Combined and sequential treatment of oral and maxillofacial malignancies: an evolving concept and clinical protocol / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To introduce the concept and rational regimens and present the latest development of combined treatment of oral and maxillofacial malignancies. Data sources The related published literature was searched through the CNKI database and MEDLINE using the terms of oral cancer, oral and maxillofacial malignancies, combined and sequential therapy, multidisciplinary approach. Study selection The available related literature was read and evaluated. Studies that met the inclusion criteria were selected.</p><p><b>RESULTS</b>The results show that oral and maxillofacial malignancies diagnosed at an early stages (stages I and II) can be well treated with surgery alone and/or radiotherapy with optimal outcome, but advanced or recurrent diseases should be treated with rational combined and sequential treatment modalities. The use of concomitant chemoradiotherapy, taxane-containing, three-drug induction regimens and Cetuximab in combination with chemotherapy or radiotherapy demonstrated favorable results in previously untreated patients with head and neck squamous cell carcinoma.</p><p><b>CONCLUSIONS</b>The concept of combined and sequential treatment of advanced oral and maxillofacial malignancies should be widely accepted, and the rational regimen for individual and each type of entity should be determined based on the anatomical site and the patient's performance status.</p>

Experimental study of hydroxycamptothecine and theprubicine in the treatment of adenoid cystic carcinoma lung metastases / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate anticancer effect of hydroxycamptothecine and theprubicine in the treatment of established human adenoid cystic carcinoma (ACC) lung metastasis of nude mice and to determine the best therapy sequence of the two drugs.</p><p><b>METHODS</b>The model of ACC lung metastasis (60 animals) was established by injecting the ACC-M cells into the nude mice from their tail veins. Animals were divided into six groups: v acuity control group, HCPT group, THP group, HCPT and THP group 1, HCPT and THP group 2, HCPT and THP group 3 (No.1 - No.6). Different treatment sequence was performed on these groups. The lung samples were collected and observed after HE staining. The area of metastases and lung tissue were analyzed by the images analysis system.</p><p><b>RESULTS</b>The size of the metastatic lesion in the treatment groups were smaller than that in the control group (P < 0.01). The treatment effects between the group with simultaneous administration of HCPT and THP and the group with single drug administration were not different (P > 0.05). No.5 and No.6 groups showed better effect of treatment than the other treatment groups (P < 0.05).</p><p><b>CONCLUSIONS</b>There are two recommended sequences: (1) HCPT should be used after THP; (2) THP is used 48 hours, After HCPT is administered. Because using two drugs together will decrease the anticancer effect, HCPT and THP should not be used simultaneously.</p>

Modulation of Chinese regimen granules of Shenyang on peripheral blood lymphocyte subsets of SD rats with SCC of tongue / 中华口腔医学杂志

<p><b>OBJECTIVE</b>Prospective research demonstrated that Chinese regimen granules of Shenyang could prolong survival time and improve survival rate of patients with oral squamous cell carcinoma (SCC). But the mechanism was not clear. The purpose of this study was to investigate Shenyang's effect on peripheral blood lymphocyte subsets of SD rats with SCC of tongue and explore immunological mechanism.</p><p><b>METHODS</b>Among 80 SD rats fed by 0.002% 4-nitroquinoline-1-oxide (4NQO) drinking water for 36 weeks, 61 rats with SCC of tongue had been found and were randomly divided into 4 groups, namely Shenyang A, Shenyang B, positive and blank control groups. Before and after high and normal dosage of Shenyang, acanthopanax senticoside and water had been given for 15 days respectively, peripheral blood lymphocyte subsets were detected with flow cytometry. The data were statistically analyzed with paired t Test.</p><p><b>RESULTS</b>Percentage of CD3+ CD4+ T cell and CD3-CD161a+ NK cell, ratio of CD4+/CD8+ were increased. Percentage of CD3+CD8+ T cell was decreased, and the effect was better than that of acanthopanax senticoside in improving the percentage of CD3-CD161a+ NK cell.</p><p><b>CONCLUSION</b>Among anti-tumor mechanisms of Shenyang it is that corrects disorder of lymphocyte subsets and increases percentage of CD3-CD161a+ NK cell.</p>

