Formulation of Chemotherapy Program and Pharmaceutical Care for a Patient with Tonsil Cancer by Clin-ical Pharmacists / 中国药房

OBJECTIVE:To explore the role of clinical pharmacists in the drug therapy for patient with tonsil cancer. METH-ODS:Clinical pharmacists participated in the drug therapy for a patient with tonsil cancer. Referring to related clinical guidelines, literatures and the characteristics of chemotherapy drug effects,combined with clinical symptoms and economic situation of pa-tient,clinical pharmacists assisted physicians to formulate chemotherapy plan of nedaplatin combined with docetaxel (Nedaplatin for injection 100 mg,d1;50 mg,d2;ivgtt,qd+Docetaxel injection 100 mg,d1,ivgtt,qd,every 3 weeks for 1 cycle)according to effectiveness and safety. Clinical pharmacists closely monitored the occurrence of ADR as depression of bone marrow,gastroin-testinal reaction and allergic reaction,and provided medication education and discharge education,such as the use of pretreated che-motherapy drugs,diet and drinking water during chemotherapy,the prevention of ADR,etc. RESULTS:Physicians adopted the suggestions of clinical pharmacists. The patient completed chemotherapy smoothly,and no ADR was found. CONCLUSIONS:In the case of there is no unified standard for chemotherapy program of tonsil cancer at present,clinical pharmacists assist physicians to formulate chemotherapy plan according to the patient's condition,the characteristics of drug effects and economical situation,as well as conduct pharmaceutical monitoring actively so as to guarantee the safety and effectiveness of chemotherapy.

A Case of Metachronous Human Papilloma Virus-Associated Squamous Cell Carcinomas in Head and Neck / 대한이비인후과학회지

Synchronous or metachronous head and neck cancer is known to occur in up to 20% of patients, negatively affecting long-term prognosis. We experienced a case of metachronous head and neck cancers in a Human papillomavirus (HPV)-positive patient without a history of smoking, initially presenting with as a cancer of unknown primary (CUP), and then with a contralateral tonsil cancer with metastatic lymphadenopathy five years later. This report highlights the clinical usefulness of HPV typing to determine the optimal extent of surgery and the follow-up strategy in CUP.

Surgical Management of Tonsil Cancer / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Surgery and postoperative radiation therapy have been the main stream management of tonsil cancer. There is a variety of surgical approach methods are used for the resection of tonsil cancer, however, there have only been a few reports of the results of surgical treatment of tonsil cancer. So, on the basis of our experience, we report the results of our surgical treatments of tonsil cancer. SUBJECT AND METHOD: 32 medical records, from 1994 April to 2003 June, of patients surgically treated for tonsil cancer were reviewed. Evaluated were disease status, surgical approach methods, types of the neck dissection, surgical margin, reconstruction methods, postoperative complications, time of oral diet and decannulation, recurrence, and survival rate. RESULTS: Mean follow up periods were 2.3 years. There was 1 patient in Stage I, 5 in Stage II, 2 in Stage III, and 24 in Stage IV. For Tumor excision, 5 patients underwent intraoral approach, 10 mandibulotomy approach, and 17 lateral pharyngotomy approach. Surgical defects were primary closed in 5 patients and reconstructed with pectoralis major myocutaneous flap in 7 patients and radial forearm fasciocutaneous free flap in 20 patients. There were 2 local recurrences, 5 regional recurrences, and one distant metastasis. The mean time of the beginning of oral diet/decannulation after operation were 19.8/11.3 days in lateral pharyngotomy and 25.3/12.9 days in mandibulotomy. The mean survival period was 41.4 months. CONCLUSION: Because most of tonsil cancers are advanced diseases, more precise tumor resection and meticulous neck management are needed. Lateral pharyngotomy approach had priority to other surgical approaches in selected cases except T4. It has advantages of full range of vision for resection, better functional status and less postoperative morbidity.

Results of Curative Treatment for Cancer of the Tonsil / 대한방사선종양학회지

PURPOSE: To report the results of curative treatment for patients with tonsil cancer by retrospective analysis. MATERIALS AND METHODS: From Jan. 1995 till Dec. 2000, 27 patients with squamous cell carcinoma of the tonsil received curative treatment at Samsung Medical Center. Therapeutic decision was made through multidisciplinary conference, and curative radiation therapy was favored when, (1) the patient's condition was not fit for general anesthesia and surgery, (2) the patient refused surgery, (3) complete resection was presumed impossible, or (4) too severe disability was expected after surgery. Surgery was the main local modality in 17 patients (S+/-RT group), and radiation therapy in 10 (RT+/-CT group). The median follow-up period was 41 months. RESULTS: AJCC stages were I/II in four, III in two, and Iv in 21 patients. The 5-year disease-free survival rate was 73.3% in all patients, 70.6% in the S+/-RT group, and 77.8% in the RT+/-CT group. Treatment failure occurred in seven patients, all with stage III/IV, and all the failures occurred within 24 months of the start of treatment. Five patients among the S CT group developed treatment failures; 2 local, 2 regional, and 1 distant (crude rate=29.4%). Two patients among the RT+/-CT group developed failures; 1 synchronous local and regional, and 1 distant (crude rate=20.0%). The 5-year overall survival rate was 77.0% in all patients, 80.9% in the S+/-RT group, and 70.0% in the RT+/-CT group. CONCLUSION: We could achieve favorable results that were comparable to previously reported data with respect to both the rates of local control and of survival by applying S+/-RT and RT+/-CT. RT+/-CT is judged to be an alternative option that can avoid the functional disability after surgical resection.