• Title/Summary/Keyword: head and neck carcinoma

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Radiosensitization of Cis-Platimum in the Treatment of Advanced Head and Neck Squamous Cell Carcinoma (국소 진행된 두경부편평 상피암에 대한 CIS-PLATINUM과 방사선치료의 동시 병행요법)

  • Chang, Hye-Sook
    • Radiation Oncology Journal
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    • v.10 no.1
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    • pp.27-34
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    • 1992
  • Cis-Platinum (DDP) was utilized as a radiosensitizer in a pilot study for stage III and IV squamous cell carcinoma between 1984-1987, and DDP 20 $mg/M^2$/day was administered for 4 days at 3 week interval with concurrent radiotherapy. This study consisted of three phases: cytoreduction phase, eradicative treatment phase and adjuvant phase. Total 59 patients were subjected to evaluate a tumor response and its toxicity. During the eradicative phase,27 patients underwent surgery (group I ), 29 patients were treated with radiotherapy only (group II) and 3 patients did not complete the second phase of therapy. At the cytoreduction phase, $95\%$ response rate with complete response (CR) $47.5\%$ and partial response (PR) $47.5\%$ was observed. Complete tumor clearance (CTC) rate following 2nd phase of therapy was $84\%$ (47/56) with 26/27($96\%$) in group I achieved CTC with surgery and 21/29 ($72\%$) patients In group II achieved CTC following 2nd phase. $67\%$ of primary lesions and $70\%$ of nodal diseases in group I showed no tumor in the surgical specimen. $34\%$ of patiets who achieved CTC at 2nd phase developed recurrence and median time to recur was 8 months. Actuarial disease free survival at 4 years was $59\%$ and $51\%$(24/27) of patients who achieved CTC at 2nd phase were alive without any evidence of disease at median follow-up 31 months (range, 10-48 months). There was no significant difference in overall and disease free survival between group I and II between CR and PR group following 1st Phase. Only significant Prognostic factor in this study was the complete tumor clearance following 2nd phase theapy. In general, toxicity was not excessive. Author concludes that this study confirmed the significant radiosensitizing effect of DDP with the acceptable toxicity and warrant the prospective study to determine optimum scheduling for DDP and radiotherapy which maximizes the therapeutic gain.

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A Clinical Review and Results of Treatment in Non-squamous Cell Tumor of the Maxilla (상악동에 발생한 비편평세포암의 임상양상 및 치료성적)

  • Kim Se-Heon;Kim Kwang-Moon;Choi Eun-Chang;Keum Ki-Chang;Koh Yoon-Woo;Hong Won-Pyo
    • Korean Journal of Head & Neck Oncology
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    • v.14 no.2
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    • pp.182-190
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    • 1998
  • Background: Most of the cancers of maxillary sinus are the squamous variety, but various histopathologic types of malignant tumor can occur in the maxillary sinus. These non-squamous cell tumors have quite different patterns of clinical behavior compared with squamous variety, such as invasive characters, route of metastasis, treatment modality, and so on. Objectives: The authors intend to establish the clinical characteristics and treatment modalities of non-squamous cell tumors of the maxillary sinus. Material and Methods: We experienced 16 cases of non-squamous cell tumors arisen from the maxillary sinus during the 10-year period from 1987 to 1996. We analyzed their clinical features, therapeutic modalities and results with review of literatures. Results: According to AJCC TNM system, 13 patients presented with $T_{1-2}$, 3 with $T_{3-}4$, Two patients were treated with surgery after radiotherapy, 3 patients with surgery after chemotherapy and radiotherapy, 4 patients with chemotherapy and radiotherpy, 5 patients with chemotherapy and radiotherapy after surgery. Conclusion: In cases of adenoid cystic carcinoma, adenocarcinoma and sarcoma, we believe that the best form of therapy is wide surgical excision. If there is microscopic evidence of disease at or close to the resection margin, postoperative radiation was used to achieve better local control. In cases of undifferentiated carcinoma, preoperative chemotherapy and radiation therapy showed improved outcomes.

