• Korean Journal of Head & Neck Oncology
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• v.27 no.2
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• pp.177-182
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• 2011

Backgrounds : Head and neck cancer is one of the most prevalent cancers in the world. It tends to remain localized at the primary site and regional lymph nodes, but if distant metastasis occurs, it has a poor prognosis. This study was performed to evaluate the prevalence of distant metastasis and to determine the risk factor in locally advanced head and neck cancer after induction chemotherapy followed locoregional control therapy. Methods : A retrospective review was performed in 420 patients with locally advanced head and neck cancer who treated with induction chemotherapy followed locoregional control therapy from January 2001 to December 2010. Among them, 31 patients who had distant metastasis as first relapse within 2 years after termination of therapy were analyzed for clinical features and the risk factors of distant metastasis. Results : The overall incidence of distant metastasis was 7.3%. The bone, lung, and liver were the most frequent metastatic organs. In univariate analysis, nodal stage, nasopharyngeal cancer, laryngeal cancer, G3/G4 neutropenia during induction chemotherapy, and concurrent chemoradiotherapy were the influencing factors for distant metastasis. In multivariate analysis, advanced N stage and nasopharynx were the risk factors of distant metastasis, and grade 3/4 neutropenia during induction chemotherapy was considered to decrease distant metastasis. Conclusion : This study suggests that the advanced N stage is the risk factor of distant metastasis and Grade 3/4 neutropenia during induction chemotherapy can be beneficial against distant metastasis in locally advanced head and neck cancer patients treated with induction chemotherapy followed locoregional control therapy.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.10
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• pp.4147-4152
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• 2014

Standard therapy for advanced head and neck cancer consists of a combination of surgery and radiation. However, survival of this patient population has not improved during the past 20 years. Many different multimodality treatment schedules have been proposed, and chemotherapy is often used with the intent of organ preservation. The present study was intended to establish the efficacy of concomitant chemoradiation with a single agent carboplatin in advanced head and neck cancers.The objectives were to investigate the feasibility of concomitant administration of carboplatin, monitor acute toxicity during radiotherapy, and determine subacute side effects, such as wound healing following surgery after chemoradiotherapy. A prospective study was conducted wherein a total of 40 patients with stage III and IV squamous cell carcinomas of oral cavity, oropharynx, hypopharynx and larynx were enrolled. All patients were treated with external beam radiotherapy and weekly carboplatin area under curve (AUC of 5). Radiotherapy was given in single daily fractions of 1.8-2 grays (Gy) to a total dose of 66-72 Gy. Salvage surgery was performed for any residual or recurrent locoregional disease. Neck dissection was recommended for all patients with neck disease showing less than a complete response after chemoradiation. A total of 40 patients were enrolled of whom 32 were males and 8 were females. Highest incidence of cancer was seen in the 5th-6th decades of life with a median age of 47.7 years. Oropharyngeal tumours constituted a maximum of 21 patients followed by hypopharynx in 10, larynx in 7 and oral cavity in 2. 80% of the patients had a neck node on presentation of which 40% had N2-N3 nodal status. TNM staging revealed that 58% of patients were in stage III and 43% in stage IV. Evaluation of acute toxicity revealed that 50% had grade II mucositis, 25% grade III mucositis, 2.5% grade IV mucositis. 50% of patients had grade I skin reactions, 65% of patients had grade I thrombocytopenia, and 24% of patients had grade I anaemia. After completion of treatment 65% of patients had complete response at the primary and regional sites, and 35% of patients had a partial response of whom 23% underwent neck dissection and 5% of them underwent salvage surgery at the primary site. At the end of one year there were six deaths and four recurrences and 70% were free of disease. Concurrent chemoradiation with carboplatin provided good locoregional control for locally advanced head and neck cancers. This regimen, although toxic, is tolerable with appropriate supportive intervention. Primary site conservation is possible in many patients. Chemoradiotherapy appears to have an emerging role in the primary management of head and neck cancers.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.16
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• pp.7309-7313
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• 2015

