Treatment Of Tongue Cancer Research Articles

Treatment of Tongue Cancer in Patient with Fanconi’s Anemia

Fanconi’s anemia is a rare autosomal recessive genetic disorder characterized by congenital abnormalities and anaplastic anemia. Patients with this disorder has predisposition for leukemia, specifically acute myeloid leukemia. Risk for head and neck solid tumors are also increased. Head and neck cancers in patients with Fanconi’s anemia are significantly different from those in patients without Fanconi’s anemia in frequency, distribution, clinical course, and treatment. Therefore, we report a case of 23-year-old male with Fanconi’s anemia, who presented with an oral tongue cancer treated with radical excision, bilateral neck dissection and careful postoperative radiation therapy. Key words: Fanconi’s anemia ㆍ Tongue cancer

High-dose ascorbic acid induces carcinostatic effects through hydrogen peroxide and superoxide anion radical generation-induced cell death and growth arrest in human tongue carcinoma cells

High-dose ascorbic acid (AsA) treatment, known as pharmacological AsA, has been shown to exert carcinostatic effects in many types of cancer cells and in vivo tumour models. Although pharmacological AsA has potential as a complementary and alternative medicine for anticancer treatment, its effects on human tongue carcinoma have not yet been elucidated. In this study, we investigated the effect of AsA treatment on human tongue carcinoma HSC-4 cells compared with non-tumourigenic tongue epithelial dysplastic oral keratinocyte (DOK) cells. Our results show that treatment with 1 and 3 mM of AsA for 60 min preferentially inhibits the growth of human tongue carcinoma HSC-4 over DOK cells. Furthermore, AsA-induced effects were accompanied by increased intracellular oxidative stress and were repressed by treatment with a hydrogen peroxide (H2O2) scavenger catalase and a superoxide anion radical (O2−) scavenger, tempol. Time-lapse observation and thymidine analog EdU incorporation revealed that AsA treatment induces not only cell death but also suppression of DNA synthesis and cell growth. Moreover, the growth arrest was accompanied by abnormal cellular morphologies whereby cells extended dendrite-like pseudopodia. Taken together, our results demonstrate that AsA treatment can induce carcinostatic effects through induction of cell death, growth arrest, and morphological changes mediated by H2O2 and O2− generation. These findings suggest that high-dose AsA treatment represents an effective treatment for tongue cancer as well as for other types of cancer cells.

Our Experience with Treatment of Tongue Cancer in a Hereditary Factor XI Deficient Patient

Our Experience with Treatment of Tongue Cancer in a Hereditary Factor XI Deficient Patient

Optimization of wound healing by correction of the oral microbiota at the stage of surgical treatment of tongue cancer

Post-resection wound healing, oral microbiota composition and saliva lysozyme activity were assessed in 36 patients with tongue carcinoma before and after surgery with the local application of 2% solution of acid-diluted chitosan in the postoperative period. The microbiocenosis of the oral cavity before treatment in cancer patients was represented by conditionally pathogenic and pathogenic bacteria, whose number is more than 4 lg CFU/cm2, indicating dysbiosis; the lysozyme level was reduced, accounting for 25.4±8.5 µg/ml. After the radical hemi-glossectomy the reduction in the frequency and quantity of conditionally pathogenic and pathogenic microorganisms was statistically determined, as well as an increase in the level of lysozyme of saliva on the 10 day of treatment. Patients receiving local treatment with chitosan showed an increasing number of normal microbiota in 1,5-2 times, and the level of lysozyme in 8 times (amounted to 202.87±56.85 µg/ml).

Identification of genes associated with tongue cancer in patients with a history of tobacco and/or alcohol use.

