記述言語：英語   掲載種別：研究論文（学術雑誌）  

INTRODUCTION: Immune-related adverse events (irAEs) are prognostic factors for patients on nivolumab. However, predictors of irAEs have not yet been identified. We aimed to investigate the predictors of irAEs occurrence and nivolumab discontinuation due to irAEs. METHODS: Sixty-two patients with recurrent/metastatic head and neck squamous cell carcinoma received nivolumab therapy between June 2017 and December 2020. Treatment outcome was compared between the groups with or without irAEs. The irAE (+) group was further divided by nivolumab discontinuation. Progression-free survival (PFS) and overall survival (OS) were compared between the groups. Predictors of irAE occurrence were analyzed. RESULTS: Twenty-one patients (33.9%) developed irAEs, and six (28.6%) discontinued nivolumab due to severe irAEs. The irAE (+) group had significantly longer PFS and OS than the irAE (-) group (median PFS, 12.7 vs. 1.9 months; median OS, 33.1 vs. 12.8 months). The treatment outcomes in the discontinuation group were comparable to those in the non-discontinuation group. The maximum absolute eosinophil count (AEC) during nivolumab therapy was significantly higher in the irAE (+) group than in the irAE (-) group (548.8 vs. 182) and higher in the discontinuation group than in the non-discontinuation group (729.3 vs. 368.6). The receiver operating characteristic curve showed that the maximum AEC had a moderate-to-high accuracy for predicting irAE occurrence (area under the curve [AUC], 0.757) and nivolumab discontinuation (AUC, 0.893). DISCUSSION: Monitoring AEC during nivolumab therapy may be useful in predicting irAE occurrence, nivolumab discontinuation, and disease prognosis.

DOI： 10.1002/cam4.6648

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: Recurrent/metastatic head and neck squamous cell carcinoma (HNSCC) treatment has changed dramatically with the introduction of immune checkpoint inhibitors (ICIs). However, there are few reports of treatment outcomes on HNSCC with distant metastasis (M1) at initial diagnosis, and its treatment strategy has not been standardized. We aimed to analyze the treatment outcome and prognostic factors of patients with HNSCC with initial M1 disease. METHODS: In this multi-institutional retrospective study, 98 patients with HNSCC were initially diagnosed with M1 disease between 2007 and 2021. The patients were divided into the non-palliative (received any systemic chemotherapy, n = 60) and palliative (did not receive systemic chemotherapy, n = 38) groups. Overall survival (OS) was compared between the groups. In the non-palliative group, predictors of OS were explored based on patient characteristics and treatment details. RESULTS: The median OS in the non-palliative group was 15 months (95% confidence interval [CI], 10-20), which was significantly longer than that in the palliative group (3 months, 95% CI, 2-5) (p < 0.001). Multivariate analysis revealed that administration of locoregional radiation therapy (RT) (hazard ratio [HR] 0.407 [95% CI 0.197-0.844]; p = 0.016), ICIs (HR 0.216 [95% CI 0.088-0.532]; p < 0.001) and RT/surgery for distant metastasis (HR 0.373 [95% CI 0.150-0.932]; p = 0.034) were the independent prognostic factors of OS. CONCLUSION: An intensive treatment strategy combining systemic therapy using ICIs with RT/surgery for locoregional or distant metastasis may yield a survival benefit for patients with HNSCC with M1 disease. LEVEL OF EVIDENCE: 4 Laryngoscope, 2023.

DOI： 10.1002/lary.31047

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記述言語：英語   掲載種別：研究論文（国際会議プロシーディングス）  

DOI： 10.1007/s00520-023-07786-4

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記述言語：英語  

Ectopic parathyroid lesions can be difficult to detect. In the present study, we used near-infrared autofluorescence imaging (NIFI) in three cases of ectopic parathyroid lesions. Our results suggest that NIFI may be a confirmation tool for parathyroid pathology and an intraoperative navigation tool in vivo and ex vivo. Laryngoscope, 2023.

DOI： 10.1002/lary.30728

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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：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：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：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：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：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：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：日本語   出版者・発行元：(一社)日本耳鼻咽喉科頭頸部外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科頭頸部外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科頭頸部外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科頭頸部外科学会  

新潟県では,1986年より新潟県頭頸部悪性腫瘍登録委員会が新規症例の腫瘍登録を開始した.このたび本研究では,頭頸部悪性腫瘍発生の経時変化を見ることを目的とし,1986～2018年までの登録症例において年毎の頭頸部悪性腫瘍総数,原発部位別数,粗罹患率を分析し,さらにT分類別でT2以上症例に対するT1以下症例の比率(T1以下/T2以上)を指標として検討した.総数は12,443例で,男性8,619例(69.3%),女性3,824例(30.7%)だった.登録初年度と比べ2018年の年次毎症例数は3.7倍(599例/160例)に増加し,年平均増加率は4.2%で,粗罹患率は4.3倍(26.7/6.2)に増加していた.年齢中央値は4歳(64歳→68歳)上昇しており,高齢化が粗罹患率上昇の要因と考えられた.「T1以下/T2以上」は頭頸部悪性腫瘍全部位では,1986～1996年,1997～2007年,2008～2018年の3年代の間で差はなかったが,下咽頭癌では2008～2018年で,ほかの2年代と比較し有意に上昇していた.すなわち,頭頸部悪性腫瘍全体では30年経過しても早期診断に至っていなかったが,内視鏡などが診断に寄与できる下咽頭では早期発見が可能になってきたことが示唆された.この結果から,頭頸部癌の早期発見のためには,癌検診,特に下咽頭を対象とした検診が有用である可能性が示唆された.(著者抄録)

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その他リンク： https://search.jamas.or.jp/default/link?pub_year=2023&ichushi_jid=J07551&link_issn=&doc_id=20230201440008&doc_link_id=%2Fdz0tokei%2F2023%2F012601%2F009%2F0038-0045%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdz0tokei%2F2023%2F012601%2F009%2F0038-0045%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: Persistent hypoparathyroidism (hypoPT) is a major complication of total thyroidectomy. Nonetheless, previous reports may have underestimated the prevalence of hypoPT due to patient selection bias. We aimed to estimate the actual prevalence of persistent hypoPT after total thyroidectomy and to find predictive factors for postoperative hypoPT. METHODS: This study retrospectively reviewed data from a health insurance claims-based database provided by the Japan Medical Data Center Co., Ltd. From 2009 to 2019, 2388 patients who underwent total thyroidectomy were identified using the medical procedure codes. Persistent hypoPT was defined as the prescription of active vitamin D supplements for >1 year postoperatively and the assignment of hypoPT codes. The prevalence of persistent hypoPT was estimated at two different levels: minimum and maximum estimations with or without postoperative osteoporosis and/or renal failure codes. Correlates for persistent hypoPT were investigated among several demographic and clinical variables. RESULTS: Of the 2388 patients, 1752 (73.4%) were women with a mean age of 45 years. The types of diseases were: benign thyroid disease (n = 235), malignant thyroid tumors (n = 1570), Graves ' disease (n = 558), and malignancy combined with Graves' disease (n = 25). The minimum and the maximum estimation of the prevalence of persistent hypoPT were 15.0 and 20.3%, respectively. Multivariate logistic regression analysis showed that the malignant tumor (odds ratio, 1.8) independently correlated with persistent hypoPT. CONCLUSIONS: The prevalence of persistent hypoPT after total thyroidectomy estimated by the claims-based database was higher than previously recognized. Comprehensive attempts to preserve parathyroid function, especially in malignant diseases, are essential.

