• Title/Summary/Keyword: 두경부암 환자

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Frailty in Geriatric Patients with Head and Neck Cancer and its Implication in Survivorship (노인 두경부암 환자의 생존에 있어 노쇠의 의의)

  • Minsu Kwon
    • Korean Journal of Head & Neck Oncology
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    • v.39 no.2
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    • pp.1-6
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    • 2023
  • The aging population, particularly those aged 65 and above, is on the rise, with projections indicating a substantial increase in the elderly demographic. This demographic shift brings challenges in managing age-related diseases, including head and neck cancers (HNCs). Frailty, often characterized by physiological decline and vulnerability to stressors, is a crucial factor affecting treatment outcomes of elderly cancer patients. Accordingly, the significance of assessing frailty in elderly HNC patients before their treatment should be emphasized, but current frailty assessment tools may not fully capture the unique challenges faced by HNC patients. Specific indicators, including respiratory and swallowing functions, are proposed for a more tailored assessment. This comprehensive review explores the impact of frailty on various treatment modalities, including surgery, radiation, and chemotherapy, highlighting the need for personalized interventions. Furthermore, it suggests avenues for future research to enhance frailty assessment tools and investigate interventions aimed at improving treatment outcomes in elderly HNC patients.

An Unusual Metastasis of Posterior Neck and Axillary Lymph Nodes from Nasopharyngeal Carcinoma (비인강암의 후경부 및 액와 림프절 전이)

  • Hong, Yong Tae;Minh, Phan Huu Ngoc;Hong, Ki Hwan
    • Korean Journal of Head & Neck Oncology
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    • v.32 no.2
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    • pp.23-27
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    • 2016
  • 비인강암은 비인강상피에 발생한 암으로 경부전이 및 간, 폐, 뼈 등의 원격전이가 흔히 나타난다. 본 증례에서는 제 4기 병기를 가진 비인강암환자에서 항암 화학요법 및 방사선 치료 후 매우 드물게 후경부 및 액와 림프절 전이를 보인 환자를 보고하는 바이다. 진행된 병기를 보이는 비인강암 환자는 방사선 치료 후 피부전이가 종종 나타나는 현상이나 후경부 림프절 전이는 흔치 않다. 특히 액와 림프절 전이는 비인강암에서 거의 전이를 보이지 않으나 본 증례에서는 매우 드물게 액와 림프절 전이를 보여 보고하는 바이다.

Functional Status, Depression, and Family Support in Head and Neck Cancer Patients (두경부암 환자의 기능상태, 우울과 가족지지)

  • Park, Yong-Kyung
    • Asian Oncology Nursing
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    • v.5 no.1
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    • pp.31-39
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    • 2005
  • Purpose: This study was to identify the levels of functional status, depression, family support and their relationship among those variables in head and neck cancer patients. Method: The subjects were 100 patients with head and neck cancer patients who visited at outpatients clinic in one university hospital in Taegu. The instrument used for this study were Functional Status in Head & Neck Cancer - Self Report Scale developed by Baker(1995), Self-Rating Depression Scale by Zung(1965) and Family support assessment tool by Kang hyun-suk(1984). The data were analysed percentage, mean, t-test, ANOVA and pearson's corelation using SAS program. Result: There was significantly negative correlation between functional status and depression(r=-.71) and between depression and family support(r=-.56). The relationship of functional status and family support was significant as r= .33. Conclusion: It was found that functional status, depression and family support of head and neck cancer patient were closely related each other. Therefore it is necessary to design nursing intervention to enhance family support or decrease depression for improving quality of life in head and neck cancer patient.

