Yasunori Ariyoshi

Determining whether a parotid tumor is in the superficial or deep lobe using magnetic resonance imaging

PURPOSE This study examined the usefulness of magnetic resonance imaging (MRI) in assessing whether parotid tumors were located in the superficial or deep lobe. PATIENTS AND METHODS Eight patients with parotid gland tumors underwent MRI using a spin echo pulse sequence. T1- and T2-weighted images were obtained. To assess tumor localization in the parotid gland, two anatomic landmarks were used: 1) a line connecting the lateral surface of posterior belly of digastric muscle and lateral surface of the cortical bone of ascending ramus (facial nerve [FN] line) and 2) the relationship to the retromandibular vein (RV). Results of all MRI examinations were compared with the surgical findings. RESULTS Seven of eight cases were correctly diagnosed using the FN line criterion. Five of eight cases were correctly diagnosed using the RV criterion. CONCLUSION MRI is an excellent modality to show tumor localization in the parotid gland.

Boron neutron capture therapy outcomes for advanced or recurrent head and neck cancer

We retrospectively review outcomes of applying boron neutron capture therapy (BNCT) to unresectable advanced or recurrent head and neck cancers. Patients who were treated with BNCT for either local recurrent or newly diagnosed unresectable head or neck cancers between December 2001 and September 2007 were included. Clinicopathological characteristics and clinical outcomes were retrieved from hospital records. Either a combination of borocaptate sodium and boronophenylalanine (BPA) or BPA alone were used as boron compounds. In all the treatment cases, the dose constraint was set to deliver a dose <10–12 Gy-eq to the skin or oral mucosa. There was a patient cohort of 62, with a median follow-up of 18.7 months (range, 0.7–40.8). A total of 87 BNCT procedures were performed. The overall response rate was 58% within 6 months after BNCT. The median survival time was 10.1 months from the time of BNCT. The 1- and 2-year overall survival (OS) rates were 43.1% and 24.2%, respectively. The major acute Grade 3 or 4 toxicities were hyperamylasemia (38.6%), fatigue (6.5%), mucositis/stomatitis (9.7%) and pain (9.7%), all of which were manageable. Three patients died of treatment-related toxicity. Three patients experienced carotid artery hemorrhage, two of whom had coexistent infection of the carotid artery. This study confirmed the feasibility of our dose-estimation method and that controlled trials are warranted.

Epidemiological study of malignant tumors in the oral and maxillofacial region: survey of member institutions of the Japanese Society of Oral and Maxillofacial Surgeons, 2002

We studied 1809 patients with oral cancer who visited and were treated, in 2002, at the 148 institutions certified as training facilities by the Japanese Society of Oral and Maxillofacial Surgeons. Of these institutions, 39 are dental university hospitals, 44 are medical university hospitals, 64 are general hospitals, and for 1 institution, the classification was not known. The patients consisted of 1071 (59.2%) males and 738 (40.8%) females (male: female ratio, 1.45:1), who had a average age of 65.2 years. The tongue (40.2%) was the most common site affected, followed by the gingiva (32.7%), buccal mucosa (10.1%), and oral floor (9.0%). There were 6 cases of multiple intraoral cancers. On histopathological examinations, squamous cell carcinoma (88.7%) was the most common type found, followed by adenoid cystic carcinoma (2.1%), and mucoepidermoid carcinoma (1.7%). Cases classified as T2N0 were the most common (32.1%), followed by T1N0 (21.4%), T4N0 (8.0%), and T2N1 (7.6%). Distant metastasis occurred in 17 patients (1.0%). Nonepithelial tumors, among which malignant melanoma was the most common type, accounted for 1.8% of the tumors. The sizes of the nonepithelial malignant tumors ranged from 1.0 to 7.0 cm, with an average size of 3.7 cm.

Study on chemosensitivity of oral squamous cell carcinomas by histoculture drug response assay

The aim of this study was to evaluate the reliability and utility of a histoculture drug response assay (HDRA) for treatment of squamous cell carcinoma in the oral cavity. Nineteen patients with squamous cell carcinoma of the oral cavity were assessed. Tumor tissue samples were histocultured on Gelfoam sponge gels in 24-well plates, followed by treatment with 5-fluorouracil (5-FU, 300 microg/ml), cisplatinum (CDDP, 20 microg/ml), 4-0-tetrahydropyranyl adriamycin (THP, 4.6 microg/ml), bleomycin (BLM, 20 microg/ml), adriamycin (ADM, 15 microg/ml) and docetaxel (TXT, 100 microg/ml). The controls were cultured without drug treatment. After completion of the culture, the relative cell survival in the tumors was determined using an MTT (3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H tetrazolium bromide) assay. The inhibition rate was calculated, and sensitivity was defined as a tumor inhibition rate greater than 60% for 5-FU, 40% for TXT, and 50% for the other drugs. All cases were successfully evaluated by the HDRA, and no apparent relationships between the chemosensitivity test results and clinico-histopathological characteristics were seen. CDDP tended to be sensitive, whereas 5-FU, THP, and BLM tended to show resistance in many cases. A good correlation was obtained between the chemosensitivity test results and clinical response. In conclusion, HDRA is a useful method for selection of an anticancer agent for individual oral cancer patients, because of its ease of evaluation and high predictability.

