記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.jds.2023.11.018

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

ABSTRACT: The purpose of this study was to investigate the clinical anatomy of the feeding artery of the submandibular gland (SMG). A total of 199 SMG removals were performed in extraoral or intraoral approach with/without endoscopic assistance by a single surgeon. The feeding artery of the SMG was always identified intraoperatively and recorded in the operation record. The clinical anatomy of the feeding artery of the SMG was investigated based on the intraoperative findings. The facial artery was ligated and transected for the involvement of tumor or severe inflammation in 16 (8.0%) procedures. The feeding artery was investigated in the remaining 183 procedures. The mean number of the glandular branch was 1.5. There were 1 branch in 98 procedures (53.6%), 2 branches in 80 procedures (43.7%), and 3 branches in 5 procedures (2.7%). Detailed anatomical knowledge of the feeding artery of the SMG is useful for proper dissection of the SMG and preservation of the facial artery.

DOI： 10.1097/SCS.0000000000008613

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本口腔診断学会  

症例は31歳男性で、左側顎下部の腫脹を主訴とした。他院にて顎下型ラヌーラの診断で約10年間OK-432の局注療法を受けたが改善しなかった。腫瘤は弾性軟で無痛性であり、CTでは多房性嚢胞状病変が左側顎下腺の後方かつ広頸筋の内側から胸鎖乳突筋の内側まで進展し、MRIではT2強調像で高信号を呈していた。超音波ガイド下穿刺吸引では淡黄色で漿液性の内容液を認め、リンパ管奇形と診断した。全身麻酔下に病変を一塊に摘出し、病理組織学的にもリンパ管奇形と診断された。術後に神経麻痺は認めず軽快退院し、5年以上経過して再発は認めず経過良好である。

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: Radioisotope (RI) tracers are generally used for preoperative mapping of sentinel lymph node (SLN) and intraoperative detection with a portable γ probe. However, the use of RI has several limitations. Therefore, a method without RI is required for the widespread application of SLN biopsy. The purpose of this study was to evaluate the feasibility of SLN biopsy with a handheld cordless magnetic probe following magnetic resonance lymphography (MRL) using superparamagnetic iron oxide (SPIO) and for clinically N0 early oral cancer. MATERIALS AND METHODS: MRL using SPIO and SLNB with the handheld cordless magnetic probe were performed for 27 patients with clinically N0 early oral cancer. RESULTS: In all 27 patients (100%), SLNs were detected by MRL, and the total and mean number of SLNs were 73 and 2.7, respectively. All SLNs identified by MRL were detectable using the magnetic probe in all patients. CONCLUSIONS: SLNB with handheld cordless magnetic probe following preoperative SLN mapping by MRL using SPIO is feasible, without RI use, for neck management in cases of clinically N0 early oral cancer.

DOI： 10.1016/j.jormas.2022.01.003

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The incidence and risk factors of severe anaphylaxis by intravenous anti-cancer drugs are unclear, whereas those of milder reactions have been reported. STUDY DESIGN: Electronic medical charts of cancer patients who have undergone intravenous chemotherapy between January 2013 and October 2020 in a university hospital were retrospectively reviewed. Non-epithelial malignancies were also included in the analysis. "Severe anaphylaxis" was judged using Brown's criteria: typical presentation of anaphylaxis and one or more of hypoxia, shock, and neurologic compromise. (UMIN000042887). RESULTS: Among 5584 patients (2964 males [53.1%], 2620 females [46.9%], median age 66 years), 88,200 person-day anti-cancer drug administrations were performed intravenously, and 27 severe anaphylaxes were observed. The causative drugs included carboplatin (14 cases), paclitaxel (9 cases), and cisplatin, docetaxel, trastuzumab, and cetuximab (1 case each). The person-based lifetime incidence of severe anaphylaxis for patients who received at least one intravenous chemotherapy was 0.48% (27/5584, 95% confidence interval (CI) 0.30%-0.67%) and the administration-based incidence was 0.031% (27/88,200, 95% CI 0.019%-0.043%). Among 124 patients who received at least 10 carboplatin administrations, 10 patients experienced carboplatin-induced severe anaphylaxis (10/124, 8.1%, 95% CI 3.0%-13.1%). Carboplatin caused severe anaphylaxis after at least 9-min interval since the drip started. Thirteen out of 14 patients experienced carboplatin-induced severe anaphylaxis within a 75-day interval from the previous treatment. Paclitaxel infusion caused severe anaphylaxis after a median of 5 min after the first drip of the day at a life-long incidence of 0.93% (9/968, 95% CI 0.27%-1.59%). CONCLUSION: We elucidated the high-risk settings of chemotherapy-induced severe anaphylaxis.

DOI： 10.1002/cam4.4252

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

ABSTRACT: The purpose of this study was to investigate the anatomical relationship between the lingual nerve and submandibular duct. This study included 1403 patients with submandibular or sublingual gland diseases who underwent intraoral removal of submandibular gland sialoliths, submandibular glands, or sublingual glands. Of all patients, 33 patients underwent bilateral surgeries. All surgeries were performed a single surgeon, and the anatomical relationship between the lingual nerve and submandibular duct was always identified intraoperatively and recorded in the operation recorded. The anatomical relationship was investigated based on the intraoperative findings. The lingual nerve which crosses above the submandibular duct was detected in 8 of 1436 sides (0.6%). There were 4 in the right sides and 4 in the left sides. The lingual nerve below the submandibular gland was seen in 99.4%. Although the lingual nerve crosses above the submandibular duct with a rarer incidence, surgeons should beware of injuring the lingual nerve during intraoral salivary gland surgery.

DOI： 10.1097/SCS.0000000000008168

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: The purpose of this pilot study was to evaluate the usefulness of magnetic resonance lymphography (MRL) with superparamagnetic iron oxide (SPIO) in sentinel lymph node (SLN) mapping of clinically N0 early oral cancer, and to conduct a comparative study of this MRL with CT lymphography (CTL). METHODS: CTL and MRL were performed for SLN mapping before surgery for 20 patients with clinically N0 early oral cancer. The detection rate, number, and location of SLNs in CTL and MRL were evaluated. Furthermore, optimal scanning/imaging timing in MRL was examined. RESULTS: SLNs were detected by CTL in 18 (90%) patients, and the total and mean number of SLN were 35 and 1.8, respectively. All SLNs could be detected 2 min and 3.5-5 min after contrast medium injection. In all patients, SLNs were detected by MRL at 10 min after SPIO injection, and the total and mean number of SLN was 53 and 2.7, respectively. MRL at 30 min after the injection showed additional 18 secondary lymph nodes. CONCLUSION: MRL with SPIO is safe and useful imaging for the detection of SLNs in clinically N0 early oral cancer, and the optimal imaging timing is 10 min after SPIO injection.

DOI： 10.1259/dmfr.20200333

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: The purpose of this study was to reevaluate preoperative computed tomography lymphography (CTL) and enhanced CT images during follow-up to clarify whether SLNs enhanced by CTL were identified accurately before primary surgery with sentinel lymph node biopsy (SLNB) for clinically N0 early oral cancer. METHODS: Thirty two early oral cancer patients without cervical lymph node metastasis were enrolled in this study. To clarify whether SLNs enhanced by CTL were identified accurately before primary surgery with SLNB, we reevaluated preoperative CTL and enhanced CT images during follow-up in all patients. RESULTS: SLNs were detected by CTL in 31 of 32 patients (96.9%). During follow-up after primary surgery with SLNB, 4 of 27 patients without SLN metastasis had occult neck metastasis. Of the 4 patients, only 1 patient with cancer of floor of the mouth had overlooking of SLN, and the overlooking rate of SLN was 3.1%. The overlooked small SLN (2.9 × 3.3 × 3.1 mm) was located at contralateral level IB. The CT numbers before, 2, 5, 10 min after iopamidol injection, were 33 HU, 37 HU, 62 HU, 52 HU, respectively. The CT numbers of overlooked SLN 5 and 10 min after the injection was higher than CT images scanned before the iopamidol injection. CONCLUSIONS: The enhancement of SLNs in CTL images after iopamidol injection should be compared sufficiently with CT images before iopamidol injection to avoid overlooking of SLNs in N0 early oral cancer.

