Oral Oncology Reports最新文献

英文中文

Optimizing outcomes in oral carcinoma with prosthesis intervention 通过假体干预优化口腔癌的治疗效果

Oral Oncology Reports

Pub Date : 2024-10-03 DOI: 10.1016/j.oor.2024.100665

N. Gopi Chander , M. Senthil Murugan

Optimal management of oral carcinoma requires a multidisciplinary approach, particularly in cases involving maxillary gingival carcinoma, where surgical and prosthetic interventions are crucial for restoring function and improving patient quality of life. This case report details the comprehensive treatment of a patient diagnosed with maxillary gingival carcinoma, presenting with pain and discharge. Histopathological examination confirmed carcinoma, necessitating surgical excision. A vascular flap was employed for closure to promote healing and preserve anatomical structures.

Post-surgical rehabilitation began with the use of an interim flexible obturator, designed to provide immediate support for speech, swallowing, and soft tissue protection during the initial healing phase. This prosthetic intervention optimized early functional outcomes and patient comfort. As healing progressed, the patient transitioned to a definitive cast partial denture obturator, featuring a cobalt-chromium alloy framework for enhanced durability and stability. The prosthesis was designed with a complete palate major connector, mesh-type denture base, and carefully positioned rest seats and retainers to ensure optimal function, aesthetics, and long-term structural support.

Regular follow-ups demonstrated significant improvements in oral functions, psychological well-being, and overall quality of life. This report underscores the vital role of prosthetic interventions in optimizing outcomes for oral carcinoma patients, highlighting the importance of individualized rehabilitation strategies that integrate surgical and prosthetic care for long-term success.

口腔癌的最佳治疗需要采用多学科方法，尤其是在涉及上颌牙龈癌的病例中，手术和修复干预对于恢复功能和改善患者的生活质量至关重要。本病例报告详细介绍了对一名确诊为上颌牙龈癌的患者的综合治疗，患者表现为疼痛和分泌物增多。组织病理学检查证实为癌，必须进行手术切除。手术后的康复治疗从使用临时柔性闭锁器开始，目的是在初期愈合阶段为言语、吞咽和软组织保护提供即时支持。这种假体干预优化了早期的功能效果和患者的舒适度。随着愈合的进展，患者过渡到了最终铸造局部义齿修复体，该修复体采用钴铬合金框架，具有更高的耐用性和稳定性。该义齿的设计包括全腭主要连接体、网状义齿基托以及精心定位的修复座和固位体，以确保最佳的功能、美观和长期的结构支持。这份报告强调了修复干预在优化口腔癌患者疗效方面的重要作用，突出了整合手术和修复护理的个性化康复策略对于长期成功的重要性。

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引用次数: 0

Direct extension from primary tumour to nodes: Can molecular profiling solve the dilemma? 原发肿瘤直接延伸至结节：分子图谱分析能解决这一难题吗？

Oral Oncology Reports

Pub Date : 2024-09-28 DOI: 10.1016/j.oor.2024.100664

Gargi Sarode, Dheeraj Meena, Sayali Tungikar, Atharv Shrotri, Sachin Sarode

引用次数: 0

Navigating the omics landscape in precision medicine: A bidirectional approach to patient care 在精准医疗中驾驭全局：患者护理的双向方法

Oral Oncology Reports

Pub Date : 2024-09-28 DOI: 10.1016/j.oor.2024.100660

Rui Vitorino

This paper presents a novel bidirectional approach to precision medicine that combines proteomic, peptidomic and metabolomic analyzes with clinical data and genome-wide association studies (GWAS). This innovative strategy improves patient care by enabling a dynamic exchange from “patient to molecular pathway” and back, which significantly refines patient cohort stratification, improves diagnostic accuracy and personalizes treatment strategies. At the heart of this approach is the use of comprehensive multi-omics data to improve patient management by tailoring interventions to individual molecular profiles. This two-way flow not only optimizes treatment based on real-time insights from molecular pathways, but also improves the application of GWAS results in clinical scenarios. Advanced computational tools such as machine learning and network analysis are critical for navigating these complex data sets and translating intricate molecular data into actionable treatment plans. This integrated, adaptive framework promises to reshape the future of healthcare by tailoring treatments to patients' unique biological and genetic profiles.

