Multi-institutional retrospective study of mucoepidermoid carcinoma treated with carbon-ion radiotherapy.

This study aimed to evaluate the clinical outcomes of patients with mucoepidermoid carcinomas in the head and neck treated with carbon-ion radiotherapy. Data from 26 patients who underwent carbon-ion radiotherapy in four facilities were analyzed in this multi-institutional retrospective study: the Japan Carbon-ion Radiation Oncology Study Group. The median follow-up time was 34 months. One patient experienced local recurrence, and the 3-year local control rate was 95%. One patient developed lymph node recurrence and five developed distant metastases. The 3-year progression-free survival rate was 73%. Five patients died, two of mucoepidermoid carcinoma and three of intercurrent disease. The 3-year overall survival rate was 89%. Acute mucositis and dermatitis of grade 3 or higher were experienced by 19% and 8% of patients, respectively; these improved with conservative therapy. Late mucositis and osteonecrosis of jaw were observed in 12% and 23% of patients, respectively. The 3-year cumulative rate of any late adverse event of grade 3 or higher was 14%. None of the patients died of the acute or late adverse events. Carbon-ion radiotherapy was efficacious and safe for treating mucoepidermoid carcinoma in this multi-institutional retrospective study (registration no. UMIN000024473). We are currently undertaking a prospective multicenter study.

Daily Intake of Heat-killed Lactobacillus plantarum L-137 Decreases the Probing Depth in Patients Undergoing Supportive Periodontal Therapy.

PURPOSE: Heat-killed Lactobacillus plantarum L-137 (HK L-137) has been shown to activate innate and acquired immunity in humans. The aim of this randomised, double-blind, placebo-controlled clinical trial was to examine the effects of the oral administration of HK L-137 on the outcome of periodontal therapy. MATERIALS AND METHODS: Thirty-nine patients undergoing supportive periodontal therapy (SPT) were randomly assigned to receive a capsule containing 10 mg of HK L-137 or a placebo capsule daily for 12 weeks. Nineteen patients in the experimental group and 17 patients in the control group were followed-up. Clinical parameters, including plaque index (PI), gingival index (GI), bleeding on probing (BOP), and probing depth (PD) were scored at baseline and weeks 4, 8 and 12 prior to prophylaxis in conjunction with regular SPT visits. RESULTS: BOP and the number of teeth or sites with PD ≥ 4 mm were significantly reduced in both groups by a successive SPT programme, while there was significantly greater PD reduction (p < 0.05) at teeth with site(s) with PD ≥ 4 mm at baseline in the experimental group than in the control group at week 12. CONCLUSION: These clinical findings suggest that daily HK L-137 intake can decrease the depth of periodontal pockets in patients undergoing supportive periodontal therapy.

A multi-institutional retrospective study of carbon-ion radiotherapy for non-squamous cell malignant tumors of the nasopharynx: Subanalysis of Japan Carbon-Ion Radiation Oncology Study Group study 1402 HN.

BACKGROUND: This multi-institutional retrospective study focused on the clinical outcome of carbon-ion radiotherapy (C-ion RT) for non-squamous cell malignant tumors of the nasopharynx. METHODS: The Japan Carbon-ion Radiation Oncology Study Group collected and analyzed data for 43 patients with non-squamous cell malignant tumors of the nasopharynx treated with C-ion RT at four institutions in Japan. RESULTS: Twenty-nine patients had adenoid cystic carcinomas, seven had malignant melanomas, three had adenocarcinomas, two had mucoepidermoid carcinomas, and two had other pathologies. Twenty-six of the 43 patients (61%) had T4 tumors. The most common dose-fractionation schedule was 64 Gy (relative biological effectiveness) in 16 fractions. The median follow-up period was 30 months. The 2-year local control (LC) and overall survival (OS) rates were 88% and 84%, respectively. For late toxicity, one patient developed grade 4 optic nerve disorder and two developed grade 5 pharyngeal hemorrhage. Actual incidence of grade 3 or higher late adverse events was 19%, and included cranial nerve dysfunction, jaw bone necrosis, central nervous system necrosis, and ear inflammation. CONCLUSIONS: C-ion RT provided good LC and OS rates with acceptable toxicity for treatment of non-squamous cell malignant tumors of the nasopharynx.

