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Japanese Journal of Head and Neck Cancer最新文献

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Discriminate potential of VTIQ between malignant tumor and benign salivary gland tumor by propagation velocity and tissue elasticity image VTIQ在恶性肿瘤和良性唾液腺肿瘤之间的传播速度和组织弹性图像鉴别潜力
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.5981/JJHNC.47.30
T. Matsuzuka, Tetsuro Kobayashi, Masahiro Suzuki, Y. Nakaegawa, Tomotaka Kawase, Y. Hasegawa, S. Murono
Discriminate potential of VTIQ between malignant tumor and benign salivary gland tumor by propagation Virtual touch tissue imaging quantification (VTIQ) is an elastography technique that measures the tissue elasticity quantitatively as the propagation velocity (Vs) of shear waves and displays tissue elasticity images. We analyzed the histological relationship of 51 salivary gland tumors whose VTIQ was measured and pathologi-cally diagnosed from 2016 to 2019 at Fukushima Medical University Hospital. There were 11 malignant tumors, 21 benign tumors with pleomorphic adenoma, and 19 other benign tumors, and Vs and tissue elasticity images were compared among the three groups. Vs of 4.8m/s or higher was 45% overall, 91% for malignant tumors, 55% for pleomorphic adenomas, and 0% for other benign tumors. Vs for pleomorphic adenomas had a large range and was difficult to distinguish from that for malignant tumors. The tissue elasticity images of each tumor were classified into four types: 91% of malignant tumors and 10% of pleomorphic adenomas were the homogeneous type or geographic type, and 9% of malignant tumors and 67% of pleomorphic adenomas were the mottled type. Although it was difficult to discriminate by Vs, it may be possible to discriminate between malignant tumors and pleomorphic adenomas by tissue elasticity images.
虚拟触摸组织成像量化(Virtual touch tissue imaging quantification, VTIQ)是一种以横波传播速度(Vs)定量测量组织弹性并显示组织弹性图像的弹性成像技术。对2016 - 2019年福岛医科大学附属医院测量并病理诊断的51例唾液腺肿瘤的组织学关系进行分析。恶性肿瘤11例,良性多形性腺瘤21例,其他良性肿瘤19例,比较三组患者的v值和组织弹性图像。4.8m/s及以上的Vs总体为45%,恶性肿瘤为91%,多形性腺瘤为55%,其他良性肿瘤为0%。多形性腺瘤的v值范围大,与恶性肿瘤的v值难以区分。每个肿瘤的组织弹性图像分为四种类型:91%的恶性肿瘤和10%的多形性腺瘤为均匀型或地理型,9%的恶性肿瘤和67%的多形性腺瘤为斑纹型。虽然v值难以区分,但组织弹性图像有可能区分恶性肿瘤和多形性腺瘤。
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引用次数: 0
A case of basal cell adenocarcinoma of the hard palate which progressed to the cheek 硬腭基底细胞腺癌进展至面颊1例
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.5981/jjhnc.47.353
Tsuyoshi Takemoto, H. Orita, Y. Okazaki, R. Murakami, Ritsuko Miyauchi
We report a case of basal cell adenocarcinoma (BCAC) of the hard palate. A 63-year-old woman visited our hospital because of swelling of the left cheek. The tumor occupied the hard palate and gingiva on her left side. CT scan and MRI scan revealed that the tumor had destroyed her maxillary bone and invaded the infraorbital wall and skin of the cheek. Pathological examination revealed that the tumor was BCAC. The tumor was resected, including the maxillary bone, skin of the cheek and orbital periosteum. After resection, we reconstructed her hard palate using a vascularized iliac flap with internal oblique muscle and reconstructed her cheek skin using a cervicofacial flap. However, the cervicofacial flap became partially necrotic three weeks after operation, so we reconstructed her cheek skin using a median forehead flap.
