• Title/Summary/Keyword: Head and neck cancer patients

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Perioperative Management of the Voice in Thyroid Cancer (갑상선암 수술과 수술 전후 음성관리)

  • Yoon, So Yeon;Hong, Hyun Jun
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.31 no.2
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    • pp.49-55
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    • 2020
  • Evaluating the patient's voice before thyroidectomy is useful for the purpose of identifying patients with vocal cord paralysis without symptoms, identifying other patient's voice abnormalities, and whether it is related to voice disorders that may occur after surgery. Also voice evaluation after thyroid surgery is helpful in diagnosis, treatment, and rehabilitation and follow-up of voice disorders that occur without clear nerve damage after thyroidectomy. And it is helpful for rapid recovery through active early rehabilitation treatment for patients who complain of speech impairment without paralysis. In particular, neck exercise can improve the adhesion of the surgical site and increase the range of motion of the neck as well as improve subjective neck discomfort. In addition, hearing, voice and breathing functions should be improved, and voice hygiene education and counseling should be provided. Vocal cord injection is the first treatment option for unilateral vocal cord palsy. By establishing a protocol for voice disorders before and after thyroid surgery and providing appropriate treatment, the quality of life of patients can be improved.

Concurrent Cisplatin and Radiotherapy in Refractory Patients to Induction Chemotherapy and Recurrent Head and Neck Cancer (유도항암요법에 반응치 않는 환자와 재발한 두경부암환자에서 Cisplatin과 방사선 동시치료)

  • Kim Hoon-Kyo;Kang Jin-Hyoung;Lee Kyung-Sik;Kim Dong-Jip;Chang Hong-Suk;Yoon Sei-Chul;Cho Seung-Ho;Sub Byung-Do
    • Korean Journal of Head & Neck Oncology
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    • v.8 no.1
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    • pp.21-24
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    • 1992
  • In patients with locally advanced head and neck cancers who do not respond to induction chemotherapy and who have locoregional recurrence after local treatment subsequent radiotherapy alone does not have any additative effect. The theoretical rationale and promising clinical response of concurrent chemoradiotherapy in patients with the head and neck cancers have been recently conducted Ten patients(9 stage IV, q stage III) were treated with concurrent chemoradiotherapy(radiotherapy start from day 1 of chemotherapy; cisplatin $100mg/m^2$ intravenously every 3 weeks for $3{\sim}4$ cycles on day 1.22 and 43..). Four patients achieved complete response(CR) and overall response rate was 80% (8/10). The major toxicities we re leukopenia (90%), nausea/vomiting(80%), stomatitis(80%) and peripheral neuropathy(30%). Most of these side effects were mild to moderate and reversible.

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T Cell-directed Immunotherapeutic Approaches for Head and Neck Squamous Cell Carcinoma (두경부편평세포암에서의 T세포 면역치료)

  • Choi, Yoon Seok
    • Korean Journal of Head & Neck Oncology
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    • v.33 no.1
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    • pp.7-13
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    • 2017
  • Despite improved treatment outcomes of locally advanced disease over the last 2 decades, the survival of patients with recurrent and/or metastatic head and neck squamous cell carcinoma (HNSCC) remains dismal. There is a clear need for development of novel therapeutic strategies for recurrent and/or metastatic HNSCC. Recent advances in understanding tumor immunology have been directly and rapidly translated into clinical success of T cell-directed immunotherapeutic approach in the treatment of several types of solid cancers. Among them, impact of immune checkpoint inhibition using neutralizing antibodies is the most striking. A variety of immunotherapeutic strategies targeting T cells have been also studied in HNSCC, especially in recurrent and/or metastatic setting even with significant survival benefit. The present article reviews the basic concept of T cell-directed immunotherapy and the current status of such approaches in the treatment of HNSCC.

Radiotherapy and Concurrent Chemo-Radiotherapy in Locally Advanced Hypopharyngeal Cancers - A Hospital Registry Based Analysis

  • Sharma, Jagannath Dev;Krishnatreya, Manigreeva;Das, Ashok Kumar;Bhattacharyya, Mouchumee;Hazarika, Munlima;Kataki, Amal Chandra;Baishya, Nizara;Nandy, Pintu
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.11
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    • pp.4723-4726
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    • 2015
  • Background: The survival of patients with hypopharyngeal cancer is low amongst head and neck cancer cases. The incidence rates of hypopharyngeal cancers in our population are amongst the highest in the world and there are limited data available on the literature on varied responses to first course of treatment with radiotherapy (RT) and concurrent chemo-radiotherapy (CRT) in our population. Materials and Methods: Clinical characteristics and initial responses to treatment in patients who had received radiotherapy and chemo-radiotherapy in a regional cancer center from January 2010 to December 2013 were evaluated. The data were obtained from the hospital cancer registry, and analysis was carried using descriptive statistics. Pearson's chi-square was used to test for differences in the variables and p<0.05 was considered statistically significant. Results: A total of 554 patients were included in the analysis, 411 (74.2%) receiving RT and 143 (25.8%) being given CRT. There was significantly lower number of patients above 70 years with a higher proportion of patients below 50 years who had received CRT (p<0.05). Some 79.3% and 84.6% of patients in the RT and CRT groups respectively presented with a favorable performance status, and in the RT group 240 (58.4%) showed complete response (CR), and in the CRT group 103 (72.0%) showed CR at the first follow-up (p<0.05). Conclusions: Concurrent chemo-radiotherapy gives better short term response to treatment in locally advanced hypopharyngeal cancers.

