記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：耳鼻と臨床会  

同一甲状腺に異なる組織型の癌が同時に発生する重複甲状腺癌の報告はまれである。骨転移を契機に発見された濾胞癌と乳頭癌を同時に合併した1例を経験したので報告する。症例は69歳、男性であり、右肩痛を主訴に近医受診し、九州大学病院整形外科を紹介受診した。MRI、FDG-PETにて甲状腺を原発とした転移性骨腫瘍と診断した。甲状腺には右葉上極と下極、峡部に腫瘍を認め、穿刺細胞診にて乳頭癌が疑われた。まず、転移性骨腫瘍摘出術を施行した。術後病理は甲状腺濾胞癌の転移を示唆する所見であった。その後、耳鼻咽喉科転科となり、甲状腺癌に対して甲状腺全摘出術および両側気管傍リンパ節郭清術を施行した。術後病理結果は、右葉上極、峡部の腫瘍は共に乳頭癌 、右葉下極の腫瘍は濾胞癌であった。術後経過は特に問題なく、その後放射性ヨード内用療法を行い外来経過観察中である。(著者抄録)

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Anticancer Research  

BACKGROUND/AIM: Most research on salivary gland carcinoma (SGC) has predominantly focused on the parotid gland or a single histological subtype. This study aimed to evaluate all patients with SGC at a single institution and determine whether the primary site affected patient survival. PATIENTS AND METHODS: Overall, data for 164 patients with SGC treated at Kyushu University Hospital were retrospectively analyzed. Patient characteristics and survival outcomes were evaluated, with tumors categorized as originating from major or minor salivary glands. RESULTS: Of 164 tumors, 127 (77.4%) arose from major salivary glands and 37 (22.6%) from minor glands. Cox proportional hazards analysis showed no significant difference in overall or distant metastasis-free survival between major and minor salivary gland tumor origin. CONCLUSION: Major or minor site of origin of SGC did not significantly affect overall or distant metastasis-free survival. Conversely, intermediate/high pathological grade, and lymph node metastasis were poor prognostic factors.

DOI： 10.21873/anticanres.18145

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Auris Nasus Larynx  

The intracranial antitumor efficacy of combination therapy with BRAF and MEK inhibitors in BRAF -mutated thyroid cancer has not been reported. Here, we describe a case of anaplastic thyroid cancer harboring BRAF V600E mutation with brain metastases which was treated with encorafenib plus binimetinib. The patient was initially diagnosed with T4bN1bM1 and experienced disease progression following surgery and lenvatinib treatment. Encorafenib plus binimetinib was initiated as second-line treatment seven months after the surgery. After achieving sustained disease stabilization, a solitary asymptomatic brain metastasis was detected following a three-week interruption due to COVID-19 infection. The lesion shrank after only two weeks of resumed encorafenib plus binimetinib, and additional stereotactic radiosurgery was performed without significant adverse events. This case suggests that the combination of BRAF and MEK inhibitors may be a viable treatment option for brain metastasis in BRAF -mutated thyroid cancer, despite general prioritization of local treatments. In addition, encorafenib plus binimetinib treatment may suppress the growth of microscopic metastasis. This possibility is supported by reliable evidence for the use of BRAF plus MEK inhibitor for brain metastasis from BRAF -mutated malignant melanoma. We conclude that encorafenib plus binimetinib treatment for brain metastasis from BRAF -mutated thyroid cancer is a safe and effective treatment choice.

DOI： 10.1016/j.anl.2025.11.007

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：In Vivo  

Background/Aim: Refractory differentiated thyroid carcinoma (DTC) and anaplastic thyroid carcinoma (ATC) are associated with poor prognoses. Molecularly targeted agents such as lenvatinib are expected to significantly improve outcomes. However, data from real-world settings remain limited. Patients and Methods: A retrospective analysis was conducted in 48 patients with thyroid carcinoma treated with lenvatinib at Kyushu University Hospital between April 2015 and October 2024. We compared overall survival (from time of treatment initiation to death, censoring, or data cutoff) and progression-free survival (from time of treatment initiation to tumor progression as confirmed by image examination) using Kaplan-Meier analysis. A subgroup analysis was also conducted for patients who had and had not received prior radioactive iodine (RAI) therapy. Results: The analysis included 29 female and 19 male cases. The histologic types were papillary thyroid carcinoma in 26 patients, follicular thyroid carcinoma in seven patients, and ATC in 15 patients. Of 33 DTC cases, RAI was not administered in nine cases. The median progression-free survival was 30 months for papillary thyroid carcinoma, 18 months for follicular thyroid carcinoma, and four months for ATC. The median progression-free survival for patients with DTC who received RAI therapy was 19 months, whereas that for patients with DTC without RAI therapy was 46 months. No significant difference was found between the two groups (p=0.243). Conclusion: Lenvatinib may be effective in patients with DTC in whom RAI treatment is not feasible in real-world settings.

