• Title/Summary/Keyword: Head and neck radiotherapy

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A Case of Osteosarcoma of the Mandible (좌측 하악골에 생긴 골육종(Osteosarcoma) 1예)

  • Kim Chan-Jong;Lee Jae-Dong;Nam Soon-Yuhl
    • Korean Journal of Head & Neck Oncology
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    • v.19 no.2
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    • pp.179-183
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    • 2003
  • Osteosarcoma is one of the most frequently occurring malignant bone tumor except for multiple myeloma. However, osteosarcoma of the mandible is rare and aggressive malignancy constituting about 5% to 13% of all cases of skeletal osteosarcoma. The authors experienced a case of osteosarcoma of the mandible in a 31-years old male patient. He visited our outpatient clinic with painless mass of the cheek. On the basis of the clinical and imaging findings, the differential diagnosis included giant cell tumor, histiocytosis and malignant bone tumor. In the first operation, the mass of the mandible was excised. Intraoperative microscopic examination of a frozen section did not yield a diagnosis: however, the final definitive histologic examination revealed osteoblastic osteosarcoma. After 15days, wide excision with hemimandibulectomy was completed followed by postoperative radiotherapy and chemotherapy. With our experience, we report the progression of diagnosis and management for mandibular osteosrcoma.

Comparison of Dose Statistics of Intensity-Modulated Radiation Therapy Plan from Varian Eclipse Treatment Planning System with Novel Python-Based Indigenously Developed Software

  • Sougoumarane Dashnamoorthy;Karthick Rajamanickam;Ebenezar Jeyasingh;Vindhyavasini Prasad Pandey;Kathiresan Nachimuthu;Imtiaz Ahmed;Pitchaikannu Venkatraman
    • Progress in Medical Physics
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    • v.33 no.3
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    • pp.25-35
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    • 2022
  • Purpose: Planning for radiotherapy relies on implicit estimation of the probability of tumor control and the probability of complications in adjacent normal tissues for a given dose distribution. Methods: The aim of this pilot study was to reconstruct dose-volume histograms (DVHs) from text files generated by the Eclipse treatment planning system developed by Varian Medical Systems and to verify the integrity and accuracy of the dose statistics. Results: We further compared dose statistics for intensity-modulated radiotherapy of the head and neck between the Eclipse software and software developed in-house. The dose statistics data obtained from the Python software were consistent, with deviations from the Eclipse treatment planning system found to be within acceptable limits. Conclusions: The in-house software was able to provide indices of hotness and coldness for treatment planning and store statistical data generated by the software in Oracle databases. We believe the findings of this pilot study may lead to more accurate evaluations in planning for radiotherapy.

A Case of Primary Small Cell Carcinoma of the Supraglottis (성문상부에 발생한 원발성소세포암 1예)

  • Lee, Su-Hyun;You, Si-Young;Choi, Hyun-Joo;Cho, Jung-Hae;Kim, Sung-Whan;Lee, Jong-Hwan;Kim, Young-Woon;Kim, Hoon-Kyo
    • Korean Journal of Head & Neck Oncology
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    • v.28 no.1
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    • pp.42-45
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    • 2012
  • Small cell carcinoma mainly occurs in the lung. Approximately 2.5-5% of small cell carcinomas are primary extrapulmonary which are commonly found in the esophagus, GI tract, skin, uterus, and urinary tract. Small cell carcinoma of the head and neck is extremely rare and its prognosis is poor. We report a case of supraglottic small cell carcinoma with cervical lymph node and rib metastasis in a 75-year-old man. The patient was treated with sequential combination of chemotherapy and radiotherapy, but the cancer has progressed. We concluded that we have to find an effective therapy for laryngeal small cell carcinoma.

