Patterns of recurrence after low-dose postoperative radiotherapy for head and neck squamous cell carcinoma

Background Postoperative chemoradiotherapy is recommended for patients with head and neck squamous cell carcinoma with positive margins or extracapsular extension at high risk of recurrence. However, high-dose radiotherapy in the head and neck region often causes severe acute and late radiation-related adversities. In our institution, the radiation dose has been relatively lower than that used in Western countries to reduce radiation-related toxicities. Therefore, in this study, we examined the treatment outcomes of low-dose postoperative chemoradiotherapy. Methods The outcomes of 90 consecutive head and neck squamous cell carcinoma patients who received postoperative radiotherapy between June 2009 and December 2016 were retrospectively analyzed. All patients received postoperative three-dimensional conformal radiotherapy with or without concurrent systemic chemotherapy. The median patient age was 65 years. Concurrent chemoradiotherapy was administered at a total dose of 50.4 Gy in 28 fractions (daily fraction, 1.8 Gy). High-risk patients received 10.8 Gy of boost irradiation in six fractions. For radiotherapy alone, the irradiation dose was up to 54 Gy in 30 fractions and 64.8 Gy in 36 fractions for high-risk patients to increase the treatment intensity. Results The median follow-up period was 40.5 months. The 3-year locoregional control and overall survival rates were 67.5% and 82.7%, respectively. A significantly higher proportion of patients with oral cavity carcinoma experienced locoregional failure (p = 0.004). The acute adverse events were mild, and the only late adverse event was grade 3 dysphagia (n = 3). Conclusion This study suggests that de-escalation of the postoperative radiation dose can potentially reduce the severe adverse events of irradiation in patients while ensuring its effectiveness. In patients with oral cavity carcinoma, it might be necessary to increase the radiation dose.

Liquid Biopsy as a Tool for the Characterisation and Early Detection of the Field Cancerization Effect in Patients with Oral Cavity Carcinoma

Oral squamous cell carcinoma (OSCC) constitutes approximately 25% of all head and neck cancer, for which the consumption of tobacco and alcohol are the main associated risk factors. The field cancerization effect of OSCC is one of the main reasons for the poor survival rates associated with this disease. Despite some advances, its ccharacterization and early diagnosis continue to challenge modern oncology, and the goal of improving the prognosis remains to be achieved. Among new early diagnostic tools for OSCC that have been proposed, liquid biopsy appears to be an ideal candidate, as studies have shown that the analysis of blood and saliva provides promising data for the early detection of relapses or second tumours.

Oxygenated Cembrene Diterpenes from Sarcophyton convolutum: Cytotoxic Sarcoconvolutum A-E

The soft coral genus Sarcophyton contains the enzymatic machinery to synthesize a multitude of cembrene-type diterpenes. Herein, highly oxygenated cembrenoids, sarcoconvolutum A-E (1–5) were purified and characterized from an ethyl acetate extract of the red sea soft coral, Sarcophyton convolutum. Compounds were assemblies according to spectroscopic methods including FTIR, 1D- and 2D-NMR as well as HRMS. Metabolite cytotoxicity was tested against lung adenocarcinoma, cervical cancer, and oral-cavity carcinoma (A549, HeLa and HSC-2, respectively). The most cytotoxic compound, (4) was observed to be active against cell lines A549 and HSC-2 with IC50 values of 49.70 and 53.17 μM, respectively.

Functional and aesthetic outcome with free fibula osteocutaneous flap in reconstruction of anterior mandibular defects in oral malignancies: our experience

<p class="abstract"><strong>Background:</strong> For anterior mandibular defects, vascularized bone flap reconstructions are the best for providing a solid arch necessary to restore form and function, especially in patients receiving tumour excision surgery in head and neck region. Our aim was to study aesthetic and functional outcome of free fibula osteocutaneous flap (FFOCF) in anterior mandibular defects in case of anterior floor of the mouth malignancies with mandibular infiltration.</p><p class="abstract"><strong>Methods:</strong> The clinical data of 15 oral cavity carcinoma patients with involvement of anterior floor of mouth with mandiblular infiltration that underwent FFOCF reconstruction at our institute, government medical college, Jammu, was prospectively collected from January 2018 till January 2020. In this study, the aesthetic and functional outcome of these patients was evaluated at 6 months and 1 year post surgery.</p><p class="abstract"><strong>Results:</strong> The aesthetic result of reconstruction was excellent in most patients. Also, there was no long-term donor-site morbidity. There was no peri-operative death. Flaps survived in all patients. Functional outcomes including the ability to tolerate oral diet and speech outcome were good in all cases.</p><p class="abstract"><strong>Conclusions:</strong> The FFOCF, in reconstruction surgery of advanced oral cavity carcinoma permits more radical resection of tumour with good functional as well aesthetic outcome.</p>