[Show abstract]ABSTRACT: Background
The increasing incidence of radiation-induced osteosarcoma of the maxilla and mandible (RIOSM) has become a significant problem that can limit long-term survival. The purpose of this study was to analyze the association of clinicopathologic characteristics with treatment outcomes and prognostic factors of patients who developed RIOSM after undergoing radiotherapy for nasopharyngeal carcinoma (NPC). Methods
We reviewed the medical records of 53,760 NPC patients admitted to Sun Yat-sen University Cancer Center during the period August 1964 to August 2012. Of these patients, 47 who developed RISOM and met inclusion criteria were included in this study. Two of these 47 patients refused treatment and were then excluded. ResultsFor all patients treated for NPC at Sun Yat-sen University Cancer Center during the study period, the total incidence of RIOSM after radiotherapy was 0.084% (47/53,760). Two patients (4.4%) had metastases at the diagnosis of RIOSM. Thirty-nine of the 45 (86.7%) patients underwent surgery for RIOSM; most patients (24/39; 61.5%) who underwent resection had gross clear margins, with 15 patients (38.5%) having either a gross or microscopic positive margin. All patients died. The 1-, 2-, and 3-year overall survival (OS) rates for the entire cohort of 45 patients were 53.3%, 35.6% and 13.5%, respectively. The independent prognostic factors associated with high OS rate were tumor size and treatment type. ConclusionsRISOM after radiotherapy for NPC is aggressive and often eludes early detection and timely intervention. Surgery combined with postoperative chemotherapy might be an effective treatment to improve patient survival.
Full-text available · Article · Dec 2016 · Chinese journal of cancer
[Show abstract]ABSTRACT: Pinato prognostic nutritional index (PNI) adequately predicts long-term outcomes of various malignancies. However, its value in predicting outcomes in laryngeal squamous cell carcinoma (LSCC) is unknown.
All patients newly diagnosed with LSCC presenting to the Department of Head and Neck Oncology at Sun Yat-sen University Cancer Center between January 1, 1990 and July 31, 2010 were eligible. The PNI was calculated as serum albumin (g/L) + 5 × total lymphocyte count/L. The Cutoff Finder software program was used to classify the patients into 3 groups for which the PNI score was at least 70% sensitive, at least 70% specific, or equivocal. Cancer-specific survival was estimated using the Kaplan–Meier method, and predictors were assessed with Cox regression analysis.
Median time between surgery and PNI administration for the 975 eligible patients was 83 months. Index score groups were significantly associated with age, T stage, TNM stage, and type of surgery. Five-year CSS and OS were 57.3% and 56.6% in patients with PNI scores below 48.65 (low-probability of survival), 72.8% and 71.3% with scores between 48.65 and 56.93 (moderate-probability of survival), and 77.6% and 75.3% with scores above 56.93 (high-probability of survival); 10-year CSS and OS were 44.2% and 42.7%, 61.6% and 55.6%, 68.3% and 63.5%, respectively. The PNI score groups significantly predicted CSS and OS (P < 0.001).
The PNI is an inexpensive and readily available score that predicted survival in patients with LSCC after curative laryngectomy.
[Show abstract]ABSTRACT: The aim of this study was to describe a new technique of combined hyoid bone and thyrohyoid membrane flap in laryngeal reconstruction after tumor resection, and to evaluate outcome.
Six patients requiring an frontal partial laryngectomy for cancer were enrolled between September 2008 and August 2012.
Nasogastric feeding was initiated within 24 hours. The mean times to swallow batter, ability to drink water and removal of the nasogastric tube were 2.6, 5.5 and 6.3 days. All patients had good respiratory function. There were no deaths, and no reports of postoperative dyspnea or dysphagia. The vocal quality was satisfactory, slightly deeper and raspy, and the volume was weak when calling. The final follow-up assessment was in August 2012, and the overall mean follow-up period was 29.5months, range 14 to 47 months. Case two subsequently underwent total laryngectomy for recurrence in the paraglottic space, but there was no evidence of further tumor recurrence at the final assessment.
The combined muscle-pedicle hyoid bone and thyrohyoid membrane flap is a reliable graft for one-stage repair of laryngotracheal defects, providing effective repair of the mucosa and cartilage support. Vocal quality, swallowing function and ventilation after the procedure were favorable.
