• Asian Pacific Journal of Cancer Prevention
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• v.17 no.4
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• pp.1617-1623
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• 2016

Cisplatin-based concurrent chemoradiation plays an undisputed key role as definitive treatment in unresectable patients with locally advanced squamous cell carcinoma head and neck or as an organ preservation strategy. Treatment with 100 mg/m2 3-weekly cisplatin is considered the standard of care but is often associated with several adverse events. The optimum drug schedule of administration remains to be defined and presently, there is insufficient data limiting conclusions about the relative tolerability of one regimen over the other. This review addresses regarding the optimal dose schedule of cisplatin focusing mainly on three-weekly and weekly dose of cisplatin based concurrent chemoradiotherapy in locally advanced head and neck cancer with an emphasis on mucositis, dermatitis, systemic toxicity, compliance, and treatment interruptions. To derive a definitive conclusion, large prospective randomized trials are needed directly comparing standard 3-weekly cisplatin ($100mg/m^2$) with weekly schedule ($30-40mg/m^2$) of concurrent cisplatin based chemoradiotherapy in locally advanced squamous cell carcinoma head and neck.

• Journal of Oral Medicine and Pain
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• v.44 no.3
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• pp.77-82
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• 2019

Purpose: With the popularity of implant therapy, clinicians need to know about treating the dental implant in patients with gingival involvement of oral lichen planus (OLP). The aim of this study is to evaluate the survival and success rates of dental implant and propose of clinical guidelines for implant treatment in OLP patient with gingival involvement. Methods: A literature search was performed in PubMed/Medline, and Cochrane database. Papers in English language published between 1990 and 2019 were evaluated. The focused questions were following; 1) Dose gingival OLP affect the survival and success rates of dental implants? 2) The management of OLP patients with gingival involvement receiving dental implant. Results: There was no study about the evaluation of dental implant only in gingival OLP patient. Five studies evaluating dental implants in OLP patients were included in this review. Implant survival rate was 100.0% in well-controlled OLP patients in all included studies. The use of topical/systemic corticosteroid in OLP patients was performed before and/or after implant placement in all included studies. Conclusions: The implant survival and success rates in well-controlled OLP patients did not different from that of non-OLP healthy subjects. The gingival OLP is associated with higher rate of peri-implant mucositis. Adequate management of gingival OLP lesions before and after implant insertion is required to reduce inflammation and associated bone loss.

• Journal of Korean Dental Science
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• v.3 no.1
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• pp.11-16
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• 2010

Objective : This prospective study sought to verify the stability of three types of short implants measuring 7mm or less. Materials and methods : Implants measuring 7mm or less were placed in patients at multicenter dental clinics in Korea, China, Taiwan, and Singapore. Initial stability, intraoperative and postoperative complications, crestal bone loss, and survival rate of the implant were prospectively evaluated. Results : The primary stability of a 6-mm implant was lower than that of a 7-mm implant. The marginal bone loss of short implants measuring less than 7mm was minimal. Complications such as wound dehiscence, implant mobility, and peri-implant mucositis developed, and these were associated with initial implant failure. The short-term survival rate of 6-mm implant was 93.7%, and that of 7-mm implant, 96.6%. Conclusion : Short implant for the mandible with insufficient height for the residual ridge can be selectively used. Poor primary stability and wound dehiscence can cause osseointegration failure and alveolar bone loss.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.4
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• pp.2557-2561
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• 2013

Background: Chemoradiation (CRT) using cisplatin-based regimens has become the standard of care in the treatment of squamous cell head and neck cancers (SCHNC). The impact of taxanes as radiosensitizing agents with concurrent CRT regimens is unknown. We therefore retrospectively evaluated the efficacy and tolerability of a weekly cisplatin+docetaxel combination with CRT in locally advanced SCHNC. Methods: Sixty-six patients with locally advanced SCHNC (39.4% stage IV, 53% stage III, and 7.6% stage II) were assessed retrospectively. Total radiation dose to the PTV of gross disease (primary and/or node) was 70 Gy/35 fractions, 5 fractions per week. Minimum doses of 60 Gy and 50 Gy were administered to PTVs of elective high risk and low risk disease, respectively. Chemotherapy (CT) consisted of weekly cisplatin (20 $mg/m^2$)+docetaxel (20 $mg/m^2$) concurrently with RT. Results: The median age of the patients was 58 years (range, 32-77). Objective response rate was 83.3%. The 2-year progression-free survival (PFS) and overall survival (OS) were 75.7% and 78.3%, respectively. The most common grade 3 and 4 toxicities were mucositis (36.4%), nausea and vomiting (12.1%), neutropenia (4.5%). Conclusion: Weekly cisplatin and docetaxel concurrent with RT for locally advanced SCHNC was found tolerable with high efficacy.

