The SLNB procedure has shown a high sensitivity rate, but the pooled sensitivity and false-negative rate were worse in SLNB alone trials than in SLNB validation trials.

Purpose. One of the common side effects experienced by head and neck cancer patients on chemoradiotherapy is mucositis. Severe mucositis may be controllable by limiting cancer therapy, but it has resulted in decreasing the completion rate of chemoradiotherapy. The efficacy of royal jelly (RJ) as prophylaxis against chemoradiotherapy-induced mucositis was evaluated through clinical scoring of oral and pharyngeal mucositis. Methods. In this randomized, single-blind (physician-blind), clinical trial, 13 patients with head and neck cancer requiring chemoradiation were randomly assigned to two groups. Seven patients assigned to the study group received RJ, and 6 patients were assigned to the control group. RJ group patients took RJ three times per day during treatment. The patients in both groups were evaluated twice a week for the development of mucositis using Common Terminology Criteria for Adverse Events version 3.0. Results. A significant reduction in mucositis was seen among RJ-treated patients compared with controls (P < 0.001). Conclusion. This study demonstrated that prophylactic use of RJ was effective in reducing mucositis induced by chemoradiotherapy in head and neck cancer patients. However, further studies are needed because of the small sample size and the absence of double blinding.

BackgroundSentinel node navigation surgery is gaining popularity in oral cancer. We assessed application of sentinel lymph node navigation surgery to pharyngeal and laryngeal cancers by evaluating the combination of contrast-enhanced ultrasonography and indocyanine green fluorescence in animal models.MethodsThis was a prospective, nonrandomized, experimental study in rabbit and swine animal models. A mixture of indocyanine green and Sonazoid was used as the tracer. The tracer mixture was injected into the tongue, larynx, or pharynx. The sentinel lymph nodes were identified transcutaneously by infra-red camera and contrast-enhanced ultrasonography. Detection time and extraction time of the sentinel lymph nodes were measured. The safety of the tracer mixture in terms of mucosal reaction was evaluated macroscopically and microscopically.ResultsSentinel lymph nodes were detected transcutaneously by contrast-enhanced ultrasonography alone. The number of sentinel lymph nodes detected was one or two. Despite observation of contrast enhancement of Sonazoid for at least 90 minutes, the number of sentinel lymph nodes detected did not change. The average extraction time of sentinel lymph nodes was 4.8 minutes. Indocyanine green fluorescence offered visual information during lymph node biopsy. The safety of the tracer was confirmed by absence of laryngeal edema both macro and microscopically.ConclusionsThe combination method of indocyanine green fluorescence and contrast-enhanced ultrasonography for detecting sentinel lymph nodes during surgery for head and neck cancer seems promising, especially for pharyngeal and laryngeal cancer. Further clinical studies to confirm this are warranted.

Background/Aim: We have previously reported that alternate-day S-1 had comparable effects and milder adverse events than the respective consecutive-day regimen in head and neck cancer (HNC) patients. The aim of this study was to investigate the anticancer effects of both regimens and underlying mechanisms in vitro. Materials and Methods: Two head and neck squamous cell carcinoma (HNSCC) cell lines were treated with 5-FU given on an alternate-day or consecutive-day schedule. The relative inhibition (RI) of tumor growth was calculated. Cell cycle distributions and cyclin expression following 5-FU treatment were analyzed. Results: The RI of both regimens was almost identical. The percentage of cells in S phase was significantly increased in the alternate-day group compared to the consecutive-day group (p<0.001). Conclusion: The cytotoxic effect of alternate-day was equivalent to that of consecutive-day. S-phase arrest was more prominently observed with the alternate-day regimen, which may help maintain 5-FU sensitivity in head and neck cancer cells.Head and neck squamous cell carcinoma (HNSCC) is still lethal because of the high percentage of recurrence and metastasis (1-4). S-1 is a novel oral anticancer agent consisting of tegafur, 5-chloro-2,4-dihydroxypyridine, and potassium oxonate at a molar ratio of 1:0.4:1, based on biochemical modulation of 5-fluorouracil (5-FU) (1, 5). A phase III study [Adjuvant Chemotherapy with S-1 after Curative Treatment in Patients with Head Neck Cancer (ACTS-HNC) trial] investigated whether adjuvant therapy with S-1 could improve the prognosis in head and neck cancer (6). S-1 was administered daily for 2 weeks, followed by a 1-week rest period. The study showed that adjuvant chemotherapy with S-1 resulted in significantly better overall survival (OS) in patients with locally advanced HNSCC compared to the control arm. However, the S-1 arm was less well-tolerated and the 1-year completion rate of S-1 was only 43.4%. Therefore, treatment completion and tolerance remain unresolved problems. Sakuma et al. reported that S-1 given on an alternate-day schedule can reduce the incidence of adverse effects without compromising the therapeutic effects of S-1 (7). The alternate-day regimen was equivalent to or better than the consecutive-day regimen in patients with other regimens for metastatic pancreatic cancer in a clinical trial (8). Likewise, we conducted a retrospective study of an alternate-day S-1 regimen as adjuvant therapy after surgery and chemoradiotherapy for advanced HNSCC. In that study, we observed that alternate-day S-1 administration caused fewer adverse effects and was tolerable for patients with advanced HNSCC (9). The completion rate was 80.7% and the occurrence of adverse events tended to be less than that reported in the ACTS-HNC trial. Three-year OS and disease-free survival rates were 74.8% and 57.3%, respectively. Other groups also reported that alternate-day S-1 treatment was associated with milder adverse events without compromising therapeutic effectiveness in clini...

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