Article · Apr 2013 · Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery
[Show abstract]ABSTRACT: Objective:
Evaluate the impact of cervical metastasis on the survival of patients with squamous cell carcinoma (SCC) of the hard palate.
155 cases of SCC of the hard palate hospitalized in Cancer Center, Sun Yat-sen University, from 1964 to 2008 were reviewed retrospectively.
The 5-year DSS rates for N+ and N0 patients were 21.54% and 47.36% (P = .048). The 5-year DSS rates were 47.36%, 27.48%, 15.55% and 0 for N0-N3 lesions, respectively (P = .041). Cervical metastasis was detected in 40% patients for initial consultation. After therapy, those individuals who presented with clinically negative necks had a 9.03% rate of cervical metastasis. Ultimately, 49.03% of patients manifested disease to the cervical lymph nodes.
The presence of cervical nodal disease in patients is associated with the decreased survival rates. SCC of the hard palate should be treated aggressively, and elective neck dissection should be considered because of the high rate of cervical metastasis.
[Show abstract]ABSTRACT: PURPOSE: The purpose of this study was to assess the clinical application and therapeutic efficacy of through-and-through cheek defects reconstructed with folded anterolateral thigh (ALT) flaps. PATIENTS AND METHODS: From January 2009 to May 2012, 10 patients with through-and-through cheek defects resulting from resection of cheek tumor underwent reconstruction with the folded ALT flap at Sun Yat-Sen University Cancer Center, Guangzhou, China. Surgical procedures in harvesting the ALT flap, as well as the surgical anatomy, are described, and the success rate is reported. RESULTS: All ALT flaps were fasciocutaneous flaps. One patient with a thrombotic event required operative exploration in the perioperative period. All 10 flaps were based on a single perforator for reconstruction of defects. In all 10 cases, the donor site was closed primarily for the ALT flap, leaving only a linear scar that was inconspicuous with normal clothing, and the thigh had no functional deficit. CONCLUSIONS: The free ALT flap has good pliability and can be folded for the reconstruction of both the inner and outer lining of through-and-through cheek defects. This flap presents good functional results at the recipient site with the additional advantages of minimal donor-site morbidity, a very acceptable esthetic result, and a high level of patient satisfaction.
Full-text available · Article · Jan 2013 · Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons
[Show abstract]ABSTRACT: To evaluate the value of using a linear stapler device for the cloure of the pharynx during total laryngectomy.
Sixteen total laryngectomies were performed between August 2010 and December 2011, during the operation, the TA 60 linear stapler was used for pharyngeal closure. Among these patients, two patients had the history of pre-operative radiotherapy, four patients recurred after radiotherapy, ten patients were treated for the first time. 100 ml methylene blue was injected into the newly closed laryngopharyngeal cavity through the nasopharyngeal breather pipe for checking up whether it was watertight or not.
Among the sixteen patients, methylene blue leakage from the mucosal joint of the gular cavity closed by the stapler were not found in fifteen patients, it was only found in one patient. The transudatory places were sutured with absorbable Vicryl sutures. This patient healed well without pharyngocutaneous fistula. Negative surgical margins were achieved in all patients. No patient needed to be tranfered to open surgery. Using a linear stapler device in total laryngectomy, 45 minutes could be saved as compaired to manual suture. One patient developed a light pharyngocutaneous fistula. The incidence of pharyngocutaneous fistula was 6.25% (1/16).
This stapled closed technique for pharyngoplasty is efficient, eliminates the risk of wound contamination, saves operation time and decreases the incidence of pharyngocutaneous fistula. This technique can be recommended as alternative for repairing the pharynx in patients undergoing total laryngectomy.