Boron neutron capture therapy for papillary cystadenocarcinoma in the upper lip : A case report

Boron neutron capture therapy (BNCT) is a tumor-selective radiation therapy using alpha and (7)Li particles, which are produced by the reaction of neutron with boron ((10)B), and taken up by the tumor. The authors report their first experience of BNCT on a patient with no history of surgery, chemotherapy or conventional radiotherapy for papillary cystadenocarcinoma in the upper lip.

Boron neutron capture therapy for recurrent oral cancer and metastasis of cervical lymph node.

We treated 6 patients with recurrent oral cancer and metastasis to the cervical lymph nodes after conventional treatments in 5 and non-conventional in 1 using BNCT, and herein report our results. The clinical response in our patients ranged from CR to PD. In 5 cases, spontaneous pain decreased immediately after BNCT. Three of the 6 are alive at the time of writing and we found that BNCT contributed to QOL improvement in all.

Magnetic resonance imaging of maxillary cancer--possibility of detecting bone destruction.

The purpose of this study was to evaluate the detectability of bone destruction of maxillary cancer with magnetic resonance imaging (MRI) using 14 cases of squamous cell carcinoma of the upper jaw. The detectability of bone destruction including the degree of spread to adjacent soft tissues was evaluated and compared to that of clinical examination, computed tomography (CT) and conventional X-ray films. MRI could show bone destruction of each bony part almost equally with CT, but differentiation among simple bone defects, bone expansion and bone destruction was difficult on MRI. The pattern of bone destruction of alveolus that could be detected on conventional X-ray examinations, could not be assessed on either CT or MRI. Soft tissue infiltration of the tumour was more clearly detected on MRI compared with CT and conventional X-ray films.

Disposition of TF-PEG-Liposome-BSH in tumor-bearing mice

BNCT requires high concentration and selective delivery of (10)B to the tumor cell. To improve the drug delivery in BNCT, we conducted a study by devising TPLB. We administrated three types of boron delivery systems: BSH, PLB and TPLB, to Oral SCC bearing mice. Results confirmed that (10)B concentration is higher in the TPLB group than in the BSH group and that TPLB is significantly effective as boron delivery system.

Carcinoma ex pleomorphic adenoma of the sublingual gland: a case report

We report a case of carcinoma ex pleomorphic adenoma of a sublingual gland in a 70-year-old man. Under a clinical diagnosis of benign salivary gland tumor, excision of the mass with the sublingual salivary gland in an en bloc fashion via an intraoral approach was performed. Histopathologically, there was a rupture of the fibrous capsule and diffuse cell-rich sheets composed of myoepithelial cells with round nuclei were also seen. Immunohistochemically, the cells that composed of cell rich sheets were positive to smooth muscle actin. Final diagnosis of myoepithelial carcinoma ex pleomorphic adenoma was made.

Analysis of enhanced MRI of tongue squamous cell carcinoma

舌扁平上皮癌40症例を対象に, dynamic enhanced MRIにおける境界性状と臨床的ならびに病理組織学的所見との関連性の検索を行った。撮像は冠状断T1強調像 (スピンエコー法, TR/TE=200/20) にて行った。関心領域 (ROI) 内の信号強度を測定し, 各時点におけるSE/Nを算出し, SE/Nが最高値を示した時点の画像において境界性状の評価を行った (明瞭型, 不明瞭型) 。臨床的には, 進展度, 発育様式, 病理組織学的には浸潤パターン, ステージならびに単核細胞浸潤と境界性状との関連性につき検索した。結果は以下の如くである。1.明瞭型を示す症例と比較し, 不明瞭型を示す症例が多く認められた。2.臨床的には, 内向型腫瘍は外向型ならびに中間型腫瘍と比較し, 造影MRIにおいて周囲組織との境界が不明瞭に描出される傾向が認められた。3.病理組織学的には, 浸潤パターンと造影MRIの境界性状との間に有意な関連性が認められた (p<0.01) 。以上より, 造影MRIにおける周囲組織との境界性状は, 腫瘍浸潤範囲をMRIにて診断する際, 重要な所見の一つであることが示された。