我们报告一例硬腭基底细胞腺癌(BCAC)。一名63岁妇女因左脸颊肿胀来我院就诊。肿瘤占据了她左侧的硬腭和牙龈。CT和MRI显示肿瘤破坏了她的上颌骨,并侵入眶下壁和脸颊皮肤。病理检查显示肿瘤为BCAC。切除肿瘤,包括上颌骨、颊皮肤和眶骨膜。切除后,我们使用带内斜肌的带血管的髂骨皮瓣重建她的硬腭,并使用颈面皮瓣重建她的脸颊皮肤。然而,颈面皮瓣在手术后三周部分坏死,因此我们使用前额正中皮瓣重建她的脸颊皮肤。
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引用次数: 0
Long-term change in the oral health related QOL of patients treated with definitive radiotherapy for head and neck cancer 头颈癌放疗患者口腔健康相关生活质量的长期变化
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.5981/jjhnc.47.290
K. Jingu, N. Takahashi, S. Tasaka, R. Umezawa, Takaya Yamamoto, Y. Ishikawa, K. Takeda, Yu Suzuki, N. Kadoya, H. Matsushita
Long-term Xerostomia is one of the most common adverse events of radiotherapy (RT) in head and neck cancer patients. The salivary glands are highly sensitive to and damaged by radiation, leading to xerostomia, which de-creases patientsʼ quality of life (QOL) after radiotherapy. The purpose of this study was to evaluate long-term changes of oral health related QOL after definitive RT. Patients who were treated by RT with 60Gy or more for head and neck cancer were analyzed retrospectively. Patients with recurrence were excluded. Oral health related QOL was assessed with the General Oral Health Assessment Index (GOHAI) at follow-up dates. Sixty-six patients without recurrence were enrolled in this study. Oral health related QOL decreased rapidly during RT and recovered to the same level as normal in 3-3.5 months after the completion of RT. The nadir of GOHAI score appeared immediately after radiotherapy and the score had recovered significantly in all periods. There was no significant difference in changes in oral related QOL after RT between patients with a mean irradiated dose to the bilateral parotid glands of less than 35Gy and those of 35Gy or more.
长期口干是头颈部肿瘤放疗后最常见的不良事件之一。唾液腺对放射高度敏感并受到放射损伤,导致口干,降低放疗后患者的生活质量。本研究的目的是评估最终放疗后口腔健康相关生活质量的长期变化。回顾性分析接受放疗60Gy及以上的头颈癌患者。排除复发患者。随访时采用口腔健康综合评估指数(GOHAI)评估口腔健康相关生活质量。66例无复发的患者参加了这项研究。口腔健康相关生活质量在放疗期间迅速下降,在放疗结束后3 ~ 3.5个月恢复至正常水平。GOHAI评分在放疗后立即出现最低点,各期评分均有明显恢复。双侧腮腺平均辐照剂量小于35Gy与大于35Gy的患者放疗后口腔相关生活质量变化无显著差异。
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引用次数: 1
A case of a malignant peripheral nerve sheath tumor on the cheek following trauma 创伤后面颊恶性周围神经鞘肿瘤1例
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.5981/jjhnc.47.388
R. Aijima, Keisuke Mori, A. Danjo, Mitsutoshi Ohishi, R. Egashira, Yuichi Yamada, Hiroyuki Irie, Y. Oda, S. Aishima, Y. Yamashita
要 旨 悪性末梢神経鞘腫瘍(MPNST:malignant peripheral nerve sheath tumor)は 末梢神経由来の肉腫で,高 率に局所再発,転移を生じる。頭頸部での発生は稀で,今回,頬部 MPNST を経験したので報告する。症例 は 75 歳,男性。自転車走行中に転倒し顔面を受傷,頬部の腫脹に改善なく当科紹介となった。受傷後 1 ヶ月 の MRI にて左側咬筋内に 40×35×25mm の充実性病変を認め,生検で malignant spindle cell tumor の所見 であった。腫瘍切除術を行った結果,MPNST の診断となった。術後 4 ヶ月で局所再発を認めたため,再発腫 瘍切除術を施行,腫瘍は顔面神経へ浸潤していた。術後に 66Gy の外部照射を施行,現在,術後 18 ヶ月で局 所再発や遠隔転移を認めていない。MPNST は広範囲の切除が第一選択とされるが,頭頸部領域では機能温存 と審美的な配慮が必要となる。
主旨恶性末梢神经鞘瘤(MPNST:malignant peripheral nerve sheath tumor)是末梢神经源性肉瘤,局部复发、转移率高。发生在头颈部的情况比较少见,这次因为经历了面颊部MPNST而进行报告。病例七十五岁,男性。在骑自行车时摔倒,面部受伤,面部肿胀没有好转,被转诊到本科。在受伤后1个月的MRI中发现左侧咬肌内有40×35×25mm的充实性病变,活检显示为malignant spindle cell tumor。进行肿瘤切除术的结果被诊断为MPNST。术后4个月,由于局部复发,施行了复发肿瘤切除术,肿瘤已浸润面部神经。术后实施66gy外部照射,目前术后18个月未出现局部复发和远处转移。MPNST的首选是大范围切除,但头颈部区域需要保留功能和审美考虑。
