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1.
Int J Clin Oncol ; 29(6): 764-770, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38555323

ABSTRACT

BACKGROUND: Pembrolizumab alone or combined with chemotherapy is the standard of care for first-line treatment of patients with recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC) with positive programmed death-ligand 1 combined positive scores. However, data on second-line chemotherapy following pembrolizumab are scarce. METHODS: A single-center, retrospective study was conducted to determine the efficacies of pembrolizumab and pembrolizumab plus chemotherapy as first-line treatments and the efficacy of second-line chemotherapy for patients with R/M HNSCC who were refractory or intolerant to first-line treatment. RESULTS: Fifty-four patients were treated with pembrolizumab, and 29 received second-line therapy, with 27 opting for cetuximab-containing regimens. The median progression-free survival (PFS), overall survival (OS), and PFS on next-line therapy for first-line treatment were 4.7 (95% confidence interval [CI], 2.1-8.7), 22.1 (95% CI, 12.6-not reached), and 15.6 months (95% CI, 9.7-not reached) in the pembrolizumab group and 5.4 (95% CI, 3.3-6.8), 15.8 (95% CI, 8.6-not reached), and 13.7 months (95% CI, 8.1-not reached) in the pembrolizumab plus chemotherapy group, respectively. The overall response rate and median PFS for second-line treatment were 48.3% (95% CI, 30.4-67.0) and 6.1 months (95% CI, 2.30-8.84). The median OS for patients who received second-line treatment was 18.4 months, which was superior to the median OS of 6.0 months for patients who received the best supportive care (log-rank p = 0.10). CONCLUSION: This study indicates that cetuximab-containing second-line chemotherapy can improve outcomes in R/M HNSCC, even after first-line therapy failure or intolerance.


Subject(s)
Antibodies, Monoclonal, Humanized , Antineoplastic Combined Chemotherapy Protocols , Head and Neck Neoplasms , Neoplasm Recurrence, Local , Squamous Cell Carcinoma of Head and Neck , Humans , Antibodies, Monoclonal, Humanized/therapeutic use , Antibodies, Monoclonal, Humanized/administration & dosage , Male , Female , Middle Aged , Squamous Cell Carcinoma of Head and Neck/drug therapy , Squamous Cell Carcinoma of Head and Neck/mortality , Retrospective Studies , Aged , Head and Neck Neoplasms/drug therapy , Head and Neck Neoplasms/mortality , Head and Neck Neoplasms/pathology , Neoplasm Recurrence, Local/drug therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Adult , Progression-Free Survival , Aged, 80 and over
2.
Cancer Sci ; 112(1): 339-346, 2021 Jan.
Article in English | MEDLINE | ID: mdl-33078505

ABSTRACT

Although nivolumab, a programmed cell death 1 (PD-1) inhibitor, is a standard therapy for platinum-refractory recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC), no definitive biomarkers have been reported thus far. This study aimed to select promising prognostic markers in nivolumab therapy and to create a novel prognostic scoring system. In this retrospective cohort study, we reviewed patients with R/M HNSCC who were treated with nivolumab from April 2017 to April 2019. We developed a prognostic score for immune checkpoint inhibitor (ICI) therapy that was weighed using hazard ratio-based scoring algorithms. Significant variables were selected from the multivariate Cox proportional hazard analyses on overall survival (OS). A total of 85 patients with HNSCC were analyzed in the present study. The relative eosinophil count (REC), the ratio of eosinophil increase (REI), and Eastern Cooperative Oncology Group Performance Status (ECOG PS) were selected as variables affecting the prognostic score. The patients were divided into four groups: very good (score = 0), good (score = 1), intermediate (score = 2), and poor (score = 3). The OS hazard ratios were 2.77, 10.18, and 33.21 for the good, intermediate, and poor risk groups compared with the very good risk group, respectively. The Eosinophil Prognostic Score is a novel prognostic score that is effective for predicting the prognosis of HNSCC patients treated with nivolumab. This score is more precise as it includes changes in biomarkers before and after the treatment.


