• Radiation Oncology Journal
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• 제30권1호
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• pp.36-42
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• 2012

Purpose: To evaluate the radial displacement of clinical target volume in the patients with node negative head and neck (H&N) cancer and to quantify the relative positional changes compared to that of normal healthy volunteers. Materials and Methods: Three node-negative H&N cancer patients and five healthy volunteers were enrolled in this study. For setup accuracy, neck thermoplastic masks and laser alignment were used in each of the acquired computed tomography (CT) images. Both groups had total three sequential CT images in every two weeks. The lymph node (LN) level of the neck was delineated based on the Radiation Therapy Oncology Group (RTOG) consensus guideline by one physician. We use the second cervical vertebra body as a reference point to match each CT image set. Each of the sequential CT images and delineated neck LN levels were fused with the primary image, then maximal radial displacement was measured at 1.5 cm intervals from skull base (SB) to caudal margin of LN level V, and the volume differences at each node level were quantified. Results: The mean radial displacements were 2.26 (${\pm}1.03$) mm in the control group and 3.05 (${\pm}1.97$) in the H&N cancer patients. There was a statistically significant difference between the groups in terms of the mean radial displacement (p = 0.03). In addition, the mean radial displacement increased with the distance from SB. As for the mean volume differences, there was no statistical significance between the two groups. Conclusion: This study suggests that a more generous radial margin should be applied to the lower part of the neck LN for better clinical target coverage and dose delivery.

• 대한두경부종양학회:학술대회논문집
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• 대한두경부종양학회 1999년도 추계 학술대회
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• pp.278-281
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• 1999

• 대한두경부종양학회지
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• 제27권1호
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• pp.77-79
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• 2011

Tracheal diverticulum is very rare, that is usually an incidental finding at routine chest computed tomography scan. Differential diagnosis of tracheal diverticulum includes pharyngocele, laryngocele, Zenker diverticulum, apical lung hernia, blebs and bulla, and pneumomediastinum. Treatment options can be devided into medical and surgical. The majority of patients is asymptomatic and requires no specific intervention. We experienced one case of tracheal diverticulum in patient with tongue cancer and report it with reviews of literature.

• Radiation Oncology Journal
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• 제13권2호
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• pp.129-142
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• 1995

Purpose: Traditionally the patients with early stage non-Hodgkin's lymphoma of the head and neck was treated with radiotherapy. But the results were not satisfactory due to distant relapse. Although combined treatment with radiotherapy and chemotherapy was tried with some improved results and chemotherapy alone was also tried in recent years, the choice of treatment for the patients with early stage non-Hodgkin's lymphoma of the head and neck has not been defined Therefore, in order to determine the optimum treatment method, we analysed retrospectively the outcomes of the patients with Ann Arbor stage I and II non-Hodgkin's lymphoma localized to the head and neck who were treated at Severance Hospital. Materials and Methods: 159 patients with stage I and II non-Hodgkin's lymphoma localized to the head and neck were treated at our hospital from January, 1979 to December, 1992. Of these patients, 114 patients whose primary sites were Waldeyer's ring or nodal region, and received prescribed radiation dose and/or more than 2 cycles of chemotherapy. were selected to analyze the outcomes according to the treatment methods ( radiotherapy alone, chemotherapy alone. and combined treatment with radiotherapy and chemotherapy ). Results: Five year overall actuarial survival of the patients whose Primary site was Waldeyer's ring was $62.5\%.$ and that of the Patients whose primary site was nodal region was $53.8\%$ There was no statistically significant difference between survivals of both groups. Initial response rate to radiotherapy. chemotherapy, and combined treatment was $92\%,\;83\%,\;94\%$ respectively, and 5 year relapse free survival was $49.9\%,\;52.4\%,\;58.5\%$ respectively ( statistically not significant ). In the patients with stage I. 3 year relapse free survival of chemotherapy alone group was $75\%$ and superior to other treatment groups. In the Patients with stage II, combined treatment group revealed the best result with $60.1\%$ of 3 year relapse free survival. The effect of sequential schedule of each treatment method in the Patients who were treated by combined modality was analyzed and the sequence of primary chemotherapy + radiotherapy + maintenance chemotherapy showed the best result ( 3 year relapse free survival was $79.1\%).$ There was no significant survival difference between BACOP regimen and CHOP regimen. Response to treatment was only one significant (p(0.005) prognostic factor on univariate analysis and age and mass size was marginally significant ( p(0.1). On multivariate analysis, age (p=0.026) and mass size (p=0.013) were significant prognostic factor for the relapse free survival. Conclusion: In summary, the patients who have non-Hodgkin's lymphoma of the head and neck with stage I and mass size smaller than 10 cm, can be treated by chemotherapy alone, but remainder should be treated by combined treatment method and the best combination schedule was the sequence of initial chemotherapy followed by radiotherapy and maintenance chemotherapy.

