Projects / Programmes
Cancer of the head and neck - analysis of biological characteristics and an attempt to improve treatment results
January 1, 2014
- December 31, 2018
| Code |
Science |
Field |
Subfield |
| 3.04.00 |
Medical sciences |
Oncology |
|
| Code |
Science |
Field |
| B000 |
Biomedical sciences |
|
| Code |
Science |
Field |
| 3.02 |
Medical and Health Sciences |
Clinical medicine |
Researchers (20)
Organisations (2)
Abstract
Proposed research program consists of 4 work packages of themes dealing with problems important for patients with cancer of the head and neck (CHN), not properly addressed in the literature or being new.
WP1. New approaches to treatment
Studies are focused at identification of patients who are candidates for individual treatment regimens and at implementation of new treatment methods.
Theme 1: Assessment of skin reaction (rash) after targeted therapy with cetuximab and radiotherapy as a predictive marker for treatment efficacy (prospective phase II clinical study).
Theme 2: Evaluation of changes in MR- diffusion and perfusion parameters during radiochemotherapy as markers predictive for early tumor response to therapy (prospective clinical study).
Theme 3: Assessment of possible implementation of electrochemotherapy as a new mode of treatment for selected tumors of the head and neck (prospective phase I-II pilot study).
WP2. Adverse effects of oncological treatment
Studies are focused at analysis of functional impairments of upper aerodigestive organs (breathing, swallowing, speech) after oncological treatment and at assessment of chances for prevention and rehabilitation.
Theme 1: Systematic assessment (subjective, objective) of breathing, swallowing and speech in patients treated for CHN with analysis of factors affecting these functions (prospective clinical study).
Theme 2: Options of prevention and early rehabilitation (simulation dosimetric studies, implementation and prospective evaluation of new methods).
WP3. Human papillomavirus (HPV)
Studies are focused at comprehensive assessment (epidemiological, clinical) of problem related to HPV-positive CHN.
Theme 1: Assessment of epidemiological situation and clinical study on the influence of HPV-positive CHN in Slovenian population (epidemiological analysis of Cancer Registry for Slovenia database and retrospective clinical and histopathological study).
Theme 2: Evaluation of possibilities for intensity de-escalation of non-surgical treatment in HPV-positive CHN (in vitro and in vivo study).
WP4. Nutritional status
Studies are focused at investigation of relationship between nutritional status and efficacy/toxicity of oncological treatment and at assessment of methods for recognition and prediction of malnutrition development.
Theme 1: Assessment of the impact of nutritional parameters to efficacy and toxicity of oncological treatment (prospective cohort study).
Theme 2: Comparison of different methods for recognition and prediction of development of different malnutrition stages in patients with CHN (prospective clinical study).
Significance for science
Studies, planned in frame of the program, are important for development of science.
1. New approaches to treatment
Evaluation of predictive value of skin reaction to cetuximab (Theme 1) and assessment of early tumor response to treatment with radiochemotherapy by MR-diffusion and perfusion (Theme 2) are from scientific point original approaches to the problem of personalized medicine. Only preliminary/early identification of patients who are candidates for individual type of treatment (because for them the effect of treatment would be either significant or absent and they should be treated differently) allows optimal utilization of treatment capacities and best effect/toxicity ratio for individual patient.
Electrochemotherapy (Theme 3) is not an established treatment method in head and neck cancer. Systematic assessment of its possible utilization in this type of cancer represents an original contribution to the science.
1 Adverse effects of oncological treatment
Prospective, systematic and multidimensional analysis of functional parameters of breathing, swallowing and speech in appropriately homogenous groups of oncological patients will allow detailed insight into impairments resulted from malignant disease itself and from different types of treatment, which is topic neglected in the literature (Theme 1). The same holds true for simulation studies of dose distribution (Theme 2). This way, important information will be obtained which can be used as an objective basis for planning preventive measures and rehabilitation.
3. Human papillomavirus (HPV)
As one of the most important etiological factors in squamous cell carcinoma of the head and neck, particularly of the oropharynx, and as a causative factor for modulation of tumor response to treatment, the HPV represents one of the central topics in head and neck oncology. An epidemiological and clinical/histopathological snap-shot of situation in Slovenia (Theme 1) will provide missing information in European database. Preclinical study on causes for increased sensitivity of HPV-positive tumors for non-surgical modes of treatment and possibilities for intensity modulation of existing non-surgical therapies (Theme 2) represents an original contribution to studies of one of the most up-to-date topics at the moment.
4. Nutritional status
Evaluation of relationship between nutritional status and effects of oncological treatment (Theme 1) is focused at the identification of nutritional status parameters predictive for successful termination of planned treatment in respect to its intensity (i.e. efficacy) and toxicity (i.e. compliance). From this point of view, the study belongs to the field of treatment personalization. Comparison of different methods for recognition and prediction of various malnutrition stages (Theme 2) is also an original contribution to the science in the field of nutrition. We anticipate that study results will allow early (in time, i.e. before treatment) identification of patients who need more intensive nutritional counseling and support.
Significance for the country
Studies focused at individual management of patients (assessment of early tumor response to treatment on basis of skin reaction to cetuximab and MR-diffusion and perfusion) allow more targeted and individual patient-adjusted treatment. Namely, it is of paramount importance to treat with sufficient intensity and with appropriate modes of therapy patients with more aggressive forms of the disease (to avoid disease recurrences), while treating the rest less intensively (to save them from excessive toxicity). Also the studies in the field of nutritional status of patients and its influence to treatment outcome allow better selection of patients for individual treatment programs. If proved effective and safe, electrochemotherapy might represent an additional treatment option for selected patients. Prospective recording and detailed analysis of treatment effects to breathing, swallowing and speech gives a solid basis for creation of guidelines for introduction of preventive measures, early rehabilitation and appropriate supportive therapies which will alleviate confrontation of the patients with disease and treatment. Complex assessment of situation on HPV infection in patients with cancer of the head and neck in Slovenia will allow comprehensive insight into this problem on national level. We can claim this study to be of national interest.
The extension and renewal of therapeutic and diagnostic offer with more focused (to distinct, i.e. targeted groups of patients) and complex protocols means a greater competitive ability of local oncological community (in relation to abroad). This is linked to demand for increase in the number of medical doctors nursing and other professional staff (due to more demanding diagnostics, treatment and control of adverse effects), upgrade of their educational profile, technological restructuring of activities (diagnostics and radiotherapy in particular) and introduction/wide accessability to new technologies (MRI, CT, 3D-radiotherapy). Activities of the program group members directed to public awareness (internet, lectures, assistance/collaboration with laic patients’ associations) will contribute to the changes in the attitude and consciousness of civil society about the danger of this particular cancer type and difficulties in its treatment, which will stimulate development of some social activities (e.g. volunteers, social-work centers). Pedagogical activity of the programme group members at undergraduate and postgraduate level (academic, specialistic) will improve the knowledge of current and future professionals about the disease and potential treatment options. Final result of all these efforts should be more cured patients and better quality of their life.
Every new finding of indigenous researchers that belongs to either the field of tumor biology or clinically oriented topics of the program, which find confirmation abroad will strengthen their self-confidence and contribute to consolidation of national identity.
Most important scientific results
Annual report
2014,
2015,
final report
Most important socioeconomically and culturally relevant results
Annual report
2014,
2015,
final report
