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1. The use of bone wax for protection from sharp ends of interdental wires

Author: Özgür Pilanci, Kerstin M. Stenson, and Samet Vasfi Kuvat
Subjects: Surgery, RD1-811
Published: 2011
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2. Phase 1/2a, open‐label, multicenter study of<scp>RM</scp>‐1929 photoimmunotherapy in patients with locoregional, recurrent head and neck squamous cell carcinoma

Author: Nilesh R. Vasan, Merrill A. Biel, Jennifer Johnson, Joseph Curry, Samith T. Kochuparambil, Darren McDonald, Mary J. Fidler, Frank E. Mott, Mohammad Razaq, Miguel Garcia-Guzman, Kosuke Ishida, Grace Mann, David Cognetti, Ann M. Gillenwater, John Campana, Kerstin M. Stenson, and Patrick K. Ha
Subjects: medicine.medical_specialty, Squamous Cell Carcinoma of Head and Neck, business.industry, Cetuximab, Photoimmunotherapy, Phototherapy, medicine.disease, Gastroenterology, Head and neck squamous-cell carcinoma, Clinical trial, Otorhinolaryngology, Multicenter study, Pharmacokinetics, Head and Neck Neoplasms, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, In patient, Immunotherapy, Neoplasm Recurrence, Local, Open label, business, Adverse effect
Abstract: Background Recurrent head and neck squamous cell carcinoma (rHNSCC) represents a significant global health burden with an unmet medical need. In this study we determined the safety and efficacy of RM-1929 photoimmunotherapy in patients with heavily pretreated rHNSCC. Methods RM-1929 (anti-EGFR-IR700 dye conjugate) was infused, followed by tumor illumination. We evaluated safety, tumor response, and pharmacokinetics. Results Nine patients were enrolled in Part 1 (dose-finding) and 30 patients in Part 2 (safety and efficacy). No dose-limiting toxicities were experienced in Part 1; 640 mg/m2 with fixed light dose (50 J/cm2 or 100 J/cm) was recommended for Part 2. Adverse events (AEs) in Part 2 were mostly mild to moderate but 19 (63.3%) patients had AE ≥Grade 3, including 3 (10.0%) with serious AEs leading to death (not treatment related). Efficacy in Part 2: unconfirmed objective response rate (ORR) 43.3% (95% CI 25.46%-62.57%); confirmed ORR 26.7% (95% CI 12.28%-45.89%); median overall survival 9.30 months (95% CI 5.16-16.92 months). Conclusions Treatment was well tolerated. Responses and survival following RM-1929 photoimmunotherapy in heavily pretreated patients with rHNSCC were clinically meaningful and warrant further investigation. Clinical trial information NCT02422979.
Published: 2021
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3. Clinical Practice Guideline: Opioid Prescribing for Analgesia After Common Otolaryngology Operations Executive Summary

Author: Sandra A. Finestone, David E. Tunkel, Allison Paisley, David S. Boisoneau, Ahmad R. Sedaghat, Angela K. Sturm, Anna H. Messner, Michael Brenner, Richard M. Rosenfeld, Nui Dhepyasuwan, Adam J. Folbe, Deepa Galaiya, Erin M. Lambie, Kerstin M. Stenson, David M. Dickerson, Samantha Anne, James W. Mims, John D. Cramer, and Taskin M. Monjur
Subjects: Pain, Postoperative, medicine.medical_specialty, Executive summary, business.industry, Guideline, Drug Prescriptions, Opioid prescribing, Otorhinolaryngologic Surgical Procedures, Analgesics, Opioid, Clinical Practice, 03 medical and health sciences, 0302 clinical medicine, Otorhinolaryngology, Practice Guidelines as Topic, medicine, Humans, Surgery, 030212 general & internal medicine, Intensive care medicine, business, 030217 neurology & neurosurgery
Abstract: Opioid use disorder (OUD), which includes the morbidity of dependence and mortality of overdose, has reached epidemic proportions in the United States. Overprescription of opioids can lead to chronic use and misuse, and unused narcotics after surgery can lead to their diversion. Research supports that most patients do not take all the prescribed opioids after surgery and that surgeons are the second largest prescribers of opioids in the United States. The introduction of opioids in those with OUD often begins with prescription opioids. Reducing the number of extra opioids available after surgery through smaller prescriptions, safe storage, and disposal should reduce the risk of opioid use disorder in otolaryngology patients and their families.The purpose of this specialty-specific guideline is to identify quality improvement opportunities in postoperative pain management of common otolaryngologic surgical procedures. These opportunities are communicated through clear actionable statements with explanation of the support in the literature, evaluation of the quality of the evidence, and recommendations on implementation. Employing these action statements should reduce the variation in care across the specialty and improve postoperative pain control while reducing risk of OUD. The target patients for the guideline are any patients treated for anticipated or reported pain within the first 30 days after undergoing common otolaryngologic procedures. The target audience of the guideline is otolaryngologists who perform surgery and clinicians who manage pain after surgical procedures. Outcomes to be considered include whether the patient has stopped using opioids, has disposed of unused opioids, and was satisfied with the pain management plan.The guideline addresses assessment of the patient for OUD risk factors, counseling on pain expectations, and identifying factors that can affect pain duration and/or severity. It also discusses the use of multimodal analgesia as first-line treatment and the responsible use of opioids. Last, safe disposal of unused opioids is discussed.This guideline is intended to focus on evidence-based quality improvement opportunities judged most important by the guideline development group. It is not a comprehensive guide on pain management in otolaryngologic procedures. The statements in this guideline are not intended to limit or restrict care provided by clinicians based on their experiences and assessments of individual patients.The guideline development group made
Published: 2021
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4. Management of the Clinical and Academic Mission in an Urban Otolaryngology Department During the COVID‐19 Global Crisis

Author: Peter Papagiannopoulos, Kerstin M. Stenson, Peter C. Revenaugh, Elias M. Michaelides, Ryan M. Smith, Inna Husain, Samer Al-Khudari, R. Mark Wiet, Phillip S. LoSavio, Bobby A. Tajudeen, and Pete S. Batra
Subjects: medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), telehealth, Pneumonia, Viral, novel coronavirus, tracheostomy, Telehealth, Betacoronavirus, Otolaryngology, 03 medical and health sciences, 0302 clinical medicine, Pandemic, Disease Transmission, Infectious, Urban Health Services, medicine, Humans, Disease management (health), 030223 otorhinolaryngology, Pandemics, Retrospective Studies, Original Research, biology, SARS-CoV-2, business.industry, pandemic, COVID-19, Disease Management, Retrospective cohort study, Safe delivery, biology.organism_classification, medicine.disease, Telemedicine, Otorhinolaryngologic Diseases, Otorhinolaryngology, 030220 oncology & carcinogenesis, Surgery, Medical emergency, Emergencies, Coronavirus Infections, business
Abstract: Objective The objective of this study was to assess the strategic changes implemented in the departmental mission to continue safe delivery of otolaryngology care and to support the broader institutional mission during the COVID-19 pandemic response. Study Design Retrospective assessment was performed to the response and management strategy developed to transform the clinical and academic enterprise. Setting Large urban tertiary care referral center. Results The departmental structure was reorganized along new clinical teams to effectively meet the system directives for provision of otolaryngology care and support for inpatient cases of COVID-19. A surge deployment schedule was developed to assist frontline colleagues with clinical support as needed. Outpatient otolaryngology was consolidated across the system with conversion of the majority of visits to telehealth. Operative procedures were prioritized to ensure throughput for emergent and time-critical urgent procedures. A tracheostomy protocol was developed to guide management of emergent and elective airways. Educational and research efforts were redirected to focus on otolaryngology care in the clinical context of the COVID-19 crisis. Conclusion Emergence of the COVID-19 global health crisis has challenged delivery of otolaryngology care in an unparalleled manner. The concerns for preserving health of the workforce while ethically addressing patient career needs in a timely manner has created significant dilemmas. A proactive, thoughtful approach that reorganizes the overall departmental effort through provider and staff engagement can facilitate the ability to meet the needs of otolaryngology patients and to support the greater institutional mission to combat the pandemic.
Published: 2020
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5. Effect of histopathological grade on treatment and survival in base of tongue adenocarcinoma

Author: Tirth R Patel, Thomas K. Houser, Mihir K. Bhayani, Kerstin M. Stenson, Samer Al-Khudari, and Bobby A. Tajudeen
Subjects: Pathology, medicine.medical_specialty, business.industry, Adenocarcinoma, medicine.disease, Tongue Neoplasms, medicine.anatomical_structure, Otorhinolaryngology, Tongue, medicine, Humans, Base (exponentiation), business, Proportional Hazards Models, Retrospective Studies
Abstract: The purpose of this study was to investigate survival differences between low-grade and high-grade base of tongue (BOT) adenocarcinoma by examining demographics, tumor characteristics, and treatment modalities.The National Cancer Database was queried for patients with BOT adenocarcinoma between 2004 and 2017. Univariate and multivariate analyses were performed for all cases of BOT adenocarcinoma. Subsequent analysis focused on low-grade (grade 1 and grade 2) and high-grade (grade 3 and grade 4) BOT adenocarcinoma.A total of 286 patients with BOT adenocarcinoma were included in the main cohort and divided into low grade (n = 137) and high grade (n = 66). The 5-year overall survival for all patients, low-grade, and high-grade was 67%, 85%, and 58%, respectively. Prognostic factors associated with decreased survival for the main cohort include advanced age (hazard ratio [HR]: 1.04; 95% confidence interval [CI]: 1.02-1.06), non-white race (HR: 1.79; 95% CI: 1.04-3.25), public insurance (HR: 1.79; 95% CI: 1.02-3.14) and high-grade 3,4 (HR: 2.63; 95% CI: 1.51-4.56). The prognostic factor associated with increased survival for the main cohort was surgery (HR: 0.59; 95% CI: 0.36-0.96). Radiotherapy was associated with improved overall survival for high-grade BOT adenocarcinoma (HR: 0.09; 95% CI: 0.02-0.49) but not for low-grade BOT adenocarcinoma (HR: 0.93; 95% CI: 0.38-2.32).This investigation is the largest to date analyzing the association of treatment modalities with overall survival in BOT adenocarcinoma. Surgery remains standard of treatment, particularly in low-grade cases, with radiotherapy offering additional survival benefit for high-grade BOT adenocarcinoma.
Published: 2021

6. Prognostic Indicators in Base of Tongue Adenocarcinoma: A Population-Based Analysis

Author: Max A. Plitt, Ashwin Ganti, Kristen L. Kraimer, Bobby A. Tajudeen, Peter C. Revenaugh, Kerstin M. Stenson, and Samer Al-Khudari
Subjects: Male, Oncology, medicine.medical_specialty, Population, Kaplan-Meier Estimate, Population based, Adenocarcinoma, Disease-Free Survival, 03 medical and health sciences, 0302 clinical medicine, Tongue, Internal medicine, Epidemiology, medicine, Humans, 030223 otorhinolaryngology, education, Base (exponentiation), Aged, Proportional Hazards Models, Retrospective Studies, education.field_of_study, business.industry, Middle Aged, Prognosis, medicine.disease, Tongue Neoplasms, Survival Rate, medicine.anatomical_structure, Otorhinolaryngology, 030220 oncology & carcinogenesis, Multivariate Analysis, Female, Neoplasm Grading, business, SEER Program
Abstract: Introduction: The objectives of this investigation are to characterize the epidemiology of base of tongue adenocarcinoma utilizing a population-based database and to identify prognostic factors that may affect survival. Methods: A retrospective cohort study was conducted using the Surveillance, Epidemiology, and End Results database. Univariate Kaplan-Meier analysis and multivariate Cox-regression analysis were performed to evaluate the association of suspected prognostic factors with survival. Overall survival (OS) and disease-specific survival (DSS) were the primary outcome measures. Results: A total of 176 cases were eligible based on inclusion criteria. The 5-year OS and DSS were 49% and 66%, respectively. On multivariate analysis, surgical management was associated with improved OS and DSS (OS hazard ratio [HR]: 0.34, 95% confidence interval [CI]: 0.20-0.58, P < .001; DSS HR: 0.20, 95% CI: 0.09-0.48, P < .001), while higher tumor grade was associated with worse OS and DSS (OS HR: 1.58, 95% CI: 1.14-2.19, P = .006; DSS HR: 1.68, 95% CI: 1.01-2.79, P = .045). Administration of chemotherapy or radiation did not have a significant association with OS or DSS. Conclusion: This investigation is the largest to date to analyze the base of tongue adenocarcinoma as its own entity. Surgery remains the mainstay of treatment, and lower tumor grade is associated with improved survival in these patients. Administration of radiation or chemotherapy was not associated with improved survival.
Published: 2019
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7. Association of Perioperative Opioid-Sparing Multimodal Analgesia With Narcotic Use and Pain Control After Head and Neck Free Flap Reconstruction

Author: Michael Eggerstedt, Ryan M. Smith, Peter C. Revenaugh, Deborah Vaughan, Hannah N. Kuhar, Danny Jandali, Emily A. Ramirez, Samer Al-Khudari, and Kerstin M. Stenson
Subjects: Male, Narcotics, Narcotic, medicine.medical_treatment, Free flap, 030230 surgery, Free Tissue Flaps, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Medical prescription, 030223 otorhinolaryngology, Head and neck, Original Investigation, Aged, Pain Measurement, Retrospective Studies, Pain, Postoperative, integumentary system, business.industry, Pain scale, Perioperative, Middle Aged, Plastic Surgery Procedures, Head and Neck Neoplasms, Anesthesia, Morphine, Free flap reconstruction, Female, Surgery, Analgesia, business, medicine.drug
Abstract: IMPORTANCE: An increase in narcotic prescription patterns has contributed to the current opioid epidemic in the United States. Opioid-sparing perioperative analgesia represents a means of mitigating the risk of opioid dependence while providing superior perioperative analgesia. OBJECTIVE: To assess whether multimodal analgesia (MMA) is associated with reduced narcotic use and improved pain control compared with traditional narcotic-based analgesics at discharge and in the immediate postoperative period after free flap reconstructive surgery. DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study assessed a consecutive sample of 65 patients (28 MMA, 37 controls) undergoing free flap reconstruction of a through-and-through mucosal defect within the head and neck region at a tertiary academic referral center from June 1, 2017, to November 30, 2018. Patients and physicians were not blinded to the patients’ analgesic regimen. Patients’ clinical courses were followed up for 30 days postoperatively. INTERVENTIONS: Patients were administered a preoperative, intraoperative, and postoperative analgesia regimen consisting of scheduled and as-needed neuromodulating and anti-inflammatory medications, with narcotic medications reserved for refractory cases. Control patients were administered traditional narcotic-based analgesics as needed. MAIN OUTCOMES AND MEASURES: Narcotic doses administered during the perioperative period and at discharge were converted to morphine-equivalent doses (MEDs) for comparison. Postoperative Defense and Veterans Pain Rating Scale pain scores (ranging from 0 [no pain] to 10 [worst pain imaginable]) were collected for the first 72 hours postoperatively as a patient-reported means of analyzing effectiveness of analgesia. RESULTS: A total of 28 patients (mean [SD] age, 64.1 [12.3] years; 17 [61%] male) were included in the MMA group and 37 (mean [SD] age, 65.0 [11.0] years; 22 [59%] male) in the control group. The number of MEDs administered postoperatively was 10.0 (interquartile range [IQR], 2.7-23.1) in the MMA cohort and 89.6 (IQR, 60.0-104.5) in the control cohort (P
Published: 2019
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8. Enhanced recovery after surgery in head and neck surgery: Reduced opioid use and length of stay

Author: Michael Eggerstedt, Emily A. Ramirez, Ryan M. Smith, Danny Jandali, Peter C. Revenaugh, Holly Scheltens, Kerstin M. Stenson, Deborah Vaughan, Ashwin Ganti, and Samer Al-Khudari
Subjects: Male, medicine.medical_specialty, Narcotic, medicine.medical_treatment, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, 030223 otorhinolaryngology, Enhanced recovery after surgery, Aged, Retrospective Studies, Morphine, business.industry, Head and neck cancer, Retrospective cohort study, Length of Stay, Middle Aged, medicine.disease, Drug Utilization, Colorectal surgery, Analgesics, Opioid, Otorhinolaryngology, 030220 oncology & carcinogenesis, Anesthesia, Cohort, Head and neck surgery, Female, Enhanced Recovery After Surgery, business, Head, Neck, medicine.drug
Abstract: OBJECTIVES Enhanced recovery after surgery (ERAS) protocols were first developed in colorectal surgery and sought to standardize patient care. There have been several studies in the head and neck surgical literature looking at outcomes after ERAS protocol, but no studies focusing on narcotic use and length of stay. This study aimed to evaluate narcotic usage and length of stay, in addition to several other outcomes, following the implementation of an ERAS protocol. METHODS A head and neck-specific ERAS protocol was implemented at this tertiary care center beginning July 2017. A retrospective cohort study was performed comparing this cohort to that of a retrospective control group. Outcomes included mean morphine equivalent dose, mean pain score, and percentage of patients prescribed narcotics on discharge. Secondary outcomes included ICU and total length of stay. RESULTS The mean morphine equivalent dose (MED) administered within 72 hours postoperatively was significantly lower in the ERAS group (17.5 ± 46.0 mg vs. 82.7 ± 116.1 mg, P
Published: 2019
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9. Laryngeal Chondrosarcoma Characteristics and Survival Analysis in the National Cancer Database

Author: Matthew J. Urban, Inna Husain, Mihir K Bhayani, Christopher Wojcik, Kerstin M. Stenson, Samer Al-Khudari, Bobby A. Tajudeen, Vidit M Talati, and Tirth R Patel
Subjects: Oncology, Male, medicine.medical_specialty, 2019-20 coronavirus outbreak, Databases, Factual, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Chondrosarcoma, Laryngectomy, Malignancy, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Overall survival, medicine, Humans, 030223 otorhinolaryngology, Laryngeal Neoplasms, Survival analysis, Aged, Neoplasm Staging, Retrospective Studies, business.industry, Cancer, Margins of Excision, Middle Aged, medicine.disease, Treatment characteristics, Combined Modality Therapy, Survival Analysis, United States, Survival Rate, Otorhinolaryngology, Socioeconomic Factors, 030220 oncology & carcinogenesis, Surgery, Female, Neoplasm Grading, business
Abstract: To highlight various patient, tumor, diagnostic, and treatment characteristics of laryngeal chondrosarcoma (LC) as well as elucidate factors that may independently affect overall survival (OS) for LCs.Retrospective cohort study.National Cancer Database (NCDB).All LC cases from 2004 to 2016 were extracted from the NCDB. Several demographic, diagnostic, and treatment variables were compared between LC subgroups using χThere were 348 LCs included in the main cohort. LCs were predominantly non-Hispanic white males with similar rates of private and government insurance (49.4% vs 45.4%). Most LCs (81.6%) underwent primary surgery, particularly partial and total laryngectomy. The 1-, 5-, and 10-year survivals for LC were 95.7%, 88.2%, and 66.3%, respectively. On multivariate analysis, lack of insurance (This is the first multivariate survival analysis and largest single cohort study of LCs in the literature. Overall, LCs enjoy an excellent prognosis, with insurance status, grade, and histology as the main predictors of survival.
Published: 2021

10. Clinical Practice Guideline: Opioid Prescribing for Analgesia After Common Otolaryngology Operations

Author: Ahmad R. Sedaghat, Michael Brenner, Erin M. Lambie, Samantha Anne, Nui Dhepyasuwan, David S. Boisoneau, Deepa Galaiya, Anna H. Messner, Kerstin M. Stenson, John D. Cramer, Richard M. Rosenfeld, James W. Mims, Taskin M. Monjur, Allison Paisley, David E. Tunkel, Sandra A. Finestone, Adam J. Folbe, David M. Dickerson, and Angela K. Sturm
Subjects: medicine.medical_specialty, business.industry, Guideline, Opioid prescribing, Clinical Practice, 03 medical and health sciences, 0302 clinical medicine, Otorhinolaryngology, medicine, Surgery, 030212 general & internal medicine, 030223 otorhinolaryngology, Intensive care medicine, business
Abstract: ObjectiveOpioid use disorder (OUD), which includes the morbidity of dependence and mortality of overdose, has reached epidemic proportions in the United States. Overprescription of opioids can lead...
Published: 2021
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11. Occult Lymph Node Metastasis in Early‐Stage Glottic Cancer in the National Cancer Database