Article · Jul 2012 · Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery
[Show abstract]ABSTRACT: Minor salivary gland carcinoma of the hard palate is rare, and its long-term survival rate is high, making it difficult to evaluate the prognostic factors and the efficacy of treatment. This study was designed to evaluate the treatment outcome of minor salivary gland carcinoma of the hard palate. 103 cases of minor salivary gland carcinoma of the hard palate treated with surgery alone or underwent surgery combined with post-operative radiotherapy hospitalized in Cancer Center, Sun Yet-Sen University, from 1968 to 2008 were reviewed retrospectively. The most common histologic types were adenoid cystic carcinoma in 48 patients(46.6%), mucoepidermoid carcinoma in 37(35.92%), malignant mixed tumor in 15(14.56%), and acinic cell carcinoma in 3(2.91%). The median follow-up time was 74.83 months (range 0.9-356.57 months). Overall outcomes at 5 and 10 years were overall survival (OS), 77.9% and 65.7%; recurrence-free survival (RFS), 64.4% and 53.2%; and disease specific survival (DSS), 77.9% and 67.7%, respectively. There was no significant difference in overall survival (P=0.52), recurrence-free survival (P=0.762) and disease specific survival (P=0.449) between patients who underwent surgery alone and those who underwent surgery plus post-operative radiotherapy. Surgery has been accepted as the primary treatment for minor salivary gland carcinoma of hard palate. Sufficient surgical excision with adequate margins is essential for a favorable outcome. We advocate using radiotherapy in the post-operative context for patients with poorly differentiated, cervical lymph node metastasis, positive or close margins, and large primary lesions.
[Show abstract]ABSTRACT: The free jejunum flap approach is the optimal option for circumferential pharyngolaryngectomy reconstruction. In this study, we designed a "watch window" for monitoring buried free jejunum flaps, thereby allowing us to assess graft viability. From 2007 to 2011, 14 patients with hypopharyngeal cancer underwent circumferential pharyngolaryngectomy that was reconstructed using a free jejunum flap at the Sun Yat-sen University Cancer Centre. During the closing of the neck incision, a "watch window" was designed for postoperative monitoring. Two patients experienced thrombosis of the pedicle. One was detected early and successfully rescued by removal of the thrombosis, the other one managed with a second free jejunum flap. The success rate of the buried flaps was 92.9%. No pharyngocutaneous fistulas or strictures occurred. All patients eventually resumed oral feeding and swallowing. The "watch window" technique for monitoring buried free jejunum flaps is simple, reliable and useful for finding vascular problems. Level of evidence Case series.
Article · Nov 2011 · Archives of Oto-Rhino-Laryngology
[Show abstract]ABSTRACT: This study compared the reliability, practicability and impact to donor site functionality of radial forearm (RF) and anterolateral thigh (ALT) flaps used for the reconstruction of head and neck soft-tissue defects. The clinical data of patients who underwent reconstruction using RF flaps (n = 53) and ALT flaps (n = 21) after tumour ablation were reviewed. Pedicle length, skin area harvested and flap survival rate were compared between the two flap types. A questionnaire was used to compare the patients' perceptions of donor site functionality. Pedicle length did not significantly differ between RF and ALT flaps (7.5 vs. 9 cm, p = 0.733). A significantly larger mean area of skin was harvested in the ALT group than in the RF group (65 vs. 38 cm(2), p = 0.001). Flap survival rates did not differ between the two groups (p = 0.554). Patients in the ALT group were more satisfied with the appearance of the donor sites than were those in the RF group (p = 0.029). Significantly more patients in the RF group complained of donor site numbness than in the ALT group (p = 0.014). No ALT group patients complained of movement impairment or weakness at the donor sites, but 10% of RF group patients experienced impairment (p = 0.014) and 35% felt weakness (p = 0.001). The ALT and RF flaps showed similar practicability and reliability for the reconstruction of soft-tissue defects, but ALT flaps had fewer impacts to donor site functionality than RF flaps.
Article · Mar 2011 · Archives of Oto-Rhino-Laryngology
[Show abstract]ABSTRACT: The objective of this study was to evaluate whether elective neck dissection could improve regional control or survival time in clinical stage I squamous cell carcinoma of the oral tongue (OTSCC). This was a retrospective study of patients with surgical treatment between January 1991 and December 2003. A total of 131 patients were included in the study, and all of them received operation of the primary site, while 88 cases underwent selective neck dissection simultaneously including level I-III neck dissection in 49 patients and level I-V neck dissection in 39 patients. In all these cases, the rate of occult neck metastases was 23.7%. The 4-year local control rates in patients with only primary site treatment, patients with level I-III neck dissection and patients with level I-V neck dissection were 81.0%, 83.6% and 89.1%, respectively. By univariate analyse, neck dissection did not increase regional control rate, disease free survival (DFS) or overall survival (OS). Multivariate analyses showed that neck dissection was not an independent factor for DFS or OS. This study showed that the occult neck metastases rate was 23.7% in clinical stage I OTSCC. Elective neck dissection did not significantly improve regional control, DFS and OS in clinical stage I patients. There is a need for accurate and valid methods to select the patients who would benefit from elective neck treatment.
