Researcher Profile and Settings

Affiliation

• Faculty of Medicine　Specialized Medicine　Sensory Organ Medicine

Job Title

• Professor

Degree

• (BLANK)

J-Global ID

• 200901040028392893

Research Interests

• 頭頸部外科学   耳鼻咽喉科学   head and neck surgery   Otolaryngology   

Research Areas

• Life sciences / Otorhinolaryngology

Educational Organization

•  Bachelor's degree program　Departments of Medicine, School of Medicine
•  Master's degree program　Graduate School of Medicine
•  Doctoral (PhD) degree program　Graduate School of Medicine

Education

• 2017/11 - Today  Hokkaido University  Faculty of Medicine and Graduate School of Medicine  Department of Otolaryngology – Head & Neck Surgery
•        - 1989  Hokkaido University  School of Medicine
•        - 1989  Hokkaido University  Faculty of Medicine

Association Memberships

• 日本癌治療学会   日本臨床腫瘍学会   日本頭頸部外科学会   日本頭頸部腫瘍学会   日本耳鼻咽喉科学会   

Research Activities

Published Papers

• SlicerPIT: software development and implementation for planning and image-guided therapy in photoimmunotherapy.

  Takayoshi Suzuki, Satoshi Kano, Masanobu Suzuki, Seijiro Hamada, Hiroshi Idogawa, Nayuta Tsushima, Yuichi Ashikaga, Yuki Wakabayashi, Takeshi Soyama, Yasuhiro Hida, Akihiro Homma

  International journal of clinical oncology 2024/04/23 

  BACKGROUND: Photoimmunotherapy is a treatment modality that induces targeted cell death by binding a molecular-targeted drug activated by infrared light to the tumor cells and subsequently illuminating the lesion with infrared light. For deep lesions, a needle catheter is used to puncture the tumor, and an illumination fiber (cylindrical diffuser) is inserted into the catheter lumen for internal illumination. However, it can be challenging to place the cylindrical diffusers in an appropriate position as the deep lesions cannot be often confirmed accurately during surgery. MATERIALS AND METHODS: We have developed "SlicerPIT", a planning simulation software for photoimmunotherapy. SlicerPIT allows users to place the cylindrical diffuser with its illumination range on preoperative images in 2D and 3D and export the planning data to external image-guided surgical navigation systems. We performed seven cycles of photoimmunotherapy with SlicerPIT in three patients with recurrent head and neck cancer. RESULTS: Preoperative planning for photoimmunotherapy was conducted using SlicerPIT, which could be imported into the navigation system. During the operation, we punctured the needle catheters along with the treatment plan on the navigation screen. Subsequently, intraoperative CT imaging was performed and overlaid with the preoperative treatment plan to confirm the alignment of the cylindrical diffusers as planned, followed by infrared light illumination. Postoperative imaging showed necrosis and shrinkage of the entire tumor in all cycles. CONCLUSION: SlicerPIT allows for detailed preoperative treatment planning and accurate puncture. It may be a valuable tool to improve the accuracy of photoimmunotherapy for deep lesions and improve patient outcomes.
• Current status and future perspective of postoperative treatment for locally advanced squamous cell carcinoma of the head and neck.

  Naomi Kiyota, Makoto Tahara, Akihiro Homma

  Japanese journal of clinical oncology 2024/03/07 

  Surgery remains a foundation of treatment for locally advanced squamous cell carcinoma of the head and neck. For postoperative patients at high risk of recurrence, however, surgery by itself is not enough, and improvement in survival requires postoperative treatment. Unlike the case with most other malignancies, the standard postoperative treatment for locally advanced squamous cell carcinoma of the head and neck patients with high-risk factors for recurrence is radiotherapy or chemoradiotherapy with cisplatin. However, chemoradiotherapy with cisplatin at a dose of 100 mg/m2 once every 3 weeks has raised discussion over insufficient cisplatin delivery due to high-dose-related toxicity. As a possible solution, a recent randomized trial of the JCOG1008 has proved the non-inferiority of postoperative chemoradiotherapy with weekly cisplatin at a dose of 40 mg/m2 to 3-weekly cisplatin in terms of overall survival. Here, this review article focuses on current evidence and future perspectives of postoperative treatment for locally advanced squamous cell carcinoma of the head and neck.
• Impact of adaptive radiotherapy on survival in locally advanced nasopharyngeal carcinoma treated with concurrent chemoradiotherapy.

  Yusuke Uchinami, Koichi Yasuda, Hideki Minatogawa, Yasuhiro Dekura, Noboru Nishikawa, Rumiko Kinoshita, Kentaro Nishioka, Norio Katoh, Takashi Mori, Manami Otsuka, Naoki Miyamoto, Ryusuke Suzuki, Keiji Kobashi, Yasushi Shimizu, Jun Taguchi, Nayuta Tsushima, Satoshi Kano, Akihiro Homma, Hidefumi Aoyama

  Radiation oncology journal 42 (1) 74 - 82 2024/03 

  PURPOSE: To investigate the clinical significance of adaptive radiotherapy (ART) in locally advanced nasopharyngeal carcinoma treated with intensity-modulated radiotherapy (IMRT). MATERIALS AND METHODS: Eligible patients were treated with concurrent chemoradiotherapy using IMRT. Planning computed tomography in ART was performed during radiotherapy, and replanning was performed. Since ART was started in May 2011 (ART group), patients who were treated without ART up to April 2011 (non-ART group) were used as the historical control. The Kaplan-Meier method was used to calculate overall survival (OS), locoregional recurrence-free survival (LRFS), progression-free survival (PFS), and distant metastasis-free survival (DMFS). LRFS for the primary tumor (LRFS_P) and regional lymph node (LRFS_LN) were also studied for more detailed analysis. Statistical significance was evaluated using the log-rank test for survival. RESULTS: The ART group tended to have higher radiation doses. The median follow-up period was 127 months (range, 10 to 211 months) in the non-ART group and 61.5 months (range, 5 to 129 months) in the ART group. Compared to the non-ART group, the ART group showed significantly higher 5-year PFS (53.8% vs. 81.3%, p = 0.015) and LRFS (61.2% vs. 85.3%, p = 0.024), but not OS (80.7% vs. 80.8%, p = 0.941) and DMFS (84.6% vs. 92.7%, p = 0.255). Five-year LRFS_P was higher in the ART group (61.3% vs. 90.6%, p = 0.005), but LRFS_LN did not show a significant difference (91.9% vs. 96.2%, p = 0.541). CONCLUSION: Although there were differences in the patient backgrounds between the two groups, this study suggests the potential effectiveness of ART in improving locoregional control, especially in the primary tumor.
• Improved image quality in contrast-enhanced 3D-T1 weighted sequence by compressed sensing-based deep-learning reconstruction for the evaluation of head and neck.

  Noriyuki Fujima, Junichi Nakagawa, Yohei Ikebe, Hiroyuki Kameda, Taisuke Harada, Yukie Shimizu, Nayuta Tsushima, Satoshi Kano, Akihiro Homma, Jihun Kwon, Masami Yoneyama, Kohsuke Kudo

  Magnetic resonance imaging 108 111 - 115 2024/02/09 

  PURPOSE: To assess the utility of deep learning (DL)-based image reconstruction with the combination of compressed sensing (CS) denoising cycle by comparing images reconstructed by conventional CS-based method without DL in fat-suppressed (Fs)-contrast enhanced (CE) three-dimensional (3D) T1-weighted images (T1WIs) of the head and neck. MATERIALS AND METHODS: We retrospectively analyzed the cases of 39 patients who had undergone head and neck Fs-CE 3D T1WI applying reconstructions based on conventional CS and CS augmented by DL, respectively. In the qualitative assessment, we evaluated overall image quality, visualization of anatomical structures, degree of artifacts, lesion conspicuity, and lesion edge sharpness based on a five-point system. In the quantitative assessment, we calculated the signal-to-noise ratios (SNRs) of the lesion and the posterior neck muscle and the contrast-to-noise ratio (CNR) between the lesion and the adjacent muscle. RESULTS: For all items of the qualitative analysis, significantly higher scores were awarded to images with DL-based reconstruction (p < 0.001). In the quantitative analysis, DL-based reconstruction resulted in significantly higher values for both the SNR of lesions (p < 0.001) and posterior neck muscles (p < 0.001). Significantly higher CNRs were also observed in images with DL-based reconstruction (p < 0.001). CONCLUSION: DL-based image reconstruction integrating into the CS-based denoising cycle offered superior image quality compared to the conventional CS method. This technique will be useful for the assessment of patients with head and neck disease.
• Diagnosis of skull-base invasion by nasopharyngeal tumors on CT with a deep-learning approach.

  Junichi Nakagawa, Noriyuki Fujima, Kenji Hirata, Taisuke Harada, Naoto Wakabayashi, Yuki Takano, Akihiro Homma, Satoshi Kano, Kazuyuki Minowa, Kohsuke Kudo

  Japanese journal of radiology 2024/01/27 

  PURPOSE: To develop a convolutional neural network (CNN) model to diagnose skull-base invasion by nasopharyngeal malignancies in CT images and evaluate the model's diagnostic performance. MATERIALS AND METHODS: We divided 100 malignant nasopharyngeal tumor lesions into a training (n = 70) and a test (n = 30) dataset. Two head/neck radiologists reviewed CT and MRI images and determined the positive/negative skull-base invasion status of each case (training dataset: 29 invasion-positive and 41 invasion-negative; test dataset: 13 invasion-positive and 17 invasion-negative). Preprocessing involved extracting continuous slices of the nasopharynx and clivus. The preprocessed training dataset was used for transfer learning with Residual Neural Networks 50 to create a diagnostic CNN model, which was then tested on the preprocessed test dataset to determine the invasion status and model performance. Original CT images from the test dataset were reviewed by a radiologist with extensive head/neck imaging experience (senior reader: SR) and another less-experienced radiologist (junior reader: JR). Gradient-weighted class activation maps (Grad-CAMs) were created to visualize the explainability of the invasion status classification. RESULTS: The CNN model's diagnostic accuracy was 0.973, significantly higher than those of the two radiologists (SR: 0.838; JR: 0.595). Receiver operating characteristic curve analysis gave an area under the curve of 0.953 for the CNN model (versus 0.832 and 0.617 for SR and JR; both p < 0.05). The Grad-CAMs suggested that the invasion-negative cases were present predominantly in bone marrow, while the invasion-positive cases exhibited osteosclerosis and nasopharyngeal masses. CONCLUSIONS: This CNN technique would be useful for CT-based diagnosis of skull-base invasion by nasopharyngeal malignancies.
• Correction: Treatment outcomes of radiotherapy with concurrent weekly cisplatin in older patients with locally advanced head and neck squamous cell carcinoma.

  Yusuke Uchinami, Koichi Yasuda, Satoshi Kano, Manami Otsuka, Seijiro Hamada, Takayoshi Suzuki, Nayuta Tsushima, Shuhei Takahashi, Yoshihiro Fujita, Tomohiko Miyazaki, Hajime Higaki, Jun Taguchi, Yasushi Shimizu, Tomohiro Sakashita, Akihiro Homma, Hidefumi Aoyama

  Discover. Oncology 15 (1) 18 - 18 2024/01/25
• Radiotherapy with or without chemotherapy for locally advanced head and neck cancer in elderly patients: analysis of the Head and Neck Cancer Registry of Japan.

  Koichi Yasuda, Yusuke Uchinami, Satoshi Kano, Jun Taguchi, Daisuke Kawakita, Megumi Kitayama, Kentaro Nishioka, Takashi Mori, Fuki Koizumi, Yuri Fujii, Yasushi Shimizu, Keiji Kobashi, Seiichi Yoshimoto, Ken-Ichi Nibu, Akihiro Homma, Hidefumi Aoyama

  International journal of clinical oncology 2023/12/29 

  BACKGROUND: Whether concurrent chemotherapy with radiotherapy (CRT) is effective for elderly patients with head and neck cancer is a controversial topic. This study aimed to analyze the effectiveness of CRT vs. radiation therapy (RT) among elderly patients in Japan. METHODS: Data from the Head and Neck Cancer Registry of Japan were extracted and analyzed. Patients with locally advanced squamous cell carcinoma of the oropharynx, hypopharynx, or larynx who received definitive CRT or RT between 2011 and 2014 were included. RESULTS: CRT was administered to 78% of the 1057 patients aged ≥ 70 years and 67% of the 555 patients aged ≥ 75 years. For the patients aged ≥ 75 years, the overall survival (OS) rate was significantly better in the CRT group than in the RT group (P < 0.05), while the progression-free survival (PFS) rate was not significantly different (P > 0.05). The add-on effect of CRT was significantly poor in elderly patients (P < 0.05), and it was not a significant factor in the multivariate analysis for patients aged ≥ 75 years. After propensity score matching, there were no significant differences in the OS and PFS rates between the patients aged ≥ 70 years and those aged ≥ 75 years (all, P > 0.05). CONCLUSION: Although aggressive CRT is administered to elderly patients in Japan, its effectiveness is uncertain. Further prospective randomized trials are needed to verify whether CRT is superior to RT alone for elderly patients.
• Treatment outcomes of radiotherapy with concurrent weekly cisplatin in older patients with locally advanced head and neck squamous cell carcinoma.

  Yusuke Uchinami, Koichi Yasuda, Satoshi Kano, Manami Otsuka, Seijiro Hamada, Takayoshi Suzuki, Nayuta Tsushima, Shuhei Takahashi, Yoshihiro Fujita, Tomohiko Miyazaki, Hajime Higaki, Jun Taguchi, Yasushi Shimizu, Tomohiro Sakashita, Akihiro Homma, Hidefumi Aoyama

  Discover. Oncology 14 (1) 226 - 226 2023/12/08 

  BACKGROUND: Tri-weekly cisplatin and radiotherapy (CDDP + RT) is a standard of care for locally advanced head and neck squamous cell carcinoma (LA-HNSCC) but is sometimes challenging to complete in older patients. Weekly CDDP + RT has shown mild toxicity compared to tri-weekly CDDP + RT for LA-HNSCC and is a promising option for older adults. We aimed to report the treatment outcomes and prognostic factors in patients with LA-HNSCC treated with weekly CDDP + RT. METHODS: We analyzed patients aged ≥ 70 years who started weekly CDDP + RT for LA-HNSCC between July 2006 and October 2022. LA-HNSCC includes cancer in the oropharynx, hypopharynx, or larynx with a clinical stage of 3 or 4 without distant metastases based on the Union for International Cancer Control staging system 8th edition. The radiation dose of 70 Gy was delivered in 35 fractions by 3-dimensional conformal radiotherapy, intensity-modulated radiotherapy, or proton beam therapy. The primary endpoint was the 3-year overall survival (OS), and the secondary endpoints were the 3-year progression-free survival (PFS) and 3-year cause-specific survival (CSS). The Kaplan-Meier method was used to calculate survival rates, and the log-rank test was used to evaluate statistical significance. A Cox proportional hazards model was used for the multivariate analysis of prognostic factors. RESULTS: The median age of the 49 patients was 72 (range: 70-78) years. The median CDDP dose was 200 (40-280) mg/ m2, and 47 patients completed scheduled radiotherapy. Forty-eight patients (98.0%) had a performance status of ≥ 1 at the initial visit. The 3-year OS, PFS, and CSS were 80.9% (95% confidence interval [CI]: 64.8-90.7), 68.3% (95% CI 51.8-81.2), and 85.0% (95% CI 68.7-93.4), respectively. In the multivariate analysis, the cumulative CDDP dose (< 200 or ≥ 200 mg/m2) was a significant factor for OS (hazard ratio: 0.29 [95% CI 0.08-0.97], p = 0.044). There was one case of early mortality. Grade 3 or higher late adverse events were observed in four patients (8.2%). CONCLUSIONS: Weekly CDDP + RT in older patients led to good survival outcomes with an acceptable rate of adverse events. CDDP should be administered at a dose of at least 200 mg/m2 in older patients. Trial registration Retrospectively registered.
• Improvement of image quality in diffusion-weighted imaging with model-based deep learning reconstruction for evaluations of the head and neck.

  Noriyuki Fujima, Junichi Nakagawa, Hiroyuki Kameda, Yohei Ikebe, Taisuke Harada, Yukie Shimizu, Nayuta Tsushima, Satoshi Kano, Akihiro Homma, Jihun Kwon, Masami Yoneyama, Kohsuke Kudo

  Magma (New York, N.Y.) 2023/11/21 

  OBJECTIVES: To investigate the utility of deep learning (DL)-based image reconstruction using a model-based approach in head and neck diffusion-weighted imaging (DWI). MATERIALS AND METHODS: We retrospectively analyzed the cases of 41 patients who underwent head/neck DWI. The DWI in 25 patients demonstrated an untreated lesion. We performed qualitative and quantitative assessments in the DWI analyses with both deep learning (DL)- and conventional parallel imaging (PI)-based reconstructions. For the qualitative assessment, we visually evaluated the overall image quality, soft tissue conspicuity, degree of artifact(s), and lesion conspicuity based on a five-point system. In the quantitative assessment, we measured the signal-to-noise ratio (SNR) of the bilateral parotid glands, submandibular gland, the posterior muscle, and the lesion. We then calculated the contrast-to-noise ratio (CNR) between the lesion and the adjacent muscle. RESULTS: Significant differences were observed in the qualitative analysis between the DWI with PI-based and DL-based reconstructions for all of the evaluation items (p < 0.001). In the quantitative analysis, significant differences in the SNR and CNR between the DWI with PI-based and DL-based reconstructions were observed for all of the evaluation items (p = 0.002 ~ p < 0.001). DISCUSSION: DL-based image reconstruction with the model-based technique effectively provided sufficient image quality in head/neck DWI.
• Extent of thyroidectomy and paratracheal lymph node dissection in total pharyngolaryngectomy for pyriform sinus cancer, and recurrence, survival, and postoperative hypoparathyroidism: A multicenter retrospective study.

  Yosuke Ariizumi, Nobuhiro Hanai, Takahiro Asakage, Akira Seto, Toshifumi Tomioka, Junji Miyabe, Hisashi Kessoku, Takashi Mukaigawa, Go Omura, Masanori Teshima, Daisuke Nishikawa, Yuki Saito, Yukinori Asada, Takuo Fujisawa, Takuma Makino, Hiroshi Nishino, Daisuke Sano, Mitsuhiko Nakahira, Kunihiko Tokashiki, Hirokazu Uemura, Tsutomu Ueda, Akihiro Sakai, Muneyuki Masuda, Takahiro Tsujikawa, Yusuke Hiei, Naoki Nishio, Hidetoshi Matsui, Naomi Kiyota, Akihiro Homma

  Head & neck 2023/11/13 

  BACKGROUND: Total pharyngolaryngectomy (TPL) is standard treatment for hypopharyngeal cancer. However, extensive thyroidectomy and paratracheal nodal dissection (PTND) can cause hypoparathyroidism. We sought to determine the optimum extent of resection. METHODS: We analyzed the clinicopathological information of 161 pyriform sinus cancer patients undergoing TPL from 25 Japanese institutions. Rates of recurrence and risk factors for hypoparathyroidism, as well as incidence of pathological contralateral level VI nodal metastasis and stomal recurrence, were investigated. RESULTS: The extent of thyroidectomy and nodal dissection were not independent risk factors for recurrence. Incidences of contralateral level VI nodal involvement and stomal recurrence were 1.8% and 1.2%, respectively. Patients undergoing hemithyroidectomy/ipsilateral PTND did not develop stomal recurrence and had the lowest incidence of hypoparathyroidism. Prognosis in patients without tracheostomy prior to hemithyroidectomy/ipsilateral PTND was comparable to that with more extensive resections. CONCLUSIONS: Hemithyroidectomy/ipsilateral PTND may be sufficient for pyriform sinus cancer cases without tracheostomy.
• Daily fraction dose-adjusted radiotherapy policy to avoid prolonging the overall treatment time for early glottic squamous cell carcinoma: a single-institutional retrospective study.

  Yasuhiro Dekura, Koichi Yasuda, Hideki Minatogawa, Yusuke Uchinami, Nayuta Tsushima, Takayoshi Suzuki, Satoshi Kano, Takashi Mori, Kentaro Nishioka, Keiji Kobashi, Norio Katoh, Akihiro Homma, Hidefumi Aoyama

  Journal of radiation research 2023/11/10 

  The objective of this study was to determine the outcomes of radical radiotherapy for early glottic squamous cell carcinoma (EGSCC) with the policy of increasing the fraction size during radiotherapy when the overall treatment time (OTT) was expected to be prolonged. Patients diagnosed with clinical T1-2N0M0 EGSCC, who were treated with radical radiotherapy between 2008 and 2019 at Hokkaido University Hospital, were included. Patients received 66 Gy in 33 fractions for T1 disease and 70 Gy in 35 fractions for T2 disease as our standard regimen (usual group [UG]). If the OTT was expected to extend for >1 week, the dose fraction size was increased from 2.0 to 2.5 Gy from the beginning or during radiotherapy (adjusted group [AG]). At this time, we performed a statistical analysis between UG and AG. In total, 116 patients were identified, and the treatment schedules of 29 patients were adjusted. The median follow-up was 60.9 months. In the T1 group, the cumulative 5-year local failure rate was 12.0% in the AG and 15.4% in the UG, and in the T2 group, the rate was 40.7% in the AG and 25.3% in the UG. There were no significant differences between the AG and UG. Similarly, no significant differences were observed for overall survival and progression-free survival rates. Our single-institutional retrospective analysis of EGSCC patients suggested that a method of adjusting the radiotherapy schedule to increase fraction size from the beginning or during the course may be effective in maintaining treatment outcomes.
• Comparative study of physiological FDG uptake in small structures between silicon photomultiplier-based PET and conventional PET.

  Shiro Watanabe, Kenji Hirata, Keiichi Magota, Junki Takenaka, Naoto Wakabayashi, Daiki Shinyama, Koichi Yasuda, Akihiro Homma, Kohsuke Kudo

  Annals of nuclear medicine 2023/11/09 

  OBJECTIVE: Silicon photomultiplier-based positron emission tomography/computed tomography (SiPM-PET/CT) has the superior spatial resolution to conventional PET/CT (cPET/CT). This head-to-head comparison study compared the images of physiological 18F-fluorodeoxyglucose (FDG) accumulation in small-volume structures between SiPM-PET/CT and cPET/CT in patients scanned with both modalities, and we investigated whether the thresholds that are reported to be useful for differentiating physiological accumulations from malignant lesions can also be applied to SiPM-PET/CT. METHODS: We enrolled 21 consecutive patients with head and neck malignancies who underwent whole-body FDG-PET/CT for initial staging or a follow-up evaluation (October 2020 to March 2022). After being injected with FDG, all patients underwent PET acquisition on both Vereos PET-CT and Gemini TF64 PET-CT systems (both Philips Healthcare) in random order. For each patient, the maximum standardized uptake value (SUVmax) was measured in the pituitary gland, esophagogastric junction (EGJ), adrenal glands, lumbar enlargement of the spinal cord, and epididymis. We measured the liver SUVmean and the blood pool SUVmean to calculate the target-to-liver ratio (TLR) and the target-to-blood ratio (TBR), respectively. Between-groups differences in each variable were examined by a paired t-test. We also investigated whether there were cases of target uptake greater than the reported threshold for distinguishing pathological from physiological accumulations. RESULTS: Data were available for 19 patients. Ten patients were in Group 1, i.e., the patients who underwent SiPM-PET first, and the remaining nine patients who underwent cPET first were in Group 2. In the SiPM-PET results, the SUVmax of all targets was significantly higher than that obtained by cPET in all patients, and this tendency was also observed when the patients were divided into Groups 1/2. The TLRs of all targets were significantly higher in SiPM-PET than in cPET in all patients, and SiPM-PET also showed significantly higher TBRs for all targets except the EGJ (p = 0.052). CONCLUSIONS: The physiological uptake in the small structures studied herein showed high accumulation on SiPM-PET. Our results also suggest that the thresholds reported for cPET to distinguish pathological accumulations likely lead to false-positive findings in SIPM-PET evaluations.
• Novel approach of prophylactic radiation to reduce toxicities comparing 2-step40 with 56-Gy simultaneous integrated boost intensity-modulated radiation therapy for locally advanced squamous cell carcinoma of the head and neck, an intergroup phase III trial (JCOG1912, NEW BRIDGE).

  Tomoya Yokota, Sadamoto Zenda, Takeshi Kodaira, Naomi Kiyota, Yasushi Fujimoto, Koichiro Wasano, Ryo Takahashi, Takashi Mizowaki, Akihiro Homma, Keita Sasaki, Ryunosuke Machida, Yuta Sekino, Haruhiko Fukuda

  BMC cancer 23 (1) 1068 - 1068 2023/11/06 

  BACKGROUND: Chemoradiotherapy (CRT) with concurrent cisplatin is the standard of care as a nonsurgical definitive treatment for patients with locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN). However, CRT is associated with increased severe late adverse events, including swallowing dysfunction, xerostomia, ototoxicity, and hypothyroidism. Few strategies aimed at less invasive CRT without compromising treatment outcomes have been successful. The purpose of this study is to confirm the non-inferiority of reduced dose prophylactic radiation with 40 Gy compared to standard dose prophylactic radiation with 56 Gy in terms of the time to treatment failure (TTF) among patients with clinical stage III-IVB LA-SCCHN. METHODS: This study is a multicenter, two-arm, open-label, randomized phase III trial. Patients with LA-SCCHN excluding p16 positive oropharynx cancer are randomized to the standard arm or experimental arm. A total dose of 70 Gy for tumors with concurrent cisplatin at 100 mg/m2 are administered in both arms. For prophylactic field, patients in the standard arm receive a total dose of 56 Gy in 35 fractions for 7 weeks using simultaneous integrated boost (SIB56) and those in the experimental arm receive 40 Gy in 20 fractions using two-step methods for 4 weeks (2-step40). A total of 400 patients will be enrolled from 52 Japanese institutions within 5 years. The primary endpoint is TTF, and the secondary endpoints are overall survival, complete response rate, progression-free survival, locoregional relapse-free survival, acute and late adverse events, quality of life score, and swallowing function score. DISCUSSION: If the experimental arm is non-inferior to the standard arm in terms of TTF and superior on the safety endpoints, the 2-step40 procedure is the more useful treatment than SIB56 for definitive CRT. TRIAL REGISTRATION: This trial has been registered in the Japan Registry of Clinical Trials as jRCTs031210100 ( https://jrct.niph.go.jp/latest-detail/jRCTs031210100 ). Date of Registration: May 2021.
• Targeted next-generation sequencing of Japanese patients with sinonasal mucosal melanomas identifies frequent NRAS and CTNNB1 mutations

  Nayuta Tsushima, Satoshi Kano, Kanako C. Hatanaka, Takayoshi Suzuki, Seijiro Hamada, Hiroshi Idogawa, Yuji Nakamaru, Masanobu Suzuki, Yutaka Hatanaka, Akihiro Homma

  Auris Nasus Larynx 0385-8146 2023/11
• Quantitative Evaluations of Vestibular Function in Patients With Petrous Apex Cholesterol Granulomas Treated With an Endoscopic Transsphenoidal Approach: A Report of Two Cases.

  Yuuki Fujiwara, Keishi Fujiwara, Hiroaki Motegi, Yukitomo Ishi, Shinya Morita, Kimiko Hoshino, Atsushi Fukuda, Yuji Nakamaru, Akihiro Homma

  Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 44 (8) 809 - 812 2023/09/01 

  OBJECTIVE: We report two cases of petrous apex cholesterol granuloma (PACG) treated with an endoscopic transsphenoidal approach. Vestibular functions of the two patients were evaluated quantitatively by video Head Impulse Test (vHIT) and/or vestibular evoked myogenic potentials (VEMPs). PATIENTS: Two patients with PACG who experienced episodes of dizziness are presented. INTERVENTION: An endoscopic transsphenoidal approach to PACG. MAIN OUTCOME MEASURE: The preoperative and postoperative vestibular functions as evaluated by vHIT and VEMP. RESULTS: Two cases of PACG were treated by a transsphenoidal approach. The internal auditory canal was compressed by the PACG in both cases. The patients both experienced episodes of dizziness before surgery and preoperative vestibular testing including vHIT and VEMP indicated dysfunction of vestibular nerves. After surgery, their symptoms were completely resolved, and the vestibular testing results were improved. CONCLUSIONS: This article is noteworthy for being the first to publish quantitative vestibular function testing for patients with PACG with vestibular dysfunction. PACG may show various symptoms, with dizziness being one of the most common symptoms. In cases in which the internal auditory canal is compressed by the PACG, vestibular functions should be evaluated by vHIT and VEMP. In the present cases, dizziness was found to be resolved by surgery to release the compression on internal auditory canal. Based on the present cases, the transsphenoidal approach is considered to be both safe and effective.
• Summary of Japanese clinical practice guidelines for head and neck cancer - 2022 update edited by the Japan society for head and neck cancer.

  Akihiro Homma, Mizuo Ando, Nobuhiro Hanai, Hiroyuki Harada, Yoshitaka Honma, Tomonori Kanda, Satoshi Kano, Daisuke Kawakita, Naomi Kiyota, Yoshiyuki Kizawa, Masahiro Nakagawa, Takenori Ogawa, Hirotaka Shinomiya, Takeshi Shinozaki, Motoyuki Suzuki, Tetsuya Tsuji, Koichi Yasuda, Sadamoto Zenda, Takeshi Kodaira, Tadaaki Kirita, Ken-Ichi Nibu

  Auris, nasus, larynx 2023/07/21 

  The aim of the "Japanese Clinical Practice Guidelines for Head and Neck Cancer - 2022 Update" is to review the latest evidence regarding head and neck cancer and to present the current standard approaches for diagnosis and treatment. These evidence-based recommendations were created with the consensus of the Guideline Committee, which is composed of otorhinolaryngologists and head and neck surgeons, together with radiologists, radiation oncologists, medical oncologists, plastic surgeons, dentists, palliative care physicians, and rehabilitation physicians. These guidelines were created by the Clinical Practice Guideline Committee of the Japan Society for Head and Neck Cancer based on the "Head and Neck Cancer Treatment Guidelines 2018 Edition," and the revised draft was compiled after evaluation by the Assessment Committee and public comments. The 'Clinical questions and recommendations' section consists of 13 categories, and 59 clinical questions are described in total. Here we describe 6 clinical questions specific to other sets of guidelines with recommendations and comments.
• Early prediction of treatment outcome for lenvatinib using 18F-FDG PET/CT in patients with unresectable or advanced thyroid carcinoma refractory to radioiodine treatment: a prospective, multicentre, non-randomised study.

  Satoshi Takeuchi, Kenji Hirata, Keiichi Magota, Shiro Watanabe, Rika Moku, Akihiko Shiiya, Jun Taguchi, Shin Ariga, Tomohiro Goda, Yoshihito Ohhara, Takurou Noguchi, Yasushi Shimizu, Ichiro Kinoshita, Rio Honma, Yasushi Tsuji, Akihiro Homma, Hirotoshi Dosaka-Akita

  EJNMMI research 13 (1) 69 - 69 2023/07/17 

  BACKGROUND: Lenvatinib is widely used to treat unresectable and advanced thyroid carcinomas. We aimed to determine whether 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) performed 1 week after lenvatinib treatment initiation could predict treatment outcomes. RESULTS: This was a prospective, nonrandomised, multicentre study. Patients with pathologically confirmed differentiated thyroid carcinoma (DTC) and lesions refractory to radioiodine treatment were eligible for inclusion. Patients were treated with 24 mg lenvatinib as the initial dose and underwent PET/CT examination 1 week after treatment initiation. Contrast-enhanced CT was scheduled at least 4 weeks later as the gold standard for evaluation. The primary endpoint was to evaluate the discrimination power of maximum standardised uptake value (SUVmax) obtained by PET/CT compared to that obtained by contrast-enhanced CT. Evaluation was performed using the area under the receiver operating characteristic (ROC-AUC) curve. Twenty-one patients were included in this analysis. Receiver operating characteristic (ROC) curve analysis yielded an AUC of 0.714 for SUVmax after 1 week of lenvatinib treatment. The best cut-off value for the treatment response for SUVmax was 15.211. The sensitivity and specificity of this cut-off value were 0.583 and 0.857, respectively. The median progression-free survival was 26.3 months in patients with an under-cut-off value and 19.7 months in patients with an over-cut-off value (P = 0.078). CONCLUSIONS: The therapeutic effects of lenvatinib were detected earlier than those of CT because of decreased FDG uptake on PET/CT. PET/CT examination 1 week after the initiation of lenvatinib treatment may predict treatment outcomes in patients with DTC. TRIAL REGISTRATION: This trial was registered in the University Hospital Medical Information Network (UMIN) Clinical Trials Registry (number UMIN000022592) on 6 June, 2016.
• Utility of Color Doppler Ultrasonography in Monitoring of a Free Jejunal Flap

  Taku Maeda, Kosuke Ishikawa, Yoichiro Oda, Satoshi Kano, Nayuta Tsushima, Tomohiro Sakashita, Akihiro Homma, Yuhei Yamamoto, Emi Funayama

  The Laryngoscope 0023-852X 2023/06/29
• Treatment outcomes of the patient with sinonasal mucosal melanoma: the role of endoscopic resection and postoperative radiotherapy.

  Nayuta Tsushima, Satoshi Kano, Koichi Yasuda, Takayoshi Suzuki, Seijiro Hamada, Yuji Nakamaru, Masanobu Suzuki, Yusuke Uchinami, Hidefumi Aoyama, Akihiro Homma

  International journal of clinical oncology 28 (9) 1218 - 1226 2023/06/17 

  BACKGROUND: The standard of care for sinonasal mucosal melanoma is surgery and postoperative radiotherapy (PORT). Our treatment strategy comprises endoscopic resection and PORT. We performed combined endoscopic and open resection or applied an external approach alone when sufficient resection was difficult to achieve endoscopically. The objective of this study was to evaluate the validity of our treatment strategy. METHODS: We assessed 30 patients with sinonasal mucosal melanoma who underwent definitive therapy between January 2002 and April 2021, and conducted a retrospective analysis. The median follow-up period was 2.2 years. The primary endpoint was overall survival. The Kaplan-Meier method was used for the calculation of survival rates, the cumulative incidence of distant metastasis, and local recurrence. RESULTS: Twenty-eight patients underwent surgery. The other two patients were treated by definitive proton beam therapy. Twenty-one of 28 (75%) patients underwent resection by endoscopic approach alone. Postoperative radiotherapy was performed for all 28 patients who underwent surgery. Twenty-one patients (70%) experienced recurrence during the observation period. Overall, distant metastasis was observed in 19 patients. Twelve patients died during the observation period, with 10 of the 12 patients (83%) dying of distant metastasis. The overall survival rate at 2 and 5 years was 70% and 46%, respectively. The cumulative incidence rate of distant metastasis at 2 years was 63%, while the 2-year cumulative incidence rate of local recurrence was 6.7%. CONCLUSION: The local disease was controlled by our treatment strategy. To improve treatment outcomes, control of the distant metastasis is needed.
• The superselective intra-arterial infusion of cisplatin and concomitant radiotherapy (RADPLAT) is effective for metastatic lymph nodes in head and neck squamous cell carcinoma.

  Satoshi Kano, Takayoshi Suzuki, Daisuke Yoshida, Nayuta Tsushima, Seijiro Hamada, Koichi Yasuda, Yusuke Uchinami, Hidefumi Aoyama, Akihiro Homma

  International journal of clinical oncology 28 (9) 1121 - 1128 2023/06/08 

  BACKGROUND: Superselective intra-arterial infusion of cisplatin and concomitant radiotherapy (RADPLAT) is a very promising treatment modality for locally advanced head and neck squamous cell carcinoma. However, there are some concerns regarding its potential for the control of neck lymph node metastasis. The objective of this study was to investigate whether RADPLAT provided inferior regional control compared to intravenous chemoradiotherapy (IV-CRT). METHODS: A total of 172 patients with neck lymph node metastases, 66 of whom underwent RADPLAT and 106 IV-CRT, were enrolled in this study. We retrospectively compared regional control rates between RADPLAT and IV-CRT. Furthermore, to adjust for differences in factors related to patient background between the groups, we conducted inverse probability weighting (IPW) analysis using the propensity score. RESULTS: A comparison between the two groups revealed that the regional control rates were almost equal under unadjusted conditions; however, after adjustment by IPW analysis, the RADPLAT group had a relatively better regional control rate than did the IV-CRT group (1 year regional control rate: 86.6% vs. 79.4%). In addition, the analysis of relative risk factors for regional control in the RADPLAT group showed that the absence of intra-arterial cisplatin infusion into metastatic lymph nodes was the only independent risk factor (Hazard ratio: 4.23, p = 0.04). CONCLUSION: This study showed that the regional control rate in patients treated with RADPLAT was noninferior to that for IV-CRT. Locally advanced head and neck cancers is a good indication for RADPLAT, even if the patients have neck lymph node metastases.
• SlicerPIT 頭頸部アルミノックス治療の治療計画ソフトウェアの開発

  鈴木 崇祥, 足利 雄一, 若林 侑輝, 勝俣 量平, 浜田 誠二郎, 井戸川 寛志, 対馬 那由多, 加納 里志, 本間 明宏

  頭頸部癌 (一社)日本頭頸部癌学会 49 (2) 127 - 127 1349-5747 2023/05
• 頭頸部アルミノックス治療におけるニードルカテーテル穿刺のためのガイドプレートの製作について

  足利 雄一, 鈴木 崇祥, 若林 侑輝, 格口 渉, 関口 珠希, 栗林 和代, 本間 明宏, 大廣 洋一

  頭頸部癌 (一社)日本頭頸部癌学会 49 (2) 127 - 127 1349-5747 2023/05
• 高齢者の局所進行頭頸部扁平上皮癌患者におけるweeklyシスプラチン併用放射線治療の治療成績

  打浪 雄介, 安田 耕一, 加納 里志, 対馬 那由多, 鈴木 崇祥, 浜田 誠二郎, 田口 純, 清水 康, 坂下 智博, 本間 明宏

  頭頸部癌 (一社)日本頭頸部癌学会 49 (2) 134 - 134 1349-5747 2023/05
• 当院で治療した頭頸部原発横紋筋肉腫症例の検討

  勝俣 量平, 加納 里志, 対馬 那由多, 鈴木 崇祥, 浜田 誠二郎, 清水 康, 田口 純, 安田 耕一, 打浪 雄介, 本間 明宏

  頭頸部癌 (一社)日本頭頸部癌学会 49 (2) 161 - 161 1349-5747 2023/05
• 高齢者の頭頸部癌に対する放射線治療と化学療法併用の実態 日本頭頸部癌学会悪性腫瘍全国登録調査の解析

  安田 耕一, 打浪 雄介, 加納 里志, 田口 純, 清水 康, 本間 明宏

  頭頸部癌 (一社)日本頭頸部癌学会 49 (2) 171 - 171 1349-5747 2023/05
• 唾液腺癌の局所頸部制御における術後照射の有用性の検討

  加納 里志, 対馬 那由多, 鈴木 崇祥, 浜田 誠二郎, 安田 耕一, 打浪 雄介, 本間 明宏

  頭頸部癌 (一社)日本頭頸部癌学会 49 (2) 192 - 192 1349-5747 2023/05
• 頭頸部アルミノックス治療におけるニードルカテーテル穿刺のためのガイドプレートの製作について

  足利 雄一, 鈴木 崇祥, 若林 侑輝, 格口 渉, 関口 珠希, 栗林 和代, 本間 明宏, 大廣 洋一

  頭頸部癌 (一社)日本頭頸部癌学会 49 (2) 127 - 127 1349-5747 2023/05
• 局所進行上顎洞癌に対する超選択的動注と放射線同時併用療法(JCOG1212試験) 有効性検証相(T4aN0M0)の結果

  大越 明, 四宮 弘隆, 林 隆一, 齊藤 祐毅, 別府 慎太郎, 志賀 清人, 浅田 行紀, 上村 裕和, 上田 勉, 松浦 一登, 本間 明宏

  日本耳鼻咽喉科頭頸部外科学会会報 (一社)日本耳鼻咽喉科頭頸部外科学会 126 (4) 630 - 630 2436-5793 2023/04
• TRIM27 expression is associated with poor prognosis in sinonasal mucosal melanoma.

  S Kimura, M Suzuki, Y Nakamaru, S Kano, M Watanabe, A Honma, A Nakazono, N Tsushima, S Hatakeyama, A Homma

  Rhinology 2023/03/09 

  BACKGROUND: Tripartite motif-containing 27 (TRIM27) has been implicated in the progression of various cancers. However, the role of TRIM27 in sinonasal mucosal melanoma (SNMM) remains poorly understood. MATERIALS & METHODS: We retrospectively examined 28 patients with SNMM treated with between 2003 and 2021. We undertook immunohistochemical analysis of TRIM27, Ki-67, and p-Akt1 expression in SNMM tissues. We also investigated the relationship between TRIM27 expression and clinical characteristics, prognosis, Ki-67 as a tumor growth potential marker, and p-Akt1 as one of the prognostic factors in mucosal melanoma. RESULTS: TRIM27 expression was significantly higher in T4 disease than in T3 disease and was higher in stage IV than in stage III. Patients with high-TRIM27 SNMM had a significantly poorer prognosis in terms of overall survival (OS) and disease-free survival.There was also a significantly higher rate of distant metastasis. Univariate analysis for OS revealed that TRIM27 and T classification were significant poor prognostic factors. In addition, the Ki-67 positive score and the p-Akt1 total staining score were significantly higher in the high-TRIM27 group than in the low-TRIM27 group. CONCLUSIONS: High TRIM27 expression in SNMM was associated with advanced T classification, poor prognosis and distant metastasis. We suggest that TRIM27 has potential as a novel biomarker for prognosis in SNMM.
• Nasal irrigation improving nasal obstruction and QoL of patients: two cases of HHT after nasal dermoplasty

  Hideaki Takeda, Masanobu Suzuki, Yuji Nakamaru, Shogo Kimura, Akira Nakazono, Aya Honma, Akihiro Homma

  JOURNAL OF JAPAN SOCIETY FOR HEAD AND NECK SURGERY 32 (3) 299 - 303 1349-581X 2023
• Mental workload during endoscopic sinus surgery is associated with surgeons' skill levels.

  Masanobu Suzuki, Kou Miyaji, Kotaro Matoba, Takashige Abe, Yuji Nakamaru, Ryosuke Watanabe, Takayoshi Suzuki, Akira Nakazono, Atsushi Konno, Dominik Hinder, A J Psaltis, P J Wormald, Akihiro Homma

  Frontiers in medicine 10 1090743 - 1090743 2023 

  INTRODUCTION: Surgeons' mental workload during endoscopic sinus surgery (ESS) has not been fully evaluated. The assessment was challenging due to the great diversity of each patient's anatomy and the consequence variety of surgical difficulties. In this study, we examined the mental workload of surgeons with various surgical skill levels during ESS under the standardized condition provided by novel-designed 3D sinus models. MATERIALS AND METHODS: Forty-seven participants performed a high-fidelity ESS simulation with 3D-printed sinus models. Surgeons' mental workload was assessed with the national aeronautics and space administration-task load index (NASA-TLX). Associations between the total and subscales score of NASA-TLX and surgical skill index, including the board certification status, the number of experienced ESS cases, and the objective structured assessment of technical skills (OSATS), were analyzed. In addition, 10 registrars repeated the simulation surgery, and their NASA-TLX score was compared before and after the repetitive training. RESULTS: The total NASA-TLX score was significantly associated with OSATS score (p = 0.0001). Primary component analysis classified the surgeons' mental burden into three different categories: (1) the skill-level-dependent factors (temporal demand, effort, and performance), (2) the skill-level-independent factors (mental and physical demand), and (3) frustration. After the repetitive training, the skill-level-dependent factors were alleviated (temporal demand; z = -2.3664, p = 0.0091, effort; z = -2.1704, p = 0.0346, and performance; z = -2.5992, p = 0.0017), the independent factors were increased (mental demand; z = -2.5992, p = 0.0023 and physical demand; z = -2.2509, p = 0.0213), and frustration did not change (p = 0.3625). CONCLUSION: Some of the mental workload during ESS is associated with surgical skill level and alleviated with repetitive training. However, other aspects remain a burden or could worsen even when surgeons have gained surgical experience. Routine assessment of registrars' mental burdens would be necessary during surgical training to sustain their mental health.
• 腹臥位・人工気胸下での胸腔内剥離が有用であった巨大縦隔内甲状腺腫の1例

  武藤 潤, 加納 里志, 山崎 雅久, 千葉 龍平, 野村 俊介, 藤原 晶, 氏家 秀樹, 樋田 泰浩, 加賀 基知三, 本間 明宏, 加藤 達哉

  日本臨床外科学会雑誌 日本臨床外科学会 83 (12) 2119 - 2119 1345-2843 2022/12
• Detailed analysis of failure patterns using deformable image registration in hypopharyngeal cancer patients treated with sequential boost intensity-modulated radiotherapy.

  Manami Otsuka, Koichi Yasuda, Yusuke Uchinami, Nayuta Tsushima, Takayoshi Suzuki, Satoshi Kano, Ryusuke Suzuki, Naoki Miyamoto, Hideki Minatogawa, Yasuhiro Dekura, Takashi Mori, Kentaro Nishioka, Jun Taguchi, Yasushi Shimizu, Norio Katoh, Akihiro Homma, Hidefumi Aoyama

  Journal of medical imaging and radiation oncology 67 (1) 98 - 110 2022/11/14 [Refereed]
   

  INTRODUCTION: Sequential boost intensity-modulated radiotherapy (SQB-IMRT) uses two different planning CTs (pCTs) and treatment plans. SQB-IMRT is a form of adaptive radiotherapy that allows for responses to changes in the shape of the tumour and organs at risk (OAR). On the other hand, dose accumulation with the two plans can be difficult to evaluate. The purpose of this study was to analyse patterns of loco-regional failure using deformable image registration (DIR) in hypopharyngeal cancer patients treated with SQB-IMRT. METHODS: Between 2013 and 2019, 102 patients with hypopharyngeal cancer were treated with definitive SQB-IMRT at our institution. Dose accumulation with the 1st and 2nd plans was performed, and the dose to the loco-regional recurrent tumour volume was calculated using the DIR workflow. Failure was classified as follows: (i) in-field (≥95% of the recurrent tumour volume received 95% of the prescribed dose); (ii) marginal (20-95%); or (iii) out-of-field (<20%). RESULTS: After a median follow-up period of 25 months, loco-regional failure occurred in 34 patients. Dose-volume histogram analysis showed that all loco-regional failures occurred in the field within 95% of the prescribed dose, with no marginal or out-of-field recurrences observed. CONCLUSION: The dosimetric analysis using DIR showed that all loco-regional failures were within the high-dose region. More aggressive treatment may be required for gross tumours.
• Pretreatment elevated mean corpuscular volume as an indicator for high risk esophageal second primary cancer in patients with head and neck cancer.

  Nayuta Tsushima, Satoshi Kano, Takayoshi Suzuki, Seijiro Hamada, Akihiro Homma

  Auris, nasus, larynx 2022/10/10 

  OBJECTIVE: Esophageal cancer is the most common second primary cancer (SPC) in patients with head and neck cancer (HNC). Esophageal SPC has a negative impact on survival. Elevated mean corpuscular volume (MCV) is an accepted predictor of esophageal cancer risk. The aim of this study was to elucidate the usefulness of elevated MCV as an indicator of a high risk for esophageal SPC. METHODS: We retrospectively reviewed the medical records of patients with oropharyngeal, hypopharyngeal, and laryngeal squamous cell carcinoma who underwent chemoradiotherapy between 2003 and 2012. We excluded patients younger than 20 years or who had received treatment for esophageal cancer and who had a histologically unproven lesion. Patients were divided into two groups according to their MCV. The cut-off for MCV was defined by receiver operating characteristics curve analysis. The primary endpoint was the cumulative incidence of esophageal SPC. RESULTS: A total of 295 patients were included. The median follow-up period for surviving patients was 7.4 years and the optimal cut-off point was 99.0 fL. One hundred ninety-five patients (66%) had an MCV < 99.0 fL and 100 (34%) had an MCV ≥ 99.0 fL. The 5-year cumulative incidence in patients with an MCV < 99.0 fL and ≥ 99.0 fL was 8.7% and 27%, respectively. In the multivariate analysis, an MCV ≥ 99.0 fL (HR=2.2; 95%CI, 1.1-4.2) was an independent risk factor. CONCLUSION: MCV ≥ 99.0 fL was found to be a risk factor for esophageal SPC. We, therefore, recommend that patients with an MCV ≥ 99.0 fL should undergo intensive monitoring.
• Utility of the deep learning technique for the diagnosis of orbital invasion on CT in patients with a nasal or sinonasal tumor.

  Junichi Nakagawa, Noriyuki Fujima, Kenji Hirata, Minghui Tang, Satonori Tsuneta, Jun Suzuki, Taisuke Harada, Yohei Ikebe, Akihiro Homma, Satoshi Kano, Kazuyuki Minowa, Kohsuke Kudo

  Cancer imaging : the official publication of the International Cancer Imaging Society 22 (1) 52 - 52 2022/09/22 

  BACKGROUND: In nasal or sinonasal tumors, orbital invasion beyond periorbita by the tumor is one of the important criteria in the selection of the surgical procedure. We investigated the usefulness of the convolutional neural network (CNN)-based deep learning technique for the diagnosis of orbital invasion, using computed tomography (CT) images. METHODS: A total of 168 lesions with malignant nasal or sinonasal tumors were divided into a training dataset (n = 119) and a test dataset (n = 49). The final diagnosis (invasion-positive or -negative) was determined by experienced radiologists who carefully reviewed all of the CT images. In a CNN-based deep learning analysis, a slice of the square target region that included the orbital bone wall was extracted and fed into a deep-learning training session to create a diagnostic model using transfer learning with the Visual Geometry Group 16 (VGG16) model. The test dataset was subsequently tested in CNN-based diagnostic models and by two other radiologists who were not specialized in head and neck radiology. At approx. 2 months after the first reading session, two radiologists again reviewed all of the images in the test dataset, referring to the diagnoses provided by the trained CNN-based diagnostic model. RESULTS: The diagnostic accuracy was 0.92 by the CNN-based diagnostic models, whereas the diagnostic accuracies by the two radiologists at the first reading session were 0.49 and 0.45, respectively. In the second reading session by two radiologists (diagnosing with the assistance by the CNN-based diagnostic model), marked elevations of the diagnostic accuracy were observed (0.94 and 1.00, respectively). CONCLUSION: The CNN-based deep learning technique can be a useful support tool in assessing the presence of orbital invasion on CT images, especially for non-specialized radiologists.
• Association of gene mutations with clinicopathologic features in patients with external auditory canal squamous cell carcinoma.

  Shinya Morita, Satoshi Kano, Kanako C Hatanaka, Yutaka Hatanaka, Takayoshi Suzuki, Atsushi Fukuda, Kimiko Hoshino, Keishi Fujiwara, Yuji Nakamaru, Akihiro Homma

  International journal of clinical oncology 27 (9) 1394 - 1403 2022/09 

  BACKGROUND: External auditory canal squamous cell carcinoma (EACSCC) is a rare form of malignant tumor. Due to the extremely limited understanding of the genomic landscape in EACSCC, the association between gene mutations and clinicopathologic features remains unclear. This study aimed to explore somatic gene mutations associated with the clinicopathological features in patients with EACSCC, and to identify the candidate gene mutations for predicting survival outcome in EACSCC. METHODS: Twenty-two tissue samples obtained from patients with EACSCC were analyzed for genetic mutations based on targeted next-generation sequencing and genetic expression based on IHC staining to investigate the driver of tumorigenesis and/or the candidates of genes for predicting clinical outcome in EACSCC. RESULTS: Gene alterations were most frequently observed in TP53 (59.1%), followed by CREBBP (9.1%). TP53 mutations showed significant correlation with T classification (P = 0.027) and p53 expression phenotype (P < 0.001). The 5-year overall survival (OS) rates for EACSCC patients with TP53 mutations and wild-type TP53 were 45.0% and 75.0%, respectively. Multivariable analysis using the Cox proportional hazards model demonstrated that TP53 mutations were independent predictors of OS rates for EACSCC patients (P = 0.007). CONCLUSION: This study has suggested that TP53 mutations have potential for use as a biomarker for identifying individuals at high risk of developing tumors and for predicting survival outcome in EACSCC. IHC staining for p53 might play a useful role as screening tool for detecting TP53 mutations in patients with EACSCC.
• Real-world clinical outcomes in Japanese patients with locally advanced squamous cell carcinoma of the head and neck treated with radiotherapy plus cetuximab: a prospective observational study (JROSG12-2).

  Yosuke Ota, Takeshi Kodaira, Hirofumi Fujii, Mototsugu Shimokawa, Tomoya Yokota, Torahiko Nakashima, Nobuya Monden, Akihiro Homma, Shinya Ueda, Tetsuo Akimoto

  International journal of clinical oncology 27 (11) 1675 - 1683 2022/08/24 

  BACKGROUND: Radiotherapy plus cetuximab (bioradiotherapy: BRT) is a standard option in the treatment of locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN). Published data on its safety and efficacy in real-world settings is limited. Here, we conducted a prospective multi-institutional observational study to evaluate clinical outcomes of BRT in patients with LA-SCCHN. METHODS: We analyzed real-world data of all patients who underwent BRT from 2013 to 2016. The primary endpoint was 1-year progression-free survival (PFS). Secondary endpoints were 1-year locoregional PFS (LPFS), treatment completion rate (TCR), and adverse events (AEs). RESULTS: A total of 171 patients with a minimum 1-year follow-up were analyzed. Median age was 67 (36-85) years, and 37 patients (21.6%) were aged 75 years or older. 1-year PFS and LPFS were 51.5 and 56.1%, respectively. N stage (p = 0.049) was significantly associated with PFS. TCR was 77.2%. Cetuximab was definitively discontinued in 30 patients (17.5%), in 15 cases due to severe mucositis. N stage, T stage, and comorbidity were significantly associated with TCR. Major AEs of grade 3 or higher were pharyngeal mucositis (48.5%), radiation dermatitis (45.6%), and oral mucositis (40.4%). Pneumonitis was observed in 12 patients (7.0%); 6 cases (3.5%) were grades 3-4 and 2 (1.2%) were grade 5. CONCLUSION: As a result of the large number of elderly patients in clinical practice, toxicity reduced TCR. BRT-induced pneumonitis, which is sometimes fatal, was found to be more frequent than with chemotherapy plus cetuximab.
• Repetitive simulation training with novel 3D-printed sinus models for functional endoscopic sinus surgeries.

  Masanobu Suzuki, Kou Miyaji, Ryosuke Watanabe, Takayoshi Suzuki, Kotaro Matoba, Akira Nakazono, Yuji Nakamaru, Atsushi Konno, Alkis James Psaltis, Takashige Abe, Akihiro Homma, Peter-John Wormald

  Laryngoscope investigative otolaryngology 7 (4) 943 - 954 2022/08 

  Background: The purpose of this study was to find a utility of a newly developed 3D-printed sinus model and to evaluate the educational benefit of simulation training with the models for functional endoscopic sinus surgery (FESS). Material and methods: Forty-seven otolaryngologists were categorized as experts (board-certified physicians with ≥200 experiences of FESS, n = 9), intermediates (board-certified physicians with <200 experiences of FESS, n = 19), and novices (registrars, n = 19). They performed FESS simulation training on 3D-printed models manufactured from DICOM images of computed tomography (CT) scan of real patients. Their surgical performance was assessed with the objective structured assessment of technical skills (OSATS) score and dissection quality evaluated radiologically with a postdissection CT scan. First we evaluated the face, content, and constructive values. Second we evaluated the educational benefit of the training. Ten novices underwent training (training group) and their outcomes were compared to the remaining novices without training (control group). The training group performed cadaveric FESS surgeries before and after the repetitive training. Results: The feedback from experts revealed high face and content value of the 3D-printed models. Experts, intermediates, and novices demonstrated statistical differences in their OSATS scores (74.7 ± 3.6, 58.3 ± 10.1, and 43.1 ± 11.1, respectively, p < .001), and dissection quality (81.1 ± 13.1, 93.7 ± 15.1, and 126.4 ± 25.2, respectively, p < .001). The training group improved their OSATS score (41.1 ± 8.0 to 61.1 ± 6.9, p < .001) and dissection quality (122.1 ± 22.2 to 90.9 ± 10.3, p = .013), while the control group not. After training, 80% of novices with no prior FESS experiences completed surgeries on cadaver sinuses. Conclusion: Repeated training using the models revealed an initial learning curve in novices, which was confirmed in cadaveric mock FESS surgeries. Level of evidence: N/A.
• The utility of diffusion-weighted T2 mapping for the prediction of histological tumor grade in patients with head and neck squamous cell carcinoma.

  Noriyuki Fujima, Yukie Shimizu, Masami Yoneyama, Junichi Nakagawa, Hiroyuki Kameda, Taisuke Harada, Seijiro Hamada, Takayoshi Suzuki, Nayuta Tsushima, Satoshi Kano, Akihiro Homma, Kohsuke Kudo

  Quantitative imaging in medicine and surgery 12 (8) 4024 - 4032 2022/08 

  Background: In head and neck cancers, histopathological information is important for the determination of the tumor characteristics and for predicting the prognosis. The aim of this study was to assess the utility of diffusion-weighted T2 (DW-T2) mapping for the evaluation of tumor histological grade in patients with head and neck squamous cell carcinoma (SCC). Methods: The cases of 41 patients with head and neck SCC (21 well/moderately and 17 poorly differentiated SCC) were retrospectively analyzed. All patients received MR scanning using a 3-Tesla MR unit. The conventional T2 value, DW-T2 value, ratio of DW-T2 value to conventional T2 value, and apparent diffusion coefficient (ADC) were calculated using signal information from the DW-T2 mapping sequence with a manually placed region of interest (ROI). Results: ADC values in the poorly differentiated SCC group were significantly lower than those in the moderately/well differentiated SCC group (P<0.05). The ratio of DW-T2 value to conventional T2 value was also significantly different between poorly and moderately/well differentiated SCC groups (P<0.01). Receiver operating characteristic (ROC) curve analysis of ADC values showed a sensitivity of 0.76, specificity of 0.67, positive predictive value (PPV) of 0.62, negative predictive value (NPV) of 0.8, accuracy of 0.71 and area under the curve (AUC) of 0.73, whereas the ROC curve analysis of the ratio of DW-T2 value to conventional T2 value showed a sensitivity of 0.76, specificity of 0.83, PPV of 0.76, NPV of 0.83, accuracy of 0.8 and AUC of 0.82. Conclusions: DW-T2 mapping might be useful as supportive information for the determination of tumor histological grade in patients with head and neck SCC.
• Distribution pattern and pathologic analysis of metastatic sentinel and non-sentinel lymph nodes in lymphatic basin dissection for clinical T2/T3 oral cancer with clinical N0 status.

  Hitoshi Hirakawa, Takashi Matsuzuka, Hirokazu Uemura, Seiichi Yoshimoto, Kouki Miura, Akihiro Shiotani, Masashi Sugasawa, Akihiro Homma, Junkichi Yokoyama, Kiyoaki Tsukahara, Tomokazu Yoshizaki, Nobuhiro Hanai, Hidenori Suzuki, Mikio Suzuki, Yasuhisa Hasegawa

  Auris, nasus, larynx 49 (4) 680 - 689 2022/08 

  OBJECTIVE: The localization pattern of metastatic sentinel lymph node (SN) and non-SNs and pathologic analysis of metastatic lymph nodes in SN lymphatic basin dissection (SLBD) were investigated in patients with cT2/T3cN0 oral squamous cell carcinoma (OSCC). METHODS: This prospective multicenter trial involved 10 institutions nationwide in Japan. A total of 57 patients were enrolled. The lateral neck was divided into 5 lymphatic basins. The lymphatic basin containing SNs was defined as the SN lymphatic basin. All patients underwent SLBD with backup selective neck dissection (I-III) combined with primary tumor removal. When SNs were found outside of levels I-III, including in the contralateral neck, SLBD was performed by removing the compartments containing SNs separately. SN metastasis was classified as isolated tumor cells (ITCs), micrometastasis, or macrometastasis. ITCs are defined as a lesion no larger than 0.2 mm in largest dimension and are classified as pN0. RESULTS: SN metastasis was observed in 22 cases. All metastatic lymph nodes, including false-negative cases, were detected in the SN lymphatic basin. Isolated tumor cells in the SNs did not affect prognosis, whereas micrometastasis tended to have poor prognosis. After adjusting for other risk factors, a positive SN remained a significant predictor of poor 5-year overall survival in pT2-4 OSCC. CONCLUSION: SLBD for intraoperative SN biopsy is a sufficient therapeutic procedure and is valuable for determining pathologic nodal stage in OSCC. SN positivity was demonstrated to be an independent predictor of poor prognosis in patients with pT2-4 disease undergoing SLBD with backup selective neck dissection (I-III).
• Amide proton transfer imaging for the determination of human papillomavirus status in patients with oropharyngeal squamous cell carcinoma.

  Noriyuki Fujima, Yukie Shimizu, Masami Yoneyama, Junichi Nakagawa, Hiroyuki Kameda, Taisuke Harada, Seijiro Hamada, Takayoshi Suzuki, Nayuta Tsushima, Satoshi Kano, Akihiro Homma, Kohsuke Kudo

  Medicine 101 (28) e29457  2022/07/15 

  The aim of this study was to investigate the utility of amide proton transfer (APT) imaging for the determination of human papillomavirus (HPV) status in patients with oropharyngeal squamous cell carcinoma (SCC). Thirty-one patients with oropharyngeal SCC were retrospectively evaluated. All patients underwent amide proton transfer imaging using a 3T magnetic resonance (MR) unit. Patients were divided into HPV-positive and -negative groups depending on the pathological findings in their primary tumor. In APT imaging, the primary tumor was delineated with a polygonal region of interest (ROI). Signal information in the ROI was used to calculate the mean, standard deviation (SD) and coefficient of variant (CV) of the APT signals (APT mean, APT SD, and APT CV, respectively). The value of APT CV in the HPV-positive group (0.43 ± 0.04) was significantly lower than that in the HPV-negative group (0.48 ± 0.04) (P = .01). There was no significant difference in APT mean (P = .82) or APT SD (P = .13) between the HPV-positive and -negative groups. Receiver operating characteristic (ROC) curve analysis of APT CV had a sensitivity of 0.75, specificity of 0.8, positive predictive value of 0.75, negative predictive value of 0.8, accuracy of 0.77 and area under the curve (AUC) of 0.8. The APT signal in the HPV-negative group was considered heterogeneous compared to the HPV-positive group. This information might be useful for the determination of HPV status in patients with oropharyngeal SCC.
• Evaluation of Semicircular Canal Function by Video Head Impulse Test in Patients With Labyrinthine Fistula Due to Cholesteatoma.

  Keishi Fujiwara, Shinya Morita, Atsushi Fukuda, Kimiko Hoshino, Yuji Nakamaru, Akihiro Homma

  Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 43 (5) 587 - 593 2022/06/01 

  OBJECTIVES: To evaluate semicircular canal function in patients with labyrinthine fistula (LF) due to cholesteatoma by the video Head Impulse Test (vHIT). STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: Ten patients with LF due to cholesteatoma and six without LF underwent vestibular examination. INTERVENTION: Diagnostic. MAIN OUTCOME MEASURES: The gain in vestibulo-ocular reflex (VOR) and the presence of catch-up saccade were examined for the semicircular canals in patients with LF. RESULTS: Seven of 10 cases (70.0%) in the fistula group were judged to have semicircular canal dysfunction based on preoperative evaluation. VOR gains in the patients with LF were significantly lower than those in the patients without LF. VOR gain decreased significantly in accordance with the severity of the LF. The postoperative VOR gain more than 6 months after surgery was significantly improved compared with the preoperative VOR gain. CONCLUSIONS: The vHIT is thought to be the most suitable method for evaluating semicircular canal function in patients with LF due to cholesteatoma as it is not influenced by middle ear pathology and can evaluate the function of the vertical canals. The vHIT could predict whether a LF is present or not before surgery, and the vHIT is essential for surgery for patients with LF.
• 咽喉頭癌に対するシスプラチン超選択的動注併用放射線治療(RADPLAT)による頸部制御の検討

  加納 里志, 対馬 那由多, 鈴木 崇祥, 浜田 誠二郎, 吉田 大介, 打浪 雄介, 安田 耕一, 本間 明宏

  頭頸部癌 (一社)日本頭頸部癌学会 48 (2) 151 - 151 1349-5747 2022/05
• 高齢の頭頸部悪性腫瘍に対する放射線治療の後ろ向き検討

  安田 耕一, 打浪 雄介, 浜田 誠二郎, 鈴木 崇祥, 対馬 那由多, 田口 純, 清水 康, 加納 里志, 本間 明宏

  頭頸部癌 (一社)日本頭頸部癌学会 48 (2) 200 - 200 1349-5747 2022/05
• Discrepancies in the caloric testing and video Head Impulse Test results in a case with bilateral lateral semicircular canal malformations.

  Keishi Fujiwara, Shinya Morita, Atsushi Fukuda, Kimiko Hoshino, Yuji Nakamaru, Akihiro Homma

  Auris, nasus, larynx 2022/04/22 

  Lateral semicircular canal (LSCC) malformations represent one of the most common types of inner ear malformation. As many cases of LSCC malformations are asymptomatic, detailed vestibular functions in such cases remain unclear. We present a case with bilateral LSCC malformations for whom the function of each vestibular organ was evaluated by caloric testing, video Head Impulse Test (vHIT) and vestibular evoked myogenic potentials (VEMP). Caloric testing showed canal paresis of the left side, whereas vHIT showed bilateral normal semicircular canal function. The results of VEMP indicated left saccular dysfunction. Discrepancies in caloric testing and vHIT results were observed and these discrepancies are thought to be due to endolymphatic hydrops rather than vestibular hypofunction, similar to that in Meniere disease.
• Systemic therapy for salivary gland malignancy: current status and future perspectives.

  Yoshinori Imamura, Naomi Kiyota, Makoto Tahara, Nobuhiro Hanai, Takahiro Asakage, Kazuto Matsuura, Ichiro Ota, Yuki Saito, Daisuke Sano, Takeshi Kodaira, Atsushi Motegi, Koichi Yasuda, Shunji Takahashi, Tomoya Yokota, Susumu Okano, Kaoru Tanaka, Takuma Onoe, Yosuke Ariizumi, Akihiro Homma

  Japanese journal of clinical oncology 52 (4) 293 - 302 2022/04/06 

  Salivary gland malignancies are rare neoplasms that have a broad histological spectrum and a variety of biologic behaviors. Salivary gland malignancies are known as chemo-resistant tumors, which render optimal treatment challenging. This review summarizes the role of systemic therapy for salivary gland malignancies. To date, the advantage of adding concurrent chemotherapy has remained undefined for both postoperative and inoperable locally advanced salivary gland malignancy patients undergoing radiotherapy. For recurrent/metastatic disease, local and/or systemic treatment options should be discussed in a multidisciplinary setting with consideration to both patient needs and tumor factors. For symptomatic patients or those who may compromise organ function, palliative systemic therapy can be a reasonable option based on the results of phase II studies. Platinum combination regimens as first-line therapy have been widely accepted. Personalized therapies have become established options, particularly for androgen receptor-positive, HER2-positive and NTRK fusion-positive salivary gland malignancies (i.e. androgen receptor and HER2 in salivary duct carcinoma and NTRK3 in secretory carcinoma). For patients with adenoid cystic carcinoma, multi-targeted tyrosine kinase inhibitors have also been developed. Anti-PD1 checkpoint inhibitors have shown limited activity to date. Investigation of active systemic treatments for salivary gland malignancy remains a significant unmet need. Future directions might include a more comprehensive genomic screening approach (usually next-generation sequencing-based) and combination strategies using immune checkpoint inhibitors. These are rare malignancies that require ongoing effort in the conduct of high-quality clinical trials.
• Human papillomavirus-related oropharyngeal carcinoma.

  Yuki Saito, Akihiro Homma, Naomi Kiyota, Makoto Tahara, Nobuhiro Hanai, Takahiro Asakage, Kazuto Matsuura, Ichiro Ota, Tomoya Yokota, Daisuke Sano, Takeshi Kodaira, Atsushi Motegi, Koichi Yasuda, Shunji Takahashi, Kaoru Tanaka, Takuma Onoe, Susumu Okano, Yoshinori Imamura, Yosuke Ariizumi, Ryuichi Hayashi

  Japanese journal of clinical oncology 52 (7) 692 - 698 2022/04/05 

  It was not until around 2000 that human papillomavirus-related oropharyngeal carcinoma was recognized as carcinoma with clinical presentations different from nonrelated head and neck carcinoma. Twenty years after and with the revision of the tumor-node-metastasis classification in 2017, various clinical trials focused on human papillomavirus-related oropharyngeal carcinoma to improve the prognosis and quality of life of patients with this disease. However, the incidence of human papillomavirus-related cancers is increasing, which is expected to be particularly prominent in Japan, where human papillomavirus vaccination is not widely available. In this review, we describe the current status of clinical trials (mainly focused on initial surgery and radiation dose reduction) for, primary and secondary prevention of, and the present status of human papillomavirus-related oropharyngeal carcinoma in Japan.
• Managing Cachexia in Head and Neck Cancer: a Systematic Scoping Review.

  Antti A Mäkitie, Rasheed Omobolaji Alabi, Helena Orell, Omar Youssef, Alhadi Almangush, Akihiro Homma, Robert P Takes, Fernando López, Remco de Bree, Juan P Rodrigo, Alfio Ferlito

  Advances in therapy 39 (4) 1502 - 1523 2022/04 

  INTRODUCTION: Patients with head and neck cancer (HNC) are usually confronted with functional changes due to the malignancy itself or its treatment. These factors typically affect important structures involved in speech, breathing, chewing, swallowing, and saliva production. Consequently, the intake of food will be limited, which further contributes to loss of body weight and muscle mass, anorexia, malnutrition, fatigue, and anemia. This multifactorial condition can ultimately lead to cancer cachexia syndrome. This study aims to examine the treatment of cachexia in HNC patients. METHODS: We systematically searched OvidMedline, PubMed, Scopus, and Web of Science for articles examining the treatment of cachexia in HNC. RESULTS: A total of nine studies were found, and these suggested interventions including nutritional, pharmacologic, therapeutic exercise, and multimodal approaches. The nutritional intervention includes essential components such as dietary counseling, oral nutritional supplements, and medical nutritional support. Individualized nutritional interventions include oral, enteral (feeding tubes i.e., percutaneous endoscopic gastrostomy [PEG], nasogastric tube [NGT]) and parenteral nutrition. The pharmacologic interventions aim at increasing the appetite and weight of cachectic patients. Therapeutic exercise and increased physical activity can help to enhance the synthesis of muscle protein, reducing inflammation and the catabolic effects of cachexia syndrome. CONCLUSION: Owing to the multifactorial nature of this syndrome, it is expected that the management approach should be multi-interventional. Early implementation of these interventions may help to improve survival and quality of health and life of cachectic HNC patients.
• 内視鏡下頭蓋底手術を考慮した嗅神経芽細胞腫に対する新規病期分類の検討

  中薗 彬, 中丸 裕爾, 鈴木 正宣, 本間 あや, 木村 将吾, 本間 明宏

  日本耳鼻咽喉科頭頸部外科学会会報 (一社)日本耳鼻咽喉科頭頸部外科学会 125 (4) 702 - 702 2436-5793 2022/04
• Weekly Cisplatin Plus Radiation for Postoperative Head and Neck Cancer (JCOG1008): A Multicenter, Noninferiority, Phase II/III Randomized Controlled Trial.

  Naomi Kiyota, Makoto Tahara, Junki Mizusawa, Takeshi Kodaira, Hirofumi Fujii, Tomoko Yamazaki, Hiroki Mitani, Shigemichi Iwae, Yasushi Fujimoto, Yusuke Onozawa, Nobuhiro Hanai, Takenori Ogawa, Hiroki Hara, Nobuya Monden, Eiji Shimura, Shujiro Minami, Takashi Fujii, Kaoru Tanaka, Akihiro Homma, Seiichi Yoshimoto, Nobuhiko Oridate, Koichi Omori, Tsutomu Ueda, Kenji Okami, Ichiro Ota, Kiyoto Shiga, Masashi Sugasawa, Takahiro Asakage, Yuki Saito, Shigeyuki Murono, Yasumasa Nishimura, Kenichi Nakamura, Ryuichi Hayashi

  Journal of clinical oncology : official journal of the American Society of Clinical Oncology 40 (18) JCO2101293 - 1990 2022/03/01 

  PURPOSE: The standard treatment for postoperative high-risk locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN) is chemoradiotherapy with 3-weekly cisplatin (100 mg/m2). However, whether chemoradiotherapy with weekly cisplatin (40 mg/m2) yields comparable efficacy with 3-weekly cisplatin in postoperative high-risk LA-SCCHN is unknown. PATIENTS AND METHODS: In this multi-institutional open-label phase II/III trial, patients with postoperative high-risk LA-SCCHN were randomly assigned to receive either chemoradiotherapy with 3-weekly cisplatin (100 mg/m2) or with weekly cisplatin (40 mg/m2) to confirm the noninferiority of weekly cisplatin. The primary end point of phase II was the proportion of treatment completion, and that of phase III was overall survival. A noninferiority margin of hazard ratio was set at 1.32. RESULTS: Between October 2012 and December 2018, a total of 261 patients were enrolled (3-weekly cisplatin, 132 patients; weekly cisplatin, 129 patients). At the planned third interim analysis in the phase III part, after a median follow-up of 2.2 (interquartile range 1.19-3.56) years, chemoradiotherapy with weekly cisplatin was noninferior to 3-weekly cisplatin in terms of overall survival, with a hazard ratio of 0.69 (99.1% CI, 0.374 to 1.273 [< 1.32], one-sided P for noninferiority = .0027 < .0043). Grade 3 or more neutropenia and infection were less frequent in the weekly arm (3-weekly v weekly, 49% v 35% and 12% v 7%, respectively), as were renal impairment and hearing impairment. No treatment-related death was reported in the 3-weekly arm, and two (1.6%) in the weekly arm. CONCLUSION: Chemoradiotherapy with weekly cisplatin is noninferior to 3-weekly cisplatin for patients with postoperative high-risk LA-SCCHN. These findings suggest that chemoradiotherapy with weekly cisplatin can be a possible treatment option for these patients.
• postコロナ・withコロナの耳鼻咽喉科診療 頭頸部の診療

  本間 明宏, 中丸 裕爾, 鈴木 正宣, 本間 あや

  日本耳鼻咽喉科免疫アレルギー感染症学会抄録集 日本耳鼻咽喉科免疫アレルギー感染症学会 2回 71 - 71 2022/03
• 術前呼吸機能検査による鼻茸を伴う副鼻腔炎の予後推測

  中丸 裕爾, 鈴木 正宣, 本間 あや, 中薗 彬, 木村 将吾, 本間 明宏

  日本耳鼻咽喉科免疫アレルギー感染症学会抄録集 日本耳鼻咽喉科免疫アレルギー感染症学会 2回 77 - 77 2022/03
• 鼻粘膜上皮細胞での細菌・ウィルス結合受容体発現に対する自然免疫シグナルの影響

  中薗 彬, 木村 将吾, 本間 あや, 鈴木 正宣, 中丸 裕爾, 本間 明宏

  日本耳鼻咽喉科免疫アレルギー感染症学会抄録集 日本耳鼻咽喉科免疫アレルギー感染症学会 2回 168 - 168 2022/03
• 鼻粘膜上皮におけるMetallothionein-3発現解析

  鈴木 正宣, 中丸 裕爾, 中薗 彬, 本間 あや, 木村 将吾, 本間 明宏

  日本耳鼻咽喉科免疫アレルギー感染症学会抄録集 日本耳鼻咽喉科免疫アレルギー感染症学会 2回 185 - 185 2022/03
• The Quantification of Extracellular Trap Cell Death-Derived Products as Diagnostic Biomarkers for Otitis Media With Antineutrophil Cytoplasmic Antibody-Associated Vasculitis and Eosinophilic Otitis Media.

  Shinya Morita, Yuji Nakamaru, Atsushi Fukuda, Keishi Fujiwara, Masanobu Suzuki, Kimiko Hoshino, Aya Honma, Akihiro Homma

  Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 43 (3) e337-e343  2022/03/01 

  OBJECTIVE: This study aimed to quantify the cell-free deoxyribonucleic acid (DNA), citrullinated-histone H3 (cit-H3)-DNA complex, and myeloperoxidase (MPO)-DNA complex as extracellular trap cell death (ETosis)-derived products in the middle ear fluid, and to identify diagnostic biomarkers for the discrimination of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (OMAAV) from eosinophilic otitis media (EOM). STUDY DESIGN: Prospective study. SETTING: Tertiary referral center. PATIENTS: OMAAV patients were eligible for inclusion in this analysis. Patients with EOM were examined as controls. INTERVENTION: All samples were obtained from the middle ear fluid in patients with OMAAV or EOM. The fluid samples were aspirated from the middle ear through the anterior-inferior portion of the tympanic membrane using a 1-ml tuberculin syringe with a 24- or 26-gauge needle under a microscope. MAIN OUTCOME MEASURES: The levels of cell-free DNA, cit-H3-DNA complex and MPO-DNA complex in the fluid samples were quantified using an enzyme-linked immunosorbent assay. RESULTS: Patients with OMAAV showed significantly higher levels of MPO-DNA complex compared to patients with EOM, regardless of the serum ANCA status at the time of sampling (p < 0.001 and p < 0.001, respectively). Meanwhile, there were no significant differences in the values of cell-free DNA or cit-H3-DNA complex between the OMAAV and EOM patients. CONCLUSION: The findings of this study suggest that the detection and quantification of MPO-DNA complex in the otitis media fluid can be utilized to discriminate OMAAV, especially in cases of eosinophilic granulomatosis with polyangiitis, from EOM regardless of the serum ANCA status. It should be noted that it is possible for cell-free DNA and cit-H3-DNA complex in fluid samples to be derived from dead cells other than neutrophils that undergo ETosis.
• Management of elderly patients with head and neck cancer.

  Ryo Ishii, Akira Ohkoshi, Naomi Kiyota, Kazuto Matsuura, Koichi Yasuda, Yoshinori Imamura, Yuki Saito, Akihiro Homma

  Japanese journal of clinical oncology 52 (4) 313 - 321 2022/02/15 

  There are no established guidelines for managing older patients with head and neck cancer. Most clinical trials that define current standard therapy included few elderly patients. On the other hand, there is great variability in patients' comorbidities, physical functions, cognitive function, familial and financial background and values. The key point appears to be appropriate geriatric assessment, clarifying the patients' outcomes and a multidisciplinary team approach, including the treatment decision-making policy. Although these processes should be scientific in nature, the evidence for the treatment of elderly head and neck patients is very limited. This review summarizes the evidence available regarding the management of geriatric assessment, each treatment modality and the multidisciplinary team approach for older patients with head and neck cancers.
• 前頭開頭術後に生じた前頭蓋底粘液嚢胞の2例

  山田 真司, 鈴木 正宣, 中丸 裕爾, 本間 あや, 中薗 彬, 木村 将吾, 安川 真一郎, 蠣崎 文彦, 本間 明宏

  耳鼻咽喉科・頭頸部外科 94 (2) 183 - 187 2022/02
• Cystic Intracranial Recurrence of Olfactory Neuroblastoma without Accumulation on Fluorine-18-fluorodeoxyglucose Positron Emission Tomography.

  Yukitomo Ishi, Shigeru Yamaguchi, Kanako C Hatanaka, Emi Takakuwa, Hiroaki Motegi, Taishi Honda, Hiroyuki Kobayashi, Shunsuke Terasaka, Akihiro Homma, Miki Fujimura, Kiyohiro Houkin

  Acta medica Okayama 76 (1) 93 - 98 2022/02 

  A 66-year-old man underwent multimodal treatment for olfactory neuroblastoma (ONB). When he was 72 years old, a cystic intracranial lesion without accumulation on fluorine-18-fluorodeoxyglucose positron emission tomography was detected. Surgical resection was performed when the patient was 73 years old. The pathological examination revealed recurrence of ONB, and the patient underwent focal irradiation. At age 81, he presented with a second recurrence in the right occipital lobe with radiological and pathological findings similar to the prior recurrence. This case suggests that pathological confirmation should be considered in cases with atypical radiological findings following the treatment of ONB.
• Schlafen family member 11 indicates favorable prognosis of patients with head and neck cancer following platinum-based chemoradiotherapy.

  Seijiro Hamada, Satoshi Kano, Junko Murai, Takayoshi Suzuki, Nayuta Tsushima, Takatsugu Mizumachi, Masanobu Suzuki, Tsuyoshi Takashima, Daiki Taniyama, Naoya Sakamoto, Yoichiro Fujioka, Yusuke Ohba, Akihiro Homma

  Frontiers in oncology 12 978875 - 978875 2022 

  Recently, Schlafen family member 11 (SLFN11) has been reported to increase the sensitivity of cancer cells to DNA-damaging agents, including platinum derivatives; thus, SLFN11 may be a predictive biomarker for platinum-based chemoradiotherapy (CRT). In this study, we examined whether SLFN11 expression was associated with the therapeutic outcome of platinum-based CRT in head and neck squamous cell carcinoma (HNSCC). We performed immunohistochemical analyses for SLFN11 expression in 161 HNSCC tissues from patients who had been administered cisplatin-based CRT and examined the correlation between SLFN11 expression and progression-free survival (PFS). Additionally, SLFN11 expression was examined in 10 paired samples obtained before and after CRT in patients with local failure. Furthermore, in vitro experiments were performed using several HNSCC cell lines and isogenic SLFN11-knockout cells to assess the association between SLFN11 expression and drug sensitivity. PFS was found to be significantly better in the SLFN11-positive group than in the SLFN11-negative group among the 161 patients (5-year PFS: 78.8% vs. 52.8%, respectively, p < 0.001). Similar results were observed for the PFS at each primary site. The percentage of SLFN11 positivity was lower in tumor samples from patients with local failure after CRT than that in the corresponding primary tumors before CRT in 8 of 10 cases. Results of the in vitro assay demonstrated that SLFN11-knockout cells exhibited reduced sensitivity to DNA-damaging agents but not to the non-DNA-damaging agent docetaxel. Our findings suggest that SLFN11 may serve as a potential biomarker for predicting the response of HNSCC patients to platinum-based CRT.
• Outcomes of long-term nivolumab and subsequent chemotherapy in Japanese patients with head and neck cancer: 2-year follow-up from a multicenter real-world study.

  Ryuji Yasumatsu, Yasushi Shimizu, Nobuhiro Hanai, Shin Kariya, Tomoya Yokota, Takashi Fujii, Kiyoaki Tsukahara, Mizuo Ando, Kenji Hanyu, Tsutomu Ueda, Hitoshi Hirakawa, Shunji Takahashi, Takeharu Ono, Daisuke Sano, Moriyasu Yamauchi, Akihito Watanabe, Koichi Omori, Tomoko Yamazaki, Nobuya Monden, Naomi Kudo, Makoto Arai, Syuji Yonekura, Takahiro Asakage, Takahiro Nekado, Takayuki Yamada, Akihiro Homma

  International journal of clinical oncology 27 (1) 95 - 104 2022/01 

  BACKGROUND: We have previously reported the effectiveness and safety of nivolumab in patients with head and neck cancer (HNC) in real-world clinical practice in Japan. Here, we report long-term outcomes from this study in the overall population and subgroups stratified by subsequent chemotherapy. METHODS: In this multicenter, retrospective observational study, Japanese patients with recurrent or metastatic (R/M) HNC receiving nivolumab were followed up for 2 years. Effectiveness endpoints included overall survival (OS), OS rate, progression-free survival (PFS), and PFS rate. Safety endpoints included the incidence of immune-related adverse events (irAEs). RESULTS: Overall, 256 patients received a median of 6.0 doses (range: 1-52) of nivolumab over a median duration of 72.5 days (range: 1-736). Median OS was 9.5 months [95% confidence interval (CI) 8.2-12.0] and median PFS was 2.1 months (95% CI 1.8-2.7). A significant difference between 2-year survivors (n = 62) and non-2-year survivors was observed by median age (P = 0.0227) and ECOG PS (P = 0.0001). Of 95 patients who received subsequent chemotherapy, 54.7% received paclitaxel ± cetuximab. The median OS and PFS from the start of paclitaxel ± cetuximab were 6.9 months (95% CI 5.9-11.9) and 3.5 months (95% CI 2.3-5.5), respectively. IrAEs were reported in 17.2% of patients. Endocrine (7.0%) and lung (4.3%) disorders were the most common irAEs; kidney disorder (n = 1) was newly identified in this follow-up analysis. CONCLUSIONS: Results demonstrated the long-term effectiveness of nivolumab and potential effectiveness of subsequent chemotherapy in patients with R/M HNC in the real-world setting. Safety was consistent with that over the 1-year follow-up.
• Clinical Characteristics of Patients and Factors Associated with Switching Biologics in Asthma.

  Machiko Matsumoto-Sasaki, Kaoruko Simizu, Masanobu Suzuki, Masaru Suzuki, Hirokazu Kimura, Yuji Nakamaru, Yoichi M Ito, Akihiro Honma, Satoshi Konno

  Journal of asthma and allergy 15 187 - 195 2022 

  Purpose: Biologics have been used increasingly for the treatment of severe asthma. However, established guidelines for the selection, switching, or discontinuation of biologics do not exist. We aimed to identify the clinical characteristics of patients with asthma who required switching biologics and the factors associated with switching biologics. Patients and Methods: This was a retrospective study of 42 patients with severe asthma treated with biologics at the Hokkaido University Hospital between 23rd June 2016 and 30th April 2021, when two biologics were available in Japan. We compared the characteristics of subjects who continued and switched biologics. The time to switch the biologics was assessed by type 2 inflammatory biomarkers, pulmonary function indices, and the presence of comorbidities, including the Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis (JESREC) score and aspirin exacerbated respiratory diseases (AERD), using the Kaplan-Meier method and a multivariate Cox proportional hazards model. Results: Eight and five patients were treated by mepolizumab and benralizumab at baseline, respectively among the 31% (13/42) who switched the biologics. Subjects who required switching biologics were characterized by high blood eosinophil counts, younger age, JESREC scores of 11 points or higher, and AERD. The time taken to switch biologics was significantly shorter in the subgroups with high JESREC scores (≥11) or AERD, compared with their counterparts with low JESREC scores or without AERD (both, P < 0.05). JESREC scores of ≥11, but not the presence of AERD, were associated with time to switch biologics. Conclusion: The presence of eosinophilic chronic rhinosinusitis based on JESREC scores of ≥11 and younger age were factors associated with switching biologics in asthma.
• Reply to P. Kaul et al.

  Yasuhisa Hasegawa, Kiyoaki Tsukahara, Seiichi Yoshimoto, Kouki Miura, Junkichi Yokoyama, Shigeru Hirano, Hirokazu Uemura, Masashi Sugasawa, Tomokazu Yoshizaki, Akihiro Homma, Kazuaki Chikamatsu, Mikio Suzuki, Akihiro Shiotani, Takashi Matsuzuka, Naoyuki Kohno, Masakazu Miyazaki, Isao Oze, Keitaro Matsuo, Shigeru Kosuda, Yasushi Yatabe

  Journal of clinical oncology : official journal of the American Society of Clinical Oncology 39 (31) 3518 - 3519 2021/11/01
• Phase 3 Randomized Trial of Topical Steroid Versus Placebo for Prevention of Radiation Dermatitis in Patients With Head and Neck Cancer Receiving Chemoradiation.

  Tomoya Yokota, Sadamoto Zenda, Ichiro Ota, Tomoko Yamazaki, Takuhiro Yamaguchi, Takenori Ogawa, Hiroyuki Tachibana, Takashi Toshiyasu, Akihiro Homma, Tempei Miyaji, Tomoe Mashiko, Satoshi Hamauchi, Kuniko Tominaga, Shinobu Ishii, Yui Otani, Noriko Orito, Yosuke Uchitomi

  International journal of radiation oncology, biology, physics 111 (3) 794 - 803 2021/11/01 [Refereed]
   

  PURPOSE: Radiation dermatitis is one of the most common acute toxicities induced by chemoradiation therapy (CRT) for head and neck cancer (HNC). The benefit of topical steroids in the management of radiation dermatitis is still unclear. This phase 3, multi-institutional, randomized, double-blind, placebo-controlled trial evaluated the efficacy and safety of topical steroids for radiation dermatitis in patients with locally advanced HNC receiving CRT. METHODS AND MATERIALS: Eligible patients were scheduled to receive bilateral neck irradiation (≥66 Gy) with concurrent cisplatin (≥200 mg/m2) as definitive or postoperative CRT. Patients were randomly assigned to receive either topical steroid or placebo when grade 1radiation dermatitis was observed or the total radiation dose reached 30 Gy. Basic skin care including gentle washing and moistening in the head and neck region was performed in both groups. The primary endpoint was the frequency of grade ≥2 radiation dermatitis, in accordance with the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0. Grading of radiation dermatitis was performed by independent central review using photographs taken weekly. RESULTS: A total of 211 patients were enrolled (intention to treat: steroid 101 and placebo 102). The frequency of grade ≥2 radiation dermatitis was not significantly reduced with the steroid (73.3%; 95% confidence interval, 64.6%-81.9%) compared with the placebo (80.4%; 95% confidence interval, 72.7%-88.1%; P = .23), whereas the steroid significantly reduced the frequency of grade ≥3 radiation dermatitis (13.9% vs 25.5%; P = .034). No significant differences in adverse events, including local infection or compliance with CRT, were observed between the groups. CONCLUSIONS: Topical steroid may reduce the severity of radiation dermatitis in patients with HNC and thus may become an important therapeutic tool in the management of radiation dermatitis.
• Remote Training of Functional Endoscopic Sinus Surgery With Advanced Manufactured 3D Sinus Models and a Telemedicine System

  Masanobu Suzuki, Erich Vyskocil, Kazuhiro Ogi, Kotaro Matoba, Yuji Nakamaru, Akihiro Homma, Peter J. Wormald, Alkis J. Psaltis

  Frontiers in Surgery 8 2021/10/01 

  Objective: Traditionally, cadaveric courses have been an important tool in surgical education for Functional Endoscopic Sinus Surgery (FESS). The recent COVID-19 pandemic, however, has had a significant global impact on such courses due to its travel restrictions, social distancing regulations, and infection risk. Here, we report the world-first remote (Functional Endoscopic Sinus Surgery) FESS training course between Japan and Australia, utilizing novel 3D-printed sinus models. We examined the feasibility and educational effect of the course conducted entirely remotely with encrypted telemedicine software. Methods: Three otolaryngologists in Hokkaido, Japan, were trained to perform frontal sinus dissections on novel 3D sinus models of increasing difficulty, by two rhinologists located in Adelaide, South Australia. The advanced manufactured sinus models were 3D printed from the Computed tomography (CT) scans of patients with chronic rhinosinusitis. Using Zoom and the Quintree telemedicine platform, the surgeons in Adelaide first lectured the Japanese surgeons on the Building Block Concept for a three Dimensional understanding of the frontal recess. They in real time directly supervised the surgeons as they planned and then performed the frontal sinus dissections. The Japanese surgeons were asked to complete a questionnaire pertaining to their experience and the time taken to perform the frontal dissection was recorded. The course was streamed to over 200 otolaryngologists worldwide. Results: All dissectors completed five frontal sinusotomies. The time to identify the frontal sinus drainage pathway (FSDP) significantly reduced from 1,292 ± 672 to 321 ± 267 s (p = 0.02), despite an increase in the difficulty of the frontal recess anatomy. Image analysis revealed the volume of FSDP was improved (2.36 ± 0.00 to 9.70 ± 1.49 ml, p = 0.014). Questionnaires showed the course's general benefit was 95.47 ± 5.13 in dissectors and 89.24 ± 15.75 in audiences. Conclusion: The combination of telemedicine software, web-conferencing technology, standardized 3D sinus models, and expert supervision, provides excellent training outcomes for surgeons in circumstances when classical surgical workshops cannot be realized.
• Metallothionein-3 is a clinical biomarker for tissue zinc levels in nasal mucosa.

  Masanobu Suzuki, Mahnaz Ramezanpour, Clare Cooksley, Kazuhiro Ogi, Alkis J Psaltis, Yuji Nakamaru, Akihiro Homma, Peter-John Wormald, Sarah Vreugde

  Auris, nasus, larynx 48 (5) 890 - 897 2021/10 [Refereed]
   

  OBJECTIVE: Recently, depleted tissue zinc levels were found in nasal mucosa from patients with chronic rhinosinusitis (CRS) in correlation with tissue eosinophilia, however, no clinical biomarkers for tissue zinc levels have been identified. Metallothionein-3 (MT3) is an intracellular zinc chelator and previous data showed MT3 mRNA levels to be reduced in CRS patients with nasal polyps (CRSwNP). In this study, we examined the correlation between MT3 expression and zinc levels in nasal mucosa and primary human nasal epithelial cells (HNECs) to investigate whether MT3 could be a clinical biomarker for tissue zinc levels. METHOD: Tissue was harvested from 36 patients and mounted on tissue micro-array (TMA) slides. MT3 expression and tissue zinc fluorescence intensity were measured at different areas within the mucosa (surface epithelium and lamina propria) and compared between controls, CRSwNP and CRS without nasal polyps (CRSsNP) patients. MT3 mRNA and protein expression were examined in zinc-depleted HNECs by qPCR and immunofluorescence microscopy. RESULTS: MT3 expression in CRSwNP was significantly decreased in both surface epithelium (p<0.001 to controls) and lamina propria (p = 0.0491 to controls). There was a significant positive correlation between tissue zinc levels and MT3 expression in nasal mucosa (r = 0.45, p = 0.007). In zinc-deplete HNECs, MT3 expression was significantly decreased at mRNA (p = 0.02) and protein level (p<0.01). There was a significant positive correlation between tissue zinc levels and MT3 expression within individual HNECs (r = 0.59, p<0.001). CONCLUSIONS: MT3 expression reflects intramucosal zinc levels in both nasal mucosa and HNECs indicating MT3 could be used as a clinical biomarker for monitoring intracellular zinc levels in the nasal mucosa.
• Notch Signaling in Acquired Middle Ear Cholesteatoma.

  Atsushi Fukuda, Satoshi Kano, Yuji Nakamaru, Shinya Morita, Kimiko Hoshino, Keishi Fujiwara, Akihiro Homma

  Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 42 (9) e1389-e1395  2021/10/01 [Refereed]
   

  HYPOTHESIS: We hypothesized that an anomalous change of Notch signaling might be involved in the pathophysiology of cholesteatoma. BACKGROUND: The Notch signaling pathway regulates integrated growth and differentiation control of keratinocytes. Its involvement in cholesteatoma proliferation has not been elucidated. METHODS: We obtained cholesteatoma and external auditory canal (EAC) skin samples from patients with middle ear cholesteatoma who underwent tympanomastoid surgery. We performed polymerase chain reaction using the RT2 Profiler™ PCR Array Human Notch Signaling Pathway (Qiagen) in the cholesteatoma and EAC skin samples (n = 6 each). This was followed by immunohistochemical staining of Notch1, enhancer of split-1 (HES1), and p53 in 41 and 8 cholesteatoma and EAC skin samples, respectively. RESULTS: The fold change of Notch1 gene expression was lowest in cholesteatoma, with a statistically significant difference (p = 0.0424). Moreover, the fold change of HES1 expression decreased (p = 0.272). The positive rates of Notch1 and HES1 protein expressions in the cholesteatoma (48.5 ± 32.4% and 44.9 ± 17.8%, respectively) were significantly lower than in the EAC skin (83.4 ± 17.5% and 55.7 ± 7.1%, respectively) (p < 0.001 and p < 0.01). In contrast, the positive rate of p53 expression in the cholesteatoma (8.5 ± 11.4%) was significantly higher than in the EAC skin (0.5 ± 0.7%) (p < 0.001). CONCLUSION: The decreases in Notch1 and HES1 protein expression might play an important role in the hyperproliferative character of the keratinizing squamous epithelium in cholesteatoma. An increase in p53 might reflect the reaction to cellular hyperproliferation.
• Sites of invasion of cancer of the external auditory canal predicting oncologic outcomes.

