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Background/aim: There are no real-world comparative data of nivolumab doses of 3 mg/kg and 240 mg/body for recurrent/metastatic squamous cell carcinoma of the head and neck (R/M SCCHN). We investigated the efficacy and safety of nivolumab in treating recurrent/metastatic squamous cell carcinoma of the head and neck (R/M SCCHN) at different doses using real-world data., Patients and Methods: R/M SCCHN patients who received nivolumab were divided into the 3 mg/kg and 240 mg/body groups and retrospectively examined for efficacy and safety., Results: A total of 199 patients (3 mg/kg and 240 mg/body, 88 and 111 patients, respectively) were included. The 3 mg/kg vs. 240 mg/body groups had similar overall response rates (15% vs. 25, p=0.15), disease control rates (46% vs. 57%, p=0.15), overall survival (9.5 months vs. 10.9 months), and progression-free survival (3.7 months vs. 3.8 months, p=0.95). The incidence of immune-related adverse events was also similar in both groups., Conclusion: In R/M SCCHN patients, nivolumab showed similar efficacy and safety at doses of 3 mg/kg and 240 mg/body., (Copyright © 2022 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Thanks to the introduction of virtual surgical planning (VSP), mandibular reconstruction using a fibula flap has become simplified, and patient-specific reconstruction is now possible. With a VSP software, surgical "cutting guides" and custom-made titanium plates can be designed to help surgeons. However, they are expensive and require extended periods of time either for prototyping or to acquire the advanced knowledge necessary for operating the VSP software. The aim of this article is to introduce a new easy and low-cost method of surgical planning for mandible reconstruction using a computer-aided design and the syringe-aided manufacturing technique. Simulations of fibula osteotomy are performed using regular and commercially available 10-ml syringes. The syringes are cut into separate segments to fit the defect of the 3-dimensional mandible model and to match the prebent titanium plate. The syringe segments are then connected together 3-dimensionally to confirm that the shape matched both the contour of the defect and the angles of the mandible. The simulated syringe segments are used as cutting guides. Then osteotomies are performed according to the cutting guide to obtain the exact lengths and angles required to achieve precise bony reconstruction. The mandibular reconstruction procedures are successful, with a good match between the preoperative planned syringe models and the final results of the surgery. Although further clinical investigation will be required to confirm its efficacy, the computer-aided design and the syringe-aided manufacturing method has the potential to be a useful technique for mandible reconstruction using a vascularized fibula flap., Competing Interests: Disclosure: The authors have no financial interest to declare in relation to the content of this article, (Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)

An 83-year-old man was admitted to our institution for the purpose of investigation of hoarseness in January 2014. He was diagnosed with cancer in the supraglottis via biopsy while undergoing laryngeal microsurgery. Positron emission tomography (PET)evaluation for tumor staging revealed two hot spots, 1 in the hepatoduodenal ligament and 1 in the pancreas head. Accordingly, the patient was diagnosed with synchronous double cancer in the middle bile duct and the pancreas head. The treatment of the bile duct cancer and pancreatic cancer was performed prior to that of the supraglottic cancer. Curative pancreatoduodenectomy was performed, and the postoperative course was uneventful. Three weeks after the surgery, chemoradiotherapy for the supraglottic lesion was initiated. The tumor almost disappeared 2 months after the start of chemoradiotherapy, as observed by using a laryngoscope. Multidisciplinary therapy based on the therapeutic guidelines for each of the cancers was beneficial for the patient.

The Cigarette-associated diseases will be decreased only by stopping smoking. At a smoking cessation clinic, we evaluated 22 subjects for smoking cessation after a three-month smoking cessation program. The program was completed by 20 subjects, or 90%, of whom 15, or 68%, quit smoking. Varenicline tartrate was used to treat 90% of subject, of whom 8, or 40%, suffered nausea. This was treated using an anti-nausea agent, which relieved symptoms immediately.