Treatment Of Tongue Cancer Research Articles

Objective approach in the assessment of speech quality in patients with tongue cancer after hemiglossectomy

Introduction. Surgery is the leading treatment for tongue cancer, performance which leads to impaired speech function. Because speech is one of the most important tools of social interaction, its disorder can significantly affect patients’ quality of life. To date, there is no generally accepted objective approach to assessing the quality of speech that would make it possible to analyze speech changes at different stages of therapy and help in development of treatment strategy.Aim. To compare the sound reproduction of patients with tongue cancer after hemiglossectomy with and without reconstruction using an objective assessment method, namely – a special software.Materials and methods. The study included 29 patients who received surgical treatment in the volume of hemiglossectomy with ipsilateral cervical lymphodissection. The patients were divided into 2 groups: the group 1 included 14 patients who underwent reconstruction with submental, radial and buccal flaps, the group 2 – 15 patients who did not underwent it. Sound reproduction by each patient was recorded before the operation, no earlier than 10–12 days after it (session of type 1) and after the end of specialized treatment: radiation therapy, chemoradiation therapy (session of type 2). If adjuvant therapy was not prescribed, the type 2 session was performed 3–6 months after surgery. The records made during sessions of the types 1 and 2 were compared with records of preoperative session. During each session, the pronunciation of 30 syllables containing 3 problematic sounds was recorded: [k], [s] and [t] (10 syllables with each of the sounds). The differences in the data obtained during the sessions types 1 and 2 were analyzed according both the syllable set and separately for each sound studied.Results. The reconstruction performed improves sound pronunciation [t] after hemiglossectomy both after surgery and 3–6 months after the end of specialized treatment (p <0.01). After completion of specialized treatment, the pronunciation of the sound [s] significantly improved in both groups. However, in the reconstruction group, the variations in pronunciation values of this sound before the operation and after it obtained in the groups 1 and 2 were significantly reduced. During the assessment of the pronunciation of sound [k], the similar data were obtained. When comparing the quality of speech of patients during the type 2 session, the best results were obtained in group 1: in patients of this group, there were smaller mean differences in the sounds pronunciation as compared to the initial recording (p <0.001) than in patients of group 2.Conclusion. Resection of the tongue most negatively affects pronunciation of the dental-alveolar sounds than the whistling or palatine-dental sounds. The time factor has a positive effect on the speech quality of patients, therefore, the assessment of sound reproduction in patients after hemiglossectomy should be performed no earlier than 3–6 months after the end of specialized treatment.

Feasibility of a Novel 3D Ultrasound Imaging Technique for Intraoperative Margin Assessment during Tongue Cancer Surgery.

Squamous cell carcinoma (SCC) of the tongue is the most prevalent form of oral cavity cancer, with surgical intervention as the preferred method of treatment. Achieving negative or free resection margins of at least 5 mm is associated with improved local control and prolonged survival. Nonetheless, margins that are close (1-5 mm) or positive (less than 1 mm) are often observed in practice, especially for the deep margins. Ultrasound is a promising tool for assessing the depth of invasion, providing non-invasive, real-time imaging for accurate evaluation. We conducted a clinical trial using a novel portable 3D ultrasound imaging technique to assess ex vivo surgical margin assessment in the operating room. During the operation, resected surgical specimens underwent 3D ultrasound scanning. Four head and neck surgeons measured the surgical margins (deep, medial, and lateral) and tumor area on the 3D ultrasound volume. These results were then compared with the histopathology findings evaluated by two head and neck pathologists. Six patients diagnosed with tongue SCC (three T1 stage and three T2 stage) were enrolled for a consecutive cohort. The margin status was correctly categorized as free by 3D ultrasound in five cases, and one case with a "free" margin status was incorrectly categorized by 3D ultrasound as a "close" margin. The Pearson correlation between ultrasound and histopathology was 0.7 (p < 0.001), 0.6 (p < 0.001), and 0.3 (p < 0.05) for deep, medial, and lateral margin measurements, respectively. Bland-Altman analysis compared the mean difference and 95% limits of agreement (LOA) for deep margin measurement by 3D ultrasound and histopathology, with a mean difference of 0.7 mm (SD 1.15 mm). This clinical trial found that 3D ultrasound is accurate in deep margin measurements. The implementation of intraoperative 3D ultrasound imaging of surgical specimens may improve the number of free margins after tongue cancer treatment.

Fucoxanthin Induces Ferroptosis in Cancer Cells via Downregulation of the Nrf2/HO-1/GPX4 Pathway.