Author: Jaijeet Toor, Bobby A. Tajudeen, Kerstin M. Stenson, Samer Al-Khudari, Tirth R Patel, Michael Eggerstedt, and Inna Husain
Subjects: Male, Glottis, medicine.medical_specialty, Databases, Factual, medicine.medical_treatment, computer.software_genre, Metastasis, medicine, Humans, Stage (cooking), Laryngeal Neoplasms, Aged, Neoplasm Staging, Retrospective Studies, Database, business.industry, Cancer, Neck dissection, Retrospective cohort study, Middle Aged, medicine.disease, Occult, Survival Rate, Otorhinolaryngology, Lymphatic Metastasis, Cohort, Neck Dissection, Female, Histopathology, business, computer
Abstract: OBJECTIVES Early-stage glottic cancer (cT1-T2 cN0) may be treated by primary surgery or radiation. Elective treatment of the neck in clinically N0 disease is usually not performed due to low rates of regional lymph node metastasis. This study examines the role of elective neck dissection (END) and rate of occult nodal metastasis in cT1-T2 cN0 glottic cancer treated with primary surgery. STUDY DESIGN Retrospective cohort study. METHODS The National Cancer Database was used to identify patients treated for early-stage glottic cancer. Demographic variables, disease characteristics, and overall survival were compared between the subgroups of patients who did and did not receive END. Factors predictive of occult lymph node metastasis were also identified using a multivariate logistic regression model. RESULTS Thirty-eight percent of the 991 patients in this cohort underwent END. Younger age, treatment at an academic facility, advanced T-stage, and higher tumor grade were associated with receiving END. Sixteen percent of the 372 patients undergoing END had occult nodal metastasis. Higher tumor histopathologic grade was associated with occult metastasis (P = .004). While undergoing END did not affect significantly survival, those with occult metastasis had poorer survival (P
Published: 2020
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12. Enhanced recovery protocol for transoral robotic surgery demonstrates improved analgesia and narcotic use reduction

Author: Ashwin Ganti, Michael Eggerstedt, Kerstin M. Stenson, Peter C. Revenaugh, Emily A. Ramirez, Kevin Grudzinski, Samer Al-Khudari, and Deborah Vaughan
Subjects: Male, Narcotics, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Enhanced recovery, Robotic Surgical Procedures, Transoral robotic surgery, Medicine, Humans, 030223 otorhinolaryngology, Enhanced recovery after surgery, Aged, Pain Measurement, Retrospective Studies, Protocol (science), Pain, Postoperative, business.industry, Retrospective cohort study, Middle Aged, Drug Utilization, Prescriptions, Treatment Outcome, Otorhinolaryngology, Opioid, Head and Neck Neoplasms, 030220 oncology & carcinogenesis, Anesthesia, Morphine, Female, Analgesia, business, NARCOTIC USE, Enhanced Recovery After Surgery, medicine.drug
Abstract: No study has evaluated the impact of the Enhanced Recovery After Surgery (ERAS) protocol on opioid usage among patients undergoing transoral robotic surgery (TORS).In this retrospective study, patients undergoing TORS were enrolled in an ERAS protocol and compared to control patients. Primary outcome measures included postoperative mean morphine equivalent dose (MED), Defense and Veterans Pain Rating Scale (DVPRS) pain scores, and opioid prescriptions on discharge.The mean MED administered postoperatively was lower in the ERAS group (17.6 mg) than in the control group (65.0 mg) (p .001). Average postoperative DVPRS scores were 2.9 in the ERAS group vs. 4.2 in the control group (p = .042). Fewer patients in the ERAS group received opioid prescriptions on discharge (31.6%) than controls (96.2%) (p .001).The TORS ERAS protocol is associated with reduced postoperative opioid usage, lower pain scores, and reduced opioid requirements on discharge.
Published: 2020

13. Implementation of Preoperative Screening Protocols in Otolaryngology During the COVID-19 Pandemic

Author: Tirth R Patel, Bobby A. Tajudeen, Phillip S. LoSavio, Inna Husain, R. Mark Wiet, Kerstin M. Stenson, Matthew J. Urban, Ryan M. Smith, Thomas E. Nielsen, Peter C. Revenaugh, Peter Papagiannopoulos, Richard A. Raad, Samer Al-Khudari, and Pete S. Batra
Subjects: medicine.medical_specialty, Point-of-care testing, Pneumonia, Viral, 030230 surgery, Preoperative care, Tertiary Care Centers, 03 medical and health sciences, Betacoronavirus, Otolaryngology, 0302 clinical medicine, COVID-19 Testing, Pandemic, Preoperative Care, medicine, Humans, Mass Screening, 030212 general & internal medicine, Pandemics, Mass screening, Retrospective Studies, Protocol (science), Chicago, business.industry, Clinical Laboratory Techniques, SARS-CoV-2, COVID-19, Retrospective cohort study, medicine.disease, Workflow, Otorhinolaryngology, Point-of-Care Testing, Surgery, Medical emergency, business, Coronavirus Infections
Abstract: To highlight emerging preoperative screening protocols and document workflow challenges and successes during the early weeks of the COVID-19 pandemic.This retrospective cohort study was conducted at a large urban tertiary care medical center. Thirty-two patients undergoing operative procedures during the COVID-19 pandemic were placed into 2 preoperative screening protocols. Early in the pandemic a "high-risk case protocol" was utilized to maximize available resources. As information and technology evolved, a "universal point-of-care protocol" was implemented.Of 32 patients, 25 were screened prior to surgery. Three (12%) tested positive for COVID-19. In all 3 cases, the procedure was delayed, and patients were admitted for treatment or discharged under home quarantine. During this period, 86% of operative procedures were indicated for treatment of oncologic disease. There was no significant delay in arrival to the operating room for patients undergoing point-of-care screening immediately prior to their procedure (Currently, few studies address preoperative screening for COVID-19. A substantial proportion of individuals in this cohort tested positive, and both protocols identified positive cases. The major strengths of the point-of-care protocol are ease of administration, avoiding subsequent exposures after testing, and relieving strain on "COVID-19 clinics" or other community testing facilities.Preoperative screening is a critical aspect of safe surgical practice in the midst of the widespread pandemic. Rapid implementation of universal point-of-care screening is possible without major workflow adjustments or operative delays.
Published: 2020

14. Definitive chemoradiation for locally-advanced oral cavity cancer: A 20-year experience

Author: Daniel J. Haraf, Corey C. Foster, Zhen Gooi, Ryan J. Brisson, Nishant Agrawal, Louis G. Portugal, Kerstin M. Stenson, J.M. Melotek, Ezra E.W. Cohen, Everett E. Vokes, Tanguy Y. Seiwert, and Elizabeth A. Blair
Subjects: Adult, Male, Cancer Research, medicine.medical_specialty, Osteoradionecrosis, medicine.medical_treatment, 03 medical and health sciences, Enteral Nutrition, 0302 clinical medicine, medicine, Humans, 030212 general & internal medicine, Oral Cavity Squamous Cell Carcinoma, Stage (cooking), Feeding tube, Aged, Aged, 80 and over, business.industry, Chemoradiotherapy, Middle Aged, medicine.disease, Survival Analysis, Surgery, Radiation therapy, Oncology, Fluorouracil, 030220 oncology & carcinogenesis, Concomitant, Carcinoma, Squamous Cell, Female, Mouth Neoplasms, Oral Surgery, business, medicine.drug
Abstract: Objectives Definitive chemoradiation (CRT) for oral cavity squamous cell carcinoma (OC-SCC) is often criticized for poor efficacy or toxicity. We describe a favorable 20-year experience of primary CRT for locally-advanced OC-SCC. Materials and Methods Patients with locally-advanced, stage III/IV OC-SCC receiving primary concomitant CRT on protocols from 1994 to 2014 were analyzed. Chemotherapy included fluorouracil and hydroxyurea with other third agents. Radiotherapy (RT) was delivered once or twice daily to a maximum dose of 70–75 Gy. Intensity-modulated RT (IMRT) was exclusively used after 2004. Progression-free survival (PFS), overall survival (OS), locoregional control (LRC), and distant control (DC) were calculated by the Kaplan-Meier method and compared across treatment decades using the log-rank test. Rates of osteoradionecrosis (ORN) requiring surgery were compared across treatment decades using the Chi-square test. Results 140 patients with locally-advanced OC-SCC were treated with definitive CRT. Of these, 75.7% had T3/T4 disease, 68.6% had ≥N2 nodal disease, and 91.4% had stage IV disease. Most common primary sites were oral tongue (47.9%) and floor of mouth (24.3%). Median follow-up was 5.7 years. Five-year OS, PFS, LRC, and DC were 63.2%, 58.7%, 78.6%, and 87.2%, respectively. Rates of ORN and long-term feeding tube dependence were 20.7% and 10.0%, respectively. Differences in LRC (P = 0.90), DC (P = 0.24), PFS (P = 0.38), OS (P = 0.10), or ORN (P = 0.38) were not significant across treatment decades. Conclusion Definitive CRT is a viable and feasible strategy for organ preservation for patients with locally-advanced OC-SCC.
Published: 2018
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15. Neck dissection planning based on postchemoradiation computed tomography in patients with head and neck cancer

Author: Alexander Langerman, Richard Comstock, Sheela Konda, Anna Abramovitch, Kristen Kasza, Everett E. Vokes, and Kerstin M. Stenson
Subjects: Head and neck cancer -- Care and treatment, Head and neck cancer -- Research, Radical neck dissection -- Research, CT imaging -- Research, Health
Published: 2009

16. Heterogeneity in the clinical presentation, diagnosis, and treatment initiation of p16-positive oropharyngeal cancer

Author: Mary J. Fidler, Ethan M. Ritz, Peter C. Revenaugh, Kerstin M. Stenson, Anish Raman, Neilayan Sen, and Samer Al-Khudari
Subjects: Adult, Male, medicine.medical_specialty, Databases, Factual, Neck mass, Biopsy, Fine-Needle, Clinical Decision-Making, Asymptomatic, Risk Assessment, Metastasis, Cohort Studies, 03 medical and health sciences, Genetic Heterogeneity, 0302 clinical medicine, Reference Values, Statistical significance, Internal medicine, Biopsy, medicine, Humans, 030223 otorhinolaryngology, Aged, Retrospective Studies, Human papillomavirus 16, medicine.diagnostic_test, business.industry, Cancer, Middle Aged, medicine.disease, Prognosis, Combined Modality Therapy, United States, Oropharyngeal Neoplasms, Otorhinolaryngology, 030220 oncology & carcinogenesis, Carcinoma, Squamous Cell, Female, medicine.symptom, Presentation (obstetrics), business, P16 Positive
Abstract: Background Human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC) has a patient demographic, presentation, and clinical treatment response distinct from HPV-unassociated OPSCC. The heterogeneity in presentation and diagnosis within a patient population with HPV-positive OPSCC and its impact on times to presentation, diagnosis, and treatment have yet to be characterized. Participants Patients with biopsy-proven p16-positive OPSCC seen and/or treated at our institution between 2008 and 2018. Of 136 patients with OPSCC seen and/or treated at our institution, 101 met criteria for inclusion. Methods Patients were grouped by several parameters including presenting symptom category (asymptomatic neck mass, neck mass with primary-site symptoms, or primary-site symptoms without a neck mass), p16 status on fine-needle aspiration (FNA), and date of presentation. Median time intervals between presentation to imaging, biopsy, and treatment were compared within each parameter using the Kruskal-Wallis test with a significance level of 0.05. Results Sixty-five of the 101 study patients presented with a neck mass. Patients without a neck mass had a longer interval from presentation to imaging than patients with a neck mass (median 4 vs 0 days, p = 0.025). Initial FNA obtained on 61 patients was positive for p16 in 19 patients. Unknown or negative p16 status on FNA was associated with shorter intervals from initial imaging to treatment initiation (39 vs 46.5 days, p = 0.045). Patients presenting in the final three years had a longer interval from presentation to treatment initiation (55 vs 41 days, p = 0.024). Conclusion A neck mass is absent from the clinical picture of a substantial proportion of HPV-associated OPSCC patients. Primary-site symptom category and regional metastasis were not associated with differences in times to diagnosis or treatment initiation at this major referral center. The increased awareness and complexity of treatment decisions related to OPSCC may contribute to the delays in treatment initiation observed in patients with p16-positive FNAs and those who presented in more recent years.
Published: 2019

17. Measurement of associated production of a $$\mathrm {W}$$ W boson and a charm quark in proton–proton collisions at $$\sqrt{s} = 13\,\text {Te}\text {V} $$ s = 13 Te