[Show abstract]ABSTRACT: To investigate the feasibility and efficacy of laryngeal framework reconstruction using titanium mesh in patients with glottic cancer after frontolateral vertical partial laryngectomy.
Defect of laryngeal framework, caused by frontolateral vertical partial laryngectomy in nine patients with T2 or T3 squamous cell carcinoma of glottic, were reconstructed with titanium mesh from 2007 to 2009. Computed tomography (CT) and fiberscopic examinations were performed at two weeks and three months postoperatively.
No aspiration and laryngeal stenosis was observed in the nine patients. CT scanning showed that titanium mesh was fastened well without displacement and deformity and that there was no laryngeal stenosis. Fiberscopic inspection showed that the larynx lumen was maintained well without stricture, shrinkage, and necrosis. No titanium mesh was exposed to the larynx lumen.
Titanium mesh was a good alternative for reconstruction of the laryngeal framework. It provided adequate structural support to maintain airway patency.
[Show abstract]ABSTRACT: To evaluate clinical feature, diagnosis, treatment and prognosis of myoepithelial carcinoma (MC) in the head and neck.
Clinical data of 11 patients which were confirmed by pathology and immunohistochemistry in Cancer Center, Sun Yat-sen University from Jan. 1992 to Dec. 2006, were reviewed. There were 5 cases in parotid gland, 1 in hard palate, 1 in maxillary sinus, 1 in pharyngeal recess, 1 in bucca cavioris, 1 in scalp, and 1 in gingiva. Male female ratio is 4 to 7. The median age at diagnosis was 37 years (range: 14 - 60 years).
All cases were operated, 4 underwent surgery alone, 2 underwent surgery plus adjuvant radiotherapy, 2 received surgery plus adjuvant chemotherapy, 3 underwent surgery plus adjuvant chemoradiation. After operation, 8 cases occurred local recurrence and 4 cases occurred distance and lymph nodes metastasis. There was spindle cell type in 5 cases, clear cell type, plasmacytoid cell type in 2 cases, epithelioid cell type, mixed type in 1 case. The median follow-up time was 40 months. AS to the last follow-up time, 8 patients died.
The characteristics of the tumor were rapidly enlarging, invading the surrounding regions, high rates of lymph node metastasis, high rates of distance metastasis. It was easily recurrence if the surgical excision was not radically for MC, and the prognosis was poorly. MC was a sort of malignant tumor. Radical operation must be advocated initially. Chemotherapy and radiotherapy may be effective after operation.
Article · Feb 2010 · Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery
[Show abstract]ABSTRACT: Although anterolateral thigh (ALT) flap has the advantage of limited damage to the donor site, its clinical application is not common. This study was to study the clinical value of ALT flap in the reconstruction of head and neck soft tissue defects.
Twenty patients receiving reconstruction of head and neck soft tissue defects using ALT flap at Sun Yat-sen University Cancer Center between November 2004 and May 2008 were retrospectively reviewed. Surgical procedures in the harvest of ALT flap were described. The surgical anatomy and successful rate were reported.
Twenty patients were all alive. The vessel pedicle length of ALT flap ranged from 5 cm to 14 cm, with an average of 9.9 cm. The harvested ALT flap was (4-9) cm X (6-16) cm. The skin perforator was classified into four cases of intermuscular septal branch (20%) and 16 cases of musculocutaneous branch (80%). The head and neck soft tissue defects included 14 cases (nine cases of tongue and oral floor, three cases of buccal mucosas, one case of hard palate, and one case of retromolar trigone mucosa) intraoral mucosa and six cases of facial-cervical skin defects. Except for one case, the donor sites were primarily sutured.
ALT flap is one of valuable and potential donor site for the reconstruction of head and neck soft tissue defects. It could achieve a high successful rate and causes little influence to the donor sites.
Article · Oct 2009 · Ai zheng = Aizheng = Chinese journal of cancer
[Show abstract]ABSTRACT: To investigate the clinical manifestations, EB virus serology and treatment outcome of nasopharyngeal adenocarcinoma (NPAC).
Clinical records of NPAC patients between 1964 and 2000 in Cancer Center of Sun Yat-sen University were retrospectively reviewed.