This study investigated the mechanism by which fucoxanthin acts as a novel ferroptosis inducer to inhibit tongue cancer. The MTT assay was used to detect the inhibitory effects of fucoxanthin on SCC-25 human tongue squamous carcinoma cells. The levels of reactive oxygen species (ROS), mitochondrial membrane potential (MMP), glutathione (GSH), superoxide dismutase (SOD), malondialdehyde (MDA), and total iron were measured. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and Western blotting were used to assess glutathione peroxidase 4 (GPX4), nuclear factor erythroid 2-related factor 2 (Nrf2), Keap1, solute carrier family 7 member 11 (SLC7A11), transferrin receptor protein 1 (TFR1), p53, and heme oxygenase 1 (HO-1) expression. Molecular docking was performed to validate interactions. Compared with the control group, the activity of fucoxanthin-treated SCC-25 cells significantly decreased in a dose- and time-dependent manner. The levels of MMP, GSH, and SOD significantly decreased in fucoxanthin-treated SCC-25 cells; the levels of ROS, MDA, and total iron significantly increased. mRNA and protein expression levels of Keap1, GPX4, Nrf2, and HO-1 in fucoxanthin-treated cells were significantly decreased, whereas levels of TFR1 and p53 were significantly increased, in a concentration-dependent manner. Molecular docking analysis revealed that binding free energies of fucoxanthin with p53, SLC7A11, GPX4, Nrf2, Keap1, HO-1, and TFR1 were below -5 kcal/mol, primarily based on active site hydrogen bonding. Our findings suggest that fucoxanthin can induce ferroptosis in SCC-25 cells, highlighting its potential as a treatment for tongue cancer.

The effect of active patient management on life expectancy in tongue cancer

The result of the treatment of tongue cancer, which includes surgical treatment at the first stage followed by radiation therapy, is presented. Carrying out radical combined treatment of tongue cancer in the future leads to the appearance of a post-radiation ulcer in the area of surgery, followed by the development of a recurrence of tongue cancer in it and metastasis to regional lymph nodes or submandibular salivary glands. All of the above requires oncologists to actively monitor this group of patients. With the development of a post-radiation chronic long-term non-healing ulcer in the area of surgery, surgical rehabilitation should be carried out. Surgical removal of such an ulcer prevents further development of cancer recurrence. Regular examination, neck ultrasound, cytological examination of suspicious areas of the tongue and regional lymph nodes allows timely detection of relapse and metastases and radical surgical treatment. Such an active tactic of managing this pathology affected the patient’s life expectancy — 17 years.

Increasing stage and depth of invasion (DOI) in patients with tongue cancer during the COVID-19 pandemic: A time series study.

The outbreak of the Coronavirus disease 2019 (COVID-19) pandemic had a significant effect on the diagnosis and treatment of head and neck cancers. Therefore, in this study, we decided to discuss the impact of COVID-19 on the stage and histological characteristics of patients with tongue cancer from March 2020 to March 2021 and compared to the previous 3 years. In this time series study, patients diagnosed with squamous cell carcinoma of the operated tongue cancer were divided into two groups. Patients who operated from March 2020 to March 2021 (n = 36) and patients who operated 3 years ago (n = 70) were included in the study. The results were analyzed using SPSS 21 software. The study found that during the pandemic, the stage of tongue cancer in patients who underwent surgery was higher than before the pandemic (p = 0.01). Moreover, the depth of invasion was significantly higher during the COVID-19 outbreak in the pathology sample of the patients (p = 0.006), while the involvement of lymph nodes and other variables between the groups was not statistically significant. COVID-19 has adverse effects on the diagnosis and treatment of tongue cancer. Also, it leads to advanced stages of the tumor and increases the depth of invasion of the cancer. Hence, it is important to plan correctly and appropriately for the diagnosis and treatment of these patients in conditions such as the COVID-19 pandemic.

A Comparative Study of Serum Butyric Acid in Subjects with Tongue Cancer

Abstract Aim: The aim of the study was to study the level of butyric acid in tongue cancer subjects. Materials and Methods: Thirty controls and 30 tongue cancer subjects were recruited for the study. Serum butyric acid levels were estimated using ELISA kits. Statistical analyses were done using SPSS vs 22. The Mann–Whitney U and Kruskal–Wallis tests were used. P ≤ 0.05 was considered statistically significant. Results: Butyric acid levels were significantly higher in control subjects when compared to case subjects. Conclusion: Butyric acid could be used as a potential anticancer agent in tongue cancer treatment.