Subject(s)
Antineoplastic Agents, Immunological/therapeutic use , Biomarkers, Tumor/blood , Eosinophils , Head and Neck Neoplasms/drug therapy , Nivolumab/therapeutic use , Squamous Cell Carcinoma of Head and Neck/drug therapy , Adult , Aged , Female , Head and Neck Neoplasms/blood , Humans , Leukocyte Count , Male , Middle Aged , Prognosis , Retrospective Studies , Squamous Cell Carcinoma of Head and Neck/blood
3.
BMC Cancer ; 21(1): 1186, 2021 Nov 06.
Article in English | MEDLINE | ID: mdl-34742280

ABSTRACT

BACKGROUND: We investigate whether pathological continuous variables of lymph nodes were related with survival results of carcinomas of minor salivary gland carcinoma in head and neck. METHODS: Forty-four cases with minor salivary gland carcinoma who underwent both primary resection and neck dissection were retrospectively enrolled. The pathological continuous variables were evaluated by the number of positive lymph nodes, lymph node ratio, and log odds of positive lymph nodes. Receiver operating curve analysis was used for the cut-off values of the carcinoma-specific death. Log-rank test and Cox's proportional hazards model were used for uni-/multi-variate survival analyses adjusting for pathological stage, respectively. RESULTS: Lymph node ratio = 0.05 as well as log odds of positive lymph nodes = - 2.73 predicted the carcinoma-specific death. Both lymph node ratio and log odds of positive lymph nodes were significantly related with survival outcomes by the univariate analysis. Lymph node ratio ≥ 0.05 was associated with shorter disease-specific (hazard ratio = 7.90, 95% confidence interval = 1.54-57.1), disease-free (hazard ratio = 4.15, 95% confidence interval = 1.48-11.2) and overall (hazard ratio = 4.84, 95% confidence interval = 1.05-24.8) survival in the multivariate analysis. CONCLUSION: A higher lymph node ratio of minor salivary gland carcinoma is a predictor of shorter survival results.


Subject(s)
Lymph Node Ratio , Salivary Gland Neoplasms/mortality , Salivary Gland Neoplasms/pathology , Salivary Glands, Minor/pathology , Confidence Intervals , Female , Humans , Lymph Nodes/pathology , Male , Middle Aged , Neck Dissection , Proportional Hazards Models , ROC Curve , Retrospective Studies , Salivary Gland Neoplasms/surgery , Salivary Glands, Minor/surgery , Survival Analysis
4.
Int J Clin Oncol ; 26(7): 1188-1195, 2021 Jul.
Article in English | MEDLINE | ID: mdl-33821363

ABSTRACT

BACKGROUND: Until the emergence of immune checkpoint inhibitors, the EXTREME regimen comprising platinum-based chemotherapy plus cetuximab was the standard of care for recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC). Recent reports suggest the usefulness of regimens including taxanes in combination with cetuximab as treatment options for R/M HNSCC patients with contraindications for platinum. However, comparisons of weekly paclitaxel plus cetuximab (wPTX-Cmab) to the EXTREME regimen are limited. MATERIALS AND METHODS: We compared the clinical impact of wPTX-Cmab to EXTREME as first line treatment for R/M HNSCC in Aichi Cancer Center Hospital. The primary outcome was overall survival (OS) and secondary outcomes were progression-free survival (PFS), overall response rate (ORR) and disease control rate (DCR). Propensity score-adjusted Cox proportional hazard models were used to determine hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: From 2012 to 2018, 77 patients, including 55 treated with EXTREME and 22 refractory or intolerant to platinum treated with wPTX-Cmab, were analyzed. wPTX-Cmab was comparable to EXTREME on OS [adjusted HR 0.82 (95% CI 0.39-1.48)], PFS [adjusted HR 0.90 (95% CI 0.49-1.65)], ORR [wPTX-Cmab 34.7% (12-43), EXTREME 30.9% (18-43), p = 0.877] and DCR [wPTX-Cmab 72.7% (52-92), EXTREME 65.4% (52-78), p = 0.337]. Survival trends remained similar after stratification by platinum-refractory or intolerance status. Disease control with wPTX-Cmab was significantly associated with better OS [adjusted HR 0.18 (0.05-0.57)]. CONCLUSION: wPTX-Cmab may be a suitable treatment option for R/M HNSCC patients with contraindications for platinum.


Subject(s)
Head and Neck Neoplasms , Paclitaxel , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Cetuximab/therapeutic use , Head and Neck Neoplasms/drug therapy , Humans , Neoplasm Recurrence, Local/drug therapy , Paclitaxel/therapeutic use , Squamous Cell Carcinoma of Head and Neck/drug therapy
5.
Cancer ; 124(1): 118-124, 2018 Jan 01.
Article in English | MEDLINE | ID: mdl-28881386