Author: Jian Sun, Artur Kalinowski, Alessandro Rossi, David J. Smith, Tariq Aziz, Dave M Newbold, Marco Alexander Harrendorf, Dmitry Philippov, Fábio Lúcio Alves, Marko Dragicevic, Valery Zhukov, Alexander Spiridonov, I. A. Melzer-Pellmann, Francesca Nessi-Tedaldi, Ibrahim Soner Zorbakir, A. A. Abdelalim, Matti J Kortelainen, Efe Yazgan, Luciano Orsini, Cheng-Chieh Peng, Luca Pacher, George Karathanasis, Shalhout Shalhout, Y. Choi, Brandon Allen, Claire Shepherd-Themistocleous, Antonis Agapitos, Thi Hien Doan, Daniel Denegri, David Vannerom, Sergei Baidali, Dustin Burns, Elvire Bouvier, Hartmut Stadie, Natascha Krammer, James Zabel, S. J. Qian, L. J. Sanchez Rosas, Urs Langenegger, Martino Dall'Osso, A. De Cosa, Hannes Sakulin, Dooyeon Gyun, Giuseppe Iaselli, Adrian Byszuk, F. Gasparini, Nikoloz Skhirtladze, Crisostomo Sciacca, Maxim Goncharov, K. Ehataht, Tilman Rohe, Jing Wang, M. Bluj, Georgi Sultanov, Evan Wolfe, Andreas Werner Jung, Chandiprasad Kar, M. R. 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Kim, Nathan Mirman, Willem Verbeke, Armando Lanaro, Monika Grothe, Grigory Safronov, A. B. Meyer, Joshua Hardenbrook, Lucia Silvestris, Giancarlo Mantovani, Carlo Battilana, Neeti Parashar, Sezen Sekmen, S. Bheesette, Emanuele Usai, Fabio Ravera, Charles Ferraioli, Z. Liu, Pooja Saxena, W. T. Hung, Klaus Rabbertz, Sebastiano Albergo, Igor Lokhtin, Myriam Schönenberger, Daniel Bloch, Maximilian Heindl, Zachary Lesko, Gabriella Pugliese, Alexander Savin, M. Finger, I. Van Parijs, Burak Bilki, Kevin Lannon, Jasper Lauwers, Wajid Ali Khan, A. G. Stahl Leiton, Nicolò Trevisani, Dirk Krücker, G. Della Ricca, Inna Kucher, Guenakh Mitselmakher, S. Orfanelli, Maren Tabea Meinhard, Gianluca Cerminara, Jordan Damgov, D. Di Croce, Peter Hansen, Kisung Lee, Vivek Sharma, Basile Vermassen, Jay Mathew Lawhorn, Claude Amsler, Brent Yates, Lorenzo Russo, Prasant Kumar Rout, Laurent Favart, Cristian Pena, S. Fonseca De Souza, Thomas Reis, Martin Lipinski, Viatcheslav Stolin, Frank Würthwein, Manas Maity, Alexi Mestvirishvili, Ulrich Goerlach, Joze Zobec, Steve Nahn, Paolo Capiluppi, James Rohlf, Carlos Avila, Sergei Bitioukov, Giuseppe Barbagli, Ricardo Eusebi, Simone Pigazzini, Ping Tan, Giuseppe Benedetto Cerati, Riccardo Paramatti, Andrea Giammanco, Priyanka Kumari, Tuure Tuuva, Elizabeth Kennedy, Margaret Zientek, S. Slabospitskii, E. Eskut, James Keaveney, Unki Yang, Nikola Godinovic, Ozgun Kara, Daniel Gastler, Stavros Mallios, Johannes Wittmann, James D. Olsen, Alain Givernaud, Seth Moortgat, P. Sphicas, Altan Cakir, Paolo Meridiani, N. V. Krasnikov, Aron Soha, W. A. T. Wan Abdullah, Jamal Rorie, Jason Gilmore, Aobo Zhang, M. G. Albrow, Marco Paganoni, Anindya Roy, Muhammad Waqas, Izaak Neutelings, Predrag Milenovic, Peter R Hobson, Don Lincoln, Li Yuan, Constantin Heidegger, W. De Boer, Jory Sonneveld, Hafeez R Hoorani, Simon Kurz, A. Bat, E. Eskandari Tadavani, Sudarshan Paramesvaran, Victor Daniel Elvira, Bilal Kiani, Alexander Snigirev, F. Hartmann, Stephane Cooperstein, S. Ragazzi, Daniel John Karmgard, Manfred Jeitler, Fabrizio Palla, J. S. Lange, Gianni Zumerle, Sunil Bansal, Owen Baron, Vivekanand Jha, Steve Schnetzer, Saranya Ghosh, Elizabeth Starling, René Caspart, Klaas Padeken, Nicholas Smith, Renato Campanini, Lieselotte Moreels, Pushpalatha C Bhat, Elisabetta Manca, Christoph Grab, Jean-Charles Fontaine, Anton Dimitrov, Carlos Lourenco, Alexander Nehrkorn, Andrea Gozzelino, Werner Lustermann, Andromachi Tsirou, Andrey Popov, Najaf Amin, Henning Kirschenmann, James Strait, Stephane Perries, L. J. Gutay, Luca Perrozzi, Manfred Krammer, S. h. Seo, David Curry, Carsten Heidemann, Costas Foudas, Kevin Sung, Florent Lacroix, Devdatta Majumder, Emanuela Barberis, Michael Dittmar, R. Kunnawalkam Elayavalli, Steven Kaplan, Joona Havukainen, Aleksandar Aleksandrov, Jacob Linacre, Konstanty Sumorok, Semiray Girgis, Dominique Gigi, Benoit Courbon, Yongbin Feng, Bernard Ille, V. Andreev, Raffaello D'Alessandro, Ali Mohammadi, Dinko Ferencek, Giovanni Franzoni, Evrim Ersin Kangal, Ashok Kumar, Andrei Sobol, Krishna Thapa, Francesco Fienga, Gabriella Pasztor, Rachael Bucci, Ravindra Kumar Verma, E. Belchior Batista Das Chagas, Hao Qiu, Mario Pelliccioni, Anne Dabrowski, Roy Montalvo, T. Y. Ling, Tulika Bose, Claudia Pistone, Wolfgang Adam, Wuming Luo, Giovanni Abbiendi, R. Sharma, Rishika Bhardwaj, János Karancsi, P. Rebello Teles, Amandeep Kaur Kalsi, Leonard Spiegel, Francesco Romeo, Robert Klanner, Andrea Benaglia, G. Zevi Della Porta, Andreas Kornmayer, Batool Safarzadeh, Marc Dünser, Darin Acosta, Youngkwon Jo, Kristian Allan Hahn, Federico Ambrogi, Matthias Endres, Marcos Cerrada, Andrei Gritsan, Kerstin M. Stenson, Christopher Mcginn, Daniel Robert Marlow, Thea Klaeboe Aarrestad, Haiyan Wang, Quan Wang, S. Baur, Yves Sirois, Mehmet Oglakci, Li Li, Sarah Freed, Alicia Calderon, Seyed Mohsen Etesami, Sandra Oliveros, Alfredo Gurrola, Ufuk Guney Tok, Christopher Brew, Lothar At Bauerdick, Leonardo Giannini, Weinan Si, Robert M Harris, G. Correia Silva, Elliot Hughes, Andrew Buccilli, Charles C. Richardson, James Bowen, Daniele Spiga, J. Alexander, G. M. Bilei, David Jonathan Hofman, Shubham Pandey, Wei Shi, O. Rieger, Thomas Klijnsma, Mikhail Gavrilenko, W. S. Hou, Nadezda Chernyavskaya, Juska Pekkanen, M. Franco Sevilla, Giacomo Bruno, Tomas Hreus, Maryam Zeinali, Patrick Jarry, Benjamin Charles Radburn-Smith, Damir Devetak, Michele Bianco, Kevin Nash, Gourab Saha, Valentina Dutta, W. E. Johns, Mariana Shopova, Eric Christian Chabert, Sean Flowers, Sandeep Bhowmik, Nikkie Deelen, E. M. Da Costa, Prakash Thapa, A. Rinkevicius, Olivier Davignon, Dmitri Konstantinov, Debabrata Bhowmik, Adrian Perieanu, A. Meyer, Russell Richard Betts, Conor Henderson, Francisco Yumiceva, Prasenjit Mal, Christina Snyder, Ritva Kinnunen, Konstantin Matchev, J. J. Hollar, Jean-Marie Brom, Xavier Coubez, Fabrice Couderc, Petar Maksimovic, Patrick Janot, Thorsten Chwalek, Egidio Longo, Francesca Ricci-Tam, Ivan Marchesini, Matthew Carver, Mohsan Waseem Ather, Anna Stakia, Sébastien Wertz, Salvatore Rappoccio, L. Kreczko, Geng-Yuan Jeng, Irene Bachiller, Loukas Gouskos, Maksim Azarkin, J. Alcaraz Maestre, Basil Schneider, Cristina Biino, Ivan Mikulec, Francesco Micheli, Gul Gokbulut, Savvas Kyriacou, Denis Rathjens, Alexandre Zabi, Xavier Janssen, S. M. A. Ghiasi Shirazi, Igor Miagkov, Shane Breeze, Iban Jose Cabrillo, C. Barth, Andrius Juodagalvis, Kerstin Borras, Dong-Chul Son, Metin Yalvac, Liliana Teodorescu, Stephan Lammel, Aaron Bundock, Katerina Lipka, Martin Kirakosyan, Hugo Delannoy, Daniel Noonan, M. H.L.S. Wang, Sourav Chatterjee, M. Alhusseini, Howard Wells Wulsin, F. Vazquez Valencia, Clément Leloup, Alexander Nikitenko, Jasvinder A. Singh, M. Rahmani, Markus Spanring, N. De Filippis, Dipanwita Dutta, Alexei Safonov, Enrico Robutti, Kurtis F Johnson, Janos Erö, Julia Velkovska, Sudha Ahuja, Greg P Heath, R. Granier de Cassagnac, Alexey Kalinin, Maxime Gouzevitch, Halil Saka, Pietro Govoni, Andrea Beschi, Marek Niedziela, Christoph Schäfer, Alexander Grohsjean, Dimitrios Tsitsonis, Peter Thomassen, Phillip Russell Dudero, Lev Uvarov, Rajdeep Mohan Chatterjee, Stilianos Kesisoglou, Junquan Tao, O. Kukral, Abhisek Datta, O. Hlushchenko, Tiziano Rovelli, Andrey Marinov, Francesca Cenna, Alberto Ruiz-Jimeno, Gabriel Ramirez-Sanchez, Giuliana Galati, Didar Dobur, S. Goy Lopez, Nicole Ruckstuhl, Austin Ball, S. M. Spanier, James S. Wright, Vladimir Blinov, Nathaniel Odell, Baokai Wang, Sa. Jain, Alessandro Montanari, Luc Pape, Vassili Kachanov, Moritz Guthoff, Stephen Sanders, A. Escalante Del Valle, Joosep Pata, A. Baden, Gino Bolla, M. Barrio Luna, Colin Bernet, Nadia Pastrone, P. Martinez Ruiz del Arbol, Dan Quach, Ugur Kiminsu, Rylan Conway, J. F. de Trocóniz, Matthias Ulrich Mozer, A. Morelos Pineda, Johannes Brandstetter, S. B. Oh, Alexander Malakhov, Günter Flügge, Qiao Xu, Danyyl Brzhechko, M. Naimuddin, Martti Raidal, Tyler Ruggles, Robert Clare, Patrizia Azzi, Thomas Hebbeker, Paul Lecoq, A. De Roeck, A. J. Campbell, Pamela Klabbers, A. David, Ksenia Shchelina, Albert M. Sirunyan, K. Vellidis, E. Di Marco, Gaël Touquet, M. Weber, Chiara Amendola, A. Di Florio, A. De Wit, Frans Meijers, Edward Scott, Stefano Colafranceschi, C. Scharf, Siarhei Shulha, A. Di Mattia, Paolo Gunnellini, Burin Asavapibhop, Juliet Ritchie Patterson, Joao Varela, Leander Litov, Jean-Pierre Merlo, Joanne Cole, A. K. Virdi, Eija Tuominen, Luigi Fiore, Patrick Connor, Giovanna Selvaggi, Daniel Abercrombie, Gabor Istvan Veres, Alexandre Mertens, Sarah Catherine Eno, Jan-Frederik Schulte, G. Bauer, Till Arndt, Matthew Nguyen, V. Rodríguez Bouza, Hugues Brun, Pieter Everaerts, J. Y. Han, Titas Roy, Pedro G Mercadante, Alexx Perloff, Roman Ryutin, Federica Primavera, Roberto Carlin, Pierre Depasse, Vyacheslav Klyukhin, Hans-Christian Kaestli, Luisa Benussi, Richard B. Lipton, Mustafa Numan Bakirci, Lorenzo Viliani, Kurt Jung, G. L. Pinna Angioni, F. De Guio, Pierluigi Paolucci, Zuhal Seyma Demiroglu, Thomas Strebler, Marc Osherson, A. Vorobyev, E. E. Boos, Ruslan Chistov, Kadri Ozdemir, Heriberto Castilla-Valdez, Adam Dishaw, Claudia Seitz, Daniel Pitzl, Maciej A. Walczak, Joaquin Emilo Siado, Maksat Haytmyradov, Paolo Montagna, Othmane Bouhali, Carlos Erice, H. Zhang, David Mason, Luigi Moroni, Luca Lista, L. R. Sulak, C. C. Wang, M. A. Segura Delgado, Jesus Marco, David Krofcheck, J. P. Fernández Ramos, Anirban Saha, Andrew Evans, Ekaterina Avdeeva, Roberto Leonardi, Alexander Barnyakov, Markus Merschmeyer, Eduardo Coelho, Ozlem Kaya, Sevil Salur, Y. Wang, Jim Hanlon, Jose Chinellato, Richard Cavanaugh, Anton Taurok, Ivan Pozdnyakov, Ruchi Chudasama, Marco Rovere, Marco Toliman Lucchini, Mauricio Thiel, Ilya Gorbunov, Andreas Güth, Peter Timothy Cox, Michael Mulhearn, Ilya Kravchenko, Jeroen Hegeman, Maria Teresa Grippo, Anatoli Zarubin, O. Zenaiev, James Wetzel, B. McMaster, Fan Xia, Dietrich Liko, Mykhailo Dalchenko, Jingyu Luo, Ayman Al-bataineh, Prafulla Kumar Behera, Riccardo Andrea Manzoni, Christian Veelken, Yu. Andreev, Markus Klute, Joel Goldstein, Luciano Ristori, Milena Misheva, Luigi Calligaris, Kevin Pedro, Silvano Tosi, Ryan Heller, Maxime Guilbaud, Daniel Treille, Kelvin Mei, S. R. Dugad, D. De Jesus Damiao, German Martinez, T. Susa, Giannis Flouris, Cristina Botta, Georg Sieber, Viesturs Veckalns, Dario Bisello, Pascal Paganini, R. Walsh, S. Zhang, and Cameron Bravo
Subjects: Quantum chromodynamics, Physics, Particle physics, Strange quark, Muon, Physics and Astronomy (miscellaneous), Meson, Physics::Instrumentation and Detectors, 010308 nuclear & particles physics, High Energy Physics::Phenomenology, Computer Science::Computation and Language (Computational Linguistics and Natural Language and Speech Processing), 01 natural sciences, 7. Clean energy, Charm quark, Pseudorapidity, 0103 physical sciences, High Energy Physics::Experiment, Neutrino, Nuclear Experiment, 010306 general physics, Engineering (miscellaneous), Boson
Abstract: Measurements are presented of associated production of a $\mathrm {W}$ boson and a charm quark ( $\mathrm {W}+\mathrm {c}$ ) in proton–proton collisions at a center-of-mass energy of 13 $\,\text {Te}\text {V}$ . The data correspond to an integrated luminosity of 35.7 $\,\text {fb}^{-1}$ collected by the CMS experiment at the CERN LHC. The $\mathrm {W}$ bosons are identified by their decay into a muon and a neutrino. The charm quarks are tagged via the full reconstruction of ${\mathrm {D}^{*}(2010)^{\pm }}$ mesons that decay via ${\mathrm {D}^{*}(2010)^{\pm }}\rightarrow \mathrm {D}^0 + {\pi ^{\pm }}\rightarrow \mathrm {K}^{\mp } + {\pi ^{\pm }}+ {\pi ^{\pm }}$ . A cross section is measured in the fiducial region defined by the muon transverse momentum $p_{\mathrm {T}} ^{\mu } > 26\,\text {Ge}\text {V} $ , muon pseudorapidity $|\eta ^{\mu } | 5\,\text {Ge}\text {V} $ . The inclusive cross section for this kinematic range is $\sigma (\mathrm {W}+\mathrm {c})=1026\pm 31\,\text {(stat)} \begin{array}{c} +76\\ -72 \end{array}\,\text {(syst)} \text { pb} $ . The cross section is also measured differentially as a function of the pseudorapidity of the muon from the $\mathrm {W}$ boson decay. These measurements are compared with theoretical predictions and are used to probe the strange quark content of the proton.
Published: 2019
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18. Cytopathologic assessment of gloves and instruments after major head and neck surgery

Author: Samer Al-Khudari, Kerstin M. Stenson, Aryan Shay, Bobby A. Tajudeen, Paolo Gattuso, Ryan M. Smith, Peter C. Revenaugh, and Hannah N. Kuhar
Subjects: Male, medicine.medical_specialty, Cytological Techniques, Tumor resection, Pilot Projects, 03 medical and health sciences, Neoplasm Seeding, 0302 clinical medicine, Cytology, medicine, Humans, Gloves, Surgical, Neoplasm Invasiveness, Prospective Studies, 030223 otorhinolaryngology, Prospective cohort study, Aged, Salvage Therapy, business.industry, Head and neck cancer, Margins of Excision, Sarcoma, Surgical Instruments, medicine.disease, Otorhinolaryngologic Surgical Procedures, Surgery, Parotid gland, medicine.anatomical_structure, Otorhinolaryngology, Head and Neck Neoplasms, 030220 oncology & carcinogenesis, Scalp, Cancer cell, Carcinoma, Squamous Cell, Female, Neoplasm Recurrence, Local, business
Abstract: Purpose To investigate the potential for cancer cells to be transferred between anatomic sites via instruments and other materials. Materials and methods Pilot prospective study from April 2018–January 2019 at Rush University Medical Center. Glove and instrument washings were collected from 18 high-risk head and neck cancer resection cases (36 samples total). Each case maintained at least one of the following features in addition to a diagnosis of squamous cell carcinoma or sarcoma: palliative/salvage surgery, positive margins, extensive tumor burden, and/or extra capsular extension (ECE). Surgical gloves and four main instruments were placed through washings for blind cytological assessment (2 samples/case). Results 18 patients undergoing surgical tumor resection for biopsy-proven squamous cell carcinoma with at least one of the aforementioned characteristics were included. 26.7% of cases had ECE, 40.0% had positive final margins and 46.7% had close final margins. Tumor locations included: oral cavity (10), neck (4), parotid gland (2), and skin (2). Malignant cells were isolated on glove washings in 1 case (5.5%). No malignant cells were isolated from instrument washings. The single case of malignant cells on glove washings occurred in a recurrent, invasive squamous cell carcinoma of the scalp with intracranial extension. Anucleated squamous cells likely from surgeon skin were isolated from 94.4% of washings. Squamous cells were differentiated from mature cells by the absence of nuclei. Conclusions Malignant squamous cells can be isolated from surgical glove washings, supporting the practice of changing of gloves after gross tumor resection during major head and neck cancer resections.
Published: 2021
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19. Functional outcomes after extracapsular dissection with partial facial nerve dissection for small and large parotid neoplasms

Author: Samuel R. Auger, Samer Al-Khudari, Mehmet Kocak, Kerstin M. Stenson, Brendan Hardy, Danny Jandali, and Dallas E. Kramer
Subjects: medicine.medical_specialty, business.industry, Retrospective cohort study, Sialocele, Parotidectomy, medicine.disease, Facial nerve, Parotid gland, Pleomorphic adenoma, 03 medical and health sciences, Dissection, 0302 clinical medicine, medicine.anatomical_structure, Otorhinolaryngology, 030220 oncology & carcinogenesis, medicine, Radiology, 030223 otorhinolaryngology, Complication, business
Abstract: Purpose Multiple surgical options exist for benign parotid tumors without agreement upon a single, best approach. We evaluated the short-term outcomes and rate of complications using the ECD-FND technique for small and large parotid neoplasms involving the superficial and deep lobes of the parotid gland using a categorical approach. Material and methods A single surgeon retrospective cohort study with analysis of patient demographics, outcomes, and complication rates was conducted of patients undergoing the ECD-FND for benign parotid neoplasm. Cases from May 2014 to May 2020 with at least 6 months follow up were considered. Complications were assessed by chart review and tumors were categorized by size and by European Salivary Gland Society (ESGS) classification assigned by a neuroradiologist. Results Fifty-one patients who underwent ECD-FND of suspected benign parotid mass met inclusion criteria. The most common histology was pleomorphic adenoma (56.9%) followed by Warthin's tumor (19.6%). Overall rate of complications was 31.4% with no major complications. Most patients (88.2%) had normal facial nerve function immediately after surgery and all recovered completely in the post operative period. Sialocele occurred in 15.7% of patients with 87.5% resolved within one month and seromas occurred in four patients (7.8%). There was no significant difference in complication rates between the size of tumor (p = 0.889), depth (p = 0.770), or ESGS classification (p = 0.846). Conclusions The ECD-FND technique achieved excellent facial nerve outcomes among our cohort, which included a - proportion of large (>3 cm) and deep lobe tumors. Complications rates and outcomes were similar for larger and deep lobe tumors that underwent a ECD-FND approach. Level of evidence: 3.
Published: 2021
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20. Final Results of a Randomized Phase 2 Trial Investigating the Addition of Cetuximab to Induction Chemotherapy and Accelerated or Hyperfractionated Chemoradiation for Locoregionally Advanced Head and Neck Cancer

Author: Victoria M. Villaflor, Everett E. Vokes, Ryan J. Brisson, Masha Kocherginsky, Tanguy Y. Seiwert, Mary Ellyn Witt, Apoorva Chawla, Daniel J. Haraf, Kerstin M. Stenson, Allison Dekker, Joseph K. Salama, Mark W. Lingen, Elizabeth A. Blair, J.M. Melotek, and Ezra E.W. Cohen
Subjects: Adult, Male, 0301 basic medicine, Oncology, Cancer Research, medicine.medical_specialty, medicine.medical_treatment, Cetuximab, Disease-Free Survival, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, Humans, Medicine, Radiology, Nuclear Medicine and imaging, neoplasms, Survival rate, Aged, Aged, 80 and over, Radiation, Squamous Cell Carcinoma of Head and Neck, business.industry, Head and neck cancer, Dose fractionation, Induction chemotherapy, Radiotherapy Dosage, Chemoradiotherapy, Induction Chemotherapy, Middle Aged, medicine.disease, Carboplatin, Survival Rate, Radiation therapy, Treatment Outcome, 030104 developmental biology, chemistry, Head and Neck Neoplasms, 030220 oncology & carcinogenesis, Carcinoma, Squamous Cell, Female, Dose Fractionation, Radiation, Neoplasm Recurrence, Local, Accelerated Radiation Therapy, business, medicine.drug
Abstract: The role of cetuximab in the treatment of locoregionally advanced head and neck squamous cell cancer (LA-HNSCC) remains poorly defined. In this phase 2 randomized study, we investigated the addition of cetuximab to both induction chemotherapy (IC) and hyperfractionated or accelerated chemoradiation.Patients with LA-HNSCC were randomized to receive 2 cycles of weekly IC (cetuximab, paclitaxel, carboplatin) and either Cetux-FHX (concurrent cetuximab, 5-fluorouracil, hydroxyurea, and 1.5 Gy twice-daily radiation therapy every other week to 75 Gy) or Cetux-PX (cetuximab, cisplatin, and accelerated radiation therapy with delayed concomitant boost to 72 Gy in 42 fractions). The primary endpoint was progression-free survival (PFS), with superiority compared with historical control achieved if either arm had 2-year PFS ≥70%.110 patients were randomly assigned to either Cetux-FHX (n=57) or Cetux-PX (n=53). The overall response rate to IC was 91%. Severe toxicity on IC was limited to rash (23% grade ≥3) and myelosuppression (38% grade ≥3 neutropenia). The 2-year rates of PFS for both Cetux-FHX (82.5%) and Cetux-PX (84.9%) were significantly higher than for historical control (P.001). The 2-year overall survival (OS) was 91.2% for Cetux-FHX and 94.3% for Cetux-PX. With a median follow-up time of 72 months, there were no significant differences in PFS (P=.35) or OS (P=.15) between the treatment arms. The late outcomes for the entire cohort included 5-year PFS, OS, locoregional failure, and distant metastasis rates of 74.1%, 80.3%, 15.7%, and 7.4%, respectively. The 5-year PFS and OS were 84.4% and 91.3%, respectively, among human papillomavirus (HPV)-positive patients and 65.9% and 72.5%, respectively, among HPV-negative patients.The addition of cetuximab to IC and chemoradiation was tolerable and produced long-term control of LA-HNSCC, particularly among poor-prognosis HPV-negative patients. Further investigation of cetuximab may be warranted in the neoadjuvant setting and with non-platinum-based chemoradiation.
Published: 2016
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21. Locoregional Recurrent or Second Primary Head and Neck Cancer: Management Strategies and Challenges

Author: Diane C. Ling, Dwight E. Heron, Kerstin M. Stenson, John A. Vargo, and Stuart J. Wong
Subjects: Oncology, medicine.medical_specialty, medicine.medical_treatment, Population, Antineoplastic Agents, Disease, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Carcinoma, Humans, Combined Modality Therapy, Disease management (health), 030223 otorhinolaryngology, education, Chemotherapy, education.field_of_study, Squamous Cell Carcinoma of Head and Neck, business.industry, Incidence (epidemiology), Head and neck cancer, Disease Management, Neoplasms, Second Primary, General Medicine, Prognosis, medicine.disease, Head and Neck Neoplasms, 030220 oncology & carcinogenesis, Carcinoma, Squamous Cell, Neoplasm Recurrence, Local, business
Abstract: Treatment of patients with locoregional recurrent or second primary head and neck squamous cell cancer (HNSCC) has been guided by well-reasoned principles and informed by carefully tested chemotherapy and radiation regimens. However, clinical decision making for this population is complicated by many factors. Although surgery is generally considered the treatment of choice for patients with HNSCC with recurrent disease or new second primary disease in a previously irradiated field, operability of cases is not always straightforward. Postoperative treatment is frequently warranted but carries significant risk. In addition, the rapid rise in the incidence of HPV-associated HNSCC raises the question of whether established treatment paradigms should be re-examined in this population of patients with a much better prognosis than the non-HPV population. Furthermore, new radiation techniques and new systemic agents show early promising results in recent clinical studies, suggesting potential for practice-changing effects in the future management of this disease. This article examines each of the treatment modalities used in the care of patients with HNSCC with recurrent or new second primary disease and provides a perspective to aid clinicians in the management of this disease.
Published: 2016
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22. Cost-Effectiveness Analysis of Chemoradiation Therapy Versus Transoral Robotic Surgery for Human Papillomavirus–Associated, Clinical N2 Oropharyngeal Cancer

