutrition during chemoradiation (CRT) for head and neck cancer is critical maximizing quality of life (QOL). We sought to assess patient-reported QOL outcomes after integrating exclusive liquid meal replacement with Soylent, a novel meal replacement agent, in patients with head and neck cancer undergoing CRT. Methods: Patients undergoing definitive or adjuvant concurrent CRT for locally advanced head and neck cancer enrolled on our single-institution, prospective phase II protocol evaluating nutritional replacement with Soylent. Patients who reached 5% body weight loss during CRT were transitioned to Soylent meal replacement for all nutritional needs. Patients who reached 10% body weight loss were recommended for gastrostomy tube (G-tube) placement. UW-QOL and FACT-H&N questionnaires assessed patient-reported QOL prior to the receipt of CRT and following conclusion of CRT. Paired t-test or Wilcoxon signed-rank test were performed to assess for differences between scores at each follow-up time point and baseline. Results: Of the 60 enrolled patients, 51/60 (85%) lost 5% of their pre-treatment body weight. Among these patients, 48/51 (94%) were successfully transitioned to Soylent. 22/48 patients subsequently lost 10% of their pre-treatment body weight, and 3/22 (14%) underwent G-tube placement with the remainder declining. This resulted in an overall G-tube rate of 5%. Among the 41 patients evaluable for QOL data, the nadirs for overall and health-related UW-QOL were reached at 1 month and rebounded to exceed baseline by 6 months. FACT-H&N survey scores were reduced from 32 at baseline to 20 at 1 month (adjusted p<0.001) and 26 at 3 months (adjusted p<0.001), but increased to 29, 30, and 27 at 6, 12, and 18 months, without significant differences as compared to baseline (adjusted p>0.38 for all). Conclusions: We report high patient adherence and a 5% G-tube placement rate with exclusive meal replacement with Soylent in patients undergoing concurrent CRT for head and neck cancers. [ABSTRACT FROM AUTHOR]

Skin adnexal carcinomas (SACs) represent a diverse range of cancerous growths originating from the appendages of the skin. SACs are exceedingly rare malignancies that primarily manifest in individuals with fair skin and predominantly affect the head and neck. In the present study, a 70-year-old male presented with swelling and redness around the right eye, accompanied by skin desquamation. A tissue biopsy from the lesion showed a poorly differentiated SAC. Magnetic resonance imaging (MRI) of the neck and base of the skull revealed the presence of a large, well-defined heterogeneous mass involving the right orbit and periorbital tissue, measuring 62×38×43 mm. The patient declined wide local excision of the tumor. Eventually, the patient received a combination of chemotherapy and radiotherapy, followed by additional cycles of chemotherapy. Then, 1 month after the final chemotherapy, an MRI showed a small, linear lesion (8×4 mm) in the lower right orbital cavity, reduced by 90% from its original size. The scan also revealed diffuse volume loss and irregularity in the right eye, likely due to radiation, leading to vision loss in the affected eye. At present, the exact cause of SACs remains largely unidentified. While SACs frequently develop spontaneously, some may originate from precursor lesions or preexisting benign counterparts. The incidence of SAC is exceedingly rare, particularly when it is found in the eyelid. A combination of chemotherapy and radiotherapy followed by additional cycles of chemotherapy may be an effective therapeutic modality in shrinking the tumor. [ABSTRACT FROM AUTHOR]