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Influence of Parotid from Various Dose Rate in Intensity Modulated Radiation Therapy Planning for Head and Neck Cancer (두경부암 세기변조방사선치료 계획 시 선량율 변화가 이하선에 미치는 영향)

  • Hong, Joo-Wan;Jeong, Yun-Ju;Won, Hui-Su;Chang, Nam-Jun;Choi, Ji-Hun;Seok, Jin-Yong
    • The Journal of Korean Society for Radiation Therapy
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    • v.22 no.2
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    • pp.105-111
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    • 2010
  • Purpose: There are various beam parameter in intensity modulated radiation therapy (IMRT). The aim of this study is to investigate how various dose rate affect the parotid in treatment plan of IMRT. Materials and Methods: The study was performed on 10 nasopharyngeal carcinoma patients who have undergone IMRT. CT images were scanned 3 mm of thickness in the same condition and the treatment plan was performed by Eclipse (Ver.7.1, Varian, Palo Alto, USA). The parameters for planning used 6 MV energy and 8 beams under the same dose volume constraint. The variation of dose rates were used 300, 400, 500 MU/min. The mean dose of both parotid was accessed from the calculated planning among the 10 patients. The mean dose of parotid was verificated by 2D diode array (Mapcheck from Sun Nuclear Corporation, Melbourne, Florida). Also, Total monitor unit (MU) and beam-on time was analysed. Results: According to the dose rate, the mean dose of parotid was increased by 0.8%, 2.0% each, when dose rate was changed from 300 MU/min to 400, 500 MU/min, moreover Total MU was increased by 5.4% and 10.6% each. There was also a dose upward trend in the dose measurement of parotid by 2D diode array. However, beam - on time difference of 1~2 minutes was no signigicant in the dose rate increases. Conclusion: From this study, when the dose rates increase, there was a signigicant increase of Total MU and the parotid dose accordingly, however the shortened treatment time was not significant. Hence, it is considered that there is a significant decrease of late side effect in parotid radiation therapy, if the precise dose rate in IMRT is used.

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miR-155, miR-191, and miR-494 as diagnostic biomarkers for oral squamous cell carcinoma and the effects of Avastin on these biomarkers

  • Emami, Naghmeh;Mohamadnia, Abdolreza;Mirzaei, Masoumeh;Bayat, Mohammad;Mohammadi, Farnoush;Bahrami, Naghmeh
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.5
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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.

Genomic characterization of clonal evolution during oropharyngeal carcinogenesis driven by human papillomavirus 16

  • Chae, Jeesoo;Park, Weon Seo;Kim, Min Jung;Jang, Se Song;Hong, Dongwan;Ryu, Junsun;Ryu, Chang Hwan;Kim, Ji-Hyun;Choi, Moon-Kyung;Cho, Kwan Ho;Moon, Sung Ho;Yun, Tak;Kim, Jong-Il;Jung, Yuh-Seog
    • BMB Reports
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    • v.51 no.11
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    • pp.584-589
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    • 2018
  • Secondary prevention via earlier detection would afford the greatest chance for a cure in premalignant lesions. We investigated the exomic profiles of non-malignant and malignant changes in head and neck squamous cell carcinoma (HNSCC) and the genomic blueprint of human papillomavirus (HPV)-driven carcinogenesis in oropharyngeal squamous cell carcinoma (OPSCC). Whole-exome (WES) and whole-genome (WGS) sequencing were performed on peripheral blood and adjacent non-tumor and tumor specimens obtained from eight Korean HNSCC patients from 2013 to 2015. Next-generation sequencing yielded an average coverage of $94.3{\times}$ for WES and $35.3{\times}$ for WGS. In comparative genomic analysis of non-tumor and tumor tissue pairs, we were unable to identify common cancer-associated early mutations and copy number alterations (CNA) except in one pair. Interestingly, in this case, we observed that non-tumor tonsillar crypts adjacent to HPV-positive OPSCC appeared normal under a microscope; however, this tissue also showed weak p16 expression. WGS revealed the infection and integration of high-risk type HPV16 in this tissue as well as in the matched tumor. Furthermore, WES identified shared and tumor-specific genomic alterations for this pair. Clonal analysis enabled us to infer the process by which this transitional crypt epithelium (TrCE) evolved into a tumor; this evolution was accompanied by the subsequent accumulation of genomic alterations, including an ERBB3 mutation and large-scale CNAs, such as 3q27-qter amplification and 9p deletion. We suggest that HPV16-driven OPSCC carcinogenesis is a stepwise evolutionary process that is consistent with a multistep carcinogenesis model. Our results highlight the carcinogenic changes driven by HPV16 infection and provide a basis for the secondary prevention of OPSCC.