  Kiyoto Shiga, Ken-Ichi Nibu, Yasushi Fujimoto, Takahiro Asakage, Akihiro Homma, Hiroki Mitani, Takenori Ogawa, Kenji Okami, Shigeyuki Murono, Shigeru Hirano, Tsutomu Ueda, Nobuhiro Hanai, Kiyoaki Tsukahara, Ichiro Ota, Seiichi Yoshimoto, Takeshi Shinozaki, Shigemichi Iwae, Katsunori Katagiri, Daisuke Saito, Naomi Kiyota, Makoto Tahara, Fumiaki Takahashi, Ryuichi Hayashi

  Head & neck 43 (10) 3097 - 3105 2021/10 [Refereed]
   

  BACKGROUND: This study aimed to reveal the influence of the invasion site of external auditory canal (EAC) cancer by analyzing the outcome of patients with advanced tumor. METHODS: A total of 111 patients with T4 EAC cancer were enrolled in this study. Of these patients, 79 underwent chemoradiotherapy and 32 underwent surgery under curative intent. Univariate and multivariate analyses and the Kaplan-Meier method were used to focus on the tumor invasion sites and overall survival of the patients. RESULTS: The 3-year overall survival rate of all patients was 55.0%. In multivariate analysis, the only significant invasion site for overall survival was the facial nerve, with the dura mater being the next most influential site. When Kaplan-Meier survival curve was calculated, facial nerve and dura mater were the significant factors resulting in poor patient outcomes. CONCLUSION: The facial nerve and dura mater are crucial sites of EAC cancer for patient outcomes.
• 鼻中隔前彎の客観的評価と適切な鼻中隔矯正術の術式選択

  木村 将吾, 中丸 裕爾, 鈴木 正宣, 本間 あや, 中薗 彬, 本間 明宏

  日本鼻科学会会誌 (一社)日本鼻科学会 60 (3) 312 - 312 0910-9153 2021/09
• 鼻粘膜上皮細胞におけるTLR3依存性自然免疫シグナル

  鈴木 正宣, 中丸 裕爾, 中薗 彬, 本間 あや, 木村 将吾, Sarah Vreugde, Wormald PJ, 本間 明宏

  日本鼻科学会会誌 (一社)日本鼻科学会 60 (3) 352 - 352 0910-9153 2021/09
• Prediction of the local treatment outcome in patients with oropharyngeal squamous cell carcinoma using deep learning analysis of pretreatment FDG-PET images.

  Noriyuki Fujima, V Carlota Andreu-Arasa, Sara K Meibom, Gustavo A Mercier, Minh Tam Truong, Kenji Hirata, Koichi Yasuda, Satoshi Kano, Akihiro Homma, Kohsuke Kudo, Osamu Sakai

  BMC cancer 21 (1) 900 - 900 2021/08/06 [Refereed]
   

  BACKGROUND: This study aimed to assess the utility of deep learning analysis using pretreatment FDG-PET images to predict local treatment outcome in oropharyngeal squamous cell carcinoma (OPSCC) patients. METHODS: One hundred fifty-four OPSCC patients who received pretreatment FDG-PET were included and divided into training (n = 102) and test (n = 52) sets. The diagnosis of local failure and local progression-free survival (PFS) rates were obtained from patient medical records. In deep learning analyses, axial and coronal images were assessed by three different architectures (AlexNet, GoogLeNET, and ResNet). In the training set, FDG-PET images were analyzed after the data augmentation process for the diagnostic model creation. A multivariate clinical model was also created using a binomial logistic regression model from a patient's clinical characteristics. The test data set was subsequently analyzed for confirmation of diagnostic accuracy. Assessment of local PFS rates was also performed. RESULTS: Training sessions were successfully performed with an accuracy of 74-89%. ROC curve analyses revealed an AUC of 0.61-0.85 by the deep learning model in the test set, whereas it was 0.62 by T-stage, 0.59 by clinical stage, and 0.74 by a multivariate clinical model. The highest AUC (0.85) was obtained with deep learning analysis of ResNet architecture. Cox proportional hazards regression analysis revealed deep learning-based classification by a multivariate clinical model (P < .05), and ResNet (P < .001) was a significant predictor of the treatment outcome. In the Kaplan-Meier analysis, the deep learning-based classification divided the patient's local PFS rate better than the T-stage, clinical stage, and a multivariate clinical model. CONCLUSIONS: Deep learning-based diagnostic model with FDG-PET images indicated its possibility to predict local treatment outcomes in OPSCCs.
• Characteristics of and Prognosis for Facial Palsy in Patients With Otitis Media With ANCA-Associated Vasculitis (OMAAV).

  Keishi Fujiwara, Shinya Morita, Atsushi Fukuda, Hiroko Yanagi, Kimiko Hoshino, Yuji Nakamaru, Yasushi Furuta, Akihiro Homma

  Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 42 (10) e1577-e1582  2021/08/04 [Refereed]
   

  OBJECTIVES: The aim of the present study was to investigate the characteristics and prognosis of facial palsy in patients with otitis media with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (OMAAV). STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: Thirty-seven patients with OMAAV. MAIN OUTCOME MEASURES: The patients were divided into the facial palsy group and non-palsy group. The severity of and prognosis for facial palsy were evaluated using the House-Brackmann facial grading system (HB). Characteristics were compared between the facial palsy group and non-palsy group. RESULTS: Facial palsy was observed in eight patients. The last HB grade for all patients was either grade I or II after treatment with a combination of corticosteroids and immunosuppressant therapy. There were no cases in which palsy relapsed. Facial palsy in OMAAV was significantly more common in female patients, and patients with facial palsy demonstrated significantly higher rates of hypertrophic pachymeningitis than did those without facial palsy. CONCLUSIONS: Facial palsy in patients with OMAAV was detected in 21.6% and a good prognosis was obtained by use of the appropriate treatment. Facial palsy is one of the most important symptoms by which to diagnose OMAAV. When encountering the patients with intractable otitis media complicated with facial palsy, appropriate examination including ANCA titer should be performed.
• Predictors of the need for prophylactic percutaneous endoscopic gastrostomy in head and neck cancer patients treated with concurrent chemoradiotherapy.

  Satoshi Kano, Nayuta Tsushima, Takayoshi Suzuki, Seijiro Hamada, Taizo Yokokawa, Hiroshi Idogawa, Koichi Yasuda, Hideki Minatogawa, Yasuhiro Dekura, Hidefumi Aoyama, Akihiro Homma

  International journal of clinical oncology 26 (7) 1179 - 1187 2021/07 [Refereed]
   

  BACKGROUND: We investigated whether prophylactic percutaneous endoscopic gastrostomy (PEG) is used effectively for patients treated with definitive concurrent chemoradiotherapy (CCRT) and the predictors of the need for PEG. METHODS: 326 patients with laryngeal, oropharyngeal or hypopharyngeal cancers were retrospectively reviewed. RESULTS: The PEG tube use group had more favorable results than the total parenteral nutrition and nasogastric tube groups in terms of rate of serum albumin loss, incidence of severe fever and aspiration pneumonia, CCRT completion rate and hospitalization period. However, it was inferior to oral intake. Analysis of the relative risk of requiring enteral or parenteral nutrition revealed that performance status (PS) 2, primary site (supraglottis, oropharynx, or hypopharynx), N3 disease, and cisplatin were predictors of the need for nutritional support. CONCLUSIONS: Prophylactic PEG is effective for patients treated with definitive CCRT and is especially required for patients with PS2 or oropharyngeal cancer.
• Neck Dissections Based on Sentinel Lymph Node Navigation Versus Elective Neck Dissections in Early Oral Cancers: A Randomized, Multicenter, and Noninferiority Trial.

  Yasuhisa Hasegawa, Kiyoaki Tsukahara, Seiichi Yoshimoto, Kouki Miura, Junkichi Yokoyama, Shigeru Hirano, Hirokazu Uemura, Masashi Sugasawa, Tomokazu Yoshizaki, Akihiro Homma, Kazuaki Chikamatsu, Mikio Suzuki, Akihiro Shiotani, Takashi Matsuzuka, Naoyuki Kohno, Masakazu Miyazaki, Isao Oze, Keitaro Matsuo, Shigeru Kosuda, Yasushi Yatabe

  Journal of clinical oncology : official journal of the American Society of Clinical Oncology 39 (18) 2025 - 2036 2021/06/20 [Refereed]
   

  PURPOSE: This study aimed to compare patients with early oral cavity squamous cell carcinoma (OCSCC) (tumor category [T] 1-2, node-negative, and no distant metastasis) treated with traditional elective neck dissection (ND) with those managed by sentinel lymph node biopsy (SLNB) using survival and neck function and complications as end points. METHODS: Sixteen institutions in Japan participated in the study (trial registration number: UMIN000006510). Patients of age ≥ 18 years with histologically confirmed, previously untreated OCSCC (Union for International Cancer Control TNM Classification of Malignant Tumors 7th edition T1-2, node-negative no distant metastasis), with ≥ 4 mm (T1) depth of invasion, were randomly assigned to undergo standard selective ND (ND group; n = 137) or SLNB-navigated ND (SLNB group; n = 134). The primary end point was the 3-year overall survival rate, with a 12% noninferiority margin; secondary end points included postoperative neck functionality and complications and 3-year disease-free survival. Sentinel lymph nodes underwent intraoperative multislice frozen section analyses for the diagnosis. Patients with positive sentinel lymph nodes underwent either one-stage or second-look ND. RESULTS: Pathologic metastasis-positive nodes were observed in 24.8% (34 of 137) and 33.6% (46 of 134) of patients in the ND and SLNB groups, respectively (P = .190). The 3-year overall survival in the SLNB group (87.9%; lower limit of one-sided 95% CI, 82.4) was noninferior to that in the ND group (86.6%; lower limit 95% CI, 80.9; P for noninferiority < .001). The 3-year disease-free survival rate was 78.7% (lower limit 95% CI, 72.1) and 81.3% (75.0) in the SLNB and ND groups, respectively (P for noninferiority < .001). The scores of neck functionality in the SLNB group were significantly better than those in the ND group. CONCLUSION: SLNB-navigated ND may replace elective ND without a survival disadvantage and reduce postoperative neck disability in patients with early-stage OCSCC.
• 【上部消化管手術におけるトラブルシューティング-困難症例・偶発症への対策】頸部食道癌術後の永久気管孔の合併症予防とトラブルシューティング

  七戸 俊明, 村上 壮一, 倉島 庸, 海老原 裕磨, 平野 聡, 本間 明宏

  手術 金原出版(株) 75 (7) 1147 - 1152 0037-4423 2021/06
• 当科で経験した頭蓋底骨髄炎の1例

  佐藤 禄, 福田 篤, 藤原 圭志, 本間 明宏

  耳鼻咽喉科臨床 補冊 耳鼻咽喉科臨床学会 (補冊157) 58 - 58 0912-1870 2021/06
• 当科におけるアブミ骨手術症例の検討

  小林 諒, 福田 篤, 藤原 圭志, 中丸 裕爾, 本間 明宏

  耳鼻咽喉科臨床 補冊 耳鼻咽喉科臨床学会 (補冊157) 65 - 65 0912-1870 2021/06
• Management of tracheostomy in COVID-19 patients: The Japanese experience.

  Taizo Yokokawa, Yosuke Ariizumi, Mariko Hiramatsu, Yujin Kato, Kazuhira Endo, Kazufumi Obata, Kayoko Kawashima, Toshifumi Sakata, Shigeru Hirano, Torahiko Nakashima, Tatsurou Sekine, Asanori Kiyuna, Saeko Uemura, Keisuke Okubo, Taro Sugimoto, Ichiro Tateya, Yasushi Fujimoto, Arata Horii, Yurika Kimura, Masamitsu Hyodo, Akihiro Homma

  Auris, nasus, larynx 48 (3) 525 - 529 2021/06 [Refereed]
   

  OBJECTIVE: Involvement in the tracheostomy procedure for COVID-19 patients can lead to a feeling of fear in medical staff. To address concerns over infection, we gathered and analyzed experiences with tracheostomy in the COVID-19 patient population from all over Japan. METHODS: The data for health-care workers involved in tracheostomies for COVID-19-infected patients were gathered from academic medical centers or their affiliated hospitals from all over Japan. RESULTS: Tracheostomies have been performed in 35 COVID-19 patients with a total of 91 surgeons, 49 anesthesiologists, and 49 surgical staff members involved. Twenty-eight (80%) patients underwent surgery more than 22 days after the development of COVID-19-related symptoms (11: 22-28 days and 17: ≥29 days). Thirty (85.7%) patients underwent surgery ≥ 15 days after intubation (14: 15-21 days, 6: 22-28 days, and 10: ≥29 days). Among the total of 189 health-care workers involved in the tracheostomy procedures, 25 used a powered air-purifying respirator (PAPR) and 164 used a N95 mask and eye protection. As a result, no transmission to staff occurred during the 2 weeks of follow-up after surgery. CONCLUSION: No one involved in tracheostomy procedures were found to have been infected with COVID-19 in this Japanese study. The reason is thought to be that the timing of the surgery was quite late after the infections, and the surgery was performed using appropriate PPE and surgical procedure. The indications for and timing of tracheostomy for severe COVID-19 patients should be decided through multidisciplinary discussion.
• Effectiveness of nivolumab affected by prior cetuximab use and neck dissection in Japanese patients with recurrent or metastatic head and neck cancer: results from a retrospective observational study in a real-world setting.

  Shin Kariya, Yasushi Shimizu, Nobuhiro Hanai, Ryuji Yasumatsu, Tomoya Yokota, Takashi Fujii, Kiyoaki Tsukahara, Masafumi Yoshida, Kenji Hanyu, Tsutomu Ueda, Hitoshi Hirakawa, Shunji Takahashi, Takeharu Ono, Daisuke Sano, Moriyasu Yamauchi, Akihito Watanabe, Koichi Omori, Tomoko Yamazaki, Nobuya Monden, Naomi Kudo, Makoto Arai, Shuji Yonekura, Takahiro Asakage, Akinori Fujiwara, Takayuki Yamada, Akihiro Homma

  International journal of clinical oncology 26 (6) 1049 - 1056 2021/06 

  BACKGROUND: To examine the effect of prior use of cetuximab and neck dissection on the effectiveness of nivolumab, we conducted a large-scale subgroup analysis in Japanese patients with recurrent/metastatic head and neck cancer. METHODS: Data on the effectiveness of nivolumab were extracted from patient medical records. All patients were analyzed for effectiveness by prior cetuximab use. In the analyses for prior neck dissection, only patients with locally advanced disease were included. RESULTS: Of 256 patients analyzed, 155 had received prior cetuximab. Nineteen of 50 patients with local recurrence underwent neck dissection. The objective response rate was 14.7 vs 17.2% (p = 0.6116), median progression-free survival was 2.0 vs 3.1 months (p = 0.0261), and median overall survival was 8.4 vs 12 months (p = 0.0548) with vs without prior cetuximab use, respectively. The objective response rate was 23.1 vs 25.9% (p = 0.8455), median progression-free survival was 1.8 vs 3.0 months (p = 0.6650), and median overall survival was 9.1 vs 9.9 months (p = 0.5289) with vs without neck dissection, respectively. CONCLUSIONS: These findings support the use of nivolumab for patients with recurrent/metastatic head and neck cancer regardless of prior cetuximab use or neck dissection history. TRIAL REGISTRATION NUMBER: UMIN-CTR (UMIN000032600), Clinicaltrials.gov (NCT03569436).
• Standardization for oncologic head and neck surgery.

  Ohad Ronen, K Thomas Robbins, Remco de Bree, Orlando Guntinas-Lichius, Dana M Hartl, Akihiro Homma, Avi Khafif, Luiz P Kowalski, Fernando López, Antti A Mäkitie, Wai Tong Ng, Alessandra Rinaldo, Juan P Rodrigo, Alvaro Sanabria, Alfio Ferlito

  European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery 2021/05/12 [Refereed]
   

  The inherent variability in performing specific surgical procedures for head and neck cancer remains a barrier for accurately assessing treatment outcomes, particularly in clinical trials. While non-surgical modalities for cancer therapeutics have evolved to become far more uniform, there remains the challenge to standardize surgery. The purpose of this review is to identify the barriers in achieving uniformity and to highlight efforts by surgical groups to standardize selected operations and nomenclature. While further improvements in standardization will remain a challenge, we must encourage surgical groups to focus on strategies that provide such a level.
• Objective evaluation of caudal deviation of the nasal septum and selection of the appropriate septoplasty technique.

  Shogo Kimura, Masanobu Suzuki, Aya Honma, Akira Nakazono, Masayuki Osawa, Yuji Nakamaru, Akihiro Homma

  Auris, nasus, larynx 49 (1) 67 - 76 2021/05/06 [Refereed]
   

  OBJECTIVE: Several methods have been reported to correct caudal deviation of the nasal septum, including open septorhinoplasty (OSR) and septoplasty with Killian incision (KI). In general, OSR is applied instead of KI for caudal deviation. However, there is little objective evidence own on the effects of OSR and KI for caudal deviation. In this study, we compared surgical outcomes between OSR and KI by quantifying nasal septum deviation using two simple and objective parameters on routine paranasal sinus CT scans. METHODS: We retrospectively analyzed 18 patients who underwent OSR and 11 patients who underwent septoplasty with KI between April 2006 and October 2019. Caudal deviation was defined on the basis of the "Anterior-posterior Position of the most deviated point of the nasal septum (AP)," which was measured on computerized tomography. The deformation rate (DR) of the nasal septum was also calculated. Nasal airway resistance and visual analogue scale (VAS) score for nasal obstruction were examined. RESULTS: The AP was significantly correlated with the VAS score (r=-0.58, p=0.017). The DR in patients with caudal septal deviation was significantly decreased by OSR (0.14±0.06 to 0.03±0.03, p=0.004), but not by KI (0.09±0.08 to 0.04±0.03, p=0.25). OSR also improved nasal airway resistance (1.10±0.44 to 0.42±0.15, p=0.02), and the VAS score (79.11±14.74 to 5.78±7.89, p=0.004). CONCLUSION: Nasal obstruction is more severe in patients with the caudal deviation. OSR corrects caudal deviation of the nasal septum more effectively than does KI. The AP could be useful for the evaluation of the deviation of the nasal septum and help in selecting the appropriate septoplastic technique.
• Psychological evaluation for patients with non-cured facial nerve palsy.

  Keishi Fujiwara, Atsushi Fukuda, Shinya Morita, Hiroko Yanagi, Kimiko Hoshino, Yuji Nakamaru, Yasushi Furuta, Akihiro Homma

  Auris, nasus, larynx 49 (1) 53 - 57 2021/05/04 [Refereed]
   

  OBJECTIVE: The aim of the present study was to evaluate the psychological condition of patients with non-cured facial nerve palsy and to investigate whether their psychological condition is correlated with the degree of facial nerve palsy, synkinesis or quality of life. METHODS: Thirty patients with non-cured facial nerve palsy were enrolled in this study. Psychological conditions were evaluated by questionnaires including State-Trait Anxiety Inventory and Self-rating Depression Scale. RESULTS: Of the thirty patients with non-cured facial nerve palsy, 17 (56.7%) and 15 patients (50.0%) felt anxiety and depression, respectively. Although there were no significant correlations between their psychological condition and the degree of facial nerve palsy or that of sequelae, significant correlations were observed between psychological condition and the degree of QOL, especially in terms of social function. CONCLUSIONS AND SIGNIFICANCE: Disabilities associated with facial nerve palsy may be overlooked when evaluation is performed by physician-graded instruments alone. To resolve this problem, patients with non-cured facial nerve palsy should be evaluated by not only physician-graded tools but also patient-based assessment tools.
• 早期舌癌治療のパラダイムシフトへ向けて-医科歯科病理の知の融合- Stage I/II舌癌に対する予防的頸部郭清省略の意義を検証するランダム化比較第III相試験(JCOG1601) RESPOND

  花井 信広, 朝蔭 孝宏, 本間 明宏, 林 隆一, 福島 啓文, 佐野 大佑, 向川 卓志, 上田 勉, 門田 伸也

  頭頸部癌 (一社)日本頭頸部癌学会 47 (2) 140 - 140 1349-5747 2021/05
• 鼻腔粘膜上皮細胞における新型コロナウィルス細胞侵入因子の発現制御機構

  中薗 彬, 鈴木 正宣, 木村 将吾, 本間 あや, 中丸 裕爾, Ramezanpour Mahnaz, Vreugde Sarah, Wormald P.J., 本間 明宏

  日本耳鼻咽喉科免疫アレルギー感染症学会抄録集 日本耳鼻咽喉科免疫アレルギー感染症学会 1回 127 - 127 2021/05
• 咽喉頭扁平上皮癌IMRTの照射中における線量分布変化に関する解析

  安田 耕一, 打浪 雄介, 湊川 英樹, 小泉 富基, 大塚 愛美, 藤田 祥博, 井戸川 寛志, 鈴木 崇祥, 対馬 那由多, 加納 里志, 本間 明宏

  頭頸部癌 (一社)日本頭頸部癌学会 47 (2) 210 - 210 1349-5747 2021/05
• CCRTを施行した頭頸部癌患者に対する予防的胃瘻増設の有用性の検討

  加納 里志, 対馬 那由多, 鈴木 崇祥, 井戸川 寛志, 浜田 誠二郎, 横川 泰三, 安田 耕一, 湊川 英樹, 打浪 雄介, 本間 明宏

  頭頸部癌 (一社)日本頭頸部癌学会 47 (2) 211 - 211 1349-5747 2021/05
• Correction to: Effectiveness and safety of nivolumab in patients with head and neck cancer in Japanese real‑world clinical practice: a multicentre retrospective clinical study.

  Nobuhiro Hanai, Yasushi Shimizu, Shin Kariya, Ryuji Yasumatsu, Tomoya Yokota, Takashi Fujii, Kiyoaki Tsukahara, Masafumi Yoshida, Kenji Hanyu, Tsutomu Ueda, Hitoshi Hirakawa, Shunji Takahashi, Takeharu Ono, Daisuke Sano, Moriyasu Yamauchi, Akihito Watanabe, Koichi Omori, Tomoko Yamazaki, Nobuya Monden, Naomi Kudo, Makoto Arai, Daiju Sakurai, Takahiro Asakage, Issei Doi, Takayuki Yamada, Akihiro Homma

  International journal of clinical oncology 26 (5) 1005 - 1006 2021/05
• Salvage surgery improves the treatment outcome of patients with residual/recurrent maxillary sinus cancer after superselective intra-arterial cisplatin infusion with concomitant radiation therapy.

  Nayuta Tsushima, Satoshi Kano, Takayoshi Suzuki, Hiroshi Idogawa, Daisuke Yoshida, Koichi Yasuda, Manami Otsuka, Hidefumi Aoyama, Akihiro Homma

  European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery 279 (2) 899 - 905 2021/04/18 [Refereed]
   

  PURPOSE: We have performed superselective intra-arterial cisplatin infusion with concomitant radiotherapy (RADPLAT) for patients with maxillary sinus cancer. The promising treatment outcomes of this non-surgical treatment were reported in past studies. However, few clinical studies have been conducted to evaluate the outcome of salvage surgery following RADPLAT. The purpose of this study was to analyze the treatment outcomes of salvage surgery for patients with recurrent maxillary sinus cancer after RADPLAT. METHODS: We assessed 45 patients who had recurrence following RADPLAT between 1999 and 2017, and conducted a retrospective analysis. We excluded patients who did not complete RADPLAT. Patients were not considered to have completed RADPLAT if they underwent intra-arterial cisplatin less than three times or received a total radiation dose of less than 60 Gy. The primary endpoint was overall survival. The median follow-up period for surviving patients after recurrence was 5.1 years. RESULTS: Twenty-five of the 45 (56%) patients underwent salvage surgery. The 5-year overall survival rate was 68% in patients who underwent salvage surgery, while all patients who did not undergo salvage surgery died during the observation period. Fifteen of 24 (63%) patients with local recurrence underwent salvage surgery. Eight patients did not undergo salvage surgery because of unresectable disease; five of the eight patients had unresectable posterior extension. All nine patients with nodal recurrence underwent neck dissection. CONCLUSION: Treatment outcomes of salvage surgery following RADPLAT were favorable enough for it to be generally recommended. To reduce unresectable recurrence, the posterior section should be eradicated by RADPLAT.
• Usefulness of the Video Head Impulse Test for the Evaluation of Vestibular Function in Patients With Otitis Media With Antineutrophil Cytoplasmic Antibody-Associated Vasculitis.

  Keishi Fujiwara, Shinya Morita, Atsushi Fukuda, Hiroko Yanagi, Kimiko Hoshino, Yuji Nakamaru, Akihiro Homma

  Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 42 (4) e483-e488  2021/04/01 

  OBJECTIVES: To investigate usefulness of the video Head Impulse Test (vHIT) as a method for evaluating semicircular canal function in patients with otitis media with antineutrophil cytoplasmic antibody-associated vasculitis (OMAAV). STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: Fourteen patients with OMAAV underwent vestibular examination. MAIN OUTCOME MEASURES: The gain in vestibulo-ocular reflex (VOR) and the presence of catch-up saccade were examined for each semicircular canal. RESULTS: Seven (50.0%) of the 14 patients felt subjective symptoms of disequilibrium. Dysfunction in at least one semicircular canal was detected in all ears of the OMAAV patients evaluated by vHIT. Dysfunction in posterior semicircular canal was detected more frequently than that in the anterior or horizontal canal. There were no significant correlations between the gain in VOR and hearing loss. CONCLUSIONS: vHIT is thought to be the most suitable method for evaluating semicircular canal function in patients with OMAAV as vHIT is not influenced by middle ear pathology and was able to evaluate vertical canal function including the posterior canal.
• 新型コロナウイルス感染症患者に対する気管切開術 医療者感染リスクの全国調査

  有泉 陽介, 平松 真理子, 本間 明宏, 加藤 雄仁, 遠藤 一平, 小幡 和史, 川島 佳代子, 藤本 保志, 堀井 新, 木村 百合香, 兵頭 政光

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科頭頸部外科学会 124 (4) 559 - 559 0030-6622 2021/04
• 新型コロナウイルス感染症患者に対する気管切開術 医療者感染リスクの全国調査

  有泉 陽介, 平松 真理子, 本間 明宏, 加藤 雄仁, 遠藤 一平, 小幡 和史, 川島 佳代子, 藤本 保志, 堀井 新, 木村 百合香, 兵頭 政光

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 124 (4) 559 - 559 0030-6622 2021/04
• Role of intracellular zinc in molecular and cellular function in allergic inflammatory diseases.

  Masanobu Suzuki, Takayoshi Suzuki, Masashi Watanabe, Shigetsugu Hatakeyama, Shogo Kimura, Akira Nakazono, Aya Honma, Yuji Nakamaru, Sarah Vreugde, Akihiro Homma

  Allergology international : official journal of the Japanese Society of Allergology 70 (2) 190 - 200 2021/04 

  Zinc is an essential micronutrient in human body and a vital cofactor for the function of numerous proteins encoded by the human genome. Zinc has a critical role in maintaining many biochemical and physiological processes at the molecular, cellular, and multiple organ and systemic levels. The alteration of zinc homeostasis causes dysfunction of many organs and systems. In the immune system, zinc regulates the differentiation, proliferation and function of inflammatory cells, including T cells, eosinophils, and B cells, by modifying several signaling pathways such as NFκB signaling pathways and TCR signals. An adequate zinc level is essential for proper immune responses and decreased zinc levels were reported in many allergic inflammatory diseases, including atopic dermatitis, bronchial asthma, and chronic rhinosinusitis. Decreased zinc levels often enhance inflammatory activation. On the other hand, the inflammatory conditions alter the intracellular homeostasis of zinc, often decreasing zinc levels. These findings implied that there could be a vicious cycle between zinc deficiency and inflammatory conditions. In this review, we present recent evidence on the involvement of zinc in atopic dermatitis, bronchial asthma, and chronic rhinosinusitis, with insights into the involvement of zinc in the underlying molecular and cellular mechanisms related to these allergic inflammatory diseases.
• Analysis of acute-phase toxicities of intensity-modulated proton therapy using a model-based approach in pharyngeal cancer patients.

  Koichi Yasuda, Hideki Minatogawa, Yasuhiro Dekura, Seishin Takao, Masaya Tamura, Nayuta Tsushima, Takayoshi Suzuki, Satoshi Kano, Takatsugu Mizumachi, Takashi Mori, Kentaro Nishioka, Motoyasu Shido, Norio Katoh, Hiroshi Taguchi, Noriyuki Fujima, Rikiya Onimaru, Isao Yokota, Keiji Kobashi, Shinichi Shimizu, Akihiro Homma, Hiroki Shirato, Hidefumi Aoyama

  Journal of radiation research 62 (2) 329 - 337 2021/03/10 

  Pharyngeal cancer patients treated with intensity-modulated proton therapy (IMPT) using a model-based approach were retrospectively reviewed, and acute toxicities were analyzed. From June 2016 to March 2019, 15 pharyngeal (7 naso-, 5 oro- and 3 hypo-pharyngeal) cancer patients received IMPT with robust optimization. Simulation plans for IMPT and intensity-modulated X-ray therapy (IMXT) were generated before treatment. We also reviewed 127 pharyngeal cancer patients with IMXT in the same treatment period. In the simulation planning comparison, all of the normal-tissue complication probability values for dysphagia, dysgeusia, tube-feeding dependence and xerostomia were lower for IMPT than for IMXT in the 15 patients. After completing IMPT, 13 patients completed the evaluation, and 12 of these patients had a complete response. The proportions of patients who experienced grade 2 or worse acute toxicities in the IMPT and IMXT cohorts were 21.4 and 56.5% for dysphagia (P < 0.05), 46.7 and 76.3% for dysgeusia (P < 0.05), 73.3 and 62.8% for xerostomia (P = 0.43), 73.3 and 90.6% for mucositis (P = 0.08) and 66.7 and 76.4% for dermatitis (P = 0.42), respectively. Multivariate analysis revealed that IMPT was independently associated with a lower rate of grade 2 or worse dysphagia and dysgeusia. After propensity score matching, 12 pairs of IMPT and IMXT patients were selected. Dysphagia was also statistically lower in IMPT than in IMXT (P < 0.05). IMPT using a model-based approach may have clinical benefits for acute dysphagia.
• 顔面神経麻痺非治癒例の不安・うつ状態の評価

  藤原 圭志, 古田 康, 本間 明宏

  Facial Nerve Research 日本顔面神経学会 40 127 - 129 0914-790X 2021/03 

  当院に通院している顔面神経麻痺患者のうち、発症後1年以上が経過した時点でSunnybrook法の複合スコアが99点以下の非治癒例30例を対象とし、不安・うつ状態の評価をSTAIとSDSで行い、麻痺・後遺症の程度やQOLとの関連について検討した。麻痺の程度の指標はSunnybrook複合スコアとし、後遺症の程度の指標はSunnybrook病的共同運動スコアとした。QOLの評価にはFaCEスケールを用いた。検討の結果、STAI・SDSと複合スコアとの間に有意な相関は認められず、STAI・SDSと病的共同運動スコアとの間にも有意な相関は認められなかった。STAI・SDSとFaCEスケール合計点との間にも有意な相関は認められなかったが、FaCEスケールの「社会活動スコア」とSTAI・SDSとの間に有意な負の相関が認められた。
• VZV再活性化例における好中球・リンパ球比の意義

  古田 康, 松村 道哉, 藤原 圭志, 本間 明宏

  Facial Nerve Research 日本顔面神経学会 40 149 - 151 0914-790X 2021/03 

  Bell麻痺よりも重症例が多いHunt症候群では、Bell麻痺に比べて好中球/リンパ球比(NLR)が高値を示すことが報告されており、これはVZV再活性化に起因するHunt症候群が、免疫機能の低下と関連し、より高度の炎症を伴っていることを示唆する。Zoster sine herpete(ZSH)もHunt症候群と同様に重症例が多いことが報告されている。今回、Hunt症候群、ZSH、Bell麻痺例のNLRを比較することで、VZV再活性化とNLRとの関連について検討した。対象は発症後7日以内に初診したHunt症候群25例、ZSH 25例、Bell麻痺105例とした。検討の結果、Hunt症候群例とZSH例を合わせたVZV再活性化群はBell麻痺群に比べてNLRが有意な高値を示し、NLR値は皮疹・粘膜疹の重症度と関連していることが示唆された。
• 顔面神経麻痺非治癒例の不安・うつ状態の評価

  藤原 圭志, 古田 康, 本間 明宏

  Facial Nerve Research 日本顔面神経学会 40 127 - 129 0914-790X 2021/03
• VZV再活性化例における好中球・リンパ球比の意義

  古田 康, 松村 道哉, 藤原 圭志, 本間 明宏

  Facial Nerve Research 日本顔面神経学会 40 149 - 151 0914-790X 2021/03
• Effectiveness and safety of nivolumab in patients with head and neck cancer in Japanese real-world clinical practice: a multicenter retrospective clinical study.

  Nobuhiro Hanai, Yasushi Shimizu, Shin Kariya, Ryuji Yasumatsu, Tomoya Yokota, Takashi Fujii, Kiyoaki Tsukahara, Masafumi Yoshida, Kenji Hanyu, Tsutomu Ueda, Hitoshi Hirakawa, Shunji Takahashi, Takeharu Ono, Daisuke Sano, Moriyasu Yamauchi, Akihito Watanabe, Koichi Omori, Tomoko Yamazaki, Nobuya Monden, Naomi Kudo, Makoto Arai, Daiju Sakurai, Takahiro Asakage, Issei Doi, Takayuki Yamada, Akihiro Homma

  International journal of clinical oncology 26 (3) 494 - 506 2021/03 

  BACKGROUND: To fill the data gap between clinical trials and real-world settings, this study assessed the overall effectiveness and safety of nivolumab in patients with head and neck cancer (HNC) during Japanese real-world clinical practice. METHODS: This was a multicenter, retrospective study in Japanese patients with recurrent or metastatic HNC who received nivolumab for the first time between July and December 2017. Data on the clinical use, effectiveness, and safety of nivolumab were extracted from patient medical records. RESULTS: Overall, 256 patients were enrolled in this study. The median duration of nivolumab treatment was 72.5 days, with patients receiving a median of 6.0 (range 1-27) doses. Median overall survival (OS) was 9.5 (95% confidence interval [CI] 8.2-12.0) months and the estimated 12-month OS rate was 43.2%. The objective response rate (ORR) was 15.7% overall and 21.1%, 7.1%, and 13.6% in patients with primary nasopharynx, maxillary sinus, and salivary gland tumors, respectively, who had been excluded from CheckMate 141. Grade ≥ 3 immune-related adverse events occurred in 5.9% of patients. No new safety signals were identified compared with adverse events noted in CheckMate 141. CONCLUSIONS: The effectiveness and safety of nivolumab in real-world clinical practice are consistent with data from the CheckMate 141 clinical trial. Therapeutic response was also observed in the groups of patients excluded from CheckMate 141. TRIAL REGISTRATION NUMBER: UMIN-CTR (UMIN000032600), Clinicaltrials.gov (NCT03569436).
• Multi‐institutional Survey of Squamous Cell Carcinoma of the External Auditory Canal in Japan

  Kiyoto Shiga, Ken‐ichi Nibu, Yasushi Fujimoto, Takahiro Asakage, Akihiro Homma, Hiroki Mitani, Takenori Ogawa, Kenji Okami, Shigeyuki Murono, Shigeru Hirano, Tsutomu Ueda, Nobuhiro Hanai, Kiyoaki Tsukahara, Ichiro Ota, Seiichi Yoshimoto, Takeshi Shinozaki, Shigemichi Iwae, Katsunori Katagiri, Daisuke Saito, Naomi Kiyota, Makoto Tahara, Fumiaki Takahashi, Ryuichi Hayashi

  The Laryngoscope 131 (3) E870 - E874 0023-852X 2021/03 [Refereed]
   

  OBJECTIVES: This study aimed to evaluate the efficacy of chemoradiotherapy (CRT) for patients with advanced cancer of the external auditory canal (EAC) by analyzing the outcome of the patients. METHODS: This is a multi-institutional retrospective survey, and we reviewed the medical records of the subjects. A total of 181 patients with tumor (T)3 or T4 tumor in 17 institutions were enrolled. Further analysis was performed for 74 patients who underwent CRT under curative intent. RESULTS: Overall 5-year survival rates of the patients who underwent CRT (n = 74) were 54.6%. Those of the patients who underwent CRT with modified TPF (docetaxel, cisplatin [CDDP], and 5-fluorouracil) regimen (n = 50) and CRT with CDDP regimens (n = 24) were 64.4% and 36.7%, respectively. Significant differences were observed between these two groups. CONCLUSION: Given the tendency that head and neck surgeons prefer CRT for advanced larger cancer of the EAC, CRT for advanced EAC cancer using the modified TPF regimen showed good clinical outcomes. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:E870-E874, 2021.
• Prognostic factors for duration of vertigo after stapes surgery via a time-to-event analysis.

  Atsushi Fukuda, Keishi Fujiwara, Shinya Morita, Kimiko Hoshino, Hiroko Yanagi, Yuji Nakamaru, Akihiro Homma

  Acta oto-laryngologica 141 (3) 216 - 221 2021/03 [Refereed]
   

  BACKGROUND: Vertigo or dizziness after stapes surgery occurs sometimes, and it is generally temporary. However, while rare, it can be prolonged. AIMS/OBJECTIVES: To investigate the prognostic factors for duration of vertigo following stapedotomy using a time-to-event analysis. MATERIALS AND METHODS: The present study included a total of 35 primary ears (26 with otosclerosis and nine with congenital stapes fixation) from 31 patients. We assessed residual rates of nystagmus and complaints of subjective vestibular symptoms using Kaplan-Meier time-to-event methods. RESULTS: Postoperative spontaneous nystagmus was observed in 23 (65.7%) ears, and postoperative subjective vestibular symptoms were confirmed in 27 (77.1%) ears. The total mean duration of postoperative spontaneous nystagmus and subjective vestibular symptoms was 9.8 (range: 0-158) and 33.9 days (0-732), respectively. A history of stapes surgery in the opposite ear was a significant predictive factor for prolonged nystagmus and subjective vestibular symptoms (p = .0059 and p = .0146). CONCLUSIONS AND SIGNIFICANCE: For individuals with a history of stapes surgery in the opposite ear, spontaneous nystagmus and vertigo/dizziness sensations following stapedotomy may persist for a longer duration than in those without a history of stapes surgery in the opposite ear.
• Induction chemotherapy in locally advanced squamous cell carcinoma of the head and neck.

  Susumu Okano, Akihiro Homma, Naomi Kiyota, Makoto Tahara, Nobuhiro Hanai, Takahiro Asakage, Kazuto Matsuura, Takenori Ogawa, Yuki Saito, Daisuke Sano, Takeshi Kodaira, Atsushi Motegi, Koichi Yasuda, Shunji Takahashi, Kaoru Tanaka, Takuma Onoe, Tomoya Yokota, Yoshinori Imamura, Yosuke Ariizumi, Tetsuo Akimoto, Ryuichi Hayashi

  Japanese journal of clinical oncology 51 (2) 173 - 179 2021/02/08 

  In order to maximize the benefit of induction chemotherapy, practice based on a comprehensive interpretation of a large number of clinical trials, as in this review, is essential. The standard treatment for locally advanced squamous cell carcinoma of the head and neck is surgery or chemoradiation. However, induction chemotherapy followed by (chemo) radiotherapy may be used in some circumstances. Although many clinical trials of induction chemotherapy have been conducted, a rationale other than to preserve the larynx is still controversial. Selection of this modality should therefore be made with care. The current standard regimen for induction chemotherapy is docetaxel, cisplatin and 5-FU, but concerns remain about toxicity, cost and the duration of treatment. Regarding treatment after induction chemotherapy, it is also unclear whether radiation alone or chemoradiation is the better option. Furthermore, there is no answer as to what drugs should be used in combination with radiation therapy after induction chemotherapy. Several new induction chemotherapy treatment developments are currently underway, and future developments are expected. This review article summarizes the current position of induction chemotherapy for head and neck squamous cell carcinoma, based on the evidence produced to date, and discusses the future prospects for this treatment.
• The role of endoscopic resection for selected patients with sinonasal squamous cell carcinoma.

  Yuji Nakamaru, Masanobu Suzuki, Satoshi Kano, Takatsugu Mizumachi, Nayuta Tsushima, Takayoshi Suzuki, Aya Honma, Akira Nakazono, Shogo Kimura, Rikiya Onimaru, Koichi Yasuda, Hiroki Shirato, Akihiro Homma

  Auris, nasus, larynx 48 (1) 131 - 137 2021/02 

  OBJECTIVE: Despite of rapid advances in endoscopic surgery, the gold standard for sinonasal squamous cell carcinoma (SNSCC) surgery has remained the open approach with en-block resection due to the aggressive nature of SNSCC, including frequent recurrence and high mortality rate. For that reason, few studies have focused on SNSCC treated by endoscopic surgery alone. The objective of this study was to evaluate the usefulness of endoscopic surgery for patients with SNSCC. METHODS: A retrospective analysis was performed for 15 consecutive SNSCC patients who underwent endoscopic surgery without an open approach. We carefully selected patients whose tumor attachment sites could be fully visualized and completely resected through an endonasal approach. RESULTS: Of the fifteen patients, 4 patients (27%) were diagnosed with T1, 7 (47%) with T2, 4 (27%) with T3, and no patients with T4a or T4b disease. Four of the 15 (27%) patients showed positive surgical margins. The 5-yr overall survival, disease-specific survival, and local control rate was 72.4%, 79.6%, and 92.9%, respectively. The 5-yr disease-specific survival for T1, T2, and T3 disease was 100% and 75% and 75%, respectively. Patients with negative surgical margins had a better disease-specific survival rate than did those with positive surgical margins (p = 0.0253). CONCLUSION: Endoscopic surgery for patients with SNSCC appears to afford an effective method in selected cases. The achievement of negative surgical margins with a good view of the tumor attachment site was considered to be critical to the management of SNSCC.
• Real-world clinical outcomes and prognostic factors in Japanese patients with recurrent or metastatic squamous cell carcinoma of head and neck treated with chemotherapy plus cetuximab: a prospective observation study (JROSG12-2).

  Tomoya Yokota, Yosuke Ota, Hirofumi Fujii, Takeshi Kodaira, Mototsugu Shimokawa, Torahiko Nakashima, Nobuya Monden, Akihiro Homma, Shinya Ueda, Tetsuo Akimoto

  International journal of clinical oncology 26 (2) 316 - 325 2021/02 

  BACKGROUND: The aims of this study are to evaluate the efficacy and safety of first-line treatment with chemotherapy plus cetuximab in real-world patients with recurrent or metastatic squamous cell carcinoma of the head and neck (RM-SCCHN) and to identify prognostic factors for overall survival (OS). METHODS: This is a prospective observation study involving 20 oncology institutions in Japan. Patients with RM-SCCHN treated with a first-line therapy consisting of cetuximab plus any chemotherapy regimen between December 2013 and February 2017 were enrolled. The primary objective of the study was 1-year OS. Secondary objectives included response rate and adverse events. RESULTS: Of 120 patients recruited, 114 patients were analyzed. Median age was 64 years. Cetuximab in combination with platinum plus 5-FU (EXTREME regimen) was chosen in 86 patients (75.4%). The median OS was 12.4 months. A point estimate of the 1-year survival rate was 51.1%. Overall response rate was 26.3%. Grade 3 or worse adverse events included neutropenia (22.8%), hypokalemia (9.6%), acneiform rash (7.0%), pneumonitis (1.8%), and infusion-related reaction (0.9%). On multivariate analysis, regional lymph node metastasis, absence of intervention by dermatologists, lack of response to therapy, skin metastasis, and non-EXTREME regimen were identified as independent unfavorable prognostic factors for OS. CONCLUSION: The combination of cetuximab plus chemotherapy was tolerable and efficacious in patients with RM-SCCHN in a real-world setting. Clinical outcomes and prognostic factors extracted from this study provide a reference of the current clinical practice as well as for the future development of novel therapy in RM-SCCHN.
• Endonasal endoscopic surgery for sinonasal squamous cell carcinoma from an oncological perspective.

  Akihiro Homma, Yuji Nakamaru, Valerie J Lund, Ehab Y Hanna, Luiz Paulo Kowalski, Ronaldo Nunes Toledo, Antti A Mäkitie, Juan Pablo Rodrigo, Alessandra Rinaldo, Carl H Snyderman, Alfio Ferlito

  Auris, nasus, larynx 48 (1) 41 - 49 2021/02 [Refereed]
   

  Endonasal endoscopic surgery (EES) has been applied to the management of sinonasal (SN) tumors based on recent advances in endoscopic surgical techniques and technologies over the past three decades. EES has been mainly indicated for benign tumors and less aggressive malignant tumors. Notwithstanding this, EES has been gradually adopted for squamous cell carcinoma (SCC), which is the most common histology among SN malignancies. However, an analysis of the outcomes of EES for patients with SCC is difficult because most articles included SCC a wide range of different tumor histologies. Therefore, we herein review and clarify the current status of EES focusing on SCC from an oncological perspective. The oncologic outcomes and the ability to achieve a histologically complete resection are similar between endoscopic and open approaches in highly selected patients with SN-SCC. Surgical complications associated with EES are likely similar for SN-SCC compared to other sinonasal malignancies. The indications for a minimally invasive approach such as EES in the management of patients with SN-SCC should be stricter than those for less aggressive malignant tumors because of the aggressive nature of SCC. Also, it is important to achieve negative surgical margins with EES in patients with SCC. We believe that the indications for EES for SN-SCC are widening due to advances in diagnostic imaging, and endoscopic surgical techniques and technologies. However, while expanding the indications for EES for SN-SCC we must carefully confirm that the outcomes support this strategy.
• TLR Signals in Epithelial Cells in the Nasal Cavity and Paranasal Sinuses.

  Masanobu Suzuki, Clare Cooksley, Takayoshi Suzuki, Mahnaz Ramezanpour, Akira Nakazono, Yuji Nakamaru, Akihiro Homma, Sarah Vreugde

  Frontiers in allergy 2 780425 - 780425 2021 

  The respiratory tract is constantly at risk of invasion by microorganisms such as bacteria, viruses, and fungi. In particular, the mucosal epithelium of the nasal cavity and paranasal sinuses is at the very forefront of the battles between the host and the invading pathogens. Recent studies have revealed that the epithelium not only constitutes a physical barrier but also takes an essential role in the activation of the immune system. One of the mechanisms equipped in the epithelium to fight against microorganisms is the Toll-like receptor (TLR) response. TLRs recognize common structural components of microorganisms and activate the innate immune system, resulting in the production of a plethora of cytokines and chemokines in the response against microbes. As the epithelia-derived cytokines are deeply involved in the pathogenesis of inflammatory conditions in the nasal cavity and paranasal sinuses, such as chronic rhinosinusitis (CRS) and allergic rhinitis (AR), the molecules involved in the TLR response may be utilized as therapeutic targets for these diseases. There are several differences in the TLR response between nasal and bronchial epithelial cells, and knowledge of the TLR signals in the upper airway is sparse compared to that in the lower airway. In this review, we provide recent evidence on TLR signaling in the upper airway, focusing on the expression, regulation, and responsiveness of TLRs in human nasal epithelial cells (HNECs). We also discuss how TLRs in the epithelium are involved in the pathogenesis of, and possible therapeutic targeting, for CRS and AR.
• Multiparametric Analysis of Tumor Morphological and Functional MR Parameters Potentially Predicts Local Failure in Pharynx Squamous Cell Carcinoma Patients.

  Noriyuki Fujima, Yukie Shimizu, Daisuke Yoshida, Satoshi Kano, Takatsugu Mizumachi, Akihiro Homma, Koichi Yasuda, Rikiya Onimaru, Osamu Sakai, Kohsuke Kudo, Hiroki Shirato

  The journal of medical investigation : JMI 68 (3.4) 354 - 361 2021 

  Purpose : To predict local control / failure by a multiparametric approach using magnetic resonance (MR)-derived tumor morphological and functional parameters in pharynx squamous cell carcinoma (SCC) patients. Materials and Methods : Twenty-eight patients with oropharyngeal and hypopharyngeal SCCs were included in this study. Quantitative morphological parameters and intratumoral characteristics on T2-weighted images, tumor blood flow from pseudo-continuous arterial spin labeling, and tumor diffusion parameters of three diffusion models from multi-b-value diffusion-weighted imaging as well as patients' characteristics were analyzed. The patients were divided into local control / failure groups. Univariate and multiparametric analysis were performed for the patient group division. Results : The value of morphological parameter of 'sphericity' and intratumoral characteristic of 'homogeneity' was revealed respectively significant for the prediction of the local control status in univariate analysis. Higher diagnostic performance was obtained with the sensitivity of 0.8, specificity of 0.75, positive predictive value of 0.89, negative predictive value of 0.6 and accuracy of 0.79 by multiparametric diagnostic model compared to results in the univariate analysis. Conclusion : A multiparametric analysis with MR-derived quantitative parameters may be useful to predict local control in pharynx SCC patients. J. Med. Invest. 68 : 354-361, August, 2021.
• Comparison of clinical characteristics of the nasal manifestations of eosinophilic granulomatosis with polyangiitis (EGPA) and eosinophilic chronic rhinosinusitis (ECRS).

  Masanobu Suzuki, Akira Nakazono, Shinya Morita, Atsushi Fukuda, Aya Honma, Takayoshi Suzuki, Shogo Kimura, Yuji Nakamaru, Akihiro Homma

  Allergology international : official journal of the Japanese Society of Allergology 70 (1) 143 - 144 2021/01
• Phase II trial of combination treatment with S-1/cetuximab in patients with platinum-ineligible recurrent and/or metastatic squamous cell carcinoma of the head and neck.

  Jun Taguchi, Yasushi Shimizu, Shin Ariga, Tomohiro Goda, Yoshihito Ohhara, Rio Honma, Takuro Noguchi, Satoshi Takeuchi, Ichiro Kinoshita, Toraji Amano, Takatsugu Mizumachi, Satoshi Kano, Miki Takahara, Takahisa Abe, Akihiro Homma, Hirotoshi Dosaka-Akita

  International journal of clinical oncology 26 (1) 51 - 58 1341-9625 2021/01 [Refereed]
   

  BACKGROUND: The standard of care for first-line treatment of recurrent and/or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN) in patients who cannot tolerate platinum-based regimens has not been clarified. We aimed to develop a new treatment regimen for patients with R/M SCCHN who are ineligible for platinum-based therapy, by evaluating the effects and safety of tegafur/gimeracil/oteracil (S-1) and cetuximab. METHODS: Platinum-ineligibility was defined as: elderly (aged ≥ 75 years), poor PS, comorbidity, platinum resistance and refusal to undergo platinum-based therapy. Patients received S-1 (80 mg/m2/day for 14 days followed by a seven-day break) and cetuximab (initial dose, 400 mg/m2, followed by 250 mg/m2 weekly) until disease progression or unacceptable toxicity. The primary endpoint was overall response rate (ORR). RESULTS: Between September 2014 and September 2018, we enrolled 23 patients. Among the 21 patients who were evaluable, 20 were male [median age, 69 years (range 49-82)]. The ORR was 9 (43%) of 21 patients [95% confidence interval (CI) 22-66]. One and eight patients achieved complete response (CR) and partial response (PR), respectively. The median overall survival (OS) was 13.7 months (95% CI 9.0-18.3) and progression-free survival (PFS) was 5.7 months (95% CI 3.1-8.2). Grade 3/4 adverse events included acneiform rash and skin reactions (33%), hypomagnesemia (19%), hand-foot syndrome (14%), fatigue (14%), mucositis (10%), and anorexia (10%). CONCLUSIONS: Combination treatment with S-1 and cetuximab was effective and tolerated well by patients with platinum-ineligible R/M SCCHN. Registered clinical trial number: UMIN000015123.
• Fluticasone Propionate Suppresses Poly(I:C)-Induced ACE2 in Primary Human Nasal Epithelial Cells.

  Akira Nakazono, Yuji Nakamaru, Mahnaz Ramezanpour, Takeshi Kondo, Masashi Watanabe, Shigetsugu Hatakeyama, Shogo Kimura, Aya Honma, P J Wormald, Sarah Vreugde, Masanobu Suzuki, Akihiro Homma

  Frontiers in cellular and infection microbiology 11 655666 - 655666 2021 [Refereed]
   

  Background: From the first detection in 2019, SARS-CoV-2 infections have spread rapidly worldwide and have been proven to cause an urgent and important health problem. SARS-CoV-2 cell entry depends on two proteins present on the surface of host cells, angiotensin-converting enzyme 2 (ACE2) and transmembrane protease serine 2 (TMPRSS2). The nasal cavity is thought to be one of the initial sites of infection and a possible reservoir for dissemination within and between individuals. However, it is not known how the expression of these genes is regulated in the nasal mucosa. Objective: In this study, we examined whether the expression of ACE2 and TMPRSS2 is affected by innate immune signals in the nasal mucosa. We also investigated how fluticasone propionate (FP), a corticosteroid used as an intranasal steroid spray, affects the gene expression. Methods: Primary human nasal epithelial cells (HNECs) were collected from the nasal mucosa and incubated with Toll-like receptor (TLR) agonists and/or fluticasone propionate (FP), followed by quantitative PCR, immunofluorescence, and immunoblot analyses. Results: Among the TLR agonists, the TLR3 agonist Poly(I:C) significantly increased ACE2 and TMPRSS2 mRNA expression in HNECs (ACE2 36.212±11.600-fold change, p<0.0001; TMPRSS2 5.598±2.434-fold change, p=0.031). The ACE2 protein level was also increased with Poly(I:C) stimulation (2.884±0.505-fold change, p=0.003). The Poly(I:C)-induced ACE2 expression was suppressed by co-incubation with FP (0.405±0.312-fold change, p=0.044). Conclusion: The activation of innate immune signals via TLR3 promotes the expression of genes related to SARS-CoV2 cell entry in the nasal mucosa, although this expression is suppressed in the presence of FP. Further studies are required to evaluate whether FP suppresses SARS-CoV-2 viral cell entry.
• Attempting to define sentinel node micrometastasis in oral squamous cell carcinoma.

  Takashi Matsuzuka, Hirokazu Uemura, Seiichi Yoshimoto, Kouki Miura, Akihiro Shiotani, Masashi Sugasawa, Akihiro Homma, Junkichi Yokoyama, Kiyoaki Tsukahara, Tomokazu Yoshizaki, Yasushi Yatabe, Takehiro Kobari, Shigeru Kosuda, Shigeyuki Murono, Yasuhisa Hasegawa

  Fukushima journal of medical science 66 (3) 143 - 147 2020/12/10 

  OBJECTIVE: The aim of this supplemental study of a sentinel node (SN) biopsy (SNB) trial for oral squamous cell carcinoma (OSCC) was to assess the effectiveness in identifying micrometastasis and determining whether elective neck dissection (END) is necessary. MATERIALS AND METHODS: Twenty-three patients with pathologically positive SNs were included. The sizes of the metastatic lesions in positive SNs (SMSNs) were classified and the rates of occult metastasis of non-SNs were compared. RESULTS: The patients were divided according to the SMSN:<0.2 mm (group A, n=3);0.2 mm to <2.0 mm (group B, n=7);and ≥2.0 mm (group C, n=13). The rates of occult metastasis in groups A, B, and C were 0% (0/3), 14% (1/7) and 23% (3/13), respectively. CONCLUSION: Rare cancer cell distribution to nodes other than SNs was observed in the patients with SN metastatic lesions of at least smaller than 0.2 mm in size, suggesting the possibility of defining SN micrometastasis in N0 OSCC.
• 北海道胆振東部地震における地震後めまい症候群の検討

  藤原 圭志, 野村 泰之, 本間 明宏

  耳鼻咽喉科臨床 補冊 耳鼻咽喉科臨床学会 (補冊155) 158 - 158 0912-1870 2020/12
• 実臨床下での頭頸部癌患者に対するニボルマブの有効性と安全性、2年フォローアップ

  大塚 倫之, 清水 康, 花井 信広, 假谷 伸, 安松 隆治, 横田 知哉, 塚原 清彰, 安藤 瑞生, 羽生 健司, 上田 勉, 平川 仁, 山田 智美, 山田 孝之, 本間 明宏

  日本癌治療学会学術集会抄録集 58回 O1 - 3 2020/10
• video Head Impulse Testを用いたOMAAVにおける半規管障害の検討

  藤原 圭志, 柳 紘子, 本間 明宏

  Equilibrium Research (一社)日本めまい平衡医学会 79 (5) 466 - 466 0385-5716 2020/10
• Zinc-depletion associates with tissue eosinophilia and collagen depletion in chronic rhinosinusitis.

  M Suzuki, M Ramezanpour, C Cooksley, T J Lee, B Jeong, S Kao, T Suzuki, A J Psaltis, Y Nakamaru, A Homma, P J Wormald, S Vreugde

  Rhinology 58 (5) 451 - 459 2020/10/01 

  BACKGROUND: Zinc plays an important role in many biological processes. Reduced zinc levels have been found in chronic rhinosinusitis (CRS) patients, however, its role in the pathophysiology of this disease remains unknown. This study examined zinc levels in the serum, mucus and tissue from CRS patients in relation to collagen content and eosinophil infiltration. The effect of zinc depletion on inflammatory cytokine production and collagen synthesis was assessed in vitro. METHODOLOGY: Zinc levels were determined in serum, mucus and tissue from controls, CRS with (CRSwNP) and without nasal polyps (CRSsNP) patients. Tissue zinc levels, collagen and inflammatory cell infiltration was examined using zinquin assays, immunofluorescence and histology on Tissue Micro Arrays. Cytokine expression and collagen synthesis was evaluated in zinc depleted primary human nasal epithelial cells (HNECs) and primary fibroblasts. RESULTS: CRSwNP patients showed reduced tissue zinc levels in correlation with a reduction in collagen content, and increased eosinophil numbers. Zinc depletion of HNECs and fibroblasts induced the production of pro-inflammatory cytokines and MUC5AC and reduced collagen secretion. CONCLUSIONS: These results suggest mucosal zinc depletion associates with tissue eosinophilia and collagen depletion in CRSwNP and induces pro-inflammatory cytokine expression and reduction of collagen synthesis in vitro.
• 頭頸部癌放射線照射後遺残、異時性多発癌に対する内視鏡治療成績

  井上 雅貴, 清水 勇一, 霜田 佳彦, 田中 一光, 木脇 佐代子, 石川 麻倫, 大野 正芳, 山本 桂子, 小野 尚子, 本間 明宏, 坂本 直哉

  Gastroenterological Endoscopy (一社)日本消化器内視鏡学会 62 (Suppl.2) 2127 - 2127 0387-1207 2020/10
• video Head Impulse Testを用いたOMAAV症例の半規管機能評価

  藤原 圭志, 柳 紘子, 森田 真也, 干野 季美子, 福田 篤, 中丸 裕爾, 本間 明宏

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科頭頸部外科学会 123 (4) 1142 - 1142 0030-6622 2020/09
• Immunotherapy for squamous cell carcinoma of the head and neck.

  Tomoya Yokota, Akihiro Homma, Naomi Kiyota, Makoto Tahara, Nobuhiro Hanai, Takahiro Asakage, Kazuto Matsuura, Takenori Ogawa, Yuki Saito, Daisuke Sano, Takeshi Kodaira, Atsushi Motegi, Koichi Yasuda, Shunji Takahashi, Kaoru Tanaka, Takuma Onoe, Susumu Okano, Yoshinori Imamura, Yosuke Ariizumi, Ryuichi Hayashi

  Japanese journal of clinical oncology 50 (10) 1089 - 1096 2020/08/08 [Refereed][Not invited]
   

  Squamous cell carcinoma of the head and neck is characterized by an immunosuppressive environment and evades immune responses through multiple resistance mechanisms. A breakthrough in cancer immunotherapy employing immune checkpoint inhibitors has evolved into a number of clinical trials with antibodies against programmed cell death 1 (PD-1), its ligand PD-L1 and cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) for patients with squamous cell carcinoma of the head and neck. CheckMate141 and KEYNOTE-048 were practice-changing randomized phase 3 trials for patients with platinum-refractory and platinum-sensitive recurrent or metastatic squamous cell carcinoma of the head and neck, respectively. Furthermore, many combination therapies using anti-CTLA-4 inhibitors, tyrosine kinase inhibitors and immune accelerators are currently under investigation. Thus, the treatment strategy of recurrent or metastatic squamous cell carcinoma of the head and neck is becoming more heterogeneous and complicated in the new era of individualized medicine. Ongoing trials are investigating immunotherapeutic approaches in the curative setting for locoregionally advanced disease. This review article summarizes knowledge of the role of the immune system in the development and progression of squamous cell carcinoma of the head and neck, and provides a comprehensive overview on the development of immunotherapeutic approaches in both recurrent/metastatic and locoregionally advanced diseases.
• 北海道胆振東部地震における地震後めまい症候群に関するアンケート調査

  藤原 圭志, 野村 泰之, 柳 紘子, 本間 明宏

  Equilibrium Research (一社)日本めまい平衡医学会 79 (4) 251 - 256 0385-5716 2020/08 

  2011年の東日本大震災以降、実際には地面が揺れていないにもかかわらず揺れているように感じる地震後めまい症候群の存在が報告され、その病態が徐々に明らかになってきている。著者等は2018年の胆振東部地震後、北海道内の複数施設で本症候群に関するアンケート調査を行っている。今回、震度5強を記録した札幌市北区に位置する北海道大学病院耳鼻咽喉科でのアンケート結果を報告した。対象は、地震発生以前から前庭外来に通院していためまい患者50例とし、地震後に従来のめまい疾患による症状とは異なるめまい症状が出現したか否かを尋ねた。結果、「出現した」と答えたのは19例(38%)であった。出現した群と非出現群とで「男女比」「年齢」「めまい疾患の種類(末梢性・中枢性)」「性格・気質」などについて比較検討した結果、出現群は女性の比率が有意に高く、また「地震が苦手」と感じている割合が有意に高かった。
• Optimization of therapeutic strategy for p16‐positive oropharyngeal squamous cell carcinoma: Multi‐institutional observational study based on the national Head and Neck Cancer Registry of Japan

  Yuki Saito, Ryuichi Hayashi, Yoshiyuki Iida, Takatsugu Mizumachi, Takashi Fujii, Fumihiko Matsumoto, Takeshi Beppu, Masafumi Yoshida, Hirotaka Shinomiya, Ryosuke Kamiyama, Mutsukazu Kitano, Kazuhiko Yokoshima, Yasushi Fujimoto, Takanori Hama, Taku Yamashita, Kenji Okami, Kouki Miura, Takuo Fujisawa, Daisuke Sano, Hisayuki Kato, Shujiro Minami, Masashi Sugasawa, Muneyuki Masuda, Ichiro Ota, Shigemichi Iwae, Ryo Kawata, Nobuya Monden, Takayuki Imai, Takahiro Asakage, Masafumi Okada, Takanori Yoshikawa, Kensuke Tanioka, Megumi Kitayama, Mariko Doi, Satoshi Fujii, Masato Fujii, Nobuhiko Oridate, Munenaga Nakamizo, Seiichi Yoshimoto, Akihiro Homma, Ken‐ichi Nibu, Katsunari Yane

  Cancer 126 (18) 4177 - 4187 0008-543X 2020/07/10 [Refereed][Not invited]
  
• Preoperative Pulmonary Function Testing to Predict Recurrence of Chronic Rhinosinusitis With Nasal Polyps

  Yuji Nakamaru, Masanobu Suzuki, Aya Honma, Akira Nakazono, Shogo Kimura, Keishi Fujiwara, Shinya Morita, Satoshi Konno, Akihiro Homma

  ALLERGY & RHINOLOGY 11 2152-6567 2020/07 

  Background: Although the close relationship between the upper and lower airways has been highlighted previously, little is known about the association between lung function and the recurrence of chronic rhinosinusitis with nasal polyps (CRSwNP). This study aimed to evaluate the factors associated with pulmonary function that affect CRSwNP recurrence after surgery.Methods: We performed a series of routine pulmonary function tests for general anesthesia prior to CRSwNP surgery. The values for each parameter were compared in the presence or absence of recurrence.Results: Sixty-nine patients with CRSwNP were included. The percent predicted forced expiratory volume in one second (%FEV1) in the recurrent group was significantly lower than that in the non-recurrent group (P = .005). A multivariable logistic regression model revealed that %FEV1 was a positive predictor of recurrence (odds ratio: 0.96, 95% CI: 0.92-0.99, P = .023). There were no significant differences in the other pulmonary functions between the two groups.Conclusions: We found that %FEV1 may be a predictor of CRSwNP recurrence after surgery. As %FEV1 is a pulmonary function test that is routinely performed before surgery, this parameter is readily applicable. Moreover, as %FEV1 appears to have the potential to reveal concealed asthma, %FEV1 might be a particularly useful tool for the prediction of CRSwNP recurrence after surgery.
• 上・中・下咽頭癌に対する陽子線治療の初期経験

  安田 耕一, 湊川 英樹, 出倉 康裕, 対馬 那由多, 鈴木 崇祥, 加納 里志, 鬼丸 力也, 清水 伸一, 本間 明宏, 青山 英史

  頭頸部癌 (一社)日本頭頸部癌学会 46 (2) 161 - 161 1349-5747 2020/07
• 休日による総治療期間延長に対して1回線量増加の方法を組み合わせて放射線治療を行った早期声門癌の検討

  出倉 康裕, 安田 耕一, 湊川 英樹, 対馬 那由多, 鈴木 崇祥, 加納 里志, 鬼丸 力也, 本間 明宏, 青山 英史

  頭頸部癌 (一社)日本頭頸部癌学会 46 (2) 179 - 179 1349-5747 2020/07
• 頭頸部粘膜悪性黒色腫に対する術後陽子線治療30GyE/5回の初期経験

  湊川 英樹, 安田 耕一, 出倉 康裕, 鈴木 正宣, 中丸 裕爾, 中薗 彬, 鈴木 崇祥, 対馬 那由多, 加納 里志, 鬼丸 力也, 清水 伸一, 本間 明宏, 青山 英史

  頭頸部癌 (一社)日本頭頸部癌学会 46 (2) 188 - 188 1349-5747 2020/07
• Recommendations for head and neck surgical oncology practice in a setting of acute severe resource constraint during the COVID-19 pandemic: an international consensus.

  Hisham Mehanna, John C Hardman, Jared A Shenson, Ahmad K Abou-Foul, Michael C Topf, Mohammad AlFalasi, Jason Y K Chan, Pankaj Chaturvedi, Velda Ling Yu Chow, Andreas Dietz, Johannes J Fagan, Christian Godballe, Wojciech Golusiński, Akihiro Homma, Sefik Hosal, N Gopalakrishna Iyer, Cyrus Kerawala, Yoon Woo Koh, Anna Konney, Luiz P Kowalski, Dennis Kraus, Moni A Kuriakose, Efthymios Kyrodimos, Stephen Y Lai, C Rene Leemans, Paul Lennon, Lisa Licitra, Pei-Jen Lou, Bernard Lyons, Haitham Mirghani, Anthonny C Nichols, Vinidh Paleri, Benedict J Panizza, Pablo Parente Arias, Mihir R Patel, Cesare Piazza, Danny Rischin, Alvaro Sanabria, Robert P Takes, David J Thomson, Ravindra Uppaluri, Yu Wang, Sue S Yom, Yi-Ming Zhu, Sandro V Porceddu, John R de Almeida, Chrisian Simon, F Christopher Holsinger

  The Lancet. Oncology 21 (7) e350-e359  2020/07 [Refereed]
   

  The speed and scale of the global COVID-19 pandemic has resulted in unprecedented pressures on health services worldwide, requiring new methods of service delivery during the health crisis. In the setting of severe resource constraint and high risk of infection to patients and clinicians, there is an urgent need to identify consensus statements on head and neck surgical oncology practice. We completed a modified Delphi consensus process of three rounds with 40 international experts in head and neck cancer surgical, radiation, and medical oncology, representing 35 international professional societies and national clinical trial groups. Endorsed by 39 societies and professional bodies, these consensus practice recommendations aim to decrease inconsistency of practice, reduce uncertainty in care, and provide reassurance for clinicians worldwide for head and neck surgical oncology in the context of the COVID-19 pandemic and in the setting of acute severe resource constraint and high risk of infection to patients and staff.
• Evaluation of Semicircular Canal Function by Video Head Impulse Test in Patients With Facial Nerve Schwannoma.

  Keishi Fujiwara, Shinya Morita, Yasushi Furuta, Hiroko Yanagi, Kimiko Hoshino, Atsushi Fukuda, Yuji Nakamaru, Akihiro Homma

  Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 41 (5) e615-e622  2020/06 

  OBJECTIVES: The aim of the present study was to evaluate semicircular canal function by video Head Impulse Test (vHIT) in patients with facial nerve schwannoma (FNS). STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: Seven patients with FNS underwent vHIT examination. MAIN OUTCOME MEASURES: The gain in vestibulo-ocular reflex and the presence of catch-up saccade were examined for the semicircular canals including the vertical canals. RESULTS: Dysfunction of the semicircular canals was detected by vHIT in three of seven cases. Nystagmus beating toward the non-affected side was observed in all three cases with semicircular canal dysfunction. Dysfunction was observed in a case with no direct compression of the vestibular nerve or semicircular canals by FNS. CONCLUSIONS: Semicircular canal function in patients with FNS could be evaluated by vHIT. vHIT has two advantages for the evaluation of vestibular function in patients with FNS. First, vHIT could be used for the patients in whom a tumor exists in the external auditory canal or middle ear, unlike caloric testing. Second, as vHIT could evaluate all three canals, impaired vestibular nerves could be speculated from vHIT results when a tumor exists in internal auditory canal. vHIT should be performed in patients with FNS, especially before surgery, to evaluate vestibular function.
• Prevalence, clinical course, and predictive factors of immune checkpoint inhibitor monotherapy-associated hepatitis in Japan.

  Takashi Kitagataya, Goki Suda, Kazunori Nagashima, Takehiko Katsurada, Koji Yamamoto, Megumi Kimura, Osamu Maehara, Ren Yamada, Taku Shigesawa, Kazuharu Suzuki, Akihisa Nakamura, Masatsugu Ohara, Machiko Umemura, Naoki Kawagishi, Masato Nakai, Takuya Sho, Mitsuteru Natsuizaka, Kenichi Morikawa, Koji Ogawa, Shunsuke Ohnishi, Yoshito Komatsu, Hiroo Hata, Satoshi Takeuchi, Takashige Abe, Jun Sakakibara-Konishi, Takanori Teshima, Akihiro Homma, Naoya Sakamoto

  Journal of gastroenterology and hepatology 35 (10) 1782 - 1788 2020/03/18 [Refereed][Not invited]
   

  BACKGROUND AND AIM: Immune checkpoint inhibitors (ICI) have revolutionized anti-malignancy therapy and thus have been increasingly used. Although ICI may cause immune-related adverse events (irAE) in various organs, including the liver, the prevalence and predictive factors of irAE have not been clarified. METHODS: In this retrospective study, consecutive patients who had malignancies and were treated with ICI without other chemotherapeutic agents at Hokkaido University Hospital between 2014 and 2019 were screened. Patients were excluded if they were < 20 years old and had insufficient clinical data. RESULTS: Of the 233 patients screened, 202 patients met the inclusion criteria and were included in the analysis. The patients were aged 25-92 years, and 60.9% were male. The patients received nivolumab (n = 137), pembrolizumab (n = 45), ipilimumab (n = 17), atezolizumab (n = 2), and avelumab (n = 1). The prevalence of any grade and grade ≥ 3 irAE hepatitis was 8.4% (17/202) and 4.0% (8/202), respectively. irAE hepatitis occurred at a median duration of 42 days in any grade and 36 days in grade ≥ 3 after ICI initiation. The clinical course of grade ≥ 3 irAE hepatitis was generally favorable; however, 50% required corticosteroid treatment and two patients required additional mycophenolate mofetil. Female sex and history of ICI treatment were significantly associated with the incidence of grade ≥ 3 irAE hepatitis. CONCLUSIONS: Grade ≥ 3 irAE hepatitis was observed in 4.0% of the patients who were treated with ICI. Female sex and history of ICI treatment were significantly associated with the incidence of grade ≥ 3 irAE hepatitis.
• video Head Impulse Testを用いた顔面神経鞘腫症例の半規管機能評価

  藤原 圭志, 古田 康, 本間 明宏

  Facial Nerve Research 日本顔面神経学会 39 121 - 124 0914-790X 2020/03 

  顔面神経鞘腫7例を対象に、video Head Impulse Test(vHIT)を用いて半規管機能を評価した。vHITはGN otometrics社のICS impulseを用いた。被検者は壁から1m離れた椅子に座り、目の高さに貼付された指標を固視するよう指示した。水平半規管は水平方向の回転刺激で評価された(A)。垂直半規管は頭部と体を指標に対し左右45度回転した状態で指標を固視し、頭部を前後方向に回転させることで左前半規管と右後半規管に一致した平面(B)と、右半規管と左後半規管に一致した平面(C)で回転刺激が与えられた。A、B、Cの3方向で各20回以上の頭部回転刺激を加え、その際の頭部速度と眼球速度を記録した。頭部速度と眼球速度の比(VOR gain)を算出し、水平半規管0.8未満、垂直半規管0.7未満でgain低下と判定した。VOR gain低下かつcatch-up saccade(CUS)陽性で半規管機能低下と判定した。その結果、7例中3例(43%)に患側の半規管の機能低下を認めた。
• A multicenter phase II trial of paclitaxel, carboplatin, and cetuximab followed by chemoradiotherapy in patients with unresectable locally advanced squamous cell carcinoma of the head and neck.

  Tomohiro Enokida, Takenori Ogawa, Akihiro Homma, Kenji Okami, Shujiro Minami, Ayako Nakanome, Yasushi Shimizu, Daisuke Maki, Yuri Ueda, Takao Fujisawa, Atsushi Motegi, Akira Ohkoshi, Jun Taguchi, Koji Ebisumoto, Shogo Nomura, Susumu Okano, Makoto Tahara

  Cancer medicine 9 (5) 1671 - 1682 2020/03 [Refereed][Not invited]
   

  BACKGROUND: Induction chemotherapy (IC) in locally advanced squamous cell carcinoma of the head and neck (LA-SCCHN) often compromises compliance with subsequent chemoradiotherapy (CRT), which negatively affects outcomes. Here, we assessed the combination of paclitaxel (PTX), carboplatin (CBDCA), and cetuximab (Cmab) as IC for unresectable LA-SCCHN. METHODS: Induction chemotherapy consisted of weekly CBDCA area under the plasma concentration-time curve = 1.5, PTX 80 mg/m2 and Cmab with an initial dose of 400 mg/m2 followed by 250 mg/m2 for 8 weeks. Following IC, CDDP (20 mg/m2 , 4 days × 3 cycles) and concurrent radiotherapy (70 Gy/35 fr) were started. Primary endpoint was the proportion of CRT completion (%CRT completion). PCE was planned to be deemed effective if the Bayesian posterior probability (PP), defined as the probability that %CRT completion was larger than the threshold value of 65%, exceeded 84%. RESULTS: Thirty-five patients were enrolled. Cases were hypopharynx/oropharynx/larynx in 17/17/1 patients, all at Stage IV. Of 35 patients, 34 (97%) completed IC and 32 received CRT and met the criteria of full analysis set (FAS). In FAS, the %CRT completion was 96.9%, and PP was 99.9%, exceeding the prespecified boundary of 84%. Mean cumulative dose and relative to dose intensity of CDDP in CRT was 232.5 mg/m2 and 100%, respectively. Response rate was 88.6% by IC and 93.8% in the CRT phase. Three year overall survival was 83.5%. Main grade 3 toxicities included neutropenia (11.4%) and skin rash (5.7%) during IC; and oral mucositis (31.3%) and neutropenia (12.5%) during CRT. No grade 4 toxicity or treatment-related death was seen. CONCLUSIONS: PCE as IC was feasible, with promising efficacy and no effect on compliance with subsequent CRT in unresectable LA-SCCHN.
• Minimally invasive surgery for laryngopharyngeal cancer: Multicenter feasibility study of a combination strategy involving transoral surgery and real-time indocyanine green fluorescence-navigated sentinel node navigation surgery.

  Koji Araki, Masayuki Tomifuji, Akihiro Shiotani, Shigeru Hirano, Junkichi Yokoyama, Kiyoaki Tsukahara, Akihiro Homma, Seichi Yoshimoto, Yasuhisa Hasegawa

  Head & neck 42 (2) 254 - 261 2020/02 

  BACKGROUND: Sentinel node navigation surgery using indocyanine green (ICG-SNNS) can be performed in the operation room. The combination of minimally invasive transoral surgery (TOS) with ICG-SNNS can provide functional preservation options for both primary lesions and lymph node (LN) metastasis. This multicenter feasibility study of this strategy was conducted in Japan. METHODS: Patients with clinical T1 or T2, N0 oropharyngeal, hypopharyngeal, or supraglottic cancer were enrolled. The identification rate of sentinel nodes, delayed cervical LN metastasis in 2 years, and survival rate were assessed. RESULTS: Twenty-two patients (10 oropharynx, 8 hypopharynx, 4 supraglottic cancer) were enrolled. The identification rate was 100%. One case had delayed nodal metastasis. The accuracy was 95.5%, sensitivity was 75%, and specificity was 100%. The 5-year disease-specific survival was 100%, overall survival was 72.3%, and disease-free survival was 60.5%. CONCLUSIONS: The combination of TOS with ICG-SNNS is feasible as a minimally invasive strategy and has favorable oncological outcomes.
• Analysis of semicircular canal function as evaluated by video Head Impulse Test in patients with vestibular schwannoma.

  Keishi Fujiwara, Shinya Morita, Atsushi Fukuda, Hiroki Akamatsu, Hiroko Yanagi, Kimiko Hoshino, Yuji Nakamaru, Satoshi Kano, Akihiro Homma

  Journal of vestibular research : equilibrium & orientation 30 (2) 101 - 108 2020 

  OBJECTIVE: The aim of the present study was to investigate the factors influencing semicircular canal function as evaluated by video Head Impulse Test (vHIT) in patients with vestibular schwannoma. METHODS: Twenty-four patients with untreated vestibular schwannoma underwent vHIT examination. The correlations between semicircular canal function and factors including age, tumor size, disease duration and hearing loss were evaluated. RESULTS: The functions of all three semicircular canals on the affected side evaluated by vHIT were significantly lower than those on the unaffected side. Although there were no significant correlations between semicircular canal function and age, tumor size or disease duration, a negative significant correlation between vestibulo-ocular reflex (VOR) gain as evaluated by vHIT and hearing loss was observed. CONCLUSIONS: From the results of the relationship between hearing loss and VOR gain, the damage to the audio and vestibular systems in patients with VS may be correlated. As it has been suggested that tumor size was not a significant factor in the VOR gain evaluated by vHIT, multifactorial causes rather than the simple compression of the vestibular nerves alone may be related to the dysfunction of the semicircular canals in patients with vestibular schwannoma.
• Enhanced Angiogenesis in Salivary Duct Carcinoma Ex-Pleomorphic Adenoma.

  Takayoshi Suzuki, Satoshi Kano, Masanobu Suzuki, Shinichiro Yasukawa, Takatsugu Mizumachi, Nayuta Tsushima, Kanako C Hatanaka, Yutaka Hatanaka, Yoshihiro Matsuno, Akihiro Homma

  Frontiers in oncology 10 603717 - 603717 2020 [Refereed]
   

  Salivary duct carcinoma (SDC) is morphologically similar to breast cancer, with HER2-overexpression reported. With regard to the pattern of disease onset, SDC can arise from de novo or carcinoma ex-pleomorphic adenoma (Ca-ex-PA). Recently, multiple molecular profiles of SDC as well as breast cancer have been reported, with significant differences in HER2 expression between Ca-ex-PA and de novo. We assessed the differences in gene expression between onset classifications. We conducted immunohistochemical analysis and HER2-DISH for 23 patients and classified SDCs into three subtypes as follows: "HER2-positive" (HER2+/any AR), "Luminal-AR" (HER2-/AR+), and "Basal-like" (HER2-/AR-). We assessed the expression levels of 84 functional genes for 19 patients by using a qRT-PCR array. Ten cases were classified as HER2-positive, seven cases as Luminal-AR, and six cases as Basal-like. The gene expression pattern was generally consistent with the corresponding immunostaining classification. The expression levels of VEGFA, ERBB2(HER2), IGF1R, RB1, and XBP1 were higher, while those of SLIT2 and PTEN were lower in Ca-ex-PA than in de novo. The functions of those genes were concentrated in angiogenesis and AKT/PI3K signaling pathway (Fisher's test: p-value = 0.025 and 0.004, respectively). Multiple machine learning methods, OPLS-DA, LASSO, and RandomForest, also show that VEGFA can be a candidate for the characteristic differences between Ca-ex-PA and de novo. In conclusion, the AKT/PI3K signaling pathway leading to angiogenesis was hyper-activated in all SDCs, particularly in those classified into the Ca-ex-PAs. VEGFA was over-expressed significantly in the Ca-ex-PA, which can be a crucial factor in the malignant conversion to SDC.
• Nutritional support dependence after curative chemoradiotherapy in head and neck cancer: supplementary analysis of a phase II trial (JCOG0706S1)

  Yoshinori Imamura, Naomi Kiyota, Gakuto Ogawa, Tetsuo Akimoto, Masato Fujii, Nobuhiro Hanai, Shigemichi Iwae, Nobuya Monden, Kazuto Matsuura, Yusuke Onozawa, Ryuichi Hayashi, Makoto Tahara, Shujiro Minami, Hirofumi Fujii, Akihiro Homma, Junko Eba

  JAPANESE JOURNAL OF CLINICAL ONCOLOGY 49 (11) 1009 - 1015 0368-2811 2019/11 [Refereed][Not invited]
   

  Objectives: To explore the risk factors of laryngo-esophageal dysfunction-free survival and nutritional support dependence over 12 months in patients with unresectable locally advanced head and neck carcinomas who received chemoradiotherapy in a phase II trial of JCOG0706 (UMIN000001272).Methods: Forty-five patients received radiation therapy for a total of 70 Gy/35fr concurrently with S-1 and cisplatin. Risk factors of laryngo-esophageal dysfunction-free survival and nutritional support dependence over 12 months were analyzed using Cox regression models and logistic regression models, respectively, with consideration to patient laboratory data just before chemoradiotherapy. Radiation fields were reviewed to analyze the relationship between the extent of the irradiated field and functional outcome.Results: With a median follow-up period of 3.5 years, 3-year laryngo-esophageal dysfunction-free survival was 48.9%. For laryngo-esophageal dysfunction-free survival, hazards ratio of 2.35 in patients with nutritional support at registration (vs. without nutritional support; 95% confidence interval 0.96-5.76). For nutritional support dependence over 12 months, odds ratio was 6.77 in patients with hemoglobin less than the median of 13.4 g/dl (vs. higher than or equal to the median; 95% confidence interval 1.24-36.85) and was 6.00 in patients with albumin less than the median of 3.9 g/dl (vs. higher than or equal to the median; 95% confidence interval 1.11-32.54). Primary sites in disease-free patients with nutritional support dependence over 12 months were the oropharynx (N = 2) or hypopharynx (N = 1), and all pharyngeal constrictor muscles were included in irradiated fields with a curative dose.Conclusions: This supplementary analysis showed that pretreatment severe dysphagia requiring nutritional support, anemia and hypoalbuminemia might have a negative prognostic impact on long-term functional outcomes after curative chemoradiotherapy in head and neck cancer.
• 北海道胆振東部地震における地震後めまい症候群に関するアンケート調査

  藤原 圭志, 野村 泰之, 柳 紘子, 矢島 諒人, 高野 賢一, 氷見 徹夫, 本間 明宏

  Equilibrium Research (一社)日本めまい平衡医学会 78 (5) 539 - 539 0385-5716 2019/10
• 地震後めまい症候群 「平成30年北海道胆振東部地震」における苫小牧での経験

  野村 泰之, 志津木 健, 藤原 圭志, 本間 明宏, 矢島 諒人, 高野 賢一, 氷見 徹夫, 大島 猛史

  日本耳科学会総会・学術講演会抄録集 (一社)日本耳科学会 29回 350 - 350 2019/10
• 好酸球性中耳炎(EOM)と中耳炎を合併した好酸球性多発血管炎性肉芽腫症(EGPA)の比較

  福田 篤, 森田 真也, 藤原 圭志, 干野 季美子, 中丸 裕爾, 本間 明宏

  日本耳科学会総会・学術講演会抄録集 (一社)日本耳科学会 29回 508 - 508 2019/10
• 当科における局所進行外耳道扁平上皮癌の治療成績の検討

  加納 里志, 森田 真也, 中丸 裕爾, 水町 貴諭, 対馬 那由多, 鈴木 崇祥, 中薗 彬, 福田 篤, 安田 耕一, 鬼丸 力也, 白土 博樹, 本間 明宏

  頭頸部癌 (一社)日本頭頸部癌学会 45 (3) 300 - 304 1349-5747 2019/10 

  我々は、局所進行外耳道扁平上皮癌に対する治療成績、特にドセタキセル、シスプラチン、5-FUの併用(TPF)の化学療法同時併用放射線療法(CCRT)の治療成績と安全性、および腫瘍の進展範囲と予後との関係を検討した。対象は当科で根治治療を行った外耳道癌扁平上皮癌で、ピッツバーグ分類のT3-4の21症例とした。その結果、硬膜と顎関節への進展が頸部転移と相関を示し、顎関節への進展が局所再発と相関を示した。全症例の2年粗生存率(OS)は61.1%、2年局所制御率(LC)は52.1%であった。CCRT症例では、TPF併用の2年OSは85.7%、それ以外では25.0%、TPF併用の2年LCは57.1%、それ以外では25.0%であった。また、TPF併用CCRTにおけるG3以上の白血球減少は55%、好中球減少は45%であった。TPF併用のCCRTは局所進行外耳道扁平上皮癌に対して高い有効性と安全性を示した。(著者抄録)
• 日本人の頭頸部扁平上皮癌患者に対するCetuximab併用放射線治療の観察研究(JROSG12-2) 有害事象に関する中間評価

  太田 陽介, 古平 毅, 藤井 博文, 下川 元継, 中島 寅彦, 門田 伸也, 横田 知哉, 本間 明宏, 上田 眞也, 秋元 哲夫

  頭頸部癌 (一社)日本頭頸部癌学会 45 (3) 330 - 336 1349-5747 2019/10 [Refereed]
   

  頭頸部扁平上皮癌に対するセツキシマブ(Cmab)の国内実施状況、安全性と有効性を調査する多施設共同前向き観察研究(JROSG12-2)において、局所進行例に対するCmab併用放射線治療(BRT)の中間評価を行った。予定集積180例中90例のうち、解析が可能であった69例を解析した。年齢中央値66歳で75歳以上の後期高齢者は14例(20%)含まれた。「Cmab投与6回以上かつ放射線治療60Gy以上」の治療完遂割合は75%であった。Grade 3-4の急性期有害事象は咽頭粘膜炎58%、放射線皮膚炎42%、口腔粘膜炎39%と頻度が高く、また誤嚥性肺炎5%、肺臓炎3%と呼吸器合併症に注意が必要と思われた。実臨床におけるBRTの治療完遂割合は過去の臨床試験結果よりやや低く、許容しうる有害事象の発生割合と考えられた一方で、粘膜炎や呼吸器合併症には慎重な観察と支持療法の徹底が重要と考えられた。(著者抄録)
• 【二次出版】ANL Secondary Publication 急性感音難聴患者における抗ムンプスIgM抗体陽性率 北海道における後向き多施設共同研究

  福田 篤, 森田 真也, 中丸 裕爾, 干野 季美子, 藤原 圭志, 赤澤 茂, 坂下 智博, 小原 修幸, 本間 明宏

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 122 (9) 1267 - 1268 0030-6622 2019/09
• 当院における外鼻形成術および鼻中隔矯正術施行例の検討

  木村 将吾, 中丸 裕爾, 鈴木 正宣, 本間 あや, 中薗 彬, 本間 明宏

  日本鼻科学会会誌 (一社)日本鼻科学会 58 (3) 632 - 632 0910-9153 2019/09
• Differentiation Between Eosinophilic Otitis Media and Otitis Media Associated With Eosinophilic Granulomatosis With Polyangiitis.

  Atsushi Fukuda, Shinya Morita, Yuji Nakamaru, Kimiko Hoshino, Keishi Fujiwara, Akihiro Homma

  Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 40 (8) e796-e802  2019/09 

  OBJECTIVE: To perform comparisons and clarify differences in clinical manifestations between eosinophilic otitis media (EOM) and otitis media associated with eosinophilic granulomatosis with polyangiitis (EGPA). STUDY DESIGN: Retrospective case review. SETTING: Tertiary referral center. PATIENTS: Twenty-two ears of 11 patients exhibiting EOM (EOM group) and 20 ears of 12 patients exhibiting otitis media associated with EGPA (EGPA group). MAIN OUTCOME MEASURES: Otological manifestations, nasal and paranasal manifestations, incidence of asthma, positivity for serum antineutrophil cytoplasmic antibodies (ANCA), total serum immunoglobulin (Ig) E level, peripheral blood eosinophil fraction, and hearing outcomes. RESULTS: The incidence and age of onset of asthma and chronic rhinosinusitis were comparable between the EOM and EGPA groups. Moreover, otological findings and hearing outcomes at the initial visit were similar in both groups. Computed tomography images of the paranasal sinus showed predominant opacification of the ethmoid sinus in both groups. Although the total serum IgE level was not significantly different, the peripheral blood eosinophil fraction was significantly larger in the EGPA group than in the EOM group (p = 0.0035). Furthermore, the rate of myeloperoxidase-antineutrophil cytoplasmic antibodies (ANCA) positivity was significantly higher in the EGPA group than in the EOM group (p = 0.019). CONCLUSIONS: The findings of the present study suggest that the phenotypic characteristics of EOM closely resemble those of otitis media associated with EGPA in early stages before the appearance of vasculitis. Therefore, it is challenging to differentiate the two conditions purely on the basis of otorhinological examinations.
• Make-Up Therapy for Patients With Facial Nerve Palsy.

  Keishi Fujiwara, Yasushi Furuta, Wakae Aoki, Yuji Nakamaru, Shinya Morita, Kimiko Hoshino, Atsushi Fukuda, Akihiro Homma

  The Annals of otology, rhinology, and laryngology 128 (8) 721 - 727 2019/08 

  OBJECTIVES: To investigate the effectiveness of make-up therapy for patients with facial nerve palsy. METHODS: Seven female patients with facial nerve palsy who received specialist make-up therapy were enrolled. The objective of the make-up therapy was to obtain a symmetrical facial appearance. RESULTS: Overall score for the Facial Clinimetric Evaluation (FaCE) scale was significantly improved after make-up therapy. There was a tendency for symptoms of depression to be improved among patients after make-up therapy. CONCLUSION: Make-up therapy to improve the symmetry of facial appearance could afford a noninvasive and low-cost treatment for patients with facial nerve palsy, especially in terms of patient quality of life and psychological condition.
• Afatinib vs Placebo as Adjuvant Therapy After Chemoradiotherapy in Squamous Cell Carcinoma of the Head and Neck: A Randomized Clinical Trial.

  Barbara Burtness, Robert Haddad, José Dinis, José Trigo, Tomoya Yokota, Luciano de Souza Viana, Ilya Romanov, Jan Vermorken, Jean Bourhis, Makoto Tahara, José Getulio Martins Segalla, Amanda Psyrri, Irina Vasilevskaya, Chaitali Singh Nangia, Manuel Chaves-Conde, Naomi Kiyota, Akihiro Homma, Petra Holeckova, Josep Maria Del Campo, Nirav Asarawala, Ulisses Ribaldo Nicolau, Daniel Rauch, Caroline Even, Bushi Wang, Neil Gibson, Eva Ehrnrooth, Kevin Harrington, Ezra E W Cohen

  JAMA oncology 5 (8) 1170 - 1180 2019/08/01 

  Importance: Locoregionally advanced head and neck squamous cell cancer (HNSCC) is treated curatively; however, risk of recurrence remains high among some patients. The ERBB family blocker afatinib has shown efficacy in recurrent or metastatic HNSCC. Objective: To assess whether afatinib therapy after definitive chemoradiotherapy (CRT) improves disease-free survival (DFS) in patients with HNSCC. Design, Setting, and Participants: This multicenter, phase 3, double-blind randomized clinical trial (LUX-Head & Neck 2) studied 617 patients from November 2, 2011, to July 4, 2016. Patients who had complete response after CRT, comprising radiotherapy with cisplatin or carboplatin, with or without resection of residual disease, for locoregionally advanced high- or intermediate-risk HNSCC of the oral cavity, hypopharynx, larynx, or oropharynx were included in the study. Data analysis was of the intention-to-treat population. Interventions: Patients were randomized (2:1) to treatment with afatinib (40 mg/d) or placebo, stratified by nodal status (N0-2a or N2b-3) and Eastern Cooperative Oncology Group performance status (0 or 1). Treatment continued for 18 months or until disease recurrence, unacceptable adverse events, or patient withdrawal. Main Outcomes and Measures: The primary end point was DFS, defined as time from the date of randomization to the date of tumor recurrence or secondary primary tumor or death from any cause. Secondary end points were DFS at 2 years, overall survival (defined as time from the date of randomization to death), and health-related quality of life. Results: A total of 617 patients were studied (mean [SD] age, 58 [8.4] years; 528 male [85.6%]). Recruitment was stopped after a preplanned interim futility analysis on July 4, 2016, on recommendation from an independent data monitoring committee. Treatment was discontinued. Median DFS was 43.4 months (95% CI, 37.4 months to not estimable) in the afatinib group and not estimable (95% CI, 40.1 months to not estimable) in the placebo group (hazard ratio, 1.13; 95% CI, 0.81-1.57; stratified log-rank test P = .48). The most common grade 3 and 4 drug-related adverse effects were acneiform rash (61 [14.8%] of 411 patients in the afatinib group vs 1 [0.5%] of 206 patients in the placebo group), stomatitis (55 [13.4%] in the afatinib group vs 1 [0.5%] in the placebo group), and diarrhea (32 [7.8%] in the afatinib group vs 1 [0.5%] in the placebo group). Conclusions and Relevance: This study's findings indicate that treatment with afatinib after CRT did not improve DFS and was associated with more adverse events than placebo in patients with primary, unresected, clinically high- to intermediate-risk HNSCC. The use of adjuvant afatinib after CRT is not recommended. Trial Registration: ClinicalTrials.gov identifier: NCT01345669.
• Machine-Learning-Based Prediction of Treatment Outcomes Using MR Imaging-Derived Quantitative Tumor Information in Patients with Sinonasal Squamous Cell Carcinomas: A Preliminary Study.

  Fujima N, Shimizu Y, Yoshida D, Kano S, Mizumachi T, Homma A, Yasuda K, Onimaru R, Sakai O, Kudo K, Shirato H

  Cancers 11 (6) 2019/06 [Refereed][Not invited]
   

  The purpose of this study was to determine the predictive power for treatment outcome of a machine-learning algorithm combining magnetic resonance imaging (MRI)-derived data in patients with sinonasal squamous cell carcinomas (SCCs). Thirty-six primary lesions in 36 patients were evaluated. Quantitative morphological parameters and intratumoral characteristics from T2-weighted images, tumor perfusion parameters from arterial spin labeling (ASL) and tumor diffusion parameters of five diffusion models from multi-b-value diffusion-weighted imaging (DWI) were obtained. Machine learning by a non-linear support vector machine (SVM) was used to construct the best diagnostic algorithm for the prediction of local control and failure. The diagnostic accuracy was evaluated using a 9-fold cross-validation scheme, dividing patients into training and validation sets. Classification criteria for the division of local control and failure in nine training sets could be constructed with a mean sensitivity of 0.98, specificity of 0.91, positive predictive value (PPV) of 0.94, negative predictive value (NPV) of 0.97, and accuracy of 0.96. The nine validation data sets showed a mean sensitivity of 1.0, specificity of 0.82, PPV of 0.86, NPV of 1.0, and accuracy of 0.92. In conclusion, a machine-learning algorithm using various MR imaging-derived data can be helpful for the prediction of treatment outcomes in patients with sinonasal SCCs.
• A review of head and neck cancer staging system in the TNM classification of malignant tumors (eighth edition).

