The Clinical Investigation of the 125i Radioactive Seeds Brachytherapy Combined Chemotherapy in the Treatment of Pediatric Rhabdomyosarcoma in Head and Neck

Abstract To transfer the preplan for the head and neck brachytherapy to the clinical implantation procedure, a preplan-based 3D-printed individual template for needle insertion guidance had previously been designed and used. The accuracy of needle insertion using this kind template was assessed in vivo. In the study, 25 patients with head and neck tumors were implanted with 125I radioactive seeds under the guidance of the 3D-printed individual template. Patients were divided into four groups based on the site of needle insertion: the parotid and masseter region group (nine patients); the maxillary and paranasal region group (eight patients); the submandibular and upper neck area group (five patients); and the retromandibular region group (six patients). The distance and angular deviations between the preplanned and placed needles were compared, and the complications and time required for needle insertion were assessed. The mean entrance point distance deviation for all 619 needles was 1.18 ± 0.81 mm, varying from 0.857 ± 0.545 to 1.930 ± 0.843 mm at different sites. The mean angular deviation was 2.08 ± 1.07 degrees, varying from 1.85 ± 0.93 to 2.73 ± 1.18 degrees at different sites. All needles were manually inserted to their preplanned positions in a single attempt, and the mean time to insert one needle was 7.5 s. No anatomical complications related to inaccurately placed implants were observed. Using the 3D-printed individual template for the implantation of 125I radioactive seeds in the head and neck region can accurately transfer a CT-based preplan to the brachytherapy needle insertion procedure. Moreover, the addition of individual template guidance can reduce the time required for implantation and minimize the damage to normal tissues.

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CLINICAL INVESTIGATION OF PROLONGED INDUCED HYPOTENSION IN HEAD AND NECK SURGERY

Survey of Anesthesiology ◽

10.1097/00132586-197106000-00021 ◽

1971 ◽

Vol 15 (3) ◽

pp. 230 ◽

Cited By ~ 2

Author(s):

W. A. WARNER ◽

D. A. SHUMRICK ◽

J. A. CAFFREY ◽

O. Mayrhofer

Keyword(s):

Head And Neck ◽

Clinical Investigation ◽

Neck Surgery ◽

Head And Neck Surgery ◽

Induced Hypotension

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Larynx preservation with combined chemotherapy and radiation therapy in advanced but resectable head and neck cancer.

Journal of Clinical Oncology ◽

10.1200/jco.1991.9.5.850 ◽

1991 ◽

Vol 9 (5) ◽

pp. 850-859 ◽

Cited By ~ 101

Author(s):

D G Pfister ◽

E Strong ◽

L Harrison ◽

I E Haines ◽

D A Pfister ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Radiation Therapy ◽

Survival Rate ◽

Cell Carcinoma ◽

Head And Neck ◽

Neck Dissection ◽

Combined Chemotherapy ◽

Larynx Preservation ◽

Preservation Rate ◽

Disease Free

Forty patients with advanced, resectable squamous cell carcinoma of the larynx, oropharynx, or hypopharynx whose surgery would have required total laryngectomy (TL), were treated with one to three cycles of cisplatin-based chemotherapy before local therapy with the goal of larynx preservation. Clinical complete responses (CRs) or partial responses (PRs) to chemotherapy were seen in 26 of 40 patients (65%). Three patients with primary-site disease unresponsive to chemotherapy underwent resection of the primary lesion and neck dissection followed by radiation therapy (RT). Thirty-seven patients were referred after chemotherapy for RT +/- neck dissection. Thirty-one of 40 patient (78%) were rendered disease-free (no evidence of disease [NED]). With a median follow-up of 49 months (range, 31 to 76), the overall actuarial survival rate for the group was 58% at 2 years and 33% at 5 years. The failure-free survival rate was 42% and 33% at 2 and 5 years, respectively. Seven patients refused recommended TL throughout their course. This may have adversely affected survival results. A greater proportion of patients who achieved a CR or PR to chemotherapy remained disease-free compared with those who achieved less than a PR (P less than .001). Sixteen patients relapsed, 10 with locoregional disease. Six patients underwent TL, either for initial induction failure or at relapse, for an actual larynx-preservation rate of 34 of 40 patients (85%). If the seven patients who refused TL are included, the anticipated preservation rate is 27 of 40 patients (68%). Larynx preservation with combined chemotherapy and radiation is feasible and effective in patients with advanced, resectable squamous cell carcinoma of the head and neck (SCHN). This treatment approach requires a motivated patient, careful patient monitoring, and close interdisciplinary cooperation among oncologists.

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Combined chemotherapy and radiation versus radiation alone in the management of localized angiocentric lymphoma of the head and neck

European Journal of Cancer ◽

10.1016/s0959-8049(01)80825-x ◽

2001 ◽

Vol 37 ◽

pp. S92

Author(s):

G. Kim ◽

S. Lee ◽

S. Chang ◽

H. Park ◽

H. Pyo ◽

...

Keyword(s):

Head And Neck ◽

Combined Chemotherapy ◽

Angiocentric Lymphoma

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Significance of panendoscopy and CT in the follow-up and management of squamous cell carcinoma of the head and neck: A retrospective clinical assessment.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e17003 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e17003-e17003

Author(s):

Adrian Muenscher ◽

Susanne Sehner ◽

Jegane Taleh ◽

Silke Tribius ◽

Carsten Dalchow ◽

...

Keyword(s):

Head And Neck ◽

Squamous Cell ◽

Structural Information ◽

Clinical Investigation ◽

Medical Center ◽

Tnm Staging ◽

Histological Evaluation ◽

Female Ratio ◽

Male Predominance

e17003 Background: Treatment of patients with head and neck squamous cell carcinomas (HNSCC) require an evidence-based multidisciplinary approach which varies from medical centres. Panendoscopy has been traditionally used as a routine screening examination tool. We discuss and compare its clinical effectiveness, safety and predictive value in patients with computed tomography (CT) scans in a routine outpatient follow up. Methods: Between 2004-2007, in a retrospective study (204 patients; male:156 (76.5%); female:48 (23.5%))with head and neck cancer, fulfilled all inclusion and exclusion criteria were evaluated at the University Medical Center Hamburg-Eppendorf, Germany. Follow-ups were performed every 2 to 3 months for the first 3 years and every 6 month for the following 2 years. UICC-TNM staging system divided patients into seven categories. Results: The mean age of patients was (male: 59.2±9.3 years; female: 59.5±10.2 years), the highest incidence rate was recorded in the 51 to 60 age group (n = 77). There was a male predominance, with a male/female ratio of 3:1. In comparing normal versus abnormal CT a 12-fold higher frequency of recurrence (odds ratio [OR]; 95% CI: 3.99, 37.51; p<0.001) was interpreted.Additionally, patient anamnesis (OR: 3.33; 95% CI: 1.57, 7.07; p=0.002), clinical investigation (OR: 5.85; 95% CI: 3.01,11.36; p<0.001) and recurrence pattern (OR: 4.82; 95% CI: 2.26,10.32; p<0.001) was observed. Conclusions: In staging / follow-up HNSCC patients, CT-diagnostics also provided similar levels of accuracy as panendoscopy. Panendoscopy in patients with HNSCC was avoided (169 out of 364) when the diagnostic parameters remained satisfactory. Higher patient satisfaction, structural information at a high spatial resolution and comfort was noted in the CT group, indicating a gradual move towards CT diagnostics. For safety-related reasons in particular, we recommend panendoscopy for histological evaluation i.e.in predicting cancer recurrence and progression.

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