DOI： 10.21873/invivo.14085

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Thyroid  

Background: Although accumulated experience with lenvatinib in patients with differentiated thyroid cancer (DTC) and progressive radioactive iodine (RAI)-refractory disease has been used to improve management strategies for this disease, findings regarding the actual clinical picture and long-term observation data are insufficient. Methods: We conducted a retrospective cohort study of patients with DTC who received lenvatinib treatment from 2011 to 2022 at the National Cancer Center Hospital East, Japan. The patients were treated under the following treatment and management policies (1) starting dose at 24 mg/day, (2) schedule modification according to individual adverse events status (planned drug holidays), (3) dose escalation of lenvatinib, and (4) local therapy at disease progression, if applicable. This is a retrospective cohort study, although some patients were enrolled in a prospective clinical trial (NCT01321554 and UMIN000022243). Results: Of 91 patients, 59 (64.8%) had papillary carcinoma and 22 (24.2%) had follicular carcinoma. Best overall response in all patients was 60.4% (partial response in 55 and complete response in 0). With a median observation period of 2.9 years (range, 0.1-12.4; interquartile range, 1.7-4.6) under supportive management, including the planned drug holidays (n = 72, 79.1%), dose escalation of lenvatinib at systemic disease progression (n = 21, 23.1%), and local therapy for oligoprogressive disease (n = 11, 12.1%), median progression-free survival and overall survival were 2.4 years (95% confidence interval [CI] 1.9-3.3) and 5.1 years (95% CI 3.3-6.7), respectively. At the time of data cutoff, 19.8% had discontinued lenvatinib treatment due to adverse events, although no adverse event was grade 5. Conclusions: In patients with RAI-refractory DTC treated with lenvatinib, careful treatment optimization and management of adverse events contribute to a favorable, durable prognosis.

DOI： 10.1089/thy.2025.0040

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Cancer Diagnosis and Prognosis  

Background/Aim: Neuroendocrine neoplasms (NEN) of the head and neck (HN) region are rare, with limited reported cases. NENs are classified into neuroendocrine tumors (NET) grades G1, G2, and G3, and neuroendocrine carcinomas (NECs), with varying treatment strategies. This study investigated patient outcomes of HN-NENs and proposed a treatment algorithm based on pathological classification. Patients and Methods: This retrospective study analyzed 24 HN-NEN cases treated at Kyushu University Hospital (2007-2023). Tumors were classified using the 2022 WHO criteria, and overall survival rates were evaluated using the Kaplan–Meier method. Results: Among the 24 patients, 29% had NETs and 71% had NECs. The most common primary sites were the sinonasal cavity (42%) and larynx (29%). Seven-year survival rates were 100% for NET G1 and G2, 50% for NET G3, and 43% for NEC. Two NET cases treated with somatostatin analogs (SSA) and radionuclide therapy (PRRT) showed tumor reduction. Conclusion: Prognosis of HN-NENs varies significantly by pathological grade. While NET G1 and G2 showed favorable outcomes, NET G3 and NEC had poorer survival. SSA and PRRT may be effective options for selected HN-NETs. A preliminary treatment algorithm is proposed to guide management, warranting validation in larger studies.

DOI： 10.21873/cdp.10460

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：日本皮膚科学会-西部支部  

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Journal of Medical Case Reports  

Background: Sinonasal ameloblastic tumors exhibit unique clinical, pathological, and genetic traits distinct from mandibular bone cases, accounting for the majority of ameloblastic tumors. Recent findings emphasize a notable genetic disparity, showing high BRAF mutation rates in mandibular cases versus very low rates in maxillary cases. Case presentation: We analyzed five sinonasal ameloblastic tumor cases treated at Kyushu University Hospital. All patients were Japanese, four male and one female, and their age ranged from 43 to 73 years. Three were diagnosed with ameloblastoma, with one experiencing recurrence that progressed to a life-threatening condition owing to the lack of effective treatment. One patient was histologically diagnosed as ameloblastic carcinoma, and another patient, although histologically diagnosed as ameloblastoma, presented with lymph node metastasis, confirming it as a metastasizing ameloblastoma with clinical malignancy. Local radical resection was performed in all five patients; however, three of them had positive resection margins, and two received postoperative (chemotherapy) radiation therapy. Recurrence was confirmed in two patients, with one patient undergoing chemoradiation therapy and achieving local control. BRAF mutations were detected in only one patient. Conclusion: Owing to anatomical challenges in achieving negative resection margins and the low BRAF mutation frequency, sinonasal ameloblastic tumors exhibit poor prognosis with high recurrence, malignancy, and metastasis rates. When factors predicting recurrence post-radical resection in these tumors are identified, chemoradiation therapy is recommended as an adjuvant postoperative treatment. However, it should be noted that this presentation of adjuvant therapy is based on the experience of only five cases.