DOI： 10.1007/s12020-022-03153-1

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: The management for malodour of malignant fungating wounds (MFWs) in head and neck cancer (HNC) is unestablished. We evaluated the effects of a novel odour transferrer on malodour generated by MFWs in patients with HNC. METHODS: A spray-type odour transferrer approved by the Japanese government for safe use in humans produces a good scent by binding to bad odour. The odour of MFWs in 13 patients with HNC was scored by 37 medical staff and the patients' families using an odour scale ranging from 0 to 4 before and 1 week after application of the odour transferrer. RESULTS: The odour score marked by all investigators (n=37), nurses (n=21) and doctors (n=11) decreased significantly (p<0.01). The odour score decreased by more than 2 points for 73% of all investigators after odour transferrer application. CONCLUSION: This novel odour transferrer functions as an effective deodorant for MFWs in patients with HNC. It can be used by non-medical staff and may benefit patients with bad odours arising from MFWs as well as their families and medical staff.

DOI： 10.1136/spcare-2022-003824

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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：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：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：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）  

OBJECTIVE: Basal information of head and neck small-cell carcinoma (HNSmCC) including epidemiology, primary site, treatment, and prognosis remains sparse due to its rarity. We report here a multicenter retrospective study on the diagnosis, treatment, and outcomes of patients with HNSmCC. MATERIALS AND METHODS: This study involved 47 patients with HNSmCC from 10 participating institutions. Eight patients were excluded for whom no pathological specimens were available (n = 2) and for discrepant central pathological judgements (n = 6). The remaining 39 patients were processed for data analysis. RESULTS: As pretreatment examinations, computed tomography (CT) was performed for the brain (n = 8), neck (n = 39), and chest (n = 32), magnetic resonance imaging (MRI) for the brain (n = 4) and neck (n = 23), positron emission tomography-CT (PET-CT) in 23 patients, bone scintigraphy in 4, neck ultrasonography in 9, and tumor markers in 25. Primary sites were oral cavity (n = 1), nasal cavity/paranasal sinuses (n = 16), nasopharynx (n = 2), oropharynx (n = 4), hypopharynx (n = 2), larynx (n = 6), salivary gland (n = 3), thyroid (n = 2), and others (n = 3). Stages were II/III/IV-A/IV-B/IV-C/Not determined = 3/5/16/6/5/4; stage IV comprised 69%. No patient had brain metastases. First-line treatments were divided into 3 groups: the chemoradiotherapy (CRT) group (n = 27), non-CRT group (n = 8), and best supportive care group (n = 4). The CRT group included concurrent CRT (CCRT) (n = 17), chemotherapy (Chemo) followed by radiotherapy (RT) (n = 5), and surgery (Surg) followed by CCRT (n = 5). The non-CRT group included Surg followed by RT (n = 2), Surg followed by Chemo (n = 1), RT alone (n = 2), and Chemo alone (n = 3). The 1-year/2-year overall survival (OS) of all 39 patients was 65.3/53.3%. The 1-year OS of the CRT group (77.6%) was significantly better compared with the non-CRT group (31.3%). There were no significant differences in adverse events between the CCRT group (n = 22) and the Chemo without concurrent RT group (n = 9). CONCLUSION: Neck and chest CT, neck MRI, and PET-CT would be necessary and sufficient examinations in the diagnostic set up for HNSmCC. CCRT may be recommended as the first-line treatment. The 1-year/2-year OS was 65.3%/53.3%. This study would provide basal data for a proposing the diagnostic and treatment algorithms for HNSmCC.

DOI： 10.3389/fsurg.2022.1049116

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Head and neck mucosal melanoma (HNMM) is a rare and aggressive subtype of melanoma. HNMM often develops as a recurrent or metastatic disease, and its prognosis is worse than that of cutaneous melanoma. Recent large-scale clinical studies have reported favorable outcomes with immune checkpoint inhibitors (ICIs) for melanoma. However, these clinical trials included only a small number of HNMM cases. This study aimed to estimate treatment outcomes and prognostic predictors of ICIs for advanced HNMM. METHODS: Cases of advanced HNMM, defined as unresectable or metastatic HNMM at the initial diagnosis (five patients) or development of recurrent/metastatic HNMM after initial treatment (27 patients), were included in this study. Survival analysis and a search for prognostic factors were performed for these 32 patients. Furthermore, the detailed clinical course of patients who received ICI treatment was investigated. RESULTS: The median overall survival (OS) of 32 patients with advanced HNMM was 25.3 months. The estimated 1-, 3-, and 5-year OS rates were 68.4%, 42.8%, and 34.3%, respectively. Fourteen patients (43.7%) received ICIs, whereas 18 (56.3%) did not. Univariate analysis showed that ICI treatment was the only factor associated with a better 1-year OS. Patients who received ICI treatment had significantly longer OS (median OS: not reached, 1-year OS: 85.7%) than those who did not (median OS: 11.3 months, 1-year OS: 54.5%). The overall response and disease control rates of patients who received ICI treatment were 50% and 64.3%, respectively. Patients who achieved complete response (CR) or partial response (PR) to ICI treatment survived significantly longer (1-year OS: 100%) than those who did not (1-year OS: 71.4%). Among the five patients who discontinued ICI treatment due to severe immune-related adverse events (irAEs), four did not receive salvage treatments but showed durable treatment effects and survived for 9.8-54.2 months at the end of the follow-up period. CONCLUSIONS: ICI treatment achieved a favorable OS for advanced HNMM. CR/PR to ICI treatment and discontinuation owing to severe irAEs were favorable predictors of OS.

