Otolaryngology (ENT)

Postoperative primary-bed SBRT achieves high control with low severe late toxicity in early OCSCC/OPSCC

This phase 2 multicenter trial treated 90 patients with pT1–2 OCSCC/OPSCC, close or positive margins, and no neck RT indication using postoperative SBRT to the bed only. SBRT was 36 Gy in 6 fractions over 2 weeks with VMAT or CyberKnife and image guidance. At 2 years, grade ≥3 late toxicity occurred in 2.2%, while 14.6% experienced any grade 3 late event, mainly transient necrosis or osteoradionecrosis. Two-year local control was 92.0%, and severe acute toxicity was largely limited to mucositis resolving by 3 months. 1

Serial tumor-informed ctDNA provides early molecular relapse signal in resected HNSCC

Seventy-six HNSCC patients had tumor-informed ctDNA measured longitudinally in 656 plasma and 128 saliva samples before and after curative surgery. High preoperative ctDNA shedding correlated with advanced pathologic stage, nodal disease, adverse histology, and molecular features including PD-1 expression and high tumor mutational burden. Postoperative plasma ctDNA detected at least 14 days after surgery identified 91.3% of recurrences, sometimes up to 500 days before clinical confirmation. Transcriptomic data linked high shedding to increased proliferation, EGFR/MAPK pathway activity, and invasion-metastasis gene expression. 2

WPOI-5 identifies early oral SCC patients who appear to benefit from adjuvant radiotherapy

This international cohort included 1374 OSCC patients treated with upfront curative resection across 14 institutions. WPOI 5 was associated with worse 3-year disease-free survival, locoregional control, and overall survival versus WPOI 1–4 on univariable analysis. In pT1–2N0 patients managed with surgery alone, WPOI-5 independently predicted poorer DFS, OS, and locoregional control after correcting for selection bias. Interaction modeling suggested adjuvant radiotherapy significantly reduced DFS and locoregional failure risk in early-stage WPOI-5 cases. 3

Real-world mepolizumab yields sustained 52-week improvements in severe CRSwNP

This retrospective registry analyzed 110 severe CRSwNP patients from 12 European tertiary centers, most with comorbid asthma, treated with mepolizumab up to 52 weeks. Nasal polyp scores, SNOT-22, and VAS symptom scores improved significantly at 24 weeks and continued improving through 52 weeks. Asthma Control Test scores increased, with many patients reaching well-controlled asthma by week 24. By EUFOREA criteria, 85.6% and 78.7% met at least one response criterion at 24 and 52 weeks, respectively. 4