DOI： 10.1186/s13256-025-05224-z

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(一社)日本頭頸部癌学会  

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Oral Oncology  

Background: Locally advanced nasoethmoidal squamous cell carcinoma (SCC) is rare and often unsuitable for surgical resection. Data on the potential clinical benefits of combining induction chemotherapy (IC) and sequential definitive chemoradiotherapy for this condition is limited. Methods: We retrospectively investigated T4 nasoethmoidal SCC patients who underwent proton or photon chemoradiotherapy with curative intent at the National Cancer Center Hospital East between April 2014 and May 2022. Patients were categorized into three groups based on IC regimen: no IC (No-IC), paclitaxel plus carboplatin plus cetuximab (IC-PCE), and docetaxel plus cisplatin plus S-1 (IC-TPS). Results: Twenty-five patients were analyzed (No IC, 9; IC-PCE, 10; and IC-TPS, 6). The IC-PCE group had the highest ratio of Stage IVB to IVA patients. IC-PCE and IC-TPS yielded objective responses in eight (80 %) and two (33 %) patients, respectively. All subjects completed radiotherapy, with the median relative to dose intensity of concurrent cisplatin reaching 100 % in all groups. Complete responses were observed in 22 patients. Three patients in the No IC or IC-TPS group showed a partial response after the completion of planned treatment. On a median follow-up of 42 months, the 3-year recurrence-free survival (RFS) rate was 90.0 % in the IC-PCE group and 33.3 % in the remaining groups. Of note, the IC-PCE group had significantly better RFS (log-rank p-value; 0.023) despite no differences in overall survival, time-to-locoregional progression, or time-to-distant metastasis. Conclusion: Sequential IC-PCE followed by concurrent chemoradiotherapy with cisplatin appears promising as an effective therapeutic strategy for T4 nasoethmoidal SCC.

DOI： 10.1016/j.oraloncology.2025.107235

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：シュプリンガー・ジャパン(株)  

分化型甲状腺癌(DTC)患者に対するレンバチニブ用量漸増後の抗腫瘍活性、生存予後、安全性に着目し、用量漸増が行われなかった患者との比較を行った。2011年9月から2022年6月までにレンバチニブ治療中に疾患進行を経験したDTC患者を後ろ向きに調査した。患者33例を特定し、そのうち15例(初回病勢進行時年齢48～82歳)が用量漸増を受け、18例(初回病勢進行時年齢54～85歳)がレンバチニブの投与を中止した。両群ともレンバチニブの開始用量は24mg/日であり、初回病勢進行時の用量中央値は10mg/日であった。用量漸増群では、用量漸増中央値は6mg/日(範囲4～12mg/日)であった。客観的奏効率は13.3%、漸増による臨床的有効率は73.3%、用量漸増期の治療期間中央値は9.9ヵ月であった。初回病勢進行からの全生存期間中央値は用量漸増群で有意に長かった(全生存期間中央値20.4ヵ月対3.9ヵ月)。グレード5の有害事象はなく、グレード3の肺膿瘍により中止した患者は1例であった。以上より、DTCに対してレンバチニブ治療を受けた患者における用量漸増戦略は病勢進行後の安全かつ効果的な治療選択肢であることが示唆された。

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：International Journal of Clinical Oncology  

Background: Treatment options for patients with differentiated thyroid cancer (DTC) who experience disease progression on lenvatinib treatment are limited. Although dose escalation of treatment with tyrosine kinase inhibitors at disease progression has been reported across cancer types, clinical significance in patients with DTC has not been investigated. Methods: We retrospectively reviewed patients with DTC who experienced disease progression on lenvatinib treatment from September 2011 to June 2022. We compared subjects who received dose-escalation treatment with standard treatment of termination at the time of initial disease progression. The escalated dose was decided by referencing to the previous effective and tolerated dose. Results: Thirty-three patients were identified, 15 with dose escalation and 18 with lenvatinib termination. In both groups, the starting dose of lenvatinib was 24 mg/day, and the median dose at initial disease progression was 10 mg/day. In the former, the median dose escalation was 6 mg/day (range: 4–12). Objective response rate, clinical benefit rate by escalation, and median treatment duration of the dose-escalation phase were 13.3%, 73.3%, and 9.9 months (95% confidence interval [CI] 5.71–27.6), respectively. Median overall survival from initial disease progression was significantly longer in the dose-escalation group (median OS: 20.4 months [95% CI 7.0–NA] vs. 3.9 months [95% CI 1.7–7.9], log-rank p-value; 0.0004, hazard ratio; 0.22 [95% CI 0.09–0.55]). There were no grade 5 adverse events, and one patient discontinued due to a grade 3 lung abscess. Conclusion: The dose-escalation strategy appears to be a safe and effective treatment option after disease progression in patients treated with lenvatinib for DTC.

DOI： 10.1007/s10147-024-02581-5

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Anticancer Research  

Background/Aim: The benefit of neoadjuvant chemotherapy (NAC) in the treatment of head and neck squamous cell carcinoma (HNSCC) remains unclear. Patients and Methods: We retrospectively collected 30 patients with HNSCC who had undergone radical resection after NAC. We pathologically evaluated the therapeutic response to NAC, and classified the residual tumor patterns. In addition, we compared the maximum horizontal diameter on pathology with imaging. Results: The residual patterns were categorized as follows: 10 cases of shrunken type, 11 cases of mixed type, and seven cases of fragmented type. The majority of underestimation cases – those cases in which the maximum horizontal diameter measured on post-NAC imaging was less than the pathological size after resection – were multifocal residual lesions, with a tendency for more frequent “positive” or “close” surgical margins. Conclusion: The strategy of performing NAC to reduce resection volume is not appropriate, and resection margins should be based on the assessment before NAC.

