• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제46권5호
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• pp.341-347
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• 2020

Objectives: Oral squamous cell carcinoma (OSCC) is one of the most common types of head and neck cancer. MicroRNAs, as new biomarkers, are recommended for diagnosis and treatment of different types of cancers. Bevacizumab, sold under the trade name Avastin, is a humanized whole monoclonal antibody that targets and blocks VEGF-A (vascular endothelial growth factor A; angiogenesis) and oncogenic signaling pathways. Materials and Methods: This study comprised 50 cases suffering from OSCC and 50 healthy participants. Peripheral blood samples were collected in glass test tubes, and RNA extraction was started immediately. Expression levels of miR-155, miR-191, and miR-494 biomarkers in the peripheral blood of OSCC-affected individuals and healthy volunteers in vivo were evaluated using real-time PCR. The influence of Avastin on the expression levels of the aforementioned biomarkers in vitro and in the HN5 cell line was also investigated. Results: Expression levels of miR-155, miR-191, and miR-494 in the peripheral blood of individuals affected by OSCC were higher than in those who were healthy. Moreover, Avastin at a concentration of 400 μM caused a decrease in the expression levels of the three biomarkers and a 1.5-fold, 3.5-fold, and 4-fold increase in apoptosis in the test samples compared to the controls in the HN5 cell line after 24, 48, and 72 hours, respectively. Conclusion: The findings of this study demonstrate that overexpression of miR-155, miR-191, and miR-494 is associated with OSCC, and Avastin is able to regulate and downregulate the expression of those biomarkers and increase apoptosis in cancerous cells in the HN5 cell line.

• The Korean Journal of Pain
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• 제6권1호
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• pp.100-104
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• 1993

Malignant tumors of the paranasal sinuses are quite rare entity, with maxillary neoplasms accounting for less than 1 percent of all head and neck malignancies. When considering the paranasal sinuses alone, 77 percent of cancers arise in the maxillary sinuses. There is no situation more frustrating than the management of the patients with chronic facial pain due to cancer. The initial step in managing patients with cancer pain is the use of oncologic therapy in the form of radiotherapy, surgery, chemotherapy, alone or combined, either to effect a cure or decrease the size of the tumor and thus decrease or eliminate the pain. When oncologic therapy is ineffective in providing relief, the pain must be treated by one or more of the followings: Systemic analgesics and adjuvant drugs, psychologic techniques of analgesia, neurostimulating techniques, neuroablative surgical procedures, regional analgesia with local anesthetics or neurolytic blocks. An 82-year old patient had severe pain of the orbital and infraorbital region due to squamous cell carcinoma of the maxillary sinus. We successfully treated this patient with the percutaneous retrogasserian ethanol gangliolysis by a H$\ddot{a}$rtel approach, and the analgesia lasts until the death of the patient.

• International Journal of Oral Biology
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• 제41권1호
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• pp.1-8
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• 2016

OSCC is currently the most common malignancy of the head and neck, affecting tens of thousands of patients per year worldwide. Natural flavonoids from plants are potential sources for novel anti-cancer drugs. Icariin is the active ingredient of flavonol glycoside, which is derived from the medical plant Herba Epimedii. A metabolite of icariin, icariside II exhibits a variety of pharmacological actions, including anti-rheumatic, anti-depressant, cardiovascular protective, and immunomodulatory functions. However, the exact mechanism causing the apoptosis-inducing effect of icariside II in OSCC is still not fully understood. In the present study, we assessed the anti-cancer effect of icariside II in OSCC cell lines by measuring its effect on cell viability, cell proliferation, and mitochondria membrane potential (MMP). Icariside II treatment of OSCC cells resulted in a dose- and time-dependent decrease in cell viability. Hoechst staining indicated apoptosis in icariside II-treated HSC cells. Icariside II inhibited cell proliferation and induced apoptosis in HSC cells, with significant increases in all present parameters in HSC-4 cells. The results clearly suggested that icariside II induced apoptosis via activation of intrinsic pathways and caspase cascades in HSC-4 cell lines. The collective findings of the study suggested that Icariside II is a potential treatment for OSCC; in addition, the data could provide a basis for the development of a novel anti-cancer strategy.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권4호
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• pp.353-358
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• 2008

