Backgrounds : Head and neck cancer is one of the most prevalent cancers in the world. It tends to remain localized at the primary site and regional lymph nodes, but if distant metastasis occurs, it has a poor prognosis. This study was performed to evaluate the prevalence of distant metastasis and to determine the risk factor in locally advanced head and neck cancer after induction chemotherapy followed locoregional control therapy. Methods : A retrospective review was performed in 420 patients with locally advanced head and neck cancer who treated with induction chemotherapy followed locoregional control therapy from January 2001 to December 2010. Among them, 31 patients who had distant metastasis as first relapse within 2 years after termination of therapy were analyzed for clinical features and the risk factors of distant metastasis. Results : The overall incidence of distant metastasis was 7.3%. The bone, lung, and liver were the most frequent metastatic organs. In univariate analysis, nodal stage, nasopharyngeal cancer, laryngeal cancer, G3/G4 neutropenia during induction chemotherapy, and concurrent chemoradiotherapy were the influencing factors for distant metastasis. In multivariate analysis, advanced N stage and nasopharynx were the risk factors of distant metastasis, and grade 3/4 neutropenia during induction chemotherapy was considered to decrease distant metastasis. Conclusion : This study suggests that the advanced N stage is the risk factor of distant metastasis and Grade 3/4 neutropenia during induction chemotherapy can be beneficial against distant metastasis in locally advanced head and neck cancer patients treated with induction chemotherapy followed locoregional control therapy.
The primary treatment modality of malignant tumors of the nasopharynx is radiation therapy owing to its inaccessibility to surgical intervention. Over the last two decades there were many changes in techniques of delivery, which include the use of higher doses of radiotherapy, the use of wide radiation field, including the elective radiation of the whole neck, the combined use of brachy- and teletherapy, and the use of split-course therapy. In spite of these advances local and regional recurrences remain the major cause of death. As a boost therapy after external irradiation, high-dose-rate intracavitary irradiation using remote control afterloading system(RALS) was used in two patients. Our results were satisfactory, however, this procedure should only be performed by those who have developed enough expertise in the use of intracavitary techniques for the treatment of nasopharyngeal cancer and have a supportive team including a physicist, dosimetrist, nurse, and trained technologist.
Background: Nasopharyngeal carcinoma (NPC), a malignancy arising from the epithelial lining of the nasopharynx, is distinct from others cancers in terms of its epidemiologic features. It is rare in most parts of the world except for a few regions with populations of Mongoloid origin. Objectives: To study the expression pattern of Epstein Barr virus (EBV) encoded oncoproteins EBNA1 and LMP1 in different histological types of NPC and to correlate expression patterns with sex, age and histological types. Materials and Methods: A total of 40 formalin-fixed, paraffin-embedded NPC biopsy samples and tissues from 20 healthy controls were collected to study the expression level of EBNA1 and LMP1 using immunohistochemistry. Results: EBNA1 and LMP1 expression was found in 92.5% and 90% respectively, of the cases and none of the control specimens. The expression patterns of EBNA1 and LMP1 were determined to be statistically significant (p<0.05) when correlated with sex, age and histological distributions. Also immunohistochemistry was found to be a sensitive technique in the detection of EBV. Conclusions: The study reveals that the potent oncoproteins EBNA1 and LMP1 were over expressed in our population cohort. Our findings are to some extent inconsistent with earlier reports as our population showed a higher expression of both EBNA1 and LMP1 compared to other studies.
The present study was purposed to evaluate the incidence and the characteristics of metastatic "cold" lesions in $^{99m}Tc$-MDP bone scans of adult patients with solid malignancies. There were 29 cold lesions in 24 patients. The incidence of cold lesions was about 1% of total cases of bone scans for the patients with malignancy, or 2.5% of cases with bone metastases. Th primary sites of malignancies were lung (four cases), uterine cervix (three cases), kidney, nasopharynx, thyroid, urinary bladder, prostate, lymphoma (two cases each other), liver, breast and others (one case each other). But the relative incidence of cold lesion in lung cancer and breast cancer was low. The most frequent site of cold lesion was spine, and pelvis, skull and rib were followed. The incidence of cold lesion was related to the regional incidence of bone metastases. The size of the cold lesions was greater than that of the hot. There were six cases of single cold lesion without any other abnormalities and two cases of cold lesion which were initially hot. So it should be considered that bone metastases might be presented as cold lesions in bone scan.
Park Yoon-Kyu;Kim Chang-Soo;Yoo Bong-Ok;Chung Eul-Sam;Seel David J.