Transtumoral approach and piecemeal resection (Steiner principle) for the treatment of tongue cancer at stage T1-T2: A pilot study.

To assess the feasibility of maximizing negative margins with minimal resection of healthy tissue, as confirmed by intraoperative assessment. This approach aims to be safe, effective, and to be considered a standard procedure. A prospective pilot study. Peritumoral ink marking aided in identifying margins. Transtumoral incisions were made along the central line until healthy tissue was visible. If positive or close margins were identified, an extension was performed only in the involved area. The tumor bed and outer part of the tumor were inked to determine margins for intraoperative assessment of the specimen. Twelve patients with oral squamous cell carcinoma participated in the study, comprising 3 men and 9 women, with a mean age of 58 years. Four patients were diagnosed with clinical stage I (T1N0), while eight were classified as stage II (T2 N0). All patients underwent ipsilateral neck dissection (levels I-III). Intraoperative outcomes included negative, positive, or close margins. The number of tissue blocks varied based on the size of the tongue tumor and the segments that required expansion to ensure a tumor-free margin (>1 mm), which was necessary in 8 patients. All final pathological reports indicated negative margins of >1 mm. Piecemeal resection emerges as a feasible and oncologically sound procedure for achieving margins >1mm, which are deemed safe. Precisely identifying positive areas within the tumor proves significantly safer than en bloc resections. The prognoses observed in this series depended more on regional disease factors than on specific characteristics of the primary tumor.

Quality of life and functional outcomes in tongue cancer patients: a long-term, prospective, comparative study.

The tongue has an indispensable role in communication, swallowing and breathing. Tongue cancer treatment involves direct resection of the tumor and surrounding tissue, which can limit many essential functions of the tongue. There are few patient-reported quality of life studies involving tongue cancer exclusively. There is also a lack of data on the outcomes of quality of life regarding different reconstructive methods, adjuvant non-surgical therapies and other predicting factors. Our objective is to assess the quality of life, functional status, and predicting factors in patients with tongue cancer up to one year after surgical resection. Thirty-six patients with tongue cancer were prospectively identified between October of 2017 and January 2021. Patients were examined before and one, three, six and twelve months after surgical resection with the validated University of Washington Quality of Life questionnaire (UW-QOL). Data collection included patient age, sex, TNM staging, size of resection, neck dissection, tracheostomy, reconstructive method and adjuvant therapies. Outcome scores were compared using the Friedman test. Multiple linear regression analysis was used to identify the predictors of quality of life and functional status. The use of UWQOL scores as dependent variables revealed the following predicting factors: age, tobacco use, radiotherapy, chemotherapy, reconstruction method and neck dissection. The most relevant findings in our study are that flap reconstruction becomes increasingly necessary when a glossectomy resection is over 45 mm, in order to maintain tongue function. We established that the reconstructive flap type does not influence quality of life in the long term. Also, we have found that cervical sentinel node biopsy provides better quality of life over neck dissection in the first 3 months after surgery.

Efficacy of first-line immunization combined with antiangiogenesis treatment and chemotherapy for the treatment of tongue cancer: A case report.

There is currently no uniform and effective treatment for patients with locally advanced oral cancer who cannot tolerate surgery or radiotherapy. The prognosis of oral cancer patients with lymph node metastasis is very poor, but the clinical treatment of such patients faces certain challenges. Case 1 was a 59-year-old patient with tongue cancer (cT 3 N x M 0 G 2) who refused radiotherapy because of a history of leukoderma. After evaluation of disease condition, a 4-drug combination therapy of toripalimab + anlotinib + nabpaclitaxel + carboplatin was administered. Case 2 was a 55-year-old patient with tongue cancer (cT 3 N 2 M 0 G 1) who could not receive radiotherapy because of a medical history of cervicofacial burns. After disease evaluation, toripalimab + anlotinib + docetaxel + carboplatin combination therapy was administered. Both patients did not experience any adverse reactions during treatment and achieved a complete response after 2 cycles of treatment. Their progression-free survival is currently 6 and 8 months, respectively, and they are in sustained remission. Currently, the efficacy of immune checkpoint inhibitors targeting programmed death-1 as a first-line treatment of inoperable and non-radiatable locally advanced oral cancer is unknown. Here, we describe 2 cases of locally advanced oral cancer treated with first-line immune checkpoint inhibitors in combination with targeted therapy and chemotherapy. This approach was successful in these patients, but a larger sample size is required to verify our findings.