DOI： 10.3389/fsurg.2022.1032626

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: The global standard for chemoradiation therapy (CCRT) for head and neck squamous cell carcinoma is cisplatin 100 mg/m2 administered once every three weeks, although cisplatin 80 mg/m2 is also widely used as an alternative treatment to reduce adverse events in Japan. We aimed to assess the long-term survival outcomes and late adverse events associated with CCRT with a 3-weekly cisplatin dose of 80 mg/m2. METHODS: A phase 2 study on CCRT with a 3-weekly cisplatin dose of 80 mg/m2 was performed in 47 patients between April 2015 and December 2016 at four centers in Japan. Survival outcomes and late adverse events at 5 years after this phase 2 trial were investigated. RESULTS: The median follow-up period was 61 months. The 5-year progression-free survival/overall survival of all 47 patients was 66.0%/76.6%, while that of patients with stage III, IV disease (UICC) was 65.6%/71.9%. Seventeen patients (36%) experienced dysphagia as a late adverse event. Univariate and multivariate analyses revealed a significant association between acute mucositis/low body mass index (BMI) during CCRT and late dysphagia. CONCLUSION: The survival outcomes of CCRT with a 3-weekly cisplatin dose of 80 mg/m2 may be comparable to the previously reported dose of 100 mg/m2. Acute mucositis and low BMI at CCRT were risk factors for late dysphagia, indicating the importance of managing these conditions during CCRT to prevent late adverse events. Caution and care for acute mucositis and swallowing training in patients with low BMI may be important for preventing late-stage dysphagia.

DOI： 10.3389/fsurg.2022.1035349

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: To examine the role of autofluorescence (AF) monitoring with near-infrared fluorescence imaging (NIFI) in identifying parathyroid lesions in primary or secondary hyperparathyroidism (P-HPT or S-HPT) surgeries. STUDY DESIGN: Prospective study. METHODS: Twelve lesions each were resected from 12 and 3 patients with P-HPT and S-HPT, respectively. The mean and maximum AF intensities of the lesions normalized to that of the thyroid tissue for in situ and ex vivo preparations were compared between P-HPT and S-HPT. Subjective visual classifications of AF intensity were compared with postoperative quantitative assessments. The unevenness of AF distribution inside the lesions was assessed by determining the ratio of maximum to mean AF intensity and comparing them with the corresponding ratio for normal parathyroid glands (PGs). RESULTS: In all quantitative comparisons (in situ/ex vivo, mean, and maximum AF), AF intensities of P-HPT were stronger than those of S-PHT. The AF-positive rate in in situ subjective visual classification was higher for P-HPT (100% vs. 33%). Subjective visual classifications showed a positive correlation with AF intensities. The ratio of maximum to mean AF was higher in P-HPT and S-HPT than in normal PGs. CONCLUSIONS: For P-HPT, AF intensity in both in situ and ex vivo preparations was sufficiently high and correlated with the subjective visual classification, suggesting that NIFI may be useful for confirming P-HPT lesions. In contrast, NIFI may have only a minor role in S-HPT surgeries owing to the weak-AF of S-HPT lesions. HPT lesions show an uneven AF intensity distribution compared with normal PGs. LEVEL OF EVIDENCE: 3 Laryngoscope, 131:E2097-E2104, 2021.

DOI： 10.1002/lary.29310

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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）  

OBJECTIVES/HYPOTHESIS: To assess the ability of near-infrared fluorescence imaging (NIFI) to identify parathyroid glands (PGs) among histologically proven PG/non-PG specimens compared with a surgeon's visual acumen, and to determine NIFI sensitivity in detecting incidentally resected PGs from thyroidectomy specimens, compared to the surgeon's visual inspection. STUDY DESIGN: Prospective study. METHODS: With mean age of 61 years, 36 patients with various thyroid diseases were enrolled. Possible PGs (n = 28) and lymph nodes (n = 32) were identified by the experienced surgeon's visual inspection. Using NIFI, 15 PGs were further identified from thyroidectomy specimens. For these 75 specimens, the surgeon's judgments (PG vs. non-PG) were recorded. Histological evaluation was performed after examining the NIFI auto-fluorescence of each specimen. RESULTS: There were no significant differences in sensitivity, specificity, positive predictive value, and negative predictive value between the surgeon's visual inspection and NIFI in identifying PGs, with values of 100%/97.1%, 85.0%/87.5%, 85.4%/87.2%, and 100%/97.2%, respectively. The sensitivity of NIFI (82.9%) for detection of PGs from thyroidectomy specimens was significantly higher than that of the surgeon's visual inspection (61.0%). False negative specimens contained bleeding/congestion and/or encapsulation by thick tissues, whereas false positive specimens contained electrocoagulated tissues. CONCLUSIONS: NIFI showed results comparable to the experienced surgeon's visual inspection in identifying PGs. This could benefit novice surgeons. NIFI may be useful for experienced surgeons to locate incidentally resected PGs within thyroidectomy specimens for auto-transplantation. Prevention of intra-gland bleeding and congestion, careful removal of thick capsules, and bloodless surgeries without electrocoagulation are important for reducing false positive and false negative results. Laryngoscope, 131:1188-1193, 2021.

DOI： 10.1002/lary.29163

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記述言語：英語  

DOI： 10.1002/lary.29425

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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：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：日本語   出版者・発行元：(NPO)日本頭頸部外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科学会  