DOI： 10.21873/anticanres.17289

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Cancers  

The optimal timing for actively discontinuing immune checkpoint inhibitor therapy in long-term responders with recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC) remains unresolved. We conducted a retrospective study of 246 patients with R/M HNSCC treated with nivolumab to determine the optimal timing to actively discontinue nivolumab therapy. We examined the point at which progression-free survival (PFS) plateaued in all cases. We compared the prognosis of 19 (7.7%) ongoing cases and 227 (92.3%) discontinued cases and analyzed treatment duration and treatment-free interval (TFI). The 6-year overall survival was 11.8% (median, 12.1), and the 6-year PFS was 15.3% (median, 3.0). The PFS curve remained stable for 3 years. The median duration of nivolumab treatment was 2.9 months (range 0.03–81.9): Ongoing group, 41.8 (5.6–81.9); Decision group, 36.8 (4.0–70.1); Toxicity group, 30.6 (2.8–64.8); and progressive disease group, 2.0 (0.03–42.9). TFI in the Decision group was 15.1 months (0.6–61.6) and 30.6 months (2.8–64.8) in the Toxicity group. Long-term responses in R/M HNSCC patients treated with nivolumab are rare but gradually increasing. For this patient group, our best estimate of the optimal time to end treatment is 3 years, as the PFS in this study reached a plateau at that timepoint.

DOI： 10.3390/cancers16142527

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：耳鼻と臨床会  

頭頸部領域には発生学的に病因の異なる嚢胞が生じることがあり、正中頸嚢胞、側頸嚢胞、リンパ管腫/奇形などの先天性嚢胞や、ガマ腫などの後天性嚢胞が挙げられる。これら嚢胞の治療法としては、手術摘出とOK-432(ピシバニール)に代表される硬化療法の2つに大別される。手術摘出や複数回の穿刺排液を繰り返すも難治性であった、咽頭に発生した嚢胞に対し、OK-432(ピシバニール)を投与し、効果を認めた2例を経験したので報告する。症例1は30代の女性で、舌根の嚢胞を2回切除するも数ヵ月で再増大した症例である。症例2は60代の女性で、30年以上にわたり舌根の嚢胞に手術処置を繰り返した症例である。2例ともOK-432(ピシバニール)投与で、縮小した状態が維持できるようになった。頭頸部領域に発生する嚢胞の中には、まれではあるが複数回再発し難治性のものもあり、この場合治療に難渋することとなる。外科的治療法で対応が困難な症例において、OK-432(ピシバニール)による硬化療法は、外来で対応可能な、かつ効果的な治療選択肢の一つとなり得ると思われた。(著者抄録)

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Cancer Diagnosis and Prognosis  

Background/Aim: Approximately half of head and neck squamous cell carcinoma (HNSCC) cases recur, with most recurrences occurring within the first two years after treatment. Although it has been suggested that the interval to recurrence after radical treatment is associated with prognosis in patients with HNSCC, further investigation is needed. Patients and Methods: Patients diagnosed with HNSCC at Kyushu University Hospital were retrospectively analyzed (n=500). Early recurrence (ER) was defined as disease recurrence within six months of radical treatment, whereas late recurrence (LR) was defined as recurrence after more than six months. Continuous variables were assessed using the Mann–Whitney U-test and categorical variables were assessed using Fisher’s exact test. Results: A total of 234 patients experienced recurrence, with 110 and 124 patients experiencing ER (recurrence within two to six months) and LR (recurrence after six months), respectively. Multivariate analyses identified two independent risk factors for poor prognosis: ER [hazard ratio (HR)=3.200, 95% confidence interval (CI)=1.570-6.521, p=0.001] and absence of radiotherapy (HR=0.374, 95%CI=0.191-0.733, p=0.004). In patients with recurrent HNSCC, a short interval to recurrence is a risk factor for poor prognosis and survival. This study demonstrated the prognostic value of ER in these patients. Conclusion: The selection of treatment for patients with recurrent head and neck squamous cell carcinoma should consider the timing of recurrence, the initial treatment regimen, and the strategy for changing salvage therapy depending on the recurrence status.

DOI： 10.21873/cdp.10378

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掲載種別：研究論文（学術雑誌）   出版者・発行元：Frontiers in Oncology  

Background: Olfactory neuroblastoma (ONB) is a rare malignant tumor of the head and neck. Due to its rarity, standard systemic therapy for this condition has yet to be established. In particular, the use of immune checkpoint inhibitors (ICIs) for the recurrent or metastatic (R/M) ONB population remains unclear. Methods: We retrospectively evaluated 11 patients with R/M ONB who received any systemic chemotherapy at two Japanese institutions (National Cancer Center Hospital East and Kyushu Medical Center) between January 2002 and March 2022 and analyzed outcomes by use of anti-PD-1 antibody (nivolumab or pembrolizumab) monotherapy. Results: Of the 11 patients, 6 received ICI (ICI-containing treatment group) and the remaining 5 were treated with systemic therapy but not including ICI (ICI-non-containing treatment group). Overall survival (OS) was significantly longer in the ICI-containing group (median OS: not reached vs. 6.4 months, log-rank p-value: 0.035). The fraction of ICI systemic therapy in the entire treatment period of this group reached 85.9%. Four patients (66.7%) in the ICI-containing treatment group experienced immune-related adverse events (irAE), with grades of 1/2. No irAE of grade 3 or more was seen, and no patient required interruption or discontinuation of treatment due to toxicity. Conclusion: ICI monotherapy appears to be effective and to contribute to prolonged survival in R/M ONB.

