• Title/Summary/Keyword: Head and neck radiotherapy

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A Case of Well-Differentiated Liposarcoma on the Anterior and Posterior Neck (전, 후경부에 동시 발생한 호분화성 지방육종 1예)

  • Sah, Dae Jin;Kim, Yoon Jung;Baek, Hun Hee;Kim, Seung Woo
    • Korean Journal of Head & Neck Oncology
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    • v.30 no.1
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    • pp.31-34
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    • 2014
  • Liposarcoma is a malignant tumor originated from adipose tissue, accounting for 20% of all soft tissue sarcomas. A 69-year-old man with anterior and posterior neck mass visited to our department and we performed an excisional biopsy in level I. Histopathological examination revealed liposarcoma, so we performed wide excision in anterior and posterior neck, and adjuvant radiotherapy. We report a unique case of well-differentiated liposarcoma on anterior and posterior neck with literature review. To our best knowledge, such case has not been reported earlier in Korea previously.

Clinical Characteristics of Head and Neck Mucosal Melanoma (두경부에 발생한 점막형 악성흑색종의 임상적 특성)

  • Choi Jong-Ouck;Seok Youn-Sik;Choi Geon;Yoo Hong-Kyoun
    • Korean Journal of Head & Neck Oncology
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    • v.12 no.2
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    • pp.188-192
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    • 1996
  • The biological behavior of mucosal melanoma is aggressive with frequent local recurrence and distant metastasis owing to the abundantly surrounding blood vessels and lymphatics adding to the fact that diagnosis is frequently delayed due to non-specific clinical outcome. The management for mucosal melanoma of the head and neck is controversial in view of the poor prognosis. Ten cases treated over the past 10 years are reported. The average age of the patients was 54.4 years. Seven cases were localized in the nasal cavity and paranasal sinuses and three cases in the oral cavity and nasopharynx. Eight patients had local tumors, one had regional lymph node metastases and one hed lung metastases. Six patients underwent surgical resection, with postoperative radiotherapy in five patients, three patients received radiotherapy and one patient received combination therapy. Recurrence occured in 80% of the patients and the median time to recurrence was 10.5months. The median survival for those who received surgical resection followed by postoperative radiation therapy was 20.8 months and 14.7 months in the radiation therapy only treated group. The author's conclusion is that mucosal melanoma is a highly aggressive disease of the upper respiratory tract in which the best treatment modality is wide surgical resection followed by postoperative radiation therapy.

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The Effects of Radiotherapy on Parotid Salivary Function (방사선치료 후의 이하선 기능의 변화)

  • Lee Jong-Young;Park Kyung-Ran;Yoon Kap-Jun;Hong In-Soo
    • Korean Journal of Head & Neck Oncology
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    • v.11 no.2
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    • pp.153-157
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    • 1995
  • The effects of radiation therapy on salivary function of parotid gland were studied 20 male patients by radiation for tumors of head and neck. Saliva samples were collected before, during the radiotherapy and follow up. Parotid salivary function was quantitatively evaluated using a sialometry, sialochemistry, and scintigraphy. Salivary flow rates decreased in all individuals after irradiation. Glands than were partially irradiated were more likely to have some residual function than fully irradiated glands. Sodium and chloride contents were increased in parotid saliva of radiation patients where as potassium content was not changed definitively, pH was not changed during radiotherapy, but increased during follow up period. Scintigraphic stimulatory response rates showed similar result as flow rates. These results showed that exclusion of partial parotid gland from radiation is necessary to prevent severe xerostomia.