Author: Roy B. Tishler, Mary J. Fidler, David J. Sher, Kerstin M. Stenson, and Samer Al-Khudari
Subjects: Oncology, Cancer Research, medicine.medical_specialty, Cost-Benefit Analysis, medicine.medical_treatment, Sensitivity and Specificity, 03 medical and health sciences, 0302 clinical medicine, Robotic Surgical Procedures, Internal medicine, Transoral robotic surgery, medicine, Carcinoma, Humans, Radiology, Nuclear Medicine and imaging, 030223 otorhinolaryngology, Papillomaviridae, Radiation, business.industry, Cancer, Chemoradiotherapy, Cost-effectiveness analysis, medicine.disease, Markov Chains, Surgery, Quality-adjusted life year, Radiation therapy, Oropharyngeal Neoplasms, Oropharyngeal Carcinoma, 030220 oncology & carcinogenesis, Carcinoma, Squamous Cell, Radiotherapy, Adjuvant, Quality-Adjusted Life Years, Neoplasm Recurrence, Local, business
Abstract: Purpose To perform a cost-effectiveness analysis of primary chemoradiation therapy (CRT) versus transoral robotic surgery (TORS) for clinical N2, human papillomavirus (HPV)-positive oropharyngeal carcinoma. Methods and Materials We developed a Markov model to describe the health states after treatment with CRT or TORS, followed by adjuvant radiation therapy or CRT in the presence of high-risk pathology (positive margins or extracapsular extension). Outcomes, toxicities, and costs were extracted from the literature. One-way sensitivity analyses (SA) were performed over a wide range of parameters, as were 2-way SA between the key variables. Probabilistic SA and value of information studies were performed over key parameters. Results The expected quality-adjusted life years (QALYs)/total costs for CRT and TORS were 7.31/$50,100 and 7.29/$62,200, respectively, so that CRT dominated TORS. In SA, primary CRT was almost always cost-effective up to a societal willingness-to-pay of $200,000/QALY, unless the locoregional recurrence risk after TORS was 30% to 50% lower, at which point it became cost effective at a willingness-to-pay of $50-100,000/QALY. Probabilistic SA confirmed the importance of locoregional recurrence risk, and the value of information in precisely knowing this parameter was more than $7M per year. If the long-term utility after TORS was 0.03 lower than CRT, CRT was cost-effective over nearly any assumption. Conclusions Under nearly all assumptions, primary CRT was the cost-effective therapy for HPV-associated, clinical N2 OPC. However, in the hypothetical event of a large relative improvement in LRR with surgery and equivalent long-term utilities, primary TORS would become the higher-value treatment, arguing for prospective, comparative study of the 2 paradigms.
Published: 2016
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23. Abstract B36: Avoidance of 'prophylactic' tracheostomy in free-flap reconstruction surgery of the head and neck: Implications for postoperative outcomes and patient quality of life

Author: Pete S. Batra, Peter C. Revenaugh, Samer Al-Khudari, Kerstin M. Stenson, Hannah N. Kuhar, and Ashley Heilingoetter
Subjects: Cancer Research, medicine.medical_specialty, business.industry, Incidence (epidemiology), Head and neck cancer, medicine.disease, Surgery, Resection, Oncology, Quality of life, medicine, Free flap reconstruction, University medical, Airway, Head and neck, business
Abstract: Introduction: Elective “prophylactic” tracheostomy has routinely been performed intraoperatively at the time of resection and reconstruction of defects of the head and neck for airway protection in anticipation of potential airway complications. We hypothesized that selected patients do not require “prophylactic” or intraoperative tracheostomy placement at the time of resection and free flap reconstruction. Methods: Retrospective review over a 3-year period (2015-2018) of free flap reconstruction cases for defects resulting from the resection of head and neck pathology at Rush University Medical Center. Incidence and timing of tracheostomy placement, sites of resection and reconstruction, postoperative complications, length of stay (LOS), demographics, and procedure details were assessed. Results: 88 patients (59 male, 29 female, average age 63.06 years) undergoing free flap reconstruction for defects resulting from the resection of head and neck pathology were included. 59 patients did not receive “prophylactic” tracheostomy and 29 received “prophylactic” tracheostomy at the time of surgery. Of the 29 “prophylactic” tracheostomies, 16 underwent decannulation prior to discharge. Compared to those patients who did not receive “prophylactic” tracheostomies, patients who received “prophylactic” tracheostomies had longer average ICU LOS (6.41 ± 1.54 days vs. 3.34 ± 0.14 days, p Conclusions: Patients who received “prophylactic” tracheostomies had increased ICU LOS, hospital LOS, and rate of airway-related postoperative complications, suggesting that select patients do not require “prophylactic” tracheostomy placement at the time of resection and free flap reconstruction. Citation Format: Hannah N. Kuhar, Ashley Heilingoetter, Samer Al-Khudari, Peter C. Revenaugh, Pete S. Batra, Kerstin Stenson. Avoidance of “prophylactic” tracheostomy in free-flap reconstruction surgery of the head and neck: Implications for postoperative outcomes and patient quality of life [abstract]. In: Proceedings of the AACR-AHNS Head and Neck Cancer Conference: Optimizing Survival and Quality of Life through Basic, Clinical, and Translational Research; 2019 Apr 29-30; Austin, TX. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(12_Suppl_2):Abstract nr B36.
Published: 2020
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24. Abstract B37: Cytopathologic assessment of gloves and instruments after major head and neck surgery: Implications for intraoperative practices

Author: Bobby A. Tajudeen, Hannah N. Kuhar, Paolo Gattuso, Peter C. Revenaugh, Kerstin M. Stenson, Samer Al-Khudari, and Aryan Shay
Subjects: Cancer Research, medicine.medical_specialty, Oncology, business.industry, General surgery, Head and neck surgery, medicine, business
Abstract: Introduction: The purpose of the present study was to investigate the potential for cancer cells to be transferred between anatomic sites via instruments and other materials, promoting the dissemination of cancerous cells from existing tumors to previously unaffected regions of the body. Methods: Pilot prospective study over a 6-month period (April-August 2018) at Rush University Medical Center of glove and instrument washings from 15 high-risk head and neck cancer resection cases (30 samples total). Each case maintained at least one of the following features in addition to a biopsy-proven diagnosis of squamous cell carcinoma or sarcoma of the head and neck: palliative surgery or salvage surgery, positive initial or final margins, extensive tumor burden, and/or extracapsular extension (ECE). After completion of each ablative procedure, surgical gloves of the primary surgeon and the four main surgical instruments in direct contact with the tumor were placed through washings for cytologic assessment (2 samples per case). Tumor and case characteristics were recorded. Samples were blindly evaluated by a board-certified cytopathologist for cytologic assessment. Results: 15 patients (11 males, 4 females, average age 65.13 years) undergoing surgical tumor resection for biopsy-proven squamous cell carcinoma with at least one of the aforementioned additional characteristics were included in the study. 26.7% of cases had ECE, 40.0% of cases had positive final margins, and 46.7% of cases had close final margins. Resected tumor locations included the oral cavity (7 cases), neck (4 cases), parotid gland (2 cases), and skin (2 cases). Malignant cells were isolated on glove washings in 1 case (6.7% of cases). No malignant cells were isolated from instrument washings. The single case of malignant cells on glove washings occurred in a recurrent, invasive squamous cell carcinoma of the scalp with intracranial extension. Anucleated squamous cells likely from surgeon skin contamination were isolated from 93.3% of instrument washings and 93.3% of glove washings. These squamous cells were differentiated from mature cells of the oral cavity by the absence of nuclei. Conclusions: Malignant squamous cells can be isolated from surgical glove washings. This supports the common practice of changing gloves during major head and neck cancer resections and may have important implications for intraoperative practices. Additional investigation is needed to assess for viability of detected malignant cells. Citation Format: Hannah N. Kuhar, Aryan Shay, Peter C. Revenaugh, Kerstin Stenson, Bobby Tajudeen, Paolo Gattuso, Samer Al-Khudari. Cytopathologic assessment of gloves and instruments after major head and neck surgery: Implications for intraoperative practices [abstract]. In: Proceedings of the AACR-AHNS Head and Neck Cancer Conference: Optimizing Survival and Quality of Life through Basic, Clinical, and Translational Research; 2019 Apr 29-30; Austin, TX. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(12_Suppl_2):Abstract nr B37.
Published: 2020
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25. Survival Following Photoimmunotherapy in Patients (Pts) with Recurrent Head and Neck Squamous Cell Carcinoma (rHNSCC)

Author: Jennifer Johnson, J. Campana, Mohammad Razaq, Nilesh R. Vasan, Kerstin M. Stenson, Mary J. Fidler, Ann M. Gillenwater, David Cognetti, Joseph Curry, D. McDonald, G. Mann, and S.T. Kochuparambil
Subjects: Oncology, Cancer Research, medicine.medical_specialty, Radiation, business.industry, Photoimmunotherapy, medicine.disease, Head and neck squamous-cell carcinoma, Internal medicine, medicine, Radiology, Nuclear Medicine and imaging, In patient, business
Published: 2020
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26. Clinical features and outcomes in young adults with oral tongue cancer

Author: Neilayan Sen, Samer Al-Khudari, Mary J. Fidler, Aryan Shay, Courtney Miller, Bobby A. Tajudeen, Kerstin M. Stenson, and Paolo Gattuso
Subjects: Adult, Male, medicine.medical_specialty, Adolescent, Perineural invasion, Disease-Free Survival, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Internal medicine, medicine, Humans, Neoplasm Invasiveness, Young adult, Stage (cooking), 030223 otorhinolaryngology, Survival rate, Cyclin-Dependent Kinase Inhibitor p16, Neoplasm Staging, Retrospective Studies, Univariate analysis, business.industry, Age Factors, Cancer, Retrospective cohort study, medicine.disease, Tongue Neoplasms, Log-rank test, Survival Rate, Treatment Outcome, Otorhinolaryngology, 030220 oncology & carcinogenesis, Female, business
Abstract: Objective To evaluate outcomes and survival in young patients with oral tongue cancer (OTC). Methods Retrospective chart review of patients aged 18–40 with OTC treated between 2000 and 2016. Tumor characteristics of p16 expression, perineural invasion (PNI), and lymph-vascular invasion (LVI) were evaluated. Recurrence-free (RFS) and overall survival (OS) data were analyzed according to Kaplan-Meier method with univariate analysis. Results A total of 23 patients were identified: 12 with early stage disease (ESD, stage I), and 11 with advanced stage disease (ASD, stage III or IV), (17 men and 6 women). Mean age at presentation was 34.5 years (±5 months) and mean follow-up was 46.6 months. For all patients, 5-year RFS was 62% and OS 66%. RFS for ESD was 73% and ASD 25% (log rank p = 0.011). OS for ESD was 100% and ASD 55% (log rank p = 0.012). 22% indicated tobacco use >5 pack-years and 9% heavy alcohol use. Factors associated with worse OS were neck disease (log rank p = 0.073), positive margins (log rank p = 0.001), and LVI (log rank p = 0.002). Factors associated with worse RFS were chemotherapy or radiation therapy prior to surgery (log rank p = 0.002), neck disease (log rank p = 0.047), positive margins (log rank p = 0.039), and PNI (log rank p = 0.001). Expression of p16 was observed in five cases and was not significantly associated with OS or RFS. Conclusion In young patients with OTC, factors associated with worse outcomes are similar to known predictors in older patients. Expression of p16 was not statistically associated with improved OS. OS in patients with ESD was excellent (100%), and significantly worse for ASD.
Published: 2018

27. Results of a phase 2a, multicenter, open-label, study of RM-1929 photoimmunotherapy (PIT) in patients with locoregional, recurrent head and neck squamous cell carcinoma (rHNSCC)

Author: Jennifer Johnson, Mohammad Razaq, Darren McDonald, Kerstin M. Stenson, Merrill A. Biel, Nilesh R. Vasan, Samith T. Kochuparambil, Mary J. Fidler, Joseph Curry, Frank E. Mott, Ann M. Gillenwater, John Campana, and David Cognetti
Subjects: Cancer Research, medicine.medical_specialty, Standard of care, business.industry, Photoimmunotherapy, medicine.disease, Head and neck squamous-cell carcinoma, 03 medical and health sciences, 0302 clinical medicine, Oncology, Open label study, 030220 oncology & carcinogenesis, Medicine, In patient, Radiology, business, 030215 immunology
Abstract: 6014 Background: Patients with rHNSCC who have failed standard of care have poor prognoses and limited therapeutic options. In this study, final results are reported of a phase 2a trial of photoimmunotherapy (PIT) with a targeted drug RM-1929, consisting of the EGFR-directed antibody cetuximab conjugated to a photoactivatable dye (IRDye 700DX). Binding of the antibody-dye conjugate to cancer cells followed by photoactivation with nonthermal red light induces selective and rapid necrosis of the cancer cells, with minimal damage to surrounding tissue. Methods: A phase 2a, multicenter, open-label, study of RM-1929 PIT in patients with locoregional, rHNSCC who could not be satisfactorily treated with surgery, radiation, or platinum chemotherapy was conducted to evaluate the safety and efficacy of the drug, RM-1929. For each treatment, nonthermal red light (690 nm) was applied to the tumors 24 hours post IV infusion of the drug. Surface illumination was administered for superficial tumors and interstitial illumination via intratumoral placement of fiber optic diffusers for deep tumors. Therapeutic response was assessed using CT RECIST 1.1 by an independent blinded radiologist. Results: Thirty rHNSCC patients were enrolled. There were no dose-limiting toxicities and one Grade 1 photosensitivity reaction. Most reported AEs were mild to moderate in severity with 96.7% (29/30) of patients with Grade 1 and 83.3% (25/30) with Grade 2, respectively. There were 13 (43.3%) patients who had at least one SAE. 86% (19/22) of SAEs were deemed unlikely related to treatment, including all 3 fatal SAEs. Three SAEs were reported to be possibly/probably related to treatment (site/oral pain, tumor hemorrhage, and airway obstruction). ORR was 50% (15/30) with 16.7% (5/30) CR and 86.7% (26/30) DCR. Median PFS and OS results will be forthcoming. Conclusions: These data indicate that RM-1929 PIT treatment was generally well tolerated with majority of AEs as mild to moderate in severity. Preliminary data showed favorable response rates in a heavily pre-treated population. A global phase 3 clinical trial is currently underway. Clinical trial information: NCT02422979.
Published: 2019
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28. Impact of reactive gastrostomy tube placement on clinical course of oropharynx cancer patients treated with chemoradiation

Author: Mary J. Fidler, Neilayan Sen, M. Bojko, Yanyu Zhang, Ami Dave, Samer Al-Khudari, Kerstin M. Stenson, M. Mozer, and Amanda A Huff
Subjects: Gastrostomy tube placement, Cancer Research, medicine.medical_specialty, business.industry, technology, industry, and agriculture, Clinical course, Percutaneous gastrostomy tube, Cancer, macromolecular substances, medicine.disease, Surgery, Oncology, Medicine, business, Head and neck, Feeding tube
Abstract: e17540 Background: Prophylactic percutaneous gastrostomy tube (PEG) insertion reduces toxicity from chemoradiation to the head and neck but is thought to increase long term feeding tube dependence. This study retrospectively examines incidence and risk factors for treatment related complications of oropharynx cancer patients with and without prophylactic PEGs. Methods: Rush University Medical Center oropharynx cancer patients who received definitive chemoradiation treatment between 2007-2018 were included. Classifications were: “therapeutic” PEG (pretreatment for immediate use due to inability to swallow), prophylactic PEG, reactive PEG (patient/physician preference or 10% weight loss from baseline), and no PEG inserted on treatment. We compared patients with reactive or no PEG to (1) patients with prophylactic PEG, and (2) patients with prophylactic PEG and therapeutic PEG. Multivariate linear and logistical regression models were used to test PEG effect on weight loss, hospital admission, and incidence of acute kidney injury (AKI). Models were adjusted for covariates (age, gender, race, HTN, CAD, DM, other comorbidity). Acute kidney injury (AKI) was creatinine 1.5-2x above baseline. Results: In all, 104 patients were included with mean age 60.1 (SD = 8.65) and baseline BMI 29.6 (SD = 5.62). 53.4% (N = 55) had a prophylactic PEG, 38.8% (N = 40) had reactive or no PEG, 7.8% (N = 8) had a therapeutic PEG. 80 (76.9%) were treated with cisplatin. For all patients, analyses showed that reactive PEG or no PEG patients were more likely to develop AKI during treatment compared to patients with a prophylactic PEG (OR:3.2, p = 0.03), and to patients with prophylactic PEG and therapeutic PEG combined (OR:3.5, p = 0.02). There were no statistically significant differences between PEG groups for weight loss and hospital admission rate. In cisplatin treated patients, reactive PEG or no PEG patients were more likely to be admitted to the hospital compared to prophylactic PEG patients (OR:3.8, p = 0.04). Compared to patients with prophylactic and therapeutic PEG combined, however, there was no statistically significant difference. Patients with reactive or no PEG were more likely to have AKI than prophylactic PEG (OR:5.2, p < 0.01), and as compared to patients with therapeutic or prophylactic PEG (OR:4.4, p = 0.02). Conclusions: Reactive PEGs were associated with increased AKI and hospitalizations compared with prophylactic PEG. With a reactive PEG model, patients may need to have routine lab work and monitoring adjusted to reduce treatment complications.
Published: 2019
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29. Lymph node density-Prognostic value in head and neck cancer

Author: Michael T. Spiotto, Mary Ellyn Witt, Kerstin M. Stenson, Sonali Rudra, Elizabeth A. Blair, and Daniel J. Haraf
Subjects: Oncology, medicine.medical_specialty, business.industry, Head and neck cancer, Head neck, medicine.disease, Treatment failure, Dissection, medicine.anatomical_structure, Otorhinolaryngology, Internal medicine, Overall survival, Medicine, In patient, Radiology, business, Head and neck, Lymph node
Abstract: Background The purpose of this study was to determine the prognostic value of lymph node density in head and neck cancer. Methods We utilized a prospective, multicenter database of 223 patients with head and neck cancer to identify patients who underwent lymph node dissection before chemoradiation to assess the prognostic significance of lymph node density. Results In 38 patients who met study criteria, lymph node density ≤0.20 predicted for improved overall survival (OS; 79% vs 50%; p = .04). Lymph node density was also associated with a trend toward improved 3-year locoregional control (96% vs 79%; p = .14) and distant metastasis–free survival (93% vs 78%; p = .13). In the patients with treatment failure distantly or locoregionally, that failure was earlier in patients with lymph node density >0.20 than in patients with lymph node density ≤0.20 (median, 12.7 months vs 5.2 months; p = .004). Conclusion Our data suggest that lymph node density predicts for OS in patients with head and neck cancer and that the difference in OS may be because of differences in time to failure. © 2013 Wiley Periodicals, Inc. Head Neck 36: 266–272, 2014
Published: 2013
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30. Outcomes of induction chemotherapy followed by concurrent chemoradiation for nasopharyngeal carcinoma