3D Ultrasound and MRI in Assessing Resection Margins during Tongue Cancer Surgery: A Research Protocol for a Clinical Diagnostic Accuracy Study.

Surgery is the primary treatment for tongue cancer. The goal is a complete resection of the tumor with an adequate margin of healthy tissue around the tumor.Inadequate margins lead to a high risk of local cancer recurrence and the need for adjuvant therapies. Ex vivo imaging of the resected surgical specimen has been suggested for margin assessment and improved surgical results. Therefore, we have developed a novel three-dimensional (3D) ultrasound imaging technique to improve the assessment of resection margins during surgery. In this research protocol, we describe a study comparing the accuracy of 3D ultrasound, magnetic resonance imaging (MRI), and clinical examination of the surgical specimen to assess the resection margins during cancer surgery. Tumor segmentation and margin measurement will be performed using 3D ultrasound and MRI of the ex vivo specimen. We will determine the accuracy of each method by comparing the margin measurements and the proportion of correctly classified margins (positive, close, and free) obtained by each technique with respect to the gold standard histopathology.

Efficacy of High-Intensity Training in Patients with Moderate to Severe Dysphagia after Glossectomy.

Dysphagia is the main impairment arising from glossectomy for tongue cancer treatment. The study aimed to determine if an eight-week training protocol paired with accuracy tasks and swallowing exercises is effective and can improve tongue strength and swallowing in patients after tongue resection. Maximum isometric pressures, tongue endurance, swallowing pressures, mealtime duration, and oropharyngeal swallow function were studied in patients with moderate to severe dysphagia after glossectomy. Twenty-five (25) patients and thirty-one (31) healthy participants were enrolled in the study. The therapy group (TG) consisted of seventeen (17) patients who followed an 8-week treatment protocol and had multiple measurements. The follow-up control group (FUG) consisted of eight non-treated patients who had a baseline and an 8-week follow-up examination. Healthy participants served as the reference group (RF). Maximum isometric pressures, endurance, and swallowing pressures increased significantly in the TG versus the FUG. Significant improvement was documented in the TG regarding the EAT-10 questionnaire, the Penetration-Aspiration Scale scores at thickened and solid boluses, and post-swallow residues at thickened and solid boluses. The treatment protocol with tongue strength exercises combined with accuracy tasks and swallowing exercises improves the post-operative swallowing function in patients after glossectomy. Patients in the TG had more significant and quicker improvement in pressures and endurance compared to FUG.

CCL2 promotes lymphatic metastasis via activating RhoA and Rac1 pathway and predict prognosis to some extent in tongue cancer

ABSTRACT Background Oral tongue cancer is an extremely malignant tumor with high rate of lymphatic metastasis. Little is known about its invasion and metastasis mechanisms so far. Methods To clarify the main role of CCL2 in tongue cancer progression, we performed Transwell migration assay to confirm the effects of different concentrations of CCL2 on the migration and invasion of tongue cancer cells. Next, by siRNA interference of RhoA and Rac1 in LNMTca8113 cells, we are able to observe that these two molecules block the effect of CCL2 on cell migration and cytoskeleton reorganization by laser confocal microscopy. Moreover, the AKT phosphorylation level of PI3K downstream molecule under the action of CCL2 also be detected by qRT-PCR and western blot, so as to determine whether CCL2 affects the proliferation of LNMTca8113 cells through PI3K/AKT pathway. Finally, we analyzed the relationship between plasma CCL2 level and various clinicopathological parameters in patients with tongue cancer. Results: We found that tongue cancer cells treated with CCL2 migrate faster at first. CCL2 may enhance the invasion and migration of LNMTca8113 cells by activating RhoA and Rac1 to promote cytoskeleton reorganization. Promotion of LNMTca8113 migration induced by CCL2 was inhibited by silence of RhoA and Rac1. CCL2 could increase the phosphorylation of downstream Akt/PI3K signal and promoted the proliferation. Plasma concentration confirmed that the CCL2 level was closely related to the clinical stage of tongue cancer. Patients with lower CCL2 levels had a relatively longer progression-free survival and total survival time. Results After adding CCL2, the number of proliferation and migration of tongue cancer cells increased and the expression of RhoA and Rac1 rose up in LNMTca8113 cell line. The cytoskeleton reorganization was notable. Patients with higher serum levels of CCL2 had shorter progression-free survival than those with lower levels of CCL2 (P < 0.0001). Conclusions CCL2 promotes the invasion and metastasis of tongue cancer by PI3K/Akt pathway. The plasma level of CCL2 may predict prognosis of tongue cancer patients. CCL2 can serve as a potential therapeutic target for tongue cancer treatment.

