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Kuribayashi N, Tokuzen N, Goda H, Hino S, Uchida D. A Case of Nonocclusive Mesenteric Ischemia During Bioradiotherapy With Cetuximab. Cureus 2024; 16:e57229. [PMID: 38686280 PMCID: PMC11056803 DOI: 10.7759/cureus.57229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2024] [Indexed: 05/02/2024] Open
Abstract
Nonocclusive mesenteric ischemia (NOMI) causes mesenteric ischemia and intestinal necrosis despite the absence of organic obstruction, such as thrombi and emboli in mesenteric blood vessels, and it has an extremely poor prognosis. We report a case of NOMI developed during bioradiotherapy (BRT) with cetuximab for cervical lymph node metastasis of tongue cancer. The patient was a 73-year-old man who underwent right radical neck dissection for neck lymph node metastasis after tongue cancer surgery. Postoperatively, the patient received BRT with cetuximab. On the 34th day after BRT, the patient had abdominal distension and a decreased level of consciousness. Contrast-enhanced computed tomography revealed mesenteric ischemia without thrombi and extensive intestinal emphysema. The patient was diagnosed with NOMI. Furthermore, he had septic shock and was treated with vasopressors and antibacterial agents; however, the condition of the patient did not improve, and he died on the same day.
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Affiliation(s)
- Nobuyuki Kuribayashi
- Department of Oral and Maxillofacial Surgery, Ehime University Graduate School of Medicine, Toon, JPN
| | - Norihiko Tokuzen
- Department of Oral and Maxillofacial Surgery, Ehime University Graduate School of Medicine, Toon, JPN
| | - Hiroyuki Goda
- Department of Oral and Maxillofacial Surgery, Ehime University Graduate School of Medicine, Toon, JPN
| | - Satoshi Hino
- Department of Oral and Maxillofacial Surgery, Ehime University Graduate School of Medicine, Toon, JPN
| | - Daisuke Uchida
- Department of Oral and Maxillofacial Surgery, Ehime University Graduate School of Medicine, Toon, JPN
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Morimoto M, Takano M, Sato T, Makino S. Combination treatment with paclitaxel, carboplatin and cetuximab in maxillary sinus cancer: A case report. Oncol Lett 2024; 27:93. [PMID: 38288039 PMCID: PMC10823329 DOI: 10.3892/ol.2024.14226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 11/17/2023] [Indexed: 01/31/2024] Open
Abstract
The standard treatment for maxillary sinus cancer is surgery; however, surgery for advanced cases often leads to significant aesthetic and functional disability. Combination treatment (induction chemotherapy) with paclitaxel, carboplatin and cetuximab (PCE) can be effective in head and neck cancer. The present study describes the case of a patient with advanced maxillary sinus cancer that was successfully treated using the PCE regimen. A 69-year-old man presented to the Department of Dentistry and Oral Surgery, Hokuto Hospital (Obihiro, Japan) with left buccal swelling and an irregular mass on the left maxillary gingiva. The lesion filled the ethmoid and maxillary sinus, and destroyed the pterygoid process. Numerous lymph node metastases were suspected in the bilateral cervical region. The patient was diagnosed with left maxillary sinus cancer T4aN2cM0 and treated with PCE. The size of the tumor was markedly reduced after the initial treatment. After six cycles of PCE, bioradiotherapy (BRT; 66 Gy/33 Fr) was performed for the remaining lesion, and a complete response was achieved. Ten months after BRT, the tumor recurred in the anterior wall of the left maxillary sinus, which was treated by partial maxillary resection and split-thickness skin grafting. No local or cervical recurrence was observed 2 years after the surgery. These findings suggested that PCE could be considered as the first step for the treatment of highly advanced malignant tumors in the head and neck.
