상단 PDF Molecular Targeted Therapy in Head and Neck Cancer

Dosimetric comparison of coplanar and non-coplanar volumetric-modulated arc therapy in head and neck cancer treated with radiotherapy

Dosimetric comparison of coplanar and non-coplanar volumetric-modulated arc therapy in head and neck cancer treated with radiotherapy

Irradiation of tumors in the head and neck cancer patients is technically challenging especially in the patients with a short neck or high shoulders. Considering patient comfort, we had fixed the patient position by applying a mask. Higher stage head neck cases required comprehensive irradiation of the neck region extending inferiorly to the level of the lung apices. Owing to the body struc- ture, if we planned with coplanar beam arrangements, dose to the healthy tissue of the shoulder region would be higher than non-co- planar beam arrangements because of the photon path length to the PTV, i.e., photon beams had to pass through the shoulders and soft tissue of neck region [39]. For this reason, we evaluated the dose for bilateral humeral heads. A significant dose reduction was noted for D max of bilateral humeral heads in non-coplanar beam ar- rangements.
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Evaluation of skin surface dose for head and neck cancer patients treated with intensity-modulated radiation therapy using in vivo dosimetry

Evaluation of skin surface dose for head and neck cancer patients treated with intensity-modulated radiation therapy using in vivo dosimetry

서 론 Use of intensity-modulated radiation therapy (IMRT) for head and neck cancer is gradually increasing, because it could facilitate more sophsticated treatment of target volumes and reduction of acute and late sequelae. However, theoretically, there is a potential risk of increased skin surface dose resulting from multiple obliquity effects caused by multiple tangential beams.

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Late side effects of radiation treatment for head and neck cancer

Late side effects of radiation treatment for head and neck cancer

Patients undergoing radiation therapy for head and neck cancer (HNC) experience significant early and long-term side effects. The likelihood and severity of complications depends on a number of fac- tors, including the total dose of radiation delivered, over what time it was delivered and what parts of the head and neck received radiation. Late side effects include: permanent loss of saliva; osteoradio- necrosis; radiation recall myositis, pharyngoesophageal stenosis; dental caries; oral cavity necrosis; fi- brosis; impaired wound healing; skin changes and skin cancer; lymphedema; hypothyroidism, hyper- parathyroidism, lightheadedness, dizziness and headaches; secondary cancer; and eye, ear, neurologi- cal and neck structures damage. Patients who undergo radiotherapy for nasopharyngeal carcinoma tend to suffer from chronic sinusitis. These side effects present difficult challenges to the patients and their caregivers and require life-long strategies to alleviate their deleterious effect on basic life func- tions and on the quality of life. This review presents these side effects and their management.
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Feasibility study of the usefulness of SRS thermoplastic mask for head & neck cancer in tomotherapy

Feasibility study of the usefulness of SRS thermoplastic mask for head & neck cancer in tomotherapy

Purpose : When head&neck cancer radiation therapy, thermoplastic mask is applied for patients with fixed. The purpose of this study is to evaluate usefulness of thermoplastic mask for SRS in tomotherapy by conparison with the conventional mask. Materials and Methods : Typical mask(conventional mask, C-mask) and mask for SRS are used to fix body phantom(rando phantom) on the same iso centerline, then simulation is performed. Tomotherapy plan for orbit and salivary glands is made by treatment planning system(TPS). A thick portion and a thin portion located near the treatment target relative to the mask S- mask are defined as region of interest for surface dose dosimetry. Surface dose variation depending on the type of mask was analyzed by measuring the TPS and EBT film.
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Metachronous second primary malignancy in head and neck cancer patients: is five years of follow-up sufficient?

Metachronous second primary malignancy in head and neck cancer patients: is five years of follow-up sufficient?

survival observed in long-term follow-up can be attributed to the development of SPM; the median time to develop another tumor was 67 months. Patients with SPM have a relatively long-term survival, and many patients do well considering it is their second tu- mor. Therefore, efforts should be made to implement regular follow-ups for early diagnosis 13 . In our study, many patients were diagnosed when they were not monitored because they had completed their 5 years of follow-up. We suggest that treated head and neck cancer patients be followed up throughout their lives to detect early SPMs, which should be treated aggressively to attain maximum benefit. Despite the better outcomes observed in this study, multi-institutional data are required to confirm the results.
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How to improve the survival rate of implants after radiotherapy for head and neck cancer?

