Carbon ion radiotherapy for basal cell adenocarcinoma of the head and neck: preliminary report of six cases and review of the literature

<p>Abstract</p> <p>Background</p> <p>Basal cell adenocarcinoma accounts for approximately 1.6% of all salivary gland neoplasms. In this report, we describe our experiences of treatment for BCAC with carbon ion radiotherapy in our institution.</p> <p>Methods</p> <p>Case records of 6 patients with diagnosis of basal cell adenocarcinoma of the head and neck, who were treated by carbon ion radiotherapy with 64.0 GyE/16 fractions in our institution, were retrospectively reviewed.</p> <p>Results</p> <p>In a mean follow-up period of 32.1 months (14.0-51.3 months), overall survival and local control rates of 100% were achieved. Only one grade 4 (CTCAE v3.0) late complication occurred. There was no other grade 3 or higher toxicity.</p> <p>Conclusions</p> <p>Carbon ion radiotherapy should be considered as an appropriate curative approach for treatment of basal cell adenocarcinoma in certain cases, particularly in cases of unresectable disease and postoperative gross residual or recurrent disease.</p

Non-Invasive Early Detection of Oral Cancers Using Fluorescence Visualization with Optical Instruments

Background: Oral cancer screening is important for early detection and early treatment, which help improve survival rates. Biopsy is the gold standard for a definitive diagnosis but is invasive and painful, while fluorescence visualization is non-invasive, convenient, and real-time, and examinations can be repeated using optical instruments. The purpose of this study was to clarify the usefulness of fluorescence visualization in oral cancer screening. Methods: A total of 502 patients, who were examined using fluorescence visualization with optical instruments in our hospitals between 2014 and 2019, were enrolled in this study. The final diagnosis was performed by pathological examination. Fluorescence visualization was analyzed using subjective and objective evaluations. Results: Subjective evaluations for detecting oral cancer offered 96.8% sensitivity and 48.4% specificity. Regarding the objective evaluations, sensitivity and specificity were 43.7% and 84.6% for mean green value, 55.2% and 67.0% for median green value, 82.0% and 44.2% for coefficient of variation of value, 59.6% and 45.3% for skewness, and 85.1% and 75.8% for value ratio. For the sub-analysis of oral cancer, all factors on objective and subjective evaluation showed no significant difference. Conclusions: Fluorescence visualization with subjective and objective evaluation is useful for oral cancer screening

Carbon Ion Radiotherapy for Skull Base and Paracervical Tumors

Purpose: To estimate the toxicity and efficacy of carbon ion radiotherapy for skull base and paracervicaltumors in clinical trials.Patients and Methods: A phase I/II dose escalation study for skull base and paracervical tumors was initiated inApril 1997. The patients were treated with 16 fractions for 4 weeks with a total dose of 48.0, 52.8, 57.6, or60.8Gy equivalents (GyE). In April of 2004, a phase II study was initiated with an irradiation schedule of60.8GyE in 16 fractions over four weeks. There were 76 patients included in the analysis. Histologically, 44patients had chordoma, 12 chondrosarcoma, 9 olfactory neuroblastoma, 7 malignant meningioma, 1 giant celltumor, and 1 had a neuroendocrine carcinoma. The patients were treated with a dose of 48.0 GyE (4 patients),52.8 GyE (6 patients), 57.6 GyE (9 patients) or 60.8 GyE (57 patients).Results: The follow-up periods ranged from 3 to 158 months, with a median period of 46 months. At the timeof the analysis, there was no evidence of any serious acute (Grade &#8805;4 ) or late (Grade &#8805;3) reactions. The 5-yearlocal control and overall survival rates for all patients were 88% and 82%, respectively. The 5-year local controland overall survival rates for chordoma patients were 88% and 87%, respectively.Conclusion: A carbon ion dose of 60.8GyE in 16 fractions was effective and safe for the treatment of skullbase and paracervical tumors.2nd NIRS-ETOILE Joint Symposium on Carbon Ion Therap

Carbon Ion Radiotherapy For Malignant Head-and-Neck Tumors Invading the Skull Base

Purpose/Objective(s): To estimate the toxicity and efficacy of carbon ion radiotherapy for malignant head-and-neck tumors invading the skull base.Material/Methods: Between April 1997 and March 2008, a total of 313 patients with head-and-neck tumors were treated with carbon ion radiotherapy with a phase II clinical trial. All of these patients had neither regional lymph node nor distant metastasis before carbon ion radiotherapy. The prescribed tumor doses were 57.6 or 64.0 GyE in 16 fractions over four weeks. Of the 313 patients, 104 patients with skull base invasion were analyzed. The patients consisted of 56 males and 48 females aged from 23 to 78 years with an average age of 55.7 years. Histologically, tumors were classified as follows: 49 were adenoid cystic carcinoma, 23 were malignant mucosal melanoma, 22 were adenocarcinoma, and 10 were 5 other histological types. The CTV ranged from 53.6 to 670.1 ml, with an average of 208.1 ml. Median follow-up time was 32.5 months (range, 2.6-152 months).Results: Although acute grade 3 skin and mucosal reactions appeared in 4 patients (4 %) and 10 patients (10 %), almost all of the late skin and mucosal reactions were grade 1 or less. Three patients developed late grade 2 mucosal reaction. In regard to brain toxicity, patients were divided into two groups according to intracranial involvement; Group A was made up of 50 patients whose tumors abutted the cranial fossa, Group B consisted of 54 patients whose tumors displaced or invaded the frontal or temporal lobe. A late grade 2 brain reaction was detected in 3 patients (6 %) for Group A and in 11 patients (20 %) for Group B, which necessitated steroid administration. All these patients can now manage without any medication because these reactions improved within a short time. At the time of analysis, there was no evidence of any serious late brain reactions. The 5-year local control and overall survival rates of all patients were 76 % and 44 %, respectively. There were no significant differences in local control rates between histological types. In total 59 patients died, 31 were distant metastasis, 9 were in-field recurrence, 8 were marginal recurrences, 2 were meningeal disseminations, and 9 were due to other causes that are not associated with tumors. As for the tumor status studied, the 5-year local control rates were 75 % for Group A and 77 % for Group B. The 5-year overall survival rates were 45 % for Group A and 42 % for Group B. There was no significant difference in outcome between the two groups.Conclusion: Our results showed acceptable brain toxicities and excellent therapeutic effectiveness for unresectable malignant head-and-neck tumor