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Evaluation of the Response of Radiotherapy to Squamous Cell Carcinoma of the Head and Neck using $^{18}FDG-PET$ (두경부 편평상피세포암종에서 $^{18}FDG-PET$을 이용한 방사선치료 반응평가)

  • Lee Sang-Wook;Ryu Jin-Sook;Yi Byong-Yong;Kim Jong-Hoon;Ahn Seung-Do;Shin Seong-Soo;Kim Sang-Yoon;Nam Soon-Yuhl;Song Si-Yeol;Yoon Sang-Min;Park Jin-Hong;Kim Sung-Bae;Kim Jae-Seung
    • Korean Journal of Head & Neck Oncology
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    • v.19 no.1
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    • pp.58-62
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    • 2003
  • Purpose: To evaluate the efficacy of positron emission tomography with 2-[F-18] fluoro-2-deoxy-D-glucose in discrimination of response in the nasopharyngeal carcinoma patients who treated with radiotherapy. Methods and Materials: Twenty-four patients who underwent FDG-PET scan before and after radiotherapy for no disseminated head and neck carcinoma at the Asan Medical Center between August 2001 and September 2002 were evaluate by prospective analysis. First FDG-PET scan performed before radiotherapy within 1 month, and second FDG-PET scan performed 1 month after radiotherapy. FDG-PET images were analyzed by standard uptake value (SUV). Follow-up period was more than 6 months. Results: The pretreatment SUV was 3.4-14.0 (median: 6.0) and posttreatment SUV was ground level-7.7 (median: 2.0). The overall sensitivity and specicity of FDG-PET to evaluate residual tumors in the nasopharyngeal carcinoma patients were 94% and 94%. Conclusion: FDG-PET is effective in evaluation of radiation response in the nasopharyngeal carcinoma. We think that the timing of one month after finished radiotherapy FDG-PET scan was not too fast to evaluation of radiation response.

A Case of Anaplastic Carcinoma Arising Ectopic Thyroid (이소성 갑상선에 발생한 역형성 암종 1예)

  • Kang, Jae-Ho;Choi, Kyung-Min;Kim, Yoon-Jung;Kim, Seung-Woo
    • Korean Journal of Head & Neck Oncology
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    • v.25 no.2
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    • pp.153-155
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    • 2009
  • Ectopic thyroid glands generally occur in the midline as a result of abnormal median migration, and their presence lateral to the midline is extremly rare. We report a 83-year-old male with anaplastic carcinoma admix papillary carcinoma in the extrathyroid area. We suspected left lateral neck metastasis on preoperative fine needle aspiration result and computed tomography. the patient underwent total thyroidectomy and left selective neck dissection(level II, III, IV, V). The patient was diagnosed as having an ectopic thyroid gland on the lateral neck with anaplastic carcinoma admix papillry carcinoma. The patient is alive without incident of tumor recurrence at 5month after surgery and radiotherapy.

Free-flap reconstruction in recurrent head and neck cancer: A retrospective review of 124 cases

  • Kim, Hyeong Seop;Chung, Chul Hoon;Chang, Yong Joon
    • Archives of Craniofacial Surgery
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    • v.21 no.1
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    • pp.27-34
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    • 2020
  • Background: Free-flap reconstruction for recurrent head and neck cancer may be challenging depending on the previous treatments, those are, chemotherapy, radiotherapy, and surgery, including neck dissection or free tissue transfer. Specifically, the previous treatment could compromise the neck vessels, thereby making free-flap reconstruction more difficult. This study aimed to investigate the correlation between previous treatments and vascular compromise of the free flap. Methods: In this retrospective study, 124 free-flap reconstructions in 116 patients for recurrent head and neck cancer between 1993 and 2017 were investigated. The demographic characteristics, previous treatments, flap choices, infections, recipient vessels, and vascular crises were evaluated. Results: Of the 124 reconstruction cases, 10 had vascular crises. There were six revisions, totaling six flap failures. The success rate of free-flap reconstruction for recurrent cancer was 95.2%, which significantly differed from that for primary cancer (98.8%, p= 0.006). Moreover, in the recurrent cancer group, no correlation was found between previous treatments and vascular crises (p> 0.05). Increased rates of contralateral or uncommon anastomoses were found following neck dissection (p< 0.05). Conclusion: Previous neck dissection or radiotherapy could lead to scarring and tissue damage, which could in turn make microvascular reconstruction more challenging; however, the effect was not definite in this study. Approximately 60% of patients with previous neck dissection had compromised ipsilateral recipient vessels, which resulted in contralateral or uncommon anastomoses. In this study, free-flap reconstruction seems to be quite safe and preferable in patients with recurrent head and neck cancer based on the overall survival rate.