• Radiation Oncology Journal
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• 제38권2호
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• pp.99-108
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• 2020

Purpose: The probability of recurrence of cancer after adjuvant or definitive radiotherapy in patients with human papillomavirus-negative (HPV(-)) head and neck squamous cell carcinoma (HNSCC) varies for each patient. This study aimed to identify and validate radiation sensitivity signature (RSS) of patients with HPV(-) HNSCC to predict the recurrence of cancer after radiotherapy. Materials and Methods: Clonogenic survival assays were performed to assess radiosensitivity in 14 HNSCC cell lines. We identified genes closely correlated with radiosensitivity and validated them in The Cancer Genome Atlas (TCGA) cohort. The validated RSS were analyzed by ingenuity pathway analysis (IPA) to identify canonical pathways, upstream regulators, diseases and functions, and gene networks related to radiosensitive genes in HPV(-) HNSCC. Results: The survival fraction of 14 HNSCC cell lines after exposure to 2 Gy of radiation ranged from 48% to 72%. Six genes were positively correlated and 35 genes were negatively correlated with radioresistance, respectively. RSS was validated in the HPV(-) TCGA HNSCC cohort (n = 203), and recurrence-free survival (RFS) rate was found to be significantly lower in the radioresistant group than in the radiosensitive group (p = 0.035). Cell death and survival, cell-to-cell signaling, and cellular movement were significantly enriched in RSS, and RSSs were highly correlated with each other. Conclusion: We derived a HPV(-) HNSCC-specific RSS and validated it in an independent cohort. The outcome of adjuvant or definitive radiotherapy in HPV(-) patients with HNSCC can be predicted by analyzing their RSS, which might help in establishing a personalized therapeutic plan.

• 대한핵의학회지
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• 제33권6호
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• pp.466-474
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• 1999

목적 : 본 연구는 두경부종양 환자의 병기결정 및 수술이나 방사선 치료 후 재발의 발견에 있어 [$^{18}F$]-FDG PET의 진단적 정확도를 알아보고 치료 종료 후 재발 진단을 위한 적절한 [$^{18}F$]FDG PET 시행시기를 알아보기 위하여 시행하였다. 대상 및 방법: 59명의 두경부종앙 환자를 대상으로 [$^{18}F$]FDG PET 전신촬영을 시행하였고 치료 방법에 따라 환자를 4군으로 나누었다. [ I군 (14명); 치료를 시행받지 않은 환자군, II군(17명); 수술만을 받은 환자군, III군 (9명): 방사선치료만을 받은 환자군, IV군(19명); 수술과 방사선치료 모두를 받은 환자군]. [$^{18}F$]FDG PET 결과를 임상경과, CT 및 조직학적 소견과 비교하였다. 결과: I 군의 치료받지 않은 14명의 환자에서 림프절전이를 진단하는데 있어서 [$^{18}F$]FDG PET는 100% (10/10)의 예민도와 75% (3/4)의 특이도를 CT는 80% (8/10)의 예민도와 100% (4/4)의 측이도를 보였다. 치료 후 [$^{18}F$]FDG PET를 시행한 45명의 환자를 대상으로 한 $II{\sim}IV$군에서 재발의 진단에 있어 [$^{18}F$]FDG PET의 예민도와 특이도는 각각 96.2% (25/26)와 78.9% (15/19)를 보였다(II군; 100%와 75%, III군: 80%와 50%, 그리고 IV군; 100%와 100%). 치료 전 [$^{18}F$]FDG PET 시행 군과 치료 후 [$^{18}F$]FDG PET 시행군 사이의 통계적인 차이는 없었다(P>0.1). 그러나 치료 종료 후 2개월 이내에 [$^{18}F$]FDG PET를 시행한 16명의 환자에서 [$^{18}F$]FDG PET의 예민도와 특이도는 90.9% (10/11)와 20% (1/5)로서 치료 종료 훈 2개월 이후에 PET를 시행한 29명의 환자를 대상으로 한 PET(예민도와 특이도 각각 100%)보다 특이도가 유의하게 낮았다(p<0.05) 결론: [$^{18}F$]FDG PET는 두경부종양의 병기결정 및 재발의 진단에 있어서 유용한 진단 방법이다. 또한 수술이나 방사선 조사 후 염증조직의 [$^{18}F$]FDG 섭취 증가는 재발을 진단하는 데 있어 위양성을 초래할 수가 있기 때문에 치료 종료 후 2개월 이후에 [$^{18}F$]FDG PET를 시행함으로써 염증반응으로 인한 곤란을 최소화하면서 보다 정확하게 재발을 진단할 수 있다고 생각한다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권5호
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• pp.287-293
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• 2009

Cell survival is the result of a balance between programmed cell death and cellular proliferation. Cell membrane receptors and their associated signal transducing proteins control these processes. Of the numerous receptors and signaling proteins, epidermal growth factor receptor (EGFR) is one of the most important receptors involved in signaling pathways implicated in the proliferation and survival of cancer cells. EGFR is often highly expressed in human tumors including oral squamous cell carcinomas, and there is increasing evidence that high expression of EGFR is correlated with poor clinical outcome of common human cancers. Therefore, we examined the antiproliferative activity of gefitinib, epidermal growth factor receptor tyrosine kinase inhibitor (EGFR TKI), in head and neck cancer cell lines. 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 phosphorylation 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 phosphorylation 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 investigations on more reliable predictive factor indicating gefitinib response are awaited to be useful gefitinib treatment in head and neck cancer patients.