Korean Journal of Head & Neck Oncology
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v.2
no.1
/
pp.23-31
/
1986
During the past 14years 267 patients presented with a lump in the neck proven to be metastatic cancer histologically. In most cases the primary site was discovered by thorough physical examination, E.U.A.(examination under anesthesia) and radiodiagnostic studies. However in 31 cases complete diagnostic evaluation failed to reveal the primary site. This paper discusses the characteristics of this group of patients in terms of the frequency of the ultimately discovered primary sites, policies for diagnosis, methods of management, and the ultimate prognosis for such cases in Korea. The male: female ratio was 6.8:1 and 84 % of all cases occurred in the $51{\sim)70$ age group. The majority of these cancers were epidermoid carcinomas(67.7%) and 22 of the 31(71 %) were Stage IV lesinos(17 N3A lesions and 5 N3B lesions). Surgical management was employed in 7 cases only, and in 5 cases this was combined with rediotherapy, chemotherapy, or both. Nevertheless, the only patients who survived disease-free for two years or more (one for over 5 years) were two patients in this management group. None of the patients treated by radiotherapy or chemotherapy of a combination of these two modalities survived. Occult primary sites were eventually discovered in 5 of the 31 cases, two in the nasopharynx, and one each in the base of tongue, pyrifrom sinus, middle ear. Of the 21 cases with epidermoid carcinoma which presented in the neck, 2 are free of disease for 3years or more. Of those who underwent radical surgery two of five survived. This study thus confirms the principle enunciated by MacComb in 1972 that surgical treatment in the form of radical neck dissection is the cornerstone of management whenever feasible.
Proceedings of the Plant Resources Society of Korea Conference
/
1999.10a
/
pp.1-45
/
1999
To date many kinds of compounds have been obtained from plants kingdom as antineoplastic and anti-cancerous agents. However, there is no special type of compounds for ncancer therapy. Various types of substances are effective for various types of cancers and tumors: for instance, alkaloids, lignans, terpenes and steroids etc. Curcumol obtained from Curcuma aromatica was tested and noticed to be effective against cancer of the uterine cervix clinically Oridonin isolated from Rabdosia ssp.is now investigated for clinical trials in China. Moreover, camptothecine isolated from Camptotheca acuminata is also antineoplastic alkaloid, but is very toxic. Chemical modification has been tried to decrease its toxicity. This compound is now using as clinical agent. Harringtonin was investigated as an anticancerous drug in China. Taxol, a compound with a taxane ring isolated from the bark of Taxus brevifolia, has been demonstrated to have substantial anticancer activity in patients with solid tumors refractory standard chemotherapy. Supply of this drug has severely limited full exploration of its antineoplastic potential. Some efforts are continued in National Cancer Institute NCI) Washington for surveying various Taxus species for optimal taxol content, improvement in semi-synthesis from baccatin III, improvement in method of extraction, and development of alternative renewable resources. Further, there are many compounds which have been reported as antineoplastic agents. On the other hand, we have screened on higher plants collected in Japan, China, Korea, Southeast Asia and South America for antineoplastic activity, which has been done using Sarcoma 180 ascites in mice, P388 Iymphocytic leukemia in mice, Chinese hamster lung V-79 cells, P388 cells and nasopharynx carcinoma (KB) cells in our laboratory, as primary screening. In this meeting, I will present on antitumor and cytotoxic substances of the higher plants (Rubia cordifolia, Ailanfhus Vilmoriniana, Aster tataricus, Taxus cuspidata var. nana, Cephalotaxus harringtonia var drupacea, etc.) selected from above screening tests.
Objective: The role of chemotherapy in locally advanced head and neck cancer has been established in nasopharynx and larynx as definitive therapy and organ preserving therapy, respectively. Oral cavity cancers are relatively uncommon and local recurrence is the main cause of treatment failure. We planned this retrospective study to evaluate the role of neoadjuvant chemotherapy in locally advanced oral cavity cancer patients. Materials and Methods: From 1988 March to 2001 February, locally advanced, previously untreated oral cavity cancer patients who received neoadjuvant chemotherapy were examined. Chemotherapy had been done in the following patients: Histologically proven squamous cell or poorly differentiated carcinoma, stage 3 or 4, and performance state 0-2 patients. Chemotherapy regimen consisted of cisplatin and infusional 5-fluorouracil. Response was evaluated after 2 cycles and in case of no response, definitive local therapy was done; otherwise 3 cycles was done before local treatment. Results: 48 patients were treated and 47 patients were evaluable for responses. Complete response rate was 6.4%(3/47) and partial response 80.0%(38/47), scoring overall response rate of 87.2%. Median time to progression was 27.0 months (95% CI : 0-58months) and overall 5 year survival was 54.8%. 5-year disease-free survival in the patients in remission after local treatment was 51.9%. In multivariate analysis, contributing factor to the survival were response to neoadjuvant chemotherapy and local treatment modalities. Extensive surgery was done in 10 patients and 25 patents (52.1%) was followed up with preserved function. With median follow-up of 57.0 months, 19 recurrences were detected, most of which were local or regional type. Conclusion: Neoadjuvant chemotherapy followed by local treatment in oral cavity cancer showed high response rate and was thought to be effective therapeutic approach especially in view of organ preservation.
