ABSTRACT
Intra-arterial chemoradiotherapy for advanced oral cancer has recently been reported and can preserve the form and function of the tongue by avoiding surgery at the primary site. We report here a case of advanced tongue cancer treated with intra-arterial chemoradiotherapy that preserved phonation and swallowing function. A 71-year-old man presented with an ulcerative mass, 43×28 mm in size, extending from the left lingual margin to the base of the tongue. The pathological diagnosis was squamous cell carcinoma based on biopsy results, and the clinical diagnosis was left lingual carcinoma (cT3N0M0, stage III) based on imaging findings. A polyurethane catheter was inserted into the left lingual artery, and intra-arterial chemotherapy was administered using docetaxel (15 mg/m2/week, total dose 60 mg/m2) and cisplatin (5 mg/m2/ day, total dose 125 mg/m2) with concurrent radiotherapy (2 Gy/day, total dose 50 Gy). Posttreatment biopsy results showed no tumor cells, and complete response was achieved, thus avoiding surgical resection of the primary site. Six years after completing treatment, the patient remains in good health with no recurrence, metastasis, phonation problems, or dysphagia.
ABSTRACT
In recent years, favorable therapeutic outcomes have been reported for arterial injection chemoradiotherapy for tongue cancer. The present case involves an 80-year-old woman in our palliative care department who had high-grade, advanced tongue cancer. Because there was a request for surgery to prevent airway occlusion due to growth of the tumor, she was referred to our department in April 2009. As a treatment policy for controlling tumor growth in high-grade, advanced tongue cancer, arterial injection chemoradiotherapy was carried out through the superficial temporal artery, with a tongue artery catheter in place on both sides. Therapeutic effect was obtained, and it was possible to avoid airway occlusion through tumor regression. Dysphagia and dysphemia were improved, which in turn improved quality of life. In this case, there was an opportunity to carry out multidisciplinary team medicine, including support from the oral care and palliative care teams as part of the process of cancer therapy. Here, we present our findings in this case.
ABSTRACT
Hematopoietic stem cell transplantation (HSCT) involves the administration of anticancer treatment at high doses that exceed the patient’s maximum required dose for total body irradiation, to eliminate malignancy and achieve myeloablation. Hematopoietic stem cells are then transfused to re-establish the lost hematopoietic function. The use of radiation, anticancer drugs, and immunosuppressive drugs can cause adverse events in the oral cavity such as mucositis, bleeding, opportunistic infections, and graft versus host disease. This collaborative report by the departments of hematology and oncology as well as dentistry and oral surgery at our institution discusses the perioperative oral functional management of patients undergoing HSCT. Subjects enrolled were 191 transplantation patients (52 autologous, 139 allogeneic) between 2008 and 2015. The subjects underwent professional tooth cleaning before commencing a transplant conditioning regimen. When the professional oral health care (POHC) treatment was completed, professional tooth cleaning (PTC), professional mechanical tooth cleaning (PMTC), and treatment with a dental drug delivery (3DS) system were provided. This perioperative oral functional management resulted in a decrease in the frequency of oropharyngeal candidiasis from 19.3% to 4.3%. We devised a standardized supportive oral care program from the preoperative period onward to minimize adverse oral events associated with HSCT. The program could effectively improve the quality of life of patients undergoing HSCT.