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Draghini L, Lancellotta V, Fionda B, De Angeli M, Cornacchione P, Massaccesi M, Trippa F, Kovács G, Morganti AG, Bussu F, Iezzi R, Tagliaferri L. Can interventional radiotherapy (brachytherapy) be an alternative to surgery in early-stage oral cavity cancer? A systematic review. Strahlenther Onkol 2024; 200:367-376. [PMID: 38108835 DOI: 10.1007/s00066-023-02184-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 11/12/2023] [Indexed: 12/19/2023]
Abstract
PURPOSE Brachytherapy (BT), also known as interventional radiotherapy (IRT), has proven its utility in the treatment of localized tumors. The aim of this review was to examine the efficacy of modern BT in early-stage oral cavity cancer (OCC) in terms of local control (LC), overall survival (OS), disease-free survival (DFS), cancer-specific survival (CSS), and safety. METHODS The SPIDER framework was used, with sample (S), phenomena of interest (PI), design (D), evaluation (E), and research type (R) corresponding to early-stage oral cavity cancer (S); BT (PI); named types of qualitative data collection and analysis (D); LC, OS, DFS, CSS, and toxicity (E); qualitative method (R). Systematic research using PubMed and Scopus was performed to identify full articles evaluating the efficacy of BT in patients with early-stage OCC. The studies were identified using medical subject headings (MeSH). We also performed a PubMed search with the keywords "brachytherapy oral cavity cancer, surgery." The search was restricted to the English language. The timeframe 2002-2022 as year of publication was considered. We analyzed clinical studies of patients with OCC treated with BT alone only as full text; conference papers, surveys, letters, editorials, book chapters, and reviews were excluded. RESULTS The literature search resulted in 517 articles. After the selection process, 7 studies fulfilled the inclusion criteria and were included in this review, totaling 456 patients with early-stage node-negative OCC who were treated with BT alone (304 patients). Five-year LC, DFS, and OS for the BT group were 60-100%, 82-91%, and 50-84%, respectively. CONCLUSION In conclusion, our review suggests that BT is effective in the treatment of early-stage OCC, particularly for T1N0 of the lip, mobile tongue, and buccal mucosa cancers, with good functional and toxicity profiles.
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Affiliation(s)
- Lorena Draghini
- S.C. Radiation Oncology Centre, S.Maria Hospital, via T. Di Joannuccio 1, 05100, Terni, Italy.
| | - Valentina Lancellotta
- UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italy
| | - Bruno Fionda
- UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italy
| | - Martina De Angeli
- UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italy
| | - Patrizia Cornacchione
- UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italy
| | - Mariangela Massaccesi
- UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italy
| | - Fabio Trippa
- S.C. Radiation Oncology Centre, S.Maria Hospital, via T. Di Joannuccio 1, 05100, Terni, Italy
| | - Gyoergy Kovács
- Gemelli-INTERACTS, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Alessio Giuseppe Morganti
- Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale Settore Scientifico Disciplinare, Università di Bologna, Bologna, Italy
| | - Francesco Bussu
- Otolaryngology Division, Azienda Ospedaliero Universitaria, Sassari, Italy
- Department of Medical, Surgical and Experimental Science, University of Sassari, Sassari, Italy
| | - Roberto Iezzi
- Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia-U.O.C. Radiologia Diagnostica e Interventistica Generale, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
- Università Cattolica del Sacro Cuore, L.go A.Gemelli 8, 00168, Roma, Italy
| | - Luca Tagliaferri
- UOC Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli, IRCCS, Roma, Italy
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Konishi M, Shimabukuro K, Hirokawa J, Sadatoki T, Katsuta T, Imano N, Nishibuchi I, Murakami Y, Kakimoto N. Radiation doses of medical radiation workers performing low-dose-rate brachytherapy with 198Au grains and 192Ir pins for patients with oral cancers. Oral Radiol 2024; 40:234-241. [PMID: 38108954 DOI: 10.1007/s11282-023-00728-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/15/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVES Low-dose-rate brachytherapy (LDR-BT) with 198Au grains and 192Ir pins is an essential treatment option for oral cancer due to its high rate of local control and low invasiveness. However, the radiation exposure of medical radiation workers is concerning. Thus, we aimed to determine the radiation dose delivered to medical radiation workers during LDR-BT using 198Au grains and 192Ir pins for oral cancer. METHODS Thirty-two patients with oral cancer underwent 198Au grain interstitial LDR-BT between June 2016 and May 2023, and 23 patients with tongue cancer underwent 192Ir pin interstitial LDR-BT between March 2015 and November 2017 at our hospital. Dosimetry was performed by attaching a dosimeter to the chest pocket of the operator and assistant during 198Au grain or 192Ir pin LDR-BT. Since the operator also loads 198Au grains into the implantation device, the operator's radiation dose includes the dose received during this preparation. RESULTS Mean radiation doses of the operators with 198Au grain and 192Ir pin LDR-BT were 165.8 and 211.2 μSv, respectively. Statistically significant differences between the radioactive sources of 198Au grain and 192Ir pin LDR-BT were observed (p = 0.0459). The mean radiation doses of the assistants with 198Au grain and 192Ir pin LDR-BT were 92.0 and 162.0 μSv, respectively. Statistically significant differences were observed between the radioactive sources of 198Au grains and 192Ir pin LDR-BT (p = 0.0003). CONCLUSIONS Regarding radioactive source differences, 192Ir pin LDR-BT resulted in higher doses delivered to medical radiation workers than 198Au grain LDR-BT.