The present study aimed to identify genes associated with tongue cancer in patients with a history of tobacco and/or alcohol use. Microarray dataset GSE42023, including 10 tissue samples of tongue cancer from patients with a history of tobacco and/or alcohol use (habit group) and 11 tissue samples of non-habit-associated tongue cancer (non-habit group), were downloaded from the Gene Expression Omnibus database. Differentially-expressed genes (DEGs) between the habit and non-habit groups were identified using the Linear Models for Microarray Data software package. The enrichment functions and pathways of these genes were subsequently predicted using Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analysis. Transcription factors (TFs) and tumor-associated genes (TAGs) were selected from the DEGs using the Encyclopedia of DNA Elements database and the TAG database, respectively. Protein-protein interaction (PPI) networks for DEGs were constructed using Cytoscape. In addition, functional module analysis was performed using BioNet. This analysis identified 642 DEGs between the habit and non-habit groups, including 200 upregulated and 442 downregulated genes. The majority of upregulated DEGs were functionally enriched in the regulation of apoptosis and the calcium signaling pathway. The majority of downregulated DEGs were functionally enriched in fat cell differentiation and the adipocytokine signaling pathway. In addition, 31 TFs and 42 TAGs were identified from the DEGs. Furthermore, this analysis demonstrated that certain DEGs, including AKT serine/threonine kinase 1 (AKT1), E1A binding protein p300 (EP300), erb-b2 receptor tyrosine kinase 2 (ERBB2) and epiregulin (EREG), had high connectivity degrees in the PPI networks and/or functional modules. Overall, DEGs in a functional module, such as AKT1, EP300, ERBB2 and EREG, may serve important roles in the development of tongue cancer in patients with a history of tobacco and/or alcohol use. These DEGs are potential therapeutic targets for the treatment of tongue cancer in these groups.

The overexpressed functional transient receptor potential channel TRPM2 in oral squamous cell carcinoma.

TRPM2, one member of the transient receptor potential (TRP) protein super-family, is a Ca2+-permeable channel that is activated by oxidative stress and confers susceptibility to cell death. In the human tongue specimens of carcinoma and the tongue carcinoma SCC cell lines, we observed the enhanced expression of TRPM2. By means of the whole-cell electrophysiological recording, the ADPR-induced currents mediated by TRPM2 were recorded in cultured SCC9 cells. Moreover, after H2O2 treatment for 24 hours, the apoptotic number of SCC9 cells was significantly increased. However, the selectively knocked-down TRPM2 with the small interfering RNA technique inhibited the survival and migration of the SCC9 cancer cells, which was independent of the p53-p21 pathway, since the expression of p21 was enhanced after TRPM2 knockdown. Furthermore, the sub-cellular localization of TRPM2 was remarkably different between cancerous and non-cancerous cells. A significant amount of the TRPM2 proteins were located in the nuclei in cancer cells. All these data suggest that TRPM2 is essential for the survival and migration of SCC cancer cells and may be a potential target for the selective treatment of tongue cancer.

The anterolateral thigh flap for soft tissue reconstruction in patients with tongue squamous cell carcinoma.

BackgroundSurgery remains the first choice of treatment for tongue cancer. Immediate reconstruction should be performed after wide resection of tumour. The aim of this study was to evaluate the anterolateral thigh flap for reconstruction of lingual defects.MethodsWe report 39 consecutive oral tongue squamous cell carcinoma patients who underwent lingual reconstruction with the anterolateral thigh flap between 2009 and 2010.ResultsThe width of the skin island was 4 to 5 cm and the length of the skin island was 6 to 8 cm in 31 patients with T2 tumour, while the width of the skin island was 5.5 to 6 cm and the length of the skin island was 9 to 12 cm in 8 patients with T3/4 tumours. The all flap survival rate was 97.5 % in our series.ConclusionsWe could obtain sufficient flap volume using the anterolateral thigh flap for tongue reconstruction. The single perforator-based anterolateral thigh flap is a good option for soft tissue reconstruction in patients with oral tongue squamous cell carcinoma.

TONGUE CANCER SURGERY EVOLUTION, NEW TECHNOLOGIES, REHABILATION AND QUALITY OF LIFE

In this article we conducted an analysis of methods and results of surgical treatment of tongue cancer for the time period of 30 years. Different technologies of surgical treatment of tongue cancer, both with and without the reconstructive operation, were used during the analyzed period. Aim - to improve the oncological and functional results of surgical treatment of the tongue squamous cell carcinoma. Within the few decades, the ideology of tongue cancer treatment has changed from simple resection to enhanced combined operation with one-stage reconstruction. Materials and methods. The unprecedented in its positive qualities and set of benefits operation was developed, with use of skin flap from the anterior surface of the neck, including the infrahyoid muscles, at different extents of resection or complete removal of the tongue. Conclusion. The positive functional and aesthetic results of surgical treatment of tongue cancer with high oncological reliability were obtained.