Purpose: The purpose of this clinical retrospective study was to evaluate our experience of radial forearm free flap for reconstruction of the oral cavity. Material and methods: From 1997 to 2006, 50 radial forearm free flaps were employed for head and neck reconstruction in 50 patients at department of oral and maxillofacial surgery, Yonsei University, Korea. Data were obtained from chart review, and clinical follow-up. Results: Patients' age ranged from 26 to 82 years (mean 53.2). There were 39 men and 11 women. 43 of the 50(86%) patients had squamous cell carcinoma. The total flap survival were 47(94%), complication rate were revealed for 15(30%). Conclusion: In the reconstruction of soft tissue within the oral cavity, several free flaps have been used. Because of its constant anatomy, long pedicle allows a hypothetic vascular anastomosis in the contralateral neck, contourability for various type of oral defects, pliability and can be used simultaneous reconstruction in intraoral and extra oral defects, the radial forearm free flap constitutes one of the best choice of intraoral soft tissue reconstruction.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권4호
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• pp.391-395
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• 2000

Malignant tumors of the maxilla represent about 3-4% of head and neck malignant neoplasm and the origins are maxillary gingiva, hard palate and maxillary sinus. We are to investigate clinical features and results according to various treatment modalities of maxillary malignant tumor to get information for better treatment results. Sixty patients with malignant maxillary tumors treated at Yonsei medical center from 1992 to 1997 were studied retrospectively. They are evaluated according to clinical signs & symptoms, stages at first diagnosis, primary site, histopathologic features, treatment method, recurrence and survival rate with clinical records, biopsy results and CT radiograph. The most common primary site was maxillary sinus and most common histopathology was squamous cell carcinoma. The local recurrence rate was 18% at 5 years, neck failure was 3% and distant metastasis was 18%. Overall survival rate was 78% at 2 years and 69% at 5 years. Failure at primary site is the main problem in the curative treatment. So, to improve survival in these patients efforts should be directed toward improvement of local control.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권6호
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• pp.490-496
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• 2010

Introduction: This study examined the effect of a conservative neck dissection in patients with head and neck cancer. Materials and Methods: A total of 24 patients, who underwent a conservative neck dissection for the treatment of oral cancer from January 2002 to December 2007, were included. All procedures were performed by one oral and maxillofacial surgeon. The mean age was 58.2 years (range, 19 to 79 years). The medical recordings, pathologic findings, and radiographic findings were evaluated. The mean follow up period was 41.1 months (range, 4 to 88 months). Results: 1. Oral cancer was more common in men than women with a 3:1 ratio. 2. Histopathologically, squamous cell carcinoma(83%) was the most prevalent oral cancer in this study. 3. The most common primary site was the tongue(6 cases, 25%) followed by the mouth floor (5 cases, 21%), buccal mucosa (3 cases, 13%), lower lip, mandible, palate (2 cases, respectively) and salivary gland, retromolar area, oropharynx, alveolus (1 case, each). 4. Three out of the 24 (13%) subjects had a recurrence at the primary sites. 5. Two out of 24 (8%) subjects had a distant metastasis. 6. All 24 patients survived and there were eleven patients who passed 5 years postoperatively. Conclusion: A conservative neck dissection is a reliable and effective method for controlling neck node metastases in patients with oral cancer of the N0 or N1 neck node without serious complications.