末梢挿入型中心静脈カテーテル(peripherally inserted central catheter、PICC)は安全性が高く頭頸部癌の薬物療法でも用いられるが、留置側の左右差に着目した報告は少ない。PICC留置後の先端位置移動と合併症発生率の左右差について検討した。PICC留置を行った頭頸部癌145例172件を対象とし後方視的な調査を行った。留置側は右36件、左136件で、留置期間中央値は65日であった。121例137件でX線による留置時・留置後の先端位置評価が可能であった。先端位置をZone A:上大静脈下半分と右心房上部、Zone B:上大静脈上半分と左腕頭静脈合流部、Zone C:左腕頭静脈に分類し、Zone A・Bを適正位置とした。右側では留置時33件(100%)、留置後30件(91%)が適正位置であったのに対し、左側では留置時97件(93%)、留置後82件(79%)が適正位置で、留置時と留置後では有意な変化を認めた(p=0.001)。そのほかの合併症発生率に左右差は認めなかった。左側からのPICC留置では上大静脈右側壁にカテーテル先端が当たり、Zone Aへの留置率が低い。さらに留置後の体位・肢位の変化により先端が移動し、適正位置であるZone A・Bに留まりにくい。不適正な先端位置は遅発性の上大静脈壁損傷や血栓症を招くため、右側からのPICC留置が望ましいと考えられた。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J01099&link_issn=&doc_id=20210226330006&doc_link_id=10.3950%2Fjibiinkoka.124.122&url=https%3A%2F%2Fdoi.org%2F10.3950%2Fjibiinkoka.124.122&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Early detection of head and neck carcinoma (HNC) as superficial HNC (SHNC) identified using recently developed optical techniques, such as magnifying endoscopy and narrow-band imaging (NBI), in combination with endoscopic surgeries enables minimally invasive treatment with favorable outcomes for HNC. This study aimed to identify the predictive factors for the rare but important clinical issue of SHNC, namely cervical lymph node metastasis (CLNM), following endoscopic resection. METHODS: Sixty-nine patients with SHNC who underwent endoscopic resection were enrolled in the study. Clinical data, preoperative endoscopic findings, pathological findings, and treatment outcomes were retrospectively reviewed. Because the pharyngeal mucosa lacks the muscularis mucosa, we measured tumor thickness in permanent pathology as an alternative to the depth of invasion. Correlations with the occurrence of CLNM were statistically examined. RESULTS: The 5-year disease-specific survival rate was 100%. Of 69 patients, 3 (4.3%) developed CLNM. All had subepithelial but not epithelial tumors. The 0-IIa type in the macroscopic findings, type B2/B3 vessels in narrow-band imaging, tumors ≥ pathological stage T2, lymphatic invasion, positive surgical margins, and tumor thickness >1,000 μm showed significant correlations with CLNM following endoscopic resection. Furthermore, the classification of type B vessels was significantly associated with tumor thickness. CONCLUSION: The treatment outcomes following endoscopic resection for SHNC were favorable. The risk of CLNM following endoscopic resection in SHNC can be predicted by several preoperative endoscopic and postoperative pathological findings. Among them, the classification of type B vessels, which correlated with both tumor thickness and CLNM, might be a useful predictive factor.

DOI： 10.3389/fsurg.2021.813260

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Objective: We aimed to compare the outcomes and safety of chemoradiotherapy (CRT) between elderly and non-elderly patients with head and neck squamous cell carcinoma (HNSCC). It is difficult to assess the causal effect of age because of possible differences in general conditions among individuals. Therefore, we adjusted the background factors of elderly and non-elderly patients using propensity score matching (PSM). Methods: A total of 146 patients with HNSCC who received CRT were divided into an elderly (≥70 years, n = 35) and non-elderly group (<70 years, n = 111). Pre-treatment characteristics, including the performance status, Charlson comorbidity index, body mass index, primary site, and TNM stage were adjusted by PSM. We compared the outcomes and safety of CRT with high-dose single-agent cisplatin (CDDP) as well as outcomes following recurrence between the groups, before and after PSM. Results: The total dose of CDDP administered during CRT was significantly lower in the elderly group before PSM. However, it became comparable to the non-elderly group and adverse events did not differ between the groups following PSM, resulting in a comparable CRT completion rate. Overall-, disease specific-, and progression-free survivals of elderly patients were comparable to those of non-elderly patients following PSM. In contrast, elderly patients with recurrence could receive fewer salvage treatments than their non-elderly counterparts, resulting in worse survival. Conclusions: CRT with high-dose CDDP is safe and effective for the treatment of elderly patients with HNSCC. However, salvage treatments can be rarely conducted for elderly patients with a recurrence, considering a deterioration of their general condition.

DOI： 10.3389/fsurg.2021.753049

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

We examined the role of lateral temporal bone resection (LTBR) in the treatment of external ear canal (EAC) carcinoma between 2007 and 2018. The estimated 3-year disease-free survival (DFS) and disease-specific survival (DSS) according to the tumor stage and treatments were investigated in 36 patients with EAC squamous cell carcinoma. T stage classification according to the University of Pittsburgh staging system was as follows: 14 patients in T1, four patients in T2, nine patients in T3, and nine patients in T4. The 3-year DFS rate was 77.4% for T1 tumors, 100% for T2, 44.4% for T3 tumors, and 11.1% for T4 tumors (p < 001). The 3-year DSS rate was 100% for T1/T2 tumors, 87.5% for T3 tumors, and 11.1% for T4 tumors (p < 0.01). T1/T2 patients received mostly LTBR. Among nine T3 tumors, five patients (56%) received LTBR combined with preoperative chemotherapy and/or postoperative radiation (RT). Four of them had negative surgical margin and survived with no evidence of disease. The DFS of T3 patients who underwent concurrent chemoradiotherapy and LTBR was 0 and 80%, respectively (p = 0.048). For T1/T2 tumors, surgery achieved an excellent outcome. For T3 tumors, LTBR achieved negative surgical margin and showed good survival when combined with preoperative chemotherapy and/or postoperative RT. In contrast, the prognosis of T3 patients who could not undergo surgery was as poor as that of T4 patients. Therefore, in addition to subtotal temporal bone resection, LTBR-based treatment strategy may be a treatment option for limited cases of T3 patients.

DOI： 10.3389/fsurg.2021.708245

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: It was reported that treatment outcomes of the salvage chemotherapy (SCT) following nivolumab are fairly good compared with those of nivolumab itself. However, predictive factors of SCT for recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC) were not determined. METHODS: Twenty-one R/M HNSCC patients received SCT following nivolumab. The treatment outcome and predictive factors for the favorable response to SCT were investigated. RESULTS: The objective response rate (ORR) and the disease control rate of SCT were 52.4% and 81.0%, respectively. The median progression-free survival and the median overall survival time were 5.4 and 12.9 months, respectively. Patients with positive programmed death-ligand 1 (PD-L1) expression showed greater tumor shrinkage evaluated by the response evaluation criteria in solid tumors and higher ORR than those with negative PD-L1 expression. CONCLUSIONS: Treatment outcome of SCT following nivolumab in R/M HNSCC was favorable. PD-L1 expression may be a predictive factor of SCT.

DOI： 10.1002/hed.26374

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Endoscopic submucosal dissection (ESD) has gained wide acceptance as a minimally invasive and curative surgery for superficial head and neck carcinoma. However, the safety of ESD for superficial pharyngeal carcinoma after radiotherapy has not been elucidated. Superficial hypopharyngeal carcinoma of the left pyriform sinus developed in a 76-year-old man who had undergone concurrent chemoradiotherapy for T2N2bM0 pyriform sinus carcinoma on the opposite side 12 months before. He underwent ESD without complications. Because tumor invasion into the muscular layer was a concern, the muscular layer was partially resected with the tumor. Twelve days after discharge, he presented with a sore throat and difficulty in swallowing. Endoscopy and computed tomography revealed necrosis due to wound infection with abscess formation around the left carotid artery. The common carotid artery subsequently ruptured. Although the surgical intervention was performed, he passed away 46 days after ESD due to carotid blowout. ESD is a minimally invasive treatment for superficial head and neck carcinoma, but carotid blowout can occur in cases after radiation. Prior radiotherapy and deeper dissection into the muscular layer may hamper wound epithelization, resulting in infection-induced necrosis and carotid blowout. Diligent monitoring of wound healing is essential in patients who have previously undergone irradiation.