Among 48 patients with NPAC, 45.2% (7 cases of N1, 8 cases of N2 and 4 cases of N3) of them presented with cervical metastasis. Pathologically, common type and salivary gland type of NPAC accounted for 58.3% (28 cases) and 41.7% (20 cases) respectively. The positive rate of the EB virus antibody VCA-IgA was 56.7% in the whole group and only 23.7% in the salivary gland type of NPAC. The overall local control rate and the 5-year disease free survival rate by Kaplan-Meier method were 87.0% (40/46) and 65.2% respectively. Baseline data analysis showed that age, gender, N stage and M stage were not the significant factors, never the less the T stage was not balanced between the two groups (surgery plus radiotherapy vs radiotherapy alone, chi2 = 4.801, P = 0.045). The patients treated by surgery plus radiotherapy had significantly higher 5-year disease free survival rate than by radiotherapy alone (88.9% vs 74.7%, Log Rank test: chi2 = 4.272, P = 0.039). Cox's multivariate analysis showed treatment modality and N stage were the significant factors influencing survival (RR were 15.276 and 6.529, P < 0.05).
NPAC is a distinct entity in all types of nasopharyngeal carcinoma. EB virus serology has limited value in its diagnosis. Surgery plus radiotherapy could be another choice of treatment for early lesions of NPAC.
Article · Mar 2009 · Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery
[Show abstract]ABSTRACT: Post irradiation osteosarcoma (PIOS) in patients with nasopharyngeal carcinoma (NPC) is rare and a potential late complication of radiation. We investigate its clinicopathological features and prognosis.
426 cases of bone sarcomas in Cancer Center of Sun Yat-sen University, China between 1964 and 2003 were reviewed retrospectively. Fifteen patients were determined to have PIOS after radiation of NPC. Its prevalence rate, onset time, site, image features, and treatment were described. Kaplan-Meier analysis was used to determine the relative prognostic factors.
In 12 patients undertaken radical surgery, one patient had residual tumor and six patients presented tumor recurrence five to 19 months (mean of nine months) after surgery. All patients survived seven to 41 months with a mean of 18 months. The one-year and two-year survival rates were 60% and 24% respectively. Female patients with large area of tumor bone formation in images had better survival than male patients without or few tumor bone formation. Age, radiation dosage, onset time of PIOS, tumor size, and treatment were probably not significant factors to prognosis.
PIOS in patients with NPC is a high malignant disease and often has poor prognosis. Surgery with pre-and post-operative chemotherapy might be a way to improve its survival.
Article · Dec 2005 · Zhonghua er bi yan hou tou jing wai ke za zhi = Chinese journal of otorhinolaryngology head and neck surgery
[Show abstract]ABSTRACT: Tumor markers which relate to cell proliferation and metabolism have seldom been studied in maxillary sinus cancer. This study was conducted to identify the correlation of glutathione S-transferase pi (GST-pi) and proliferating cell nuclear antigen (PCNA) expression to prognosis of advanced maxillary sinus squamous cell carcinoma (SCC).
The expression of GST-pi and PCNA in 54 specimens of maxillary sinus SCC, 29 specimens of benign maxillary tumor, and 20 specimens of normal nasal mucosa was detected by immunohistochemistry. The correlation of GST-pi and PCNA expression to prognosis of advanced maxillary sinus SCC was analyzed by Kaplan-Meier method. The prognosis was analyzed by Cox multivariate model.
The overexpression rates of GST-pi and PCNA were significantly higher in maxillary sinus SCC than in benign maxillary tumor and normal nasal mucosa (74.1% vs. 89.6% and 15.0%, P<0.01; 79.6% vs. 3.4% and 0, P<0.01). The 5-year survival rate was significantly higher in advanced maxillary sinus SCC patients with high expression of GST-pi than in the patients with low expression of GST-pi (34.5% vs. 21.2%, P=0.025); the difference between the patients with high and low expression of PCNA was not significant (18.0% vs. 27.0%, P=0.890). The expression of GST-pi was an independent prognostic factor of advanced maxillary sinus SCC (P=0.039, odds ratio>1).
The overexpression of GST-pi is an independent prognostic factor of advanced maxillary sinus SCC, but that of PCNA isn't.