Author: Ezra E.W. Cohen, Everett E. Vokes, Daniel J. Haraf, Daniel W. Golden, Sonali Rudra, Elizabeth A. Blair, Kerstin M. Stenson, Tobenna Nwizu, and M. E. Witt
Subjects: Adult, Male, Oncology, Cancer Research, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Disease-Free Survival, Young Adult, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, Hydroxyurea, Child, Survival rate, Neoadjuvant therapy, Aged, Neoplasm Staging, Platinum, Aged, 80 and over, Chemotherapy, business.industry, Carcinoma, Remission Induction, Induction chemotherapy, Nasopharyngeal Neoplasms, Radiotherapy Dosage, Chemoradiotherapy, Induction Chemotherapy, Middle Aged, medicine.disease, Neoadjuvant Therapy, Surgery, Survival Rate, Radiation therapy, Treatment Outcome, Nasopharyngeal carcinoma, Chemotherapy, Adjuvant, Female, Fluorouracil, Neoplasm Recurrence, Local, Oral Surgery, business, Progressive disease, Follow-Up Studies
Abstract: Summary Purpose Current standard therapy for nasopharyngeal carcinoma (NPC) is concurrent chemoradiation based on randomized data. However, limited randomized data exist to support the addition of induction chemotherapy (ICT). Methods 58 Patients with NPC were treated from 1990 to 2010. All patients received platinum-based ICT. All 58 patients were treated with chemoradiation, 57 in a week-on/week-off (WOWO) fashion. Concurrent chemotherapy included hydroxyurea/5-fluorouracil for all patients. Median radiation dose was 70 Gy. No patient received adjuvant chemotherapy. Results AJCC 2009 stage was II = 13, III = 21, IVa = 13, and IVb = 11. Median follow-up for surviving patients was 66 months. Response to ICT was complete response (CR) 17% and partial response (PR) 64%. The CR rate after chemoradiation was 96%. Five-year actuarial freedom from local failure (FFLF), freedom from distant failure (FFDF), cause-specific survival (CSS), and overall survival (OS) was 98%, 90%, 90%, and 76%, respectively. Analysis of pediatric patients ( n = 9) demonstrated 5-year actuarial FFLF, FFDF, CSS, and OS of 100%, 88%, 80%, and 80%, respectively. Conclusions ICT followed by concurrent chemoradiation demonstrates excellent FFLF, FFDF, CSS, and OS with tolerable toxicity. Induction chemotherapy followed by concurrent chemoradiation for patients with NPC should be explored further in a randomized setting.
Published: 2013
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31. A phase I dose escalation study of Ad GV.EGR.TNF.11D (TNFerade™ Biologic) with concurrent chemoradiotherapy in patients with recurrent head and neck cancer undergoing reirradiation

Author: Mark W. Lingen, Joseph K. Salama, Victoria M. Villaflor, Everett E. Vokes, Daniel J. Haraf, Elizabeth A. Blair, Tanguy Y. Seiwert, Kerstin M. Stenson, Thomas E. Darga, Ezra E.W. Cohen, Ralph R. Weichselbaum, and M. E. Witt
Subjects: Adult, Male, Oncology, Radiation-Sensitizing Agents, medicine.medical_specialty, Maximum Tolerated Dose, medicine.medical_treatment, Kaplan-Meier Estimate, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, Biopsy, Carcinoma, medicine, Humans, Hydroxyurea, Aged, medicine.diagnostic_test, Squamous Cell Carcinoma of Head and Neck, business.industry, Radiotherapy Planning, Computer-Assisted, Head and neck cancer, Dose fractionation, Original Articles, Chemoradiotherapy, DNA, Genetic Therapy, Hematology, Middle Aged, medicine.disease, Radiation therapy, Treatment Outcome, Head and Neck Neoplasms, Fluorouracil, Retreatment, Toxicity, Carcinoma, Squamous Cell, Female, Dose Fractionation, Radiation, Radiotherapy, Intensity-Modulated, Nuclear medicine, business, medicine.drug
Abstract: Background AdGV.EGR.TNF.11D (TNFerade™ Biologic) is a replication-deficient adenoviral vector expressing human tumor necrosis factor alpha (TNF-α) under the control of the chemoradiation-inducible EGR-1 promoter. TNF-α has been shown to function as a radiation sensitizer. We conducted a phase I dose escalation study to determine the maximum tolerated dose (MTD) and dose-limiting toxicity (DLT) of TNFerade™ Biologic, when added to chemoradiotherapy in poor prognosis patients with recurrent, previously irradiated head and neck cancer (HNC). Methods TNFerade™ Biologic was injected intratumorally on day 1 of each 14-day cycle and dose-escalated in log increments from 4 × 109 to 4 × 1011 PU. Daily radiation, infusional 5-fluorouracil (5-FU), and hydroxyurea were given on days 1–5 for seven cycles (FHX). Tumor biopsies were obtained before, during, and after treatment. Results Fourteen patients were treated. DLT was reached at a dose level of 3 (4 × 1011 PU) with three thrombotic events. The response rate was 83.3%. The median survival was 9.6 months. One patient (7.1%) remained alive 3 years after treatment. Biopsies were obtained in 90% of patients. Nearly all tumors expressed adenovirus receptors, TNF-α, and TNF-α receptors. Adenoviral DNA was detected in three biopsies from one patient. Conclusions TNFerade™ Biologic can be safely integrated with FHX chemoradiotherapy at an MTD of 4 × 1010 PU. Monitoring for thrombotic events is indicated.
Published: 2013
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32. Search for Narrow Resonances in Dijet Final States ats=8 TeVwith the Novel CMS Technique of Data Scouting