Epithelial-Myoepithelial carcinoma of parotid glands: 3 cases misdiagnosed as pleomorphic adenoma (다형성 선종으로 오인된 이하선 상피-근상피암종 3례)

  • Lee, Jong Won;Choi, Jong Joong;Kim, Myeong Hee;Kim, Yeon Soo
    • Korean Journal of Head & Neck Oncology
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    • v.33 no.2
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    • pp.43-47
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    • 2017
  • Epithelial-myoepithelial carcinoma (EMC) is a rare type of low-grade malignant tumor that account for approximately 0.5% to 1% of salivary gland neoplasm and arises most commonly in the parotid gland (80%). We introduce three cases of parotid EMC arose as painless cystic mass in male patients over 70 years old. All patients were diagnosed as benign tumors (pleomorphic adenoma) by image and pathologic study (fine needle aspiration) before surgery, but the final histopathologic results were EMC. All three patients underwent parotidectomy without adjuvant radiotherapy. There were no complications such as facial paralysis. No complications or recurrences were observed during follow-up for 6 to 9 months. Since the reports of EMC are still relatively few, we report our three cases with the clinical and pathological review.

Epidermal Growth Factor Receptor-Related DNA Repair and Radiation-Resistance Regulatory Mechanisms: A Mini-Review

  • Bai, Jing;Guo, Xiao-Guang;Bai, Xiao-Ping
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.10
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    • pp.4879-4881
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    • 2012
  • Epidermal growth factor receptor (EGFR) overexpression is associated with resistance to chemotherapy and radiotherapy. The EGFR modulates DNA repair after radiation-induced damage through an association with the catalytic subunit of DNA protein kinase. DNA double-strand breaks (DSBs) are the most lethal type of DNA damage induced by ionizing radiation, and non-homologous end joining is the predominant pathway for repair of radiation-induced DSBs. Some cell signaling pathways that respond to normal growth factors are abnormally activated in human cancer. These pathways also invoke the cell survival mechanisms that lead to resistance to radiation. The molecular connection between the EGFR and its control over DNA repair capacity appears to be mediated by one or more signaling pathways downstream of this receptor. The purpose of this mini-review was not only to highlight the relation of the EGFR signal as a regulatory mechanism to DNA repair and radiation resistance, but also to provide clues to improving existing radiation resistance through novel therapies based on the above-mentioned mechanism.

A Treatment Outcomes and Prognostic Factors of Malignant Submandibular Gland Tumor (악하선 암의 치료성적과 예후인자)

  • Lim Chi-Young;Nam Kee-Hyun;Lee Jan-Dee;Chang Hang-Seok;Chung Woong-Youn;Cha In-Ho;Lee Chang-Geol;Choi Eun-Chan;Park Cheong-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.21 no.2
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    • pp.201-207
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    • 2005
  • Purpose: Submandibular gland tumor is rare, less than 6% of head and neck tumor. The purpose of this article is to analysis the clinical experience and treatment outcomes of malignant submandibular gland tumor, suggesting a guideline of management. Methods: We retrospectively evaluated 26 patients who underwent operation for malignant submandibular gland tumor at Severence hospital between 1986 and 2004. Statistical analysis was performed by Kaplan-Meier method, log rank test, Chi-square test, Fisher's exact test using SPSS v12.0 for Windows. Results: They consisted of 18 males and 8 females whose median age was 47 years(range: 20-71). 10 cases of adenocystic carcinoma, 8 cases of carcinoma ex pleomorphic adenoma, 4 cases of mucoepidermoid carcinoma, 1 case each for acinic cell carcinoma, undifferentiated carcinoma, adeno carcinoma, epithelioid hemangioendothelioma. Sialoadenectomy only was performed in 10 cases(36.5%) and sialoadenectomy with neck node dissection was performed in 16 cases(63.5%). Adjuvant radiotherapy was done in 22 cases(84.6%). 10 year disease free survival rate for malignant submandibular gland tumor was 63.1 % and 10 year overall survival rate for malignant submandibular gland tumor was 70.1%. In univariate analysis, prognostic factors affecting recurrence of malignant submandibular gland tumor was initially papable lateral neck node in physical examination and metastasis of lateral neck node in pathologic confirmation. The prognostic factors affecting survival of malignant submandibular gland tumor was tumor size, TNM stage, recurrence and type of recurrence. Conclusion: In this study, prognostic factors affecting recurrence of malignant submandibular gland tumor was initially papable lateral neck node in physical examination and metastasis of lateral neck node in pathologic confirmation. The prognostic factors affecting survival of malignant submandibular gland tumor was tumor size, TNM stage, recurrence and type of recurrence. To prevent recurrence and to improve survival, early diagnosis and aggressive surgery must be considered.