Background: The organ preservation approach of choice for the treatment of locally advanced head and neck cancers is concurrent chemoradiation with three weekly high doses of cisplatin. Although this is an efficacious treatment policy, it has high acute systemic and mucosal toxicities, which lead to frequent treatment breaks and increased overall treatment time. Hence, the current study was undertaken to evaluate the efficacy of concurrent chemoradiation using 40 mg/m2 weekly cisplatin. Materials and Methods: This is a single institutional retrospective study including the data of 266 locally advanced head and neck cancer patients who were treated with concurrent chemoradiation using 40 mg/m2 weekly cisplatin from January 2012 to January 2014. A p-value of < 0.05 was taken to be significant statistically for all purposes in the study. Results: The mean age of the study patients was 48.8 years. Some 36.1% of the patients had oral cavity primary tumors. The mean overall treatment time was 57.2 days. With a mean follow up of 15.2 months for all study patients and 17.5 months for survivors, 3 year local control, locoregional control and disease free survival were seen in 62.8%, 42.8% and 42.1% of the study patients. Primary tumor site, nodal stage of disease, AJCC stage of the disease and number of cycles of weekly cisplatin demonstrated statistically significant correlations with 3 year local control, locoregional control and disease free survival. Conclusions: Concurrent chemoradiotherapy with moderate dose weekly cisplatin is an efficacious treatment regime for locally advanced head and neck cancers with tolerable toxicity which can be used in developing countries with limited resources.

• 대한두경부종양학회:학술대회논문집
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• 2009.05a
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• pp.71-71
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• 2009

• Korean Journal of Head & Neck Oncology
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• v.12 no.1
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• pp.88-91
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• 1996

• Korean Journal of Head & Neck Oncology
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• v.30 no.2
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• pp.95-99
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• 2014

Brown tumor is characterized as the classic skeletal manifestation of advanced hyperparathyroidism. It is considered as a benign tumor because of its reparative cellular process. We have experienced 6 patients of brown tumor with hyperparathyroidism, enrolled at Korea Cancer Center Hospital from November 2007 to September 2013. Five of the patients were diagnosed as parathyroid adenoma and treated with parathyroidectomy, and one female patient was diagnosed as parathyroid carcinoma and treated with parathyroidectomy and thyroid lobectomy. These six cases demonstrated that early parathyroidectomy after diagnosis helps to relieve symptomatic pain, normalize calcium level, treat hyperparathyroidism, prevent tumor progression and also prevent osteoporosis in bones. We present these 6 patients with a review of literature.

• Korean Journal of Head & Neck Oncology
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• v.3 no.1
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• pp.107-114
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• 1987

Clinical application of hyperthermia using 8 MHz radiofrequency(capacitive type THERMOTRON RF-8) in cancer treatment was begun at Yonsei Cancer Center in 1985. From April 1985 to April 1986, 23 patients with loco-regionally advanced and persistent or recurrent carcinomas of the head and neck were treated with hyperthermia at the Department of Radiation Oncology, Yonsei University College of Medicine. Radiation therapy and/or chemotherapy were combined with hyperthermia to improve the tumor response. The response rate of 23 patients was 52%, 4 had complete response, and 7 had partial response. The factors affecting the tumor response were dose of irradiation(P=0.009). Complications related to treatment were found in 8 patients and all of them were self-limited. The result of this study indicates that localized hyperthermia as a combined modality has a significant role in palliation of advanced and recurrent head and neck cancer.

• 대한두경부종양학회:학술대회논문집
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• 2002.11a
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• pp.276-278
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• 2002

• 대한두경부종양학회:학술대회논문집
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• 2006.05a
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• pp.83-85
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• 2006

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.3
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• pp.885-890
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• 2012

Background: Head and neck cancers are prevalent in Thailand, in particular in the southern region of the country. However, survival with a large data set has not been reported. The purpose of the present study was to evaluate the survival figures and the prognostic factors in a cohort of patients treated in a university hospital located in the south of Thailand. Patients and Methods: Consecutive new cases of primary carcinoma of the oral cavity, oropharyx, hypopharynx and larynx, treated at Songklanagarind Hospital during 2002 to 2004, were analyzed. The 5-year overall survival rates were obtained by the Kaplan-Meier method. Prognostic factors were identified through multivariate Cox regression analysis. Results: A total 1,186 cases were analyzed. Two-thirds (66.6%) of the cases were at advanced stage (stage III & IV) at presentation. The five-year overall survivals for the whole cohort, oral cavity, oropharynx, hypopharynx and larynx were 24.1%, 25.91%, 19.2%, 13.4%, 38.0% respectively. Stage and treatment type were strong prognostic factors for all sites. An age ${\geq}$ 80 years was associated with poor survival in oral cavity and larynx cancer. Conclusions: The results revealed remarkably poor outcomes of the patients in the series, indicating a strong need to increase the proportion of early stage presentations and maximize the treatment efficacy to improving outcomes. Very old patients are of particular concern for treatment care of oral cavity and larynx cancer.