Multicenter Study of Carbon-Ion Radiation Therapy for Adenoid Cystic Carcinoma of the Head and Neck: Subanalysis of the Japan Carbon-Ion Radiation Oncology Study Group (J-CROS) Study (1402 HN).

PURPOSE: To retrospectively analyze the treatment outcomes of carbon-ion radiation therapy for adenoid cystic carcinoma (ACC) of the head and neck at 4 active carbon-ion facilities in Japan. METHODS AND MATERIALS: A total of 289 patients who underwent carbon-ion radiation therapy for histology-proven ACC of the head and neck at 4 institutions in Japan between November 2003 and December 2014 were included in this study. RESULTS: Median patient age was 58 years (range, 12-83 years). Tumor sites included the nasal cavity and paranasal sinuses (42%), nasopharynx and oropharynx (19%), oral cavity (12%), major salivary glands (12%), and others (15%). Tumor classifications were T4 in 200 (69%) patients, T3 in 45 (16%), T2 in 22 (8%), T1 in 15 (5%), and unclassified in 7 (2%). The median total dose was 64 Gy (relative biological effectiveness [RBE]; range, 55.2-70.4 Gy [RBE]) in 16 fractions (range, 12-32 fractions). Median follow-up time was 30 months (range, 2-118 months). The 2-year overall survival, progression-free survival, and local control rates were 94%, 68%, and 88%, respectively. Estimated 5-year overall survival, progression-free survival, and local control rates were 74%, 44%, and 68%, respectively. In all, 43 patients (15%) experienced grade ≥3 late toxicity, of which osteonecrosis of the jaw bone was the most common. Two patients treated for nasopharyngeal ACC died from a bleeding ulcer at the tumor site (grade 5 toxicity). CONCLUSIONS: Carbon-ion radiation therapy seems to be a promising treatment for ACC of the head and neck.

Prevalence and risk factors for peri-implant diseases in Japanese adult dental patients.

We investigated the prevalences and risk factors for peri-implant diseases in Japanese adult dental patients attending a follow-up visit at dental hospitals or clinics as part of their maintenance program. This cross-sectional multicenter study enrolled patients with dental implants who attended regular check-ups as part of a periodontal maintenance program during the period from October 2012 through September 2013. Patients with implants with at least 3 years of loading time were included in the study. The condition of peri-implant tissue was examined and classified into the following categories: healthy, peri-implant mucositis, and peri-implantitis. Patients were also evaluated for implant risk factors. A total of 267 patients (110 men, 157 women; mean age: 62.5 ± 10.7 years) were analyzed. The prevalence of patient-based peri-implant mucositis was 33.3% (n = 89), and the prevalence of peri-implantitis was 9.7% (n = 26). Poor oral hygiene and a history of periodontitis were strong risk factors for peri-implant disease. The present prevalences were lower than those previously reported. The quality of periodontal therapy before and after implant installation and patient compliance and motivation, as indicated by plaque control level, appear to be important in maintaining peri-implant tissue health.

The influence of ß-tricalcium phosphate blocks containing extracellular matrix on osteogenic differentiation of rat bone marrow stromal cells.

BACKGROUND: The aim of the present study is to assess the osteogenic differentiation of rat bone marrow stromal cells (RBMCs) in ß-tricalcium phosphate (ß-TCP) blocks containing extracellular matrix (ECM) produced by human alveolar bone periosteal cells (HABPCs). METHODS: HABPCs were cultured in ß-TCP blocks for 1 week (group 1) and 2 weeks (group 2). ß-TCP blocks containing ECM were then created by drying the blocks for 3 days. RBMCs were cultured in the blocks containing ECM for 2 weeks. In the control group, RBMCs were cultured in ß-TCP blocks alone for 2 weeks. HABPCs and RBMCs in the blocks were examined by histologic and immunohistochemical analyses. RESULTS: Histology revealed a significantly higher number of HABPCs in the group 2 blocks than in the group 1 blocks. HABPCs produced several bone matrix proteins in the blocks, and these positive reactions in group 2 were significantly higher than in group 1. Both groups showed a significantly higher number of RBMCs than the control group. RBMCs produced osteopontin and osteocalcin in the blocks, and these positive reactions were significantly higher in both test groups than in the control group. The number of osteocalcin-positive reactions was higher in group 2 than in group 1. CONCLUSION: Osteogenic differentiation of RBMCs cultured for 2 weeks in ß-TCP blocks containing ECM was significantly higher than that of cells cultured for 1 week or without ECM.