Quality of life after tongue cancer treatment and its influencing factors: A cross‐sectional study of Japanese patients

AbstractAimThe post‐treatment quality of life (QOL) of patients with cancer has become an important issue owing to significant improvements in the outcomes of cancer treatment. The oral cavity has not only life‐sustaining functions but also important social functions, including talking. Thus, many reports have assessed the post‐treatment QOL of patients with oral cancer. However, the sample sizes in most studies were insufficient to control for potential confounding variables. Additionally, previous studies have indicated that racial/ethnic differences may be associated with health‐related QOL. Thus, this study aimed to clarify factors influencing post‐treatment QOL using multiple regression analysis in a large number of Japanese patients with tongue cancer.MethodsIn total, 106 patients with tongue cancer were recruited from the oral surgery departments of three university hospitals sharing a common treatment plan for tongue cancer. QOL was evaluated using the University of Washington Quality of Life Questionnaire, and depressive tendencies were assessed using the Self‐rating Depression Scale (SDS).ResultsNeck dissection was most widely associated with physical and socio‐emotional QOL. Reconstruction, radiotherapy, and higher T‐stage and SDS scores were the second most widely associated factors with QOL. Interestingly, a higher SDS score was negatively related only to socio‐emotional factors. Furthermore, only SDS scores were associated with the general QOL.ConclusionThis study suggested that the physical and socio‐emotional QOL was widely affected by neck dissection, reconstruction, radiotherapy, T‐stage, and SDS scores, whereas the general QOL was affected only by SDS scores. These findings should be considered when treating patients with oral cancer.

Subjective and objective assessments of sweet, umami, and bitter tastes after brachytherapy for patients with tongue cancer

AbstractAimThe aim of this study is to investigate subjective symptoms and expression of receptors for sweet, umami, and bitter tastes after brachytherapy in patients with tongue cancer.MethodsPost‐brachytherapy changes in taste were investigated both subjectively (visual analog scale [VAS] score) and objectively (expression of taste receptors) through 37 examinations on 10 patients who received brachytherapy for treatment of tongue cancer at our hospital. The VAS was scored on a scale of 0–100. A VAS score of ≥90 was considered to indicate restoration of taste. For taste receptor expression, taste cells were collected from the brachytherapy (BRT) and non‐brachytherapy (non‐BRT) sides of the tongue, which were separated in the middle of the dorsum of the tongue, and evaluated by the ratio of the expression level of one side to the other. The mRNA expression levels of taste receptors were classified into three groups according to the number of days after BRT: ≤99, 100–299, and ≥300 days.ResultsThe number of days to a post‐brachytherapy VAS score of 90 or more was 284, 308, and 308 days for sweet, umami, and bitter tastes, respectively. Taste receptor expression was compared in three groups by number of days after radiotherapy: ≤99, 100–299, and ≥300, and no statistically significant differences were found among the tastes.ConclusionThe VAS scores showed that these tastes recovered approximately 300 days after brachytherapy. The ratio of taste receptor expression levels varied widely, and no specific indications of changes in taste receptor expression over time were obtained.

Predicting Survival of Tongue Cancer Patients by Machine Learning Models

Tongue cancer is a common oral cavity malignancy that originates in the mouth and throat. Much effort has been invested in improving its diagnosis, treatment, and management. Surgical removal, chemotherapy, and radiation therapy remain the major treatment for tongue cancer. The treatment effect is determined by patients’ survival status. Previous studies have identified certain survival and risk factors based on descriptive statistics, ignoring the complex, nonlinear relationship among clinical and demographic variables. In this study, we utilize five cutting-edge machine learning models and clinical data to predict the survival of tongue cancer patients after treatment. Five-fold cross-validation, bootstrap analysis, and permutation feature importance are applied to estimate and interpret model performance. The prognostic factors identified by our method are consistent with previous clinical studies. Our method is accurate, interpretable, and thus useable as additional evidence in tongue cancer treatment and management.