DOI： 10.1007/s11282-020-00442-1

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掲載種別：研究論文（学術雑誌）   出版者・発行元：The Japanese Society of Oral Diagnosis/Oral Medicine  

DOI： 10.15214/jsodom.34.20

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掲載種別：研究論文（学術雑誌）   出版者・発行元：The Japanese Society of Oral Diagnosis/Oral Medicine  

DOI： 10.15214/jsodom.35.29

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: We compared outcomes and toxicities between concurrent retrograde super-selective intra-arterial chemoradiotherapy (IACRT) and concurrent systemic chemoradiotherapy (SCRT) for gingival carcinoma (GC). METHODS: We included 84 consecutive patients who were treated for non-metastatic GC ≥ stage III, from 2006 to 2018, in this retrospective analysis (IACRT group: n = 66; SCRT group: n = 18). RESULTS: The median follow-up time was 24 (range: 1-124) months. The median prescribed dose was 60 (6-70.2) Gy (IACRT: 60 Gy; SCRT: 69 Gy). There were significant differences between the two groups in terms of 3-year overall survival (OS; IACRT: 78.8, 95% confidence interval [CI]: 66.0-87.6; SCRT: 50.4, 95% CI: 27.6-73.0; P = 0.039), progression-free survival (PFS; IACRT: 75.6, 95% CI: 62.7-85.2; SCRT: 42.0, 95% CI: 17.7-70.9; P = 0.028) and local control rates (LC; IACRT: 77.2, 95% CI: 64.2-86.4; SCRT: 42.0, 95% CI: 17.7-70.9; P = 0.015). In univariate analysis, age ≥ 65 years, decreased performance status (PS) and SCRT were significantly associated with worse outcomes (P < 0.05). In multivariate analysis, age ≥ 65 years, clinical stage IV, and SCRT were significantly correlated with a poor OS rate (P < 0.05). Patients with poorer PS had a significantly worse PFS rate. Regarding acute toxicity, 22 IACRT patients had grade 4 lymphopenia, and osteoradionecrosis was the most common late toxicity in both groups. CONCLUSIONS: This is the first report to compare outcomes from IACRT and SCRT among patients with GC. ALL therapy related toxicities were manageable. IACRT is an effective and safe treatment for GC.

DOI： 10.1186/s12885-020-07638-y

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: This study evaluated the usefulness of sentinel lymph node (SLN) biopsy with preoperative computed tomographic lymphography (CTL) and intraoperative indocyanine green (ICG) fluorescence imaging for N0 early tongue cancer. METHODS: Twenty-seven patients with N0 early oral tongue cancer underwent CTL with a 128-slice multi-detector row CT scanner to detect SLN on the day before resection of primary tumor and SLN biopsy under ICG fluorescence guidance. We identified the location and number of SLNs mapped by CTL and evaluated whether CTL-enhanced SLNs could be identified intraoperatively as ICG fluorescent lymph nodes. Prognosis was also evaluated. RESULTS: SLNs were detected by CTL in 26 of 27 patients (96.3%). The total and mean numbers of SLNs were 41 and 1.5, respectively. All SLNs enhanced by CTL could be identified intraoperatively as ICG fluorescent lymph nodes. Two SLNs were found under ICG fluorescent guidance in only one patient without SLN enhanced by CTL. Among the 27 patients, five (18.5%) had SLN with metastasis. Median follow-up was 76 months (range 44-82 months). During follow-up, three of 22 patients without SLN metastasis had occult cervical lymph node metastasis. The 5-year overall survival rate was 100%. CONCLUSION: SLN biopsy with preoperative CTL and intraoperative ICG fluorescence imaging is a feasible and reliable procedure, without radioisotope tracers, for neck management in cases of early tongue cancer.

DOI： 10.1016/j.jcms.2020.01.007

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The objectives of this retrospective study were to evaluate the usefulness of computed tomography lymphography (CTL) and to clarify the optimal timing of CTL in sentinel lymph node (SLN) mapping of clinically N0 early oral cancer. METHODS: Twenty patients with clinically N0 early oral cancer underwent CTL with a 128 multi-detector row CT scanner to detect SLN the day before resection of primary tumor and SLN biopsy with indocyanine green (ICG) fluorescence guidance. CT scanning was performed in the first 10 patients at 2, 5, and 10 min after submucosal injection of iopamidol and in the remaining 10 patients at 2, 3.5, 5, and 10 min after the injection of contrast medium. We evaluated the SLN detection rate at each scan timing and the number and location of SLNs. We evaluated whether CTL-enhanced SLNs could be identified intraoperatively as ICG fluorescent lymph nodes. RESULTS: SLNs were detected by CTL in 19 of the 20 patients (95.0%), and the mean number of SLNs was 2 (range, 1-4). All SLNs were located on the ipsilateral side; 35 of 37 SLNs were located at level I and II, and 2 SLNs were lingual lymph nodes. All SLNs could be detected 2 min and 3.5-5 min after contrast medium injection, and CTL-enhanced SLNs could be identified intraoperatively as fluorescent lymph nodes. CONCLUSIONS: CTL could facilitate the detection of SLNs in early oral cancer, and the optimal timing of CT scanning was at 2 and 5 min after injection of contrast medium.

DOI： 10.1186/s40644-019-0258-9

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: This study aimed to evaluate swallowing function in advanced tongue cancer patients before and after bilateral neck dissection following superselective intra-arterial chemoradiotherapy (CRT). METHODS: A videofluoroscopic swallowing study (VFSS) was used to evaluate swallowing function in 10 patients with advanced tongue cancer before and after bilateral neck dissection. RESULTS: Laryngeal penetration increased in the postoperative VFSS. Temporal analysis comparing two time points revealed that, after surgery, oral transit time increased significantly, but there was no difference in pharyngeal delay time or pharyngeal transit time. Spatial analysis revealed significant decreases after surgery in the maximum distance of upper esophageal sphincter (UES) opening, the maximum distance of hyoid bone movement in both the anterior and superior direction, and the maximum velocity of hyoid bone movement. CONCLUSIONS: Laryngeal penetration and aspiration increased as a result of limited hyoid movement and diminished UES opening after bilateral neck dissection following superselective intra-arterial CRT for advanced tongue cancer.

DOI： 10.1007/s11282-018-0341-0

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The aim of this study was to evaluate the prognostic factors and treatment outcomes of advanced maxillary gingival squamous cell carcinoma (SCC) treated with intra-arterial infusion chemotherapy concurrent with radiotherapy. METHODS: A total of 46 patients were reviewed retrospectively in this study. The treatment schedule comprised intra-arterial chemotherapy (total, 60 mg/m2 docetaxel and 150 mg/m2 cisplatin) and three-dimensional computed tomography based, daily conventional radiotherapy (total, 60 Gy/30 fr) for 6 weeks. RESULTS: The median follow-up period was 40 months (range, 3-110 months). The 3-year overall survival and locoregional control rates for all patients were 64.3% and 84.3%, respectively. The OS rate of the patients with N0-1 was significantly higher than that of the patients with N ≥ 2 (P < .05). No grade 5 toxicities were observed. CONCLUSIONS: Intra-arterial infusion chemotherapy concurrent with radiotherapy was effective for advanced maxillary gingival SCC.

DOI： 10.1002/hed.25607

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

AIM: We aimed to retrospectively investigate the outcomes and pathological effects of retrograde superselective intra-arterial chemoradiotherapy (IACRT) combined with hyperthermia on metastatic lymph nodes of patients with oral squamous cell carcinoma. PATIENTS AND METHODS: Patients with lymph node metastasis from oral cancer were treated with IACRT using cisplatin plus docetaxel combined with hyperthermia prior to surgical removal 8 weeks after completion of IACRT and hyperthermia. The locoregional control and overall survival rates were calculated using the Kaplan-Meier method. RESULTS: A total of 35 patients received the combination therapy of whom 26 received it as definitive treatment and in the rest, it was administered as preoperative treatment. The 5-year locoregional control and overall survivaI rates were 95.6% and 80.2% in the definitive-treatment group, and 100% and 66.6% in the preoperative-treatment group, respectively. CONCLUSION: The combination therapy provided good outcomes in patients with lymph node metastases from advanced oral cancer.

DOI： 10.21873/anticanres.13250

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background and objectives: The aim of present study was to compare the treatment results of daily cisplatin (CDDP), weekly docetaxel (DOC) intra-arterial infusion chemotherapy combined with radiotherapy (DIACRT) regimen and weekly CDDP intra-arterial infusion chemotherapy combined with radiotherapy (WIACRT) for patients with tongue cancer. Materials and Methods: Between January 2007 and December 2016, a total of 11 patients treated with WIACRT and 45 patients treated with DIACRT were enrolled in the present study. In the DIACRT group, 25 patients had late T2, and 20 patients had T3. A total of nine patients had late T2 and two had T3 in WIACRT (p = NS). In DIACRT, the treatment schedule consisted of intra-arterial chemotherapy (DOC, total 60 mg/m²; CDDP, total 150 mg/m²) and daily concurrent radiotherapy (RT) (total, 60 Gy). In WIACRT, the treatment schedule consisted of intra-arterial chemotherapy (CDDP, total 360 mg/m²) and daily concurrent RT (total, 60 Gy). Results: The median follow-up periods for DIACRT and WIACRT were 61 and 66 months, respectively. The five-year local control (LC) and overall survival (OS) rate were 94.5% and 89.6% for the DIACRT group, and 60.6% and 63.6% for the WIACRT group, respectively. The LC rate and OS of the DIACRT group were significantly higher than those of the WIACRT group. As regards toxicities, no treatment-related deaths were observed during the follow-up periods in both groups. Conclusions: DIACRT was found to be feasible and effective for patients with tongue cancer and could become a new treatment modality.

