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1.
Acta Med Okayama ; 77(2): 227-232, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37094963

RESUMO

We describe the use of the tyrosine kinase inhibitor lenvatinib in a patient with brain tumor metastases from anaplastic thyroid carcinoma (ATC). A 52-year-old Japanese male presented with consciousness loss. Imaging revealed a thyroid tumor and multiple brain lesions. After the brain tumor's resection, pathology results provided the diagnosis of ATC. Total thyroidectomy was performed, followed by whole-brain irradiation. Additional brain lesions later developed, and lenvatinib therapy was initiated with no remarkable complications. However, the treatment effects were limited, and the patient died 2 months after starting lenvatinib, 202 days after the initial brain surgery. Relevant literature is discussed.


Assuntos
Antineoplásicos , Neoplasias Encefálicas , Carcinoma Anaplásico da Tireoide , Neoplasias da Glândula Tireoide , Masculino , Humanos , Pessoa de Meia-Idade , Carcinoma Anaplásico da Tireoide/tratamento farmacológico , Carcinoma Anaplásico da Tireoide/patologia , Antineoplásicos/uso terapêutico
2.
Acta Med Okayama ; 75(3): 335-343, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34176937

RESUMO

Recurrent or metastatic head and neck squamous cell carcinoma (R/MHNSCC) has a poor prognosis. Although nivolumab is approved in Japan for treating R/MHNSCC, the response rate is low. Therefore, identifying pretreatment prognostic factors is necessary. This study assessed the utility of the neutrophil-to-lymphocyte ratio (NLR) and Glasgow Prognostic Score (GPS) as biomarkers of response to nivolumab. We retrospectively collected the data of 56 R/MHNSCC patients treated with nivolumab between May 2017 and December 2019. The Kaplan-Meier method and log-rank test were used to estimate overall survival (OS) and progression-free survival (PFS), and multivariate Cox hazard regression analysis was used to identify independent predictors of survival. Patients with a low pretreatment NLR had prolonged OS, and patients with a low pretreatment GPS had increased OS and PFS. A performance score (PS) of 0-1, development of immune-related adverse events, and GPS of 0-1 were significantly associated with OS in multivariate analysis. In summary, baseline pretreatment NLR and GPS are independently associated with OS in R/MHNSCC patients treated with nivolumab. Administration of nivolumab while maintaining the PS reflects a immune status of the host and leads to a good OS.


Assuntos
Antineoplásicos Imunológicos/administração & dosagem , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Nivolumabe/administração & dosagem , Carcinoma de Células Escamosas de Cabeça e Pescoço/tratamento farmacológico , Idoso , Antineoplásicos Imunológicos/efeitos adversos , Biomarcadores/sangue , Feminino , Neoplasias de Cabeça e Pescoço/imunologia , Neoplasias de Cabeça e Pescoço/mortalidade , Humanos , Estimativa de Kaplan-Meier , Linfócitos/imunologia , Masculino , Pessoa de Meia-Idade , Neutrófilos/imunologia , Nivolumabe/efeitos adversos , Intervalo Livre de Progressão , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Carcinoma de Células Escamosas de Cabeça e Pescoço/imunologia , Carcinoma de Células Escamosas de Cabeça e Pescoço/mortalidade
3.
Auris Nasus Larynx ; 47(2): 299-304, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30904199

RESUMO

BACKGROUND: Extra-axial chordomas are exceedingly rare malignant tumours. Herein, we present the first case of an extra-axial chordoma in the gingivae. METHODS AND RESULTS: A 21-year-old man presented with a suspected chordoma in the upper right gingiva. Diagnosis was difficult; however, owing to strong expression of the chordoma marker brachyury, extra-axial chordoma was ultimately diagnosed. The tumour was completely resected without performing a facial incision. To ensure its safety and effectiveness, the surgical procedure was simulated several times before its performance using a three-dimensional (3D) model. Twenty-four months after surgery, the patient remains disease-free. CONCLUSION: A diagnosis of extra-axial chordoma can be confirmed by immunohistochemical staining for brachyury.


Assuntos
Cordoma/cirurgia , Neoplasias Gengivais/cirurgia , Maxila/cirurgia , Cordoma/diagnóstico por imagem , Cordoma/patologia , Proteínas Fetais/metabolismo , Neoplasias Gengivais/diagnóstico por imagem , Neoplasias Gengivais/patologia , Humanos , Imuno-Histoquímica , Imageamento por Ressonância Magnética , Masculino , Margens de Excisão , Modelos Anatômicos , Proteínas com Domínio T/metabolismo , Tomografia Computadorizada por Raios X , Adulto Jovem
4.
Acta Otolaryngol ; 140(2): 181-187, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31825711

