Clinical analysis of diversity of defect repair with supraclavicular island flap after head and neck tumor surgery / 临床耳鼻咽喉头颈外科杂志

Objective:To investigate the diversity and clinical effect of supraclavicular island flap in repairing the defect after head and neck tumor surgery. Methods:A retrospective analysis was performed on 30 patients who received the repair of head and neck defects with supraclavicular island flaps at Department of Otorhinolaryngology Head and Neck Surgery of the First Affiliated Hospital of Chongqing Medical University from January 2017 to March 2023. The sites and types of defects, intraoperative blood loss, time of flaps preparation, areas of flaps, survival of the flaps and other complications were recorded. Results:A total of 30 patients were enrolled, including 26 males and 4 females, aged 36-82 years. Among them, 22 patients with hypopharyngeal partial defect were repaired （19 patients with ipsilateral defect and 3 patients with contralateral defect）. In addition, 2 patients were repaired with contralateral pectoralis major musculocutaneous flap around the hypopharynx, the neck skin defect was repaired in 2 patients, the parotid skin defect was repaired in 2 patients, the temporal bone skin defect was repaired in 1 patient, and the cervical esophageal defect was repaired in 1 patient. The average blood loss during the operation was 8 ml, and the average time was 32 min. The flap areas ranged from 5.0 cm×4.0 cm to 20.0 cm×8.0 cm. 27 of 30 flaps survived（90.0%）, and pharyngeal fistula occurred in 6 patients after operation（4 flaps survived after local dressing）. One patient was complicated with venous thrombosis（the flap necrosis after local dressing）. Shoulder and neck functions（lift, internal rotation and abduction） were not significantly affected in 29 patients, and the function of 1 patient with shoulder infection was not affected after treatment. Conclusion:Supraclavicular island flap is a highly vascularized axial fascial flap. It is easy to make, thin, and soft in texture, and can be used to repair different sites and types of postoperative head and neck tumor defects with a low donor site complication rate. Good results in post-operative repair of head and neck tumors are worth promoting.

Recipient vessels for free flaps in advanced facial oncologic defects

Abstract Objectives To prospectively compare the results of microvascular flap reconstruction of midface and scalp advanced oncologic defects using superficial temporal versus cervical as recipient vessels. Methods This is a parallel group clinical trial with 1:1 allocation ratio of patients who underwent midface and scalp oncologic reconstruction with free tissue flap from April 2018 to April 2022 in a tertiary oncologic center. Two groups were analyzed: those in whom superficial temporal vessels were used as the recipient vessels (Group A) and those in whom cervical vessels were used as the recipient vessels (Group B). Patient gender and age, cause and localization of the defect, flap choice for reconstruction, recipient vessels, intraoperative outcome, postoperative course, and complications were recorded and analyzed. A Fisher's exact test was used to compare outcomes between the 2 groups. Results On the basis of the different recipient vessels, 32 patients were randomized into 2 groups, and of these 27 patients completed the study: Group A with superficial temporal recipient vessels (n = 12) and Group B with cervical recipient vessels (n = 15). There were 18 male and 09 female patients with an average age of 53.92 ± 17.49 years. The overall flap survival rate was 88.89%. The overall complication rate for vascular anastomosis was 14.81%. The total flap loss rate in patients with superficial temporal recipient vessels was higher than the complication rate in those with cervical recipient vessels but with no statistical significance (16.67% vs. 6.66%, p= 0.569). Minor complications occurred in 05 patients without statistical significance between the groups (p= 0.342). Conclusion In the group with superficial temporal recipient vessels, the postoperative rate of free flap complications was similar than the cervical recipient vessel group. Therefore the use of superficial temporal recipient vessels for midface and scalp oncologic reconstruction could be a reliable option.

