1
|
Near-Infrared Photoimmunotherapy for Oropharyngeal Cancer. Cancers (Basel) 2022; 14:cancers14225662. [PMID: 36428754 PMCID: PMC9688155 DOI: 10.3390/cancers14225662] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 11/19/2022] Open
Abstract
Human papillomavirus (HPV)-associated oropharyngeal cancer has a better prognosis than other head and neck cancers. However, rates of recurrence and metastasis are similar and the prognosis of recurrent or metastatic HPV-associated oropharyngeal cancer is poor. Near-infrared photoimmunotherapy (NIR-PIT) is a treatment involving administration of a photosensitizer (IRDye®700DX) conjugated to a monoclonal antibody followed by activation with near-infrared light illumination. It is a highly tumor-specific therapy with minimal toxicity in normal tissues. Moreover, NIR-PIT is expected to have not only direct effects on a treated lesion but also immune responses on untreated distant lesions. NIR-PIT with cetuximab-IR700 (AlluminoxTM) has been in routine clinical use since January 2021 for unresectable locally advanced or locally recurrent head and neck cancer in patients that have previously undergone radiotherapy in Japan. NIR-PIT for head and neck cancer (HN-PIT) is expected to provide a curative treatment option for the locoregional recurrent or metastatic disease after radiotherapy and surgery. This article reviews the mechanism underlying the effect of NIR-PIT and recent clinical trials of NIR-PIT for head and neck cancers, treatment-specific adverse events, combination treatment with immune checkpoint inhibitors, illumination approach and posttreatment quality of life, and provides a case of series of two patients who receive NIR-PIT for oropharyngeal cancer at our institution.
Collapse
|
2
|
Brambullo T, Azzena GP, Toninello P, Masciopinto G, De Lazzari A, Biffoli B, Vindigni V, Bassetto F. Current Surgical Therapy of Locally Advanced cSCC: From Patient Selection to Microsurgical Tissue Transplant. Review. Front Oncol 2021; 11:783257. [PMID: 34950589 PMCID: PMC8690035 DOI: 10.3389/fonc.2021.783257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 11/17/2021] [Indexed: 11/29/2022] Open
Abstract
Among the non-melanoma skin cancers (NMSC) the squamous cell carcinoma (SCC) is one of the most challenging for the surgeon. Local aggressiveness and a tendency to metastasize to regional lymph nodes characterize the biologic behavior. The variants locally advanced and metastatic require wide excision and node dissection. Such procedures can be extremely detrimental for patients. The limit of the surgery can be safely pushed forward with a multidisciplinary approach. The concept of skin oncoplastic surgery, the ablative procedures and the reconstructive options (skin graft, pedicled flap, microsurgical free flap) are discussed together with a literature review.
Collapse
Affiliation(s)
- Tito Brambullo
- Clinic of Plastic Surgery, Department of Neurosciences, Padua University Hospital, Padua, Italy
| | - Gian Paolo Azzena
- Clinic of Plastic Surgery, Department of Neurosciences, Padua University Hospital, Padua, Italy
| | - Paolo Toninello
- Clinic of Plastic Surgery, Department of Neurosciences, Padua University Hospital, Padua, Italy
| | - Giuseppe Masciopinto
- Clinic of Plastic Surgery, Department of Neurosciences, Padua University Hospital, Padua, Italy
| | - Alberto De Lazzari
- Clinic of Plastic Surgery, Department of Neurosciences, Padua University Hospital, Padua, Italy
| | - Bernardo Biffoli
- Clinic of Plastic Surgery, Department of Neurosciences, Padua University Hospital, Padua, Italy
| | - Vincenzo Vindigni
- Clinic of Plastic Surgery, Department of Neurosciences, Padua University Hospital, Padua, Italy
| | - Franco Bassetto
- Clinic of Plastic Surgery, Department of Neurosciences, Padua University Hospital, Padua, Italy
| |
Collapse
|
3
|
Thyroid Gland Flap for Minimally Invasive Reconstructive Head and Neck Surgery. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2020; 8:e3297. [PMID: 33425608 PMCID: PMC7787277 DOI: 10.1097/gox.0000000000003297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 10/02/2020] [Indexed: 11/26/2022]
Abstract
Head and neck surgery sometimes causes small defects, and salvage surgery after chemoradiotherapy poses some risk because of damage to the surgical site from the previous treatment. We have developed a novel thyroid gland flap for head and neck surgical reconstruction and here we describe elevating the flap, including arc rotation, size, and suture technique, and our outcomes to date. Methods Thyroid gland flap reconstruction was performed in 13 cases (11 patients) between July 2009 and May 2020. The clinical importance and adverse effects of the procedure were examined. Thyroid function and blood flow of the flap were assessed, and the status of the flap and irradiated recipient tissue was examined histopathologically. Results Median age at surgery was 64.6 years (range 49-77 years). Two of the patients underwent reconstruction with a thyroid gland flap twice. There were 4 cases of primary head and neck cancer resection with neck dissection in which the flap was harvested from the thyroid gland as reinforcement. In 1 case, surgery was performed for cervical esophageal diverticulum. In all cases, the arc was limited to 6 cm and suturing was basic. There were no complications of the surgical procedure, and the postoperative course was uneventful. Contrast-enhanced computed tomography revealed adequate enhancement of the flap. Postoperative thyroid function was normal. The thyroid gland flap was firmly adapted and fused with the irradiated recipient tissue. Conclusion The thyroid gland flap could be an effective tissue flap fed by the superior thyroid arteriovenous pedicle for head and neck reconstruction.