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Affiliation(s)
- Masaru Konishi
- Department of Oral and Maxillofacial Radiology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8553, Japan.
| | - Kiichi Shimabukuro
- Department of Oral and Maxillofacial Radiology, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8553, Japan
| | - Junichi Hirokawa
- Department of Radiation Oncology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8553, Japan
| | - Takashi Sadatoki
- Department of Radiation Oncology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8553, Japan
| | - Tsuyoshi Katsuta
- Department of Radiation Oncology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8553, Japan
| | - Nobuki Imano
- Department of Radiation Oncology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8553, Japan
| | - Ikuno Nishibuchi
- Department of Radiation Oncology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8553, Japan
| | - Yuji Murakami
- Department of Radiation Oncology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8553, Japan
| | - Naoya Kakimoto
- Department of Oral and Maxillofacial Radiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8553, Japan
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Muacevic A, Adler JR, Kuroshima T, Yoshimura RI, Miura M. Retrograde Migration of an Au-198 Grain to the Submandibular Gland Post Brachytherapy Treatment of Floor of Mouth Cancer. Cureus 2022; 14:e31904. [PMID: 36579276 PMCID: PMC9792345 DOI: 10.7759/cureus.31904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2022] [Indexed: 11/27/2022] Open
Abstract
At our institution, radiation oncologists routinely treat early-stage oral cancer with low-dose-rate brachytherapy (LDR-BRT) using Au-198 grains. In this report, we show a unique case of a patient with a gold grain located within the submandibular gland, found incidentally during follow-up after LDR-BRT for floor of mouth cancer. One month after the implant, he showed sialadenitis-like symptoms, but the pain resolved two months later. All the grains were detected around the anterior sublingual area by computed tomography (CT) four months after the implant. Unexpectedly, 11 months after the implant, CT revealed that a grain was located in an intraglandular site of the submandibular gland. This finding clearly demonstrates that the grain entered Wharton's duct and retrogradely migrated to the submandibular gland through the duct. As a mechanism of the calculus formation within Wharton's duct, retrograde migration of foreign bodies to the inside of the duct has been proposed. Our incidental finding after LDR-BRT highlights the need for monitoring post-LDR-BRT using Au-198 grains for the treatment of floor of mouth cancer and sheds additional light on retrograde theory within Wharton's duct.
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Noguchi T, Sugiura Y, Dohi A, Yamada M, Okada N, Sasaguri KI, Takahashi S, Mori Y. Evaluation of patients with oral squamous cell carcinoma treated by radical irradiation with mold radiotherapy using a customized device: a retrospective clinical study. J Med Case Rep 2022; 16:178. [PMID: 35488241 PMCID: PMC9052617 DOI: 10.1186/s13256-022-03311-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 02/03/2022] [Indexed: 11/23/2022] Open
Abstract
Background It is very important to determine the indication of mold radiotherapy for the radical treatment of oral cancer. We investigated eight patients with oral squamous cell carcinoma who were treated by radical irradiation with mold radiotherapy using a customized device. Methods The subject is a case of curable superficial oral cancer of a few millimeters, or cancer of a size that can be cured by the placement of the radiation source. Of the eight patients, six were male and two were female, aged 64–93 years (mean, 78.9 years; median, 73.5 years). The primary sites were the buccal mucosa in three cases, gingiva in two cases, and floor of the mouth, soft palate, and lower lip in one case each. Five cases were in the T1 stage, and the remaining three cases were in T2. With respect to thickness, seven cases were of the superficial type and could not be detected by magnetic resonance imaging or computed tomography, and the remaining case showed a tumor thickness of 7.5 mm. All cases were diagnosed as squamous cell carcinoma by biopsy. Radical irradiation using mold radiotherapy was planned for all eight patients. Irradiation was delivered in 9–10 sessions, with a total dose of 45–50 Gy. Results Complete response was attained in six of the eight patients and partial response was observed in two patients, requiring additional treatment. Conclusion Since all patients with complete response had superficial cancers, we hypothesized that superficial cancers of the oral cavity with thicknesses of few millimeters could be indicated for mold irradiation. This method can be applied in complicated cases and older patients in whom surgery or chemotherapy may not be feasible. We believe that the results of our clinical studies will be of great help in choosing this method.
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Affiliation(s)
- Tadahide Noguchi
- Department of Dentistry, Oral and Maxillofacial Surgery, Jichi Medical University, 3311-1 Yakushiji , Shimotsuke-shi, Tochigi, 329-0498, Japan.
| | - Yasushi Sugiura
- Department of Dentistry, Oral and Maxillofacial Surgery, Jichi Medical University, 3311-1 Yakushiji , Shimotsuke-shi, Tochigi, 329-0498, Japan
| | - Akihiro Dohi
- Department of Dentistry, Oral and Maxillofacial Surgery, Jichi Medical University, 3311-1 Yakushiji , Shimotsuke-shi, Tochigi, 329-0498, Japan
| | - Manabu Yamada
- Department of Dentistry, Oral and Maxillofacial Surgery, Jichi Medical University, 3311-1 Yakushiji , Shimotsuke-shi, Tochigi, 329-0498, Japan.,Department of Dentistry, Oral and Maxillofacial Surgery, National Hospital Tochigi Hospital, 1-10-37 Nakatomatsuri, Utsunomia, Tochigi, 320-8580, Japan
| | - Naruo Okada
- Department of Dentistry, Oral and Maxillofacial Surgery, Jichi Medical University, 3311-1 Yakushiji , Shimotsuke-shi, Tochigi, 329-0498, Japan
| | - Ken-Ichi Sasaguri
- Department of Dentistry, Oral and Maxillofacial Surgery, Jichi Medical University, 3311-1 Yakushiji , Shimotsuke-shi, Tochigi, 329-0498, Japan
| | - Satoru Takahashi
- Department of Radiology, Jichi Medical University, 3311-1, Yakushiji, Shimotsuke-shi, Tochigi, 329-0498, Japan
| | - Yoshiyuki Mori
- Department of Dentistry, Oral and Maxillofacial Surgery, Jichi Medical University, 3311-1 Yakushiji , Shimotsuke-shi, Tochigi, 329-0498, Japan
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Is There Still a Place for Brachytherapy in the Modern Treatment of Early-Stage Oral Cancer? Cancers (Basel) 2022; 14:cancers14010222. [PMID: 35008386 PMCID: PMC8750481 DOI: 10.3390/cancers14010222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 12/30/2021] [Accepted: 01/01/2022] [Indexed: 12/24/2022] Open