Research progress on evaluation methods for head-neck nail position in femoral intertrochanteric fractures / 中国修复重建外科杂志

OBJECTIVE@#To summarize the research progress on the evaluation methods of head-neck nail positions in femoral intertrochanteric fractures.@*METHODS@#The literature about the evaluation methods of head-neck nail positions for femoral intertrochanteric fractures in recent years was extensively reviewed, and research progress in the aspects of evaluation methods, clinical applications, and limitations were summarized.@*RESULTS@#The position of head-neck nails in femoral intertrochanteric fractures is closely related to postoperative complications of head-neck nail cutting. Currently, the tip-apex distance (TAD) and femoral head zoning are widely used to evaluate the position of head-neck nails. The main opinion in the literature is that the use of TAD and femoral head zoning can effectively reduce the incidence of head-neck nails cutting. Parker's ratio, as one of the evaluation methods, has been controversial in subsequent studies and has not been widely used in clinical practice. The TAD as referenced to the calcar (CalTAD), which was modified based on TAD, has been gradually accepted by the clinic, but whether it is better than the TAD has not yet been conclusively determined. In recent years, new evaluation methods have been proposed to supplement the previous evaluation methods, such as the tip-neck distance ratio (TNDR) and the standardized TAD (STAD) to avoid the limitations of the TAD and the CalTAD by the volume of the femoral head, and the axis-blade angle (ABA) to supplement the direction of the head-neck nails channel, but at present the clinical application is relatively underutilized, and the validity of the method needs to be further verified.@*CONCLUSION@#Currently, there are many methods for evaluating the position of head-neck nails in femoral intertrochanteric fractures, TAD<25 mm combined with head-neck nails placed in the middle-middle quadrant or lower-middle quadrant of the femoral head division is currently a highly recognized assessment in the literature, but the optimal assessment is still controversial, and further research needs to be studied.

Is there any correlation between tumor infiltrating lymphocytes and expression of EGFR in squamous cell carcinoma of head and neck? A retrospective observational study

Background: The dismal survival of one of the commonest malignancies of the world, head neck squamous cell carcinomas (HNSCC), has prompted researchers to probe into its various characteristics, especially those which reflect the outcome. Over the years, even though epidermal growth factor receptor (EGFR) and tumor-infiltrating lymphocytes (TIL) have emerged as useful biomarkers of the disease, the two parameters have rarely been considered in conjunction. Aims and Objectives: The study aimed to assess if there is any correlation between TIL levels (both stromal and intratumoral) and site, grade, stage, and EGFR score of HNSCC. Materials and Methods: A retrospective observational study was conducted in which histopathologically confirmed cases of HNSCC were included. The site of tumor, grade, stage, stromal and intratumoral TIL levels, and EGFR score were noted for each case. The data were analyzed using standard statistical tests. Results: The study population consisted of 122 patients with a mean age of 53.8 ± 9.2 years. The oral cavity was the commonest site of tumor (109 cases, 89.3%). Most cases were moderately differentiated (75, 61.5%). Pathological staging showed 66 cases (54%) to be in pT1, and 92 cases (75.4%) to be in pN0. In 68 cases (55.7%), stromal TIL level was high, and intratumoral TIL was low in 102 cases (83.6%). A statistically significant correlation was found between TIL levels and site, grade, pathological stage, and EGFR score of HNSCC. Conclusion: This pioneering study is unique in its exploration of the correlation between two significant biomarkers of HNSCC – TIL and EGFR score.

Study of scanning method of T 1WI_Star_VIBE_FS in MRI simulation of neck radiotherapy / 中华放射肿瘤学杂志

Objective:To compare and analyze the image quality, signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) of T 1WI_Star_VIBE_FS sequence in MRI simulation of neck tumors with different scanning methods, aiming to determine the optimal scanning method. Methods:A retrospective analysis of 78 patients receiving MRI contrast scan was performed. All patients were randomly divided into three groups according to three different scanning methods including bolus mode (group A, n=23), segmentation splicing mode (group B, n=18) and the combination mode (group C, n=37). The image quality, SNR and CNR of the anterior soft tissues of neck were statistically compared. Results:A higher image quality score was obtained in group C. The mean SNR and CNR in three groups were calculated as 214.70±148.78, 91.95±59.26, 307.61±127.80, and 208.74±148.27, 85.79±59.50, 301.58±127.48, respectively. The image quality score, SNR and CNR in group C were significantly better compared with those in group A and B (all P<0.01). Conclusion:Combination of bolus and segmentation splicing modes is a recommended approach in MRI simulation during radiotherapy of neck tumors.