  Head and, Neck Cancer, Study Group, HNCSG, Monden N, Asakage T, Kiyota N, Homma A, Matsuura K, Hanai N, Kodaira T, Zenda S, Fujii H, Tahara M, Yokota T, Akimoto T, Iwae S, Onitsuka T, Ogawa T, Okano S, Takahashi S, Shimizu Y, Yonezawa K, Hayashi R

  Japanese journal of clinical oncology 49 (7) 589 - 595 0368-2811 2019/06 [Refereed][Not invited]
   

  © The Author(s) 2019. A number of major modifications were made to the classification of head and neck carcinomas in the eighth edition of the American Joint Committee on Cancer, Cancer Staging Manual and Union for International Cancer Control TNM classification of Malignant Tumors. These modifications were aimed at improving the prognosis prediction accuracy of the system. In this article, we review the new edition of the TNM classification system. Among the several changes in the new system, a separate algorithm for p16-positive oropharyngeal carcinoma was included, as were new chapters on ‘Head and Neck Skin Carcinoma’ and ‘Unknown Primary Carcinoma—Cervical Nodes.’ Changes to Tumor (T) classification were made by introducing the depth of invasion of oral carcinoma, whereas changes to Node (N) classification were made by adding extra-nodal extension. It is believed that these changes will help improve the accuracy of the system in the prediction of prognosis. However, it is necessary to verify their validity through further clinical research.
• 扁平上皮癌におけるTripartite motif-containing protein 29(TRIM 29)の検討

  柳 輝希, 秦 洋郎, 北村 真也, 清水 宏, 柳 紘子, 本間 明宏, 渡部 昌, 畠山 鎮次

  日本皮膚科学会雑誌 (公社)日本皮膚科学会 129 (5) 1170 - 1170 0021-499X 2019/05
• 舌扁平上皮癌における改訂UICC TNM分類第8版の有用性の検討

  加納 里志, 対馬 那由多, 水町 貴諭, 鈴木 崇祥, 浜田 誠二郎, 本間 明宏

  頭頸部癌 (一社)日本頭頸部癌学会 45 (2) 157 - 157 1349-5747 2019/05
• 多形腺腫由来型唾液腺導管癌に特徴的な遺伝子発現の探索

  鈴木 崇洋, 加納 里志, 浜田 誠二郎, 対馬 那由多, 水町 貴諭, 本間 明宏

  頭頸部癌 (一社)日本頭頸部癌学会 45 (2) 221 - 221 1349-5747 2019/05
• Safety and efficacy of concurrent carboplatin or cetuximab plus radiotherapy for locally advanced head and neck cancer patients ineligible for treatment with cisplatin.

  Satoshi Hamauchi, Tomoya Yokota, Takatsugu Mizumachi, Yusuke Onozawa, Hirofumi Ogawa, Tsuyoshi Onoe, Tomoyuki Kamijo, Yoshiyuki Iida, Tetsuo Nishimura, Tetsuro Onitsuka, Hirofumi Yasui, Akihiro Homma

  International journal of clinical oncology 24 (5) 468 - 475 2019/05 

  BACKGROUND: Locally advanced squamous cell carcinoma of the head and neck (LASCCHN) is usually treated with cisplatin (CDDP)-based chemoradiotherapy, except when patients are elderly or have renal, cardiac, or neurogenic dysfunction. This study compared the safety and efficacy of concurrent carboplatin (CBDCA) to cetuximab (Cmab) plus radiotherapy (RT) in patients ineligible for CDDP treatment. METHODS: We retrospectively analyzed LASCCHN patients who received CBDCA plus RT (n = 29) or Cmab plus RT (n = 18) due to ineligibility for CDDP treatment at two Japanese institutions between August 2006 and December 2015. RESULTS: Patients characteristics for CBDCA plus RT and Cmab plus RT were: median age, 74 and 75 years; 0-1 performance status, 90% and 100%; main primary tumor site, hypopharynx 52% (n = 15) and oropharynx 39% (n = 7); and stage IV, 90% (n = 26) and 50% (n = 9), respectively. With a median follow-up time of 60.0 months for CBDCA plus RT and 53.6 months for Cmab plus RT, 3-year locoregional control rates were 56% versus 58%, and median progression-free survival was 42.7 versus 11.6 months. CBDCA plus RT was associated with more grade 3/4 hematologic toxicities, including neutropenia and thrombocytopenia, whereas Cmab plus RT was associated with more grade 3/4 oral mucositis and radiation dermatitis. CONCLUSIONS: CBDCA or Cmab as a concurrent systemic therapy with RT is a possible treatment option for LASCCHN patients ineligible for CDDP treatment, although attention to hematological toxicity should be paid.
• 強度変調X線治療および強度変調陽子線治療における皮膚炎と皮膚線量に関する検討

  安田 耕一, 湊川 英樹, 出倉 康裕, 対馬 那由多, 鈴木 崇祥, 加納 里志, 水町 貴諭, 鬼丸 力也, 清水 伸一, 本間 明宏, 白土 博樹

  頭頸部癌 (一社)日本頭頸部癌学会 45 (2) 134 - 134 1349-5747 2019/05
• 外耳道癌における強度変調陽子線治療と強度変調X線治療との線量分布の比較

  出倉 康裕, 安田 耕一, 湊川 英樹, 対馬 那由多, 鈴木 崇祥, 加納 里志, 水町 貴諭, 鬼丸 力也, 清水 伸一, 本間 明宏, 白土 博樹

  頭頸部癌 (一社)日本頭頸部癌学会 45 (2) 138 - 138 1349-5747 2019/05
• 頭頸部癌におけるがん免疫療法の進展

  田原 信, 清田 尚臣, 本間 明宏

  がん免疫療法 (株)メディカルレビュー社 3 (1) 12 - 19 2432-8138 2019/05
• Desmoplastic small round cell tumor of the parotid gland-report of a rare case and a review of the literature.

  Hatanaka KC, Takakuwa E, Hatanaka Y, Suzuki A, IIzuka S, Tsushima N, Mitsuhashi T, Sugita S, Homma A, Morinaga S, Hashegawa T, Matsuno Y

  Diagnostic pathology 14 (1) 43 - 43 2019/05 [Refereed][Not invited]
   

  BACKGROUND: Desmoplastic small round cell tumor (DSRCT) is a rare soft tissue tumor that generally involves the retroperitoneum, pelvis, omentum and mesentery in younger patients. However, extra-abdominal DSRCT is very rare. CASE PRESENTATION: A 49-year-old Japanese man noticed a mass in the right parotid gland. Ultrasound examination revealed a solid tumor about 2 cm in diameter. Computed tomography (CT) of the whole body revealed no other tumors or lymph node swelling. Superficial parotidectomy was performed. Histologically, the tumor was composed of various-sized tumor cell nests in an abundant fibromyxoid and collagenous background. The tumor cells were small to medium-sized. Immunohistochemistry showed that the tumor cells were immunoreactive for epithelial markers and desmin. They also showed strong nuclear staining with a Wilms tumor 1 (WT1) antibody detecting the C-terminal region (C-WT1), but not the N-terminal region (N-WT1). We also performed 3'/5' expression imbalance assay based on reverse transcription polymerase chain reaction (RT-PCR) to determine whether aberrant WT1 gene expression was present. This tumor was found to lack 5'-regional expression of the WT1 gene, as well as immunoreactivity with the N-WT1 antibody. Finally, fluorescence in situ hybridization (FISH) and RT-PCR analyses revealed the presence of a gene showing fusion between exon 7 of EWSR1 and exon 8 of WT1. The tumor was diagnosed as a DSRCT of the right parotid gland. The patient has been followed for 3 years without recurrence or metastasis. CONCLUSIONS: Although DSRCT in the salivary gland is extremely rare, it should be included in the differential diagnosis of poorly differentiated salivary gland neoplasms, especially with a fibromyxoid background. Pathologists should bear in mind that DSRCT may occur in major salivary glands and should perform immunohistochemistry with appropriate antibodies, not only those against keratin and desmin, but also one detecting the C-terminal region of WT-1. Furthermore, molecular detection of EWSR1-WT1 fusion gene conclusively confirmed the diagnosis of DSRCT in this uncommon location.
• 好酸球性中耳炎EOMと中耳炎を合併した好酸球性多発血管炎性肉芽腫症EGPAの比較

  福田 篤, 森田 真也, 藤原 圭志, 干野 季美子, 中丸 裕爾, 本間 明宏

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 122 (4) 627 - 627 0030-6622 2019/04
• video Head Impulse Testを用いた聴神経腫瘍患者の半規管機能評価

  藤原 圭志, 柳 紘子, 森田 真也, 干野 季美子, 福田 篤, 赤松 明樹, 中丸 裕爾, 本間 明宏

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 122 (4) 704 - 704 0030-6622 2019/04
• 切除不能局所進行頭頸部扁平上皮がんに対するPCE導入化学療法後の化学放射線療法の実施可能性検証試験

  南 修司郎, 榎田 智弘, 小川 武則, 本間 明宏, 大上 研二, 岩江 信法, 中目 亜矢子, 清水 康, 槇 大輔, 上田 百合, 藤澤 孝夫, 茂木 厚, 野村 尚吾, 岡野 晋, 田原 信

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 122 (4) 711 - 711 0030-6622 2019/04
• 頭頸部癌化学放射線療法におけるEPA高配合栄養機能食品(プロシュア)の有用性の検討

  水町 貴諭, 加納 里志, 本間 明宏, 赤澤 美樹子, 長谷川 千春, 城石 陽子, 岡本 千秋, 熊谷 聡美, 西村 雅勝, 高崎 裕代, 武田 宏司, 安田 耕一, 湊川 英樹, 出倉 康裕, 鬼丸 力也, 白土 博樹, 福田 諭

  癌と化学療法 (株)癌と化学療法社 46 (4) 685 - 689 0385-0684 2019/04 

  頭頸部癌に対する化学放射線療法により生じる代表的な副作用には口腔粘膜炎と体重減少があげられる。今回われわれは、中咽頭癌、下咽頭癌症例にてシスプラチンと放射線療法を同時併用する化学放射線療法施行症例において、ω3系脂肪酸高配合栄養機能食品であるプロシュアの口腔粘膜炎と体重減少に対する有用性の検討を行った。放射線治療開始から終了までの期間プロシュアを投与し、最大体重減少率、口腔粘膜炎、化学放射線療法完遂率についてプロシュアの介入を行っていない過去の当科症例を対照群として比較検討を行った。プロシュア投与群は対照群と比べ体重減少率の改善(7.3% vs 10.3%、p<0.01)、口腔粘膜炎の改善を認めた(CTCAE v3.0 Grade 3以上;24% vs 58%、p<0.05)が、化学放射線療法完遂率は両群の差を認めなかった(77% vs 60%、NS)。プロシュアの投与が化学放射線療法施行中において、体重減少や口腔粘膜炎の改善に寄与する可能性が示唆された。(著者抄録)
• Controversies in relation to neck management in N0 early oral tongue cancer.

  Nobuhiro Hanai, Takahiro Asakage, Naomi Kiyota, Akihiro Homma, Ryuichi Hayashi

  Japanese journal of clinical oncology 49 (4) 297 - 305 0368-2811 2019/04/01 [Refereed][Not invited]
   

  The standard local treatment for early-stage tongue cancer with no clinical lymph node metastases is partial glossectomy. The frequency of occult lymph node metastasis is ~20-30%. Thus, whether prophylactic neck dissection with glossectomy or glossectomy alone should be performed has been a controversial issue since the 1980s. Both treatments have advantages and disadvantages; however, especially in cases involving prophylactic neck dissection, surgical invasion and complications including the cosmetic disadvantage caused by neck skin incision, accessory nerve paralysis or facial nerve (mandibular marginal branch) paralysis, stiffness of the shoulder or neck and a feeling of neck tightness have been considered issues that could be solved by providing less-invasive treatment to the 70-80% of patients without occult lymph node metastasis. A more accurate preoperative diagnosis and strict follow-up are required to provide minimally invasive treatment while ensuring the therapeutic effect. It is also necessary to narrow down the target based on the risk-benefit balance. The depth of invasion should be considered in cases involving oral cavity malignancies. This was also taken into account in recent revisions of eighth edition of the TNM Classification of Malignant Tumors and it is an important factor for N0 neck management. This review article summarizes previous and recent reports on neck management, focusing on the risk-benefit and future perspectives of the diagnosis and treatment of early-stage oral tongue cancer. This effort is an attempt to establish treatment from the patient's point of view, with the patient's quality of life taken into account.
• Short-Term Hearing Prognosis of Ossiculoplasty in Pars Flaccida Cholesteatoma Using the EAONO/JOS Staging System.

  Fukuda A, Morita S, Nakamaru Y, Hoshino K, Fujiwara K, Homma A

  The journal of international advanced otology 15 (1) 2 - 7 1308-7649 2019/04 [Refereed][Not invited]
   

  OBJECTIVES: The aim of the present study was to investigate the prognostic factors for short-term hearing outcomes of ossiculoplasty for primary pars flaccida cholesteatoma according to the European Academy of Otology and Neurotology/Japanese Otological Society (EAONO/JOS) and 2015 JOS staging systems. MATERIALS AND METHODS: A total of 34 patients with primary pars flaccida cholesteatoma who underwent one-stage tympanomastoidectomy with partial ossicular reconstruction using double cartilage block were included in the study. The postoperative pure-tone average air-bone gap (PTA-ABG) was calculated, and two criteria of successful hearing outcomes were defined as ≤10 and ≤20 dB. Patients were classified according to the EAONO/JOS and 2015 JOS staging systems. Cochran-Armitage test was used to statistically analyze staging, and Fisher's exact test was used to analyze other factors. RESULTS: Successful hearing outcome with postoperative PTA-ABG ≤10 and ≤20 dB occurred in 23.5% and 55.9% of cases, respectively. When postoperative PTA-ABG ≤20 dB was defined as successful, the success rate significantly decreased with increase in EAONO/JOS stage, and S0 pathological status of the stapes (no involvement) was a significantly favorable predictive factor. When postoperative PTA-ABG ≤10 dB was regarded as successful, the significantly favorable predictive factors were S0 pathological status of the stapes and development of mastoid cells with MC2-3 (better developed cells). CONCLUSION: Favorable prognostic factors for hearing outcomes of tympanomastoidectomy with partial ossicular reconstruction for primary pars flaccida cholesteatoma were low stage following the EAONO/JOS staging system and no stapes involvement and better development of mastoid cells following the 2015 JOS staging system.
• [A Nutritional Supplement with a High Blend Ratio of ω-3 Fatty Acids(Prosure®) Reduces Severe Oral Mucositis and Body Weight Loss for Head and Neck Cancer Patients Treated with Chemoradiotherapy].

  Mizumachi T, Kano S, Homma A, Akazawa M, Hasegawa C, Shiroishi Y, Okamoto C, Kumagai S, Nishimura M, Takasaki H, Takeda H, Yasuda K, Minatogawa H, Dekura Y, Onimaru R, Shirato H, Fukuda S

  Gan to kagaku ryoho. Cancer & chemotherapy 46 (4) 685 - 689 0385-0684 2019/04 [Refereed][Not invited]
   

  BACKGROUND: Oral mucositis and body weight loss are the most critical conditions known to lead to the discontinuation of chemoradiotherapy for head and neck cancer. We investigated the effect of a nutritional supplement with a high blend ratio of w-3 fatty acids(Prosure®)on body weight loss, oral mucositis, and the completion rate of chemoradiotherapy in patients with oropharyngeal and hypopharyngeal cancer. PATIENTS AND METHODS: The study group comprised patients with oropharyngeal and hypopharyngeal cancer who were treated with concomitant cisplatin and 70 Gy of radiotherapy. These patients received 2 packs of Prosure®per day during chemoradiotherapy. RESULTS: A total of 17 patients were included in this study. The reduction in body weight was significantly improved compared with that in the historical control group that did not receive Prosure®(7.3% vs 10.3%, p<0.01), and the rate of Grade 3-4 oral mucositis was significantly reduced for the patient groups that received Prosure®(CTCAE v3.0 GradeB3; 24% vs 58%, p<0.05). The completion rate of chemoradiotherapy was not significantly different between both groups(77% vs 60%, NS). CONCLUSIONS: A nutritional supplement with a high blend ratio of w-3 fatty acids(Prosure®)had effects on oral mucositis and body weight loss in head and neck cancer patients treated with chemoradiotherapy.
• 顔面神経麻痺患者に対するメーキャップ治療の精神面に対する効果

  藤原 圭志, 古田 康, 青木 和香恵, 本間 明宏

  Facial Nerve Research 日本顔面神経学会 38 147 - 149 0914-790X 2019/03 

  女性の顔面神経麻痺患者7例(26〜64歳)に施行した、メーキャップ治療の精神面に対する効果について検討した。その結果、顔面神経麻痺患者のQOLは患者の不安状態と負の相関を示すことが明らかとなり、また、メーキャップ治療により不安やうつ状態が改善する可能性のあることが示唆された。
• 強度変調放射線治療中に皮下気腫をきたし,再検証を要した頭頸部癌患者の1例

  湊川 英樹, 安田 耕一, 白土 博樹, 土屋 和彦, 鈴木 隆介, 宮本 直樹, 坂下 智博, 本間 明宏, 福田 諭

  Japanese Journal of Radiology (公社)日本医学放射線学会 37 (Suppl.) 4 - 4 1867-1071 2019/02
• Evaluation of Vertical Semicircular Canal Function in Patients With Vestibular Schwannoma.

  Fujiwara K, Yanagi H, Morita S, Hoshino K, Fukuda A, Nakamaru Y, Homma A

  The Annals of otology, rhinology, and laryngology 128 (2) 113 - 120 0003-4894 2019/02 [Refereed][Not invited]
   

  OBJECTIVES:: The aim of this study was to investigate vertical semicircular canal function in patients with vestibular schwannoma (VS) by video head impulse test (vHIT). METHODS:: Fifteen patients with VS who had not received any treatment, including surgery or stereotactic radiotherapy, before vHIT examination were enrolled. Vestibulo-ocular reflex gain and catch-up saccade in vHIT were evaluated. RESULTS:: Dysfunction of anterior and posterior semicircular canals was detected by vHIT in 26.7% and 60.0%, respectively. Six patients (40.0%) demonstrated abnormalities referable to both vestibular nerve divisions. Abnormalities referable to the superior vestibular nerve were identified in 3 patients (20.0%), while 3 patients (20.0%) demonstrated a pattern indicative of inferior vestibular nerve involvement. Anterior semicircular canal vHIT produced fewer abnormalities than did either horizontal or posterior semicircular canal vHIT. CONCLUSIONS:: Dysfunction of the semicircular canals, including the vertical canals, in patients with VS was detected by vHIT. The anterior semicircular canal was less frequently involved than the horizontal or posterior semicircular canal. The examination of the vertical canals by vHIT is useful in the evaluation of vestibular function in patients with VS.
• The Diagnostic and Clinical Utility of the Myeloperoxidase-DNA Complex as a Biomarker in Otitis Media With Antineutrophil Cytoplasmic Antibody-associated Vasculitis.

  Morita S, Nakamaru Y, Nakazawa D, Suzuki M, Hoshino K, Fukuda A, Hattanda F, Kusunoki K, Tomaru U, Ishizu A, Homma A

  Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology 40 (2) e99 - e106 1531-7129 2019/02 [Refereed][Not invited]
   

  OBJECTIVE: This prospective study aimed to evaluate the diagnostic and clinical utility of the myeloperoxidase (MPO)-DNA complex as a NETosis-derived product in the middle ear fluid of patients with otitis media with antineutrophil cytoplasmic antibody-associated vasculitis (OMAAV). STUDY DESIGN: Prospective study. SETTING: Tertiary referral center. PATIENTS: Twenty-two patients diagnosed with OMAAV. INTERVENTION: Collection of the fluid samples from middle ear. MAIN OUTCOME MEASURE: The levels of the MPO-DNA complex in the fluid samples were quantified using an enzyme-linked immunosorbent assay. RESULTS: Patients with both systemic and localized forms of OMAAV showed significantly higher levels of the MPO-DNA complex compared to the controls (p < 0.001 and p = 0.002, respectively). In particular, they showed significantly higher levels of MPO-DNA complex compared to the controls, regardless of serum antineutrophil cytoplasmic antibody status (p < 0.001 and p < 0.001, respectively) or immunosuppressive therapy (p < 0.001 and p < 0.001, respectively) at the time of sampling. An optical density cutoff value of 0.16 at 405 nm according to the receiver operating characteristic curve showed a sensitivity of 86.4%, specificity of 95.5%, positive predictive value of 95.0% and negative predictive value of 87.5% for the diagnosis of OMAAV. Significant positive correlations were observed between the levels of MPO-DNA complex and the values for air conduction - (r = 0.49, p = 0.022) and bone conduction - pure tone average thresholds (r = 0.45, p = 0.035). CONCLUSIONS: The detection and quantification of the MPO-DNA complex in the otitis media fluid may aid in providing a definite diagnosis as well as predicting the activity and severity of OMAAV.
• The utility of MRI histogram and texture analysis for the prediction of histological diagnosis in head and neck malignancies.

  Fujima N, Homma A, Harada T, Shimizu Y, Tha KK, Kano S, Mizumachi T, Li R, Kudo K, Shirato H

  Cancer imaging : the official publication of the International Cancer Imaging Society 19 (1) 5 - 5 1740-5025 2019/02 [Refereed][Not invited]
   

  BACKGROUND: To assess the utility of histogram and texture analysis of magnetic resonance (MR) fat-suppressed T2-weighted imaging (Fs-T2WI) for the prediction of histological diagnosis of head and neck squamous cell carcinoma (SCC) and malignant lymphoma (ML). METHODS: The cases of 57 patients with SCC (45 well/moderately and 12 poorly differentiated SCC) and 10 patients with ML were retrospectively analyzed. Quantitative parameters with histogram features (relative mean signal, coefficient of variation, kurtosis and skewness) and gray-level co-occurrence matrix (GLCM) features (contrast, correlation, energy and homogeneity) were calculated using Fs-T2WI data with a manual tumor region of interest (ROI). RESULTS: The following significantly different values were obtained for the total SCC versus ML groups: relative mean signal (3.65 ± 0.86 vs. 2.61 ± 0.49), contrast (72.9 ± 16.2 vs. 49.3 ± 8.7) and homogeneity (2.22 ± 0.25 × 10- 1 vs. 2.53 ± 0.12 × 10- 1). In the comparison of the SCC histological grades, the relative mean signal and contrast were significantly lower in the poorly differentiated SCC (2.89 ± 0.63, 56.2 ± 12.9) compared to the well/moderately SCC (3.85 ± 0.81, 77.5 ± 13.9). The homogeneity in poorly differentiated SCC (2.56 ± 0.15 × 10- 1) was higher than that of the well/moderately SCC (2.1 ± 0.18 × 10- 1). CONCLUSIONS: Parameters obtained by histogram and texture analysis of Fs-T2WI may be useful for noninvasive prediction of histological type and grade in head and neck malignancy.
• 扁平上皮におけるTripartite motif-containing protein 29(TRIM29)の機能解析

  柳 輝希, 秦 洋郎, 北村 真也, 今福 恵輔, 清水 宏, 柳 紘子, 本間 明宏, 渡部 昌, 畠山 鎮次

  日本皮膚科学会雑誌 (公社)日本皮膚科学会 129 (1) 45 - 45 0021-499X 2019/01
• Spontaneous Regression of Swollen Submandibular Glands in IgG4-Related Disease

  Masanobu Suzuki, Yuji Nakamaru, Dai Takagi, Aya Honma, Takayoshi Suzuki, Emi Takakuwa, Shinya Morita, Sarah Vreugde, Akihiro Homma

  Allergy & Rhinology 10 215265671881673 - 215265671881673 2152-6567 2019/01 

  IgG4-related disease is a new clinical entity frequently associated with swelling of the submandibular glands (SMGs). The long-term outcome of SMG swelling without steroid therapy remains unknown. To examine whether swollen SMGs spontaneously regress without steroid therapy in the context of IgG4-related disease and to identify biomarkers that can predict the spontaneous regression of SMG swelling. The SMG volume of 49 patients diagnosed with IgG4-related disease was calculated by measuring the axial and coronal planes of computed tomography scans. The change in SMG volume over time was measured and examined by treatment regimen, clinical data, and serum complement level. We found 28 of 49 (57%) IgG4-related disease patients to have swollen SMGs, with 15 of 20 (75%) of the swollen SMGs regressing without steroid therapy. The time required for the SMGs swelling to regress was significantly shorter in the steroid therapy group than in the no-steroid therapy group. Serum complement components at the initial visit were significantly lower in the regressed SMG group than in the nonregressed SMG group. We observed 75% of swollen SMGs spontaneously regressed in patients with IgG4-related disease. The time required for the swollen SMGs to regress was longer in patients without steroid therapy than in those with steroid therapy. Serum complement level could be used as a predictor for the spontaneous regression of swollen SMGs in patients with IgG4-related disease.
• Treatment outcomes of local advanced external auditory canal squamous cell carcinomas

  Satoshi Kano, Shinya Morita, Yuji Nakamaru, Takatsugu Mizumachi, Nayuta Tsushima, Takayoshi Suzuki, Akira Nakazono, Atsushi Fukuda, Koichi Yasuda, Rikiya Onimaru, Hiroki Shirato, Akihiro Homma

  Japanese Journal of Head and Neck Cancer 45 (3) 300 - 304 1349-5747 2019 [Refereed][Not invited]
   

  © 2019, Japan Society for Head and Neck Cancer. All rights reserved. We analyzed the treatment outcomes and safety of concomitant chemoradiotherapy (CCRT), especially with a combination of docetaxel, cisplatin and 5FU (TPF), for local advanced external auditory canal squamous cell carcinomas. In addition, we analyzed the correlation between tumor invasion site and prognosis. The study comprised 21 patients with the following criteria: (1) external auditory canal squamous cell carcinomas which were subject to radical treatment at Hokkaido University Hospital between 2007 and 2017, and (2) T3–4 classified according to the University of Pittsburg system. As a result, tumor invasion into the dura or temporomandibular joint was associated with neck lymph node metastasis, and tumor invasion into the temporomandibular joint was associated with local recurrence. The 2-year overall survival rate (OS) and 2-year local control rate (LC) were 61.1％ and 52.1％ in all patients, respectively. In patients treated with CCRT, the 2-year OS was 85.7％ in CCRT with TPF and 25.0％ in CCRT with others, and the 2-year LC was 57.1％ in CCRT with TPF and 25.0％ in CCRT with others. Grade 3︲4 leucopenia and neutropenia occurred in 55％ and 45％ of patients treated with CCRT with TPF, respectively. CCRT with TPF shows high efficacy and safety for local advanced external auditory canal squamous cell carcinomas.
• 頭頸部癌患者の口腔支持療法と地域連携

  秦 浩信, 吉川 和人, 今待 賢治, 村井 知佳, 上田 倫弘, 永橋 立望, 西山 典明, 安田 耕一, 本間 明宏, 北川 善政

  頭頸部癌 (一社)日本頭頸部癌学会 44 (4) 380 - 386 1349-5747 2018/12 

  頭頸部癌治療では様々な機能障害や、有害事象により患者のQOLが著しく低下する。多くの場合、治療後緩やかに改善するが、様々な不具合を受容しながら生活している。長期生存者の口腔管理の継続は重要な課題である。2012年度から開始された全国共通がん医科歯科連携講習会により、全国で14,000名以上がん診療連携歯科医が登録され、連携の受け入れ体制が整った。北海道大学病院で2011年に行った、2007年から2010年までの4年間の実態調査では、退院後に院内外で口腔管理を継続できたのは34.3%で、地域歯科医院に依頼したものは7.5%に過ぎなかった。今回行った2011年から2016年までの6年間の調査では、退院後口腔管理を継続できたのは70.5%であり、地域歯科医院に依頼したものは40.4%と著明に増加した。頭頸部癌患者のQOLに寄与するため、適切な口腔管理を地域歯科医院と共に継続することが肝要である。(著者抄録)
• Randomized phase III study to evaluate the value of omission of prophylactic neck dissection for stage I/II tongue cancer: Japan Clinical Oncology Group study (JCOG1601, RESPOND).

  Kiyo Tanaka, Nobuhiro Hanai, Junko Eba, Junki Mizusawa, Takahiro Asakage, Akihiro Homma, Naomi Kiyota, Haruhiko Fukuda, Ryuichi Hayashi

  Japanese journal of clinical oncology 48 (12) 1105 - 1108 0368-2811 2018/12/01 [Refereed][Not invited]
   

  For stage I/II tongue cancer patients, it is controversial whether prophylactic neck dissection should be performed with partial glossectomy. Based on the evidence of the primary tumor's depth of invasion as a predictive factor of occult lymph node metastases and a prognostic factor of disease-free survival, randomized phase III trial was initiated in November 2017 to evaluate the omission value for prophylactic neck dissection for stage I/II tongue cancer with 3-10 mm of depth of invasion. In 5 years, 440 patients will be accrued from 28 institutions. The primary end point of the study is the overall survival, whereas the secondary end points are relapse-free survival, local relapse-free survival, proportion of unresectable relapse and of cervical lymph node relapse, post-operative function (paralysis of the accessory and facial nerves and subjective symptoms) and adverse events. This trial has been registered with the UMIN Clinical Trials Registry (registration number: UMIN000030098; http://www.umin.ac.jp/ctr/index.htm).
• Integrating quantitative morphological and intratumoural textural characteristics in FDG-PET for the prediction of prognosis in pharynx squamous cell carcinoma patients.

  N Fujima, K Hirata, T Shiga, R Li, K Yasuda, R Onimaru, K Tsuchiya, S Kano, T Mizumachi, A Homma, K Kudo, H Shirato

  Clinical radiology 73 (12) 1059.e1-1059.e8  2018/12 [Refereed][Not invited]
   

  AIM: To assess potential prognostic factors in pharynx squamous cell carcinoma (SCC) patients by quantitative morphological and intratumoural characteristics obtained by 2-[18F]-fluoro-2-deoxy-d-glucose positron-emission tomography/computed tomography (FDG-PET/CT). MATERIALS AND METHODS: The cases of 54 patients with pharynx SCC who underwent chemoradiation therapy were analysed retrospectively. Using their FDG-PET data, the quantitative morphological and intratumoural characteristics of 14 parameters were calculated. The progression-free survival (PFS) and overall survival (OS) information was obtained from patient medical records. Univariate and multivariate analyses were performed to assess the 14 quantitative parameters as well as the T-stage, N-stage, and tumour location data for their relation to PFS and OS. When an independent predictor was suggested in the multivariate analysis, the parameter was further assessed using the Kaplan-Meier method. RESULTS: In the assessment of PFS, the univariate and multivariate analyses indicated the following as independent predictors: the texture parameter of homogeneity and the morphological parameter of sphericity. In the Kaplan-Meier analysis, the PFS rate was significantly improved in the patients who had both a higher value of homogeneity (p=0.01) and a higher value of sphericity (p=0.002). With the combined use of homogeneity and sphericity, the patients with different PFS rates could be divided more clearly. CONCLUSION: The quantitative parameters of homogeneity and sphericity obtained by FDG-PET can be useful for the prediction of the PFS of pharynx SCC patients, especially when used in combination.
• Loss of TRIM29 alters keratin distribution to promote cell invasion in squamous cell carcinoma.

  Yanagi T, Watanabe M, Hata H, Kitamura S, Imafuku K, Yanagi H, Homma A, Wang L, Takahashi H, Shimizu H, Hatakeyama S

  Cancer research 78 (24) 6795 - 6806 2018/11 [Refereed][Not invited]
   

  : TRIM29 (tripartite motif-containing protein 29) is a TRIM family protein that has been implicated in breast, colorectal, and pancreatic cancers. However, its role in stratified squamous epithelial cells and tumors has not been elucidated. Here, we investigate the expression of TRIM29 in cutaneous head and neck squamous cell carcinomas (SCC) and its functions in the tumorigenesis of such cancers. TRIM29 expression was lower in malignant SCC lesions than in adjacent normal epithelial tissue or benign tumors. Lower expression of TRIM29 was associated with higher SCC invasiveness. Primary tumors of cutaneous SCC showed aberrant hypermethylation of TRIM29. Depletion of TRIM29 increased cancer cell migration and invasion; conversely, overexpression of TRIM29 suppressed these. Comprehensive proteomics and immunoprecipitation analyses identified keratins and keratin-interacting protein FAM83H as TRIM29 interactors. Knockdown of TRIM29 led to ectopic keratin localization of keratinocytes. In primary tumors, lower TRIM29 expression correlated with the altered expression of keratins. Our findings reveal an unexpected role for TRIM29 in regulating the distribution of keratins, as well as in the migration and invasion of SCC. They also suggest that the TRIM29-keratin axis could serve as a diagnostic and prognostic marker in stratified epithelial tumors and may provide a target for SCC therapeutics. SIGNIFICANCE: These findings identify TRIM29 as a novel diagnostic and prognostic marker in stratified epithelial tissues.
• 喉頭癌cT3の喉頭温存治療(CRT vs RADPLAT) 喉頭癌に対する超選択的動注と放射線同時併用療法

  本間 明宏, 加納 里志, 水町 貴諭, 中薗 彬, 鈴木 崇祥, 坂下 智博, 福田 諭, 鬼丸 力也, 安田 耕一, 湊川 英樹, 出倉 康裕, 土屋 和彦, 白土 博樹

  日本気管食道科学会会報 (NPO)日本気管食道科学会 69 (5) 319 - 320 0029-0645 2018/10
• 聴神経腫瘍症例の半規管機能と関連する因子の検討

  藤原 圭志, 赤松 明樹, 本間 明宏

  Equilibrium Research (一社)日本めまい平衡医学会 77 (5) 499 - 499 0385-5716 2018/10
• Sirtuin-1 Controls Poly (I:C)-Dependent Matrix Metalloproteinase 9 Activation in Primary Human Nasal Epithelial Cells.

  Masanobu Suzuki, Mahnaz Ramezanpour, Clare Cooksley, Jian Li, Yuji Nakamaru, Akihiro Homma, Alkis Psaltis, Peter-John Wormald, Sarah Vreugde

  American journal of respiratory cell and molecular biology 59 (4) 500 - 510 2018/10 

  Matrix metalloproteinase (MMP)-9 is thought to be involved in the etiopathogenesis of chronic rhinosinusitis (CRS) with nasal polyps and cleaves collagen IV, causing hyperpermeability of the basement membrane within mucosal tissue. It is known that MMP-9 expression is negatively affected by sirtuin (SIRT)-1 in human monocytotic cells, retinal endothelial cells, and epithelial carcinoma cells. However, it is unknown which factors affect MMP-9 expression and activity in human nasal epithelial cells (HNECs). To examine factors affecting MMP-9 expression and activity in HNECs, HNECs were stimulated with Toll-like receptor (TLR) agonists, followed by quantitative PCR, immunofluorescence, and zymography to examine MMP-9 expression and activity. MMP-9 expression was evaluated in sinonasal tissue of control subjects without CRS, and patients with CRS without nasal polyps and those with CRS with nasal polyps, in relation to the expression of SIRT1 using a tissue microarray. The effect of SIRT1 stimulation/inhibition on MMP-9 expression in HNECs was also tested. TLR3 agonists increased MMP-9 mRNA expression (473 fold, P = 0.0198) and activity (20.4-fold, P < 0.05). SIRT1 activation or inhibition reciprocally affected MMP-9 expression in the presence of TLR3 agonists. MMP-9 and SIRT1 expression within the epithelial layer of sinonasal tissue was inversely correlated only in patients with CRS but not in control subjects. TLR3 agonists increased MMP-9 expression and activity in HNECs, and the effect was abolished in the presence of SIRT1 activation. SIRT1 and MMP-9 expression was inversely correlated in CRS tissue, supporting SIRT1 as a possible therapeutic target for nasal polyp formation.
• Anti-mumps IgM antibody positive rate with sudden sensorineural hearing loss using second-generation enzyme immunoassay: A retrospective, multi-institutional investigation in Hokkaido, Japan

  Atsushi Fukuda, Shinya Morita, Yuji Nakamaru, Kimiko Hoshino, Keishi Fujiwara, Shigeru Akazawa, Tomohiro Sakashita, Nobuyuki Obara, Akihiro Homma

  Auris Nasus Larynx 45 (5) 911 - 915 1879-1476 2018/10/01 [Refereed][Not invited]
   

  Objective: Although elevated anti-mumps IgM antibody levels were reported in 5.7%–7.2% of Japanese patients with sudden sensorineural hearing loss (SSNHL), there were several reports of false-positive cases, such as the continually IgM positive case and the IgM positive case in normal adults. To improve specificity, the new enzyme immuno assay (EIA) anti-mumps IgM antibody measurement kit was introduced in December 2009. This study re-examined the frequency of anti-mumps IgM antibody test positivity with SSNHL using the new measurement kit and compared the results with those from a previous report that used old kit. Methods: This is a retrospective multi-institutional study involving patients diagnosed with SSNHL who exhibited the anti-mumps IgM antibody. We compared the positive rate of anti-mumps IgM antibody and the annual average number of mumps cases per sentinel in Hokkaido between the patients in the present study and patients previously evaluated. Results: Overall, 100 patients with SSNHL were enrolled. One case (1.0%) was positive for anti-mumps IgM antibody. Of the 69 patients evaluated in the previous study, 5 cases (7.2%) were positive for anti-mumps IgM antibody. The positive rate of the anti-mumps IgM antibody in the present cases was significantly lower than that previously reported (p = 0.042). The annual average number of mumps cases per sentinel in Hokkaido of the present and previous surveillance period was 34.47 and 42.77, respectively no significant difference was seen in these data (p = 0.4519). Conclusion: The present study revealed that 1.0% of SSNHL was positive for the anti-mumps IgM antibody using the new EIA-IgM measurement kit. After the introduction of the new EIA-IgM measurement kit, anti-mumps IgM antibody positive rate with SSNHL significantly decreased, indicating that the proportion of asymptomatic mumps among etiology of SSNHL may be lower than those previously reported.
• EAONO/JOS中耳真珠腫進展度分類を用いた術後聴力予後因子の検討

  福田 篤, 森田 真也, 干野 季美子, 藤原 圭志, 中丸 裕爾, 本間 明宏

  Otology Japan (一社)日本耳科学会 28 (4) 468 - 468 0917-2025 2018/09
• vHITを用いた聴神経腫瘍症例の垂直半規管機能評価

  藤原 圭志, 森田 真也, 干野 季美子, 福田 篤, 中丸 裕爾, 本間 明宏

  Otology Japan (一社)日本耳科学会 28 (4) 637 - 637 0917-2025 2018/09
• 当院における嗅神経芽細胞腫の治療方針と成績

  中薗 彬, 中丸 裕爾, 鈴木 正宣, 水町 貴諭, 高木 大, 本間 明宏

  日本鼻科学会会誌 (一社)日本鼻科学会 57 (3) 429 - 429 0910-9153 2018/09
• 篩骨動脈を茎とする鼻中隔粘膜弁を用いた鼻中隔穿孔閉鎖術の1例

  勝俣 量平, 鈴木 正宣, 中薗 彬, 中丸 裕爾, 本間 明宏

  日本鼻科学会会誌 (一社)日本鼻科学会 57 (3) 504 - 504 0910-9153 2018/09
• Semi-quantitative analysis of pre-treatment morphological and intratumoral characteristics using F-18-fluorodeoxyglucose positron-emission tomography as predictors of treatment outcome in nasal and paranasal squamous cell carcinoma

  Fujima Noriyuki, Hirata Kenji, Shiga Tohru, Yasuda Koichi, Onimaru Rikiya, Tsuchiya Kazuhiko, Kano Satoshi, Mizumachi Takatsugu, Homma Akihiro, Kudo Kohsuke, Shirato Hiroki

  QUANTITATIVE IMAGING IN MEDICINE AND SURGERY 8 (8) 788 - 795 2223-4292 2018/09 [Refereed][Not invited]
   

  Background: To investigate the utility of quantitative morphological and intratumoral characteristics obtained by 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (FDG-PET/CT) for the prediction of treatment outcome in patients with nasal or paranasal cavity squamous cell carcinoma (SCC). Methods: Twenty-four patients with nasal or paranasal cavity SCC who received curative non-surgical therapy (a combination of super-selective arterial cisplatin infusion and radiotherapy) were retrospectively analyzed. From pre-treatment FDG-PET data, a total of 13 parameters of quantitative morphological characteristics (tumor volume, surface area and sphericity), intratumoral characteristics (the maximum and mean standard uptake value, three intratumoral histogram and four textural parameters) and total lesion glycolysis (TLG) were respectively calculated. Information regarding the treatment outcome was determined from the histological diagnosis or clinical follow-up. Each of the 13 quantitative parameters as well as T- and N-stage was assessed for its relation to treatment outcome of local control or failure. Results: In univariate analysis, significant differences in surface area and sphericity between the local control and failure groups were observed. The receiver operating characteristic (ROC) curve analysis showed that sphericity had the highest accuracy of 0.88. In the multivariate analysis, sphericity was revealed as an independent predictor of the local control or failure. Conclusions: The quantitative parameters of sphericity are useful to predict the treatment outcome in patients with nasal or paranasal SCC.
• 【ちょっと気になる頭頸部癌化学療法】 動注療法 上顎洞

  本間 明宏

  JOHNS (株)東京医学社 34 (8) 975 - 977 0910-6820 2018/08 [Not refereed][Not invited]
  
• Early prediction of lenvatinib treatment efficacy by using ¹⁸F-FDG PET/CT in patients with unresectable or advanced thyroid carcinoma that is refractory to radioiodine treatment: a protocol for a non-randomized single-arm multicenter observatio

  Takeuchi S, Shiga T, Hirata K, Taguchi J, Magota K, Ariga S, Gouda T, Ohhara Y, Homma R, Shimizu Y, Kinoshita I, Tsuji Y, Homma A, Iijima H, Tamaki N, Dosaka-Akita H

  BMJ open 8 (8) e021001  2018/08 [Refereed][Not invited]
   

  INTRODUCTION: Lenvatinib, an oral molecular targeted drug, is used to treat patients with unresectable or advanced thyroid carcinoma that is refractory to radioiodine treatment. Effective methods for evaluating molecular targeted drugs are a critical unmet need owing to their expensive costs and unique adverse events. The aim of this study is to determine whether 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT at 1 week after commencing lenvatinib can predict treatment outcomes. DESIGN AND METHODS: This study is planned as a non-randomised single-arm multicentre study; patients with pathologically confirmed differentiated thyroid carcinoma (DTC) with lesions that are refractory to radioiodine treatment are eligible. The main exclusion criteria are medullary or anaplastic carcinoma, prior treatment with chemotherapy, poor general condition and thromboembolism-requiring treatment. Patients to be included in the study will be treated with lenvatinib and undergo FDG-PET/CT examination twice: before and 1 week after the initiation of treatment. Contrast-enhanced CT, the gold standard for evaluation, will be performed at least 4 weeks after the initiation of treatment. The primary objective is to evaluate the ability of the lesion maximum standard uptake value for FDG PET/CT performed 1 week after the initiation of treatment to predict outcomes compared with the response evaluation obtained via contrast-enhanced CT performed at least 4 weeks after the initiation of treatment. ETHICS AND DISSEMINATION: This study is conducted in accordance with the Declaration of Helsinki and has received ethical approval from the institutional review board of the Hokkaido University Hospital (approval number: 015-402). The results of this study will be disseminated through a presentation at a conference and the publication of the data in a peer-reviewed journal. The study will be implemented and reported in line with the SPIRIT statement. TRIAL REGISTRATION NUMBER: UMIN000022592.
• Intra-arterial Chemoradiation Therapy as an Option for Maxillary Sinus Cancers

  Akihiro Homma, Rikiya Onimaru

  International Journal of Radiation Oncology Biology Physics 101 (4) 763  0360-3016 2018/07/15 [Not refereed][Not invited]
  
• Rapid detection of superficial head and neck squamous cell carcinoma by topically spraying fluorescent probe targeting dipeptidyl peptidase-IV.

  Mizushima T, Ohnishi S, Shimizu Y, Hatanaka Y, Hatanaka KC, Kuriki Y, Kamiya M, Homma A, Yamamoto K, Ono S, Urano Y, Sakamoto N

  Head & neck 40 (7) 1466 - 1475 1043-3074 2018/07 [Refereed][Not invited]
  
• Comparison of the University of Pittsburgh staging system and the eighth edition of the American Joint Committee on Cancer TNM classification for the prognostic evaluation of external auditory canal cancer.

  Morita S, Mizumachi T, Nakamaru Y, Sakashita T, Kano S, Hoshino K, Fukuda A, Fujiwara K, Homma A

  International journal of clinical oncology 23 (6) 1029 - 1037 1341-9625 2018/07 [Refereed][Not invited]
   

  BACKGROUND: The purpose was to compare survival differences between patients with external auditory canal (EAC) cancer treated according to the University of Pittsburgh modified TNM staging system and those treated in accordance with the 8th edition of the American Joint Committee on Cancer (AJCC) staging manual on the TNM staging system for cutaneous cancers of the head and neck. METHODS: We performed a retrospective, single-institution review of 60 patients with EAC cancer treated with curative intent between September 2002 and March 2018. Survival outcomes were measured on the basis of the two staging systems. RESULTS: The C-index values for the overall survival (OS) rate revealed that the University of Pittsburgh staging system had higher prognostic accuracy than the 8th edition of the AJCC staging system. Univariable and multivariable analysis showed that T classification according to the University of Pittsburgh staging system was an independent predictor of the OS rate (hazard ratio 5.25; 95% confidence interval 1.38-24.9; P = 0.015). Meanwhile, the AJCC staging system could not differentiate T2 from T3-4 cancers. CONCLUSION: The University of Pittsburgh staging system for patients with EAC cancer is a valuable tool for use in clinical decision-making and predicting survival outcome.
• 喉頭癌に対する超選択的動注と放射線同時併用療法

  本間 明宏

  耳鼻咽喉科展望 耳鼻咽喉科展望会 61 (3) 142 - 149 0386-9687 2018/06 [Not refereed][Not invited]
   

  喉頭癌に対する大量シスプラチンの超選択的動注療法と放射線治療の同時併用療法(RADPLAT)について述べる。北海道大学では2003〜2015年に喉頭原発扁平上皮癌新鮮例16例にRADPLATを行い、原発巣は全例RADPLATで制御されていた。遠隔転移で死亡が3例、他病死が1例あった。晩期合併症は嚥下障害が2例、喉頭壊死が1例に出現した。喉頭癌に対するRADPLATは、上顎洞癌よりも慎重なinterventional radiology(IVR)の技術が必要ではあるが、適応を厳選して行えば良好な結果が期待できる。今後は、多施設共同前向き試験で喉頭壊死、嚥下障害などの晩期障害の発生頻度も加味して至適スケジュールを検討し、有効性を検証することが必要である。そして、RADPLATの立ち位置は喉頭温存手術、化学放射線療法の適応を含め、喉頭癌全体の治療戦略を考えるなかで決まるであろう。(著者抄録)
• Genetic mutation analysis of the malignant transformation of sinonasal inverted papilloma by targeted amplicon sequencing

  Shinichiro Yasukawa, Satoshi Kano, Hiromitsu Hatakeyama, Yuji Nakamaru, Dai Takagi, Takatsugu Mizumachi, Masanobu Suzuki, Takayoshi Suzuki, Akira Nakazono, Shinya Tanaka, Hiroshi Nishihara, Akihiro Homma

  International Journal of Clinical Oncology 1 - 9 1437-7772 2018/05/19 [Refereed][Not invited]
   

  Background: The mechanism underlying the malignant transformation of inverted papilloma (IP) has not yet been elucidated. Methods: To clarify the genes responsible for the malignant transformation, we analyzed 10 cases of IP, 8 of IP with dysplasia, and 11 of squamous cell carcinoma (SCC) by targeted amplicon sequencing. Results: The number of mutant genes increased in the order of IP < dysplasia < SCC. Significant differences were observed in the mutation rates of three genes (KRAS, APC and STK11) in particular. TP53 was altered frequently in each group and might be involved in malignant transformation based on to the site of the mutation. A comparison of the genetic variants by region of IP tissue among patients with IP alone, and those with dysplasia or SCC revealed significant differences in the mutation rate of the KRAS gene. Conclusion: Identification of genetic mutations in KRAS is effective for predicting the malignant transformation of IP.
• 慢性肉芽腫症に対する骨髄移植後に発生した小児甲状腺乳頭癌の1例

  坂下 智博, 本間 明宏, 対馬 那由多, 川浪 康太郎, 福田 諭

  北海道医学雑誌 北海道医学会 93 (1) 70 - 70 0367-6102 2018/05 [Not refereed][Not invited]
  
• 切除不能局所進行頭頸部扁平上皮がんに対するPCE導入化学療法後の化学放射線療法の実施可能性検証試験

  岡野 晋, 榎田 智弘, 小川 武則, 本間 明宏, 大上 研二, 南 修司郎, 岩江 信法, 中目 亜矢子, 清水 康, 槇 大輔, 上田 百合, 藤澤 孝夫, 茂木 厚, 野村 尚吾, 田原 信

  頭頸部癌 (一社)日本頭頸部癌学会 44 (2) 148 - 148 1349-5747 2018/05 [Not refereed][Not invited]
  
• 次世代シーケンサーを用いたHPV陽性およびHPV陰性中咽頭癌の遺伝子解析 頭頸部癌基礎研究会報告

  家根 旦有, 藤井 正人, 太田 一郎, 菅澤 正, 本間 明宏, 水田 啓介, 倉富 勇一郎, 丹生 健一, 加藤 久幸, 大上 研二, 北村 守正, 辻 裕之, 安松 隆治, 永澤 昌

  頭頸部癌 (一社)日本頭頸部癌学会 44 (2) 125 - 125 1349-5747 2018/05 [Not refereed][Not invited]
  
• 放射線治療による頭頸部がん治療成績改善の取り組みと展望 動注化学放射線療法

  水町 貴諭, 松浦 一登, 鬼丸 力也, 林 隆一, 本間 明宏

  頭頸部癌 (一社)日本頭頸部癌学会 44 (2) 97 - 97 1349-5747 2018/05 [Not refereed][Not invited]
  
• 当科における局所進行外耳道扁平上皮癌の治療成績の検討

  加納 里志, 森田 真也, 中丸 裕爾, 水町 貴諭, 中薗 彬, 福田 篤, 安田 耕一, 鬼丸 力也, 白土 博樹, 本間 明宏

  頭頸部癌 (一社)日本頭頸部癌学会 44 (2) 181 - 181 1349-5747 2018/05 [Not refereed][Not invited]
  
• Quality of Survivalを考慮した頭頸部癌支持療法 頭頸部がん患者の口腔支持療法と地域連携

  秦 浩信, 吉川 和人, 今待 賢治, 上田 倫弘, 永橋 立望, 西山 典明, 安田 耕一, 本間 明宏, 北川 善政

  頭頸部癌 (一社)日本頭頸部癌学会 44 (2) 115 - 115 1349-5747 2018/05 [Not refereed][Not invited]
  
• 次世代シーケンサーを用いたHPV陽性およびHPV陰性中咽頭癌の遺伝子解析 頭頸部癌基礎研究会報告

  家根 旦有, 藤井 正人, 太田 一郎, 菅澤 正, 本間 明宏, 水田 啓介, 倉富 勇一郎, 丹生 健一, 加藤 久幸, 大上 研二, 北村 守正, 辻 裕之, 安松 隆治, 永澤 昌

  頭頸部癌 (一社)日本頭頸部癌学会 44 (2) 125 - 125 1349-5747 2018/05
• Quality of Survivalを考慮した頭頸部癌支持療法 頭頸部がん患者の口腔支持療法と地域連携

  秦 浩信, 吉川 和人, 今待 賢治, 上田 倫弘, 永橋 立望, 西山 典明, 安田 耕一, 本間 明宏, 北川 善政

  頭頸部癌 (一社)日本頭頸部癌学会 44 (2) 115 - 115 1349-5747 2018/05
• 当科における局所進行外耳道扁平上皮癌の治療成績の検討

  加納 里志, 森田 真也, 中丸 裕爾, 水町 貴諭, 中薗 彬, 福田 篤, 安田 耕一, 鬼丸 力也, 白土 博樹, 本間 明宏

  頭頸部癌 (一社)日本頭頸部癌学会 44 (2) 181 - 181 1349-5747 2018/05
• Validation of the 8th edition of the AJCC/UICC TNM staging system for tongue squamous cell carcinoma

  Satoshi Kano, Tomohiro Sakashita, Nayuta Tsushima, Takatsugu Mizumachi, Akira Nakazono, Takayoshi Suzuki, Shinichiro Yasukawa, Akihiro Homma

  International Journal of Clinical Oncology 1 - 7 1437-7772 2018/04/19 [Refereed][Not invited]
   

  Background: The revised 8th edition of the AJCC/UICC staging system was released in January 2017, and depth of invasion (DOI) was added to the new criteria for T classification in oral cavity cancer. In this study, we evaluated whether the 8th edition presents the prognosis and risk of nodal metastasis in patients with squamous cell carcinoma of tongue more accurately than did the 7th edition. Methods: The data for 112 patients were obtained and reclassified based on the criteria presented in the 8th edition. Results: Seven patients previously staged as T1 based on the criteria in the 7th edition were reclassified as T2 based on the 8th edition, while 19 T2 patients were reclassified as T3, and 9 T4a patients were reclassified as T3. T3 in the 8th edition represents a homogenous population showing the same prognosis, while T2 in the 8th edition represents a heterogenous population. Nodal metastasis was significantly correlated with T classification in both editions and DOI. However, neither the T classification in the 7th or 8th edition, nor DOI could predict the probability of potential nodal metastasis in patients with cN0 disease. Conclusions: The classification on T3 in the 8th edition can be seen as reasonable with regard to prognosis. Nodal metastasis was significantly correlated with T classification and DOI however, the probability of subsequent nodal metastasis in patients with T2N0 was almost same for the criteria in the 7th and 8th editions, therefore, the same careful management as before is required for patients with N0 disease.
• 舌扁平上皮癌における新しいTNM分類の有用性の検討

  加納 里志, 水町 貴諭, 対馬 那由多, 鈴木 崇祥, 中薗 彬, 安川 真一郎, 本間 明宏

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 121 (4) 578 - 578 0030-6622 2018/04 [Not refereed][Not invited]
  
• AMED研究:頭頸部癌領域 進行上顎洞癌に対する超選択的動注化学療法を併用した放射線治療による新規治療法開発に関する研究

  本間 明宏, 松浦 一登, 鬼丸 力也, 林 隆一

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 121 (4) 383 - 384 0030-6622 2018/04 [Not refereed][Not invited]
  
• 両側半規管麻痺を呈した大動脈炎症候群の1例

  藤原 圭志, 本間 明宏

  Equilibrium Research (一社)日本めまい平衡医学会 77 (2) 64 - 68 0385-5716 2018/04 [Refereed][Not invited]
   

  症例は48歳男性で、右突発性難聴(38歳時)があったが、めまいの既往はなかった。頭痛、発熱、炎症反応高値の精査目的で入院中に、左難聴めまいを自覚した。純音聴力検査にて高音域中心の感音難聴を認め、CCDフレンツェル下の頭位眼振検査にて方向固定性右向き水平回旋混合性眼振を認めた。左内耳障害と診断し、プレドニゾロン(PSL)の治療を開始したが、難聴は悪化した。全身精査の造影CTで造影効果を伴う大動脈の壁肥厚を認め、炎症反応高値を伴い、大動脈炎症候群と診断した。内耳障害も大動脈炎症候群に関連するものとして、メチルプレドニゾロンのステロイドパルス療法を施行し、その後メトトレキセート、トシリズマブ併用の上、PSL漸減投与を行い、炎症反応は改善した。左聴力は初診後4ヵ月の時点で改善し、その後は増悪を認めていない。眼振は初診後1ヵ月で消失したがjumbling現象は持続した。video head impulse testとカロリックテストの結果から両側の高度半規管麻痺が持続していることが示唆された。めまい症状に対してはリハビリテーションを継続していく予定である。
• Elevated Level of Myeloperoxidase-Deoxyribonucleic Acid Complex in the Middle Ear Fluid Obtained from Patients with Otitis Media Associated with Antineutrophil Cytoplasmic Antibody-associated Vasculitis

  Shinya Morita, Yuji Nakamaru, Daigo Nakazawa, Fumihiko Hattanda, Haruki Shida, Yoshihiro Kusunoki, Kanako Watanabe, Sakiko Masuda, Dai Takagi, Masanobu Suzuki, Kimiko Hoshino, Atsushi Fukuda, Utano Tomaru, Akihiro Homma, Akihiro Ishizu

  Otology and Neurotology 39 (4) e257 - e262 1537-4505 2018/04/01 [Refereed][Not invited]
   

  Objective:The purpose was to explore the presence of myeloperoxidase (MPO)-deoxyribonucleic acid (DNA) complex as a surrogate marker of neutrophil extracellular traps (NETs) in the middle ear fluid, and to clarify the correlation between its quantifiable level and hearing outcome in patients with otitis media associated with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV).Study Design:Prospective study.Setting:Tertiary referral center.Patients:Nine AAV patients presenting with otitis media.Intervention:Collection of the fluid samples from middle ear.Main Outcome Measure:The quantifiable levels of MPO-DNA complex using an enzyme-linked immunosorbent assay.Results:The quantifiable levels of MPO-DNA complex in patients with AAV were significantly higher than those in controls (p < 0.001). In particular, both ANCA-positive and-negative cases indicated higher levels of MPO-DNA complex compared with the controls (p = 0.004 and p = 0.006, respectively). The significant negative correlations were observed between the level of MPO-DNA complex and the functional hearing values for air (r =-0.82, p = 0.009) and bone conduction (r =-0.73, p = 0.028), respectively.Conclusion:This analysis is the first to reveal the presence of elevated levels of MPO-DNA complex in the middle ear fluid, suggesting the pathogenic role of NETs in otitis media associated with AAV. NETs may be a valuable biomarker for use in clinical decision-making and predicting hearing outcome, regardless of ANCA status.
• A case of aortitis syndrome with bilateral canal paresis

  Keishi Fujiwara, Akihiro Homma

  Equilibrium Research 77 (2) 64 - 68 0385-5716 2018/04/01 [Refereed][Not invited]
   

  Objective: Aortitis syndrome with bilateral canal paresis: a case report. Patient: A 48-year-old man with aortitis syndrome is presented. The patient had no history of vertigo or dizziness. Result: The patient experienced hearing loss on the left side and dizziness during the investigation for fever of an unknown origin. Sensorineural hearing loss on the left side and nystagmus beating toward the right side were detected with otological examination. Furthermore, a thoracic and abdominal enhanced CT scan revealed a thickened aorta wall, and the patient was diagnosed as having aortitis syndrome. The inner ear disorders were considered to be related to the aortitis syndrome and corticosteroids were administered. Hearing loss was completely restored, but oscillopsia during head movements persisted. A monothermal caloric test showed bilateral canal paresis. Both cervical and ocular VEMP showed no response bilaterally, indicating the dysfunction associated with bilateral otoliths. The results of a video head impulse test revealed decrease in the gain of the vestibuleocular reflex and appearance of catch-up saccade bilaterally, indicating bilateral canal paresis. Conclusion: In this case, the inner ear disorder was considered to be related to the patient's aortitis syndrome. Although hearing loss improved, vestibular impairment persisted. Bilateral canal paresis was demonstrated by vHIT, as well as the caloric test.
• Phase II trial of combination treatment with paclitaxel, carboplatin and cetuximab (PCE) as first-line treatment in patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck (CSPOR-HN02)

  Makoto Tahara, N. Kiyota, T. Yokota, Y. Hasegawa, K. Muro, S. Takahashi, T. Onoe, A. Homma, J. Taguchi, M. Suzuki, K. Minato, K. Yane, S. Ueda, H. Hara, K. Saijo, T. Yamanaka

  Annals of Oncology 29 (4) 1004 - 1009 1569-8041 2018/04/01 [Refereed][Not invited]
   

  Background: The standard of care for first-line treatment of recurrent and/or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN) is combination treatment with platinum, 5-FU and cetuximab (PFE). However, this regimen requires hospitalization to ensure proper hydration and continuous infusion of 5-FU, and causes severe nausea and anorexia. We evaluated the efficacy and safety of paclitaxel, carboplatin and cetuximab (PCE) as first-line treatment in patients with R/M SCCHN. Patients and methods: Eligibility criteria included recurrent and/or metastatic, histologically proven SCC of the oropharynx, oral cavity, hypopharynx or larynx PS 0-1 adequate organ function no suitable local therapy for R/M SCCHN and no prior systemic chemotherapy for R/M SCCHN. Chemotherapy consisted of paclitaxel 100 mg/m2 on days 1, 8 carboplatin area under the blood concentration-time curve 2.5 on days 1, 8, repeated every 3 weeks for up to 6 cycles and cetuximab at an initial dose of 400 mg/m2, followed by 250 mg/m2 weekly until disease progression or unacceptable toxicities. Primary end point was overall response rate. Secondary end points were safety, treatment completion rate, progression-free survival, overall survival, and clinical benefit rate. Planned sample size was 45 patients. Results: Forty-seven subjects were accrued from July 2013 to October 2014. Of 45 evaluable, 40 were male median age was 63 years Eastern Cooperative Oncology Group Performance Status was 0/1 in 23/22 cases site was the hypopharynx/ oropharynx/oral cavity/larynx in 17/11/10/7 cases and 36/9 cases were smokers/nonsmokers, respectively. Overall response rate, the primary end point, was 40%. Median overall survival was 14.7 months and progression-free survival was 5.2 months. Grade 3/4 adverse events included neutropenia (68%), skin reaction (15%), fatigue (9%) and febrile neutropenia (9%). A potentially treatment-related death occurred in one patient with intestinal pneumonia. Conclusions: The PCE regimen shows promising activity with acceptable toxicity in the outpatient clinic. Further studies are needed to compare PCE with PFE in this population.
• AMED研究:頭頸部癌領域 進行上顎洞癌に対する超選択的動注化学療法を併用した放射線治療による新規治療法開発に関する研究

  本間 明宏, 松浦 一登, 鬼丸 力也, 林 隆一

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 121 (4) 383 - 384 0030-6622 2018/04 [Refereed][Not invited]
  
• The surgical outcome of minimally invasive pharyngo-laryngo-oesophagectomy in prone position.

  Ogino M, Ebihara Y, Homma A, Tanaka K, Nakanishi Y, Asano T, Noji T, Kurashima Y, Murakami S, Nakamura T, Tsuchikawa T, Okamura K, Shichinohe T, Hirano S

  Journal of minimal access surgery 15 (2) 98 - 102 0972-9941 2018/03 [Refereed][Not invited]
   

  PURPOSE: Pharyngo-laryngo-oesophagectomy (PLE) which is mainly indicated for cervical oesophageal cancer or synchronous double cancer of the thoracic oesophagus and the pharynx or larynx, is extremely invasive. Since minimally invasive oesophagectomy (MIE) using video-assisted thoracic surgery has become popular recently, the procedure can be adopted to PLE. Moreover, the use of the prone position (PP) in MIEs has been increasing recently because technical advantages and fewer post-operative complications were reported. To assess the validity of PP, this study compared surgical outcomes of minimally invasive PLE (MIPLE) in PP with that in the left lateral decubitus position (LLDP). PATIENTS AND METHODS: This study enrolled consecutive 15 patients that underwent MIPLE with LLDP (n = 7) or PP (n = 8) between January 1996 and October 2016. The patients' background characteristics, operative findings and post-operative complications were examined. RESULTS: Eligible diseases are 5 cases of cervical oesophageal cancer, 9 cases of synchronous double cancer of the thoracic oesophagus and head and neck and 1 case of cervical oesophageal recurrence of the head-and-neck cancer. The patients' background characteristics were not significantly different. During surgery, thoracic blood loss was significantly lower in PP than in LLDP (P = 0.0487). Other operative findings and post-operative complications were not significantly different between the two groups. CONCLUSIONS: In MIPLE, the PP could reduce blood loss due to the two-lung ventilation under artificial pneumothorax and was associated with lower surgical stress than LLDP.
• Dose-finding and efficacy confirmation trial of the superselective intra-arterial infusion of cisplatin and concomitant radiotherapy for locally advanced maxillary sinus cancer (Japan Clinical Oncology Group 1212): Dose-finding phase

  Akihiro Homma, Rikiya Onimaru, Kazuto Matsuura, Hirotaka Shinomiya, Tomohiro Sakashita, Kiyoto Shiga, Hiroyuki Tachibana, Kenichi Nakamura, Junki Mizusawa, Hideaki Kitahara, Junko Eba, Haruhiko Fukuda, Masato Fujii, Ryuichi Hayashi

  Head and Neck 40 (3) 475 - 484 1043-3074 2018/03 [Refereed][Not invited]
   

  © 2017 Wiley Periodicals, Inc. Background: We are currently undertaking a multi-institutional prospective trial of the superselective intra-arterial infusion of high-dose cisplatin with concomitant radiotherapy for patients with T4aN0M0 or T4bN0M0 locally advanced maxillary sinus squamous cell carcinomas (SCC). We herein report the results of the dose-finding phase. Methods: The dose-finding phase sought to evaluate the incidence of dose-limiting toxicities and determine the recommended number of cycles of the intra-arterial infusion of cisplatin. In this phase, 100 mg/m2 of cisplatin was administered intra-arterially weekly for 7 weeks with concomitant radiotherapy (70 Gy). Results: All 18 patients received a full dose of radiotherapy. The number of cycles of cisplatin was 7 in 13 patients and 6 in 5 patients. The dose-limiting toxicities were observed in 5 patients. Conclusion: These results indicated that this therapy is safe and well-tolerated at 7 cycles of cisplatin, which was determined to be the recommended number of cycles for locally advanced maxillary sinus SCC.
• 同時期に異所性に発生した悪性腫瘍に対して、二部位同時にIMRTを施行した症例

  湊川 英樹, 安田 耕一, 白土 博樹, 土屋 和彦, 原田 八重, 水町 貴諭, 坂下 智博, 本間 明宏, 福田 諭, 石嶋 漢, 宮本 直樹, 高尾 聖心, 鈴木 隆介, 松浦 妙子, 牧永 綾乃, 田村 昌也

  Japanese Journal of Radiology (公社)日本医学放射線学会 36 (Suppl.) 6 - 6 1867-1071 2018/02
• 咽喉頭直達鏡固定システムの試作

  本間 明宏, 清水 勇一, 畠山 博充, 溝口 兼司, 水町 貴諭, 加納 里志, 坂下 智博, 福田 諭

  耳鼻咽喉科展望 耳鼻咽喉科展望会 61 (1) 66 - 67 0386-9687 2018/02 [Refereed][Not invited]
  
• 頭頸部癌に対する超選択的動注化学療法の適応と実際

  本間 明宏

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 121 (2) 150 - 151 0030-6622 2018/02 [Not refereed][Not invited]
  
• Clinical Characteristics and Treatment Outcomes for Patients with External Auditory Canal Cholesteatoma

  Shinya Morita, Yuji Nakamaru, Atsushi Fukuda, Keishi Fujiwara, Kimiko Hoshino, Akihiro Homma

  Otology and Neurotology 39 (2) 189 - 195 1537-4505 2018/02/01 [Refereed][Not invited]
   

  Objective: We aimed to evaluate the clinical features and treatment outcomes for patients with idiopathic and secondary external auditory canal cholesteatoma (EACC), and to validate the treatment strategy from the perspective of hearing as well as etiology and staging. Study Design: Retrospective case series. Setting: Tertiary referral center and affiliated hospitals. Patients: Fifty-eight patients with idiopathic EACC and 14 patients with secondary EACC. Intervention: Conservative management and surgery. Main Outcome Measure: Air conduction (AC) pure-tone averages (PTAs) and mean air-bone gaps (ABGs). Results: There were no significant differences between hearing values before and after conservative management for idiopathic EACC patients with stages I-III, indicating that hearing abilities were preserved. For idiopathic EACC patients with stage IV disease treated with surgery, the AC PTA threshold and mean ABG significantly improved from a preoperative value of 60.3 dB HL to a postoperative value of 32.4 dB HL (p = 0.013), and from 34.3 to 9.5 dB HL (p < 0.001), respectively. For secondary EACC, the AC PTA threshold and mean ABG significantly improved from a preoperative value of 49.5 dB HL to a postoperative value of 23.2 dB HL (p < 0.001), and from 31.4 to 6.7 dB HL (p < 0.001), respectively. Conclusion: The treatment modalities should be selected based on the perspective of hearing as well as the extent of disease and etiology. The early lesions can be treated conservatively, whereas the advanced lesions or cases refractory to conservative management require complete surgical removal of EACC.
• Utility of a Hybrid IVIM-DKI Model to Predict the Development of Distant Metastasis in Head and Neck Squamous Cell Carcinoma Patients.

  Noriyuki Fujima, Tomohiro Sakashita, Akihiro Homma, Daisuke Yoshida, Kohsuke Kudo, Hiroki Shirato

  Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine 17 (1) 21 - 27 1347-3182 2018/01/10 [Refereed][Not invited]
   

  PURPOSE: To evaluate the diagnostic power of hybrid intravoxel incoherent motion (IVIM)-diffusion kurtosis imaging (DKI) model parameters in pretreatment for the prediction of future distant metastasis in head and neck squamous cell carcinoma (HNSCC) patients. MATERIALS AND METHODS: We retrospectively evaluated 49 HNSCC patients who underwent curative chemoradiation therapy. Diffusion-weighted image (DWI) acquired by single-shot spin-echo echo-planar imaging with 12 b-values (0-2000) was performed in all patients before any treatment. We calculated the IVIM-DKI parameters and the conventional apparent diffusion coefficient (ADC) in the ROI placed on the primary lesion. The presence of future distant metastasis was determined by histological findings or clinical follow-up. RESULTS: A univariate analysis revealed significant differences between the patients with distant metastasis and those without in slow diffusion coefficient (D) and kurtosis value (K). Highest diagnostic accuracy was obtained by the D value. In addition, a multivariate analysis revealed that the D value was an independent predictor of future distant metastasis. CONCLUSION: The D and K values obtained by this hybrid IVIM-DKI model can be one of the diagnostic tools for the prediction of future distant metastasis in HNSCC patients.
• Regional dental cooperation and oral supportive care for head and neck cancer patients

  Hironobu Hata, Kazuhito Yoshikawa, Kenji Imamachi, Chika Murai, Michihiro Ueda, Tatsumi Nagahashi, Noriaki Nishiyama, Kouichi Yasuda, Akihiro Honma, Yoshimasa Kitagawa

  Japanese Journal of Head and Neck Cancer 44 (4) 380 - 386 1349-5747 2018 

  Due to various functional disorders and adverse events with head and neck cancer treatment, the QOL of cancer survivors markedly decreases. In many cases, there is a gradual improvement in QOL, though patients experience various discomforts daily. A critical issue is how long long-term survivors can continue to manage their oral condition. Since 2012, cooperating cancer dentists have been registered and presently there are more than 14,000 such dentists in Japan, creating a framework for referring such cancer patients to dentists in general practice. In 2011, for patients who were treated from 2007 to 2010, we performed a survey of continued oral management after discharge from Hokkaido University Hospital. After discharge, 34.3% of cases continued oral management, but when limited to patients in the care of general practice dentists, the rate was only 7.5%. In this study of patients from 2011 to 2016, the patients who continued oral management after discharge and the patients in the care of general practice dentists were higher, at 70.5% and 40.4%. It is essential that appropriate oral management in cooperation with local dental clinics is continued to improve the QOL of head and neck cancer patients.
• Auditory perceptual study of homonym discriminations in speakers with adductor spasmodic dysphonia

  Saori Yanagida, Noriko Nishizawa, Kenji Mizoguchi, Hiromitsu Hatakeyama, Akihiro Homma, Satoshi Fukuda

  Japan Journal of Logopedics and Phoniatrics 日本音声言語医学会 59 (1) 16 - 21 0030-2813 2018 [Refereed][Not invited]
   

  Ten patients diagnosed with adductor spasmodic dysphonia (ADSD) read aloud eight homonyms while ten healthy university students who speak standard Japanese judged the word meanings. Results of the assessments revealed that the intra-evaluator matching was 88.6%, with 19/80 samples (23.8%) misjudged by more than half of the evaluators. These samples were classified as either 1) voiced/unvoiced or 2) an accent kernel position. Homonyms that were constructed from serial voiced syllables (11/19 samples) or with the accent kernel position in the second mora (13/19 samples) tended to be misjudged. Difficulty of speech in ADSD patients affects not only “voice” disorders but also “speech” disorders, including voice pitch adjustment, and these adjustment errors may lead to low speech intelligibility.
• Oncocytoma of the Parotid Gland with Facial Nerve Paralysis.

  Seijiro Hamada, Keishi Fujiwara, Hiromitsu Hatakeyama, Akihiro Homma

  Case reports in otolaryngology 2018 7687951 - 7687951 2090-6765 2018 [Refereed][Not invited]
   

  Parotid gland tumor with facial nerve paralysis is strongly suggestive of a malignant tumor. However, several case reports have documented benign tumors of the parotid gland with facial nerve paralysis. Here, we report a case of oncocytoma of the parotid gland with facial nerve paralysis. A 61-year-old male presented with pain in his right parotid gland. Physical examination demonstrated the presence of a right parotid gland tumor and ipsilateral facial nerve paralysis of House-Brackmann (HB) grade III. Due to the facial nerve paralysis, a malignant tumor of the parotid gland was suspected and right parotidectomy was performed. Oncocytoma was confirmed histopathologically. The facial nerve paralysis was resolved 2 months after surgery. During the follow-up period (one and a half years), no recurrence was observed. As the tumor showed a distinctive dumbbell shape and increased somewhat due to inflammation (i.e., infection), the facial nerve was pinched by the enlarged tumor. Ischemia and strangulation of the nerve were considered to be the cause of the facial nerve paralysis associated with the benign tumor in this case.
• Detection of Superficial Head and Neck Squamous Cell Carcinoma by Topically Spraying Fluorescent Probe Targeting DPP-IV

  Ohnishi Shunsuke, Mizushima Takeshi, Shimizu Yuichi, Hatanaka Yutaka, Hatanaka Kanako, Yamamoto Keiko, Homma Akihiro, Kuriki Yugo, Kamiya Mako, Urano Yasuteru, Sakamoto Naoya

  CANCER SCIENCE 109 730  1349-7006 2018/01 [Refereed][Not invited]
  
• 【どこが変わった頭頸部がんTNM分類】 鼻副鼻腔がん

  坂下 智博, 本間 明宏

  耳鼻咽喉科・頭頸部外科 (株)医学書院 89 (13) 1068 - 1073 0914-3491 2017/12 [Not refereed][Not invited]
   

  ＜POINT＞N分類:リンパ節転移の被膜外進展(extranodal extension:ENE)による分類が加わり,臨床的N3を,N3a,N3bに,病理学的N2をN2a,N2b,N2cに,病理学的N3をN3a,N3bに分類することとなった。粘膜原発悪性黒色腫は,大きな変更点はないが,鼻副鼻腔がんとは異なる分類を用いる点に注意する。頭頸部原発の軟部肉腫の項目が新設された。組織学的グレード分類は,分化度,核分裂度,壊死の程度をスコア化して総合的に判断される。病期分類については現時点では設けられていない。(著者抄録)
• Matched-pair analysis of patients with advanced hypopharyngeal cancer: surgery versus concomitant chemoradiotherapy

  Shigemichi Iwae, Masato Fujii, Ryuichi Hayashi, Yasuhisa Hasegawa, Takashi Fujii, Kenji Okami, Akihiro Homma, Tetsuro Onitsuka, Takakuni Kato, Takenori Ogawa, Kyoichi Terao, Nobuya Monden, Naoki Otsuki, Hiroshi Nishino, Ichiro Ota, Yasushi Fujimoto, Kazuto Matsuura, Kazuyoshi Kawabata, Hidetoshi Matsui, Koichiro Yonezawa, Ken-ichi Nibu

  INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY 22 (6) 1001 - 1008 1341-9625 2017/12 [Refereed][Not invited]
   

  Background The aim of this study was to compare the therapeutic outcomes of total pharyngolaryngectomy with those of concomitant chemoradiotherapy in advanced hypopharyngeal cancer. Methods This is a retrospective multi-institutional study. The medical records of 979 patients with hypopharyngeal cancer, who were initially treated between 2006 and 2008, were reviewed. In this study, we matched a group of total pharyngolaryngectomy patients with a second group of chemoradiotherapy patients, according to age, gender, subsite, arytenoid fixation, cartilage invasion, and N classification, and analyzed overall survival, disease-specific survival, and locoregional control rates. Results The matched-pair analysis included 254 patients. The 5-year overall survival, disease-specific survival, and locoregional control rates were 58.5% and 53.5% (P = 0.30), 68.9% and 68.0% (P = 0.80), and 82.2% and 63.6% (P < 0.01), respectively, for patients in the total pharyngolaryngectomy and chemoradiotherapy groups. For T4a patients with cartilage invasion, the matched-pair analysis included 46 patients. The 5-year overall survival, disease-specific, and locoregional control rates were 56.5% and 26.0% (P = 0.092), 56.5% and 41.3% (P = 0.629), and 43.0% and 42.5% (P = 0.779), respectively, for patients in the total pharyngolaryngectomy and chemoradiotherapy groups. Conclusions The data from this large-scale multi-institutional joint research program of hypopharyngeal cancer in Japan suggest that chemoradiotherapy may provide adequate survival benefit for hypopharyngeal cancer patients with the distinct advantage of larynx preservation. Our data also suggest that chemoradiotherapy is as beneficial as total pharyngolaryngectomy for the local control of locally advanced hypopharyngeal cancer.
• Value of T1-weighted magnetic resonance imaging in cholesteatoma detection

  Atsushi Fukuda, Shinya Morita, Taisuke Harada, Keishi Fujiwara, Kimiko Hoshino, Yuji Nakamaru, Akihiro Homma

  Otology and Neurotology 38 (10) 1440 - 1444 1537-4505 2017/12/01 [Refereed][Not invited]
   

  Objective: To reveal the usefulness of T1-weighted (T1W) imaging on diagnostic magnetic resonance (MR) imaging for cholesteatoma. Study Design: A retrospective case review. Setting: Tertiary referral center. Patients: Fifty-three patients (57 ears) suspected to have cholesteatomas and treated (6-82 yr of age). Intervention: Preoperative MR imaging, including non-echo planar (non-EP) diffusion-weighted (DW) and T1W imaging. Main Outcome Measures: Primary outcome measures included the comparison between the diagnostic accuracy for the detection of cholesteatomas using non-EP DW imaging alone (criterion 1) and non-EP DW imaging along with T1W imaging (criterion 2). Diagnostic accuracy was evaluated in each case by comparing MR imaging with surgical findings. Secondary outcome measures included the comparison of the rates of cases showing a high T1W signal between cholesteatomas and noncholesteatomas which showed a high non-EP DW signal. Results: The sensitivity, specificity, and accuracy according to criterion 1 were 93.5, 63.6, and 87.7% and those according to criterion 2 were 89.1, 100, and 91.2%, respectively. Of 43 cholesteatoma cases indicating a high non-EP DW signal, only 2 cases showed a high T1W signal (5%). On the other hand, all four noncholesteatoma cases indicating high non-EP DW signal showed a high T1W signal (100%), and these rates were significantly different ( p< 0.001). Conclusion: Our results suggest that T1W imaging may aid in the exclusion of false-positive cases on diagnostic non-EP DW MR imaging for cholesteatomas. A combination of non- EP DW and T1W imaging may improve the specificity and accuracy compared with non-EP DW imaging alone.
• 舌扁平上皮癌における新しいTNM分類の有用性の検討

  加納 里志, 中薗 彬, 水町 貴諭, 本間 明宏

  日本癌治療学会学術集会抄録集 (一社)日本癌治療学会 55回 P157 - 4 2017/10 [Not refereed][Not invited]
  
• 舌扁平上皮癌における新しいTNM分類の有用性の検討

  加納 里志, 中薗 彬, 水町 貴諭, 本間 明宏

  日本癌治療学会学術集会抄録集 (一社)日本癌治療学会 55回 P157 - 4 2017/10 [Not refereed][Not invited]
  
• 根治切除不能な頭頸部扁平上皮癌における悪液質と予後の検討 JCOG0706副次的解析

  松塚 崇, 清田 尚臣, 水澤 純基, 秋元 哲夫, 長谷川 泰久, 岩江 信法, 門田 伸也, 松浦 一登, 小野澤 祐輔, 本間 明宏, 藤井 博文, 福田 治彦, 林 隆一, 田原 信

  日本癌治療学会学術集会抄録集 (一社)日本癌治療学会 55回 P108 - 3 2017/10 [Not refereed][Not invited]
  
• 抗好中球細胞質抗体関連血管炎症候群に伴う難治性中耳炎における好中球細胞外トラップの発現

  森田 真也, 中丸 裕爾, 干野 季美子, 福田 篤, 本間 明宏

  Otology Japan (一社)日本耳科学会 27 (4) 429 - 429 0917-2025 2017/10 [Not refereed][Not invited]
  
• 外耳・中耳病変を有する症例の半規管機能評価 video Head Impulse Testを用いて

  藤原 圭志, 本間 明宏

  Equilibrium Research (一社)日本めまい平衡医学会 76 (5) 490 - 490 0385-5716 2017/10
• 急性感音難聴患者におけるムンプスIgM抗体陽性率の検討(第2報)

  福田 篤, 森田 真也, 干野 季美子, 藤原 圭志, 赤澤 茂, 中丸 裕爾, 本間 明宏

  Otology Japan (一社)日本耳科学会 27 (4) 568 - 568 0917-2025 2017/10
• 根治切除不能な頭頸部扁平上皮癌における悪液質と予後の検討 JCOG0706副次的解析

  松塚 崇, 清田 尚臣, 水澤 純基, 秋元 哲夫, 長谷川 泰久, 岩江 信法, 門田 伸也, 松浦 一登, 小野澤 祐輔, 本間 明宏, 藤井 博文, 福田 治彦, 林 隆一, 田原 信

  日本癌治療学会学術集会抄録集 (一社)日本癌治療学会 55回 P108 - 3 2017/10
• Atypical adenoma of the thyroid diagnosed as anaplastic cancer by cytopathology

  Hiromitsu Hatakeyama, Kimiko Hoshino, Kenji Mizoguchi, Takayoshi Suzuki, Kanako C. Hatanaka, Yukie Yamaya, Satoshi Kano, Takatsugu Mizumachi, Akihiro Homma

  DIAGNOSTIC CYTOPATHOLOGY 45 (10) 928 - 933 8755-1039 2017/10 [Refereed][Not invited]
   

  Atypical adenoma of the thyroid is a rare form of tumor, and its accurate diagnosis prior to surgical resection is difficult as the histological and pathological morphologies are very similar to those of anaplastic thyroid carcinoma (ATC), and its anaplastic transformation remains to be elucidated. We reported a case of a 75-year-old female with a thyroid isthmus nodule diagnosed repeatedly by FNAC as anaplastic carcinoma. Both the first and second FNAC specimen slides showed a large number of scattered or aggregated atypical cells consisting of large, pleomorphic nuclei with irregular membranes, chromatin clumps and prominent nucleoli. The morphology of the surgical specimen was similar to that of an anaplastic carcinoma and although it showed signs of transition from a normal follicular epithelium, there was no invasive growth or mitosis. This lesion was diagnosed as an atypical adenoma, and a papillary carcinoma was also present in the right lobe of the thyroid. Here we evaluate the molecular features of atypical adenomas in comparison with 9 ATC samples, and discuss whether or not atypical adenomas represent a form of premalignant lesion. Ki-67 expression was found to be very low in atypical adenomas whereas all ATC samples showed high levels of Ki-67 expression. Epithelial-mesenchymal transition (EMT) marker expression suggested that atypical adenomas maintain their epithelial phenotype to a higher degree than do ATCs. Differential diagnosis between ATC and atypical adenoma is difficult by cytological and histological methods alone, and Ki-67 and EMT marker expression may support the diagnosis.
• 鼻粘膜上皮細胞での自然免疫シグナルによるMMP9の発現誘導

  鈴木 正宣, 中丸 裕爾, 高木 大, 本間 あや, Vreugde Sarah, Wormald Peter-John, 本間 明宏

  日本鼻科学会会誌 (一社)日本鼻科学会 56 (3) 429 - 429 0910-9153 2017/09 [Not refereed][Not invited]
  
• Dipeptidylpeptidase-IVの酵素活性により蛍光を発するプローブによる頭頸部表在癌の検出

  大西 俊介, 水島 健, 清水 勇一, 畑中 豊, 畑中 佳奈子, 山本 桂子, 本間 明宏, 栗木 優五, 神谷 真子, 浦野 泰照, 坂本 直哉

  日本癌学会総会記事 日本癌学会 76回 P - 2320 0546-0476 2017/09 [Not refereed][Not invited]
  
• 日本の多施設共同研究によるHPV関連中咽頭癌の遺伝子解析

  家根 旦有, 澤西 和恵, 西尾 和人, 坂井 和子, 藤井 正人, 本間 明宏, 菅澤 正, 大上 研二, 太田 一郎

  日本癌学会総会記事 日本癌学会 76回 P - 1030 0546-0476 2017/09 [Not refereed][Not invited]
  
• 鼻粘膜上皮細胞での自然免疫シグナルによるMMP9の発現誘導

  鈴木 正宣, 中丸 裕爾, 高木 大, 本間 あや, Vreugde Sarah, Wormald Peter-John, 本間 明宏

  日本鼻科学会会誌 (一社)日本鼻科学会 56 (3) 429 - 429 0910-9153 2017/09 [Not refereed][Not invited]
  
• Dipeptidylpeptidase-IVの酵素活性により蛍光を発するプローブによる頭頸部表在癌の検出

  大西 俊介, 水島 健, 清水 勇一, 畑中 豊, 畑中 佳奈子, 山本 桂子, 本間 明宏, 栗木 優五, 神谷 真子, 浦野 泰照, 坂本 直哉

  日本癌学会総会記事 日本癌学会 76回 P - 2320 0546-0476 2017/09 [Not refereed][Not invited]
  
• 日本の多施設共同研究によるHPV関連中咽頭癌の遺伝子解析

  家根 旦有, 澤西 和恵, 西尾 和人, 坂井 和子, 藤井 正人, 本間 明宏, 菅澤 正, 大上 研二, 太田 一郎

  日本癌学会総会記事 日本癌学会 76回 P - 1030 0546-0476 2017/09 [Not refereed][Not invited]
  
• 【頭頸部悪性腫瘍の疑問に答える】 治療後の対応 咽頭癌、喉頭癌に対して化学放射線療法を行いCRとなった場合の経過観察について教えてください

  坂下 智博, 本間 明宏

  JOHNS (株)東京医学社 33 (9) 1325 - 1327 0910-6820 2017/09 [Not refereed][Not invited]
  
• 【頭頸部悪性腫瘍の疑問に答える】 治療選択 全身合併症がある場合の治療選択について教えてください

  本間 明宏

  JOHNS (株)東京医学社 33 (9) 1254 - 1256 0910-6820 2017/09 [Not refereed][Not invited]
  
• 舌扁平上皮癌における新しいTNM分類の有用性の検討

  加納 里志, 坂下 智博, 水町 貴諭, 本間 明宏

  口腔・咽頭科 日本口腔・咽頭科学会 30 (3) 429 - 429 0917-5105 2017/08 [Not refereed][Not invited]
  
• Confirmation of the eighth edition of the AJCC/UICC TNM staging system for HPV-mediated oropharyngeal cancer in Japan

  Takatsugu Mizumachi, Akihiro Homma, Tomohiro Sakashita, Satoshi Kano, Hiromitsu Hatakeyama, Satoshi Fukuda

  INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY 22 (4) 682 - 689 1341-9625 2017/08 [Refereed][Not invited]
   

  Background Several studies have demonstrated that the seventh edition of the American Joint Committee on Cancer/American Joint Committee on Cancer (AJCC/UICC) TNM staging system does not consistently distinguish between prognostic subgroups for human papillomavirus (HPV)-mediated oropharyngeal squamous cell carcinoma (OPSCC). The eighth edition of the AJCC/UICC TNM staging system came into effect for use with HPV-mediated OPSCC on or after 1 January 2017. This study confirms that the eighth edition of the AJCC/UICC TNM staging system for HPV-mediated OPSCC accurately reflects disease outcomes. Patients and methods We retrospectively analyzed 195 patients with OPSCC treated at Hokkaido University Hospital, Sapporo, Japan between 1998 and 2015. HPV status was evaluated by immunohistochemical analysis of p16. Results Of the 195 OPSCC patients evaluated, 111 (56.9%) were p16 positive and 84 (43.1%) were p16 negative. The 3-year overall survival rate (OS) was significantly lower in the p16-negative patients with stage III-IV in comparison with those with stage I-II (55.0 vs. 93.1%, respectively; p < 0.01). The 3-year OS did not differ significantly between stage I-II and stage III-IV in the p16-positive patients (86.7 vs 87.7%). According to the eighth edition of the AJCC/UICC TNM staging system, stage I-II and stage III can be differentiated on the basis of the 3-year OS in the p16-positive patients (90.9 vs 70.2%, respectively; p < 0.01). Conclusions The seventh edition of the AJCC/UICC TNM staging system is suitable for use with p16-negative patients; however, it does not effectively discriminate between p16-positive patients. Therefore, the eighth edition of the AJCC/UICC TNM staging system is more suitable for HPV-mediated OPSCC in Japan.
• Japanese Clinical Practice Guideline for Head and Neck Cancer

  Ken-ichi Nibu, Ryuichi Hayashi, Takahiro Asakage, Hiroya Ojiri, Yoshihiro Kimata, Takeshi Kodaira, Toshitaka Nagao, Torahiko Nakashima, Takashi Fujii, Hirofumi Fujii, Akihiro Homma, Kazuto Matsuura, Nobuya Monden, Takeshi Beppu, Nobuhiro Hanai, Tadaaki Kirita, Yuzuru Kamei, Naoki Otsuki, Naomi Kiyota, Sadamoto Zenda, Ken Omura, Koichi Omori, Tetsuo Akimoto, Kazuyoshi Kawabata, Seiji Kishimoto, Hiroya Kitano, Iwai Tohnai, Takashi Nakatsuka

  AURIS NASUS LARYNX 44 (4) 375 - 380 0385-8146 2017/08 [Refereed][Not invited]
   

  Objective: The first revision of "Japanese Clinical Practice Guideline for Head and Neck Cancer" was made in 2013 by the clinical practice guideline committee of Japan Society for Head and Neck Cancer, in response to the revision of the TNM classification.Methods: 34 CQs (Clinical Questions) were newly adopted to describe the diagnosis and treatment methods currently considered most appropriate, and offered recommendation grade made by the consensus of the committee. A comprehensive literature search was performed for studies published between 2001 and 2012 using PubMed. Qualified studies were analyzed and the results were evaluated, consolidated and codified by all the committee members.Results: Elective neck dissection (ND) does contribute to improvement in survival and should be performed for patients with high-risk tongue cancer. At present, no research has clearly demonstrated the utility of superselective arterial infusion chemotherapy. However, depending on the site and stage of the cancer, combination with radiotherapy may be useful for preserving organ function or improving survival rate. Concurrent CDDP chemotherapy and adjuvant radiotherapy contributes to improvement of survival rate as an adjuvant therapy for advanced squamous cell carcinoma of the head and neck in patients at high risk of recurrence. The anti-EGFR antibody cetuximab (Cmab) has an additive effect with radiotherapy. However, the indication must be carefully considered since this treatment has not been compared with the standard treatment of chemoradiotherapy. Cmab has been shown to have an additive effect with chemotherapy (CDDP/5-FU) in patients with unresectable metastatic or recurrent cancer. Preoperative and postoperative oral care may reduce the risk of postoperative complications such as surgical wound infection and pneumonia in head and neck cancers. Rehabilitation soon after ND for cervical lymph node metastasis is recommended for maintaining and restoring shoulder function.Conclusions: In this article, we described most relevant guidelines and CQs for the diagnosis and treatment of head and neck cancer in Japan. These guidelines are not intended to govern therapies that are not shown here, but rather aim to be used as a guide in searching for the most appropriate treatment for individual patient. (C) 2017 Elsevier B.V. All rights reserved.
• Reliability and Validity of Speech Evaluation in Adductor Spasmodic Dysphonia.

  Yanagida S, Nishizawa N, Hashimoto R, Mizoguchi K, Hatakeyama H, Homma A, Fukuda S

  Journal of voice : official journal of the Voice Foundation 32 (5) 585 - 591 0892-1997 2017/08 [Refereed][Not invited]
   

  OBJECTIVES: The aim of this study was to evaluate speech in patients with adductor spasmodic dysphonia (ADSD) by perceptual evaluations and acoustic measures, and to examine the reliability and validity of these measures. METHODS: Twenty-four patients with ADSD and 24 healthy volunteers were included in the study. Speech materials consisted of three sentences constructed from serial voiced syllables to elicit abductor voice breaks. Three otolaryngologists rated the degree of voice symptoms using a visual analog scale (VAS). VAS sheets with five 100-mm horizontal lines were given to each rater. The ends of the lines were labeled normal vs severe, and the five lines were labeled as overall severity of each of the four speech symptoms (strangulation, interruption, tremor and strained speech). Nine words were selected for acoustic analysis, and abnormal acoustic events were classified into one of the three categories. To evaluate the intra- and inter-rater and intermeasurer reliabilities of the VAS scores or acoustic measures, Pearson r correlations were calculated. To examine the validity of perceptual evaluations and acoustic measures, the sensitivity and the specificity were calculated. RESULTS: Pearson r correlation coefficients for overall severity showed the highest intra- and inter-rater reliabilities. For acoustic events, the intrameasurer reliabilities were r = .645 (frequency shifts), r = .969 (aperiodic segments), and r = 1.0 (phonation breaks), and the intermeasurer reliability ranged from r = .102 to r = 1.0. Perceptual evaluation showed high sensitivity (91.7%) and specificity (100%), whereas acoustic analysis showed low sensitivity (70.8%) and high specificity (100%). CONCLUSION: Both perceptual evaluation and acoustic measures alone were found likely to overlook patients with true ADSD.
• Osteoradionecrosis of the hyoid bone after intra-arterial chemoradiotherapy for oropharyngeal cancer: MR imaging findings

  Hiromitsu Hatakeyama, Noriyuki Fujima, Kazuhiko Tsuchiya, Kenji Mizoguchi, Takatsugu Mizumachi, Tomohiro Sakashita, Satoshi Kano, Akihiro Homma, Satoshi Fukuda

  CANCER IMAGING 17 1470-7330 2017/07 [Refereed][Not invited]
   

  Background: Osteoradionecrosis (ORN) of the hyoid bone sometimes induces severe front neck infection and can cause laryngeal stenosis and carotid rupture. Although ORN of the hyoid bone is known to be a complication of chemoradiotherapy for head and neck cancer, there has been no basis for its evaluation. Our purpose is to present the clinical and MR imaging features of ORN of the hyoid bone. Methods: The study group comprised patients with advanced oropharyngeal cancer treated with targeted intra-arterial cisplatin infusion with concomitant radiotherapy. ORN of the hyoid bone was identified on the basis of decreased signal intensity of the bone marrow on T1WI images. Signal intensity on T2WI images was used to distinguish between inflammation and fibrosis. Results: A total of 39 pre-treatment MR images and follow-up MR images were reviewed. ORN of the hyoid bone were detected in 30% of patients after treatment, with 23% of them showing inflammation and 7.7% fibrosis. Two patients developed severe neck infection and received antibiotics and underwent surgical intervention by tracheostomy and resection of the hyoid bone. Conclusion: Our MR imaging study showed that ORN of the hyoid bone is not particularly rare in patients with oropharyngeal cancer treated with chemoradiotherapy. Clinicians should evaluate images carefully to prevent the development of severe complication due to infection associated with ORN of the hyoid bone.
• 化学放射線療法

  本間 明宏

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 120 (7) 962 - 965 0030-6622 2017/07 [Not refereed][Not invited]
  
• Osteoradionecrosis of the hyoid bone after intra-arterial chemoradiotherapy for oropharyngeal cancer: MR imaging findings.