Collapse
|
4
|
Ogawa T, Okamoto H, Inukai D, Sano R, Katahira N, Yamanaka S, Yo K, Kan T, Ueda H. A novel larynx-preserving pharyngectomy technique using a thyroid gland flap after chemoradiotherapy. Clin Case Rep 2019; 7:2181-2186. [PMID: 31788275 PMCID: PMC6878092 DOI: 10.1002/ccr3.2477] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 08/13/2019] [Accepted: 08/14/2019] [Indexed: 12/27/2022] Open
Abstract
This case report describes larynx-preserving pharyngectomy after chemoradiotherapy using a thyroid gland flap. A thyroid gland flap has good blood supply and reconstruction can be done in the same surgical field. The thyroid gland flap has potential as a novel appropriate flap for use in head and neck surgery.
Collapse
Affiliation(s)
- Tetsuya Ogawa
- Department of OtorhinolaryngologyAichi Medical UniversityAichiJapan
| | - Hiroki Okamoto
- Department of OtorhinolaryngologyAichi Medical UniversityAichiJapan
| | - Daisuke Inukai
- Department of OtorhinolaryngologyAichi Medical UniversityAichiJapan
| | - Rui Sano
- Department of OtorhinolaryngologyAichi Medical UniversityAichiJapan
| | | | - Syunpei Yamanaka
- Department of OtorhinolaryngologyAichi Medical UniversityAichiJapan
| | - Kinga Yo
- Department of OtorhinolaryngologyAichi Medical UniversityAichiJapan
| | - Taichi Kan
- Department of OtorhinolaryngologyAichi Medical UniversityAichiJapan
| | - Hiromi Ueda
- Department of OtorhinolaryngologyAichi Medical UniversityAichiJapan
| |
Collapse
|
5
|
Suzuki H, Terada H, Hanai N, Nishikawa D, Koide Y, Beppu S, Kodaira T, Tachibana H, Koide Y, Tanaka H, Hasegawa Y. Treatment package time predicts cancer-specific survival and distant metastasis in laryngeal cancer. Oncol Lett 2019; 17:1384-1390. [PMID: 30655910 PMCID: PMC6313000 DOI: 10.3892/ol.2018.9664] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Accepted: 10/26/2018] [Indexed: 01/12/2023] Open
Abstract
We investigated whether treatment package time was significantly associated with survival outcomes of resectable locally-advanced laryngeal squamous cell carcinoma in patients who consecutively underwent various treatments, including surgery alone and salvage surgery for residual tumor. A total of 100 patients with clinical T3-T4 resectable laryngeal squamous cell carcinoma were enrolled in this study. The treatment package time was calculated in days between the start of any treatment and the end of all treatments, including postoperative radiotherapy and salvage surgery for residual tumors. Using a log-rank test, a treatment package time of ≥68 days showed significantly shorter cancer-specific (P=0.0013) and distant metastasis-free survival (P=0.0017), compared with a treatment package time of <68 days. Multivariate survival analyses of two Cox's hazards proportional models was conducted. In both model-1, which adjusted for cT3/cT4, cN0-1/cN2-3 and total laryngectomy/non-total laryngectomy, and model-2, which adjusted for cT3/cT4, cN0-1/cN2-3 and induction therapy/non-induction therapy, the cancer-specific survival and distant metastasis-free survival, according to treatment package time, were significantly longer with <68 days compared with ≥68 days (P<0.01). The present study demonstrated that a prolonged treatment package time is a prognostic factor for shorter cancer-specific and distant metastasis-free survival after various treatments for resectable locally-advanced laryngeal cancer.