Low-dose Radioactive I-131 Therapy after Total Thyroidectomy for Differentiated Thyroid Cancer (갑상선 분화암 수술 후 저용량 방사성 옥소(I-131)요법)

  • Choi Chung-Jin;Jung Sung-Hoo
    • Korean Journal of Head & Neck Oncology
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    • v.14 no.2
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    • pp.214-219
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    • 1998
  • Objectives: To assess the effectiveness of the low-dose(30mCi) I-131 ablation therapy for remnant thyroid tissue following total thyroidectomy for differentiated thyroid cancer. Methods: Between March 1995 and December 1997, forty-eight patients were given ablative doses(30mCi) of I-131 after total thyroidectomy for differentiated thyroid cancer in the presence of I-131 uptake in remnant thyroid tissue. Effective ablation of remnant thyroid tissue was determined by following I-131 whole body scan. if remnant thyroid tissue remained, we repeated the same management at 6 months interval. Results: Thirty-eight(79.1%) patients had papillary, 8(16.7%) follicular, 1(2.1%) medullary and 1(2.1%) Hurthle cell type cancer. Forty-eight patients underwent total thyroidectomy, among those central neck dissection was performed in 35 cases, and modified radical neck dissection in 14 cases. Postoperative complication developed in 8 cases, which included 4 cases of transient hypoparathyroidism, 1 case of permanent hypoparathyroidism, 2 cases of transient recurrent laryngeal nerve palsy, and 1 case of wound hematoma. There were significant remnant thyroid tissue in 46 cases(95.8%) of patients after total thyroidectomy, which could be ablated by low dose(30mCi) I-131. There were no statistical difference between operative procedures and number of treatment of I-131. Conclusions: These results suggested that repeated low-dose(30mCi) I-131 therapy would be needed, therefore, high -dose I-131 therapy could be considered as ablation therapy for the remnant thyroid tissue after total thyroidectomy for differentiated thyroid cancer.

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Validation of the Korean Version of the Neck Dissection Impairment Index in Patients Who Underwent Neck Dissection (경부청소술을 시행한 환자를 대상으로 한 경부청소술 후 장애지수에 대한 한글화 버전 표준화)

  • Lim, Won Sub;Lee, Chang Wook;Lee, Yoon Se;Jo, Min-Woo;Jung, Young Ho;Choi, Seung-Ho;Kim, Sang Yoon;Nam, Soon Yuhl
    • Korean Journal of Head & Neck Oncology
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    • v.37 no.2
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    • pp.43-50
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    • 2021
  • Background/Objectives: Shoulder function is an important aspect of health related quality of life (QOL). Neck dissection impairment index (NDII) is a simple shoulder-specific questionnaire. This study aimed to evaluate the association between QOL and NDII in patients who underwent neck dissection to validate the Korean version of NDII. Materials & Methods: This study enrolled 74 patients with head and neck cancer who underwent neck dissection from December 2013 to April 2014. Patients completed questionnaires on QOL including the European Organization of Research and Treatment of Cancer 30-item Core QOL questionnaire (EORTC QLQ-C30) and NDII which was translated into Korean. Validity was evaluated by calculating the Pearson correlation coefficient between NDII and EORTC QLQ-C30. Results: We compared preoperative, postoperative within a week, 1st and 3rd months NDII scores. The total NDII scores were 14.7, 47.4, 33.7 and 34.3 each. Clinical variables including gender, site of primary tumor, performing revision neck dissection, radiotherapy and flap reconstruction were not significantly associated with NDII. However NDII mean score of patients who underwent unilateral neck dissection over 3 levels is most increased after operation. During all periods NDII scores were significantly associated with functioning score. Although other scores are lower correlation than function scores, global health status scores and symptom scores are also correlation with NDII. Conclusion: NDII was valid instrument and can be used not only in the clinical practice to assess shoulder dysfunction but also in the simple instrument to evaluate global QOL in Korea patients with having neck dissection.

