Tomohiro Sakashita | Hokkaido University (original) (raw)
Papers by Tomohiro Sakashita
International Cancer Conference Journal, 2012
ABSTRACT Squamous cell carcinoma of the nasal vestibule (SCC-NV) is rare among head and neck mali... more ABSTRACT 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 neutralize cisplatin toxicity, together with conventional radiotherapy. 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.
Head & neck, Jan 7, 2015
The purpose of this study was to compare the hearing outcomes after surgery with reconstruction o... more 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. 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. 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 + RT (n = 5) groups. Adequate techniques for reconstruction of the external auditory canal in combination with tympanoplasty after complete surgical resection is useful for hearing pre...
Nippon Jibiinkoka Gakkai Kaiho, 2014
JOURNAL OF JAPAN SOCIETY FOR HEAD AND NECK SURGERY, 2011
Nihon Jibiinkoka Gakkai kaiho, 2014
In the case of oropharyngeal carcinoma, patients may present with symptoms similar to cervical ly... more 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 fro...
Auris, nasus, larynx, 2015
We retrospectively assessed the indications for superselective intra-arterial infusion of cisplat... more We retrospectively assessed the indications for superselective intra-arterial infusion of cisplatin with concomitant radiotherapy (RADPLAT) in patients with hypopharyngeal cancer (HPC). Between April 2000 and March 2013, 41 previously untreated patients received superselective intra-arterial infusion of cisplatin (100-120mg/m(2) per week) with simultaneous intravenous infusions of thiosulfate to neutralize cisplatin toxicity and conventional radiotherapy (65-70Gy). 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. Indications for RADPLAT in patients with HPC wer...
JOURNAL OF JAPAN SOCIETY FOR HEAD AND NECK SURGERY, 2012
ABSTRACT We retrospectively analyzed 27 patients with T3 laryngeal carcinoma treated at our depar... more ABSTRACT We retrospectively analyzed 27 patients with T3 laryngeal carcinoma treated at our department from 2004 to 2008. The patients ranged from 38 to 73 years of age (median: 62) and consisted of 24 men and 3 women. Cases included 21 supraglottic and 6 glottic. Of the 27 patients, 7 were treated by total laryngectomy, 14 by chemoradiotherapy and 6 by radiation alone. The 3-year disease-specific survival rate was 85.7% for operative cases, 77.9% for chemoradiotherapy cases, and 66.7% for radiotherapy cases. In the sixth edition of the UICC staging system, paraglottic space invasion was added as a factor in T3-stage carcinoma. The 3-year disease-specific survival rate was 100% for the cases of paraglottic space invasion, 70.0% for the cases of vocal cord fixation, and 53.6% for the cases of preepiglottic space invasion. These results suggest that the cases of paraglottic space invasion showed a good prognosis, and that laryngeal preservation is indicated.
British Journal of Dermatology
Primary mucinous carcinoma of the skin (PMCS) is a rare cutaneous malignant neoplasm; its regiona... more Primary mucinous carcinoma of the skin (PMCS) is a rare cutaneous malignant neoplasm; its regional node metastasis is also rare. To date, positron emission tomography-computed tomography (PET-CT) is known to be a useful tool for searching for early metastatic lesions in various carcinomas. However, PET-CT is not always specific for head and neck lesions because of physiological uptakes in brain, palatine tonsil, salivary gland, thyroid, and so on. Herein we present two cases of head and neck PMCS in which metastasis was diagnosed accurately by PET-CT. In these cases, nodal uptakes of FDG (Fluor-Deoxy-D-glucose) were histopathologically proved PMCS metastasis verifying the utility of PET-CT in detail. A surgeon was involved in the verification to compare the histopathological manifestations with the imaging results. Histopathologically, 2 of 13 nodes were positive in case 1 and 1 of 41 nodes was positive in case 2. These positive nodes were completely in accordance with FDG uptake fi...
European journal of radiology, Jan 30, 2015
To investigate the diagnostic value of tumor blood flow (TBF) obtained with pseudo-continuous art... more To investigate the diagnostic value of tumor blood flow (TBF) obtained with pseudo-continuous arterial spin labeling (pCASL) for the differentiation of squamous cell carcinoma (SCC) and malignant lymphoma (ML) in the nasal or sinonasal cavity. 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 diagno...