Abstract
Simple Summary Brachytherapy involves the direct application of radioactive sources to the tumour. This technique is characterised by a delivery of high dose of radiation to the target volume and simultaneous sparring of healthy tissues. Historically, low-dose-rate brachytherapy played an important role in the treatment of early-stage oral cancer, with treatment outcomes that were comparable to surgery. Interest in brachytherapy as a primary treatment for oral cancer has declined in recent years due to the emergence of better surgical techniques, to advances in external beam radiotherapy, and to concerns regarding toxicity of modern high-dose-rate brachytherapy. At present, the main indications for brachytherapy are in the postoperative setting due to the superior dose conformity and better quality of life offered by brachytherapy compared to external beam radiation therapy. Postoperative brachytherapy can be administered as a monotherapy in early-stage tumours (T1N0) and in combination with elective neck dissection or EBRT to treat larger or deeper tumours. Brachytherapy yields excellent results for lip carcinoma in older patients and in tumours with unfavourable localisations. Brachytherapy is an effective salvage therapy for local recurrences in previously-irradiated areas. Abstract Brachytherapy (BT) involves the direct application of radioactive sources to the tumour. This technique is characterised by a steep dose gradient, the delivery of high-dose radiation to the target volume centre, and the sparing of surrounding healthy tissues. Low-dose-rate (LDR) BT and manual afterloading played an important role in the treatment of early-stage oral cancer, with treatment outcomes that were comparable to surgery. Interest in BT as a primary treatment for oral cancer has declined in recent years due to the emergence of better surgical techniques, the switch from LDR BT to high-dose-rate (HDR) BT (which has a higher risk of complications), and to advances in external beam radiotherapy (EBRT). At present, the main indications for BT are in the postoperative setting due to the superior dose conformity and better quality of life offered by BT versus EBRT. Postoperative BT can be administered as monotherapy in early-stage (T1N0) cancers and in combination with elective neck dissection or EBRT to treat larger or deeper tumours. BT yields excellent results for lip carcinoma in older patients and in tumours with unfavourable localisations. BT is an effective salvage therapy for local recurrences in previously-irradiated areas. Despite its many advantages, brachytherapy is a complex treatment requiring meticulous technique and close cooperation between the radiation oncologist, physicist, and surgeon.
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Venkat P, Han J, Demanes DJ. Brachytherapy of the head and neck: An University of California Los Angeles guide to morbidity reduction. Brachytherapy 2021; 20:1014-1040. [PMID: 33487561 DOI: 10.1016/j.brachy.2020.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/30/2020] [Accepted: 12/06/2020] [Indexed: 11/16/2022]
Abstract
The head and neck (H&N) region is among the most intricate and functional part of our anatomy. Major functional nerves and blood vessels with importance that affect the entire body emanate from the base of skull. Brachytherapy plays an important role as a single modality therapy in early cancer of the lip and oral cavity and a supplemental role in the pharynx or in advanced or recurrent disease. Morbidity in the H&N is intensely personal and disabling. Its avoidance is critical in determining the success or failure of a treatment program, and it is essential to preservation of quality of life. This article summarizes the current literature regarding morbidity related to H&N brachytherapy to aid patients and physicians to achieve optimal outcomes.
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Affiliation(s)
- Puja Venkat
- Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA.
| | - James Han
- Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA
| | - D Jeffrey Demanes
- Department of Radiation Oncology, University of California Los Angeles, Los Angeles, CA
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Alva RC, Koushik ASK, Sweta B, Janaki MG, Ponni TRA, Kumar M, Yuvaraj B, Revath T. Brachytherapy for Oral Cavity Cancers in the Era of Intensity-Modulated Radiotherapy: Save it or Shelve it. Indian J Surg Oncol 2020; 11:406-411. [PMID: 33013119 DOI: 10.1007/s13193-020-01075-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 04/07/2020] [Indexed: 10/24/2022] Open
Abstract
Head and neck cancer treatment includes a multidisciplinary approach involving all specialties. Surgery and radiotherapy are equally effective in controlling small tumors. Intensity-modulated radiotherapy (IMRT) and interstitial brachytherapy (ISBT) play an important role in the treatment of head and neck cancers. Both are proved to be highly conformal techniques of radiotherapy. Our aim is to compare dosimetric aspects of ISBT alone, IMRT alone, and IMRT combined with ISBT in early stage node negative oral cavity cancer. Ten cases of histopathologically proven early stage node negative oral cavity cancer were treated with external beam therapy followed by interstitial brachytherapy boost or ISBT alone. All these patients had undergone computerized tomography (CT) planning for brachytherapy. Retrospectively, these images were utilized, and three sets of plans were done for each patient's CT image set. Group A was IMRT alone plans, groups B had combined IMRT with ISBT boost, and group C was ISBT alone plans. Dosimetric details such as target coverage, dose to critical organs, and conformity index were compared between the three sets of plans. The mean values of the doses to the critical organs with IMRT alone and IMRT with ISBT boost were brainstem 10.40 Gy and 9.20 Gy, spinal cord 19.20 Gy and 16.10 Gy, mandible 62.99 Gy and 66.50 Gy, and I/L and C/L parotids were 6.03 Gy and 5.50 Gy and 5.70 Gy and 5.10 Gy where as in ISBT alone plans mean values were brainstem 1.30 Gy, spinal cord 1.40 Gy, mandible 36.50 Gy, I/L, and C/L parotids were 1.60 Gy and 1.00 Gy. Conformity index (CI) between IMRT and ISBT plans were 0.8580 and 0.7140 respectively. With comparable CI values, doses to critical organs appear to be in favor of ISBT plans as opposed to IMRT, and this was found to be statistically significant. Brachytherapy shows a dosimetric advantage over IMRT in this setting and could be translated to a benefit in terms of toxicities, organ preservation, and cosmesis in the actual clinical scenario. However, whether this would translate to significant benefit in terms of clinical outcome needs to be still verified.
