Hiroshi Nagafuji

Feasibility of ICG fluorescence-guided sentinel node biopsy in animal models using the HyperEye Medical System.

BackgroundThe sentinel lymph node (SLN) concept is accepted for several types of cancers. Current methods for sentinel node detection involve radioisotopes and blue dye. They have shown good results, but some drawbacks remain. Indocyanine green (ICG) fluorescence using the HyperEye Medical System (HEMS) was evaluated as a new method.MethodsThis was a prospective, nonrandomized, experimental study in four Japanese white rabbits and six Yorkshire pigs. ICG and indigo carmine were injected into the tongue, larynx, or hypopharynx, and ICG fluorescence detection was evaluated using both transcutaneous visualization of lymphatic vessels and intraoperative identification of SLNs.ResultsThe SLNs appeared as shining fluorescent spots with HEMS transcutaneously in rabbits, but no SLNs were detected transcutaneously in pigs. Eleven procedures identified SLNs, but one did not due to a technical problem.ConclusionsHEMS could become useful for predicting lymph node metastasis during surgery for head and neck cancer.

Diagnostic evaluation of sentinel lymph node biopsy in early head and neck squamous cell carcinoma: A meta-analysis

The purpose of this study was to evaluate the efficacy of sentinel lymph node biopsy (SLNB) in early head and neck squamous cell carcinoma (HNSCC).

Phase I study of S-1 plus nedaplatin in patients with advanced/recurrent head and neck cancer.

Background: Cisplatin plus fluorouracil is widely used for the treatment of head and neck cancer. However, the cisplatin plus fluorouracil regimen necessitates hospitalization. Therefore, we planned to develop a new regimen that can be administered on an outpatient basis and performed a phase I study of S-1 + nedaplatin. Methods: S-1 was given orally at a fixed dose for 14 days, and nedaplatin was administered intravenously on day 8 of S-1 administration. The dose of nedaplatin was increased in 10-mg/m2 steps to find the maximum tolerated dose, depending on the appearance of dose-limiting toxicities. Results: A total of 14 patients were registered. The maximum tolerated dose of nedaplatin was determined to be 90 mg/m2. The main toxicities were neutropenia and thrombocytopenia. The response rate was 57.1%. Conclusion: The recommended dose of nedaplatin for a phase II study was determined to be 80 mg/m2. We concluded that our regimen was well tolerated and that the response rate was acceptable.

Head and Neck Cancer with Dermatomyositis: A Report of Two Clinical Cases

Dermatomyositis is well known to be associated with several types of malignancy and patients with dermatomyositis have higher rates of mortality from cancer. Although rare in Japan, head and neck cancer, especially nasopharyngeal cancer, is the predominant type of cancer associated with dermatomyositis in several areas in Asia, including Hong Kong and Singapore. Here we report two cases of head and neck cancer with dermatomyositis as well as a literature review. Both cases were treated with chemotherapy and radiotherapy. Although the patients were immunosuppressed due to dermatomyositis treatment, no grade 3 or 4 adverse events occurred.