• 제목/요약/키워드: Head and Neck

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두경부암에서 방사면역치료의 역할 (Radioimmunotherapy in Head and Neck Cancer)

  • 최익준
    • Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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    • 제61권12호
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    • pp.637-643
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    • 2018
  • Radioimmunotherapy (RIT) is a therapy that takes advantage of the "cross-fire" effect of emitted radiation by radionuclides conjugated to tumor-directed monoclonal antibodies (mAb) (including those fragments) or peptides. While RIT has been successfully employed for the treatment of lymphoma, mostly with radiolabeled antibodies against CD20 [$^{90}yttrium$ ($^{90}Y$)-ibritumomab tiuxetan; $Zevalin^{(R)}$ and $^{131}iodine$ ($^{131}I)-tositumomab$; $Bexxar^{(R)}$], its use in solid tumors is more challenging, so far. Immuno-PET, a tool for tracking and quantification of mAbs with PET in vivo, is an exciting novel option to improve diagnostic imaging and guide mAb-based therapy. RIT in solid tumors including head and neck cancer may be an alternative treatment with advances in various biological, chemical, and treatment procedures, and it may help to reduce unnecessary exposure and enhance the therapeutic efficacy. Also, immuno-PET based on RIT might play an important role in cancer staging, in patients or targets selection of targeted therapeutics and in monitoring the response of targeted therapeutics as precision medicine. In this review, fundamentals of RIT/immune-PET and current knowledge of the preclinical/clinical trials in RIT for solid tumor including head and neck cancer are reviewed.

갑상선 유두암의 외측 경부림프절 전이에 대한 수술 전 평가로서 CT의 역할 (The Role of CT as a Preoperative Evaluation of Lateral Cervical Lymph Node Metastasis in Papillary Thyroid Carcinoma)

  • 석준걸;김형규;김윤중;한규희;안순현
    • 대한두경부종양학회지
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    • 제29권2호
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    • pp.37-40
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    • 2013
  • Background and Objectives : To assess the usefulness of computed tomography image before papillary thyroid cancer surgery, focus on confirmation of lateral cervical lymph node metastasis not detected by ultrasonography. Material and Methods : From January 2008 to May 2009, total 150 patients who had undergone thyroid surgery and been confirmed papillary thyroid cancer pathologically were enrolled. They had taken neck computed tomography following the ultrasonography. Results : Computed tomography had found suspicious metastatic lateral neck lesion in 13 patients. After the image study, lateral neck lymph node dissection had been included in their surgical plan. Of these, only 7 cases were confirmed pathologically lateral neck lymph node metastasis(positive predictive value=0.54). Taken as whole 150 patients, additionally 4.7% of patients confirmed lateral neck lymph node metastasis by preoperative computed tomography. Conclusion : If preoperative ultrasonography was performed precisely, additional benefits that could be achieved by computed tomography were not much.

양측 경부곽청술의 임상적 고찰 (A Clinical Study of Synchronous Bilateral Neck Dissection)

  • 김용주;양훈식
    • 대한두경부종양학회지
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    • 제12권2호
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    • pp.147-152
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    • 1996
  • For advanced head and neck cancers that originate in midline structures, bilateral neck dissection should be considered even if the lymph nodes were negative clinically. But, many complications and mortalities may occur in synchronous bilateral neck dissection at sacrifing of both internal jugular vein. Therefore several types of bilateral neck dissection have been proposed, but the effective and safe methods were not determined yet. So, we have prefered the method of synchronous bilateral neck dissection with preserving one internal jugular vein at least. We operated 21 patients who might be expected high incidences of bilateral neck metastases with above type of neck dissection. We analyzed the data of 21 cases(42 sides) retrospectively. The results were as follows: 1) The primary sites were transglottic(33%), supraglottic(29%), hypopharynx(29%) and tongue base(9%). 2) Types of neck dissection were RND(4 sides), MND(7 sides), FND(16 sides), and SND (15 sides). 3) Postoperative complications were minimal and did not influenced morbidity. 4) Mean interval time of neck recurrence was 21 months. Overall neck recurrent rate after bilateral neck dissecton was 19%. In 19%, neck recurrence from positive lymph nodes was 63% and from negative lymph nodes was 37%. As a results, synchronous bilateral neck dissection with preservation of one internal jugular vein minimally should be done in cases which were suspected high incidence of bilateral lymph node metastases for cure and prevention of neck recurrence.

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두경부 재건에 있어서 천공지 피판의 다양한 유용성 (Various Utility of Perforator Flaps in Head and Neck Reconstruction)

  • 김정태;이철용;김순진
    • Archives of Plastic Surgery
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    • 제32권3호
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    • pp.271-280
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    • 2005
  • There are various types of flap in head and neck reconstruction. We chose the appropriate flap considering the indication and patient's condition. In case of conventional flaps, its type is decided according to the reconstruction site. In other words, the types of considerable flaps are limited in a way. But, perforator flaps can reduce donor limitation and harvest flaps depending on the condition of the recipient. Therefore, the flap is very useful for the head and neck reconstruction needed for 2-dimensional or 3-dimensional reconstruction. We report the 29 cases of perforator-based flap including 8 cases of latissimus dorsi perforator free flap, 5 thoracodorsal perforator free flap, 4 anterolateral thigh perforator free flap, 3 peroneal osteocutaneous perforator free flap and 9 submental perforator island flap for the head and neck reconstruction. Free flaps include 2 cases of chimeric pattern, 7 controlled resurfacing pattern, 4 3-D pattern, 3 dermoadiposal pattern, 1 folded pattern and 3 osteocutaneous pattern. The flaps were successfully used for the head and neck reconstruction. But one patient died during a follow up period because of the recurrence of tumor. Various perforator flaps(island/free pattern) can be highly competitive to the conventional flaps in the head and neck reconstruction, considering a thin character for resurfacing, more flexible and versatile option, variable composition, long pedicle with donor structures saved, and less prominent donor morbidity.