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引用次数: 0
Clinicopathological study on local recurrence of primary oral squamous cell carcinoma 原发性口腔鳞状细胞癌局部复发的临床病理研究
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.5981/JJHNC.47.35
A. Abe, Yu Ito, Hiroki Hayashi, Takanori Ishihama, H. Furuta, Hiroshi Horibe, K. Tange
A clinicopathological study, focusing on local recurrence, was performed on 107 patients who were histologically diagnosed with oral squamous cell carcinoma and who underwent radical surgery at the Department of Oral and Maxillofacial Surgery of Nagoya Ekisaikai Hospital between January 2007 and March 2020. Among these 107 patients, 14 developed local recurrence with a recurrence rate of 13.1%. The median interval between surgery and local recurrence was 293.5 days (range: 21-1,408 days). An analysis of the risk factors for local recurrence was performed, and depth of invasion was identified as an independent risk factor. Salvage treatments included surgery in 7 patients, radiation and chemoradiotherapy in 4 patients, and palliative care in 3 patients. Seven of the 11 patients (63.6%) were successfully salvaged. Analysis of the patients with local recurrence showed that the surgery resulted in a better outcome. However, further studies are needed to analyze the risk factors for the recurrence and efficacy of the salvage treatments from multiple perspectives.
对2007年1月至2020年3月在名古屋Ekisaikai医院口腔颌面外科接受根治性手术的107例组织学诊断为口腔鳞状细胞癌的患者进行了一项以局部复发为重点的临床病理研究。107例患者局部复发14例,复发率13.1%。手术至局部复发的中位间隔为293.5天(范围:21- 1408天)。对局部复发的危险因素进行了分析,并确定浸润深度为独立的危险因素。抢救治疗包括手术7例,放化疗4例,姑息治疗3例。11例患者中7例(63.6%)抢救成功。对局部复发患者的分析表明,手术效果较好。然而,需要进一步的研究,从多个角度分析复发的危险因素和挽救治疗的疗效。
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引用次数: 0
A case of treatment related death caused by mucosal necrosis, brain necrosis and osteonecrosis after carbon ion radiotherapy in nasopharyngeal adenoid cystic carcinoma 鼻咽腺样囊性癌碳离子放疗后黏膜坏死、脑坏死、骨坏死致治疗相关性死亡1例
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.5981/JJHNC.47.71
Yusuke Nakata, Y. Demizu, T. Okimoto, Takeshi Shimizu
A 41-year old man with nasopharyngeal adenoid cystic carcinoma (T4aN0M0) received carbon ion radiotherapy of 65 Gy (RBE) in 25 fractions. The treatment was well tolerated and complete response was obtained. At 30 months after the therapy, mucosal necrosis and brain necrosis were observed as a late toxicity. Despite treatment with oral steroid, brain necrosis worsened and osteonecrosis of the skull base and cervical spine was newly observed. The patient died of intracranial infection caused by mucosal necrosis, brain necrosis and osteonecrosis of the skull base and cervical spine at 54 months after the carbon ion radiotherapy. A pathological au-topsy revealed no recurrence of adenoid cystic carcinoma. Carbon ion radiotherapy may be a useful treatment option for radioresistant malignant tumors of the head and neck. Optimal treatment planning and long-term careful follow-up are necessary to control fatal late toxicities.