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Affiliation(s)
- Ram Charith Alva
- Department of Radiation Oncology, Ramaiah Medical College, Bangalore, India
| | - A S Kirthi Koushik
- Department of Radiation Oncology, Ramaiah Medical College, Bangalore, India
| | - B Sweta
- Department of Radiation Oncology, Ramaiah Medical College, Bangalore, India
| | - M G Janaki
- Department of Radiation Oncology, Ramaiah Medical College, Bangalore, India
| | - T R Arul Ponni
- Department of Radiation Oncology, Ramaiah Medical College, Bangalore, India
| | - Mohan Kumar
- Department of Radiation Oncology, Ramaiah Medical College, Bangalore, India
| | - B Yuvaraj
- Physicist in the Department of Radiation Oncology, Ramaiah Medical College, Bangalore, India
| | - T Revath
- Physicist in the Department of Radiation Oncology, Ramaiah Medical College, Bangalore, India
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Liu TJ, Guo JL, Xu X. CXC chemokine‑7 inhibits growth and migration of oral tongue squamous cell carcinoma cells, mediated by the epithelial‑mesenchymal transition signaling pathway. Mol Med Rep 2017; 16:6896-6903. [PMID: 28901471 DOI: 10.3892/mmr.2017.7441] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 05/11/2017] [Indexed: 11/05/2022] Open
Abstract
Oral tongue squamous cell carcinoma (OTSCC) is the most common oral malignancy with different histopathological symptoms and etiology of tumorigenesis. Migration and invasion is the most important characteristics of OTSCC, and limits tumor therapy in clinics. The epithelial‑to‑mesenchymal transition (EMT) signaling pathway is an important process in the progress of tumor cell migration and invasion. Previous studies have indicated that C‑X‑C chemokine receptor‑7 (CXCR‑7) promotes the progression and metastasis of tumor cells, presenting a potential target molecule for cancer therapy. The present study investigated the inhibitory effects of C‑X‑C chemokine‑7 (CXC‑7) on human OTSCC cells both in vitro and in vivo. The results demonstrated that the Tca8113 human OTSCC cell line expressed higher levels of CXC‑7 mRNA compared with the hNOE human normal oral epithelial cell line. MTT assays indicated that CXC‑7 suppressed Tca8113 cell growth, and the cytotoxicity of CXC‑7 was indicated as the cell survival of the negative control group was significantly decreased compared with the blank control and hNOE cells. Migration and invasion assays revealed that CXC‑7 inhibited Tca8113 cell local expansion and distant metastasis. In addition, the results demonstrated that the extracellular signal‑regulated kinase (ERK)/protein kinase B (AKT) signaling pathway was inhibited after CXC‑7 treatment in Tca8113 cells. N‑cadherin, E‑Cadherin, Snail and Slug expression levels in the ERK/AKT signaling pathway were inhibited in Tca8113 cells after treatment with CXC‑7. It was demonstrated that important extracellular matrix proteins involved in cell migration, including Slug, collagen type I and Vimentin, were significantly downregulated by CXC‑7 treatment. In conclusion, CXC‑7 inhibited growth and migration in OTSCC cells, mediated by the EMT signaling pathway. This suggests that CXC‑7 serves an inhibitory role in OTSCC migration, implicating CXCR‑7 as a promising biomarker for chemokine receptor‑based drug development.
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Affiliation(s)
- Tong-Jun Liu
- Department of Implantology, Shandong Provincial Key Laboratory of Oral Biomedicine, School of Stomatology, Shandong University, Jinan, Shandong 250012, P.R. China
| | - Jian-Lian Guo
- Department of Ophthalmology, The Eighth People's Hospital of Jinan, Jinan, Shandong 250014, P.R. China
| | - Xin Xu
- Department of Implantology, Shandong Provincial Key Laboratory of Oral Biomedicine, School of Stomatology, Shandong University, Jinan, Shandong 250012, P.R. China
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Gondivkar SM, Gadbail AR, Choudhary MG, Vedpathak PR, Likhitkar MS. Photodynamic treatment outcomes of potentially-malignant lesions and malignancies of the head and neck region: A systematic review. ACTA ACUST UNITED AC 2017; 9. [PMID: 28480637 DOI: 10.1111/jicd.12270] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 02/28/2017] [Indexed: 01/19/2023]
Abstract
AIM The aim of the present study was to systematically review the efficacy of photodynamic therapy (PDT) in the management of oral potentially-malignant disorders (PMDS) and head and neck squamous cell carcinoma (HNSCC). METHODS From 1985 to 2015, PubMed/Medline, Google Scholar, EMBASE, and ISI Web of Knowledge were searched using different combinations of the following key words: PDT, oral precancer, leukoplakia, erythroplakia, erythroleukoplakia, verrucous hyperplasia, oral submucous fibrosis, and HNSCC. Review articles, experimental studies, case reports, commentaries, letters to the editor, unpublished articles, and articles published in languages other than English were excluded. RESULTS Twenty-six studies were included in the present study. The number of patients ranged from 2 to 147, with a mean age of 50-67 years. The reported numbers of PMDS and HNSCC ranged between 5 and 225. Photosensitizers used were aminolevulinic acid, meta-tetrahydroxyphenylchlorin, Foscan, hematoporphyrin derivatives, Photofrin, Photosan, and chlorine-e6. Laser wavelength, power density, irradiation duration were 585-652 nm, 50-500 mW/cm2 , and 1-143 minutes, respectively. Complete, partial, and no response to PDT was found in 22.58%-100%, 4%-66%, and 0%-38.70% of PMDS, respectively, and 16%-100% of complete response in HNSCC patients. CONCLUSION PDT is effective in the management of PMDS and HNSCC.