How to improve the survival rate of implants after radiotherapy for head and neck cancer?

showed long-term results of implants following radical head and neck cancer surgery with adjuvant radiation therapy, and the over- all 1-, 5-, and 10-year survival rates of all implants were 96.6%, 96.6%, and 86.9%, respectively. Based on the results of the re- search mentioned above, it was concluded that radiotherapy was the essential cause of implant failure. Irradiation can produce both early and late tissue changes. Early effects include those on the salivary glands, skin, and oral mucosa, whereas later effects involve bone changes leading to demineralization, fibrosis, increased sus- ceptibility to infection, and finally, avascular necrosis [16-18]. Thus, the treatments against the changes in the soft and hard tissues af- ter radiotherapy are meaningful for the success of dental implants in patients with head and neck cancer.
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Draft genome sequence of Streptococcus sp. strain NM isolated from head and neck cancer patients

Draft genome sequence of Streptococcus sp. strain NM isolated from head and neck cancer patients

(Received November 23, 2018; Revised December 17, 2018; Accepted December 17, 2018) *For correspondence. E-mail: sjpark@jejunu.ac.kr; Tel.: +82-64-754-3524; Fax: +82-64-756-3541 Streptococcus sp. strain NM belonging to Firmicutes was isolated from head and neck cancer patients. Here, we report the draft genome sequence of strain NM with a size of approximately 1.90 Mbp and a mean G+C content of 39.3%. The draft genome included 1,845 coding sequences, and 12 ribosomal RNA and 58 transfer RNA genes. In the draft genome, genes involved in the antimicrobial resistance, hemolysis and defense system have been identified.
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An anesthetic management of head and neck cancer reconstructive surgery in a patient having hemophilia A: a case report

An anesthetic management of head and neck cancer reconstructive surgery in a patient having hemophilia A: a case report

Hemophilia A is a hemorrhagic disease caused by coagulation factor VIII deficiency. In head and neck cancer surgery, especially during a reconstructive one, complications can occur. These include hematomas due to bleeding which can then lead to flap ischemia, necrosis, and impaired wound healing. There are fewer cases of reconstructive surgery in patients with hemophilia A. Here in we report, a reconstructive surgery that involved mass resection, partial glossectomy (right), selective neck dissection (right, Levels I, II, III, IV), and reconstruction at the lateral arm free flap (left) in a 25-year-old man with hemophilia A. The surgery was successfully performed without any complications after pretreatment with Factor VIII concentrate, which has not been reported earlier.
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Performance prediction of prompt gamma measurement system for range verification in head and neck cancer treatment with proton beam

Performance prediction of prompt gamma measurement system for range verification in head and neck cancer treatment with proton beam

1 한양대학교 원자력공학과 ․ 2 한양대학병원 E-mail: chkim@hanyang.ac.kr 중심어 : 양성자 치료, spot scanning, 즉발감마선, 두경부, 몬테칼로 전산모사 Fig 1. Schematic diagram of prompt gamma measurement system for head and neck cancer treatment.

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The effectiveness of an enhanced recovery after surgery protocol in head and neck cancer surgery with free-flap reconstruction

The effectiveness of an enhanced recovery after surgery protocol in head and neck cancer surgery with free-flap reconstruction

Principles of the ERAS protocol in Ajou University Hospital Before implementation of the ERAS approach, perioperative care was directed by the individual surgeon and did not follow a specific protocol. Beginning in August 2015, a protocol was established according to the basic ERAS principles and applied to perioperative care. The main contents of the Ajou Hospital- developed ERAS protocol for head and neck cancer surgery with free-flap reconstruction patients were as follows. Patients were informed regarding the surgical procedure and precautions before surgery, and the operation proceeded with voluntary consent. Prophylactic intravenous antibiotics were administered 1 to 2 hours before surgery and preanesthetic medication was administered before anesthesia. Patients were routinely admitted to the intensive care unit (ICU) on the operation day, and ventilator weaning took place immediately if there were no cardiopulmonary difficulties. If there were no specific problems or complications on postoperative day (POD) 1, the patient was transferred to the general ward. Routine anticoagulation was
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Growth inhibition in head and neck cancer cell lines by gefitinib, an epidermal growth factor receptor tyrosine kinase inhibitor