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Multidimensional Rehabilitation in Patients with Aspiration Following Head and Neck Cancer Treatment (두경부암 치료에 따라 발생한 흡인 환자에 대한 다각적 재활운동 치료)

  • Jung, Young Ho;Jin, Young Ju
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.29 no.1
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    • pp.5-8
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    • 2018
  • Patients who have the head and neck cancer are usually treated by surgery, radiation therapy, chemotherapy, or combinations of them. These treatments can induce variable degree of aspiration with dysphagia. The type and severity of aspiration depends on the size and location of the original tumor, the structures involved, and the treatment modality used for treatment. The management of aspiration after the head and neck cancer's treatment begins with an accurate evaluation for the cause and mechanism of aspiration through modified barium swallow (MBS) and fiberoptic endoscopic examination of swallowing (FEES). Then, the clinician can use postures, maneuvers, and exercises to treat the swallow disorder and to help the patient achieve optimal function. To achieve optimal swallowing without aspiration, multidimensional rehabilitation by various medical personnel is definitely necessary.

Symptom Severity according to the Presence of Depressive and Anxiety Symptoms among Patients with Head and Neck Cancer (두경부암 환자의 우울과 불안증상 유무에 따른 증상의 심각성)

  • Kim, Hyun-Joo;Cho, Ok-Hee;Yoo, Yang-Sook
    • Korean Journal of Adult Nursing
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    • v.28 no.2
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    • pp.148-155
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    • 2016
  • Purpose: The purpose of this study was to compare symptom severity and the impact of presence of depressive and/or anxiety symptoms among patients with head and neck cancer (HNC). Methods: One hundred and fifteen patients diagnosed with HNC completed two questionnaires: Hospital Anxiety and Depression Scale (HADS) and the M. D. Anderson Symptom Inventory-Head and Neck Cancer (MDASI-HN). Results: Of the total sample, 55.6% reported depressive symptoms and 33% reported anxiety symptoms. Patients who reported either depressive or anxiety symptoms also had significantly more severe symptoms. The most severe symptom was dry mouth. Participants who were depressed reported that interference in the enjoyment of life due to symptoms was the most distressing whereas participants with anxiety reported symptom interference in work was of most concern. Of patients reporting moderate to severe symptoms, more than 60% reported depressive symptoms. Of patients reporting moderate to severe feelings of being distress and feeling sad, more than 70% reported anxiety symptoms. Conclusion: Patients with HNC reporting moderate to severe symptoms also report depressive and/or anxiety symptoms. The results suggest the need to develop an integrated nursing intervention of both physical and emotional symptoms for patients with HNC.

Dosimetric evaluation of using in-house BoS Frame Fixation Tool for the Head and Neck Cancer Patient (두경부암 환자의 양성자 치료 시 사용하는 자체 제작한 BoS Frame 고정장치의 선량학적 유용성 평가)

  • Kim, kwang suk;Jo, kwang hyun;Choi, byeon ki
    • The Journal of Korean Society for Radiation Therapy
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    • v.28 no.1
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    • pp.35-46
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    • 2016
  • Purpose : BoS(Base of Skull) Frame, the fixation tool which is used for the proton of brain cancer increases the lateral penumbra by increasing the airgap (the distance between patient and beam jet), due to the collision of the beam of the posterior oblique direction. Thus, we manufactured the fixation tool per se for improving the limits of BoS frame, and we'd like to evaluate the utility of the manufactured fixation tool throughout this study. Materials and Methods : We've selected the 3 patients of brain cancer who have received the proton therapy from our hospital, and also selected the 6 beam angles; for this, we've selected the beam angle of the posterior oblique direction. We' ve measured the planned BoS frame and the distance of Snout for each beam which are planned for the treatment of the patient using the BoS frame. After this, we've proceeded with the set-up that is above the location which was recommended by the manufacturer of the BoS frame, at the same beam angle of the same patient, by using our in-house Bos frame fixation tool. The set-up was above 21 cm toward the superior direction, compared to the situation when the BoS frame was only used with the basic couch. After that, we've stacked the snout to the BoS frame as much as possible, and measured the distance of snout. We've also measured the airgap, based on the gap of that snout distance; and we've proceeded the normalization based on each dose (100% of each dose), after that, we've conducted the comparative analysis of lateral penumbra. Moreover, we've established the treatment plan according to the changed airgap which has been transformed to the Raystation 5.0 proton therapy planning system, and we've conducted the comparative analysis of DVH(Dose Volume Histogram). Results : When comparing the result before using the in-house Bos frame fixation tool which was manufactured for each beam angle with the result after using the fixation tool, we could figure out that airgap than when not used in accordance with the use of the in-house Bos frame fixation tool was reduced by 5.4 cm ~ 15.4 cm, respectively angle. The reduced snout distance means the airgap. Lateral Penumbra could reduce left, right, 0.1 cm ~ 0.4 cm by an angle in accordance with decreasing the airgap while using each beam angle in-house Bos frame fixation tool. Due to the reduced lateral penumbra, Lt.eyeball, Lt.lens, Lt. hippocampus, Lt. cochlea, Rt. eyeball, Rt. lens, Rt. cochlea, Rt. hippocampus, stem that can be seen that the dose is decreased by 0 CGE ~ 4.4 CGE. Conclusion : It was possible to reduced the airgap by using our in-house Bos frame fixation tool for the proton therapy; as a result, it was possible to figure out that the lateral penumbra reduced. Moreover, it was also possible to check through the comparative analysis of the treatment plan that when we reduce the lateral penumbra, the reduction of the unnecessary irradiation for the normal tissues. Therefore, Using the posterior oblique the Brain cancer proton therapy should be preceded by decreasing the airgap, by using our in-house Bos frame fixation tool; also, the continuous efforts for reducing the airgap as much as possible for the proton therapy of other area will be necessary as well.