本文介绍了一种新颖的精准医疗双向方法，它将蛋白质组、肽组和代谢组分析与临床数据和全基因组关联研究（GWAS）相结合。这种创新策略通过实现从 "患者到分子通路 "再到 "分子通路 "的动态交流来改善患者护理，从而显著完善患者队列分层、提高诊断准确性并个性化治疗策略。这种方法的核心是利用全面的多组学数据，根据个体分子特征调整干预措施，从而改善患者管理。这种双向流动不仅能根据分子通路的实时见解优化治疗，还能改进 GWAS 结果在临床中的应用。机器学习和网络分析等先进的计算工具对于浏览这些复杂的数据集以及将复杂的分子数据转化为可操作的治疗方案至关重要。这种集成的自适应框架有望根据患者独特的生物和遗传特征量身定制治疗方案，从而重塑未来的医疗保健。

引用次数: 0

How to choose a sampling technique and determine sample size for research: A simplified guide for researchers 如何选择抽样技术并确定研究样本量：研究人员简化指南

Oral Oncology Reports

Pub Date : 2024-09-26 DOI: 10.1016/j.oor.2024.100662

Sirwan Khalid Ahmed

An appropriate sampling technique with the exact determination of sample size involves a very vigorous selection process, which is actually vital for any empirical research. It is obvious that these methodological decisions would greatly affect the internal and external validity and the overall generalizability of the study findings. This paper has comprehensively updated the guidelines on sampling methods and sample size calculation, hence giving enough evidence that will be beneficial in assisting researchers to advance the credibility and statistical power of their research work. The differences between probability sampling techniques, including simple random sampling, stratified sampling, and cluster sampling, and non-probability methods, such as convenience sampling, purposive sampling, and snowball sampling, have been fully explained. Probability is the only that can ensure the generalizability, while non-probability sampling is useful in exploratory situations. Another significant process is the determination of an optimal sample size, which, among other things, has to take into account the total population size, effect size, statistical power, confidence level, and margin of error. The paper contributes both theoretical guidance and practical tools that researchers need in choosing appropriate strategies for sampling and validating methodologically appropriate sample size calculations. In sum, such a paper sets the standard for best practice in research methodology that will drive reliability, validity, and empirical rigor across diverse studies.

适当的抽样技术和样本量的准确确定涉及到一个非常严格的选择过程，这对任何实证研究来说都是至关重要的。显而易见，这些方法上的决定会极大地影响研究结果的内部和外部效度以及整体可推广性。本文全面更新了有关抽样方法和样本量计算的指导原则，从而提供了足够的证据，有利于帮助研究人员提高其研究工作的可信度和统计能力。本文充分解释了简单随机抽样、分层抽样和聚类抽样等概率抽样技术与方便抽样、目的抽样和滚雪球抽样等非概率抽样方法之间的区别。只有概率抽样才能确保普遍性，而非概率抽样则适用于探索性情况。另一个重要过程是确定最佳样本量，除其他事项外，还必须考虑到总人口规模、效应大小、统计能力、置信水平和误差范围。本文既提供了理论指导，也提供了研究人员在选择适当的抽样策略和验证方法上适当的样本量计算时所需的实用工具。总之，这样的论文为研究方法的最佳实践设定了标准，将推动各种研究的可靠性、有效性和实证严谨性。

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引用次数: 0

Optimizing 3D printing prosthesis technology for rehabilitation of oral cancer patients 优化用于口腔癌患者康复的 3D 打印假体技术

Oral Oncology Reports

Pub Date : 2024-09-25 DOI: 10.1016/j.oor.2024.100661

N. Gopi Chander, Lakshita Sharma, Amrutha Manoj Kumar, Lakshmi Raj

Oral cancer patients face significant challenges in prosthetic rehabilitation due to tissue loss from surgical interventions and the lasting side effects of treatments such as radiation therapy. Traditional methods of prosthesis fabrication often struggle to account for the anatomical changes caused by cancer treatments, leading to functional and aesthetic limitations. 3D printing technology, with its ability to produce customized, patient-specific prostheses, presents a promising solution for overcoming these challenges. By employing advanced imaging techniques like CT and MRI, 3D printing allows for the precise modeling of the oral cavity, improving the fit, comfort, and functionality of prostheses.