후두와 기관을 침범한 갑상선암의 치료 (Management of Thyroid Cancer with Laryngotracheal Invasion)

  • 김광현;성명훈;노종렬;정원호;김춘동;서정호
    • 대한두경부종양학회지
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    • 제12권1호
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    • pp.8-15
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    • 1996
  • When thyroid carcinoma invades the larynx or trachea, the proper treatment is needed because of significant morbidity and mortality due to airway obstruction. Hemoptysis and dyspnea are the result of intraluminal extension of the tumor and call for immediate investigation with endoscopic examination and CT. If the thyroid carcinoma with extracapsular spread invades only outer perichondrium of the tracheal or laryngeal cartilage, the shaving operation would be sufficient, but if the tumor invades the cartilage or if there is intraluminal invasion, it is mandatory to remove partial or total part of some aerodigestive tract structures. We retrospectively analyzed 14 surgical cases of the thyroid cancer with laryngotracheal invasion(12 papillary carcinomas and 2 anaplastic carcinomas) at the Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital. The analysis was focused on clinical manifestation, pathologic findings, types of management and results. Survival result was not adequately analyzed due to some recently operated cases.

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Effect of prehydration solution on hearing threshold after chemotherapy in patients with head and neck cancers: a retrospective study

  • Dongbin Ahn;Kyu-Yup Lee;Eunjung Oh;Minji Oh;Boseung Jung;Da Jung Jung
    • Journal of Yeungnam Medical Science
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    • 제40권2호
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    • pp.164-171
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    • 2023
  • Background: The study aimed to evaluate the effect of prehydration solution on hearing thresholds after cisplatin chemotherapy. Methods: In this retrospective cohort study, we reviewed the data of patients who underwent ≥3 courses of cisplatin-based chemotherapy for locally advanced head and neck cancers at a tertiary referral center (n=64). The dextrose solution (DW) group (n=26) received 2 L of normal saline and 1 L of 5% dextrose. The Hartmann solution (HS) group (n=38) received 2 L of normal saline and 1 L of HS. Hearing data were measured 1 day before starting the first course of chemotherapy, and again 20 days after the first, second, and third courses of chemotherapy. The severity of hearing loss was evaluated using the Common Terminology Criteria for Adverse Events (CTCAE). Results: Thresholds at all frequencies after chemotherapy were greater in the DW group than in the HS group. The increase in thresholds in 1 to 4 kHz after the third course of chemotherapy was greater in the DW group than in the HS group. CTCAE grades after the second and third courses of chemotherapy were greater in the DW group than in the HS group. Logistic regression showed that the odds ratio for CTCAE grade 3 or 4 after the third course of chemotherapy in the DW group was 4.84 on univariate analysis. Conclusion: Prehydration using a solution with salt was associated with a decrease in change in hearing thresholds after cisplatin chemotherapy in patients with head and neck cancers.

점액표피양 암종과 동반된 경부 캐슬만 병 1예 (Synchronous Mucoepidermoid Carcinoma of Parotid Gland and Unicentric Cervical Cathleman's Disease : A Case Report)

  • 노민호;배공근;반명진;박재홍;이승원;박기남;김재욱;고윤우
    • 대한두경부종양학회지
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    • 제31권1호
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    • pp.14-17
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    • 2015
  • Castleman's disease is an uncommon lymphoproliferative disorder. The disorder can be classified based on histological subtype, such as hyaline vascular type, plasma cell type, and mixed type, and can also be clinically divided into either unicentric or multicentric type. Its exact pathophysiology is not clearly identified. The unicentric type is able to be treated by surgical resection. However, there is no standard treatment modlity for the multicentric type. Treatment of multicentric type includes anti-cancer chemotherapy and radiation therapy. Recently, authors have experienced a rare case of unicentric type of Castleman's disease accompanying a mucoepidermoid carcinoma of parotid gland and report a case which is discussed with references.

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갑상선 후방 피막을 침범하는 갑상선미세유두암의 임상양상에 대한 고찰 (Clinical Characteristics of Papillary Thyroid Microcarcinoma Involving Posterior Thyroidal Capsule)

  • 장성욱;오정호;김서빈;김성원;이형신;노웅재;이강대
    • 대한두경부종양학회지
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    • 제31권2호
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    • pp.6-10
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    • 2015
  • Background and Objective : Papillary thyroid microcarcinoma(PTMC) is known as slow growing cancer with good prognosis. However, extrathyroidal extension may increase the risk of cervical lymph node metastasis and local invasion to surrounding structures. The aim of this study was to assess the characteristic features of the tumor invading the posterior thyroid capsule. Material and Methods : We made a retrospective review of 123 PTMC patients with thyroid capsule invasion, pathologically staged as T3 or T4. 74 patients (60.2%) had invasion to posterior thyroid capsule (group A) while 49 patients (39.8%) had invasion to-anterior thyroid capsule or anterior wall of trachea (group B). We assessed the clinicopathologic factors of the patients according to the location of capsular invasion of PTMC. Results : There was no difference regarding age, gender, T and N classification and incidence of lymph node metastasis between two groups. Local invasion rate to recurrent laryngeal nerve was 6.8% in patients with posterior thyroid capsule invasion, while the incidence was zero in those with capsular invasion to other locations Conclusion : Increased risk of local invasion to the recurrent laryngeal nerve should be considered in patients with PTMC presenting invasion of the posterior capsule.

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