Ultrasound visual feedback in articulation therapy following partial glossectomy

Disordered speech is common following treatment for tongue cancer, however there is insufficient high quality evidence to guide clinical decision making about treatment. This study investigated use of ultrasound tongue imaging as a visual feedback tool to guide tongue placement during articulation therapy with two participants following partial glossectomy.A Phase I multiple baseline design across behaviors was used to investigate therapeutic effect of ultrasound visual feedback during speech rehabilitation. Percent consonants correct and speech intelligibility at sentence level were used to measure acquisition, generalization and maintenance of speech skills for treated and untreated related phonemes, while unrelated phonemes were tested to demonstrate experimental control. Swallowing and oromotor measures were also taken to monitor change.Sentence intelligibility was not a sensitive measure of speech change, but both participants demonstrated significant change in percent consonants correct for treated phonemes. One participant also demonstrated generalization to non-treated phonemes. Control phonemes along with swallow and oromotor measures remained stable throughout the study. This study establishes therapeutic benefit of ultrasound visual feedback in speech rehabilitation following partial glossectomy.Learning outcomes: Readers will be able to explain why and how tongue cancer surgery impacts on articulation precision. Readers will also be able to explain the acquisition, generalization and maintenance effects in the study.

先天性第XI因子欠乏症患者に発症した舌癌の治療経験

先天性第XI因子欠乏症患者に発症した舌癌の治療経験

Swallowing function after surgical treatment of tongue cancer

Swallowing function after surgical treatment of tongue cancer

Vascular endothelial growth factor C (VEGF-C) expression predicts metastasis in tongue cancer

We evaluated predictive factors for cervical lymph node metastasis of tongue squamous cell carcinoma (SCC). We present a retrospective analysis of 90 patients with T1-2 N0 SCC who underwent primary excision as initial treatment without preoperative radiotherapy or chemotherapy. We examined the clinicopathologic factors (gender, age, clinical stage, surgical margin, grade of differentiation, lymphatic invasion, tumor depth of invasion, pattern of invasion [POI]) and immunohistochemical factors (vascular endothelial growth factor [VEGF]-A and VEGF-C expression) to predict the probability of lymph node metastasis. The local progression-free 5-year survival rate was 100%. Tumor depth of invasion (≥4 mm, P= .022), POI (score >4, P= .000), and VEGF-C expression (P= .008) were associated with the lymph node metastasis of tongue SCC in a multiple logistic regression analysis (odds ratios [ORs]: 5.075, 17.383, and 9.533, respectively). The local control rate of tongue SCC in the early stages has significantly improved as a result of development of surgical techniques. On the other hand, we believe that tumor depth of invasion (≥4 mm), POI, and VEGF-C expression all need to be considered in the preoperative and postoperative planning stages for tongue cancer treatment.

Establishment of an orthotopic transplantation model of tongue carcinoma.

This study aims to establish an orthotopic transplantation model of rabbit tongue carcinoma and study its biological characteristics. Tongue carcinoma was induced in purebred New Zealand white rabbits by exposure to 7,12-dimethylbenz[α]anthracene and mechanical stimulation. Fresh tumor tissues obtained from the induced tongue carcinoma model were then serially transplanted orthotopically into tongues of healthy rabbits. The tumor formation rate, invasion to surrounding tissues, regional lymph node metastases, and distant-organ metastases were investigated. Morphological observation by optical and electron microscopy, immunohistochemical examination, and chromosome analysis were performed. An orthotopic transplantation model of rabbit tongue carcinoma, designated as RSCC-2, was established. The tongue cancer was poorly differentiated squamous cell carcinoma. The tumor cell was hypotetraploid with a chromosome mode of 70. Immunohisto chemical examination showed positive staining for keratin. The tongue carcinoma survived in rabbits for 73 rounds of transplantation, using 465 rabbits in total. The average latent period was 12.5 days, and the average rabbit survival period was 37.5 days. The tumor formation rate was 10% to 20% in the first 20 rounds and increased gradually thereafter. After the 45th transplantation, the tumor formation rate and success rate of preservation in liquid nitrogen reached 100%. Regional lymph node metastases (35%) and lung metastases (20%) occurred after 50 rounds. In the advanced stage, tumors invaded the entire tongue. Animals suffered from weight loss and died of cachexia. RSCC-2 is the first animal model for orthotopical transplantation of primary tongue carcinoma. It successfully simulates the clinical pathological process of primary tongue cancer in human, provides invaluable insights into the pathogenesis and metastasis mechanisms, and can be useful for evaluating new therapeutics for the treatment of tongue cancer.