In addition to enhancing the accuracy of prosthesis design, 3D printing plays a crucial role in surgical reconstruction by enabling surgeons to plan more precise interventions. This reduces the need for multiple surgeries and improves recovery time. The integration of 3D printing with oncologic care, including collaboration between surgical teams and oncologists, further streamlines treatment and enhances patient outcomes. Despite these advantages, limitations remain, particularly regarding the durability and biocompatibility of 3D printing materials. Future advancements, including bioprinting and the development of smart materials, hold the potential to further revolutionize prosthetic rehabilitation for oral cancer patients.

由于手术治疗造成的组织损失以及放射治疗等治疗的持久副作用，口腔癌患者在假体康复方面面临着巨大挑战。传统的假体制作方法往往难以考虑到癌症治疗所造成的解剖学变化，从而导致功能和美观方面的限制。三维打印技术能够生产定制的、患者专用的假体，为克服这些挑战提供了一种前景广阔的解决方案。通过采用先进的成像技术（如 CT 和 MRI），3D 打印技术可以对口腔进行精确建模，从而改善假体的贴合度、舒适度和功能性。除了提高假体设计的准确性，3D 打印技术还在手术重建中发挥着至关重要的作用，使外科医生能够规划更精确的干预措施。这减少了多次手术的需要，并缩短了恢复时间。3D 打印与肿瘤治疗的整合，包括外科团队和肿瘤专家之间的合作，进一步简化了治疗过程，提高了患者的治疗效果。尽管有这些优势，但仍然存在局限性，特别是在 3D 打印材料的耐用性和生物相容性方面。未来的进步，包括生物打印和智能材料的开发，有可能进一步彻底改变口腔癌患者的修复康复。

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引用次数: 0

Sebaceous adenoma of the parotid gland encasing the facial nerve: Case report and review of the literature 包裹面神经的腮腺皮脂腺瘤：病例报告和文献综述

Oral Oncology Reports

Pub Date : 2024-09-25 DOI: 10.1016/j.oor.2024.100663

Bhavik Singh , Kelly R. Magliocca , David Chou , Jennifer H. Gross , Jennifer L. Becker , Nicole C. Schmitt

Background

Sebaceous adenoma of the salivary glands are uncommon benign neoplasms, comprising about 0.1 % of salivary tumors. These tumors can be difficult to recognize with heterogeneous appearance on imaging.

Case report

A 67-year-old man presented with a painless, progressively growing left parotid mass. Imaging showed a heterogenous, partially cystic mass in the superficial and deep lobes of the parotid with some areas of adipose density. Intraoperatively, a mass with sebaceous differentiation was found to be encasing the main trunk and pes anserinus of the facial nerve, requiring nerve sacrifice for en bloc resection. Final pathology revealed a sebaceous adenoma with intense xanthomatous reaction compressing the facial nerve.

Conclusion

Although benign and associated with little risk of recurrence, sebaceous adenomas may be difficult to recognize on preoperative workup and may be locally aggressive. Complete surgical resection is the mainstay of therapy, but rehabilitation may be required in the event of facial nerve involvement.