  Hatakeyama H, Fujima N, Tsuchiya K, Mizoguchi K, Mizumachi T, Sakashita T, Kano S, Homma A, Fukuda S

  Cancer imaging : the official publication of the International Cancer Imaging Society 17 (1) 22 - 22 1740-5025 2017/07 [Refereed][Not invited]
   

  BACKGROUND: Osteoradionecrosis (ORN) of the hyoid bone sometimes induces severe front neck infection and can cause laryngeal stenosis and carotid rupture. Although ORN of the hyoid bone is known to be a complication of chemoradiotherapy for head and neck cancer, there has been no basis for its evaluation. Our purpose is to present the clinical and MR imaging features of ORN of the hyoid bone. METHODS: The study group comprised patients with advanced oropharyngeal cancer treated with targeted intra-arterial cisplatin infusion with concomitant radiotherapy. ORN of the hyoid bone was identified on the basis of decreased signal intensity of the bone marrow on T1WI images. Signal intensity on T2WI images was used to distinguish between inflammation and fibrosis. RESULTS: A total of 39 pre-treatment MR images and follow-up MR images were reviewed. ORN of the hyoid bone were detected in 30% of patients after treatment, with 23% of them showing inflammation and 7.7% fibrosis. Two patients developed severe neck infection and received antibiotics and underwent surgical intervention by tracheostomy and resection of the hyoid bone. CONCLUSION: Our MR imaging study showed that ORN of the hyoid bone is not particularly rare in patients with oropharyngeal cancer treated with chemoradiotherapy. Clinicians should evaluate images carefully to prevent the development of severe complication due to infection associated with ORN of the hyoid bone.
• Role of microRNA-296-3p in the malignant transformation of sinonasal inverted papilloma

  Tomohiko Kakizaki, Hiromitsu Hatakeyama, Yuji Nakamaru, Dai Takagi, Takatsugu Mizumachi, Tomohiro Sakashita, Satoshi Kano, Akihiro Homma, Satoshi Fukuda

  ONCOLOGY LETTERS 14 (1) 987 - 992 1792-1074 2017/07 [Refereed][Not invited]
   

  Inverted papilloma (IP) is a benign tumor occurring in the nasal cavity and paranasal sinuses. It is reported that 5-15% of IPs undergo malignant transformation into squamous cell carcinoma (SCC), and the role of microRNAs (miRNA/miR) in this process remains to be elucidated. In the present study, whole miRNA profiles using samples of IP and SCC were investigated, in order to detect the function of miRNA in the carcinogenesis of IP. Samples from IPs (n=5) and SCC lesions (n=5), which arose from IPs, were used for miRNA analysis. A total of 200 miRNAs exhibited a > 2-fold differential expression between IP and SCC. miR-296-3p was markedly upregulated in SCC with a 23-fold difference. Computational analysis indicated that miR-296-3p targeted PTEN, which regulates the phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway and PTEN is involved in the carcinogenesis of SCC. miR-296-3p directly regulated PTEN expression in head and neck cancer cells, with PTEN protein levels decreased in 4/19 the SCCs (21.0%), as compared with those in the IPs (76.4%). Positive p21 staining was observed in 64.7% of IPs; this was a significantly increased rate compared with that for SCCs (26.3%, P=0.0086). The results of the present study indicated that there were marked changes in the miRNA expression signature during the malignant transition. miR-296-3p may serve an important role in the malignant transformation of IPs via the regulation of PTEN, combined with the subsequent inhibition of the PI3K/Akt signaling pathway, and may be a novel agent for cancer prevention.
• 北海道大学病院における舌癌治療の現況・選択的動注化学療法の意義

  坂下 智博, 本間 明宏, 畠山 博充, 加納 里志, 水町 貴諭, 蠣崎 文彦, 対馬 那由多, 福田 諭

  耳鼻咽喉科展望 耳鼻咽喉科展望会 60 (補冊1) 50 - 51 0386-9687 2017/06 [Not refereed][Not invited]
  
• 北海道大学病院における喉頭癌治療の現況

  中薗 彬, 水町 貴諭, 本間 明宏, 畠山 博充, 加納 里志, 古沢 純, 坂下 智博, 鈴木 章之, 福田 諭

  耳鼻咽喉科展望 耳鼻咽喉科展望会 60 (補冊1) 8 - 9 0386-9687 2017/06 [Not refereed][Not invited]
  
• 放射線動注化学療法後の救済手術 上顎全摘術について

  坂下 智博, 本間 明宏

  頭頸部癌Frontier (株)メディカルレビュー社 5 (1) 51 - 55 2187-5502 2017/06 [Not refereed][Not invited]
  
• Sentinel node biopsy for oral cancer: A prospective multicenter Phase II trial

  Kouki Miura, Hitoshi Hirakawa, Hirokazu Uemura, Seiichi Yoshimot, Akihiro Shiotani, Masashi Sugasawa, Akihiro Homma, Junkichi Yokoyama, Kiyoaki Tsukahara, Tomokazu Yoshizaki, Yasushi Yatabe, Keitaro Matsuo, Yasuo Ohkura, Shigeru Kosuda, Yasuhisa Hasegawa

  AURIS NASUS LARYNX 44 (3) 319 - 326 0385-8146 2017/06 [Refereed][Not invited]
   

  Objective: A recent study identified a survival benefit with prophylactic neck dissection (ND) at the time of primary surgery as compared with watchful waiting followed by therapeutic neck dissection for nodal relapse, in patients with cN0 oral squamous cell carcinoma (OSCC). Alternative management of cN0 neck cancer is recommended to minimize the adverse effects of ND, indicating the need for sentinel node biopsy (SNB) and limited neck dissection. We conducted a multicenter Phase II study to examine the feasibility of SNB for clinically N0 OSCC. Methods: Previously untreated N0 OSCC patients (n = 57) with clinical late-T2 or T3 tumors were enrolled across 10 institutions. SNB navigated with multislice frozen section analysis of sentinel nodes (SNs) and SNB supported sentinel node lymphatic basin dissection (SN basin dissection) were performed in a one-stage procedure. The endpoint was to investigate the rate of false-negative metastases after SN basin dissection and SNB alone. Results: Most tumors were late-T2 lesions (n = 50; 87.7%). SNs were identified in all patients. A total of 196 SNs were detected. Among these SNs, 35 (17.8%) were positive for metastasis (9 in level I, 12 in level II, 12 in level III, 1 in level V and 2 in the contralateral region of the neck). The false-negative rate of SNB supported by SN basin dissection and SNB alone was 4.5% and 9.1%, respectively. The concordance of the SN status in intraoperative frozen sections with the permanent histopathology was 97.4% (191/196). The sensitivity and specificity of intraoperative pathological evaluation were 85.7% (30/35) and 100% (30/30), respectively. The 3-year overall survival (OS) and disease-free survival was 89.5% and 82.5%, respectively. The OS of SN-negative patients was significantly longer than that of SN-positive patients (P = 0.047). Conclusion: The current study verified that SN basin dissection was a useful back-up procedure for SNB performed as a one-stage procedure, showing a low false-negative rate. SNB, alone is an appropriate staging method for patients with clinical N0 staging, and a reliable procedure to determine the appropriate levels for neck dissection. (C) 2016 Elsevier Ireland Ltd. All rights reserved.
• 甲状腺癌分化癌の骨転移に対するIMRTを含めた外照射の治療成績

  安田 耕一, 加藤 徳雄, 岡本 祥三, 木下 留美子, 志賀 哲, 水町 貴諭, 畠山 博充, 本間 明宏, 田口 純, 清水 康, 森 崇, 土屋 和彦, 白土 博樹

  頭頸部癌 (一社)日本頭頸部癌学会 43 (2) 221 - 221 1349-5747 2017/05 [Not refereed][Not invited]
  
• 舌扁平上皮癌における腫瘍免疫チェックポイントの解析

  加納 里志, 鈴木 崇祥, 倉本 倫之介, 坂下 智博, 水町 貴諭, 畠山 博充, 本間 明宏, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 43 (2) 207 - 207 1349-5747 2017/05 [Not refereed][Not invited]
  
• 個別化治療を目指した頭頸部癌診療ガイドライン

  本間 明宏, 丹生 健一, 中溝 宗永, 水町 貴諭, 林 隆一

  頭頸部癌 (一社)日本頭頸部癌学会 43 (2) 143 - 143 1349-5747 2017/05 [Not refereed][Not invited]
  
• Rapid Detection of Superficial Head and Neck Squamous Cell Carcinoma by Topically Spraying Fluorescent Probe Targeting Dipeptidylpeptidase-Iv

  Shunsuke Ohnishi, Takeshi Mizushima, Yuichi Shimizu, Yutaka Hatanaka, Kanako Hatanaka, Keiko Yamamoto, Akihiro Homma, Yugo Kuriki, Mako Kamiya, Yasuteru Urano, Naoya Sakamoto

  GASTROINTESTINAL ENDOSCOPY 85 (5) AB530 - AB530 0016-5107 2017/05 [Refereed][Not invited]
  
• Perioperative complications and safety of type II thyroplasty (TPII) for adductor spasmodic dysphonia

  Kenji Mizoguchi, Hiromitsu Hatakeyama, Saori Yanagida, Noriko Nishizawa, Nobuhiko Oridate, Satoshi Fukuda, Akihiro Homma

  EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY 274 (5) 2215 - 2223 0937-4477 2017/05 [Refereed][Not invited]
   

  Type II thyroplasty (TPII) is one of the surgical options offered in the management of adductor spasmodic dysphonia (AdSD); however, there have been no detailed reports of its safety and associated complications during the perioperative period. Our aim was to assess the complications and safety of TPII. TPII was performed for consecutive 15 patients with AdSD from April 2012 through May 2014. We examined retrospectively the perioperative complications, the degree of surgical invasion, and recovery process from surgery. All patients underwent successful surgery under only local anesthesia. Vocal fold erythema was observed in 14 patients and vocal fold edema in 10 patients; however, all of them showed complete resolution within 1 month. No patient experienced severe complications such as acute airway distress or hemorrhage. Fourteen patients were able to have oral from the 1st postoperative morning, with the remaining patient able to have oral intake from the 2nd postoperative day. In addition, no patient experienced aspiration postoperatively. In conclusion, only minor complications were observed in association with TPII in this study. No dysphagia was observed postoperatively, which is an advantage over other treatments. The results of our study suggest that TPII is a safe surgical treatment for AdSD.
• Non-invasive prediction of the tumor growth rate using advanced diffusion models in head and neck squamous cell carcinoma patients

  Noriyuki Fujima, Tomohiro Sakashita, Akihiro Homma, Taisuke Harada, Yukie Shimizu, Khin Khin Tha, Kohsuke Kudo, Hiroki Shirato

  ONCOTARGET 8 (20) 33631 - 33643 1949-2553 2017/05 [Refereed][Not invited]
   

  We assessed parameters of advanced diffusion weighted imaging (DWI) models for the prediction of the tumor growth rate in 55 head and neck squamous cell carcinoma (HNSCC) patients. The DWI acquisition used single-shot spin-echo echo-planar imaging with 12 b-values (0-2000). We calculated 14 DWI parameters using mono-exponential, bi-exponential, tri-exponential, stretched exponential and diffusion kurtosis imaging models. We directly measured the tumor growth rate from two sets of different-date imaging data. We divided the patients into a discovery group (n = 40) and validation group (n = 15) based on their MR acquisition dates. In the discovery group, we performed univariate and multivariate regression analyses to establish the multiple regression equation for the prediction of the tumor growth rate using diffusion parameters. The equation obtained with the discovery group was applied to the validation group for the confirmation of the equation's accuracy. After the univariate and multivariate regression analyses in the discovery-group patients, the estimated tumor growth rate equation was established by using the significant parameters of intermediate diffusion coefficient D-2 and slow diffusion coefficient D-3 obtained by the tri-exponential model. The discovery group's correlation coefficient between the estimated and directly measured tumor growth rates was 0.74. In the validation group, the correlation coefficient (r = 0.66) and intra-class correlation coefficient (0.65) between the estimated and directly measured tumor growth rates were respectively good. In conclusion, advanced DWI model parameters can be a predictor for determining HNSCC patients' tumor growth rate.
• Residual tumour detection in post-treatment granulation tissue by using advanced diffusion models in head and neck squamous cell carcinoma patients

  Noriyuki Fujima, Daisuke Yoshida, Tomohiro Sakashita, Akihiro Homma, Kohsuke Kudo, Hiroki Shirato

  EUROPEAN JOURNAL OF RADIOLOGY 90 14 - 19 0720-048X 2017/05 [Refereed][Not invited]
   

  Purpose: To evaluate the detectability of the residual tumour in post-treatment granulation tissue using parameters obtained with an advanced diffusion model in patients with head and neck squamous cell carcinoma (HNSCC) treated by chemoradiation therapy. Materials and methods: We retrospectively evaluated 23 patients with HNSCC after the full course of chemoradiation therapy. The diffusion-weighted image (DWI) acquisition used single-shot spin-echo echo-planar imaging with 11 b-values (0-1000). We calculated 10 DWI parameters using a monoexponential model, a bi-exponential model, a stretched exponential model (SEM), a diffusion kurtosis imaging (DKI) model and a statistical diffusion model (SDM) in the region of interest (ROI) placed on the post-treatment granulation tissue. The presence of residual tumour was determined by histological findings or clinical follow-up. Results: Among the 23 patients, seven patients were revealed to have residual tumour. The univariate analysis revealed significant differences in six parameters between the patients with and without residual tumour. From the receiver operating characteristic curve analysis, the highest area under curve was detected in the center of the Gaussian distribution of diffusion coefficient (D-s) obtained by the SDM. The multivariate analysis revealed that the D-s and diffusion heterogeneity (alpha) obtained by the SEM were predictors for the presence of residual tumour. Conclusion: DWI parameters obtained by advanced fitting models will be one of the diagnostic tools for the detection of residual tumour. (C) 2017 Elsevier B.V. All rights reserved.
• HPV関連中咽頭癌症例におけるTNM分類改訂に伴う病期分類と生存率の検討

  水町 貴諭, 本間 明宏, 坂下 智博, 加納 里志, 畠山 博充, 福田 諭

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 120 (4) 611 - 611 0030-6622 2017/04 [Not refereed][Not invited]
  
• 外耳道癌組織における免疫組織化学的手法に基づく発現分子解析

  森田 真也, 本間 明宏, 中丸 裕爾, 安川 真一郎, 福田 篤, 福田 諭

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 120 (4) 566 - 566 0030-6622 2017/04 [Not refereed][Not invited]
  
• 外耳道癌組織における免疫組織化学的手法に基づく発現分子解析

  森田 真也, 本間 明宏, 中丸 裕爾, 安川 真一郎, 福田 篤, 福田 諭

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 120 (4) 566 - 566 0030-6622 2017/04 [Not refereed][Not invited]
  
• 頭頸部癌に対する化学放射線療法と有害事象対策

  本間 明宏

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 120 (3) 248 - 251 0030-6622 2017/03 [Not refereed][Not invited]
  
• 上顎洞癌に対するシスプラチンの超選択的動注と放射線治療の同時併用療法

  本間 明宏, 坂下 智博, 吉田 大介, 鬼丸 力也

  耳鼻咽喉科臨床 耳鼻咽喉科臨床学会 110 (3) 160 - 161 0032-6313 2017/03 [Not refereed][Not invited]
  
• Prediction of the treatment outcome using intravoxel incoherent motion and diffusional kurtosis imaging in nasal or sinonasal squamous cell carcinoma patients

  Noriyuki Fujima, Daisuke Yoshida, Tomohiro Sakashita, Akihiro Homma, Akiko Tsukahara, Yukie Shimizu, Khin Khin Tha, Kohsuke Kudo, Hiroki Shirato

  EUROPEAN RADIOLOGY 27 (3) 956 - 965 0938-7994 2017/03 [Refereed][Not invited]
   

  To evaluate the diagnostic value of intravoxel incoherent motion (IVIM) and diffusional kurtosis imaging (DKI) parameters in nasal or sinonasal squamous cell carcinoma (SCC) patients to determine local control/failure. Twenty-eight patients were evaluated. MR acquisition used single-shot spin-echo EPI with 12 b-values. Quantitative parameters (mean value, 25th, 50th and 75th percentiles) of IVIM (perfusion fraction f, pseudo-diffusion coefficient D*, and true-diffusion coefficient D), DKI (kurtosis value K, kurtosis corrected diffusion coefficient D-k) and apparent diffusion coefficient (ADC) were calculated. Parameter values at both the pretreatment and early-treatment period, and the percentage change between these two periods were obtained. Multivariate logistic regression analysis: the percentage changes of D (mean, 25th, 50th, 75th), K (mean, 50th, 75th), Dk (mean, 25th, 50th), and ADC (mean, 25th, 50th) were predictors of local control. ROC curve analysis: the parameter with the highest accuracy = the percentage change of D value with the histogram 25th percentile (0.93 diagnostic accuracy). Multivariate Cox regression analyses: the percentage changes of D (mean, 25th, 50th), K (mean, 50th, 75th), Dk (mean, 25th, 50th) and ADC (mean, 25th, 50th) are predictors. IVIM and DKI parameters, especially the D-value's histogram 25th percentile, are useful for predicting local control. Noninvasive assessment of treatment outcome in SCC patients was achieved using IVIM/DKI. Several IVIM and DKI parameters can predict the local control. Especially, the D-value's histogram 25th percentile has high diagnostic accuracy.
• 顔面神経麻痺をきたした耳下腺oncocytomaの1例

  浜田 誠二郎, 藤原 圭志, 畠山 博充, 本間 明宏, 福田 諭

  Facial Nerve Research 日本顔面神経学会 36 191 - 193 0914-790X 2017/02 

  症例は61歳男性で、来院の10年ほど前から右耳下部の腫瘤を自覚していた。某月某日、夜間に右耳下部周囲痛を自覚した。右耳下部に3cm大の圧痛を伴う可動性不良な腫瘤を触知し、右顔面神経麻痺を認めた。CTでは右耳下腺内に造影効果のある辺縁不整の腫瘍を認め、MRIでは腫瘍はT1強調像で低信号、T2強調像では内部不均一で一部高信号を示した。臨床経過と所見から耳下腺悪性腫瘍が疑われ当院紹介となった。エコーでは右耳〜下腺内に30×25mmの内部不均一で一部分葉状の腫瘤を認めた。悪性腫瘍を想定し、顔面神経合併切除での右耳下腺腫瘍全摘術+顔面神経再建術を予定したが、術中所見で良性が予想される場合は顔面神経を温存する方針とした。術中迅速病理検査では、充実部分は周囲に線維性の被膜を伴い、嚢胞壁は異型に乏しい扁平上皮で覆われており、明らかな悪性所見は認めなかった。術中所見と迅速病理結果から良性の可能性が高いと判断し、顔面神経は温存し、耳下腺正常組織を一部含めて腫瘍を顔面神経上下枝の間から摘出した。病理組織学的所見からoncocytomaと最終診断された。術後は鼻翼に軽度の麻痺を認めたが、約2ヵ月後に柳原法40/40点と改善した。術後1年以上経過した現時点で腫瘍再発は認めていない。
• 顔面神経麻痺をきたした耳下腺oncocytomaの1例

  浜田 誠二郎, 藤原 圭志, 畠山 博充, 本間 明宏, 福田 諭

  Facial Nerve Research 日本顔面神経学会 36 191 - 193 0914-790X 2017/02 [Not refereed][Not invited]
  
• 【頭頸部癌学-診断と治療の最新研究動向-】 頭頸部癌臨床研究の動向 多施設での中咽頭癌の治療成績(手術、放射線)

  加納 里志, 本間 明宏

  日本臨床 (株)日本臨床社 75 (増刊2 頭頸部癌学) 184 - 189 0047-1852 2017/02 [Not refereed][Not invited]
   

  頭頸部癌グループに属する12施設486症例(男414例、女72例)を対象に、後ろ向きに検討した。根治治療の内訳は手術が41%、放射線単独治療が24%、化学療法同時併用放射線治療(CCRT)が35%であった。手術治療は経口切除が36%、外切開が64%で、喉頭温存できたのは86%であった。再建手術は56%に、頸部郭清は76%に施行された。放射線単独治療のうち2例で小線源治療が行われていた。CCRTにおける化学療法で最も多かったのはシスプラチンと5FUの併用、次いでシスプラチン単剤であった。5年粗生存率は手術群で74.8%、放射線単独群で66.0%、CCRT群で67.1%であった。手術群とCCRT群のmatched-pair解析で抽出された186例の5年無増悪生存率は手術群51.0%、CCRT群54.4%、5年局所制御率はそれぞれ75.2%、80.3%であった。さらにT3-T4の局所進行例に限定すると、5年無増悪生存率は手術群37.6%、CCRT群50.2%、5年局所制御率はそれぞれ64.1%、73.2%であった。
• 【頭頸部癌学-診断と治療の最新研究動向-】 頭頸部癌の治療 頭頸部癌の外科治療 頭頸部癌の外科治療(低侵襲・機能温存) 口腔癌 超選択的動注化学療法併用放射線治療

  本間 明宏

  日本臨床 (株)日本臨床社 75 (増刊2 頭頸部癌学) 324 - 328 0047-1852 2017/02 [Not refereed][Not invited]
  
• 【頭頸部癌学-診断と治療の最新研究動向-】 頭頸部癌臨床研究の動向 多施設での上顎洞癌の治療成績

  坂下 智博, 本間 明宏

  日本臨床 (株)日本臨床社 75 (増刊2 頭頸部癌学) 179 - 183 0047-1852 2017/02 [Not refereed][Not invited]
  
• Expression of p53, p16, cyclin D1, epidermal growth factor receptor and Notch1 in patients with temporal bone squamous cell carcinoma

  Shinya Morita, Yuji Nakamaru, Akihiro Homma, Shinichiro Yasukawa, Hiromitsu Hatakeyama, Tomohiro Sakashita, Satoshi Kano, Atsushi Fukuda, Satoshi Fukuda

  INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY 22 (1) 181 - 189 1341-9625 2017/02 [Refereed][Not invited]
   

  Background The aim of this study was to investigate the expression of p53, p16, cyclin D1, epidermal growth factor receptor (EGFR) and Notch1 in temporal bone squamous cell carcinoma (TBSCC) tissue samples by immunohistochemistry (IHC), and to evaluate the association between these biomarkers and clinicopathological features. Methods We performed a retrospective, single-institution review of 30 TBSCC patients treated with curative intent between April 2006 and March 2015. All tissue samples were obtained from pretreatment biopsy specimens or surgical specimens and using IHC staining. Results Ten patients were categorized as T1, seven as T2, five as T3 and eight as T4. Nine patients had clinically positive lymph node metastasis. The positive expression of p53 and EGFR was significantly associated with T classification (P = 0.042 and P = 0.0039). EGFR expression was significantly more frequent in patients with positive lymph node metastasis compared with patients without node involvement (P = 0.017). In the analysis of the association between protein expression by IHC staining and prognosis, the positive expression of EGFR and Notch1 was significantly correlated with poor survival outcomes in TBSCC (P = 0.015 and P = 0.025) Conclusion Overexpression of p53 and EGFR may be valuable biomarkers for identifying individuals at high risk of developing tumors in TBSCC. Furthermore, the positive expression of EGFR was significantly associated with poor survival outcome. Anti-EGFR therapy has potential for use as the treatment modality of choice for advancedstage TBSCC as well as other head and neck squamous cell carcinomas.
• Pretreatment lymphocyte-to-monocyte ratio as an independent prognostic factor for head and neck cancer

  Satoshi Kano, Akihiro Homma, Hiromitsu Hatakeyama, Takatsugu Mizumachi, Tomohiro Sakashita, Tomohiko Kakizaki, Satoshi Fukuda

  HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK 39 (2) 247 - 253 1043-3074 2017/02 [Refereed][Not invited]
   

  Background. The purpose of this study was to analyze the relationship between pretreatment inflammatory markers and the prognosis of patients with oropharyngeal, hypopharyngeal, and laryngeal cancers. Methods. The data for 285 patients treated with curative intent by concurrent chemoradiotherapy (CRT) were obtained and their pretreatment inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) were calculated. Results. Significant relationships were observed between a high NLR and oropharyngeal or hypopharyngeal cancer, T3 to T4, N2b to N3, and clinical stage III to IV, whereas significant relationships were observed between a high LMR and laryngeal cancer, T1 to T2, and clinical stage I to II. With regard to survival outcomes, a high NLR, a high PLR, and a low LMR were all significantly associated with decreases in overall survival OS) and disease-free survival (DFS). Furthermore, multivariate analysis showed that LMR was an independent prognostic factor. Conclusion. Pretreatment LMR was found to be an independent prognostic factor for patients with head and neck cancers treated by concurrent CRT. (C) 2016 Wiley Periodicals, Inc.
• Advanced diffusion models in head and neck squamous cell carcinoma patients: Goodness of fit, relationships among diffusion parameters and comparison with dynamic contrast-enhanced perfusion

  Noriyuki Fujima, Tomohiro Sakashita, Akihiro Homma, Yukie Shimizu, Atsushi Yoshida, Taisuke Harada, Khin Khin Tha, Kohsuke Kudo, Hiroki Shirato

  MAGNETIC RESONANCE IMAGING 36 16 - 23 0730-725X 2017/02 [Refereed][Not invited]
   

  Purpose: We assessed advanced fitting models of diffusion weighted imaging (DWI) in head/neck squamous cell carcinoma (HNSCC) patients to determine the best goodness of fit and correlations among diffusion parameters. We compared these results with those of dynamic contrast-enhanced (DCE) perfusion parameters. Materials and methods: We retrospectively evaluated 32 HNSCC patients (12 sinonasal, 20 pharynx/oral cavity). The DWI acquisition used single-shot spin-echo echo-planar imaging (EPI) with 12 b-values (0 - 2000). We calculated 14 DWI parameters using mono-exponential, bi-exponential, and tri-exponential models, stretched exponential model (SEM) and diffusion kurtosis imaging (DKI) models. We compared each model's goodness of fit using the residual sum of squares (RSS), Akaike Information Criterion (AIC) and Bayesian information criterion (BIC) value. We determined the correlation between each pair of DWI parameters and between each DWI parameter and DCE perfusion parameter. Results: The tri-exponential fit's RSS, AIC and BIC values were significantly smaller than those for bi-exponential fit. The RSS, AIC and BIC values of the SEM fit and DKI fit were significantly smaller than mono-exponential model. Significant correlations were observed in 30 pairs (sinonasal cavity) and 31 (sinonasal cavity group) among 91 DWI parameter combinations. Significant correlations were also observed in nine pairs (both sinonasal cavity and pharynx/oral cavity group) among 64 DWI/DCE perfusion parameter pairs, in particular, high positive correlations between the tri-exponential model's intermediate diffusion fraction (f(2)) and the volume of the extracellular extravascular space per unit volume of tissue (v(e)) were observed in both patient groups. Conclusion: We identified several correlations between DWI parameters by advanced fitting models and correlations between DWI and DCE parameters. These will help determine HNSCC patients' detailed tissue structures. (C) 2016 Elsevier Inc. All rights reserved.
• 内転型痙攣性発声障害話者の同音異義語弁別について

  柳田 早織, 西澤 典子, 溝口 兼司, 畠山 博充, 本間 明宏, 福田 諭

  音声言語医学 日本音声言語医学会 58 (1) 77 - 77 0030-2813 2017/01 [Not refereed][Not invited]
  
• 甲状軟骨形成術II型の周術期合併症についての検討

  溝口 兼司, 畠山 博充, 柳田 早織, 西澤 典子, 本間 明宏, 福田 諭

  音声言語医学 日本音声言語医学会 58 (1) 76 - 76 0030-2813 2017/01 [Not refereed][Not invited]
  
• Synchronous HPV-positive carcinoma of the oropharynx and nasal cavity

  Hiroshi Idogawa, Takatsugu Mizumachi, Akihiro Homma, Satoshi Fukuda

  Journal of Otolaryngology of Japan (一社)日本耳鼻咽喉科学会 120 (6) 841 - 846 0030-6622 2017 [Not refereed][Not invited]
   

  There have been several reports of synchronous HPV-associated tonsillar carcinomas, however, there are no reports until date of synchronous HPV-associated carcinomas arising in the oropharynx and nasal cavity. Herein, we report the case of a 64-year-old man with synchronous HPV-positive SCCs of the tonsil and nasal cavity. A 64-year-old man presented with pain in the throat on swallowing. He also had 3-year history of excessive lacrimation. Initial CT imaging showed masses in the right tonsil and right nasal cavity. PET-CT revealed no evidence of lymph node metastasis or distant metastasis. Biopsies of the right tonsillar tumor and right nasal cavity revealed poorly differentiated carcinoma at both sites. Immunohistochemistry revealed positive staining for p16 in both the right tonsillar and right nasal cavity carcinomas. Evidence of HPV infection was searched for using multiplex-PCR. HPV-16 and HPV- 45 were detected from the right tonsillar tumor, and HPV-59 from the right nasal cavity tumor. The right tonsillar tumor was classified as T3N0M0, and the right nasal cavity tumor as T4aN0M0. After complete staging, the patient received concomitant weekly cisplatin plus radiotherapy at a total dose of 70 Gy. Both tumors responded well to chemoradiotherapy, and at the follow-up conducted 2 years after completion of the chemoradiation therapy, there was no evidence of recurrence or metastasis.
• Evaluation of Vestibular Functions in Patients with Vogt-Koyanagi-Harada Disease

  Keishi Fujiwara, Shinya Morita, Kimiko Hoshino, Atsushi Fukuda, Yuji Nakamaru, Akihiro Homma

  AUDIOLOGY AND NEURO-OTOLOGY 22 (3) 190 - 195 1420-3030 2017 [Refereed][Not invited]
   

  Vogt-Koyanagi-Harada (VKH) disease is an idiopathic, multi-system autoimmune disorder characterized by bilateral, diffuse granulomatous uveitis associated with neurological, audiovestibular, and dermatological manifestations. The purpose of this study is to investigate vestibular functions in patients with VKH disease. A total of 43 patients with VKH disease in Hokkaido University Hospital were enrolled in this study. Subjective symptoms such as dizziness or vertigo and the results of various vestibular examinations including nystagmus testing, caloric testing, and vestibular-evoked myogenic potential (VEMP) testing were investigated. Eight of 42 patients (19.0%) complained of subjective vestibular symptoms. On the other hand, 12 of 28 patients (42.9%) showed nystagmus, and 7 of 15 patients (46.7%) showed unilateral or bilateral weakness in the caloric test. VEMP testing was performed for 16 patients. Seven (43.8%) and 8 (50.0%) patients were evaluated as abnormal in cervical VEMP and ocular VEMP testing, respectively. The rate of detection of nys-tagmus was significantly higher than that of subjective symptoms. As vestibular dysfunction in patients with VKH disease cannot be detected through history taking alone, nystagmus testing, caloric testing, and VEMP testing should be performed to evaluate vestibular functions associated with VKH disease. It is considered that abnormal VEMP findings are associated with otolith organ dysfunction. (C) 2017 S. Karger AG, Basel
• 当院におけるバイオバンクシステム構築の取り組み

  鈴木 崇祥, 畠山 博充, 安川 真一郎, 本間 明宏, 西原 広史, 松野 吉宏, 福田 諭

  耳鼻咽喉科展望 耳鼻咽喉科展望会 59 (6) 371 - 376 0386-9687 2016/12 [Not refereed][Not invited]
  
• 用語解説 胸骨上隙(suprasternal space)

  本間 明宏

  日本気管食道科学会会報 (NPO)日本気管食道科学会 67 (6) 439 - 440 0029-0645 2016/12 [Not refereed][Not invited]
  
• Reduction of blood eosinophil counts in eosinophilic chronic rhinosinusitis after surgery

  A. Honma, D. Takagi, Y. Nakamaru, A. Homma, M. Suzuki, S. Fukuda

  JOURNAL OF LARYNGOLOGY AND OTOLOGY 130 (12) 1147 - 1152 0022-2151 2016/12 [Refereed][Not invited]
   

  Objective: This study aimed to predict eosinophilic chronic rhinosinusitis prognosis by investigating changes in the blood eosinophil count and other disease biomarkers after surgery. Methods: Blood eosinophil numbers and serum interleukin- 5 levels were measured in 22 eosinophilic chronic rhinosinusitis patients before and after functional endoscopic sinus surgery, and compared with equivalent measures in non-eosinophilic chronic rhinosinusitis patients and chronic rhinosinusitis without polyps patients. Differences between well-controlled eosinophilic chronic rhinosinusitis patients and those who experienced recurrence were also assessed. Results: Blood eosinophil numbers and serum interleukin- 5 level decreased after surgery in eosinophilic chronic rhinosinusitis patients. In this patient group, blood eosinophil counts before surgery were significantly higher in patients who experienced recurrence (825.7 +/- 26.1 vs 443.9 +/- 76.6 cells/mu l, p < 0.05), and decreased significantly after surgery (825.7 +/- 26.1 vs 76.7 +/- 25.8 cells/mu l, p < 0.05). Conclusion: Blood eosinophil numbers may reflect disease severity in eosinophilic chronic rhinosinusitis patients and their prognosis after surgery.
• The role of prophylactic neck dissection and tumor thickness evaluation for patients with cN0 tongue squamous cell carcinoma

  Nayuta Tsushima, Tomohiro Sakashita, Akihiro Homma, Hiromitsu Hatakeyama, Satoshi Kano, Takatsugu Mizumachi, Tomohiko Kakizaki, Takayoshi Suzuki, Satoshi Fukuda

  EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY 273 (11) 3987 - 3992 0937-4477 2016/11 [Refereed][Not invited]
   

  Prophylactic neck dissection (PND) for patients with clinically N0 (cN0) tongue carcinoma remains controversial. We assessed the efficacy of PND for patients with cN0 tongue squamous cell carcinoma (SCC) and investigated the prognostic role of tumor thickness as assessed by diagnostic imaging in predicting the risk of nodal micrometastasis or late nodal recurrence. Eighty-eight patients with cN0 tongue carcinomas underwent surgical treatment. Tumor thickness was measured from magnetic resonance (MR) images or computed tomography (CT) scans. The overall survival rates of patients with or without PND were 94 and 81 %, respectively (p = 0.2857). MR images or CT scans were available for 68 patients. A tumor thickness aeyen10 mm or aeyen5 mm did not increase the probability of nodal metastasis, with late nodal metastasis observed in 15 % of patients with graphically undetected small tumors. PND appears to have the potential to improve overall survival for patients with cN0 tongue SCC. Careful follow-up management or PND is considered to be needed regardless of tumor thickness in the pre-treatment evaluation.
• Glucose Metabolism and Its Complicated Relationship with Tumor Growth and Perfusion in Head and Neck Squamous Cell Carcinoma

  Noriyuki Fujima, Tomohiro Sakashita, Akihiro Homma, Kenji Hirata, Tohru Shiga, Kohsuke Kudo, Hiroki Shirato

  PLOS ONE 11 (11) e0166236  1932-6203 2016/11 [Refereed][Not invited]
   

  Objective To determine the relationship between tumor glucose metabolism and tumor blood flow (TBF) in head and neck squamous cell carcinoma (HNSCC). Methods We retrospectively analyzed 57 HNSCC patients. Tumor glucose metabolism was assessed by maximum and mean standardized uptake values (SUVmax and SUVmean) obtained by 18 F-fluorodeoxyglucose positron-emission tomography. TBF values were obtained by arterial spin labeling with 3-tesla MRI. The correlations between both SUVs and TBF were assessed in the total series and among patients divided by T-stage (T1-T3 and T4 groups) and tumor location (pharynx/oral cavity and sinonasal cavity groups). Pearson's correlation coefficients were calculated for significant correlations. Results Significant correlations were detected: a negative correlation in the advanced T-stage group (TBF and SUV max: r, -0.61, SUVmean: r, -0.62), a positive correlation in the non-advanced T-stage pharynx/oral cavity group (TBF and SUVmax: r, 0.70, SUVmean: r, 0.73), a negative correlation in the advanced T-stage pharynx/oral cavity group (TBF and SUVmax: r, -0.62, SUVmean: r, -0.65), and a negative correlation in the advanced Tstage sinonasal cavity group (TBF and SUVmax: r, -0.61, SUVmean: r, -0.65). Conclusion Significant correlations between glucose uptake and TBF in HNSCC were revealed by the division of T-stage and tumor location.
• 頭頸・口腔 頭頸部がんの集学的治療 表在性頭頸部扁平上皮癌のGGT活性化標的薬を用いた蛍光イメージング(Fluorescent imaging of superficial head and neck squamous cell carcinoma using a GGT-Activated targeting agent)

  大西 俊介, 水島 健, 清水 勇一, 畑中 豊, 畑中 佳奈子, 本間 明宏, 浦野 泰照, 坂本 直哉

  日本癌治療学会学術集会抄録集 (一社)日本癌治療学会 54回 WS81 - 6 2016/10 [Not refereed][Not invited]
  
• 頭頸・口腔 頭頸部がんに対する治療戦略 局所進行上顎洞癌に対するCDDP超選択的動注と放射線併用療法(JCOG1212)用量探索の結果

  四宮 弘隆, 本間 明宏, 鬼丸 力也, 松浦 一登, 林 隆一, 志賀 清人, 立花 弘之, 中村 健一, 水澤 純基, 藤井 正人

  日本癌治療学会学術集会抄録集 (一社)日本癌治療学会 54回 WS80 - 5 2016/10 [Not refereed][Not invited]
  
• 頭頸・口腔 頭頸部がんに対する治療戦略 再発・転移頭頸部癌に対するPaclitaxel+Carboplatin+Cetuximab療法の第II相試験

  清田 尚臣, 横田 知哉, 長谷川 泰久, 室 圭, 高橋 俊二, 尾上 琢磨, 本間 明宏, 鈴木 政美, 家根 旦有, 原 浩樹, 西條 憲, 山中 竹春, 田原 信

  日本癌治療学会学術集会抄録集 (一社)日本癌治療学会 54回 WS80 - 1 2016/10 [Not refereed][Not invited]
  
• Effectiveness of superselective intra-arterial chemoradiotherapy targeting retropharyngeal lymph node metastasis

  Takayoshi Suzuki, Tomohiro Sakashita, Akihiro Homma, Hiromitsu Hatakeyama, Satoshi Kano, Takatsugu Mizumachi, Daisuke Yoshida, Noriyuki Fujima, Rikiya Onimaru, Kazuhiko Tsuchiya, Koichi Yasuda, Hiroki Shirato, Fumiyuki Suzuki, Satoshi Fukuda

  EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY 273 (10) 3331 - 3336 0937-4477 2016/10 [Refereed][Not invited]
   

  We sought to evaluate the efficacy and feasibility of superselective intra-arterial infusion of high-dose cisplatin with concomitant radiotherapy (hereafter RADPLAT) for head and neck squamous cell cancer (hereafter HNSCC) patients with retropharyngeal lymph node (hereafter RPLN) metastasis. A retrospective case series review was conducted at University medical center in Japan. Ten HNSCC patients with RPLN metastasis treated by RADPLAT were analyzed. The ascending pharyngeal artery was targeted for the treatment of RPLN metastasis in 9 patients. The median total dose of cisplatin was 26.6 mg/m(2) (mean 31.5 mg/m(2), range 11.7-87.9 mg/m(2)). In the remaining patient, the RPLN was supplied by the ascending palatine artery. As grade 3 and 4 adverse effects, leukopenia was observed in three, mucositis in four and nausea in one patient. No neurological complications were observed in any patients. Metastatic RPLNs were evaluated as a complete response in all patients. There was no recurrence of RPLN metastasis in any patients. Four patients remain alive without any evidence of disease and six patients died of disease. The 5-year overall survival rate was 50 %. We have shown that superselective intra-arterial cisplatin infusion for RPLNs was a feasible and effective approach for HNSCC patients with RPLN metastasis.
• Association of impaired renal function and poor prognosis in oropharyngeal squamous cell carcinoma

  Akihiro Homma, Ryuichi Hayashi, Kazuyoshi Kawabata, Takashi Fujii, Shigemichi Iwae, Yasuhisa Hasegawa, Kenichi Nibu, Takakuni Kato, Kiyoto Shiga, Kazuto Matsuura, Nobuya Monden, Masato Fujii

  HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK 38 (10) 1495 - 1500 1043-3074 2016/10 [Refereed][Not invited]
   

  Background. Renal function influences decisions regarding treatment for patients with oropharyngeal squamous cell carcinoma (SCC). However, the importance of renal function in oropharyngeal SCC has not yet been reported. Methods. Four hundred sixty patients with oropharyngeal SCC treated with curative intent between April 2005 and March 2007 in 12 institutions in Japan were analyzed retrospectively. Results. Four hundred three patients (87.6%) showed a creatinine clearance (CrCl) >= 50 mL/min and 57 (12.4%) with a CrCl < 50 mL/min. Age was associated with worse overall survival (OS), whereas stage IVB, radiotherapy (RT), and CrCl < 50 were associated with worse OS on univariate analyses. Surgery and hypertension were associated with better OS on univariate analyses. On multivariate analysis, age, stage, hypertension, and CrCl were also found to be significantly associated with OS. Conclusion. Based on this retrospective study, impaired renal function is an independent predictor of increased risk of death in patients with oropharyngeal SCC. (C) 2016 Wiley Periodicals, Inc.
• The Outcomes of Surgery and Chemoradiotherapy for Temporal Bone Cancer

  Shinya Morita, Akihiro Homma, Yuji Nakamaru, Tomohiro Sakashita, Hiromitsu Hatakeyama, Satoshi Kano, Atsushi Fukuda, Satoshi Fukuda

  OTOLOGY & NEUROTOLOGY 37 (8) 1174 - 1182 1531-7129 2016/09 [Refereed][Not invited]
   

  Objective: We aimed to evaluate the prognostic factors and efficacy of treatment modalities for patients with temporal bone cancer, and to determine if definitive chemoradiotherapy (CRT) for advanced-stage disease can provide a substitute for highly invasive surgeries. Study Design: Retrospective case series. Setting: Tertiary referral center. Patients: Sixty-six patients with previously untreated squamous cell carcinoma of the temporal bone treated with curative intent between April 1997 and March 2015. Intervention: Surgery alone, radiotherapy (RT) alone, surgery followed by RT or definitive CRT. Main Outcome Measure: The overall survival (OS) rate. Results: The 5-year OS rate for each T classification was 100% for T1, 76.2% for T2, 55.6% for T3, and 36.7% for T4. Univariable and multivariable analysis showed that T classification was an independent predictor of the OS rate (hazard ratio 5.66; 95% confidence interval 1.51-27.0; p = 0.015). Analysis by treatment modality revealed that the 5-year OS rate for patients with T1-2 was 100% for surgery and 81.3% for RT alone. The rate for patients with T3-4 was 52.1% for definitive CRT and 55.6% for surgery followed by RT with or without chemotherapy. Conclusions: Patients with T1-2 benefited from surgical intervention without significant morbidity or mortality. Our findings also suggested that definitive CRT might be appropriate as the first-line treatment for T3-4, especially in cases with unresectable tumors.
• 舌癌N0症例における予防的頸部郭清術の役割と潜在的頸部転移陽性率に関する検討

  坂下 智博, 本間 明宏, 対馬 那由多, 福田 諭

  口腔・咽頭科 日本口腔・咽頭科学会 29 (3) 401 - 401 0917-5105 2016/08 [Not refereed][Not invited]
  
• TORS 米国におけるTransoral Robotic Surgery(TORS)の現況 2nd International TransOral Robotic Surgery(TORS)Conferenceに参加して

  本間 明宏, 水町 貴諭, 花井 信広, 西川 大輔

  日本気管食道科学会会報 (NPO)日本気管食道科学会 67 (4) 319 - 319 0029-0645 2016/08 [Not refereed][Not invited]
  
• A Retrospective Study of G-Tube Use in Japanese Patients Treated with Concurrent Chemoradiotherapy for Hypopharyngeal Cancer

  Akihiro Homma, Hiromitsu Hatakeyama, Takatsugu Mizumachi, Satoshi Kano, Tomohiro Sakashita, Rinnosuke Kuramoto, Yuji Nakamaru, Rikiya Onimaru, Kazuhiko Tsuchiya, Daisuke Yoshida, Koichi Yasuda, Hiroki Shirato, Satoshi Fukuda

  PLOS ONE 11 (8) e0161734  1932-6203 2016/08 [Refereed][Not invited]
   

  Objective Late toxicity after concurrent chemoradiotherapy (CCRT), such as dysphagia, in patients with squamous cell carcinoma of the head and neck has received a good deal of attention recently. The gastrostomy tube (G-tube) dependence rate 1 year after CCRT was reported to be 16.7-42.9% in Western countries. We evaluated swallowing outcomes after CCRT in patients with hypopharyngeal cancer (HPC) treated in our hospital and compared them with previous reports. Methods We reviewed 96 consecutive patients with a HPC treated by radiotherapy with intravenous or intra-arterial chemotherapy between 2006 and 2013 at Hokkaido University Hospital, Sapporo, Japan. Results At 1 month after CCRT, 13 patients (13.7%) used a G-tube, whereas 5/91 (5.5%) and 4/81 (4.9%) used a G-tube at 3 and 6 months, respectively. Two patients used a G-tube at 12 and 24 months after CCRT (G-tube use rate: 2.8% at 12 months, and 3.2% at 24 months). The variables female, posterior wall primary, stage IV, ECOG performance status of 2, and smoking status were significantly associated with G-tube use at 12 months after CCRT, whereas the route of cisplatin administration was not related to G-tube use (p = 0.303). Conclusions The G-tube use rate up to 1year could be lower in Japanese patients than in Western patients according to previous reports. In particular, Japanese patients resume oral intake sooner than Western patients. Further study of the incidence of dysphagia after CCRT by ethnicity is required to clarify the differences in dysphagia after CCRT.
• 骨固定型ピックアップから導出した直接骨導音の音響特性

  前田 秀彦, 西澤 典子, 武市 紀人, 本間 明宏, 前田 昌紀, 玉重 詠子, 米本 清

  音声言語医学 日本音声言語医学会 57 (3) 294 - 304 0030-2813 2016/07 [Not refereed][Not invited]
   

  骨固定型ピックアップから導出した直接骨導音の音響特性について検討した。bone anchored hearing aid(Baha:骨固定型補聴器)のチタニウムインプラントと圧電式加速度ピックアップを利用した頭蓋振動検出システムを構築した。片耳は正常聴力で、一側性の高度感音難聴のため、難聴耳側にBaha埋め込み術(術後5年以上)を受けた成人男性1例を対象とした。頭蓋骨の振動実験において、1000、2000、4000Hzの各周波数における入力に対する出力は、250、500Hzと比較すると、経皮骨導音導出系では約17〜35dB程度減衰し、直接骨導音導出系では10dB程度減衰した。直接骨導音のLTASは、経皮骨導音と比較して1000Hz以上の高周波数帯域の出力パワーの減衰が少なく、気導コンデンサマイクロホンと比較して約0〜10dB程度の差であった。単音節を用いた受聴明瞭度検査において、直接骨導音と経皮骨導音を比較すると、母音部分の正答率に有意差を認め、直接骨導音は、経皮骨導音で見られた母音の異聴傾向を認めなかった。
• Fluorescent imaging of superficial head and neck squamous cell carcinoma using a Upsilon-glutamyltranspeptidase-activated targeting agent: a pilot study

  Takeshi Mizushima, Shunsuke Ohnishi, Yuichi Shimizu, Yutaka Hatanaka, Kanako C. Hatanaka, Hidetaka Hosono, Yoshimasa Kubota, Mitsuteru Natsuizaka, Mako Kamiya, Shouko Ono, Akihiro Homma, Mototsugu Kato, Naoya Sakamoto, Yasuteru Urano

  BMC CANCER 16 411  1471-2407 2016/07 [Refereed][Not invited]
   

  Background: Detecting superficial head and neck squamous cell carcinoma (HNSCC) by endoscopy is challenging because of limited morphological hallmarks, and iodine cannot be applied to head and neck lesions due to severe mucosal irritation. Upsilon-glutamyltranspeptidase (GGT), a cell surface enzyme, is overexpressed in several cancers, and it has been reported that Upsilon-glutamyl hydroxymethyl rhodamine green (gGlu-HMRG), a fluorescent targeting agent which can be enzymatically activated and becomes fluorescent after cleavage of a GGT-specific sequence, can be activated within a few minutes after application to animal models. We investigated whether early HNSCC can be detected by applying gGlu-HMRG to clinical samples. Methods: gGlu-HMRG was applied to four HNSCC cell lines, and fluorescence was observed by fluorescence microscopy and flow cytometry. Immunohistological examination was performed in three recent cases of endoscopic submucosal dissection (ESD) to investigate GGT expression. Fluorescence imaging with gGlu-HMRG in eight clinical samples resected by ESD or surgery was performed, and fluorescence intensity of tumor and normal mucosa regions of interest (ROI) was prospectively measured. Results: All four gGlu-HMRG-applied cell lines emitted green fluorescence. Immunohistological examination demonstrated that GGT was highly expressed in HNSCC of the recent three ESD cases but barely in the normal mucosa. Fluorescence imaging showed that iodine-voiding lesions became fluorescent within a few minutes after application of gGlu-HMRG in all eight resected tumors. Tumor ROI fluorescence intensity was significantly higher than in the normal mucosa five minutes after gGlu-HMRG application. Conclusions: Fluorescence imaging with gGlu-HMRG would be useful for early detection of HNSCC.
• 頭頸部癌症例 あなたならどうする? 鼻副鼻腔

  本間 明宏

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 119 (6) 903 - 904 0030-6622 2016/06 [Not refereed][Not invited]
  
• 下咽頭癌に対するCisplatin週1回放射線化学療法と導入化学療法の有用性と治療完遂率に関する検討

  坂下 智博, 対馬 那由多, 本間 明宏, 水町 貴諭, 福田 諭

  口腔・咽頭科 日本口腔・咽頭科学会 29 (2) 169 - 174 0917-5105 2016/06 [Not refereed][Not invited]
   

  当科では、下咽頭癌に対して喉頭機能温存を期待してシスプラチン40mg/m2週一回投与の放射線化学療法(CRT)を行っており、遠隔転移ハイリスク症例には3剤併用(タキソテール75mg/m2xday1、シスプラチン75mg/m2xday1、5-FU 750mg/m2xday1-5)の導入化学療法を先行している。CRTを行った下咽頭癌40例について検討したが、うち10例は導入化学療法を先行した。全体の87.5%、導入化学療法を行った10例のうち90%においてシスプラチン5コース以上のCRTを行うことができた。全体および導入化学療法を行った10例の喉頭温存生存率は66%(5年)、58.3%(3年)であった。本レジメンは下咽頭癌の喉頭温存治療として有用であり、高い完遂率から導入化学療法と組み合わせて行う治療として妥当と考えられた。(著者抄録)
• 中咽頭扁平上皮癌に対する化学放射線療法施行症例の臨床的検討

  水町 貴諭, 坂下 智博, 加納 里志, 畠山 博充, 本間 明宏, 土屋 和彦, 安田 耕一, 鬼丸 力也, 白土 博樹, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 42 (2) 181 - 181 1349-5747 2016/05 [Not refereed][Not invited]
  
• 化学放射線治療を行った頭頸部扁平上皮癌患者における治療前血中炎症細胞と予後に関する検討

  加納 里志, 本間 明宏, 畠山 博充, 水町 貴諭, 坂下 智博, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 42 (2) 183 - 183 1349-5747 2016/05 [Not refereed][Not invited]
  
• 再発・転移頭頸部扁平上皮癌に対するPCE併用療法の第II相試験(CSPOR-HN02)

  福田 裕次郎, 長谷川 泰久, 鬼塚 哲郎, 丹生 健一, 川端 一嘉, 岩江 信法, 本間 明宏, 鈴木 政美, 家根 且有, 山中 竹春, 田原 信

  頭頸部癌 (一社)日本頭頸部癌学会 42 (2) 194 - 194 1349-5747 2016/05 [Not refereed][Not invited]
  
• 日本人の頭頸部癌患者におけるCetuximabを含む治療の観察研究(JROSG12-2) BRT有害事象に関する中間評価

  太田 陽介, 古平 毅, 藤井 博文, 下川 元継, 中島 寅彦, 門田 伸也, 横田 知哉, 本間 明宏, 上田 眞也, 秋元 哲夫

  頭頸部癌 (一社)日本頭頸部癌学会 42 (2) 195 - 195 1349-5747 2016/05 [Not refereed][Not invited]
  
• 下咽頭癌に対する化学放射線療法後の嚥下障害 欧米の報告との比較

  本間 明宏, 畠山 博充, 水町 貴諭, 加納 里志, 坂下 智博, 鬼丸 力也, 土屋 和彦, 安田 耕一, 白土 博樹, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 42 (2) 214 - 214 1349-5747 2016/05 [Not refereed][Not invited]
  
• 次世代遺伝子シークエンサーを用いた、鼻副鼻腔内反性乳頭腫の悪性転化に関与する変異遺伝子の解析

  安川 真一郎, 畠山 博充, 鈴木 崇祥, 水町 貴諭, 中丸 裕爾, 本間 明宏, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 42 (2) 220 - 220 1349-5747 2016/05 [Not refereed][Not invited]
  
• 頭頸部癌における免疫チェックポイント分子と増殖・刺激因子シグナル伝達経路

  畠山 博充, 加納 里志, 水町 貴諭, 坂下 智博, 本間 明宏, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 42 (2) 220 - 220 1349-5747 2016/05 [Not refereed][Not invited]
  
• Phase II trial of combination treatment with paclitaxel, carboplatin and cetuximab (PCE) as first- line treatment in patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck (CSPOR-HN02).

  Makoto Tahara, Naomi Kiyota, Tomoya Yokota, Yasuhisa Hasegawa, Kei Muro, Shunji Takahashi, Takuma Onoe, Akihiro Homma, Jun Taguchi, Masami Suzuki, Koichi Minato, Katsunari Yane, Shinya Ueda, Hiroki Hara, Ken Saijo, Takeharu Yamanaka

  JOURNAL OF CLINICAL ONCOLOGY 34 (15) 0732-183X 2016/05 [Not refereed][Not invited]
  
• 喉頭腫瘍におけるHPV感染の検討

  水町 貴諭, 中薗 彬, 坂下 智博, 加納 里志, 畠山 博充, 本間 明宏, 福田 諭

  日本気管食道科学会会報 (NPO)日本気管食道科学会 67 (2) s61 - s61 0029-0645 2016/04 [Not refereed][Not invited]
  
• 気管切開術後の輪状軟骨壊死に対して喉頭全摘術を施行した1例

  浜田 誠二郎, 溝口 兼司, 畠山 博充, 本間 明宏, 福田 諭

  日本気管食道科学会会報 (NPO)日本気管食道科学会 67 (2) s66 - s66 0029-0645 2016/04 [Not refereed][Not invited]
  
• 【耳鼻咽喉科処方マニュアル】 頭頸部がん 副鼻腔がん

  本間 明宏, 清水 康

  耳鼻咽喉科・頭頸部外科 (株)医学書院 88 (5) 292 - 295 0914-3491 2016/04 [Not refereed][Not invited]
   

  ＜処方のPoint＞治療は小細胞癌以外では手術を中心に放射線治療を組み合わせて行う方法が基本となる。化学療法は補助的な位置づけであるが,化学療法が有効な症例は稀ではない。また,手術を行わずに根治を目指すRADPLATや静注の抗がん剤と照射の同時併用では化学療法の果たす役割は非常に大きい。(著者抄録)
• Comparison of hearing outcomes after treatment for early-stage external auditory canal cancer

  Shinya Morita, Yuji Nakamaru, Akihiro Homma, Tomohiro Sakashita, Hiromitsu Hatakeyama, Masayori Masuya, Satoshi Fukuda

  HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK 38 E1110 - E1116 1043-3074 2016/04 [Refereed][Not invited]
   

  Background. The purpose of this study was to compare the hearing outcomes after surgery with reconstruction of the external auditory canal in combination with tympanoplasty, radiotherapy (RT) alone, and surgery followed by postoperative RT for T1 to 2N0M0 external auditory canal cancer. Methods. We performed a retrospective, single-institution review of consecutive patients with early-stage external auditory canal cancer treated with surgery and/or RT between April 1997 and August 2013. Audiological data included the pretreatment hearing thresholds and those obtained at 12 months after the completion of therapy. Results. When we compared the functional gains for air-conduction pure-tone average thresholds and mean air-bone gaps, those in the surgery group (n = 10) were significantly higher than those in the RT (n = 13) and surgery 1 RT (n = 5) groups. Conclusion. Adequate techniques for reconstruction of the external auditory canal in combination with tympanoplasty after complete surgical resection is useful for hearing preservation in addition to good survival outcomes. (c) 2015 Wiley Periodicals, Inc.
• Sonographic findings of immunoglobulin G4-related sclerosing sialadenitis

  Satomi Omotehara, Mutsumi Nishida, Megumi Satoh, Mamiko Inoue, Yusuke Kudoh, Tatsunori Horie, Akihiro Homma, Yuji Nakamaru, Kanako C. Hatanaka, Chikara Shimizu

  JOURNAL OF MEDICAL ULTRASONICS 43 (2) 257 - 262 1346-4523 2016/04 [Refereed][Not invited]
   

  Purpose We evaluated the sonographic findings of immunoglobulin G4-related sclerosing sialadenitis (IgG4-SS). Methods Nineteen patients with IgG4-SS and 12 healthy volunteers (controls) were enrolled. The following sonographic features were evaluated: (1) enlargement of the submandibular gland by measurement of the longitudinal diameter and thickness; (2) the contour texture of the submandibular gland (smooth or rough); (3) the internal echo texture, categorized into three sonographic patterns (homogeneous, multiple hypoechoic nodule, and diffuse hypoechoic); and (4) quantitative color Doppler signaling. Results The longitudinal diameter and the thickness (mean +/- A SD) of the submandibular gland were significantly greater in patients than in controls (p = 0.005 and p < 0.001, respectively). Contour roughness was seen in 62.9 and 8.3 % of patients and controls (p < 0.001), respectively. Homogeneous echo textures alone were seen in controls, whereas multiple hypoechoic nodule patterns were seen in 60 % of the patients, and diffuse hypoechoic patterns were seen in 40 %. Color Doppler signaling (mean +/- A SD) was significantly higher in patients as compared with controls (p < 0.001). Conclusion Patients could be distinguished from healthy volunteers using four distinctive sonographic findings, suggesting that ultrasonography would be a useful diagnostic tool for IgG4-SS.
• 【中咽頭癌-HPVの視点からみた大きな変化】 治療 中咽頭癌の予後因子は?

  水町 貴諭, 本間 明宏

  JOHNS (株)東京医学社 32 (3) 323 - 325 0910-6820 2016/03 [Not refereed][Not invited]
  
• 手術手技 私が愛用する手術器具 上顎全摘術の骨切りに使う器械 ギグリ線鋸と田川式彎曲ノミ

  本間 明宏

  JOHNS (株)東京医学社 32 (2) 255 - 257 0910-6820 2016/02 [Not refereed][Not invited]
  
• Usefulness of pseudocontinuous arterial spin-labeling for the assessment of patients with head and neck squamous cell carcinoma by measuring tumor blood flow in the pretreatment and early treatment period

  N. Fujima, D. Yoshida, T. Sakashita, A. Homma, A. Tsukahara, K. K. Tha, K. K. Tha, K. Kudo, H. Shirato, H. Shirato

  American Journal of Neuroradiology 37 (2) 342 - 348 0195-6108 2016/02/01 [Not refereed][Not invited]
   

  Background and Purpose: For the assessment of the treatment response in non-surgical treatment, tumor blood flow provides the functional information of the tumor which is different from the morphological information such as tumor volume. The purpose of this study was to evaluate the diagnostic value of tumor blood flow values obtained by pseudocontinuous arterial spin-labeling in patients with head and neck squamous cell carcinoma. Materials and Methods: Forty-one patients with head and neck squamous cell carcinoma were evaluated by using pseudocontinuous arterial spin-labeling. Quantitative tumor blood flow was calculated at the pretreatment and the early treatment periods in all the patients, and the percentage change of tumor blood flow between the two was calculated. At the early treatment period, based on their tumor volume reduction rate, we divided the patients into stable disease and partial response groups for a subgroup analysis. The local control or failure was confirmed either by histopathology or by radiologic evaluation within the follow-up. RESULTS: Pretreatment tumor blood flow in patients in the failure group was significantly lower than that in patients in the local control group. In the subgroup analysis of patients with stable disease, the percentage change of tumor blood flow was significantly larger (due to the tumor blood flow increase from pretreatment value) in the local control group than in the failure group. In addition, in patients with a partial response, the percentage change of tumor blood flow was significantly smaller (due to the tumor blood flow decrease from the pretreatment value) in the local control group than in the failure group. The accuracy for determination of the local control group or the failure group in pretreatment tumor blood flow was 0.83 and that in the combination use of the percentage change of tumor blood flow and tumor volume in the early treatment period was 0.93. Conclusions: Tumor blood flow obtained by pseudocontinuous ar terial spin-labeling can be useful for the determination of local control. The combined use of the percentage change of tumor blood flow and tumor volume had particularly high diagnostic accuracy.
• Current Status and New Developments in Chemotherapy for Head and Neck Cancer

  Homma A.

  Nihon Kikan Shokudoka Gakkai Kaiho 特定非営利活動法人 日本気管食道科学会 67 (2) 177 - 177 0029-0645 2016
• Investigative study on spasmodic dysphonia

  Saori Yanagida, Noriko Nishizawa, Hiromitsu Hatakeyama, Kenji Mizoguchi, Akihiro Homma, Satoshi Fukuda

  Japan Journal of Logopedics and Phoniatrics 日本音声言語医学会 57 (4) 391 - 397 0030-2813 2016 [Not refereed][Not invited]
   

  This investigation retrospectively examined subtypes, sex, age at the first medical examination, job, main complaint, complication with other involuntary movement, period of affliction, consultation history and treatment outcomes for 85 cases of spasmodic dysphonia. The majority of participants were females in their 20s who were diagnosed with adductor spasmodic dysphonia. Over 70% of the participants were required to use their voice frequently in their work. Twenty-six percent of the participants were diagnosed within 6 months of the onset of voice problems however, 34% had had voice symptoms for 5 years or more. The majority of participants visited multiple medical institutions, including departments of otolaryngology and psychosomatic medicine. The treatment most frequently received was voice therapy, followed by botulinum toxin injection and thyroplasty. Spasmodic dysphonia has recently received a good deal of attention, and the number of patients visiting hospital with this complaint has increased. For this reason, diagnostic criteria, standard evaluation methods, and environmental improvements are urgently required.
• Indications for superselective intra-arterial cisplatin infusion and concomitant radiotherapy in cases of hypopharyngeal cancer

  Jun Furusawa, Akihiro Homma, Rikiya Onimaru, Tomohiro Sakashita, Daisuke Yoshida, Hiromitsu Hatakeyama, Takatsugu Mizumachi, Satoshi Kano, Kazuhiko Tsuchiya, Koichi Yasuda, Hiroki Shirato, Satoshi Fukuda

  Journal of Otolaryngology of Japan 一般社団法人 日本耳鼻咽喉科学会 119 (5) 782 - 783 0030-6622 2016/01/01 [Not refereed][Not invited]
  
• Intra-arterial chemoradiotherapy for head and neck cancer

  Akihiro Homma, Rikiya Onimaru, Kazuto Matsuura, K. Thomas Robbins, Masato Fujii

  JAPANESE JOURNAL OF CLINICAL ONCOLOGY 46 (1) 4 - 12 0368-2811 2016/01 [Refereed][Not invited]
   

  Intra-arterial chemotherapy has been used to treat localized malignant neoplasms in patients with head and neck cancer for over 50 years as the head and neck region is particularly well suited to regional chemotherapy. Early intra-arterial chemotherapy did not prove its efficacy. In addition, the additional complications associated with establishing and maintaining arterial access have further dampened enthusiasm for this approach. Subsequent significant advances in vascular radiology techniques and the development of new devices, such as fluoroscopy units and angiographic catheters, have made possible safe, accurate and repeated superselective intra-arterial chemotherapy. Intra-arterial infusion of high-dose cisplatin with systemic neutralization by intravenous sodium thiosulfate (RADPLAT) is a theoretically attractive approach to the treatment of advanced head and neck cancer. However, a Dutch trial comparing intra-arterial and intravenous chemoradiotherapy for advanced head and neck cancer showed that RADPLAT was not superior to intravenous chemoradiotherapy. Therefore, further investigation of RADPLAT, including the refinement of the indications for its application, is needed.
• Otologic and Rhinologic Manifestations of Eosinophilic Granulomatosis with Polyangiitis.

  Yuji Nakamaru, Dai Takagi, Masanobu Suzuki, Aya Homma, Shinya Morita, Akihiro Homma, Satoshi Fukuda

  Audiology & neuro-otology 21 (1) 45 - 53 1420-3030 2016 [Refereed][Not invited]
   

  Background: Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic autoimmune disease that manifests as asthma, recurrent sinusitis and peripheral eosinophilia. In this study, we investigated the clinical features of the ear and nasal manifestations of EGPA in comparison with those of granulomatosis with polyangiitis (GPA). Materials and Methods: Twenty-one patients diagnosed with EGPA were studied. The frequency of otologic manifestations, the degree of hearing loss and the frequency of nasal symptoms were assessed. The onset of ear symptoms, sinusitis and asthma in patients with EGPA were also examined. Results: Eleven patients (52.4%) with EGPA demonstrated otologic symptoms. The EGPA patients commonly presented mild-to-moderate mixed or sensorineural hearing loss. The pattern of hearing loss was mainly flat, and all but 1 patient achieved complete remission from their hearing impairments. Eighteen patients (85.7%) with EGPA demonstrated nasal symptoms. Patients with EGPA showed a significantly higher incidence of nasal polyps than did those with GPA. The median Lund and Mackey scoring system score was 13.7 for patients with EGPA, and ethmoid sinus shadows were more severe than those of the maxillary sinus. Most ear symptoms associated with EGPA were observed after definitive diagnosis, although sinusitis and asthma tended to manifest themselves before diagnosis. There were significant differences between the onset of ear symptoms and those of asthma and sinusitis. Conclusion: As over 80% of patients with EGPA had nasal symptoms and over half had ear symptoms, otolaryngologists should be aware of this disease. Recognition of the characteristic ear and nasal symptoms are thought to be particularly important to obtain an early diagnosis of EGPA. (C) 2016 S. Karger AG, Basel
• The Short- and Long-Term Outcome of Intratympanic Steroid Therapy as a Salvage Treatment for Acute Low-Tone Sensorineural Hearing Loss without Episodes of Vertigo

  Shinya Morita, Yuji Nakamaru, Keishi Fujiwara, Keiji Iizuka, Masayori Masuya, Akihiro Homma, Atsushi Fukuda, Satoshi Fukuda

  AUDIOLOGY AND NEURO-OTOLOGY 21 (3) 132 - 140 1420-3030 2016 [Refereed][Not invited]
   

  Objectives: To evaluate the hearing outcomes of intratympanic steroid (ITS) treatment for patients with acute low-tone sensorineural hearing loss (ALHL) after failure of initial therapy and to investigate the recurrence and progression to definite Meniere's disease (MD) during a long-term follow-up. Methods: We retrospectively reviewed the medical records of 90 patients with refractory ALHL who were followed up for at least 1 year between January 2000 and April 2014. Patients who responded poorly to initial medical treatment received intratympanic dexamethasone injections (ITS group) or isosorbide administration for 4 weeks (diuretic group) as salvage treatment options according to their choice of management. The control group did not receive ITS or the diuretic, due to their refusal of both medical treatments. The hearing outcomes were evaluated 1 month, 1 year and 5 years after the completion of the second-line therapy, and the rates of recurrence and progression to MD were measured during a follow-up period of at least 1 year. Results: Twenty-seven patients in the ITS group, 39 patients in the diuretic group and 24 patients in the control group were enrolled. Of these, 12 patients in the ITS group, 15 patients in the diuretic group and 12 patients in the control group were followed up for over 5 years. We found that the recovery rates and the audiometric functional values after 1 month and 1 year in the ITS group were significantly higher than those in the diuretic and control groups. However, there were no significant differences in the recovery rates or the audiometric functional values after 5 years, or in the rates of recurrence and progression to MD between the groups. Conclusions: Salvage ITS therapy can provide a relatively good short-term hearing outcome for ALHL patients who have persistent hearing loss despite conventional treatment. However, both recurrence and progression to MD after treatment were observed in some patients during the long-term follow-up. (C) 2016 S. Karger AG, Basel
• Clinical outcomes of weekly cisplatin chemoradiotherapy for patients with pyriform sinus cancer

  Tomohiro Sakashita, Akihiro Homma, Hiromitsu Hatakeyama, Jun Furusawa, Satoshi Kano, Takatsugu Mizumachi, Satoshi Iizuka, Rikiya Onimaru, Kazuhiko Tsuchiya, Koichi Yasuda, Hiroki Shirato, Satoshi Fukuda

  INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY 20 (6) 1081 - 1085 1341-9625 2015/12 [Refereed][Not invited]
   

  Background Pyriform sinus squamous cell carcinoma (SCC) has one of the worst prognoses of all upper aerodigestive tract cancers. Improving clinical outcomes for patients with hypopharyngeal SCC has been particularly challenging for head and neck surgeons and oncologists. Methods We investigated 30 patients with pyriform sinus SCC to verify the effectiveness of weekly cisplatin chemotherapy with concurrent radiotherapy. Cisplatin was administered at a dose of 40 mg/m(2) on weeks 1, 2, 3, 5, 6, and 7 during definitive radiotherapy with the aim of preserving the larynx. Results All 30 patients achieved definitive radiotherapy at a median dose of 70 Gy (range 64-70 Gy). Cisplatin was administrated concomitantly a median of five times (range 2-6 times). Persistent or recurrent primary disease was observed in four patients (13 %). Persistent or recurrent nodal metastasis was observed in five patients (17 %). Nine salvage surgeries were performed for eight patients, of whom seven survived without any evidence of disease. Post-operative complications were observed in two patients (22 %). The 5-year overall survival and locoregional control rates were 87 and 96 %, respectively. The 5-year laryngeal preservation rate was 74 %. Conclusions The regimen of weekly cisplatin CRT may be effective for pyriform sinus SCC; however, there were problems with strong selection bias in the current study due to the large number of T2 patients. Salvage surgery was safe and was able to improve the survival rate. This chemoradiation regimen was considered successful in preserving laryngeal function.
• Indications for superselective intra-arterial cisplatin infusion and concomitant radiotherapy in cases of hypopharyngeal cancer

  Jun Furusawa, Akihiro Homma, Rikiya Onimaru, Tomohiro Sakashita, Daisuke Yoshida, Hiromitsu Hatakeyama, Takatsugu Mizumachi, Satoshi Kano, Kazuhiko Tsuchiya, Koichi Yasuda, Hiroki Shirato, Satoshi Fukuda

  AURIS NASUS LARYNX 42 (6) 443 - 448 0385-8146 2015/12 [Refereed][Not invited]
   

  Objective: We retrospectively assessed the indications for superselective intra-arterial infusion of cisplatin with concomitant radiotherapy (RADPLAT) in patients with hypopharyngeal cancer (HPC). Methods: Between April 2000 and March 2013,41 previously untreated patients received superselective intra-arterial infusion of cisplatin (100-120 mg/m(2) per week) with simultaneous intravenous infusions of thiosulfate to neutralize cisplatin toxicity and conventional radiotherapy (65-70 Gy). Results: During the median follow-up period of 5.5 years, a statistically significant difference in the 5-year overall survival was noted between patients with N0-1 (n = 14) and N2b-3 disease (n = 27). One-half of deaths were observed to be the result of distant metastasis. The 5-year local control and overall survival were significantly better in patients with unilateral than in those with bilateral primary tumors. All the patients with T4b disease (n = 3) died of disease within 2 years. Conclusion: Indications for RADPLAT in patients with HPC were defined as patients with unilateral tumors staged as T3-4a and N0-1. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
• 唾液腺導管癌におけるHER2下流シグナルの解析

  加納 里志, 本間 明宏, 畠山 博充, 水町 貴諭, 坂下 智博, 鈴木 崇祥, 福田 諭

  日本唾液腺学会誌 日本唾液腺学会 56 34 - 34 0916-1104 2015/11 [Not refereed][Not invited]
  
• Induction chemotherapy in locally advanced head and neck cancer

  Yasushi Shimizu, Jun Taguchi, Ichiro Kinoshita, Kazuhiko Tsuchiya, Hiroki Shirato, Akihiro Homma, Satoshi Fukuda, Hirotoshi Akita

  ANNALS OF ONCOLOGY 26 33 - 33 0923-7534 2015/11 [Not refereed][Not invited]
  
• Locally advanced head and neck squamous cell carcinomas treated with TPF(docetaxel, cisplatin, 5-FU) induction chemotherapy

  Jun Taguchi, Yasushi Shimizu, Ichiro Kinoshita, Rio Honma, Satoshi Takeuchi, Kazuhiko Tsuchiya, Hiroki Shirato, Akihiro Homma, Satoshi Fukuda, Hirotoshi Akita

  ANNALS OF ONCOLOGY 26 90 - 90 0923-7534 2015/11 [Not refereed][Not invited]
  
• Early and long-term morbidity after minimally invasive total laryngo-pharyngo-esophagectomy with gastric pull-up reconstruction via thoracoscopy, laparoscopy and cervical incision

  Akihiro Homma, Yuji Nakamaru, Hiromitsu Hatakeyama, Takatsugu Mizumachi, Satoshi Kano, Jun Furusawa, Tomohiro Sakashita, Toshiaki Shichinohe, Yuma Ebihara, Satoshi Hirano, Hiroshi Furukawa, Toshihiko Hayashi, Yuhei Yamamoto, Satoshi Fukuda

  EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY 272 (11) 3551 - 3556 0937-4477 2015/11 [Refereed][Not invited]
   

  Total laryngo-pharyngo-esophagectomy (TLPE) with gastric pull-up reconstruction is still considered to be associated with major complications and a significant risk of in-hospital death. Minimally invasive esophagectomy, avoiding thoracotomy and laparotomy, has been increasingly performed for esophageal malignancies with the hope of reducing mortality and morbidity, such as pulmonary complications. The aim in this study was to assess early and long-term morbidity as well as treatment outcomes in patients treated with TLPE with gastric pull-up reconstruction via thoracoscopy, laparoscopy and cervical incision. From 2004 to 2013, 10 patients with a median age of 64 years (range 47-71 years) underwent minimally invasive TPLE with gastric pull-up reconstruction. Seven of the 10 patients had previously received radiotherapy. As for early postoperative complications, no patient died during the early postoperative period, and pneumonia was observed in 1, skin necrosis in 1, pseudomembranous enterocolitis in 1, arrhythmia in 2, hemorrhage in the neck in 2, anastomotic leakage in the neck in 3, and tracheal necrosis in 6 patients. Three patients developed tracheostomal stenosis as a long-term postoperative complication, and an anastomotic stricture was observed in one patient. All patients were able to achieve oral intake, but 3 patients required feeding tube support. In conclusion, postoperative systemic complications during the early postoperative period were considered to be acceptable, although wound complications such as tracheal necrosis and anastomotic leakage were commonly observed. Therefore, this minimally invasive procedure might help reduce mortality and morbidity in patients requiring TLPE with gastric pull-up reconstruction.
• Diagnostic value of tumor blood flow and its histogram analysis obtained with pCASL to differentiate sinonasal malignant lymphoma from squamous cell carcinoma

  Noriyuki Fujima, Hiroyuki Kameda, Akiko Tsukahara, Daisuke Yoshida, Tomohiro Sakashita, Akihiro Homma, Khin Khin Tha, Kohsuke Kudo, Hiroki Shirato

  EUROPEAN JOURNAL OF RADIOLOGY 84 (11) 2187 - 2193 0720-048X 2015/11 [Refereed][Not invited]
   

  Objectives: To investigate the diagnostic value of tumor blood flow (TBF) obtained with pseudocontinuous arterial spin labeling (pCASL) for the differentiation of squamous cell carcinoma (SCC) and malignant lymphoma (ML) in the nasal or sinonasal cavity. Methods: Thirty-three patients with SCC and 6 patients with ML in the nasal or sinonasal cavity were retrospectively analyzed. Quantitative TBF values were obtained using whole-tumor region of interest (ROI) from pCASL data. The histogram analysis of TBF values within the tumor ROI was also performed by calculating the coefficient of variation (CV), kurtosis, and skewness. The mean TBF value, histogram CV, kurtosis and skewness of the patients with SCC were compared with those of the ML patients. The diagnostic accuracy to differentiate SCC from ML was also calculated by receiver operating characteristic (ROC) curve analysis. In addition, multiple logistic regression models were also performed to determine their independent predictive value, and diagnostic accuracy with the combined use of these parameters. Results: Between the SCC and ML groups, significant differences were observed in mean TBF, CV, and kurtosis, but not in skewness. In ROC curve analysis, the diagnostic accuracy values for the differentiation of SCC from ML in mean TBF, CV, and kurtosis were all 0.87, respectively. Multiple logistic regression models revealed TBF and CV were respectively independent predictive value. With the combination of these parameters, the diagnostic accuracy was elevated to 0.97. Conclusions: The TBF value and its histogram analysis obtained with pCASL can help differentiate SCC and ML. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
• 人工血管置換・大胸筋皮弁再建によっても救命しえなかった気管腕頭動脈瘻の1例

  浜田 誠二郎, 坂下 智博, 本間 明宏, 溝口 兼司, 福田 諭

  頭頸部外科 (NPO)日本頭頸部外科学会 25 (2) 241 - 245 1349-581X 2015/10 [Not refereed][Not invited]
   

  症例は82歳、女性。脳梗塞を発症し当院ICUに救急搬送され、保存治療中に経皮的気管切開術を施行された。術後2ヵ月で気管腕頭動脈瘻による出血を認めたため、腕頭動脈穿孔部の縫合・前頸筋による縫合部の被覆を施行した。術後3週間目の造影CTにて腕頭動脈仮性瘤の形成を認め切迫破裂が懸念されたため、人工血管置換・大胸筋皮弁再建術を施行した。術後当初は良好に経過したが、約1ヵ月半後に人工血管中枢側吻合部の離開による止血不能な出血を認め、最初の止血術から約3ヵ月で永眠された。気管腕頭動脈瘻は救命困難な合併症であり、日常のカニューレ管理等による予防が大変重要であることが再確認された。(著者抄録)
• γ-Glutamyltranspeptidaseにより蛍光を発するprobeによる早期頭頸部がんの検出

  大西 俊介, 清水 勇一, 水島 健, 畑中 豊, 畑中 佳奈子, 久保田 良政, 夏井坂 光輝, 神谷 真子, 本間 明宏, 加藤 元嗣, 浦野 泰照, 坂本 直哉

  日本癌学会総会記事 日本癌学会 74回 P - 3308 0546-0476 2015/10 [Not refereed][Not invited]
  
• Management for squamous cell carcinoma of the nasal cavity and ethmoid sinus: A single institution experience

  Akihiro Homma, Yuji Nakamaru, Tomohiro Sakashita, Rikiya Onimaru, Shunsuke Terasaka, Kazuhiko Tsuchiya, Daisuke Yoshida, Koichi Yasuda, Hiromitsu Hatakeyama, Jun Furusawa, Takatsugu Mizumachi, Satoshi Kano, Hiroki Shirato, Satoshi Fukuda

  AURIS NASUS LARYNX 42 (5) 377 - 381 0385-8146 2015/10 [Refereed][Not invited]
   

  Objective: Here we report our experience of patients with squamous cell carcinoma (SCC) of the nasal cavity and ethmoid sinus (NC&ES) together with an analysis of treatment outcomes. Methods: A retrospective analysis was performed using data from 25 consecutive patients treated between 2000 and 2012. Four patients were diagnosed with T1, 3 with T2, 4 with T3, 7 with T4a, and 7 with T4b disease. No patient had lymph node metastasis. Results: Twelve patients were treated with surgery with/without radiotherapy and with/without chemotherapy. Of these, 4 underwent endoscopic surgery without an open approach and 3 required an anterior skull base approach. Thirteen were treated with radiotherapy; 1 with radiotherapy alone, and 4 and 8 with intravenous and intra-arterial chemotherapy, respectively. The 5-yr overall survival for T1-3, T4a, and T4b disease was 53.9%, 71.4%, and 29.0%, respectively. The 5-yr disease-specific survival for T1-3, T4a, and T4b disease was 74.1%, 71.4%, and 29.0%, respectively. Conclusion: Our treatment policy for patients with SCC of NC&ES, which basically follows the NCCN guideline, was considered to be appropriate. However, several points in terms of surgery and nonsurgical approach remain to be solved through further research. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
• 【耳鼻咽喉科薬物療法2015】 耳鼻咽喉科の疾患・症候別薬物療法 頭頸部扁平上皮癌の動注化学療法

  本間 明宏

  JOHNS (株)東京医学社 31 (9) 1356 - 1357 0910-6820 2015/09 [Not refereed][Not invited]
  
• 耳下腺原発唾液腺導管癌の検討

  蠣崎 文彦, 加納 里志, 折舘 伸彦, 本間 明宏, 鈴木 清護, 畠山 博充, 水町 貴諭, 坂下 智博, 福田 諭

  耳鼻咽喉科展望 耳鼻咽喉科展望会 58 (補冊1) 12 - 13 0386-9687 2015/09 [Not refereed][Not invited]
  
• 北海道大学における原発不明頸部リンパ節転移癌の解析

  加納 里志, 本間 明宏, 畠山 博充, 水町 貴諭, 古沢 純, 坂下 智博, 福田 諭

  耳鼻咽喉科展望 耳鼻咽喉科展望会 58 (補冊1) 52 - 53 0386-9687 2015/09 [Not refereed][Not invited]
  
• 頭頸部・口腔がん治療の未来を展望する 頭頸部癌ゲノム・プロテオーム解析からの個別化分子標的治療へ

  畠山 博充, 本間 明宏, 坂下 智博, 水町 貴諭, 加納 里志, 蠣崎 文彦, 福田 諭

  日本癌治療学会誌 (一社)日本癌治療学会 50 (3) 323 - 323 0021-4671 2015/09 [Not refereed][Not invited]
  
• 頭頸部扁平上皮癌患者における治療前血中炎症細胞と予後に関する検討

  加納 里志, 本間 明宏, 畠山 博充, 水町 貴諭, 坂下 智博, 福田 諭

  日本癌治療学会誌 (一社)日本癌治療学会 50 (3) 2350 - 2350 0021-4671 2015/09 [Not refereed][Not invited]
  
• 腎機能は中咽頭癌の予後因子である

  本間 明宏, 林 隆一, 川端 一喜, 藤井 隆, 岩江 信法, 長谷川 泰久, 丹生 健一, 加藤 孝邦, 志賀 清人, 松浦 一登, 門田 伸也, 藤井 正人

  日本癌治療学会誌 (一社)日本癌治療学会 50 (3) 2352 - 2352 0021-4671 2015/09 [Not refereed][Not invited]
  
• 北日本12施設における耳下腺多形腺腫由来癌の治療成績

  鈴木 政博, 松塚 崇, 近藤 敦, 西條 聡, 大森 孝一, 高原 幹, 小川 武則, 片桐 克則, 福井 奈緒子, 石田 晃弘, 山田 和之, 舘田 勝, 阿部 尚央, 本間 明宏, 松浦 一登

  日本癌治療学会誌 (一社)日本癌治療学会 50 (3) 2358 - 2358 0021-4671 2015/09 [Not refereed][Not invited]
  
• 梨状陥凹原発扁平上皮癌に対するシスプラチン週一回投与併用放射線化学療法の検討

  対馬 那由多, 坂下 智博, 本間 明宏, 水町 貴諭, 福田 諭

  口腔・咽頭科 日本口腔・咽頭科学会 28 (3) 367 - 367 0917-5105 2015/08 [Not refereed][Not invited]
  
• Comparison of acute toxicities associated with cetuximab-based bioradiotherapy and platinum-based chemoradiotherapy for head and neck squamous cell carcinomas: A single-institution retrospective study in Japan

  Tomohiro Sakashita, Akihiro Homma, Hiromitsu Hatakeyama, Jun Furusawa, Satoshi Kano, Takatsugu Mizumachi, Satoshi Iizuka, Rikiya Onimaru, Kazuhiko Tsuchiya, Koichi Yasuda, Hiroki Shirato, Satoshi Fukuda

  ACTA OTO-LARYNGOLOGICA 135 (8) 853 - 858 0001-6489 2015/08 [Refereed][Not invited]
   

  Conclusion: Grade >= 3 mucositis/stomatitis and inability to feed orally were problematic for patients undergoing cetuximab-based bioradiotherapy (BRT) as well as platinum-based chemoradiotherapy (CRT). Severe mucositis/stomatitis and radiation dermatitis should be addressed carefully in patients undergoing cetuximab-based BRT as well. Objectives: The efficacy of cetuximab-based BRT in locally advanced head and neck squamous cell carcinomas has been established. However, the safety of cetuximab-based BRT in comparison with platinum-based CRT is currently under investigation. Method: This study retrospectively analyzed 14 patients undergoing cetuximab-based BRT and 29 patients undergoing platinum-based CRT to compare the incidence of acute toxicities. In the BRT group, an initial cetuximab loading dose of 400 mg/m(2) was delivered 1 week before the start of radiotherapy. Seven weekly infusions of 250 mg/m(2) of cetuximab followed during the definitive radiotherapy. In the CRT group, cisplatin was administered at a dose of 40 mg/m(2) weekly during the definitive radiotherapy. Results: The BRT group had a higher incidence of Grade >= 3 radiation dermatitis than did the CRT group (43% vs 3%, respectively, p < 0.01). The incidence rate of Grade >= 3 mucositis/stomatitis was 64.3% and 41.4% in the BRT and CRT group, respectively (p = 0.1484), while the incidence rate of the inability to feed orally was 38.5% and 55.2%, respectively (p = 0.2053).
• 顎下腺内顔面動脈瘤の1例

  井戸川 寛志, 本間 明宏, 福田 諭

  耳鼻咽喉科臨床 補冊 耳鼻咽喉科臨床学会 (補冊142) 173 - 173 0912-1870 2015/06 [Not refereed][Not invited]
  
• Phase II trial of chemoradiotherapy with S-1 plus cisplatin for unresectable locally advanced head and neck cancer (JCOG0706).

  Tahara M, Kiyota N, Mizusawa J, Nakamura K, Hayashi R, Akimoto T, Hasegawa Y, Iwae S, Monden N, Matsuura K, Fujii H, Onozawa Y, Homma A, Kubota A, Fukuda H, Fujii M

  Cancer science 106 (6) 726 - 733 1347-9032 2015/06 [Refereed][Not invited]
   

  We conducted a phase II study to evaluate the efficacy and safety of chemoradiotherapy concurrent with S-1 plus cisplatin in patients with unresectable locally advanced squamous cell carcinoma of the head and neck. Chemotherapy consisted of S-1 twice daily on days 1-14 at 60 mg/m(2) /day and cisplatin at 20 mg/m(2) /day on days 8-11, repeated twice at a 5-week interval. Single daily radiation of 70 Gy in 35 fractions was given concurrently starting on day 1. For patients achieving an objective response after chemoradiotherapy, two additional cycles of chemotherapy were administered. Of the 45 enrolled patients, the percentage of clinical complete remission, the primary endpoint, was 64.4% (8 complete response, 21 good partial response) on central review. After a median follow-up of 3.52 years, 3-year local progression-free survival was 62.2%, with 3-year progression-free survival of 60.0%, 3-year overall survival of 64.4%, and 3-year time to treatment failure of 48.9%. Grade 3 or 4 toxicity included pharyngeal mucositis (46.7%), oral mucositis (44.4%), dysphagia (46.7%), anorexia (42.2%), radiation dermatitis (26.7%), neutropenia (26.7%), and febrile neutropenia (4.4%). No treatment-related deaths were observed. This combination showed promising efficacy with acceptable toxicities.
• Feasibility and efficacy of induction docetaxel, cisplatin, and 5-fluorouracil chemotherapy combined with concurrent weekly cisplatin chemoradiotherapy for locally advanced head and neck squamous cell carcinoma

  Takatsugu Mizumachi, Akihiro Homma, Tomohiko Kakizaki, Tomohiro Sakashita, Satoshi Kano, Hiromitsu Hatakeyama, Kazuhiko Tsuchiya, Koichi Yasuda, Rikiya Onimaru, Hiroki Shirato, Jun Taguchi, Yasushi Shimizu, Ichiro Kinoshita, Hirotoshi Akita, Satoshi Fukuda

  INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY 20 (3) 431 - 437 1341-9625 2015/06 [Refereed][Not invited]
   

  The aim of this study was to evaluate the feasibility of induction docetaxel, cisplatin, and 5-fluorouracil chemotherapy followed by concurrent weekly cisplatin chemoradiotherapy for patients with locally advanced head and neck squamous cell carcinoma (HNSCC). Between 2010 and 2013, 30 patients with Stage IV HNSCC were treated in Hokkaido University Hospital with three cycles of induction chemotherapy (docetaxel 75 mg/m(2) and cisplatin 75 mg/m(2), day 1; and 5-fluorouracil 750 mg/m(2)/day 120 h continuous infusion, every 3 weeks) followed by concurrent weekly cisplatin (40 mg/m(2), on weeks 1, 2, 3, 5, 6 and 7) chemoradiotherapy. Three courses of induction chemotherapy were performed in 25 patients (83 %) with grade 3-4 toxicities during induction chemotherapy observed in 22 patients (73 %). The major toxicities were hematologic, with 22 cases (73 %) showing grade 3-4 neutropenia. Radiotherapy was completed (70 Gy) in 29 patients (97 %), while a total of 19 patients (63 %) completed five (13 patients) or six (6 patients) courses of chemotherapy. During concurrent chemoradiotherapy, no grade 4 hematological toxicities were observed. Grade 4 dermatitis was observed in one patient, and grade 3 mucositis was observed in 12 patients. There were no treatment-related deaths during the induction chemotherapy or concurrent chemoradiotherapy. The 1- and 2-year progression-free survival rates and the 1- and 2-year overall survival rates were 86 %, 72 %, and 89 %, 81 %, respectively. Sequential therapy composed of induction chemotherapy followed by concurrent weekly cisplatin chemoradiotherapy is feasible, showing encouraging results in patients with locally advanced HNSCC. Concurrent weekly cisplatin chemoradiotherapy following induction chemotherapy appears to be a suitable alternative to three-weekly high-dose cisplatin therapy.
• 日本人の頭頸部癌患者におけるCetuximabを含む治療の観察研究(JROSG12-2) 急性期有害事象の中間評価

  太田 陽介, 古平 毅, 藤井 博文, 下川 元継, 中島 寅彦, 門田 伸也, 横田 知哉, 本間 明宏, 上田 眞也, 秋元 哲夫

  頭頸部癌 (一社)日本頭頸部癌学会 41 (2) 189 - 189 1349-5747 2015/05 [Not refereed][Not invited]
  
• 当院における下咽頭癌に対する強度変調放射線治療(IMRT)の初期臨床成績

  土屋 和彦, 安田 耕一, 鬼丸 力也, 白土 博樹, 本間 明宏, 福田 諭, 清水 康, 秋田 弘俊

  頭頸部癌 (一社)日本頭頸部癌学会 41 (2) 254 - 254 1349-5747 2015/05 [Not refereed][Not invited]
  
• 唾液腺癌を対象としたHER2タンパク過剰発現および遺伝子増幅検査法の臨床的バリデーションに関する検討

  加納 里志, 畑中 豊, 松野 吉宏, 本間 明宏, 秋田 弘俊, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 41 (2) 257 - 257 1349-5747 2015/05 [Not refereed][Not invited]
  
• 喉頭癌T1症例の臨床的検討

  水町 貴諭, 中薗 彬, 溝口 兼司, 坂下 智博, 加納 里志, 畠山 博充, 本間 明宏, 福田 諭

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 118 (4) 504 - 504 0030-6622 2015/04 [Not refereed][Not invited]
  
• 頭頸部癌化学放射線療法におけるEPA高配合栄養機能食品(プロシュア)の有用性の検討

  水町 貴諭, 中薗 彬, 坂下 智博, 加納 里志, 畠山 博充, 本間 明宏, 福田 諭

  日本気管食道科学会会報 (NPO)日本気管食道科学会 66 (2) s20 - s20 0029-0645 2015/04 [Not refereed][Not invited]
  
• 喉頭に生じたInflammatory Myofibroblastic Tumorの一例

  横川 泰三, 加納 里志, 溝口 兼司, 畠山 博充, 本間 明宏, 福田 諭

  日本気管食道科学会会報 (NPO)日本気管食道科学会 66 (2) s64 - s64 0029-0645 2015/04 [Not refereed][Not invited]
  
• Multi-institutional retrospective study for the evaluation of ocular function-preservation rates in maxillary sinus squamous cell carcinomas with orbital invasion

  Tomohiro Sakashita, Ryuichi Hayashi, Akihiro Homma, Kazuto Matsuura, Kengo Kato, Kazuyoshi Kawabata, Nobuya Monden, Yasuhisa Hasegawa, Tetsuro Onitsuka, Yasushi Fujimoto, Shigemichi Iwae, Kenji Okami, Takashi Matsuzuka, Kunitoshi Yoshino, Masato Fujii

  HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK 37 (4) 537 - 542 1043-3074 2015/04 [Refereed][Not invited]
   

  BackgroundThe purpose of this retrospective analysis was to evaluate ocular function and survival rates among treatment modalities in patients with maxillary sinus cancer with orbital invasion. MethodsEighty-seven patients were classified according to the main treatment modality. Ocular function preservation rates and survival rates were evaluated for each therapeutic modality. ResultsThe 5-year overall survival rate for the en bloc resection, conservative surgery, superselective intra-arterial chemotherapy, and radiotherapy (RADPLAT), intravenous chemoradiotherapy (IV-CRT) was 70%, 35%, 49%, and 31%, respectively. The ocular function preservation rate for each group was 15%, 27%, 30%, and 17%, respectively. In the en bloc resection group, there was no significant difference in the 5-year overall survival rate between patients with orbital exenteration and those without orbital exenteration (72% vs 71%; p=.9321). ConclusionThe en bloc resection group showed a favorable survival rate but a low preservation rate. Preservation of orbital contents did not reduce the survival rate. (c) 2014 Wiley Periodicals, Inc. Head Neck37: 537-542, 2015
• Measurement of Tumor Blood Flow in Head and Neck Squamous Cell Carcinoma by Pseudo-Continuous Arterial Spin Labeling: Comparison With Dynamic Contrast-Enhanced MRI

  Noriyuki Fujima, Kohsuke Kudo, Akiko Tsukahara, Daisuke Yoshida, Tomohiro Sakashita, Akihiro Homma, Khin Khin Tha, Hiroki Shirato

  JOURNAL OF MAGNETIC RESONANCE IMAGING 41 (4) 983 - + 1053-1807 2015/04 [Refereed][Not invited]
   

  PurposeTo investigate the feasibility of tumor blood flow (TBF) measurement in head and neck squamous cell carcinoma (HNSCC) using pseudo-continuous arterial spin labeling (pCASL) in a comparison with dynamic contrast-enhanced (DCE) perfusion. Materials and MethodsWe prospectively scanned 18 patients with HNSCC using 3T magnetic resonance imaging (MRI) with both pCASL and DCE perfusion. Quantitative TBF value in the whole-tumor region of interest (ROI), and regional TBF in the ROIs of the central and peripheral areas in the tumor were respectively measured. Relative TBF value in the whole-tumor ROI was also calculated. We determined the correlation and agreement between each measured TBF by pCASL and DCE perfusion using Pearson's correlation coefficients, intraclass correlation coefficients (ICC), and Bland-Altman analysis. ResultsIn the whole-tumor ROIs, significant correlation was observed between the absolute TBF values (r=0.72, P<0.01), with an ICC of 0.72; moreover, higher correlation was observed in the relative TBF (r=0.79). The correlation was higher in the peripheral ROI (r=0.70) than the central ROI (r=0.65), with an ICC of 0.62 and 0.54, respectively. Bland-Altman plots revealed the underestimation of TBF by pCASL in central ROIs. ConclusionTBF measurement by pCASL was feasible in patients with HNSCC. J. Magn. Reson. Imaging 2015;41:983-991. (c) 2014 Wiley Periodicals, Inc.
• Measurement of tumor blood flow in head and neck squamous cell carcinoma by pseudo-continuous arterial spin labeling: comparison with dynamic contrast-enhanced MRI.