Chemotherapy for Head and Neck Squamous Cell Carcinoma (두경부 상피세포암의 화학요법)

  • Roh Jae-Kyung
    • Korean Journal of Head & Neck Oncology
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    • v.6 no.1
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    • pp.11-23
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    • 1990
  • Systemic chemotherapy is usually regarded as the standard treatment for palliation in patients with recurrent or metastatic cancer who have failed the definite local treatment with surgery and/or radiotherapy. Recently, with the introduction of more active chemotherapeutic agents and combinations, systemic chemotherapy is being increasingly used before or after local therapy in patients with previously untreated locally advanced head and neck cancer. The most active agents for the head and neck caner are methotrexate, 5-fluorouracil (5-FU), cisplatin and bleomycin. The overall response rates to each of these four drugs are 15-30% expecially when used as first line therapy. But most of these responses are partial with a mean duration of 3-5 months. Various combinations with methotrexate, 5-FU, cisplatin, and bleomycin have been tried with overall response rates of 50-90%, and 10-20% of complete responses. The introduction of chemotherapy prior to local therapy, induction chemotherapy, has been investigated with improved survivals in patients with complete response, especially pathologic, though improvement in overall survival has not been proved yet after the induction chemotherapy. Other therapeutic modalities, such as 'Sandwich' chemotherapy between surgery and radiotherapy, concomittent chemo-radiotherapy and post local treatment adjuvant chemotherapy have been pursued with some hopeful results but these trials should be compared with prospective randomized Phase III trials. To increase the response rates and enhance the survival, important work still remains; 1. Identification of better prognostic factors, 2. Improvement in staging, 3. Development of more active and safter chemotherapeutic agents, 4. Identification of the proper sequence for the addition of chemotherapy to multimodality treatment, and 5. Testing the value of such chemotherapy in locally advanced cancer patients.

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Salvage Treatment of Nasopharyngeal Carcinoma (비인강암종의 구제치료)

  • Choi Jong-Ouck;Kim Yong-Hwan;Min Hun-Ki;Choi Geon;Kweon Hee-Weon
    • Korean Journal of Head & Neck Oncology
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    • v.12 no.1
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    • pp.3-7
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    • 1996
  • Nasopharyngeal carcinoma(NPC) is a disease whose primary initial treatment is radiation. Results of radiation therapy in early stage disease is promising; however, in stage IV disease, the best reported five-year survival is only about 30%. In patients with post-radiation recurrent disease, radiation controls only a small portion of patients, as well as being associated with significant radiation injury. In this paper we discuss the use of salvage treatment modalities for post-radiation recurrence. A retrospective chart review and analysis of salvage treatment results were performed for 39 patients with recurrent post-radiation NPC and positive cervical lymph nodes during the period beginning 1985 until 1995. Mean age of these patients was 52.3$\pm$10.37 years and male: female ratio was 1.8 : 1. Twenty patients were treated with salvage treatment, and ten patients were treated by salvage chemotherapy. A total of nine patients underwent surgical salvage treatment, including neck dissection(6), transnasal laser surgery and booster radiotherapy(2), and primary surgery(1). Salvage treatment were effective in reducing patients' pain in twenty patients (51.3%) and prolonging life in nine patients(23.1%); however, recurrence of disease within six months and/or residual disease by clinical or radiologic exam was noted in all patients receiving salvage radiotherapy, chemotherapy, laser surgery with radiotherapy, and primary site surgery. In the group undergoing salvage neck dissection, three patients(50%) were disease free for at least two years. Of the different modalities, radiotherapy was associated with the best quality of life while catastrophic salvage surgery resulting in insignificant prolongation of life was associated with the poorest quality of life. We conclude that salvage surgery is the optimal choice of treatment for regional recurrence such as nodal failure, however palliative salvage therapy could be preferred in other cases with recurrent post-radiation NPC.

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