Author: Pawandeep Jandir, Vardan Khachatryan, Alexandre Zabi, Vladimir Rekovic, Igor Miagkov, P. Verdier, Marino Missiroli, C. Barth, A. Savoy-Navarro, Andrius Juodagalvis, Kevin Lannon, G. Della Ricca, S. Cihangir, Vipin Bhatnagar, Markus Stoye, Ran Du, Kai Yi, Kristen Flowers, Mircho Rodozov, B. Roland, Felix Bachmair, Andrés G Delannoy, Christopher Hill, Paolo Lariccia, A. Baden, Georgia Karapostoli, Andrea Gozzelino, Gino Bolla, Yang Wang, W. L. Aldá Júnior, Daniele Fasanella, Fan Xia, Dietrich Liko, Jesse Heilman, Mykhailo Dalchenko, Ece Aşılar, Manoj Jha, J. P. Alexander, J. A. Nash, Vladimir Karjavin, Kerstin Borras, Lei Feng, L. Malgeri, Kamuran Dilsiz, Steven Wasserbaech, Eleni Ntomari, Seema Bahinipati, Paolo Rumerio, Lorenzo Uplegger, Jan Hoss, Y. F. Liu, Michael Krohn, Jeremie Alexandre Merlin, Piotr Zalewski, Xinmei Niu, Vitaly Smirnov, Guenakh Mitselmakher, Nayana Majumdar, Dragos Velicanu, Qamar Hassan, Jordan Damgov, Giacomo Fedi, Peter Hansen, Rylan Conway, Kisung Lee, J. F. de Trocóniz, Matthias Ulrich Mozer, Andrii Gizhko, Nuno Leonardo, Manfred Paulini, Brian Pollack, Pierluigi Bortignon, Massimiliano Chiorboli, A. Morelos Pineda, Martina Machet, C. Wissing, A. Castaneda Hernandez, Johannes Brandstetter, Valery Zhukov, Alexander Spiridonov, I. A. Melzer-Pellmann, Ashutosh Bhardwaj, Ajit Kumar Mohanty, Francesca Nessi-Tedaldi, Yongjie Xin, Jingyu Luo, Ayman Al-bataineh, Prafulla Kumar Behera, Riccardo Andrea Manzoni, Christian Veelken, S. B. Oh, Christian Autermann, Alexander Malakhov, Efe Yazgan, Vyacheslav Valuev, Kelly Beernaert, Qiao Xu, C. Woehrmann, Can You, Kenneth Bloom, Dong-Chul Son, Liliana Teodorescu, I. K. Furic, Claude Amsler, Brent Yates, Laurent Favart, Cristian Pena, Ugo Gasparini, Veikko Karimäki, Th. A. Mueller, Adam Elwood, Madhulika G. Varma, Yu. Andreev, Markus Klute, Elisabetta Gallo, M. Lo Vetere, Tomasz Frueboes, J. A. Gomez, G. Grenier, Nathan Kellams, Robin Aggleton, Ferhat Ozok, Peter Raics, Peicho Petkov, Achille Petrilli, Chun-Hua Jiang, Sushil Chauhan, Kajari Mazumdar, Nickolas Mccoll, Andreas Werner Jung, Pete Markowitz, M. Naimuddin, Tyler Ruggles, S. Thueer, Robert Clare, Patrizia Azzi, Jacopo Bernardini, Kevin Klapoetke, Tobias Pook, Thomas Perry, P. Busson, Aaron Bundock, Thomas Hebbeker, Paul Lecoq, M. Dordevic, Katerina Lipka, Martin Kirakosyan, Thomas Reis, Martin Lipinski, Sara Fiorendi, Allison Reinsvold, Joel Goldstein, Luciano Ristori, Luigi Calligaris, B. Marzocchi, Kevin Pedro, Tiehui Liu, Silvano Tosi, Ryan Heller, Laurent Thomas, Mark Derdzinski, Maxime Guilbaud, Daniel Treille, Dario Menasce, M. De Mattia, G. Quast, Hannsjoerg Artur Weber, Gordon H. Hanson, Geonmo Ryu, T. Mueller, Marcus Hohlmann, Hannes Neugebauer, Victor Murzin, Howard Wells Wulsin, J. R. Castiñeiras De Saa, Q. Li, Tutanon Sinthuprasith, Mark Olschewski, Katja Klein, R. F. Harr, Ivan Glushkov, Katarzyna Romanowska-Rybinska, Jimin George, Carlos Florez, Jay Hauser, A. Vilela Pereira, F. Costanza, Michael Brodski, Roberto Castello, Ilaria Vai, Markus Radziej, Natale Demaria, Philip Hebda, Ian Macneill, T. Geralis, Stephane Fartoukh, Jaehyeok Yoo, F. Vazquez Valencia, Pablo Garcia-Abia, Raymond Patrick Kenny Iii, Alain Hervé, A. Di Mattia, M. Correa Martins Junior, Ivan Vila, S. Carrillo Moreno, Frank Roscher, Kristin Goebel, Frank Würthwein, Manas Maity, Alexi Mestvirishvili, Ulrich Goerlach, Massimo Casarsa, A. De Roeck, Steve Nahn, Marco Meschini, Paolo Capiluppi, James Rohlf, Vasken Hagopian, G. M. Dallavalle, Sami Lehti, Adish Vartak, M. Vazquez Acosta, Adrian Perieanu, A. Meyer, Russell Richard Betts, Julie Malcles, Fengwangdong Zhang, Simranjit Singh Chhibra, Eric Conte, David Barney, Aleksandra Lelek, S. Salva, Stephanie Beauceron, Joshua Kunkle, Ulrich Husemann, Ian Michael Nugent, A. J. Campbell, A. David, Ksenia Shchelina, Albert M. Sirunyan, Valentina Sola, M. Weber, Carlotta Favaro, Boris Grynyov, Zeynep Demiragli, Yalcin Guler, Gregor Kasieczka, Y. Chao, Conor Henderson, Prasenjit Mal, Christina Snyder, Konstantin Matchev, J. J. Hollar, Jean-Marie Brom, Igor Bayshev, A. De Cosa, Hannes Sakulin, Alice Magnani, Pramod Lamichhane, Alexander Nikitenko, Tilman Rohe, David Petyt, Dan Knowlton, Jasvinder A. Singh, Dimitri Bourilkov, Vassili Kachanov, M. Bluj, Andrey Ostapchuk, A. De Wit, John Stupak, S. W. Cho, Andrew Whitbeck, Yusuf Erdogan, S. R. Dugad, D. De Jesus Damiao, Babak Rahbaran, Dipanwita Dutta, Laura Dodd, Viktor Veszpremi, Abdulla Abdulsalam, Michael Seidel, Andrew Levin, Tengizi Toriashvili, S. Bhattacharya, Sudhir Malik, Lutz Feld, Andrey Gribushin, Guido Tonelli, Frans Meijers, Tomas Lindén, N. Van Remortel, Elizabeth Sexton-Kennedy, Matthias Wolf, Paolo Ronchese, Shang Liu, Sanjay Kumar Swain, Marc M Baarmand, Daniele Trocino, A. Stahl, David Sabes, Ali Fahim, Roger Wolf, Marina Chadeeva, Yongsun Kim, Lev Dudko, Jeremy Andrea, Lesya Shchutska, Ashley Parker, D. H. Miller, Rizki Syarif, Ia Iashvili, Fabio Colombo, Jean-Roch Vlimant, Brajesh C Choudhary, Paul David Luckey, Marco Trovato, Malte Hoffmann, Alice Florent, Stefano Colafranceschi, C. Scharf, Siarhei Shulha, Ketino Kaadze, Christian Contreras-Campana, E. W. Vaandering, V. Re, André Holzner, Werner Sun, Joschka Lingemann, Paolo Gunnellini, V. Knuenz, Raffaele Tito D'Agnolo, Igor Golutvin, Jean-Louis Faure, Philipp Millet, Juliet Ritchie Patterson, Carlos Avila, Sergei Bitioukov, Jan Veverka, Ricardo Eusebi, Brian Francis, Joao Varela, Paolo Checchia, I. Gonzalez Caballero, Leander Litov, Alberto Messineo, John Almond, Joseph Goodell, Andrea Massironi, Raffaella Radogna, Piotr Traczyk, Jennifer Ngadiuba, Thomas Schoerner-Sadenius, German Martinez, Zeljko Antunovic, Donald Belknap, Winston Ko, I. De Bruyn, Sunil Dogra, Joseph Heideman, Nicholas Eminizer, Sébastien Viret, Shengquan Tuo, M. A. B. Ali, Francesco Navarria, Raffaele Gerosa, Alexander Ledovskoy, Vincent J Smith, Hong Ni, Michail Bachtis, Nikolai Skatchkov, Louis Antonelli, N Hoermann, W. Van Doninck, Xin Shi, Hans Rykaczewski, J. M. Grados Luyando, G. P. Van Onsem, Zaixing Mao, Attila Racz, Roberta Arcidiacono, Jonathan Fulcher, Anatoli Pashenkov, Avto Kharchilava, Mikhail Ignatenko, Jelena Luetic, Alexander Dierlamm, Giannis Flouris, Cristina Botta, Georg Sieber, Viesturs Veckalns, Christoph Paus, Daniele Bonacorsi, Alexei Safonov, Stephen Sanders, Arthur Moraes, Jian-Guo Bian, Andrey Pozdnyakov, Dario Bisello, Pascal Paganini, A. Quintario Olmeda, Jean-Pierre Merlo, Rocky Bala Garg, Shabnam Jabeen, O. Gonzalez Lopez, A. Van Spilbeeck, R. D. Field, Dmytro Kovalskyi, T. Weiler, Reza Goldouzian, Andrea Schizzi, Mohd Nizam Yusli, W. T. Ford, Gyorgy Vesztergombi, G. P. Siroli, S. Tkaczyk, Ren-Yuan Zhu, Narumon Suwonjandee, M. Schroeder, Christopher Bruner, Ali Harb, Tapio Lampén, Frank Jm Geurts, Riccardo Paramatti, Andrea Giammanco, Betty Calpas, J. Seixas, Alexandra Junkes, R. Walsh, Suyong Choi, J. C. Ruiz Vargas, Michal Szleper, Philippe Gras, Pierluigi Zotto, S. Lee, Hwi Dong Yoo, Roberto Chierici, Chia-Ming Kuo, Robert Bainbridge, I Kraetschmer, James Faulkner, A. Escalante Del Valle, Y. J. Mao, Zhaoxia Meng, Chiara Mariotti, Christopher George Tully, Ian Fisk, Joosep Pata, Colin Bernet, R. Vidal, Julia Velkovska, Tobias Lapsien, Etiennette Auffray, T. Yetkin, Y. J. Lu, Maria Elena Pol, David Stuart, Joanne Cole, Nadia Pastrone, Renato Potenza, Alice Mignerey, Chayanit Asawatangtrakuldee, Yetkin Yilmaz, Candan Dozen, Myung-kwan Ryu, G. Steinbrueck, Lucia Perrini, Patrick Connor, Vladimir Epshteyn, L. Di Matteo, C. Diez Pardos, Michael Wayne Arenton, Andrea Triossi, Christoph Schwick, Darren Burton, J. Vaitkus, W. A. T. Wan Abdullah, Sinan Sagir, Jamal Rorie, Jason Gilmore, Marta Felcini, Gabor Istvan Veres, Alexandre Mertens, P. Van Hove, Sarah Catherine Eno, Marco Paganoni, Jan-Frederik Schulte, Marissa Rodenburg, D. Benedetti, Vitaliano Ciulli, Hugues Brun, Guenter Eckerlin, Annik Olbrechts, Armen Tumasyan, R. Teixeira De Lima, Paula Eerola, Manoj Sharan, Rakesh Kumar, G. Fluegge, Y. Mohammed, Philip Symonds, Paul Geffert, Z. Wang, Norraphat Srimanobhas, Dermot Moran, A. Kuensken, Giuseppe Fasanella, Sung Keun Park, Don Lincoln, W. De Boer, Hafeez R Hoorani, Nikitas Loukas, Hui Li, Sara Alderweireldt, Olena Karacheban, Andreas Kornmayer, Luigi Benussi, A. Khan, Gouranga Kole, Stefan Gundacker, A. Starodumov, Alexander Schmidt, Nadir Daci, David Sheffield, Roumyana Hadjiiska, Martti Raidal, Emmanuel Contreras-Campana, Pamela Klabbers, Ravi Janjam, Siddharth Narayanan, Ian Anderson, Sean Kalafut, Sudha Ahuja, Nikolai Gorbounov, Halil Saka, Pietro Govoni, Maryam Zeinali, Patrick Jarry, Benjamin Charles Radburn-Smith, Kevin Nash, Valentina Dutta, Mani Tripathi, Rachel Bartek, Alexis Fagot, Simone Gennai, C. E. Flores, Inga Bucinskaite, Florian Scheuch, Boaz Klima, Michael Tytgat, Robin Erbacher, Senta Greene, Bugra Bilin, Kati Lassila-Perini, James Dolen, Freya Blekman, David Michael Morse, G. Hamel de Monchenault, Aditee Rane, Kai-Feng Chen, Ettore Focardi, Alexander Belyaev, Claudio Campagnari, Stephanie Brandt, R. Mankel, Wolfgang Lohmann, Sherif Elgammal, Daniel John Karmgard, Stephan Linn, Manfred Jeitler, Marguerite Tonjes, David Mark Raymond, Olivier Bondu, E. O. Olaiya, Esteban Curras, Christophe Delaere, Marco Peruzzi, L. Lloret Iglesias, Owen Rosser Long, Warren Clarida, Alessio Boletti, Jie Zhang, Jose Chinellato, Richard Cavanaugh, Maxim Konyushikhin, Jeannine Wagner-Kuhr, Vallary Bhopatkar, John Rander, Xavier Coubez, Fabrice Couderc, Alex Garabedian, Egidio Longo, Francesca Ricci-Tam, Ivan Marchesini, Pascal Vanlaer, Richard Breedon, L. S. Durkin, Souvik Das, Josef Strauss, Maria Toms, John Michael Marraffino, Owen Baron, Vivekanand Jha, Eric Spencer, Steve Schnetzer, Saranya Ghosh, Dana Z. Anderson, Cesare Calabria, Nicola Amapane, Jose Monroy, Caleb Fangmeier, Filip Moortgat, Igor Vorobiev, Josef Hammer, Suneel Dutt, Roberto Dell'Orso, J. W. Gary, Sergey Troshin, E. De La Cruz-Burelo, David D'Enterria, G. 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Garay Garcia, Esa Tuovinen, Pedro G Mercadante, Hans-Christian Kaestli, Francesca Romana Cavallo, Viktor Savrin, Marco Rovere, Oliver Pooth, Jan Steggemann, Andrés Cabrera, Bibhuprasad Mahakud, G. Gomez Ceballos, Nikos Varelas, Helen F Heath, Mariana Vutova, D. P. Stickland, Koushik Mandal, Konstantinos Kousouris, Joshua Bendavid, Kenneth Call, Cesar Augusto Bernardes, Klaas Padeken, Dominik Haitz, Renato Campanini, Rosamaria Venditti, Nicanor Colino, Amitabh Lath, Y. H. Chang, Lucas Brito, Panos A Razis, Steven R. Simon, John Gabriel Acosta, Helio Nogima, W. H. Smith, Zhenyu Chen, Elif Asli Yetkin, T. L. Cheng, J. G. Branson, Jasper Lauwers, Alberto Orso Maria Iorio, Wajid Ali Khan, Cosmin Dragoiu, Maria Roberta Monge, Teresa Rodrigo, H. Weber, Radia Redjimi, Marco Toliman Lucchini, Victor Kim, Armando Lanaro, Svenja Schumann, Rami Kamalieddin, E. M. Da Costa, Daniel Bloch, G. L. Pinna Angioni, Geoffrey Smith, Amedeo Staiano, A. 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Torassa, Robert Hirosky, Alexander Snigirev, F. Hartmann, Stephane Cooperstein, S. W. Lee, G. De Lentdecker, Marco Cuffiani, J. D. Richman, Brian L Winer, Donato Creanza, Marc Dobson, Heiner Tholen, Andrzej Zuranski, Harry Cheung, Andrew Johnson, Lukas Vanelderen, Karl Gill, Susan Gascon, Umberto Dosselli, Peter Schleper, K. Krajczar, Predrag Cirkovic, Viola Sordini, Erika Garutti, Anton Dimitrov, Werner Lustermann, Andromachi Tsirou, Tatiana Medvedeva, Lalit Mohan Pant, R. Placakyte, Aaron Dominguez, Suresh C Tonwar, Sylvie Braibant-Giacomelli, Jeffrey Roskes, Elsayed Salama, Clara Jorda, H. Topakli, Brendan Diamond, Giulia D'imperio, Jovan Milosevic, Ahmad Borzou, Metin Yalvac, A. Saha, Andrei Leonidov, Deborah Duchardt, Darien Wood, Stephan Lammel, Hugo Delannoy, Daniel Noonan, G. B. Yu, Richard Barbieri, Sharon Hagopian, Ralf Ulrich, M. H.L.S. Wang, Fanbo Meng, Caroline Collard, Vineet Kumar, Juliette Alimena, Z. Xu, Oliver Buchmuller, Jyothsna Rani Komaragiri, Patricia McBride, Krzysztof Doroba, Gunther Roland, Yacine Haddad, L. J. Gutay, David Curry, V. Andreev, Rishi Patel, Y. D. Oh, Fabrizio Palla, Claudio Grandi, W. Van Driessche, Carlo Battilana, Yue Shi Lai, Sezen Sekmen, S. Sanchez Cruz, Mauro Menichelli, Luca Perniè, Roland Horisberger, Maciej Misiura, Hongfang Liu, Georgios Mavromanolakis, Charles Ferraioli, Z. Liu, Pooja Saxena, Felicitas Pauss, Georgios Anagnostou, Melody A. Swartz, P. Martinez Ruiz del Arbol, Maxwell Chertok, Danek Kotlinski, Simone Gelli, Darren Puigh, L. Viliani, Andrea Perrotta, Apostolos Panagiotou, Benjamin Kilminster, Sébastien Gadrat, Mayda Velasco, Aniello Spiezia, Christopher West, Fuqiang Wang, Zhoudunming Tu, Marc Weinberg, Wolfgang Treberer-Treberspurg, Gregor Mittag, M. Y. Choi, Jennifer Chu, Michele Arneodo, Gilvan Alves, Eric Takasugi, E. J. Tonelli Manganote, Krzysztof Piotrzkowski, Ekaterina Kuznetsova, Luca Martini, Emanuela Barberis, Ie. Korol, Giacomo Ortona, Julian Bunn, T. Boccali, Avraham Yagil, Nicolo Magini, Vincenzo Innocente, Maurizio Pierini, David Cussans, A. Melo, Denis Gelé, Chang-Seong Moon, Anna Teresa Meneguzzo, Alexander Gude, Nicholas John Hadley, Mark Turner, Jehad Mousa, Yen-Jie Lee, Mauro Emanuele Dinardo, Doga Gulhan, Louis Lyons, C. La Licata, Lea Caminada, Sven Dildick, Charles Welke, Nicola Bacchetta, Maximilian Heindl, Rong-Shyang Lu, Takashi Matsushita, Christopher Anelli, Austin Baty, Michael Dittmar, R. Kunnawalkam Elayavalli, Steven Kaplan, Karl Matthew Ecklund, J. A. Brochero Cifuentes, Zhen Hu, Keith Ulmer, Isabel Ojalvo, Youn Roh, Barry Blumenfeld, Brieuc Francois, Jorge Luis Rodriguez, Dylan Rankin, Andrew Brinkerhoff, Joonas Talvitie, Zoltan Laszlo Trocsanyi, Troy Mulholland, Matthew Chasco, Rachel Yohay, Giancarlo Mantovani, N. De Filippis, Giuseppe Antonio Pierro, J. K. Lim, F. Simonetto, J. Conway, James Castle, Seungkyu Ha, Thomas Ferguson, Thierry Maerschalk, D. Del Re, Valerio Calvelli, A. B. Meyer, Shin-Shan Yu, F. L. Fabbri, Aleksandar Aleksandrov, Frank Raupach, Jacob Linacre, Bernard Ille, Silvia Maselli, Ali Mohammadi, Christian Hartl, Ioannis Papadopoulos, Efstathios Paganis, Erica Brondolin, K. W. Bell, Alexander Savin, M. Finger, Nataliia Kovalchuk, Sanmay Ganguly, Simon Regnard, Mauro Donegà, G. De Nardo, Mikhail Kirsanov, Viktor Khristenko, Wenxing Fang, Geoffrey Hall, William Mcbrayer, G. N. Kim, Dinko Ferencek, Nhan Viet Tran, Christof Roland, Sanjay Padhi, Jian Sun, Artur Kalinowski, Salvatore My, Giovanni Franzoni, Evrim Ersin Kangal, Ashok Kumar, Leonid Levchuk, Josef Hrubec, A. Rizzi, Frank Chlebana, A. Pérez-Calero Yzquierdo, Kuntal Mondal, Giovanni Organtini, E. A. De Wolf, Salim Cerci, Nicolas Chanon, Kurtis F Johnson, Greg P Heath, Jin Yong Lee, Justin Pilot, Rui Wang, R. Granier de Cassagnac, Alexey Kalinin, Maxime Gouzevitch, Petr Moisenz, David Ja Cockerill, Wolfgang Lange, Erik Gottschalk, Andrea Delgado, David Colling, Duncan Leggat, Yuriy Pakhotin, Amina Zghiche, Dean Hidas, Maral Alyari, Krishna Thapa, Daryl Hare, Luca Brianza, Luca Scodellaro, S. Schael, Giovanni Petrucciani, Dawn Leslie, Marco Zanetti, U. Bhawandeep, R. Cousins, B. Fabbro, Helena Malbouisson, Alex J. Barker, Jose Flix, Camelia Mironov, R. Sharma, Wolfgang Funk, Alessandro Degano, James Hirschauer, Benjamin Carlson, Kirika Uchida, P. Van Mechelen, Jordon Rowe Adams, Ulascan Sarica, M. Miñano Moya, Panagiotis Kokkas, Andrew Gilbert, Maria Cepeda, Jorgen D'Hondt, Davide Piccolo, Gaël Perrin, Fábio Lúcio Alves, E. Belchior Batista Das Chagas, Paolo Spagnolo, Umesh Joshi, Simon Spannagel, Marek Niedziela, Amithabh Shrinivas, Stefan Michael Heindl, W. Ji, Ryo Yonamine, Nicholas Mucia, Lindsey Gray, Niels Dupont, Himali Kalakhety, Yeng-Ming Tzeng, Zhengcheng Tao, Gy L. Bencze, Matthieu Marionneau, Arne-Rasmus Draeger, Mehmet Zeyrek, Yuta Takahashi, János Karancsi, Andrew Beretvas, Otto Hindrichs, Bahareh Roozbahani, Nadeesha Wickramage, Anna Zanetti, Q. Ingram, Xin Sun, Sumit Keshri, Benedikt Vormwald, Ilknur Hos, T. Tabarelli de Fatis, S. Abu Zeid, A. Richards, J. D. Ruiz Alvarez, Andrew Hart, Demetrios Loukas, Erik Butz, Jan Kieseler, Mikhail Makouski, Laurent Forthomme, Luciano Orsini, Luca Pacher, Vincent Lemaitre, Anne Dabrowski, Tulika Bose, J. M. Hernandez, Alberto Belloni, P. Kyberd, Edward Laird, Paul Avery, Salavat Abdullin, Lisa Benato, Luca Mastrolorenzo, Claire Shepherd-Themistocleous, Antonis Agapitos, Doris Eckstein, Achim Geiser, Thi Hien Doan, Daniel Denegri, Norbert Tambe, David Nash, Ridhi Chawla, J. N. Butler, Genius Walia, Rudolf Fruehwirth, Peter Thomassen, Phillip Russell Dudero, Philipp Eller, Evgueni Vlasov, Attilio Santocchia, Jeson Jacob, Vieri Candelise, Lana Beck, Jean Fay, Abideh Jafari, R. Kelley, Ted Kolberg, C. Uribe Estrada, Muhammad Shoaib, R. Stringer, M. De Palma, V. Monaco, Mark Grimes, Wuming Luo, P. Rebello Teles, Amandeep Kaur Kalsi, Leonard Spiegel, Mark Baber, Thomas Esch, Quentin Python, D. Ciangottini, Meenakshi Narain, Mirena Ivova Paneva, Randy Ruchti, Joe Incandela, Mohsen Naseri, Vladimir Popov, Otman Charaf, Luca Cadamuro, Virginia Azzolini, Simon Knutzen, Javier Duarte, S. Di Guida, Giorgia Rauco, Nancy Marinelli, Hartmut Stadie, Kerstin M. Stenson, Claude Charlot, Jacopo Pazzini, Burton Betchart, Reddy Pratap Gandrajula, Nathan Mirman, Tae Jeong Kim, Thomas Eichhorn, Alessandro Thea, Francesco Romeo, Robert Klanner, Paolo Giacomelli, Isabel Pedraza, Camille Beluffi, Batool Safarzadeh, Maria Hempel, Darin Acosta, Youngkwon Jo, Kristian Allan Hahn, Christopher Mcginn, J Eroe, Rajdeep Mohan Chatterjee, Stilianos Kesisoglou, James Zabel, Stefan Piperov, Burak Bilki, Nicolò Trevisani, Gianluca Cerminara, Junquan Tao, Florian Zenoni, Jennifer Poehlsen, A. Gueth, L. Gauthier, Daniel Robert Marlow, J. Fernandez Menendez, Nicola Pozzobon, Bajrang Sutar, E. Casimiro Linares, Javier Cuevas, Claus Kleinwort, S. J. Qian, Tiziano Rovelli, Peter Robmann, Giuseppe Lanza, Andrey Marinov, Paolo Azzurri, F. Gasparini, Nikoloz Skhirtladze, E. Navarro De Martino, Charles Maguire, Alberto Ruiz-Jimeno, Alexey Finkel, Daniel Pitzl, Michal Simon, Tiziano Camporesi, L. Brigliadori, Maciej A. Walczak, Patrick Dunne, Seema Sharma, Marcello Abbrescia, Thea Klaeboe Aarrestad, Plamen Iaydjiev, Louise Skinnari, Nural Akchurin, Alexandre Aubin, M. R. Adams, Yeonju Go, Christophe Ochando, Joram Berger, Francesco Santanastasio, Stoyan Stoynev, A. Sanchez-Hernandez, Sheng Wang, Frank Jensen, Emilien Chapon, Vittorio Raoul Tavolaro, Didier Contardo, Y. Chen, Sanjay Kumar, Ali Celik, Danila Tlisov, S. Paktinat Mehdiabadi, Giuseppe Codispoti, Simon Fink, Sergo Jindariani, J. Schwandt, M. Ruspa, M. Guchait, Michael Murray, Enrique Calvo, Pavel Sorokin, Jakob Salfeld-Nebgen, Kunal Kothekar, John Bradmiller-Feld, John Hakala, Kenichi Hatakeyama, Yves Sirois, Anna Woodard, Nikolai Golubev, Maria Girone, Martina Malberti, Hannes Mildner, Jay Dittmann, Daniel Teyssier, John Yelton, T. Lenzi, Victor Perelygin, Alessandra Fanfani, P. Miné, Pawan Kumar Netrakanti, Didar Dobur, S. Goy Lopez, Nicole Ruckstuhl, Austin Ball, Petar Adzic, S. M. Spanier, Katharina Bierwagen, Nathaniel Odell, Andrew Askew, R. L. Lander, Gurpreet Singh, Styliani Orfanelli, M. Olmedo Negrete, Francesco Pandolfi, D. R. Claes, Marcel Rieger, Ana Ovcharova, Anders Ryd, Gavin Davies, Anna Julia Zsigmond, Andrea Venturi, M. Voutilainen, M. Khakzad, Rino Castaldi, J. Ellison, Paul Baillon, D. Winn, Sa. Jain, Alajos Makovec, Artur Apresyan, Joaquin Emilo Siado, Li Xu, Muhammad Gul, P. Van Mulders, Maksat Haytmyradov, Paolo Montagna, Michele Gallinaro, P. H. Butler, Giorgia Miniello, Peter Wittich, Valentin Sulimov, V. M. Ghete, Marco Rossini, Alessandro Montanari, P. Lobelle Pardo, Luc Pape, Hadi Behnamian, Moritz Guthoff, Alexander Lanev, Andres Tiko, Milena Quittnat, A. M. Rossi, Ferdinando Giordano, Aruna Nayak, Francesco Fabozzi, Michal Olszewski, Paolo Vitulo, Michael Plagge, Christine O'Brien, Stefaan Tavernier, Paul Sheldon, Alicia Calderon, Gervasio Gomez, Sachiko Toda, Arno Heister, Seyed Mohsen Etesami, T. Kress, Susan Dittmer, Kalyanmoy Chatterjee, Georgios Daskalakis, Mythra Varun Nemallapudi, A. Delgado Peris, Yuichi Kubota, Sergei Gninenko, Ying Lu, A. Solano, J. C. Freeman, Nicolas Filipovic, Senka Duric, Guler Karapinar, S. Petrushanko, Nazar Bartosik, Ta-Wei Wang, Piet Verwilligen, Sandra Oliveros, Alfredo Gurrola, Brian Calvert, Erik Dietz-Laursonn, R. Loveless, Alessio Magitteri, Othmane Bouhali, Y. t. Duh, H. Zhang, David Mason, Christopher Brew, Luigi Moroni, Byung-Sik Hong, Alessandro Giassi, Süleyman Durgut, Marc Besancon, Dinyar Rabady, Stefano Casasso, Mario Pelliccioni, Michael Hildreth, John Paul Chou, Lothar At Bauerdick, Brian Paul Padley, Fabrizio Margaroli, Nairit Sur, Marvin Johnson, Anthony Poll, N. Woods, Michael Squires, Jessica Brinson, Gregory Iles, Archana Sharma, Daniel Salerno, Bożena Boimska, C. F. González Hernández, Cyril X. George, Robert M Harris, Manuel Meyer, Kerem Cankocak, Rohan Bhandari, David Zou, Andrey Korytov, P. Chang, Harrison Prosper, Stephen Robert Wagner, Young Ho Shin, Sourav Dey, Elliot Hughes, Mariarosaria D'Alfonso, Mario Galanti, Zoltan Szillasi, Luca Lista, C. Schaefer, Pavel Jez, L. R. Sulak, C. C. Wang, C. A. Carrillo Montoya, Bibhuti Parida, Wolfram Dietrich Zeuner, Charles C. Richardson, James Bowen, Eduardo De Moraes Gregores, Ashfaq Ahmad, Luigi Fiore, Aristotle Calamba, Victor Krychkine, G. M. Bilei, David Jonathan Hofman, M. Goerner, Jesus Marco, F. Rezaei Hosseinabadi, Andrey Uzunian, Christopher Palmer, Annika Vanhoefer, Alice Bean, David Krofcheck, Vladimir Cherepanov, Hasan Ogul, Daniel Duggan, Loic Quertenmont, Aram Apyan, Sergey Rusakov, David Futyan, J. C. Sanabria, Joseph Mccartin, Jan Krolikowski, Luiz Mundim, C.-E. Wulz, Duccio Abbaneo, Elizabeth Locci, Cristina Biino, Gabriele Benelli, Stanislav Lisniak, Aidan Randle-Conde, Mikhail Gavrilenko, W. S. Hou, J. P. Fernández Ramos, Juska Pekkanen, Andrew Evans, Ekaterina Avdeeva, Roberto Leonardi, Balazs Ujvari, M. Franco Sevilla, Patrizia Barria, Aaron Levine, Somnath Choudhury, Nazar Stefaniuk, John Perry Cumalat, Swagata Mukherjee, Malgorzata Kazana, Mikhail Danilov, Giacomo Bruno, Joao Pela, Markus Merschmeyer, Arie Bodek, Mohammed Zakaria, Ozlem Kaya, Sevil Salur, Inkyu Park, H. Wei, Shervin Nourbakhsh, S. Belforte, Nabarun Dev, Marion Murumaa, L. F. Chaparro Sierra, D. Sunar Cerci, Oliver Gutsche, Olga Evdokimov, Junghwan Goh, Terence Libeiro, Min Suk Kim, Tomas Hreus, Damir Devetak, W. E. Johns, Jia Fu Low, Andreas Pfeiffer, Kreso Kadija, M. Centis Vignali, Eric Christian Chabert, Sean Flowers, Sandeep Bhowmik, Hyunyong Kim, Kirill Skovpen, Y. W. Chang, Emine Gurpinar, Sabino Meola, Roberto Covarelli, Tom Cornelis, Shivali Malhotra, Ennio Monteil, Aldo Penzo, Natalie Heracleous, Sergio Cittolin, Jared Sturdy, Kaya Tatar, A. Bornheim, Peisen Ma, Manqi Ruan, John J. Leonard, Matteo Cremonesi, R. Vilar Cortabitarte, J. Suarez Gonzalez, Sandra S. Padula, Maximilian Knut Kiesel, William J Spalding, Jay Roberts, Stefano Bianco, H. S. Chen, Yury Ivanov, P. G. Ferreira Parracho, Alexander Ershov, Andre Sznajder, Serdal Damarseckin, Yuri Gershtein, Nathaniel Rupprecht, Emmanuelle Perez, G. G. Da Silveira, Cristina Riccardi, Daniele Vadruccio, Claude Nuttens, Francois Lagarde, Andreas Hinzmann, Marcin Konecki, Artur Lobanov, Nathaniel Pastika, Ioannis Evangelou, A. Romero, Bryan Dahmes, Roman Ryutin, A. A. Bin Anuar, Damir Lelas, Tai Sakuma, Olga Driga, Zukhaimira Zolkapli, Kevin Deroover, G. Selvagg, Anterpreet Kaur, Alexey Volkov, Yutaro Iiyama, Mehmet Kaya, Intae Yu, Giacomo Sguazzoni, Tapomoy Guha Sarkar, Anna Elliott-Peisert, Jeremy Mans, Vuko Brigljevic, Lucia Silvestris, David Taylor, B. Jayatilaka, I. D. Sandoval Gonzalez, Zainol Abidin Ibrahim, Aran Garcia-Bellido, Sho Maruyama, D. E. Pellett, Konstantinos Theofilatos, Sandor Czellar, Manuel Giffels, T. du Pree, Debarati Roy, Franco Ligabue, Pavel Bunin, Guo-Ming Chen, Sasa Micanovic, Menglei Sun, Arabella Martelli, Victoria Zhukova, Soureek Mitra, Muhammad Ahmad, Felix Hoehle, Suman Bala Beri, Helena Bialkowska, Vivian O'Dell, Kenneth Long, Andrea Carlo Marini, Ernesto Migliore, Lucija Sudic, Hans-Jürgen Simonis, Jean-Baptiste Sauvan, Gigi Rolandi, Alexander Tapper, Vyacheslav Krutelyov, Suvadeep Bose, Todd Adams, Wit Busza, Deborah Pinna, Caterina Vernieri, Michael Mooney, A. Lopez Virto, N. Zaganidis, A. Mott, Cecilia Elena Gerber, Gian Michele Innocenti, A. Ranieri, Christopher Seez, S. Qazi, Stefano Argiro, Alexey Ferapontov, Catherine Newman-Holmes, B. De La Cruz, Salvatore Costa, J. Puerta Pelayo, Indara Suarez, M. De Gruttola, Ajeeta Khatiwada, Maciej Górski, Zhenbin Wu, Bhawna Gomber, Christopher Clarke, Thomas Bergauer, Marcello Mannelli, Michael Planer, Vladimir Mossolov, Eike Schlieckau, Sarmad Masood Shaheen, Ludivine Ceard, Hualin Mei, Marco Musich, Jingzhou Zhao, Andris Skuja, Sébastien Brochet, Ivica Puljak, Pedro Silva, J. Mejia Guisao, Regina Demina, Sourabh Dube, Matthew Walker, Hans Reithler, Ben Bylsma, Anna Kropivnitskaya, P. de Barbaro, Alberto Santoro, Monika Grothe, Grigory Safronov, Emanuele Usai, R. Lopes De Sá, Roberto Tenchini, Meng Xiao, Alexandre Léonard, Jacobo Konigsberg, Stephane Perries, Y. Musienko, M. C. Fouz, Guillermo Breto, Carsten Heidemann, Costas Foudas, Devdatta Majumder, Dominique Gigi, Benoit Courbon, M. Chamizo Llatas, Hans J. Vogel, Raffaello D'Alessandro, Sridhara Dasu, Emilio Meschi, Andrei Sobol, H. Bakhshiansohi, W. T. Lin, Dylan Hsu, Raman Khurana, J. P. Gomez, Aytul Adiguzel, T. R. Fernandez Perez Tomei, F. De Guio, Raphael Friese, Alexandros Attikis, Bradley Cox, David J. Smith, Claudia Pistone, Filip Thyssen, Dominick Olivito, S. Roy Chowdhury, Colin Jessop, Wolfgang Adam, Tariq Aziz, Dave M Newbold, G. Zevi Della Porta, M. Calderon De La Barca Sanchez, Matthias Endres, P. Lenzi, L. Alunni Solestizi, Matthias Kasemann, D. Romero Abad, Marcos Cerrada, Paola Salvini, Samuel Bein, Andrei Gritsan, Marko Dragicevic, K. Hurtado Anampa, Jian Wang, Iasonas Topsis-Giotis, Florian Beaudette, Andrew Kubik, Daniel Arcaro, Virgil E Barnes, Alessio Ghezzi, Shalhout Shalhout, Y. Choi, Dustin Burns, Nikolai Shumeiko, Nishu Nishu, Johannes Haller, Bora Akgun, Christian Schomakers, Vadim Oreshkin, Francesca Cavallari, B. Tali, Luigi Guiducci, Gregory R Snow, Fabio Ravera, Maren Tabea Meinhard, Urs Langenegger, Nikola Godinovic, Jared Turkewitz, Martino Dall'Osso, Michael Buttignol, Altan Cakir, Paolo Meridiani, Tomislav Seva, Aron Soha, Rajarshi Bhattacharya, Christoph Grab, Jennifer A. Smith, Henning Kirschenmann, Igor Volobouev, Maria Agnese Ciocci, Adrian Byszuk, Brian Dorney, Crisostomo Sciacca, Maxim Goncharov, Marco Pieri, David Fehling, Ian R Tomalin, David Saltzberg, M. Duenser, Vladimir Palichik, Krzysztof Nawrocki, S. Lacaprara, Daniele Pedrini, Benedikt Maier, Konrad Deiters, Anna Cimmino, G. B. Mohanty, Eunhyang Kwon, Christine Mclean, Shirin Chenarani, M. M. Obertino, Jozsef Molnar, Y. Ban, Alessandro Braghieri, Johannes Schulz, Gregory Rakness, Roger Rusack, Marc Dejardin, Robyn Lucas, Garrett Funk, Johannes Hauk, Daniel Gonzalez, P. A. Piroué, Atanu Modak, Bastian Kargoll, Marco Cipriani, Peter Elmer, F. M. Stober, Marcella Diemoz, M. Flechl, Mikhail Dubinin, Wei Li, Wei Xie, Rainer Wallny, Piero Giorgio Verdini, Ivan Amos Cali, A. Carvalho Antunes De Oliveira, Norbert Neumeister, K. H. Lo, Philip Baringer, Enrico Robutti, George Stephans, Dominik Nowatschin, S. Nandan, Pietro Vischia, Fionn Ball, L. Wendland, Francisco Matorras, John A Coughlan, J. M. Vizan Garcia, E. Palencia Cortezon, Gabriella Pugliese, I. Van Parijs, and Jason Gran
Subjects: Quark, Physics, Particle physics, Large Hadron Collider, Luminosity (scattering theory), Mass distribution, 010308 nuclear & particles physics, General Physics and Astronomy, Resonance, 01 natural sciences, Nuclear physics, 0103 physical sciences, Quark–gluon plasma, High Energy Physics::Experiment, 010306 general physics, Compact Muon Solenoid, Boson
Abstract: A search for narrow resonances decaying into dijet final states is performed on data from proton-proton collisions at a center-of-mass energy of 8 TeV, corresponding to an integrated luminosity of 18.8 fb(-1). The data were collected with the CMS detector using a novel technique called data scouting, in which the information associated with these selected events is much reduced, permitting collection of larger data samples. This technique enables CMS to record events containing jets at a rate of 1 kHz, by collecting the data from the high-level-trigger system. In this way, the sensitivity to low-mass resonances is increased significantly, allowing previously inaccessible couplings of new resonances to quarks and gluons to be probed. The resulting dijet mass distribution yields no evidence of narrow resonances. Upper limits are presented on the resonance cross sections as a function of mass, and compared with a variety of models predicting narrow resonances. The limits are translated into upper limits on the coupling of a leptophobic resonance Z'(B) to quarks, improving on the results obtained by previous experiments for the mass range from 500 to 800 GeV.
Published: 2016
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33. Phase II study of gefitinib adaptive dose escalation to skin toxicity in recurrent or metastatic squamous cell carcinoma of the head and neck