• Asian Pacific Journal of Cancer Prevention
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• 제16권7호
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• pp.2903-2908
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• 2015

Background: Head and neck cancer (HNC) is the eighth most common cancer as estimated from worldwide data. The incidence of HNC in Peninsular Malaysia was reported as 8.5 per 100,000 population. This study was aimed to determine the treatment outcomes for HNC patients treated in the Oncology Unit of University Malaya Medical Centre (UMMC). Materials and Methods: All newly diagnosed patients with squamous cell carcinoma of head and neck (HNSCC) referred for treatment to the Oncology Unit at UMMC from 2003-2010 were retrospectively analyzed. Treatment outcomes were 5-year overall survival (OS), cause specific survival (CSS), loco-regional control (LRC) and radiotherapy (RT) related side effects. Kaplan-Meier and log rank analyses were used to determine survival outcomes, stratified according to American Joint Committee on Cancer (AJCC) stage. Results: A total of 130 cases were analysed. Most cases (81.5%) were at late stage (AJCC III-IVB) at presentation. The 5-year OS for the whole study population was 34.4% with a median follow up of 24 months. The 5-year OS according to AJCC stage was 100%, 48.2%, 41.4% and 22.0% for stage I, II, III and IVA-B, respectively. The 5-year overall CSS and LCR were 45.4% and 55.4%, respectively. Late effects of RT were documented in 41.4% of patients. The most common late effect was xerostomia. Conclusions: The treatment outcome of HNSCC at our centre is lagging behind those of developed nations. Efforts to increase the number of patients presenting in earlier stages, increase in the use of combined modality treatment, especially concurrent chemoradiotherapy and implementation of intensity modulated radiotherapy, may lead to better outcomes for our HNC patients.

• Asian Pacific Journal of Cancer Prevention
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• 제14권3호
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• pp.1681-1685
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• 2013

Background: Head and neck SCC is a common cancer related to various factors. IL-10, a pleiotropic cytokine produced by macrophages, T-helper-2 cells, and B lymphocytes, is thought to play a potential pathogenetic or therapeutic role in a number of human conditions, such as inflammation, autoimmunity and cancer. The present study was designed to evaluate the relation between tissue expression, serum and salivary levels of IL-10 in head and neck squamous cell carcinomas (HNSCCs) and their correlation with clinicopathologic features. Materials and Methods: Samples were collected from 30 patients with HNSCCs and 24 healthy volunteers. IHC analysis was used to examine the tissue expression and ELISA was employed to measure serum and salivary levels. Results: Our study showed tissue expression of IL-10 to be significantily higher in patients (P: 0.001), but there was no relation between tissue expression, serum and salivary levels of the marker (P>0.05). Also except for a positive correlation between tissue expression of IL-10 and stage (P: 0.044), there was no relation between this marker and clinicopathologic features. There was no correlation between serum and salivary levels in either patients or controls. Conclusions: It seems there is no correlation between level of IL-10 in serum and saliva and this marker in saliva and serum does not reflect tissue expression.

• Asian Pacific Journal of Cancer Prevention
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• 제16권15호
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• pp.6715-6717
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• 2015

Background: The purpose of this study was to provide epidemiological and histological data of thyroid cancers in Togo. Materials and Methods: This was a retrospective cross-sectional study of cases of thyroid cancers diagnosed from 2000 to 2014 (15 years) at the pathology laboratory of the Sylvanus Olympio Teaching Hospital of $Lom{\acute{e}}$. All cases of review of a thyroid sample (biopsies, surgical specimens) were collected from the data records of that laboratory. Results: Thyroid cancers represented 1.1% (7930cases) of all cancers registered during the study period. Mean age was $45.4{\pm}0.3$ years and the proportion of females was 78.3%. We identified 92.4% carcinomas and 7.6% lymphomas. Carcinomas were well differentiated in 80 cases and were dominated by the papillary type (47 cases). Metastasis was observed in 13% of patients. The pTNM classification evaluated in 18 cases showed a predominance of grade I (13 cases). Lymphomas were dominated by lymphoma diffuse large B-cell (5 cases). Conclusions: This study is the first global standard for thyroid cancer pathology in Togo. The high frequency of follicular form suggests an unrecognized iodine deficiency. The improvement of the technical platform of the LAP (immunohistochemistry) will increase the diagnosis of rare forms of thyroid cancer.