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Affiliation(s)
- Shailesh M Gondivkar
- Department of Oral Medicine and Radiology, Government Dental College and Hospital, Nagpur, Maharashtra, India
| | - Amol Ramchandra Gadbail
- Department of Dentistry, Indira Gandhi Government Medical College and Hospital, Nagpur, Maharashtra, India
| | - Manjari G Choudhary
- Department of Oral Medicine and Radiology, Mahatma Gandhi Vidyamandir's Karmaveer Bhausaheb Hirey Dental College and Hospital, Nashik, Maharashtra, India
| | - Priyanka R Vedpathak
- Department of Oral Medicine and Radiology, Mahatma Gandhi Vidyamandir's Karmaveer Bhausaheb Hirey Dental College and Hospital, Nashik, Maharashtra, India
| | - Manoj S Likhitkar
- Department of Conservative and Endodontics, HSRS Dental College and Hospital, Hingoli, Maharashtra, India
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Toratani S, Tani R, Kanda T, Koizumi K, Yoshioka Y, Okamoto T. Photodynamic therapy using Photofrin and excimer dye laser treatment for superficial oral squamous cell carcinomas with long-term follow up. Photodiagnosis Photodyn Ther 2016; 14:104-10. [DOI: 10.1016/j.pdpdt.2015.12.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2015] [Revised: 12/22/2015] [Accepted: 12/24/2015] [Indexed: 10/22/2022]
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Huo X, Jia Y, Liu D, Gao L, Zhang L, Li L, Qi Y, Cao L. Photodynamic diagnosis of gastric cancer using HPPH-CD. RSC Adv 2016. [DOI: 10.1039/c5ra27746a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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12
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Rohrbach DJ, Rigual N, Arshad H, Tracy EC, Cooper MT, Shafirstein G, Wilding G, Merzianu M, Baumann H, Henderson BW, Sunar U. Intraoperative optical assessment of photodynamic therapy response of superficial oral squamous cell carcinoma. JOURNAL OF BIOMEDICAL OPTICS 2016; 21:18002. [PMID: 26780226 PMCID: PMC5996863 DOI: 10.1117/1.jbo.21.1.018002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 12/11/2015] [Indexed: 06/05/2023]
Abstract
This study investigated whether diffuse optical spectroscopy (DOS) measurements could assess clinical response to photodynamic therapy (PDT) in patients with head and neck squamous cell carcinoma (HNSCC). In addition, the correlation between parameters measured with DOS and the crosslinking of signal transducer and activator of transcription 3 (STAT3), a molecular marker for PDT-induced photoreaction, was investigated. Thirteen patients with early stage HNSCC received the photosensitizer 2-[1-hexyloxyethyl]-2-devinylpyropheophorbide-a (HPPH) and DOS measurements were performed before and after PDT in the operating room (OR). In addition, biopsies were acquired after PDT to assess the STAT3 crosslinking. Parameters measured with DOS, including blood volume fraction, blood oxygen saturation (StO2), HPPH concentration (cHPPH), HPPH fluorescence, and blood flow index (BFI), were compared to the pathologic response and the STAT3 crosslinking. The best individual predictor of pathological response was a change in cHPPH (sensitivity=60%, specificity=100%), while discrimination analysis using a two-parameter classifier (change in cHPPH and change in StO2) classified pathological response with 100% sensitivity and 100% specificity. BFI showed the best correlation with the crosslinking of STAT3. These results indicate that DOS-derived parameters can assess the clinical response in the OR, allowing for earlier reintervention if needed.
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Affiliation(s)
- Daniel J. Rohrbach
- Roswell Park Cancer Institute, Department of Cell Stress Biology, Elm and Carlton Streets, Buffalo, New York 14263, United States
- Wright State University, Department of Biomedical, Industrial and Human Factors Engineering, 207 Russ Center, Dayton, Ohio 45435, United States
| | - Nestor Rigual
- Roswell Park Cancer Institute, Department of Head and Neck Surgery, Elm and Carlton Streets, Buffalo, New York 14263, United States
| | - Hassan Arshad
- Roswell Park Cancer Institute, Department of Head and Neck Surgery, Elm and Carlton Streets, Buffalo, New York 14263, United States
| | - Erin C. Tracy
- Roswell Park Cancer Institute, Department of Cellular and Molecular Biology, Elm and Carlton Streets, Buffalo, New York 14263, United States
| | - Michelle T. Cooper
- Roswell Park Cancer Institute, Department of Cell Stress Biology, Elm and Carlton Streets, Buffalo, New York 14263, United States
| | - Gal Shafirstein
- Roswell Park Cancer Institute, Department of Cell Stress Biology, Elm and Carlton Streets, Buffalo, New York 14263, United States
| | - Gregory Wilding
- Roswell Park Cancer Institute, Department of Biostatistics and Bioinformatics, Elm and Carlton Streets, Buffalo, New York 14263, United States
| | - Mihai Merzianu
- Roswell Park Cancer Institute, Department of Pathology and Laboratory Medicine, Elm and Carlton Streets, Buffalo, New York 14263, United States
| | - Heinz Baumann
- Roswell Park Cancer Institute, Department of Cellular and Molecular Biology, Elm and Carlton Streets, Buffalo, New York 14263, United States
| | - Barbara W. Henderson
- Roswell Park Cancer Institute, Department of Cell Stress Biology, Elm and Carlton Streets, Buffalo, New York 14263, United States
| | - Ulas Sunar
- Roswell Park Cancer Institute, Department of Cell Stress Biology, Elm and Carlton Streets, Buffalo, New York 14263, United States
- Wright State University, Department of Biomedical, Industrial and Human Factors Engineering, 207 Russ Center, Dayton, Ohio 45435, United States
- State University of New York at Buffalo, Department of Biomedical Engineering, 332 Bonner Hall, Buffalo, New York 14228, United States
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Head and Neck Brachytherapy: A Description of Methods and a Summary of Results. Brachytherapy 2016. [DOI: 10.1007/978-3-319-26791-3_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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The role of brachytherapy in the treatment of squamous cell carcinoma of the head and neck. Eur Arch Otorhinolaryngol 2014; 273:269-76. [DOI: 10.1007/s00405-014-3332-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 10/13/2014] [Indexed: 11/26/2022]
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Mohanti BK, Sahai P, Thakar A, Sikka K, Bhasker S, Sharma A, Sharma S, Bahadur S. Institutional Experience of Interstitial Brachytherapy for Head and Neck Cancer with a Comparison of High- and Low Dose Rate Practice. Asian Pac J Cancer Prev 2014; 15:813-8. [DOI: 10.7314/apjcp.2014.15.2.813] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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16
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Rigual N, Shafirstein G, Cooper MT, Baumann H, Bellnier DA, Sunar U, Tracy EC, Rohrbach DJ, Wilding G, Tan W, Sullivan M, Merzianu M, Henderson BW. Photodynamic therapy with 3-(1'-hexyloxyethyl) pyropheophorbide a for cancer of the oral cavity. Clin Cancer Res 2013; 19:6605-13. [PMID: 24088736 DOI: 10.1158/1078-0432.ccr-13-1735] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The primary objective was to evaluate safety of 3-(1'-hexyloxyethyl)pyropheophorbide-a (HPPH) photodynamic therapy (HPPH-PDT) for dysplasia and early squamous cell carcinoma of the head and neck (HNSCC). Secondary objectives were the assessment of treatment response and reporters for an effective PDT reaction. EXPERIMENTAL DESIGN Patients with histologically proven oral dysplasia, carcinoma in situ, or early-stage HNSCC were enrolled in two sequentially conducted dose escalation studies with an expanded cohort at the highest dose level. These studies used an HPPH dose of 4 mg/m(2) and light doses from 50 to 140 J/cm(2). Pathologic tumor responses were assessed at 3 months. Clinical follow up range was 5 to 40 months. PDT induced cross-linking of STAT3 were assessed as potential indicators of PDT effective reaction. RESULTS Forty patients received HPPH-PDT. Common adverse events were pain and treatment site edema. Biopsy proven complete response rates were 46% for dysplasia and carcinoma in situ and 82% for squamous cell carcinomas (SCC) lesions at 140 J/cm(2). The responses in the carcinoma in situ/dysplasia cohort are not durable. The PDT-induced STAT3 cross-links is significantly higher (P = 0.0033) in SCC than in carcinoma in situ/dysplasia for all light doses. CONCLUSION HPPH-PDT is safe for the treatment of carcinoma in situ/dysplasia and early-stage cancer of the oral cavity. Early-stage oral HNSCC seems to respond better to HPPH-PDT in comparison with premalignant lesions. The degree of STAT3 cross-linking is a significant reporter to evaluate HPPH-PDT-mediated photoreaction.