背景唾液腺的浆液性腺瘤是一种不常见的良性肿瘤，约占唾液腺肿瘤的 0.1%。病例报告一名 67 岁的男子因无痛性、逐渐增大的左侧腮腺肿块就诊。影像学检查显示，腮腺浅叶和深叶有异质、部分囊性肿块，部分区域有脂肪密度。术中发现，一个皮脂腺分化的肿块包裹着面神经主干和鞍上神经，需要牺牲神经进行全切。最后的病理结果显示，皮脂腺瘤伴有强烈的黄瘤反应，压迫了面神经。结论皮脂腺瘤虽然是良性肿瘤，复发风险很小，但术前检查可能难以识别，而且可能具有局部侵袭性。完全手术切除是治疗的主要方法，但如果累及面神经，可能需要进行康复治疗。

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引用次数: 0

Trismus following facial nerve sacrifice and reanimation surgery: Incidence and management 面神经牺牲和再植手术后的三联症：发生率和处理

Oral Oncology Reports

Pub Date : 2024-09-21 DOI: 10.1016/j.oor.2024.100658

Lachlan Jackson , Emma Charters , Masako Dunn , Jonathan Clark , Tsu-Hui (Hubert) Low

引用次数: 0

Sex & marital differences in delayed pharyngeal cancer treatment before and after medicaid expansion 医疗补助扩展前后咽癌延迟治疗的性别和婚姻差异

Oral Oncology Reports

Pub Date : 2024-09-19 DOI: 10.1016/j.oor.2024.100653

Jason Semprini

Objective

In the United States, pharyngeal cancer has become the most common type of head and neck cancer, with 80 % of cases found in males. Although disparities in treatment delays have been observed in pharyngeal patients, less is known about how policies facilitate timely care. This study aimed to estimate the association between Medicaid expansion and delaying initiation of pharyngeal cancer treatment.

Methodology

We extracted Surveillance, Epidemiological, End Results (SEER) case data to analyze pharyngeal cancers diagnosed between 2000 and 2018. The outcome of interest was a binary variable indicating if the patient initiated treatment two or more months after diagnosis. We conducted subgroup analyses by sex, marital status, and type of treatment received (surgery, radiation, chemotherapy, post-operative radiation, systemic therapy). We implemented the Matrix Completion algorithm to account for staggered rollout of Medicaid expansion within our difference-in-differences design.

Results

Our sample included 79,433 patients diagnosed with pharynx cancer. Delayed treatment was lowest among married females receiving systemic therapy (5 %), and highest among married males and females not recommended to receive surgery (43 %). Generally, there was no association between Medicaid expansion and changes in delayed treatment. Subgroup analyses show that Medicaid expansion was associated with reduced treatment delays in unmarried females receiving systemic therapy (−4.5%-points), and married males receiving chemotherapy (Est. = −2.6%-points), radiotherapy (Est. = −3.1%-points), and married males not recommended to receive surgery (Est. = −4.6%-points).

Conclusions

Given the importance of timely pharyngeal cancer treatment, health systems must identify and address the drivers of treatment delays to advance cancer equity.

目标在美国，咽癌已成为最常见的头颈部癌症，其中 80% 的病例为男性。虽然在咽部患者中已经观察到了治疗延迟的差异，但对政策如何促进及时治疗却知之甚少。本研究旨在估算医疗补助（Medicaid）扩展与咽癌治疗延迟启动之间的关联。方法我们提取了监测、流行病学、最终结果（SEER）病例数据，分析2000年至2018年间诊断出的咽癌。相关结果是一个二进制变量，表示患者是否在确诊后两个月或两个月以上开始治疗。我们按照性别、婚姻状况和接受的治疗类型（手术、放疗、化疗、术后放疗、全身治疗）进行了亚组分析。我们采用了矩阵完成算法，以便在差分设计中考虑到医疗补助扩展的交错推出。在接受系统治疗的已婚女性中，延迟治疗的比例最低（5%），而在不建议接受手术治疗的已婚男性和女性中，延迟治疗的比例最高（43%）。总体而言，医疗补助计划的扩大与延迟治疗的变化之间没有关联。分组分析表明，在接受系统治疗的未婚女性（-4.5%-points）、接受化疗的已婚男性（Est. = -2.6%-points）、接受放疗的已婚男性（Est. = -3.1%-points）和不建议接受手术的已婚男性（Est. = -4.6%-points）中，医疗补助计划的扩大与治疗延迟的减少有关。

