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The objective of this study was to investigate the predictive factors of late cervical lymph node metastasis in patients with tongue cancer, based on the intraoral ultrasonographic (IUS) findings of the primary tongue lesion.Patients with T1/2N0M0 primary tongue cancer (n=106) were examined using IUS between September 2014 and September 2020. The relationships between the incidence of late cervical lymph node metastasis with the longest diameter, thickness, margin type, internal echo intensity, and internal or peripheral vascularity of the tongue lesion on Doppler IUS were assessed.Multivariate analysis indicated that irregular margins of the lesion and the presence of internal echo intensity were significantly related to the incidence of late cervical lymph node metastasis.Irregular margins and internal echo intensity of the tongue cancer lesion assessed using IUS may predict the occurrence of late cervical lymph node metastasis in T1/2N0M0 cases.

It is often challenging to determine the accurate size and shape of oral lesions through computed tomography (CT) or magnetic resonance imaging (MRI) when they are very small or obscured by metallic artifacts, such as dental prostheses. Intraoral ultrasonography (IUS) has been shown to be beneficial in obtaining precise information about total tumor extension, as well as the exact location and guiding the insertion of catheters during interstitial brachytherapy. We evaluated the role of IUS in assessing the clinical outcomes of interstitial brachytherapy with 198Au grains in tongue cancer through a retrospective medical chart review. The data from 45 patients with T1 (n = 21) and T2 (n = 24) tongue cancer, who were mainly treated with 198Au grain implants between January 2005 and April 2019, were included in this study. 198Au grain implantations were carried out, and positioning of the implants was confirmed by IUS, to ensure that 198Au grains were appropriately placed for the deep border of the tongue lesion. The five-year local control rates of T1 and T2 tongue cancers were 95.2% and 95.5%, respectively. We propose that the use of IUS to identify the extent of lesions and the position of implanted grains is effective when performing brachytherapy with 198Au grains.

This study aimed to retrospectively evaluate the radiation dose and complications in soft tissue and mandible caused by 198Au grain brachytherapy alone or the combination with other modalities in patients with the cancer of the floor of the mouth. Twelve patients with T1 (n = 5) and T2 (n = 7) squamous cell carcinoma of the floor of the mouth, who were treated with 198Au grain brachytherapy alone (n = 5) or the combination of external beam radiotherapy (EBRT) and/or chemotherapy and 198Au grain brachytherapy (n = 7) from January 2005 to December 2016, were included. The relationships between the radiation dose and the complications of the soft tissue or mandible were investigated. Seven of 12 patients had died. Of these 7 patients, one with T1 and 2 with T2 had died of the causes related to the cancer of the floor of the mouth. Two with T1 and 2 with T2 had died of other diseases. Two patients had grade 2 complications of the soft tissue and mandible. These patients were treated by the combination of EBRT and/or chemotherapy and 198Au grain brachytherapy and irradiated with 123 or 139 Gy in total dose, respectively. And one of these patients was treated by the chemotherapy in addition to EBRT. Our study showed that the combination of EBRT and 198Au grains brachytherapy for the floor of the mouth cancer patients might be associated with risks of developing complications of soft tissue ulcer and mandibular bone necrosis.

Purpose: The purpose of this study was to investigate the relationship between the visual characteristics of tongue lesion images obtained through intraoral ultrasonographic examination and the occurrence of late cervical lymph node metastasis in patients with tongue cancer. Patients and Methods: This study investigated patients with primary tongue cancer who were examined using intraoral ultrasonography at Hiroshima University Hospital between January 2014 and December 2017. The inclusion criteria were squamous cell carcinoma, curative treatment administration, lateral side of tongue, surgery or brachytherapy alone, no cervical lymph node or distant metastasis as primary treatment, and treatment in our hospital. The exclusion criteria were carcinoma in situ, palliative treatment, dorsum of tongue, and multiple primary cancers. The follow-up period was more than 1 year. The primary endpoint was the occurrence of late cervical lymph node metastasis, and the primary predictor variables were age, gender, longest diameter, thickness, margin or border shapes of the lesion, and treatment methods. The relationship between the occurrence of late cervical lymph node metastasis and the longest diameter, thickness, margin types, and border types as evaluated through intraoral ultrasonography were assessed. The data were collected through a retrospective chart review. Results: Fifty-four patients were included in this study. The analysis indicated that irregular lesion margins were significantly associated with the occurrence of late cervical lymph node metastasis (P < .0001). The cutoff value for late cervical lymph node metastasis was 21.2 mm for the longest diameter and 3.9 mm for the thickness. Conclusions: The results of this study indicates that the irregular lesion margin assessed using intraoral ultrasonography may serve as an effective predictor of late cervical lymph node metastasis in N0 cases. (C) 2020 American Association of Oral and Maxillofacial Surgeons