  Noriyuki Fujima, Kohsuke Kudo, Akiko Tsukahara, Daisuke Yoshida, Tomohiro Sakashita, Akihiro Homma, Khin Khin Tha, Hiroki Shirato

  Journal of magnetic resonance imaging : JMRI 41 (4) 983 - 91 1053-1807 2015/04 [Refereed][Not invited]
   

  PURPOSE: To investigate the feasibility of tumor blood flow (TBF) measurement in head and neck squamous cell carcinoma (HNSCC) using pseudo-continuous arterial spin labeling (pCASL) in a comparison with dynamic contrast-enhanced (DCE) perfusion. MATERIALS AND METHODS: We prospectively scanned 18 patients with HNSCC using 3T magnetic resonance imaging (MRI) with both pCASL and DCE perfusion. Quantitative TBF value in the whole-tumor region of interest (ROI), and regional TBF in the ROIs of the central and peripheral areas in the tumor were respectively measured. Relative TBF value in the whole-tumor ROI was also calculated. We determined the correlation and agreement between each measured TBF by pCASL and DCE perfusion using Pearson's correlation coefficients, intraclass correlation coefficients (ICC), and Bland-Altman analysis. RESULTS: In the whole-tumor ROIs, significant correlation was observed between the absolute TBF values (r = 0.72, P < 0.01), with an ICC of 0.72; moreover, higher correlation was observed in the relative TBF (r = 0.79). The correlation was higher in the peripheral ROI (r = 0.70) than the central ROI (r = 0.65), with an ICC of 0.62 and 0.54, respectively. Bland-Altman plots revealed the underestimation of TBF by pCASL in central ROIs. CONCLUSION: TBF measurement by pCASL was feasible in patients with HNSCC. J. Magn. Reson. Imaging 2015;41:1-1. © 2014 Wiley Periodicals, Inc.
• Olfactory neuroblastoma: the long-term outcome and late toxicity of multimodal therapy including radiotherapy based on treatment planning using computed tomography

  Takashi Mori, Rikiya Onimaru, Shunsuke Onodera, Kazuhiko Tsuchiya, Koichi Yasuda, Hiromitsu Hatakeyama, Hiroyuki Kobayashi, Shunsuke Terasaka, Akihiro Homma, Hiroki Shirato

  RADIATION ONCOLOGY 10 88  1748-717X 2015/04 [Refereed][Not invited]
   

  Background: Olfactory neuroblastoma (ONB) is a rare tumor originating from olfactory epithelium. Here we retrospectively analyzed the long-term treatment outcomes and toxicity of radiotherapy for ONB patients for whom computed tomography (CT) and three-dimensional treatment planning was conducted to reappraise the role of radiotherapy in the light of recent advanced technology and chemotherapy. Methods: Seventeen patients with ONB treated between July 1992 and June 2013 were included. Three patients were Kadish stage B and 14 were stage C. All patients were treated with radiotherapy with or without surgery or chemotherapy. The radiation dose was distributed from 50 Gy to 66 Gy except for one patient who received 40 Gy preoperatively. Results: The median follow-up time was 95 months (range 8-173 months). The 5-year overall survival (OS) and relapse-free survival (RFS) rates were estimated at 88% and 74%, respectively. Five patients with stage C disease had recurrence with the median time to recurrence of 59 months (range 7-115 months). Late adverse events equal to or above Grade 2 in CTCAE v4.03 were observed in three patients. Conclusion: Multimodal therapy including radiotherapy with precise treatment planning based on CT simulation achieved an excellent local control rate with acceptable toxicity and reasonable overall survival for patients with ONB.
• 第８７群 鼻副鼻腔癌

  座長:西野 宏, 本間 明宏

  日本耳鼻咽喉科学会会報 The Oto-Rhino-Laryngological Society of Japan, Inc. 118 (4) 593 - 594 0030-6622 2015
• Lymph node metastasis in the suprasternal space from thyroid papillary cancer

  Homma Akihiro, Hatakeyama Hiromitsu, Mizumachi Takatsugu, Furusawa Jun, Kano Satoshi, Sakashita Tomohiro, Fukuda Satoshi

  International Cancer Conference Journal Springer 4 (1) 57 - 60 2192-3183 2015/01 

  The suprasternal space is a narrow space between the superficial and deep layers of the investing layers of the deep cervical fascia above the manubrium of the sternum. The suprasternal space has been paid littleattention as a space with the potential for lymph nodemetastasis from both thyroid cancer and head and neckcancer. We experienced 2 patients who were found to have a lymph node in the suprasternal space preoperatively. Both of them had well-differentiated thyroid papillary carcinomas and level III and IV lymph node metastases as well as metastasis in the suprasternal space. We have not previously dissected the suprasternal space prophylactically in other patients with thyroid papillary cancer, but no patient has developed metastasis in this space to date. Thesuprasternal space is not usually dissected in atients with thyroid cancer. However, suprasternal space metastasis has been reported to occur occasionally in patients with lymph node metastases in levels III and IV. We consider that dissection of the suprasternal space, which is not routinely performed, should be done when preoperative examination suggests lymph node metastasis in the suprasternal space as dissection of this space is less invasive, easy to achieve, and is not time consuming. Greater attention should be paidto the suprasternal space as an area with the otential for lymph node metastasis from thyroid cancer.
• Differentiation of squamous cell carcinoma and inverted papilloma using non-invasive MR perfusion imaging

  N. Fujima, Y. Nakamaru, T. Sakashita, A. Homma, A. Tsukahara, K. Kudo, H. Shirato, H. Shirato

  Dentomaxillofacial Radiology 44 (9) 20150074 - 20150074 0250-832X 2015/01/01 [Not refereed][Not invited]
   

  Objectives: To investigate the diagnostic value of tumour blood flow (TBF) obtained with pseudocontinuous arterial spin labelling for the differentiation of squamous cell carcinoma (SCC) and inverted papilloma (IP) in the nasal or sinonasal cavity. Methods: We retrospectively analysed the cases of 33 patients with SCC and 8 patients with IP in the nasal or sinonasal cavity. Pseudocontinuous arterial spin labelling scanning was performed for all patients using a 3.0-T MR unit. Quantitative TBF values were measured by two neuroradiologists by respectively delineating the whole-tumour regions of interest, and the mean of them was determined as TBF value in each patient. Additionally, the presence of imaging findings of convoluted cerebriform pattern (CCP) on MR T 2 weighted images was determined in all patients. As a subgroup analysis, patients with IP were divided into aggressive and non-aggressive IPs depending on their progression range. First, an intraclass correlation coefficient (ICC) of TBF values between two neuroradiologists was determined. Next, a statistical comparison of the TBF value by a Mann-Whitney U test between the patients with SCC and IP was performed. Additionally, the comparison by an ANOVA with a post hoc test of Tukey's method among the SCC, non-aggressive IP and aggressive IP groups was also performed. If significance was observed, the diagnostic accuracy to differentiate SCCs from IPs was calculated. Diagnostic accuracy by CCP findings alone and by the combination of CCP findings and TBF were also assessed. Results: The ICC of TBF values between two neuroradiologists was 0.82. The mean TBF values in the patients with SCC, all patients with IP, those with aggressive IP and those with non-aggressive IP were 141.2 ± 33.1, 77.8 ± 31.5, 109.4 ± 16.7 and 58.8 ± 19.9ml 100 g -1 min -1 , respectively. A significant difference was observed between SCC and IP (p,0.001), SCC and non-aggressive IP (p < 0.01) and non-aggressive IP and aggressive IP (p < 0.01). The diagnostic accuracy values obtained with receiver operating characteristic curve analysis for the differentiation of SCC from IP and for SCC from non-aggressive IP were 0.90 and 0.92, respectively. The diagnostic accuracy was elevated (0.95 from 0.88) by adding the TBF value to CCP findings. Conclusions: The pseudocontinuous arterial spin labelling technique can be a useful noninvasive diagnostic tool to differentiate SCC from IP in nasal or sinonasal cavity.
• Dose-finding and efficacy confirmation trial of superselective intra-arterial infusion of cisplatin and concomitant radiotherapy for patients with locally advanced maxillary sinus cancer (JCOG1212, RADPLAT-MSC)

  Akihiro Homma, Kenichi Nakamura, Kazuto Matsuura, Junki Mizusawa, Rikiya Onimaru, Haruhiko Fukuda, Masato Fujii

  JAPANESE JOURNAL OF CLINICAL ONCOLOGY 45 (1) 119 - 122 0368-2811 2015/01 [Refereed][Not invited]
   

  A dose-finding and efficacy confirmation trial was started in Japan in April 2014 to evaluate the efficacy and safety of superselective intra-arterial infusion of cisplatin and concomitant radiotherapy for locally advanced maxillary sinus cancer. A total of 18 patients will be enrolled in the dose-finding phase for the determination of the recommended number of cisplatin cycles, and 65 patients with T4aN0M0 and 62 patients with T4bN0M0, including those who received the recommended number of or fewer cycles in the dose-finding phase, will be enrolled from 16 institutions within a 5-year period in the efficacy confirmation phase. The primary endpoints of the dose-finding and the efficacy confirmation phases are dose-limiting toxicities and 3-year overall survival, respectively. This trial was registered at the UMIN Clinical Trials Registry (http://www.umin.ac.jp/ctr/) under Trial No. UMIN000013706.
• Oxidative Stress Regulates IL-4 Gene Expression in Mast Cells through the Reduction of Histone Deacetylase

  Yuji Nakamaru, Dai Takagi, Akihiro Homma, Shigetsugu Hatakeyama, Satoshi Fukuda

  OTOLARYNGOLOGY-HEAD AND NECK SURGERY 152 (1) 48 - 52 0194-5998 2015/01 [Refereed][Not invited]
   

  Objective Many proinflammatory cytokines are regulated by the acetylation and deacetylation of the core histone. Since dysregulation of T helper 2 cytokine production is a key in the pathogenesis of allergic diseases, we examined the role of histone deacetylase (HDAC) on interleukin (IL)-4 gene expression in mast cells. We also examined whether oxidative stress has any impact on HDAC activity. Study Design In vitro study. Setting Academic research laboratory. Methods An IgE-sensitized mast cell line (RBL-2H3 cells) was treated with varying concentrations of the HDAC inhibitors trichostatin A (TSA) and H2O2 and stimulated with antigens. The amount of IL-4 gene expression was quantified by real-time polymerase chain reaction. Quantitative measurement of IL-4 in the cell supernatant was performed using enzyme-linked immunosorbent assay. Moreover, HDAC activity was measured with the use of a nonisotopic assay that utilized an HDAC Fluorescent Activity Assay Kit. Results IL-4 mRNA expression was induced by antigens in IgE-sensitized RBL-2H3 cells. Pretreatment with TSA and H2O2 enhanced IL-4 mRNA expression up to 5-fold in a dose-dependent manner. Furthermore, HDAC activity in RBL-2H3 cells was reduced after treatment with H2O2. Conclusion Our results suggest that oxidative stress may up-regulate IL-4 gene expression in mast cells via a decrease in HDAC activity.
• Hangeshashinto Improves the Completion Rate of Chemoradiotherapy and the Nutritional Status in Patients with Head and Neck Cancer

  Hiromitsu Hatakeyama, Hiroki Takahashi, Nobuhiko Oridate, Rinnosuke Kuramoto, Keishi Fujiwara, Akihiro Homma, Hiroshi Takeda, Satoshi Fukuda

  ORL-JOURNAL FOR OTO-RHINO-LARYNGOLOGY HEAD AND NECK SURGERY 77 (2) 100 - 108 0301-1569 2015 [Refereed][Not invited]
   

  Purpose: Severe oral and pharyngeal mucositis is one of the most critical toxicities known to lead to the discontinuation of chemoradiotherapy (CRT) for head and neck cancer (HNC). Hangeshashinto (TJ-14) is a Kampo medicine that relieves chemotherapy-induced oral mucositis. We. investigated the effect of TJ-14 on mucositis, nutritional status, and the completion rate of CRT. Methods: The study group comprised patients with advanced HNC who were treated with concomitant weekly cisplatin and 70 Gy of radiotherapy. The primary endpoint was the completion rate of chemotherapy, and the secondary endpoints were the grade of mucositis and the nutritional status. Results: A total of 57 patients were included in this study. The completion rate of CRT among patients who were treated with TJ-14 was 91.4%. There was a significant difference in the completion rate of CRT between the groups treated with and without TJ-14 (p = 0.0452). The reduction in body weight was significantly improved from 10.89 to 5.89% with TJ-14 administration (p = 0.003), and the reduction in serum albumin was also significantly decreased from 17.37 to 8.73%. (p = 0.024). Conclusion: This therapy allowed a high completion rate of CRT as well as significant benefits in terms of nutritional status. We plan to carry out a further large-scale study of TJ-14. (C) 2015 S, Karger AG, Basel
• The efficacy of superselective intra-arterial infusion with concomitant radiotherapy for adenoid cystic carcinoma of the head and neck

  Akihiro Homma, Tomohiro Sakashita, Hiromitsu Hatakeyama, Satoshi Kano, Takatsugu Mizumachi, Yuji Nakamaru, Daisuke Yoshida, Rikiya Onimaru, Kazuhiko Tsuchiya, Koichi Yasuda, Hiroki Shirato, Satoshi Fukuda

  ACTA OTO-LARYNGOLOGICA 135 (9) 950 - 954 0001-6489 2015 [Refereed][Not invited]
   

  Conclusions: Superselective intra-arterial cisplatin infusion with concomitant radiotherapy (RADPLAT) is considered to be one of the treatments of choice for patients with adenoid cystic carcinoma (ACC) who prefer not to undergo radical surgery. Objective: To evaluate the efficacy of RADPLAT for patients with ACC of the head and neck. Patients and methods: Between 2001-2010, nine patients with untreated ACC were given superselective intra-arterial infusion of cisplatin (100-120 mg/m(2)/ week) with simultaneous intravenous infusion of thiosulfate to neutralize cisplatin toxicity and radiotherapy (65-70 Gy). Results: Five patients had tumors arising in the base of the tongue, two in the maxillary sinus, and the remaining two in the nasopharynx. The median follow-up period was 9 years 7 months (9; 7) (range = 4; 6-12; 5), and the 5-year local control (LC), overall survival (OS), and disease-free survival rates were 88.9%, 88.9%, and 55.6%, respectively. The 10-year OS rate was 57.1%, but all patients who remained alive for over 10 years are still alive with disease. Primary tumor recurrence was observed in five of the nine patients, with the median time to recurrence being 6 years (range = 4-9 years). Five of the nine patients had distant metastasis, and of these three patients also had primary recurrence.
• 魚骨異物に対し頸部外切開施行時の術中3D-CTの有用性

  高橋 紘樹, 坂下 智博, 佐藤 宏紀, 藤原 由有希, 水町 貴諭, 本間 明宏, 福田 諭

  耳鼻咽喉科展望 耳鼻咽喉科展望会 57 (6) 349 - 349 0386-9687 2014/12 [Not refereed][Not invited]
  
• A clinical study of cases diagnosed as being oropharyngeal carcinoma after cervical mass extirpation/biopsy

  Takatsugu Mizumachi, Satoshi Kano, Tomohiro Sakashita, Hiromitsu Hatakeyama, Akihiro Homma, Satoshi Fukuda

  Journal of Otolaryngology of Japan (一社)日本耳鼻咽喉科学会 117 (12) 1463 - 1470 0030-6622 2014/12/01 [Not refereed][Not invited]
   

  In the case of oropharyngeal carcinoma, patients may present with symptoms similar to cervical lymphadenopathy, and the primary lesion may only be diagnosed after cervical mass extirpation/biopsy. We retrospectively analyzed the clinical course in 11 oropharyngeal carcinoma patients that were diagnosed after cervical mass extirpation/biopsy between 1998 and 2013. Before the diagnosis was made of oropharyngeal carcinoma, a cervical lymph node biopsy was performed in six patients the lymph node was extirpated due to an initial diagnosis of lateral cervical cyst in four patients and neck dissection was performed due to an initial diagnosis of primary unknown carcinoma in one patient. The primary tumor site in the oropharynx was the palatine tonsil in six patients and the lingual tonsil in five patients. Five of six patients with palatine tonsil carcinoma and three of five patients with lingual tonsil carcinoma were found to be positive for human papillomavirus (HPV). The duration from cervical lymph node extirpation/biopsy to final diagnosis was 1 to 13 months. All patients finally underwent radiation therapy or chemoradiotherapy, and they had no recurrence or metastasis. As the incidence of HPV-related oropharyngeal carcinoma increases, the number of oropharyngeal carcinomas assumed to be cervical lymphadenopathy due to the presenting symptoms may increase. It is important to investigate the oropharynx thoroughly so as to adequately differentiate the possibility of oropharyngeal carcinoma from that of cervical lymphadenopathy. Metastatic lymph nodes might present as cysts in cases of oropharyngeal carcinoma, it is therefore necessary to take the potential for metastatic lymph nodes in the oropharyngeal cancer into consideration when differentiating this disease from cervical cyst-shaped lesions.
• Intravoxel incoherent motion diffusion-weighted imaging in head and neck squamous cell carcinoma: Assessment of perfusion-related parameters compared to dynamic contrast-enhanced MRI

  Noriyuki Fujima, Daisuke Yoshida, Tomohiro Sakashita, Akihiro Homma, Akiko Tsukahara, Khin Khin Tha, Kohsuke Kudo, Hiroki Shirato

  MAGNETIC RESONANCE IMAGING 32 (10) 1206 - 1213 0730-725X 2014/12 [Refereed][Not invited]
   

  Purpose: To investigate the correlation between perfusion-related parameters obtained with intravoxel incoherent motion (IVIM) and classical perfusion parameters obtained with dynamic contrast-enhanced (DCE) magnetic resonance imaging in patients with head and neck squamous cell carcinoma (HNSCC), and to compare direct and asymptotic fitting, the pixel-by-pixel approach, and a region of interest (ROI)-based approach respectively for IVIM parameter calculation. Materials and methods: Seventeen patients with HNSCC were included in this retrospective study. All magnetic resonance (MR) scanning was performed using a 3 T MR unit. Acquisition of IVIM was performed using single-shot spin-echo echo-planar imaging with three orthogonal gradients with 12 b-values (0, 10, 20, 30, 50, 80, 100, 200, 400, 800, 1000, and 2000). Perfusion-related parameters of perfusion fraction 'f' and the pseudo-diffusion coefficient 'D*' were calculated from IVIM data by using least square fitting with the two fitting methods of direct and asymptotic fitting, respectively. DCE perfusion was performed in a total of 64 dynamic phases with a 3.2-s phase interval. The two-compartment exchange model was used for the quantification of tumor blood volume (TBV) and tumor blood flow (TBF). Each tumor was delineated with a polygonal ROI for the calculation of f, f center dot D* performed using both the pixel-by-pixel approach and the ROI-based approach. In the pixel-by-pixel approach, after fitting each pixel to obtain f, f center dot D* maps, the mean value in the delineated ROI on these maps was calculated. In the ROI-based approach, the mean value of signal intensity was calculated within the ROI for each b-value in IVIM images, and then fitting was performed using these values. Correlations between fin a total of four combinations (direct or asymptotic fitting and pixel-by-pixel or ROI-based approach) and TBV were respectively analyzed using Pearson's correlation coefficients. Correlations between f center dot D* and TBF were also similarly analyzed. Results: In all combinations of f and TBV, f center dot D* and TBF, there was a significant correlation. In the comparison of f and TBV, a moderate correlation was observed only between f obtained by direct fitting with the pixel-by-pixel approach, whereas a good correlation was observed in the comparisons using the other three combinations. In the comparison of f center dot D* and TBF, a good correlation was observed only with f center dot D* obtained by asymptotic fitting with the ROI-based approach. In contrast, moderate correlations were observed in the comparisons using the other three combinations. Conclusion: IVIM was found to be feasible for the analysis of perfusion-related parameters in patients with HNSCC. Especially, the combination of asymptotic fitting with the ROI-based approach was better correlated with DCE perfusion. (C) 2014 Elsevier Inc. All rights reserved.
• Epithelial-mesenchymal transition in human papillomavirus-positive and -negative oropharyngeal squamous cell carcinoma

  Hiromitsu Hatakeyama, Takatsugu Mizumachi, Tomohiro Sakashita, Satoshi Kano, Akihiro Homma, Satoshi Fukuda

  ONCOLOGY REPORTS 32 (6) 2673 - 2679 1021-335X 2014/12 [Refereed][Not invited]
   

  High-risk human papillomavirus (HPV) infection is associated with carcinogenesis in oropharyngeal squamous cell carcinoma (OPSCC) and patients with HPV-positive tumors have a significantly favorable prognosis. However, the underlying mechanism of this favorable clinical outcome remains unclear. Epithelial-mesenchymal transition (EMT) causes aggressiveness of cancer cells and we investigated the expression of the EMT markers and analyzed their correlation with HPV status and prognosis in order to examine the treatment response of HPV-positive OPSCCs. A total of 79 patients with OPSCC were examined in the present study. All high-risk HPV infections were determined with the multiplex PCR kit from each formalin-fixed paraffin-embedded (FFPE) sample. We performed immunohistochemical staining for E-cadherin and vimentin. Expression of the markers was graded and we statistically analyzed the correlation between tumor, node, metastasis (TNM) stages and prognosis. High-risk HPV-positive tumors were detected in 23 cases. The five-year survival rate in HPV-positive and -negative tumors was 82.7 and 48.3%, respectively. High E-cadherin expression rate in HPV-negative samples was 76.7% and 43.4% in HPV-positive samples (p=0.007). Vimentin expression did not show a difference between HPV-positive and -negative tumors. HPV-negative patients presented significantly greater heterogeneity of E-cadherin expression compared to HPV-positive patients (p=0.0349). HPV-positive OPSCCs originally lost their epithelial cell phenotype compared with HPV-negative tumors. Therefore, the paradoxical favorable prognosis of HPV-positive OPSCC may be due to the intratumor homogeneity in EMT.
• A clinical study of cases diagnosed as being oropharyngeal carcinoma after cervical mass extirpation/biopsy

  Takatsugu Mizumachi, Satoshi Kano, Tomohiro Sakashita, Hiromitsu Hatakeyama, Akihiro Homma, Satoshi Fukuda

  Journal of Otolaryngology of Japan 117 (12) 1463 - 1470 0030-6622 2014/12/01 [Refereed][Not invited]
   

  In the case of oropharyngeal carcinoma, patients may present with symptoms similar to cervical lymphadenopathy, and the primary lesion may only be diagnosed after cervical mass extirpation/biopsy. We retrospectively analyzed the clinical course in 11 oropharyngeal carcinoma patients that were diagnosed after cervical mass extirpation/biopsy between 1998 and 2013. Before the diagnosis was made of oropharyngeal carcinoma, a cervical lymph node biopsy was performed in six patients the lymph node was extirpated due to an initial diagnosis of lateral cervical cyst in four patients and neck dissection was performed due to an initial diagnosis of primary unknown carcinoma in one patient. The primary tumor site in the oropharynx was the palatine tonsil in six patients and the lingual tonsil in five patients. Five of six patients with palatine tonsil carcinoma and three of five patients with lingual tonsil carcinoma were found to be positive for human papillomavirus (HPV). The duration from cervical lymph node extirpation/biopsy to final diagnosis was 1 to 13 months. All patients finally underwent radiation therapy or chemoradiotherapy, and they had no recurrence or metastasis. As the incidence of HPV-related oropharyngeal carcinoma increases, the number of oropharyngeal carcinomas assumed to be cervical lymphadenopathy due to the presenting symptoms may increase. It is important to investigate the oropharynx thoroughly so as to adequately differentiate the possibility of oropharyngeal carcinoma from that of cervical lymphadenopathy. Metastatic lymph nodes might present as cysts in cases of oropharyngeal carcinoma, it is therefore necessary to take the potential for metastatic lymph nodes in the oropharyngeal cancer into consideration when differentiating this disease from cervical cyst-shaped lesions.
• Effect of local extension sites on survival in locally advanced maxillary sinus cancer

  Satoshi Kano, Ryuichi Hayashi, Akihiro Homma, Kazuto Matsuura, Kengo Kato, Kazuyoshi Kawabata, Nobuya Monden, Yasuhisa Hasegawa, Tetsuro Onitsuka, Yasushi Fujimoto, Shigemichi Iwae, Kenji Okami, Takashi Matsuzuka, Kunitoshi Yoshino, Masato Fujii

  HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK 36 (11) 1567 - 1572 1043-3074 2014/11 [Refereed][Not invited]
   

  BackgroundWe analyzed the effects of local extension sites on survival in patients with locally advanced maxillary sinus cancer. MethodsThe criteria for inclusion in this study were as follows: (1) previously untreated maxillary sinus cancer; (2) squamous cell carcinoma; (3) T4 disease; and (4) curative-intent treatment. The data for 118 patients were obtained from 28 institutions across Japan and analyzed for overall survival and local control rates by local extension site. ResultsSites with a poor prognosis included the cribriform plate, dura, nasopharynx, middle cranial fossa, and cranial nerves other than V2. There was a significant correlation among these sites, except for the cranial nerves. Additionally, the hard palate was the only site that correlated with nodal involvement and showed a poor treatment outcome. ConclusionEven in cases presenting with similar T4 maxillary sinus cancer, treatment should be performed in consideration of the local extension site. (c) 2013 Wiley Periodicals, Inc. Head Neck 36: 1567-1572, 2014
• Analysis of human papillomavirus in metastatic lymph nodes from unknown primary head and neck carcinomas

  Satoshi Kano, Akihiro Homma, Seigo Suzuki, Hiromitsu Hatakeyama, Jyun Furusawa, Takatsugu Mizumachi, Tomohiro Sakashita, Nobuhiko Oridate, Satoshi Fukuda

  Japanese Journal of Head and Neck Cancer (一社)日本頭頸部癌学会 40 (3) 344 - 348 1881-8382 2014/10/31 [Not refereed][Not invited]
   

  We analyzed human papillomavirus (HPV) in metastatic lymph nodes from unknown primary head and neck carcinomas with the aim of estimating the primary site. The study comprised 32 patients with the following criteria: (1) previously untreated unknown primary carcinomas treated at Hokkaido University Hospital between 1991 and 2011, (2) histological proof of squamous cell carcinoma or undifferentiated carcinoma, (3) no distant metastasis, and (4) presence of adequate lymph node tissue for histological analysis. HPV-DNA was detected by PCR and the expression of p16 was examined by immunohistochemistry. As a result, 8 cases showed both HPV-DNA and overexpression of p16 in metastatic lymph nodes. A comparison of the HPV-positive group with the HPV-negative group showed that the patients were younger in the HPV-positive group. The primary sites (oropharynx) were found in 4 of the 8 HPV-positive cases after their primary treatment. The 5-year overall survival rate was 80.0% in the HPV-positive group and 52.1% in the HPV-negative group. Our results suggested that detection of HPV-DNA in the metastatic lymph nodes may make it possible to estimate the primary sites in cases of unknown primary carcinoma.
• 初診時メラノーシスと診断され2年以上経過したあとに悪性黒色腫と診断された1例

  木村 将吾, 水町 貴諭, 干野 季美子, 本間 明宏, 福田 諭

  耳鼻咽喉科・頭頸部外科 (株)医学書院 86 (11) 931 - 935 0914-3491 2014/10 [Not refereed][Not invited]
   

  59歳男性。脳ドック検診にて副鼻腔炎を指摘され、近医にて慢性副鼻腔炎と診断され内服治療されたが、経過中に左鼻腔粘膜の黒色病変が増大傾向のため著者らの施設へ受診となった。初診時、左中鼻道を中心に黒色の粘膜病変が認められ、内視鏡下に左副鼻腔粘膜切除生検を施行、病理組織学的にはメラニン色素の沈着がみられたが悪性所見は認めなかった。その後、鼻腔内所見に著変はなく定期的経過観察終了したが、2年6ヵ月後、左眼奥の疼痛を自覚して再診となった。所見では左中鼻道に黒色の腫瘍性病変を認め、MRI T1強調像では軽度の高信号、T2強調像で中等度から低信号の不均一な信号強度を呈する腫瘍性病変が左上・中鼻道から篩骨洞にかけて存在していた。そこで、頭蓋底浸潤や眼窩内浸潤が疑われ、内視鏡下に左中鼻道の腫瘍から生検を施行したところ、病理組織学的所見では間質深層における核腫大・大小不同の異型細胞の増殖やメラニン顆粒を含有する胞体が認められた。一方、FDG-PET/CTでは左副鼻腔腫瘍の高度FDG集積、左胸膜・第6胸椎横突起に集積があり、遠隔転移が認められた。以上より、本症例は左鼻腔原発悪性黒色腫(T4bN1M1)と診断され、化学療法にて左胸膜・第6胸椎の遠隔転移は著明に減少し、原発腫瘍に対し陽子線治療を施行したが、再発から1年6ヵ月時点では原発巣は残存、遠隔転移は新規病変が出現中である。
• The incidence of late neck recurrence in N0 maxillary sinus squamous cell carcinomas after superselective intra-arterial chemoradiotherapy without prophylactic neck irradiation

  Tomohiro Sakashita, Akihiro Homma, Hiromitsu Hatakeyama, Satoshi Kano, Takatsugu Mizumachi, Jun Furusawa, Daisuke Yoshida, Noriyuki Fujima, Rikiya Onimaru, Kazuhiko Tsuchiya, Koichi Yasuda, Hiroki Shirato, Satoshi Fukuda

  EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY 271 (10) 2767 - 2770 0937-4477 2014/10 [Refereed][Not invited]
   

  The efficacy of elective neck irradiation (ENI) for patients with N0 carcinoma of the maxillary sinus has been controversial. The purpose of our study was to investigate the incidence of late neck recurrence and the mortality rate from regional disease in patients with N0 maxillary sinus cancer after superselective cisplatin infusion and concomitant radiotherapy (RADPLAT) without ENI. We retrospectively analyzed 48 patients with N0 maxillary sinus cancer who underwent RADPLAT. Chemotherapy consisted of 100-120 mg/m(2) superselective intra-arterial cisplatin administered at a median rate of four times weekly. Concurrent radiation therapy was administered at a median dose of 65 Gy without ENI. Late neck recurrence was observed in 8.3 % (4/48). Three patients underwent salvage neck dissection and survived without any evidence of disease. The remaining patient did not undergo neck dissection due to coexistence with distant metastasis, and he died of regional disease. The mortality rate from regional disease was calculated to be 2 % (1/48). The incidence of late neck recurrence was not frequent, and the mortality rate from regional disease was low. Salvage neck dissection was considered to be feasible for patients with late neck recurrence. When definitive radiotherapy and concomitant chemotherapy are applied, it is considered that ENI is not required for cases of N0 maxillary sinus cancer.
• Arterial Spin Labeling to Determine Tumor Viability in Head and Neck Cancer Before and After Treatment

  Noriyuki Fujima, Kohsuke Kudo, Daisuke Yoshida, Akihiro Homma, Tomohiro Sakashita, Akiko Tsukahara, Khin Khin Tha, Yuri Zaitsu, Satoshi Terae, Hiroki Shirato

  JOURNAL OF MAGNETIC RESONANCE IMAGING 40 (4) 920 - 928 1053-1807 2014/10 [Refereed][Not invited]
   

  Purpose: To evaluate the feasibility of arterial spin-labeling (ASL) in head and neck cancer for noninvasive measurement of tumor blood flow (TBF), by comparing 1) the TBF change before and after the treatment, and 2) posttreatment TBF and its reduction rate between residual and nonresidual tumors after treatment. Materials and Methods: Twenty-two patients with head and neck cancer were evaluated using ASL on 3.0-T magnetic resonance imaging (MRI) before and after nonsurgical treatment. A pulsed ASL sequence with Look-Locker readout was used to calculate quantitative TBF. TBF reduction rates between pre- and posttreatment values were also calculated. Residual tumors were confirmed when present with either histopathologically or clinical follow-up. Results: Pre- and posttreatment mean TBF values were 121.4 +/- 27.8 (standard deviation) and 24.9 +/- 14.9 mL/100g/min, respectively. Pre-and posttreatment TBF differed significantly. Posttreatment TBF was significantly higher in patients with residual tumors (five patients, 46.9 +/- 7.1 mL/100g/min) than in those without (17 patients, 18.4 +/- 9.2 mL/100g/min). The TBF reduction rate was significantly lower in patients with residual tumors (0.540.55 +/- 0.120.12) than in those without (0.85 +/- 0.06). Conclusion: ASL allows quantitative assessment of TBF in head and neck cancer. ASL may be useful for noninvasive assessment of tumor viability in head and neck cancer.
• 術前細胞診にて悪性が確定しなかった甲状腺結節におけるエコー陽性所見の数と悪性リスクの関係について

  坂下 智博, 本間 明宏, 畠山 博充, 水町 貴諭, 加納 里志, 古沢 純, 飯塚 さとし, 干野 季美子, 畑中 佳奈子, 福田 諭

  日本内分泌・甲状腺外科学会雑誌 日本内分泌外科学会・日本甲状腺外科学会 31 (Suppl.2) S234 - S234 2186-9545 2014/09 [Not refereed][Not invited]
  
• 頸部転移を有する中咽頭扁平上皮癌における初回頸部郭清術の意義

  坂下 智博, 本間 明宏, 林 隆一, 岩江 信法, 藤井 正人

  口腔・咽頭科 日本口腔・咽頭科学会 27 (3) 329 - 329 0917-5105 2014/08 [Not refereed][Not invited]
  
• 頭頸部がんの化学療法 臨床試験から日常臨床へ

  本間 明宏

  口腔・咽頭科 日本口腔・咽頭科学会 27 (3) 267 - 267 0917-5105 2014/08 [Not refereed][Not invited]
  
• Japanese Board Certification System for head and neck surgeons

  Seiichi Yoshimoto, Torahiko Nakashima, Takashi Fujii, Kazuto Matsuura, Naoki Otsuki, Takahiro Asakage, Yasushi Fujimoto, Nobuhiro Hanai, Akihiro Homma, Nobuya Monden, Kenji Okami, Masashi Sugasawa, Yasuhisa Hasegawa, Ken-ichi Nibu, Shin-etsu Kamata, Seiji Kishimoto, Naoyuki Kohno, Satoshi Fukuda, Yasuo Hisa

  AURIS NASUS LARYNX 41 (4) 327 - 330 0385-8146 2014/08 [Refereed][Not invited]
   

  The Japan Society for Head and Neck Surgery (JSHNS) started a board certification system for head and neck surgeons in 2010. To become certified, the following qualification and experiences are required: (I) board certification as otorhinolaryngologist, (2) 2 years of clinical experience in a board-certified training facility, (3) clinical care of 100 patients with head and neck cancer under the supervision of board-certified faculty and (4) surgical experience in 50 major head and neck surgical procedures, including 20 neck dissections, under the supervision of board-certified faculty. The following scientific activities are also required during the preceding 5 years: (1) two clinical papers on head and neck cancers presented at major scientific meetings, (2) one clinical paper on head and neck cancer published in a major journal, (3) attendance at two annual meetings of JSHNS and (4) enrolment in three educational programs approved by JSHNS. The qualifying examination consists of multiple choice tests and oral examinations. A total of 151 head and neck surgeons were certified in 2010 followed by 43 in 2011 and 34 in 2012, while the membership of JSHNS dramatically increased from 1201 in 2007 to 1748 in 2013. Although the board certification system for head and neck surgeons was started only recently, it has encouraged many residents and fellows as well as established head and neck surgeons. We believe that this system will contribute to further advancement in the clinical practice for head and neck cancers in Japan. (C) 2014 Elsevier Ireland Ltd. All rights reserved.
• The role of initial neck dissection for patients with node-positive oropharyngeal squamous cell carcinomas

  Tomohiro Sakashita, Akihiro Homma, Ryuichi Hayashi, Kazuyoshi Kawabata, Kunitoshi Yoshino, Shigemichi Iwae, Yasuhisa Hasegawa, Kenichi Nibu, Takakuni Kato, Kiyoto Shiga, Kazuto Matsuura, Nobuya Monden, Masato Fujii

  ORAL ONCOLOGY 50 (7) 657 - 661 1368-8375 2014/07 [Refereed][Not invited]
   

  Background: The current study sought to assess the role of initial neck dissection (ND) for patients with node-positive oropharyngeal squamous cell carcinomas (OPSCC). Methods: The data for 202 patients with previously untreated node-positive OPSCC were gathered from 12 institutions belonging to the Head and Neck Cancer Study Group in the Japan Clinical Oncology Group. These patients were categorized into two groups, consisting of the initial ND group and the wait-and-see group, according to treatment policy. Results: Regional recurrence was observed in 17 of 93 patients undergoing initial ND, whereas, recurrent or persistent diseases were observed in 40 of 109 patients who did not undergo initial ND. The 4-year overall survival rates (OS) for the wait-and-see group and initial ND groups were 74.0% and 78.7%, respectively, and the 4-year regional control rates (RC) for each group were 77.6% and 84.9%. There were no significant differences in either OS or RC (p = 0.3440 and p = 0.2382, respectively). However, for patients with N3 disease, the 4-year OS of the initial ND group (100%) was favorable. For patients with N2a disease, the 4-year RC of the initial ND group was higher than that of the wait-and-see group statistically (100% vs 62.5%, p = 0.0156). Conclusions: The role of initial ND was limited in patients with node-positive OPSCC. The treatment strategy not involving initial ND is considered feasible and acceptable when nodal evaluation after definitive radiotherapy or chemoradiotherapy is applied adequately. However, it is possible that initial ND improves outcomes in patients with resectable large-volume nodal disease. (C) 2014 Elsevier Ltd. All rights reserved.
• 上顎洞原発扁平上皮癌T4症例の頸部転移について 多施設後ろ向き観察研究

  本間 明宏, 林 隆一, 松浦 一登, 加藤 健吾, 川端 一嘉, 門田 伸也, 長谷川 泰久, 鬼塚 哲郎, 藤本 保志, 加藤 孝邦, 丹生 健一, 西野 宏, 朝蔭 孝宏, 池淵 嘉一郎, 藤井 正人

  日本癌治療学会誌 (一社)日本癌治療学会 49 (3) 1053 - 1053 0021-4671 2014/06 [Not refereed][Not invited]
  
• 喉頭軟骨肉腫の2症例

  藤原 由有希, 水町 貴諭, 本間 明宏, 福田 諭

  耳鼻咽喉科臨床 補冊 耳鼻咽喉科臨床学会 (補冊139) 104 - 104 0912-1870 2014/06 [Not refereed][Not invited]
  
• 頸部外切開を要した魚骨異物の3例

  高橋 紘樹, 坂下 智博, 本間 明宏, 福田 諭

  口腔・咽頭科 日本口腔・咽頭科学会 27 (2) 143 - 146 0917-5105 2014/06 [Not refereed][Not invited]
   

  魚骨異物は、日常診療においてしばしば遭遇するが、少ないながらも経口腔的に摘出不可能な症例が存在する。今回我々は、頸部外切開を要した魚骨異物の症例を3例経験した。症例は68歳女性、58歳女性、81歳女性で、いずれもカレイの魚骨異物をCTで同定し、頸部外切開にて異物を摘出した。症例2では異物の捜索に難渋したが、手術操作により異物が移動したためと考えられた。症例3では異物は咽頭収縮筋内に完全に迷入し、術中の触診では異物の部位特定が困難であった。ペンローズドレーンを目印として留置して術中CTを撮影し、魚骨の正確な位置を確かめつつ手術を行った。術中CTを3D構築した画像は異物の部位特定に有用であった。(著者抄録)
• 癌予測に有用なエコー所見に関する検討 術前細胞診で癌が確定しなかった症例を対象に

  坂下 智博, 本間 明宏, 畠山 博充, 水町 貴諭, 加納 里志, 古沢 純, 飯塚 さとし, 畑中 佳奈子, 福田 諭

  日本内分泌・甲状腺外科学会雑誌 日本内分泌外科学会・日本甲状腺外科学会 31 (2) 130 - 133 2186-9545 2014/06 [Not refereed][Not invited]
   

  穿刺細胞診で悪性が確定しなかった場合にも画像的に甲状腺癌が疑わしいなどの理由により手術を行うことが少なくない。術後病理診断と画像所見との関係について比較し、どのような画像所見が癌予測因子として有用であるかについて検討した。対象は甲状腺腫瘍摘出を行ったもののうち、術前細胞診で悪性以外であった58症例。術前エコー検査所見(微細石灰化、辺縁不整、内部low echo、縦横比1以上、Haloの消失)が陽性であった場合に、術後病理で悪性であった陽性適中率(PPV)、陰性であった場合に術後病理が良性であった陰性適中率(NPV)をそれぞれ算出した。前述した各エコー所見のそれぞれのPPVは74、89、71、89、65%。NPVはいずれの所見も51〜58%にとどまった。辺縁不整および縦横比1以上がみられた場合のPPVは89%であり、これらの所見は有用な癌予測因子となりうると考えられた。(著者抄録)
• 当院における下咽頭癌に対する強度変調放射線治療(IMRT)の初期経験

  土屋 和彦, 安田 耕一, 鬼丸 力也, 白土 博樹, 本間 明宏, 福田 諭, 清水 康, 秋田 弘俊

  頭頸部癌 (一社)日本頭頸部癌学会 40 (2) 257 - 257 1349-5747 2014/05 [Not refereed][Not invited]
  
• 下咽頭癌化学放射線療法後再発症例における救済治療と予後の検討 多施設による観察研究

  米澤 宏一郎, 林 隆一, 鬼塚 哲郎, 長谷川 泰久, 大上 研二, 本間 明宏, 岩江 信法, 加藤 孝邦, 丹生 健一, 加藤 健吾, 藤井 正人

  頭頸部癌 (一社)日本頭頸部癌学会 40 (2) 199 - 199 1349-5747 2014/05 [Not refereed][Not invited]
  
• 下咽頭癌に対するRADPLATとweekly CDDP併用化学放射線治療の比較検討

  古沢 純, 本間 明宏, 坂下 智博, 畠山 博充, 加納 里志, 水町 貴諭, 土屋 和彦, 吉田 大介, 安田 耕一, 白土 博樹, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 40 (2) 198 - 198 1349-5747 2014/05 [Not refereed][Not invited]
  
• 唾液腺導管癌におけるHER2下流シグナルの解析

  加納 里志, 本間 明宏, 畠山 博充, 古沢 純, 水町 貴諭, 坂下 智博, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 40 (2) 191 - 191 1349-5747 2014/05 [Not refereed][Not invited]
  
• セツキシマブ投与におけるEGFRリガンド発現変化と効果

  畠山 博充, 坂下 智博, 水町 貴諭, 加納 里志, 本間 明宏, 福田 諭, 古沢 純

  頭頸部癌 (一社)日本頭頸部癌学会 40 (2) 187 - 187 1349-5747 2014/05 [Not refereed][Not invited]
  
• 局所進行頭頸部癌に対する導入化学療法後のweekly CDDP併用化学放射線療法の安全性と有用性の検討

  水町 貴諭, 本間 明宏, 坂下 智博, 加納 里志, 畠山 博充, 清水 康, 秋田 弘俊, 土屋 和彦, 安田 耕一, 鬼丸 力也, 白土 博樹, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 40 (2) 177 - 177 1349-5747 2014/05 [Not refereed][Not invited]
  
• 眼窩骨壁浸潤を伴う進行上顎洞癌における治療別生存率比較 眼窩内容温存全摘術の妥当性について

  坂下 智博, 林 隆一, 本間 明宏, 松浦 一登, 加藤 健吾, 川端 一嘉, 松塚 崇, 岩江 信法, 大上 研二, 藤井 正人

  頭頸部癌 (一社)日本頭頸部癌学会 40 (2) 172 - 172 1349-5747 2014/05 [Not refereed][Not invited]
  
• 腹腔鏡下遊離空腸採取に伴う問題点と対策

  村尾 尚規, 古川 洋志, 林 利彦, 山本 有平, 本間 明宏, 七戸 俊明

  頭頸部癌 (一社)日本頭頸部癌学会 40 (2) 165 - 165 1349-5747 2014/05 [Not refereed][Not invited]
  
• Lymph Node Metastasis in T4 Maxillary Sinus Squamous Cell Carcinoma: Incidence and Treatment Outcome

  Akihiro Homma, Ryuichi Hayashi, Kazuto Matsuura, Kengo Kato, Kazuyoshi Kawabata, Nobuya Monden, Yasuhisa Hasegawa, Tetsuro Onitsuka, Yasushi Fujimoto, Shigemichi Iwae, Kenji Okami, Takashi Matsuzuka, Kunitoshi Yoshino, Ken-ichi Nibu, Takakuni Kato, Hiroshi Nishino, Takahiro Asakage, Ichiro Ota, Morimasa Kitamura, Akira Kubota, Tsutomu Ueda, Kaichiro Ikebuchi, Akihito Watanabe, Masato Fujii

  ANNALS OF SURGICAL ONCOLOGY 21 (5) 1706 - 1710 1068-9265 2014/05 [Refereed][Not invited]
   

  The purpose of this study was to evaluate the incidence of lymph node metastasis among patients with T4 maxillary sinus squamous cell carcinoma (MS-SCC) as well as the delayed metastasis rate and the treatment outcome for untreated N0 neck in patients with T4 MS-SCC. Consecutive series of all patients (n = 128) with previously untreated T4 maxillary sinus SCC between 2006 and 2007 were obtained from 28 institutions belonging to or cooperating in the Head and Neck Cancer Study Group of the Japan Clinical Oncology Group. Of the 128 patients, 28 (21.9 %) had lymph node metastasis, and six patients (4.7 %) had distant metastasis at diagnosis. Among the 111 patients who were treated with curative intent, 98 had clinically N0 neck disease and did not receive prophylactic neck irradiation. A total of 11 patients (11.2 %) subsequently developed evidence of lymph node metastasis, of whom eight were among the 83 patients with an N0 neck and had not received elective neck treatment. There were 15 patients who received an elective neck dissection as part of the initial treatment, of whom three had pathologically positive for lymph node metastases. Of 11 patients, six patients with nonlateral retropharyngeal lymph node metastasis without primary or distant disease were successfully salvaged. This study identified the incidence of lymph node metastasis among patients with T4 MS-SCC as well as the delayed metastasis rate and the treatment outcome for untreated N0 neck in patients with T4 MS-SCC. These results will be of assistance in selecting treatment strategy for T4 MS-SCC in the future.
• Burns spaceに転移を来した甲状腺乳頭癌の2例

  本間 明宏, 畠山 博充, 水町 貴諭, 古沢 純, 加納 里志, 坂下 智博, 福田 諭

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 117 (4) 605 - 605 0030-6622 2014/04 [Not refereed][Not invited]
  
• 早期外耳道癌症例に対する治療前後の聴力に関する検討

  森田 真也, 中丸 裕爾, 本間 明宏, 坂下 智博, 桝谷 将偉, 福田 諭

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 117 (4) 565 - 565 0030-6622 2014/04 [Not refereed][Not invited]
  
• 口腔癌に対するセンチネルリンパ節ナビゲーション頸部郭清術の研究

  上村 裕和, 平川 仁, 三浦 弘規, 吉本 世一, 塩谷 彰浩, 菅澤 正, 小須田 茂, 本間 明宏, 横山 純吉, 吉崎 智一, 塚原 清彰, 長谷川 泰久

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 117 (4) 455 - 455 0030-6622 2014/04 [Not refereed][Not invited]
  
• 【画像診断パーフェクトガイド 読影のポイントとピットフォール】 部位別診断法 鼻・副鼻腔 鼻・副鼻腔癌

  藤間 憲幸, 本間 明宏

  耳鼻咽喉科・頭頸部外科 (株)医学書院 86 (5) 149 - 155 0914-3491 2014/04 [Not refereed][Not invited]
  
• Salvage operations for patients with persistent or recurrent cancer of the maxillary sinus after superselective intra-arterial infusion of cisplatin with concurrent radiotherapy

  Tomohiro Sakashita, Akihiro Homma, Hiromitsu Hatakeyama, Satoshi Kano, Takatsugu Mizumachi, Jun Furusawa, Daisuke Yoshida, Noriyuki Fujima, Rikiya Onimaru, Kazuhiko Tsuchiya, Koichi Yasuda, Hiroki Shirato, Fumiyuki Suzuki, Satoshi Fukuda

  BRITISH JOURNAL OF ORAL & MAXILLOFACIAL SURGERY 52 (4) 323 - 328 0266-4356 2014/04 [Refereed][Not invited]
   

  Our aim was to evaluate the feasibility of salvage operations for patients with persistent or recurrent cancer of the maxillary sinus after superselective intra-arterial infusion of cisplatin with concurrent radiotherapy. We retrospectively analysed the records of 61 patients with cancer of the maxillary sinus who were treated in this way. Chemotherapy comprised 100-120 mg/m(2) superselective intra-arterial infusions of cisplatin given a median of 4 times weekly (range 2-5). Concurrent radiotherapy was given in a median dose of 65 Gy (range 24-70 Gy). Persistent or recurrent cancer of the maxillary sinus was found in 17 patients, of whom 11 had salvage surgery. The disease was controlled in 8 of the 11, and 7 of the 11 survived with no evidence of disease. Their 5-year overall survival was 61%. Two of the 11 developed serious operative complications. Salvage surgery for patients with persistent or recurrent cancer of the maxillary sinus treated by superselective chemoradiotherapy is both safe and successful. Salvage surgery is a good option when this sort of persistent or recurrent cancer is followed up after the regimen of chemoradiotherapy described. (C) 2014 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
• Synchronous HPV-Positive Squamous Cell Carcinoma of the Bilateral Base of the Tongue

  Takatsugu Mizumachi, Tomohiro Sakashita, Yusuke Hishimura, Tomohiko Kakizaki, Akihiro Homma, Tomoko Mitsuhashi, Satoshi Fukuda

  Otolaryngology 4 (2) 2014/03 [Refereed][Not invited]
  
• Concomitant weekly cisplatin and radiotherapy for oropharyngeal squamous cell carcinoma

  Takatsugu Mizumachi, Akihiro Homma, Tomohiro Sakashita, Satoshi Kano, Hiromitsu Hatakeyama, Kazuhiko Tsuchiya, Kouichi Yasuda, Rikiya Onimaru, Hiroki Shirato, Satoshi Fukuda

  Japanese Journal of Head and Neck Cancer (一社)日本頭頸部癌学会 40 (1) 66 - 70 1349-5747 2014 [Not refereed][Not invited]
   

  The most common chemoradiotherapy regimen is high-dose (100 mg/m2) three-weekly cisplatin with concomitant radiotherapy; however, this protocol is associated with acute and late toxicities. A recent study demonstrated that HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) patients showed good prognosis. Here, we reviewed the efficacy of concomitant weekly cisplatin and radiotherapy in patients with OPSCC. Twenty-two patients with untreated OPSCC were enrolled and evaluated at our institution from July 2006 to June 2012. Weekly cisplatin (40 mg/m2) was given at weeks 1, 2, 3, 5, 6 and 7 with radiotherapy, which comprised a standard dose of 70 Gy delivered in 35 daily fractions over 7 weeks. The presence of HPV was analyzed using the multiplex PCR method. Median follow-up time was 38.6 months for surviving patients. Of the 22 oropharyngeal carcinomas, 13 (59%) were HPV-positive. Twenty-one patients (95.4%) received the full dose of radiotherapy. Over the course of the chemotherapy, 14 patients (63.6%) received more than 200 mg/m2 cisplatin. The acute and late toxicity was manageable in all cases. HPV-positive patients had better three-year overall survival rates (92.3% vs 66.7%) than HPV-negative patients. For HPV-positive patients, 1 of 13 died of distant metastasis, whereas for HPV-negative patients, 1 of 9 died of local recurrence and 2 of 9 died of distant metastasis. Because of its favorable outcome and lower toxicity, concomitant weekly cisplatin and radiotherapy appears to be a suitable treatment for HPV-positive OPSCC.
• Salvage operations for patients with persistent or recurrent cancer of the maxillary sinus after superselective intra-arterial infusion of cisplatin with concurrent radiotherapy

  Sakashita T, Homma A, Hatakeyama H, Kano S, Mizumachi T, Furusawa J, Yoshida D, Fujima N, Onimaru R, Tsuchiya K, Yasuda K, Shirato H, Suzuki F, Fukuda S

  Br J Oral Maxillofac Surg 52 (4) 323 - 8 1532-1940 2014 [Refereed][Not invited]
  
• The potential diagnostic role of the number of ultrasonographic characteristics for patients with thyroid nodules evaluated as bethesda I-v.

  Tomohiro Sakashita, Akihiro Homma, Hiromitsu Hatakeyama, Takatsugu Mizumachi, Satoshi Kano, Jun Furusawa, Satoshi Iizuka, Kimiko Hoshino, Kanako C Hatanaka, Koji Oba, Satoshi Fukuda

  Frontiers in oncology 4 261 - 261 2014 [Refereed][Not invited]
   

  OBJECTIVE: Fine-needle aspiration cytology (FNAC) is considered to be the most reliable method of examination for thyroid nodules. However, when thyroid nodules are evaluated as Bethesda I-V, the role of ultrasonography is considered to be enhanced. We investigated the association between a number of ultrasonographic (US) characteristics and the risk of thyroid malignancy, and assessed the optimal compromise on the number of US characteristics for predicting thyroid malignancy. METHODS: Seventy-three patients, whose thyroid nodules were evaluated as Bethesda I-V by FNAC prior to surgery, were treated surgically. A number of US characteristics, such as microcalcification, irregular margins, hypoechogenicity, a taller-than-wide shape, and the absence of halo sign, were assessed before surgery. The optimal compromise on the number of US characteristics was analyzed using a receiver operating characteristics (ROC) curve. The area under the ROC curve (AUC) represents the overall discriminatory ability of a test. RESULTS: The risk of malignancy was 11.8% in patients without any US characteristics, 44.4% in those with one characteristic, 61.5% in those with two characteristics, 75% in those with three characteristics, 90% in those with four characteristics, and 100% in those with five characteristics. The AUC was favorable (0.81599). At least two US characteristics were revealed to be the optimal compromise on the number of US characteristics based on the ROC curve. CONCLUSION: We proved the role of the number of US characteristics in predicting thyroid malignancy. It was thought that a surgical approach should be considered for patients with at least two US characteristics.
• Hearing Preservation after Lateral Temporal Bone Resection for Early-Stage External Auditory Canal Carcinoma

  Shinya Morita, Yuji Nakamaru, Akihiro Homma, Tomohiro Sakashita, Masayori Masuya, Satoshi Fukuda

  AUDIOLOGY AND NEURO-OTOLOGY 19 (6) 351 - 357 1420-3030 2014 [Refereed][Not invited]
   

  Objective: To evaluate postoperative hearing outcomes after lateral temporal bone resection (LTBR) with reconstruction of the external auditory canal (EAC) and conductive function for early-stage EAC carcinoma. Methods: We retrospectively examined patients diagnosed with early-stage EAC carcinoma treated with surgery alone between January 2006 and December 2012. Patients who had postoperative adjuvant chemotherapy and/or radiotherapy were excluded. Patients receiving LTBR in combination with tympanoplasty were divided into two groups based on the reconstruction of the EAC with and without (w/o) split-thickness skin grafts (STSGs). Audiological data included the preoperative hearing thresholds and the most recent postoperative hearing thresholds obtained at least 12 months after surgery. The hearing outcome was evaluated based on puretone audiograms using the Committee on Hearing and Equilibrium guidelines of the American Academy of Otolaryngology-Head and Neck Surgery for the evaluation of the results of treatment of conductive hearing loss. The postoperative quality of life (QOL) for patients was evaluated using the Glasgow Benefit Inventory (GBI). Results: All patients (n = 15) achieved disease-free survival without significant morbidity or mortality. When we compared the mean air-bone gaps after surgery, those in the STSG group (n = 8) were found to be significantly lower than those in the w/o STSG group (n = 7; p < 0.001). The success rate for postoperative hearing was 75.0% in the STSG group, which was significantly higher than that in the w/o STSG group (p = 0.014). All patients in the w/o STSG group showed stenosis and closure of the EAC at fewer than 10 months after surgery. In contrast, all patients in the STSG group showed preserved conformation of the new EAC for more than 12 months after surgery. When we compared the mean GBI score between the two groups of patients, the overall and general health scores in the STSG group were found to be significantly higher than those in the w/o STSG group (p = 0.021, p = 0.001). Conclusions: Reconstruction of the EAC using a rolled-up STSG technique in combination with tympanoplasty after LTBR is useful for hearing preservation and the observation of locoregional lesions after surgery, resulting in improved QOL for patients. (C) 2014 S. Karger AG, Basel
• LOCALLY ADVANCED HEAD AND NECK SQUAMOUS CELL CARCINOMAS TREATED WITH DCF (DOCETAXEL, CISPLATIN, 5-FU) INDUCTION CHEMOTHERAPY

  J. Taguchi, T. Amano, I. Kinoshita, R. Honma, Y. Shimizu, K. Tsuchiya, H. Shirato, A. Homma, S. Fukuda, H. Akita

  ANNALS OF ONCOLOGY 24 0923-7534 2013/11 [Not refereed][Not invited]
  
• Combined analysis of HPV status and pl6 expression in patients with oropharyngeal squamous cell carcinoma

  Takatsugu Mizumachi, Hiromitsu Hatakeyama, Satoshi Kano, Tomohiro Sakashita, Seigo Suzuki, Akihiro Homma, Nobuhiko Oridate, Satoshi Fukuda

  Japanese Journal of Head and Neck Cancer (一社)日本頭頸部癌学会 39 (3) 334 - 338 1881-8382 2013/10/28 [Not refereed][Not invited]
   

  Oropharyngeal squamous cell carcinoma (OPSCC) that are associated with human papilloma virus (HPV) infection carry a more favourable prognosis than those that are HPV-negative. For detection of HPV in tumor material, in situ hybridization and PCR-based methods have been used. Recently, p16 is suggested to be an excellent surrogate marker for HPV infection. The simplicity, low cost, and high sensitivity of p16 immunohistochemical analysis (IHC) have prompted consideration of replacing HPV DNA in situ hybridization and PCR-based methods. However, p16 overexpression could suggest pRB pathway disturbances unrelated to HPV. This issue has not yet been fully evaluated in Japan. We performed a retrospective analysis of the association between p16 expression and HPV status of 91 patients with OPSCC at Hokkaido University Hospital, Japan, between 1998 and 2011. Of the 91 patients with OPSCC, 29 were HPV-positive and 31 were p16-positive. The 3-year overall survival rates were 82.2% in the p16-positive subgroup and 65.1% in the p16-negative subgroup these figures were significantly different As combined HPV and p16 status, the 3-year overall survival rates were 91.1% (HPV+/p16+groups, n = 24), 60.0%(HPV+/p16+ groups, n=5), 65.7%(HPV-/p16- groups, n=55), 60.0%(HPV-/p16+ groups, n=7). Our results showed that the patients with HPV-/p16+ had poor prognosis as compared with the patients with HPV+/p16+ therefore, p16 IHC alone may not be a perfect surrogate marker for HPV infection.
• The current status of the treatment for T4 maxillary sinus cancer in Japan - A multi-institutional retrospective observation study

  Akihiro Homma, Ryuichi Hayashi, Kazuto Matsuura, Kengo Kato, Kazuyoshi Kawabata, Nobuya Mon-Den, Yasuhisa Hasegawa, Tetsuro Onitsuka, Yasushi Fujimoto, Shigemichi Iwae, Kenji Okami, Takashi Matsuzuka, Kunitoshi Yoshino, Masato Fujii

  Japanese Journal of Head and Neck Cancer (一社)日本頭頸部癌学会 39 (3) 310 - 316 1881-8382 2013/10/28 [Not refereed][Not invited]
   

  Purpose To assess the current status in Japan of the treatment for squamous cell carcinoma of the T4 maxillary sinus (MS-SCC)and its use to plan clinical trials in the future. Patients The data for 128 patients with previously untreated MS-SCC were obtained from 28 institutions from 2006 to 2007. Of the 128 patients, 118 patients with curative intent were included in an analysis of the treatment and its results. Results Of the 118 patients, 73 patients had T4a disease, and 45 with T4b. Thirty-nine patients (33.1%)were treated with total maxillectomy, 25 (21.2%)with partial maxillectomy, 22 patients (18.6%)with RAD-PLAT, 19 patients (16.1%)with IV-CRT, and 13 patients (11.0%)with others. The 5-year overall survival rate and local control rate for 118 patients were 49.8% and 48.9%, respectively. The 5-year overall survival rates for patients with T4aN0M0 and T4bN0M0 were 67.5% and 29.8%, respectively. Conclusion This study was retrospective, but we could understand the tendency of treatment choice and treatment results. It will be useful information to plan clinical trials in the future.
• 当科における二期的気管食道瘻形成術 彎曲型食道直達鏡の試作

  水町 貴諭, 本間 明宏, 坂下 智博, 加納 里志, 畠山 博充, 鈴木 清護, 折舘 伸彦, 福田 諭

  耳鼻咽喉科展望 耳鼻咽喉科展望会 56 (5) 334 - 337 0386-9687 2013/10 [Not refereed][Not invited]
  
• Salvage surgery for recurrent oropharyngeal cancer after chemoradiotherapy

  Satoshi Kano, Akihiro Homma, Ryuichi Hayashi, Kazuyoshi Kawabata, Kunitoshi Yoshino, Shigemichi Iwae, Yasuhisa Hasegawa, Kenichi Nibu, Takakuni Kato, Kiyoto Shiga, Kazuto Matsuura, Nobuya Monden, Masato Fujii

  INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY 18 (5) 817 - 823 1341-9625 2013/10 [Refereed][Not invited]
   

  The current study aimed to assess the role of salvage surgery for failure cases of oropharyngeal cancer (OPC) undergoing initial chemoradiotherapy (CRT). The data for 523 patients with previously untreated OPC were gathered from 12 institutions belonging to the Head and Neck Cancer Study Group in Japan Clinical Oncology Group (JCOG). Of the 170 patients who received CRT, 35 patients (21 %) had local recurrence or residual disease. Only 11 patients underwent further salvage surgery, and 24 patients received nonsurgical treatment. There were statistically significant differences between the two groups in terms of patient age and the presence of a simultaneous regional recurrence. The 5-year overall survival rates for the patients who underwent salvage surgery were 49.1 %, whereas those for the patients who received nonsurgical treatment were 16.3 %. The initial treatment method for OPC should be decided carefully and the limitations of salvage surgery should be fully considered.
• Improved survival of Japanese patients with human papillomavirus-positive oropharyngeal squamous cell carcinoma

  Takatsugu Mizumachi, Satoshi Kano, Tomohiro Sakashita, Hiromitsu Hatakeyama, Seigo Suzuki, Akihiro Homma, Nobuhiko Oridate, Satoshi Fukuda

  INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY 18 (5) 824 - 828 1341-9625 2013/10 [Refereed][Not invited]
   

  The prevalence of oropharyngeal carcinoma is rising in western Europe and the United States, where there appears to be a strong association between human papillomavirus (HPV) and oropharyngeal squamous cell carcinoma (OPSCC). However, such a correlation has not yet been fully evaluated in Japan. We performed a retrospective analysis of the association between tumour HPV status and the demographic and clinicopathological parameters of 71 patients with OPSCC at Hokkaido University Hospital, Japan, between 1998 and 2009. The parameters included age, gender, survival, tumour subsite, tumour-node-metastasis (TNM) stage, smoking history, second primary tumour status, recurrence/residual disease at the primary site, and overall survival. HPV status was established by multiplex polymerase chain reaction (PCR) analysis. Of the 71 oropharyngeal cancers, 20 were positive for HPV-16, two for HPV-18, and one for HPV-58. Kaplan-Meier survival analysis showed improved overall survival rates in patients with HPV-positive tumours (p = 0.0038) compared with HPV-negative tumours. Of the 45 patients who received chemoradiotherapy, HPV-positive patients experienced better overall survival than HPV-negative patients (p = 0.0032). In a multivariate analysis, the survival benefit of HPV-positive patients was independent of age and T and N classification. HPV status is a significantly favourable prognostic factor in oropharyngeal cancer and could be used as a marker to optimize the treatment of patients with this type of cancer in Japan.
• 進行喉頭癌に対する喉頭温存療法の後ろ向き多施設共同研究

  藤井 正人, 本間 明宏, 藤本 保志, 太田 一郎, 林 隆一, 田原 信, 大上 研二, 岩江 信法, 大月 直樹, 清田 尚臣, 西野 宏, 鬼塚 哲郎

  日本癌治療学会誌 (一社)日本癌治療学会 48 (3) 2164 - 2164 0021-4671 2013/09 [Not refereed][Not invited]
  
• 進行下咽頭癌に対する根治的化学放射線療法の治療成績 多施設共同による後ろ向き研究

  岩江 信法, 林 隆一, 大上 研二, 本間 明宏, 米澤 宏一郎, 鬼塚 哲郎, 長谷川 泰久, 加藤 健吾, 加藤 孝邦, 太田 一郎, 田原 信, 藤井 正人

  日本癌治療学会誌 (一社)日本癌治療学会 48 (3) 1250 - 1250 0021-4671 2013/09 [Not refereed][Not invited]
  
• 中咽頭癌に対する放射線化学療法の検討 多施設による後方視的観察研究

  加納 里志, 本間 明宏, 林 隆一, 川端 一喜, 吉野 邦俊, 岩江 信法, 長谷川 泰久, 丹生 健一, 加藤 孝邦, 志賀 清人, 松浦 一登, 門田 伸也, 藤井 正人

  日本癌治療学会誌 (一社)日本癌治療学会 48 (3) 1248 - 1248 0021-4671 2013/09 [Not refereed][Not invited]
  
• Prognostic value of cyclin D1 expression in tumor-free surgical margins in head and neck squamous cell carcinomas

  Tomohiro Sakashita, Akihiro Homma, Seigo Suzuki, Hiromitsu Hatakeyama, Satoshi Kano, Takatsugu Mizumachi, Nobuhiko Oridate, Satoshi Fukuda

  ACTA OTO-LARYNGOLOGICA 133 (9) 984 - 991 0001-6489 2013/09 [Refereed][Not invited]
   

  Conclusion: It was proved that cyclin D1-positive status in surgical margins was an independent prognostic indicator of local recurrence. The expression of cyclin D1 in tumor-free surgical margins may better predict local recurrence in patients with head and neck squamous cell carcinoma (HNSCC) after surgical treatment with curative intent. Objective: This retrospective study aimed to determine the prognostic indicators for local recurrence in HNSCC. Methods: A total of 116 HNSCC patients who underwent surgical treatment with curative intent and had histopathologically tumor-free margins were eligible for this study. The expression of p53 and cyclin D1 was assessed by immunohistochemical staining in surgical margins as well as in tumor specimens. Results: In all, 63 patients (54.3%) had p53-positive tumor specimens and 34 patients (29.3%) had p53-positive margins. Seventy-six patients (65.6%) had cyclin D1-positive tumor specimens and 54 patients (46.6%) had cyclin D1-positive margins. A significant difference in local control rates was observed between patients with cyclin D1-positive and -negative margins (77.2% vs 91.5%, log rank test, p = 0.0139). Multivariate Cox proportional hazards testing indicated that the hazard ratio of cyclin D1-positive margins for local recurrence was 4.58 (95% confidence interval 1.14-21.69, p = 0.0304).
• 頸部外切開を要した魚骨異物の3例

  高橋 紘樹, 坂下 智博, 本間 明宏, 福田 諭

  口腔・咽頭科 日本口腔・咽頭科学会 26 (3) 317 - 317 0917-5105 2013/08 [Not refereed][Not invited]
  
• リンパ節および肺転移をきたしたprimary mucinous carcinoma of the skinの1例

  本間 英里奈, 青柳 哲, 濱出 洋平, 西村 慶子, 保科 大地, 秦 洋郎, 清水 宏, 坂下 智博, 本間 明宏, 加賀 基知三

  日本皮膚科学会雑誌 (公社)日本皮膚科学会 123 (8) 1547 - 1547 0021-499X 2013/07 [Not refereed][Not invited]
  
• 頭頸部癌 超選択的動注化学療法

  本間 明宏

  癌と化学療法 (株)癌と化学療法社 40 (7) 857 - 860 0385-0684 2013/07 [Not refereed][Not invited]
  
• 中咽頭癌症例におけるHPV感染と転移リンパ節の検討

  水町 貴諭, 加納 里志, 本間 明宏, 折舘 伸彦, 福田 諭

  口腔・咽頭科 日本口腔・咽頭科学会 26 (2) 161 - 166 0917-5105 2013/06 [Not refereed][Not invited]
   

  HPV陽性中咽頭癌は陰性例に比べ予後が良好であるが、陽性例であっても予後不良例も存在する。Spectorらは"matted nodes"というリンパ節の転移様式のみられる症例は遠隔転移しやすく予後不良であると報告した。中咽頭扁平上皮癌症例61例に対してretrospectiveに"matted nodes"および臨床的検討を行った。このうち"matted nodes"を認めたのは9例であった。全症例における"matted nodes"の有無別の生存率には有意差を認めなかったが、"matted nodes"あり群の方が有意に遠隔転移しやすい傾向にあった。HPV陽性例のみでの検討では"matted nodes"あり群の方がなし群に比べ有意に予後が不良であった。HPV陽性であっても"matted nodes"のある症例は遠隔転移のリスクが高く予後不良であるので導入化学療法を行った方が望ましいと考えられた。(著者抄録)
• 甲状腺未分化癌・低分化癌症例における分化機構についての免疫組織学的検討

  干野 季美子, 畠山 博充, 坂下 智博, 加納 里志, 水町 貴諭, 本間 明宏, 畑中 佳奈子, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 39 (2) 244 - 244 1349-5747 2013/05 [Not refereed][Not invited]
  
• 両側に生じたHPV陽性舌根癌症例

  水町 貴諭, 坂下 智博, 加納 里志, 畠山 博充, 本間 明宏, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 39 (2) 228 - 228 1349-5747 2013/05 [Not refereed][Not invited]
  
• II-IV期上咽頭癌に対する化学放射線同時併用療法 併用化学療法に関する後ろ向き比較検討

  土屋 和彦, 安田 耕一, 木下 留美子, 鬼丸 力也, 白土 博樹, 本間 明宏, 福田 諭, 清水 康, 秋田 弘俊

  頭頸部癌 (一社)日本頭頸部癌学会 39 (2) 218 - 218 1349-5747 2013/05 [Not refereed][Not invited]
  
• 上顎洞扁平上皮癌に対する超選択的動注併用放射線治療後の救済手術に関する検討

  坂下 智博, 本間 明宏, 鈴木 章之, 畠山 博充, 加納 里志, 水町 貴諭, 古沢 純, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 39 (2) 202 - 202 1349-5747 2013/05 [Not refereed][Not invited]
  
• 上顎洞原発扁平上皮癌T4症例の進展部位別予後解析 多施設後ろ向き観察研究

  加納 里志, 林 隆一, 本間 明宏, 松浦 一登, 加藤 健吾, 川端 一喜, 松塚 崇, 大上 研二, 岩江 信法, 藤井 正人

  頭頸部癌 (一社)日本頭頸部癌学会 39 (2) 201 - 201 1349-5747 2013/05 [Not refereed][Not invited]
  
• HPV陽・陰性中咽頭扁平上皮癌の上皮間葉移行における特性

  畠山 博充, 水町 貴諭, 坂下 智博, 加納 里志, 本間 明宏, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 39 (2) 188 - 188 1349-5747 2013/05 [Not refereed][Not invited]
  
• HPV陽性中咽頭癌に対するweekly CDDP併用化学放射線治療の臨床的検討

  水町 貴諭, 本間 明宏, 坂下 智博, 加納 里志, 畠山 博充, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 39 (2) 139 - 139 1349-5747 2013/05 [Not refereed][Not invited]
  
• 化学放射線療法の現状と役割 動注化学療法による化学放射線療法 上顎洞癌を中心に

  本間 明宏, 畠山 博充, 加納 里志, 水町 貴諭, 坂下 智博, 吉田 大介, 鬼丸 力也, 土屋 和彦, 安田 耕一, 白土 博樹, 藤井 正人, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 39 (2) 134 - 134 1349-5747 2013/05 [Not refereed][Not invited]
  
• 北海道大学病院における上咽頭癌の治療 10年間(2000〜2010)のまとめ

  土屋 和彦, 安田 耕一, 西川 由記子, 木下 留美子, 鬼丸 力也, 原田 慶一, 井上 哲也, 加藤 徳雄, 清水 伸一, 白土 博樹, 西岡 健, 鈴木 恵士郎, 田口 大志, 長谷川 雅一, 折舘 伸彦, 本間 明宏, 鈴木 清護, 畠山 博充, 加納 里志, 水町 貴諭, 坂下 智博, 福田 諭, 竹内 啓, 田口 純

  耳鼻咽喉科展望 耳鼻咽喉科展望会 56 (補冊2) 174 - 175 0386-9687 2013/05 [Not refereed][Not invited]
  
• 北海道大学病院における鼻副鼻腔癌の治療成績 上顎洞原発扁平上皮癌を中心に

  本間 明宏, 折舘 伸彦, 鈴木 清護, 畠山 博充, 加納 里志, 古沢 純, 水町 貴諭, 坂下 智博, 鈴木 章之, 瀧 重成, 稲村 直哉, 福田 諭

  耳鼻咽喉科展望 耳鼻咽喉科展望会 56 (補冊2) 130 - 131 0386-9687 2013/05 [Not refereed][Not invited]
  
• Platinum-based chemotherapy plus cetuximab for the first-line treatment of Japanese patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck: Results of a phase II trial

  Takayuki Yoshino, Yasuhisa Hasegawa, Shunji Takahashi, Nobuya Monden, Akihiro Homma, Kenji Okami, Yusuke Onozawa, Masato Fujii, Takahide Taguchi, Barbara de Blas, Frank Beier, Makoto Tahara

  Japanese Journal of Clinical Oncology 43 (5) 524 - 531 0368-2811 2013/05 [Refereed][Not invited]
   

  Objective: To assess the efficacy and safety of cetuximab in combination with cisplatin and 5-fluorouracil for first-line treatment of Japanese patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck. Methods: In this open-label, single-arm, multicenter, Phase II study conducted in Japan, patients with confirmed recurrent and/or metastatic squamous cell carcinoma of the head and neck received weekly cetuximab (week 1, 400 mg/m2 subsequent weeks, 250 mg/m2) plus a maximum of six three-weekly cycles of cisplatin (100 mg/m2, day 1) and 5-fluorouracil (1000 mg/m2/day, 24-h infusion, days 1-4). The primary endpoint was the best overall response assessed by an independent review committee according to the modified World Health Organization criteria. Results: In total, 33 patients received treatment. The most frequent primary tumor site was the hypopharynx (42%), and most patients had metastatic disease (85%). The best overall response rate as assessed by the independent review committee was 36% (95% confidence interval: 20, 55) and was significantly greater (P = 0.002) than the protocol-specified threshold of 15% at the one-sided 5% level. The disease control rate was 88%. The median progression-free survival and overall survival were 4.1 and 14.1 months, respectively. There were no unexpected safety concerns. Grade 3 or 4 adverse events were experienced by nearly all patients (32, 97%). No adverse events were fatal. Conclusions: The demonstrated efficacy and safety of cetuximab in combination with cisplatin and 5-fluorouracil for the first-line treatment of Japanese patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck justify the further use of this combination treatment in this patient population (ClinicalTrials.gov number, NCT00971932). © The Author 2013. Published by Oxford University Press.
• 当科における導入化学療法後の放射線化学療法例の検討

  蠣崎 文彦, 本間 明宏, 折舘 伸彦, 鈴木 清護, 畠山 博充, 加納 里志, 水町 貴諭, 坂下 智博, 福田 諭

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 116 (4) 524 - 524 0030-6622 2013/04 [Not refereed][Not invited]
  
• 眼窩骨壁浸潤を認める進行上顎洞癌における治療別視機能温存率についての検討

  坂下 智博, 林 隆一, 本間 明宏, 松浦 一登, 加藤 健吾, 川端 一嘉, 松塚 崇, 岩江 信法, 大上 研二, 藤井 正人

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 116 (4) 440 - 440 0030-6622 2013/04 [Not refereed][Not invited]
  
• 頭頸部癌化学放射線療法における小野寺栄養指数の意義

  折舘 伸彦, 倉本 倫之介, 本間 明宏, 鈴木 清護, 畠山 博充, 加納 里志, 水町 貴諭, 坂下 智博, 蠣崎 文彦, 福田 諭

  日本気管食道科学会会報 (NPO)日本気管食道科学会 64 (2) s55 - s55 0029-0645 2013/04 [Not refereed][Not invited]
  
• Regional control after concomitant chemoradiotherapy without planned neck dissection in node-positive head and neck squamous cell carcinomas

  Tomohiro Sakashita, Akihiro Homma, Nobuhiko Oridate, Seigo Suzuki, Hiromitsu Hatakeyama, Satoshi Kano, Takatsugu Mizumachi, Rikiya Onimaru, Kazuhiko Tsuchiya, Koichi Yasuda, Hiroki Shirato, Satoshi Fukuda

  AURIS NASUS LARYNX 40 (2) 211 - 215 0385-8146 2013/04 [Refereed][Not invited]
   

  Objectives: Although three-weekly high-dose (100 mg/m(2)) cisplatin (three cycles) chemoradiotherapy has been considered a standard regimen for patients with advanced head and neck squamous cell carcinomas (HNSCC), this protocol is associated with significant acute and late toxicities. Therefore, weekly cisplatin at a dose of 40 mg/m(2) has been used at our institution since 2006. This retrospective study was aimed at assessing the oncologic efficacy of weekly cisplatin chemoradiotherapy for the control of nodal metastasis. Methods: We analyzed 28 patients with node-positive HNSCC treated with weekly cisplatin and concurrent radiotherapy. Computed tomography was performed 4-8 weeks after the completion of chemoradiotherapy to evaluate nodal response. If residual neck disease was apparent or suspected, we performed early salvage neck dissection (ND). In cases with a complete response (CR), we took a "wait and see" approach. When no viable tumor cells were observed in the surgical specimens obtained by ND, nodal metastasis was defined as controlled by weekly cisplatin chemoradiotherapy alone. Results: Nodal metastasis was evaluated as having a CR in 20 patients (71%). Eight patients (29%) underwent early salvage ND. Recurrent primary tumors were observed in the other four patients (14%). Salvage primary resection and associated ND were performed for these four patients. In 7 of 12 patients undergoing ND, no viable tumor cells were observed. In 23 of 28 patients, neck diseases were controlled by chemoradiotherapy alone (not including salvage by ND). In 27 of 28 patients, neck diseases were controlled by the overall treatment (including salvage by ND). The rate of nodal control by chemoradiotherapy alone and by the overall treatment was found to be 82.0% and 96.3%, respectively, using the Kaplan-Meier method. The three-year overall and disease free survival rates were 86.8% and 80.8%, respectively. Conclusion: Concomitant weekly cisplatin at a dose of 40 mg/m(2) chemoradiotherapy showed a good control rate of not only primary lesions but also neck diseases. (C) 2012 Elsevier Ireland Ltd. All rights reserved.
• 喉頭癌T3症例の治療成績の検討

  水町 貴諭, 折舘 伸彦, 本間 明宏, 坂下 智博, 加納 里志, 畠山 博充, 鈴木 清護, 福田 諭

  頭頸部外科 (NPO)日本頭頸部外科学会 22 (3) 317 - 321 1349-581X 2013/02 [Not refereed][Not invited]
   

  2004年から2008年に当科にて治療を行った声門下癌を除く喉頭癌T3症例27例の治療成績を検討した。治療内容は喉頭全摘手術が7例、化学放射線治療が14例、放射線単独治療が6例であった。治療法別の疾患特異的3年生存率は手術群が85.7%、化学放射線治療群が77.9%、放射線単独治療群が66.7%であったが各群間に統計学的有意差は認めなかった。喉頭温存を希望する症例に対して、化学放射線治療は有用な治療法であると考えられた。T3規定因子別の検討では、声門周囲腔進展例は声帯固定例および喉頭蓋前方進展例と比べ統計学的有意差をもって予後が良好であり、声門周囲腔進展しているが声帯固定していない症例は喉頭温存治療を積極的に行って良いのではと考えられた。(著者抄録)
• 当科で放射線治療を施行した頭頸部原発小細胞癌症例の検討

  西川 由記子, 安田 耕一, 土屋 和彦, 鬼丸 力也, 白土 博樹, 本間 明宏, 竹内 啓, 田口 純

  Japanese Journal of Radiology (公社)日本医学放射線学会 31 (Suppl.I) 12 - 12 1867-1071 2013/02 [Not refereed][Not invited]
  
• The current status of treatment for oropharyngeal cancer in Japan - A multi-institutional retrospective observation study

  Akihiro Homma, Ryuichi Hayashi, Kazuyoshi Kawabata, Kunitoshi Yoshino, Shigemichi Iwae, Yasuhisa Hasegawa, Satoshi Kano, Kenichi Nibu, Takakuni Kato, Kiyoto Shiga, Kazuto Matsuura, Nobuya Monden, Masato Fujii

  Japanese Journal of Head and Neck Cancer (一社)日本頭頸部癌学会 39 (4) 449 - 455 1881-8382 2013 [Not refereed][Not invited]
   

  Purpose: To assess the current status of the treatment for oropharyngeal cancer (OPC) in Japan to assist the planning of clinical trials in the future. Patients: The data for 523 patients with previously untreated OPC were obtained from 12 institutions from April 2005 to March 2007. Of the 523 patients, 471 patients with squamous cell carcinoma and with curative intent were included in an analysis of the treatment and its results. Results: Of the 471 patients with OPC treated with curative intent, 186 patients (39.5%) were treated with surgery, 118 (25.1%) with RT alone and 167 (355%) with CRT. Surgery was indicated for 60.4% of the patients with stage I, 47.8% in stage II, 29.4% in stage III, and 36.44% in stage IV. CRT was indicated for 8.3% in stage II, but the percentage increased with higher stage. The percentage of RT was around 30% among stage I-III, but in stage IV, 21.3% of the patients were indicated for RT. The median follow-up period was 4 years and 5 months. The 2-year and 5-year overall survival rates for the 471 patients were 85% and 69.9%, respectively. The 5-year overall survival rates for patients treated initially with surgery, RT and CRT were 73%, 69.1% and 65.6%, respectively. The 5-year overall survival rates for patients with stage I, II, III, IVA, and IVB were 78.9%, 87.3%, 69.7%, 66.6%, and 47.7%, respectively. Conclusions: Although this study was retrospective, we could understand the tendency of treatment choice according to various factors and treatment results. The information will be useful for planning clinical trials in the future. © 2013 Japan Society for Head and Neck Cancer.
• Superselective intra-arterial cisplatin infusion and concomitant radiotherapy for maxillary sinus cancer

  Homma A, Sakashita T, Yoshida D, Onimaru R, Tsuchiya K, Suzuki F, Yasuda K, Hatakeyama H, Furusawa J, Mizumachi T, Kano S, Inamura N, Taki S, Shirato H, Fukuda S

  Br J Cancer Nature publishing group 109 (12) 2980 - 6 1532-1827 2013 [Refereed][Not invited]
   

  Background: The purpose of this study was to evaluate the efficacy of superselective cisplatin infusion with concomitant radiotherapy (RADPLAT) for previously untreated patients with the squamous cell carcinoma of maxillary sinus (SCC-MS). Methods: Between 1999 and 2010, 54 patients were given superselective intra-arterial infusions of cisplatin (100-120mgm(-2) per week) with simultaneous intra-venous infusions of thiosulfate to neutralise cisplatin toxicity and conventional radiotherapy (65-70 Gy). Results: One patient (1.9%) was diagnosed with T2, 14 (25.9%) with T3, 27 (50%) with T4a, and 12 (22.2%) with T4b disease. Lymph-node involvement was present in 12 patients (22.2%). During the median follow-up period of 6.4 years, the 5-year local progression-free and overall survival rates were 65.8 and 67.9% for all patients, respectively. No patient died as a result of treatment toxicity or experienced a cerebrovascular accident. Osteonecrosis (n-5), brain necrosis (n-1), and ocular/ visual problems (n = 14) were observed as late adverse reactions. Conclusion: We have shown excellent overall survival and local progression-free rate in SCC-MS patients treated by RADPLAT with acceptable rates of acute and late toxicity. A multi-institutional trial is needed to prove that this strategy is a feasible and effective approach for the treatment of SCC-MS.
• Matched-Pair Analysis in Patients with Advanced Oropharyngeal Cancer: Surgery versus Concurrent Chemoradiotherapy

  Satoshi Kano, Akihiro Homma, Ryuichi Hayashi, Kazuyoshi Kawabata, Kunitoshi Yoshino, Shigemichi Iwae, Yasuhisa Hasegawa, Kenichi Nibu, Takakuni Kato, Kiyoto Shiga, Kazuto Matsuura, Nobuya Monden, Masato Fujii

  ONCOLOGY 84 (5) 290 - 298 0030-2414 2013 [Refereed][Not invited]
   

  Objective: The current study aimed to compare the therapeutic outcomes of surgery with those of chemoradiation for patients with advanced oropharyngeal cancer (OPC). Methods: The data for 523 patients with previously untreated OPC were obtained from 12 institutions belonging to the Head and Neck Cancer Study Group in the Japan Clinical Oncology Group from April 2005 to March 2007. In this study, we matched a group of patients who underwent surgery with a second group treated with chemoradiation according to age, gender, subsite, and T and N classification, and analyzed the overall survival, progression-free survival, local control and swallowing function. Results: The final matched-pair analysis included 186 patients. The 5-year overall survival, progression-free survival and local control rates were 69.8 and 71.4% (p = 0.762), 51.0 and 54.4% (p = 0.531), and 75.2 and 80.3% (p = 0.399), respectively, in patients treated with surgery and those treated with chemoradiation. Swallowing function in patients treated with chemoradiation was significantly better than that in patients treated with surgery (p = 0.015). Conclusion: Although this study was not randomized, this matched-pair analysis of patients treated with surgery or chemoradiation showed that chemoradiation is as effective as surgery in the treatment of OPC. Copyright (C) 2013 S. Karger AG, Basel
• 切除可能T3、T4上顎洞扁平上皮癌における手術の位置付け 当院における治療戦略

  本間 明宏, 折舘 伸彦, 鈴木 清護, 鈴木 章之, 畠山 博充, 加納 里志, 水町 貴諭, 坂下 智博, 吉田 大介, 鬼丸 力也, 土屋 和彦, 安田 耕一, 白土 博樹, 福田 諭

  耳鼻と臨床 耳鼻と臨床会 58 (Suppl.1) S52 - S56 0447-7227 2012/11 [Not refereed][Not invited]
   

  大量シスプラチンの超選択的動注療法と放射線治療の同時併用療法を1999年から2009年までに北海道大学病院で行った上顎洞原発扁平上皮癌未治療例41例についての救済手術について検討した。原発巣が残存あるいは再発した例は12例あり、そのうちの9例に救済手術が行われた。9例のうち7例は、その後原発巣の再発なく経過し、原発巣の救済率は全体で7/12=58.3%、T別ではT3:66.7%(2/3)、T4a:66.7%(4/6)、T4b:33.3%(1/3)であった。全症例の5年粗生存率は73.6%であった。術後合併症は、遊離皮弁による再建を行った症例で重篤な合併症が出現した。救済率が比較的良好であったのは、再発が前方に生じた例が多かったためと考えられた。以上の結果を、今後の症例の初回治療の選択、救済手術を行うかどうかの参考にしていきたい。(著者抄録)
• Platinum concentration in sentinel lymph nodes after preoperative intra-arterial cisplatin chemotherapy targeting primary tongue cancer

  坂下 智博, 本間 明宏, 折舘 伸彦, 鈴木 清護, 畠山 博充, 加納 里志, 水町 貴諭, 吉田 大介, 藤間 憲幸, 福田 諭

  北海道醫學雜誌 = Acta medica Hokkaidonensia 87 (6) 261 - 261 0367-6102 2012/11/01 [Not refereed][Not invited]
  
• Rapid superselective high-dose cisplatin infusion with concomitant radiotherapy for squamous cell carcinoma of the nasal vestibule: a report of two cases

  Homma Akihiro, Suzuki Fumiyuki, Hatakeyama Hiromitsu, Sakashita Tomohiro, Yoshida Daisuke, Tsuchiya Kazuhiko, Onimaru Rikiya, Oridate Nobuhiko, Shirato Hiroki, Fukuda Satoshi

  International Cancer Conference Journal Springer 1 (4) 215 - 219 2192-3183 2012/10 

  Squamous cell carcinoma of the nasal vestibule (SCC-NV) is rare among head and neck malignancies. It behaves differently from cancers arising in the nasal cavity and paranasal sinuses, and skin cancer of the external nose. Prognosis is more favorable than nasal cavity tumors and less favorable than skin cancers. We experienced two cases of SCC-NV who were treated with rapid superselective high-dose cisplatin infusion with concomitant radiotherapy (RADPLAT). A 56-year-old male and a 68-year-old female with SCC-NV, classified as T4aN0M0 according to UICC and T2 according to Wang classification, were given superselective intra-arterial infusions of cisplatin, with simultaneous intravenous infusions of thiosulfate to neutralizecisplatin toxicity, together with conventionalradiotherapy. In both cases, the internal maxillary artery and the facial artery were considered to be feeders of the tumor. No serious adverse events have been observed in either patient to date during follow-up of 7.3 and 5.3 years, respectively. Both patients are alive without disease and show excellent cosmetic results. RADPLAT is considered to be useful for the treatment of patients with SCC of the nasal vestibule.
• 早期舌癌におけるセンチネルリンパ節の領域分布に関する検討

  坂下 智博, 本間 明宏, 折舘 伸彦, 鈴木 清護, 畠山 博充, 加納 里志, 水町 貴諭, 福田 諭

  耳鼻咽喉科展望 耳鼻咽喉科展望会 55 (5) 364 - 368 0386-9687 2012/10 [Not refereed][Not invited]
   

  5mm以上の深部浸潤を認めるT1-2N0舌癌10例を対象に、センチネルリンパ節(SN)生検を施行し、同定されたSNの領域分布、潜在的リンパ節転移の領域分布を調査した。領域はHasegawaらの定めるLNDSGの分類に従った。採取したSNは、HE染色およびサイトケラチン抗体免疫染色を用いて病理学的に分析を行った。その結果、全例でSNが同定でき、6例(60%)に病理学的リンパ節転移を認めた。SNの同定部位については患側上頸部が最も多く、全例において同部位にSNを認め、4例(40%)に同部位のSN転移を認めた。健側頸部には2例(20%)にSNを認めたが、病理組織学的に転移は認めなかった。
• 当科で導入化学療法を施行した頭頸部局所進行扁平上皮癌症例の治療成績

  天野 虎次, 田口 純, 木下 一郎, 合田 智宏, 本間 理央, 竹内 啓, 清水 康, 安田 耕一, 土屋 和彦, 白土 博樹, 本間 明宏, 福田 諭, 秋田 弘俊

  日本癌治療学会誌 (一社)日本癌治療学会 47 (3) 2112 - 2112 0021-4671 2012/10 [Not refereed][Not invited]
  
• 再発/転移性頭頸部扁平上皮癌患者対象の化学療法併用によるcetuximabの第II相臨床試験

  長谷川 泰久, 吉野 孝之, 高橋 俊二, 門田 伸也, 小野澤 祐輔, 本間 明宏, 大上 研二, 藤井 正人, 田口 享秀, 太田 雅貴, 田原 信

  日本癌治療学会誌 (一社)日本癌治療学会 47 (3) 1378 - 1378 0021-4671 2012/10 [Not refereed][Not invited]
  
• 頭頸部癌化学放射線療法における経管栄養の役割に関する検討

  倉本 倫之介, 折舘 伸彦, 本間 明宏, 及川 敬太, 藤田 香, 鈴木 清護, 畠山 博充, 加納 里志, 水町 貴諭, 坂下 智博, 福田 諭

  嚥下医学 日本嚥下医学会 1 (2) 359 - 363 2186-3199 2012/10 [Not refereed][Not invited]
   

  頭頸部癌における化学放射線併用療法(CRT)では粘膜炎により経口摂取困難をきたすため、胃ろうを造設することも少なくない。胃ろうと栄養状態・完遂率との関連について北海道大学病院において平成18年6月から平成23年1月までの間にCRTを施行した声門上癌、中咽頭癌、下咽頭癌52例についてレトロスペクティブに検討した。胃ろう使用群は非使用群と比較して治療前からの体重、アルブミン値が有意に低下を認め、当科での現在の胃ろうの使用方法をより栄養状態を向上のため工夫する必要があると考えられた。また、胃ろう留置群は非留置群よりも有意にCRT完遂率が高く、胃ろう造設がCRT完遂に寄与していると考えられた。原発部位別に見ると、声門上癌・下咽頭癌では胃ろう造設はCRT完遂に寄与しており、中咽頭癌では胃ろうを留置してもCRT完遂率は十分ではなく、今後検討が必要と思われる。(著者抄録)
• Combined modality therapy for laryngeal cancer with superselective intra-arterial cisplatin infusion and concomitant radiotherapy

  Shigenari Taki, Akihiro Homma, Fumiyuki Suzuki, Nobuhiko Oridate, Hiromitsu Hatakeyama, Takatsugu Mizumachi, Satoshi Kano, Jun Furusawa, Tomohiro Sakashita, Naoya Inamura, Daisuke Yoshida, Rikiya Onimaru, Hiroki Shirato, Satoshi Fukuda

  INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY 17 (5) 441 - 446 1341-9625 2012/10 [Refereed][Not invited]
   

  Concomitant radiotherapy and superselective arterial infusion of cisplatin for laryngeal cancer has shown excellent therapeutic outcomes. It is expected to be a reasonable treatment option for laryngeal cancer, especially in locally advanced cases.
• Platinum concentration in sentinel lymph nodes after preoperative intra-arterial cisplatin chemotherapy targeting primary tongue cancer

  Tomohiro Sakashita, Akihiro Homma, Nobuhiko Oridate, Seigo Suzuki, Hiromitsu Hatakeyama, Satoshi Kano, Takatsugu Mizumachi, Daisuke Yoshida, Noriyuki Fujima, Satoshi Fukuda

  ACTA OTO-LARYNGOLOGICA 132 (10) 1121 - 1125 0001-6489 2012/10 [Refereed][Not invited]
   

  Conclusion: We conclude that intra-arterially injected cisplatin passed via lymph flow into sentinel nodes (SNs) as the platinum concentration in the SNs was higher than that in the non-sentinel nodes (NSNs). It is possible that preoperative intra-arterial chemotherapy targeting primary cancer also has a therapeutic effect on subclinical metastatic SNs. Objectives: Intra-arterial chemoradiotherapy has been reported to be effective against not only primary tumors but also nodal metastases. We considered the hypothesis that intra-arterially injected cisplatin passed via lymph flow into regional nodes. This study aimed to investigate intra-arterially injected cisplatin distribution to regional nodes by comparing platinum concentrations in SNs and NSNs. Methods: Five patients with T1-2 N0 tongue cancer were treated with preoperative intra-arterial chemotherapy (cisplatin, 100 mg/m(2)) targeting primary cancer. Partial glossectomy together with SN biopsy and elective neck dissection were performed 2 weeks after intra-arterial chemotherapy. Platinum concentrations in the lymph nodes were measured using a Zeeman atomic absorption spectrometer. Results: Thirteen SNs were harvested together with eight NSNs from the areas adjacent to the SNs. Platinum concentrations were then measured, revealing a significant difference in platinum concentration between the SNs and the NSNs (mean +/- SD, 0.682 +/- 0.246 mu g/g vs 0.506 +/- 0.274 mu g/g; p = 0.049).
• HPV陽性中咽頭癌の転移リンパ節の臨床像

  水町 貴諭, 加納 里志, 本間 明宏, 折舘 伸彦, 福田 諭

  口腔・咽頭科 日本口腔・咽頭科学会 25 (3) 295 - 295 0917-5105 2012/08 [Not refereed][Not invited]
  
• 【頭頸部扁平上皮癌の最新情報】 頭頸部扁平上皮癌に対する新しい治療戦略 化学療法 同時放射線治療と超選択的動注療法

  本間 明宏

  JOHNS (株)東京医学社 28 (8) 1181 - 1184 0910-6820 2012/08 [Not refereed][Not invited]
  
• 舌根癌における放射線同時併用超選択的動注化学療法

  加納 里志, 本間 明宏, 折舘 伸彦, 鈴木 章之, 畠山 博充, 水町 貴諭, 古沢 純, 坂下 智博, 吉田 大介, 鬼丸 力也, 白戸 博樹, 福田 諭

  北海道醫學雜誌 = Acta medica Hokkaidonensia 87 (4) 208 - 208 0367-6102 2012/08/01 [Not refereed][Not invited]
  
• PET-CT検査にてはじめて原因が特定しえた喉頭麻痺の2症例

  折舘 伸彦, 溝口 兼司, 加納 里志, 本間 明宏, 福田 諭

  耳鼻咽喉科臨床 補冊 耳鼻咽喉科臨床学会 (補冊133) 110 - 110 0912-1870 2012/07 [Not refereed][Not invited]
  
• 大量シスプラチンの超選択的動注療法と照射の同時併用療法の現状

  本間 明宏

  頭頸部外科 (NPO)日本頭頸部外科学会 22 (1) 29 - 31 1349-581X 2012/06 [Not refereed][Not invited]
   

  Robbinsが開発した大量シスプラチンの超選択的動注療法と照射の同時併用療法(RADPLAT)は、日本では多くの施設で行われている。しかし、オランダの比較試験で、静注のシスプラチンと照射の併用療法と比較し、RADPLATの有用性は示されなかった。通常の照射と静注の化学療法の併用療法も良好な成績が得られているため、動注のメリットを生かせる症例に適応を絞っていくこと、確実な動注を行うことが必要である。今後はRADPLATが有用な部位と予想される上顎洞などの腫瘍に対して、前向きの試験を行い動注が本当に有用であるかどうかを検討していかなくてはならない。(著者抄録)
• Evaluation of nodal response after intra-arterial chemoradiation for node-positive head and neck cancer

  Tomohiro Sakashita, Akihiro Homma, Nobuhiko Oridate, Hiromitsu Hatakeyama, Satoshi Kano, Takatsugu Mizumachi, Satoshi Fukuda

  EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY 269 (6) 1671 - 1676 0937-4477 2012/06 [Refereed][Not invited]
   

  This retrospective study aimed to compare the accuracy of two nodal evaluation criteria using computed tomography after intra-arterial chemoradiation in node-positive head and neck squamous cell carcinomas. Computed tomography was used to evaluate radiographic nodal response 4-8 weeks after intra-arterial chemoradiation. We compared the accuracy of two different criteria: criterion 1 (radiographic complete response was recorded in the absence of focal abnormalities and if the maximum diameter of the metastatic node was less than 15 mm), and criterion 2 (radiographic complete response was recorded in the absence of focal abnormalities and if the minimum diameter of metastatic nodes was less than 7 mm in level II and if the minimum diameter of metastatic nodes in the rest of the neck was less than 6 mm). Positive predictive values were criterion 1: 69.2%, criterion 2: 47.8%; negative predictive values were criterion 1: 88.5%, criterion 2: 90.5%. Positive likelihood ratios were criterion 1: 7.50, criterion 2: 3.06. The difference between each criteria was statistically significant using McNemar's test ( = 0.0016). Computed tomography evaluation accuracy of nodal response after intra-arterial chemoradiation was comparable to recent reports, and it was feasible to perform salvage neck dissection by computed tomography evaluation for nodal response. We recommend using criterion 1 because of its simplicity and reliability.
• 進行上顎洞癌症例の多施設による後ろ向き観察研究

  本間 明宏, 林 隆一, 松浦 一登, 加藤 健吾, 川端 一嘉, 門田 伸也, 長谷川 泰久, 鬼塚 哲郎, 藤本 保志, 藤井 正人

  頭頸部癌 (一社)日本頭頸部癌学会 38 (2) 245 - 245 1349-5747 2012/05 [Not refereed][Not invited]
  
• 頭頸部癌化学放射線療法における経管栄養の役割に関する検討

  折舘 伸彦, 倉本 倫之介, 本間 明宏, 鈴木 清護, 畠山 博充, 加納 里志, 水町 貴諭, 坂下 智博, 及川 敬太, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 38 (2) 210 - 210 1349-5747 2012/05 [Not refereed][Not invited]
  
• 中咽頭癌に対する治療の現状(第2報) 多施設による後ろ向き観察研究

  林 隆一, 川端 一嘉, 吉野 邦俊, 岩江 信法, 長谷川 泰久, 加納 里志, 丹生 健一, 加藤 孝邦, 志賀 清人, 本間 明宏, 藤井 正人

  頭頸部癌 (一社)日本頭頸部癌学会 38 (2) 205 - 205 1349-5747 2012/05 [Not refereed][Not invited]
  
• 頭頸部扁平上皮癌根治切除症例の切除断端における免疫組織学的予後因子の検討

  坂下 智博, 折舘 伸彦, 本間 明宏, 鈴木 清護, 畠山 博充, 加納 里志, 水町 貴諭, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 38 (2) 182 - 182 1349-5747 2012/05 [Not refereed][Not invited]
  
• 原発不明頸部リンパ節転移におけるp16とヒト乳頭腫ウイルスの解析

  加納 里志, 折舘 伸彦, 本間 明宏, 鈴木 清護, 畠山 博充, 水町 貴諭, 坂下 智博, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 38 (2) 162 - 162 1349-5747 2012/05 [Not refereed][Not invited]
  
• 中咽頭扁平上皮癌症例におけるHPV感染とp16の発現に関する検討

  水町 貴諭, 鈴木 清護, 畠山 博充, 加納 里志, 坂下 智博, 本間 明宏, 折舘 伸彦, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 38 (2) 161 - 161 1349-5747 2012/05 [Not refereed][Not invited]
  
• Phase II trial of chemoradiotherapy concurrent with S-1 plus cisplatin in patients with unresectable, locally advanced squamous cell carcinoma of the head and neck (SCCHN): Results of the Japan Clinical Oncology Group study, JCOG 0706

  Makoto Tahara, Naomi Kiyota, Junki Mizusawa, Kenichi Nakamura, Ryuichi Hayashi, Tetsuo Akimoto, Yasuhisa Hasegawa, Shigemichi Iwae, Nobuya Monden, Kazuto Matsuura, Hirofumi Fujii, Yusuke Onozawa, Akihiro Homma, Akira Kubota, Haruhiko Fukuda, Masato Fujii

  JOURNAL OF CLINICAL ONCOLOGY 30 (15) 0732-183X 2012/05 [Not refereed][Not invited]
  
• Weekly CDDP同時併用放射線療法後の頸部郭清・頸部制御率

  坂下 智博, 本間 明宏, 折舘 伸彦, 鈴木 清護, 畠山 博充, 加納 里志, 水町 貴諭, 福田 諭

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 115 (4) 519 - 519 0030-6622 2012/04 [Not refereed][Not invited]
  
• 女性喉頭癌症例におけるHPV感染の検討

  水町 貴諭, 加納 里志, 畠山 博充, 坂下 智博, 鈴木 清護, 本間 明宏, 折舘 伸彦, 福田 諭

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 115 (4) 466 - 466 0030-6622 2012/04 [Not refereed][Not invited]
  
• 中咽頭癌に対する治療の現状 多施設による後ろ向き観察研究

  本間 明宏, 林 隆一, 川端 一喜, 吉野 邦俊, 岩江 信法, 長谷川 泰久, 丹生 健一, 加藤 孝邦, 志賀 清人, 松浦 一登, 門田 信也, 藤井 正人

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 115 (4) 458 - 458 0030-6622 2012/04 [Not refereed][Not invited]
  
• 【最新の診療NAVI 日常診療必携】 腫瘍性疾患診療NAVI 鼻副鼻腔腫瘍

  本間 明宏

  耳鼻咽喉科・頭頸部外科 (株)医学書院 84 (5) 249 - 253 0914-3491 2012/04 [Not refereed][Not invited]
  
• 上咽頭癌再発症例に対する再照射例の検討

  鬼丸 力也, 安田 耕一, 西川 昇, 米山 理奈, 白土 博樹, 本間 明宏, 折舘 伸彦, 福田 諭

  Japanese Journal of Radiology (公社)日本医学放射線学会 30 (Suppl.I) 5 - 5 1867-1071 2012/02 [Not refereed][Not invited]
  
• 舌根部癌に対する喉頭機能温存治療 中咽頭前壁原発扁平上皮癌に対する超選択的動注化学療法と照射の同時併用療法

  本間 明宏, 坂下 智博, 折舘 伸彦, 鈴木 清護, 畠山 博充, 加納 里志, 水町 貴諭, 福田 諭

  日本気管食道科学会会報 (NPO)日本気管食道科学会 63 (1) 77 - 78 0029-0645 2012/02 [Not refereed][Not invited]
  
• Two Cases of Effective Combined Treatment with a Histamine H₁ Receptor Antagonist and Perospirone for Intractable Nausea and Vertigo Induced by Opioid Treatment

  Osada Takayuki, Sakashita Tomohiro, Oridate Nobuhiko, Homma Akihiro, Fukuda Satoshi, Sugawara Mitsuru, Iseki Ken, Shibayama Yoshihiko, Kumai Masayoshi, Yamada Takehiro, Kasashi Kumiko, Kuramoto Rinnosuke, Sunosaki Shingo, Akazawa Shigeru, Maeda Hiroyuki

  Iryo Yakugaku (Japanese Journal of Pharmaceutical Health Care and Sciences) 一般社団法人日本医療薬学会 38 (1) 51 - 55 1346-342X 2012 [Not refereed][Not invited]
   

  Intractable nausea and vertigo induced by opioid treatment are occasionally difficult to treat. It has been reported that antiemetic drugs and opioid rotation may be effective in treating nausea in such cases; however, this approach has been occasionally ineffective. Symptomatic treatment has not been developed for vertigo induced by opioid treatment. Here, we report a case study where combined treatment with perospirone and a histamine H₁ receptor antagonist was used in 2 patients who developed intractable nausea and vertigo induced by opioid treatment. Treatment with a histamine H₁ receptor antagonist drug (tablet form, containing 40 mg diphenhydramine salicylate and 26 mg diprophylline) suppressed the nausea and vertigo. However, increasing the opioid dosage exacerbated the symptoms, and treatment involving the histamine H₁ receptor antagonist and opioid rotation was ineffective. Subsequently, combination treatment with the histamine H₁ receptor antagonist (3 tablets per day) and perospirone (maximum daily dose, 16 mg) improved the symptoms. The results of the present study suggest that combination treatment with a histamine H₁ receptor antagonist and perospirone might improve intractable nausea and vertigo induced by opioid treatment.
• 骨固定型ピックアップを用いた食道発声支援装置用骨伝導マイクロホンの開発 非経皮的骨導音導出に関する予備的検討

  前田 秀彦, 西澤 典子, 武市 紀人, 本間 明宏, 玉重 詠子, 目須田 康, 葛西 聡子, 折舘 伸彦, 福田 諭

  音声言語医学 日本音声言語医学会 53 (1) 84 - 85 0030-2813 2012/01 [Not refereed][Not invited]
  
• 当院で施行した頭頚部局所進行扁平上皮癌に対するDCF(docetaxel,cisplatin,5‐FU)導入化学療法の検討

  田口純, 天野虎次, 木下一郎, 合田智宏, 本間理央, 竹内啓, 清水康, 安田耕一, 土屋和彦, 鬼丸力也, 本間明宏, 福田諭, 秋田弘俊

  日本臨床腫瘍学会学術集会プログラム・抄録集 10th 179 - 180 2012 [Not refereed][Not invited]
  
• Otolaryngologic Manifestations of Antineutrophil Cytoplasmic Antibody-Associated Vasculitis

  Yuji Nakamaru, Dai Takagi, Nobuhiko Oridate, Akihiro Homma, Satoshi Fukuda

  OTOLARYNGOLOGY-HEAD AND NECK SURGERY 146 (1) 119 - 121 0194-5998 2012/01 [Refereed][Not invited]
   

  Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis is characterized by systemic necrotizing vasculitis, and patients fall into 2 groups: those with proteinase 3-ANCA and those with myeloperoxidase-ANCA. As infections are a trigger of ANCA-associated vasculitis, this disease tends to localize in areas around the upper airway. In this study, the authors compared ear and nasal symptoms between patients with proteinase 3-ANCA and those with myeloperoxidase-ANCA. We undertook a retrospective case series study of 34 patients diagnosed with ANCA-associated vasculitis. The otologic symptoms were divided into 3 types: chronic otitis media, secretory otitis media, and sensorineural hearing loss. Chronic otitis media was more common in patients with proteinase 3-ANCA (P=.001), whereas secretory otitis media was more frequently found in patients with myeloperoxidase-ANCA (P=.007). Crust formation (P=.001), saddle nose (P=.024), and sinusitis (P=.001) were more common in patients with proteinase 3-ANCA than in those with myeloperoxidase-ANCA. Marked differences were observed in the disease spectrum between the 2 ANCA groups.
• [Hearing loss of aging].