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Affiliation(s)
- Nestor Rigual
- Authors' Affiliations: Photodynamic Therapy Center at the Department of Cell Stress Biology, Departments of Head and Neck Surgery, Molecular and Cellular Biology, Biostatistics and Bioinformatics, Dentistry, and Pathology, Roswell Park Cancer Institute (RPCI), Buffalo, New York
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Liu Z, Huang S, Zhang D. High dose rate versus low dose rate brachytherapy for oral cancer--a meta-analysis of clinical trials. PLoS One 2013; 8:e65423. [PMID: 23762369 PMCID: PMC3677879 DOI: 10.1371/journal.pone.0065423] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2013] [Accepted: 04/24/2013] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To compare the efficacy and safety of high dose rate (HDR) and low dose rate (LDR) brachytherapy in treating early-stage oral cancer. DATA SOURCES A systematic search of MEDLINE, EMBASE and Cochrane Library databases, restricted to English language up to June 1, 2012, was performed to identify potentially relevant studies. STUDY SELECTION Only randomized controlled trials (RCT) and controlled trials that compared HDR to LDR brachytherapy in treatment of early-stage oral cancer (stages I, II and III) were of interest. DATA EXTRACTION AND SYNTHESIS Two investigators independently extracted data from retrieved studies and controversies were solved by discussion. Meta-analysis was performed using RevMan 5.1. One RCT and five controlled trials (607 patients: 447 for LDR and 160 for HDR) met the inclusion criteria. The odds ratio showed no statistically significant difference between LDR group and HDR group in terms of local recurrence (OR = 1.12, CI 95% 0.62-2.01), overall mortality (OR = 1.01, CI 95% 0.61-1.66) and Grade 3/4 complications (OR = 0.86, CI 95% 0.52-1.42). CONCLUSIONS This meta-analysis indicated that HDR brachytherapy was a comparable alternative to LDR brachytherapy in treatment of oral cancer. HDR brachytherapy might become a routine choice for early-stage oral cancer in the future.
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Affiliation(s)
- Zhenxing Liu
- Department of Oral and Maxillofacial Surgery, Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Shengyun Huang
- Department of Oral and Maxillofacial Surgery, Provincial Hospital Affiliated to Shandong University, Jinan, China
| | - Dongsheng Zhang
- Department of Oral and Maxillofacial Surgery, Provincial Hospital Affiliated to Shandong University, Jinan, China
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Yanamoto S, Yamada SI, Takahashi H, Kawasaki G, Ikeda H, Shiraishi T, Fujita S, Ikeda T, Asahina I, Umeda M. Predictors of locoregional recurrence in T1-2N0 tongue cancer patients. Pathol Oncol Res 2013; 19:795-803. [PMID: 23677778 DOI: 10.1007/s12253-013-9646-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Accepted: 04/24/2013] [Indexed: 01/15/2023]
Abstract
Locoregional recurrence of oral tongue squamous cell carcinoma (OTSCC) has been considered a poor prognostic entity in terms of survival rate. The purpose of this study was to evaluate the incidence of locoregional recurrence and to identify significant risk factors for locoregional recurrence in early-stage OTSCC. We retrospectively reviewed the records of 58 patients who underwent radical surgery for T1-2N0 OTSCC. The local recurrence and regional recurrence rates were 10.3 % (6/58 patients) and 15.5 % (9/58 patients) in this study, respectively. The survival rate of patients with local recurrence was 66.7 %, which was significantly lower than that (96.2 %) of patients without local recurrence, whereas the survival rates of patients with or without regional recurrence were not significantly difference. Pattern of invasion (POI), neoadjuvant chemotherapy (NAC) and the status of the surgical margin were identified as factors influencing local recurrence. In particular, the status of the deep surgical margin was a high potential independent risk factor. The deep surgical margin was resected closely in many NAC-treated cases, suggesting that NAC may lead to local recurrence and a poor outcome. No efficacy of NAC was observed, suggesting that the standard treatment for early OTSCC is surgery alone.