Carbon Ion Radiotherapy for Malignant Head-and-Neck Tumors.

To evaluate the efficacy of carbon ion radiotherapy for malignant head-and-neck tumors.Between April 1 997 and February 20 1 1 , 407 cases with locally advanced, histologically proven, and primary or recurrent malignant tumors of the head-and-neck were treated with carbon ions. Treatment dose was 64.0 GyE in16 fractions over 4 weeks (or 57.6 GyE when a wide area of skin was included in the target volume).There were no acute reactions worse than grade 3 and no late toxicities worse than grade 2. The five-year local control and overall survival rates were 73% and 53%, respectively. But the five-year local control rate was 24% for bone and soft tissue sarcomas, and the five-year overall survival rate was 35% for malignant melanomas.Carbon ion radiotherapy for malignant head-and-neck tumors can be described as presenting no clinicalproblems. Although local control of carbon ion radiotherapy was promising for malignant head-and-neck tumor excluding sarcoma, the survival rate was not commensurate with the favorable local control rate of malignant melanoma. On the basis of the results of the analysis, this part of the study was divided into two additional protocols, one for bone and soft tissue sarcomas and another for mucosal malignant melanomas.NIRS-KFSHRC Joint Symposium on Carbon Ion Radiotherapy and Radiation Emergency Medicin

Carbon Ion Radiotherapy for Malignant Head-and-Neck Tumors

To evaluate the efficacy of carbon ion radiotherapy for malignant head-and-neck tumors.Between April 1997 and February 2011, 407 cases with locally advanced, histologically proven, and primary or recurrent malignant tumors of the head-and-neck were treated with carbon ions. Treatment dose was 64.0 GyE in 16 fractions over 4 weeks (or 57.6 GyE when a wide area of skin was included in the target volume).There were no acute reactions worse than grade 3 and no late toxicities worse than grade 2. The five-year local control and overall survival rates were 73% and 53%, respectively. But the five-year local control rate was 24% for bone and soft tissue sarcomas, and the five-year overall survival rate was 35% for malignant melanomas.Carbon ion radiotherapy for malignant head-and-neck tumors can be described as presenting no clinical problems. Although local control of carbon ion radiotherapy was promising for malignant head-and-neck tumor excluding sarcoma, the survival rate was not commensurate with the favorable local control rate of malignant melanoma. On the basis of the results of the analysis, this part of the study was divided into two additional protocols, one for bone and soft tissue sarcomas and another for mucosal malignant melanomas.2nd NIRS-ETOILE Joint Symposium on Carbon Ion Therap

Carbon Ion Radiotherapy for Skull Base and Head-and-Neck Tumors

1. Skull Base and Paracervical TumorsAbstractTo estimate the toxicity and efficacy of the clinical trials for patients with skull base and paracervical tumors treated with carbon ion radiotherapy.A phase I/II dose escalation study for skull base and paracervical tumor was initiated in April 1997. The phase I/II dose escalation trial was performed up to the fourth-stage dose level. From April 2004, a phase II clinical trial was initiated under the Highly Advanced Medical Technology scheme with an irradiation schedule of 60.8 GyE in 16 fractions over four weeks.At the time of analysis, there was no evidence of any serious acute or late reactions in skull base and paracervical tumors. For skull base and paracervical tumor, the carbon ion dose in excess of 57.6 GyE improves local control. \n2. Head-and-Neck TumorsAbstractTo evaluate the efficacy of carbon ion radiotherapy for malignant head-and-neck tumors.Between April 1997 and February 2010, 378 cases with locally advanced, histologically proven, and new or recurrent malignant tumors of the head-and-neck were treated with carbon ions. Treatment dose was 64.0 GyE in 16 fractions over 4 weeks (or 57.6 GyE when a wide area of skin was included in the target volume).There were no acute reactions worse than grade 3 and no late toxicities worse than grade 2. The five-year local control and overall survival rates were 75% and 54%, respectively. But the five-year local control rate was 25% for bone and soft tissue sarcomas, and the five-year overall survival rate was 36% for malignant melanomas. Carbon ion radiotherapy for malignant head-and-neck tumors can be described as presenting no clinical problems. Although local control of carbon ion radiotherapy was promising for malignant head-and-neck tumor excluding sarcoma, the survival rate was not commensurate with the favorable local control rate of malignant melanoma. On the basis of the results of the analysis, this part of the study was divided into two additional protocols, one for bone and soft tissue sarcomas and another for mucosal malignant melanomas.The 4th Japanese-European Joint Symposium on Ion Cancer Therap