  Homma A, Takeichi N, Tsubuku T, Obara N

  [Hokkaido igaku zasshi] The Hokkaido journal of medical science 87 (1) 7 - 9 0367-6102 2012/01 [Refereed][Not invited]
  
• Multicenter phase II study of an opioid-based pain control program for head and neck cancer patients receiving chemoradiotherapy

  Sadamoto Zenda, Kazuto Matsuura, Hiroyuki Tachibana, Akihiro Homma, Tadaaki Kirita, Nobuya Monden, Shigemichi Iwae, Yojiro Ota, Tetsuo Akimoto, Hiroshi Otsuru, Makoto Tahara, Kengo Kato, Masao Asai

  RADIOTHERAPY AND ONCOLOGY 101 (3) 410 - 414 0167-8140 2011/12 [Refereed][Not invited]
   

  Background: The aim of this multi-center phase II study was to clarify the clinical benefit of an opioid-based pain control program for head and neck cancer patients during chemoradiotherapy. Patients and methods: Head and neck cancer patients who were to receive definitive or postoperative chemoradiotherapy were enrolled. The opioid-based pain control program consisted of a three-step ladder, with basic regimens of: Step 1: acetaminophen at 500-1000 mg three times a day. Step 2: fast-acting morphine at 5 mg three times a day before meals for a single day. Step 3: long-acting morphine administered around-the-clock, with a starting dosage of 20 mg/day and no upper limit set in principle. Patients and methods: The primary endpoint of this study was compliance with radiotherapy. Results: A total of 101 patients from 10 institutions were registered between February 2008 and May 2009 and included in the analysis. The major combination chemotherapy regimen was cisplatin alone (76%). The rate of completion of radiotherapy was 99% and the rate of unplanned breaks in radiotherapy was 13% (13/101, 90% confidence interval: 9.9-16.5%). Median maximum quantity of morphine used per day was 35 mg (range 0-150 mg). Conclusions: Use of a systematic pain control program may improve compliance with CRT. (C) 2011 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 101 (2011) 410-414
• 頭頸部がん治療update 頭頸部癌治療における超選択的動注の役割

  福田 諭, 本間 明宏

  日本医学会総会会誌 日本医学会 28回 (I) 298 - 298 2011/10 [Not refereed][Not invited]
  
• WEERDA型拡張式ビデオ喉頭鏡を用いた経口的喉頭・咽頭手術

  折舘 伸彦, 本間 明宏, 中丸 裕爾, 鈴木 清護, 福田 諭

  耳鼻咽喉科展望 耳鼻咽喉科展望会 54 (5) 355 - 359 0386-9687 2011/10 [Not refereed][Not invited]
  
• 唾液導管癌におけるHER2の発現解析

  鈴木 崇祥, 加納 里志, 折舘 伸彦, 本間 明宏, 鈴木 清護, 畠山 博充, 水町 貴諭, 古沢 純, 坂下 智博, 福田 諭

  頭頸部外科 (NPO)日本頭頸部外科学会 21 (2) 195 - 201 1349-581X 2011/10 [Not refereed][Not invited]
   

  唾液導管癌は乳癌に類似する予後不良な悪性腫瘍である。近年乳癌と同様に唾液導管癌においてもHER2の発現が報告されているため、今回われわれは手術標本を用いて免疫染色を行いHER2の発現を解析し臨床背景と検討した。その結果、唾液導管癌5例中HER2陽性例は3例であった。病理組織別のHER2陽性率は唾液導管癌で60%、腺様嚢胞癌で0%、粘表皮癌で17%、腺癌で38%であった。また病理学的悪性度による比較ではHER2陽性例は全て高悪性度群に、HER2陰性例は全て低悪性度群に属しHER2の過剰発現と病理学的悪性度との関連が示唆された。HER2陽性唾液導管癌に対する抗HER2抗体を用いた治療法の開発が強く望まれる。(著者抄録)
• 放射線療法の進歩と将来展望 放射線治療におけるPositron emission tomography(PET)検査の利用

  鬼丸 力也, 安田 耕一, 加藤 徳男, 白土 博樹, 志賀 哲, 岡本 祥三, 玉木 長良, 本間 明宏, 折舘 伸彦, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 37 (3) 376 - 380 1349-5747 2011/10 [Not refereed][Not invited]
   

  陽電子放射断層撮影(Positron emission tomography、PET)検査では機能・代謝情報を得ることができる。PETによる低酸素イメージングで得られた情報を放射線治療に応用し、放射線抵抗性を示す腫瘍内の低酸素領域への線量増加をしようという試みも報告されている。北海道大学病院では、核医学診療科が中心となってdetectorに半導体を用いたPETを開発し、臨床に用いている。また、[18F]fluoromisonidazole(FMISO)PETによる低酸素イメージングも行われており、それを用いた強度変調放射線治療(Intensity modulated radiation therapy、IMRT)を用いた線量増加についても検討を始めている。本シンポジウムでは、北海道大学病院での放射線治療におけるPETの利用について、上記の項目を中心に発表する。(著者抄録)
• 骨固定型ピックアップによる非経皮的骨導音の検出 周波数特性に関する予備的検討

  前田 秀彦, 西澤 典子, 武市 紀人, 本間 明宏, 玉重 詠子, 葛西 聡子, 前田 昌紀, 中津 政典, 大橋 正實, 福田 諭

  Audiology Japan 日本聴覚医学会 54 (5) 615 - 616 0303-8106 2011/09/30 [Not refereed][Not invited]
  
• HPV感染による中咽頭癌治療の層別化戦略

  水町 貴諭, 加納 里志, 本間 明宏, 折舘 伸彦, 福田 諭

  口腔・咽頭科 日本口腔・咽頭科学会 24 (3) 353 - 353 0917-5105 2011/08 [Not refereed][Not invited]
  
• 機能温存をめざした下咽頭癌の治療 下咽頭癌に対する超選択的動注化学療法と照射の同時併用療法の有用性

  本間 明宏, 加納 里志, 水町 貴諭, 福田 諭

  口腔・咽頭科 日本口腔・咽頭科学会 24 (3) 229 - 229 0917-5105 2011/08 [Not refereed][Not invited]
  
• Concomitant Weekly Cisplatin and Radiotherapy for Head and Neck Cancer

  Akihiro Homma, Naoya Inamura, Nobuhiko Oridate, Seigo Suzuki, Hiromitsu Hatakeyama, Takatsugu Mizumachi, Satoshi Kano, Tomohiro Sakashita, Rikiya Onimaru, Koichi Yasuda, Hiroki Shirato, Satoshi Fukuda

  JAPANESE JOURNAL OF CLINICAL ONCOLOGY 41 (8) 980 - 986 0368-2811 2011/08 [Refereed][Not invited]
   

  Objective: The most common chemoradiotherapy regimen is high-dose (100 mg/m(2)) three-weekly cisplatin with concomitant radiotherapy; however, this protocol is associated with acute and late toxicities. Here, we reviewed the dose intensity and toxicity for concomitant weekly cisplatin and radiotherapy in patients with head and neck cancer. Methods: Fifty-three patients with untreated head and neck cancer were enrolled and evaluated at our institution from April 2006 to April 2010. Weekly cisplatin (40 mg/m(2)) was given on weeks 1, 2, 3, 5, 6 and 7 with radiotherapy, which comprised a standard dose of 70 Gy delivered in 35 daily fractions over 7 weeks. Results: Fifty-one patients (96.2%) received the full dose of radiotherapy, while the course was disrupted by adverse events in two. Over the course of the chemotherapy, 31 patients (58.5%) received more than 200 mg/m(2) cisplatin. The toxicity was manageable in all except one patient, who died of sepsis after completing treatment. The 2-year overall survival rate and local progression-free rate for all patients were 93.7% and 88.0%, respectively. The primary site showed a complete response in 52 patients (98.1%) and a partial response in 1 patient (1.9%). The primary disease was well controlled by chemoradiotherapy in 47 patients (88.7%). Conclusions: Weekly cisplatin could be easier to manage than three-weekly cisplatin, because patients can be monitored more regularly for toxicity allowing the schedule to be altered if required. This regimen appears to be a suitable alternative to three-weekly high-dose cisplatin with concomitant radiotherapy.
• 【頭頸部癌診療の今】 化学療法 超選択的動注療法

  福田 諭, 本間 明宏

  Pharma Medica (株)メディカルレビュー社 29 (7) 35 - 38 0289-5803 2011/07 [Not refereed][Not invited]
  
• Superselective arterial cisplatin infusion with concomitant radiation therapy for base of tongue cancer

  Satoshi Kano, Akihiro Homma, Nobuhiko Oridate, Fumiyuki Suzuki, Hiromitsu Hatakeyama, Takatsugu Mizumachi, Jun Furusawa, Tomohiro Sakashita, Daisuke Yoshida, Rikiya Onimaru, Hiroki Shirato, Satoshi Fukuda

  ORAL ONCOLOGY 47 (7) 665 - 670 1368-8375 2011/07 [Refereed][Not invited]
   

  The treatment of base of tongue (BOT) cancer is highly controversial with differing options according to individual institutions, or the primary surgical or radiation therapy bias. We aimed to determine patient outcomes and discuss technical aspects following treatment with concurrent radiation therapy and targeted cisplatin chemotherapy (RADPLAT). We utilized RADPLAT for the definitive treatment of patients with BOT cancers. The 5-year local control and overall survival rate was 92.3% and 90.9% for all patients, respectively, and all surviving patients achieved normal swallowing without a feeding-tube and normal speech without tracheostoma after treatment. Our study found that RADPLAT gave excellent survival rates and organ functions for patients with BOT cancers. We consider that BOT cancer is a good indication for RADPLAT and that the angiographic technique and patient selection are keys to success. (C) 2011 Elsevier Ltd. All rights reserved.
• 私たちが行っている化学放射線療法後の救済手術における皮膚切開デザインの工夫

  本間 明宏, 折舘 伸彦, 鈴木 章之, 鈴木 清護, 原 敏浩, 真栄田 裕行, 水町 貴諭, 稲村 直哉, 福田 諭

  頭頸部外科 (NPO)日本頭頸部外科学会 21 (1) 103 - 106 1349-581X 2011/06 [Not refereed][Not invited]
   

  化学放射線療法後の救済手術においては皮膚切開のデザインは、特別な配慮が必要である。われわれの救済手術を行う際の皮膚切開のデザインの基本的なコンセプトは以下のとおりである。(1)胸部の皮膚を上方に進展して利用できるようなデザインにする。(2)皮膚縫合線が再建組織の上にのるようにする。(3)必ずしも3ポイントは禁忌ではない。ただし、それぞれの皮弁先端の血流が維持されるように、かつ、再建組織の上に3ポイントがくるようにする。術後合併症を避けるためには、手術中の手技のみならず、皮膚切開のデザインなどの手術の戦略も同様に重要である。(著者抄録)
• 高齢、併存疾患と頭頸部癌治療

  本間 明宏

  耳鼻咽喉科臨床 耳鼻咽喉科臨床学会 104 (6) 460 - 461 0032-6313 2011/06 [Not refereed][Not invited]
  
• 【頭頸部悪性腫瘍の初期症状とその対応】 嗄声・呼吸困難・誤嚥

  本間 明宏, 鈴木 崇祥

  ENTONI (株)全日本病院出版会 (128) 8 - 13 1346-2067 2011/06 [Not refereed][Not invited]
   

  頭頸部悪性腫瘍の初期症状としての嗄声・呼吸困難を中心に、診察の進め方、対応について解説した。嗄声については、問診・診察の際には、癌を常に念頭に置きながら進めていくことが大切である。癌を疑う場合には、ファイバースコープでじっくりと十分に観察する。初期の癌の可能性を完全には否定できない場合には、時間をあけて定期的に診察するのが望ましい。喫煙は、癌を含め嗄声の原因となっていることが多く、生活指導も重要である。声帯麻痺は、頭頸部領域のみならず、肺癌、食道癌、縦隔腫瘍、胸部大動脈瘤など胸部疾患が原因であることも多く、胸部を含めた精査をしなくてはならない。呼吸困難については、様々な要素を考慮しながら気管切開を行うか否か、いつ行うかを判断することが求められる。(著者抄録)
• 唾液腺悪性腫瘍におけるEGFR、HER2、c-KITの発現解析

  加納 里志, 鈴木 清護, 折舘 伸彦, 本間 明宏, 畠山 博充, 水町 貴諭, 坂下 智博, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 37 (2) 270 - 270 1349-5747 2011/05 [Not refereed][Not invited]
  
• 頭頸部進行癌に対する集学的治療 "導入化学療法→化学放射線同時併用療法"

  本間 明宏, 清水 康, 折舘 伸彦, 鬼丸 力也, 鈴木 清護, 畠山 博充, 加納 里志, 水町 貴諭, 坂下 智博, 安田 耕一, 秋田 弘俊, 白土 博樹, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 37 (2) 233 - 233 1349-5747 2011/05 [Not refereed][Not invited]
  
• 頭頸部扁平上皮癌N+症例における放射線動注化学療法後の頸部評価 Wait and See Policyは成立するか

  坂下 智博, 本間 明宏, 折舘 伸彦, 鈴木 清護, 畠山 博充, 加納 里志, 水町 貴諭, 古沢 純, 稲村 直哉, 福田 諭, 吉田 大介, 鬼丸 力也, 安田 耕一, 白土 博樹

  頭頸部癌 (一社)日本頭頸部癌学会 37 (2) 231 - 231 1349-5747 2011/05 [Not refereed][Not invited]
  
• 頭頸部癌におけるNF-kBパスウエイの活性化とセツキシマブ耐性

  畠山 博充, 鈴木 清護, 坂下 智博, 加納 里志, 水町 貴諭, 本間 明宏, 折舘 伸彦, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 37 (2) 230 - 230 1349-5747 2011/05 [Not refereed][Not invited]
  
• 個別化を目指す薬物療法 HPV陽性中咽頭癌に対する個別化治療戦略

  水町 貴諭, 畠山 博充, 加納 里志, 坂下 智博, 鈴木 清護, 本間 明宏, 折舘 伸彦, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 37 (2) 191 - 191 1349-5747 2011/05 [Not refereed][Not invited]
  
• 放射線治療の進歩と将来展望 放射線治療におけるPETの利用

  鬼丸 力也, 安田 耕一, 加藤 徳男, 白土 博樹, 志賀 哲, 玉木 長良, 本間 明宏, 折舘 伸彦, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 37 (2) 185 - 185 1349-5747 2011/05 [Not refereed][Not invited]
  
• 頭頸部癌患者を支えるチーム医療 大学病院での頭頸部がん治療における口腔ケアの取り組みについて

  秦 浩信, 山崎 裕, 佐藤 淳, 村田 翼, 村井 知佳, 今待 賢治, 本間 明宏, 北川 善政

  頭頸部癌 (一社)日本頭頸部癌学会 37 (2) 181 - 181 1349-5747 2011/05 [Not refereed][Not invited]
  
• 鼻副鼻腔腫瘍治療戦略の新しい可能性を探る 鼻副鼻腔悪性腫瘍に対する超選択的動注療法

  本間 明宏, 水町 貴諭, 原 敏浩, 福田 諭

  日本鼻科学会会誌 (一社)日本鼻科学会 50 (1) 92 - 94 0910-9153 2011/04 [Not refereed][Not invited]
  
• 喉頭癌T1症例の検討

  中薗 彬, 折舘 伸彦, 本間 明宏, 坂下 智博, 鬼丸 力也, 福田 諭

  日本気管食道科学会会報 (NPO)日本気管食道科学会 62 (2) 261 - 262 0029-0645 2011/04 [Not refereed][Not invited]
  
• 頭頸部癌セツキシマブ耐性獲得におけるEGFRリガンドの発現とmicroRNA制御

  畠山 博充, 本間 明宏, 折舘 伸彦, 福田 諭

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 114 (4) 356 - 356 0030-6622 2011/04 [Not refereed][Not invited]
  
• 【ここまで変わった頸部郭清術】 外科的治療以外で頸部リンパ節はどこまで制御できるか 超選択的動注化学療法

  本間 明宏, 坂下 智博, 福田 諭

  JOHNS (株)東京医学社 27 (2) 229 - 233 0910-6820 2011/02 [Not refereed][Not invited]
   

  頸部リンパ節転移を認めた頭頸部癌に対し、大量シスプラチン動注と照射の同時併用療法(RADPLAT)を施行した65例(男59例・女6例・平均58.3歳)の治療成績を検討した。N分類はN1:15例、N2b:35例、N2c:13例、N3:2例であった。Kaplan-Meier法による5年粗生存率は61.6%、RADPLATのみによる5年頸部制御率は75.3%であった。RADPLATによる5年頸部制御率をN分類別にみるとN1:80%、N2b:72.1%、N2c:83.9%、N3:50%で、また、リンパ節転移へ動注を行った33例の頸部制御率は72.3%、行わなかった32例は78.1%であった。その後の救済手術を含めた最終的な頸部制御率は87.1%であった。RADPLAT後、リンパ節の残存が疑われ早期に頸部郭清術(ND)を行ったのは7例、再増大がありNDを行ったのが11例で、頸部制御率はそれぞれ100%、44.4%、5年粗生存率は100%、17.7%で有意差を認めた。ND後に重篤な合併症は認めなかったが、再増大によるND施行群でリンパ漏と創部感染を各1例認めた。
• 喉頭摘出後の音声リハビリテーションに関する実態調査 医療現場と喉摘者福祉団体との比較

  前田 秀彦, 西澤 典子, 目須田 康, 苅安 誠, 本間 明宏, 折舘 伸彦, 葛西 聡子, 大橋 正實, 福田 諭

  音声言語医学 日本音声言語医学会 52 (1) 79 - 79 0030-2813 2011/01 [Not refereed][Not invited]
  
• Clinical analysis of malignant submandibular tumor

  Kyoko Kitao, Akihiro Homma, Nobuhiko Oridate, Seigo Suzuki, Fumiyuki Suzuki, Toshihiro Hara, Satoshi Káno, Takatsugu Mizumachi, Shigenari Taki, Naoya Inamura, Satoshi Fukud

  Journal of Otolaryngology of Japan (一社)日本耳鼻咽喉科学会 114 (3) 126 - 132 0030-6622 2011 [Not refereed][Not invited]
   

  The 14 cases of malignant submandibular tumor whose treatment outcome we analyzed between 1989 and 2008 uncluded 5 of adenoid cystic carcinoma, 3 of squamous cell carcinoma, 2 each of mucoepidermoid carcinoma, and carcinoma ex pleomorphic adenoma, and 1 each of carcinosarcoma and large-cell carcinoma. One subject was diagnosed with T1, 7 with T2, 4 with T3, and 2 with T4. Lymph node involvement occurred in 5, -1 with N1 and 4 with N2. None had distant metastasis on the first visit. Seven were treated by surgery alone, 3 by surgery followed by radiotherapy, 2 by surgery followed by radio-and chemotherapy, and 1 by optimized supportive care. The surgical resection area was decided by tumor extension. Neck dissection was done in 9. Overall 5-year survival for all cases based on the Kaplan-Meier method was 57%. All with carcinoma ex pleomorphic adenoma, carcinosarcoma, or large-cell carcinoma remain alive. For those with adenoid cystic carcinoma 5-year survival is 80%, with mucoepidermoid carcinoma 50%, with squamous cell carcinoma 0%, and with carcinosarcoma 0%, respectively. The 5-year survival for stage I subjects was 100%, for stage II 83%, for stage III 50%, and for stage IV 0%. Surgical resection and postoperative radiotherapy were done in cases of minimal extraglandular extension or microscopically positive margins, with satisfactory results. Treatment efficacy for high-grade and advanced stage, however, requires more inprovement.
• An opioid-based pain control program for head and neck cancer patients undergoing chemoradiation therapy achieves a high completion rate of radiation

  Kengo Kato, Kazuto Matsuura, Sadamoto Zenda, Hiroyuki Tachibana, Akihiro Homma, Tadaaki Kirita, Nobuya Monden, Yojiro Ota, Shigemichi Iwae, Hiroshi Otsuru, Tetsuo Akimoto, Makoto Tahara, Masao Asai

  Japanese Journal of Head and Neck Cancer (一社)日本頭頸部癌学会 37 (1) 153 - 157 1349-5747 2011 [Not refereed][Not invited]
   

  Background: Appropriate supportive care is essential for intensive chemoradiation therapy (CRT), and pain management is an important supportive care for CRT for head and neck cancer. We developed an opioid-based pain control program for head and neck cancer patients undergoing CRT, and assessed its efficacy and safety. Objective and Method: 110 head and neck cancer patients undergoing platinum-based concomitant CRT were enrolled from 10 cancer centers or university hospitals. Their pain caused by CRT was managed with a four-step opioid-based pain control program, and adverse events and usage of opioid were analyzed. Results: 101 suitable cases of 110 patients were analyzed. 53% of cases suffered grade 3-4 mucositis. The rate of completion of radiotherapy was 99% and the rate of unplanned breaks in radiotherapy was 13%. The usage rate of opioid was 83% and the rate of compliance with the pain control program was 92%. The median maximum quantity of morphine used per day was 35 mg. No patient had to stop the opioid program or radiotherapy due to adverse effects of opioids. Conclusion: An opioid-based pain control program for head and neck cancer patients undergoing CRT achieves a high completion rate of radiation.
• Strategy for personalized treatment of human papillomavirus-positive oropharyngeal squamous cell carcinoma

  Takatsugu Mizumachi, Hiromitsu Hatakeyama, Satoshi Kano, Tomohiro Sakashita, Seigo Suzuki, Akihiro Homma, Nobuhiko Oridate, Satoshi Fukuda

  Japanese Journal of Head and Neck Cancer (一社)日本頭頸部癌学会 37 (3) 394 - 397 1349-5747 2011 [Not refereed][Not invited]
   

  We performed a retrospective analysis of the association between tumor HPV status and the demographic and clinicopathological parameters of 83 patients with oropharyngeal squamous cell carcinoma at Hokkaido University Hospital, Japan, between 1998 and 2010. The parameters included age, gender, tumor subsite, Tumor-Node-Metastasis (TNM) stage, and overall survival. HPV status was established by multiplex polymerase chain reaction analysis. Of the 83 oropharyngeal cancers, 22 were positive for HPV-16, two for HPV-18, and one for HPV-35 and HPV-58. Kaplan-Meier survival analysis showed improved overall survival rates in patients with HPV-positive tumors (p = 0.0024) compared with HPV-negative tumors. Of the 51 patients who received chemoradiotherapy, HPV-positive patients experienced better overall survival than HPV-negative patients (p = 0.0024). HPV status is a significantly favorable prognostic factor in oropharyngeal cancer in Japan.
• Oral care for patients with head and neck cancer in Hokkaido University Hospital

  Hironobu Hata, Yutaka Yamazaki, Kenji Imamachi, Chika Murai, Jun Sato, Takathugu Mizumachi, Satoshi Kanou, Akihiro Honma, Satoshi Fukuda, Yoshimasa Kitagawa

  Japanese Journal of Head and Neck Cancer (一社)日本頭頸部癌学会 37 (4) 486 - 493 1349-5747 2011 [Not refereed][Not invited]
   

  We have been providing oral care for patients with head and neck cancer in Hokkaido University Hospital since 2007. In this paper, we report clinical statistics of the 254 head and neck cancer patients who received oral care. About 80 percent of these patients were treated with radiation therapy, so it is important to cope with adverse events related to such therapy. Oral care is helpful for cancer patients when it is started as soon as possible (at least 1 week before radiation therapy is started). The percentage of patients who could start oral care 4 days before radiation therapy gradually increased to about 60 percent by fiscal 2009. In fiscal 2010, the percentage decreased to its lowest level of 37.9 percent. To start oral care for all patients 7 days before irradiation, we are going to change our system and start oral care in the outpatient period. In their hometowns, oral care was continued for only 19 (27.0 percent) of the 74 patients who could not visit our hospital. An important task for our project is to establish a medical cooperation system for discharged patients treated for head and neck cancer.
• Human Papillomavirus Frequency in Oropharyngeal Squamous Cell Carcinoma in Japan

  Takatsugu Mizumachi, Satoshi Kano, Naoya Inamura, Toshihiro Hara, Fumiyuki Suzuki, Seigo Suzuki, Akihiro Homma, Nobuhiko Oridate, Satoshi Fukuda

  RECENT ADVANCES IN TONSILS AND MUCOSAL BARRIERS OF THE UPPER AIRWAYS 72 208 - 208 0065-3071 2011 [Not refereed][Not invited]
  
• Radiotherapy for glottic T1N0 carcinoma with slight hypofractionation and standard overall treatment time: importance of overall treatment time.

  Onimaru R, Hasegawa M, Yasuda K, Homma A, Oridate N, Fukuda S, Shirato H

  Jpn J Clin Oncol 41 (1) 103 - 9 1465-3621 2011 [Refereed][Not invited]
  
• Concomitant weekly cisplatin and radiotherapy for head and neck cancer.

  Homma A, Inamura N, Oridate N, Suzuki S, Hatakeyama H, Mizumachi T, Kano S, Sakashita T, Onimaru R, Yasuda K, Shirato H, Fukuda S

  Jpn J Clin Oncol 41 (8) 980 - 6 1465-3621 2011 [Refereed][Not invited]
  
• Radiotherapy for Glottic T1N0 Carcinoma with Slight Hypofractionation and Standard Overall Treatment Time: Importance of Overall Treatment Time

  Rikiya Onimaru, Masakazu Hasegawa, Kouichi Yasuda, Akihiro Homma, Nobuhiko Oridate, Satoshi Fukuda, Hiroki Shirato

  JAPANESE JOURNAL OF CLINICAL ONCOLOGY 41 (1) 103 - 109 0368-2811 2011/01 [Refereed][Not invited]
   

  We retrospectively investigated treatment outcomes in patients with glottic T1 carcinoma treated with 65 Gy in 26 fractions four times a week and discuss the importance of the overall treatment time. Two hundred one patients with glottic T1 carcinoma were evaluated. Sixty-five Gray in 26 fractions were delivered for 200 patients, whereas 1 patient received 62.5 Gy in 25 fractions. We delivered radiotherapy once daily four times a week in this period, for a weekly dose of 10 Gy. Weekdays except Wednesday were treatment days. The overall survival rate was 96.8 +/- 1.3% (standard error) at 3 years and 90.8 +/- 2.2% at 5 years. The local control rate was 91.9 +/- 2.0% at 3 years and 89.8 +/- 2.3% at 5 years. In patients with an overall treatment time equal to or longer than 47 days, the local control rate was 82.6 +/- 6.0% at both 3 and 5 years. In the patients with overall treatment time equal to or less than 46 days, the local control rate was 94.6 +/- 1.9% at 3 years and 91.8 +/- 2.4% at 5 years. There was a significant difference between these two groups (P = 0.0349). A severe late radiation reaction occurred in one patient. He experienced severe laryngeal edema that required tracheotomy at 6 months after the completion of radiotherapy. The tracheotomy was closed at 14 months after completion of radiotherapy. Overall treatment time seems to be an important factor for a good local control rate for glottic T1N0 carcinoma even when treated with slight hypofractionation.
• Clinical analysis of malignant submandibular tumor

  Kyoko Kitao, Akihiro Homma, Nobuhiko Oridate, Seigo Suzuki, Fumiyuki Suzuki, Toshihiro Hara, Satoshi Káno, Takatsugu Mizumachi, Shigenari Taki, Naoya Inamura, Satoshi Fukud

  Journal of Otolaryngology of Japan 114 (3) 126 - 132 0030-6622 2011 [Refereed][Not invited]
   

  The 14 cases of malignant submandibular tumor whose treatment outcome we analyzed between 1989 and 2008 uncluded 5 of adenoid cystic carcinoma, 3 of squamous cell carcinoma, 2 each of mucoepidermoid carcinoma, and carcinoma ex pleomorphic adenoma, and 1 each of carcinosarcoma and large-cell carcinoma. One subject was diagnosed with T1, 7 with T2, 4 with T3, and 2 with T4. Lymph node involvement occurred in 5, -1 with N1 and 4 with N2. None had distant metastasis on the first visit. Seven were treated by surgery alone, 3 by surgery followed by radiotherapy, 2 by surgery followed by radio-and chemotherapy, and 1 by optimized supportive care. The surgical resection area was decided by tumor extension. Neck dissection was done in 9. Overall 5-year survival for all cases based on the Kaplan-Meier method was 57%. All with carcinoma ex pleomorphic adenoma, carcinosarcoma, or large-cell carcinoma remain alive. For those with adenoid cystic carcinoma 5-year survival is 80%, with mucoepidermoid carcinoma 50%, with squamous cell carcinoma 0%, and with carcinosarcoma 0%, respectively. The 5-year survival for stage I subjects was 100%, for stage II 83%, for stage III 50%, and for stage IV 0%. Surgical resection and postoperative radiotherapy were done in cases of minimal extraglandular extension or microscopically positive margins, with satisfactory results. Treatment efficacy for high-grade and advanced stage, however, requires more inprovement.
• 術後感染予防に対するレボフロキサシン(クラビット)の術前単回投与の有用性について

  対馬 那由多, 本間 明宏, 福田 諭

  耳鼻と臨床 耳鼻と臨床会 56 (6) 254 - 258 0447-7227 2010/11 [Not refereed][Not invited]
   

  レボフロキサシン(LVFX、クラビットR)は、幅広い抗菌スペクトラムを示す経口キノロン系抗菌薬である。1回投与量を増すことで高い血中濃度を得られ、殺菌力は用量依存的である。諸外国では以前より1回500mg以上の単回投与が行われており、本邦でも500mg単回投与が認可された。今回、われわれはこの様なLVFXの特徴に注目し、術後感染予防を目的として使用した。2008年1月から2009年12月末までに頭頸部領域の清潔手術36例(耳下腺13例、甲状腺7例、リンパ節摘出術6例、顎下腺4例、頸部郭清1例、その他5例)において、LVFX500mgを術後感染予防抗菌薬として手術2時間前に1回のみ投与した。その結果、36例全例に感染兆候は認められなかった。また、術後経過で特に問題となるような有害事象もなかった。LVFX500mgの1回のみの内服で、頭頸部領域の清潔手術の術後感染予防薬として十分であることが示唆された。(著者抄録)
• 下咽頭癌 喉頭機能温存治療 超選択的動注療法

  本間 明宏, 折舘 伸彦, 鈴木 章之, 原 敏浩, 真栄田 栄行, 加納 里志, 水町 貴諭, 瀧 重成, 稲村 直哉, 古沢 純, 福田 諭

  耳鼻と臨床 耳鼻と臨床会 56 (Suppl.1) S66 - S70 0447-7227 2010/11 [Not refereed][Not invited]
   

  2000年から2009年1月までに超選択的動注化学療法と放射線の同時併用療法を下咽頭原発扁平上皮癌新鮮例34例に行った。観察期間は1年3ヵ月-6年4ヵ月(中央値:3年7ヵ月)で、粗生存率(5年)は42.8%で、RADPLATによる局所制御率(5年)は77.8%であった。N0-1症例(10例)は全例生存しているが、N2b-3(24例)の5年生存率は19%と不良であった。下咽頭癌への動注は難しく、リスクも他の部位よりもやや高いといえる。最近は、T4a以下かつN1以下で、原発巣が片側に限局している動注のメリットを発揮できる症例を適応としている。(著者抄録)
• Salvage surgery for local recurrence after chemoradiotherapy or radiotherapy in hypopharyngeal cancer patients

  Shigenari Taki, Akihiro Homma, Nobuhiko Oridate, Seigo Suzuki, Fumiyuki Suzuki, Tomohiro Sakashita, Satoshi Fukuda

  EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY 267 (11) 1765 - 1769 0937-4477 2010/11 [Refereed][Not invited]
   

  This retrospective study aimed to assess the role of salvage surgery for local recurrence in hypopharyngeal cancer (HPC) patients who had received radiotherapy (RT) or concomitant chemoradiotherapy (CRT) as an initial treatment. The local recurrence rate, salvage rate after local recurrence and overall survival rate were investigated in 104 HPC patients who received treatment between 1991 and 2005. Local recurrence in the primary site was observed in 41 patients (rate, 39.4%) of whom only 12 could undergo further salvage surgery. Disease control was achieved in seven of these patients (successful salvage rate, 17.1%). The 5-year overall survival rate was 40.6% in the RT/CRT patient group and successful salvage rates for T1, T2, T3 and T4 primary disease were 33.3% (1/3), 20.0% (4/20), 16.7% (2/12) and 0% (0/6), respectively. Severe postoperative complications such as pharyngo-cutaneous fistula were seen in six patients (50.0%). Prognosis of patients with locally recurring HPC after RT/CRT is poor at any primary T-stage and the incidence of postoperative complication is relatively high. This should be taken into consideration when the initial treatment plan is decided and the choice of salvage surgery for such recurrent cases should be carefully determined.
• 頭頸部癌に対する化学放射線療法での体重減少率の検討

  松浦 一登, 全田 貞幹, 立花 弘之, 本間 明宏, 桐田 忠昭, 門田 伸也, 田原 信, 加藤 健吾, 浅井 昌大

  日本癌治療学会誌 (一社)日本癌治療学会 45 (2) 666 - 666 0021-4671 2010/09 [Not refereed][Not invited]
  
• 化学放射線療法を行う頭頸部がん患者を対象とするクリニカルパスを用いた疼痛管理法

  全田 貞幹, 松浦 一登, 立花 弘之, 本間 明宏, 桐田 忠和, 門田 伸也, 岩江 信法, 大田 洋二郎, 秋元 哲夫, 大鶴 洋, 浅井 昌大

  日本癌治療学会誌 (一社)日本癌治療学会 45 (2) 502 - 502 0021-4671 2010/09 [Not refereed][Not invited]
  
• 中咽頭側壁・前壁癌に対する放射線化学療法の検討

  加納 里志, 本間 明宏, 折舘 伸彦, 福田 諭

  口腔・咽頭科 日本口腔・咽頭科学会 23 (3) 373 - 373 0917-5105 2010/08 [Not refereed][Not invited]
  
• Screening examination for superficial carcinoma of the head and neck following endoscopic resection for esophageal carcinoma.

  Shimizu Y, Yoshida T, Kato M, Ono S, Homma A, Oridate N, Asaka M

  Endoscopy 42 (8) 686 - 687 0013-726X 2010/08 [Refereed][Not invited]
  
• 鼻副鼻腔腫瘍治療戦略の新しい可能性を探る 鼻副鼻腔悪性腫瘍に対する超選択的動注療法

  本間 明宏, 水町 貴諭, 原 敏浩, 福田 諭

  日本鼻科学会会誌 (一社)日本鼻科学会 49 (3) 326 - 326 0910-9153 2010/07 [Not refereed][Not invited]
  
• 鼻腔・副鼻腔癌に対する超選択的動注を併用した根治的化学放射線療法

  長谷川 雅一, 安田 耕一, 吉田 大介, 加藤 徳雄, 鬼丸 力也, 浅野 剛, 白土 博樹, 本間 明宏, 折舘 伸彦, 福田 諭, 石川 正純, Bengua Gerard, Sutherland Kenneth, 宮本 直樹, 鈴木 隆介

  Japanese Journal of Radiology (公社)日本医学放射線学会 28 (Suppl.I) 7 - 7 1867-1071 2010/07 [Not refereed][Not invited]
  
• Cesium Implant for Tongue Carcinoma with a Thickness of 1.5 cm or More: Cases Successfully Treated with a Modified Manchester System

  Takeshi Nishioka, Masaharu Fujino, Akihiro Homma, Tetsuro Yamashita, Akira Sato, Keiichi Ohmori, Kenichi Obinata, Hiroki Shirato, Kenichi Notani, Masamichi Nishio

  YONSEI MEDICAL JOURNAL 51 (4) 557 - 561 0513-5796 2010/07 [Refereed][Not invited]
   

  Purpose: Deciding on treatment carcinoma of the tongue when the tumor has a thickness of 1.5 cm or more is difficult. Surgery often requires wide resection and re-construction, leading to considerable functional impairment. A cesium implant is an attractive option, but according to the Manchester System, a two plane implant is needed. Materials and Methods: According to the textbook, a tumor is sandwiched between the needles, which are implanted at the edge of the tumor. This may cause an unnecessarily high dose to the outer surface of the tongue, which sometimes leads to a persistent ulcer. To avoid this complication, we invented a modified implantation method, and applied the method to five consecutive patients. Results: With a minimum follow-up of 2 years, all primary tumors in 5 consecutive patients have been controlled. No complications occurred in soft tissue of the tongue or in the mandible. Conclusion: Our modified Manchester System was feasible and effective for tumors that has a thickness of 1.5 cm or more.
• 耳下腺癌切除後のネットワーク型再建による顔面神経の即時再建

  古川 洋志, 七戸 龍司, 大澤 昌之, 斎藤 亮, 山本 有平, 本間 明宏, 福田 諭, 古田 康, 関堂 充

  日本マイクロサージャリー学会会誌 (一社)日本マイクロサージャリー学会 23 (2) 206 - 206 0916-4936 2010/06 [Not refereed][Not invited]
  
• 北海道大学における中咽頭癌症例の検討

  加納 里志, 折舘 伸彦, 本間 明宏, 鈴木 清護, 鈴木 章之, 原 敏浩, 水町 貴諭, 稲村 直哉, 福田 諭

  耳鼻咽喉科展望 耳鼻咽喉科展望会 53 (補冊1) 6 - 7 0386-9687 2010/06 [Not refereed][Not invited]
   

  著者らは1998年1月〜2007年12月に根治治療を施行した中咽頭癌新鮮例157例(平均年齢62歳)を対象に後方視的に検討した。1)5年粗生存率は1989〜1996の成績と比較して52%から65%と改善し、特に前壁癌で30%から59%と著明に改善していた。2)前壁癌の約4割にはRADPLATが施行されており、治療成績向上に寄与したものと考えられた。3)治療別の検討では早期癌に対しては手術が最も良い生存率であり、進行癌に対しては経静脈的なCRTに比べてRADPLATによる生存率、局所制御率が高かった。特に腫瘍の栄養血管が比較的単純な前壁癌や側壁癌にはRADPLATが良い適応と考えられた。4)原発の再発率は17%、その救済率は35%で、主にT3-4症例の原発再発の救済はほとんどできていなかった。また頸部の再発率は16%で、その救済率は26%であった。したがって、原発の再発に対してはRADPLATの側壁癌への適応の拡大や再発の早期発見による救済手術、強力な化学療法の開発等が必要であると考えられた。
• 内視鏡下に摘出し得た鼻腔神経鞘腫の1例

  洲崎 真吾, 本間 明宏, 福田 諭

  耳鼻咽喉科臨床 補冊 耳鼻咽喉科臨床学会 (補冊128) 82 - 82 0912-1870 2010/06 [Not refereed][Not invited]
  
• 超選択的動注化学療法と放射線の同時併用療法

  本間 明宏, 福田 諭

  耳鼻咽喉科臨床 補冊 耳鼻咽喉科臨床学会 (補冊128) 47 - 47 0912-1870 2010/06 [Not refereed][Not invited]
  
• 化学放射線療法 下咽頭がんに対する超選択的動注化学療法

  本間 明宏

  日本気管食道科学会会報 (NPO)日本気管食道科学会 61 (3) 338 - 338 0029-0645 2010/06 [Not refereed][Not invited]
  
• 化学放射線療法を行う頭頸部がん患者を対象とするクリニカルパスを用いた疼痛管理法 有効性/安全性評価試験

  立花 弘之, 全田 貞幹, 松浦 一登, 本間 明宏, 桐田 忠昭, 門田 伸也, 大田 洋二郎, 岩江 信法, 大鶴 洋, 秋元 哲夫, 浅井 昌大

  頭頸部癌 (一社)日本頭頸部癌学会 36 (2) 212 - 212 1349-5747 2010/05 [Not refereed][Not invited]
  
• 頭頸部癌に対するweekly cisplatinと放射線同時併用療法の検討

  稲村 直哉, 本間 明宏, 折舘 伸彦, 鈴木 清護, 鈴木 章之, 原 敏浩, 真栄田 裕行, 加納 里志, 水町 貴諭, 福田 諭, 鬼丸 力也, 長谷川 雅一, 安田 耕一, 白土 博樹

  頭頸部癌 (一社)日本頭頸部癌学会 36 (2) 206 - 206 1349-5747 2010/05 [Not refereed][Not invited]
  
• 中咽頭扁平上皮癌におけるHPV感染と治療成績の検討

  水町 貴諭, 加納 里志, 原 敏浩, 鈴木 章之, 鈴木 清護, 本間 明宏, 折舘 伸彦, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 36 (2) 205 - 205 1349-5747 2010/05 [Not refereed][Not invited]
  
• 化学放射線治療後の頸部郭清の必要性について

  本間 明宏, 折舘 伸彦, 鈴木 章之, 鈴木 清護, 原 敏浩, 加納 里志, 水町 貴諭, 古沢 純, 稲村 直哉, 福田 諭, 吉田 大介, 鬼丸 力也, 安田 耕一, 白土 博樹

  頭頸部癌 (一社)日本頭頸部癌学会 36 (2) 191 - 191 1349-5747 2010/05 [Not refereed][Not invited]
  
• Phase I/II Study of S-1 plus Cisplatin Combination Chemotherapy in Patients with Advanced/Recurrent Head and Neck Cancer

  Masato Fujii, Kitinobu Tomita, Wataru Nishijima, Mamoru Tsukuda, Yasuhisa Hasegawa, Junichi Ishitoya, Hideo Yamane, Akihiro Homma, Toshiki Tomita

  JAPANESE JOURNAL OF CLINICAL ONCOLOGY 40 (3) 214 - 221 0368-2811 2010/03 [Refereed][Not invited]
   

  The objectives of this study were to determine the maximum tolerated dose (MTD) and recommended dose (RD) of S-1 plus cisplatin (CDDP) and to evaluate safety and efficacy using the defined RD in advanced/recurrent head and neck cancer (HNC). S-1 was administered orally at 40 mg/m(2) twice daily for 14 consecutive days, and CDDP was infused on day 8 at a dose of 60 and 70 mg/m(2). Each course was repeated every 4 weeks. A total of 38 patients were registered, 10 patients for the Phase I study and an additional 28 patients for the Phase II study. Although no dose-limiting toxicity (DLT) was observed in the CDDP 60 mg/m(2) (Level 1) group, two of six patients in the CDDP 70 mg/m(2) (Level 2) group exhibited DLT (fatigue/diarrhea). The MTD was not achieved in the Phase I study. Level 2 was therefore determined as the RD. In the Phase II study, 34 patients, including 6 patients from the Phase I study, were evaluated. At the termination of treatment, the confirmed response rate was 44.1% (15/34, 95% CI: 27.4-60.8). The best response rate without an adequate duration time was 67.6% (95% CI: 51.9-83.4). The median survival period was 16.7 months, and the 1-year survival rate was 60.1%. The main toxicities of Grade 3 or above were anorexia (26.5%), nausea (14.7%), neutropenia/thrombocytopenia (11.8%) and anemia/fatigue (8.8%). This is considered to be an effective regimen with acceptable toxicities for HNC.
• IMPORTANCE OF COMORBIDITY IN HYPOPHARYNGEAL CANCER

  Akihiro Homma, Tomohiro Sakashita, Nobuhiko Oridate, Fumiyuki Suzuki, Seigo Suzuki, Hiromitsu Hatakeyama, Takatsugu Mizumachi, Shigenari Taki, Satoshi Fukuda

  HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK 32 (2) 148 - 153 1043-3074 2010/02 [Refereed][Not invited]
   

  Background. Comorbidity has an impact on survival in laryngeal cancer in several reports. However, the importance of comorbidity in hypopharyngeal cancer (HPC) has not been reported. Methods. A retrospective medical record review of 156 patients with HPC treated between 1995 and 2005 was performed. Comorbid illness was measured by the Adult Comorbidity Evaluation-27. A Cox proportional hazards model was used to determine the factors related to overall survival. Results. Comorbidity was absent in 55 (35.2%) of the patients, mild in 39 (25%), moderate in 28 (17.9%), and severe in 34 (21.8%). There were statistically significant differences between the survival rates in accord with age, stage, subsite, and comorbidity (45.1% for none or mild vs 27.7% for moderate or severe; p = .0073). Age, stage, and comorbidity were identified as independent prognostic factors in the multivariate analysis. Conclusion. Comorbidity, along with the clinical stage, should be considered in treatment planning for patients with HPC. (C) 2009 Wiley Periodicals, Inc. Head Neck 32: 148-153, 2010
• Prevention of wound complications after salvage total laryngectomy following chemoradiotherapy with a pectoralis major muscle interposition flap

  Yasushi Furuta, Michiya Matsumura, Fumio Ohtani, Masanobu Suzuki, Hiroki Satoh, Shinya Morita, Akihiro Homma, Nobuhiko Oridate, Satoshi Fukuda

  Journal of Otolaryngology of Japan (一社)日本耳鼻咽喉科学会 113 (1) 9 - 14 0030-6622 2010 [Not refereed][Not invited]
   

  There is an increased risk of wound complications in patients undergoing salvage laryngectomy following chemoradiotherapy. To reduce the rate of wound complications after a salvage total laryngectomy, a fresh tissue reinforcement of the pharyngeal suture line (pharyngeal interposition graft) has been reported to be useful. In the present study, wound complications after a salvage total laryngectomy with a pectoralis major muscle flap as a pharyngeal interposition graft were analyzed. Four patients with recurrent laryngeal cancer (three with supraglottis and one with glottic cancer) after chemoradiotherapy underwent salvage total laryngectomy using a pectoralis major muscle interposition flap. Minor wound complications were observed in three of the four patients, with an infection around the tracheostoma, a minor subcutaneous abscess, and a superficial skin necrosis in one patient each. These complications were managed with local wound care. No patients had major wound complications such as pharyngocutaneous fistulas. There were no necroses or wound complications of the pectoralis major muscle flap. This study has suggested that the pectoralis major muscle flap as a pharyngeal interposition graft is safe and useful for prevention of wound complications in salvage total laryngectomy following chemoradiotherapy.
• Prevalence and prognosis of human papillomavirus in oropharyngeal cancer

  Takatsugu Mizumachi, Satoshi Kano, Toshihiro Hara, Fumiyuki Suzuki, Seigo Suzuki, Akihiro Homma, Nobuhiko Oridate, Satoshi Fukuda

  Toukeibu Gan (一社)日本頭頸部癌学会 36 (4) 498 - 501 1881-8382 2010 [Not refereed][Not invited]
   

  We analyzed the presence of HPV from 53 patients diagnosed with oropharyngeal squamous cell carcinoma. In total 14/53 (26%) were HPV-positive. In 14 HPV-positive patients, 12 patients (86%) were HPV-16-positive, 1 patient was HPV-18-positive, and 1 patient was HPV-58-positive. HPV-positive patients had significantly better disease-specific survival rates than HPV-negative patients. Compared with patients with HPV-negative tumors, patients with HPV-positive tumors had higher response rates after chemoradiation treatment. For patients with HNSCC of the oropharynx, tumor HPV status is strongly associated with chemoradiation response and survival. © 2010, Japan Society for Head and Neck Cancer. All rights reserved.
• 喉頭癌T1症例の検討

  中薗彬, 折舘伸彦, 本間明宏, 坂下智博, 鬼丸力也, 福田諭

  日本気管食道科学会総会ならびに学術講演会プログラム・予稿集 62nd 116  2010 [Not refereed][Not invited]
  
• Prevention of wound complications after salvage total laryngectomy following chemoradiotherapy with a pectoralis major muscle interposition flap

  Yasushi Furuta, Michiya Matsumura, Fumio Ohtani, Masanobu Suzuki, Hiroki Satoh, Shinya Morita, Akihiro Homma, Nobuhiko Oridate, Satoshi Fukuda

  Journal of Otolaryngology of Japan 113 (1) 9 - 14 0030-6622 2010 [Refereed][Not invited]
   

  There is an increased risk of wound complications in patients undergoing salvage laryngectomy following chemoradiotherapy. To reduce the rate of wound complications after a salvage total laryngectomy, a fresh tissue reinforcement of the pharyngeal suture line (pharyngeal interposition graft) has been reported to be useful. In the present study, wound complications after a salvage total laryngectomy with a pectoralis major muscle flap as a pharyngeal interposition graft were analyzed. Four patients with recurrent laryngeal cancer (three with supraglottis and one with glottic cancer) after chemoradiotherapy underwent salvage total laryngectomy using a pectoralis major muscle interposition flap. Minor wound complications were observed in three of the four patients, with an infection around the tracheostoma, a minor subcutaneous abscess, and a superficial skin necrosis in one patient each. These complications were managed with local wound care. No patients had major wound complications such as pharyngocutaneous fistulas. There were no necroses or wound complications of the pectoralis major muscle flap. This study has suggested that the pectoralis major muscle flap as a pharyngeal interposition graft is safe and useful for prevention of wound complications in salvage total laryngectomy following chemoradiotherapy.
• 【頭頸部腫瘍診療における論点 耳鼻口腔咽頭編】 舌癌T1-3症例の原発部位に対する治療法の選択は? 超選択的動注療法の立場から

  本間 明宏, 鈴木 章之, 福田 諭

  JOHNS (株)東京医学社 25 (10) 1503 - 1506 0910-6820 2009/10 [Not refereed][Not invited]
  
• Superselective High-Dose Cisplatin Infusion With Concomitant Radiotherapy in Patients With Advanced Cancer of the Nasal Cavity and Paranasal Sinuses A Single Institution Experience

  Akihiro Homma, Nobuhiko Oridate, Fumiyuki Suzuki, Shigenari Taki, Takeshi Asano, Daisuke Yoshida, Rikiya Onimaru, Takeshi Nishioka, Hiroki Shirato, Satoshi Fukuda

  CANCER 115 (20) 4705 - 4714 0008-543X 2009/10 [Refereed][Not invited]
   

  BACKGROUND: The current study aimed to evaluate the efficacy of superselective high-dose cisplatin infusion with concomitant radiotherapy (RADPLAT) for previously untreated patients with advanced cancer of the nasal cavity and paranasal sinuses. METHODS: Between October 1999 and December 2006, 47 patients were given superselective intra-arterial infusions of cisplatin (100-120 mg/m(2) per week) with simultaneous intravenous infusions of thiosulfate to neutralize cisplatin toxicity and conventional external-beam radiotherapy (65-70 grays), RESULTS: There were 7 patients (14.9%) diagnosed with T3, 22 (46.8%) with T4a, and 18 (38.3%) with T4b disease. During the median follow-up period of 4.6 years, the 5-year local progression-free survival rate was 78.4% for all patients (n=47), 69.0% for patients with T4b disease (n=18), and 83.2% for patients with <T4b disease (n=29). The 5-year overall survival rate was 69.3% for all patients, 61.1% for patients with T4b disease, and 71.1% for patients with < T4b disease. RADPLAT was feasible in 45 patients (95.7%). No patient died as a result of treatment toxicity or had a cerebrovascular accident. Osteonecrosis (n=7), brain necrosis (n=2), and ocular/visual problems (n=16) were observed as late adverse reactions. CONCLUSIONS: Although a single institution experience, the results of the current study suggest that RADPLAT can cure the majority of patients with advanced cancer of the nasal cavity and paranasal sinuses, as well as preserve organs. Late adverse reactions should be monitored in future studies. Cancer 2009;115:4705-14. (C) 2009 American Cancer Society.
• 当科における顎下腺悪性腫瘍1次症例の検討

  北尾 恭子, 本間 明宏, 福田 諭

  口腔・咽頭科 日本口腔・咽頭科学会 22 (3) 355 - 355 0917-5105 2009/08 [Not refereed][Not invited]
  
• 【新・静脈栄養・経腸栄養ガイド NSTに必須の知識と実践のすべて】 周術期の栄養管理の実際 頭頸部手術

  本間 明宏, 福田 諭

  Medical Practice (株)文光堂 26 (臨増) 354 - 358 0910-1551 2009/07 [Not refereed][Not invited]
  
• Value of fluorodeoxyglucose positron emission tomography before radiotherapy for head and neck cancer: does the standardized uptake value predict treatment outcome?

  Keishiro Suzuki, Takeshi Nishioka, Akihiro Homma, Kazuhiko Tsuchiya, Motoaki Yasuda, Hidefumi Aoyama, Rikiya Onimaru, Nagara Tamaki, Hiroki Shirato

  JAPANESE JOURNAL OF RADIOLOGY 27 (6) 237 - 242 1867-1071 2009/07 [Refereed][Not invited]
   

  Purpose. The aim of this study was to determine if the standardized uptake value (SUV) of fluorodeoxyglucose positron emission tomography (FDG-PET) for head and neck cancer can predict the outcome of radiotherapy and if the SUV is correlated with histological grade, mitosis, and apoptosis. Materials and methods. The study included 45 head and neck cancer patients who underwent FDG-PET scanning before radiotherapy. The maximum SUV (SUVmax) of their primary lesions were measured. Biopsy was performed in all patients to determine the histological diagnosis. Altogether, 14 biopsy specimens were available for mitotic and apoptotic cell counts. Results. The mean SUVmax of T3 tumors was significantly higher than that of T1 (P = 0.01) and T2 (P = 0.011) tumors. The mean SUVmax of stage II disease was significantly lower than that of stage III (P = 0.028) and stage IV (P = 0.007) disease. There was a tendency toward a better locoregional control rate and disease-free survival for the lower SUV group using a cutoff value of 5.5. For 41 patients with squamous cell carcinoma or undifferentiated carcinoma, SUVmax did not reflect the histological grade. There was no correlation between the SUVmax and the mitotic/apoptotic status. Conclusion. SUVmax may correlate with the T classification and stage, but there was no predictive value for outcome of radiation therapy. Neither histological grading nor mitotic/apoptotic status is correlated with SUVmax.
• 当科における耳下腺悪性腫瘍症例の検討

  稲村 直哉, 本間 明宏, 福田 諭

  口腔・咽頭科 日本口腔・咽頭科学会 22 (2) 167 - 172 0917-5105 2009/06 [Not refereed][Not invited]
   

  過去19年5ヵ月間の耳下腺原発悪性腫瘍1次症例55例について検討した。組織型は13種類あり、粘表皮癌12例と腺様嚢胞癌11例が比較的多かった。TNM分類ではT1が5例、T2が18例、T3が10例、T4が22例、リンパ節転移は7例あり全てN2であった。M1は6例あり、肺転移5例、腋窩転移1例であった。初診時の顔面神経麻痺(FP)の有無では、FP+が19例、FP-が36例であった。5年粗生存率は全体で73%。組織型でみると、未分化癌33%、腺癌40%、粘表皮癌62%、多形腺腫由来癌67%、腺様嚢胞癌と腺房細胞癌は100%であった。T分類では、T1が100%、T2が88%、T3が90%、T4が44%であった。FP+は36%、FP-は94%であった。T4およびFP+は予後不良であった。(著者抄録)
• 【機能温存をめざした頭頸部癌治療update】 超選択的動注療法

  本間 明宏

  ENTONI (株)全日本病院出版会 (103) 7 - 13 1346-2067 2009/06 [Not refereed][Not invited]
   

  大量シスプラチンの超選択的動注療法を、照射との同時併用療法(IA-CRT、新鮮例136例に対して)、術前治療(18例)、再発例への救済治療(11例)として行った。その結果、術前治療、再発例への効果は乏しく、新鮮例に対して照射と併用で行うのが有用であった。特に鼻副鼻腔と中咽頭前壁で良い結果が得られた。喉頭癌でも良好な喉頭温存が得られている。下咽頭については、局所制御率は良好だが、生存率向上には結びついていない。当科の経験では、IA-CRTの良い適応は、上顎洞癌、舌根癌と考えられた。IA-CRTは動注のメリットを生かせる症例にアンギオCTなどを利用した精度の高い確実な動注を行うことが重要である。(著者抄録)
• 頭頸部がん治療における多職種医療普及のためのサテライト講演会 その成果と課題

  全田 貞幹, 大田 洋二郎, 本間 明宏, 丹生 健一, 神田 亨, 妻木 浩美, 清田 尚臣, 浅井 昌大

  頭頸部癌 (一社)日本頭頸部癌学会 35 (2) 173 - 173 1349-5747 2009/05 [Not refereed][Not invited]
  
• 喉頭癌に対する超選択動注併用放射線療法の治療成績

  瀧 重成, 本間 明宏, 折舘 伸彦, 鈴木 清護, 鈴木 章之, 原 敏浩, 水町 貴諭, 福田 諭, 鬼丸 力也, 長谷川 雅一, 白土 博樹

  頭頸部癌 (一社)日本頭頸部癌学会 35 (2) 116 - 116 1349-5747 2009/05 [Not refereed][Not invited]
  
• 上咽頭癌に対するCDDP、5-FUを用いた放射線化学療法の治療成績

  木下 留美子, 長谷川 雅一, 安田 耕一, 田口 大志, 鬼丸 力也, 土屋 和彦, 西岡 健, 本間 明宏, 折舘 伸彦, 福田 諭, 白土 博樹

  頭頸部癌 (一社)日本頭頸部癌学会 35 (2) 93 - 93 1349-5747 2009/05 [Not refereed][Not invited]
  
• 頭頸部癌治療における口腔ケアの実際 頭頸部進行癌に対する再建手術の合併症減少に口腔ケアは寄与するか

  秦 浩信, 山崎 裕, 佐藤 淳, 村井 知佳, 中村 裕介, 今待 賢治, 北川 善政, 本間 明宏, 瀧 重成, 折舘 伸彦, 福田 諭, 斉藤 亮, 古川 洋志, 山本 有平, 関堂 充

  頭頸部癌 (一社)日本頭頸部癌学会 35 (2) 71 - 71 1349-5747 2009/05 [Not refereed][Not invited]
  
• 臨床パネル「頭頸部癌とヒト乳頭腫ウイルス(HPV)」 頭頸部癌におけるヒト乳頭腫ウイルスによる発癌のメカニズムと検出について

  水町 貴諭, 瀧 重成, 加納 里志, 原 敏浩, 鈴木 章之, 鈴木 清護, 本間 明宏, 折舘 伸彦, 福田 諭, 古田 康

  頭頸部癌 (一社)日本頭頸部癌学会 35 (2) 68 - 68 1349-5747 2009/05 [Not refereed][Not invited]
  
• 強度変調放射線治療(IMRT)の中長期成績 北海道大学病院での頭頸部癌に対する強度変調放射線治療の成績

  鬼丸 力也, 長谷川 雅一, 安田 耕一, 木下 留美子, 白土 博樹, 本間 明宏, 折舘 伸彦, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 35 (2) 65 - 65 1349-5747 2009/05 [Not refereed][Not invited]
  
• 化学放射線療法後の救済手術 問題点とその対策 喉頭下咽頭癌に対する化学放射線療法後の救済手術

  鈴木 章之, 本間 明宏, 折舘 伸彦, 鈴木 清護, 水町 貴諭, 加納 里志, 瀧 重成, 稲村 直哉, 鬼丸 力也, 長谷川 雅一, 白土 博樹, 古田 康, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 35 (2) 61 - 61 1349-5747 2009/05 [Not refereed][Not invited]
  
• 耳下腺癌切除後の顔面神経即時再建 我々の手技と工夫 Network型再建による耳下腺癌切除後の顔面神経即時再建

  古川 洋志, 齋藤 亮, 山本 有平, 本間 明宏, 福田 諭, 古田 康, 関堂 充

  頭頸部癌 (一社)日本頭頸部癌学会 35 (2) 54 - 54 1349-5747 2009/05 [Not refereed][Not invited]
  
• 耳下腺癌切除後の顔面神経即時再建 我々の手技と工夫 耳下腺癌切除後の顔面神経即時再建の適応と現状、術後の評価について

  古田 康, 大谷 文雄, 稲村 直哉, 鈴木 章之, 本間 明宏, 折舘 伸彦, 山本 有平, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 35 (2) 51 - 51 1349-5747 2009/05 [Not refereed][Not invited]
  
• Long-term outcome after endoscopic resection in patients with hypopharyngeal carcinoma invading the subepithelium: a case series.

  Shimizu Y, Yoshida T, Kato M, Ono S, Nakagawa M, Homma A, Oridate N, Asaka M

  Endoscopy 41 (4) 374 - 376 0013-726X 2009/04 [Refereed][Not invited]
  
• Voice-Related Quality of Life After Treatment of Laryngeal Cancer

  Nobuhiko Oridate, Akihiro Homma, Seigo Suzuki, Yuji Nakamaru, Fumiyuki Suzuki, Hiromitsu Hatakeyama, Shigenari Taki, Tomohiro Sakashita, Noriko Nishizawa, Yasushi Furuta, Satoshi Fukuda

  ARCHIVES OF OTOLARYNGOLOGY-HEAD & NECK SURGERY 135 (4) 363 - 368 0886-4470 2009/04 [Refereed][Not invited]
   

  Objective: To determine patient-perceived voice-related quality of life in patients treated with various methods based on the results of Voice-Related Quality of Life (VRQOL) and Voice Handicap Index-10 (VHI-10) questionnaires. Design: The VRQOL and VHI-10 questionnaires. Setting: University hospital. Patients: One hundred thirty-seven patients who had received definitive treatment of laryngeal cancer were followed-up at Hokkaido University Hospital, Sapporo, Japan, and were alive with no evidence of malignancy at the time of the survey. Main Outcome Measure: Patient-perceived voice-related quality of life based on the results of the VRQOL and VHI-10 questionnaires. Results: The mean VRQOL scores for patients who had undergone radiotherapy (n=63), chemoradiotherapy (n=29), laser surgery (n=14), or total laryngectomy (n=27) as final treatment of laryngeal cancer were 92.6, 92.9, 85.5, and 68.4, respectively; the mean VHI-10 scores were 2.87, 2.34, 5.43, and 11.26, respectively. Conclusion: The VRQOL and VHI-10 questionnaires are important in judging the overall effectiveness of treatment options for laryngeal cancer.
• マイクロデブリッダーが有用であった成人型多発性喉頭乳頭腫の1症例

  鈴木 正宣, 折舘 伸彦, 本間 明宏, 中丸 裕爾, 畠山 博充, 目須田 康, 古田 康, 福田 諭

  耳鼻咽喉科・頭頸部外科 (株)医学書院 81 (3) 219 - 221 0914-3491 2009/03 [Not refereed][Not invited]
   

  42歳男。4ヵ月前に嗄声が出現し、保存的治療でいったん改善したが、再増悪を来たした。間接喉頭鏡で左披裂部内側壁、左声帯に3ヶ所、右声帯に2ヶ所の喉頭腫瘍を認め、喉頭ファイバースコピーで腫瘍は乳頭状増殖を示した。喉頭乳頭腫の診断で喉頭直達鏡による腫瘍切除術を施行し、一部採取した腫瘍の迅速病理では悪性所見なしの結果であった。喉頭用スキマーブレード(2.9mm)を装着したマイクロデブリッダーを用いて腫瘍切除を行い、腫瘍自体は軟らかく、ブレード内に吸引された腫瘍のみを切除可能であった。回転数はブレードの熱による瘢痕化を防ぐため、毎分60回転の超低速とした。ごく少量の出血を認めたが、マイクロデブリッダーによる吸引と20万倍エピネフリン塗布で対処できた。切除組織の病理組織像は核異型、分裂像に乏しく、乳頭腫と診断された。術後は沈黙療法を行い、4日目に退院した。嗄声は改善し、術後5ヵ月で再増悪、腫瘍再発はない。
• Complications of Skull Base Surgery: An Analysis of 30 Cases

  Tomohiro Sakashita, Nobuhiko Oridate, Akihiro Homma, Yuji Nakamaru, Fumiyuki Suzuki, Hiromitsu Hatakeyama, Shigenari Taki, Yutaka Sawamura, Yuhei Yamamoto, Yasushi Furuta, Satoshi Fukuda

  SKULL BASE-AN INTERDISCIPLINARY APPROACH 19 (2) 127 - 132 1531-5010 2009/03 [Refereed][Not invited]
   

  Objectives: To evaluate the risk factors for perioperative complications among patients undergoing craniofacial resection for the treatment of skull base tumors. Design: Retrospective analysis. Participants: The study group comprised 29 patients with skull base tumors (22 malignant and 7 benign) who underwent 30 craniofacial resections at Hokkaido University Hospital between 1989 and 2006. Of these cases, 21 had undergone prior treatment by radiation (16 cases), surgery (7 cases), or chemotherapy (1 case). Moreover, 19 needed extended resection involving the dura (11 cases), brain (5 cases), orbit (12 cases), hard palate (5 cases), skin (3 cases), or cavernous sinus (2 cases). Main outcome measures: Perioperative complications and risk factor associated with their incidence. Results: Perioperative complications occurred in 12 patients (40%; 13 cases). There was a significant difference between complication rates for cases with and without prior therapy (52.4% vs. 11.1%). The complication rate for dural resection cases was 81.8%. There was a significant difference between complication rates for cases with and without dura resection. No postoperative mortality was reported. Conclusions: Craniofacial resection is a safe and effective treatment for skull base tumors. However, additional care is required in patients with extended resection (especially dural) and those who have undergone prior therapy.
• レボフロキサシンの術後感染予防への使用

  飯塚 さとし, 本間 明宏, 福田 諭

  頭頸部外科 (NPO)日本頭頸部外科学会 18 (3) 273 - 277 1349-581X 2009/02 [Not refereed][Not invited]
   

  レボフロキサシン(LVFX、クラビット)は耳鼻科領域における術後感染起因菌であるグラム陽性菌に対して高い抗菌活性を有するニューキノロン系抗菌薬であり、用量依存的に殺菌力を示す、この特性に注目し2007年7月から2008年2月まで北海道大学病院耳鼻咽喉科で手術を行った71症例に対しLVFX 500mgを術前1回投与し術後感染の有無を追跡した。術後感染は1例も認めず、有害事象も呈さなかった。1回投与のため服薬コンプライアンスも高く、経済的利得の面でも有用性が示された。短時間の手術であれば術後感染予防は抗生剤単回投与で十分とされているが、症例を選択すれば抗生剤内服でも十分であることが示された。(著者抄録)
• 高Ca血症をきたさなかった巨大上皮小体癌の1例

  蠣崎 文彦, 本間 明宏, 畠山 博充, 前田 昌紀, 福田 諭

  耳鼻咽喉科・頭頸部外科 (株)医学書院 81 (2) 133 - 136 0914-3491 2009/02 [Not refereed][Not invited]
   

  頸部腫脹が自覚・急速増大した72歳女性について検討した。触診で、11×10.5cm大の辺縁整、弾性硬、可動性良好な腫瘤を認めた。甲状腺ホルモン値に異常はなく、血清カルシウム(Ca)も10.2mg/dlであった。CTでは、境界明瞭で内部不均一に造影される巨大な腫瘤が右側を中心に頸部全体に存在した。気管は左方に偏移し、下方では圧迫されて変形をきたしていた。正常甲状腺との境界は明瞭で、総頸動脈、内頸動脈は外側に偏移していた。穿刺吸引細胞診で甲状腺未分化癌、もしくはかなりの低分化癌との結果が得られ、腫瘍全摘術を行った。摘出腫瘤は9×8.5×6.5cm大で、病理組織検査では腫瘍細胞の甲状腺組織への浸潤を認め、壊死や出血、ヘモジデリンの沈着、硝子性変化を伴っていた。腫瘍細胞の異型化は乏しく、淡明胞体の所見から上皮小体癌と最終診断した。術後照射を行ったが、肺、脳転移を認め、術後約1年現在、局所再発および遠隔転移に注意して経過を観察している。
• p53 expression in concurrent chemoradiotherapy with docetaxel for head and neck squamous cell carcinoma

  Nobuhiko Oridate, Akihiro Homma, Eisaku Higuchi, Fumiyuki Suzuki, Hiromitsu Hatakeyama, Takatsugu Mizumachi, Jun Furusawa, Shigenari Taki, Yasushi Furuta, Satoshi Fukuda

  AURIS NASUS LARYNX 36 (1) 57 - 63 0385-8146 2009/02 [Refereed][Not invited]
   

  Background: The current study aimed to evaluate the significance of an immunohistochemical assessment of tumor suppressor p53 as a prognostic marker in head and neck squamous cell carcinoma (HNSCC) patients treated with docetaxel and radiotherapy. Methods: The expression of tumor suppressor p53 and its phosphorylated form at the Ser392 residue was retrospectively evaluated by immunohistochemistry in 51 Stage T1-3N0-2M0 (except T1N0 glottis) HNSCC patients who were treated with 10 mg/m(2)/Week docetaxel four to six times and received concurrent chemoradiotherapy. Results: Kaplan-Meier univariate analysis revealed that no difference in rates for overall and disease-free survival (DFS) between patients with p53-positive and -negative tumors (p = 0.786 and p = 0.924, respectively). The prognostic significance of phosphorylated p53 at the Ser392 residue was neither observed. Conclusions: An immunohistochemical assessment of the expression of p53 and its phosphorylated form might not be of clinical use in defining subgroups of patients with poor prognosis. (C) 2008 Elsevier Ireland Ltd. All rights reserved.
• Clinical results of intensity modulated radiotherapy (IMRT) for head and neck cancer: Experience of Hokkaido University Hospital

  Rikiya Onimaru, Masakazu Hasegawa, Koichi Yasuda, Rumiko Kinoshita, Hiroki Shirato, Akihiro Homma, Nobuhiko Oridate, Satoshi Fukuda

  Toukeibu Gan (一社)日本頭頸部癌学会 35 (3) 245 - 249 1349-5747 2009 [Not refereed][Not invited]
   

  We evaluated the clinical outcome of 37 patients who had received intensity modulated radiation therapy (IMRT) in Hokkaido University Hospital from May 2002 to December 2007. Thirteen patients had nasopharyngeal cancer, 19 had oropharyngeal cancer, 3 had hypopharyngeal cancer, 1 had maxillary sinus cancer, and 1 had oral cancer. One patient who had oropharyngeal cancer died of pharyngeal abscess which was a treatment-related complication. Three patients died of other cancers. One patient with nasopharyngeal cancer had local recurrence. In patients with oropharyngeal cancer, recurrence at the primary site occurred in 3 patients, and residual/recurrence at neck lymph nodes occurred in 2 patients. One patient with hypopharyngeal cancer had residual neck lymph node metastasis. Some patients experienced severe reactions to the radiation. One patient had pharyngeal abscess and died of this treatment complication. One patient who had nasopharyngeal cancer experienced hearing loss and angle closure glaucoma. © 2009, Japan Society for Head and Neck Cancer. All rights reserved.
• Immediate reconstruction of total facial nerve plexus after radical total parotidectomy: Facial-hypoglossal network system based on neural signal augmentation

  Hiroshi Furukawa, Akira Saito, Toshihiko Hayashi, Yuhei Yamamoto, Akihiro Homma, Satoshi Fukuda, Yasushi Furuta, Mitsuru Sekido

  Toukeibu Gan (一社)日本頭頸部癌学会 35 (3) 217 - 222 1881-8382 2009 [Not refereed][Not invited]
   

  Three reconstruction cases of total facial nerve plexus after radical total parotidectomy are presented. With nerve grafts, the facial-hypoglossal network was reconstructed using the end-to-side neurorrhaphy technique. Facial mimetic muscle function was improved, and postoperative ENMG findings showed double innervation of the mimetic muscles supplied by the facial and hypoglossal nerve. © 2009, Japan Society for Head and Neck Cancer. All rights reserved.
• Current status and assessments of reanimation for facial palsy after resection of parotid gland carcinoma

  Yasushi Furuta, Fumio Ohtani, Naoya Inamura, Fumiyuki Suzuki, Akihiro Homma, Nobuhiko Oridate, Yuhei Yamamoto, Satoshi Fukuda

  Toukeibu Gan (一社)日本頭頸部癌学会 35 (3) 213 - 216 1881-8382 2009 [Not refereed][Not invited]
   

  Reanimation for facial palsy after resection of parotid gland carcinomas has been one of the most important issues for improving the quality of life of the patients. In the present article, we describe the current status of facial reconstructive surgeries after resection of parotid gland carcinomas. According to a nationwide questionnaire survey on facial reconstructive surgeries after resection of parotid gland carcinomas, primary reconstruction at the time of resection of the tumor is the basic policy in most institutions and plastic surgeons are involved in the facial reconstructive surgeries in 60% of the institutions. These results suggest that plastic surgeons play an important role in the reanimation for facial palsy after resection of parotid gland carcinomas including secondary plastic surgeries. We also discuss the methods for postoperative assessments of facial reconstructive surgery and show applications of the Sunnybrook facial grading system. Both head and neck surgeons and plastic surgeons should use a common method for postoperative assessments. © 2009, Japan Society for Head and Neck Cancer. All rights reserved.
• Detection and mechanism of HPV infection in human head and neck cancer

  Takatsugu Mizumachi, Shigenari Taki, Satoshi Kano, Toshihiro Hara, Fumiyuki Suzuki, Seigo Suzuki, Akihiro Homma, Nobuhiko Oridate, Satoshi Fukuda, Yasushi Furuta

  Toukeibu Gan (一社)日本頭頸部癌学会 35 (4) 356 - 359 1881-8382 2009 [Not refereed][Not invited]
   

  Cervical cancer is initiated by infection with high-risk human papillomaviruses (HPVs). It has been suggested that the link between HPV and head and neck squamous cell carcinoma is specific to carcinoma of the tonsil. We systematically summarize HPV infection, carcinogenic mechanisms and detection of HPV in head and neck cancer. It will be necessary to develop preventive and therapeutic strategies aimed at reducing the incidence and mortality of HPV-associated cancers. © 2009, Japan Society for Head and Neck Cancer. All rights reserved.
• Salvage surgery for recurrent cases of laryngeal or hypopharyngeal cancer following concurrent chemoradiotherapy

  Fumiyuki Suzuki, Akihiro Homma, Nobuhiko Oridate, Seigo Suzuki, Takathugu Mizumachi, Satoshi Kanou, Shigenari Taki, Naoya Inamura, Satoshi Fukuda, Rikiya Onimaru, Masakazu Hasegawa, Hiroki Shirato, Yasushi Furuta

  Toukeibu Gan (一社)日本頭頸部癌学会 35 (4) 344 - 349 1349-5747 2009 [Not refereed][Not invited]
   

  Complication rates for salvage surgery after concurrent chemoradiotherapy (CCRT) have been reported to be high. From 1995 to 2008, 131 patients with laryngeal cancer and 107 with hypopharyngeal cancer underwent CCRT at Hokkaido University Hospital, Japan. Of the 131 patients with laryngeal cancer, a local recurrence developed in 43 (33%), of whom 38 (88%) underwent salvage surgery. The local control rate after salvage surgery was 79% (30/38). On the other hand, a local recurrence developed in 30 (28%) of 107 patients with hypopharyngeal cancer, of whom only 10 (33%) underwent salvage surgery, the local control rate after which was 60% (6/10). In 34 patients who underwent salvage laryngectomy or laryngopharyngectomy in our hospital (laryngeal cancer 28, hypopharyngeal cancer 6), overall wound complications, major wound complications and pharyngocutaneous fistulas were observed in 53%, 29% and 26%, respectively. CCRT can cause difficulties in wound healing and wound complications, such as infection or pharyngocutaneous fistulas. To reduce the incidence of wound complications, we have taken steps including appropriate skin incisions, preservation of the strap muscles, thyroid glands and major veins, and pectoralis major myofascial flap transfer to reinforce the primary pharyngeal closure (pharyngeal interposition graft). High incidences of wound complications and poor wound recovery in patients undergoing salvage surgery following CCRT should be taken into account before the initiation of CCRT, and emphasis should be placed on taking steps to prevent wound complications associated with salvage surgery. © 2009, Japan Society for Head and Neck Cancer. All rights reserved.
• Novel Function of Transcription Factor ATF5: Blockade of p53-dependent Apoptosis Induced by Ionizing Irradiation

  Takeshi Nishioka, Yusuke Miyai, Hisashi Haga, Kazushige Kawabata, Hiroki Shirato, Akihiro Homma, Kenichiro Shibata, Motoaki Yasuda

  CELL STRUCTURE AND FUNCTION 34 (1) 17 - 22 0386-7196 2009 [Refereed][Not invited]
   

  Purpose: To find a new molecule that affects p53-dependent radiosensitivity.Methods and Materials: A mouse sarcoma cell line, QRsP(p53+/+), was used. From this cell line, we established a radiosensitive clone and a radioresistant one. Colony assay, p53 gene transfer, a luciferase assay for p53 and p21, animal transplantation experiment, and DNA array analyses were performed.Results: Microarray showed marked reduction of a transcription factor, ATF5, both in vitro and in vivo for the radiosensitive clone. Interestingly, flow cytometric analysis demonstrated marked apoptosis for the radiosensitive clone by p53 cloned adenovirus infection. Luciferase reporter assay revealed that ATF5 suppressed the transactivational activity of p53 and p63. By ATF5 gene transfer, the radiosensitive clone regained resistance to both ionizing-radiation and Ad-p53 infection-induced cell death. Surprisingly, time-lapse cell migration observation revealed greater cell motility for ATF5-transfected radiosensitive clone.Conclusions: It seems likely that ATF5 is a potent repressor of p53 and elevated expression of ATF5 in a tumor may relate to enhanced malignant phenotypes, such as radioresistance or greater cell motility.
• Computer image-guided surgery for total maxillectomy

  Akihiro Homma, Masahiko Saheki, Fumiyuki Suzuki, Satoshi Fukuda

  EUROPEAN ARCHIVES OF OTO-RHINO-LARYNGOLOGY 265 (12) 1521 - 1526 0937-4477 2008/12 [Refereed][Not invited]
   

  In total maxillectomy, the entire upper jaw including the tumor is removed en bloc from the facial skeleton. An intraoperative computed tomographic guidance system (ICTGS) can improve orientation during surgical procedures. However, its efficacy in head and neck surgery remains controversial. This study evaluated the use of an ICTGS in total maxillectomy. Five patients with maxillary sinus neoplasms underwent surgery using a StealthStation (R) ICTGS. The headset was used for anatomic registration during the preoperative CT scan and surgical procedure. The average accuracy was 0.95 mm. The ICTGS provided satisfactory accuracy until the end of resection in all cases, and helped the surgeon to confirm the anatomical location and decide upon the extent of removal in real time. It was particularly useful when the zygoma, maxillary frontal process, orbital floor, and pterygoid process were divided. All patients remained alive and disease free during short-term follow-up. The ICTGS played a supplementary role in total maxillectomy, helping the surgeon to recognize target points accurately in real time, to determine the minimum accurate bone-resection line, and to use the most direct route to reach the lesion. It could also reduce the extent of the skin incision and removal, thus maintaining oncological safety.
• Surgical complications of salvage total laryngectomy following concurrent chemoradiotherapy

  Yasushi Furuta, Akihiro Homma, Nobuhiko Oridate, Fumiyuki Suzuki, Hiromitsu Hatakeyama, Keishiro Suzuki, Takeshi Nishioka, Hiroki Shirato, Satoshi Fukuda

  INTERNATIONAL JOURNAL OF CLINICAL ONCOLOGY 13 (6) 521 - 527 1341-9625 2008/12 [Refereed][Not invited]
   

  Surgical complication rates of total laryngectomy vary according to the preoperative treatments performed and patient factors. Wound complications after salvage laryngectomy following concurrent chemoradiotherapy (CCRT) were analyzed. Eighty-six patients who had undergone total laryngectomy for laryngeal cancer at Hokkaido University Hospital, Japan, between 1990 and 2006 were divided into three groups according to preoperative treatments received: group I (n = 35) without radiotherapy (RT) or CCRT, group II (n = 17) RT alone, and group III (n = 34) low-dose CCRT. Salvage total laryngectomy was performed as a consequence of residual or recurrent disease after completion of the treatments. Wound complications such as pharyngocutaneous fistulas, bleeding, infections, and skin necrosis were retrospectively analyzed in each group. A considerable (not statistically significant) difference in the incidence of major wound complications was observed between groups I and III (11.4% vs 29.4%, P = 0.078), but not between groups II and III. In stage III/IV patients, a significant increase in the incidence of wound complications was observed in group III compared to group I. Pharyngocutaneous fistulas were the most common complication, occurring in 8/34 (23.5%) of the group III patients. Additional pharyngeal reconstruction surgery was performed in 5 of the 8 (62.5%) group III patients with pha ryngocutaneous fistulas, while no such patients (0/3) in group I required reconstruction surgery. There was an increased risk of wound complications in patients undergoing salvage laryngectomy following CCRT. Patients who developed pharyngocutaneous fistulas after CCRT tended to require surgical reintervention for repair. These findings should be taken into account before the initiation of CCRT and salvage surgery.
• 化学放射線療法後の手術治療 化学放射線療法後のsalvage手術法の選択 喉頭癌の場合

  古田 康, 本間 明宏, 折舘 伸彦, 愛宕 義浩, 鈴木 清護, 鈴木 章之, 福田 諭

  耳鼻と臨床 耳鼻と臨床会 54 (Suppl.1) S61 - S66 0447-7227 2008/11 [Not refereed][Not invited]
   

  喉頭癌の化学放射線療法(chemoradiotherapy;CRT)後の再発症例において、salvage手術法の選択について検討した。1995年-2001年のCBDCAまたはCDDP併用CRT後の再発例においては23例全例で喉頭全摘術が施行された。2002年-2005年のDOC併用CRT後の再発例においては喉頭機能温存手術が4例に、喉頭全摘術が6例に施行された。症例を選択すれば喉頭機能温存手術は可能であると考えられた。CRT後においては2年以上経過してからの再発例も多くみられ、喉頭機能温存手術を施行するためには、2年以上経過しても画像検査を含め、経過観察を慎重に行うべきであると考えられた。喉頭全摘術を余儀なくされた場合でも、人工喉頭挿入によるTEシャント発声によりquality of life(QOL)の向上を図ることができた。また、いずれのsalvage手術においても術後の創合併症の発生率が高く、創合併症に対する適切な対処が重要であると考えられた。(著者抄録)
• 舌進行癌手術症例における術前超選択的動注化学療法

  鈴木 章之, 折舘 伸彦, 本間 明宏, 鈴木 清護, 畠山 博充, 瀧 重成, 坂下 智博, 福田 諭

  日本癌治療学会誌 (一社)日本癌治療学会 43 (2) 528 - 528 0021-4671 2008/10 [Not refereed][Not invited]
  
• 頭頸部癌における集学的治療 頭頸部癌に対する超選択的動注療法・照射同時併用療法

  本間 明宏, 折舘 伸彦, 鈴木 清護, 鈴木 章之, 原 敏浩, 水町 貴諭, 加納 里志, 瀧 重成, 浅野 剛, 吉田 大介, 西岡 健, 鬼丸 力也, 長谷川 雅一, 白土 博樹, 福田 諭

  日本癌治療学会誌 (一社)日本癌治療学会 43 (2) 284 - 284 0021-4671 2008/10 [Not refereed][Not invited]
  
• Intra-arterial chemotherapy for head and neck cancer: Experiences from three continents

  K. Thomas Robbins, Akihiro Homma

  SURGICAL ONCOLOGY CLINICS OF NORTH AMERICA 17 (4) 919 - + 1055-3207 2008/10 [Refereed][Not invited]
   

  Intra-arterial infusion of chemotherapy agents for cancer of the head and neck has been used for several decades. This article provides the rationale, historical background, and Current state of investigations for patients treated in this manner. The experience with this route of drug delivery comes from three geographic regions: Europe, Japan, and North America. While the results of the trials have yet to establish the approach as being superior to intravenous infusions, continued research is warranted.
• 鼻腔/副鼻腔癌に対する超選択的動注を併用した根治的化学放射線療法の治療成績

  長谷川雅一, 安田耕一, 吉田大介, 加藤徳雄, 鬼丸力也, 浅野剛, 白土博樹, 本間明宏, 折館伸彦, 福田諭

  日本放射線腫よう学会誌 20 (Supplement 1) 223  1040-9564 2008/09/22 [Not refereed][Not invited]
  