A prospective study to assess the predictive factors of radiation-induced oral mucositis in head-and-neck carcinoma and its impact on treatment outcome: Long-term results and lessons learned

Background: Radiation-induced oral mucositis (RIOM) is one of the major dose-limiting toxicities in head-and-neck cancer patients. It is due to normal tissue damage by radiation. It is a potential hazard to treatment delivery as it threatens to alter the therapeutic ratio. The radiation oncologist must find a way to balance between tumor control and sparing of normal mucosa to validate the age-old principle of cancer treatment. The onus lies on them to find the contributory factors to curb them accordingly. Objective: The objective of the study was as follows: (1) To find out the factors associated with RIOM in head-neck squamous cell cancer (HNSCC) and (2) to assess the impact of the RIOM on treatment outcome. Materials and Methods: This was a single-institutional, prospective, non-randomized, and open-label study. All cases were treated after informed consent and tumor board approval. This was an observational study with standard treatment according to the stage of the disease. Results: Tumor site, poor oral hygiene, modality of radiation, addiction, and fractionation appeared to be the significant predictive factors of RIOM in HNSCC. Conclusion: This study helps to identify the contributory factors and gives a comprehensive understanding of the same. More multi-institutional subsite-specific studies are warranted to validate the same.

Impact of Oral Metronomic Therapy on Quality of Life in Advanced/Recurrent Head and Neck Squamous Cell Carcinoma Patients

Introduction: Metronomic chemotherapy (MC) is an emerging therapeutic option in clinical oncology and it may prove usefulat least in metastatic head and neck squamous cell carcinoma (HNSCC) patients. To develop rational therapeutic strategies,it is important to identify molecular targets that are linked to the pathogenesis of HNSCC.Aim: The aim of the study was to assess the effect of oral MC on changes in quality of life (QOL) in advanced/recurrent HNSCCpatients.Materials and Methods: Patients with advanced, metastatic, and recurrent HNSCC patients who are not amenable to localtreatment with surgery, radiotherapy, and chemotherapy were included in the study. QOL assessed with the European organizationfor research and treatment of cancer (EORTC) QLQ-C30 and QLQ-H&N 35 questionnaires.Results: In this study, 50 patients were included, 37 patients (74%) become pain-free at the end of 6 months. A decreasedpain grade was observed in another 13 patients (26%). Mean QLQ-C 30 score at the time of presentation was 68.67, 75.35at 2 months, 81.26 at 4 months, and 85.38 at the end of 6 months. Mean QLQ-H&N 35 score at the time of presentation was61.53, 72.16 at 2 months, 76.43 at 4 months, and 81.69 at the end of 6 months. In subgroup analysis, both QLQ-C30 andQLQ-H&N 35 significantly correlated with disease progression.Conclusion: The use of oral metronomic therapy with methotrexate and celecoxib significantly improves the QOL and improvespain control in patients with advanced/recurrent HNSCC

The Effect on Head-Neck Injuries of Six-Year-Old Child Occupant by Misusing the Restraint System / 医用生物力学

Objective To explore the effect of restraint system misuse on head-neck injuries for rear occupant of 6-year-old children in frontal impact crashes. Methods Based on the previously validated 6-year-old child occupant finite element model, in terms of ECE R44 testing regulations, the impact crash under right and wrong use of restraint system was simulated in Pam-Crash software. Results The force and moment of the neck were the minimum by merely using booster seat, but the maximum intracranial pressure, the maximum stress and the maximum principal strain were larger than their damage threshold and would cause fatal brain damage in child head. The only use of adult safety belt would cause more serious damage in child neck with larger force and moment. Conclusions Two ways of misusing the restraint system would aggravate head-neck injuries of the 6-year-old child. The proper use of the restraint system can provide the best protective effect for head and neck of the 6-year-old child occupant.