41岁男性鼻咽腺样囊性癌(T4aN0M0)接受25次65 Gy的碳离子放射治疗。治疗耐受性良好,完全缓解。治疗30个月后出现黏膜坏死和脑坏死的晚期毒性反应。尽管口服类固醇治疗,脑坏死恶化,颅底和颈椎骨坏死新发现。患者于碳离子放疗后54个月死于颅底及颈椎粘膜坏死、脑坏死及骨坏死所致颅内感染。病理解剖显示腺样囊性癌未复发。碳离子放射治疗可能是头颈部放射耐药恶性肿瘤的有效治疗选择。最佳的治疗计划和长期仔细的随访是控制致命的晚期毒性的必要条件。
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引用次数: 0
Cochlear implantation for bilateral severe hearing loss after a single administration of cisplatin: A case report 单次顺铂治疗双侧重度听力损失的人工耳蜗植入一例
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.5981/JJHNC.47.78
S. Kinoshita, M. Hara, Kazuhiro Mitsumura, M. Ōsaki, Eikichi Tokunaga, Akio Hatanaka, W. Nishijima
We encountered a patient who underwent cochlear implant surgery for bilateral severe hearing loss after administration of cisplatin. The patient was a 69-year-old man who received cisplatin and vinorelbine as post-operative chemotherapy for lung cancer. On day 7 of administration, the patient experienced hearing loss. On day 9, pure tone audiometry showed bilateral deafness. The patient also developed a renal disorder, but it subsequently improved. As hearing aids were ineffective, cochlear implantation was performed to treat the bilateral severe hearing loss. The patientʼs hearing ability was favorable immediately after the implantation. This case shows that hearing loss can be induced by cisplatin after not only dose accumulation but also single administration. Identifying genes related to cisplatin-induced hearing loss to predict post-administration hearing can contribute to a safer cancer treatment plan. Currently, there is no method for predicting or preventing the onset of hearing loss; therefore, cochlear implant surgery may be the only option for patients who develop bilateral severe hearing loss after the first administration of cisplatin.
我们遇到了一位患者,他在服用顺铂后接受了双侧严重听力损失的人工耳蜗手术。患者是一名69岁的男性,接受顺铂和长春瑞滨作为肺癌术后化疗。服药第7天,患者出现听力损失。第9天,纯音测听显示双侧耳聋。患者还出现肾脏疾病,但随后有所改善。由于助听器效果不佳,采用人工耳蜗植入术治疗双侧重度听力损失。患者的听力在植入后立即恢复良好。本病例表明,顺铂不仅在剂量积累后,而且在单次给药后均可引起听力损失。鉴定与顺铂致听力损失相关的基因以预测给药后听力,有助于制定更安全的癌症治疗计划。目前,还没有预测或预防听力损失发生的方法;因此,人工耳蜗手术可能是首次顺铂治疗后双侧严重听力损失患者的唯一选择。
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引用次数: 1
The clinical utility of comprehensive genomic profiling for recurrent / metastatic head and neck cancer 综合基因组图谱在复发/转移性头颈癌中的临床应用
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.5981/jjhnc.47.359
Kohki Tohyama, Y. Kano, Rika Noji, Yasuko Aoyagi, Shotaro Matsudera, K. Ohno, Yosuke Ariizumi, Y. Michi, H. Tomioka, H. Shimamoto, R. Yoshimura, T. Asakage, H. Harada, S. Miyake, M. Miura, S. Ikeda
要 旨 頭頸部癌患者 14 例 18 件に対し FoundationOne CDx などのがん遺伝子パネル検査を使用し,組織検体 15 件(83.3%),血液検体 3 件(16.6%)における遺伝子変異の解析を行った。原発部位別では,舌癌が 6 例(42.8%) と最多で,検出された遺伝子変異としては TP53,TERT promoter,CDKN2A などであり,全ゲノム解析を 用いた既報と矛盾しない結果となった。14 例のうち,治療候補があった症例は 11 例(78.6%)であったが, 実際に遺伝子パネル検査に基づいて治療を行った症例は 2 例(14.3%)であり治療薬へのアクセス率の向上が 今後の課題となった。また,TMB(Tumor Mutational Burden)が高値を示した 3 症例のうち 2 例で免疫チェッ クポイント阻害剤による奏効が得られ,TMB が頭頸部癌の実臨床における新たなバイオマーカーとして有用 である可能性が示唆された。
对14例18例头颈癌患者使用FoundationOne CDx等癌基因面板检查,组织检件15件(83.3%),血液检件3对事件(16.6%)的基因变异进行了分析。从原发部位来看,舌癌最多,有6例(42.8%),检测出的基因变异有TP53、TERT promoter、CDKN2A等,全基因组分析成为了与使用的既报不矛盾的结果。14例中,11例(78.6%)有治疗候选,实际基于基因板检测进行治疗的病例为2例(14.3%),提高治疗药物的接触率是今后的课题。另外,在TMB(Tumor Mutational Burden, Tumor Mutational Burden)显示值高的3例病例中,有2例因免疫切点抑制剂而奏效,TMB在治疗头颈癌的临床实践中,这可能是一种新的生物标志物。
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引用次数: 0
Hybrid cadaver training with holograms by mixed reality technique 混合现实技术的全息混合尸体训练
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.5981/jjhnc.47.366
Kayo Sakamoto, Sohei Mitani, Eriko Sato, Takashi Kitani, Tomoyoshi Sanada, N. Hato
Virtual reality is a rapidly developing technology in the field of computer science and can contribute to surgical care. The mixed reality (MR) technique is the merging of real and virtual worlds and provides the user with a hologram in the real world. Here, we report a new cadaver training technique with holograms called hybrid cadaver training. The MR technique makes it possible to show teaching materials as holograms during cadaver training. The application for the MR was developed by the faculty of engineering, Ehime University. Four oto-laryngology-head and neck surgery residents participated in the hybrid cadaver training and answered a ques-tionnaire. All participants rated the usefulness of the training as 5 points out of 5. The hybrid cadaver training with holograms may be a new promising simulation training for otolaryngology-head and neck surgery residents.