Expression of Sodium-Iodide Symporter (NIS) in Thyroid Nodules: Comparison of RT-PCR and Immunohistochemical Staining Methods (갑상선 결절에서 Sodium Iodide Symporter (NIS)의 발현: RT-PCR방법과 면역조직화학염색법의 비교)

  • Bae, Sang-Kyun;Lee, Kang-Dae;Chang, Hee-Kyung
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.6
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    • pp.511-515
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    • 2004
  • Purpose: The sodium-iodide symporter (NIS) expression is an important factor in determining the sensitivity of radioiodine therapy in well-differentiated thyroid cancers. Several previous studies for the expression of NIS in thyroid tissues show diverse results. To investigate whether there is difference between methods in determining the expression of NIS in thyroid tissues of patients with thyroid nodules, we measured the expression ot NIS using two different methods (RT-PCR and immunoshistochemical staining) and compared the results. Materials & Methods: We measured the expression of NIS by reverse transcriptase-polymerase chain reaction (RT-PCR) and also by immunohistochemical staining using anti-NIS antibody in thyroid cancers and other benign thyroid diseases. We compared the results of each method. We included 19 papillary carcinomas, 1 follicular carcinoma, 7 medullary carcinoma, 4 adenomas and 7 nodular hyperplasias. Results: By RT-PCR analysis, 10 of 19 papillary carcinomas expressed NIS, but 1 follicular cancer didn't express NIS. By immunohistochemical staining, 15 of 19 papaillary carcinomas express NIS, but 1 follicular lancer didn't express NIS. There was a significant correlation between the semiquautitative results of RT-PCR and immunohistochemical staining of NIS expression. (p<0.01) Conclusion: Our data demonstrated that the expression of NIS in thyroid cancers and other benign diseases investigated by RT-PCR and immunohistochemical staining correlated well each other. However, by immunohistochemical staining, more NIS expression was found.

DNA Ligase4 as a Prognostic Marker in Nasopharyngeal Cancer Patients Treated with Radiotherapy

  • Kim, Dong Hyun;Oh, Sung Yong;Kim, So Yeon;Lee, Seul;Koh, Myeong Seok;Lee, Ji Hyun;Lee, Suee;Kim, Sung-Hyun;Park, Heon Soo;Hur, Won Joo;Jeong, Jin Sook;Ju, Mi Ha;Seol, Young Mi;Choi, Young-Jin;Chung, Joo Seop;Kim, Hyo-Jin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.24
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    • pp.10985-10989
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    • 2015
  • Background: The capability for DNA double-strand breaks (DSBs) repair is crucial for inherent radiosensitivity of tumor and normal cells. We have investigated the clinicopathologic significance of DNA repair gene expression in nasopharyngeal (NP) carcinoma. Materials and Methods: A total of 65 NP cancer patients who received radiotherapy were included. The immunopositivity to Ku 70, DNA-PKcs, MRN, RAD50, XRCC4, and LIG4 were examined in all tumor tissues. Results: The patients comprised 42 males and 23 females, with a median age of 56 years (range, 18-84). The expression levels of RAD50 (0,+1,+2,+3) were 27.7%, 32.3%, 21.5%, and 18.5%. LIG4 (${\pm}$) were 43.1% and 56.9% respectively. The 5-year OS rate of patients with LIG4 (${\pm}$) were 90% and 67.9%, respectively (p=0.035). The 5-year TTP rate of patients with LIG4 (${\pm}$) were 75.9%, 55.5%, respectively (P=0.039). Conclusions: Our results suggest the possibility of predicting the radiosensitivity of NP cancer by performing immunohistochemical analysis of LIG4.

Comparison of Results according to the Treatment Method in Maxillary Sinus Carcinoma (상악동암의 치료 방법에 따른 성적 비교)

  • Chung Woong Ki;Jo Jae Sik;Ahn Sung Ja;Nam Taek Keun;Nah Byung Sik;Park Seung Jin
    • Radiation Oncology Journal
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    • v.13 no.1
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    • pp.9-18
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    • 1995
  • Purpose : A retrospective analysis was performed to investigate the proper management of maxillary sinus carcinoma. Materials and Methods : Authors analysed 33 patients of squamous cell carcinoma of maxillary sinus treated at Chonnam University Hospital from January 1986 to December 1992. There were 24 men and 9 women with median age of 55 years. According to AJCC TNM system of 1988, a patient of T2, 10 patients of T3 and 22 patients of T4 were availalbe, respectively. Cervical lymph node metastases was observed in 5 patients(N 1;4/33, N2b; 1/33). Patients were classified as 3 groups according to management method. The first group, named as 'FAR' (16 patients), was consisted or preoperative intra-arterial chemotherapy with 5-fluorouracil(5-FU;mean of total dosage;3078mg) through the superficial temporal artery with concurrent radiation(mean dose delivered:3433cGy, daily 180-200cGy) and vitamin A(50,000 IU daily), and followed by total maxillectomy and postoperative radiation therapy(mean dose;2351cGy). The second group, named as 'SR'(7 patients), was consisted of total maxillectomy followed by postoperative radiation therapy(mean dose 5920 cGy). The third group, named as 'R'(6 patients), was treated with radiation alone(mean dose;7164cGy). Kaplan-Meier product limit method was used for survival analysis and Mantel-Cox test was performed for significance of survival difference between two groups. Results : Local recurrence free survival rate in the end of 2 year was $100\%$, $50\%$ and $0\%$ in FAR, SR and R group, respectively. Disease free survival rate in 2 years was $88.9\%$, $28.0\%$ and $0\%$ in FAR, SR and R group, respectively. Overall survival rate in 2 years was $88.9\%$, $40\%$ and $50\%$ in FAR, SR and R group, respectively. There were statistically significant difference between FAR and SR or FAR and R group in their local recurrence free, disease free and overall survial rates. But difference of each survival rate between SR and R group was not significant. Conclusion : In this study FAR group revealed better results than SR or R group. In the future prospective randomized study is in need.