​Outcome of Oral Metronomic Therapy with Methotrexate and Celecoxib in Advanced/ Recurrent Head and Neck Squamous Cell Carcinoma

Introduction: Metronomic chemotherapy (MC) is an emerging therapeutic option in clinical oncology and it may prove usefulat least in metastatic HNSCC patients. To develop rational therapeutic strategies, it is important to identify molecular targetsthat are linked to the pathogenesis of HNSCC.Aim: This study aims to assess the efficacy and toxicity of oral MC with methotrexate and celecoxib in the treatment of advanced/recurrent HNSCC.Methods: Patients who received MC for advanced/recurrent HNSCC were analyzed. The combination of weekly oral methotrexate5 mg twice daily for 2 days/week and oral celecoxib 200 mg twice daily was offered as MC. The efficacy was noted in terms ofclinical benefit rate (CBR), pain control, changes in quality of life (QOL), and median time to progression (TTP).Results: A total of 50 patients were included in this study. At the end of 6 months, 4 patients (8%) had partial response (PR), 28patients (56%) had stable disease (SD), and 18 patients (36%) had progressive disease. The CBR (complete response+PR+SD)was 64% at 6 months. The median TTP was 8 weeks. At the end of 6 months, 60% of patients were pain free. The most common(>20% of patients) treatment-related adverse events were nausea (22%), vomiting (22%), and mucositis (20%). 6 patients (12%)developed anorexia and 3 patients (6%) developed fatigue. Mean QOL scores were improved with this MC.Conclusion: Oral MC with methotrexate and celecoxib for patients with advanced/recurrent HNSCC was effective, well tolerated,provides good pain control, and improves QOL with least toxicity profile.

Clinical Study of Eight Nape Needle Therapy for Mild Cognitive Impairment After Cerebral Stroke / 上海针灸杂志

Objective To observe the therapeutic efficacy of eight nape needle therapy in treating mild cognitive impairment (MCI) after cerebral stroke. Method By following a randomized controlled trial design, 200 eligible patients were randomized into an eight nape needle group and a medication group by the random number table, with 100 cases in each group. The patients all received basic medications, while the eight nape needle group was additionally intervened by acupuncture at the eight nape acupoints including Fengchi (GB20), Fengfu (GV16), Dazhui (GV14) and Xiangsihua points (Extra), and the medication group additionally received oral administration of nimodipine. The intervention lasted eight weeks, followed by a three-month follow-up. Before and after treatment, the two groups of patients were evaluated by Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and Barthel Index (BI). Result Respectively at four-week and eight-week treatment and the follow-up, the scores of MMSE, MoCA and BI showed improvements compared with the corresponding baseline (P<0.01, P<0.05);compared with the medication group, the eight nape needle group was superior to the medication group comparing the MMSE score at each time point after treatment (P<0.01, P<0.05); there were no significant differences in the MoCA and BI scores between the two groups at four-week treatment (P>0.05), but the differences were significant at eight-week treatment and the follow-up (P<0.01). Conclusion Eight nape needle therapy can effectively improve the cognitive function in patients with MCI after cerebral stroke.

The measurement and clinical significance of the rotation angles of head-neck fragments after cephalomedullary nail fixation in intertrochanteric fractures / 中国修复重建外科杂志