DOI： 10.3390/medicina54040052

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

INTRODUCTION: Although chemoradiotherapy (CRT) for oral squamous cell carcinoma (SCC) has been shown to preserve organ function and improve cosmetic results, site-specific data, especially mandible, are limited. The aim of this study was to evaluate the predictability of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) on response to super-selective intra-arterial CRT for advanced SCC of the mandible. METHODS: Fifteen patients with advanced SCC of the mandible underwent super-selective intra-arterial CRT followed by radical resection. Maximum standardized uptake value (SUVmax) of the mandibular lesion was evaluated with FDG-PET/CT before and after CRT. The SUVmax before and after CRT was defined as pre-SUVmax and post-SUVmax, respectively. The difference between pre- and post-SUVmax was calculated as SUVmax reduction rate to evaluate treatment response of the mandibular lesion. Each SUVmax reduction rate and surgical specimen of the corresponding lesion was analyzed to evaluate an accuracy of the modality for predicting pathological response. RESULTS: The median of pre-SUVmax was significantly lower than that of post-SUVmax (p = 0.001). Of the 15 patients, 6 had a pathological complete response (pCR) and 9 had a non-pCR. Neither pCR patients nor non-pCR patients showed significant difference of the median of SUVmax between pre- and post-CRT (pre-CRT p = 0.099 post-CRT p =0.074). The SUVmax reduction rate in patients with pCR was significantly higher than that with non-pCR (p = 0.002). Receiver operating characteristic analysis revealed that the optimal cut-off point of the reduction rate was 64.7%, with 83% sensitivity and 100% specificity. CONCLUSIONS: These results concluded that SUVmax reduction rate can predict pathological complete response of preoperative super-selective intra-arterial CRT for advanced SCC of the mandible.

DOI： 10.1016/j.jbo.2018.02.001

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier Ltd  

Osteomas are benign, slow-growing osteogenic tumors that consist of compact or cancellous bone. They sometimes arise from the craniomaxillofacial region. Among the peripheral, central, and extraskeletal types, peripheral osteomas arise from the periosteum, usually as unilateral, pedunculated, mushroom-like masses. Here, we report an unusual peripheral osteoma arising from the lateral surface of the mandibular ramus. A 57-year-old woman with a mass at the left mandibular ramus was referred to us. The hard and immobile mass had been growing for 15 years, and she had facial asymmetry. She had no trismus, temporomandibular joint dysfunction, previous facial trauma, or infection. Computed tomography showed a mushroom-like lesion (21.1 × 13.4 × 13.1 mm) arising from the lateral surface of the left mandibular ramus. Clinical diagnosis was peripheral osteoma. The lesion was removed using rotary instruments and a chisel through an intraoral approach under general anesthesia. The lesion had intruded into the masseter muscle. Pathological diagnosis was compact osteoma. The postoperative course was uneventful and there has been no recurrence 1.5 years after surgery.

DOI： 10.1016/j.ajoms.2018.02.004

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Obstructive sialadenitis of the submandibular gland is commonly caused by sialoliths, but more rarely by foreign body-induced sialoliths. Here, we report minimally invasive sialendoscopic removal of fish bone-induced sialoliths in the duct of the submandibular gland. A 43-year-old woman presented with recurrent swelling of the right submandibular gland at other hospital. Computed tomography (CT) showed an 8-mm linear calcification in the posterior part of Wharton's duct. The lesion was deemed difficult to remove and she was followed up. However, because the lesion did not resolve spontaneously within 9 months and chronic sialadenitis symptoms persisted, she was referred to our department for endoscopic removal. CT showed a linear calcification (5.6×1.2×0.8mm) connecting 2 spherical calcifications (2.3×2.1×1.9mm; 1.8×1.4×1.1mm) in the anterior part of Wharton's duct. The patient underwent endoscopic removal of the lesion using a 1.6-mm-diameter sialendoscope under local anesthesia. The specimen contained a fish bone connecting 2 sialoliths. The patient was unaware of the fish-bone injury. After removal, there was no recurrence of submandibular gland swelling during 6 months follow-up.

DOI： 10.1016/j.anl.2017.03.010

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: To evaluate the therapeutic results and rate of organ preservation in patients with squamous cell carcinoma of the tongue treated with retrograde superselective intra-arterial chemoradiotherapy. MATERIALS AND METHODS: Between June 2006 and June 2015, 118 patients with tongue cancer were treated with intra-arterial chemoradiotherapy. Treatment consisted of radiotherapy (total 50-70 Gy) and daily concurrent intra-arterial chemotherapy (docetaxel, total 50-70 mg/m2; cisplatin, total 125-175 mg/m2) for 5-7 weeks. Locoregional control and overall survival rates were calculated by the Kaplan-Meier method. Cox's proportional hazards model was used for both univariate and multivariate analyses. RESULTS: The median follow-up for all patients was 38.5 months (range, 3-129 months). After intra-arterial chemoradiotherapy, primary site complete response was achieved in 113 (95.8%) of 118 cases. Three-year locoregional control and overall survival rates were 80.3% and 81.5%, respectively. Grade 3 or 4 toxicities included neutropenia in 16.1% and mucositis in 87.3%. Grade 3 toxicities included anemia in 12.7%, thrombocytopenia in 3.4%, nausea/vomiting in 3.4%, dermatitis in 45.7%, dysphagia in 74.6%, and fever in 2.5% of patients. Late toxicity consisting of grade 3 osteoradionecrosis of the jaw occurred in 4.2% of patients. On univariate analysis, T stage and overall stage were significantly associated with locoregional control, and N stage and overall stage were significantly associated with overall survival. On multivariate analysis, the only significant predictor of overall survival was overall stage classification. CONCLUSION: Retrograde superselective intra-arterial chemoradiotherapy for tongue cancer provided good overall survival and locoregional control.

DOI： 10.1016/j.oraloncology.2018.02.002

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記述言語：英語  

Intraoral removal of a submandibular gland stone is less invasive than submandibulectomy, with no life-threatening airway complications reported until now. We report a case involving airway obstruction caused by pharyngolaryngeal swelling after intraoral removal of a submandibular gland stone. A 31-year-old man with a left submandibular gland stone underwent intraoral removal of the stone under general anesthesia and was discharged 1 day after surgery. That night, he was transported back to our hospital by ambulance for dyspnea. Because computed tomography showed pharyngolaryngeal swelling, he was intubated and managed by a ventilator. Four days later, the pharyngolaryngeal swelling had mostly resolved and he was extubated and discharged. Surgeons should be vigilant of the potential risk of airway complications following an intraoral approach for submandibular gland stone removal.

DOI： 10.2147/TCRM.S180797

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier Ltd  

Objective As the first step in sialendoscopy, the orifice of the salivary duct is progressively dilated using different sized salivary probes before the sialendoscope is inserted. However, the procedure can be challenging as surgeons may lose the duct orifice and find it difficult to re-identify after each probe change. To overcome this problem, we previously reported a simple technique using a guidewire, but a more cost-effective and time-saving approach is needed. We describe a modified method for simple dilatation of the papilla orifice to introduce the sialendoscope easily into the ductal lumen. Methods A 24 G angiocatheter and a 0.5-mm-diameter salivary or lacrimal probe is prepared preoperatively. The tip of the angiocatheter (3.3–0.7 mm outer diameter) is cut and the probe is threaded into the tapered catheter. On identifying the duct orifice by pressing the salivary gland, they are inserted together into the duct orifice. Only the catheter is advanced into the duct along the probe to dilate the orifice. The orifice can be easily dilated without losing the papilla entrance. After removing the catheter, a sialoendoscope can be inserted easily into the duct. Results We performed more than 100 procedures using this modified method and the sialendoscope could be inserted into the duct within 10 s after probe insertion into the orifice. Conclusion This method offers simple dilatation of the papilla orifice to introduce the sialendoscope.

DOI： 10.1016/j.ajoms.2017.05.003

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：SPRINGER  

Aneurysms of the external carotid artery and its branches are rare, and usually occur in the more superficial branches. Lingual artery (LA) aneurysms are particularly rare, and pseudoaneurysms are associated with trauma, infection, and surgical intervention. Only a few cases of idiopathic LA aneurysms have been reported in the English literature. LA aneurysms can be fatal if they are not recognized and treated. Here, we report a case of bilateral idiopathic aneurysms of the LA identified by three-dimensional (3D) computed tomography angiography (CTA). An 80-year-old man with right tongue cancer (T2N0M0) and left tongue leukoplakia was referred to our department for treatment. He had no previous history of trauma, infection, surgery, or aneurysm in the oral and maxillofacial region. CTA with 3D reconstruction showed right and left aneurysms of the LA, with sizes of 2.4 x 2.3 x 2.1 mm and 3.4 x 3.2 x 2.5 mm, respectively. The patient underwent bilateral partial glossectomy under general anesthesia without intervention for the aneurysms, and the post-operative course was uneventful. A radiological follow-up has been performed regularly for the small unruptured aneurysms.