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Postoperative Radiotherapy for Parotid Gland Malignancy (귀밑샘 악성 종양의 수술 후 방사선 치료)

  • Eom Keun-Yong;Wu Hong-Gyun;Kim Jae-Sung;Park Charn Il;Kim In-Ah;Kim Kwang Hyun;Lee Chae Seo
    • Radiation Oncology Journal
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    • v.23 no.3
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    • pp.131-136
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    • 2005
  • Purpose: The aim of this study was to evaluate the clinical results of postoperative radiotherapy for parotid gland malignancy, and determine prognostic factors for locoregional control and survival. Materials and Methods: Between 1980 and 2002, 130 patients with parotid malignancy were registered In the database of the Department of Radiation Oncology, Seoul National University Hospital. The subjects of this analysis were the 72 of these 130 patients who underwent postoperative Irradiation, There were 42 males and 30 females, with a median age of 46.5 years. The most common histological type was a mucoepidermoid carcinoma. There were 6, 23, 23 and 20 patients in Stages I, II, III and IV, respectively. The median dose to the tumor bed was 60 Gy, with a median fraction size of 1.8 Gy. Results: The overall 5 and 10 year survival rates were 85 and $76\%$, respectively, The five-year locoregional control rate was $85\%$, which reached a plateau phase after 6 years. Sex and histological type were found to be statistically significant for overall survival from a multivariate analysis. No other factors, Including age, facial nerve palsy and stage, were related to overall survival. For locoregional control, nodal involvement and positive resection margin were associated with poor local control. Histological type, tumor size, perineural invasion and type of surgery were not significant for locoregional control. Conclusion: A high survival rate of parotid gland malignancies, with surgery and postoperative radiotherapy, was confirmed. Sex and histological type were significant prognostic factors for overall survival. Nodal Involvement and a positive resection margin were associated with poor locoregional control.

Identification of Genes Connected with the Sensitivity to 5-FU and Cisplatin in Squamous Cell Carcinoma Cell Lines (편평세포암 세포주에서 5-FU와 Cisplatin에의 감수성과 관련된 유전자의 동정)

  • Choi, Na-Young;Kim, Ok-Joon;Lee, Geum-Sug;Kim, Byung-Gook;Kim, Jae-Hyeong;Jang, Youn-Young;Lim, Won-Bong;Chong, Min-A;Choi, Hong-Ran
    • Journal of Oral Medicine and Pain
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    • v.30 no.3
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    • pp.287-300
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    • 2005
  • Squamous cell carcinoma (SCC) in head and neck show a variability in the response to chemotherapy, even when it present with similar histological tumor type, grade, and clinical stage. The purpose of present study it to identify predictive bio-marker for the sensitivity or resistance to conventional chemotherapeutic agents, 5-fluorouracil (5-FU) and Cisplatin Oral cancer cell lines were used in present study. MTT assay was performed to evaluate the sensitivity and/or resistance to 5-FU and Cisplatin. And RT-PCR was carried out for evaluation of the mRNA expressions of various genes associated with mutation, inflammation (COX pathway), cell cycle, senescence and extracellular matrix (ECM). The molecules which are correlated with the sensitivity to 5-FU are XPA, XPC, OGG, APEX, COX-2, PPAR, Cyclin E, Cyclin B1, CDC2, hTERT, hTR, TIMP-3, TIMP-4 and HSP47. And the molecules are correlated with the sensitivity to Cisplatin are COX-1, iNOS, eNOS, PCNA, collagen 1 and MMP-9. Taken together, when choosing the appropriate chemotherpeutic agents for patients, considering the molecules which are correlated or reversely correlated is helpful to choose the resonable agents for cancer patients.