DOI： 10.3389/fonc.2024.1379013

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Frontiers in Oncology  

Background: Immune checkpoint inhibitors (ICIs) are essential in treating recurrent/metastatic squamous cell carcinoma of the head and neck (R/M SCCHN). However, the overall response rate (ORR) is limited to 10-20%, and subsequent chemotherapy is critical to maximizing the subjects’ prognosis. Methods: We retrospectively reviewed 59 patients with R/M SCCHN treated with paclitaxel+cetuximab (PE)-based chemotherapy (PCE, paclitaxel+carboplatin+cetuximab; or PTX+Cmab, paclitaxel+cetuximab) following disease progression after either pembrolizumab or nivolumab monotherapy. Results: Of 59 patients, 15 were treated with pembrolizumab, with an ORR of 13.3%, and the remaining 44 with nivolumab, with an ORR of 11.4%. All patients in the pembrolizumab cohort had platinum-sensitive disease. Following ICI treatment, 19 patients were treated with PCE and the remaining 40 with PTX+Cmab. PE-based chemotherapy induced favorable and prompt tumor shrinkage even in cases where ICI was not effective, with a median change in the summed dimensions of target lesions of -43.4%, resulting in an ORR of 62.7%. Median time to response was 1.8 months. The patients in the pembrolizumab cohort appeared to have a numerically higher response rate than those receiving nivolumab (80.0% vs. 56.8%). For the 59 patients, progression-free survival and overall survival, calculated from the initiation of PE-based chemotherapy, were 4.6 months and 17.1 months, respectively. Grade ≥3 adverse events occurred in 40.7%, and no treatment-related death was observed. Conclusion: PE-based chemotherapy following ICI is encouraging for its robust antitumor efficacy in R/M SCCHN.

DOI： 10.3389/fonc.2023.1221352

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担当区分：筆頭著者   記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：シュプリンガー・ジャパン(株)  

ニボルマブ治療後の再発または転移性頭頸部扁平上皮癌(R/M SCCHN)患者に対する局所療法(LT)の有効性を後ろ向きに検討した。LTには、手術や根治的放射線療法(RT)などのサルベージLT、または選択された進行性病変に対する緩和的RTが含まれた。2017年5月から2020年3月までに当院でニボルマブ治療を受けたR/M SCCHN患者120例のうち24例(65歳未満:17例)がLTを受けた。サルベージLTは9例に行われ、それぞれ5例と4例に手術と根治的RTが行われた。一方で、緩和的RTは15例に行われた。LTはオリゴプログレッシブ疾患の10例に対して行われた。12例はLT後すぐに全身療法を受けた。治療法に基づく分類により、患者はサルベージLT後に全身療法を受けた群(3例)、サルベージLT単独群(6例)、緩和的RT後に全身療法を受けた群(9例)、緩和的RT単独群(6例)の4つのサブグループに分けられ、それぞれ全生存期間中央値は、24.5ヵ月、9.0ヵ月、7.3ヵ月、2.4ヵ月であった(p=0.001)。加えて、サルベージLT後に全身療法を受けた群では、全例がニボルマブの投与を継続した。以上より、ニボルマブを投与されたR/M SCCHN患者において、選択された進行性病変に対するサルベージLTとニボルマブの継続投与は優れた生存予後をもたらす可能性があった。

掲載種別：研究論文（学術雑誌）   出版者・発行元：Frontiers in Oncology  

Background: Despite advances in precision medicine, most patients with recurrent or metastatic salivary gland carcinoma still need conventional chemotherapies, such as the combination of taxane and platinum. However, evidence for these standardized regimens is limited. Methods: We retrospectively reviewed patients with salivary gland carcinoma treated with a taxane and platinum, which contained docetaxel at a dose of 60 mg/m2 plus cisplatin at a dose of 70 mg/m2 on day 1, or paclitaxel at a dose of 100 mg/m2 plus carboplatin at a dose of area under the plasma concentration-time curve = 2.5 on days 1 and 8 (both on 21-day cycles), between January 2000 and September 2021. Result: Forty patients with ten adenoid cystic carcinomas and thirty other pathologies were identified. Of these, 29 patients were treated with docetaxel plus cisplatin and 11 with paclitaxel plus carboplatin. For the total population, the objective response rate (ORR) and median progression-free survival (mPFS) were 37.5% and 5.4 months (95% confidence interval: 3.6–7.4 months), respectively. On subgroup analysis, docetaxel plus cisplatin provided favorable efficacy compared with paclitaxel plus carboplatin (ORR: 46.5% vs. 20.0%, mPFS: 7.2 vs. 2.8 months), and the findings were well retained in patients with adenoid cystic carcinoma (ORR: 60.0% vs. 0%, mPFS: 17.7 vs. 2.8 months). Grade 3/4 neutropenia was relatively frequent in the docetaxel plus cisplatin (59% vs.27%), although febrile neutropenia was uncommon (3%) in the cohort. No treatment-related death was seen in any case. Conclusion: The combination of taxane and platinum is generally effective and well-tolerated for recurrent or metastatic salivary gland carcinoma. In contrast, paclitaxel plus carboplatin appears unfavorable in terms of efficacy in certain patients, such as those with adenoid cystic carcinoma.