PURPOSE An arterial spin-labeling (ASL) technique can provides functional information in assessin... more PURPOSE An arterial spin-labeling (ASL) technique can provides functional information in assessing various tumors. The aim of this study was to detect the viability change of head and neck cancer by measuring tumor perfusion before and after the treatment. METHOD AND MATERIALS Eighteen patients with head and neck cancer were evaluated by ASL before and after the treatment. Each patient was treated by non-operative treatment (superselective cisplatin infusion with concomitant radiotherapy in 16, systemic chemotherapy in 1, radiotherapy alone in 1). All MR scanning were performed on a 3.0-Tesla unit (Philips, Achieva with 16 channel neurovascular coil). As an ASL sequence, EPI signal targeting by alternating radiofrequency pulses (EPI STAR) with look-locker readout method was used. Before the treatment, tumor blood flow (TBF) was quantitatively measured. After the treatment, tissue blood flow of post-treatment sequelae (BF-PTS) was also quantitatively measured. All patients were obser...
PURPOSE The purpose of this study is to investigate the usefulness of 3-T MR diffusion kurtosis i... more PURPOSE The purpose of this study is to investigate the usefulness of 3-T MR diffusion kurtosis imaging (DKI) for the assessment of patients with head and neck squamous cell carcinoma (HNSCC). METHOD AND MATERIALS Eighteen patients who were histopathologically diagnosed as HNSCC were included in this study. All patients were treated with super-selective arterial infusion of cisplatin with concomitant radiotherapy. TDKhey underwent magnetic resonance imaging (MRI) using DKI sequence before the treatment and at the early treatment period (at time point of 15-25 Gyin total 65 Gy radiotherapy). All MR scanning was performed by using a 3-T unit (Achieva TX; Philips Medical Systems, Best, The Netherlands) with a 16-channel neurovascular coil. DKI was obtained by using single-shot echo planar diffusion weighted imaging with 4 different b values of 0, 800, 1000, 2000s/mm2. Three orthogonal motion probing gradient was used. The quantitativeDK value of the tumor in each of the 18 patients was...
Acta Oto-laryngologica, 2015
Superselective intra-arterial cisplatin infusion with concomitant radiotherapy (RADPLAT) is consi... more 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. To evaluate the efficacy of RADPLAT for patients with ACC of the head and neck. 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). 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.
Iryo Yakugaku (Japanese Journal of Pharmaceutical Health Care and Sciences), 2012
Acta Oto-laryngologica, 2015
Grade ≥ 3 mucositis/stomatitis and inability to feed orally were problematic for patients undergo... more 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. 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. 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. 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).
International Cancer Conference Journal, 2012
ABSTRACT Squamous cell carcinoma of the nasal vestibule (SCC-NV) is rare among head and neck mali... more ABSTRACT 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 neutralize cisplatin toxicity, together with conventional radiotherapy. 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.
Head & neck, Jan 7, 2015
The purpose of this study was to compare the hearing outcomes after surgery with reconstruction o... more 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. 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. 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 + RT (n = 5) groups. Adequate techniques for reconstruction of the external auditory canal in combination with tympanoplasty after complete surgical resection is useful for hearing pre...
Nippon Jibiinkoka Gakkai Kaiho, 2014
JOURNAL OF JAPAN SOCIETY FOR HEAD AND NECK SURGERY, 2011
Nihon Jibiinkoka Gakkai kaiho, 2014
In the case of oropharyngeal carcinoma, patients may present with symptoms similar to cervical ly... more 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 fro...
Auris, nasus, larynx, 2015
We retrospectively assessed the indications for superselective intra-arterial infusion of cisplat... more We retrospectively assessed the indications for superselective intra-arterial infusion of cisplatin with concomitant radiotherapy (RADPLAT) in patients with hypopharyngeal cancer (HPC). Between April 2000 and March 2013, 41 previously untreated patients received superselective intra-arterial infusion of cisplatin (100-120mg/m(2) per week) with simultaneous intravenous infusions of thiosulfate to neutralize cisplatin toxicity and conventional radiotherapy (65-70Gy). 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. Indications for RADPLAT in patients with HPC wer...
JOURNAL OF JAPAN SOCIETY FOR HEAD AND NECK SURGERY, 2012
ABSTRACT We retrospectively analyzed 27 patients with T3 laryngeal carcinoma treated at our depar... more ABSTRACT We retrospectively analyzed 27 patients with T3 laryngeal carcinoma treated at our department from 2004 to 2008. The patients ranged from 38 to 73 years of age (median: 62) and consisted of 24 men and 3 women. Cases included 21 supraglottic and 6 glottic. Of the 27 patients, 7 were treated by total laryngectomy, 14 by chemoradiotherapy and 6 by radiation alone. The 3-year disease-specific survival rate was 85.7% for operative cases, 77.9% for chemoradiotherapy cases, and 66.7% for radiotherapy cases. In the sixth edition of the UICC staging system, paraglottic space invasion was added as a factor in T3-stage carcinoma. The 3-year disease-specific survival rate was 100% for the cases of paraglottic space invasion, 70.0% for the cases of vocal cord fixation, and 53.6% for the cases of preepiglottic space invasion. These results suggest that the cases of paraglottic space invasion showed a good prognosis, and that laryngeal preservation is indicated.