• 대한두경부종양학회지
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• 제17권2호
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• pp.179-184
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• 2001

Objective: The role of chemotherapy in locally advanced head and neck cancer has been established in nasopharynx and larynx as definitive therapy and organ preserving therapy, respectively. Oral cavity cancers are relatively uncommon and local recurrence is the main cause of treatment failure. We planned this retrospective study to evaluate the role of neoadjuvant chemotherapy in locally advanced oral cavity cancer patients. Materials and Methods: From 1988 March to 2001 February, locally advanced, previously untreated oral cavity cancer patients who received neoadjuvant chemotherapy were examined. Chemotherapy had been done in the following patients: Histologically proven squamous cell or poorly differentiated carcinoma, stage 3 or 4, and performance state 0-2 patients. Chemotherapy regimen consisted of cisplatin and infusional 5-fluorouracil. Response was evaluated after 2 cycles and in case of no response, definitive local therapy was done; otherwise 3 cycles was done before local treatment. Results: 48 patients were treated and 47 patients were evaluable for responses. Complete response rate was 6.4%(3/47) and partial response 80.0%(38/47), scoring overall response rate of 87.2%. Median time to progression was 27.0 months (95% CI : 0-58months) and overall 5 year survival was 54.8%. 5-year disease-free survival in the patients in remission after local treatment was 51.9%. In multivariate analysis, contributing factor to the survival were response to neoadjuvant chemotherapy and local treatment modalities. Extensive surgery was done in 10 patients and 25 patents (52.1%) was followed up with preserved function. With median follow-up of 57.0 months, 19 recurrences were detected, most of which were local or regional type. Conclusion: Neoadjuvant chemotherapy followed by local treatment in oral cavity cancer showed high response rate and was thought to be effective therapeutic approach especially in view of organ preservation.

• Asian Pacific Journal of Cancer Prevention
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• 제15권3호
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• pp.1119-1123
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• 2014

Head and neck cancers (HNC) are extremely complex disease types and it is likely that chromosomal instability is involved in the genetic mechanisms of its genesis. However, there is little information regarding the background levels of chromosome instability in these patients. In this pilot study, we examined spontaneous chromosome instability in short-term lymphocyte cultures (72 hours) from 72 study subjects - 36 newly diagnosed HNC squamous cell carcinoma patients and 36 healthy ethnic controls. We estimated chromosome instability (CIN) using chromosomal aberration (CA) analysis and nuclear level anomalies using the Cytokinesis Block Micronucleus Cytome Assay (CBMN Cyt Assay). The proliferation rates in cultures of peripheral blood lymphocytes (PBL) were assessed by calculating the Cytokinesis Block Proliferation Index (CBPI). Our results showed a significantly higher mean level of spontaneous chromosome type aberrations (CSAs), chromatid type aberration (CTAs) dicentric chromosomes (DIC) and chromosome aneuploidy (CANE UP) in patients (CSAs, $0.0294{\pm}0.0038$; CTAs, $0.0925{\pm}0.0060$; DICs, $0.0213{\pm}0.0003$; and CANE UPs, $0.0308{\pm}0.0035$) compared to controls (CSAs, $0.0005{\pm}0.0003$; CTAs, $0.0058{\pm}0.0015$; DICs, $0.0005{\pm}0.0003$; and CANEUPs, $0.0052{\pm}0.0013$) where p<0.001l. Similarly, spontaneous nuclear anomalies showed significantly higher mean level of micronuclei (MNi), nucleoplasmic bridges (NPBs) and nuclear buds (NBUDs) among cases (MNi, $0.01867{\pm}0.00108$; NPBs, $0.0156{\pm}0.00234$; NBUDs, $0.00658{\pm}0.00068$) compared with controls (MNi, $0.00027{\pm}0.00009$; NPBs, $0.00002{\pm}0.00002$; NBUDs, $0.00011{\pm}0.00007$).The evaluation of CBPI supported genomic instability in the peripheral blood lymphocytes showing a significantly lower proliferation rate in HNC patients ($1.525{\pm}0.005552$) compared to healthy subjects ($1.686{\pm}0.009520$) (p<0.0001). In conclusion, our preliminary results showed that visible spontaneous genomic instability and low rate proliferation in the cultured peripheral lymphocytes of solid tumors could be biomarkers to predict malignancy in early stages.