We investigated treatment outcomes and complications during reirradiation of patients with oral cancers.Six patients who received definitive radiotherapy for oral cancer as the initial treatment and brachytherapy for recurrence were included. Local control and overall survival rates, soft tissue and mandibular complications, and tooth extraction were investigated.The five-year local control and overall survival rates were 83.3% and 100%, respectively. The occurrence rate of grade 2 soft tissue and mandible complications was 33.3%, and the primary sites were the buccal mucosa and the floor of mouth. The positions of the extracted tooth in the two cases were adjacent to the tumor, and one case developed grade 2 complication of the mandible.During recurrence of the buccal mucosa and the floor of mouth cancers, reirradiation should be avoided considering mandibular complications. To avoid reirradiation-related complications, tooth extraction near the radiation field should be avoided.

This study aimed to investigate status of displacement of gold-198 (The present study included 34 patients with oral cancers, who were exclusively treated withOf the 34 patients included in this study,When performing brachytherapy with

This study aimed to retrospectively evaluate the radiation dose and complications in soft tissue and mandible caused byTwelve patients with T1 (n = 5) and T2 (n = 7) squamous cell carcinoma of the floor of the mouth, who were treated withSeven of 12 patients had died. Of these 7 patients, one with T1 and 2 with T2 had died of the causes related to the cancer of the floor of the mouth. Two with T1 and 2 with T2 had died of other diseases. Two patients had grade 2 complications of the soft tissue and mandible. These patients were treated by the combination of EBRT and/or chemotherapy andOur study showed that the combination of EBRT and

Objective: Patients with medication-related osteonecrosis of the jaw (MRONJ) often visit their dentists at advanced stages and subsequently require treatments that greatly affect quality of life. Currently, no clear diagnostic criteria exist to assess MRONJ, and the definitive diagnosis solely relies on clinical bone exposure. This ambiguity leads to a diagnostic delay, complications, and unnecessary burden. This article aims to identify imaging modalities’ usage and findings of MRONJ to provide possible approaches for early detection. Methods: Literature searches were conducted using PubMed, Web of Science, Scopus, and Cochrane Library to review all diagnostic imaging modalities for MRONJ. Results: Panoramic radiography offers a fundamental understanding of the lesions. Imaging findings were comparable between non-exposed and exposed MRONJ, showing osteolysis, osteosclerosis, and thickened lamina dura. Mandibular cortex index Class II could be a potential early MRONJ indicator. While three-dimensional modalities, CT and CBCT, were able to show more features unique to MRONJ such as a solid type periosteal reaction, buccal predominance of cortical perforation, and bone-within-bone appearance. MRI signal intensities of vital bones are hypointense on T1WI and hyperintense on T2WI and STIR when necrotic bone shows hypointensity on all T1WI, T2WI, and STIR. Functional imaging is the most sensitive method but is usually performed in metastasis detection rather than being a diagnostic tool for early MRONJ. Conclusion: Currently, MRONJ-specific imaging features cannot be firmly established. However, the current data are valuable as it may lead to a more efficient diagnostic procedure along with a more suitable selection of imaging modalities.

Objective The aim of the study was to perform a systematic literature search and meta-analysis to reveal the most effective mouthwash for head and neck cancer patients who are experiencing radiation therapy-induced mucositis. Methods Using two electronic databases, a literature search and data interpretation were systematically performed as follows: (i) problem specification, (ii) devising of a literature search plan, (iii) literature search and retrieval of publications, and (iv) meta-analysis and data interpretation. The main problem was specified as follows: what mouthwash is effective in alleviating oral mucositis for head and neck cancer patients who are undergoing radiotherapy? Results The literature search yielded 354 titles and abstracts. After reviewing the extracted literature, 25 publications met the inclusion criteria for this study and 17 of 25 were eventually evaluated in the meta-analysis. Conclusion The results of the meta-analysis indicated that the use of a mouthwash that includes anti-inflammatory properties contributes the most to alleviating oral mucositis in patients who are undergoing radiotherapy to treat head and neck cancer.