Author: Everett E. Vokes, Tanguy Y. Seiwert, Cesar A. Perez, Hunho Song, Ezra E.W. Cohen, Olufunmilayo I. Olopade, Mark Agulnik, Luis E. Raez, Elizabeth A. Blair, Kerstin M. Stenson, Tatyana A. Grushko, and Allison Dekker
Subjects: Oncology, Cancer Research, medicine.medical_specialty, medicine.drug_class, Phases of clinical research, Antineoplastic Agents, Disease-Free Survival, Tyrosine-kinase inhibitor, Gefitinib, Internal medicine, medicine, Carcinoma, Humans, Neoplasm Metastasis, In Situ Hybridization, Fluorescence, Skin, Dose-Response Relationship, Drug, business.industry, Head and neck cancer, medicine.disease, Rash, Clinical trial, Head and Neck Neoplasms, Carcinoma, Squamous Cell, Quinazolines, Neoplasm Recurrence, Local, Oral Surgery, medicine.symptom, business, Progressive disease, medicine.drug
Abstract: Gefitinib has activity in patients with advanced squamous cell carcinoma of the head and neck (SCCHN) and skin toxicity has been postulated to be a predictor of response and improved outcome.This open-label, multi-institution, phase II study evaluated the activity of gefitinib at individually escalated doses up to 750 mg to achieve the skin toxicity grade ≥2.Forty four patients were enrolled. Only twenty-three (52%) experienced skin rash grade ≥2. Of 44 patients, partial responses were noted in 3 (7%), stable disease in 8 (18%) and progressive disease in 33 patients. Median progression-free survival was 1.9 months (95% CI 1.6-2.2) and median overall survival was 5.1 months (95% CI 2.4-7.8). Grade of skin rash was not associated with response rate (p=0.169) nor tumor control rate (p=0.284); however, higher gefitinib trough levels were associated with disease control. Of the 11 tissue samples analyzed for EGFR gene copy by FISH, 7 were EGFR FISH positive, but this was not associated with improved tumor control or survival.Gefitinib has clinical activity as monotherapy in SCCHN. Dose escalation of gefitinib is feasible and may increase skin toxicity, but our data do not support increased activity.
Published: 2012
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34. Superselective retrograde lymphatic duct embolization for management of postoperative lymphatic leak

Author: Kerstin M. Stenson, Bulent Arslan, Abdulrahman Masrani, J. Tasse, and Ulku C. Turba
Subjects: Leak, medicine.medical_specialty, medicine.medical_treatment, 030204 cardiovascular system & hematology, Thoracic duct, Thoracic Duct, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Interventional Radiology, medicine, Lymphatic vessel, Humans, Radiology, Nuclear Medicine and imaging, Embolization, Lymphatic Diseases, business.industry, Lymph duct, Lymphography, Neck dissection, Middle Aged, Embolization, Therapeutic, Surgery, Treatment Outcome, medicine.anatomical_structure, Lymphatic system, Neck Dissection, Female, Radiology, Cardiology and Cardiovascular Medicine, Complication, business
Abstract: Lymphatic leak is a well-documented complication following neck dissection surgeries. When conservative methods fail to control the leak, thoracic duct embolization becomes an option. Transabdominal access is the standard for this procedure; however, it is not always feasible. We discuss a technique of selective lymphatic vessel embolization utilizing retrograde transvenous access.
Published: 2017
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35. Chemoradiation for patients with large-volume laryngeal cancers

Author: Ezra E.W. Cohen, Victoria M. Villaflor, Ellen MacCracken, Everett E. Vokes, Daniel J. Haraf, Elizabeth A. Blair, Tanguy Y. Seiwert, Joseph K. Salama, Rangesh Kunnavakkam, Kerstin M. Stenson, and Louis G. Portugal
Subjects: Adult, medicine.medical_specialty, Laryngeal Cancers, Gastroenterology, Disease-Free Survival, Swallowing, Internal medicine, medicine, Intravascular volume status, Humans, Laryngeal Neoplasms, Aged, Retrospective Studies, Aged, 80 and over, Performance status, business.industry, Head and neck cancer, Cancer, Radiotherapy Dosage, Chemoradiotherapy, Middle Aged, medicine.disease, Surgery, Otorhinolaryngology, Gastrostomy tube, Cohort, Radiotherapy, Intensity-Modulated, Deglutition Disorders, business, Organ Sparing Treatments, Follow-Up Studies
Abstract: Background Patients with T4 laryngeal cancers, including those with large-volume (cartilage or tongue-base invasion) lesions, are often excluded from organ-preservation trials due to expectations of inferior outcome in terms of survival and function. We hypothesize that such patients indeed have acceptable survival and function when treated with organ-preservation strategies. Methods Retrospective analysis of prospectively collected data of a cohort of patients with T4 laryngeal cancer was carried out. Follow-up ranged from 0.18 to 15.6 years. All T4 laryngeal cancer patients who were enrolled in the University of Chicago concomitant chemoradiotherapy protocols from 1994 to the present were reviewed. This study was composed of 80 newly diagnosed T4 laryngeal cancer patients. Efficacy of treatment was determined through evaluations of survival and function. Survival was evaluated via Kaplan–Meier methods. Swallowing function was evaluated by an oropharyngeal motility (OPM) study and swallowing scores were assigned. Higher scores reflected increasing swallowing dysfunction. Results Fifty-five of 80 patients (∼69%) had documented large-volume tumor. Two- and 5-year overall survivals were 60.0% and 48.7%, respectively. Disease-specific 2- and 5-year survivals for the group were 80.1% and 71.3%, and 79.4 and 74.3%, respectively, for the 55 patients with large volume status. Progression-free survival rates were 52.6% and 47.6%. Forty-four of 65 patients (∼68%) with OPM data had a Swallowing Performance Status Scale (SPSS) score of ≤5, indicating various degrees of swallowing abnormalities not requiring a gastrostomy tube. This is a functional-preservation rate of 67.7%. Conclusions Chemoradiation for patients with T4 laryngeal cancer appears to be an effective and reasonable option, particularly in light of the satisfactory survival and function-preservation rates. © 2011 Wiley Periodicals, Inc. Head Neck, 2012
Published: 2011
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36. Phase II trial of pemetrexed-based induction chemotherapy followed by concomitant chemoradiotherapy in previously irradiated patients with squamous cell carcinoma of the head and neck

Author: R. Williams, Everett E. Vokes, Tanguy Y. Seiwert, Joseph K. Salama, P. Beniwal, Alexander Langerman, Louis G. Portugal, Masha Kocherginsky, Allison Dekker, Elizabeth A. Blair, M. E. Witt, Kerstin M. Stenson, G. Gomez-Abuin, Daniel J. Haraf, Ezra E.W. Cohen, and Victoria M. Villaflor
Subjects: Adult, Male, Oncology, medicine.medical_specialty, Guanine, Phases of clinical research, Pemetrexed, Deoxycytidine, chemistry.chemical_compound, Glutamates, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Mucositis, Humans, Prospective Studies, Progression-free survival, Aged, Radiotherapy, Squamous Cell Carcinoma of Head and Neck, business.industry, Induction chemotherapy, Induction Chemotherapy, Hematology, Middle Aged, medicine.disease, Combined Modality Therapy, Gemcitabine, Carboplatin, Surgery, chemistry, Head and Neck Neoplasms, Carcinoma, Squamous Cell, Female, Neoplasm Recurrence, Local, business, Progressive disease, medicine.drug
Abstract: Background Concurrent chemoreirradiation therapy (CRRT) offers a therapeutic option for patients with locoregionally recurrent squamous cell carcinoma of the head and neck (SCCHN). We hypothesized that response to induction chemotherapy (IC) would improve outcome and predict increased survival. Patients and methods Subjects with recurrent SCCHN not amenable to standard therapy were eligible. IC consisted of two 28-day cycles of gemcitabine and pemetrexed on days 1 and 14, followed by surgical resection, if appropriate, and/or CRRT consisting of carboplatin, pemetrexed, and single daily fractionated radiotherapy. Results Thirty-five subjects were enrolled, 31 were assessable for response, with 11 responders [response rate = 35%; 95% confidence interval (CI) 19.2–54.6]. Among 24 subjects who started CRRT, 11 were assessable for radiographic response, 4 complete response, 2 partial response, and 5 progressive disease. Median progression-free survival and overall survival (OS) were 5.5 months (95% CI 3.6–8.3) and 9.5 months (95% CI 7.2–15.4), respectively. One-year OS was 43% (95% CI 26% to 58%). Subjects who responded to IC had improved survival (P = 0.02). Toxic effects included mucositis, dermatitis, neutropenia, infection, hemorrhage, dehydration, and pain. Conclusions The combination of pemetrexed plus gemcitabine was active and well tolerated in recurrent SCCHN. Response to IC may help stratify prognosis and offer an objective and dynamic metric in recurrent SCCHN patients being considered for CRRT.
Published: 2011
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37. A randomized phase II study of 5-fluorouracil, hydroxyurea, and twice-daily radiotherapy compared with bevacizumab plus 5-fluorouracil, hydroxyurea, and twice-daily radiotherapy for intermediate-stage and T4N0-1 head and neck cancers

Author: Everett E. Vokes, Joseph K. Salama, Daniel J. Haraf, Kerstin M. Stenson, M. E. Witt, T. Seiwert, R. Williams, R. Kunnavakkam, Elizabeth A. Blair, and Ezra E.W. Cohen
Subjects: Adult, Male, medicine.medical_specialty, Randomization, Bevacizumab, medicine.medical_treatment, Phases of clinical research, Antibodies, Monoclonal, Humanized, Gastroenterology, Disease-Free Survival, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, Hydroxyurea, Aged, Neoplasm Staging, Aged, 80 and over, Squamous Cell Carcinoma of Head and Neck, business.industry, Head and neck cancer, Radiotherapy Dosage, Hematology, Middle Aged, medicine.disease, Combined Modality Therapy, Surgery, Clinical trial, Radiation therapy, Oncology, Head and Neck Neoplasms, Fluorouracil, Carcinoma, Squamous Cell, Disease Progression, Female, business, Chemoradiotherapy, medicine.drug
Abstract: Introduction We conducted a randomized phase II study to evaluate the impact of adding bevacizumab (B) to 5-fluorouracil (5-FU), hydroxyurea (HU), and radiotherapy (FHX) for intermediate-stage and select T4 head and neck squamous cell cancers (HNSCC). Patients and methods Eligible patients had newly diagnosed HNSCC. Randomization was 2:1 in favor of BFHX. All patients received 500 mg HU p.o. b.i.d., 600 mg/m2/day continuous infusion 5-FU, and b.i.d. radiotherapy with or without bevacizumab 10 mg/kg administered on day 1 of each 14-day cycle. Patients received five cycles consisting of chemoradiotherapy for 5 days followed by 9 days without therapy. Results Twenty-six patients were enrolled (19 BFHX and 7 FHX). The study was halted following unexpected locoregional progression. Two-year survival was 68%; 89% treated with FHX and 58% (95% confidence interval 33% to 78%) treated with BFHX. Two-year locoregional control was 80% after chemoradiotherapy and 85% after surgical salvage. All locoregional progression occurred in T4 tumors randomized to BFHX. Two patients receiving BFHX died during therapy, and one died shortly after therapy. No catastrophic bleeding events were seen. Conclusions Locoregional progression seen in T4N0-1 tumors treated with BFHX was unexpected and led to study termination. The addition of bevacuzimab to chemoradiotherapy for HNSCC should be limited clinical trials.
Published: 2011
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38. Concurrent Chemotherapy and Intensity-Modulated Radiotherapy for Organ Preservation of Locoregionally Advanced Oral Cavity Cancer

Author: Aaron W. Pederson, Daniel J. Haraf, Elizabeth A. Blair, Kerstin M. Stenson, Everett E. Vokes, Mary Ellen Witt, and Joseph K. Salama
Subjects: Adult, Male, Oncology, Cancer Research, medicine.medical_specialty, Osteoradionecrosis, medicine.medical_treatment, Adenocarcinoma, Clinical Trials, Phase II as Topic, Tongue, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Carcinoma, Humans, Hydroxyurea, Oral Cavity Squamous Cell Carcinoma, Survival rate, Aged, Aged, 80 and over, Mouth, Clinical Trials, Phase I as Topic, business.industry, Cancer, Organ Preservation, Middle Aged, medicine.disease, Combined Modality Therapy, Surgery, Survival Rate, Radiation therapy, Regimen, Treatment Outcome, medicine.anatomical_structure, Carcinoma, Squamous Cell, Quality of Life, Female, Mouth Neoplasms, Fluorouracil, Radiotherapy, Intensity-Modulated, business, Follow-Up Studies
Abstract: Objectives: To report outcomes of oral cavity cancer patients treated with concurrent chemotherapy and intensity-modulated radiotherapy (chemoIMRT). Methods: Between 2001 and 2004, 21 patients with oral cavity squamous cell carcinoma underwent definitive chemoIMRT. Sites included were oral tongue (n = 9), floor of mouth (n = 6), buccal mucosa (n = 3), retromolar trigone (n = 2), and hard palate (n = 1). Most had stage III-IV disease (n = 20). The most common regimen was 5 days infusional 5-fluorouracil (600 mg/m2/d × 5 days), hydroxyurea (500 mg, PO BID), and 1.5 Gy twice-daily irradiation to 72 to 75 Gy. Results: The median follow-up for surviving patients was 60 months. Treatment failure occurred as follows: local-1, regional-1, and distant metastases-2. The 2- and 5-year estimates of locoregional progression-free survival, disease-free survival, and overall survival were 90% and 90%, 71% and 71%, and 76% and 76%, respectively. Late complications included osteoradionecrosis (3 patients, 14%). Conclusions: Concurrent chemoIMRT results in promising locoregional control for oral cavity squamous cell carcinomas with acceptable toxicity.
Published: 2011
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39. Prior chemoradiotherapy adversely impacts outcomes of recurrent and second primary head and neck cancer treated with concurrent chemotherapy and reirradiation

