• 제목/요약/키워드: Head and neck cancer patients

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두경부 악성종양 환자에서 조기 방사선치료를 위한 구강관리법에 대한 실험적 연구 (The experimental study of oral care for early radiation therapy in the head and neck cancer patients)

  • 문원규;차인호;김형준;정영수;이천의;이종영;유미현;유재하
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제37권3호
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    • pp.169-175
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    • 2011
  • Background: Teeth requiring extraction before radiotherapy in head & neck cancer patients should be removed as long as possible before the initiation of radiation therapy. Conventionally, a minimum 2-week waiting primary healing period is recommended. Although the above 2-week period is ideal, it was not uncommon for the radiotherapist and cancer patient to feel an urgent need to process with radiotherapy despite the need for dental care. Therefore, alternative approaches for early radiotherapy, including conservative endodontic treatment and a 1-week waiting primary healing period after dental extraction at the time of radiotherapy, were considered and applied based on the experimental study Materials and Methods: Eighteen dogs were processed for histopathologic wound healing. The effect of the primary endodontic treatment and extraction before early radiotherapy was examined. Results: No specific complication, such as, post-extraction wound infection, radiation osteitis and osteoradionecrosis, were encountered despite the early radiotherapy. Conclusion: Based on the experimental study, a minimum 1-week waiting primary healing period for oral care before radiotherapy is suitable for the early radiotherapy in head and neck cancer patients.

활배근피판을 이용한 두경부 재건술 (Latissimus Dorsi Myocutaneous Flap in Head and Neck Reconstruction)

  • 김광현;성명훈;진태훈
    • 대한두경부종양학회지
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    • 제6권2호
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    • pp.71-78
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    • 1990
  • The reconstruction of huge surgical defect is one of the major problems in the surgical treatment of the cancer of the head and neck. The latissimus dorsi myocutaneous flap, which is one of the most versatile myocutaneous flap, is a reliable method of reconstruction for extensive wounds in the head and neck. Due to the difficult patient positioning, its uses are reserved for the extensive defects or for the cases in which other traditional flaps have failed. The authors successfully reconstructed large surgical defects in the head and neck region using LDMC flap in five patients.

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변형적 경부청소술 후 내경정맥의 유지 (Internal Jugular Vein Patency after Modified Radical Neck Dissection)

  • 조정일;김영모;김철호;김형진
    • 대한두경부종양학회지
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    • 제14권2호
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    • pp.169-174
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    • 1998
  • 저자들은 변형적 경부청소술을 시행받은 두경부암환자 23례를 대상으로 술 후 내경정맥의 유지여부을 후향적으로 연구한 결과 총 34측 경부청소술 중 28측(82.4%)에서 내경정맥이 유지됨을 알 수 있었다. 이는 기존의 연구결과와 비슷한 개존율임을 알 수 있었다. 내경정맥의 폐쇄요인으로 술중 정맥의 손상과 혈류정체, 장기간 수술로 인한 정맥벽의 건조, 수술시 제거되는 근막의 소실이 정맥의 유착과 압박을 초래하는 것으로 알려져 있다. 또한 다양한 치료방법과 술 후 발생하는 여러 요인들에 의해 내경정맥이 영향을 받는데 본 연구에서는 국소재발과 창상합병증등이 주된 영향을 준 것으로 판단된다. 방사선치료는 다른 복합적인 요소가 결부되어 단독적인 영향으로 판단하기엔 충분치 않으며 양측 경부청소술은 내경정맥의 폐색과는 무관한 것으로 생각된다. 본 연구는 증례수가 작고 추적기간이 짧은 한계점이 있으므로 향후 좀 더 많은 증례와 충분한 추적기간을 통한 연구가 필요하리라 판단된다.

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편평세포암 동물 모델에서 고려인삼잎-다당체(MB40)의 항암치료효과 (The Anti-tumor Effect of Polysaccharide from the Leaves of Panax Ginseng C.A. Meyer(MB40) in a Murine Squamous Cell Carcinoma Model)