ABSTRACT

BACKGROUND: Major salivary gland cancers (M-SGCs) are rare, and have distinct heterogeneous histopathological subtypes. To the authors' knowledge, no consistent evidence of an association between cigarette smoking and the risk of M-SGCs has appeared to date. Furthermore, evidence of potential heterogeneity in the impact of smoking on histopathological subtypes is scarce, despite the fact that the histopathological subtypes of M-SGC exhibit different genetic features. METHODS: The authors conducted a case-control study to investigate the association between smoking and M-SGC by histopathological subtype. Cases were 81 patients with M-SGCs and the controls were 810 age-matched and sex-matched first-visit outpatients without cancer treated at Aichi Cancer Center Hospital from 1988 to 2005. Odds ratios (OR) and 95% confidence intervals (95% CI) were assessed by conditional logistic regression analysis with adjustment for potential confounders. RESULTS: Smoking was found to be associated with a significantly increased risk of M-SGC overall, with an OR of 3.45 (95% CI, 1.58-7.51; P =.001) for heavy smokers compared with never-smokers. A significant dose-response relationship was observed (P for trend, .001). When stratified by histological subtype, no obvious impact of smoking was observed among patients with mucoepidermoid carcinoma (MEC). In contrast, smoking demonstrated a significantly increased risk of M-SGCs other than MEC, with an OR of 5.15 (95% CI, 2.06-12.87; P<.001) for heavy smokers compared with never-smokers. The authors observed possible heterogeneity with regard to the impact of smoking on risk between MEC and M-SGCs other than MEC (P for heterogeneity, .052). CONCLUSIONS: The results of the current study demonstrate a significant positive association between cigarette smoking and the risk of M-SGC overall. However, the impact of smoking appeared to be limited to M-SGCs other than MEC. Cancer 2018;124:118-24. © 2017 American Cancer Society.


Subject(s)
Adenocarcinoma/epidemiology , Adenoma, Pleomorphic/epidemiology , Carcinoma, Acinar Cell/epidemiology , Carcinoma, Adenoid Cystic/epidemiology , Carcinoma, Mucoepidermoid/epidemiology , Carcinoma, Squamous Cell/epidemiology , Head and Neck Neoplasms/epidemiology , Salivary Gland Neoplasms/epidemiology , Smoking/epidemiology , Adenocarcinoma/pathology , Adenoma, Pleomorphic/pathology , Adult , Aged , Carcinoma/epidemiology , Carcinoma/pathology , Carcinoma, Acinar Cell/pathology , Carcinoma, Adenoid Cystic/pathology , Carcinoma, Mucoepidermoid/pathology , Carcinoma, Squamous Cell/pathology , Case-Control Studies , Female , Head and Neck Neoplasms/pathology , Humans , Male , Middle Aged , Odds Ratio , Parotid Neoplasms/epidemiology , Parotid Neoplasms/pathology , Risk Factors , Salivary Gland Neoplasms/pathology , Squamous Cell Carcinoma of Head and Neck , Sublingual Gland Neoplasms/epidemiology , Sublingual Gland Neoplasms/pathology , Submandibular Gland Neoplasms/epidemiology , Submandibular Gland Neoplasms/pathology , Tobacco Smoking
6.
Cancer Sci ; 108(1): 91-100, 2017 Jan.
Article in English | MEDLINE | ID: mdl-27801961

ABSTRACT

Alcohol consumption is an established risk factor, and also a potential prognostic factor, for squamous cell carcinoma of the head and neck (HNSCC). However, little is known about whether the prognostic impact of alcohol consumption differs by treatment method. We evaluated the association between alcohol drinking and survival by treatment method to the primary site in 427 patients with HNSCC treated between 2005 and 2013 at Aichi Cancer Center Central Hospital (Nagoya, Japan). The impact of alcohol on prognosis was measured by multivariable Cox regression analysis adjusted for established prognostic factors. Among all HNSCC patients, the overall survival rate was significantly poorer with increased levels of alcohol consumption in multivariable analysis (trend P = 0.038). Stratification by treatment method and primary site revealed that the impact of drinking was heterogeneous. Among laryngopharyngeal cancer (laryngeal, oropharyngeal, and hypopharyngeal cancer) patients receiving radiotherapy (n = 141), a significant dose-response relationship was observed (trend P = 0.034). In contrast, among laryngopharyngeal cancer patients treated with surgery (n = 80), no obvious impact of alcohol was observed. This heterogeneity in the impact of alcohol between surgery and radiotherapy was significant (for interaction, P = 0.048). Furthermore, among patients with oral cavity cancer treated by surgery, a significant impact of drinking on survival was seen with tongue cancer, but not with non-tongue oral cancer. We observed a significant inverse association between alcohol drinking and prognosis among HNSCC patients, and its impact was heterogeneous by treatment method and primary site.