DOI： 10.1007/s11282-016-0255-7

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.7860/JCDR/2017/29383.10391

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: The aim of this retrospective observational study was to evaluate toxicities, overall survival, and locoregional control in elderly oral squamous cell carcinoma patients who had undergone retrograde intra-arterial chemotherapy combined with radiotherapy. METHODS: Thirty-one elderly patients over 80 years old with oral squamous cell carcinoma were enrolled in present study. The treatment schedule consisted of intra- arterial chemotherapy (docetaxel, total 60 mg/m2; cisplatin, total 150 mg/m2) and daily concurrent radiotherapy (total, 60 Gy) for 6 weeks. RESULTS: The median patient age was 82.5 years old (range, 80-88 years). Of the 31 patients, six (19%) had stage II, 6 (19%) had stage III, 17 (55%) had stage IVA, and 2 (6%) had stage IVB. The median follow-up period for all patients was 37 months (range, 7-86 months). The 3-year overall survival and locoregional control rates were 78% and 81%, respectively. The major acute grade 3 adverse events were oral mucositis in 22 (71%) patients, neutropenia in 16 (52%), and dermatitis in 11 (35%). With respect to late toxicities, 1 patient (3%) developed grade 3 osteoradionecrosis of the jaw. No grade 4 or higher toxicities were observed during the treatment and follow-up periods. CONCLUSIONS: Retrograde intra-arterial chemotherapy combined with radiotherapy was effective in improving overall survival and locoregional control even for elderly patients.

DOI： 10.1186/s13014-017-0847-3

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: To evaluate the therapeutic results and control of occult neck metastasis in patients with T2-4N0 oral tongue squamous cell carcinoma treated with retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy. STUDY DESIGN: Forty-two patients with T2-4N0 tongue cancer (17 with late T2; 13 with T3; and 12 with T4a disease, M0) were treated with intra-arterial chemoradiotherapy. Treatment consisted of retrograde superselective intra-arterial chemotherapy (docetaxel 50-70 mg/m2, cisplatin 125-175 mg/m2) and daily concurrent radiotherapy (50-70 Gy) for 5-7 weeks. RESULTS: The median follow-up for all patients was 46.5 months (range, 8-105 months). Primary-site complete response was achieved in 42 of 42 cases (100%). Three-year overall survival, progression-free survival, and local control rates were 85.0%, 77.8%, and 91.7%, respectively. Delayed neck metastasis was detected in 5 of 42 cases (11.9%). Grade 3 or 4 toxic changes included oral mucositis in 92.9%, neutropenia in 21.4%, and thrombocytopenia in 4.8%. Grade 3 toxicities included anemia in 16.7%, radiation dermatitis in 9.5%, nausea in 4.8%, and fever in 2.4%. CONCLUSIONS: Retrograde superselective intra-arterial chemotherapy for T2-4N0 tongue cancer provided good overall survival and local control rates and was effective for occult neck metastasis.

DOI： 10.1016/j.oooo.2017.02.004

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：CHURCHILL LIVINGSTONE  

Facial nerve paralysis (FNP) after super-selective intra-arterial chemotherapy (SSIAC) is a relatively rare local side effect of SSIAC to the maxillary artery (MA) or the middle meningeal artery (MMA). The incidence and prognosis of FNP after SSIAC in 381 patients with oral cancer (133 with catheterization of the MA, 248 without) was investigated retrospectively. Only three patients (two male and one female) had FNP, for an incidence of 0.8%. All patients with FNP had undergone catheterization of the MA, and the incidence of FNP in this group was 2.3% (3/133). One of the three patients with FNP had paralysis of the third branch of the trigeminal nerve. FNP occurred a mean of 8.7 days (range 5-11 days) after initial SSIAC, and the mean total dose of cisplatin was 55.8 mg (range 42.5-67.2 mg) and of docetaxel was 25.4 mg (range 17.0-33.6 mg). FNP resolved completely a mean of 12.7 months (range 6-19 months) after onset. Because the administration of anticancer agents via the MA or MMA carries a risk of FNP, this information will be useful when obtaining informed consent from patients before treatment.

DOI： 10.1016/j.ijom.2017.01.011

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Squamous cell carcinoma (SCC) of the tongue is the most common oral cancer. Most cases occur on the lateral border of the tongue and only very rarely on the dorsum. We retrospectively investigated the incidence of SCC of the tongue dorsum in our department between April 2006 and March 2015. Of the 368 patients with tongue cancer, only 3 had SCC of the tongue dorsum (incidence, 0.8 %). All patients with advanced cancer of the tongue dorsum underwent superselective intra-arterial chemoradiotherapy for organ preservation. We discuss the present findings in relation to past case reports and series in the English language literature as well as discuss treatments for SCC of the tongue dorsum.

DOI： 10.1007/s12070-016-0979-z

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：CHURCHILL LIVINGSTONE  

DOI： 10.1016/j.bjoms.2016.07.032

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE INC  

Objective. To investigate whether 2-[(18) F] fluoro-2-deoxy-D-glucose (FDG) uptake of primary tumor in oral squamous cell carcinoma (OSCC) could predict prognosis.
Study Design. Sixty-nine patients with OSCC who underwent retrograde superselective intra-arterial chemoradiotherapy were recruited and underwent dual-time-point FDG positron emission tomography twice, before treatment and 4 weeks after treatment. FDG uptake was defined as the standardized uptake value (SUVmax). The retention index (RI) and the percent change in SUV (% change SUV), derived from the dual-time-point scan, were calculated.
Results. On univariate analysis, patients with high pre-SUV, RI, and percent change SUV values had significantly worse overall survival and disease-free survival compared with patients with low values. On multivariate analysis, high pre-RI (&gt;= 20.6%) and high percent change SUV (&gt;= 60.0%) (delayed-image) were associated with significantly worse overall survival. High pre-SUV (&gt;= 9.6) (delayed-image) and high pre-RI (&gt;= 20.6%) were associated with significantly shorter disease-free survival.
Conclusions. Dual-time-point FDG positron emission tomography in OSCC provided prognostic information and predicted patient outcome.

DOI： 10.1016/j.oooo.2015.10.018

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER IRELAND LTD  

Purpose: To evaluate the therapeutic results and rate of organ preservation in patients with stage III or IV oral cancer treated with retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy.
Materials and methods: One hundred and twelve patients with stage III and IV oral squamous cell carcinoma underwent intra-arterial chemoradiotherapy. Catheterization from the superficial temporal and occipital arteries was performed. Treatment consisted of superselective intra-arterial chemotherapy (docetaxel, total 60 mg/m(2), cisplatin, total 150 mg/m(2)) and daily concurrent radiotherapy (total of 60 Gy) for 6 weeks.
Results: The median follow-up for all patients was 46.2 months (range, 10-76 months). After intra-arterial chemoradiotherapy, primary site complete response was achieved in 98 (87.5%) of 112 cases. Five-year survival and local control rates were 71.3% and 79.3%, respectively. Grade 3 or 4 toxicities included mucositis in 92.0%, neutropenia in 30.4%, dermatitis in 28.6%, anemia in 26.8%, and thrombocytopenia in 7.1% of patients. Grade 3 toxicities included dysphagia in 72.3%, nausea/vomiting in 21.4%, fever in 8.0%, and renal failure in 0.9% of patients.
Conclusion: Retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy for stage III and IV oral cancer provided good overall survival and local control. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.radonc.2014.03.005

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：URBAN & VOGEL  

Purpose. The aim of this study was to review the efficacy and toxicity of radiation therapy with concurrent retrograde superselective intra-arterial chemotherapy in the treatment of gingival carcinoma.
Methods and materials. In all, 34 patients (21 men and 13 women) with squamous cell carcinoma of the gingiva underwent radiation therapy with concurrent retrograde superselective intra-arterial chemotherapy. Treatment consisted of daily external irradiation and concurrent retrograde superselective intra-arterial infusion with cisplatin and docetaxel. A median total dose of 60 Gy in 30 fractions was delivered to tumors.
Results. Of the 34 patients, 29 (85 %) achieved a complete response (CR) and 5 had residual tumors. Of the 29 patients with a CR, 2 had local recurrences and 1 had distant metastasis 1-15 months after treatment. Twenty-six of the 36 patients had survived at a median follow-up time of 36 months (range 12-79 months); 4 died of cancer and 4 died of non-cancer-related causes. At both 3 and 5 years after treatment, the overall survival rates were 79 % and the cause-specific survival rates were 85 %. Osteoradionecrosis of the mandibular bone only developed in 1 patient after treatment.
Conclusion. Radiation therapy with concurrent retrograde superselective intra-arterial chemotherapy was effective and safe in the treatment of gingival carcinoma. This treatment may be a promising curative and organ-preserving treatment option for gingival carcinoma.