  • 주은정;최준;정은재;홍석진;조재구;백승국;우정수;정광윤;권순영
    • 대한두경부종양학회지
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    • 제25권1호
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    • pp.3-7
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    • 2009
  • Background and Objectives : Panax ginseng C.A. Meyer is a medical plant that has been widely utilized as a tonic and nutritional agent since ancient times in Korea. Ginseng has anti-metastatic property of cancer and immunomodulating activity. The novel acidic polysaccharide compound(MB40) was isolated from the leaves of Panax ginseng C.A. Meyer. To determine immunomodulating activities of MB40, we evaluate anti-cancer and anti-metastatic effects of MB40 in tumor bearing immune competent mice. Material and Methods : C3H mice were divided into three equal groups(Cisplatin treatment group, MB40 treat-ment group, Cisplatin and MB40 treatment group) and were transplanted SCC(Squamous Cell Carcinoma) cells(2${\times}$106) to the lateral side of abdomen. From day 4 after transplantation, MB40 was administrated at dose of 10mg/kg, respectively, every other day by intratumoral injection. Cisplatin was systemically administrated at doses of 1mg/kg, respectively, every week by intraperitoneal injection. Results : 5 days after administration, tumors can be palpated in every mice group. After 13 days of administration, the mice group to which MB40 were administrated exhibited reduction in tumor size respectively, compared to cisplatin group. Overall status of mice such as body weight and activity were superior in MB40 group than cisplatin group. Conclusion : The result of this study indicates MB40 may have significant therapeutic effect and decreases complications induced by systemic chemotheraphy. MB40 may be developed as a novel and potent immunotropics to improve the cell immune system and anti-cancer drug for the treatment of cancer patients in head and neck squamous cell carcinoma.

Gene signature for prediction of radiosensitivity in human papillomavirus-negative head and neck squamous cell carcinoma

  • Kim, Su Il;Kang, Jeong Wook;Noh, Joo Kyung;Jung, Hae Rim;Lee, Young Chan;Lee, Jung Woo;Kong, Moonkyoo;Eun, Young-Gyu
    • Radiation Oncology Journal
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    • 제38권2호
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    • pp.99-108
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    • 2020
  • Purpose: The probability of recurrence of cancer after adjuvant or definitive radiotherapy in patients with human papillomavirus-negative (HPV(-)) head and neck squamous cell carcinoma (HNSCC) varies for each patient. This study aimed to identify and validate radiation sensitivity signature (RSS) of patients with HPV(-) HNSCC to predict the recurrence of cancer after radiotherapy. Materials and Methods: Clonogenic survival assays were performed to assess radiosensitivity in 14 HNSCC cell lines. We identified genes closely correlated with radiosensitivity and validated them in The Cancer Genome Atlas (TCGA) cohort. The validated RSS were analyzed by ingenuity pathway analysis (IPA) to identify canonical pathways, upstream regulators, diseases and functions, and gene networks related to radiosensitive genes in HPV(-) HNSCC. Results: The survival fraction of 14 HNSCC cell lines after exposure to 2 Gy of radiation ranged from 48% to 72%. Six genes were positively correlated and 35 genes were negatively correlated with radioresistance, respectively. RSS was validated in the HPV(-) TCGA HNSCC cohort (n = 203), and recurrence-free survival (RFS) rate was found to be significantly lower in the radioresistant group than in the radiosensitive group (p = 0.035). Cell death and survival, cell-to-cell signaling, and cellular movement were significantly enriched in RSS, and RSSs were highly correlated with each other. Conclusion: We derived a HPV(-) HNSCC-specific RSS and validated it in an independent cohort. The outcome of adjuvant or definitive radiotherapy in HPV(-) patients with HNSCC can be predicted by analyzing their RSS, which might help in establishing a personalized therapeutic plan.

고선량율 강내 조사를 이용한 두경부암의 방사선 치료 (Radiation Therapy of Head and Neck Cancer with CO-60 HDR Transcatheteric Irradiation)

  • 신세원;김성규;김명세
    • Journal of Yeungnam Medical Science
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    • 제7권2호
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    • pp.109-114
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    • 1990
  • 저자들은 두경부암의 포괄적인 치료의 일부로서 외부 방사선 조사와 고선량율 경관조사를 시행하여 12명중 9명에서 완전 관해를 얻었으며, 치료중이나 치료후 경관조사와 직접 관련된 급성 부작용이나 합병중의 발생이 없었다. 그러나 대상환자가 적고 추적기간이 짧은관계로 생존율의 향상은 추측하기 어려우나 완전 관해를 얻은 환자는 장기간 무병 상태로 추적되고 있어서 외부방사선 조사와 경관 조사는 두경부암 치료에 큰 역할을 하리라 기대된다.