Subject(s)
Alcohol Drinking , Head and Neck Neoplasms/therapy , Carcinoma, Squamous Cell/drug therapy , Carcinoma, Squamous Cell/radiotherapy , Carcinoma, Squamous Cell/surgery , Confounding Factors, Epidemiologic , Female , Head and Neck Neoplasms/drug therapy , Head and Neck Neoplasms/radiotherapy , Head and Neck Neoplasms/surgery , Humans , Kaplan-Meier Estimate , Laryngeal Neoplasms/drug therapy , Laryngeal Neoplasms/radiotherapy , Laryngeal Neoplasms/surgery , Life Style , Male , Middle Aged , Pharyngeal Neoplasms/drug therapy , Pharyngeal Neoplasms/radiotherapy , Pharyngeal Neoplasms/surgery , Prognosis , Prospective Studies , Smoking , Treatment Outcome
7.
Laryngoscope Investig Otolaryngol ; 9(4): e1297, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38974601

ABSTRACT

Objectives: The aim of present study was to evaluate the clinical efficacy of hyperbaric oxygen therapy (HBOT) as a primary therapy combined with standard systemic corticosteroid treatment for sudden sensorineural hearing loss (SSNHL) compared to treatment without the use of HBOT (non-HBOT) through clinical data and advanced analytical approaches. Study Design: Case-control study. Methods: Conducted across three Japanese medical centers involving 298 SSNHL patients diagnosed between 2020 and 2023. Inclusion criteria encompassed first onset and treatment, WHO grade 3 or 4 initial hearing impairment, receipt of systemic corticosteroid therapy within 14 days of symptom onset, and initiation of HBOT within the same timeframe for the case group. The primary outcome measure was the difference in hearing improvement (mean hearing level in decibels, dB) between the two groups, assessed by pure-tone audiometry at baseline and 3 months post-treatment, using the inverse probability of treatment weighting (IPTW) method adjusted for covariate differences. Results: The study included 67 patients in the HBOT group and 68 in the non-HBOT group. The HBOT group exhibited significantly greater hearing improvement (IPTW-adjusted difference: 7.6 dB, 95% CI 0.4-14.7; p = 0.038). Patients without vertigo in the HBOT group demonstrated substantial hearing improvement (11.5 dB, 95% CI 2.3-20.6; p = 0.014), whereas those with vertigo showed no significant improvement (-1.8 dB, 95% CI -11.8-8.3; p = 0.729). The HBOT group also had a significantly higher association with complete recovery (IPTW-adjusted odds ratio: 2.57, 95% CI 1.13-5.85; p = 0.025). Conclusion: In SSHNL, HBOT combination therapy yielded slightly but significantly improved hearing outcomes compared to non-HBOT treatment. Level of Evidence: 4.

8.
Head Neck ; 46(8): 1855-1864, 2024 08.
Article in English | MEDLINE | ID: mdl-38229255

ABSTRACT

BACKGROUND: It is unclear witch regimen is optimal as salvage chemotherapy (SCT) after immune checkpoint inhibitor (ICI) monotherapy for recurrent or metastatic head and neck cancer (RM-HNC). METHODS: This study enrolled 109 patients. Overall survival (OS) and progression-free survival 2 (PFS2) were compared between patients stratified by SCT regimen. RESULTS: Of the 109 patients, 55 underwent SCT after the failure of ICI monotherapy. The OS of these 55 patients was longer than that of patients who did not undergo SCT. The OS and PFS2 were similar between patients treated with paclitaxel (PTX) and cetuximab (Cmab) combination and those treated with PTX monotherapy. The occurrence of irAEs did not impact PFS2 nor OS. CONCLUSIONS: SCT can improve the survival outcomes of patients with RM-HNC. In addition to PTX and Cmab, PTX monotherapy is also considered an effective SCT regimen. SCT is effective regardless of the presence or absence of irAEs.


Subject(s)
Head and Neck Neoplasms , Immune Checkpoint Inhibitors , Neoplasm Recurrence, Local , Paclitaxel , Salvage Therapy , Humans , Male , Immune Checkpoint Inhibitors/therapeutic use , Middle Aged , Female , Head and Neck Neoplasms/drug therapy , Head and Neck Neoplasms/mortality , Head and Neck Neoplasms/pathology , Head and Neck Neoplasms/therapy , Neoplasm Recurrence, Local/drug therapy , Aged , Paclitaxel/therapeutic use , Paclitaxel/administration & dosage , Retrospective Studies , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Adult , Cetuximab/therapeutic use , Progression-Free Survival
9.
Anticancer Res ; 44(3): 1227-1232, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38423663

