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Post-treatment surveillance of patients with squamous cell oropharyngeal carcinoma (SCOPC) consists of routine follow-up visits for 5 years. It has been suggested that this program is inefficient for finding recurrences and increasing survival. The primary study objective was to investigate how recurrences after treatment for SCOPC were detected, i.e., at routine follow-up visits, at patient-initiated visits, or incidentally. The secondary objective was to investigate whether 2-year survival after diagnosis of recurrence depended on the manner of detection.Patients with recurrences from SCOPC between 1988 and 2018 were included. Survival was analysed by the Kaplan-Meier method with log-rank test.A total of 75 patients were included. Almost one-third were alive 2 years after the diagnosis of recurrence. Recurrences were detected at routine follow-up visits in 50.7%, at patient-initiated visits in 42.7% and 6.6% were found incidentally. There was an increased survival in the patient-initiated group, but this was not significant.The majority of recurrences in both groups compared were amenable to curative treatment.

BACKGROUND/AIM Electrochemotherapy (ECT) is a cancer treatment modality where the efficacy of a chemotherapeutic agent is enhanced by an electrical field. It is an established palliative treatment for cutaneous metastases but its role in curative treatment remains mostly undetermined. Studies have previously reported that ECT can be a safe curative treatment in both skin cancer and oral cavity cancer. The primary aim of this case study was to report the long-term results of ECT in curative treatment of four patients with skin or oral cavity cancer. The study also compares two different ECT treatment protocols. PATIENTS AND METHODS Three patients with oral cavity cancer and one patient with skin cancer were included. One patient had a primary oral tongue cancer and the others had persistent/recurrent tumors after previous treatment. They were treated with ECT either as a primary, adjuvant or salvage treatment with curative intent. The median follow-up period was 60 months. RESULTS There was one case of local recurrence after treatment in the follow-up period. In the other three patients, no recurrence was recorded. There was one serious adverse airway event. There was a significant difference in the bleomycin dose between the two studied protocols, especially for large tumors. CONCLUSION ECT can be a safe mono-modality and adjuvant curative treatment in advanced skin cancer and primary and recurrent oral cavity cancer.

Background/aim Electrochemotherapy (ECT) is a predominately palliative treatment for cutaneous metastases where an electric field is used to increase the intracellular accumulation of a chemotherapeutic drug (bleomycin or cisplatin). ECT induces a strong anti-vascular effect and endothelial cells seem especially vulnerable. To date, almost no neurological and/or cerebrovascular complications after ECT treatment have been published. In this paper two such cases are reported. Case report A seizure in a man treated with ECT for a basal cell carcinoma in the temporal region and a fatal ischemic stroke in a woman treated for cutaneous metastases in the neck are reported. In both cases a causal relationship to ECT treatment was strongly suspected. Conclusion ECT in the head and neck can potentially cause severe neurological complications. Ultrasound is recommended for ECT treatment in the neck.

Background and purpose An earlier prospective randomised multicentre study (ARTSCAN) in head and neck cancer patients that compared conventionally fractionated radiotherapy (CF) with accelerated radiotherapy (AF) was inconclusive. In the subgroup of oral cavity squamous cell cancer (OCSCC) a large absolute, but not statistically significant, difference in local control was seen in favour of AF. This difference was more pronounced in resectable tumours. The finding raised the hypothesis that AF could be beneficial for OCSCC patients. In addition, the longstanding controversy on pre- or postoperative radiotherapy was addressed. Materials and methods Patients with OCSCC, judged to withstand and likely benefit from combined therapy, were recruited. Subjects were randomised to either preoperative AF with 43 fractions given as a concomitant boost with two fractions/day to the tumour bearing volume to a total dose of 68 Gy in 4.5 weeks followed by surgery, or primary surgery with postoperative CF, total dose 60 or 66 Gy in 6-7 weeks. For patients whose tumours had high-risk features, 66 Gy and concomitant cisplatin was prescribed. Results 250 patients were randomised. Median follow-up was 5 years for locoregional control (LRC) and 9 years for overall survival (OS). There were no statistically significant differences between the two treatment arms regarding LRC and OS. LRC at five years was 73% (95% CI, 65-82) in preoperative AF and 78% (95% CI, 70-85) in postoperative CF. Toxicity was more pronounced in preoperative AF. Conclusion This study does not support that AF prior to surgery improves outcome in oral cavity cancer compared with postoperative CF.