Author: Joseph K. Salama, Louis G. Portugal, Kerstin M. Stenson, Kevin S. Choe, Everett E. Vokes, Ezra E.W. Cohen, Abhishek A. Solanki, Tanguy Y. Seiwert, Mary Ellyn Witt, Victoria M. Villaflor, Elizabeth A. Blair, and Daniel J. Haraf
Subjects: Cancer Research, medicine.medical_specialty, business.industry, medicine.medical_treatment, Head and neck cancer, Dose fractionation, Cancer, Retrospective cohort study, medicine.disease, Debulking, Surgery, Radiation therapy, Oncology, Concomitant, medicine, business, Chemoradiotherapy
Abstract: BACKGROUND: It has been shown that concomitant chemotherapy (C) with reirradiation (ReRT) is feasible and effective for select patients with recurrent or second primary head and neck cancer (HNC). To examine potential prognostic factors associated with survival, the authors of this report retrospectively reviewed the outcomes of patients who received CReRT. METHODS: The study cohort comprised previously irradiated patients with nonmetastatic disease from 9 consecutive phase 1 and 2 protocols for poor-prognosis HNC. For all patients, reirradiation (ReRT) was delivered with concurrent chemotherapy. Chemotherapy generally was 5-fluorouracil, hydroxyurea, and a third agent. RESULTS: One hundred sixty-six patients were identified, including 81 patients who underwent surgical resection or debulking before enrollment. The median ReRT dose was 66 gray. After a median follow-up of 53 months among surviving patients, the median overall survival (OS) was 10.3 months. The 2-year rates for OS, disease-free survival, locoregional control, and freedom from distant metastasis were 24.8%, 19.9%, 50.7%, and 61.4%, respectively. Thirty-three patients (19.9%) died of treatment-related toxicity. In subgroup analysis, survival was significantly reduced in patients who received previous concurrent chemoradiotherapy (CRT) compared with patients who were naive to CRT (2-year OS rate, 10.8% vs 28.4%; P = .0043). In multivariable analysis, prior CRT was associated independently with OS along with surgery before protocol treatment, full-dose ReRT, and radiotherapy interval. CONCLUSIONS: CReRT achieved a long-term cure for a small group of patients with recurrent or second primary HNC. Previous treatment with CRT was among the important prognostic factors for survival. Because of the associated risk of severe toxicity, CReRT should be limited only to carefully selected patients. Cancer 2011;. © 2011 American Cancer Society.
Published: 2011
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40. Airway management before chemoradiation for advanced head and neck cancer

Author: Ezra E.W. Cohen, Alexander Langerman, Riddhi M. Patel, Elizabeth A. Blair, and Kerstin M. Stenson
Subjects: Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Tracheotomy, medicine, Humans, Laryngeal Neoplasms, Retrospective Studies, Hypopharyngeal Neoplasms, Squamous Cell Carcinoma of Head and Neck, business.industry, Radiotherapy Dosage, Chemoradiotherapy, Supraglottitis, Airway obstruction, Debulking, medicine.disease, Tongue Neoplasms, Surgery, Airway Obstruction, Airway Compromise, Tumor Debulking, Otorhinolaryngology, Head and Neck Neoplasms, Carcinoma, Squamous Cell, Female, Airway management, Tomography, X-Ray Computed, Airway, business, Algorithms
Abstract: Background Patients with upper aerodigestive tract tumors can have development of airway compromise both before and during chemoradiotherapy (CRT). Tracheotomy is the classic method for securing a safe airway, but tumor debulking may also be used. Methods This was a retrospective review of locoregionally advanced tumors of the base of tongue, larynx, or hypopharynx undergoing CRT between 1995 and 2007. Results Forty-two of the 109 patients presented with signs or symptoms of airway obstruction. Of these, 28 underwent tracheotomy before CRT, and 11 had tumor debulking. Two of the 11 patients who underwent debulking required tracheotomy within 1 year after CRT for persistent edema and fibrosis. Larynx tumors were more likely to require tracheotomy or debulking than other tumors (p = .01). Conclusions Debulking is a safe and effective alternative to tracheotomy in select patients with tumor-related airway obstruction before CRT. Patients who undergo debulking should be monitored closely for recurrence of airway compromise during and after CRT. © 2011 Wiley Periodicals, Inc. Head Neck, 2012
Published: 2011
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41. Scar Bolus Omission During Adjuvant Intensity Modulated Radiation Therapy (IMRT) Does Not Increase Risk of Incisional Recurrence for Oral Cavity Cancers

Author: J. Showel, Mary J. Fidler, C. Hogue, Neilayan Sen, Kerstin M. Stenson, and Samer Al-Khudari
Subjects: Cancer Research, medicine.medical_specialty, Radiation, business.industry, medicine.medical_treatment, Intensity-modulated radiation therapy, Oral cavity, Oncology, medicine, Radiology, Nuclear Medicine and imaging, Radiology, business, Adjuvant, Bolus (radiation therapy)
Published: 2018
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42. Adoption of AJCC 8th Edition for p16+ Oropharynx Cancers May Result in Decreased Utilization of Adjuvant Therapies Due to Shifts in Pathologic Nodal Staging

Author: Neilayan Sen, J.Y. Shin, R. Ghai, Paolo Gattuso, Samer Al-Khudari, Kerstin M. Stenson, Mary J. Fidler, and J. Showel
Subjects: Oncology, Cancer Research, medicine.medical_specialty, Radiation, business.industry, medicine.medical_treatment, Nodal staging, Internal medicine, Oropharynx Cancers, medicine, Radiology, Nuclear Medicine and imaging, business, Adjuvant
Published: 2018
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43. Adjuvant chemotherapy prior to postoperative concurrent chemoradiotherapy for locoregionally advanced head and neck cancer

Author: Kerstin M. Stenson, Ezra E.W. Cohen, Daniel J. Haraf, Joseph K. Salama, Elizabeth A. Blair, Everett E. Vokes, Mary Ellyn Witt, and Kevin S. Choe
Subjects: Adult, Male, Oncology, medicine.medical_specialty, medicine.medical_treatment, Phases of clinical research, Antineoplastic Agents, Disease-Free Survival, chemistry.chemical_compound, Internal medicine, medicine, Humans, Radiology, Nuclear Medicine and imaging, Postoperative Period, Stage (cooking), Aged, Neoplasm Staging, Retrospective Studies, Radiotherapy, business.industry, Head and neck cancer, Induction chemotherapy, Hematology, Middle Aged, medicine.disease, Carboplatin, Surgery, Radiation therapy, Paclitaxel, chemistry, Chemotherapy, Adjuvant, Head and Neck Neoplasms, Female, business, Chemoradiotherapy
Abstract: Background and purpose Induction chemotherapy prior to definitive concurrent chemoradiotherapy (CCRT) is a promising treatment option for unresectable head and neck cancer (HNC). In the postoperative setting, the efficacy of such an approach with adjuvant chemotherapy (AdjCT) followed by postoperative CCRT is unclear. Materials and methods Forty-one postoperative patients with stage III–IV (M0) HNC enrolled on 3 consecutive phase II clinical trials were retrospectively analyzed. Twenty-five of the patients were treated on a protocol which included AdjCT with carboplatin and paclitaxel prior to postoperative CCRT (AdjCT group). Sixteen were treated on protocols with similar postoperative CCRT but without AdjCT (control group). CCRT consisted of paclitaxel, 5-fluorouracil, hydroxyurea, and twice-daily radiotherapy. Results After a median follow-up of 72 months, there were no locoregional failures (LRF) or distant metastases (DM) in the AdjCT group. In the control group, there were 2 LRF and 2 DM. The 5-year risk of disease recurrence was 0% in the AdjCT group, compared to 28.9% in the control group ( p = 0.0074). No patients had disease progression during AdjCT, and all proceeded to postoperative CCRT without delay. Conclusions Adjuvant chemotherapy after surgery followed by CCRT may be a treatment strategy associated with favorable disease outcomes in locoregionally advanced HNC. These results pose a hypothesis which warrants further investigation.
Published: 2010
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44. Epidermal Growth Factor Receptor Inhibitor Gefitinib Added to Chemoradiotherapy in Locally Advanced Head and Neck Cancer

Author: Everett E. Vokes, Allison Dekker, Daniel J. Haraf, Mary Ellyn Witt, Ezra E.W. Cohen, Tatyana A. Grushko, James J. Dignam, Elizabeth A. Blair, R. Williams, Mark W. Lingen, Kerstin M. Stenson, Olufunmilayo I. Olopade, Eric P. Lester, Bruce Brockstein, Joseph K. Salama, and Rangesh Kunnavakkam
Subjects: Male, Oncology, Cancer Research, medicine.medical_specialty, Disease-Free Survival, Drug Administration Schedule, chemistry.chemical_compound, Gefitinib, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Mucositis, Humans, Epidermal growth factor receptor, Aged, Performance status, biology, business.industry, Induction chemotherapy, Middle Aged, medicine.disease, Combined Modality Therapy, Carboplatin, Surgery, ErbB Receptors, chemistry, Head and Neck Neoplasms, Fluorouracil, Quinazolines, biology.protein, Female, business, Chemoradiotherapy, medicine.drug
Abstract: Purpose Assess efficacy and toxicity of gefitinib, an epidermal growth factor receptor (EGFR) inhibitor, added to, and in maintenance after, concurrent chemoradiotherapy (CCRT) in locally advanced head and neck cancer (LA-HNC) and correlate outcomes with EGFR gene copy number alterations. Patients and Methods Patients with stage III to IV LA-HNC received two cycles of carboplatin/paclitaxel induction chemotherapy (IC) followed by split-course CCRT with fluorouracil, hydroxyurea, twice daily radiotherapy (FHX), and gefitinib (250 mg daily) followed by continued gefitinib for 2 years total. The primary end point was complete response (CR) rate after CCRT. EGFR gene copy number was assessed by fluorescent in situ hybridization. Results Sixty-nine patients (66 with stage IV disease, 37 with oropharynx primary tumors, and 67 with performance status 0 to 1) were enrolled with a median age of 55 years. Predominant grade 3 or 4 toxicities during IC and CCRT were neutropenia (n = 20) and in-field mucositis (n = 59) and dermatitis (n = 23), respectively. CR rate after CCRT was 90%. After median follow-up of 3.5 years, 4-year overall, progression-free, and disease-specific survival rates were 74%, 72%, and 89%, respectively. To date, one patient has developed a second primary tumor in the aerodigestive tract. In 31 patients with available tissue, high EGFR gene copy number was associated with worse overall survival (P = .02). Conclusion Gefitinib can be administered with FHX and as maintenance therapy for at least 2 years, demonstrating CR and survival rates that compare favorably with prior experience. High EGFR gene copy number may be associated with poor outcome in patients with LA-HNC treated with this regimen.
Published: 2010
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45. RM-1929 photo-immunotherapy in patients with recurrent head and neck cancer: Results of a multicenter phase 2a open-label clinical trial

Author: David Cognetti, Joseph Curry, Jennifer Johnson, Frank E. Mott, Mary J. Fidler, John Campana, Nilesh R. Vasan, Mohammad Razaq, Kerstin M. Stenson, Samith Thomas Kochuparambil, Ann M. Gillenwater, and Darren McDonald
Subjects: 0301 basic medicine, Oncology, Cancer Research, medicine.medical_specialty, Poor prognosis, business.industry, medicine.medical_treatment, Head and neck cancer, Photoimmunotherapy, Immunotherapy, medicine.disease, Clinical trial, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, 030220 oncology & carcinogenesis, Internal medicine, medicine, In patient, Open label, business
Abstract: 6039Background: Patients with recurrent HNSCC (rHNSCC) have limited therapeutic options and poor prognosis. We report promising results of a Phase 2a trial of photoimmunotherapy (PIT) for the treat...
Published: 2018
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46. Retrograde Endoscopic-Assisted Esophageal Dilation

Author: Alexander Langerman, Mark K. Ferguson, and Kerstin M. Stenson
Subjects: Gastrostomy, medicine.medical_specialty, business.industry, medicine.medical_treatment, fungi, Head and neck cancer, Gastroenterology, food and beverages, medicine.disease, Dilatation, Esophageal dilation, Esophageal stricture, Endoscopic assisted, Esophageal Stenosis, medicine, Humans, Dilation (morphology), Surgery, Esophagoscopy, Radiology, Complication, business, Chemoradiotherapy
Abstract: Esophageal stricture is a well-known complication of chemoradiotherapy for head and neck malignancies. These strictures almost exclusively occur in the cervical esophagus within the field of radiation. For some patients, identification of the esophageal lumen for antegrade dilation of these strictures can be a challenge, and creation of a false lumen can occur during attempts at dilation.We report a method of identifying the esophageal lumen using retrograde esophagoscopy through an existing gastrostomy, thereby allowing confident dilation of an esophageal stricture.The esophagoscope is used to pass a guide wire from below the stricture, and this guide wire is used for bougie dilation of the stricture. Following retrograde dilation, we often place a modified feeding tube to preserve the lumen for future dilation attempts.This method can be used to safely place a guide wire for dilation in patients who have a difficult cervical esophageal stricture and an established gastrostomy.
Published: 2010
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47. A Phase 2a, Multicenter, Open-Label Study of RM-1929 Photoimmunotherapy in Patients With Recurrent Head And Neck Cancer

Author: Joseph Curry, W.N. William, D. McDonald, J. Campana, David Cognetti, Mohammad Razaq, Ann M. Gillenwater, Jennifer Johnson, Kerstin M. Stenson, Nilesh R. Vasan, S.T. Kochuparambil, and Mary J. Fidler
Subjects: 0301 basic medicine, Cancer Research, medicine.medical_specialty, Radiation, business.industry, Head and neck cancer, Photoimmunotherapy, medicine.disease, 03 medical and health sciences, 030104 developmental biology, 0302 clinical medicine, Oncology, Open label study, 030220 oncology & carcinogenesis, Medicine, Radiology, Nuclear Medicine and imaging, In patient, Radiology, business
Published: 2018
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48. Induction chemotherapy and concurrent chemoradiotherapy for locoregionally advanced head and neck cancer: a multi-institutional phase II trial investigating three radiotherapy dose levels

Author: Bruce Brockstein, E.O. Kistner, Everett E. Vokes, Fred R. Rosen, Ezra E.W. Cohen, Bharat B. Mittal, M. E. Witt, Athanassios Argiris, Kerstin M. Stenson, Joseph K. Salama, and Daniel J. Haraf
Subjects: Adult, Male, Oncology, medicine.medical_specialty, Paclitaxel, medicine.medical_treatment, Phases of clinical research, Disease-Free Survival, Carboplatin, Cohort Studies, chemistry.chemical_compound, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, Hydroxyurea, Aged, Neoplasm Staging, business.industry, Remission Induction, Head and neck cancer, Induction chemotherapy, Dose-Response Relationship, Radiation, Hematology, Middle Aged, medicine.disease, Combined Modality Therapy, Radiation therapy, chemistry, Head and Neck Neoplasms, Cohort, Carcinoma, Squamous Cell, Female, Fluorouracil, Nuclear medicine, business, Chemoradiotherapy, Cohort study
Abstract: Background We hypothesized induction chemotherapy (IndCT) would improve distant control (DC) without compromising locoregional control (LRC) for locoregionally advanced head and neck cancer patients. Additionally, we systematically lowered radiotherapy (RT) doses attempting to maintain LRC while decreasing toxicity. Patients and methods Stages III–IV (M0) locoregionally advanced head and neck cancer patients received carboplatin/paclitaxel (Taxol) IndCT followed by four or five cycles consisting of 5 days of paclitaxel, fluorouracil, hydroxyurea, and BID RT followed by a nine day break. RT dose to gross disease (high risk), intermediate, and low-risk volumes were reduced from cohort A (n = 68): 75, 60, and 45 Gy; to cohort B (n = 64): 75, 54, and 39 Gy; then cohort C (n = 90): 72, 51, and 36 Gy. Results A total of 222 patients accrued from November 1998 to September 2002. Median follow-up is 56 months. In all, 93/96/76% achieved a complete response to concurrent chemoradiotherapy (CRT) in cohort A/B/C. Three- and 5-year overall survivals (OSs) are 68% and 62%, respectively. Five-year LRC and DC are 91% and 87%, respectively. Response to IndCT predicted for OS, LRC, and time to progression (TTP). Cohort C patients had similar OS (P = 0.95), LRC, and DC, but worse (TTP) (P = 0.027). Conclusions IndCT before CRT reduces distant progression while maintaining high LRC. The cohort B schedule provides the best therapeutic ratio. A randomized trial investigating IndCT before CRT has been initiated.
Published: 2008
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49. Functional organ preservation with definitive chemoradiotherapy for T4 laryngeal squamous cell carcinoma

Author: Joseph K. Salama, Kerstin M. Stenson, B.R. Knab, Ezra E.W. Cohen, Abhishek A. Solanki, Everett E. Vokes, Daniel J. Haraf, and M. E. Witt
Subjects: Adult, Male, Oncology, medicine.medical_specialty, Paclitaxel, medicine.medical_treatment, Kaplan-Meier Estimate, Risk Assessment, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Carcinoma, Humans, Hydroxyurea, Laryngeal Neoplasms, Aged, Neoplasm Staging, Probability, Retrospective Studies, business.industry, Standard treatment, Head and neck cancer, Cancer, Induction chemotherapy, Radiotherapy Dosage, Organ Preservation, Hematology, Middle Aged, medicine.disease, Combined Modality Therapy, Immunohistochemistry, Survival Analysis, Laryngectomy, Radiation therapy, Treatment Outcome, Area Under Curve, Carcinoma, Squamous Cell, Quality of Life, Female, Fluorouracil, business, Chemoradiotherapy, Follow-Up Studies
Abstract: Background Randomized trials established chemoradiotherapy as standard treatment for advanced laryngeal cancer. Patients with large-volume T4 disease (LVT4) were excluded from these trials. The purpose of this study was to report T4 laryngeal cancer patient outcome, including those with LVT4 disease, treated with chemoradiotherapy. Patients and methods This study is a retrospective subset analysis of 32 patients with T4 laryngeal carcinoma including LVT4 tumors treated on three consecutive protocols investigating paclitaxel (Taxol), 5-fluorouracil, hydroxyurea, and 1.5-Gy twice daily (BID) radiotherapy (TFHX). Results Median follow-up is 43 months. Four-year locoregional control (LRC), disease-free survival (DFS), overall survival (OS), and laryngectomy-free survival (LFS) was 71%, 67%, 53%, and 86%, respectively. Four patients required laryngectomy for recurrent or persistent disease. Of disease-free patients with ≥1 year follow-up, 90% demonstrated normal or understandable speech. None required laryngectomy for complications. Among LVT4 patients, 4-year LRC, DFS, OS, and LFS was 71%, 65%, 56%, and 81%, respectively. Induction chemotherapy improved 4-year LRC (90% versus 46%, P = 0.03) and DFS (84% versus 42%, P = 0.03). Conclusions Promising control and functional outcomes are achieved with TFHX for T4 laryngeal patients. LVT4 disease had outcomes similar to patients with less advanced disease treated on Radiation Therapy Oncology Group 91-11. Induction chemotherapy improved outcomes, warranting further investigation.
Published: 2008
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50. The Thoracoacromial Trunk: Alternative Recipient Vessels in Reoperative Head and Neck Reconstructive Microsurgery

Author: Joyce K. Aycock, Lawrence J. Gottlieb, and Kerstin M. Stenson
Subjects: Adult, Male, Reoperation, Microsurgery, medicine.medical_specialty, medicine.medical_treatment, Anastomosis, Surgical Flaps, Thoracic Arteries, Reconstructive microsurgery, Humans, Medicine, Head and neck, Aged, Aged, 80 and over, Radiotherapy, business.industry, Microcirculation, Anastomosis, Surgical, Head and neck cancer, Middle Aged, Plastic Surgery Procedures, medicine.disease, Trunk, Surgery, medicine.anatomical_structure, Head and Neck Neoplasms, Microvascular anastomosis, Female, business, Blood vessel
Abstract: Reoperative free tissue transfer in head and neck cancer patients is often a challenging endeavor. Finding adequate recipient vessels for microvascular anastomosis can be difficult, as scar is present from previous surgery and irradiation, and the usual recipient vessels may have been damaged or sacrificed.Seventeen consecutive cases of head and neck reconstruction with free tissue transfer using the thoracoacromial vessels as the recipient pedicle were reviewed. Clinical data were analyzed, including indication for surgery, preoperative radiation dose, previous pectoralis major myofascial flap, free flap design, operative technique, perioperative complications, and follow-up.Of the 17 cases of free tissue transfer using thoracoacromial vessels for anastomosis, 13 flaps were performed in 12 patients who had received double irradiation. Twelve thoracoacromial trunks used as recipient vessels were in patients with transferred pectoral myofascial flaps. Anastomotic patency was achieved in all flaps.The thoracoacromial trunk is a good alternative for recipient vessels in reoperative reconstructive microsurgery of the head and neck when first-line vessels are not available. This choice of vessels is feasible whether or not a pectoralis myofascial flap has previously been used.
Published: 2008
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