DOI： 10.1007/s00066-013-0468-1

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/j.anl.2013.07.001

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCI LTD  

Paragangliomas are highly vascular tumors that arise from chief cells in extra-adrenal paraganglia of the autonomic nervous system. Vagal paragangliomas occur along the vagal nerve, usually located in the rostral portion of the vagus nerve in the vicinity of the gangliom nodosum. Actively functional vagal paragangliomas are rare. We report a patient with functioning vagal paraganglioma located in the infrahyoid carotid sheath. The patient had no history of hypertension and catecholamines were not measured before surgery. The findings of diagnostic imaging workup, including computed tomography, ultrasonography and magnetic resonance, were suggestive of paraganglioma. The blood pressure and pulse rates increased sharply intraoperatively during tumor manipulation, together with spikes in noradrenaline and dopamine. The tumor was removed with successful preservation of the vagus nerve trunk. The blood catecholamine levels returned to normal immediately after surgery. Head and neck surgeons should be aware of occult functioning paragangliomas and patients with such tumors should undergo full hormonal assessment. (C) 2012 Elsevier Ireland Ltd. All rights reserved.

DOI： 10.1016/j.anl.2012.05.007

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

It is recognized that the branches of the external carotid artery (ECA) can show variation, but the presence of a thyrolinguofacial trunk is extremely rare and always originates from the ECA. We report a case of the thyrolinguofacial trunk arising from the carotid bifurcation (CB) on the left side in a 76-year-old man with advanced tongue cancer, as revealed by three-dimensional computed tomography angiography for vascular mapping of the carotid vessels prior to superselective intra-arterial catheterization. The thyrolinguofacial trunk arose 1.6 mm below the CB from the anterior surface of the left CB. The inner diameter of the thyrolinguofacial trunk at origin was 4.4 mm and the angle between the thyrolinguofacial trunk and CB was 128. After a 1.7-mm course, the trunk divided into the superior thyroid artery and a linguofacial trunk, the inner diameters of which were 1.5 and 3.4 mm, respectively, at origin. The angle between the two arteries was 88. After a 9.8-mm course from the bifurcation, the linguofacial trunk divided into the lingual artery and facial artery, the inner diameters of which were 1.8 and 1.9 mm, respectively, at origin. The angle between the two arteries was 61. It is important to recognize such an anatomic variation of the branches of the ECA prior to superselective intra-arterial catheterization or microsurgical reconstruction for head and neck cancer. © 2012 Springer-Verlag.

DOI： 10.1007/s00276-012-1004-1

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE BV  

IL-1 and TNF-alpha are thought to be important bone-remodeling regulators. However, mice lacking either them or their receptors reportedly grow healthily. Here, we examined the roles of IL-1 and TNF-alpha in bone. Although a significant IL-1 level was detected in the tibia of non-stimulated wild-type (WT) mice, no significant physicochemical, morphological, or histological defects were detected in the tibias in mice lacking IL-1 (both alpha and beta types) (IL-1KO) or lacking both IL-1 and TNF-alpha (IL-1/TNF-alpha KO). Injection of sub-lethal doses of lipopolysaccharide (LPS) into WT mice induced a transient hypocalcemia, increased IL-1 (in the plasma and markedly in the tibia), and increased TNF-alpha (markedly in the plasma, but only slightly in the tibia). LPS-induced hypocalcemia was modest in IL-1KO mice, and not detected in IL-1/TNF alpha KO mice. IL-1 alpha (but not TNF alpha) induced hypocalcemia in both WT and IL-1KO mice. In both WT and IL-1KO mice treated with clodronate (osteoclast inhibitor), the LPS-induced hypocalcemia was markedly augmented. Nifedipine (inhibitor of both voltage-activated and capacitative Ca2+-entry) reduced the LPS-induced hypocalcemia. These results suggest that in mice: (i) IL-1 and TNF-alpha may contribute little to physiological bone-formation, and (ii) a time-lag between IL-1- and TNF-alpha-stimulated Ca2+-entry into cells throughout the body from the circulation and IL-1-stimulated Ca2+-release from the bone may cause the observed transient LPS-induced hypocalcemia. Thus, the prime role of bone IL-1 may reside in the supply of Ca2+ from the bone to cells throughout the body when the need is urgent. (C) 2012 Elsevier B.V. All rights reserved.

DOI： 10.1016/j.intimp.2012.10.001

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE INC  

Purpose: To evaluate the therapeutic results and histopathological effects of treatment with thermochemoradiation therapy using superselective intra-arterial infusion via the superficial temporal and occipital arteries for N3 cervical lymph node metastases of advanced oral cancer.
Methods and Materials: Between April 2005 and September 2010, 9 patients with N3 cervical lymph node metastases of oral squamous cell carcinoma underwent thermochemoradiation therapy using superselective intra-arterial infusion with docetaxel (DOC) and cisplatin (CDDP). Treatment consisted of hyperthermia (2-8 sessions), superselective intra-arterial infusions (DOC, total 40-60 mg/m(2); CDDP, total 100-150 mg/m(2)) and daily concurrent radiation therapy (total, 40-60 Gy) for 4-6 weeks.
Results: Six of 9 patients underwent neck dissection 5-8 weeks after treatment. In four of these 6 patients, all metastatic lymph nodes, including those at N3, were grade 3 (non-viable tumor cells present) or grade 4 (no tumor cells present) tumors, as classified by the system by Shimosato et al (Shimosato et al Jpn J Clin Oncol 1971; 1:19-35). In 2 of these 6 patients, the metastatic lymph nodes were grade 2b (destruction of tumor structures with a small amount of residual viable tumor cells). The other 3 patients did not undergo neck dissection due to distant metastasis after completion of thermochemoradiation therapy (n=2) and refusal (n=1). The patient who refused neck dissection underwent biopsy of the N3 lymph node and primary sites and showed grade 3 cancer. During follow-up, 5 patients were alive without disease, and 4 patients died due to pulmonary metastasis (n=3) and noncancer-related causes (n=1). Five-year survival and locoregional control rates were 51% and 88%, respectively.
Conclusions: Thermochemoradiation therapy using intra-arterial infusion provided good histopathologic effects and locoregional control rates in patients with N3 metastatic lymph nodes. However, patients with N3 metastatic lymph nodes experienced a high rate of distant metastases. (C) 2012 Elsevier Inc.

DOI： 10.1016/j.ijrobp.2012.02.057

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(一社)日本頭頸部癌学会  

頭頸部再建手術においては、切除側と再建側がお互いの要望するところを熟知し、協調性をもって計画的にチーム医療を実施することが大事である。切除側の注意点には、特に原発巣切除断端の良好な血流ならびに健常組織の保存、血管吻合の候補となる血管の愛護的操作と保存がある。一方再建側の注意点には、最適なvolumeを持ち血流の安定した皮弁の採取、術後機能を最大限に引き出し、かつ合併症を回避すべく工夫を施した再建が挙げられる。実際の手術が時間の点でも、人員配置の点でも継ぎ目なく有効に行われるためには、切除、再建の両者が要求する細かい部分までをよく熟知し、お互いが協調していく体制が必須である。(著者抄録)

DOI： 10.5981/jjhnc.35.1

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記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1016/S0925-4439(02)00217-X

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：ELSEVIER SCIENCE BV  

Histamine is involved in the development of gastric lesions. To examine the contribution of the histamine-forming enzyme, histidine decarboxylase, to drug-induced gastric lesions, we compared the effects of aspirin, indomethacin and dexamethasone on histidine decarboxylase activity in mice. Administration of these drugs, orally or intraperitoneally, elevated histidine decarboxylase activity in the stomach but not in the liver, lung or spleen, dexamethasone being the most potent. In contrast, acetaminophen (a non-ulcerogenic drug) was inactive. These results and our previously reported findings (elevation of histidine decarboxylase activity by lipopolysaccharide, interleukin-1 and tumour necrosis factor, and by different types of stress) suggest that an elevation of histidine decarboxylase activity in the stomach may be a common feature of the responses to ulcerogenic stimuli. The possible participation of histidine decarboxylase in gastric lesions is discussed on the basis of the known actions of histamine, our findings and the effect of histamine H, receptor antagonists on histidine decarboxylase activity. (C) 2002 Elsevier Science B.V. All rights reserved.

DOI： 10.1016/S0014-2999(02)02878-9

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：AMER SOC MICROBIOLOGY  

Within a few hours of its injection into mice, lipopolysaccharide (LPS) induces hypoglycemia and the production of various cytokines. We previously found that interleukin-1alpha (IL-1alpha), IL-1beta, and tumor necrosis factor alpha (TNF-alpha) induce hypoglycemia and that the minimum effective dose of IL-1alpha or IL-1beta is about 1/1,000 that of TNF-alpha. In the present study, we examined the contribution made by IL-1 to the hypoglycemic action of LPS. Nine other cytokines tested were all inactive at inducing hypoglycemia. LPS produced hypoglycemia in mice deficient in either IL-1alpha or IL-1beta but not in mice deficient in both cytokines (IL-1alpha and -1beta knockout [IL-1alpha/beta KO] mice). IL-1alpha, IL-1beta, and TNF-alpha induced hypoglycemia in IL-1alpha/beta KO mice, as they did in normal control mice. The LPS-induced elevation of serum cortisol was weaker in IL-1alpha/beta KO mice than in control mice, and, in the latter, serum cortisol was markedly raised while blood glucose was declining. IL-1alpha decreased blood glucose both in NOD mice (which have impaired insulin production) and in KK-Ay mice (insulin resistant). These results suggest that (i) cortisol may not be involved in mediating the resistance of IL-1alpha/beta KO mice to the hypoglycemic action of LPS, (ii) as a mediator, IL-1 is a prerequisite for the hypoglycemic action of LPS, (iii) IL-1alpha and IL-1beta perform mutual compensation, and (iv) IL-1 plays a role as the primary stimulator of the many anabolic reactions required for the elaboration of immune responses against infection.