• 当科における耳下腺悪性腫瘍症例の検討

  稲村 直哉, 本間 明宏, 福田 諭

  口腔・咽頭科 日本口腔・咽頭科学会 21 (1) 87 - 87 0917-5105 2008/08 [Not refereed][Not invited]
  
• 領域別に見る64列MDCTの検査と診断 心・大血管領域 心・大血管領域における造影64列MDCTの有用性

  藤田 安彦, 大川 智彦, 太田 淑子, 永野 尚登, 本間 明宏, 宗像 雅則, 中埜 信太郎, 香川 昇

  INNERVISION (株)インナービジョン 23 (9) 88 - 92 0913-8919 2008/08 [Not refereed][Not invited]
   

  4列から始まったCTの多列化の波は、現在320列まで進化し、臨床に多大なインパクトを与えている。64列CTの普及により、冠動脈CTが侵襲性の高い心臓血管造影検査に取って代わりつつある。撮影時間の短縮化、等方向性のボリュームデータの収集による恩恵によるものであるが、膨大な情報量を処理するコンピュータの発達もあり、モニタ上で診断することが日常化してきている。従来、心臓血管造影検査がゴールドスタンダードとされてきたが、最近のCore64の報告で、あらゆる人種の冠動脈疾患の診断において、64列MDCTは心臓カテーテル検査(CAG)に匹敵、あるいは凌駕するとしている。64列MDCTでは、息止め時間が約10秒以下で撮影できるようになり、モーションアーチファクトの少ない画像が得られるようになった点が大きな理由と思われる。MIP,curved MPR(multiplanar reformation),VR(volume rendering)などの多彩な表示機能により、血管内腔が静止画像で多角的にとらえられるようになり、血管の内腔の評価やプラークの性状についても詳細な検討ができるようになった点も大きな利点と言える。当院では、2005年9月の開院当初より64列MDCTを導入し、574例の冠動脈造影CTをルーチンで施行してきたが、従来の報告と同様の診断能が得られている。本稿では、当院における撮影プロトコールを紹介し、臨床例を提示しながら臨床面における利点、問題点などについて述べる。(著者抄録)
• 喉頭癌治療後の音声に関するQOLの検討

  折舘 伸彦, 本間 明宏, 福田 諭

  耳鼻咽喉科・頭頸部外科 (株)医学書院 80 (9) 597 - 603 0914-3491 2008/08 [Not refereed][Not invited]
   

  根治治療を行った喉頭扁平上皮癌患者137例(男127例・女10例・中央値70歳)を対象に、Voice-Related Quality of Life(V-RQOL)およびVoice Handicap index(VHI)-10質問票を用い、音声に関するQOL評価を行った。治療は放射線単独63例(A群)、化学療法併用放射線29例(B群)、喉頭全摘27例(C群)、レーザー手術14例(D群)、喉頭部分切除4例であった。治療終了後1〜298ヵ月で、V-RQOLスコアの平均値はA群92.6、B群92.9、C群68.4、D群85.5、VHI-10スコアは順に2.87、2.34、11.26、5.43であった。A群およびB群はC群と比較して有意に良好であったが、治療後1年経過するとわずかに増悪する傾向を示し、D群ではその傾向はなかった。音声障害を認める症例に対しGRBASによる聴覚印象評価を行ったが、そのスコアはV-RQOLと相関係数-0.654の中程度の相関を示した。早期声門癌(T1)であったA群43例およびD群10例を比較したところ、音声QOLスコアに有意差はなかった。
• Initial CT findings in early tongue and oral floor cancer as predictors of late neck metastasis

  Jun Furusawa, Nobuhiko Oridate, Fumiyuki Suzuki, Akihiro Homma, Yasushi Furuta, Satoshi Fukuda

  ORAL ONCOLOGY 44 (8) 793 - 797 1368-8375 2008/08 [Refereed][Not invited]
   

  Detecting the risk factors for late neck metastasis (LNM) in early tongue and oral floor cancer is important for establishing an accurate prognosis, as well as for increasing survival rates. Patients with either stage I or II tongue and oral floor cancer underwent either a resection of the primary tumor or interstitial radiotherapy without neck dissection. We measured the short- and long-axis diameters of lymph nodes on initial CT images. Of the 38 patients, 20 had LNM and 18 did not. CT images showed a total of 161 lymph nodes. Twenty-five "occult lymph nodes" developed into LNM, whereas the remaining 136 "reactive lymph nodes" did not. Comparison between "occult" and "reactive" lymph nodes revealed significant differences in the short-axis diameters (p = 0.01). The measure of short-axis diameters of neck lymph nodes on initial, CT images is a useful predictor of LNM in patients with early tongue and oral floor cancer. (c) 2007 Elsevier Ltd. All rights reserved.
• 鼻前庭原発扁平上皮癌に対する超選択的動注療法と照射の同時併用療法の経験

  本間 明宏, 福田 諭

  耳鼻咽喉科臨床 補冊 耳鼻咽喉科臨床学会 (補冊121) 134 - 134 0912-1870 2008/06 [Not refereed][Not invited]
  
• 大学病院における頭頸部がん治療への歯科的口腔ケア介入

  村井 知佳, 秦 浩信, 山崎 裕, 本間 明宏, 北川 善政

  頭頸部癌 (一社)日本頭頸部癌学会 34 (2) 231 - 231 1349-5747 2008/05 [Not refereed][Not invited]
  
• 北海道大学病院における口腔底癌の治療成績

  瀧 重成, 本間 明宏, 折舘 伸彦, 鈴木 清護, 鈴木 章之, 加納 里志, 水町 貴諭, 古田 康, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 34 (2) 229 - 229 1349-5747 2008/05 [Not refereed][Not invited]
  
• 超選択的動注と放射線の同時併用療法を施行した外側咽頭後リンパ節転移症例の検討

  鈴木 章之, 本間 明宏, 瀧 重成, 水町 貴諭, 鈴木 清護, 折舘 伸彦, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 34 (2) 184 - 184 1349-5747 2008/05 [Not refereed][Not invited]
  
• 機能面を考慮した口腔・中咽頭再建 舌根1/2以上を合併切除した口腔中咽頭がんに対する機能再建

  関堂 充, 山本 有平, 本間 明宏, 鈴木 章之, 福田 諭, 古田 康

  頭頸部癌 (一社)日本頭頸部癌学会 34 (2) 135 - 135 1349-5747 2008/05 [Not refereed][Not invited]
  
• 頭頸部vascular malformationに対する治療戦略 頭頸部vascular malformationに対する治療戦略

  古川 洋志, 佐々木 了, 堤田 新, 関堂 充, 山本 有平, 浅野 剛, 鈴木 章之, 本間 明宏

  頭頸部癌 (一社)日本頭頸部癌学会 34 (2) 126 - 126 1349-5747 2008/05 [Not refereed][Not invited]
  
• 選択的動注化学療法の現状と将来展望 頭頸部進行癌新鮮例に対する超選択的動注療法の現状と今後の展望

  本間 明宏, 折舘 伸彦, 鈴木 章之, 瀧 重成, 坂下 智博, 浅野 剛, 吉田 大介, 鬼丸 力也, 長谷川 雅一, 西岡 健, 白土 博樹, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 34 (2) 110 - 110 1349-5747 2008/05 [Not refereed][Not invited]
  
• 下咽頭癌におけるcomorbidity(併存疾患)の予後への影響について

  本間 明宏, 坂下 智博, 折舘 伸彦, 鈴木 章之, 鈴木 清護, 畠山 博充, 水町 貴諭, 瀧 重成, 福田 諭

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 111 (4) 392 - 392 0030-6622 2008/04 [Not refereed][Not invited]
  
• 巨大上皮体癌の1例

  蠣崎 文彦, 本間 明宏, 前田 昌紀, 畠山 博充, 福田 諭

  日本気管食道科学会会報 (NPO)日本気管食道科学会 59 (2) 287 - 287 0029-0645 2008/04 [Not refereed][Not invited]
  
• 下咽頭進行癌に対する超選択的動注と放射線の同時併用療法 治療成績とその適応

  鈴木 章之, 本間 明宏, 折舘 伸彦, 畠山 博充, 古沢 純, 古田 康, 福田 諭

  日本気管食道科学会会報 (NPO)日本気管食道科学会 59 (2) 246 - 246 0029-0645 2008/04 [Not refereed][Not invited]
  
• Preoperative embolization and postoperative complication of carotid body tumors

  Shinya Morita, Yasushi Furuta, Akihiro Honma, Fumiyuki Suzuki, Kaori Fujita, Satoshi Fukuda

  Journal of Otolaryngology of Japan (一社)日本耳鼻咽喉科学会 111 (3) 96 - 101 0030-6622 2008 [Not refereed][Not invited]
   

  Carotid body tumors are uncommon neoplasms that arise at the bifurcation of the common carotid artery. Surgical resection is generally recommended, but entails an inherent risk of cranial nerves injury and excessive blood loss. Preoperative embolization has been reported to decrease blood loss and shorten resection time. In this study, we analyzed the benefits of preoperative embolization and the postoperative complications when preoperative embolization was performed. Six patients with seven tumors were treated between 1990 and 2005. Each patient's preoperative evaluation included CT, MRI, US, and angiography, and preoperative embolization was performed in four patients with five tumors. Blood loss, in the patients who underwent preoperative embolization, ranged from 20 ml to 900 ml (mean : 291ml), and operation time ranged from 4 hours 34 minutes to 6 hours 40 minutes (mean : 4 hours 55 minutes). In the group that did not undergo preoperative embolization, blood loss ranged from 642ml to 1390ml (mean: 1016ml), and operation time ranged from 9 hours 48 minutes to 10 hours 45 minutes (mean : 10 hours 17 minutes). Five patients had postoperative cranial nerve dysfunction, and it involved cranial nerve IX in one patient (14.3%), cranial nerve X in two patients (28.5%), and cranial nerve XII in five patients (71.4%). Resection of bilateral carotid body tumors in one patient resulted in baroreflex failure syndrome. In conclusion, preoperative embolization tends to decrease blood loss and shorten operation time, resulting in lower postoperative neurologic morbidity.
• 喉頭癌治療後の音声・嚥下機能評価 放射線治療を受けた喉頭癌患者の治療後音声に関するQOLの検討

  折舘 伸彦, 古田 康, 西澤 典子, 本間 明宏, 鈴木 清護, 目須田 康, 福田 諭

  喉頭 日本喉頭科学会 19 (2) 59 - 64 0915-6127 2007/12 [Not refereed][Not invited]
   

  根治治療後の喉頭癌患者130例を対象に、音声に関する質問表調査をVoice-Related Quality of Life(V-RQOL)質問表、VOICE HANDICAP INDEX-10(VHI-10)質問表を用いて行い、治療法別に比較検討した。その結果、1)治療法別V-RQOLスコアの平均値は放射線治療92.2、化学療法併用放射線治療92.9、レーザー手術85.5、喉頭全摘術68.5で、既報の結果と矛盾しないと考えられた。2)それぞれのドメインの治療法別V-RQOLスコアでは、喉頭癌根治治療後の音声のQOL低下はSocialemotional DomainよりもPhysical-functioning Domainにより反映される傾向にあった。3)治療法別VHI-10スコアの平均値は、放射線治療2.95、化学療法併用放射線治療2.34、レーザー手術5.43、喉頭全摘術11.12であった。4)V-RQOLはVHI-10と強い相関を示したが、GRBASによる聴覚印象評価を行った症例で聴覚印象Gスコアと音声QOLの相関を検討したところ、V-RQOLあるいはVHI-10は聴覚印象Gスコアと中程度の逆相関を示した。
• 頭頸部癌に対する超選択的抗癌剤動注化学療法

  吉田 大介, 浅野 剛, 白土 博樹, 本間 明宏, 鈴木 章之, 福田 諭

  IVR: Interventional Radiology (一社)日本インターベンショナルラジオロジー学会 22 (4) 502 - 502 1340-4520 2007/10 [Not refereed][Not invited]
  
• Prognostic significance of cyclin D1 and p16 in patients with intermediate-risk head and neck squamous cell carcinoma treated with docetaxel and concurrent radiotherapy

  Eisaku Higuchl, Nobuhiko Oridate, Akihiro Homma, Fumiyuki Suzuki, Yoshihiro Atago, Tatsumi Nagahashi, Yasushi Furuta, Satoshi Fukuda

  HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK 29 (10) 940 - 947 1043-3074 2007/10 [Refereed][Not invited]
   

  Background. The current study aimed to evaluate the significance of the cell-cycle-control proteins cyclin D1 and p16 as prognostic markers in head and neck squamous cell carcinoma (HNSCC) patients treated with docetaxel and radiotherapy. Methods. Cyclin D1 and/or p16 protein expression was retrospectively evaluated by immunohistochemistry in 53 patients with stage T1-3N0-2M0 (except T1NO glottis) HNSCC who were treated with 10 mg/m(2)/week docetaxel 4 to 6 times and received concurrent chemoradiotherapy. Results. Kaplan-Meier univariate analysis revealed that patients with cyclin D1-positive tumors or p16-negative tumors had a worse prognosis compared with those with cyclin D1-negative tumors or p16-positive tumors (p =.0004 and p =.025, respectively). The prognostic significance of cyclin D1 expression, not p16 expression, was confirmed using a proportional hazard regression model. Conclusions. An assessment of cyclin D1 and p16 levels might be of clinical use in defining subgroups of patients with poor prognosis. (c) 2007 Wiley Periodicals, Inc.
• 頭頸部癌再発・転移症例に対するS-1の有用性の検討

  本間 明宏, 折舘 伸彦, 鈴木 章之, 福田 諭, 古田 康

  日本癌治療学会誌 (一社)日本癌治療学会 42 (2) 480 - 480 0021-4671 2007/09 [Not refereed][Not invited]
  
• 気管内挿管チューブの側孔を利用したvoice prosthesis二期的挿入術

  古田 康, 本間 明宏, 折舘 伸彦, 目須田 康, 西澤 典子, 福田 諭

  日本気管食道科学会会報 (NPO)日本気管食道科学会 58 (4) 417 - 421 0029-0645 2007/08 [Not refereed][Not invited]
   

  喉頭摘出を含む一次治療終了後にvoice prosthesisを二期的に挿入する場合、食道直達鏡を用いた挿入術に難渋することがある。われわれが行っている気管内挿管チューブの側孔を利用したvoice prosthesis挿入方法を紹介する。全身麻酔下に気管内挿管チューブと内視鏡を食道内に挿入し、モニターで観察しながら挿入用インサーターが気管チューブの先端にある側孔を通るように穿刺する。従来の方法で穿刺する時は、抵抗が大きく容易に穿刺できず、また食道後壁を損傷する危険性もあるが、本法では挿入用インサーターの先端が確実に気管チューブ内に誘導されるので、かなり力を入れても安全に穿刺することができる。(著者抄録)
• 【医療におけるトラブルをめぐって 予期せぬ出来事への対応】 頭頸部癌領域 癌化学療法の合併症

  福田 諭, 本間 明宏

  JOHNS (株)東京医学社 23 (8) 1138 - 1142 0910-6820 2007/08 [Not refereed][Not invited]
  
• 頭頸部癌 動注化学療法と放射線治療併用療法

  本間 明宏

  癌と化学療法 (株)癌と化学療法社 34 (7) 1027 - 1030 0385-0684 2007/07 [Not refereed][Not invited]
  
• [Head and neck: intra-arterial chemotherapy and combined radiotherapy].

  Homma A

  Gan to kagaku ryoho. Cancer & chemotherapy 34 (7) 1027 - 1030 0385-0684 2007/07 [Refereed][Not invited]
  
• Development of a radiation detector made of a cubic boron nitride polycrystal

  J. H. Kaneko, T. Taniguchi, S. Kawamura, K. Satou, F. Fujita, A. Homma, M. Furusaka

  NUCLEAR INSTRUMENTS & METHODS IN PHYSICS RESEARCH SECTION A-ACCELERATORS SPECTROMETERS DETECTORS AND ASSOCIATED EQUIPMENT 576 (2-3) 417 - 421 0168-9002 2007/06 

  Radiation detectors were fabricated using single and polycrystalline cubic boron nitride (cBN) crystals synthesized using a high-pressure and high-temperature (HP/HT) method. Although cBN single crystals obtained using a barium BN solvent system were nearly colorless and displayed high electrical resistance, in contrast to conventional amber-colored crystals, the single crystals exhibit a leakage current that renders them unsuitable for use in a detector. In contrast, a detector made of a cBN polycrystal synthesized by direct transformation had a very low leakage current of 0.2pA with bias voltage of 100V; it functioned as a radiation detector. From an experiment using alpha-particles, holes traversed a longer distance than electrons. It had a fast rise time of approximately 300ns. The detector also showed sensitivity to neutrons. However, output signals were smaller than the expected voltage from the experiment using alpha-particles, probably because of charge accumulation from the high-neutron flux. (C) 2007 Elsevier B.V. All rights reserved.
• 下咽頭癌症例における咽頭後リンパ節転移についての検討

  坂下 智博, 古田 康, 折舘 伸彦, 本間 明宏, 永橋 立望, 鈴木 章之, 畠山 博充, 古沢 純, 瀧 重成, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 33 (2) 206 - 206 1349-5747 2007/05 [Not refereed][Not invited]
  
• 喉頭癌治療後の音声に関するQOLの検討

  折舘 伸彦, 古田 康, 本間 明宏, 鈴木 清護, 中丸 裕爾, 鈴木 章之, 畠山 博充, 瀧 重成, 坂下 智博, 西澤 典子, 目須田 康, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 33 (2) 178 - 178 1349-5747 2007/05 [Not refereed][Not invited]
  
• 化学療法と放射線治療の同時併用療法(CRT)後の頸部郭清術における郭清範囲の縮小について

  本間 明宏, 折舘 伸彦, 鈴木 章之, 古田 康, 畠山 博充, 古沢 純, 瀧 重成, 坂下 智博, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 33 (2) 164 - 164 1349-5747 2007/05 [Not refereed][Not invited]
  
• 下咽頭癌における(化学)放射線療法後の救済手術の治療成績

  瀧 重成, 本間 明宏, 古田 康, 折舘 伸彦, 鈴木 章之, 古沢 純, 坂下 智博, 木下 留美子, 白戸 博樹, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 33 (2) 163 - 163 1349-5747 2007/05 [Not refereed][Not invited]
  
• 中咽頭前壁(舌根)癌に対する超選択的動注と放射線の同時併用療法

  鈴木 章之, 本間 明宏, 古沢 純, 浅野 剛, 坂下 智博, 瀧 重成, 畠山 博充, 折舘 伸彦, 古田 康, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 33 (2) 149 - 149 1349-5747 2007/05 [Not refereed][Not invited]
  
• Salvage手術 切除範囲と合併症 喉頭癌に対する化学放射線同時併用療法後salvage手術の合併症

  古田 康, 本間 明宏, 折舘 伸彦, 鈴木 章之, 畠山 博充, 瀧 重成, 坂下 智博, 西岡 健, 鈴木 恵士郎, 白土 博樹, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 33 (2) 97 - 97 1349-5747 2007/05 [Not refereed][Not invited]
  
• 遊離皮弁術による再建手術における術前治療の影響

  瀧 重成, 本間 明宏, 古田 康, 鈴木 章之, 折舘 伸彦, 坂下 智博, 関堂 充, 山本 有平, 福田 諭

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 110 (4) 365 - 365 0030-6622 2007/04 [Not refereed][Not invited]
  
• GERD 咽喉頭酸逆流症患者における酸抑制治療による典型的胃食道逆流症状と咽喉頭症状の改善の差異

  折舘 伸彦, 目須田 康, 西澤 典子, 森 美果, 本間 明宏, 古田 康, 福田 諭

  日本気管食道科学会会報 (NPO)日本気管食道科学会 58 (2) 187 - 188 0029-0645 2007/04 [Not refereed][Not invited]
  
• Evidenceに基づく下咽頭進行癌の治療戦略 超選択的動注療法

  本間 明宏, 古田 康, 鈴木 章之, 古沢 純, 折舘 伸彦, 愛宕 義浩, 樋口 栄作, 福田 諭

  日本気管食道科学会会報 (NPO)日本気管食道科学会 58 (2) 130 - 130 0029-0645 2007/04 [Not refereed][Not invited]
  
• 【口腔癌にどう対応するか 症例から学ぶ】 上歯肉癌、硬口蓋癌 T3・T4症例の化学療法・放射線治療

  本間 明宏

  JOHNS (株)東京医学社 23 (4) 599 - 602 0910-6820 2007/04 [Not refereed][Not invited]
  
• 64-MDCTによる冠動脈の評価 CAGとの比較(Evaluation of Coronary Arteries with 64-MDCT: Comparison with CAG)

  藤田 安彦, 大川 智彦, 太田 淑子, 永野 尚登, 本間 明宏, 宗像 雅則, 中埜 信太郎, 香川 昇

  日本医学放射線学会学術集会抄録集 (公社)日本医学放射線学会 66回 S165 - S165 0048-0428 2007/02 [Not refereed][Not invited]
  
• Efficacy of superselective infusion of cisplatin and radiotherapy to control neck disease in head and neck cancers

  Akihiro Homma, Yasushi Furuta, Fumiyuki Suzuki, Jun Furusawa, Nobuhiko Oridate, Hiromitsu Hatakeyama, Tatsumi Nagahashi, Satoshi Fukuda, Takeshi Asano, Keishiro Suzuki, Takeshi Nishioka, Hiroki Shirato

  Toukeibu Gan (一社)日本頭頸部癌学会 33 (1) 39 - 42 1881-8382 2007 [Not refereed][Not invited]
   

  Background: Management of lymph node metastasis in head and neck cancer is as important as that of the primary site. We analyzed the treatment outcome in the necks of patients with lymph node metastasis treated by rapid superselective intra-arterial infusion of cisplatin and concomitant radiotherapy (RADPLAT). Patients and Methods: Twenty-three patients with positive lymph nodes whose neck disease was followed up for over one year were analyzed. Primary tumor sites were hypopharynx (13 cases), oropharynx (5), paranasal sinus (4), and parotid gland (1). N stages included N1 (2 cases), N2b (10), N2c (8), and N3 (3). All patients received superselective intra-arterial infusion therapy of cisplatin (100-120 mg/m2/week) with simultaneous intravenous infusion of thiosulfate for neutralizing cisplatin toxicity, and conventional extrabeam radiotherapy (65 Gy/26f/6.5 weeks). The most cisplatin was injected to the primary site, but in patients with nodes of more than 3 cm, some of the drug (approximately 20 to 30 mg) was delivered to this region. Neck dissection was indicated in cases where the neck disease was residual or recurring. Results: Among the 23 patients, the neck diseases of 17 (74%) were well controlled by RADPLAT without surgery 2/2 (100%) with N1 disease, 7/10 (70%) with N2b, 7/8 (87.5%) with N2c, and 1/3 (33.3%) with N3. Among the 5 patients with persistent neck disease, 2 patients with N2b and 1 with N2c were treated successfully by salvage neck dissection. As a result, neck disease was successfully controlled in 20 of 23 (87%) with all patients with positive lymph nodes 2/2 (100%) patients with N1, 7/8 (87.5%) with N2b, 8/8 (100%) with N2c, and 1/3 (33.3%) with N3. Conclusions: RADPLAT was effective not only for primary disease but also neck metastasis. We should establish when and how to employ neck dissection for patients treated by chemoradiotherapy. © 2007, Japan Society for Head and Neck Cancer. All rights reserved.
• Surgical complications of salvage surgery following concurrent chemoradiotherapy for laryngeal cancer

  Yasushi Furuta, Akihiro Homma, Nobuhiko Oridate, Fumiyuki Suzuki, Hiromitsu Hatakeyama, Shigenari Taki, Tomohiro Sakashita, Satoshi Fukuda, Takeshi Nishioka, Keishiro Suzuki, Hiroki Shirato, Mitsuru Sekido, Yuhei Yamamoto

  Toukeibu Gan (一社)日本頭頸部癌学会 33 (3) 356 - 360 1881-8382 2007 [Not refereed][Not invited]
   

  Surgical complication rates of salvage laryngectomy after chemoradiotherapy (CRT) have been reported to be high. Wound complications after salvage laryngectomy following concurrent chemoradiotherapy (CCRT) were analyzed. Eighty-six patients who had undergone total laryngectomy for laryngeal cancer at Hokkaido University Hospital between 1990 and 2006 were divided into three groups according to preoperative treatments received: TL group (n = 35) without radiotherapy (RT) or CCRT, RT-TL group (n = 17) with RT alone, CRT-TL group (n = 34) with low-dose CCRT. Major wound complications were defined as major pharyngocutaneous fistulas which caused inpatient care for more than eight weeks or which were closed by surgery, bleeding that required surgical reintervention, and wound infection or skin necrosis that caused inpatient care for more than eight weeks. Minor complications were self-limited, managed with local wound care, and did not prolong inpatient care for more than eight weeks. We also analyzed wound complications of larynx preservation surgery after CCRT. Overall wound complications, both major and minor, were observed in 26% of the TL group, 35% of the RT-TL group, and 47% of the CRT-TL group. Major wound complications were observed in 11%, 18%, and 29%, respectively. A considerable but not statistically significant increase in the incidence of overall and major wound complications was observed between the TL and CRT-TL groups (p = 0.082 and 0.078, respectively). Pharyngocutaneous fistulas were the most common complication, occurring in 14/86 (16%) of patients. Patients who developed pharyngocutaneous fistulas after CCRT tended to require surgical reintervention and longer periods before the initiation of oral intake. Wound complications were observed in 2/3 (67%) of patients who had undergone larynx preservation surgery. High incidences of wound complications and poor wound recovery in patients undergoing salvage laryngectomy following CCRT should be taken into account before the initiation of CCRT. © 2007, Japan Society for Head and Neck Cancer. All rights reserved.
• Voice-Related Quality of Life after Treatment for Laryngeal Cancer

  Nobuhiko Oridate, Yasushi Furuta, Akihiro Homma, Seigo Suzuki, Fumiyuki Suzuki, Hiromitsu Hatakeyama, Shigenari Taki, Tomohiro Sakashita, Satoshi Fukuda

  Toukeibu Gan (一社)日本頭頸部癌学会 33 (4) 465 - 469 1881-8382 2007 [Not refereed][Not invited]
   

  There are many methods of treating laryngeal cancers: definitive irradiation with or without concurrent chemotherapy, endoscopic laser surgery, partial surgery techniques, and total laryngectomy. Few studies have been reported on vocal function and quality of life of patients after the definitive treatment for laryngeal cancer, using single voice related QOL measures. The aim of this study was to examine voice related QOL in patients treated with various modalities using a Voice-Related Quality of Life (V-RQOL) questionnaire as well as Voice Handicap Index-10 (VHI-10) questionnaire. Between August 2006 and May 2007, survey data on voice utilizing the V-RQOL and VHI-10 were obtained from a total of 130 patients who had received definitive treatment for laryngeal cancers with follow-up at the Hokkaido University Hospital, and who were alive with no evidence of malignancy at the time of survey. Mean V-RQOL scores of the patients who received radiation therapy (n=63), chemoradiotherapy (n=29), laser resection (n=14) and total laryngectomy (n=27) as the final treatment for laryngeal cancer were 92.6, 92.9, 85.5, and 68.4, respectively. Mean VHI-10 values were 2.87, 2.34, 5.43, and 11.26. Such measures of quality of life are important endpoints to help judge the overall effectiveness of treatment options for laryngeal cancers. © 2007, Japan Society for Head and Neck Cancer. All rights reserved.
• A novel approach to advanced carcinoma of the tongue: Cases successfully treated with combination of superselective intra-arterial chemotherapy and external/high-dose-rate interstitial radiotherapy

  Takeshi Nishioka, Akihiro Homma, Yasushi Furuta, Hidefumi Aoyama, Fumiyuki Suzuki, Keiichi Ohmori, Takeshi Asano, Daisuke Yoshida, Hiroki Shirato, Satoshi Fukuda

  JAPANESE JOURNAL OF CLINICAL ONCOLOGY 36 (12) 822 - 826 0368-2811 2006/12 [Refereed][Not invited]
   

  Objective: This study sought to evaluate the efficacy and safety of a novel treatment regimen, intra-arterial cisplatin infusion plus external/high-dose-rate radiotherapy. Methods: Superselective intra-arterial infusion of cisplatin (100-120 mg) was performed concomitantly with external radiotherapy in four patients with locally advanced carcinoma of the tongue. A high-dose-rate brachytherapy boost was performed after combination therapy in all patients. Brachytherapy was performed after external radiotherapy, and the treatment schedule was twice daily, with a fraction of 600 cGy up to a total of 30-48 Gy. Results: All patients completed the therapy as scheduled. There were no vascular or neurological complications. Grade III acute radiation mucositis developed in all patients but this did not necessitate a treatment break. With a mean follow-up period of 35 months, loco-regional control was obtained for all patients. Conclusions: The combination of weekly administration of intra-arterial cisplatin plus external/high-dose-rate radiotherapy seems effective for advanced carcinoma of the tongue.
• "Watch-and-see" policy for the clinically positive neck in head and neck cancer treated with chemoradiotherapy

  Akihiro Homma, Yasushi Furuta, Nobuhiko Oridate, Fumiyuki Suzuki, Eisaku Higuchi, Takeshi Nishioka, Hiroki Shirato, Tatsumi Nagahashi, Katsunori Yagi, Satoshi Fukuda

  International Journal of Clinical Oncology 11 (6) 441 - 448 1341-9625 2006/12 [Refereed][Not invited]
   

  Background. Chemoradiotherapy (CRT) is becoming more widely used for head and neck cancer. However, there are conflicting theories regarding the best management options for patients with advanced nodal disease. Methods. From 1990 to 1999, we treated 96 patients with N1-N2 neck disease by concomitant CRT for organ preservation, using weekly carboplatin or a low daily dose of cisplatin, followed by a "watch-and-see" policy for the neck. In the present study, we retrospectively analyzed the treatment outcome in 63 of these patients who received definitive CRT for primary and neck diseases and were monitored for neck disease for more than 2 years. Results. In 12 of the 22 (55%) N1 patients, CRT successfully controlled the neck disease. CRT was successful in 18 of the 41 (44%) patients with N2 disease. In 6 (60%) of 10 patients with residual or recurrent N1 disease, salvage surgery was successful. Of the 23 patients with residual or recurrent N2 disease, salvage surgery was successful in 8 patients (35%). The group of patients who showed a clinical complete response (CCR) to CRT had an overall survival rate of 62.4% (33 patients), whereas for those with a less than complete response (< CCR), the figure was 13.3% (30 patients P < 0.001). Among the < CCR-neck group, patients who underwent neck dissection (ND) as well (n = 20) did not have a significantly better overall survival than those who did not undergo ND (n = 10 P = 0.069). Conclusion. We propose a treatment plan for neck disease that involves observing the neck closely following CRT. ND should be planned only when there is evidence that neck disease exists. © 2006 The Japan Society of Clinical Oncology.
• 上咽頭癌放射線治療後に晩期嚥下障害を発症した3例

  目須田 康, 本間 明宏, 西澤 典子, 折舘 伸彦, 堂坂 善弘, 古田 康, 福田 諭

  耳鼻と臨床 耳鼻と臨床会 52 (Suppl.4) S286 - S290 0447-7227 2006/11 [Not refereed][Not invited]
   

  近年上咽頭癌放射線治療後晩期に嚥下障害を来した例を3例経験した。症例は男性2例女性1例で、治療時年齢は20-41歳。2例は上咽頭癌に対する標準的な放射線治療を、1例は放射線化学併用療法を受けており、治療後8-15年で嚥下障害を発症した。全例両側舌下神経麻痺を中心として咽喉頭の感覚運動障害を有し、1例では補助栄養として間欠的口腔食道栄養法(OE法)を指導し、1例では誤嚥性肺炎をコントロールするため誤嚥防止手術(喉摘)を必要とした。末梢神経線維は一般に放射線抵抗性とされるが、過去の報告では放射線障害による脳神経障害に起因した誤嚥性肺炎で死亡する例も存在する。近年上咽頭癌に対し放射線化学併用療法が積極的に行われており、予後の改善と引き換えに晩期脳神経障害を背景にした嚥下障害が増加する可能性があることを、嚥下障害を担当する医療者や頭頸部腫瘍治療担当者は銘記する必要があろう。(著者抄録)
• 【小児の耳鼻咽喉頭・頭頸部疾患 診断と治療】 頭頸部良性腫瘍

  福田 諭, 古田 康, 本間 明宏

  小児外科 (株)東京医学社 38 (11) 1366 - 1371 0385-6313 2006/11 [Not refereed][Not invited]
  
• 上顎全摘術におけるナビゲーションシステムの有用性について

  本間 明宏, 樋口 榮作, 鈴木 章之, 佐伯 昌彦, 福田 諭

  耳鼻咽喉科展望 耳鼻咽喉科展望会 49 (5) 310 - 312 0386-9687 2006/10 [Not refereed][Not invited]
   

  症例は59歳女性で、右上顎洞原発扁平上皮癌(T3M0N0)と診断された。MRI上腫瘍は右上顎洞内上方を中心に存在し篩骨洞にも進展を認め、CTでは眼窩内側壁の骨破壊を認めた。40Gyの術前照射後にナビゲーションシステムを用いて上顎洞全摘出術を施行した。ナビゲーションシステムは解剖学的位置をリアルタイムに確認しながら骨切り線を決めることができるので有用であり、本症例では特に頬骨・上内側の前頭突起・眼窩下壁の切除ラインの設定、翼状突起にノミを入れる際の位置と方向の決定に有用であった。以上よりナビゲーションシステムは上顎洞全摘術の施行に際して必要な三次元的な解剖の理解と腫瘍の局在に合わせた切除範囲の設定に補助的な役割を果すものとして有用性が高く、また安全性を確保して上で切除範囲を縮小できる可能性もあると考えられた。
• 術前に超選択的動注療法を施行した頬部有棘細胞癌の1例

  柳 輝希, 青柳 哲, 芝木 晃彦, 本間 明宏, 坪田 晶子, 清水 宏

  Skin Cancer (一社)日本皮膚悪性腫瘍学会 21 (2) 184 - 188 0915-3535 2006/10 [Not refereed][Not invited]
   

  今回我々は頬粘膜に生じ、術前動注化学療法を施行した有棘細胞癌の1例を経験した。患者は66歳男性、初診の1年半前より右頬粘膜に腫瘍を自覚し、近医での生検にて有棘細胞癌の診断に至った。当科初診時、右頬粘膜から口角に径3.5cmの腫瘍を認め、全身精査の結果転移を認めず、T2N0M0 Stage IIと診断した。根治性とQuality of lifeを考慮し、術前動注化学療法と手術療法併用による治療を行った。Cisplatin 100mg/m2による超選択的動注療法により腫瘍は著明な縮小を認め、侵襲の少ない手術を施行出来た。超選択的動注化学療法は従来、主に手術不能例に対して放射線照射との同時併用で施行されているが、手術可能でかつ再建が困難な症例に対して患者のQuality of lifeを考慮する縮小手術の点から、術前療法としても期待出来ると考えた。(著者抄録)
• 副鼻腔癌の治療方針

  橋本 省, 本間 明宏, 兵藤 伊久夫, 石原 明子

  耳鼻と臨床 耳鼻と臨床会 52 (Suppl.3) S232 - S242 0447-7227 2006/09 [Not refereed][Not invited]
  
• 鼻副鼻腔癌に対する超選択的動注療法+照射の同時併用療法

  本間 明宏, 古田 康, 鈴木 章之, 浅野 剛, 吉田 大介, 西岡 健, 鈴木 恵士郎, 白土 博樹, 福田 諭

  耳鼻と臨床 耳鼻と臨床会 52 (Suppl.3) S213 - S219 0447-7227 2006/09 [Not refereed][Not invited]
   

  鼻副鼻腔癌37例に対して根治治療として超選択的動注療法+照射の同時併用療法(以下RADPLAT)を行った。観察期間は平均で2年6ヵ月とまだ短いが、粗生存率では、全症例では73%で、T4b症例では66%、T3+T4aでは76%であった。原発巣の制御率(progression free rate)は、全体で84%、T4b症例では74%、T3+T4aでは90%であった。合併症としては視力障害、流涙、閉塞性の副鼻腔炎、骨壊死などが見られた。RADPLATの合併症は手術と比較してそれほど重篤とはいえず、RADPLATは鼻副鼻腔癌治療の一つの選択肢となり得るのではないかと考えられた。(著者抄録)
• 頭頸部癌におけるchemoradiationの有用性と限界 超選択的動注によるchemoradiationの有用性と限界

  本間 明宏, 古田 康, 鈴木 章之, 古沢 純, 折舘 伸彦, 浅野 剛, 吉田 大介, 西岡 健, 鈴木 恵士郎, 白土 博樹, 福田 諭

  日本癌治療学会誌 (一社)日本癌治療学会 41 (2) 323 - 323 0021-4671 2006/09 [Not refereed][Not invited]
  
• 【頭頸部がん患者診療のポイント】 化学療法の実際とポイント 超選択的動注化学療法

  鈴木 章之, 本間 明宏, 福田 諭

  臨床腫瘍プラクティス (株)ヴァンメディカル 2 (3) 280 - 285 1880-3083 2006/08 [Not refereed][Not invited]
  
• 【頭頸部がん患者診療のポイント】 放射線療法の適応 手術+放射線療法

  折舘 伸彦, 本間 明宏, 西岡 健

  臨床腫瘍プラクティス (株)ヴァンメディカル 2 (3) 268 - 270 1880-3083 2006/08 [Not refereed][Not invited]
  
• 【頭頸部がん患者診療のポイント】 頭頸部がんの検査とそのポイント

  樋口 榮作, 本間 明宏, 福田 諭

  臨床腫瘍プラクティス (株)ヴァンメディカル 2 (3) 235 - 241 1880-3083 2006/08 [Not refereed][Not invited]
  
• 下咽頭癌に対する超選択的動注療法と放射線同時併用療法の検討

  古沢 純, 本間 明宏, 福田 諭

  口腔・咽頭科 日本口腔・咽頭科学会 18 (3) 407 - 413 0917-5105 2006/06 [Not refereed][Not invited]
   

  超選択的動注療法と放射線同時併用療法を行なった下咽頭進行癌15例について検討した.現在までの治療経過は非担癌生存11例,原病死3例,他病死1例であった.予後はKaplan-Meier法で検討し,2年粗生存率が53.7%,喉頭温存率が78.3%であった.今回の治療は,シスプラチンの経静脈的全身投与による放射線同時化学療法と比較して有害事象が遜色なく,治療後のQOLも許容範囲内であった.また,超選択的動注を行なう際はSeldinger法が望ましく,アンギオCTにより腫瘍への血流分布を確認するのが望ましいと考えた(著者抄録)
• 外来で行うがん化学療法 頭頸部癌再発例に対するTS-1の有用性について

  本間 明宏, 福田 諭

  耳鼻咽喉科臨床 補冊 耳鼻咽喉科臨床学会 (補冊118) 38 - 38 0912-1870 2006/06 [Not refereed][Not invited]
  
• 咽喉頭酸逆流症状に対する酸抑制治療の効果とHelicobacter pylori感染との関連

  折舘 伸彦, 目須田 康, 西澤 典子, 森 美果, 中丸 裕爾, 本間 明宏, 古田 康, 福田 諭

  日本気管食道科学会会報 (NPO)日本気管食道科学会 57 (3) 262 - 267 0029-0645 2006/06 [Not refereed][Not invited]
   

  本邦では逆流性食道炎罹患率とHelicobactor pylori感染率について逆相関を示唆する報告が多いが,咽喉頭異常感,慢性咳嗽,嗄声などの咽喉頭酸逆流症状を訴える患者におけるH.pylori感染率についての報告はまだない.われわれは咽喉頭酸逆流症状にて北海道大学病院耳鼻咽喉科を受診した患者のうち血清H.pylori抗体を測定し得た67例を対象としてH.pylori抗体陽性率,咽喉頭酸逆流症状,酸抑制治療への反応性との関連を検討した.対象患者群の血清抗H.pylori抗体の陽性率は61.2%であり,H.pylori抗体陽性群と陰性群の間には,患者背景,治療前の自覚症状の各項目において有意差を認めなかった.Kaplan-Meier解析により咽喉頭症状改善率についてはH.pylori抗体陽性群は陰性群に比べ酸抑制治療に対する反応が良好であるが,食道症状については両群間に有意差を認めないことが示された(著者抄録)
• 口腔癌T1-2N0症例における後発頸部転移に関する免疫組織学的検討

  折舘 伸彦, 鈴木 章之, 鈴木 清護, 本間 明宏, 水町 貴諭, 古田 康, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 32 (2) 181 - 181 1349-5747 2006/05 [Not refereed][Not invited]
  
• 超選択的動注療法+照射の同時併用療法のリンパ節転移への効果

  本間 明宏, 古田 康, 鈴木 章之, 浅野 剛, 古沢 純, 折舘 伸彦, 樋口 栄作, 永橋 立望, 鈴木 恵士郎, 西岡 健, 白土 博樹, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 32 (2) 177 - 177 1349-5747 2006/05 [Not refereed][Not invited]
  
• 舌進行癌手術症例における術前超選択的動注化学療法

  鈴木 章之, 本間 明宏, 古沢 純, 浅野 剛, 折舘 伸彦, 樋口 栄作, 鈴木 清護, 古田 康, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 32 (2) 176 - 176 1349-5747 2006/05 [Not refereed][Not invited]
  
• 鼻副鼻腔乳頭腫T3症例に対する内視鏡下手術の検討

  及川 敬太, 古田 康, 中丸 裕爾, 本間 明宏, 折舘 伸彦, 福田 諭

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 109 (4) 410 - 410 0030-6622 2006/04 [Not refereed][Not invited]
  
• 鼻副鼻腔進行癌に対する超選択的動注と放射線の同時併用療法

  鈴木 章之, 本間 明宏, 古沢 純, 折舘 伸彦, 古田 康, 樋口 栄作, 福田 諭

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 109 (4) 408 - 408 0030-6622 2006/04 [Not refereed][Not invited]
  
• 北海道大学における声門癌T2N0症例の検討

  愛宕 義浩, 古田 康, 本間 明宏, 折舘 伸彦, 樋口 栄作, 鈴木 章之, 福田 諭, 永橋 立望

  日本気管食道科学会会報 (NPO)日本気管食道科学会 57 (2) 224 - 225 0029-0645 2006/04 [Not refereed][Not invited]
  
• 気管内挿管チューブを用いたグロニンゲン・ボイスボタン二期的挿入法

  古田 康, 本間 明宏, 折舘 伸彦, 樋口 栄作, 鈴木 章之, 目須田 康, 西澤 典子, 福田 諭

  日本気管食道科学会会報 (NPO)日本気管食道科学会 57 (2) 216 - 216 0029-0645 2006/04 [Not refereed][Not invited]
  
• 鼻副鼻腔内反性乳頭腫の術式選択におけるstaging systemの問題点

  古田 康, 及川 敬太, 中丸 裕爾, 本間 明宏, 折舘 伸彦, 福田 諭

  頭頸部外科 (NPO)日本頭頸部外科学会 15 (3) 195 - 201 1349-581X 2006/02 [Not refereed][Not invited]
   

  著者らは術前MRIにより伸展範囲を評価して術式を選択している.そこで,この方法により治療を行った20例の術式選択についてまとめた.またKrouseのstaging systemの問題点について考察した.男性13例,女性7例を対象にした結果,T1は再発例の1例,T2と診断された8例中6例で,内視鏡下副鼻腔手術(ESS)を施行した.T3と診断された10例中5例は,lateral rhinotomyアプローチによるmedial maxillectomyを選択した.T4と診断されたのは,22年前に初回手術を行った後の再発例の1例だけであった.術後5ヵ月から40ヵ月の経過観察をし,T1からT3症例においては再発は認められていない.T4症例は,放射線照射により縮小したが,照射後7ヵ月が経過し腫瘍が増大しつつある
• Marked and restricted cutaneous pigmentation induced by selective intra-arterial cisplatin infusion

  T Yanagi, M Akiyama, S Aoyagi, A Shibaki, A Homma

  JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY 54 (2) 362 - 363 0190-9622 2006/02 [Refereed][Not invited]
  
• PPI投与にて改善した機能性発声障害の3例

  目須田 康, 折舘 伸彦, 西澤 典子, 森 美果, 本間 明宏, 古田 康, 堂坂 善弘, 福田 諭

  音声言語医学 日本音声言語医学会 47 (1) 93 - 94 0030-2813 2006/01 [Not refereed][Not invited]
  
• Magnetic resonance imaging of olfactory neuroblastoma

  Mitsuhiro Iio, Akihiro Homma, Yasushi Furuta, Satoshi Fukuda

  Journal of Otolaryngology of Japan (一社)日本耳鼻咽喉科学会 109 (3) 142 - 148 0030-6622 2006 [Not refereed][Not invited]
   

  Olfactory neuroblastoma is an uncommon intranasal tumor originating from olfactory neuroepithelium. Despite the development of electron microscopy and immunohistochemical testing, the pathological diagnosis of this tumor is still difficult because of the wide range of histological features. Magnetic resonance imaging (MR) of this tumor and the pattern of contrast enhancement have not been well described. The purpose of this report was to analyze the MR characteristics of olfactory neuroblastomas. The MR signal, pattern of contrast enhancement, and correlation with high-resolution computed tomography (CT) imaging were examined. Seventeen patients with olfactory neuroblastoma were treated at Hokkaido University Hospital and a related hospital during the past 25 years. MR images taken in 12 patients and CT images taken in 9 patients with histologically confirmed olfactory neuroblastoma were retrospectively reviewed. Compared with brain gray matter, 11 tumors were hypointense on T1-weighted images, 9 homogeneously and 2 heterogenously. Eight tumors were hyperintense on T2-weighted images, 3 homogeneously and 5 heterogeneously, although their appearance was less intense than that of sinusitis. Gadolinium enhancement was moderate in one case and marked in 10 of the 11 cases, 9 homogeneously and 2 heterogeneously. Nine of the 11 tumors showed smooth regular shaped margins 2 of these tumors exhibited irregular infiltrating margins on gadolinium-enhanced images, compared to the pre-contrast T1-weighted images. Eight of the 11 tumors had clearly demarcated margins, while 3 of the 11 tumors did not exhibit gadolinium enhancement. Six of the 12 cases (50%) exhibited intracranial cysts on the gadolinium-enhanced images. T2-weighted or gadolinium-enhanced images successfully distinguished sinusitis from tumors in 4 cases whereas the CT images failed. Gadolinium enhancement, particularly in the tangential plane, demonstrated intracranial extension not apparent on the CT images in one case. In most cases, olfactory neuroblastomas are hypointense on T1-weighted images, hyperintense on T2-weighted images, and show marked homogeneous enhancement with well-demarcated regular margins upon gadolinium enhancement. Although the definite diagnosis is based on histopathology findings and MR features are nonspecific, they may suggest an imaging diagnosis of olfactory neuroblastoma when seen in the superior nasal cavity. MR is superior to CT both in delineating the extent of the tumor and in making an imaging diagnosis.
• Superselective arterial infusion and concomitant radiotherapy for advanced head and neck cancer

  Akihiro Homma, Yasushi Furuta, Fumiyuki Suzuki, Tatsumi Nagahashi, Jun Furusawa, Hiromitsu Hatakeyama, Keishiro Suzuki, Takeshi Asano, Takeshi Nishioka, Hiroki Shirato, Satoshi Fukuda

  Toukeibu Gan (一社)日本頭頸部癌学会 32 (1) 87 - 92 1881-8382 2006 [Not refereed][Not invited]
   

  Seventy patients, who were mainly considered contraindicated for surgery or who rejected radical surgery, received superselective intra-arterial infusion therapy of cisplatin (100-120mg/m2/week) with simultaneous intravenous infusion of thiosulfate to neutralize cisplatin toxicity, and conventional concomitant extrabeam radiotherapy. The five-year progression-free rate of the primary lesion and overall survival were 82.1% and 54.4% for all patients, respectively. Acute toxic effects were considered acceptable however, severe toxic events occurred in some cases, specifically cranial nerve palsy, MRSA pneumonia, sepsis, and osteoradionecrosis. We confirmed high effectiveness of superselective arterial infusion and concomitant radiotherapy, which can concentrate attacks on locoregional diseases by decadose cisplatin. Moreover, even patients with unresectable diseases can be cured. There are various techniques and protocols for superselective arterial infusion, and they must be standardized. Moreover, indication for this treatment must be established. © 2006, Japan Society for Head and Neck Cancer. All rights reserved.
• Olfactory neuroblastoma: The Hokkaido University experience

  Satoshi Kano, Yasushi Furuta, Akihiro Homma, Nobuhiko Oridate, Eisaku Higuchi, Fumiyuki Suzuki, Tatsumi Nagahashi, Yutaka Sawamura, Satoshi Fukuda

  Journal of Otolaryngology of Japan (一社)日本耳鼻咽喉科学会 109 (5) 433 - 439 0030-6622 2006 [Not refereed][Not invited]
   

  Olfactory neuroblastoma is such a rare malignancy that no consensus has been reached on its management. We analyzed 17 patients with olfactory neuroblastoma treated between April 1980 and March 2004-9 men and 8 women, aged 16 to 76 years old (mean: 50.4 years). Follow-up of current survivors vas 1 year 8 months to 16 years 6 months (average: 7 years 9 months). Initially, 2 were treated with surgery alone, 5 with surgery and radiotherapy, and 2 with a combination of these and chemotherapy. Without surgery, radiotherapy alone was conducted in 3 and combined of radiation and chemotherapy in 5. Three of the 5 patients treated with surgery and radiotherapy survive without locoregional recurrence as do 2 with chemotherapy added. All 5 initially treated with craniofacial resection survived more than 5 years. Combined radiotherapy and chemotherapy without surgery was effective in 2. 5- and 10-year overall survival for all patients were 75.5% and 64.7%. Overall 5-year survival of 8 patients with low-grade tumors was 87.5% and of 6 with high-grade tumors 33.3%. In conclusion, combined craniofacial resection plus radiotherapy and chemotherapy seemed to improve survival. Histopathological grading is a prognostic factors.
• Magnetic resonance imaging of olfactory neuroblastoma

  Mitsuhiro Iio, Akihiro Homma, Yasushi Furuta, Satoshi Fukuda

  Journal of Otolaryngology of Japan 109 (3) 142 - 148 0030-6622 2006 [Refereed][Not invited]
   

  Olfactory neuroblastoma is an uncommon intranasal tumor originating from olfactory neuroepithelium. Despite the development of electron microscopy and immunohistochemical testing, the pathological diagnosis of this tumor is still difficult because of the wide range of histological features. Magnetic resonance imaging (MR) of this tumor and the pattern of contrast enhancement have not been well described. The purpose of this report was to analyze the MR characteristics of olfactory neuroblastomas. The MR signal, pattern of contrast enhancement, and correlation with high-resolution computed tomography (CT) imaging were examined. Seventeen patients with olfactory neuroblastoma were treated at Hokkaido University Hospital and a related hospital during the past 25 years. MR images taken in 12 patients and CT images taken in 9 patients with histologically confirmed olfactory neuroblastoma were retrospectively reviewed. Compared with brain gray matter, 11 tumors were hypointense on T1-weighted images, 9 homogeneously and 2 heterogenously. Eight tumors were hyperintense on T2-weighted images, 3 homogeneously and 5 heterogeneously, although their appearance was less intense than that of sinusitis. Gadolinium enhancement was moderate in one case and marked in 10 of the 11 cases, 9 homogeneously and 2 heterogeneously. Nine of the 11 tumors showed smooth regular shaped margins 2 of these tumors exhibited irregular infiltrating margins on gadolinium-enhanced images, compared to the pre-contrast T1-weighted images. Eight of the 11 tumors had clearly demarcated margins, while 3 of the 11 tumors did not exhibit gadolinium enhancement. Six of the 12 cases (50%) exhibited intracranial cysts on the gadolinium-enhanced images. T2-weighted or gadolinium-enhanced images successfully distinguished sinusitis from tumors in 4 cases whereas the CT images failed. Gadolinium enhancement, particularly in the tangential plane, demonstrated intracranial extension not apparent on the CT images in one case. In most cases, olfactory neuroblastomas are hypointense on T1-weighted images, hyperintense on T2-weighted images, and show marked homogeneous enhancement with well-demarcated regular margins upon gadolinium enhancement. Although the definite diagnosis is based on histopathology findings and MR features are nonspecific, they may suggest an imaging diagnosis of olfactory neuroblastoma when seen in the superior nasal cavity. MR is superior to CT both in delineating the extent of the tumor and in making an imaging diagnosis.
• Olfactory neuroblastoma: The Hokkaido University experience

  Satoshi Kano, Yasushi Furuta, Akihiro Homma, Nobuhiko Oridate, Eisaku Higuchi, Fumiyuki Suzuki, Tatsumi Nagahashi, Yutaka Sawamura, Satoshi Fukuda

  Journal of Otolaryngology of Japan 109 (5) 433 - 439 0030-6622 2006 [Refereed][Not invited]
   

  Olfactory neuroblastoma is such a rare malignancy that no consensus has been reached on its management. We analyzed 17 patients with olfactory neuroblastoma treated between April 1980 and March 2004-9 men and 8 women, aged 16 to 76 years old (mean: 50.4 years). Follow-up of current survivors vas 1 year 8 months to 16 years 6 months (average: 7 years 9 months). Initially, 2 were treated with surgery alone, 5 with surgery and radiotherapy, and 2 with a combination of these and chemotherapy. Without surgery, radiotherapy alone was conducted in 3 and combined of radiation and chemotherapy in 5. Three of the 5 patients treated with surgery and radiotherapy survive without locoregional recurrence as do 2 with chemotherapy added. All 5 initially treated with craniofacial resection survived more than 5 years. Combined radiotherapy and chemotherapy without surgery was effective in 2. 5- and 10-year overall survival for all patients were 75.5% and 64.7%. Overall 5-year survival of 8 patients with low-grade tumors was 87.5% and of 6 with high-grade tumors 33.3%. In conclusion, combined craniofacial resection plus radiotherapy and chemotherapy seemed to improve survival. Histopathological grading is a prognostic factors.
• S100A2 expression as a predictive marker for late cervical metastasis in stage I and II invasive squamous cell carcinoma of the oral cavity

  F Suzuki, N Oridate, A Homma, Y Nakamaru, T Nagahashi, K Yagi, S Yamaguchi, Y Furuta, S Fukuda

  ONCOLOGY REPORTS 14 (6) 1493 - 1498 1021-335X 2005/12 [Refereed][Not invited]
   

  The purpose of this study was to discover whether S100A2 expression is associated with late cervical metastasis in patients with stage I and II invasive squamous cell carcinoma of the oral cavity. We retrospectively investigated the clinicopathological parameters and S100A2 expression in surgical specimens taken from 52 patients with T1-2N0M0 invasive squamous cell carcinoma of the oral cavity (OSCC) who had not undergone elective neck dissection or irradiation to the neck. All of the clinic opathological factors and S100A2 expression were compared in terms of late cervical metastasis. In univariate analysis, late cervical metastasis correlated with poor overall survival. A higher rate of late cervical metastasis was observed in patients with S100A2-negative tumors than those with S100A2-positive tumors. Multivariate analysis on late cervical metastasis revealed that S100A2 expression was demonstrated to be the only independent factor for late cervical metastasis. Our results indicate that patients with stage I or 11 invasive OSCC without SIOOA2 expression should be considered a high-risk group for late cervical metastasis when a wait-and-see policy for the neck is being considered.
• 上顎全摘術におけるナビゲーションシステムの使用経験

  本間 明宏, 鈴木 章之, 佐伯 昌彦, 福田 諭

  頭頸部外科 (NPO)日本頭頸部外科学会 15 (2) 153 - 157 1349-581X 2005/10 [Not refereed][Not invited]
   

  ナビゲーションシステムを,上顎洞癌例(59歳女,T3N0)に対する上顎全摘術に使用した.腫瘍切除の際,ナビゲーションシステムを用いて腫瘍の位置を確認し,切除範囲(上内側:眼窩内側,上方:眼窩下壁,外側:頬骨,後方:翼状突起,下方:硬口蓋)を決定した.術後経過は良好で,術後2年2ヵ月現在,再発はみられない.ナビゲーションシステムを併用することにより,解剖学的位置の確認や切除ラインの設定をリアルタイムに行うことができ,切除範囲を安全性を確保した上で縮小できる可能性があると思われた
• Laryngeal zoster mimicking a laryngeal cancer

  E Higuchi, Y Nakamaru, R Ohwatari, T Sakashita, Y Mesuda, A Homma, Y Furuta, S Fukuda

  OTOLARYNGOLOGY-HEAD AND NECK SURGERY 133 (4) 647 - 647 0194-5998 2005/10 [Refereed][Not invited]
  
• 口腔癌の最新治療 舌癌に対する超選択的動注療法と高線量率組織内照射の併用療法

  本間 明宏, 古田 康, 鈴木 章之, 浅野 剛, 吉田 大介, 西岡 健, 鈴木 恵士郎, 白土 博樹, 福田 諭

  日本癌治療学会誌 (一社)日本癌治療学会 40 (2) 236 - 236 0021-4671 2005/09 [Not refereed][Not invited]
  
• 【耳鼻咽喉科領域における難治性疾患】 若年性血管線維腫

  福田 諭, 本間 明宏

  JOHNS (株)東京医学社 21 (9) 1309 - 1313 0910-6820 2005/09 [Not refereed][Not invited]
  
• Voice restoration by primary insertion of indwelling voice prosthesis following circumferential pharyngolaryngectomy with free jejunal graft

  Y Furuta, A Homma, T Nagahashi, N Oridate, Y Mesuda, N Nishizawa, M Sekido, Y Yamamoto, S Okushiba, S Fukuda

  AURIS NASUS LARYNX 32 (3) 269 - 274 0385-8146 2005/09 [Refereed][Not invited]
   

  Background: Voice restoration after circumferential pharyngolaryngectomy (CPL) with free jejunal graft remains a difficult problem to solve. Few reports have analyzed the success rate and complications following primary insertion of indwelling voice prostheses during CPL with free jejunal graft. Patients and methods: Eight patients who underwent CPL with free jejunal graft had a Groningen voice prosthesis inserted as a tracheoesophageal (TE) shunt at the time of oncological surgery. A 10-point scale was used to assess each patient's speech intelligibility. Complications following the voice prosthesis insertion were also analyzed. Results: Six of the eight patients (75%) achieved excellent speech intelligibility and the remaining two patients (25%) were judged as moderate. Six of the eight patients (75%) used the TE shunt as their major means of daily communication. Leakage through or around the prosthesis, which occurred in six (75%) patients, was the most frequent prosthesis-related complication. Conclusions: This safe and reliable technique can be effective in improving the quality of life in selected patients undergoing CPL. (c) 2005 Elsevier Ireland Ltd. All rights reserved.
• 下咽頭癌に対する超選択的動注療法と放射線同時併用療法の検討

  古沢 純, 本間 明宏, 福田 諭

  口腔・咽頭科 日本口腔・咽頭科学会 18 (1) 66 - 66 0917-5105 2005/08 [Not refereed][Not invited]
  
• 頸部外切開で魚骨異物の摘出を必要とした3症例

  佐伯 昌彦, 本間 明宏, 福田 諭

  耳鼻咽喉科臨床 補冊 耳鼻咽喉科臨床学会 (補冊116) 62 - 62 0912-1870 2005/07 [Not refereed][Not invited]
  
• 舌進行癌に対する超選択的動注療法と高線量率組織内照射による治療

  本間 明宏, 福田 諭

  口腔・咽頭科 日本口腔・咽頭科学会 17 (3) 379 - 384 0917-5105 2005/06 [Not refereed][Not invited]
   

  舌進行癌新鮮例で手術拒否例4例に対して超選択的動注療法と同時に外照射を行った後に高線量率組織内照射による治療を行った.1例は4年4ヵ月経過しているが非担癌生存しており,視診上は舌の萎縮は認めるが,常食を摂取でき発症前と変わらぬ生活を送っている.原発・頸部は明らかな再発はなかったが,治療終了後に肺転移が出現し初診から8ヵ月で死亡した例が1例あった.残りの2例については観察期間は短いが,残存・再発を疑わせる所見はない.今回,我々が行った治療は手術を拒否する舌進行癌症例に対しては,根治を期待できる治療となりうる可能性が示唆された.今後,慎重に経過を観察し,晩期合併症も明らかにしていきたい(著者抄録)
• 気道上皮細胞におけるS100A2発現抑制による遺伝子発現変化の検討

  折舘 伸彦, 水町 貴諭, 鈴木 章之, 本間 明宏, 古田 康, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 31 (2) 269 - 269 1349-5747 2005/05 [Not refereed][Not invited]
  
• 北海道大学病院における超選択的動注療法+放射線の同時併用療法の治療成績

  本間 明宏, 古田 康, 鈴木 章之, 浅野 剛, 永橋 立望, 折舘 伸彦, 古沢 純, 畠山 博充, 鈴木 恵士郎, 西岡 健, 白土 博樹, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 31 (2) 242 - 242 1349-5747 2005/05 [Not refereed][Not invited]
  
• ドセタキセル・放射線同時併用療法におけるp53過剰発現と392セリン残基リン酸化の予後因子としての検討

  樋口 榮作, 折舘 伸彦, 本間 明宏, 永橋 立望, 古田 康, 鈴木 章之, 西岡 健, 鈴木 恵士郎, 滝沢 昌彦, 白土 博樹, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 31 (2) 227 - 227 1349-5747 2005/05 [Not refereed][Not invited]
  
• 頭頸部癌超選択的動注化学療法症例における癌関連遺伝子産物の免疫組織学的検討

  鈴木 章之, 本間 明宏, 折舘 伸彦, 樋口 栄作, 古田 康, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 31 (2) 227 - 227 1349-5747 2005/05 [Not refereed][Not invited]
  
• 化学放射線同時併用療法後の喉頭全摘術における合併症の検討

  古田 康, 本間 明宏, 折舘 伸彦, 樋口 栄作, 鈴木 章之, 西岡 健, 青山 英史, 鈴木 恵士郎, 白土 博樹, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 31 (2) 220 - 220 1349-5747 2005/05 [Not refereed][Not invited]
  
• 舌癌後発頸部リンパ節転移症例での治療前CTによるリンパ節評価

  古沢 純, 鈴木 章之, 折舘 伸彦, 本間 明宏, 古田 康, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 31 (2) 214 - 214 1349-5747 2005/05 [Not refereed][Not invited]
  
• 抗癌剤の耐性と感受性 ドセタキセル耐性ヒト扁平上皮癌細胞株の樹立および遺伝子発現の検討

  水町 貴諭, 折舘 伸彦, 樋口 榮作, 鈴木 章之, 本間 明宏, 古田 康, 福田 諭

  頭頸部癌 (一社)日本頭頸部癌学会 31 (2) 204 - 204 1349-5747 2005/05 [Not refereed][Not invited]
  
• 北大病院における嚥下機能改善術及び誤嚥防止手術の現況について

  目須田 康, 西澤 典子, 森 美果, 折舘 伸彦, 本間 明宏, 永橋 立望, 柏村 正明, 古田 康, 堂坂 善弘, 福田 諭

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 108 (4) 497 - 497 0030-6622 2005/04 [Not refereed][Not invited]
  
• 北海道大学病院における喉頭癌T1,T2症例の検討

  愛宕 義浩, 古田 康, 本間 明宏, 折舘 伸彦, 樋口 栄作, 鈴木 章之, 福田 諭

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 108 (4) 467 - 467 0030-6622 2005/04 [Not refereed][Not invited]
  
• 鼻副鼻腔癌に対する超選択的動注化学療法における予後予測分子指標の同定

  折舘 伸彦, 本間 明宏, 鈴木 章之, 水町 貴諭, 樋口 栄作, 古田 康, 福田 諭

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 108 (4) 458 - 458 0030-6622 2005/04 [Not refereed][Not invited]
  
• 当科における嗅神経芽細胞腫の治療経験

  加納 里志, 古田 康, 本間 明宏, 折舘 伸彦, 樋口 榮作, 鈴木 章之, 永橋 立望, 福田 諭

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 108 (4) 457 - 457 0030-6622 2005/04 [Not refereed][Not invited]
  
• 鼻副鼻腔内反性乳頭腫におけるstage別治療成績の検討

  及川 敬太, 古田 康, 本間 明宏, 折舘 伸彦, 中丸 裕爾, 福田 諭

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 108 (4) 457 - 457 0030-6622 2005/04 [Not refereed][Not invited]
  
• 頭頸部癌に対するドセタキセル・放射線同時併用療法における予後予測因子としてのcyclin D1とp16

  樋口 榮作, 本間 明宏, 折舘 伸彦, 古田 康, 鈴木 章之, 川浪 貢, 滝沢 昌彦, 福田 諭

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 108 (4) 442 - 442 0030-6622 2005/04 [Not refereed][Not invited]
  
• 化学放射線同時併用療法後の喉頭全摘・一期的T-Eシャント作成ボイスボタン挿入の問題点

  古田 康, 本間 明宏, 西澤 典子, 樋口 栄作, 鈴木 章之, 折舘 伸彦, 目須田 康, 福田 諭

  日本気管食道科学会会報 (NPO)日本気管食道科学会 56 (2) 242 - 242 0029-0645 2005/04 [Not refereed][Not invited]
  
• 【MRI症例ファイル】 副鼻腔良性腫瘍

  福田 諭, 古田 康, 本間 明宏

  JOHNS (株)東京医学社 21 (3) 401 - 407 0910-6820 2005/03 [Not refereed][Not invited]
  
• Long-term results of ethmoid squamous cell or undifferentiated carcinoma treated with radiotherapy with or without surgery.

  Uchida D, Shirato H, Onimaru R, Endou H, Aoyama H, Tsuchiya K, Nishioka T, Homma A, Furuta Y, Fukuda S, Miyasaka K

  Cancer journal (Sudbury, Mass.) 2 11 152 - 156 1528-9117 2005/03 [Refereed][Not invited]
  
• 声帯麻痺 片側声帯麻痺に対する甲状軟骨形成術I型・側筋牽引術併用例の音声機能

  目須田 康, 本間 明宏, 西澤 典子, 福田 諭, 堂坂 善弘

  音声言語医学 日本音声言語医学会 46 (1) 47 - 47 0030-2813 2005/01 [Not refereed][Not invited]
  
• Examination of efficacy of azithromycin for prevention of postoperative infection

  Akihiro Homma, Satoshi Fukuda

  Practica Oto-Rhino-Laryngologica 耳鼻咽喉科臨床学会 98 (9) 735 - 739 0032-6313 2005 [Not refereed][Not invited]
   

  〈Background〉 In the field of otolaryngology-head & neck surgery, antimicrobial agents are administered in order to prevent perioperative period infections caused by mainly Gram-positive coccus such as Staphylococcus aureus or Staphylococcus epidermidis. Short-period administration of penicillin or 1st generation cephems antibiotics are recommended for clean/clean-contaminated operations. For a short operation, a single administration within 30 minutes from the start of operation is considered sufficient. However, in Japan it is administered as a customary practice for several days after the operation in many cases. 〈Purpose〉 Oral antimicrobial agent azithromycin (AZM, Zithromac®) was administered in order to prevent postoperative infection in patients who underwent clean/clean-contaminated operations in the field of otolaryngology-head & neck surgery, and its efficacy was examined. 〈Patients and method〉 Of patients who underwent clean/clean-contaminated operations in the operation room of the Department of Otolaryngology, Hokkaido University Hospital from April 2003 to November 2004, patients who underwent minor or intermediate operations for mouth, pharyngolarynx, trachea, or neck were selected. Patients who had experience of irradiation, or past history of surgical site infection, or those who were considered to have a high risk of infection due to systemic complications and to whom a doctor in charge judged it appropriate to intravenously infuse antimicrobial agents, were excluded. 〈Results〉 Three hundred patients were administered, and of these, violation of the treatment occurred in 2 patients (0.6%). Postoperative infection occurred in 8 (2.4%) Some of them had medical problems, or past histories of MRSA infection, or operations of the head and neck area. 〈Conclusion〉 In clean/clean-contaminated operation in the field of department of otolaryngology-head & neck surgery, intravenous antimicrobial injection is commonly used to prevent postoperative infection, but these results suggest that a sufficient effect can be achieved by 3-day-administration of the oral antimicrobial agent AZM.
• Gene expression profile by RNAi-mediated suppression of S100A2 in human bronchial epithelial cells

  Nobuhiko Oridate, Takatsugu Mizumachi, Fumiyuki Suzuki, Akihiro Homma, Yasushi Furuta, Satoshi Fukuda

  Toukeibu Gan (一社)日本頭頸部癌学会 31 (4) 481 - 486 1881-8382 2005 [Not refereed][Not invited]
   

  S100A2 is a member of the S100 calcium-binding proteins, but the mechanism of its action is not clear. The expression of this protein has been reported to be accompanied by malignant changes in an in vitro bronchial epithelial carcinogenesis model. We have reported that the 1799 cells transfected with the vector expressing small hairpin RNA specific to the S100A2 gene exhibited the depletion of S100A2 and malignant phenotypes such as colony forming ability, suggesting that S100A2 serves as a tumor suppressor in this system. In this study, we applied the DNA microarray technique to clarify the changes of gene expression profile resulting from the suppression of S100A2 and identifed the genes whose expression have altered beyond 4-fold compared to the control. The altered expression of E-cadherin, one of such genes, was also confirmed at the protein level. © 2005, Japan Society for Head and Neck Cancer. All rights reserved.
• Prognostic significance of cytoplasmic macrophage migration inhibitory factor expression in patients with squamous cell carcinoma of the head and neck treated with concurrent chemoradiotherapy.

  Suzuki F, Nakamaru Y, Oridate N, Homma A, Nagahashi T, Yamaguchi S, Nishihira J, Furuta Y, Fukuda S

  Oncology reports 1 13 (1) 59 - 64 1021-335X 2005/01 [Refereed][Not invited]
   

  The macrophage migration inhibitory factor (MIF) is known to be a proinflammatory cytokine as well as a tumor growth regulator. Although the positive and negative effects of the MIF on tumor cell growth have been reported, the exact role of the MIF in tumorigenesis remains ambiguous. We examined the expression of the MIF protein in tumor specimens obtained from 50 head and neck squamous cell carcinoma (HNSCC) patients treated with concurrent chemoradiotherapy (carboplatin, 100 mg/m2), 4-7 times every week; a total radiation therapy dose of 65-75 Gy over 6.5-7.5 weeks, and determined whether the MIF level is related to clinical outcomes of these patients. Immunostaining with an MIF specific antibody was performed in formalin-fixed, paraffin-embedded specimens. The MIF protein was expressed to various extent in the tumor tissue specimens from the HNSCC patients. Prognostic analysis using the Kaplan-Meier method with regard to the MIF expression revealed that the patients with the MIF-negative tumors had a worse prognosis when compared to those with the MIF expression. The results of this study suggest that the intratumoral MIF expression has a prognostic value in HNSCC patients administered concurrent chemoradiotherapy.
• Rapid superselective high-dose cisplatin infusion with concomitant radiotherapy for advanced head and neck cancer

  A Homma, Y Furuta, F Suzuki, N Oridate, H Hatakeyama, T Nagahashi, S Ushikoshi, T Asano, T Nishioka, H Shirato, S Fukuda

  HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK 27 (1) 65 - 71 1043-3074 2005/01 [Not refereed][Not invited]
   

  Purpose. The purpose of this study was to evaluate the efficacy of rapid superselective high-dose cisplatin infusion with concomitant radiotherapy for previously untreated patients with advanced head and neck cancer. Methods. Forty-three patients for whom surgery was contraindicated or who rejected radical surgery were given superselective intra-arterial infusions of cisplatin (100-120 mg/m(2)/week) with simultaneous intravenous infusion of thiosulfate to neutralize cisplatin toxicity and conventional extra-beam radiotherapy (65 Gy/26 f/6.5 weeks). Results. Thirty-nine patients had stage IV disease, and the remaining four had stage III disease. During the median follow-up period of 21 months, the 3-year locoregional progression-free rates of all patients (n = 43) and patients with unresectable disease (n = 24) were 68.9% and 56.4%, respectively. In addition, the 3-year overall survival of all patients and patients with unresectable disease was 54.0% and 39.6%, respectively. Thirty-five patients (81.4%) experienced nonhematologic grade III to Iv toxicity, including mucositis (n = 16), nausea/vomiting (n = 8), and neurologic signs (n = 2). No patient died as a result of treatment toxicity. There are 29 surviving patients without evidence of disease, all of whom are able to have oral intakes without feeding-tube support. Conclusions. We confirmed the efficacy of superselectives arterial infusion and concomitant radiotherapy, which can concentrate the attack of supradosa cisplatin on locoregional disease. Even patients with unresectable disease can be cured. Further studies are needed to establish the indications, long-term outcome, and possible side effects of this treatment. (C) 2004 Wiley Periodicals, Inc.
• 鼻副鼻腔進行癌に対する超選択的動注療法と照射の同時併用療法

  本間 明宏, 福田 諭

  耳鼻咽喉科臨床 補冊 耳鼻咽喉科臨床学会 (補冊115) 6 - 7 0912-1870 2004/11 [Not refereed][Not invited]
  
• Pilot study of modified version of CHOP plus radiotherapy for early-stage aggressive non-Hodgkin's lymphoma of the head and neck.

  Nishioka T, Tsuchiya K, Nishioka S, Kitahara T, Ohmori K, Homma A, Aoyma H, Shindoh M, Shirato H

  International journal of radiation oncology, biology, physics 3 60 (3) 847 - 852 0360-3016 2004/11 [Refereed][Not invited]
  
• 鼻咽腔血管線維腫に対するナビゲーションガイド下鼻内内視鏡による摘出の経験

  本間 明宏, 中丸 裕爾, 佐伯 昌彦, 福田 諭

  頭頸部外科 (NPO)日本頭頸部外科学会 14 (2) 109 - 113 1349-581X 2004/10 [Not refereed][Not invited]
   

  25歳男.右鼻閉が出現し,時々鼻出血があった.ファイバースコープで上咽頭右側に表面平滑,毛細血管の豊富な拍動する腫瘤を認めた.CTでも上咽頭右側から鼻腔後方に造影CTで強く増強される陰影を認めた.MRIではT1強調画像で筋肉と同等の信号,T2強調画像で脳実質と同等の信号を呈していた.診断は上咽頭血管線維腫で,腫瘤が小さいため鼻内内視鏡下に摘出し,術前には塞栓術を行った.手術時にはナビゲーションを用い,出血量が少なく解剖学的位置を正確に確認し摘出できた
• 【悪性リンパ腫 診断・治療マニュアル】 最近の悪性リンパ腫の取り扱い その現状と展望

  本間 明宏, 福田 諭

  ENTONI (株)全日本病院出版会 (41) 1 - 8 1346-2067 2004/09 [Not refereed][Not invited]
   

  悪性リンパ腫の分類の変遷,新しい診断技術の進歩,頭頸部に発生する頻度の高い疾患群の治療,今後の展望について概説した.現在までの多くの臨床試験の結果,現段階での標準治療は代表的な疾患群についてはある程度確立されている.しかしながら治療成績の向上は限界に近づいており,最近では抗体療法,放射線免疫療法,造血幹細胞移植併用大量化学療法などが試みられ有望な結果が報告されている.今後は分子病態や予後因子による層別化に基づいた治療研究を行い,それぞれの疾患群に最も適切な治療法を選択していくようになっていくものと思われる
• 頭頸部癌治療における最近の進歩と今後の臨床展開 治療の個別化に向けて 鼻副鼻腔進行癌に対する超選択的動注療法+放射線同時併用療法

  本間 明宏, 古田 康, 永橋 立望, 白土 博樹, 福田 諭

  日本癌治療学会誌 (一社)日本癌治療学会 39 (2) 271 - 271 0021-4671 2004/09 [Not refereed][Not invited]
  
• Randomized phase II trial of concomitant chemoradiotherapy using weekly carboplatin or daily low-dose cisplatin for squamous cell carcinoma of the head and neck

  A Homma, H Shirato, Y Furuta, T Nishioka, N Oridate, K Tsuchiya, T Nagahashi, H Aoyama, Y Inuyama, S Fukuda

  CANCER JOURNAL 10 (5) 326 - 332 1528-9117 2004/09 [Not refereed][Not invited]
   

  Purpose This randomized, phase II study aimed to compare concomitant chemoradiotherapy using weekly carboplatin or daily low-dose cisplatin as a treatment for squamous cell carcinoma of the head and neck. Patients and Methods One hundred nineteen patients with moderate- to advanced-stage disease were eligible for the study. Fifty-three patients had stage II disease, 28 had stage III, and the remaining 38 had stage IV disease. Primary tumor sites included the larynx (N = 63), oropharynx (N = 30), hypopharynx (N = 23), and oral cavity (N = 3). Each patient received either a weekly carboplatin dose (100 mg/m(2)) in one arm or daily cisplatin (4 mg/m(2)) in the other arm for the initial 4 weeks of radiotherapy. The radiotherapy dose of 65 Gy was given in 26 fractions over 45 days, dependent on a good tumor response at 40 Gy. Forty-nine (81.7%) of 60 patients treated with carboplatin and 41 (69.5%) of 59 patients treated with cisplatin received the full dose of radiotherapy. Surgical resection was optionally used for the remaining patients. Results The median follow-up time was 63 months. The local control rate at 5 years was 56.2% for the carboplatin-treated arm and 35.5% for the cisplatin-treated arm, respectively. The 5-year overall survival rate did not significantly differ between treatments: 71.4% for carboplatin and 66.0% for cisplatin. Hematologic toxicity was more frequent in the carboplatin-treated arm. No difference was observed in surgical complications or in radiation-related adverse effects. Dicussion These findings suggest that weekly carboplatin treatment is preferable to daily low-dose cisplatin. This could be because the total dose of cisplatin was too low to be effective.
• Preliminary results on development of a thin GSO scintillator for neutron science

  J. H. Kaneko, N. Susa, S. Tsuchida, M. Watanabe, S. Miura, T. Mizuno, Y. Yamauchi, M. Hashiba, T. Oku, A. Homma, F. Fujita, T. Ino, M. Furusaka, T. Sawamura, H. M. Shimizu, Y. Kiyanagi

  Nuclear Instruments and Methods in Physics Research, Section A: Accelerators, Spectrometers, Detectors and Associated Equipment 529 (1-3) 307 - 309 0168-9002 2004/08/21 [Refereed][Not invited]
   

  A thin GSO scintillator was developed aiming at applications for the neutron science. In order to fabricate a large and thin GSO scintillator in the future, fabrication was started from two types of GSO powders. Although several GSO films were fabricated by evaporation techniques, these films did not have luminescence in photo luminescence (PL) spectroscopy. Thus, these samples were annealed up to 1550°C. However, it resulted in no luminescence observation. In response to these results, GSO powders were directly annealed a phenomenon looking like melting and sintering were observed for Gd2Si 2O7:Ce at a temperature higher than 1500°C. This sample was quasi-transparent and had luminescence at 405nm in PL spectrum. In addition, this sample was tougher than a GSO single crystal. In conclusion, the prospect of fabrication of a thin GSO scintillator by combination of annealing and mechanical polishing was obtained. © 2004 Elsevier B.V. All rights reserved.
• 舌進行癌に対する超選択的動注療法と高線量率組織内照射による治療

  本間 明宏, 福田 諭

  口腔・咽頭科 日本口腔・咽頭科学会 17 (1) 108 - 108 0917-5105 2004/08 [Not refereed][Not invited]
  
• 頭頸部,上部消化管再発癌における微小血管吻合を用いた再建に関する検討

  関堂 充, 山本 有平, 佐々木 了, 古川 洋志, 杉原 平樹, 本間 明宏, 永橋 立望, 古田 康, 福田 諭, 矢島 和宜, 野平 久仁彦, 新冨 芳尚, 八木 克憲, 上田 倫弘, 山下 徹郎

  頭頸部腫瘍 (一社)日本頭頸部癌学会 30 (2) 286 - 286 0911-4335 2004/05 [Not refereed][Not invited]
  
• 化学療法併用放射線療法後に喉頭全摘術後の瘻孔発生率は高まるか? 過去10年間の喉頭全摘症例の検討

  古田 康, 本間 明宏, 永橋 立望, 樋口 栄作, 鈴木 章之, 折舘 伸彦, 福田 諭, 西岡 健, 青山 英史, 白土 博樹

  頭頸部腫瘍 (一社)日本頭頸部癌学会 30 (2) 270 - 270 0911-4335 2004/05 [Not refereed][Not invited]
  
• 気道上皮細胞における潜在的癌抑制遺伝子S100A2発現抑制による形質変化

  折舘 伸彦, 鈴木 章之, 水町 貴諭, 本間 明宏, 古田 康, 福田 諭

  頭頸部腫瘍 (一社)日本頭頸部癌学会 30 (2) 249 - 249 0911-4335 2004/05 [Not refereed][Not invited]
  
• 口腔癌T1T2N0症例におけるS100A2発現消失と後発頸部リンパ節転移との関連

  鈴木 章之, 折舘 伸彦, 本間 明宏, 永橋 立望, 古田 康, 福田 諭

  頭頸部腫瘍 (一社)日本頭頸部癌学会 30 (2) 206 - 206 0911-4335 2004/05 [Not refereed][Not invited]
  
• 頬粘膜腫瘍の放射線治療成績

  大森 桂一, 中村 博行, 山崎 裕, 小野 貢伸, 青山 英史, 土屋 和彦, 西岡 健, 白土 博樹, 本間 明宏, 古田 康, 中村 太保

  頭頸部腫瘍 (一社)日本頭頸部癌学会 30 (2) 195 - 195 0911-4335 2004/05 [Not refereed][Not invited]
  
• 頭頸部癌に対するDocetaxelと放射線同時併用療法の有用性の検討

  樋口 榮作, 本間 明宏, 永橋 立望, 折舘 伸彦, 古田 康, 鈴木 章之, 西岡 健, 土屋 和彦, 青山 英史, 滝沢 昌彦, 白土 博樹, 福田 諭

  頭頸部腫瘍 (一社)日本頭頸部癌学会 30 (2) 194 - 194 0911-4335 2004/05 [Not refereed][Not invited]
  
• 頭頸部がん治療におけるチーム医療 理想的なチーム医療を行うために 北海道大学病院の実際

  本間 明宏, 古田 康, 折舘 伸彦, 永橋 立望, 鈴木 章之, 樋口 栄作, 福田 諭

  頭頸部腫瘍 (一社)日本頭頸部癌学会 30 (2) 155 - 155 0911-4335 2004/05 [Not refereed][Not invited]
  
• 下咽頭・食道の再建 下咽頭・食道の再建 難治性皮膚瘻孔

  山本 有平, 関堂 充, 堤田 新, 矢島 和宜, 杉原 平樹, 古田 康, 本間 明宏, 永橋 立望, 福田 論, 奥芝 俊一, 八木 克憲

  頭頸部腫瘍 (一社)日本頭頸部癌学会 30 (2) 128 - 128 0911-4335 2004/05 [Not refereed][Not invited]
  
• 長期留置型voice prosthesisを用いた喉頭摘出後の音声再建症例の検討

  古田 康, 西澤 典子, 目須田 康, 永橋 立望, 本間 明宏, 福田 諭

  日本気管食道科学会会報 (NPO)日本気管食道科学会 55 (2) 171 - 171 0029-0645 2004/04 [Not refereed][Not invited]
  
• 頭頸部癌再発症例,肺転移症例に対する外来化学療法としてのTS-1使用効果

  永橋 立望, 鈴木 章之, 樋口 栄作, 本間 明宏, 古田 康, 福田 諭

  頭頸部腫瘍 (一社)日本頭頸部癌学会 30 (1) 111 - 115 0911-4335 2004/04 [Not refereed][Not invited]
   

  2001年5月より2003年1月までにTS-1投与を開始した肺転移症例を含む,頭頸部癌担癌状態の23例を対象とし,外来化学療法としての頭頸部癌再発症例,肺転移症例に対するTS-1治療成績を検討した.奏効率は30.4%であった.同一症例で血小板,呼吸器にGrade 4の有害事象が認められた.腎機能障害を有する症例で治療として血小板輸血,ステロイド投与し,その後,有害事象は回復し可逆的であった.他は,特に重篤な有害事象は,認めなかった.頭頸部癌再発症例においても他剤と同等の効果をもち外来で安全に投与できた.肺転移症例においては,TS-1投与群でmedian survival time 585日,TS-1非投与で入院化学療法中心群では120日であった.外来通院可能なTS-1投与群のほうが治療後のPSの悪化を認めず,QOLは良好であった.よって,TS-1投与により肺転移症例においてQOLの維持の可能性が外来通院化学療法で示唆された
• 目でみる耳鼻咽喉科 Superolateral thyrotomyにて摘出した喉頭神経鞘腫の1例

  瀧 重成, 本間 明宏, 山田 和之, 福田 諭

  耳鼻咽喉科・頭頸部外科 (株)医学書院 76 (4) 246 - 247 0914-3491 2004/04 [Not refereed][Not invited]
  
• 選択的動注療法における抗癌剤投与量決定の考察 腫瘍容積より算出法

  横山 純吉, 西條 茂, 本間 明宏, 吉崎 智一

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 107 (4) 467 - 467 0030-6622 2004/04 [Not refereed][Not invited]
  
• 頭頸部癌に対するDocetaxelと放射線同時併用療法の有用性の検討

  樋口 榮作, 本間 明宏, 永橋 立望, 折舘 伸彦, 古田 康, 鈴木 章之, 川浪 貢, 滝沢 昌彦, 福田 諭

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 107 (4) 465 - 465 0030-6622 2004/04 [Not refereed][Not invited]
  
• 頸部リンパ節転移を初発症状とした甲状腺オカルト癌症例の検討

  水町 貴諭, 折舘 伸彦, 古田 康, 本間 明宏, 永橋 立望, 福田 諭

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 107 (4) 431 - 431 0030-6622 2004/04 [Not refereed][Not invited]
  
• 鼻副鼻腔乳頭腫の術式選択におけるstaging systemの検討

  及川 敬太, 古田 康, 永橋 立望, 本間 明宏, 折舘 伸彦, 中丸 裕爾, 福田 諭

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 107 (4) 399 - 399 0030-6622 2004/04 [Not refereed][Not invited]
  
• 【頭頸癌におけるTumor dormancy therapy/低用量化学療法】 頭頸部癌におけるTumor dormancy therapy

  永橋 立望, 本間 明宏, 福田 諭

  頭頸部外科 (NPO)日本頭頸部外科学会 13 (3) 107 - 111 1349-581X 2004/03 [Not refereed][Not invited]
  
• 【副咽頭間隙腫瘍の治療】 副咽頭間隙腫瘍摘出後のFirst Bite Syndrome

  古田 康, 本間 明宏, 永橋 立望, 高木 大, 鈴木 章之, 目須田 康, 折舘 伸彦, 福田 諭

  頭頸部外科 (NPO)日本頭頸部外科学会 13 (3) 73 - 78 1349-581X 2004/03 [Not refereed][Not invited]
  
• Groningen Voice Prosthesis挿入後合併症の検討

  古田 康, 目須田 康, 永橋 立望, 本間 明宏, 折舘 伸彦, 西澤 典子, 福田 諭

  日本気管食道科学会会報 (NPO)日本気管食道科学会 55 (1) 16 - 21 0029-0645 2004/02 [Not refereed][Not invited]
   

  Groningen Voice Prosthesis(グロニンゲンボイスボタン)挿入後合併症を検討した.対象は,喉頭摘出時にグロニンゲンボタンを挿入し1年以上経過した22例で,合併症の頻度,対処方法を検討した.その結果,挿入後合併症はシャント部からの漏れ15例(68%:1例は抜去閉鎖),感染・肉芽形成6例(27%:脱落時合併4例,非使用1例は抜去閉鎖),脱落5例(23%:全例で長シャフトに変更),気管狭窄4例(18%:全例気管孔開大術施行),食道空腸吻合部狭窄2例(9%:食道ブジー施行),食道異物1例(全麻下摘出術施行),多量呑気による急性腹症1例(保存的治療),気管食道瘻1例(シャント部近傍に腫瘍再発)であり,合併症でグロニンゲンボタンを抜去したのは2例であった.以上,これらのことからも合併症の早期発見と早期の適切な対処が必要だと考えられた
• 喉頭摘出後の音声リハビリテーション 周術期音声指導の試み

  西澤 典子, 吉田 康, 葛西 聡子, 目須田 康, 永橋 立望, 本間 明宏, 鈴木 章之, 福田 諭

  音声言語医学 日本音声言語医学会 45 (1) 66 - 67 0030-2813 2004/01 [Not refereed][Not invited]
  
• Clinical study on papillary thyroid carcinoma presenting with lymph node metastasis

  Takatsugu Mizumachi, Nobuhiko Oridate, Akihiro Homma, Tatsumi Nagahashi, Yasushi Furuta, Satoshi Fukuda

  Journal of Otolaryngology of Japan (一社)日本耳鼻咽喉科学会 107 (8) 750 - 755 0030-6622 2004 [Not refereed][Not invited]
   

  Papillary thyroid carcinoma (PTC) may metastasize to cervical lymph nodes. It is, however, uncommon for a palpable neck node alone to lead to the diagnosis of this disease when it is not apparent at presentation. Standard treatment for such cases has not yet been established. We retrospectively analyzed clinical courses in 8 patients with thyroid papillary carcinoma presenting with palpable lymph node metastasis at Hokkaido University Hospital between 1990 and 2003. Three had high thyrogloblin in cervical cystic lesions, leading to the diagnosis of PTC with lymph node metastasis. In 4, PTC was diagnosed by pathological examination of cervical lymph nodes initially diagnosed as lateral cervical cysts. Preoperative examination did not indicate PTC within the gland in any case. All 8 were alive at the last visit after follow-up from 23 to 150 months (mean: 78 months). Total thyroidectomy was done on 4 and thyroid lobectomy on 3. Pathological examination of resected thyroid glands confirmed multifocal papillary carcinoma from 4 mm to 15 mm in diameter. Six underwent unilateral neck dissection and 1 chose bilateral dissection. The other patient received no additional surgery on either the thyroid or neck after the single enlarged lymph node initially diagnosed as a lateral cervical cyst was resected. Postoperative radioiodine treatment was done in 2 undergoing total thyroidectomy. Recurrence in the cervical area were observed in 1 whose neck dissection was insufficient. Based on these observations, we concluded that patients who undergo thyroid lobectomy and adequate neck dissection may enjoy longer survival than those treated with total thyroidectomy without sacrificing thyroid and parathyroid function. We therefore propose a prospective study on the effectiveness of thyroid lobectomy with neck dissection including positive nodes in patients with occult PTC presenting with lymph node metastasis.
• “An ideal medical team” for patients with head and neck cancer: The role of nurses

  Akihiro Homma, Yasushi Furuta, Nobuhiko Oridate, Tatsumi Nagahashi, Fumiyuki Suzuki, Eisaku Higuchi, Satoshi Fukuda

  Toukeibu Gan (一社)日本頭頸部癌学会 30 (3) 391 - 394 1881-8382 2004 [Not refereed][Not invited]
   

  We discuss the role of nurses in providing an ideal medical treatment for patients with head and neck cancer. Nurses play an important role in the treatment course. Nurses and head and neck surgeons and/or oncologists should work together organically. We decide the treatment plan of each patient by working together, or we inform patients and their families efficiently and repeatedly, and consider their wishes. The discussions help to deepen our understanding of the patients' status and we give training to nurses of otolaryngology-head & neck oncology. It is crucial for a medical team to trust each other, and this requires good communication among each other. We consider that we can provide patients with good medical care through this approach in the same direction. © 2004, Japan Society for Head and Neck Cancer. All rights reserved.
• RNAi-mediated suppression of putative tumor supressor S100A2 in human bronchial epithelial cells

  Nobuhiko Oridate, Fumiyuki Suzuki, Takatsugu Mizumachi, Akihiro Homma, Yasushi Furuta, Satoshi Fukuda

  Toukeibu Gan (一社)日本頭頸部癌学会 30 (4) 651 - 656 1881-8382 2004 [Not refereed][Not invited]
   

  S100A2 is a member of the S100 calcium-binding proteins, but the mechanism of its action is not clear. The expression of this protein has been reported to be associated with the prognosis in patients with laryngeal squamous cell carcinoma and to be accompanied by malignant changes in an in vitro bronchial epithelial carcinogenesis model. To know whether S100A2 has a tumor suppressive function in this model system, we applied RNA interference to suppress the S100A2 expression in 1799 immortalized human bronchial epithelial cells. The cells transfected with the vector expressing small hairpin RNA specific to the S100A2 gene showed the depletion of S100A2. The 1799 cells without S100A2 expression exhibited malignant phenotypes such as a colony forming ability and resistance to anoikis. These results support the hypothesis that S100A2 serves as a tumor suppressor in this system. (134 words). © 2004, Japan Society for Head and Neck Cancer. All rights reserved.
• 放射線化学同時併用

  福田 諭, 藤井 博文, 本間 明宏, 山本 智矢, 藤井 正人

  耳鼻と臨床 耳鼻と臨床会 49 (Suppl.3) S188 - S190 0447-7227 2003/11 [Not refereed][Not invited]
   

  The main goal of the treatment of the head and neck cancers is to maintain the important functions such as voice, swallowing, hearing, smell, taste and look, and to keep the quality of life of the patients. For this purpose, the concurrent chemo-radiotherapy utilizing 5-FU and vitamin A (FAR regimen) has been used in the author's department. With the FAR therapy regimen, the disease-specific five year survival rate was satisfactory in head and neck cancer. Especially, the overall disease-specific five year survival rate of the laryngeal cancer (glottic type) was 92.6%. Thus, FAR regimen may play an important role in the improved survival rate, organ preservation and the quality of life of the patients.
• 少量白金製剤併用放射線化学療法と超選択的動注療法

  本間 明宏, 古田 康, 永橋 立望, 八木 克憲, 鈴木 章之, 牛越 聡, 浅野 剛, 白土 博樹, 西岡 健, 犬山 征夫, 福田 諭

  耳鼻と臨床 耳鼻と臨床会 49 (Suppl.3) S167 - S174 0447-7227 2003/11 [Not refereed][Not invited]
   

  局所切除可能な頭頸部原発扁平上皮癌患者119例に対して放射線とCDDP或いはCBDCAとの同時併用の無作為化比較試験を行ったところ,予後の結果からは有効性に大差はない可能性が認められたが,CBDCAがより有効であると思われた.手術不能又は手術拒否の進行癌症例29例では,超選択的動注と照射の同時併用で原発巣は72.4%であった
• 【癌転移】 癌転移に対する各種治療法の進歩 頭頸部癌リンパ節転移への放射線・化学療法

  本間 明宏, 古田 康, 永橋 立望, 福田 諭

  日本臨床 (株)日本臨床社 61 (増刊8 癌転移) 612 - 616 0047-1852 2003/11 [Not refereed][Not invited]
  
• Preoperative staging of sinonasal inverted papilloma by magnetic resonance imaging

  K Oikawa, Y Furuta, N Oridate, T Nagahashi, A Homma, T Ryu, S Fukuda

  LARYNGOSCOPE 113 (11) 1983 - 1987 0023-852X 2003/11 [Refereed][Not invited]
   

  Objectives/Hypothesis: Sinonasal inverted papilloma is a rare but locally aggressive benign tumor. Inverted papilloma tends to recur after surgical resection and is occasionally associated with squamous cell carcinoma. Radical en bloc resection by lateral rhinotomy and medial maxillectomy has been recommended for initial management; however, endoscopic sinus surgery is effective in selected cases. To determine adequate surgical approaches, a staging system for inverted papilloma based on extent and location of the tumor has been advocated. The study investigated whether preoperative assessment by magnetic resonance imaging (MRI) accurately predicts the extent of inverted papilloma. Study Design: Magnetic resonance imaging was retrospectively reviewed in 21 cases of inverted papilloma without knowledge of the surgical and pathological findings. Methods: Patients were categorized into stages based on MRI findings, according to the staging system proposed by Krouse. The involvement of inverted papilloma in each sinus was also assessed. Results: Stages graded by MRI were coincident with postoperative staging verified by surgical and pathological findings in 18 of the 21 cases (86%), which included 1 case of stage T1, 3 cases of stage T2, and 14 cases of stage T3. Two cases of stage T2 were judged as T3, and one case of T3 was judged as T2 by MRI. Positive predictive value of MRI diagnosis for tumor involvement was 68% to 89% in each sinus, and negative predictive value was more than 93%. Conclusion: In most cases, MRI assessment of inverted papilloma can accurately predict the extent of tumor involvement. Preoperative staging of inverted papilloma by MRI may be useful for planning an appropriate surgical approach.
• 当科における原発不明頸部転移癌の臨床的検討