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Affiliation(s)
- Souichi Yanamoto
- Department of Clinical Oral Oncology, Unit of Translational Medicine, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan,
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Yamazaki H, Yoshida K, Yoshioka Y, Shimizutani K, Furukawa S, Koizumi M, Ogawa K. High dose rate brachytherapy for oral cancer. JOURNAL OF RADIATION RESEARCH 2013; 54:1-17. [PMID: 23179377 PMCID: PMC3534285 DOI: 10.1093/jrr/rrs103] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Revised: 09/26/2012] [Accepted: 10/09/2012] [Indexed: 05/25/2023]
Abstract
Brachytherapy results in better dose distribution compared with other treatments because of steep dose reduction in the surrounding normal tissues. Excellent local control rates and acceptable side effects have been demonstrated with brachytherapy as a sole treatment modality, a postoperative method, and a method of reirradiation. Low-dose-rate (LDR) brachytherapy has been employed worldwide for its superior outcome. With the advent of technology, high-dose-rate (HDR) brachytherapy has enabled health care providers to avoid radiation exposure. This therapy has been used for treating many types of cancer such as gynecological cancer, breast cancer, and prostate cancer. However, LDR and pulsed-dose-rate interstitial brachytherapies have been mainstays for head and neck cancer. HDR brachytherapy has not become widely used in the radiotherapy community for treating head and neck cancer because of lack of experience and biological concerns. On the other hand, because HDR brachytherapy is less time-consuming, treatment can occasionally be administered on an outpatient basis. For the convenience and safety of patients and medical staff, HDR brachytherapy should be explored. To enhance the role of this therapy in treatment of head and neck lesions, we have reviewed its outcomes with oral cancer, including Phase I/II to Phase III studies, evaluating this technique in terms of safety and efficacy. In particular, our studies have shown that superficial tumors can be treated using a non-invasive mold technique on an outpatient basis without adverse reactions. The next generation of image-guided brachytherapy using HDR has been discussed. In conclusion, although concrete evidence is yet to be produced with a sophisticated study in a reproducible manner, HDR brachytherapy remains an important option for treatment of oral cancer.
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Affiliation(s)
- Hideya Yamazaki
- Department of Radiology, Kyoto Prefectural University of Medicine, 465 Kajiicho Kawaramachi Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan.
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Clinical evaluation of application of polyglycolic acid sheet and fibrin glue spray for partial glossectomy. J Oral Maxillofac Surg 2012; 71:e126-31. [PMID: 23164997 DOI: 10.1016/j.joms.2012.08.012] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Revised: 08/13/2012] [Accepted: 08/13/2012] [Indexed: 12/14/2022]
Abstract
PURPOSE The aim of this study was to evaluate the usefulness of covering open wounds with a polyglycolic acid (PGA) sheet and a fibrin glue spray after partial glossectomy. MATERIALS AND METHODS We clinically evaluated postoperative pain and scar contracture in 44 patients who underwent partial glossectomy followed by covering with a PGA sheet and a fibrin glue spray (PGA sheet group), as compared with 29 patients who were closed primarily (primary closure group). RESULTS Duration of nonsteroidal anti-inflammatory drugs was almost the same between the PGA sheet group and the primary closure group. The degree of scar contracture was mild in many cases in both groups. In the case in which the excision area was wide and depth was shallow, there was a tendency for the scar contracture to be less in the PGA sheet group. CONCLUSIONS Our findings showed that the use of a PGA sheet and fibrin glue spray for open wounds resulting from partial glossectomy was useful in terms of rapid relief from postoperative pain and prevention of scar contracture.
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Clinical evaluation of Lugol's iodine staining in the treatment of stage I–II squamous cell carcinoma of the tongue. Int J Oral Maxillofac Surg 2011; 40:593-6. [DOI: 10.1016/j.ijom.2010.11.026] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2009] [Revised: 05/20/2010] [Accepted: 11/12/2010] [Indexed: 11/18/2022]
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TAKEUCHI J, UMEDA M, MURATA M, KAKEI Y, KIMOTO A, SUZUKI H, SHIGETA T, RI S, KOMORI T. Application of polyglycolic acid sheet and fibrin glue spray for partial glossectomy: Comparison with artificial dermis. ACTA ACUST UNITED AC 2011. [DOI: 10.5794/jjoms.57.394] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Kitamura M, Hirano S, Tateya I, Kada S, Ishikawa S, Kanda T, Asato R, Ito J. Ten years single institutional experience of treatment for oral cancer in Kyoto University. Acta Otolaryngol 2010:74-8. [PMID: 20879823 DOI: 10.3109/00016489.2010.490239] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
CONCLUSIONS The prognosis of patients was related to the initial stage at diagnosis. These results suggest that early diagnosis and treatment are the most important factors to improve the prognosis in oral cancer patients. Adjuvant treatment is also warranted to improve locoregional control of advanced cases. OBJECTIVES To update the therapeutic outcome of oral cancer. METHODS In all, 129 cases with oral cancer were treated at Kyoto University Hospital during 2000-2008. Surgery with/without irradiation was performed for 34 cases in stage I, 27 in stage II, 15 in stage III, 42 in stage IVa, and 1 case in stage IVb. Brachytherapy was performed for three cases in stage II. Definitive radiotherapy was performed for three cases in stage III and five cases in stage IV. The follow-up period varied from 12 to 96 months (mean 30 months). RESULTS The 5-year cumulative overall and disease-specific survival (DSS) rates were 74.5% and 75.3%. DSS was 86.2% in stage I, 91.6% in stage II, 70.7% in stage III, 60.2% in stage IVa, and 0% in stage IVb. DSS shows worse prognosis with advanced nodal status. Locoregional recurrence occurred in 32 of 129 cases, including local recurrence in 8 cases, nodal recurrence in 18, retropharyngeal node metastasis in 1, and local and nodal recurrence in 5 cases. Salvage operation with/without postoperative radiotherapy was performed for 22 cases with locoregional recurrence and 7 of them have survived.
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Affiliation(s)
- Morimasa Kitamura
- Department of Otolaryngology Head and Neck Surgery, Kyoto University, Kyoto, Japan.