DOI： 10.1128/CDLI.9.6.1307-1312.2002

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

DOI： 10.1054/jcms.2000.0189

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© 2019 Wiley Periodicals, Inc. Background: The aim of this study was to evaluate the prognostic factors and treatment outcomes of advanced maxillary gingival squamous cell carcinoma (SCC) treated with intra-arterial infusion chemotherapy concurrent with radiotherapy. Methods: A total of 46 patients were reviewed retrospectively in this study. The treatment schedule comprised intra-arterial chemotherapy (total, 60 mg/m2 docetaxel and 150 mg/m2 cisplatin) and three-dimensional computed tomography based, daily conventional radiotherapy (total, 60 Gy/30 fr) for 6 weeks. Results: The median follow-up period was 40 months (range, 3-110 months). The 3-year overall survival and locoregional control rates for all patients were 64.3% and 84.3%, respectively. The OS rate of the patients with N0-1 was significantly higher than that of the patients with N ≥ 2 (P &lt;.05). No grade 5 toxicities were observed. Conclusions: Intra-arterial infusion chemotherapy concurrent with radiotherapy was effective for advanced maxillary gingival SCC.

DOI： 10.1002/hed.25607

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記述言語：日本語   出版者・発行元：(一社)日本口腔腫瘍学会  

頭頸部悪性腫瘍において遠隔転移は最も予後に影響する因子である。今回、われわれは肝門部リンパ節転移と腹膜播種性転移に至った。まれな下顎歯肉癌症例を経験した。患者は69歳、男性。右側下顎歯肉扁平上皮癌(T4aN3M0)に対し超選択的動注化学放射線治療を施行した。治療後1ヵ月でのFDG-PET/CT検査で肝門部リンパ節腫大を認めた。その後、腹水を伴う腹膜播種性転移を認めたため入院したが急速に全身状態が悪化し多臓器不全にて死亡した。病理解剖検査の結果、肝門部リンパ節腫大と腹膜播種性転移はいずれも右側下顎歯肉癌の転移であると診断された。(著者抄録)

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© 2019 Novin Medical Radiation Institute. All rights reserved. Background: The aim of this retrospective study was to evaluate the therapeutic outcomes and organ preservation in patients with squamous cell carcinoma of the buccal mucosa treated with radiotherapy and retrograde superselective intra-arterial chemotherapy. Materials and Methods: Between April 2006 and March 2016, 28 patients (3 with stage II; 8 with stage III; and 17 with stage IV) with squamous cell carcinoma of the buccal mucosa were treated with definitive intra-arterial chemoradiotherapy. The median follow-up for all patients was 39months (range, 4-123months). Catheterization of the tumor feeding arteries from the superficial temporal and/or occipital arteries was performed. Treatment consisted of radiotherapy (total 50-70 Gy) and daily concurrent superselective intra-arterial chemotherapy (docetaxel, 50-70 mg/m2, cisplatin, total 125-175 mg/ m2) for 5-7 weeks. Results: After intra-arterial chemoradiotherapy, primary site complete response was achieved in 25 (89.3%) of 28 cases. Three-year local control and overall survival rates were 82.1% and 85.4%, respectively. Grade 3 or 4 toxicities included mucositis in 96.4%, and dermatitis in 28.6% of patients. Grade 3 toxicities included dysphagia in 35.7%, neutropenia in 28.6%, anemia in 10.7%, and fever in 7.1% of patients. Conclusion: Retrograde superselective intra-arterial chemoradiotherapy for squamous cell carcinoma of the buccal mucosa provided good local control and overall survival.

DOI： 10.18869/acadpub.ijrr.17.2.283

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記述言語：日本語   出版者・発行元：(一社)日本口腔診断学会  

症例は70歳代男性で、右側口底部の腫瘤を自覚したが放置していた。その後に腫瘤の増大を認めたため近医歯科を受診した。口底腫瘍と診断され、某総合病院歯科口腔外科を紹介され生検が行われた。扁平上皮癌と診断されたため、加療目的に当科を紹介受診となった。画像所見より正中よりやや右側の口底癌の左側耳下腺リンパ節への転移が疑われたが、腫瘍がT1であり、健側の表在リンパ節であることより、リンパ節内に生じたWarthin腫瘍の可能性も考えられた。そのため、センチネルリンパ節生検を行った。病理組織学的所見では、耳下腺リンパ節は円柱状細胞と立方状細胞の二層性配列を示す上皮が管状、嚢胞状に増生し、間質には濾胞形成を伴うリンパ球浸潤を認め、Warthin腫瘍と診断した。センチネルリンパ節に転移を認めなかったため、経過観察を行い、術後11ヵ月経過するが無病生存中である。

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2018&ichushi_jid=J02383&link_issn=&doc_id=20181105220004&doc_link_id=10.15214%2Fjsodom.31.211&url=https%3A%2F%2Fdoi.org%2F10.15214%2Fjsodom.31.211&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

担当区分：筆頭著者   記述言語：日本語   出版者・発行元：横浜市立大学医学会  

正中の進行上顎歯肉癌で鼻部に至る場合の拡大手術は顔面皮膚欠損及び口腔機能の障害を伴い、quality of lifeの低下を引き起こす。今回われわれは上唇から鼻部に及ぶ局所進行正中上顎歯肉癌に対し4経路を用いた超選択的動注化学放射線治療を施行した。患者36歳、男性。上顎歯肉癌(T4aN1M0)。患者は手術拒否であったため、4経路を使用した逆行性超選択的動注化学放射線治療(照射total 70Gy、docetaxelをtotal 70mg/m2、cisplatinをtotal 175mg/m2)を施行した。加えて、頸部リンパ節転移に対するハイパーサーミアを週1回、計6回行なった。治療後、腫瘍原発の治療効果判定はCRを得たため原発切除を回避した。治療後58ヵ月経過し現在まで再発・転移なく経過している。(著者抄録)

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記述言語：日本語   出版者・発行元：(一社)日本口腔診断学会  

症例は50歳代男性で、右側顎下部の腫脹が食事時に生じたため、近耳鼻咽喉科を受診した。右側顎下腺唾石症と診断され、顎下腺摘出術が必要と説明されたため、唾液腺内視鏡での低侵襲な治療を希望して当科受診となった。唾石は顎下腺腺体上部に存在していたため、内視鏡下での唾石摘出が困難であった場合には、内視鏡をガイドにした口内法で唾石の摘出を行い、それが困難であった場合には顎下腺摘出術が必要になることを患者に説明し、同意を得たうえで全身麻酔での手術を計画した。細い唾液腺内視鏡は腺体内まで挿入可能であり、主導管から2分岐目に唾石を確認できた。唾液腺内視鏡のワーキングチャンネルからバスケット鉗子を挿入し唾石を把持した。唾石が類円形であったこともあり、開口部を切開せずに摘出可能であった。術後2年3ヵ月経過するも顎下腺の腫脹や唾仙痛は認めず、経過良好である。

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記述言語：日本語   出版者・発行元：(一社)日本口腔診断学会  

70歳代女。右側顎下部の腫脹を主訴とした。CTで右側顎下腺の腺体中央部に3.1×2.8×2.6mmの唾石を認め、右側顎下腺腺体内唾石症と診断した。唾石は腺体中央部に存在していたが、大きさが約3mm程度であり、CT値が低いため粉砕が容易にできる可能性が高く、更に顎下腺移行部から唾石まで唾液の貯留が描出されていたことから、内視鏡手術が可能と判断した。受診当日に外来局所麻酔下に内視鏡下唾石摘出術を施行し、手術時間は35分と短く、術後経過は良好であった。術後1年4ヵ月の現在、再発は認めていない。

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記述言語：日本語   出版者・発行元：(一社)日本口腔診断学会  

症例は10歳男児で、食事時の右側顎下部の腫脹を認めた。CTにて右側顎下腺唾石症と診断した。右側口底後方粘膜に自壊部を認めたが、排膿は認めなかった。嘔吐反射が強く口底部の触診は困難であった。右側舌下小丘部からの唾液の流出は認めなかった。CTでは右側顎下腺移行部に56×56×42mmの硬組織像を認めた。臨床所見から、急性化膿性顎下腺炎により口底粘膜から排膿ととともに唾石が排出された後に、自壊部から顎下腺移行部に生じた肉芽組織が導管を閉塞させていると考え、閉塞性顎下腺炎と診断した。抗菌薬による消炎を行い、唾液腺内視鏡による閉塞物の摘出術を計画した。全身麻酔下で内視鏡手術を行った。外来経過観察時の唾液の流出は良好となり、以後、顎下腺の腫脹は生じていない。