DEVELOPMENTAL DISTURBANCE OF PERMANENT TOOTH GERMS AFTER RADIOTHERAPY : REPORT OF CASE (방사선치료 후 영구치 치배 발육장애 증례보고)

  • Kang, Myung-Bong;Kim, Young-Jae;Kim, Jung-Wook;Jang, Ki-Taek;Lee, Sang-Hoon;Hahn, Se-Hyun;Kim, Chong-Chul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.32 no.2
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    • pp.251-255
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    • 2005
  • Radiotherapy for head and neck tumors is a viable treatment modality. However, a wide range of potentially debilitating dental complications may be accompanied by this treatment. We report two cases of developmental disturbance of permanent tooth germs after radiotherapy. The one was that of a seven-year-old girl, who had congenitally missing teeth, and microdontia of permanent tooth germs. she had received radiotherapy for acute myelocytic leukemia at the age of 19 months. The other was that of a nine-year-old boy, in which congenitally missing teeth, microdontia, root hypoplasia, and enamel hypoplasia of permanent teeth were observed. He had undergone a course of radiotherapy for bilateral retinoblastoma at the age of 13 months.

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The Effect of Adjuvant Chemotherapy in Locally Advanced Head and Neck Squamous Cell Carcinoma after Induction Chemotherapy (국소진행 두경부 상피세포암에서 선행유도약물요법 후 보조약물요법의 효과)

  • Kim Cheol-Woo;Roh Jae-Kyung;Ahn Joong-Bae;Park Joon-Oh;Chung So-Young;Lee Seok;Lee Hey-Ran;Lee Kyung-Hee;Chung Hyun-Cheol;Kim Joo-Hang;Kim Byung-Soo;Suh Chang-Ok;Kim Gwi-Eon
    • Korean Journal of Head & Neck Oncology
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    • v.10 no.1
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    • pp.13-24
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    • 1994
  • Despite optimal local therapy such as surgery and/or radiotherapy, the long term outcome is poor for patients with advanced squamous cell carcinomma of head and neck, due to frequent loco-regional recurrence and distant metastases. We studied to determine whether the combination chemotherapy, especially as an adjuvant chemotherapy, would improve the survival of these patients. Between January, 1986 and December, 1992, 57 patients with previously untreated, locally advanced squamous cell arcinoma of head and neck were assigned to receive 2-3 cycles of induction chemotherapy consisting of 5-fluorouracil(F) and cisplatin(P) every 3 weeks and standard local therapy such as surgery and/or radiotherapy followed by adjuvant chemotherapy with the same FP regimens. Of the 57 enroled patients, 45 patients were evaluable. The obtained results were as following: 1) Among 45 evaluable patients, 18 patients finished all treatment protocol including adjuvant chemotherapy and 27 patients had no adjuvant chemotherapy. The difference of age, sex, performance status, disease stage, and tumor differentiation was not significant statistically between adjuvant chemotherapy group and no-adjuvant chemotherapy group. 2) After induction chemotherapy, 7/45(15.4%), 30/45(67%) achieved complete remission and partial remission respectively with 82.4% overall response rates in entire patients. 3) The 4year progression free survival was 43.3% in adjuvant chemotherapy group and 24.1% in no-adjuvant chemotherapy group(p>0.05). The 4year overall survival was 56.9% and 25.5% respectively(p>0.05). There was no significant different in the patterns of local recurrence and distant metastasis between the two groups. 4) Adverse reactions from combination chemotherapy included nausea, vomiting, mucositis, diarrhea and hematologic bone marrow depression. These were mild and tolerated by patients, and these was no episode of any life threatening toxicities. In conclusion, adjuvant chemotherapy after induction chemotherapy and local therapy did not show statistically significant survival improvement, but there was trend of prolongation of survival when compared to no adjuvant chemotherapy. Thus, large scale phase III randomized controlled studies are strongly recommended.