ABSTRACT

BACKGROUND/AIM: Although gemcitabine plus cisplatin (GC) prolongs survival in patients with recurrent or metastatic nasopharyngeal carcinoma (R/M NPC) compared with fluorouracil plus cisplatin, no study has evaluated the efficacy and safety of GC in nonendemic regions, including Japan, yet. Therefore, we assessed the safety and efficacy of GC in Japanese patients with R/M NPC. PATIENTS AND METHODS: We retrospectively reviewed patients with R/M NPC who received GC treatment at the Aichi Cancer Center Hospital from January 2017 to March 2020. The main eligibility criteria were histologically confirmed NPC, Eastern Cooperative Oncology Group performance status (ECOG PS) of 0-2, and locally recurrent disease unsuitable for local treatment or metastatic disease. The regimen was administered every 3 weeks (gemcitabine, 1,000 mg/m2 on days 1 and 8; cisplatin, 80 mg/m2 on day 1). RESULTS: Fourteen patients (median age, 58 years) were included in the study. Two patients had an ECOG PS of 2 and 11 exhibited nonkeratinizing histology. Of the eight patients with measurable lesions, one exhibited complete response and seven exhibited partial response, with an objective response rate of 75%. Median progression-free survival and overall survival were 7.7 and 24.2 months, respectively. Common grade 3 or 4 adverse events included neutropenia (64%), thrombocytopenia (14%), and febrile neutropenia (14%). The median relative dose intensity of gemcitabine and cisplatin was 62% and 60%, respectively. No treatment-related deaths occurred. CONCLUSION: The GC regimen demonstrates promising activity and is tolerable in Japanese patients with R/M NPC.


Subject(s)
Gemcitabine , Nasopharyngeal Neoplasms , Humans , Middle Aged , Nasopharyngeal Carcinoma/drug therapy , Cisplatin/adverse effects , Retrospective Studies , Deoxycytidine/adverse effects , Chronic Disease , Nasopharyngeal Neoplasms/drug therapy , Nasopharyngeal Neoplasms/pathology , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Treatment Outcome
10.
Int J Med Robot ; 19(4): e2520, 2023 Aug.
Article in English | MEDLINE | ID: mdl-37086451

ABSTRACT

BACKGROUND: Transoral robotic surgery (TORS) for tongue base lesions located above the operative field is predominantly an upward procedure, which makes surgery difficult. METHODS: To illustrate our technique for this procedure, we report the case of an 82-year-old male with a p16-negative oropharyngeal carcinoma of the tongue base who underwent TORS. The field of view was turned upside down, and the operation switched the typical left- and right-arm functions. The daVinci Xi was docked, the 0° endoscope was rotated 180°, and the first arm was switched to the right hand and the third arm to the left hand. RESULTS: Although the lesion extended from the tongue base to the soft palate and mobile tongue, the planned resection line was followed. CONCLUSIONS: This technique improves operability by allowing downward manipulation and preventing the left and right arms from crossing. Further validation of the technique's effectiveness and safety is needed.


Subject(s)
Robotic Surgical Procedures , Male , Humans , Aged, 80 and over , Robotic Surgical Procedures/methods , Tongue/surgery
11.
J Ultrasound ; 2023 Feb 18.
Article in English | MEDLINE | ID: mdl-36807267

ABSTRACT

BACKGROUND: Photoimmunotherapy (PIT) is a new cancer treatment based on a different mechanism from conventional treatments that combines the administration of a photoabsorber and laser illumination. PIT has two characteristics: a high selectivity of target cells and the possibility of effects beyond the illuminated area. It is thus a potentially effective treatment for a wide variety of cancers. CASE PRESENTATION: We herein report a patient with oropharyngeal squamous cell carcinoma with superficial cervical lymph node recurrence. Intraoperative ultrasound confirmed the localization of the lesion and major vessels near the tumor. We punctured the tumor with catheters of laser illumination under ultrasound guidance. Laser illumination was able to be performed safely without causing serious adverse events, and the effect on the illuminated site was fully exhibited. CONCLUSIONS: Ultrasound allows for the intraoperative monitoring of each localized area and the puncture status easily in real-time. Accurate utilization of ultrasound is extremely important in PIT.