• Journal of Periodontal and Implant Science
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• v.43 no.5
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• pp.233-242
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• 2013

Purpose: Peri-implant sulcular fluid (PISF) has a production mechanism similar to gingival crevicular fluid (GCF). However, limited research has been performed comparing their behavior in response to inflammation. Hence, the aim of the present study was to comparatively evaluate PISF and GCF volume with varying degrees of clinical inflammatory parameters. Methods: Screening of patients was conducted. Based on the perimucosal inflammatory status, 39 loaded implant sites were selected from 24 patients, with equal numbers of sites in healthy, peri-implant mucositis, and peri-implantitis subgroups. GCF collection was done from age- and sex-matched dentate patients, selected with gingival inflammatory status corresponding to the implant sites. Assessment of the inflammatory status for dental/implant sites was performed using probing depth (PD), plaque index/modified plaque index (PI/mPI), gingival index/simplified gingival index (GI/sGI), and modified sulcular bleeding index (BI). Sample collection was done using standardized absorbent paper strips with volumetric evaluation performed via an electronic volume quantification device. Results: Positive correlation of the PISF and GCF volume was seen with increasing PD and clinical inflammatory parameters. A higher correlation of GCF with PD (0.843) was found when compared to PISF (0.771). PISF expressed a higher covariation with increasing grades of sGI (0.885), BI (0.841), and mPI (0.734), while GCF established a moderately positive correlation with GI (0.694), BI (0.696), and PI (0.729). Conclusions: Within the limitations of this study, except for minor fluctuations, GCF and PISF volumes demonstrated a similar nature and volumetric pattern through increasing grades of inflammation, with PISF showing better correlation with the clinical parameters.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.16
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• pp.7331-7335
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• 2015

Background: Concurrent chemoradiation with three weekly high dose cisplatin is the non-surgical standard of care for the treatment of locally advanced head and neck cancers. Although this treatment regime is efficacious, it has high acute toxicity, which leads not only to increased treatment cost, but also to increased overall treatment time. Hence, the current study was undertaken to evaluate the acute toxicity and tumor response in head and neck cancer patients treated with concurrent chemoradiation using $40mg/m^2$ weekly cisplatin, which has been our institutional practice. Materials and Methods: This single institution retrospective study included data for 287 head and neck cancer patients treated with concurrent chemoradiation from 2012 to 2014. Results: The mean age of the patients was 48.8 years. The most common site of involvement was oral cavity. Most of the study patients presented with advanced stage disease. The mean overall treatment time was 56.9 days. Some 67.2% had overall complete response to treatment as documented till 90 days from the start of treatment. According to the Radiation Therapy Oncology Group (RTOG) acute radiation morbidity scoring criteria, mucositis was seen in 95.1% of the patients. Dermatitis and emesis were observed in 81.9% and 98.6%, respectively. Regarding haematological toxicity, 48.8% and 29.6% suffered from anaemia and leukopenia, respectively, during treatment. Acute kidney injury was assessed using the Common Terminology Criteria for Adverse Events (CTCAE), and was found in 18.8% of the patients. Conclusions: Concurrent chemoradiotherapy with weekly cisplatin is an effective treatment regime for head and neck cancers with reasonable toxicity which can be used in developing countries, where cost of treatment is so important.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.5
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• pp.1971-1976
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• 2015

Background: To evaluate our results in terms of response, survival and toxicity profile of sunitinib among Egyptian patients with metastatic renal cell carcinoma. Materials and Methods: Between January 2010 and December 2013, 44 patients with metastatic renal cell carcinoma who received sunitinib at an oncology center of Cairo university hospitals were enrolled in this retrospective analysis. Results: The median age of the patients was 53 years, 22 (50%) having localized disease at presentation, while the remaining half of the patients presented with metastasis. At a median follow up of 19 months, 9 (21%) patients achieved partial remission, while disease was reported stable in 20 cases (45%) and progressive in 7 (16%), 4 (9%) being lost to follow up, and 4 (9%) had discontinued therapy due to toxicity. The median overall survival was 23 months (95%CI 15.2 - 30.9), while progression free survival was 12 months (95%CI 11.6 - 12.3). The most commonly reported non hematological grade 3 adverse events included mucositis (15.9%), hand-foot syndrome (13.6%), and fatigue (9%), while the predominant grade 3 or 4 laboratory abnormalities were neutropenia (6.8%), followed by anemia in 4.5% of patients. Conclusions: Our efficacy data were comparable to the published literature in terms of progression free survival and overall survival, while toxicity profile is different from Asian and western countries. However, sunitinib adverse events were manageable and tolerable in most of our Egyptian patients.