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A Result and Prognostic Factors of Hypofractionation Radiation Therapy in Early Glottic Cancer (초기 성문암 환자에서 소분할조사법의 방사선 치료 결과와 예후 인자)

  • Lee Mi-Jo;Kim Hun-Jung;Kim Woo-Chul;Loh Jun-Gou
    • Korean Journal of Head & Neck Oncology
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    • v.21 no.2
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    • pp.132-138
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    • 2005
  • Purpose: The purpose of this study was to establish general guidelines for the treatment of patients with early glottic cancer(T1-2N0M0), by assessing the role of primary radiation therapy and by analyzing the tumor-related and treatment-related factors that influence treatment results. We also studied the results of hypofractionated radiation therapy for early glottic cancer. Material and Methods: This retrospective study comprised 48 patients who suffered from early glottic cancer and were treated by primary radiotherapy at Inha University Hospital, between May 1997 and October 2004. T-stage distribution showed 38 patients as T1 and 10 patients as stage T2. Thirty-eight patients underwent hypofractionated radiotherapy using a 6 MY photon beam, a total tumor dose of 63Gy, in 5 weekly fractions of 2.25Gy, with an overall radiation treatment time of 38 days. Ten patients in the T2 stage tolerated a total dose of 63-72 Gy(median 68.4Gy) in 5 weekly fractions of 1.8-2.0Gy, with an overall radiation treatment time of 40-87 days(median 51 days). All patients were followed up for at least 3 years. Univariate and multivariate analyses were performed to identify the prognostic factors affecting the treatment results. Result: The 5-year survival rate was 92% for all patients, 94% for T1 patients and 91% for T2 patients. The local control rate was 93.5% for all patients, 95% for T1 and 92.2% for T2 patients. Three patients suffered a relapse following radiotherapy, and underwent subsequent salvage surgery. We included T-stage, tumor location, total radiation dose, field size and overall radiation treatment time as potential prognostic factors. Only T-stage was found to be statistically significant in the univariate analysis, but in the multivariate analysis, it was not found to be significant. Conclusion: High curative and voice preservation rates were obtained with hypofractionated radiotherapy. Further study with a larger number of patients is needed to determine the prognostic factors affecting treatment results.

A Case of Postirradiation Osteosarcoma of the Mandible (하악골에 발생한 방사선속발 골육종 1례)

  • Ahn Byung-Hoon;Park Sun-Ho;Kim Deok-Jun;Song Dal-Won
    • Korean Journal of Head & Neck Oncology
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    • v.13 no.2
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    • pp.251-255
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    • 1997
  • Although primary surgical excision is the treatment of choice for the vast majority of patients with nasopharyngeal angiofibroma, radiation therapy is also employed as a primary tool or in the cases of tumor recurrence or massive intracranial extension. But, especially in young patients, postradiation sequelae such as osteomyelitis, atrophic rhinitis, thyroid or bone malignancy are of concern. Postirradiation osteosarcoma is a rare, but well-recognized complication of radiotherapy, which comprise roughly 2 to 5 percent of all osteogenic sarcoma. Recently we experienced a case of postirradiation osteosarcoma of the mandible who had treated by radiation therapy for the nasopharyngeal angiofibroma 30 years ago, presently he is ongoing chemotherapy and relatively being well.

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