Objective: To measure the rotation angle of the head-neck fragment of intertrochanteric fracture after cephalomedullary nail fixation by three-dimensional CT imaging, and to explore its clinical significance. Methods: The clinical data of 68 patients with unstable intertrochanteric fracture of AO/Orthopaedic Trauma Association (AO-OTA) type 31-A2 treated with cephalomedullary nail fixation and with complete intraoperative fluoroscopy and postoperative three-dimensional CT imaging data between July 2016 and October 2018 were retrospectively analyzed. Among them, there were 21 males and 47 females, aged 68-93 years, with an average age of 81.8 years. There were 31 cases of AO/OTA type 31-A2.2 and 37 cases of 31-A2.3. Fracture reduction quality was evaluated according to Baumgaertner et al. and Chang et al. criteria. The anteromedial cortical contact or not of each patient was observed by three-dimensional CT imaging on T3DView software after operation. The rotation of head-neck fragments were divided into three types: non-rotation, flexion rotation, and hyperextension rotation. The rotation angles of each type were measured and the relationship between the rotation type of the head-neck fragments and the contact of the anteromedial cortex was analyzed. Results: The reduction and fixation of the small trochanter were not performed in 68 patients. According to Baumgaertner et al. criteria, the quality of fracture reduction was excellent in 15 cases (22.1%), acceptable in 50 cases (73.5%), and poor in 3 cases (4.4%). According to Chang et al. criteria, 31 cases were excellent (45.6%), 33 cases were acceptable (48.5%), and 4 cases were poor (5.9%). Thirty-nine cases (57.4%) received anteromedial cortical support and 29 cases (42.6%) did not receive cortical support. Three-dimensional CT imaging showed non-rotation in 12 cases (17.6%), flexion rotation in 39 cases (57.4%), and hyperextension rotation in 17 cases (25.0%). There were 7 cases (58.3%), 30 cases (76.9%), and 2 cases (11.8%) of cortical support in non-rotation group, flexion rotation group, and hyperextension rotation group, respectively. The rotation angles were (1.05±0.61), (13.96±6.17), (8.21±3.88)°, respectively. There were significant differences between groups ( P<0.05). Conclusion: In the unstable intertrochanteric fracture after cephalomedullary nail fixation, the rotation of head-neck fragment exists in most patients, and the types of flexion rotation and non-rotation can easily obtain cortical support reduction.

Effects of Neck Restrain on Traumatic Brain Injury of Child Occupant During Airbag Inflation / 医用生物力学

Objective To study the effect of neck restrain on traumatic brain injury during airbag inflation in traffic accidents. Methods Based on the previously validated 3-year-old child head finite element (FE) model, the impact on out-of-position (OOP) child occupant during airbag inflation was simulated by FE method, so as to investigate the effects of neck restraint on intracranial response and injury mechanism in traffic accidents. Results The head kinematics with neck restrain was different from that without neck restrain under the impact of airbag inflation. The neck restraint would obviously decrease the maximum Von Mises stress of pediatric brain. When airbag-head distance was 20 cm or 25 cm, the neck restraint would obviously decrease the maximum intracranial pressure. Conclusions Neck restraint had a relatively large influence on pediatric intracranial response. When the FE method is used to predict pediatric craniocerebral injury, consideration of neck restrain on child brain response is necessary.

Concept and clinical application of surgical margin principle on head and neck cancers / 中华耳鼻咽喉头颈外科杂志

Surgical margin principle is one of the central surgical principles for head and neck cancers. Negative surgical margin is the primary purpose of surgery for head and neck cancers. This paper is based on the current clinical application of surgical margins of head and neck cancers, and it is proposed that surgical margins of head and neck cancers may be classified into three types: surface margin, deep margin, and tissue interface margin in consideration of surgical exposure of tumors. The classification of surgical margins can make the clinical application and the research of surgical margins of head and neck cancers more systematic and clear.

Prognostic factors, failure patterns and survival analysis in patients with resectable oral squamous cell carcinoma of the tongue