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Affiliation(s)
- Masahiro Morimoto
- Department of Oral Diagnosis and Medicine, Hokkaido University Faculty of Dental Medicine, Sapporo, Hokkaido 060-8586, Japan
| | - Masashi Takano
- Department of Dentistry and Oral Surgery, Hokuto Hospital, Obihiro, Hokkaido 080-0833, Japan
| | - Takehiko Sato
- Department of Dentistry and Oral Surgery, Hokuto Hospital, Obihiro, Hokkaido 080-0833, Japan
| | - Shujiroh Makino
- Department of Dentistry and Oral Surgery, Hokuto Hospital, Obihiro, Hokkaido 080-0833, Japan
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Kapała A, Surwiłło-Snarska A, Jodkiewicz M, Kawecki A. Nutritional Care in Patients with Head and Neck Cancer during Chemoradiotherapy (CRT) and Bioradiotherapy (BRT) Provides Better Compliance with the Treatment Plan. Cancers (Basel) 2021; 13:cancers13112532. [PMID: 34064057 PMCID: PMC8196687 DOI: 10.3390/cancers13112532] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 05/17/2021] [Accepted: 05/20/2021] [Indexed: 12/15/2022] Open
Abstract
Simple Summary The nutritional status of patients with head and neck cancer (HNC) during concurrent chemoradiotherapy (CRT) with platinum derivatives or concurrent radiotherapy with cetuximab (bioradiotherapy, BRT) inevitably deteriorates during treatment. Malnutrition is responsible for increased treatment-related toxicity, an increased incidence of infectious complications, the risk of postponing or discontinuing therapy, reduced drug doses (platinum derivatives or cetuximab), deteriorating quality of life (QoL), worse outcome, and increased treatment costs. A nutritional care programme, which included prophylactic dietary counselling and early enteral nutrition, reduced the incidence of complications and prevented drug dose reduction and the deterioration of patients’ anthropometric and laboratory parameters. The study confirmed that nutritional care before and during CRT and BRT in patients with HNC is a determinant of therapeutic benefit. Abstract The treatment of locally advanced head and neck cancer (HNC) is based on extensive resections followed by concurrent chemoradiotherapy (CRT) with platinum derivatives or concurrent radiotherapy with cetuximab (bioradiotherapy; BRT). Malnutrition, which occurs in up to 60% of patients before treatment commencement, severely increases the risk of CRT/BRT drug dose reductions and the incidence of treatment-related adverse events. A prospective observational study was performed regarding the influence of nutritional care on nutritional status, compliance with the treatment’s planned regimen, and the incidence of treatment-related complications in patients with advanced HNC during CRT and BRT. The study population encompassed 153 patients compared with a retrospective control group of 72 patients treated before nutritional care was included in the standard of oncological care. Patients enrolled in the nutritional care programme received significantly higher doses of platinum derivatives or cetuximab than patients in the control group. A significant difference between the compared populations was observed in patients below 70 years of age (92.8% of the study population), after prior surgery, and with initial weight loss lower than 10%. Nutritional care reduced final weight loss and prevented a decline within the laboratory markers of nutritional status. Weight loss was comparable in both modes of treatment—CRT and BRT. The incidence of treatment-related complications was significantly higher in patients without nutritional support in the subgroups of patients under 70 years of age and after primary surgery. Nutritional care before and during CRT and BRT in patients with HNC is a determinant of therapeutic benefit, defined as preventing down-dosing, weight loss, and the incidence of complications. Platinum derivatives and cetuximab had comparable influence on weight loss.
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Affiliation(s)
- Aleksandra Kapała
- Department of Clinical Nutrition, Head and Neck Cancer Department, Maria Sklodowska-Curie National Research Institute of Oncology, 02781 Warsaw, Poland
- Correspondence: ; Tel.: +48-22-546-3396
| | - Agnieszka Surwiłło-Snarska
- Department of Clinical Nutrition, Maria Sklodowska-Curie National Research Institute of Oncology, 02781 Warsaw, Poland; (A.S.-S.); (M.J.)
| | - Magdalena Jodkiewicz
- Department of Clinical Nutrition, Maria Sklodowska-Curie National Research Institute of Oncology, 02781 Warsaw, Poland; (A.S.-S.); (M.J.)