12.
Cancers (Basel) ; 15(21)2023 Oct 26.
Article in English | MEDLINE | ID: mdl-37958324

ABSTRACT

Fluorouracil (FU) exerts its antitumor activity by inhibiting folate-mediated one-carbon metabolism. Evidence that folate may play a role in the carcinogenic process via folate-mediated one-carbon metabolism has given rise to the hypothesis that pre-diagnostic folate intake may induce heterogeneous chemosensitivity to FU-containing induction chemotherapy (IC) in head and neck cancer. To assess this hypothesis, we conducted a cohort study to investigate whether the association between prediagnostic dietary folate intake and cancer survival differed between treatment regimens with and without FU-containing IC in 504 cases of locally advanced (stage III/IV) HNSCC, using an epidemiologic database combined with clinical data. In total, 240 patients were treated with FU-containing IC followed by definitive treatment, and 264 patients were treated with definitive treatment alone. Definitive treatment is defined as (1) the surgical excision of a tumor with clear margins, with or without neck lymph node dissection; or (2) radiotherapy with or without chemotherapy. In the overall cohort of the FU-containing IC group, a higher folate intake was significantly associated with better overall survival (adjusted hazard ratios (HRs) for the highest compared to the lowest folate tertiles (HRT3-T1) = 0.42, 95%CI, 0.25-0.76, Ptrend = 0.003). Conversely, no apparent association between prediagnostic folate intake and survival was observed with definitive treatment alone (HRT3-T1: 0.83, 95%CI, 0.49-1.42, Ptrend = 0.491)). A consideration of the cumulative dose of FU-containing IC showed that the survival impact of prediagnostic folate intake differed statistically significantly by treatment regimen (Pinteraction = 0.012). In conclusion, an association between prediagnostic folate intake and HNSCC survival significantly differed by FU-containing IC. This finding indicates that in the carcinogenic process, folate status causes HNSCC to be heterogenous in terms of one-carbon metabolism.

13.
Anticancer Res ; 43(7): 3247-3253, 2023 Jul.
Article in English | MEDLINE | ID: mdl-37351957

ABSTRACT

BACKGROUND/AIM: The Warburg effect of cancer has been applied to detect various carcinomas though the 18F-fluorodeoxyglucose (18F-FDG) uptake on positron emission tomography with computed tomography (PET/CT). 18F-FDG-PET/CT in lung cancer predicted the mutation status of epidermoid growth factor receptor (EGFR). This study aimed to investigate whether 18F-FDG uptake parameters were significantly related to EGFR mutation status in patients with sinonasal tract squamous cell carcinoma (STSCC). PATIENTS AND METHODS: Twenty-nine tumor specimens of primary STSCC from patients with definitive treatment were collected. RESULTS: The 18F-FDG uptake from primary tumors was not different between mutant- and wild-status of EGFR on either Mann-Whitney U-test or the receiver operating curve. A metabolic tumor volume of ≥25 with the minimum p-value from the log-rank test for STSCC-specific survival was associated with a significantly shorter STSCC-specific, disease-free, local recurrence-free survival on the univariate and multivariate analyses adjusted for the clinical stage, treatment, and EGFR status. CONCLUSION: 18F-FDG-PET/CT did not predict mutation of the EGFR status in STSCC.


Subject(s)
Carcinoma, Squamous Cell , Head and Neck Neoplasms , Lung Neoplasms , Paranasal Sinuses , Humans , Fluorodeoxyglucose F18/metabolism , Positron Emission Tomography Computed Tomography , Lung Neoplasms/diagnostic imaging , Lung Neoplasms/genetics , Lung Neoplasms/pathology , Mutation , ErbB Receptors/genetics , Carcinoma, Squamous Cell/diagnostic imaging , Carcinoma, Squamous Cell/genetics , Squamous Cell Carcinoma of Head and Neck , Paranasal Sinuses/metabolism , Paranasal Sinuses/pathology , Radiopharmaceuticals
14.
Sci Rep ; 13(1): 6188, 2023 04 15.
Article in English | MEDLINE | ID: mdl-37061623

ABSTRACT

This sentinel node (SN) biopsy trial aimed to assess its effectiveness in identifying predictive factors of micrometastases and to determine whether elective neck dissection is necessary in oral squamous cell carcinoma. This retrospective study included 55 patients from three previous trials, with positive SNs. The relationship between the sizes of the metastatic focus and metastasis in non-sentinel node (NSN) was investigated. Four of the 55 largest metastatic focus were isolated tumor cells, and the remaining 51 were ranged from 0.2 to 15 mm, with a median of 2.6 mm. The difference of prevalence between 46 negative- and 9 positive-NSN was statistically significant with regard to age, long diameter of primary site and number of cases with regional recurrence. In comparing the size of largest metastatic focus dividing the number of positive SN, with metastaic focus range of < 3.0 mm in one-positive SN group, there were 18 (33%) negative-NSN and no positive-NSN. Regarding prognosis, 3-year overall survival rate of this group (n = 18) and other (n = 37) were 94% and 73% (p = 0.04), and 3-year recurrence free survival rate of this group and other were 94% and 51% (p = 0.03), respectively. Absolutely a further prospective clinical trial would be needed, micrometastases may be defined as solitary SN metastasis with < 3.0 mm of metastatic focus, and approximately 33% of neck dissections could be avoided using these criteria.