DOI： 10.1016/j.anl.2020.08.020

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: Sarcopenia, defined as a decrease in the skeletal muscle mass and its function, is associated with a poor clinical outcome in several malignancies. We aimed to examine whether sarcopenia can be a predictor of incompletion of concurrent chemoradiotherapy (CCRT) and survival for head and neck cancer (HNC) patients. METHODS: Forty-one male HNC patients who received CCRT were enrolled in the study. Cross-sectional muscle areas at the third lumbar vertebral level were normalized by the squared height of the patients and were termed the lumbar skeletal muscle index (LSMI, cm2/m2), a marker of sarcopenia. Patients were divided into high (30/41, 73%) and low (11/41, 27%) LSMI groups. The LSMI cut-off value was set at 39.7 cm2/m2 based on a receiver operating characteristic curve for incompletion of CCRT. The groups were compared for survival rate by the Kaplan-Meier method. Factors predicting incompletion of CCRT were investigated among several variables. RESULTS: Multivariate analysis showed that a pre-treatment low LSMI (P = 0.033) and age over 70 years (P = 0.023) were the only significant predictors for incompletion of CCRT. The 2-year disease-specific survival (DSS) rate was significantly lower in the low LSMI group (61%) than in the high LSMI group (97%, P = 0.012), whereas there were no differences in the DSS rate between the low and high body mass index groups. CONCLUSION: The prevalence of sarcopenia in HNC patients receiving CCRT was 27%. Its presence before treatment was a significant predictor of incomplete CCRT and poor DSS rate in HNC patients.

DOI： 10.1007/s00405-020-06273-4

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: The importance of nivolumab for recurrent or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) is rapidly increasing. However, prognostic factors have not been determined for predicting treatment outcome. We aimed to investigate the prognostic factors in R/M HNSCC patients treated with nivolumab. METHODS: This retrospective study included 42 patients with R/M HNSCC who received nivolumab therapy. Correlations of overall survival (OS) with various patient characteristics including age, recurrent/metastatic site, performance status (PS), programmed death-ligand 1 positivity, body mass index, neutrophil-to-lymphocyte ratio, modified Glasgow prognostic score (mGPS), previous cetuximab administration, and immune-related adverse events were investigated. RESULTS: The overall response rate and disease control rate were 16.7% and 45.2%, respectively. Estimated 1-year OS and progression-free survival (PFS) were 56.4% and 24.5%, respectively. Multivariate analysis revealed that PS = 2 (hazard ratio 0.147; 95% CI 0.041-0.527; p = 0.003) and mGPS = 2 (hazard ratio 0.188; 95% CI, 0.057-0.620; p = 0.006) were independent predictors of poor OS. Given that the PS and mGPS were independent prognostic factors, we classified patients into three groups according to PS and mGPS: Group 1, both PS and mGPS were 0 or 1 (n = 30); Group 2, either PS or mGPS was 2 (n = 9); Group 3, both PS and mGPS were 2 (n = 3). The OS curves were significantly stratified among the three groups. CONCLUSION: The combination of PS and mGPS accurately predicted OS after nivolumab therapy. Preventive intervention to maintain general condition without simultaneously exceeding level 2 of PS and mGPS might be important for improving treatment outcomes of nivolumab.

DOI： 10.1007/s00405-020-05945-5

PubMed

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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：日本語   出版者・発行元：(一社)日本内分泌外科学会  

症例は71歳女性で、血液検査にてPTH-intactが1246pg/mlと著明高値であったため当院代謝内分泌内科を紹介初診となった。頸胸腹部CT上、甲状腺左葉背側の腫瘍性病変と硬化性、溶骨性の混在した多発性骨病変が指摘され、副甲状腺癌および多発骨転移が疑われた。高カルシウム血症の補正目的にシナカルセトが開始されたが改善が得られず、手術目的に当科紹介となった。術前画像所見からは副甲状腺腫瘍と甲状腺左葉の境界が不明瞭であったことから、副甲状腺腫瘍摘出の際に甲状腺左葉も合併切除した。病理所見では線維性の被膜を有し、好酸性細胞がシート状に増殖する像を認めた。核異型は軽度であるものの、脈管侵襲を認めること、Ki-67 indexは10%でhot spotを認めることから副甲状腺癌の診断となった。骨病変に対する治療については、腰椎病変に対してのみ病的骨折予防目的に放射線治療を行い、臨床経過から副甲状腺癌にBrown tumorを合併したものと判断した。

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Background and purpose: Concurrent chemoradiotherapy (CCRT) for head and neck cancer (HNC) is a risk factor for oral candidiasis (OC). As Candida spp. are highly virulent, we conducted a retrospective study to determine whether OC increases the severity of dysphagia related to mucositis in HNC patients. Patients and methods: We retrospectively analyzed the cases of consecutive patients with carcinomas of the oral cavity, pharynx, and larynx who underwent CCRT containing cisplatin (CDDP) at our hospital. The diagnosis of OC was based on gross mucosal appearance. We performed a multivariate analysis to determine whether OC was associated with the development of grade 3 dysphagia in the Radiation Therapy Oncology Group (RTOG) Acute Toxicity Criteria. The maximum of the daily opioid doses was compared between the patients with and without OC. Results: We identified 138 HNC patients. OC was observed in 51 patients (37%). By the time of their OC diagnosis, 19 (37%) had already developed grade 3 dysphagia. Among the 30 patients receiving antifungal therapy, 12 (40%) showed clinical deterioration. In the multivariate analysis, OC was independently associated with grade 3 dysphagia (OR 2.75; 95%CI 1.22-6.23; p = 0.015). The patients with OC required significantly higher morphine-equivalent doses of opioids (45 vs. 30 mg/day; p = 0.029). Conclusion: Candida infection causes refractory dysphagia. It is worth investigating whether antifungal prophylaxis reduces severe dysphagia related to candidiasis.