  及川 敬太, 本間 明宏, 鈴木 章之, 永橋 立望, 古田 康, 福田 諭

  耳鼻咽喉科展望 耳鼻咽喉科展望会 46 (補冊2) 74 - 81 0386-9687 2003/10 [Not refereed][Not invited]
   

  1989年1月から2001年12月に治療をした原発不明頸部転移癌33例を対象に検討した.病理組織型は扁平上皮癌27例,未分化癌2例,肺の小細胞癌,腺癌,粘表皮癌,神経内分泌系悪性腫瘍が各1例であった.原発巣が判明したのは12例で扁平上皮癌9例,未分化癌2例,小細胞癌1例であった.累積5年粗生存率は43.5%であった.原発巣治療可能例の8例中,原発巣が治癒したのは7例(87.5%)と良好であった.頸部根治治療可能例28例中,頸部が制御されたのは21例(75%)と良好であった.N2b以上,レベルIV〜Vに転移を認める症例,節外浸潤,遠隔転移がある症例は予後不良であった
• 頭頸部がんに対する急速動注療法 頭頸部進行癌に対する超選択的動注療法と放射線の同時併用療法

  本間 明宏, 古田 康, 牛越 聡, 鈴木 章之, 永橋 立望, 畠山 博充, 浅野 剛, 西岡 健, 白土 博樹, 福田 諭

  頭頸部腫瘍 (一社)日本頭頸部癌学会 29 (3) 450 - 456 0911-4335 2003/09 [Not refereed][Not invited]
   

  頭頸部原発進行癌44例(男33例,女11例,中央値55歳).切除不能24例,手術拒否20例で,原発切除不能のT4bが15例であった.病理組織は扁平上皮癌37例,腺様嚢胞癌3例,未分化癌4例で,原発部位は鼻副鼻腔19例,中咽頭9例,下咽頭8例,口腔5例,上咽頭,耳下腺,聴器各1例であった.観察期間3ヵ月〜3年9ヵ月で,CRが38.6%,PRが56.8%であった.2年の原発巣のprogression free survivalは66.9%で,T4b例では57.1%,T4b未満例は72.8%であった.2年粗生存率は52.4%であった.有害事象は,白血球減少は軽度で,Grade III以上の粘膜炎を38.6%に認め,神経の障害が6例であった.Grade III以上の副作用は84.1%に認め,MRSA肺炎,菌血症を上顎洞原発例に認めた.閉塞性の副鼻腔炎は7例で,上顎洞原発・頸部リンパ節転移例に下顎骨壊死が認められた
• 頭頸部癌放射線・化学療法施行例における頸部リンパ節転移への対応

  本間 明宏, 古田 康, 永橋 立望, 白土 博樹, 西岡 健, 八木 克憲, 犬山 征夫, 福田 諭

  日本癌治療学会誌 (一社)日本癌治療学会 38 (2) 352 - 352 0021-4671 2003/09 [Not refereed][Not invited]
  
• 喉頭全摘に至った喉頭帯状疱疹の一例

  樋口 榮作, 中丸 裕爾, 大渡 隆一郎, 坂下 智博, 目須田 康, 本間 明宏, 古田 康, 福田 諭

  耳鼻咽喉科免疫アレルギー 日本耳鼻咽喉科免疫アレルギー学会 21 (2) 80 - 82 0913-0691 2003/06 [Not refereed][Not invited]
   

  73歳男.咽頭痛が出現した.炎症所見と腎機能障害も認めた.造影CT所見では,左披裂部の腫脹と両頸部リンパ節の腫脹が認められた.病理組織所見では,一部の扁平上皮に中等度から高度の異型が認められた.咽頭痛が強く,喉頭もしくは下咽頭の悪性腫瘍を疑った.喉頭浮腫によると,思われる呼吸困難が出現したため,緊急気管切開術を行った.喘息発作,誤嚥を発症し,全身状態が悪化した.喉頭直達鏡下生検術を行った.臨床所見と経過,検査結果から,一側性第IX,X,XI脳神経麻痺を伴う喉頭帯状疱疹と確定診断した.気管食道分離による誤嚥の防止を目的とした喉頭全摘術を行った.術後経過は良好で退院した.その後現在まで経過良好である
• 頭頸部がんに対する急速動注療法 頭頸部進行癌に対する超選択的動注療法と放射線の同時併用療法

  本間 明宏, 古田 康, 牛越 聡, 鈴木 章之, 永橋 立望, 畠山 博充, 浅野 剛, 西岡 健, 白土 博樹, 福田 諭

  頭頸部腫瘍 (一社)日本頭頸部癌学会 29 (2) 265 - 265 0911-4335 2003/05 [Not refereed][Not invited]
   

  Superselective arterial infusion for patients with advanced head and neck cancer has increasingly been applied in Japan. We analyzed our experiences and evaluated the efficacy and safety of this treatment. Patients and Methods: Forty-four patients, who were considered contraindicated for surgery or rejected radical surgery, received superselective intra-arterial infusion therapy of cisplatin (100-120mg/m²/week) with simultaneous intravenous infusion of thiosulfate to neutralize cisplatin toxicity, and conventional concomitant extrabeam radiotherapy (65Gy/26f/6.5weeks). Results: During the median follow-up period of 17 months, 2-year progression-free survival rate of primary lesion was 66.9%, and that of patients with T4b diseases 57%. The 2-year overall survival rate was 52.4%. Although acute toxic effects were considered acceptable, severe toxic events occurred in some cases, namely, cranial nerve palsy, MRSA pneumonia, sepsis, and osteoradionecrosis. Conclusions: We confirmed the high effectiveness of superselective arterial infusion and concomitant radiotherapy, which can concentrate the attack of decadose cisplatin on locoregional disease. Moreover, even patients with unresectable disease can be cured. We must clarify the treatment results and late side effects, and establish the indications for this treatment.
• 頭頸部扁平上皮癌の放射線化学療法施行例におけるマクロファージ遊走阻止因子の発現の検討

  鈴木 章之, 中丸 裕爾, 本間 明宏, 永橋 立望, 折館 伸彦, 古田 康, 福田 諭

  頭頸部腫瘍 (一社)日本頭頸部癌学会 29 (2) 363 - 363 0911-4335 2003/05 [Not refereed][Not invited]
  
• 頭頸部癌再発症例に対するTS-1使用効果 肺転移症例を中心として

  永橋 立望, 鈴木 章之, 樋口 栄作, 本間 明宏, 古田 康, 福田 諭

  頭頸部腫瘍 (一社)日本頭頸部癌学会 29 (2) 321 - 321 0911-4335 2003/05 [Not refereed][Not invited]
  
• コンソーシアム形式でのオリゴDNAマイクロアレイの作成と頭頸部癌における発現解析

  古田 康, 山崎 健一, 樋口 栄作, 折舘 伸彦, 畠山 博允, 本間 明宏, 永橋 立望, 福田 諭

  頭頸部腫瘍 (一社)日本頭頸部癌学会 29 (2) 298 - 298 0911-4335 2003/05 [Not refereed][Not invited]
  
• 超選択的動注と放射線の同時併用療法

  本間 明宏, 鈴木 章之, 犬山 征夫, 福田 諭

  耳鼻咽喉科臨床 耳鼻咽喉科臨床学会 96 (5) 449 - 454 0032-6313 2003/05 [Not refereed][Not invited]
   

  超選択的動注と放射線の同時併用療法について検討した.対象は,超選択的動注化学療法と放射線療法の同時併用を行った頭頸部原発進行癌29例(男性23例,女性6例・平均52.2歳)で,ステージIIIが4例,IVが25例,臨床的に手術不能が13例,手術拒否が16例であった.観察期間は平均1年8ヵ月で非担癌生存14例(48.3%),原病死11例(37.9%),担癌生存3例(10.3%),他病死1例(3.4%)で,Kaplan-Meier法による2年生存率は42.9%であった.動注と照射で原発巣が制御されたのは21例(72.4%),残る8例中7例は種々の事情で治療が予定通り行えなかった症例であった.N(+)例では16例中8例(50%)が制御された.有害事象は,Grade III以上では白血球減少11例(37.9%),粘膜炎12例(41.4%),Grade IVは粘膜炎,皮膚炎の各1例であった.本併用療法は手術不能例を含む進行癌でも高い局所制御率が得られる治療法であると考えられた
• 上部消化管再建後壊死症例のsalvage手術

  関堂 充, 山本 有平, 佐々木 了, 杉原 平樹, 矢島 和宜, 野平 久仁彦, 新冨 芳尚, 皆川 英彦, 古川 洋志, 本間 明宏, 永橋 立望, 古田 康, 福田 諭, 八木 克憲

  頭頸部腫瘍 (一社)日本頭頸部癌学会 29 (2) 335 - 335 0911-4335 2003/05 [Not refereed][Not invited]
  
• 喉頭癌に対する放射線化学療法施行例の検討

  本間 明宏, 古田 康, 永橋 立望, 八木 克憲, 鈴木 章之, 犬山 征夫, 福田 諭

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 106 (4) 428 - 428 0030-6622 2003/04 [Not refereed][Not invited]
  
• 鼻副鼻腔inverted papilloma再発例の検討

  及川 敬太, 古田 康, 永橋 立望, 本間 明宏, 折舘 伸彦, 中丸 裕爾, 福田 諭

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 106 (4) 393 - 393 0030-6622 2003/04 [Not refereed][Not invited]
  
• 難治性気管狭窄に対するステントとしてのTチューブの有用性

  目須田 康, 永橋 立望, 古田 康, 本間 明宏, 瀧 重成, 福田 諭, 森川 利昭

  日本気管食道科学会会報 (NPO)日本気管食道科学会 54 (2) 163 - 164 0029-0645 2003/04 [Not refereed][Not invited]
  
• Groningen voice prosthesis挿入後合併症の検討

  古田 康, 目須田 康, 永橋 立望, 本間 明宏, 西澤 典子, 福田 諭

  日本気管食道科学会会報 (NPO)日本気管食道科学会 54 (2) 137 - 138 0029-0645 2003/04 [Not refereed][Not invited]
  
• 喉頭神経鞘腫の1例

  瀧 重成, 本間 明宏, 目須田 康, 福田 諭

  日本気管食道科学会会報 (NPO)日本気管食道科学会 54 (2) 132 - 132 0029-0645 2003/04 [Not refereed][Not invited]
  
• 遊離空腸再建症例におけるvoice prosthesis一期的挿入による音声再建

  古田 康, 永橋 立望, 本間 明宏, 折舘 伸彦, 目須田 康, 西澤 典子, 関堂 充, 山本 有平, 奥芝 俊一, 福田 論

  頭頸部腫瘍 (一社)日本頭頸部癌学会 29 (1) 81 - 85 0911-4335 2003/03 [Not refereed][Not invited]
   

  遊離空腸再建症例6例(男5例,女1例,平均56歳)において,グロニンゲン・ボイスボタン(ボイスボタン)を一期的にT-Eシャントとして挿入する方法を試み,その発声状況を評価した.いずれも術後経過は順調であり,術後平均23日目より発声練習を開始した.術後3ヵ月以上経過した時点で会話機能評価基準に従い発声状況を評価した.その結果,8〜9点のexcellentレベルが5例,7点のmoderateレベルが1例であり,概ね良好な発声状況であった.ボイスボタン挿入後の合併症としては,シャント部からの唾液の漏れが3例に認められたが,少量のことが多く,咳嗽により排出され,大きなトラブルには至らなかった
• 術前動注併用放射線治療を行った進行舌癌の2例

  守屋 信吾, 佐藤 明, 大森 桂一, 山崎 裕, 佐藤 千晴, 西岡 健, 本間 明宏, 野谷 健一, 福田 博

  日本口腔外科学会雑誌 (公社)日本口腔外科学会 49 (2) 139 - 139 0021-5163 2003/02 [Not refereed][Not invited]
  
• 鼻中隔に発生した修復性巨細胞肉芽腫の1例

  古沢 純, 古田 康, 本間 明宏, 前田 昌紀, 福田 諭

  耳鼻咽喉科・頭頸部外科 (株)医学書院 75 (2) 117 - 119 0914-3491 2003/02 [Not refereed][Not invited]
   

  73歳男.右鼻閉を主訴とした.感冒後より右鼻閉を自覚し,右に彎曲している鼻中隔に広基性の茎を有する直径7mm大の骨様の硬さの腫瘤を認めた.CT上,骨と同様のCT値をもつ腫瘤が認められ,多形腺腫等の良性腫瘍を疑い腫瘍切除術を行った.病理所見では,数個の核を有する巨細胞を認め,紡錘形細胞からなる間質の増生を認めた.多くの二次的骨形成,出血病変も認めたが,血管腔の増生は認めず,修復性巨細胞肉芽腫(GCRG)と診断した.約1ヵ月後に同部位に腫瘤の再発を認め,その後増大したため再手術を行った.病理所見では,前回と同様にGCRGの診断であった.術後30ヵ月の現在,再発を認めていない.鼻中隔に発症したGCRC症例は海外に2例報告があるのみで,本症例は非常に稀な症例と考えられた
• 頭系部癌リンパ筋転移への放射線・化学療法

  日本臨床 61 (8) 612 - 616 2003 [Not refereed][Not invited]
  
• SUPERSELECTIVE ARTERIAL INFUSION AND CONCOMITANT RADIOTHERAPY FOR ADVANCED HEAD AND NECK CANCER

  HOMMA Akihiro, FURUTA Yasushi, USHIKOSHI Satoshi, SUZUKI Fumiyuki, NAGAHASHI Tatsumi, HATAKEYAMA Hiromitsu, ASANO Takeshi, NISHIOKA Takeshi, SHIRATO Hiroki, FUKUDA Satoshi

  Toukeibu Gan Japan Society for Head and Neck Cancer 29 (3) 450 - 456 0911-4335 2003 [Not refereed][Not invited]
   

  Superselective arterial infusion for patients with advanced head and neck cancer has increasingly been applied in Japan. We analyzed our experiences and evaluated the efficacy and safety of this treatment. Patients and Methods: Forty-four patients, who were considered contraindicated for surgery or rejected radical surgery, received superselective intra-arterial infusion therapy of cisplatin (100-120mg/m²/week) with simultaneous intravenous infusion of thiosulfate to neutralize cisplatin toxicity, and conventional concomitant extrabeam radiotherapy (65Gy/26f/6.5weeks). Results: During the median follow-up period of 17 months, 2-year progression-free survival rate of primary lesion was 66.9%, and that of patients with T4b diseases 57%. The 2-year overall survival rate was 52.4%. Although acute toxic effects were considered acceptable, severe toxic events occurred in some cases, namely, cranial nerve palsy, MRSA pneumonia, sepsis, and osteoradionecrosis. Conclusions: We confirmed the high effectiveness of superselective arterial infusion and concomitant radiotherapy, which can concentrate the attack of decadose cisplatin on locoregional disease. Moreover, even patients with unresectable disease can be cured. We must clarify the treatment results and late side effects, and establish the indications for this treatment.
• 頭頸部進行癌に対するシスプラチンの超選択的動注と放射線の同時併用療法

  本間 明宏, 鈴木 章之, 犬山 征夫, 福田 諭

  耳鼻咽喉科臨床 補冊 耳鼻咽喉科臨床学会 (補冊108) 64 - 65 0912-1870 2002/11 [Not refereed][Not invited]
  
• 頭頸部癌リンパ節転移陽性例に対する放射線化学療法の検討

  本間 明宏, 古田 康, 永橋 立望, 白土 博樹, 西岡 健, 八木 克憲, 影井 兼司, 犬山 征夫, 福田 諭

  日本癌治療学会誌 (一社)日本癌治療学会 37 (2) 383 - 383 0021-4671 2002/09 [Not refereed][Not invited]
  
• TS-1の投与により消失し,長期CRが得られた中咽頭扁平上皮癌の1例

  本間 明宏, 鈴木 章之, 折舘 伸彦, 古田 康, 犬山 征夫, 福田 諭

  癌と化学療法 (株)癌と化学療法社 29 (8) 1475 - 1478 0385-0684 2002/08 [Not refereed][Not invited]
   

  60歳男.右舌根部に扁平上皮癌が再発し,TS-1(100mg/day)の投与を4週投薬,2週休薬を1コースとして開始し,2コース終了後の肉眼的所見によりCRを確認した.副作用がなく,3コース目から120mg/dayに増量して継続し,肉眼的にCRは持続し,9コース時生検で悪性所見を認めず組織学的CRを確認した.12コース終了し,UFT 600mg/dayに切り換え,再発なく経過していたが膵臓癌となり死亡した
• [Long-term complete response to treatment with TS-1 in a patient with oropharyngeal squamous cell carcinoma].

  Homma A, Suzuki F, Oridate N, Furuta Y, Inuyama Y, Fukuda S

  Gan to kagaku ryoho. Cancer & chemotherapy 29 (8) 1475 - 1478 0385-0684 2002/08 [Refereed][Not invited]
   

  A 60-year-old man had a recurrence of squamous cell carcinoma at the right side of the tongue base. Chemotherapy with TS-1 (100 mg/day) was begun. Each course of chemotherapy consisted of 4 weeks of TS-1, followed by 2 weeks of no treatment. After the completion of two courses, macroscopic examination revealed a complete response. From the third course of TS-1 treatment, the dose was increased to 120 mg/day. The complete response persisted on macroscopic examination. A biopsy done during the ninth course of TS-1 treatment confirmed the complete response histologically, with no evidence of malignancy. After 12 courses of TS-1 treatment, the drug was switched to 600 mg/day of UFT. Although there were no signs or symptoms of recurrence, the patient died of cancer of the pancreas. There was no recurrence of the oropharyngeal cancer, even at the time of death.
• T2N0声門癌の治療方針 放射線化学同時併用療法

  永橋 立望, 福田 諭, 本間 明宏, 犬山 征夫, 白土 博樹

  耳鼻と臨床 耳鼻と臨床会 48 (Suppl.1) S41 - S45 0447-7227 2002/07 [Not refereed][Not invited]
   

  CBDCA(carboplatin)ないしCDDP(cisplatin)の放射線化学同時併用療法を行った声門癌T2N0患者33例を対象として,その結果について検討した.治療方法はCBDCA 100mg/m2を週1回ないしCDDP 4mg/m2を週4回,照射日に一致して点滴静注し,照射は2.5Gy/fr週4回行い40Gyで評価し,NCでは手術,PR,CRでは65Gyまで続行するか否かを決定した.T2N0声門癌全症例での5年累積粗生存率は88.1%であった.同時併用療法にては,好中球減少,血小板減少,皮膚の剥離にてgrade 3の副反応が出現したが,死亡例は認めなかった.同時併用療法群をhistorical controlの放射線療法群15例と比較したところ,累積粗生存率にて有意差を認めたが,累積喉頭温存率では有意差を認めなかった
• 放射線治療と化学療法の同時併用の効果予測 免疫組織化学からcDNAマイクロアレイへ

  古田 康, 本間 明宏, 樋口 栄作, 折舘 伸彦, 永橋 立望, 福田 諭

  耳鼻咽喉科免疫アレルギー 日本耳鼻咽喉科免疫アレルギー学会 20 (2) 42 - 43 0913-0691 2002/06 [Not refereed][Not invited]
  
• Duplex scan(超音波パルスドップラー法)を用いた微小血管吻合後の血流モニタリング

  関堂 充, 山本 有平, 杉原 平樹, 横山 朋子, 古川 洋志, 矢島 和宜, 本間 明宏, 永橋 立望, 折舘 伸彦, 古田 康, 福田 諭

  頭頸部腫瘍 (一社)日本頭頸部癌学会 28 (2) 442 - 442 0911-4335 2002/05 [Not refereed][Not invited]
  
• 遊離空腸再建症例におけるvoice prosthesis一期的挿入による音声再建

  古田 康, 永橋 立望, 本間 明宏, 折舘 伸彦, 目須田 康, 西澤 典子, 福田 諭, 関堂 充, 山本 有平, 奥芝 俊一

  頭頸部腫瘍 (一社)日本頭頸部癌学会 28 (2) 420 - 420 0911-4335 2002/05 [Not refereed][Not invited]
  
• 頭頸部癌切除可能例に対するCDDP+RT vs CBDCA+RTの無作為化比較試験の検討

  本間 明宏, 福田 諭, 永橋 立望, 古田 康, 八木 克憲, 犬山 征夫, 白土 博樹, 西岡 健, 影井 兼司

  頭頸部腫瘍 (一社)日本頭頸部癌学会 28 (2) 380 - 380 0911-4335 2002/05 [Not refereed][Not invited]
  
• 超選択的動注化学療法を施行した中・下咽頭癌症例における治療後の嚥下状態の検討

  鈴木 章之, 本間 明宏, 古田 康, 折館 伸彦, 永橋 立望, 畠山 博充, 福田 諭, 牛越 聡, 浅野 剛, 西岡 健, 白土 博樹

  頭頸部腫瘍 (一社)日本頭頸部癌学会 28 (2) 376 - 376 0911-4335 2002/05 [Not refereed][Not invited]
  
• 下咽頭扁平上皮癌における頸部郭清術

  山田 和之, 本間 明宏, 永橋 立望, 八木 克憲, 古田 康, 福田 諭

  頭頸部腫瘍 (一社)日本頭頸部癌学会 28 (2) 374 - 374 0911-4335 2002/05 [Not refereed][Not invited]
  
• 鼻副鼻腔乳頭腫のstaging MRIの術前評価

  及川 敬太, 古田 康, 劉 澤周, 八木 克憲, 栢村 正明, 折舘 伸彦, 永橋 立望, 本間 明宏, 福田 諭

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 105 (4) 474 - 474 0030-6622 2002/04 [Not refereed][Not invited]
  
• 頭頸部腫瘍におけるC-11 L-methionine PETの役割

  永橋 立望, 本間 明宏, 折館 伸彦, 古田 康, 福田 諭

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 105 (4) 482 - 482 0030-6622 2002/04 [Not refereed][Not invited]
  
• cDNAマイクロアレイを用いた鼻副鼻腔癌及び前癌病変における遺伝子発現の検討

  畠山 博充, 古田 康, 本間 明宏, 折舘 伸彦, 鈴木 清護, 永橋 立望, 八木 克憲, 犬山 征夫, 福田 諭, 山崎 健一, 楠崎 幸作

  頭頸部腫瘍 (一社)日本頭頸部癌学会 28 (1) 269 - 274 0911-4335 2002/03 [Not refereed][Not invited]
  
• 頬粘膜癌に対する放射線治療成績

  大森 桂一, 小日向 謙一, 金子 正範, 中村 太保, 鄭 漢忠, 戸塚 靖則, 野谷 健一, 福田 博, 西岡 健, 本間 明宏

  日本口腔科学会雑誌 (NPO)日本口腔科学会 51 (1) 91 - 91 0029-0297 2002/01 [Not refereed][Not invited]
  
• 嚥下障害をきたした喉頭麻痺に対する透視CT下経皮的声帯内注入術の経験

  目須田 康, 本間 明宏, 西澤 典子, 福田 諭, 高木 大, 須藤 敏, 犬山 征夫

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 105 (1増刊) 94 - 95 0030-6622 2002/01 [Not refereed][Not invited]
  
• 頭頸部腫瘍に対するCDDP+RT vs CBDCA+RTの無作為化比較試験

  本間 明宏, 福田 諭, 八木 克憲, 古田 康, 犬山 征夫, 白土 博樹, 西岡 健, 影井 兼司

  日本癌治療学会誌 (一社)日本癌治療学会 36 (2) 594 - 594 0021-4671 2001/10 [Not refereed][Not invited]
  
• 舌癌に対する化学療法 術前・術後化学療法 放射線と化学療法の同時併用療法(chemoradiation)と治療ガイドライン

  福田 諭, 本間 明宏, 永橋 立望, 八木 克憲, 犬山 征夫

  耳鼻と臨床 耳鼻と臨床会 47 (Suppl.1) S11 - S15 0447-7227 2001/09 [Not refereed][Not invited]
   

  舌原発扁平上皮癌新鮮例21例に対しカルボプラチン(CBDCA)と放射線の同時併用療法を行い,その治療成績について検討した.平均は57.7歳,stage Iが2例,stage IIが9例,stage IIIが7例,stage IVが3例で,観察期間は平均6年4ヵ月であった.その結果,Kaplan-Meier法による5年生存率は,stage別ではstage I-IIが81.8%,stage IIIが71.4%,stage IVが0%であった.T別では,T1-2(14例):81.8%,T3(5例):60.0%,T4(2例):0%,全体では約70%であり,進行例での成績が悪かった.癌治療におけるevidence based medicine,ガイドライン,治療の標準化の現状について言及した
• cDNA microarrayを用いた鼻副鼻腔癌及び前癌病変における遺伝子発現の解析

  畠山 博充, 古田 康, 本間 明宏, 折舘 伸彦, 鈴木 清護, 永橋 立望, 八木 克憲, 福田 諭, 犬山 征夫, 楠崎 幸作, 山崎 健一

  頭頸部腫瘍 (一社)日本頭頸部癌学会 27 (2) 407 - 407 0911-4335 2001/05 [Not refereed][Not invited]
  
• cDNA microarrayを用いたシスプラチン耐性関連遺伝子の解析

  古田 康, 畠山 博充, 樋口 栄作, 鈴木 清護, 折舘 伸彦, 本間 明宏, 永橋 立望, 八木 克憲, 福田 諭, 犬山 征夫, 楠崎 幸作, 山崎 健一

  頭頸部腫瘍 (一社)日本頭頸部癌学会 27 (2) 406 - 406 0911-4335 2001/05 [Not refereed][Not invited]
  
• 頭頸部進行癌に対するシスプラチンの超選択的動注療法

  本間 明宏, 畠山 博充, 永橋 立望, 折舘 伸彦, 八木 克憲, 古田 康, 福田 諭, 犬山 征夫, 浅野 剛, 牛越 聡, 西岡 健, 白土 博樹, 宮坂 和男

  頭頸部腫瘍 (一社)日本頭頸部癌学会 27 (2) 356 - 356 0911-4335 2001/05 [Not refereed][Not invited]
  
• 側頭骨外科,頭蓋底外科 頭蓋底外科の適応疾患,合併症,現在の動向 多施設トライアルの結果を中心として

  福田 諭, 本間 明宏, 永橋 立望, 八木 克憲, 古田 康, 犬山 征夫, 山本 有平, 澤村 豊

  頭頸部腫瘍 (一社)日本頭頸部癌学会 27 (2) 281 - 281 0911-4335 2001/05 [Not refereed][Not invited]
  
• 当科におけるシスプラチンの超選択的動注療法

  本間 明宏, 畠山 博充, 加納 里志, 永橋 立望, 八木 克憲, 古田 康, 福田 諭, 犬山 征夫

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 104 (5増刊) 640 - 641 0030-6622 2001/05 [Not refereed][Not invited]
  
• 【静脈・経腸栄養】 各種疾患における静脈・経腸栄養の実際 耳鼻咽喉科領域における静脈・経腸栄養

  本間 明宏, 犬山 征夫

  日本臨床 (株)日本臨床社 59 (増刊5 静脈・経腸栄養) 714 - 717 0047-1852 2001/05 [Not refereed][Not invited]
  
• Concurrent chemotherapy and radiotherapy as initial treatment for stage II supraglottic squamous cell carcinoma

  T Nagahashi, S Fukuda, A Homma, K Yagi, Y Furuta, Y Inuyama

  AURIS NASUS LARYNX 28 S95 - S98 0385-8146 2001/05 [Refereed][Not invited]
   

  Objective: To evaluate the efficacy and safety of concurrent carboplatin (CBDCA) and radiotherapy for laryngeal carcinoma, we investigated survival rates and laryngeal preservation rates in patients with this treatment modality and those with radiation therapy only. Methods: We underwent chemotherapy with CBDCA and conventional radiotherapy concurrently to 17 patients with untreated stage II (T2N0M0) supraglottic squamous cell carcinoma since November 1990. CBDCA (100 mg/m(2)) was administered intravenously once a week concurrently with radiotherapy (2.5 Gy/fr, 4 times a week). At the dose of 40 Gy, the results were evaluated, and some of the patients underwent planned surgery and others continued the radiotherapy up to 65 Gy. Results: Overall 5-year survival rate by Kaplan-Meier method was 81.1%. Actual laryngeal preservation rate was 76.0%. Toxicity over grade III was noticed in two patients. Compared with 14 cases of historical controls, which were treated by radiation therapy alone between 1988 and 1990, the cases with concurrent radiotherapy and chemotherapy had statistically significant advantage in overall successful laryngeal preservation rate (P < 0.05), whereas the two groups were not significantly different in the overall 5-year survival rate. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.
• A clinical study on the cervical lymph node metastasis of maxillary sinus carcinoma

  K Yagi, S Fukuda, Y Furuta, N Oridate, A Homma, T Nagahashi, Y Inuyama

  AURIS NASUS LARYNX 28 S77 - S81 0385-8146 2001/05 [Refereed][Not invited]
   

  Objective: to improve the management of maxillary sinus carcinoma, we retrospectively investigated the significance of cervical lymph node metastasis in our treated cases and discussed how to deal with the cervical lymph node metastasis as a prognostic factor. Methods: medical records of 118 patients with maxillary sinus carcinoma diagnosed and treated in our institute from 1982 to 1997 were retrospectively reviewed. Tumors were staged according to UICC classification 1987. The cumulative survival was analyzed by the Kaplan-Meier method. Generally, the patients had undergone preoperative radiotherapy and surgery. We examined the cervical lymph node metastasis detected at the first examination and the subsequent cervical lymph node metastasis in relation to the prognoses. Results: the incidence of cervical lymph node metastasis at the initial diagnosis was 7.9% (n = 9), and that of secondary cervical lymph node metastasis without recurrence at the primary site after the first treatment was 8.3% (n = 9). In most cases, we observed metastasis to the lymph nodes in the submandibular region and in the jugular chain. The result of treatment of cervical lymph node metastasis was grave. Among the patients with cervical lymph node metastasis detected at the first examination, four patients developed local recurrence and three patients developed distant metastasis. On the other hand, among those with secondary cervical metastasis, three patients developed neck recurrence and three patients developed distant metastasis, but no local recurrence. Conclusions: in the cervical metastasis of maxillary sinus carcinoma, it is important to treat the primary lesion completely. In addition to it, we should control cervical metastasis and careful neck dissection is required. For the patients with cervical lymph node metastasis, it is necessary to consider the further treatment of distant metastasis. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.
• Clinical study of adenoid cystic carcinoma of the head and neck

  D Takagi, S Fukuda, Y Furuta, K Yagi, A Homma, T Nagahashi, Y Inuyama

  AURIS NASUS LARYNX 28 S99 - S102 0385-8146 2001/05 [Refereed][Not invited]
   

  Objective: We examined prognostic factors and outcome of the primary treatment in patients with adenoid cystic carcinoma (ACC) of the head and neck. Methods: Twenty patients with ACC of the head and neck who had been treated in our institution from 1985 to 1998 were enrolled in this study. Disease-specific survival rate was analyzed by the Kaplan-Mejer method, and the log-rank test was applied to compare the survival rates. Results: The overall 5- and 10-year survival rates determined by Kaplan-Meier analysis were 81 and 57%, respectively. Patients with major salivary gland ACC obtained the best 10-year survival rate (83%), while those with paranasal sinus ACC had the worst survival rate (33%). Predominance of the solid component on pathological examination might indicate a worse prognosis. Our study revealed that postoperative radiotherapy could yield better control of the lesion focus. Chemotherapy failed in some patients and was not dramatically effective by itself. Conclusions: The long-term prognosis of ACC was poor. Long-term follow-up is necessary for better prognosis of patients treated with radical treatment regimens. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.
• A study of piriform sinus fistula cases

  H Hatakeyama, A Homma, T Nagahashi, N Oridate, K Yagi, S Fukuda, Y Inuyama

  AURIS NASUS LARYNX 28 S139 - S143 0385-8146 2001/05 [Not refereed][Not invited]
   

  We have experienced five cases of piriform sinus fistula for the last 10 years. It is a relatively rare disease, and partly because of poor understanding of the disease, in one case infection had repeatedly recurred without being adequately treated for over 20 years, and in most cases there was a long time lapse before the diagnosis. In another case, it was difficult to image the fistula with contrast medium and fistulectomy was performed without identifying it on imaging. We have applied various devices to those cases where imaging of fistula was difficult, and achieved complete resection of fistula and have not observed recurrences of infection after resection. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.
• Correlation of clinicopathological parameters and biological markers related to apoptosis and proliferative activity with a clinical outcome in squamous cell carcinoma of the larynx treated with concurrent chemoradiotherapy

  A Homma, Y Furuta, N Oridate, Y Nakano, K Yagi, T Nagahashi, S Fukuda, Y Inuyama

  AURIS NASUS LARYNX 28 (suppl) S87 - S94 0385-8146 2001/05 [Not refereed][Not invited]
   

  Objective: This study was designed to determine whether biological markers related to apoptosis or proliferative activity are associated with the clinical outcome in patients with squamous cell carcinoma (SCC) of the larynx treated with concurrent chemoradiotherapy. Methods: Immunostaining with antibodies specific to p53, bcl-2, bax, and MIB-1 was performed to evaluate expression of these proteins in formalin-fixed, paraffin-embedded specimens of 59 patients treated with concurrent chemoradiotherapy (carboplatin, 100 mg/m(2), four to six times every week; total radiation dose of 40-65 Gy over 4-6.5 weeks). Results: Multivariate analysis indicated that nodal status was a significant indicator of overall survival (OS; P = 0.001). Patients with bcl-2 positive tumors had better OS than those with bcl-2 negative tumors in both univariate (P = 0.002) and multivariate analyses (P < 0.001). In the univariate analysis, a considerable difference in OS was observed among the expressions of bax (P = 0.077), MIB-I proteins (P = 0.071), and OS, but the difference was not statistically significant. Conclusion: This study indicates that nodal status is the major prognostic factor in patients with SCC of the larynx treated with concurrent chemoradiotherapy. These results provide useful information for predicting prognosis. Further analysis of biological factors is needed to evaluate the value as predictive markers. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.
• 声門上癌における放射線・化学同時併用療法の役割

  永橋 立望, 福田 諭, 本間 明宏, 八木 克憲, 古田 康, 犬山 征夫

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 104 (4) 357 - 357 0030-6622 2001/04 [Not refereed][Not invited]
  
• 頭頸部腺様嚢胞癌39例における放射線治療の検討

  大森 桂一, 西岡 健, 本間 明宏, 鄭 漢忠, 山下 徹郎, 小日向 謙一, 細川 洋一郎, 中村 太保

  日本口腔科学会雑誌 (NPO)日本口腔科学会 50 (1) 53 - 57 0029-0297 2001/01 [Not refereed][Not invited]
   

  全症例の5年,10年の局所制御は69%,53%であった.また全症例の5年,10年の累積生存率は70%,44%であった.肺転移は39例中11例にみられた.放射線単独症例の5年局所制御率は50.0%,累積生存率は68.6%であった.口蓋原発のものは放射線治療単独4例中3例の局所制御が得られた
• 鼻中隔に発生したgiant cell reparative granulomaの1例

  古沢 純, 古田 康, 本間 明宏, 前田 昌紀, 犬山 征夫

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 104 (1増刊) 79 - 80 0030-6622 2001/01 [Not refereed][Not invited]
  
• 下咽頭癌における放射線・化学同時併用療法

  永橋 立望, 福田 諭, 本間 明宏, 八木 克憲, 古田 康, 犬山 征夫, 西岡 健, 白土 博樹

  頭頸部腫瘍 (一社)日本頭頸部癌学会 26 (3) 476 - 482 0911-4335 2000/11 [Not refereed][Not invited]
  
• 肋軟骨弁付き腹直筋皮弁による上顎再建 One buttress:zygomaticomaxillary buttress再建について

  山本 有平, 関堂 充, 古川 洋志, 杉原 平樹, 福田 諭, 古田 康, 八木 克憲, 永橋 立望, 本間 明宏, 犬山 征夫

  頭頸部腫瘍 (一社)日本頭頸部癌学会 26 (3) 436 - 440 0911-4335 2000/11 [Not refereed][Not invited]
  
• 下咽頭・頸部食道癌 治療成績・QOL向上の工夫 北大における下咽頭癌の治療成績 放射線・化学同時併用療法を中心として

  永橋 立望, 福田 諭, 本間 明宏, 八木 克憲, 古田 康, 犬山 征夫, 西岡 健, 白土 博樹

  頭頸部腫瘍 (一社)日本頭頸部癌学会 26 (2) 204 - 204 0911-4335 2000/05 [Not refereed][Not invited]
  
• 形態機能を温存するための上顎下顎再建 肋軟骨弁付き腹直筋皮弁による上顎再建 One buttress:zygomaticomaxillary buttress再建について

  山本 有平, 皆川 英彦, 川嶋 邦裕, 関堂 充, 古川 洋志, 杉原 平樹, 福田 諭, 古田 康, 八木 克憲, 永橋 立望, 本間 明宏, 犬山 征夫

  頭頸部腫瘍 (一社)日本頭頸部癌学会 26 (2) 182 - 182 0911-4335 2000/05 [Not refereed][Not invited]
  
• 頸部原発脂肪肉腫の1症例

  加納 里志, 飯尾 光博, 本間 明宏, 八木 克憲, 福田 諭, 犬山 征夫

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 103 (5増刊) 699 - 699 0030-6622 2000/05 [Not refereed][Not invited]
  
• 下咽頭癌放射線治療症例の検討

  八木 克憲, 福田 諭, 永橋 立望, 本間 明宏, 古田 康, 犬山 征夫

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 103 (4) 425 - 425 0030-6622 2000/04 [Not refereed][Not invited]
  
• 頭頸部癌に対する遊離空腸による再建 49症例の術後合併症と摂食状況について

  山田 和之, 福田 諭, 八木 克憲, 目須田 康, 横浜 優樹, 本間 明宏, 永橋 立望, 古田 康, 佐藤 信清, 犬山 征夫, 山本 有平, 大野 耕一, 奥芝 俊一

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 102 (12) 1279 - 1286 0030-6622 1999/12 [Not refereed][Not invited]
   

  1)遊離空腸再建術症例49例における術後合併症,術後の嚥下に関連する因子,及び摂食状況と吻合形式の関係について検討した.2)空腸自体の合併症は6例に生じた.空腸壊死は1例,瘻孔は3例,狭窄は2例で,うち重症群は空腸壊死1例,瘻孔2例のみであった.本術式の高い安全性が確認された.3)腸管の適度な緊張は摂食上極めて重要な因子と考えられた.吻合形式については,端々吻合がより望ましい術式と考えられた
• 頭頸部再建における形成再建手技の進歩

  山本 有平, 佐々木 了, 関堂 充, 古川 洋志, 杉原 平樹, 福田 諭, 古田 康, 八木 克憲, 永橋 立望, 本間 明宏, 犬山 征夫, 奥芝 俊一, 吉田 哲憲, 野平 久仁彦, 渡邉 昭仁, 山下 徹郎

  頭頸部腫瘍 (一社)日本頭頸部癌学会 25 (3) 471 - 475 0911-4335 1999/11 [Not refereed][Not invited]
  
• 下咽頭癌の化学療法 放射線同時併用療法

  福田 諭, 永橋 立望, 本間 明宏, 犬山 征夫, 白土 博樹

  耳鼻と臨床 耳鼻と臨床会 45 (Suppl.3) 706 - 709 0447-7227 1999/11 [Not refereed][Not invited]
   

  1990年11月より頭頸部癌患者に対しCBDCAと放射線同時併用療法を行い,評価可能147例(男125例,女22例,年齢:34歳-82歳)のうち下咽頭癌患者22例について検討を加えた.治療方法はCBDCA 100mg/m2を週1回照射日に一致して点滴静注し,照射は60Co 2.5Gy/fr週4回行い40Gyで評価し,手術かfull doseまで続行するかを決定した.下咽頭全症例での5年disease free survivalは34.1%,stage II(2例)で100%,stage III(3例)で33%,stage IV(16例)で25%,救済手術を行わないCBDCA+放射線のみでの無再発生存は3例.症例数は少ないものの進行例の予後は他の報告どおり決して良くない
• 篩骨洞悪性腫瘍の臨床的検討

  八木 克憲, 福田 諭, 本間 明宏, 永橋 立望, 古田 康, 犬山 征夫

  頭頸部腫瘍 (一社)日本頭頸部癌学会 25 (2) 369 - 369 0911-4335 1999/05 [Not refereed][Not invited]
  
• 鼻・副鼻腔inverted papilloma癌化例に対する診断治療の検討

  古田 康, 八木 克憲, 劉 沢周, 本間 明宏, 永橋 立望, 福田 諭, 犬山 征夫

  頭頸部腫瘍 (一社)日本頭頸部癌学会 25 (2) 247 - 247 0911-4335 1999/05 [Not refereed][Not invited]
  
• 当科における中咽頭扁平上皮癌の頸部リンパ節転移の治療

  本間 明宏, 八木 克憲, 永橋 立望, 古田 康, 福田 諭, 犬山 征夫, 白土 博樹, 西岡 健, 影井 兼司

  頭頸部腫瘍 (一社)日本頭頸部癌学会 25 (2) 314 - 314 0911-4335 1999/05 [Not refereed][Not invited]
  
• 当科における聴器癌治療成績の検討

  永橋 立望, 八木 克憲, 本間 明宏, 古田 康, 福田 諭, 犬山 征夫

  頭頸部腫瘍 (一社)日本頭頸部癌学会 25 (2) 317 - 317 0911-4335 1999/05 [Not refereed][Not invited]
  
• 再度遊離空腸移植術を必要とした下咽頭頸部食道再建例の検討

  古川 洋志, 山本 有平, 関堂 充, 杉原 平樹, 福田 諭, 佐藤 信清, 古田 康, 八木 克憲, 永橋 立望, 本間 明宏

  頭頸部腫瘍 (一社)日本頭頸部癌学会 25 (2) 284 - 284 0911-4335 1999/05 [Not refereed][Not invited]
  
• 上顎洞悪性腫瘍における眼窩浸潤症例の検討

  八木 克憲, 福田 諭, 本間 明宏, 永橋 立望, 古田 康, 犬山 征夫

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 102 (4) 587 - 587 0030-6622 1999/04 [Not refereed][Not invited]
  
• Prognostic significance of clinical parameters and biological markers in patients with squamous cell carcinoma of the head and neck treated with concurrent chemoradiotherapy

  A Homma, Y Furuta, N Oridate, Y Nakano, G Kohashi, K Yagi, T Nagahashi, S Fukuda, K Inoue, Y Inuyama

  CLINICAL CANCER RESEARCH 5 (4) 801 - 806 1078-0432 1999/04 [Not refereed][Not invited]
   

  Concurrent chemoradiotherapy is reported to have a fair clinical outcome with organ preservation for patients with squamous cell carcinoma of the head and neck (SCCHN), The aim of this study was to determine whether biological markers are related to proliferative activity or apoptosis of tumor cells and whether clinical factors are associated with a clinical outcome in SCCHN patients treated with concurrent chemoradiotherapy, Immunostaining with antibodies specific for p53, bcl-2, bar, and MIB-1 was performed to evaluate expression of these proteins in formalin-fixed, paraffin-embedded specimens of 111 SCCHN patients treated with concurrent chemoradiotherapy (carboplatin, 100 mg/m(2), four to six times every week; total radiation therapy dose of 40-65 Gy over 4-6.5 weeks). Multivariate analysis indicated that nodal status was a significant indicator of overall survival (OS; P = 0.001) and locoregional control (LRC; P = 0.002), In a univariate analysis, patients with a low MIB-1-positive index (< 40%) had better OS than those with a high MLB-l-positive index (greater than or equal to 40%; P = 0.013), although the difference was not statistically significant in a multivariate analysis (P = 0.060), Patients with bcl-2-positive tumors had better LRC than those with bcl-2-negative tumors, based on a multivariate analysis (P = 0.017), No statistically significant association was found between p53 or bar expression and clinical outcome. These results indicate that nodal status is the major prognostic factor in SCCHN patients treated with concurrent chemoradiotherapy, In addition, our findings suggest that bcl-2 positivity is associated with better LRC and that the proliferative activity of tumor cells might be prognostic for OS.
• 中咽頭癌に対する根治的放射線治療

  影井 兼司, 清水 伸一, 橋本 井子, 西岡 健, 白土 博樹, 本間 明宏, 金子 正範, 大森 圭一, 宮坂 和男

  頭頸部腫瘍 (一社)日本頭頸部癌学会 25 (1) 30 - 35 0911-4335 1999/03 [Not refereed][Not invited]
   

  1980年から95年までに根治的放射線治療を行った中咽頭癌新鮮例127例の治療成績を分析した.127例は一次治療として局所及び頸部に対して根治的放射線治療が行われた.ほぼ全例がコバルトγ線の1日1回照射の外照射で治療され,1回線量2.5Gy週4回照射で標準的総線量は65ないし70Gyであった.本論文では,まず全体の治療成績を検討した.ついで,口腔内乾燥症の軽減を目的したCTシミュレーターを用いた対側耳下腺をスペアーした照射法の有用性について検討した.原発病変が正中を超えず対側頸部リンパ節転移がない38例に対してウエッジを用いた斜入二門照射を行ったが,口腔内乾燥症が軽減でき,局所・頸部制御率が劣ることなく,有用な治療法と思われた.更に,カルボプラチン週1回同時併用した29例と照射のみの92例の治療成績を比較検討したが,両群間に生存率,局所制御率,頸部制御率に有意差は認めなかった
• 悪性転化したと考えられる副咽頭間隙腫瘍の1症例

  祢津 宏昭, 間口 四郎, 後藤田 裕之, 寺山 吉彦, 本間 明宏, 八木 克憲, 犬山 征夫

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 102 (1増刊) 104 - 104 0030-6622 1999/01 [Not refereed][Not invited]
  
• 上咽頭に発生したlow-grade papillary adenocarcinomaの1症例

  川原 弘匡, 本間 明宏, 古田 康, 犬山 征夫, 大谷 文雄, 藤岡 保範

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 102 (1増刊) 105 - 105 0030-6622 1999/01 [Not refereed][Not invited]
  
• 当科における重複癌の検討

  津布久 崇, 八木 克憲, 永橋 立望, 本間 明宏, 福田 諭, 犬山 征夫

  日本耳鼻咽喉科学会会報 (一社)日本耳鼻咽喉科学会 102 (1増刊) 104 - 104 0030-6622 1999/01 [Not refereed][Not invited]
  
• 【頭頸部癌 私の治療方針と成績】 声帯癌T3症例の保存的治療 北海道大学病院の場合

  犬山 征夫, 福田 諭, 古田 康, 本間 明宏, 白土 博樹

  耳鼻咽喉科・頭頸部外科 (株)医学書院 70 (12) 799 - 804 0914-3491 1998/11 [Not refereed][Not invited]
   

  1)原発部位別の5年粗生存率は,喉頭癌75.6%,口腔癌69.7%,中咽頭癌と下咽頭癌は32.9%,34.1%であった. 2)喉頭癌のII期について,照射+CBDCA群と照射単独群の5年粗生存率は86.4%,66.7%,また,5年cause-specific survivalは97%,69%で共に有意差が認められた. 3)喉頭癌のT2症例での5年生存率でも,併用群91.2%,照射単独群70.7%で有意差が認められた. 4)声門上癌T2の喉頭温存を伴った5年生存率は,併用群66.5%,対照群36%で有意差が認められた. 5)喉頭癌T3症例の喉頭温存を伴った5年粗生存率,cause-specific survivalは,おのおの51.4%,61.5%と良好であった
• 咽頭癌治療の最前線 中咽頭・口腔癌に対するChemoradiation

  福田 諭, 本間 明宏, 犬山 征夫

  癌の臨床 (株)篠原出版新社 44 (11) 1253 - 1260 0021-4949 1998/10 [Not refereed][Not invited]
  
• 中咽頭癌に対する根治的放射線治療

  影井 兼司, 清水 伸一, 橋本 井子, 西岡 健, 白土 博樹, 金子 正範, 大森 圭一, 本間 明宏, 宮坂 和男

  頭頸部腫瘍 (一社)日本頭頸部癌学会 24 (2) 148 - 148 0911-4335 1998/05 [Not refereed][Not invited]
  
• CBDCA・放射線同時併用療法を行った喉頭癌症例におけるp53,bcl-2,bax,MIB-1発現と予後との関連

  本間 明宏, 古田 康, 折舘 伸彦, 永橋 立望, 八木 克憲, 福田 諭, 犬山 征夫

  頭頸部腫瘍 (一社)日本頭頸部癌学会 24 (2) 193 - 193 0911-4335 1998/05 [Not refereed][Not invited]
  
• 重複癌の現況とその対策 頭頸部癌の立場から 現況・診断・予防

  福田 諭, 本間 明宏, 折舘 伸彦

  日本気管食道科学会会報 (NPO)日本気管食道科学会 49 (2) 146 - 150 0029-0645 1998/04 [Not refereed][Not invited]
   

  1)頭頸部領域における重複癌は確実に増加している. 2)中咽頭癌74例中27症例に重複癌が認められ,その頻度は実に36%と極めて高率であった. 3)頭頸部癌のhigh risk groupに対してはルゴール染色を含む徹底した上部消化管の精査,肺の精査が必要不可欠であり,この意味で,他科(消化器・呼吸器)との密接な連携が重要である. 4)過度の喫煙・飲酒等に対する社会的啓蒙も予防医学的見地から必要不可欠と思われ,又,癌化学予防という新しい分野でも発展が期待される
• The management of olfactory neuroblastoma: outcome of 8 cases

  S Fukuda, A Homma, T Nagahashi, Y Furuta, Y Inuyama

  1ST WORLD CONGRESS ON HEAD AND NECK ONCOLOGY 643 - 646 1998 [Refereed][Not invited]
   

  We summarized our recent 8 cases from 1989. We underwent anterior skull base surgery for operable 5 (3:fresh, 2: recurrent) cases and intensive chemoradiotherapy for inoperable 3 cases. As a result, 3 fresh operated patients showed no evidence of disease for 112, 74 and 70 months(M) after the initial treatment and 2 recurrent cases died of local recurrence again 14 and 6 M after the surgery. As for 3 chemoradiotherapy cases, 2 cases reveal no recurrence for 38 and 17 M. An another case died 6 M after initial therapy.
• 舌癌における頸部リンパ節転移

  八木 克憲, 福田 諭, 永橋 立望, 本間 明宏, 古田 康, 佐藤 信清, 犬山 征夫

  頭頸部外科 (NPO)日本頭頸部外科学会 7 (3) 147 - 151 1349-581X 1997/12 [Not refereed][Not invited]
   

  舌癌における頸部リンパ節転移状況とその対応について検討した。(1)T1,2N0では、後発転移は33%に認められ、salvageし得たのはうち46%であった。外照射と内照射併用例では、照射野内にも後発転移を認め、予防的照射の有効性は疑問であった。また辺縁型の後発転移例に対する郭清は、患側の顎下から下内深頸までで充分と考えられた。(2)深達度の大きいT2N0およびT3N0に対してはen bloc手術を行うべきである。(3)舌下面型、辺縁前方向型、後方向型、および辺縁前方向・後方向型に転移頻度が高く、転移領域も多く認められた。前・後方向進展が強いN(+)症例に対しては健側の郭清も考慮すべきと思われた。(著者抄録)
• 頸部食道癌におけるリンパ節転移の検討

  八木 克憲, 福田 論, 永橋 立望, 本間 明宏, 古田 康, 佐藤 信清, 犬山 征夫, 奥芝 俊一, 本原 敏司

  頭頸部腫瘍 (一社)日本頭頸部癌学会 23 (1) 189 - 194 0911-4335 1997/03 [Not refereed][Not invited]
   

  We investigated the presence of the lymph node metastasis in the upper mediastinum in 7 cases of the hypopharyngeal carcinomas extended to cervical esophagus and in 10 cases of cervical esophageal carinomas. In most cases of the hypopharyngeal carcinomas, we observed the metastasis to the lymph noodes in the jugular chain and in the paratracheal region, but not in the upper mediastinum, indicating that the upper mediastinal dissection is not necessary. On the other hand, 4 of 6 cases of cervical esophageal carcinomas showed the metastasis to the lymph noded in the upper mediastinum. The metastasis to this region was found when the tumor invades into adventitia of esophagus, suggesting that the depth of invasion may affect the incidence of metastasis to this region. From these results, we recommend to detect metastasis to the lymph nodes in the upper mediastinuum for the treatment of cervical esophageal carcinomas. Careful mediastinal dissection is required when the involvement of lymph node metastasis in this region is suggested.
• 当科における中咽頭扁平上皮癌症例の検討

  本間 明宏

  頭頸部腫瘍 (一社)日本頭頸部癌学会 22 (2) 360 - 360 0911-4335 1996/06 [Not refereed][Not invited]
  
• 100 当科での中咽頭癌における重複癌症例の検討

  福田 諭, 本間 明宏, 八木 克憲, 犬山 征夫

  口腔・咽頭科 日本口腔・咽頭科学会 9 (1) 134 - 134 0917-5105 1996
• 急速増大する甲状腺腫瘍

  米川 博之, 本間 明宏, 樋口 栄作

  市立釧路総合病院医学雑誌 市立釧路総合病院 7 (1) 45 - 51 0915-2520 1995/03 [Not refereed][Not invited]
   

  1)急速に増大する甲状腺腫瘍において術前診断は重要であるが困難である。67Gaシンチグラフィーが診断に有効であり,集積が認められFNAで確定不能の際は生検の施行を方針としている。2)甲状腺未分化癌の治療経験から,QOLを高めるうえでの姑息的手術が大切であると思われた
• 反回神経麻痺を生じた甲状腺腫瘍手術症例の検討

  本間 明宏, 飯塚 桂司, 米川 博之

  耳鼻咽喉科・頭頸部外科 (株)医学書院 67 (1) 61 - 64 0914-3491 1995/01 [Not refereed][Not invited]
   

  手術を行った甲状腺腫瘍247例において術前,術後に出現した反回神経麻痺を検討した。1)術前から反回神経麻痺が存在する場合は悪性腫瘍である可能性が高いが,良性腫瘍による圧迫によることもあるため術前検査により良性悪性を診断したうえで手術を行い,温存できる神経は温存する。2)甲状腺癌では反回神経に沿ったリンパ節転移が生じることが多いが,分化癌の場合は強く癒着しておらず剥離可能なことが多く,一過性に麻痺を生じても後に回復することが多い
• Therapy for Malignant Tumors of Paranasal Sinuses

  Hiroyuki Yonekawa, Akihiro Honma, Keiji Iizuka

  Practica Oto-Rhino-Laryngologica 耳鼻咽喉科臨床学会 88 (12) 1605 - 1611 0032-6313 1995 [Not refereed][Not invited]
   

  From 1985 to 1994, 36 patients with paranasal sinus carcinoma were treated with chemotherapy, radiotherapy and extensive maxillectomy and primary reconstruction at the Department of Otorhinolaryngology, Kushiro City General Hospital. Four cancers arose from an ethmoid sinus and 32 from a maxillary sinus. Of the maxillary sinus malignant tumors, six presented with T2 lesions, 13 with T3, and 10 with T4 seven had nodal disease. 1) Patients with far-advanced cancer received only palliative care. The 5-year survival rate of the other 30 was 69.5%. In the 21 with squamous cell carcinoma, the survival rate was 77.1%. 2) Adjuvant therapy could be completed in 22 patients, and their survival rate was 79.2%. 3) In 14 patients with squamous cell carcinoma, adjuvant therapy could be completed, and all survived. Especially for maxillary sinus squamous cell carcinoma, local control is directly linked with improvement of the 5-year disease-free survival rate. The success of the en-bloc operation in multidisciplinary therapy is an important factor in their prognosis. © 1995, The Society of Practical Otolaryngology. All rights reserved.
• 反回神経麻痺を生じた甲状腺手術症例の検討

  耳鼻咽喉科・頭頚部外科 67 (1) 61 - 64 1995 [Not refereed][Not invited]
  
• 頭頸部癌の化学療法

  本間 明宏, 米川 博之, 飯塚 桂司

  市立釧路総合病院医学雑誌 市立釧路総合病院 6 (1) 9 - 21 0915-2520 1994/03 [Not refereed][Not invited]
  
• 頭頸部癌に対するCBDCA,5-FU,UFT併用療法の検討

  癌と化学療法 21 (5) 627 - 631 1994 [Not refereed][Not invited]
  
• 頭頚部癌の化学療法

  市立釧路総合病院雑誌 6 (1) 9 - 21 1994 [Not refereed][Not invited]
  
• 当科における鼻骨骨折症例の検討

  中丸 裕爾, 本間 明宏, 飯塚 桂司

  耳鼻咽喉科・頭頸部外科 (株)医学書院 65 (9) 745 - 748 0914-3491 1993/09 [Not refereed][Not invited]
   

  6年間に受診した鼻骨骨折症例について,成因と治療内容に対する満足度等につきアンケート調査を行った。鼻骨骨折の成因では,暴行,交通事故,スポーツの順に多く,それぞれの項目につき更に詳しく成因を検討した。治療に対するアンケートでは,整復後の外観に関しては,83%の患者が満足しているが,約1/3の患者が鼻閉感を訴えた。固定に関しては,内固定に関する不満が多く,固定期間は4日,外固定は7日程度が苦痛を与えないという面ではよい
• Intravascular Papillary Endothelial Hyperplasia in the Left Submandibular Area; A Case Report

  Yuji Nakamaru, Keiji Iizuka, Akihiro Honma, Yutaka Yoshida

  Practica Oto-Rhino-Laryngologica 耳鼻咽喉科臨床学会 86 (12) 1747 - 1751 0032-6313 1993 [Not refereed][Not invited]
   

  A 72-year-old woman had noted left submandibular swelling for 7 years. On examination a 5 × 5 cm smooth, hard, fixed, painless mass was palpable in the left submandibular area. CT scan showed a circumscribed, isodense mass near the bifurcation of the carotid artery. Extirpation of the tumor was performed. The pathological diagnosis was intravascular papillary endothelial hyperplasia. The postoperative course was good, and the patient remains free of disease more than 5 months after surgery. Intravascular papillary endothelial hyperplasia is characterized by intravascular endothelial proliferation that resembles angiosarcoma. This disease seems to be the result of a peculiar process of thrombus undergoing organization. The prognosis is good, and the treatment is usually total extirpation of the tumor. © 1993, The Society of Practical Otolaryngology. All rights reserved.
• 当科における甲状腺結節性病変の診断-Decision makingについて-

  市立釧路総合病院雑誌 5 (1) 39 - 45 1993 [Not refereed][Not invited]
  
• 小児の喉頭に原発した悪性リンパ腫症例

  酒井 昇, 本間 明宏, 犬山 征夫

  日本気管食道科学会会報 (NPO)日本気管食道科学会 42 (3) 255 - 258 0029-0645 1991/06 [Not refereed][Not invited]
   

  10歳女児.病期はstage 1E,組織型はLSG分類でdiffuse lymphoma, medium sized cell typeであった.治療はCHOP療法と40 Gyの照射を行い,現在までのところ再発の徴候はない
• 当科におけるOlfactory neuroblastoma症例の検討

  本間 明宏

  日本鼻科学会会誌 (一社)日本鼻科学会 29 (1) 57 - 57 0910-9153 1990/09 [Not refereed][Not invited]
  

MISC

• 高齢者の局所進行頭頸部扁平上皮癌患者におけるweeklyシスプラチン併用放射線治療の治療成績

  打浪雄介, 安田耕一, 加納里志, 対馬那由多, 鈴木崇祥, 浜田誠二郎, 田口純, 清水康, 坂下智博, 本間明宏  頭頸部癌  49-  (2)  2023
• 当院で治療した頭頸部原発横紋筋肉腫症例の検討

  勝俣量平, 勝俣量平, 加納里志, 対馬那由多, 鈴木崇祥, 浜田誠二郎, 清水康, 田口純, 安田耕一, 打浪雄介, 本間明宏  頭頸部癌  49-  (2)  2023
• 高齢者の頭頸部癌に対する放射線治療と化学療法併用の実態:日本頭頸部癌学会悪性腫瘍全国登録調査の解析

  安田耕一, 打浪雄介, 加納里志, 田口純, 清水康, 本間明宏  頭頸部癌  49-  (2)  2023
• 唾液腺癌の局所頸部制御における術後照射の有用性の検討

  加納里志, 対馬那由多, 鈴木崇祥, 浜田誠二郎, 安田耕一, 打浪雄介, 本間明宏  頭頸部癌  49-  (2)  2023
• 咽喉頭癌に対するシスプラチン超選択的動注併用放射線治療(RADPLAT)による頸部制御の検討

  加納 里志, 対馬 那由多, 鈴木 崇祥, 浜田 誠二郎, 吉田 大介, 打浪 雄介, 安田 耕一, 本間 明宏  頭頸部癌  48-  (2)  151  -151  2022/05
• 高齢の頭頸部悪性腫瘍に対する放射線治療の後ろ向き検討

  安田 耕一, 打浪 雄介, 浜田 誠二郎, 鈴木 崇祥, 対馬 那由多, 田口 純, 清水 康, 加納 里志, 本間 明宏  頭頸部癌  48-  (2)  200  -200  2022/05
• 局所進行上咽頭癌におけるadaptive radiotherapyに関する検討

  打浪雄介, 安田耕一, 藤田祥博, 高橋周平, 大塚愛美, 田口純, 清水康, 加納里志, 本間明宏, 青山英史  日本放射線腫瘍学会高精度放射線外部照射部会学術大会プログラム・抄録集  35th-  2022
• 強度変調放射線治療(IMRT)を行った下咽頭癌における再発症例の検討

  大塚愛美, 安田耕一, 湊川英樹, 出倉康裕, 青山英史, 清水伸一, 鈴木隆介, 宮本直樹, 清水伸一, 鈴木崇祥, 対馬那由多, 加納里志, 田口純, 清水康, 本間明宏, 清水伸一  Japanese Journal of Radiology  40-  (Supplement)  2022
• 鼻中隔尾側弯曲(前弯)の客観的評価と適切な鼻中隔矯正術の術式選択

  木村将吾, 中丸裕爾, 鈴木正宣, 本間あや, 中薗彬, 本間明宏  日本耳鼻咽喉科学会会報  124-  (4)  2021
• Endoscopic Medial Maxillectomy With Preservation of Inferior Turbinateを用いて摘出した上顎洞血瘤腫の1例

  佐藤孝大, 中丸裕爾, 鈴木正宣, 本間あや, 木村将吾, 本間明宏  耳鼻咽喉科臨床 補冊  (157)  2021
• 鼻内内視鏡と開頭の併用による前頭蓋底手術の1例

  和田侑也, 和田侑也, 鈴木正宣, 中丸裕爾, 本間あや, 山田真司, 本間明宏  耳鼻咽喉科臨床 補冊  (157)  2021
• 前頭開頭術後に生じた前頭蓋底粘液嚢胞に対して内視鏡下鼻副鼻腔手術が有用であった2症例

  山田真司, 鈴木正宣, 中丸裕爾, 本間明宏  耳鼻咽喉科臨床 補冊  (157)  2021
• Granulomatosis with Polyangiitis (GPA) Occurring with Binocular Visual Acuity Impairment

  吉村淳, 鈴木正宣, 中丸裕爾, 鈴木崇祥, 本間あや, 中薗彬, 木村将吾, 本間明宏, 中里信一, 岡田宏美  耳鼻咽喉科臨床  114-  (2)  2021
• Development of a measurment system for nasal endscopic surgey

  宮路洸, 鈴木正宣, 中丸裕爾, 佐瀬一弥, CHEN Xiaoshuai, 辻田哲平, 小水内俊介, 本間明宏, 近野敦  計測自動制御学会北海道支部学術講演会論文集  53rd-  2021
• Inferior turbinate shoulder osteotomy in a patient with a narrow nasal cavity

  田中大地, 中丸裕爾, 鈴木正宣, 本間あや, 中薗彬, 木村将吾, 本間明宏  耳鼻咽喉科・頭頚部外科  93-  (6)  2021
• ボツリヌス毒素治療

  溝口兼司, 横川泰三, 本間明宏, 柳田早織, 西澤典子  日本耳鼻咽喉科学会会報  123-  (4)  2020
• A case of nasal septal perforation closure using unilateral mucosal flap based on the anterior ethmoidal artery

  勝俣量平, 鈴木正宣, 中薗彬, 中丸裕爾, 本間明宏  耳鼻咽喉科・頭頚部外科  92-  (9)  2020
• 低亜鉛が鼻粘膜のサイトカイン産生と炎症細胞浸潤に及ぼす影響

  鈴木正宣, 中丸裕爾, 本間あや, 中薗彬, 木村将吾, RAMENZANPOIR Mahnaz, VREUGDE Sarah, WORMALD Peter-John, 本間明宏  日本耳鼻咽喉科免疫アレルギー学会プログラム・抄録集  38th-  2020
• アレルギー性鼻炎患者の睡眠と内因性メラトニンの評価

  本間あや, 本間あや, SUNKARANENI Vishnu S, SKENE Debra J, 鈴木正宣, 中丸裕爾, 本間明宏  日本耳鼻咽喉科免疫アレルギー学会プログラム・抄録集  38th-  2020
• 狭鼻を伴うアレルギー性鼻炎,慢性副鼻腔炎に対して下甲介shoulder osteotomyを施行した1例

  田中大地, 中丸裕爾, 鈴木正宣, 本間あや, 中薗彬, 木村将吾, 本間明宏  日本耳鼻咽喉科免疫アレルギー学会プログラム・抄録集  38th-  2020
• 内視鏡的切除後に多発リンパ節転移を来たした中咽頭癌(腫瘍厚1000μm未満)の一例

  井上雅貴, 清水勇一, 霜田佳彦, 田中一光, 木脇佐代子, 石川麻倫, 大野正芳, 山本桂子, 小野尚子, 本間明宏, 岡田宏美, 坂本直哉  日本消化器病学会北海道支部例会・日本消化器内視鏡学会北海道支部例会プログラム・抄録集  126th-120th-  2020
• 頭頸部癌放射線照射後遺残,異時性多発癌に対する内視鏡治療成績

  井上雅貴, 清水勇一, 霜田佳彦, 田中一光, 木脇佐代子, 石川麻倫, 大野正芳, 山本桂子, 小野尚子, 本間明宏, 坂本直哉  Gastroenterological Endoscopy (Web)  62-  (Supplement2)  2020
• Endoscopic skull base surgery for Olfactory Neuroblastoma

  茂木洋晃, 山口秀, 伊師雪友, 岡本迪成, 澤谷亮介, 中薗彬, 鈴木正宣, 中丸裕爾, 本間明宏  日本神経内視鏡学会プログラム・抄録集  27th-  2020
• Phase II study of trastuzumab and docetaxel therapy in patients with HER2-positive recurrent and/or metastatic salivary gland carcinoma

  Ichiro Kinoshita, Satoshi Kano, Yasushi Shimizu, Naomi Kiyota, Yuichiro Tada, Kei Ijichi, Tmoko Yamazaki, Akihiro Homma, Yoichi M. Ito, Kota Ono, Keiko Kobayashi, Toshiyuki Isoe, Yutaka Hatanaka, Hitoshi Tsuda, Shojiroh Morinaga, Yoshihiro Matsuno, Hirotoshi Dosaka-Akita  CANCER RESEARCH  79-  (13)  2019/07
• 日本におけるリアルワールドデータ ニボルマブの有効性・安全性の多施設共同・後方視的臨床研究の中間解析

  津村 宗近, 花井 信広, 清水 康, 藤井 隆, 高橋 俊二, 上田 勉, 折舘 伸彦, 土井 一生, 山田 孝之, 本間 明宏  頭頸部癌  45-  (2)  142  -142  2019/05  [Not refereed][Not invited]
  
• ANCA関連血管炎性中耳炎における好中球細胞外トラップの測定と臨床応用

  森田真也, 中丸裕爾, 鈴木正宣, 本間明宏  日本耳鼻咽喉科免疫アレルギー学会プログラム・抄録集  37th-  2019
• 当院における外鼻形成術および鼻中隔矯正術施行例の検討

  木村将吾, 中丸裕爾, 鈴木正宣, 本間あや, 中薗彬, 本間明宏  日本鼻科学会会誌(Web)  58-  (3)  2019
• ANCA関連血管炎性中耳炎における好中球細胞外トラップの測定と臨床応用

  森田真也, 中丸裕爾, 鈴木正宣, 本間明宏  耳鼻咽喉科免疫アレルギー(Web)  37-  (2)  2019
• 鼻粘膜において低亜鉛はコラーゲン産生を抑制する

  鈴木正宣, 中丸祐爾, MAHNAZ Ramezanpour, 鈴木崇祥, 中薗彬, WORMALD Peter-john, VREUGDE Sarah, 本間明宏  日本耳鼻咽喉科学会会報  122-  (4)  2019
• 鼻粘膜において低亜鉛はコラーゲン産生を抑制する

  鈴木正宣, 鈴木正宣, 中丸裕爾, RAMEZANPOUR Mahnaz, 中薗彬, WORMALD Peter-John, VREUGDE Sarah, 本間明宏  日本耳鼻咽喉科免疫アレルギー学会プログラム・抄録集  37th-  2019
• 鼻粘膜において低亜鉛はコラーゲン産生を抑制する

  鈴木正宣, 鈴木正宣, 中丸裕爾, RAMEZANPOUR Mahnaz, 中薗彬, WORMALD Peter-John, VREUDGE Sarah, 本間明宏  耳鼻咽喉科免疫アレルギー(Web)  37-  (2)  2019
• 内視鏡的切除後に多発リンパ節転移を来たした中咽頭癌(腫瘍厚1,000μm未満)の1例

  井上雅貴, 清水勇一, 田中一光, 木脇佐代子, 霜田佳彦, 石川麻倫, 山本桂子, 大野正芳, 小野尚子, 本間明宏, 坂本直哉  耳鼻咽喉科展望  62-  (5)  2019
• 嗅神経芽細胞腫の進行度に応じた治療戦略決定のための新分類の提唱

  茂木洋晃, 山口秀, 伊師雪友, 遠藤将吾, 小林浩之, 寺坂俊介, 鈴木正宣, 中丸裕爾, 本間明宏, 宝金清博  日本脳腫瘍学会プログラム・抄録集  37th-  2019
• 放射線治療による頭頸部がん治療成績改善の取り組みと展望 動注化学放射線療法

  水町貴諭, 松浦一登, 鬼丸力也, 林隆一, 本間明宏  頭頸部癌  44-  (2)  97  -97  2018/05/09  [Not refereed][Not invited]
  
• 聴神経鞘腫に対する定位放射線治療後に腫瘍内出血を来した2例

  打浪雄介, 鬼丸力也, 白土博樹, 森崇, 山口秀, 寺坂俊介, 小林浩之, 藤原圭志, 本間明宏  Japanese Journal of Radiology  36-  (Supplement)  8  -8  2018/02/25  [Not refereed][Not invited]
  
• e-learningシステムを用いた痙攣性発声障害の重症度評価に関する教育プログラムの構築

  柳田早織, 柳田早織, 西澤典子, 橋本竜作, 溝口兼司, 本間明宏  音声言語医学  59-  (1)  2018
• 鼻粘膜上皮細胞においてSIRT-1はPolyICに誘導されるMMP9を負に制御する

  鈴木正宣, 中丸裕爾, 高木大, 本間あや, VREUGDE Sarah, WORMALD Peter-John, 本間明宏  日本耳鼻咽喉科免疫アレルギー学会プログラム・抄録集  36th-  2018
• 鼻副鼻腔内反性乳頭腫の悪性転化に関与する遺伝子変異の解析

  安川真一郎, 加納里志, 畠山博充, 中丸裕爾, 高木大, 水町貴諭, 鈴木正宣, 鈴木崇祥, 中薗彬, 本間明宏  日本耳鼻咽喉科学会会報  121-  (4)  2018
• 当院における嗅神経芽細胞腫の治療方針と成績

  中丸裕爾, 高木大, 鈴木正宣, 加納里志, 水町貴諭, 中薗彬, 本間明宏  日本耳鼻咽喉科学会会報  121-  (4)  2018
• 唾液腺導管癌における遺伝子発現解析および発生様式間の比較検討

  鈴木崇祥, 加納里志, 鈴木正宣, 安川真一郎, 中薗彬, 水町貴諭, 本間明宏  日本耳鼻咽喉科学会会報  121-  (4)  2018
• 唾液腺導管癌における免疫染色およびRT-PCR法を用いた分子生物学的プロファイルの検討

  鈴木崇祥, 加納里志, 畑中佳奈子, 鈴木正宣, 安川真一郎, 中薗彬, 水町貴諭, 畑中豊, 松野吉宏, 本間明宏  頭頸部癌  44-  (2)  2018
• 鼻粘膜上皮細胞においてSIRT-1はPolyICに誘導されるMMP9を負に制御する

  鈴木正宣, 鈴木正宣, 中丸裕爾, 高木大, 本間あや, VREUGDE Sarah, WORMALD Peter-John, 本間明宏  耳鼻咽喉科免疫アレルギー(Web)  36-  (2)  2018
• 篩骨動脈を茎とする鼻中隔粘膜弁を用いた鼻中隔穿孔閉鎖術の1例

  勝俣量平, 鈴木正宣, 中薗彬, 中丸裕爾, 本間明宏  日本鼻科学会会誌(Web)  57-  (3)  2018
• 当院における嗅神経芽細胞腫の治療方針と成績

  中薗彬, 中丸裕爾, 鈴木正宣, 水町貴諭, 高木大, 本間明宏  日本鼻科学会会誌(Web)  57-  (3)  2018
• 切除不能局所進行頭頸部扁平上皮がんに対するPCE導入化学療法後のCisplatin併用化学放射線療法の実施可能性検証試験

  清水康, 本間明宏, 榎田智弘, 小川武則, 大上研二, 南修司郎, 岩江信法, 田口純, 中目亜矢子, 槇大輔, 上田百合, 藤澤孝夫, 茂木厚, 野村尚吾, 岡野晋, 田原信  日本臨床腫瘍学会学術集会(CD-ROM)  16th-  2018
• Analysis of genomic alterations in HPV plus and HPV- oropharyngeal cancer in Japan Cooperative Study Group

  Katsunari Yane, Kazue Sawanishi, Kazuto Nishio, Kazuko Sakai, Masato Fujii, Akihiro Homma, Masashi Sugasawa, Kenji Okami, Ichiro Ota  CANCER SCIENCE  109-  181  -181  2018/01
• A multi-institutional dose-finding and efficacy confirmation trial of superselective intra-arterial infusion of cisplatin and concomitant radiotherapy for patients with locally advanced maxillary sinus cancer (JCOG1212, RADPLAT-MSC): Results of dose-finding phase

  T. Sakashita, A. Homma, R. Onimaru, K. Matsuura, H. Shinomiya, R. Hayashi, K. Shiga, H. Tachibana, K. Nakamura, J. Mizusawa, M. Fujii  ANNALS OF ONCOLOGY  27-  2016/10  [Not refereed][Not invited]
  
• Superselective intra-arterial cisplatin infusion and concomitant radiotherapy for maxillary sinus cancer

  A. Homma, T. Sakashita, D. Yoshida, R. Onimaru, K. Tsuchiya, F. Suzuki, K. Yasuda, H. Hatakeyama, J. Furusawa, T. Mizumachi, S. Kano, N. Inamura, S. Taki, H. Shirato, S. Fukuda  British Journal of Cancer  109-  (12)  2980  -2986  2013/12/10  [Not refereed][Not invited]
   

  Background:The purpose of this study was to evaluate the efficacy of superselective cisplatin infusion with concomitant radiotherapy (RADPLAT) for previously untreated patients with the squamous cell carcinoma of maxillary sinus (SCC-MS).Methods:Between 1999 and 2010, 54 patients were given superselective intra-arterial infusions of cisplatin (100-120 mg m-2 per week) with simultaneous intra-venous infusions of thiosulfate to neutralise cisplatin toxicity and conventional radiotherapy (65-70 Gy).Results:One patient (1.9%) was diagnosed with T2, 14 (25.9%) with T3, 27 (50%) with T4a, and 12 (22.2%) with T4b disease. Lymph-node involvement was present in 12 patients (22.2%). During the median follow-up period of 6.4 years, the 5-year local progression-free and overall survival rates were 65.8 and 67.9% for all patients, respectively. No patient died as a result of treatment toxicity or experienced a cerebrovascular accident. Osteonecrosis (n=5), brain necrosis (n=1), and ocular/visual problems (n=14) were observed as late adverse reactions.Conclusion:We have shown excellent overall survival and local progression-free rate in SCC-MS patients treated by RADPLAT with acceptable rates of acute and late toxicity. A multi-institutional trial is needed to prove that this strategy is a feasible and effective approach for the treatment of SCC-MS. © 2013 Cancer Research UK.
• 嗅神経芽細胞腫に対する治療成績と治療戦略

  茂木洋晃, 寺坂俊介, 小林浩之, 本間明宏, 加納里志, 畠山博充, 水町貴諭, 福田諭, 寳金清博  日本脳腫瘍の外科学会プログラム・抄録集  18th-  2013
• MULTICENTER PHASE II STUDY OF AN OPIOID-BASED PAIN CONTROL PROGRAM FOR PATIENTS WITH HEAD AND NECK CANCER TREATED BY CHEMORADIOTHERAPY

  A. Homma, S. Zenda, K. Matsuura, H. Tachibana, T. Kirita, N. Monden, M. Tahara, K. Kato, M. Asai  ANNALS OF ONCOLOGY  21-  379  -379  2010/10  [Not refereed][Not invited]
  
• 頭頸部放射線治療において使用される鎮痛薬と腫瘍部位の関連性に関する後ろ向き観察研究

  長田貴之, 熊井正貴, 山田武宏, 笠師久美子, 鈴木章之, 本間明宏, 福田諭, 菅原満, 井関健, 井関健  日本緩和医療薬学会年会プログラム・要旨集  3rd-  2009
• マイクロデブリッダーが有用であった成人型多発性喉頭乳頭腫の一例

  鈴木正宣, 鈴木正宣, 折舘伸彦, 本間明宏, 中丸裕爾, 畠山博充, 目須田康, 古田康, 古田康, 福田諭  日本頭頸部外科学会総会ならびに学術講演会プログラム・予稿集  19th-  2009
• Intraarterial Chemoradiation Therapy for Hypopharyngeal Carcinoma

  中谷宏章, 弘瀬かほり, 松本昇, 竹田泰三, 伊藤悟志, 山西伴明, 西岡明人, 小川恭弘, 秋定健, 本間明宏, 吉崎智一  日本気管食道科学会会報  59-  (2)  2008

Research Grants & Projects

• 近赤外光線免疫療法における3次元データ応用による治療補助システムの開発

  日本学術振興会：科学研究費助成事業

  Date (from‐to) : 2021/04 -2024/03 

  Author : 足利 雄一, 本間 明宏, 鈴木 崇祥

   

  本研究では、近赤外光線免疫療法（NIR-PIT）を安全かつ確実に行えるよう医用画像データから得た3次元データを応用し、シミュレーション模型やオーダーメイドの治療補助装置を開発することを目的としている。 2021年度は、穿刺シミュレーション用ファントム模型のプロトタイプの制作、術中CBCT撮影の際にメタルアーチファクを生じさせない非金属製開口器、非金属製ガイドニードルの制作を行った。 ファントム模型はDICOMデータから骨、血管、腫瘍、軟組織（臓器）をセグメンテーションし、３Dプリンターで造形した。皮膚、皮下組織、筋肉はシリコーンを用いて作成し、３Dプリンターで造形した模型と一体化させ、等倍大の模型を作成した。この模型は臨床解剖に則した構造が再現されており、穿刺が可能で、CTによる穿刺後の評価もできることが大きな特徴である。しかしながら、制作時間がかかること、現時点では量産が困難であることが問題点であり、制作工程の見直し、作業の簡略化を行っている。 治療の際には穿刺針を刺入後にCBCTを撮影し、腫瘍と穿刺針の位置関係を確認している。その際、金属製開口器や、穿刺針はメタルアーチファクトを生じてしまうことから、術中CBCT撮影の際に用いる非金属製開口器と穿刺位置・方向が確認できるガイドニードルを開発した。いずれもCADソフトを用いて制作し、３Dプリンターを用いてレジンで造形を行った。ガイドニードルでは10mm間隔にX線非透過性マーカーを埋め込むことで穿刺深度の計測が可能となり、ヘッド部分にナンバリングを行うことで複数の穿刺を行っても各々のガイドニードルをCBCT上で認識できるようになった。
• 頭頸部癌の個別化医療に向けた腫瘍特性の非侵襲的画像化と人工知能解析の融合

  日本学術振興会：科学研究費助成事業

  Date (from‐to) : 2021/04 -2024/03 

  Author : 藤間 憲幸, 本間 明宏

   

  本研究は第一段階の目標として、頭頸部扁平上皮癌における腫瘍の細胞増殖能および低酸素領域の非侵襲的な画像化がある。 2021年度において、腫瘍の細胞増殖能は、MRIにおける多b値の拡散強調像から得られた腫瘍の微細構造を反映させた信号データを数学的なモデルを用いて解析し、さらにその情報をamido proton transfer（APT）イメージングより得られた腫瘍のタンパク質代謝情報と掛け合わせることによって高い精度で実現することが出来た。低酸素領域においては、多b値の拡散強調像から得られた腫瘍の微細構造を反映させた信号データおよびArterial Spin Labeling（ASL）より得られた腫瘍の血流情報を反映させたデータを数学的な仮説モデルで解析することによって比較的高い精度で画像化することが可能であった。 本研究の第二段階として、第一段階にて作成した腫瘍の生物学的性状を反映させた画像（腫瘍の細胞増殖能および低酸素領域を反映させた画像）を用いて患者の予後予測のための深層学習モデルを作成するという項目がある。ゆえに、2022年度以降は上述した画像情報を用いて個々の患者の高精度な予後予測を行うための深層学習モデルを作成する予定であるが、2021年度にて深層学習に用いるネットワークの構築を行っている途中である。現状では解析に長い時間がかかる状況であるため、ネットワーク構築の調整を複数回にわたって行い、精度を保ったままの状態で解析時間を短くできるように再構築中である。
• Development of the prognosis prediction model in patients with head and neck cancer using tumor biological characteristics-reflected MRI data and the artificial intelligence-based analysis

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2018/04 -2021/03 

  Author : Fujima Noriyuki

   

  Firstly, we tried to depict the tumor biological characteristics which related to patient's prognosis using diffusion and perfusion-based MR technique in head and neck cancer. We successfully visualized the tumor growth rate, tumor perfusion and the presence of hypoxic area as tumor functional information. Next, we developed the prognosis prediction model in patients with head and neck cancer using the abovementioned MR-based tumor functional information. Machine learning technique was selected for the development of this diagnostic model. After the optimization of hyperparameters in machine learning model, high diagnostic accuracy to predict patient's treatment outcome could be successfully accomplished.
• Elucidation of signaling network of head and neck cancer by bioinformatics approach

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2014/04 -2017/03 

  Author : Hatakeyama Hiromitsu

   

  We performed gene analysis in the 500 cases with head and neck cancer to identify mutaion and expression that could be the marker of treatment strategies and treatment targets for head and neck cancer. An important prognostic factor other than TNM classification is the presence or absence of human papillomavirus (HPV) infection. In general, cancer becomes more malignant as the differentiation progresses, and the prognosis is also worsened in correlation with it. We focused on the progress of epithelial-to-mesenchymal transition as the degree of differentiation declined and the prognosis of cases in which expression of epithelial and mesenchymal markers was examined in each group.The prognosis of patients who have heterogeneity in EMT marker expression were poor. Intra-tumor heterogeneity is low in the surgical samples with HPV positive.
• Development of intensity-modulated proton therapy (IMPT) for head and neck carcinoma

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2013/04 -2016/03 

  Author : TSUCHIYA KAZUHIKO, HOMMA AKIHIRO, TORAMATSU CHIE

   

  Seven patients with hypopharyngeal cancer who treated with intensity-modulated radiotherapy (IMRT) in our institution were selected and intensity-modulated proton therapy (IMPT) plan were created for each patient using same dose constraint, targets and prescribe dose of original IMRT plan. mean dose to both parotid gland and mean dose to the oral cavity were compared between two plans. IMPT achieved same dose coverage to the targets compared to IMRT and significantly reduced the mean dose to the dose reducing side of the parotid gland and the mean dose to the oral cavity. IMPT may lead to the clinical benefit in regard to reducing toxicities without affecting treatment outcume.
• Network of signaling pathway of head and neck cancer

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2011 -2013 

  Author : HATAKEYAMA Hiromitsu, HOMMA Akihiro

   

  Signaling pathways associated with the growth of cancer cell have been gradually revealed and the regulation of the pathway has been applied to treatment of various cancers. We identified the cluster of molecular which associated with the cross-talk of signaling pathway and epithelial-mesenchymal transition of head and neck cancer cells using the genome-proteome analysis. Furthermore, we find that the sensitivity to cetuximab, monoclonal antibody of epidermal growth factor receptor (EGFR), was correlated with the expression of EGFR itself and the level of ligands to EGFR. The regulation of the ligands might contributed to enhance the effect of cetuximab and expected to overcome the resistance to cetuximab
• New application in treatment of head and neck cancer using genome and proteome analysis

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2010 -2012 

  Author : FUKUDA Satoshi, HOMMA Akihiro, HATAKEYAMA Shigetugu

   

  In this study, we could get the genome, proteome and microRNAs profile using the head and neck cancer samples from our institute. Furthermore, salivary grand samples could be added to this study and the molecular which showed difference depending on prognosis were confirmed their expression with the immunohistochemical methods. A lot of data were presented on meetings of American head and neck society, Asian society of head and neck, and other international meetings.We got the tremendous volume of data of head and neck cancer, so we need to continue the data-mining and the examination of protein-protein reaction to apply clinically.
• The secret of radiation-surviving cell : multidisciplinary approach to eradicate cancer

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2008 -2010 

  Author : NISHIOKA Takeshi, YASUDA Motoaki, HAGA Hisahi, TUTSMI Kaori, SAKAI Masaharu, HOMMA Akiniro

   

  Treatment with any cytotoxic agent can trigger surviving cells in a tumor to divide faster than before. This phenomenon is widely recognized as "repopulation". To better clarify the mechanism, gene expression profiling and pathological experiments were performed. A mouse fibrosarcoma cell line, QRsP, was used. Cells were irradiated with 10 Gy. Colony assay and cloning were performed. Six clones were established. cDNA analysis was performed on the clone that showed the largest number of colonies on the 2nd 10 Gy irradiation. Mouse transplantation experiment was then carried out. cDNA analysis showed that cyclin-dependent kinase inhibitors, p16 and p57 were down-regulated ; 14.8- and 12.0-fold, respectively for the tolerant clone. Matrix metalloproteinase 3 and 13 were up-regulated ; 22.5- and 25.8-fold, respectively. Transplantation ratio was 100% (5/5) for the tolerant clone whereas it was 40% (2/5) for the parent. Under light microscope, the mean mitotic cell number was 4.0+/-3.9 for the parent, and 12.8+/-3.4 for the tolerant clone (p<0.01, Student's t-test). This study implies that repopulation is not a temporary reaction to irradiation. It is caused probably by "clonal" gene-expression changes, though it remains unknown whether the changes are attributable to tolerant cell selection or to gene mutation/modification.
• New approach for diagnosis and treatment of head and neck cancer by proteomics analysis

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2007 -2009 

  Author : FUKUDA Satoshi, HOMMA Akihiro, HATAKEYAMA Shigetugu, SHIRATO Hiroki

   

  We analyzed the function of Ubiquitin in head and neck cancer. We considered TRIM32 and UBE2Q2 as a important factor to control the treatment of advanced head and neck Cancer.
• Radiation-induced highly-malignant cancer cells: the mechanism and how to deal with it

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2006 -2007 

  Author : NISHIOKA Takeshi, YASUDA Motoaki, HAGA Hisashi, HOMMA Akihiro, TSUTSUMI Kaori

   

  Novel function of transcription factor ATF5: blockade of p53-dependent apoptosis induced by irradiation. Purpose: p53-dependent cell death is considered as a predominant mechanism of tumor cell apoptosis induced by ionizing irradiation, and a large number of studies have shown that mutant p53-harboring tumor cells with a p53 gene mutation exhibit radioresistance. However, even tumor cells that express wild-type p53 display various degrees of radiosensitivity to ionizing irradiation. This indicates that there are additional pathways that affect p53-dependent cell death mechanisms. Here we describe a novel molecule that represses radiation-induced apoptosis by inhibiting trans-activation activity of p53. Materials and Methods: We irradiated QRsP cells, a mouse transplantable malignant cell line, at 10Gy and from surviving colonies 24 sub-clones were established. These clonal cells were re-irradiated and the most readio-sensitive clone, QRsPIR-5, was used in the current experiment. All sub-cloned cells had the same morphological appearances as the parental QRsP cells and there were no p53 mutations of among any of the clones. Colony assay indicated that the survival fraction of QRsPIR-5 cells at a dose of 10 Gy was less than 20% of the survival fraction of the parental QRsP cells. Flow cytometer analysis also indicated a higher apoptotic index after infection with recombinant adenovirus containing wild-type p53 (Ad-p53) in QRsPIR-5 cells compared with the parent cell (26.5% vs. 7.1%). Interestingly, the parental and QRsPIR-5 cells had the same degree of tumorigenicity in a transplant experiment. Results: Comprehensive cDNA array analyses demonstrated differential gene expressions between the parental and QRsPIR-5 cells, both in vitro and in vivo. Among these, 23 genes were expressed differently both in vitro and in vivo between the parent and QRsP-5 cells with a high stringent threshold (less than 0.5 or more than 2.0). One such gene, bZIP transcription factor ATF5, which might explain difference in radio-sensitivity. Exogenous expression of ATF5 gave QRsPIR-5 cells a radioresistance level similar to that of the parental cells (colony assay). Moreover, QRsPIR-5 cells gained resistance to Ad-p53-induced apoptosis. A luciferase reporter assay demonstrated that over-expressed ATF5 repressed the transcriptional activity of wild-type p53 drastically. Interestingly, time lapse analysis indicated accelerated motility in ATF5-transfected QRsPIR-5 cells. Conclusion: It is likely that ATF5 is a potent repressor of p53. Elevated expression of ATF5 in a tumor may relate to enhanced malignant phenotypes, such as radio-resistance or greater cell motility.
• Molecular Mechanisms and Visualization of Radiation-induced tumor cell repopulation

  Japan Society for the Promotion of Science：Grants-in-Aid for Scientific Research

  Date (from‐to) : 2004 -2005 

  Author : NISHIOKA Takeshi, YASUDA Motoaki, HOMMA Akihiro, NAKADA Kunihiro

   

  Purpose/Objective : Treatment with any cytotoxic agent can trigger surviving cells in a tumor to divide faster than before. This phenomenon is widely recognized as "repopulation" among radiobiologists. Many clinical studies have also indicated that repopulation is one of the major treatment failure factors in radiotherapy. However, little is known about its molecular mechanism. To better clarify the mechanism, gene expression profiling and pathological experiments were performed. Materials/Methods : A mouse fibrosarcoma cell line, QRSP (p53 wild type), was used in this study. Cells in culture medium were irradiated with 10 Gy using a 4MV linear accelerator at a dose rate of 1.8Gy/min. Ten thousand irradiated cells were seeded onto culture dishes for colony assay and cloning. After 10 days, colonies were stained and counted. At the same time, 6 clones were established and stored at -80C for future use. To observe radio-resistance in these clones, cells were irradiated again with 10Gy and colonies were counted as described above. Oligonucleotide microarray analysis (Agilent Technologies) of the expression of over 20,000 genes was performed on the clone that showed the largest number of colonies (hereafter referred to as the "tolerant clone"), using the parental QRSP cell line as a control. Twenty thousand cells of the tolerant clone and of QRSP were injected subcutaneously into 5 female mice (C57BL/6) each. The mice were sacrificed 28 days later and the transplantation ratio, tumor volume, and pathological status between the two groups were compared. For histologic analyses, tumors were fixed in 10% formalin, embedded in paraffin, and stained with H&E for light microscopy. Two pathologists examined the samples and mitotic cells were counted in 3 randomly selected high-power fields. Results : The QRSP control line produced 25 colonies after 10Gy irradiation. For the 6 clones, the number of colonies produced after the second 10Gy irradiation was 86,42,38,34,5 and 3, respectively. Gene expression was compared between QPSP and the most tolerant clone (which produced 86 colonies). A total of 133 genes were up-regulated (i.e., >2.0-fold increase) and a total of 239 genes were down-regulated (i.e., <2.0-fold decrease) in the tolerant clone. Among the up-regulated genes, the following were expressed at a particularly high level : IL6 (36.0-fold increase), matrix metalloproteinase (MMP) 13 (25.8), MMP3 (22.5), and GRO1 oncogene (12.8). Among the down-regulated genes, p16 and p57 were expressed at a particularly low level : 14.8- and 12.0-fold decrease, respectively. On sacrifice, tumors were observed in 2 of 5 mice (40%) for QRSP, and in all 5 mice (100%) for the tolerant clone (p<0.05, chi-square test). The mean tumor volume was greater for the tolerant clone : 1.92+/-1.68(SD) versus 0.82+/-1.04 g. Of the 5 tumors from the tolerant clone, one showed deep muscle invasion on palpation and under microscope examination. The mean mitotic cell number was 4.0+/-3.9 for QRSP, and 12.8+/-3.4 for the tolerant clone (p<0.01, Student's t-test). Conclusions : Colony assay showed that radio-resistant clones were established following 10Gy irradiation. The microarray data of the most tolerant clone was distinctive in terms of genes related to cell-cycle regulation (cyclin-dependent kinase inhibitors p16 and p57) and aggressive nature (GRO1 and MMPs). These in-vitro gene signatures correlated well with in-vivo tumor status. This study implies that repopulation is related to "clonal" gene expression changes caused by irradiation, though it is unknown whether the changes are attributed to tolerant cell selection or to gene mutation/modification (such as methylation).
• 頭頸部癌の超選択的動注施行例における分子生物学的予後因子の検索

  日本学術振興会：科学研究費助成事業

  Date (from‐to) : 2002 -2003 

  Author : 本間 明宏

   

  頭頸部癌進行例44例に対して大量のシスプラチンの超選択的動注と照射との併用療法を行った。性別は男性33例、女性11例で、年齢25〜73歳(中央値55歳)である。症例の内訳はT2b:1例、T3:14例、T4a:H例、T4b:15例、ステージII:1例、III:4例、IVA:22例、IVB:17例で、そのうち臨床的に手術不能と考えられたのが24例(54.5%)、手術拒否例が20例(45.5%)であった。病理組織は扁平上皮癌37例、腺様嚢胞癌3例、未分化癌4例で、原発部位は鼻副鼻腔19例、下咽頭8例、中咽頭9例、口腔5例、耳下腺1例、上咽頭1例、聴器1例であった。現在までの生存例の観察期間は9ヶ月〜4年2ヶ月(平均20ヶ月)であるが、Kaplan-Meier法による2年の原発巣のprogression free survivalは全体で66.9%で、T4b症例では57.1%、T4b未満では72.8%であった。2年粗生存率(図5)は52.4%であった。切除不能例が多く含まれており、この治療成績は十分評価されべきものと考えている。 cDNAマイクロアレイを用い既知遺伝子約1000種類から、RADPLATを行なった鼻副鼻腔癌患者における正常鼻粘膜組織、異形成上皮、癌組織の遺伝子発現の変異を解析した。異形成上皮では正常組織細胞に比べ4倍以上発現が亢進したものが8種類、抑制されたものが27種類であった。癌組織では亢進が7種類、抑制が25種類であり、うち3種の遺伝子(Humig, diubiquitin, transcription factor ISGF-3)の発現が癌組織において特異的に亢進しており、RT-PCR法を用いてその発現の差異を確認した。これらの遺伝子の頭頸部癌における発現の報告は少なく、今回の結果の意義を検討するとともに、さらに症例を積み重ね検証し考察を進めていく予定である。

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Position History

• 2023年4月1日 

  - 

  2025年3月31日 

  大学院医学研究院副研究院長
• 2022年4月1日 

  - 

  2025年3月31日 

  北海道大学病院副病院長