Subject(s)
Carcinoma, Squamous Cell , Head and Neck Neoplasms , Mouth Neoplasms , Humans , Carcinoma, Squamous Cell/surgery , Carcinoma, Squamous Cell/pathology , Squamous Cell Carcinoma of Head and Neck/pathology , Mouth Neoplasms/surgery , Mouth Neoplasms/pathology , Neoplasm Micrometastasis/pathology , Retrospective Studies , Neoplasm Staging , Sentinel Lymph Node Biopsy , Head and Neck Neoplasms/pathology , Lymph Node Excision , Lymph Nodes/pathology
15.
Biomedicines ; 10(11)2022 Nov 14.
Article in English | MEDLINE | ID: mdl-36428496

ABSTRACT

This study aimed to investigate the relationship between the lymph node ratio (LNR) and survival results of patients with head and neck squamous cell carcinoma (HNSCC) reconstructed by a submental artery flap (SMAF) to limit tumor size. This study retrospectively recruited 49 patients with HNSCC who underwent both primary resection and neck dissection with SMAF reconstruction. The LNR was the ratio of the number of metastatic lymph nodes to the sum number of examined lymph nodes. A LNR of 0.04 was the best cut-off value for HNSCC-specific death on receiver operating curve analysis. Patients with LNRs > 0.04 were univariately related to cancer-specific, disease-free, distant metastasis-free, and locoregional recurrence-free survival than those with LNRs ≤ 0.04 by log-rank test. In a Cox's proportional hazards model with hazard ratio (HR) and 95% confidence interval (CI) adjusting for pathological stage, extranodal extension and or surgical margins, the LNR (>0.04/≤0.04) predicted multivariate shorter cancer-specific (HR = 9.24, 95% CI = 1.49−176), disease-free (HR = 3.44, 95% CI = 1.23−10.3), and distant metastasis-free (HR = 9.76, 95% CI = 1.57−187) survival. In conclusion, LNR for patients of HNSCC with SMAF reconstruction for limited tumor size was a prognostic factor for survival outcomes.

16.
Cancers (Basel) ; 14(22)2022 Nov 17.
Article in English | MEDLINE | ID: mdl-36428754

ABSTRACT

Human papillomavirus (HPV)-associated oropharyngeal cancer has a better prognosis than other head and neck cancers. However, rates of recurrence and metastasis are similar and the prognosis of recurrent or metastatic HPV-associated oropharyngeal cancer is poor. Near-infrared photoimmunotherapy (NIR-PIT) is a treatment involving administration of a photosensitizer (IRDye®700DX) conjugated to a monoclonal antibody followed by activation with near-infrared light illumination. It is a highly tumor-specific therapy with minimal toxicity in normal tissues. Moreover, NIR-PIT is expected to have not only direct effects on a treated lesion but also immune responses on untreated distant lesions. NIR-PIT with cetuximab-IR700 (AlluminoxTM) has been in routine clinical use since January 2021 for unresectable locally advanced or locally recurrent head and neck cancer in patients that have previously undergone radiotherapy in Japan. NIR-PIT for head and neck cancer (HN-PIT) is expected to provide a curative treatment option for the locoregional recurrent or metastatic disease after radiotherapy and surgery. This article reviews the mechanism underlying the effect of NIR-PIT and recent clinical trials of NIR-PIT for head and neck cancers, treatment-specific adverse events, combination treatment with immune checkpoint inhibitors, illumination approach and posttreatment quality of life, and provides a case of series of two patients who receive NIR-PIT for oropharyngeal cancer at our institution.

17.
Auris Nasus Larynx ; 49(4): 658-662, 2022 Aug.
Article in English | MEDLINE | ID: mdl-34876321

ABSTRACT

OBJECTIVE: To present a new procedure for inserting a secondary voice prosthesis from the inside to the outside, which improves on the method previously reported by Fukuhara et al. METHODS: A flexible nasopharyngoscope was used to puncture pharynx (or transplanted jejunum) from the inside to the outside. In this method, it was possible to use the PROVOX® VegaTM Puncture Set as it is used for the placement of the voice prosthesis. RESULTS: We were able to place the PROVOX® VegaTM in all cases we experienced. Most of the cases had a history of radiation therapy. The time required for surgery ranged from 11-59 minutes (mean: 29 minutes) and there was no measurable amount of bleeding. CONCLUSION: This new method using the PROVOX® VegaTM Puncture Set, which is designed for the original purpose of voice prosthesis implantation, was therefore found to be safe and effective.