| | - Andrzej Kawecki
- Head and Neck Cancer Department, Maria Sklodowska-Curie National Research Institute of Oncology, 02781 Warsaw, Poland;
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Strojan P, Zakotnik B, Žumer B, Karner K, Dremelj M, Jančar B, Jereb S, Grašič-Kuhar C. Skin Reaction to Cetuximab as a Criterion for Treatment Selection in Head and Neck Cancer. Anticancer Res 2018; 38:4213-4220. [PMID: 29970553 DOI: 10.21873/anticanres.12717] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 05/19/2018] [Accepted: 05/22/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM It can be hypothesized that in patients with locally advanced head and neck cancer and prominent cetuximab (CMb)-induced skin rash, immunoradiotherapy would result in a survival advantage over chemoradiotherapy with cisplatin (CP). PATIENTS AND METHODS After a loading dose of CMb, one weekly cycle of CMb and CP concurrently with RT, patients who developed a grade ≥2 rash proceeded with immunoradiotherapy, and those with a grade 0-1 rash had chemoradiotherapy. RESULTS A grade 3-4 allergic reaction to CMb developed in 11/39 (28.2%) patients and further recruitment was stopped. These patients proceeded treatment with CP. In early assessment of skin rash 10/28 patients qualified for chemoradiotherapy and 18/28 patients for immunoradiotherapy. There was no difference in survival between the two groups. CONCLUSION Rate of serious CMb-induced hypersensitivity reactions was unacceptably high. Even though immunoradiotherapy was administered only to the prognostically most favorable group of patients, it resulted in no advantage over chemoradiotherapy.
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Affiliation(s)
- Primož Strojan
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia .,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Branko Zakotnik
- Department of Medical Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - Barbara Žumer
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - Katarina Karner
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - Marta Dremelj
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - Boris Jančar
- Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia
| | - Simona Jereb
- Department of Radiology, Institute of Oncology, Ljubljana, Slovenia
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Rovira A, Tornero J, Oliva M, Taberna M, Montal R, Nogues J, Farre A, Lares H, Navarro V, Mari A, Vinals JM, Lozano A, Mesia R, Manos M. Salvage surgery after head and neck squamous cell carcinoma treated with bioradiotherapy. Head Neck 2016; 39:116-121. [PMID: 27459296 DOI: 10.1002/hed.24549] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Revised: 02/23/2016] [Accepted: 06/22/2016] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The purpose of this study was to describe the results and complications of primary site salvage surgery after head and neck squamous cell carcinoma (HNSCC) treated with bioradiotherapy. METHODS We conducted a retrospective chart review of 268 patients treated with bioradiotherapy between March 2006 and December 2013 at the Hospital Universitari de Bellvitge-ICO. RESULTS Fifty-nine patients developed local recurrence or had residual disease with a 1-year and 3-year overall survival of 47% and 15.4%, respectively. Salvage surgery was feasible in 22 patients (37.3%). There were 16 complications in these 22 patients (72.7%), 11 (50%) of which were major. Bilateral neck dissection was identified as a risk factor for complications. CONCLUSION Salvage surgery after bioradiotherapy is associated with a high rate of complications. Neck dissection seems to be related to an increased rate of complications with no survival improvement. © 2016 Wiley Periodicals, Inc. Head Neck 39: 116-121, 2017.
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Affiliation(s)
- Aleix Rovira
- Department of Otorhinolaryngology, Bellvitge University Hospital, Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, Spain
| | - Jordi Tornero
- Department of Otorhinolaryngology, Bellvitge University Hospital, Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, Spain
| | - Marc Oliva
- Department of Medical Oncology, Catalan Institute of Oncology, Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, Spain
| | - Miren Taberna
- Department of Medical Oncology, Catalan Institute of Oncology, Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, Spain
| | - Robert Montal
- Department of Medical Oncology, Catalan Institute of Oncology, Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, Spain
| | - Julio Nogues
- Department of Otorhinolaryngology, Bellvitge University Hospital, Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, Spain
| | - Anna Farre
- Department of Otorhinolaryngology, Bellvitge University Hospital, Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, Spain
| | - Henry Lares
- Department of Otorhinolaryngology, Bellvitge University Hospital, Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, Spain
| | - Valenti Navarro
- Statistics Unit, Hospital Duran I Reynalds, Catalan Institute of Oncology, Hospitalet de Llobregat, Barcelona, Spain
| | - Antoni Mari
- Department of Maxillofacial Surgery, Bellvitge University Hospital, Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, Spain
| | - Joan Maria Vinals
- Department of Plastic and Reconstructive Surgery, Bellvitge University Hospital, Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, Spain
| | - Alicia Lozano
- Department of Radiotherapy, Hospital Duran I Reynalds, Catalan Institute of Oncology, Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, Spain
| | - Ricard Mesia
- Department of Medical Oncology, Catalan Institute of Oncology, Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, Spain
| | - Manel Manos
- Department of Otorhinolaryngology, Bellvitge University Hospital, Universitat de Barcelona, Hospitalet de Llobregat, Barcelona, Spain
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