Article · Oct 2005 · Ai zheng = Aizheng = Chinese journal of cancer
[Show abstract]ABSTRACT: To investigate the expression and clinical significance of gelatinases (MMP-2 and MMP-9) in patients with laryngeal squamous cell carcinoma (LSCC).
In a retrospective study of 72 consecutive patients with LSCC hospitalized in a single cancer center, immunohistochemistry was used to examine the expression of MMP-2 and MMP-9 in surgical samples. The results were compared to clinicopathological features and prognosis.
The positive expression of MMP-2 and MMP-9 in patients with LSCC was 50% (36/72) and 73.6% (53/72), respectively. According to the expression scale, there were 36 patients of -, 26 patients of +, 7 patients of ++, and 3 patients of +++ expression of MMP-2; 19 patients of -, 26 patients of +, 16 patients of ++, and 11 patients of +++ expression of MMP-9. There was no significant relationship found between the expression of MMP-2 or MMP-9 and clinicopathological features of LSCC, such as histological grade, primary site, T stage, N stage, and clinical stage. The 5-year overall survival (OS) and disease-free survival (DFS) rate calculated by Kaplan-Meier method in patients with negative and positive expression of MMP-9 and MMP-2 was 73.68%, 50.94%, 73.68%, and 49.06% in MMP-9 and 72.22%, 41.67%, 72.22%, and 38.89% in MMP-2, respectively. Significant 5-year survival difference was found between patients with negative and positive expression of MMP-2 (log rank = 6.74, P = 0.0094). There was significant lower survival rate in patients with higher positive expression of MMP-2 (log rank = 11.77, P = 0.0028). In glottic laryngeal cancer, positive expression of MMP-2 could predict poor survival and was more likely to present primary recurrence.
The expression of MMP-2 could be used as a potential predictor for poor prognosis in patients with LSCC.
Article · Apr 2005 · Otolaryngology Head and Neck Surgery
[Show abstract]ABSTRACT: Five-year survival rate of patients with maxillary malignant neoplasms is low, the prognostic factors of these neoplasms were unclear. This study was to investigate prognostic factors of maxillary sinus malignant neoplasms.
Records of 151 inpatients with malignant neoplasms of maxillary sinus initially treated at Cancer Center of Sun Yat-sen University from Sep. 1983 to Mar. 1999 were reviewed. Of 151 cases, 72 were squamous cell carcinoma (SCC), 44 were adenocarcinoma, 16 were sarcoma, and 19 were other histological types; according to 1997 UICC classification, 7 were stage II, 55 were stage III, and 89 were stage IV; 66 patients received combined therapy of surgery and radiotherapy, 14 received surgery alone, 25 received radiotherapy alone, 39 received other treatments, and 7 gave up treatment. All patients were followed up for more than 5 years. Influences of clinicopathologic factors on prognosis of patients with maxillary sinus malignant neoplasms were analyzed by Kaplan-Meier method, and Cox regression model with SPSS10.0 software.
Five-year overall survival rate of patients of </=40 years old was 55.7%, that of patients of >40 years old was 33.3%(P=0.030); that of patients with SCC was 30.2%, of patients with adenocarcinoma was 57.5%, of patients with sarcoma was 24.3%, of patients with tumor of other histological types was 50.7% (P=0.011); that of patients with tumor of stage II, III, and IV were 85.7%, 45.8%, and 32.7%, respectively (P=0.029); that of patients with cervical metastases was 14.4%, of patients without cervical metastases was 44.1% (P=0.005); that of patients with distant metastases was 14.3%, of patients without distant metastases was 41.1% (P=0.011); that of patients without treatment was 14.3%, of patients treated with surgery alone was 42.9%, of patients treated with radiotherapy alone was 32.3%, of patients treated with combined therapy of surgery and radiotherapy was 50.8%, of patients treated with other treatments was 29.1% (P=0.004). Univariate survival analysis showed that the above 6 factors were prognostic factors of patients with maxillary sinus malignant neoplasms. Multivariate analysis showed that combination of surgery and radiotherapy (P=0.004, OR< 1), clinical stage (P=0.025, OR >1), SCC (P=0.016, OR >1), and sarcoma (P=0.003, OR >1) were independent prognostic factors of patients with maxillary sinus malignant neoplasms.
For maxillary sinus malignant neoplasms, patients with SCC or sarcoma had poorer survival than patients with adenocarcinoma or other histological types of tumor; patients with sarcoma had poorer survival than patients with SCC. The higher the patient's clinical stage was, the worse his prognosis was. Combination of surgery and radiotherapy may be the best treatment for patients with maxillary sinus malignant neoplasms.