PURPOSE: There is sparse literature on treatment outcomes research on resectable oral tongue squamous cell carcinoma (OTSCC). The aim of this study was to measure the treatment outcomes, explore the failure patterns, and identify the potential clinicopathological prognostic factors affecting treatment outcomes for resectable OTSCC. MATERIALS AND METHODS: It is a retrospective analysis of 202 patients with resectable OTSCC who underwent upfront primary surgical resection followed by adjuvant radiotherapy with or without concurrent chemotherapy if indicated. RESULTS: The median follow-up was 35.2 months (range, 1.2 to 99.9 months). The median duration of locoregional control (LRC) was 84.9 months (95% confidence interval, 67.3–102.4). The 3- and 5-year LRC rate was 68.5% and 58.3%, respectively. Multivariate analysis showed that increasing pT stage, increasing pN stage, and the presence of extracapsular extension (ECE) were significantly associated with poorer LRC. The median duration of overall survival (OS) was not reached at the time of analysis. The 3- and 5-year OS rate was 70.5% and 66.6%, respectively. Multivariate analysis showed that increasing pT stage and the presence of ECE were significantly associated with a poorer OS. CONCLUSION: Locoregional failure remains the main cause of treatment failure in resectable OTSCC. There is scope to further improve prognosis considering modest LRC and OS. Pathological T-stage, N-stage, and ECE are strong prognostic factors. Further research is required to confirm whether adjuvant therapy adds to treatment outcomes in cases with lymphovascular invasion, perineural invasion, and depth of invasion, and help clinicians tailoring adjuvant therapy.

Corrosion at the head-neck taper as a cause for aspetic loosening after total arthroplasty / 医学研究生学报

Metal wear debris,as the most common one,may cause aspetic loosening after total hip arthroplasty.It is gradual-ly recognized that wear of head-neck taper may produce metal wear debris after the decline of application of metal on metal prothesis. Wear of head neck taper is mainly relevant to material quality and taper connection at the head neck junction.So we wrote this review to analyze the mechanical and cellular mechanisms of wear of head -neck taper,and furthermore summarize the clinical diagnosis,pre-vention and treatment on adverse local tissue reactions based on large quantities of reference.

The Adverse Effect of Proprioceptive Sense in Head-Neck according to Smartphone Usage

PURPOSE: Most studies have reported pain in the head-neck and upper-limbs according to smartphone usage, which is related to the proprioception sense in the head and neck, but there have been few studies. Therefore, the aim of this study was identify the adverse effects of the proprioceptive sense in the head-neck according to smartphone usage. METHODS: Twenty-seven young adults (male: 9, female: 18) were enrolled in this study. The proprioceptive sense was measured through the joint reposition sense error and neural positon error in the head-neck during smartphone usage for 0, 5, and 20 minutes. The Noraxon MyoMotion system was used to record the joint position angle and neutral positon in the head-neck. One-way repeated ANOVA was used to identify the differences between the three smartphone use durations and the least-squares difference was used as a post hoc test. The data were analyzed using SPSS 18.0 software. RESULTS: The joint reposition sense error and neural positon error in the head-neck were significantly different among the 0, 5, and 20 minutes of smartphone usage (p < 0.05). In the post hoc test, the joint reposition sense error and neural positon error showed a significant difference between smartphone use for 0 minute and 5 minute, and between smartphone use for 0 minute and 20 minutes. CONCLUSION: This study suggests that smartphone use within 5 minutes can have adverse effects on the proprioceptive sense. Therefore, it is necessary to consider the appropriate use time and break time when using smart phones.

Analysis of clinical efficacy, failure pattern and prognostic factors of comprehensive treatment for malignant mucosal melanoma of head and neck / 中华放射肿瘤学杂志

Objective To evaluate the clinical efficacy,failure pattern and prognostic factors of the malignant mucosal melanoma of the head and neck ( MMHN) in a single center. Methods The treatment pattern,clinical efficacy, failure pattern and prognostic factors of 194 M0MMHN patients admitted to our institution from 1982 to 2017 were retrospectively analyzed.Results The 5-year overall survival (OS),local recurrence-free survival ( LRFS ), regional recurrence-free survival ( RRFS ) and distant metastasis-free survival (DMFS) were 41. 4%,57. 8%,76. 5% and 46. 5%,respectively. The failure rate was calculated as 74. 6%(141/189).Among them,40% (56/141) had distant metastasis as the first pattern of treatment failure,37%(52/141) had local relapse,15%(21/141) had regional relapse,5%(7/141) had concurrent distant metastasis and local/regional relapse and 3% ( 5/141) had concurrent local and regional relapse. Multivariate analysis demonstrated that surgical margins (P=0. 001) and adjuvant radiotherapy (P=0. 000) were the independent prognostic factors for LRFS. Conclusions Surgery combined with radiotherapy can yield relatively high LRFS in the comprehensive treatment of MMHN.Distant metastasis is the major failure pattern.