頸部再発に対し放射線併用超選択的動注化学療法が奏効した舌扁平上皮癌の1例

The prognosis of patients with cervical recurrence of oral squamous cell carcinoma after neck dissection is extremely poor because additional surgical resection is difficult owing to anatomical factors. In this report, we describe a case of cervical recurrence of tongue squamous cell carcinoma that was clinically eliminated by superselective intra-arterial chemotherapy with concurrent radiotherapy. The patient was a man in his forties who underwent a partial glossectomy for the treatment of tongue cancer of the left side （T2N0M0）. The histopathological diagnosis was moderately differentiated squamous cell carcinoma. On follow-up examination 9 months after the operation, computed tomography and ultrasonographic examination revealed cervical lymph node metastasis on the left side. Modified radical neck dissection of the left side was thus performed. One metastatic lymph node with extracapsular spread was pathologically found in the specimen. Two months after the neck dissection, a metastatic lymph node in the right submandibular region and neck recurrence on the left side were diagnosed. Two cycles of superselective intra-arterial chemotherapy with concurrent radiotherapy were delivered by the Seldinger technique via the femoral artery. The lesions were clinically eliminated after these treatments. There has been no evidence of recurrence or metastasis as of 6 years after therapy.

Evaluation of Swallow Function After Tongue Cancer Treatment Using Real-Time Magnetic Resonance Imaging

Magnetic resonance imaging (MRI) has the advantage of imaging swallow function at any anatomical level without changing the position of patient, which can provide detailed information than modified barium swallow, by far the gold standard of swallow evaluation. To investigate the use of real-time MRI in the evaluation of swallow function of patients with tongue cancer. Real-time MRI experiments were performed on a Signa Excite HD 1.5-T scanner (GE Healthcare), with gradients capable of 40-mT/m (milli-Tesla per meter) amplitudes and 150-mT/m/ms (mT/m per millisecond) slew rates. The sequence used was spiral fast gradient echo sequence. Four men with base of tongue or oral tongue squamous cell carcinoma and 3 age-matched healthy men with normal swallowing participated in the experiment. Real-time MRI of the midsagittal plane was collected during swallowing. Coronal planes between the oral tongue and base of tongue and through the middle of the larynx were collected from 1 of the patients. Oral transit time, pharyngeal transit time, submental muscle length change, and the distance change between the hyoid bone and anterior boundary of the thyroid cartilage were measured frame by frame during swallowing. All the measurable oral transit and pharyngeal transit times of the patients with cancer were significantly longer than the ones of the healthy participants. The changes in submental muscle length and the distance between the hyoid bone and thyroid cartilage happened in concert for all 60 normal swallows; however, the pattern differed for each patient with cancer. To our knowledge, the coronal view of the tongue and larynx revealed information that has not been previously reported. This study has demonstrated the potential of real-time MRI to reveal critical information beyond the capacity of traditional videofluoroscopy. Further investigation is needed to fully consider the technique, procedure, and standard scope of applying MRI to evaluate swallow function of patients with cancer in research and clinic practice.

Frontal Meningioma Incidentally Detected in the Routine Preoperative Assessment of Tongue Cancer: A Case Report and Literature Review

Recent advances in diagnostic tools, such as computed tomography and magnetic resonance imaging (MRI), have provided clinicians with the opportunity to detect asymptomatic meningiomas. This report describes a case of frontal convexity meningioma detected incidentally at MRI during the preoperative assessment of tongue cancer. To the best of the authors' knowledge, this case report is the first regarding the successful treatment of tongue cancer in a patient with incidental meningioma. The incidence, perioperative management, and various imaging tests to detect meningiomas are discussed, with a review of the literature.

Interspeaker variability in relative tongue size and vowel production

The tongue varies across speakers in terms of the proportion of the overall speech production apparatus that it occupies. Differences in tongue size have the potential to result in speaker-specific articulatory strategies for shaping the vocal tract area function and, in turn, individual patterns of vowel acoustics. The present study examines the interplay between relative tongue size and vowel production using real-time magnetic resonance imaging with synchronous audio. Two populations of native American English subjects are considered, one containing healthy adult speakers with no relevant pathologies, and another containing speakers who had undergone glossectomy as treatment for tongue cancer. All subjects were imaged in the midsagittal plane while reading phonetically balanced English sentences. The size of the tongue and the speech production apparatus were quantified from an overall average posture, and their ratio was correlated with the shape of the vowel space in terms of acoustics (e.g., formant frequencies), constrictions (i.e., location and degree of minimum constriction), and parameterized vocal tract cross-distance functions. Results indicate that relative tongue size can be used to explain and predict observable interspeaker differences in vowel production.