RESUMO

Background: Nivolumab has been approved for recurrent or metastatic head and neck cancer (R/M HNC) on March 2017 in Japan. Recently, many researchers have been actively studying the prognostic and predictive markers. However, they have not been clarified. In this study, we evaluate the prognostic and predictive markers of the anticancer effect of nivolumab.Objective: This study assessed baseline neutrophil-to-lymphocyte ratio (NLR) as a prognostic and predictive marker for nivolumab efficacy in patients with recurrent/metastatic head and neck cancer (R/M HNC).Material and methods: This retrospective cohort study used medical records of patients with R/M HNC treated with nivolumab from May 2017 to January 2018 at a university hospital in Japan.Results: Twenty-nine patients (median age, 64 years) were included. In univariate analyses, baseline NLR ≥5 was significantly associated with overall survival (HR 4.88; p = .045) and progressive disease (HR 5.0; p = .046). More patients with baseline NLR ≥5 changed from nivolumab to best supportive care, compared to patients with baseline NLR <5 (64.3% vs 26.7%, respectively).Conclusions and significance: Baseline NLR was associated with clinical benefit from nivolumab in patients with R/M HNC. We propose that baseline NLR be used as a predictive or prognostic marker for nivolumab efficacy in these patients.


Assuntos
Antineoplásicos Imunológicos/uso terapêutico , Carcinoma de Células Escamosas/tratamento farmacológico , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Recidiva Local de Neoplasia/tratamento farmacológico , Nivolumabe/uso terapêutico , Idoso , Carcinoma de Células Escamosas/sangue , Carcinoma de Células Escamosas/mortalidade , Feminino , Neoplasias de Cabeça e Pescoço/sangue , Neoplasias de Cabeça e Pescoço/mortalidade , Humanos , Japão/epidemiologia , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/sangue , Recidiva Local de Neoplasia/mortalidade , Estudos Retrospectivos
5.
Acta Otolaryngol ; 138(10): 921-925, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30016902

RESUMO

OBJECTIVE: To determine if a lower dose of dexamethasone can be used in combination with fosaprepitant and palonosetron for cisplatin-induced nausea and vomiting in head and neck cancer patients, we conducted a single-center, two-arm, cross-over comparison study. METHODS: Patients were randomly assigned to either standard dose dexamethasone group: intravenous 9.9 mg on day 1 and 6.6 mg on days 2-4 or low-dose dexamethasone group: intravenous 3.3 mg on days 1-4 for the first course and crossed over to the other treatment for the second course. The primary endpoint was complete response (CR) in the overall period. RESULTS: Twenty-five patients were screened for the study and 22 were evaluable. Eleven patients were randomly assigned to the standard dose dexamethasone group and 12 patients to the low-dose dexamethasone group. The CR rate in the overall period was 86% in the standard dose group and 73% in the low-dose group, showing no significant difference (p = .61). CONCLUSION: The efficacy of low-dose dexamethasone with fosaprepitant and palonosetron was not inferior to that of the standard dose dexamethasone in the highly emetogenic cisplatin-based treatment for head and neck cancer patients.


Assuntos
Antieméticos/administração & dosagem , Cisplatino/efeitos adversos , Dexametasona/administração & dosagem , Morfolinas/administração & dosagem , Náusea/prevenção & controle , Palonossetrom/administração & dosagem , Vômito/prevenção & controle , Idoso , Antineoplásicos/efeitos adversos , Quimioterapia Combinada , Feminino , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade
6.
Auris Nasus Larynx ; 45(3): 644-647, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28947094

RESUMO

Extraskeletal osteosarcoma is a very rare tumor and accounts for 4-5% of all osteosarcomas. We describe a 47-year-old Japanese man who presented with a right parotid tumor. The patient underwent total resection with postoperative radiotherapy; however, the tumor recurred in the lung, whereupon he underwent chemotherapy and partial lung resection. After surgery, a hemorrhagic brain metastasis appeared; this tumor was extirpated to prevent bleeding into the brain, after which additional chemotherapy was administered. Nevertheless, the patient developed additional metastases and died 17 months after the total parotidectomy. This tumor was unique in that it arose in the parotid gland; this case provides an instructional example of an extremely rare manifestation of this type of tumor.


Assuntos
Osteossarcoma/diagnóstico por imagem , Neoplasias Parotídeas/diagnóstico por imagem , Neoplasias Encefálicas/complicações , Neoplasias Encefálicas/secundário , Neoplasias Encefálicas/cirurgia , Quimioterapia Adjuvante , Humanos , Hemorragias Intracranianas/etiologia , Neoplasias Pulmonares/secundário , Neoplasias Pulmonares/cirurgia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Osteossarcoma/patologia , Osteossarcoma/secundário , Osteossarcoma/terapia , Neoplasias Parotídeas/patologia , Neoplasias Parotídeas/terapia , Pneumonectomia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Radioterapia Adjuvante , Tomografia Computadorizada por Raios X
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