RESUMEN
INTRODUCTION: The assessment of facial symmetry, after mandibular reconstruction, currently relies on subjective esthetic assessment by an evaluator. The present study aimed to compare conventional subjective assessment with quantitative evaluation by three-dimensional (3D) stereophotogrammetry of facial cosmetic symmetry. METHODS: This retrospective study enrolled 20 patients who underwent mandibular reconstruction with free fibula flap after segmental resection between 2014 and 2018. Subjective assessments were performed by seven clinicians at 6-12 months after surgery. Simultaneously, lower face symmetry was measured by 3D stereophotogrammetry with the VECTRA H1 system and recorded as the root mean square deviation (RMSD). Data from the subjective and quantitative evaluations were compared using Spearman's rank correlation coefficient. RESULTS: The results showed that subjective assessments were strongly and negatively correlated with RMSD (P=0.00000128). This confirmed that RMSD, obtained by 3D stereophotogrammetry, reflected the subjective assessment of symmetry in our cohort. CONCLUSIONS: Three-dimensional stereophotogrammetry of facial cosmetic symmetry will be an available quantitative method for patients with head and neck cancer after mandibular reconstruction.
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Colgajos Tisulares Libres , Neoplasias de Cabeza y Cuello , Reconstrucción Mandibular , Humanos , Fotogrametría , Estudios RetrospectivosRESUMEN
This study evaluated survival in 154 patients with stages II-IV oral squamous cell carcinoma (OSCC) treated with preoperative concurrent chemoradiotherapy and assessed the future use of this treatment strategy. 14 patients exhibited advanced stage II, 73 exhibited stage III and 67 exhibited stage IV. All patients received 40Gy irradiation and concurrent cisplatin-based chemotherapy in two courses. Radical surgery was undertaken after 2-6 weeks. The clinical tumour response, histopathologic regression grade, residual tumour grade (RGrade) in the primary tumour and the level of residual pN+ were associated with prognosis. 90% of patients with complete response and 73% of patients with good partial response in the primary tumour were RGrade 0 (no residual tumour cells) or RGrade 1 (viable tumour cells remained within central superficial portion). In patients with complete response in the neck, residual pN+ was only seen in levels IB (8%) and IIA (8%); the higher the level of residual pN+, the lower the survival rate (p<0.0001). This treatment strategy was excellent for stages II-IV OSCC. It may be possible to perform minimally invasive surgery in which the extent of resection in primary tumour and neck is reduced in patients who achieve good response following preoperative chemoradiotherapy.
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Carcinoma de Células Escamosas/patología , Carcinoma de Células Escamosas/terapia , Neoplasias de la Boca/patología , Neoplasias de la Boca/terapia , Terapia Neoadyuvante , Adulto , Anciano , Carcinoma de Células Escamosas/cirugía , Quimioradioterapia Adyuvante , Distribución de Chi-Cuadrado , Supervivencia sin Enfermedad , Femenino , Humanos , Estimación de Kaplan-Meier , Metástasis Linfática , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Mínimamente Invasivos , Neoplasias de la Boca/cirugía , Estadificación de Neoplasias , Neoplasia Residual/tratamiento farmacológico , Neoplasia Residual/patología , Neoplasia Residual/radioterapia , Cuidados Preoperatorios , Estudios RetrospectivosRESUMEN
Sixteen patients with advanced breast cancer were treated with neoadjuvant intraarterial chemotherapy with high dose epirubicin. The following results were obtained: 1) Excellent down-staging effects were confirmed. Response rate of the primary tumor was 81.3%. 2) Leukopenia was the dose-limiting factor, and 81.3% of patients had WHO grade 2 or more leucopenia. However, the regimen was completed with supportive therapies. 3) At a median follow-up of 17 months, improved survival rates were noted. The present study showed the efficacy of neoadjuvant intraarterial chemotherapy with high dose epirubicin in the treatment of locally advanced breast cancer.