Growth inhibition in head and neck cancer cell lines by gefitinib, an epidermal growth factor receptor tyrosine kinase inhibitor

SCC-9, KB cells were cultured and growth inhibition activity of gefitinib was measured with MTT assay. To study influence of gefitinib in cell cycle, we performed cell cycle analysis with flow cytometry. Western blot was done to elucidate the expression of EGFR in cell lines and phosphory- lation of EGFR and downstream kinase protein, Erk and Akt. Significant growth inhibition was observed in SCC-9 cells in contrast with KB cells. Also, flow cytometric analysis showed G1 phase arrest only in SCC-9 cells. In Western blot analysis for investigation of EGFR expression and downstream molecule phosphorylation, gefitinib suppressed phospho- rylation of EGFR and downstream protein kinase Erk, Akt in SCC-9. However, in EGFR positive KB cells, weak expression of active form of Erk and Akt and no inhibitory activity of phosphorylation in Erk and Akt was observed. The antiproliferative activity of gefitinib was not correlated with EGFR expression and some possibility of phosphorylation of Erk and Akt as a predictive factor of gefitinib response was emerged. Further investiga- tions on more reliable predictive factor indicating gefitinib response are awaited to be useful gefitinib treatment in head and neck cancer patients.
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Clinical recommendations for defining platinum unsuitable head and neck cancer  patient populations on chemoradiotherapy: A literature review

Clinical recommendations for defining platinum unsuitable head and neck cancer patient populations on chemoradiotherapy: A literature review

s u m m a r y Toxicities resulting from platinum based chemotherapy in head and neck cancer is a cause for much concern. There is a lack of clinical criteria for defining these patient populations, which has posed serious problems associated with increased morbidity and consequently an adverse effect on patients’ quality of life. In addition, there is a lack of consensus on clinical criteria for defining such patient populations, who may be unsuitable for concurrent chemoradiotherapy. A group of experts in the field of head and neck cancer from the Asia Pacific Region convened in August 2014 in Korea to discuss the development of a set of clinical criteria in order to fill the knowledge gap and provide a reference tool for head and neck oncologists. This paper reports the final output from this meeting and the accompanying literature review, with the aim of aiding clinical decision making with the help of some clinical criteria to identify platinum unsuitable patient populations in head and neck cancer management. Some alternative treat- ment options are also discussed in this paper.
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High late complication and local control with Hypofractionated radiosurgery boost in advanced head and neck cancer : Is it feasible and safe ?

High late complication and local control with Hypofractionated radiosurgery boost in advanced head and neck cancer : Is it feasible and safe ?

However, FSRT with large fractional dose needs more experiences and longer follow up to define potential long-term complications. We report on the clinical outcome of Cyberknife radiosurgery (CKS) boost after external RT for locally advanced head and neck cancer with emphasis on unexpected high, late complications.

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Thioridazine enhances sensitivity to carboplatin in human head and neck cancer cells through downregulation of c-FLIP and Mcl-1 expression

Thioridazine enhances sensitivity to carboplatin in human head and neck cancer cells through downregulation of c-FLIP and Mcl-1 expression

Multiple mechanisms are involved in the anticancer activity of thioridazine. First, thioridazine inhibits PI3K/Akt signaling, which is important for cancer cell survival. Thioridazine inhibits cell viability and induces cell death through inhibition of the PI3K/Akt signaling pathway in ovarian cancer and in cervical and endometrial cancer cells. 11,12 In addition, thioridazine inhibits angiogenesis and tumor growth in ovarian cancer xenografts by inhibiting PI3K/Akt signaling. 17 In our study, thioridazine also inhibited Akt phosphorylation (Supple- mentary Figure S1a). However, PI3K/Akt inhibitors (LY294002 and wortmanin) plus carboplatin did not induce apoptosis in head and neck cancer cells (Supplementary Figure S1b). Furthermore, both PI3K/Akt inhibitors had no Figure 2 Downregulation of c-FLIP and Mcl-1 expression by carboplatin plus thioridazine contributes to apoptosis. (a and b) AMC-HN4 cells were transiently transfected with pcDNA 3.1-c-FLIP (a) or pFLAG-CMV-4/Mcl-1 (b). Twenty-four hours after transfection, cells were treated with 200 nM carboplatin in the presence or absence of 10 μM thioridazine for 24 h. The sub-G1 fraction was measured by flow cytometry. The protein expression levels of PARP, c-FLIP, Mcl-1, and actin were determined by western blotting.
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Clinical outcomes of immune checkpoint inhibitors for patients with recurrent or metastatic head and neck cancer: real-world data in Korea