DOI： 10.1016/j.ctro.2019.10.006

PubMed

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記述言語：日本語   出版者・発行元：(NPO)日本頭頸部外科学会  

再発転移頭頸部癌に対する外来化学療法の増加に伴い、安全な血管アクセスデバイス(VAD)が求められている。VADとしての末梢挿入型中心静脈カテーテル(PICC)27例と埋込型PICCである上腕ポート13例の安全性について比較した。両者に患者背景や治療内容に有意差を認めなかった。合併症発生数は上腕ポート群0例(0%、0/1,000カテーテル留置日)、PICC群8例(30%、1.8/1,000カテーテル留置日)で、上腕ポート群で有意に少なかった(p=0.037)。PICC群の合併症内訳はカテーテル閉塞4例、血栓症2例、カテーテル関連血流感染症1例、自己抜去1例であった。上腕ポートは安全なVADであり、頭頸部癌の外来化学療法において有用な選択肢と考えられた。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J04210&link_issn=&doc_id=20191115330005&doc_link_id=10.5106%2Fjjshns.29.123&url=https%3A%2F%2Fdoi.org%2F10.5106%2Fjjshns.29.123&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

記述言語：日本語   出版者・発行元：(一社)日本内分泌外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科学会  

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J01099&link_issn=&doc_id=20190926390015&doc_link_id=%2Fdz0jibik%2F2019%2F012209%2F017%2F1269-1270%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fdz0jibik%2F2019%2F012209%2F017%2F1269-1270%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  

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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：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：日本語   出版者・発行元：(一社)日本耳鼻咽喉科学会  

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記述言語：日本語   出版者・発行元：(一社)日本耳鼻咽喉科学会  

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記述言語：日本語   出版者・発行元：(NPO)日本頭頸部外科学会  

Nivolumab(Nivo)が再発・転移頭頸部癌の全生存期間を有意に延長することが報告され、本邦では2017年3月から保険収載となった。本研究では2017年6〜10月に当院でNivoを投与した再発・転移頭頸部癌10例の臨床像に関して検討した。年齢は44〜75歳で中央値62.5歳、PSは0が7例、2が3例、Cetuximab(Cetu)暴露例は8例であった。観察期間の中央値6ヵ月における効果判定はPR3例、SD2例、PD5例であり、PS不良例や急速進行例では治療効果不良、Cetu暴露の有無やPD-L1染色の陽性・陰性と治療効果の間には相関がなかった。有害事象は許容範囲内であった。CheckMate-141試験と比較すると本研究の方がPS0の患者の割合が多く、Nivo投与期間が長い傾向にあった。今後、Nivoの適応決定や投与のタイミングに関して検討する必要があると思われた。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J04210&link_issn=&doc_id=20190312410012&doc_link_id=10.5106%2Fjjshns.28.313&url=https%3A%2F%2Fdoi.org%2F10.5106%2Fjjshns.28.313&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVE: Recent data indicated that concurrent chemoradiotherapy (CCRT) using high dose cisplatin (CDDP) is the most useful treatment for advanced head and neck squamous cell carcinoma (SCC). Regarding the dose of CDDP, 100mg/m2 is most recommended in Western countries. However, in terms of a balance of efficacy and adverse events, appropriate dose of cytotoxic drugs such as CDDP may be different among the different ethnic groups. In this multicenter phase I/II study, we aimed to identify the optimal dose of CDDP in CCRT for patients with advanced head and neck SCC in the Japanese. METHODS: Patients were eligible for inclusion if they had head and neck SCC that was treated with radical CCRT comprising whole-neck irradiation of the primary lesion and level II-IV lymph nodes on both sides. For the phase I study, a CDDP dose was 70mg/m2 for level 0, 80mg/m2 for level 1, and 100mg/m2 for level 2. Maximum tolerated dose (MTD) and dose-limiting toxicity (DLT) were examined by phase I trial, by which CDDP dose for phase II was determined. The primary endpoint for the phase II was CCRT completion rate, and the secondary endpoint was full-dose-CCRT completion rate, the percentage of patients receiving a total CDDP dose of ≥200mg/m2, response rate, and incidences of adverse events. RESULTS: A CDDP dose of 100mg/m2 was the MTD for phase I, and the recommended dose for phase II was 80 mg/m2. Forty-seven patients were evaluated in the phase II trial. CCRT completion rate, full-dose-CCRT rate, and the percentage of patients receiving a total CDDP dose of ≥200mg/m2, were 93.6%, 78.7%, and 93.6%, respectively. One patient (2.1%) developed grade 2 renal dysfunction, and no patient developed febrile neutropenia or a grade 4 adverse event. CONCLUSION: The present phase I study indicated that a CDDP dose of 80mg/m2 is the optimal dose in terms of safety. The phase II study revealed that CCRT completion rate, response rate, and rates of adverse events were not inferior for a CDDP dose of 80mg/m2 as compared with a dose of 100mg/m2, and a dose of 80mg/m2 is therefore recommended in CCRT for the Japanese. This study was registered with the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR; identification No. UMIN000010369).

DOI： 10.1016/j.anl.2018.02.008

PubMed

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記述言語：日本語   出版者・発行元：日本内分泌外科学会・日本甲状腺外科学会  

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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：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：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：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：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）   出版者・発行元：TAYLOR & FRANCIS LTD  

Diffuse idiopathic skeletal hyperostosis (DISH) is a common disease in which ossification lesions occur in the bones including the vertebrae. Dysphagia may occur in advanced cases, but there are few cases that require treatment. A 68-year-old man was diagnosed with hypopharyngeal cancer of the left pyriform sinus and asymptomatic DISH on the anterior cervical vertebrae. Due to prior history of radiation, partial laryngopharyngectomy was performed. After surgery, severe dysphagia and aspiration pneumonia occurred, and the patient needed to undergo total laryngectomy. It was determined that dysphagia was due to multiple factors, including insufficient laryngeal elevation and esophageal compression by osteophytes of DISH. Asymptomatic DISH can cause severe dysphagia after partial laryngopharyngectomy. We suggest that evaluation of the swallowing function and surgical options, including laryngeal suspension and cricopharyngeal myotomy should be considered when performing partial laryngopharyngectomy in patients with DISH, even if they demonstrated no difficulties in swallowing before treatment.

DOI： 10.1080/23772484.2018.1477508

Web of Science

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Non-traumatic bone fractures in cancer patients are usually pathological fractures due to bone metastases. In head and neck cancer patients, clavicle stress fractures may occur as a result of atrophy of the trapezius muscle after neck dissection in which the accessory nerve becomes structurally or functionally damaged. CASE REPORT: A 71-year-old man underwent modified radical neck dissection with accessory nerve preservation and post-operative radiotherapy for submandibular lymph node metastases of tongue cancer. Four weeks after the radiotherapy, a clavicle fracture, with osteomyelitis and abscess formation in the pectoralis major muscle, occurred. Unlike in simple stress fracture, long-term antibiotic administration and drainage surgery were required to suppress the inflammation. CONCLUSION: As seen in the present patient, clavicle stress fractures may occur even after neck dissection in which the accessory nerve is preserved, and may be complicated by osteomyelitis and abscess formation owing to risk factors such as radiotherapy, tracheostomy and contiguous infection.