Article · Nov 2004 · Ai zheng = Aizheng = Chinese journal of cancer
[Show abstract]ABSTRACT: There were few reports about combined usage of taxotere in induction chemotherapy of head and neck cancer. It was reported previously that the total response rate in advanced head and neck cancer using TPF regimen [taxotere+cisplatin(DDP)+5-fluorouracil (5-FU)] was 93%. In this article, the authors preliminarily reported the response rate and side effects of TPF regimen in head and neck cancers.
Twenty-five cases with head and neck cancers in Guangzhou Tumor Hospital from January 1999 to June 2002 were reviewed. All cases underwent induction chemotherapy using TPF regimen (taxotere 75 mg/m(2), i.v. drip, d1; DDP 20 mg/m(2), i.v. drip, d1-3; 5-FU 300 mg/m(2), i.v. drip, d1-3; repeat per 3 weeks). All cases were followed up during chemotherapy and their response was evaluated after induction chemotherapy. The side effects were recorded.
Six cases (24.0%) and 12 cases(48.0%) presented complete remission (CR) and partial remission (PR) after induction chemotherapy using TPF regimen, respectively. There were 7 cases with minimal or none response. The total response rate (CR+PR) after TPF induction chemotherapy was 72.0%. The response rates in oral cancers and the cancers in other primary sites including the base of tongue, larynx, hypopharynx, and nasopharynx were compared. It demonstrated that the response rates were 63.6%(7/11) and 71.4%(10/14), respectively, and there was no significant difference between the two groups (P=0.504). In this study, there were 9 cases that relapsed after first treatment. Their response rate after TPF induction chemotherapy was 44.4% (4/9), which had 1 case of CR and 3 cases of PR. In this study, 36.0% (9/25) patients had leucopoenia including 16.0% (4/25) of degree I, 16.0% (4/25) of degree II, 4.0%(1/25) of degree III according to WHO standard;64%(16/25) of patients presented side effects in alimentary system, but the level was all under II according to WHO standard. The side effects in kidney in all patients were degree 0. Other side effects included hair loss but their degrees were all under II according to WHO standard.
Induction chemotherapy using TPF regimen in local advanced head and neck cancers could have good chemotherapy response. It is effective for local relapse cases after first treatment and its side effects are tolerable.
Article · Aug 2003 · Ai zheng = Aizheng = Chinese journal of cancer
[Show abstract]ABSTRACT: To investigate the factors on distant metastases (DM) of laryngeal cancer.
277 cases of laryngeal cancer hospitalized in Cancer Center of Sun Yat-sen University from 1990 to 1995 were reviewed. 18 cases with DM were investigated to confirm the distant metastatic rate, target organ, time interval, and prognosis. Kaplan-Meier and Cox model analysis were used to find the significant indicators for DM in laryngeal cancer.
The overall incidence of DM in laryngeal cancer was 6.5% (18/277). The target site of DM was mainly in lung 83.3% (15/18), liver 16.7% (3/18). 3 cases with DM in lung also combined with bone metastases which occurred in vertebra 1, lib 1 and 1 in multi-sites. 2 patients were diagnosed DM when admitted, and the rest with time interval between 1 and 103 months (median 7 months). The 3-year and 5-year cumulative survival in laryngeal cancer with DM was 23.8% and 11.9% respectively. The time interval between the presentation of DM and death was 2.77 months (median 4.6 months). The worst prognosis is liver metastasis with which the patient could survive 4.6 months at most in our study. Kaplan-Meier analysis in 277 laryngeal cancers showed that pathology, pathological differentiation of squamous cell carcinoma, N stage, and clinical stage were significant indicators for DM from laryngeal cancer. Cox model analysis showed that only N stage was the significant prognostic factor for DM in laryngeal cancer (Wald = 7.889, P = 0.005).
Laryngeal cancer has certain percentage of DM, which is mainly in lung and their prognosis is usually poor. Non-squamous cell carcinoma, low pathological differentiation, cervical metastasis and advanced cancer are the possible indicators for DM, but our study shows that only N stage significantly predicts DM from laryngeal cancer.
Article · Jul 2003 · Zhonghua er bi yan hou ke za zhi