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記述言語：日本語  

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記述言語：日本語   出版者・発行元：(一社)日本口腔診断学会  

60代男性。左側耳下腺導管内唾石症と診断され、内視鏡下唾石摘出術を行う予定であった。しかし、初診から3週間後、左側頬部の腫脹や硬結の増大を認め、その中央部は自潰していた。自潰部からは排膿を認めたため、抗菌薬による消炎処置を継続したところ、1週間後に唾石と思われる石灰化物2個が自潰部から自然排出した。エコーでも唾石の残存がなく、1ヵ月経過後には左側頬部の腫脹は消失し、自潰部は完全に閉鎖していた。本例は、唾石に感染を併発したことで膿瘍が形成され、導管外の膿瘍腔へ唾石が逸脱し、皮膚瘻孔からの排膿とともに唾石が自然排出されたと考えられた。

DOI： 10.15214/jsodom.30.193

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記述言語：日本語   出版者・発行元：(一社)日本口腔診断学会  

7歳男児。左顎下部の腫脹を主訴に前医を受診し、両側顎下腺導管移行部唾石と診断された。唾石のサイズが小さいことから、自然排出を期待して経過観察された。10ヵ月後に前医を再診し、唾石の位置と大きさに変化がみられなかったため顎下腺摘出術を提案されたが、本人と家族は内視鏡による低侵襲な治療を希望し、当科に紹介された。左側の唾石は1.7×1.7×1.1mm大で、初診2ヵ月後に開口部付近まで移動し、外来局所麻酔下に容易に摘出することができた。右側は3.0×1.6×1.5mm大で、初診8ヵ月後に開口部付近まで移動し、外来で容易に摘出することができた。

DOI： 10.15214/jsodom.30.223

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記述言語：日本語   出版者・発行元：(公社)日本口腔外科学会  

DOI： 10.5794/jjoms.63.178

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記述言語：日本語   出版者・発行元：(公社)日本口腔外科学会  

逆行性超選択的動注化学放射線療法を施行した口腔癌160例(男性100名、女性60名)を対象とし、易感染性状態を示す疾患を有する患者は24例であった。カテーテル先端の細菌培養検査では67例(41.9%)が陽性で、最も多く検出した菌種はStaphylococcus属であった。検出菌の多くが皮膚常在菌であった。3例にグラム陰性桿菌であるEnterobacter属の菌を検出し、そのうち2例はカテーテル関連血流感染症(CRBSI)発生例であった。血液培養検査は50例で行い、そのうち20例(12.5%)が陽性で、菌血症の状態を呈した。12例はカテーテル培養と血液培養検査の双方が陽性となり、そのうち7例(4.4%)で同一菌を同定したためCRBSIと診断した。160例における平均カテーテル留置日数は52.7日で、CRBSI発生率は1000×カテーテル留置口数あたり0.83であった。CRBSI発生に関与する因子について単変量解析を用いて比較検討し、年齢およびカテーテル留置日数で有意差を認めた。

DOI： 10.5794/jjoms.63.178

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記述言語：日本語   出版者・発行元：(公社)日本口腔外科学会  

症例は64歳女性で、食事時に左側頬部の腫脹を認めた。CTにて左側耳下腺唾石と診断され、その後も左側頬部の腫脹を繰り返した。CTでは左側咬筋前縁より後方外側の耳下腺導管内に3.4×2.5×2.0mm大の類円形の唾石を認め、開口部と腺体のほぼ中央に位置した。左側耳下腺導管内唾石と診断し、全身麻酔下にて内視鏡下唾石摘出術を施行した。手術翌日に退院し、その後の唾液の流出は良好で耳下腺の腫脹や唾石の再発は認めていない。

DOI： 10.5794/jjoms.63.153

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記述言語：日本語   出版者・発行元：(一社)日本口腔診断学会  

40歳代女性。左側頬部の腫脹と唾仙痛を主訴に近医耳鼻咽喉科を受診し、CTにて左側耳下腺腺体内唾石と診断され、手術目的に紹介となった。受診時、CTで唾石は1.7×1.4×1.0mmと比較的小さかったため、局所麻酔下に内視鏡下唾石摘出術を行った。術後経過は良好で、現在まで耳下腺の腫脹や唾石の再発は認められていない。

DOI： 10.15214/jsodom.30.52

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記述言語：日本語   出版者・発行元：(公社)日本口腔外科学会  

11歳女児。他院にて左側顎下腺唾石と診断され顎下腺摘出術の説明を受けたが、内視鏡による低侵襲治療を希望し当科紹介受診となった。初診時、顎下部に腫脹を認めたため抗菌薬の投与にて消炎をはかり、全身麻酔下での唾液腺内視鏡を用いた唾石摘出術を予定した。左側導管開口部に24Gの血管留置針の外筒をつけた細いブジーを挿入し、その後外筒を深く挿入することで開口部の拡大を図った。開口部から導管内に直径1.6mmの唾液腺内視鏡を挿入し、イリゲーションチャンネルから生理食塩水を注入することで導管を拡大して視野を確保した。内視鏡を導管深部に挿入すると移行部に唾石を確認することができ、バスケット鉗子を挿入して唾石を把持・牽引し、拡大した開口部から摘出した。手術時間は8分で、出血は認めなかった。手術翌日に退院となり、再発なく経過良好である。

DOI： 10.5794/jjoms.62.575

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記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

口腔内に初発症状を呈する節外性悪性リンパ腫(ML)は非常にまれである。われわれは2005年1月から2015年12月までの間に当科を受診した口腔悪性腫瘍患者1,081例のうち口腔内に初発症状を呈した節外性ML10例について臨床的特徴を検討した。男性は7例、女性は3例であり、年齢は8〜82歳(平均年齢:64.4歳)であった。8例が歯肉に生じており、その他の部位としては口底と頬粘膜に生じていた。病理診断ではびまん性大細胞型B細胞リンパ腫が7例を占めていた。Ann Arbor分類ではステージI、II、III、IVはそれぞれ、3、1、2、4例であった。さらに、本邦で報告された口腔内に初発症状を呈する節外性ML115例を検討した。口腔病変を診断する際には、MLが口腔内に発生しうることを念頭に置くべきである。(著者抄録)

DOI： 10.5981/jjhnc.42.339

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記述言語：日本語   掲載種別：記事・総説・解説・論説等（学術雑誌）   出版者・発行元：(一社)日本口腔腫瘍学会  

口腔癌N0症例のうち20〜30%の頻度で後発頸部リンパ節転移が生じるが、経過観察するか予防的頸部郭清術を行うかといった頸部に対する治療方針に統一した見解は得られていない。様々な画像診断が行われるにも関わらず頸部リンパ節転移を正確に診断することは困難であるため、色素法、ラジオアイソトープ(RI)法、あるいはその両者を用いたセンチネルリンパ節生検(SLNB)が近年行われるようになってきた。しかし、RI法を用いたSLNBはどの施設でも行えるわけではない。そのため、RIを用いない方法として、口腔癌N0症例に対するインドシアニングリーン(ICG)蛍光法を用いたSLNBについて報告する。(著者抄録)

DOI： 10.5843/jsot.28.65

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記述言語：日本語   出版者・発行元：(一社)日本口腔腫瘍学会  

われわれは頸部リンパ節転移を有する進行口腔癌に対し逆行性超選択的動注化学放射線療法(以下動注CCRT)を施行し、転移リンパ節に対する治療効果につき検討したので報告する。対象は2007年2月から2010年11月までに進行口腔癌(T2-4bN1、2M0)に対し根治的動注CCRTを施行し、原発巣がCRのため原発は手術回避、頸部郭清術のみを行った20症例である。N分類はN1:5例、N2b:10例、N2c:5例であった。治療は浅側頭動脈、後頭動脈より逆行性に腫瘍の栄養動脈に動注カテーテルを留置し、動注CCRTを5-6週間(docetaxel:total 50-60mg/m2、cisplatin:total 125-150mg/m2、RT:total 50-60Gy)施行した。治療終了後5から8週に頸部郭清術を行い、摘出したリンパ節の病理組織学的検索を行ったところ、転移リンパ節がpCRであったのは20例中13例(65%)であった。その後経過観察中に頸部再発を認めたのは2例(10%)であった。20例中13例は生存、7例が死亡(6例が遠隔転移、1例が頸部の非制御)した。以上より動注CCRTは、口腔癌の頸部転移リンパ節にも有用であることが示唆された。(著者抄録)

DOI： 10.5843/jsot.28.27

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記述言語：日本語   出版者・発行元：(一社)日本口腔腫瘍学会  