Clinical outcomes of immune checkpoint inhibitors for patients with recurrent or metastatic head and neck cancer: real-world data in Korea

Keywords: Immune checkpoint inhibitor, Head and neck cancer, Pembrolizumab, Nivolumab © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
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The clinical study of oral care for early radiation therapy in the head and neck cancer patients

The clinical study of oral care for early radiation therapy in the head and neck cancer patients

이에 착안하여 저자 등은 두경부 악성 종양으로 방사선 치료가 내정된 상태에서 방사선치료를 위한 치과적 관리 문제로 대진의뢰된 환자 중에서 치성 염증이 발생된 경우, 종양관련 의학과와 환자의 방사선치료가 시급하여 조기에 방사선치료가 불가피할 경우, 발치의 적응증이 되는 치아 는 발치를 시행하고 가장 단축된 1주일 경과 후에 방사선 치[r]

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The experimental study of oral care for early radiation therapy in the head and neck cancer patients

The experimental study of oral care for early radiation therapy in the head and neck cancer patients

이상의 동물실험을 통한 통계학적 유의성을 감안할 때, 두경부 악성종양으로 방사선치료를 시행받게 되는 환자들 이 가능한 한 조기에 방사선치료가 진행되어야 되는 상황 이라면 방사선치료 시행 전에 발치의 적응증이 되는 치아 는 발치를 시행하고 1주일 경과 후에 방사선치료를 시작하 고, 무증상의 만성 치근단 염증치아는 근관치료 등 보존적 [r]

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The clinical study of oral care for early radiation therapy in the head and neck cancer patients

The clinical study of oral care for early radiation therapy in the head and neck cancer patients

이에 착안하여 저자 등은 두경부 악성 종양으로 방사선 치료가 내정된 상태에서 방사선치료를 위한 치과적 관리 문제로 대진의뢰된 환자 중에서 치성 염증이 발생된 경우, 종양관련 의학과와 환자의 방사선치료가 시급하여 조기에 방사선치료가 불가피할 경우, 발치의 적응증이 되는 치아 는 발치를 시행하고 가장 단축된 1주일 경과 후에 방사선 치[r]

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Rick factors associated with aspiration in patients with head and neck cancer.

Rick factors associated with aspiration in patients with head and neck cancer.

Aspiration showed a signifi cantly higher incidence from onset to examination. But significant differences were not observed when other variables were controlled in the multivariate logistic regression analysis. According to the report of Logemann et al. 25 who performed VFSS on patients 3 and 12 months after they underwent radio- therapy or chemoradiotherapy, dysphagia and aspiration showed significantly higher incidences before and 3 months after treatments. But, significant changes were not observed 12 months after treatments. In a study by Petterson et al., 20 the functional endoscopic swallowing study and the 100 cc water swallowing test were per- for med on patients who underwent radiotherapy or chemoradiotherapy. The incidence of aspiration in- creased at 3, 6, and 12 months after the operations, respectively, rather than before the operations. However, no inter-period diff erences were reported. In this study, the incidence of aspiration increased in proportion to the duration from onset to examination. Th e incidence may not have been aff ected by duration itself but by increasing the proportion of patients who underwent operations, chemotherapy, or radiotherapy with time. These results were similar to those of previous studies.
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Retrospective study of osteoradionecrosis in the jaws of patients with head and neck cancer

Retrospective study of osteoradionecrosis in the jaws of patients with head and neck cancer

ORN treatment is difficult, involves a combination of ther- apies, depends on available therapeutic resources, and relies on patient compliance with instructions and their individual biological response. For many researchers, conservative treat- ment is performed only in small ORN areas since for more advanced conditions, surgical resection is considered more efficient 1 . The conservative and surgical approach associated with HOT is well documented 1,19,36 . A less invasive option for ORN control and healing involves 0.12% chlorhexidine which, when administered topically, acts as a bactericide against gram-positive and gram-negative microorganisms and some yeasts. Despite exhibiting good results when associated with superficial necrotic bone curettage, there is still no pro- tocol for the use of chlorhexidine for ORN treatment 1,17 .
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