Background/aim Follow-up after treatment for oral tongue cancer consists of routine follow-up visits for five years. It has been suggested that this program is inefficient for finding recurrences. The primary objective of this study was to investigate how recurrences are detected; at routine follow-up visits, at patient-initiated visits, or incidentally. The secondary objective was to investigate whether the two-year survival after diagnosis of recurrence depended on the manner of detection. Patients and methods Patients with recurrences from oral tongue cancer between 1988 and 2016 were included. Survival was analysed by the Kaplan-Meier method and log-rank test. Results A total of 75 patients were included. In 67% of patients, recurrences were detected at routine follow-up visits, and in 27% at patient-initiated visits. No significant difference in survival between the groups was found (p=0.56). Conclusion The majority of recurrences were detected at routine follow-up visits. Patient-initiated recurrence detection did not lead to increased survival.

The presence of graphite particles in gray cast iron commonly implies a good machinability, especially if compared to common steels. However, increasing industrial demands have resulted in a new interest for high-speed machining of these materials with higher performing tool materials than the traditionally used. Thus, the research presented in this paper focuses on evaluating the active tool wear mechanisms while high-speed machining EN-GJL-250 gray cast iron with pcBN tools with different composition, geometries and edge preparations. In addition to the expected flank and notch wear, formation of MnS, SiO2, and Al2O3 tool protection layers was found on the worn surfaces. Non-chamfered tools exhibited higher tendency towards notching. In general, the tools were found to have a rather small wear land but large edged radius indicating edge rounding being a more accurate wear criterion. (Less)

Electrochemotherapy (ECT) is a cancer treatment modality where the intracellular accumulation of chemotherapeutic agents is enhanced by an applied electrical field.To evaluate the long-term efficacy, safety and functional outcome after ECT treatment in high-risk non-melanoma skin cancer (NMSC) with curative intent.Seven patients with SCC or BCC in the head and neck area were treated with ECT with intratumoral bleomycin administration.Five patients were cured by ECT as a mono-modality treatment after a median 10-year follow-up period. Two patients had recurrences and/or persisting tumors after treatment that required salvage surgery and radiotherapy. In two patients, the eye was spared with no visual impairment. In another patient, full facial nerve function was spared.ECT can be a curative as well as an organ and function-sparing mono modality treatment in high-risk NMSC.Today ECT is mostly used as a palliative treatment. Its curative potential should be further investigated. Randomized studies comparing ECT with standard treatment is needed. Hopefully, this small study can encourage such studies.

Metal matrix composites are the desired materials in aerospace and automotive industries since they possess high specific strength. However addition of reinforcement to the matrix material brings the adverse effects of high wear rate of tool materials used in their machining. The current study addresses the issues of wear and performance of superhard tools when high speed machining cast Al-Si alloy reinforced with particulate SiC (20% vol.). A wide range of developed superhard materials was compared to the commercial PCD tools. Nano grain sized wBN-cBN, binderless cBN; B6O-cBN, nano-diamond with WC binder; diamond/MAX-phase; and diamond/SiC tool materials were employed. Use of nano-diamond/WC and diamond/MAX-phase composites resulted in their rapid deterioration due to primarily adhesive pluck-out of diamond and binder phase. Diamond/SiC material exhibited slightly lower performance than the PCD, with the primary wear being the abrasive on the SiC binder phase. Machining with cBN-based tooling at lower speed lead to formation of stable build-up layer, frequently accompanied by severe seizure of tool and workpiece material. However at speed of 400 m/min the absence of such build-up layer caused rapid tool wear. Presence of chemical and diffusional wear mechanisms for diamond tooling has been confirmed through scanning and transmission electron microscopy. Archard-type model of abrasive tool wear was developed for modelling of tool deterioration for all studied tool materials.

The kinetics of accumulation of protoporphyrin IX (PpIX) after topical application of 5-aminolevulinic acid (ALA) and its methylester (5-aminolevulinic acid methylester [ALA-Me]) was studied on rat oral mucosa. The accumulation of PpIX in mucosa and skin after intravenous injection of ALA and ALA-Me was also studied. The elimination rate of PpIX was dependent on drug and dose as well as on administration route. Application of ALA on rat oral mucosa and skin caused a systemic effect with PpIX building up in remote skin sites not exposed to the drugs. No such systemic effect was seen after application of ALA-Me either in mucosa or on skin. Intravenous injection of the drugs (0.2 g/kg) leads to more fluorescence in the skin than topical application of the drug (20%). For mucosa, the opposite is true. Maximal PpIX fluorescence appeared later after application of high concentrations of the drugs (around 8 h for 5% and 20% wt/wt) than after application of low concentrations (around 3-5 h for 1% and 2% wt/wt).