DOI： 10.1017/S0022215117001748

PubMed

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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：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：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）  

In the cochlea, a high K+ environment in the endolymph is essential for the maintenance of normal hearing function, and the transport of K+ ions through gap junctions of the cochlear epithelium is thought to play an important role in endolymphatic homeostasis. The aim of the present study was to demonstrate the three-dimensional (3D) ultrastructure of spiral ligament root cells and interdental cells, which are located at both ends of the gap junction system of the cochlea epithelium. Serial semi-thin sections of plastic-embedded rat cochlea were mounted on glass slides, stained with uranyl acetate and lead citrate, and observed by scanning electron microscopy (SEM) using the backscattered electron (BSE) mode. 3D reconstruction of BSE images of serial sections revealed that the root cells were linked together to form a branched structure like an elaborate "tree root" in the spiral ligament. The interdental cells were also connected to each other, forming a comb-shaped cellular network with a number of cellular strands in the spiral limbus. Furthermore, TEM studies of ultra-thin sections revealed the rich presence of gap junctions in both root cells and interdental cells. These findings suggest the possibility that both root cells and interdental cells contribute to K+ circulation as the end portion of the epithelial cell gap junction system of the cochlea.

DOI： 10.2220/biomedres.38.239

PubMed

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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：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：日本語   出版者・発行元：(一社)日本耳鼻咽喉科学会  

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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  

新潟県には県内の癌治療施設が一堂に会する新潟県頭頸部癌悪性腫瘍登録委員会があり、県内の頭頸部悪性腫瘍症例のデータを四半世紀にわたって登録してきた。癌登録に関しては有用なデータではあるが、放射線療法や化学療法の進歩とともに施設間の治療内容および治療成績の格差が目立ってきて、全体の予後調査という点において信頼性が低下してしまった。そこでわれわれは県内の癌治療施設が一堂に会する利点を利用して「頭頸部扁平上皮癌に対する高用量CDDP+RTの県内多施設共同研究phase I/II study」を立ち上げた。phase Iにおいては12例が登録され、最大耐用量や用量限界毒性、化学療法減量・中止基準、phase IIにおけるCDDP推奨投与量などが検討され、その結果CDDP推奨投与量は80mg/m2となった。今後はCCRT完遂率などをendpointとしたphase IIを開始する予定である。地方における治療の一つのモデルケースとして、現状の経過を報告する。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2016&ichushi_jid=J04195&link_issn=&doc_id=20160518480012&doc_link_id=10.5981%2Fjjhnc.42.70&url=https%3A%2F%2Fdoi.org%2F10.5981%2Fjjhnc.42.70&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_2.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）  

In this study, we introduce scanning electron microscopy (SEM) of semithin resin sections. In this technique, semithin sections were adhered on glass slides, stained with both uranyl acetate and lead citrate, and observed with a backscattered electron detector at a low accelerating voltage. As the specimens are stained in the same manner as conventional transmission electron microscopy (TEM), the contrast of SEM images of semithin sections was similar to TEM images of ultrathin sections. Using this technique, wide areas of semithin sections were also observed by SEM, without the obstruction of grids, which was inevitable for traditional TEM. This study also applied semithin section SEM to correlative light and electron microscopy. Correlative immunofluorescence microscopy and immune-SEM were performed in semithin sections of LR white resin-embedded specimens using a FluoroNanogold-labeled secondary antibody. Because LR white resin is hydrophilic and electron stable, this resin is suitable for immunostaining and SEM observation. Using correlative microscopy, the precise localization of the primary antibody was demonstrated by fluorescence microscopy and SEM. This method has great potential for studies examining the precise localization of molecules, including Golgi- and ER-associated proteins, in correlation with LM and SEM.

DOI： 10.1093/jmicro/dfv042

PubMed

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記述言語：日本語   出版者・発行元：日本内分泌外科学会・日本甲状腺外科学会  

【症例】43歳男性。家族歴、既往歴に特記事項なし。20xx年2月から咳嗽あり、近医CTにて甲状腺腫瘍+多発肺転移の診断となり5月に当科紹介初診された。PET-CTでは甲状腺、頭部皮膚、両肺野に集積を認めた。頭部皮膚腫瘍を生検したが良性の血管平滑筋腫の診断であり、6月に甲状腺全摘およびD1郭清を施行した。術後病理診断では筋線維腫症であり、血小板由来成長因子受容体β(platelet-derived growth factor receptor β、PDGFRB)蛋白の過剰発現を認めることから、PDGFRB遺伝子変異を伴った内臓病変を有する成人全身型筋線維腫症例と考えられた。化学療法を施行するも、肺・膵臓などの内臓病変が増悪し、初診後8ヵ月で原病死した。【まとめ】非常に稀な成人筋線維腫症例を経験した。PDGFRB遺伝子変異が診断の決め手となったが、内臓病変を伴う全身型は予後不良で、治療法の確立が望まれる。(著者抄録)

DOI： 10.11226/jaesjsts.32.3_211

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Science and Business Media LLC  

DOI： 10.1007/s13691-014-0191-5

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その他リンク： http://link.springer.com/article/10.1007/s13691-014-0191-5/fulltext.html

記述言語：日本語   出版者・発行元：(NPO)日本頭頸部外科学会  

頭頸部領域に再発を繰り返した類上皮血管内皮腫の1例を報告する。症例は40歳女性で、過去12年間に頭蓋骨左側、下顎骨左側、左耳下腺、鼻中隔左側の類上皮血管内皮腫に対して複数の医療機関で摘出術を施行され、経過観察目的に当科紹介となった。初診時は頭頸部領域に腫瘍性病変を認めなかったが、経過中に鼻中隔左側に腫瘤が出現した。生検にて類上皮血管内皮腫再発の診断となり、腫瘍切除術を施行した。腫瘍径と病理組織像から低危険度群に分類されたため、追加治療をせず経過観察を行っており、術後18ヵ月再発を認めていない。本症例では頭頸部領域の片側性再発を繰り返しており、今後も慎重な経過観察が必要と思われた。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2015&ichushi_jid=J04210&link_issn=&doc_id=20150721380009&doc_link_id=10.5106%2Fjjshns.25.55&url=https%3A%2F%2Fdoi.org%2F10.5106%2Fjjshns.25.55&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

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）  

Hematogenous metastasis is the most common form of metastasis in head and neck cancer, and reports have described successful resection of pulmonary metastases of such cancers. We report treatment outcomes after surgical resection of pulmonary metastases of head and neck cancer and identify prognostic factors. This clinicopathologic study investigated the clinical records of 16 patients with pulmonary metastases of head and neck cancer (excepting cases of thyroid cancer) who had undergone metastasectomy at our center during the period 2001-2012. The mean age of the 16 patients (11 men and 5 women) was 62.1 years. The mean interval between completion of successful treatment of the primary tumor and detection of pulmonary metastasis was 21 months (range, 6-56 months). All patients underwent pulmonary resection. The overall 1-year survival rate was 79.4 %, and the 2- to 5-year survival rate was 63.2 %. These rates compare favorably to those in previous reports on resection of pulmonary metastases. When prognostic factors for survival rates were compared, the factors associated with a negative prognosis were a disease-free interval of <12 months and partial resection of pulmonary metastases. Multivariate analysis did not reveal any prognostic factors associated with negative outcomes. Surgical resection of pulmonary metastases of head and neck cancer might improve outcomes.