われわれは頸部リンパ節転移を有する進行口腔癌に対し逆行性超選択的動注化学放射線療法(以下動注CCRT)を施行し、転移リンパ節に対する治療効果につき検討したので報告する。対象は2007年2月から2010年11月までに進行口腔癌(T2-4bN1、2M0)に対し根治的動注CCRTを施行し、原発巣がCRのため原発は手術回避、頸部郭清術のみを行った20症例である。N分類はN1:5例、N2b:10例、N2c:5例であった。治療は浅側頭動脈、後頭動脈より逆行性に腫瘍の栄養動脈に動注カテーテルを留置し、動注CCRTを5-6週間(docetaxel:total 50-60mg/m2、cisplatin:total 125-150mg/m2、RT:total 50-60Gy)施行した。治療終了後5から8週に頸部郭清術を行い、摘出したリンパ節の病理組織学的検索を行ったところ、転移リンパ節がpCRであったのは20例中13例(65%)であった。その後経過観察中に頸部再発を認めたのは2例(10%)であった。20例中13例は生存、7例が死亡(6例が遠隔転移、1例が頸部の非制御)した。以上より動注CCRTは、口腔癌の頸部転移リンパ節にも有用であることが示唆された。(著者抄録)

DOI： 10.5843/jsot.28.27

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記述言語：日本語   出版者・発行元：日本頭頸部癌学会  

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：AMER SOC CLINICAL ONCOLOGY  

DOI： 10.1200/JCO.2016.34.15_suppl.6032

Web of Science

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記述言語：日本語   出版者・発行元：日本頭頸部癌学会  

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記述言語：日本語   出版者・発行元：日本頭頸部癌学会  

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J-GLOBAL

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記述言語：日本語   出版者・発行元：日本頭頸部癌学会  

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記述言語：日本語   出版者・発行元：日本頭頸部癌学会  

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記述言語：日本語  

J-GLOBAL

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J-GLOBAL

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J-GLOBAL

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J-GLOBAL

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J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本口腔腫瘍学会  

われわれは口腔癌患者の上部消化管領域における同時性重複癌のスクリーニングとしての上部消化管内視鏡検査(GIF)とFDG-PET/CTについて比較したので報告する。2006年9月から2009年8月までの3年間に口腔癌患者133例が治療前にGIFとFDG-PET/CTを受けた。GIFで5人の患者(3.8%)に食道や胃の同時性重複癌が発見され、それらは全例早期癌であった。しかし、FDG-PET/CTでは1人のみしか同時性重複癌(食道癌)が発見できず、その感度と特異度はそれぞれ20%と100%であった。本研究は口腔癌患者の上部消化管領域における治療前スクリーニングとしてのGIFの有用性と必要性を示した。(著者抄録)

DOI： 10.5843/jsot.26.31

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J02382&link_issn=&doc_id=20140630260001&doc_link_id=%2Fdy8ortum%2F2014%2F002602%2F001%2F0031-0036%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdy8ortum%2F2014%2F002602%2F001%2F0031-0036%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

J-GLOBAL

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記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

進行口腔癌に対する逆行性超選択的動注化学療法は、放射線療法との連日同時併用が可能となることから高い抗腫瘍効果が期待できる。今回われわれは、上顎歯肉扁平上皮癌(T3、4)の一次症例17例に対して根治的逆行性超選択的動注化学放射線療法を施行し、治療効果について検討した。治療は逆行性超選択的動注化学放射線療法(DOC:60mg/m2、CDDP:150mg/m2、60Gy)を6週間行った。治療終了4週間後に画像検索および原発部位の生検にて治療効果判定を行ったところ、CRが14例(82.4%)、PRが3例(17.6%)であった。CR症例14例については、経過観察中に1例に局所再発、1例に後発頸部リンパ節転移および肺転移を認めた。全17例中の4例が死亡し、Kaplan-Meier法による2年累積局所制御率は76.5%、2年累積生存率は81.4%であった。(著者抄録)

DOI： 10.5981/jjhnc.39.443

J-GLOBAL

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記述言語：日本語   出版者・発行元：日本頭頸部癌学会  

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J-GLOBAL

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：AMER SOC CLINICAL ONCOLOGY  

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記述言語：日本語   出版者・発行元：(一社)日本口腔腫瘍学会  

舌癌のほとんどは舌側縁や舌下面に生じることが多く、舌背部に生じることは極めてまれである。われわれは両側浅側頭動脈よりの超選択的動注法を用いた連日同時放射線化学療法を施行した舌背扁平上皮癌の1例について報告する。80歳の男性は左側舌背部の腫瘤を主訴に当科を受診した。腫瘤は有茎性で、その大きさは舌背の前方の硬結を含め49×30×12mmであった。生検後、病変は扁平上皮癌と診断された。頸部リンパ節転移は認めなかった。進行舌癌に対する再建術後の機能障害を避けるために、逆行性超選択的動注化学放射線療法を計画した。両側浅側頭動脈よりの超選択的動注法を用いた連日同時放射線量療法(ドセタキセル(10mg/m2/week、total 96mg/body)、シスプラチン(5mg/m2/day、total 240mg/body)、外照射(2Gy/日、計60Gy)を6週間施行した。現在治療後25ヵ月が経過するが、再発・転移なく経過良好である。(著者抄録)

DOI： 10.5843/jsot.23.147

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2011&ichushi_jid=J02382&link_issn=&doc_id=20111221320007&doc_link_id=%2Fdy8ortum%2F2011%2F002304%2F008%2F0147-0153%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdy8ortum%2F2011%2F002304%2F008%2F0147-0153%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(一社)日本口腔腫瘍学会  

口内炎は癌化学療法による有害事象のひとつであるが、本邦では現在有効な予防法や治療法は確立されていない。欧米では癌化学療法による口内炎に対してG-CSF製剤による含嗽が応用されている。そこでわれわれはG-CSF含嗽剤を作製し、癌化学療法による口内炎に応用したところ、本治療にて口内炎治療に良好な結果が出たので報告する。対象は口腔癌を含む固形癌あるいは白血病と診断され化学療法中に口内炎が出現した6名で、口内炎がgrade 3あるいは4まで悪化した時点で、フィルグラスチム製剤による含嗽治療を1日4回1回75μgで5日間行い、口内炎改善度を評価した。口内炎は著しく良化し、疼痛や摂食も改善した。G-CSF含嗽剤は口内炎の治療に、ひいてはQOLの改善に非常に有用であった。(著者抄録)

DOI： 10.5843/jsot.23.139

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2011&ichushi_jid=J02382&link_issn=&doc_id=20111221320006&doc_link_id=%2Fdy8ortum%2F2011%2F002304%2F007%2F0139-0145%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdy8ortum%2F2011%2F002304%2F007%2F0139-0145%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(一社)日本頭頸部癌学会  

進行口腔癌に対する逆行性超選択的動注化学療法は放射線療法との連日同時併用が可能となることから高い抗腫瘍効果が得られる。今回われわれは進行口腔癌に対して根治的逆行性超選択的動注化学放射線療法を施行し、治療効果、累積生存率、局所制御率について検討したので報告する。2003年1月から2009年12月に受診した口腔・顎顔面悪性腫瘍688例中、根治的逆行性超選択的動注化学放射線療法を施行した175症例を対象とした。治療は逆行性超選択的動注化学放射線療法(docetaxel、total 60mg/m2、cisplatin、total 125-150mg/m2、total 50-60Gy)を5〜6週間行った。治療4週後に画像検索および原発の生検にて腫瘍残存の有無の確認を行ったところ、175例中160例(91.4%)がCR、腫瘍残存は15例(8.6%)に認めた。CRであった160例についてはその後の経過観察中に14例(8.0%)の再発を認めた。5年累積生存率および局所制御率はそれぞれ71.6%と82.2%であった。(著者抄録)

DOI： 10.5981/jjhnc.37.386

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記述言語：日本語   出版者・発行元：(一社)日本口腔腫瘍学会  

進行口腔癌に対する逆行性超選択的動注化学療法は、放射線療法との連日同時併用が可能となることから高い抗腫瘍効果が得られる。われわれは進行口腔癌に対し超選択的動注化学放射線療法を施行し、術前治療としての効果および原発の手術回避について報告してきた。しかし、治療後に腫瘍が残存した症例、再発症例に対しては救済手術が必要となる。今回われわれは本療法を施行し、救済手術が必要であった症例につき術後合併症、予後につき報告する。2006年8月から2009年7月の3年間に横浜市立大学附属病院歯科口腔外科を受診した頭頸部領域の悪性腫瘍304例であり、当科において治療を行った症例は193例であった。そのうち根治療法として超選択的動注化学療法を施行した口腔癌症例102例(52.8%)につき検討を行った。治療は超選択的動注化学療法(docetaxel、total 60mg/m2、cisplatin、total 150mg/m2)、放射線連日同時併用療法(total 60Gy)を6週行うことを原則とした。102例については治療4週後に画像および原発の生検にて腫瘍残存の有無の確認を行ったところ、102例中pCRが90例(88.2%)、腫瘍残存は12例(11.8%)に認めた。原発がpCRであった90例において、経過観察中に4例(3.9%)の再発を認めた。原発に腫瘍残存を認めた12症例および治療後に再発を認めた4症例の16症例中、10症例に救済手術を施行した。救済手術を施行した10例中5例に術後の合併症を認めた。救済手術を行った10症例について4例は再発を認めた。10例中6症例は生存している。(著者抄録)

DOI： 10.5843/jsot.22.102

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