Application value of sentinel node biopsy in early stage oral tongue cancer with clinically negative neck

To evaluate the liability of sentinel node biopsy in the treatment of early stage oral tongue carcinoma with clinically negative neck. Eighteen patients with T1 or T2 oral tongue carcinoma were enrolled in the prospective study. Preoperative lymphoscintigraphy and intra-operative hand-held gamma probe techniques were used to detect the sentinel lymph nodes. The sentinel lymph node biopsies were sent to frozen section pathology and the results were compared with specimen of routine selective neck dissection (I ∼ III or I ∼ IV). The accuracy of cervical metastasis prediction was compared between sentinel node biopsy and tumor thickness. Sentinel lymph nodes were identified in all 18 cases. The numbers of sentinel lymph nodes of level Ib, IIa and III were 6, 22 and 2, respectively. In this series, positive sentinel lymph nodes were revealed in 4 cases, which were also positive in the postoperative routine histology.In other cases, both sentinel lymph nodes and routine histology were negative. Both the sensitivity and specificity were 100%. Sentinel lymph node biopsy obviously improved the specificity of predicting cervical metastasis comparing with the tumor thickness. (100% vs. 36.4%). Sentinel node biopsy is effective and reliable in the treatment of early stage oral tongue cancer, and deserves clinical application.

A Nutrient Mixture Inhibits MMP Secretion, Invasion, Growth, and Induction of Apoptosis in Human Tongue Cancer Cell Line SC-255

A majority of oral cancers is squamous cell carcinoma and tongue carcinomas comprise 30% of all oral cancers. However, Phytochemicals, herbal and dietary antioxidants have been reported to prevent cancers. A nutrient mixture containing, ascorbic acid, lysine, proline and green tea extract, among other nutrients, has previously been shown to exhibit a broad spectrum chemo preventative and therapeutic anti-cancer properties in a number of cell lines. In a recent study, we found that the nutrient mixture significantly inhibited acetaminophen induced hepatic and renal toxicity, and it suppressed carbon tetrachloride induced hepatic toxicity in ICR mice as well. This study was undertaken to determine if the nutrient mixture is useful in inhibiting various parameters of cancer progression on human tongue cancer cell line SC-255. SC-255 cells were grown in a Dulbecco’s Eagle medium and treated with the nutrient mixture at 0, 10, 50, 100, 500 and 1000 μg/ml, in triplicate. The nutrient mixture exhibited 20% and 30% toxicity at 500 and 1000 μg/ml, respectively. Zymography demonstrated the expression of MMP-2 and MMP-9; and PMA treatment further enhanced MMP-9 activity. The nutrient mixture inhibited the secretion of MMP-2 and MMP-9 in a dose-dependent fashion with a total inhibition at 500 μg/ml. Matrigel invasion was significantly reduced by 40%, 80% and 100% at 100, 500 and 1000 μg/ml, respectively. The nutrient mixture also inhibited cell migration and induced apoptosis in a dose response fashion. Thus, the nutrient mixture may have a potential in the tongue cancer treatment.

4D Dynamic‐MRI as Glossectomy Speech Assessment Tool

Objective: Quantitative tools assessing functional outcomes after tongue cancer treatment are crucial for evaluation and comparison of surgical reconstruction techniques or chemoradiation protocols. Furthermore, tools measuring physiologic outcomes directly and specifically may lead to a better understanding of tongue adaptation control. We developed a 4D dynamic MRI to address these issues. Method: This MRI tool included 2 components: 1) A static 3D high-resolution MRI to identify structures spared from the surgery. 2) Dynamic cine- and tagged-MRI scans at 26 frames/second to determine the tongue surface and measure point displacement during speech. Data were collected from 3 patients and 3 controls. Results: The 3D segmentation of the residual muscles were compared to the controls. Twenty-six 3D tongue volumes with surface deformation during the utterance of the word /asouk/ showed that patients adapt their tongue shape for /S/. The medial grooving seen in controls is deviated to the surgical side and the lateral sides of the anterior tongue make palatal and dental contact in patients. The 3D tagged MRI in patients showed asymmetrical displacement in several distinct parts of the tongue not seen in controls. The local distinct pattern suggests local adaptation for utmost speech performance. All patients had above 98% intelligibility scores. Conclusion: This is the first study of 4D-MRI relating residual tongue anatomy to 3D surface and internal kinematics during speech. This technique may provide a future predictive model for treatment options.