{"title":"Sex & marital differences in delayed pharyngeal cancer treatment before and after medicaid expansion","authors":"Jason Semprini","doi":"10.1016/j.oor.2024.100653","DOIUrl":"10.1016/j.oor.2024.100653","url":null,"abstract":"<div><h3>Objective</h3><p>In the United States, pharyngeal cancer has become the most common type of head and neck cancer, with 80 % of cases found in males. Although disparities in treatment delays have been observed in pharyngeal patients, less is known about how policies facilitate timely care. This study aimed to estimate the association between Medicaid expansion and delaying initiation of pharyngeal cancer treatment.</p></div><div><h3>Methodology</h3><p>We extracted Surveillance, Epidemiological, End Results (SEER) case data to analyze pharyngeal cancers diagnosed between 2000 and 2018. The outcome of interest was a binary variable indicating if the patient initiated treatment two or more months after diagnosis. We conducted subgroup analyses by sex, marital status, and type of treatment received (surgery, radiation, chemotherapy, post-operative radiation, systemic therapy). We implemented the Matrix Completion algorithm to account for staggered rollout of Medicaid expansion within our difference-in-differences design.</p></div><div><h3>Results</h3><p>Our sample included 79,433 patients diagnosed with pharynx cancer. Delayed treatment was lowest among married females receiving systemic therapy (5 %), and highest among married males and females not recommended to receive surgery (43 %). Generally, there was no association between Medicaid expansion and changes in delayed treatment. Subgroup analyses show that Medicaid expansion was associated with reduced treatment delays in unmarried females receiving systemic therapy (−4.5%-points), and married males receiving chemotherapy (Est. = −2.6%-points), radiotherapy (Est. = −3.1%-points), and married males not recommended to receive surgery (Est. = −4.6%-points).</p></div><div><h3>Conclusions</h3><p>Given the importance of timely pharyngeal cancer treatment, health systems must identify and address the drivers of treatment delays to advance cancer equity.</p></div>","PeriodicalId":94378,"journal":{"name":"Oral Oncology Reports","volume":"12 ","pages":"Article 100653"},"PeriodicalIF":0.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2772906024004990/pdfft?md5=664276d5ddc4f7bf3248c61ca505846e&pid=1-s2.0-S2772906024004990-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142274871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluation of flap complications following pectoralis major myocutaneous flap reconstruction for oral cancers 评估胸大肌皮瓣重建治疗口腔癌后的皮瓣并发症

Oral Oncology Reports

Pub Date : 2024-09-19 DOI: 10.1016/j.oor.2024.100655

Nadimul Hoda , Aastha Moza , Ankita Saraf , Sravani Bhogaraju , Irfan Ahmed

Background

Oral cavity cancer is among the leading cause of cancer death in India. Pectoralis major myocutaneous flaps (PMMC) are still widely used for the reconstruction of defects pertaining to head and neck region, though free flaps are considered to be gold standard. The study was aimed to identify the risk factors involved in post - operative complications of PMMC Flap for oral subsites.

Methods

A total of 266 patients operated in an oncology institute over 2 years of time was evaluated based on their demographic data, pre and post-surgery details, post-operative flap morbidity were collected retrospectively from master case sheets from January 2022 to January 2024. Factors such as age, gender, stage of disease, diabetic status, and hypoprotenemia and radiation therapy were seen, analysed to find their relation in causing flap complications.

Results

Totally 266 patients were included for analysis and 16.9 % had major flap complications. On detailed analysis, it was seen that larger bipaddled flaps had higher flap complication rate, highest being wound infection.

Conclusion

PMMC Flap is a viable option for head and neck cancer reconstruction, specifically in cases where free microvascular flaps are not done routinely and patient presents with multiple comorbidities. Careful patient selection, pre – operative optimization, operating surgeon experience and post-operative care are contributing factors to reduce flap complications.