DOI： 10.3389/fonc.2023.1185198

Scopus

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：シュプリンガー・ジャパン(株)  

再発・転移性頭頸部癌(R/M HNC)の日本人患者に対する抗ヒト上皮細胞増殖因子受容体抗体であるセツキシマブ(Cmab)隔週投与の安全性を後方視的に検討した。2016年1月から2021年9月までに当院で1回以上のCmab 500mg/m2の隔週投与を受けたR/M HNC患者5例(年齢46～79歳)を対象とした。全例に対して、最初に週1回Cmab 250mg/m2と化学療法の併用療法を行った。化学療法は、パクリタキセル(PTX)+カルボプラチン2例、シスプラチン+5-FU 1例、PTX 2例であった。治療スケジュールは、3例で週1回Cmabから隔週Cmabに変更し、2例で化学療法終了後に隔週Cmabを実施した。隔週Cmabに切り替えた主な理由は、病院への通院時間が許容できないほど長かったことであった。投与期間中央値は、化学療法を伴う週1回投与では217日(範囲49～321日)、隔週投与では42日(範囲28～175日)であった。隔週投与回数の中央値は4(範囲3～12)であった。隔週投与Cmabでは、患者2例に毒性の悪化(グレード2以上)が認められた。1例はグレード2の乾燥肌、もう1例はグレード2の皮膚感染症であった。グレード3以上の有害事象の発生やCmab関連の有害事象による治療中断はなかった。以上より、R/M HNCに対する隔週投与Cmabの忍容性は高かった。

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Human Pathology  

NTRK1/3, ALK, and ROS1 translocations have been reported in a minor subset of papillary thyroid carcinomas (PTCs). We aimed to elucidate the prevalence and clinicopathological characteristics of these gene rearrangements and the utility of immunohistochemistry (IHC) in PTC and anaplastic thyroid carcinoma (ATC). We screened nonradiation-exposed cases of 307 PTCs and 16 ATCs by IHC for pan-Trk, ALK, and ROS1, followed by fluorescence in situ hybridization (FISH). In the PTC group, IHC for pan-Trk, ALK, and ROS1 was positive in 18 cases (5.9%), 1 case (0.3%), and 12 cases (3.9%), respectively. Among the pan-Trk IHC–positive cases (n = 18), 2 cases (11.1%; 0.7% of all PTCs) had NTRK1 or NTRK3 gene rearrangement with conventional PTC histology. The ALK IHC–positive case (n = 1) was the follicular variant of PTC with consistent ALK gene rearrangement. ROS1 gene rearrangement was not detectable in the ROS1 IHC–positive PTCs (0/12) by FISH. Most (approximately 70%) of the pan-Trk or ROS1 IHC–positive/FISH–negative cases had BRAF gene mutation with conventional PTC morphology. In the ATC group, neither ALK nor ROS1 IHC was positive, whereas pan-Trk IHC was positive in 1 case (6.3%) in which NTRK1 gene rearrangement was confirmed by FISH. These results suggest that NTRK, ALK, and ROS1 rearrangements are rare molecular events in nonradiation-exposed Japanese patients with PTC and ATC. Although IHC is not an entirely specific surrogate for these abnormalities and does not serve as a stand-alone companion diagnosis, the combined use of IHC and molecular testing may be helpful for determining promising therapeutic strategies with tyrosine kinase inhibitors.

DOI： 10.1016/j.humpath.2020.09.004

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記述言語：日本語   掲載種別：研究論文（その他学術会議資料等）   出版者・発行元：国家公務員共済組合連合会  

2施設で一次治療を行った頭頸部扁平上皮癌149例のp16免疫染色陽性率を部位ごとに検討した。その結果、部位ごとのp16免疫染色陽性率は中咽頭が67.6%で最も高く、次いで鼻副鼻腔33.3%、上咽頭33.3%、下咽頭21.7%、喉頭14.0%、口腔5.0%の順であった。p16免疫染色陽性原発不明頸部転移癌の大半は扁桃および舌根原発であったが、少数ながら他部位原発の症例が存在することから、原発巣の十分な検索は診断と治療において重要であると考えられた。

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(一社)日本頭頸部癌学会  

2009年9月より2017年12月までに浜の町病院耳鼻咽喉科(以下、当科)を初診し初期治療を行った中咽頭扁平上皮癌68例について、頭頸部癌取扱い規約第5版による病期診断での治療成績を検討するとともに、後方視的に頭頸部癌取扱い規約第6版で病期分類を行い、治療成績およびp16免疫染色の陽性率および治療成績への影響を検討した。65症例にp16免疫染色を行い、陽性率は58.5%であった。疾患特異的3年生存率(DSS)は全症例では78.5%で、p16陰性症例では74.1%、p16陽性症例では84.7%であった。第6版による病期別の3年DSSは、p16陰性症例でII期:100%、III期:66.7%、IVa期:70.6%で、p16陽性症例ではI期:93.8%、II期:83.3%、III期:77.1%、IV期:0%であった。(著者抄録)

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Head and Neck  

Background: Differentiating inverted papilloma from squamous cell carcinoma (SCC) is sometimes difficult. We evaluated the clinical usefulness of serum SCCA1 and SCCA2 in the management of patients with inverted papilloma or SCC. Methods: Serum and tissue samples for the analysis of SCCA1, SCCA2, and SCC antigen were taken from 18 patients with sinonasal inverted papilloma and 23 cases with sinonasal SCC. The SCCA1, SCCA2, and SCC antigen levels were determined. Results: The serum SCCA1 concentration was significantly higher in the inverted papilloma group than in the SCC group, whereas the serum SCCA2 level was significantly higher in the SCC group than in the inverted papilloma group. Conclusion: Patients with sinonasal inverted papilloma predominantly express SCCA1 protein, whereas those with SCC predominantly express SCCA2. This suggests that combined measurements of both serum SCCA1 and SCCA2 concentrations can be very useful for distinguishing sinonasal inverted papilloma from SCC.