Carcinoma epidermoide de orofaringe. Experiencia institucional / Squamous cell carcinoma of the oropharynx. Institutional experience

Los carcinomas epidermoides de cabeza y cuello (CECC), son un grupo poco frecuente de neoplasias, en los Estados Unidos representan el 3.2% de todos los cánceres1,2. Si bien su frecuencia global se encuentra en disminución, los tumores localizados en la orofaringe han aumentado de forma considerable2. El virus del papiloma humano (HPV) es responsable de este aumento. Se ha descripto que los tumores de orofaringe, asociados al HPV, ocurren en pacientes más jóvenes, con enfermedad de bajo volumen a nivel del tumor primario, pero elevada incidencia de metástasis ganglionares, con adenopatías quísticas2,3. La detección del virus del HPV, por inmunohistoquímica (IHQ) o por reacción en cadena de la polimerasa (PCR) son factores pronósticos importantes que siempre deben ser tenidos en cuenta para el tratamiento de estos tumores (AU)

Epidermoid carcinomas of the head and neck are a rare group of tumors, in the United States they account for 3.2% of all cancers. Although their overall frequency is decreasing, tumors located in the oropharynx have increased considerably. Human papillomavirus (HPV) is responsible for this increase. It has been described that oropharyngeal tumors, associated with HPV, occur in younger patients, with low volume disease at the primary tumor level but a high incidence of lymph node metastases, with cystic lymphadenopathy. Detection of HPV virus by immunohistochemistry (IHC) or polymerase chain reaction (PCR) are important prognostic factors that should always be taken into account for the treatment of these tumors (AU)

Dosimetric evaluation of four adaptive IMRT strategies for head-neck cancer / 中华放射肿瘤学杂志

Objective To investigate the effects of numerous re-planning strategies on the anatomic and dosimetric outcomes of target volume and organs at risk (OARs) in patients with head and neck cancer receiving fractionated radiotherapy.Methods From 2015 to 2016,28 patients with head and neck cancer were enrolled in this study with Shandong Cancer Hospital,consisting of 19 patients with nasopharyngeal carcinoma, 4 patients with laryngocarcinoma, and 5 patients with carcinoma of the maxillary sinus.All of them received conventionally fractionated radiotherapy.Each patient had six weekly cone-beam CT (CBCT) scans, which were performed on the first day of every week, to obtain reference images.A virtual CT image was generated by registration of planning CT and each weekly CBCT image.The four re-planning strategies were used for the reconstruction of re-planned dose, while the initial planning was used as a reference.The weekly doses calculated using virtual CT were summed together to obtain the actual dose.The actual and initial planned doses were evaluated.The nonparametric Friedman test was used to evaluate the differences between multiple groups, and the differences between any two groups were analyzed by paired t test.Results The sizes of planning target volume, clinical target volume, and left/right parotid glands (PGs) changed significantly within the six weeks (P=0.041, 0.046, 0.024, and 0.017, respectively).For these four re-planning strategies, there were significant differences between the actual dose and the initial planned dose to the PGs (all P<0.05), with average values decreased by 5.02%, 11.17%, 12.08%, and 13.19%, respectively, compared with that in the reference strategy.Conclusions Re-planning during treatment course could ensure the sparing of OARs and allow for sufficient dose to the target volume.The higher the number of re-planning strategies, the more the actual dose is close to the initial planed dose;the efficiency of two re-planning strategies is the highest.

Research progresses of long non-coding RNAs in human head neck tumor / 实用肿瘤学杂志

Long noncoding RNAs( lncRNAs) are transcribed RNA molecules more than 200 nt in length, without protein coding capacity.In recent years,emerging evidence has shown that lncRNAs act as key regulators of multiple cancers.LncRNA is possible to be a new focus for cancer treatment.Until now,only a few papers about lncRNA had been reported in head neck tumor.In this review,we report the development of lncRNA in head neck tumorbased on the latest studies.