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CANCER OF THE NASAL FOSSAE (비강 및 부비동암)

  • Seel David J.;Yoo Bong-Ok;Park Yoon-Kyu
    • Korean Journal of Head & Neck Oncology
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    • v.2 no.1
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    • pp.13-22
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    • 1986
  • Nasal fossae 의 암이란 비강과 부비동들에서 발생하는 것으로서 환자를 가장 괴롭히며 또한 가장 믿을수 없는 악성종양들중의 하나이다. 비록 본 예수병원 암환자 등록부에 의하면 전 암환자의 2.2% 발생빈도로서 주요한 발생빈도를 보이지는 않지만, 이 부위의 암을 치유하는데는 세심하고 철저한 모든 진단적 검사와 과감한 외과 및 치료방사선의 병합치료가 요구된다. 저자들은 지난 22 년간 비강 및 부비동 (Nasal fossae) 에서 발생한 원발성 악성종양중 치유목적의 근치수술을 시행한 68 예를 임상고찰 하였다. 근치수술을 시행했던 68 예중 91% 에서 제 3 병기 또는 4 병기의 진행된 경우 이었다. 외과적 수술은 한예의 사골동 (篩骨洞) 종양적출술 및 부분상악동(上顎洞)절제술 한 예를 제외한 66 예 모두에서 전상악동(全上顎洞)절제술 (total maxillectomy) 또는 확장 전상악동(全上顎洞)절제술 (extended total maxillectomy) 을 시 하였다. 저자들은 역학적(疫學的), 병리학적(病理學的), 병기(病期) 및 치료, 재발율과 생존율들을 분석 고찰하였으며 3가지 치료형태를 서로 비교하였다. 즉 수술만 시행한 군, 수술전 방사선 치료 및 수술병합군, 수술과 수술후 방사선치료 병합 군으로 나눴다. 저자들의 예비적 (preliminary) 관찰 결과는 2 년간 무병생존율 (disease-free 2-year survival) 만을 볼때, 수술만 시행한 군에서 40%로써 통계학적으로는 가장 좋았으나 실제는 수술만 시행한 군에서는 단지 40%만이 제 4 병기(病期)의 진행된 경우였으나 수술전 방사선치료 또는 수술후 방사선치료등의 병합치료에서는 제 4 병기(病期)의 진행된 상태가 무려 60 %나 되었다. 전체적인 재발율 (Overall recurrence rate) 은 68.2%로써 무서울 정도로 높았으며 전체적인 2 년 무병율은 23.7%였다. 저자들은 이 분야에서 실패의 원인분석과 치료방법의 선택등에 대한 지침을 제시하고저 한다.

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