DOI： 10.1007/s12070-014-0799-y

PubMed

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記述言語：日本語   出版者・発行元：Japan Society for Head and Neck Cancer  

類基底細胞扁平上皮癌は，類基底細胞成分と扁平上皮癌成分が混在する稀な組織型である。症例は61歳男性，嗄声と咽頭痛を主訴に当科を受診した。喉頭内視鏡では喉頭前庭左側から両声帯に至る腫瘍性病変と左声帯麻痺があり，生検で扁平上皮癌を認めた。画像所見と併せて，喉頭癌（声門上型扁平上皮癌，T3N2bM0，stage IV A）と診断した。術前化学療法後に喉頭全摘術，両頸部郭清術を施行した。手術標本の病理所見より類基底細胞扁平上皮癌の診断となり，転移リンパ節に節外浸潤を認めたため術後放射線照射を施行したが，早期に多発肺転移を生じた。CDDP，5-FU，Cetuximab投与により肺転移巣は一時的に縮小したが，その後急激に増大した。類基底細胞扁平上皮癌は遠隔転移が多く予後不良な組織型とされており，強力な化学療法を含む集学的治療の必要性が示唆された。

DOI： 10.5981/jjhnc.41.51

CiNii Article

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その他リンク： http://search.jamas.or.jp/link/ui/2015238877

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：耳鼻咽喉科臨床学会  

85歳男。発作性心房細動にてワーファリン内服中であった。血痰、咽頭違和感を主訴に近医受診し、下咽頭に腫瘍性病変を認め、生検で扁平上皮癌の診断のため当科紹介となった。初診時、右下咽頭梨状窩に潰瘍を伴う腫瘍があり、右声帯麻痺を伴っていた。右上頸部に弾性硬、可動性不良な腫瘤を触知した。造影CTでは甲状軟骨を破壊する腫瘍性病変、右上内深頸部領域にリンパ節腫大を認めた。下咽頭扁平上皮癌右梨状陥凹型T4aN1M0 Stage IVaと診断し、セツキシマブ併用放射線治療を行う方針とした。治療開始15日目にセツキシマブによるinfusion reaction(悪寒・戦慄・発熱)を認め、ヒドロコルチゾンコハク酸エステルナトリウム投与にて速やかに解熱したが、翌日の血液検査で血小板減少を認めた。薬剤性の骨髄抑制が強く疑われたため、すべての薬剤を中止したが、血小板数は更に低下して血小板輸血を要した。徐々に血液検査所見は改善し、セツキシマブは投与を中止し放射線治療のみを継続した。その後、ワーファリンを再開し、治療開始64日目に放射線治療70Gyを完遂したが、凝固能低下から右腸腰筋内血腫を生じた。ワーファリンのコントロール不良によるものと判断して同剤の中止、ビタミンK製剤投与、赤血球製剤、新鮮凍結血漿製剤の輸血を行ったところ、徐々に血液検査所見、血腫ともに改善した。放射線治療終了後22日目に退院し、治療効果はCRであった。

DOI： 10.5631/jibirin.108.63

Scopus

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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  

頭頸部領域に生じた高分化型脂肪肉腫の3例を経験したので報告する。症例1は78歳男性、頸縦隔脂肪肉腫。他院で縦隔病変の開胸切除後に当科紹介となり、頸部病変を全摘した。症例2は41歳男性、中下咽頭脂肪肉腫。経口切除後に再増大したため、頸部外切開により腫瘍を全摘した。永久病理診断にて一部粘液型部分を認めたため、術後照射を行った。症例3は62歳男性、頸縦隔脂肪肉腫。経頸部的に腫瘍を全摘した。脂肪肉腫は悪性軟部組織腫瘍の中では発生頻度が高いが、頭頸部領域では稀である。一般に悪性軟部組織腫瘍の治療には十分な安全域をつけた広範囲切除術が原則とされるが、脂肪肉腫の中でも良悪性中間腫瘍に位置する高分化型脂肪肉腫においては切除縁に関する統一見解はない。本報告では全例に辺縁切除術を行い、現在まで明らかな再発を認めていない。浸潤傾向のない頭頸部高分化型脂肪肉腫に対しては隣接臓器を温存した辺縁切除術で対応可能と思われた。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2014&ichushi_jid=J04195&link_issn=&doc_id=20140512480014&doc_link_id=10.5981%2Fjjhnc.40.75&url=https%3A%2F%2Fdoi.org%2F10.5981%2Fjjhnc.40.75&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_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  

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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：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：日本語   出版者・発行元：(NPO)日本頭頸部外科学会  

声門下狭窄を伴った先天性喉頭横隔膜症に対し、良好な治療経過を経た1例を報告する。症例は39週、2,320gで出生、直後から喘鳴を認めた。ファイバースコピーにて喉頭横隔膜症と診断され、呼吸状態が安定しないため気管切開術を施行した。1歳10ヵ月で直達喉頭鏡を施行し、喉頭横隔膜症に声門下狭窄を合併していることが分かった。2歳5ヵ月で喉頭截開を用いて根治術を施行、3ヵ月間ステントを留置し、ステント抜去後は再び気管カニューレを装用して経過観察とした。喉頭の再狭窄は生じず、3歳9ヵ月で会話が可能となり、5歳で気管孔閉鎖術を行った。現在6歳で、軽度の嗄声はあるが日常生活に支障を認めていない。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2013&ichushi_jid=J04210&link_issn=&doc_id=20130311410011&doc_link_id=10.5106%2Fjjshns.22.311&url=https%3A%2F%2Fdoi.org%2F10.5106%2Fjjshns.22.311&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

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：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：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：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：日本語   出版者・発行元：(一社)日本耳鼻咽喉科学会  

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