DOI： 10.1002/hed.25351

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：耳鼻と臨床会  

2007年1月から2016年12月までの10年間に、初回治療開始時に精査を行ったにもかかわらず原発巣が不明であり頸部リンパ節転移を認めた26例を対象とした。内訳はN1:1例、N2:23例、N3:2例であった。遠隔転移を認めた症例は4例であった。26例のうち、原発巣が初回手術後に判明した症例が4例、治療終了後経過観察中に判明した症例が2例、原発巣が不明のままであった症例が20例であった。全体の3年粗生存率は52%であり、N分類の進行とともに予後も不良な傾向であった。免疫組織染色が可能であった22例中7例(32%)においてp16陽性所見が認められた。7例中5例で最終的に原発巣が判明しており、内訳は中咽頭(扁桃)4例、下咽頭(梨状陥凹)1例であった。原発不明癌頸部リンパ節転移症例でp16陽性であった場合、p16陽性中咽頭癌と同様に取り扱うことが妥当なのか大規模な検証が必要と思われる。(著者抄録)

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier B.V.  

原発性甲状腺扁平上皮癌10例(男性3例、女性7例、平均65.1歳)を対象に、治療法の特徴と患者アウトカムについて検討した。2例に気管開口形成術と切開生検、8例に甲状腺切除術と頸部郭清術を施行し、さらに8例のうち2例には甲状腺全摘と喉頭切除術を行った。この8例のうち甲状腺癌の完全切除が得られたのは3例で、残る5例は切除断端陽性であった。10例のうち9例には術後放射線療法(総線量:50～61.2Gy)/化学療法を施行し、5例には化学放射線療法を施行、抗癌剤にはシスプラチン80mg/m2またはS-1 65mg/m2/日を用いた。7例に腫瘍遺残、3例に局所再発/遠隔転移を認め、遠隔転移では肺が最も多かった。また、手術または放射線療法の施行後、再発/増悪をきたした4例に対して経口レンバチニブ24mg/日の投与を行った。RECIST解析の結果、レンバチニブを投与された4例のうち、PRは1例、SDは1例、PDは2例、無増悪生存期間中央値は6ヵ月であった。全例における全生存期間中央値は8ヵ月、1年生存率は22.7%、2年生存率は0%であった。

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Auris Nasus Larynx  

Objectives: Primary squamous cell carcinoma (SCC) of the thyroid is a rare disease. It usually presents with locally advanced disease and has an overall poor prognosis. In this study, we investigated the characteristics and outcomes of patients with SCC of the thyroid, and reported our experience with chemotherapy with lenvatinib in the treatment of SCC of the thyroid. Methods: The management outcome of 10 patients who had SCC of the thyroid between January 2000 and 2015 at Kyushu University Hospital or associated facilities was reviewed. Results: There were 3 males and 7 females, ranging in age from 53 to 77 years. Extent of disease was staged as follows: stage IVA, 3 cases; stage IVB, 3 cases; stage IVC, 4 cases. Only tracheostomy was applied for 2 cases, surgical resection, such as total thyroidectomy and neck dissection, for the other 8 cases. Radiotherapy following surgical treatment was applied for 9 cases. Four patients started on oral lenvatinib due to recurrent or progressive SCC of the thyroid. The one year actuarial survival rate of patients was 22.7%. There was no 2-year survivor of all patients. Conclusions: Treatment should primarily be targeted at surgical resection with negative margins in patients with resectable disease. Lenvatinib may show promise to potentially extend survival.

DOI： 10.1016/j.anl.2017.07.009

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(一社)日本耳鼻咽喉科頭頸部外科学会  

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：耳鼻と臨床会  

<p>症例は 50歳、女性。1 年前から嚥下時違和感を認め、画像検査の結果、食道粘膜下腫瘍と診断した。腫瘍の増大傾向があること、乳癌治療歴があり転移が否定できないこと、嚥下時違和感などの自覚症状を有していたことから、治療目的に腫瘍摘出術を行う方針とした。腫瘍は食道筋層内に局在しており、摘出標本は 37 × 31 mm 大であった。術中所見および病理組織所見から頸部食道より発生した神経鞘腫と診断した。術後経過は良好で術後 10日目に退院となった。術後 10 カ月が経過した現在、再発所見は認めていない。今回まれな頸部食道神経鞘腫に対して文献的考察を行ったところ、上縦隔にとどまっている腫瘍については頸部切開のみで摘出可能であり、上縦隔から中縦隔にまたがる頸胸部境界部腫瘍の場合は症例ごとにアプローチ法を選択する必要があると考えられた。</p>

DOI： 10.11334/jibi.64.1_16

CiNii Research

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(一社)日本耳鼻咽喉科頭頸部外科学会  

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Elsevier B.V.  