A Study on the Optimal Information Provision for PET-MRI: Focused on Literature Article (PET-MRI에 대한 최적의 정보 제공에 대한 연구: 문헌 보고 중심으로)

  • DongSeob Son;EunHoe Goo
    • Journal of Radiation Industry
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    • v.17 no.4
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    • pp.391-396
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    • 2023
  • Currently, state-of-the-art devices such as SPECT, PET/CT, and PET/MRI are rapidly spreading nationwide, and the penetration rate of nuclear medical devices is also ranked fifth in the world. However, PET/MRI's system is slower and less common because it is more complex than PET/CT. The purpose of this study is to provide optimal information on PET/MRI according to the patient's disease. The subjects obtained information on head and neck cancer, pediatric patients, breast cancer patients, heart disease patients, lung cancer patients, and rectal cancer patients. We tried to accumulate protocols by obtaining a lot of information about each disease. In diagnosing head and neck cancer, it is believed that it is highly likely to be used in evaluating preoperative stage determination, recurrence and remote metastasis after treatment, and unclear primary cervical lymph node metastasis. Diagnosis and continuous follow-up of pediatric patients can increase patient benefits by minimizing radiation exposure. Breast cancer provides a comprehensive evaluation of the clinical need to determine the extent of disease in breast and local lymph nodes and the systematic stages of early diagnosis or recurrence. In diagnosing heart disease patients, MR-based PET motion correction helps to realize the full potential of PET images. For lung cancer patients, the clinical value and usefulness of the resolution and detection ability of integrated PET/MRI for soft tissues such as lung cancer will be sufficient. In diagnosing rectal cancer patients, the detection of missing residual diseases can change the clinical response evaluation for rectal cancer patients treated with TNT, and both the initial stage and treatment response evaluation are possible. Therefore, this literature study provided basic clinical data for PET/MRI tests.

Depression and Predictors in Taiwanese Survivors with Oral Cancer

  • Chen, Shu-Ching;Huang, Bing-Shen;Lin, Chien-Yu
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4571-4576
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    • 2013
  • Background: Depression is a comorbid disabling problem and potentially affects patient likelihood of survival. The aims of this study were to recognize the characteristics of depression and investigate associated predictor factors in patients with oral cancers. Methods: A cross-sectional and correlational design was used to collect data for this study conducted in northern Taiwan. A set of questionnaires was used to measure depression, symptom distress, performance status, social support, and demographic and disease-related information. Logistic regression was conducted to determine important factors predicting depression. Results: A total of 132 oral cancer patients participated in this study. Of these, 18.2% were identified as depression cases. The patient average performance status score was 90 or higher. Patients reported mild-to-moderate levels of symptom distress. The majority of social support was from families. Religious belief, alcohol use, symptom distress, and social support from family were found to be important factors predicting depression. Patients with religious belief with alcohol use reported greater symptom distress, and those with lower levels of social support from families were significantly more likely to develop depression. Conclusions: Clinicians should assess patient emotional status and manage symptoms in a timely manner to enhance coping abilities. Supportive care provides assurance during the acute survivor phase.

A Phenomenological Study of Experiences of Family Care Givers of Patient with Head and Neck Cancer (두경부암 환자 가족의 돌봄 경험에 관한 현상학적 연구)

  • Im, Jung-Won;Kwon, Ju-Yeon;Ahn, Son-Hee;Yoon, Eun-Ji
    • The Journal of the Korea Contents Association
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    • v.18 no.10
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    • pp.348-360
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    • 2018
  • Purpose : The purpose of this study was to explore the meaning and essence of experience of family members as care givers of patient with head and neck cancer. Methods : This study was based on the colaizzi's phenomenological method, which describes the experiences about the family care givers. We had in-depth interview with family of five head and neck cancer patients. Results : Data was classified by 24 themes, 9 theme clusters and 4 categories. The categories are as follows: 'Shocking and actuality like a deadly maze', 'Cut off from the world by changes in family's physical image', 'Exhaustion of family', 'Take-off for mature care'. Conclusion : The results of the study provide useful information in understanding care givers' experience of patient with head and neck cancer and establishing effective strategies to support these care givers.

Prognostic Value of Osteopontin in Patients Treated with Primary Radiotherapy for Head and Neck Cancer

  • Etiz, Durmus;Ataizi, Fulya Colak;Bayman, Evrim;Akcay, Melek;Acikalin, Mustafa Fuat;Colak, Ertugrul;Ciftci, Evrim
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.9
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    • pp.5175-5178
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    • 2013
  • Background: The prognostic value of tumor osteopontin (OPN) in patients with squamous-cell head and neck cancer (SCHNC) was investigated. Materials and Methods: OPN expression was assessed by immunohistochemical methods in 50 patients, who were treated with primary radiotherapy (RT) for locally advanced SCHNC. The effects of OPN on clinical parameters, local-regional control after RT and metastasis-free survival, was assessed. Results: The rate of OPN expression in tumor tissue was 76%. OPN positive cases had lower Hb levels (p=0.088). Mean time to local recurrence was 53.8 months (SE 3.9) in OPN-negative cases and 39.1 months (SE 4.7) in OPN-positive cases (p=0.047). OPN increased the risk of local recurrence 5.9 times (p=0.085). It had no effect on metastasis-free (p=0.116) or overall survival (p=0.123). OPN was positive in 12 of 19 cases that developed grade 3-4 acute radiation dermatitis (p=0.096). Conclusions: OPN expression is associated with an increase in local recurrence in patients who were treated with primary RT for locally advanced SCHNC.