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24
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Guinot JL, Santos M, Tortajada MI, Carrascosa M, Estellés E, Vendrell JB, Muelas R, Chust ML, Mengual JL, Arribas L. Efficacy of high-dose-rate interstitial brachytherapy in patients with oral tongue carcinoma. Brachytherapy 2010; 9:227-34. [PMID: 20116340 DOI: 10.1016/j.brachy.2009.10.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2009] [Revised: 09/20/2009] [Accepted: 10/16/2009] [Indexed: 11/24/2022]
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Interstitial HDR brachytherapy (HDR-BT) in early stage mobile tongue cancers in young patients - Gliwice experience. J Contemp Brachytherapy 2010; 2:61-63. [PMID: 27829846 PMCID: PMC5095262 DOI: 10.5114/jcb.2010.14403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2010] [Accepted: 06/06/2010] [Indexed: 11/24/2022] Open
Abstract
Purpose In early stage mobile tongue cancer radical radiotherapy offers good local control and organ preservation, which is especially important in the group of young patients. In our department, for many years HDR-BT has been performed in mobile tongue cancers as a sole treatment or as a “boost” with EBRT. The aim of the study was to show our experience with HDR-BT in early stage mobile tongue cancers among young patients. Material and methods From 2001 to 2006 in Maria Skłodowska-Curie Memorial Cancer Centre and Institute of Oncology, Gliwice Branch, five patients under 45 years with mobile tongue cancer were treated with HDR brachytherapy (T1N0M0 – 3/5 and T2N0M0 – 2/5); 4 with HDR brachytherapy “boost” and 1 as a sole treatment. One woman was previously treated with tumour resection, but because of positive surgical margins was referred for radiotherapy. All patients had clinically negative lymph nodes, without dissection. They were treated with interstitial HDR-BT (3-8 catheters). In 4 patients treated with HDR-BT as a “boost”, total doses ranged from 18 to 21 Gy given in 6-7 fractions (twice a day, 3 Gy per fraction). Total doses in EBRT (to local lymph nodes and tumour bed) ranged from 50 to 60 Gy (1.8-2 Gy per fraction 5 days/week). One patient, treated with radical HDR brachytherapy, received 45 Gy in 10 fractions and 50 Gy in EBRT to regional lymph nodes. Results We did not notice local recurrences or distant metastases in our group of patients. Median follow-up was 67 months (range 47-79 months). All patients preserved normal tongue function. A severe late complication occurred in 1 patient – fracture of the mandible. Conclusions In the analysed group of young patients with mobile tongue cancer interstitial HDR brachytherapy in combination with EBRT was an effective and well tolerated treatment modality which allowed preservation of the tongue and its function.
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Nakashima T, Nakamura K, Shiratsuchi H, Yasumatsu R, Toh S, Shioyama Y, Komune S. Clinical Outcome of Partial Glossectomy or Brachytherapy in Early-stage Tongue Cancer. ACTA ACUST UNITED AC 2010; 113:456-62. [DOI: 10.3950/jibiinkoka.113.456] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Nishida AT, Tanaka S, Hirano S, Tamura Y, Tamaki H, Asato R, Ito J. Therapeutic outcomes of oral cancers at Kyoto University Hospital. Acta Otolaryngol 2007:58-61. [PMID: 17453447 DOI: 10.1080/00016480601067958] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
CONCLUSION The results suggest that early diagnosis and treatment are the most important factors to improve the prognosis in oral cancer patients. OBJECTIVE In this retrospective study we analyzed the therapeutic outcome of oral cancers at out institute. PATIENTS AND METHODS Thirty-one patients with oral cancers were treated between January 2000 and December 2004 at the Department of Otolaryngology-Head and Neck Surgery, Kyoto University Hospital. Transoral resection of tumor with or without neck dissection was performed for early oral cancers (stage I and II), while more extensive resection and radical neck dissection followed by postoperative radiotherapy was performed for advanced cases (stage IIII and IV). In the treatment of early tongue cancer, either partial glossectomy or brachytherapy was selected. The 3-year disease-specific survival rates of all patients, early-staged, and advanced-staged patients were 82.2%, 92.9%, and 63.5%, respectively. The prognosis was significantly related to the clinical stage of the tumor.
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Affiliation(s)
- Akiko T Nishida
- Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Windfuhr JP, Remmert S. Infrahyoid myofascial flap for tongue reconstruction. Eur Arch Otorhinolaryngol 2006; 263:1013-22. [PMID: 16868774 DOI: 10.1007/s00405-006-0110-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2006] [Accepted: 05/10/2006] [Indexed: 11/28/2022]
Abstract
For selected cases, reconstruction of the tongue may be required after tumor removal. This study was undertaken to demonstrate a simplified concept of tongue reconstruction with emphasis on infrahyoid myofascial flaps (IMF). The defects of the tongue were classified in 23 patients according to the extent of tumor growth, functional and surgical aspects. The oral tongue (OT; n = 1), base of tongue (BT; n = 12) or both areas (OT and BT; n = 10) were involved, with (n = 14) or without (n = 9) infiltration of adjacent tissues. Minor defects (extent (1/4) or less) required no reconstructive procedure at any area. Major defect closure (extent (1/2)-3/4) was accomplished with a combination of IMF covered by a radial forearm flap (RFF). A complete reconstruction of the OT was achieved with a combination of a bilateral IMF covered by a RFF. Whenever the complete BT has to be removed, interposition of a vein graft to establish a sufficient arterial blood supply to the remaining OT is mandatory. Moreover, a larynx lift to prevent aspiration is recommendable. Resection of adjacent soft tissues requires a larger RFF (OT; BT) or flaps from the shoulder-back region (BT and OT). Whenever the integrity of the mandible has to be sacrificed, a free fibula graft serves as an excellent tool for reconstruction. IMF serves as a reliable tool for minor or major reconstructive procedures of the tongue. Reliability and versatility of IMF may contribute to a reduced time required for surgery since harvesting is performed in the neck area immediately after neck dissection. Moreover, harvesting of the IMF does not result in an increased postoperative morbidity. Hence, functional restoration can be achieved with a more cost-effective procedure.
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Affiliation(s)
- Jochen P Windfuhr
- Department of Otorhinolaryngology, Plastic Head and Neck Surgery, St. Anna Hospital, 47259 Duisburg, Germany.
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Magdelaine A, Laure B, Mahy P, Reychler H, Vacher C. [Management of a squamous-cell carcinoma T2N1 neoplasia on the free border of the tongue]. ACTA ACUST UNITED AC 2005; 106:363-6. [PMID: 16344760 DOI: 10.1016/s0035-1768(05)86062-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- A Magdelaine
- Service de Chirurgie Maxillo-Faciale et Stomatologie, CHU Trousseau, 37044 Tours Cedex
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