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두경부 암 환자의 경부 림프절 전이 분석 (Nodal Status of the Head and Neck Cancer Patients)

  • 양대식;최명선;최종욱
    • Radiation Oncology Journal
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    • 제15권4호
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    • pp.321-329
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    • 1997
  • 목적 : 두경부 암 환자에서 경부 림프절 전이 가능성이 높아지는 것은 원발병소의 해부학적위치 및 특성, 원발병소의 크기 즉 병기와 조직병리학적 종류 따라 영향을 받는다. 두경부 암 환자에서 경부 림프절의 전이 양상은 다른 나라에서 분석, 연구되어 있고, 현재 두경부 암 환자 치료와 처치를 이를 기조로 하여 사용한다. 그러나, 두경부 암 환자에 대한 경부 림프절 전이에 대한 우리나라 환자의 통계는 없어 이번 통계를 시행하게 되었다. 대상 및 방법 : 1981년 11월부터 1995년 12월까지 본 병원 방사선 종양학과에 내원한 환자중초사가 가능한 997명을 대상으로 하였다. 조사는 방사선 종양학과에 내원시 면밀한 경부 촉진과향께 컴퓨터 단층 촬영영상 상에서 확인을 하였다. 환자는 크게 경부 림프절 전이가 있는 군과 전이가 없는 군으로 나누었고, 경부 림프절의 병기는 미국 암 연합회에서 추천한 방식에 의하였다. 원발병소의 위치 및 주위로의 침윤 등은 면밀한 관찰과 촉진, 컴퓨터 단층 촬영 영상, 수술소견 및 조직병리학 소견을 참조하였다. 결 과 :방사선 종양학과에 방사선 치료를 위해 내원한 997명 중 416명$(42\%)$에서 경부 림프절 전이를 뽀였고, 581명$(58\%)$에서 전이를 보이지 않았다. 경부 림프절 전이를 보인 림프절의 병기분포를 관찰한 결과 다음과 같았다. Hl : 106$(25.5\%)$, N2a 100$(24\%)$, N2b :68$(16.4\%)$, N2c : 69$(16.6\%)$, N3 :73$(15\%)$. 두경부 암 환자에서 원발병소의 빈도는 다음과 같다. 후두암 : 283$(28.5\%)$, 부비동암 : 152$(18\%)$, 구인두암: 144$(14.5\%)$, 비인강암: In$(12\%)$, 구강암 :92$(9\%)$, 하인두암:71$(7\%)$, 타액선암:$58(6\%)$, 미지원발부위암:31$(3\%)$, 피부암: $14(2\%)$. 두경부 암 환자 중 가장 경부 림프절 전이가 높은 원발병소는 비인강암$(71\%)$으로 나타났고, 다음은 하인두암$(69\%)$, 구인두암$(64\%)$, 구강암$(39\%)$ 순이었다. 경부 림프절 전이를 보였던, 416명 중에서는 구인두암 92명$(22\%)$, 비인강암 8f명$(21\%)$, 후두암 79명$(19\%)$의 순이였다. 병리조직학적으로 가장 빈도가 높을 것은 편평상피암증으로 전체 환자 중 $65.4\%$을 차지하였고, 다음은 악성 림프종이 109명으로 $11\%$였다. 결론 : 두경부 암 환자에서 경부 림프절 전이의 양상이 외국 통계와 비교 매우 유사하게 나타났으며, 원발병소의 해부학적 특성에 따라 경부 림프절 전이가 좌우되며 원발병소의 병기가 진행됨에 따라 경부 림프절 전이 빈도도 증가 되며 또한 경부 림프절의 병기도 증가되는 것을 관찰 할 수 있었다.

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경부 림프절 종대로 발현한 원발 부위 불명의 전이암 (Metastatic Carcinoma of an Unknown Primary Site Presented to the Neck)

  • 김태용;조요한;김진수;홍용상;이근욱;윤탁;송은기;나임일;신현춘;김동완;이재서;성명훈;허대석
    • 대한두경부종양학회지
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    • 제20권2호
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    • pp.181-188
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    • 2004
  • Background: About 3% of all cancer patients suffer from cancer of unknown primary origin. Generally, carcinoma of unknown primary (CUP) carries a grave prognosis, but primary tumor presented to the neck is exception to this. The aims of study are to determine the role of chemotherapy and to find the prognostic factors in unknown primary tumor presented to the neck. Method and Material: Eighty-four patients were diagnosed with unknown primary tumor presented to the neck between January 1996 and June 2002. Among 84 patients, 43 patients (52%) received chemotherapy, radiation or surgery were performed in 20 patients (23%), 21 patients (25%) had no treatment. Results: The response rates to chemotherapy were 87.5% in CUP only localized to the neck and 44.0% in CUP systemically involved (p=0.012). A median follow-up duration was 6.4 years and overall median survival time was 9 months. The median overall survival time of patients treated with chemotherapy were 17 months and that of patients who received surgery or radiation were 20 months (p=0.3548). The important prognostic factors were performance status and the number of involved organ. Conclusion: The prognosis of patients with CUP presented to the neck is more favorable than that of patients with CUP of other localization. The effectiveness of chemotherapy for CUP only localized to the neck was similar to that of surgery or radiation. The important prognostic factors were performance status and the number of involved organ.