Ha, Tae-young;Kim, Seung-jun;Hwang, Cheol-hwan;Son, Jong-gi
The Journal of Korean Society for Radiation Therapy
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v.28
no.1
/
pp.27-34
/
2016
Purpose : Retrospective evaluation of setup changes using the corrected position during helical tomotherapy Materials and Methods : Head and neck cancer patients were randomly sampled and summarized into 3 groups: Group 1(32) Brain, Group 2 2(28)Maxillar, Nasal cavity, Group 3 (35) Nasopharynx(NPX), Tongue, Tonsil, and Oropharynx(OPX). In 3 groups, the statistical tests based on repeated measurements among 30 times of the duration of treatment by applying X, Y, Z axis errors, roll, weight changes, and vectors as variables. Results : The statistical test results showed that there was no difference between x-axis (p = 0.458) and y-axis (p=0.986) and in roll (p = 0.037), weight change (p <0.001), and the vector (p <0.001). In addition, the pattern between the three groups based on the fraction revealed no difference in x-axis (p = 0.430) and roll (p = 0.299) but a difference in y-axis (.023), weight change (p = 0.001), and vector (p = 0.028). Conclusion : The results of the retrospective evaluation found the change in the group 3 with respect Y, Z, weight, and vector and a larger random error during the treatment including low neck.
The purpose of this study was to investigate the dose-volume indices and radiobiological indices according to the change in dose calculation grid size during the planning of nasopharyngeal cancer VMAT treatment. After performing the VMAT treatment plan using the 3.0 mm dose calculation grid size, dose calculation from 1.0 mm to 5.0 mm was performed repeatedly to obtain a dose volume histogram. The dose volume index and radiobiological index were evaluated using the obtained dose volume histogram. The smaller the dose calculation grid size, the smaller the mean dose for CTV and the larger the mean dose for PTV. For OAR of spinal cord, brain stem, lens and parotid gland, the mean dose did not show a significant difference according to the change in dose calculation grid size. The smaller the grid size, the higher the conformity of the dose distribution as the CI of the PTV increases. The CI and HI showed the best results at 3.0 mm. The smaller the dose calculation grid size, the higher the TCP of the PTV. The smaller the dose calculation grid size, the lower the NTCP of lens and parotid. As a result, when performing the nasopharynx cancer VMAT plan, it was found that the dose calculation grid size should be determined in consideration of dose volume index, radiobiological index, and dose calculation time. According to the results of various experiments, it was determined that it is desirable to apply a grid size of 2.0 - 3.0 mm.
The papilloma of the nose and the sinuses is uncommon benign neoplasm that was pro bably first described by Billroth in 1855 as a "villiform cancer": It may polypoid or papillomatous in the nose or sinuses and is frequently multiple. Clinically, there are 3types of the papilloma found in the nasal cavity and sinuses, vestibule, fungiform, inverting. The vestibular type is the keratotic lesion arise from the squamous epithelium lining the vestibule of the nose. The inverting type, which is covered by the columnar or metaplastic squamous epithelium is pliable, pink and tends to bleed quite easily. The fungiform type is covered by the stratified squamous epithelium which shows varying degree of cornification. It is more caulflow like than the inverting type and does not bleed easily. Recently, the authors experienced a case of the fungiform type papilloma which occupied right nasal cavity and nasopharynx. So, we reports the case, with review of the current brief literatures. A 55 year old man was admitted with the chief complaints of right nasal obstruction by the protruded movable mass on right nasal cavity, which was noticed about 7 months ago. The biopsy report revealed fungiform type papilloma.(length 18cm. width 2.5 cm. weight 41 gr.) The tumor mass was removed surgically through intranasal approach under the general anesthesia. Postoperative course was uneventful and the patient was discharged after 7 days hospitalization. No evidence of recurrence has been observed up to date.
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