British Journal of Dermatology
Primary mucinous carcinoma of the skin (PMCS) is a rare cutaneous malignant neoplasm; its regiona... more Primary mucinous carcinoma of the skin (PMCS) is a rare cutaneous malignant neoplasm; its regional node metastasis is also rare. To date, positron emission tomography-computed tomography (PET-CT) is known to be a useful tool for searching for early metastatic lesions in various carcinomas. However, PET-CT is not always specific for head and neck lesions because of physiological uptakes in brain, palatine tonsil, salivary gland, thyroid, and so on. Herein we present two cases of head and neck PMCS in which metastasis was diagnosed accurately by PET-CT. In these cases, nodal uptakes of FDG (Fluor-Deoxy-D-glucose) were histopathologically proved PMCS metastasis verifying the utility of PET-CT in detail. A surgeon was involved in the verification to compare the histopathological manifestations with the imaging results. Histopathologically, 2 of 13 nodes were positive in case 1 and 1 of 41 nodes was positive in case 2. These positive nodes were completely in accordance with FDG uptake fi...
European journal of radiology, Jan 30, 2015
To investigate the diagnostic value of tumor blood flow (TBF) obtained with pseudo-continuous art... more To investigate the diagnostic value of tumor blood flow (TBF) obtained with pseudo-continuous arterial spin labeling (pCASL) for the differentiation of squamous cell carcinoma (SCC) and malignant lymphoma (ML) in the nasal or sinonasal cavity. 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 diagno...
PURPOSE An arterial spin-labeling (ASL) technique can provides functional information in assessin... more PURPOSE An arterial spin-labeling (ASL) technique can provides functional information in assessing various tumors. The aim of this study was to detect the viability change of head and neck cancer by measuring tumor perfusion before and after the treatment. METHOD AND MATERIALS Eighteen patients with head and neck cancer were evaluated by ASL before and after the treatment. Each patient was treated by non-operative treatment (superselective cisplatin infusion with concomitant radiotherapy in 16, systemic chemotherapy in 1, radiotherapy alone in 1). All MR scanning were performed on a 3.0-Tesla unit (Philips, Achieva with 16 channel neurovascular coil). As an ASL sequence, EPI signal targeting by alternating radiofrequency pulses (EPI STAR) with look-locker readout method was used. Before the treatment, tumor blood flow (TBF) was quantitatively measured. After the treatment, tissue blood flow of post-treatment sequelae (BF-PTS) was also quantitatively measured. All patients were obser...
PURPOSE The purpose of this study is to investigate the usefulness of 3-T MR diffusion kurtosis i... more PURPOSE The purpose of this study is to investigate the usefulness of 3-T MR diffusion kurtosis imaging (DKI) for the assessment of patients with head and neck squamous cell carcinoma (HNSCC). METHOD AND MATERIALS Eighteen patients who were histopathologically diagnosed as HNSCC were included in this study. All patients were treated with super-selective arterial infusion of cisplatin with concomitant radiotherapy. TDKhey underwent magnetic resonance imaging (MRI) using DKI sequence before the treatment and at the early treatment period (at time point of 15-25 Gyin total 65 Gy radiotherapy). All MR scanning was performed by using a 3-T unit (Achieva TX; Philips Medical Systems, Best, The Netherlands) with a 16-channel neurovascular coil. DKI was obtained by using single-shot echo planar diffusion weighted imaging with 4 different b values of 0, 800, 1000, 2000s/mm2. Three orthogonal motion probing gradient was used. The quantitativeDK value of the tumor in each of the 18 patients was...
Acta Oto-laryngologica, 2015
Superselective intra-arterial cisplatin infusion with concomitant radiotherapy (RADPLAT) is consi... more 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. To evaluate the efficacy of RADPLAT for patients with ACC of the head and neck. 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). 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.
Iryo Yakugaku (Japanese Journal of Pharmaceutical Health Care and Sciences), 2012
Acta Oto-laryngologica, 2015
Grade ≥ 3 mucositis/stomatitis and inability to feed orally were problematic for patients undergo... more 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. 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. 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. 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).