Nippon Jibiinkoka Gakkai Kaiho
Online ISSN : 1883-0854
Print ISSN : 0030-6622
ISSN-L : 0030-6622
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Volume 113, Issue 3
Displaying 1-5 of 5 articles from this issue
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Review article
Original article
  • Concurrent Chemoradiotherapy for Resectable Locoregionally Advanced Squamous Cell Carcinoma of the Head and Neck-Analysis of Factors Associated with Toxicity and Efficacy
    Akira Kubota, Madoka Furukawa, Yoshifumi Fujita, Hiroaki Yagi
    2010 Volume 113 Issue 3 Pages 101-109
    Published: 2010
    Released on J-STAGE: February 19, 2011
    DOIhttps://doi.org/10.3950/jibiinkoka.113.101
    JOURNAL FREE ACCESS
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    We evaluated clinical factors associated with concurrent chemoradiotherapy (CRT) toxicity and efficacy in resectable locoregionally advanced squamous cell carcinoma of the head and neck.
    Subjects were 115 subjects with stage III or IV carcinoma undergoing 58 to 70 Gy of irradiation (median total dose: 66 Gy) concurrently with 2 cycles of chemotherapy of 5FU at 1000 mg/m2, 120-hour continuous infusion and cisplatin at 60 mg/m2.
    Grade 3 to 4 mucositits differed significantly between 13% in N0 and 59% in N1 to 2. No significant difference in planned therapy completion was seen between 87% in N0 and 82% in N1 to 2. Three-year overall survival (OS) was 66% and progression-free survival (PFS) 55%, in median follow-up of 42 months (range: 5.8 to 91 months). OS differed significantly between 86% in stage III and 57% in IV, 78% in T0 to 2 and 62% in T3 to 4, 83% in N0 to 1 and 53% in N2, 77% in adjuvant chemotherapy (nedaplatin plus UFT) and 50% in no adjuvant chemotherapy, and 33% in the tongue and 77% in the oropharynx. PFS significantly differed between 72% in T0 to 2 and 49% in T3 to 4, 77% in CR and 53% in PR, and 22% in the tongue and 58% in the hypopharynx, 66% in the oropharynx, and 53% in the larynx. Multivariable analysis showed strongly independent risk factors associated with OS and PFS to be advanced T and N stage, no adjuvant chemotherapy, and the tongue as the site.
    CRT was effective in treating resectable locoregionally advanced squamous cell carcinoma of the head and neck. It is possible that adjuvant chemotherapy will improve CRT OS and PFS. Other additional treatment will be needed, however, to improve OS and PFS in cases having a dismal diagnosis such as tongue cancer.
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  • Evaluation of Soft Diets Using Freeze Infusion in Videofluorography
    Tomohisa Hirai, Noriyuki Fukushima, Kunihiko Ono, Masaaki Hajima, Yosh ...
    2010 Volume 113 Issue 3 Pages 110-114
    Published: 2010
    Released on J-STAGE: February 19, 2011
    DOIhttps://doi.org/10.3950/jibiinkoka.113.110
    JOURNAL FREE ACCESS
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    A food developed at the Hiroshima Prefectural Food Technology Research Center, Hiroshima, Japan, has proved to be a boon in videofluorography. The food features decreased hardness with retained their shape due to being impregnated with macerating enzymes under reduced pressure after vegetables are defrosted. Samples were removed immediately from the enzyme solution after freeze infusion. All foods tested raging from carrots to chicken contasted well in videofluorography in an evaluation of swallowing in 107 subgects with dysphagia, results for carrots compared well with those for 33% iopamidol, jelly, and yogurt. Only a subjects showed silent aspiration with carrots, compared to 19 with 33% iopamidol. Among 70 subjects showing no residual jelly and/or yogurt, just 12-8 severe and 4 moderate-showed residual carrots in the pharyngeal space. In contrast, among 67 subjects showing no residual carrots in the pharyngeal spase, 9 moderate subjects showing no residual jelly and/or yogurut.
    We concluded foods such as carrots treated as stated following jelly and/or yogurt as new nutrition sources for subfects with dysphagia.
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  • Parotid Gland Cancer Treatment with Facial Nerve Preservation
    Yoshifumi Fujita, Akira Kubota, Madoka Furukawa, Hiroaki Yagi, Mamoru ...
    2010 Volume 113 Issue 3 Pages 115-122
    Published: 2010
    Released on J-STAGE: February 19, 2011
    DOIhttps://doi.org/10.3950/jibiinkoka.113.115
    JOURNAL FREE ACCESS
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    Based on clinical features in 34 cases of parotid gland cancer treated between January 1997 and December 2007, tumor, node, and metastasis classification found 5 subjects to be T1, 12 to be T2, 7 to be T3, and 10 to be T4a. Of these, 25 were staged for N0, 3 for N1, and 6 for N2. Histopathologically, 10 different tumor types were observed, with carcinoma ex pleomorphic adenoma the most common. Preoperative fine-needle aspiration cytology (FNAC) of parotid gland tumor was done on 126 and cytological findings compared to histopathologic diagnoses of surgically resected specimens. Sensitivity for malignancy was 76.0%, specificity 95.4%, and overall accuracy 91.1%. Six malignant tumors were diagnosed as benign and 4 benign as malignant by FNAC, indicating that FNAC results alone may not be sufficient for diagnosing malignancy definitively. Among subjects, 25 underwent surgical resection, with the facial nerve preserved in 15 of 29. Postoperative radiotherapy was indicated if lymph node metastasis, intermediate or high-grade malignancy, or positive margins were seen. Of 15 subjects undergoing postoperative radiotherapy, 3 experienced recurrence. For unresectable tumors, concurrent chemoradiotherapy was used for 3 subjects and 2 underwent radiotherapy alone, with all 5 current survivors. The 5-year overall survival (OS) was 87.4% and progression-free survival (PFS) 71.4%. In terms of 5-year PFS, significant differences were seen between stage I/II (91.7%) and stage III/IV (51.6%)(P=0.032), and between N0 (86.2%) and N+(38.1%)(P=0.002).
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Educational lecture
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