• Journal of Korean Academy of Nursing
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• v.26 no.2
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• pp.428-442
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• 1996

Stomatitis is a common toxicity associated with the administration of certain cancer chemotherapeutic agents used in the treatment of malignant tumors. It represents one of the most distressing side effects of cancer chemotherapy and can interfere with the patient's ability to eat, be the cause of much pain and discomfort, and require the use of potent analgesics. The situation also creates favorable conditions for local infection which may lead to septicemia. Several authors have identified the need to establish protocols for the control and treatment of the oral discomfort associated with oral mucositis as a result of chemotherapy. Thus this study attempted to development of oral care protocol for chemotherapy patients. The effects of the mouth care using sterile normal saline, nystatine solution on oral stomatitis were investigated in 30 patients on chemotherapy. The subsect were divided into three groups : control group : not gargling experimental group A : normal saline gargling (4 times a day) experimental group B : nystatine solution gargling(4 times a day) The Oral Assessment Guide (OAG) was used to assess oral status three times(once in the prechemotherapy period, on 5th, 10th day of post chemotherapy) Oral culture was used to assess oral infection on 5th day of postchemotherapy. Data was analyzed on SAS program which used repeated ANOVA, t-test, X/sup²test. The results are as follows : 1. The incidence of stomatitis was higher in the control group and experimental group A than in experimental group B.（X/sup²＝0.002 P＝0.001）. The grade of stomatitis(mean of total score) for patients in the experimental group B were significantly lower than in the experimental group A F＝1.96 P＝0.0024）. In incidence of tongue change, control group, experimental group B were significantly higher than experimental group B（F＝6.84 P＝0.0039）. In control group and experimental group A. oral infection due to pathogenic bacteria were identified. In conclusion, mouth care with nystatine solution four times a day could reduce the incidence of stomatitis and secondary oral infection due to stomatitis. Thus active mouth care protocol which used to nystatine solution gargling need to prevention of stomatitis in chemotherapy patients.

• The Journal of Advanced Prosthodontics
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• v.8 no.2
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• pp.150-157
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• 2016

PURPOSE. The modified lateral-screw-retained implant prosthesis (LSP) is designed to combine the advantages of screw- and cement-retained implant prostheses. This retrospective study evaluated the mechanical and biological complication rates of implant-supported single crowns (ISSCs) inserted with the modified LSP in the posterior region, and determined how these complication rates are affected by clinical factors. MATERIALS AND METHODS. Mechanical complications (i.e., lateral screw loosening [LSL], abutment screw loosening, lateral screw fracture, and ceramic fracture) and biological complications (i.e., peri-implant mucositis [PM] and peri-implantitis) were identified from the patients' treatment records, clinical photographs, periapical radiographs, panoramic radiographs, and clinical indices. The correlations between complication rates and the following clinical factors were determined: gender, age, position in the jaw, placement location, functional duration, clinical crown-to-implant length ratio, crown height space, and the use of a submerged or nonsubmerged placement procedure. RESULTS. Mechanical and biological complications were present in 25 of 73 ISSCs with the modified LSP. LSL (n=11) and PM (n=11) were the most common complications. The incidence of mechanical complications was significantly related to gender (P=.018). The other clinical factors were not significantly associated with mechanical and biological complication rates. CONCLUSION. Within the limitations of this study, the incidence of mechanical and biological complications in the posterior region was similar for both modified LSP and conventional implant prosthetic systems. In addition, the modified LSP is amenable to maintenance care, which facilitates the prevention and treatment of mechanical and biological complications.

• Radiation Oncology Journal
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• v.33 no.2
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• pp.98-108
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• 2015

Purpose: The outcomes of locoregionally advanced nasopharyngeal carcinoma patients treated with concurrent chemoradiation (CCRT) using intensity-modulated radiotherapy (IMRT) with/without neoadjuvant chemotherapy (NCT) were evaluated. Materials and Methods: Eighty-three patients who underwent NCT followed by CCRT (49%) or CCRT with/without adjuvant chemotherapy (51%) were reviewed. To the gross tumor, 67.5 Gy was prescribed. Weekly cisplatin was used as concurrent chemotherapy. Results: With a median follow-up of 49.4 months, the 5-year local control, regional control, distant metastasis-free survival (DMFS), disease-free survival (DFS), and overall survival rates were 94.7%, 89.3%, 77.8%, 68.0%, and 81.8%, respectively. In multivariate analysis, the American Joint Committee on Cancer stage (p = 0.016) and N stage (p = 0.001) were negative factors for DMFS and DFS, respectively. Overall, NCT demonstrated no benefit and an increased risk of severe hematologic toxicity. However, compared to patients treated with CCRT alone, NCT showed potential of improving DMFS in stage IV patients. Conclusion: CCRT using IMRT resulted in excellent local control and survival outcome. Without evidence of survival benefit from phase III randomized trials, NCT should be carefully administered in locoregionally advanced nasopharyngeal carcinoma patients who are at high-risk of developing distant metastasis and radiotherapy-related mucositis. The results of ongoing trials are awaited.