Collapse
Affiliation(s)
- Hidenori Suzuki
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi 464-8681, Japan
| | - Hoshino Terada
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi 464-8681, Japan
| | - Nobuhiro Hanai
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi 464-8681, Japan
| | - Daisuke Nishikawa
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi 464-8681, Japan
| | - Yusuke Koide
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi 464-8681, Japan
| | - Shintaro Beppu
- Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi 464-8681, Japan
| | - Takeshi Kodaira
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Aichi 464-8681, Japan
| | - Hiroyuki Tachibana
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Aichi 464-8681, Japan
| | - Yutaro Koide
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Aichi 464-8681, Japan
| | - Hiroshi Tanaka
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Aichi 464-8681, Japan
| | - Yasuhisa Hasegawa
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Aichi 464-8681, Japan
| |
Collapse
|
6
|
Wei W, Qiu Y, Fang Q, Jia Y. Pectoralis major myocutaneous flap in salvage reconstruction following free flap failure in head and neck cancer surgery. J Int Med Res 2018; 47:76-83. [PMID: 30514138 PMCID: PMC6384490 DOI: 10.1177/0300060518795530] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective This study aimed to compare the results of the pectoralis major myocutaneous (PMM) flap in primary and salvage head and neck cancer surgery. Methods A total of 160 patients were enrolled in this study. The salvage group consisted of 30 patients who received immediate PMM flap surgery following free flap failure. In the primary group, the PMM flap was primarily chosen for 130 patients. Related information was collected and analysed. The University of Washington (UW)-Quality of Life questionnaire, version 4, was mailed to every patient. Results Partial necrosis was significantly lower in the primary group (n = 13, 10.0%) than in the salvage group (n = 7, 23.3%). Surgical site infection was found in 10 (7.8%) patients in the primary group and in six (20.0%) patients in the salvage group. The mean composite quality of life scores were 66.8 ± 20.5 and 66.2 ± 22.1 in the two groups, respectively. Differences in scores for domains of activity, mood, and anxiety were significant. Disease-specific survival and recurrence-free survival rates were not different between the two groups. Conclusion PMM flap salvage reconstruction has a higher complication rate and poorer functional results, but similar survival prognosis, compared with primary surgery.
Collapse
Affiliation(s)
- Wei Wei
- 1 Department of Anesthesia, Children's Hospital Affiliated to Zhengzhou University, Henan provincial key laboratory of children's genetics and metabolic diseases Zhengzhou Children's Hospital, China
| | - Yongsheng Qiu
- 2 Department of Anesthesia, Affiliated Children's Hospital of Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
| | - Qigen Fang
- 3 Department of Head and Neck, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Yingping Jia
- 1 Department of Anesthesia, Children's Hospital Affiliated to Zhengzhou University, Henan provincial key laboratory of children's genetics and metabolic diseases Zhengzhou Children's Hospital, China
| |
Collapse
|
7
|
Vasani SS, Youssef D, Lin C, Wellham A, Hodge R. Defining the low-risk salvage laryngectomy-A single-center retrospective analysis of pharyngocutaneous fistula. Laryngoscope Investig Otolaryngol 2018; 3:115-120. [PMID: 29721544 PMCID: PMC5915824 DOI: 10.1002/lio2.144] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 01/03/2018] [Indexed: 11/07/2022] Open
Abstract
Objectives Salvage total laryngectomies (STL) are not a homogeneous group. Most will fall into two groups: i) Patients with previous AJCC stage I/II larynx cancer who have had radiotherapy to the larynx only (STL‐LOR), or ii) Patients who have had previous AJCC stage III/IV larynx cancer and subsequent radiotherapy to the larynx and draining nodal basins with concurrent cisplatin chemotherapy (STL‐CRT). We aimed to compare PCF rates following STL in these two groups. Methods A retrospective review of the department's cohort between January 2010 and August 2015 was conducted. Results Seventy‐seven patients underwent total laryngectomy for larynx cancer between January 2010 and August 2015. There were 10 post‐laryngectomy fistulas (13.0%). Three of these occurred in the 38 patients undergoing primary total laryngectomy (PTL), and seven in the 39 patients undergoing STL, rates of 7.9% and 17.9%, respectively. Twenty‐two patients had received radiation to the larynx alone without chemotherapy (STL‐LOR) for initial Stage I/II disease. Eleven patients had received laryngeal and neck irradiation plus cisplatin chemotherapy (STL‐CRT) for initial stage III/IV disease. Of the 22 STL‐LOR patients, two developed PCF (9.1%). Of the 11 STL‐CRT patients, five developed PCF. There was no difference in the rate of PCF between PTL and STL‐LOR. There was a statistically significant increase in PCF in STL‐CRT versus PTL (p = .009) and in PCF in STL‐CRT versus STL‐LOR (p = .027). Conclusion Salvage laryngectomies are often treated as a homogenous group. We demonstrate that PCF rates vary significantly depending on preoperative radiation fields and the use of chemotherapy. Level of Evidence 2b.
Collapse
Affiliation(s)
- Sarju S. Vasani
- Department of Otolaryngology, Royal Brisbane and Women's HospitalBrisbaneQueenslandAustralia
| | - Daniel Youssef
- Department of Otolaryngology, Royal Brisbane and Women's HospitalBrisbaneQueenslandAustralia
| | - Charles Lin
- Department of Oncology, Royal Brisbane and Women's HospitalBrisbaneQueenslandAustralia
| | - Annabelle Wellham
- Department of Otolaryngology, Royal Brisbane and Women's HospitalBrisbaneQueenslandAustralia
| | - Robert Hodge
- Department of Otolaryngology, Royal Brisbane and Women's HospitalBrisbaneQueenslandAustralia
| |
Collapse
|