• Radiation Oncology Journal
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• 제27권2호
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• pp.55-63
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• 2009

목 적: 근치적 치료가 힘든 두경부 진행암 환자들을 대상으로 시행된 소분할 방사선조사의 치료반응 정도를 객관적으로 평가해 보고, 이런 환자들에 대한 적절한 방사선치료 방법을 알아보고자 이 연구를 진행하였다. 대상 및 방법: 두경부에서 발생한 상피세포암종으로 진단되어 1998년부터 2008년까지 원발 병변 또는 림프절 병변에 대해 3 Gy 분할선량으로 고식적 소분할 방사선치료를 받았던 환자 31명을 대상으로 후향적 분석을 하였다. 대상 환자들의 방사선치료 전 컴퓨터단층촬영 영상자료를 통해 종양의 용적을 측정하였고, 이를 방사선치료 종료 후 2~3개월째의 컴퓨터단층촬영 자료와 비교하여 치료반응을 평가하였다. 아울러 소분할 방사선치료로 인한 치료독성의 빈도와 정도를 확인하였고, 전체 생존율 및 무진행 생존율, 그리고 생존율이나 치료반응과 관련된 예후인자들 알아보고자 통계 분석 작업을 하였다. 결 과: 대상 환자들의 평균 연령은 70세였으며, 85%의 경우가 stage 4였다. 종양의 용적은 평균 128.4 cc였고, ECOG 활동점수 상 1점과 2점이 67.7%였다. 총방사선량은 24~45 Gy (중간값 36 Gy)로 2명을 제외한 대부분의 환자가 30 Gy 이상 조사받았으며, 치료기간은 10~25일이었다. 완전반응을 보인 경우가 4명(12.9%)이었고, 19명(61.3%)의 환자에서 부분반응을 보였다. 중간 생존기간은 8.9개월이었으며, 1년 무진행생존율은 12.9%였다. 치료반응 정도에 따른 생존율의 차이를 발견할 수 있었으며, 원발 부위, 병기, 종양의 용적, 방사선치료 범위, 총방사선량 등이 생존율이나 치료반응 정도와 유의한 관련이 있었다. 치료 기간 및 치료 종결 후 grade 4 이상의 치료독성은 없었다. 결 론: 소분할 방사선치료 결과 약 74%의 환자들에서 종양이 줄어드는 것을 객관적으로 확인할 수 있었다. 적절한 분할선량 및 추가 방사선치료가 필요한 환자들의 선별에 있어서는 추가적인 연구가 필요하겠다.

• 대한두경부종양학회지
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• 제27권2호
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• pp.183-189
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• 2011

서 론: 5-FU와 cisplatin 병용항암화학요법은 국소진행성 두경부편평상피암의 유도화학요법으로 널리 사용되고 있는 요법이다. 저자들은 5-FU 대신 경구제재인 S-1을 cisplatin과 병용하는 복합항암요법의 효과와 안전성에 대해 연구하였다. 대상 및 방법: 저자들은 2007년 2월부터 2008년 12월까지 S1과 cisplatin의 복합유도화학요법을 시행받은 3/4기 구인두, 하인두, 후두, 구강 편평상피세포암 환자 52명의 치료결과를 후향적으로 분석하였다. 유도항암화학요법은 제 1일에 cisplatin(75 또는 60mg/$m^2$), 제1일부터 14일까지 S-1(40mg/$m^2$)을 1일 2회, 21일 간격으로 투여하였고 가능한 경우에는 항암방사선동시요법 또는 수술을 뒤이어 시행하였다. 결 과: 전체 52명 중 37명(71.2%)에서 부분반응을 보였으나 완전반응은 관찰되지 않았다. 2년 무진행생존율은 56.9%, 2년 전체생존율은 68.2%였다. 유도항암요법과 관련된 유해반응으로는 호중구감소증(71.2%) 및 빈혈(63.5%) 등과 같은 혈액학적 부작용이 가장 흔했다. 결 론: S-1과 cisplatin의 복합항암화학요법은 국소진행성 두경부편평상피암 환자를 대상으로 한 유도화학요법으로 적용이 가능한 것으로 판단된다.