Expert consensus on surgical treatment of tongue squamous cell carcinoma

The annual incidence of oral cancer in the world is more than 300 000, and the five-year survival rate is 50%~60%. Every year, 145 400 people died due to tongue cancer, of which tongue cancer accounts for nearly 40%. Although tongue cancer has tumor heterogeneity and individual differences in prognosis, surgery is still the first choice for the treatment of tongue cancer. The effect of tongue cancer surgery can directly determine the survival time of patients. The defect caused by tongue cancer surgery seriously affects the patients' physical functions such as appearance, language, chewing and swallowing. The surgical treatment of tongue cancer with functional reconstruction can improve the quality of life of patients. In the past few decades, genomics has enhanced understanding of tongue cancer. The preclinical tumor model preserves the tumor heterogeneity, which has a great application prospect in the discovery of tumor biomarkers and the clinical translation of drugs. Many advances have been made in the diagnosis and treatment of tongue cancer, but there are still many controversies in clinical practice. Therefore, this expert consensus summarizes the progress and controversial hot spots of surgical diagnosis and treatment of tongue cancer, mainly including preoperative diagnosis and evaluation, surgical treatment points and postoperative functional rehabilitation.

Quality of life after surgical treatment for tongue cancer

Quality of life after surgical treatment for tongue cancer

Tongue cancer treatment and oncological outcomes: The role of glossectomy classification

BackgroundNowadays surgery remains the gold standard of treatment for tongue cancer. Via a more clear and precise terminology, the glossectomy classification by Ansarin et al. facilitates shared communication between surgeons, allowing comparison between published research and improving surgical practice and patient care. To establish the association of glossectomies, according to their classification by Ansarin et al. with overall survival (OS), disease-free survival (DSF), and cause-specific survival (CSS) in tongue cancer, we conducted a systemic retrospective study on 300 consecutive patients affected by primary oral tongue cancer and treated with surgery at the European Institute of Oncology, IRCCS (IEO). MethodsThree hundred patients with tongue squamous cell carcinoma and treated at the Division of Otorhinolaryngology and Head and Neck Surgery of the European Institute of Oncology, IRCCS were cataloged according to the glossectomy classification. OS, DFS, and CSS were compared by surgical treatments. ResultsOS-5yrs was 80% for the type I glossectomy group, 75% for type II, 65% for type III, and 35% for type IV-V. DFS-5yrs was 74%, 60%, 55%, and 27%, respectively for I, II, III, and IV-V glossectomy group; CSS-5yrs was 82%, 80%, 72%, and 48%, respectively for I, II, III, and IV-V glossectomy group (p < 0.01). ConclusionsThis study confirmed that the application of the glossectomy classification was statistically correlated with patients' oncological outcomes.

Repurposing Lovastatin Cytotoxicity against the Tongue Carcinoma HSC3 Cell Line Using a Eucalyptus Oil-Based Nanoemulgel Carrier.

Tongue cancer is one of the most common carcinomas of the head and neck region. The antitumor activities of statins, including lovastatin (LV), and the essential oil of eucalyptus (Eu oil), have been adequately reported. The aim of this study was to develop a nanoemulgel containing LV combined with Eu oil that could then be made into a nanoemulsion and assessed to determine its cytotoxicity against the cell line human chondrosarcoma-3 (HSC3) of carcinoma of the tongue. An I-optimal coordinate-exchange quadratic mixture design was adopted to optimize the investigated nanoemulsions. The droplet size and stability index of the developed formulations were measured to show characteristics of the nanoemulsions. The optimized LV loaded self-nanoemulsifying drug delivery system (LV-Eu-SNEDDS) was loaded into the gelling agent Carbopol 934 to develop the nanoemulgel and evaluated for its rheological properties. The cytotoxic efficiency of the optimized LV-Eu-SNEDDS loaded nanoemulgel was tested for cell viability, and the caspase-3 enzyme test was used against the HSC3 cell line of squamous carcinoma of the tongue. The optimized nanoemulsion had a droplet size of 85 nm and a stability index of 93%. The manufactured nanoemulgel loaded with the optimum LV-Eu-SNEDDS exhibited pseudoplastic flow with thixotropic behavior. The developed optimum LV-Eu-SNEDDS-loaded nanoemulgel had the best half-maximal inhibitory concentration (IC50) and caspase-3 enzyme values of the formulations developed for this study, and these features improved the ability of the nanoemulsion-loaded gel to deliver the drug to the investigated target cells. In addition, the in vitro cell viability studies revealed the synergistic effect between LV and Eu oil in the treatment of tongue cancer. These findings illustrated that the LV-Eu-SNEDDS-loaded gel formulation could be beneficial in the local treatment of tongue cancer.

Clinical Outcomes of Treatment for Tongue Cancer at Tokushima University Hospital

Clinical Outcomes of Treatment for Tongue Cancer at Tokushima University Hospital