1990～2013年に当院で治療を行った扁平上皮癌(SCC)合併鼻副鼻腔内反性乳頭腫(IP)患者15例(男性8例、女性7例、年齢39～81歳)を対象に、臨床特性と予後を後向きに調査した。SCC合併IP症例は内視鏡、CT、MRI、生検所見により診断した。術前のKrouse分類はT1が2例(13%)、T2が2例(13%)、T3が5例(34%)、T4が6例(40%)であった。平均追跡期間は49ヵ月(範囲:6～95ヵ月)であった。疾患特異的3年生存率は63%で、T1は100%、T2は100%、T3は62.5%、T4は25%であった。上顎洞に発生した内反性乳頭腫(8例)と鼻腔等の、他の原発部位の症例(7例)間に生存率の有意な群間差を認めなかった。組織学的に顕微鏡的SCCの生存率(100%)は優位型や異時性SCCの生存率(51%)に比べて有意に高かった。70歳未満の患者の3年生存率(80%)は70歳以上の患者(0%)より有意に高かった。

記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Auris Nasus Larynx  

Objective The aim of this study was to investigate the clinical features and prognosis of patients with squamous cell carcinoma (SCC) associated with sinonasal inverted papilloma (IP). Methods The medical records of 95 patients who were diagnosed with IP or SCC associated with IP were retrospectively reviewed. Out of 95 patients, 15 were diagnosed with SCC associated with IP. The clinical characteristics, treatment modalities, and survival outcomes of the patients were analyzed. Results The incidence of SCC associated with IP was 15.8%. Although differential diagnosis between IP and SCC associated with IP is difficult, epistaxis may be the specific symptom in SCC associated with IP cases. The 3-year disease-specific survival rate was higher in cases with T1, 2 and 3 than in cases with T4. There was no significant difference in survival rate between maxillary sinus and other primary sites. On the other hand, there was a significant difference in survival rate between the microscopic SCC with IP cases and the other cases. In addition, the patients with <70 years old better than those with >70 years old with a 3-year disease free survival of 80% versus 0%. Conclusions Some T4 patients were found to have a highly aggressive disease. Therefore, complete surgical resection followed by chemo-radiation therapy is the recommended treatment for patients with T4 disease to control of the primary tumor site.

DOI： 10.1016/j.anl.2016.04.004

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記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：(一社)日本頭頸部癌学会  

記述言語：日本語   掲載種別：研究論文（学術雑誌）   出版者・発行元：耳鼻と臨床会  

症例は63歳、女性。40年数年前から関節リウマチを罹患しており、10年以上メトトレキサート(Methotrexate:MTX)、タクロリムスを服用していた。201X年8月下旬に左耳下部腫脹と疼痛を認めたため、近医内科クリニックより総合病院耳鼻咽喉科を紹介受診した。造影MRIにて左耳下腺深葉に腫瘍性病変を認め、穿刺吸引細胞診にてclass IIIbの結果であった。悪性の可能性が否定できないため、手術加療目的に九州大学病院耳鼻咽喉科紹介受診となった。耳下腺原発悪性腫瘍が疑われたため、10月6日に左耳下腺全摘術を施行した。永久病理診断の結果、組織型はDiffuse Large B Cell Lymphoma(DLBCL)、EBER陽性であったためMTX関連リンパ増殖性疾患と診断した。術後MTX内服を中止し、以後再燃は認めていない。本邦では関節リウマチ罹患者の多くがMTXを服用している。MTX服用中の関節リウマチ患者に頭頸部腫瘍性病変を認めた場合は、本症を十分に念頭に置き、診断、治療に当たる必要である。(著者抄録)

記述言語：日本語   会議種別：口頭発表（一般）  

記述言語：日本語   会議種別：口頭発表（一般）  

記述言語：日本語   会議種別：口頭発表（一般）  

記述言語：英語   会議種別：口頭発表（一般）  

記述言語：英語   会議種別：口頭発表（一般）  

記述言語：日本語   会議種別：口頭発表（一般）  

記述言語：日本語   会議種別：口頭発表（一般）  

記述言語：日本語   会議種別：口頭発表（一般）  

記述言語：日本語   会議種別：口頭発表（一般）  

記述言語：日本語   会議種別：口頭発表（一般）  

記述言語：日本語   会議種別：口頭発表（一般）  

記述言語：日本語   会議種別：口頭発表（一般）  

記述言語：日本語   会議種別：口頭発表（一般）  

記述言語：日本語   会議種別：口頭発表（一般）  

記述言語：日本語  

記述言語：日本語  

記述言語：日本語  

記述言語：英語   会議種別：口頭発表（一般）  

記述言語：日本語   会議種別：口頭発表（一般）  

記述言語：日本語   会議種別：口頭発表（一般）  

記述言語：日本語   会議種別：口頭発表（一般）  

記述言語：日本語   会議種別：口頭発表（一般）  

記述言語：日本語   会議種別：口頭発表（一般）  

記述言語：日本語   会議種別：口頭発表（一般）