Subject(s)
Larynx, Artificial , Humans , Laryngectomy , Prosthesis Design , Prosthesis Implantation/methods , Punctures
18.
Diagnostics (Basel) ; 12(1)2022 Jan 07.
Article in English | MEDLINE | ID: mdl-35054313

ABSTRACT

BACKGROUND: High uptake of F18-fluorodeoxyglucose parameters for glucose metabolism is related to shorter survival in sinonasal tract cancer with various histological classifications. We investigated whether F18-fluorodeoxyglucose uptake parameters are associated with survival outcomes for patients with only squamous cell carcinoma (SCC) in the sinonasal tract that are treated either with surgery or nonsurgery. METHODS: We retrospectively observed F18-fluorodeoxyglucose uptake parameters on positron emission tomography with computed tomography for the primary tumour of SCC in 39 patients. Log-rank test or a Cox regression model with 95% confidence interval (95%CI) and hazard ratio (HR) were used for monovariable or multivariable analysis, respectively. We determined cut-off values of the F18-fluorodeoxyglucose uptake parameters using the lowest p value for monovariable sinonasal tract cancer-specific survival analysis. RESULTS: Monovariable analysis showed that patients with metabolic tumour volume (MTV) ≥ 21.8 had a shorter cancer-specific, disease-free and local recurrence-free survival than those with MTV < 21.8. After adjusting for age, gender, clinical stage and treatment group in the multivariable analysis, MTV (≥21.8/<21.8) was related to shorter cancer-specific (HR: 3.69, 95%CI: 1.17-12.0), disease-free (HR: 3.38, 95%CI: 1.19-9.71) and local recurrence-free (HR: 5.42, 95%CI: 1.59-20.3) survivals. CONCLUSIONS: MTV as advances in diagnostics of sinonasal tract SCC is a predictor.

19.
Anticancer Res ; 42(3): 1653-1657, 2022 Mar.
Article in English | MEDLINE | ID: mdl-35220265

ABSTRACT

BACKGROUND: During the COVID-19 pandemic, pedicle flaps instead of free flap transfer were recommended for head and neck reconstruction to reduce infection risk. Boron neutron-capture therapy in Japan was clinically approved in 2020 as a salvage radiotherapy for recurrent head and neck cancer following chemoradiotherapy. The efficacy and safety of salvage surgery following boron neutron-capture therapy remain unclear. CASE REPORT: We describe a 57-year-old male with crT4aN0M0 oral cancer after three different forms of radiotherapy including boron neutron-capture therapy, treated by salvage partial maxillectomy with both buccal fat pad and nasoseptal flaps. His postsurgical course was successful, without tracheostomy, and he had no Clavien- Dindo grade 3 or 4 complications. The pathological diagnosis was T4a squamous cell carcinoma with a negative surgical margin. No recurrence or metastasis had occurred at 113 days postoperatively. No opioid consumption was needed postoperatively. CONCLUSION: Pathological negative margins were achieved in this case and there were no severe complications. Further accrual of cases salvage surgery following boron neutron-capture therapy is required to clarify treatment strategies for recurrent head and neck cancer.


Subject(s)
COVID-19/epidemiology , Mouth Neoplasms/surgery , Neoplasm Recurrence, Local , Salvage Therapy , Squamous Cell Carcinoma of Head and Neck/surgery , Boron Neutron Capture Therapy , Humans , Japan/epidemiology , Male , Margins of Excision , Middle Aged , Mouth Neoplasms/pathology , Mouth Neoplasms/radiotherapy , Orthognathic Surgical Procedures , SARS-CoV-2 , Squamous Cell Carcinoma of Head and Neck/pathology , Squamous Cell Carcinoma of Head and Neck/radiotherapy , Surgical Flaps , Treatment Outcome
20.
Auris Nasus Larynx ; 49(6): 1083-1087, 2022 Dec.
Article in English | MEDLINE | ID: mdl-34226099

ABSTRACT

Primary squamous cell carcinoma of the thyroid (PSCCT) is a rare disease with a poor prognosis. Because of its rarity, there is no established therapeutic regimen in unresectable cases. We report a case of PSCCT treated with weekly paclitaxel (wPTX) for more than 2 years. A 59-year-old woman presented to our hospital with a progressively enlarging neck mass. CT and MRI scans showed a tumor arising from the right lobe of the thyroid, invading the esophagus and trachea, as well as partially surrounding and invading the right common carotid artery. It was deemed unresectable. Biopsy revealed poorly differentiated squamous cell carcinoma. wPTX therapy was initiated. The patient achieved a partial response and is still undergoing treatment 28 months later. Adverse events included grade 3 neutropenia and grade 2 peripheral sensory neuropathy, which were manageable. Long-term wPTX therapy has been effective in this case of unresectable PSCCT.


Subject(s)
Carcinoma, Squamous Cell , Thyroid Neoplasms , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Squamous Cell/diagnostic imaging , Carcinoma, Squamous Cell/drug therapy , Carcinoma, Squamous Cell/pathology , Child, Preschool , Female , Humans , Paclitaxel , Thyroid Neoplasms/diagnostic imaging , Thyroid Neoplasms/drug therapy , Thyroid Neoplasms/pathology
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