Quality-of-Life Evaluation of Patients with Unresectable Locally Advanced or Locally Recurrent Head and Neck Carcinoma Treated with Head and Neck Photoimmunotherapy

Okamoto, Isaku; Okada, Takenori; Tokashiki, Kunihiko; Tsukahara, Kiyoaki

doi:10.3390/cancers14184413

Cited by 9 publications

(10 citation statements)

References 30 publications

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“…Although scattered clinical reports on HN-PIT exist, Lemierre's syndrome triggered by HN-PIT has not been reported [4,[8][9][10][11][12]. Patients treated with HN-PIT are prone to mucosal infection of the head and neck region due to the nature of the treatment, and the development of Lemierre's syndrome is a high-risk event that requires caution.…”

Section: Discussionmentioning

confidence: 99%

Lemierre’s Syndrome after Head and Neck Photoimmunotherapy for Local Recurrence of Nasopharyngeal Carcinoma

Nishimura,

Okamoto,

Ito

et al. 2024

Case Rep Oncol

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Introduction: Head and neck photoimmunotherapy (HN-PIT) uses a combination of drugs and laser illumination to specifically destroy tumor cells. Lemierre’s syndrome is an infectious disease with severe systemic symptoms caused by prior infection in the pharyngeal region, leading to thrombophlebitis. Here, we report a case of Lemierre’s syndrome that developed after HN-PIT for recurrent nasopharyngeal carcinoma. Case Presentation: A 68-year-old male with nasopharyngeal carcinoma (squamous cell carcinoma) underwent HN-PIT after local recurrence with chemoradiation therapy. Three months after HN-PIT, the patient developed fever and neck pain, which led to a diagnosis of Lemierre’s syndrome. The patient was treated with antibiotics and anticoagulants for at least 1 month. The patient’s general condition and inflammatory findings on blood sampling showed gradual improvement, and a follow-up cervicothoracic computed tomography imaging showed that the venous thrombus had been obscured and the patient was doing well. Conclusion: HN-PIT is a high-risk procedure for the development of Lemierre’s syndrome due to irradiation-induced mucositis, and anticipating the development of Lemierre’s syndrome during HN-PIT is important.

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Section: Discussionmentioning

confidence: 99%

Lemierre’s Syndrome after Head and Neck Photoimmunotherapy for Local Recurrence of Nasopharyngeal Carcinoma

Nishimura,

Okamoto,

Ito

et al. 2024

Case Rep Oncol

Self Cite

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“…Additionally, while NRS tended to be lower for treatment with a frontal diffuser than with a cylindrical diffuser, opioid pain management was still necessary, suggesting that opioid pain management is essential for PIT. However, it is important to monitor the pain status and management continuously, as there have been reports of pain continuing for more than 4 weeks after administering PIT [ 17 ]. From the phase I trial results, we understood that pain is a critical adverse event of PIT.…”

Section: Discussionmentioning

confidence: 99%

A Case Series on Pain Accompanying Photoimmunotherapy for Head and Neck Cancer

et al. 2023

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One of the most severe side effects of photoimmunotherapy (PIT) for head and neck cancer is pain. As there are presently no detailed reports on pain and pain management in PIT, we conducted a retrospective case series study. We conducted a retrospective study of five patients who had received PIT at the National Cancer Center Hospital East between January 2021 and June 2022 using medical chart data. All patients experienced pain, evidenced by an increased numerical rating scale (NRS) after PIT, regardless of the illumination method. The daily change in mean NRS rating shows that the pain was highest on the day of PIT, with ratings of 6.8 and 7.8 for the frontal and cylindrical diffuser methods, respectively; it dropped the following day quickly. Four of the five patients received fentanyl injections for postoperative pain management beginning on postoperative day (POD) 0. All patients who underwent therapy using a cylindrical diffuser required postoperative pain management with opioid drugs. Pain after PIT tended to be most intense immediately after or one hour after illumination and declined the following day, suggesting the need to have a pain relief plan in place in advance.

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“…The conditions for this treatment are that the tumor must have a relatively specific target―such as EGFR―to enable the dye to bind to the tumor while bypassing normal areas, and that the tumor must be located in an area that can be irradiated with NIR. For these reasons, as mentioned above, head and neck cancer is a current indication for treatment 9) . Research and development of new methods, such as the search for molecular targets to bind dyes specific to cancer cells in other types of cancers and NIR irradiation from the tip of an endoscope, are currently underway, and it is anticipated that this technology will be expanded to other areas in the future.…”

Section: Photoimmunotherapymentioning

confidence: 99%

The Latest Treatment for Head and Neck Cancers: Transoral Robotic Surgery and Photoimmunotherapy

Matsumoto

2023

Juntendo Medical Journal

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Remarkable progress has been achieved in head and neck surgery in recent years. Transoral robotic surgery (TORS) is becoming popular worldwide for the removal of less invasive tumors. TORS is used especially for oropharyngeal cancer and is minimally invasive, with a short treatment time and minimal postoperative dysfunction. The procedure is performed by inserting one endoscope and two robotic arms. The robotic arm has a 360-degree movable tip, which enables fine manipulation, even in narrow oral cavities. The endoscope also provides three-dimensional images and enables the surgeon to get close to the operative site, making it possible to check for small blood vessels and other objects while performing the operation. Photoimmunotherapy is a new treatment for distant metastasis or recurrent head and neck cancers not indicated for surgery or radiotherapy. Treatment requires the administration of a dye, IR700, one day before the procedure. This dye disrupts cell membranes when exposed to near-infrared (NIR) radiation. To deliver this dye specifically to the tumor, an antibody drug against the epidermal growth factor receptor, which is expressed relatively specifically in tumors, is used. This treatment has a strong anti-tumor effect and the tumor shrinks relatively quickly. However, because NIR irradiation is required, the lesion must be within the infrared irradiation range. In addition, because of rapid shrinkage of the tumor, post-treatment tissue defects are serous complication, and tumor invasion into the carotid artery are contraindications due to the risk for major hemorrhage caused by tumor shrinkage.

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Quality-of-Life Evaluation of Patients with Unresectable Locally Advanced or Locally Recurrent Head and Neck Carcinoma Treated with Head and Neck Photoimmunotherapy

Cited by 9 publications

References 30 publications

Lemierre’s Syndrome after Head and Neck Photoimmunotherapy for Local Recurrence of Nasopharyngeal Carcinoma

Lemierre’s Syndrome after Head and Neck Photoimmunotherapy for Local Recurrence of Nasopharyngeal Carcinoma

A Case Series on Pain Accompanying Photoimmunotherapy for Head and Neck Cancer

The Latest Treatment for Head and Neck Cancers: Transoral Robotic Surgery and Photoimmunotherapy

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