虚拟现实是计算机科学领域的一项快速发展的技术,可以为外科护理做出贡献。混合现实(MR)技术是将真实世界和虚拟世界融合在一起,为用户提供真实世界中的全息图。在这里,我们报告了一种新的尸体训练技术与全息图称为混合尸体训练。磁共振成像技术使得在尸体训练期间以全息图的形式展示教材成为可能。MR的应用程序是由爱媛大学工程学院开发的。四名耳喉头颈外科住院医师参加了混合尸体训练并回答了一份问卷。所有参与者都给培训的有效性打了5分(满分5分)。在耳鼻喉头颈外科住院医师的模拟训练中,全息影像混合尸体训练是一种很有前途的模拟训练方法。
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引用次数: 0
82 cases of laryngeal preservation surgery for laryngeal cancer 喉保留手术治疗喉癌82例分析
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.5981/jjhnc.47.371
Katsuji Asano, Y. Somekawa, K. Takano, M. Kurose, Shigeru Koshiba, Yousuke Nagai, M. Myoujin, Hikaru Ikeda, M. Nishio
The author performed larynx-conserving surgery on a total of 82 patients (59 primary cases and 23 secondary cases) of laryngeal cancer. The disease-specific 5-year survival rate of all 82 patients was 92.6%. The larynx con-servation rate was 87.8% in all 82 cases. In regard to the treatment of early-stage laryngeal cancer (T1, 2), we suggested that larynx-conserving surgery should be considered as an option for initial treatment because it is not inferior to radiotherapy in terms of clinical outcome and preservation of laryngeal function in daily life. Larynx-conserving surgery as a salvage treatment for recurrence did not present a lower laryngeal preservation rate than for primary cases, and seemed to be an effective method of salvage surgery for recurrent patients. these 11 cases, 5 cases whose surgical margins were diagnosed as negative on histopathological examination suffered local recurrence. We performed total laryngectomy as a salvage surgery on these 5 cases. Of the 16 cases of locally advanced cancer (T3, 4), 5 cases (1 case of deep tongue muscle invasion, 3 cases of anterior invasion of the epiglottis, and 1 case of anterior wall invasion of the cricoid cartilage) showed no local recurrence and local control was successfully achieved with surgery alone. Regarding indications, in the case of locally advanced laryngeal cancer involving anterior invasion of the epiglottis, deep tongue muscle invasion, and anterior wall invasion of the cricoid cartilage, larynx-conserving surgery appropriately indicated because the cases were local controlled with surgery alone. However, in the case of recurrence, postoperative radiotherapy should be considered because of the difficulty of preserving the function of the larynx.
作者共对82例喉癌患者施行保喉手术,其中原发病例59例,继发病例23例。82例患者的疾病特异性5年生存率为92.6%。82例喉部保留率为87.8%。对于早期喉癌的治疗(T1, 2),我们建议将保喉手术作为初始治疗的一种选择,因为在临床结果和日常生活中喉功能的保存方面,保喉手术并不亚于放疗。保喉手术作为复发的挽救性治疗,其喉保存率并不低于原发病例,似乎是一种有效的治疗复发患者的挽救性手术方法。11例手术缘组织病理检查阴性的5例局部复发。我们对这5例患者进行了全喉切除术。16例局部晚期肿瘤(T3, 4)中,5例(舌深肌侵1例,会厌前侵3例,环状软骨前壁侵1例)未出现局部复发,单纯手术即可成功局部控制。在适应证方面,局部进展期喉癌累及会厌前侵、舌深肌侵犯、环状软骨前壁侵犯的病例,由于局部控制,仅行手术,宜行保喉手术。然而,在复发的情况下,应考虑术后放疗,因为难以保留喉的功能。
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引用次数: 0
期刊
Japanese Journal of Head and Neck Cancer
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