Chemotherapy with higher or lower dose of teniposide combined with cisplatin and pingyangmycin for oral squamous cell carcinoma / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To compare the clinical efficacy and toxicity of teniposide (VM26) of higher dose with those of lower dose, both combined with cisplatin (CDDP) and pingyangmycin (PYM), in the treatment of patients with squamous cell carcinoma of oral and maxillofacial region (SCCOMR).</p><p><b>METHODS</b>Sixty-five patients with SCCOMR entered into this study prospectively. Thirty-three patients were treated with higher dose of VM26 (total dose was 320 mg) combined with CDDP and PYM (PTP1), the other thirty-two patients were treated with lower dose (total dose was 158 mg) of VM26 combined with CDDP and PYM (PTP2).</p><p><b>RESULTS</b>Thirty-three patients received a total of 38 cycles of PTP1. The overall response rate was 81.82% (27/33). Thirty-two patients received a total of 36 cycles of PTP2 and showed overall response rate by 81.25% (26/32). There was no significant difference between PTP1 and PTP2 groups in response rate (P > 0.05). But the blood toxicity was more severe in PTP1 group than in PTP2 group (P < 0.01). Bone marrow depression rate (1-4 stage) was 48.48% in PTP1 group versus 25.00% in the other group.</p><p><b>CONCLUSIONS</b>A high response rate of 81.25% and relatively slighter adverse events could be obtained for lower dose of VM26 combined with CDDP and PYM (PTP2). So, the chemotherapy schedule, PTP2, a novel teniposide based regimen in SCCOMR could be employed and spread in clinical practice.</p>

Relevant factors and management for patients with squamous carcinoma in tongue without clinical cervical lymphatic node metastasis / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To discuss the treatment of cN(0) tongue carcinoma patients.</p><p><b>METHODS</b>185 cases of the mobile tongue carcinoma patients (male 102, female 83, aged 28 to 88) treated with surgery from 1988.5 to 1995.6 had been followed up and retrospectively analyzed. Extensive resection of the primary tumors and neck dissections were performed, and all the samples were pathological positive.</p><p><b>RESULTS</b>The cervical lymphatic node metastasis rates for stage I-II, III-IV disease, grade I, II disease were 16.66%, 38.05%, 17.42% and 37.50% respectively. And the rates were 9.00%, 31.37% and 55.55% for submucous infiltration, muscle infiltration and perineural infiltration, respectively. The overall 5 year survival was 72.43%, and the 5 year specific survival rate was 44.44% and 83.96% for those having or not having cervical node metastasis. The levels of 29 patients with positive node metastasis for 148 cN(0) patients were submandibular and submental lymphatic nodes (22.64%), superior deep cervical lymphatic nodes (35.84%), middle deep cervical lymphatic nodes (26.41%), inferior deep cervical lymphatic nodes (15.09%), posterior neck lymphatic nodes (0.00%). The over all 5 year survival rates for selective neck dissection were 85.13% and 21.62% in therapeutic dissection (chi(2) = 29.73, P < 0.01). Patients performed selective neck dissection the rates were 68.96% and 89.07% respectively with or without lymphatic node metastasis. Comparably the 5-year rate was only 20.00% for the patients performed the therapeutic dissection with lymphatic node metastasis.</p><p><b>CONCLUSIONS</b>(1) cN(0) patients should be observed carefully in stage I, and the selective dissection must be performed in stage II-IV. (2) Supraomohyoid ND is essential for T(2) patients, and functional ND is essential for T(3 - 4) patients. (3) There is correlation between cervical metastasis and the stage, grade or infiltration of tongue cancer (P < 0.05). The prognosis could be expected from these factors.</p>

CT assist in surgical design for the posterior pharyngeal flap / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To establish a method for assist design of the posterior pharyngeal flap (PPF).</p><p><b>METHODS</b>The width, length of velopharyngeal space in repose and phonation of "i" in 26 cases with VPI were measured with CT. The width and length of PPF needed, the location of the pedicle and the contact position with the soft palate were analyzed.</p><p><b>RESULTS</b>The width of velopharyngeal space in repose ranged from 15.10 to 37.25 mm, with the average of 27.01 mm, the length was 12.54 to 30.39 mm, with the average of 22.10 mm. The width in phonation of "i" was 9.11 to 34.06 mm, with the average of 17.69 mm, the position of the pedicle wasall located at the level of the first cervical vertebra or above and the contact area of the flap with the soft palate was in the middle posterior 1/3 mostly.</p><p><b>CONCLUSION</b>As a method to quantitatively evaluate velopharyngeal function, CT can assist in design for the PPF.</p>