背景口腔癌是印度癌症死亡的主要原因之一。尽管游离皮瓣被认为是金标准，但胸大肌肌皮瓣（PMMC）仍被广泛用于头颈部缺损的重建。该研究旨在确定口腔亚部位 PMMC 皮瓣术后并发症的风险因素。方法：从 2022 年 1 月至 2024 年 1 月的主病例表中回顾性地收集了肿瘤研究所 2 年多来手术的 266 例患者的人口统计学数据、手术前后的详细情况以及术后皮瓣发病率。对年龄、性别、疾病分期、糖尿病状态、低钙血症和放射治疗等因素进行了观察和分析，以找出它们与导致皮瓣并发症的关系。结论PMMC皮瓣是头颈部癌症重建的可行方案，尤其适用于不能常规使用游离微血管瓣且患者有多种并发症的病例。谨慎选择患者、术前优化、手术医生经验和术后护理是减少皮瓣并发症的有利因素。

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引用次数: 0

Radiant advances: The future of brachytherapy in oral oncology 辐射进步：口腔肿瘤近距离放射治疗的未来

Oral Oncology Reports

Pub Date : 2024-09-19 DOI: 10.1016/j.oor.2024.100654

Shyamaladevi Babu, Madhan Krishnan

Brachytherapy has become integral to the treatment of oral cancers, offering the advantage of delivering high doses of radiation directly to tumors while minimizing exposure to surrounding healthy tissues. This review examines recent advancements that have significantly improved the precision and effectiveness of brachytherapy. The integration of high-resolution imaging technologies, such as MRI and CT scans, has enhanced tumor delineation, enabling more accurate placement of radioactive sources. Innovations in radioactive sources, particularly high-dose-rate (HDR) brachytherapy, have optimized radiation delivery, leading to shorter treatment durations and improved patient outcomes. Personalized treatment approaches, guided by genomic and molecular profiling, allow for customized dosimeter, maximizing therapeutic effectiveness while minimizing toxicity. Additionally, combining brachytherapy with other treatment modalities such as surgery, external beam radiation therapy (EBRT), and chemotherapy has demonstrated synergistic benefits, improving local control and reducing recurrence rates. Despite its advantages, brachytherapy faces challenges, including the invasive nature of the procedure, the need for specialized equipment and training, and limitations related to tumor size. Future directions in the field include advancements in imaging and dosimeter, the development of robotic-assisted brachytherapy, and more personalized treatment plans. These innovations promise to refine brachytherapy further and expand its applicability. This review highlights the transformative potential of recent advances in brachytherapy, emphasizing its evolving role in the localized treatment of oral cancers.

近距离放射治疗已成为口腔癌治疗不可或缺的一部分，其优势在于可直接向肿瘤提供高剂量辐射，同时最大限度地减少对周围健康组织的照射。本综述探讨了近来大大提高近距离放射治疗精确度和有效性的最新进展。核磁共振成像（MRI）和 CT 扫描等高分辨率成像技术的整合加强了肿瘤的划分，使放射源的放置更加精确。放射源的创新，尤其是高剂量率（HDR）近距离放射治疗，优化了放射线的输送，从而缩短了治疗时间，改善了患者的治疗效果。以基因组和分子图谱为指导的个性化治疗方法允许定制剂量计，在最大限度地提高治疗效果的同时最大限度地降低毒性。此外，近距离放射治疗与手术、体外放射治疗（EBRT）和化疗等其他治疗方式的结合已显示出协同效应，可改善局部控制并降低复发率。尽管近距离放射治疗具有诸多优势，但它也面临着一些挑战，包括手术的侵入性、对专业设备和培训的需求以及与肿瘤大小相关的限制。该领域未来的发展方向包括成像和剂量计的进步、机器人辅助近距离放射治疗的开发以及更加个性化的治疗方案。这些创新有望进一步完善近距离放射治疗并扩大其应用范围。这篇综述突出了近距离放射治疗最新进展的变革潜力，强调了近距离放射治疗在口腔癌局部治疗中不断发展的作用。

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