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Zhang X.,Ganzhou Tumor Hospital | Liu F.,Gannan Medical University | Lan X.,Ganzhou Tumor Hospital | Luo K.,Ganzhou Tumor Hospital | Li S.,Ganzhou Institute of Cancer Research
World Journal of Surgical Oncology | Year: 2014

Background: The growth of aging populations in an increasing number of countries has led to a concomitant increase in the incidence of chronic diseases. Accordingly, the proportion of older aged patients with oral cavity and oropharyngeal cancers and comorbidities has also increased. Thus, improvements must be made in the tolerance and safety of surgical procedures for these patients with complex medical conditions. In this study, we investigated combined submandibular gland flap and sternocleidomastoid musculocutaneous flap for postoperative reconstruction in older aged patients with oral cavity and oropharyngeal cancers in terms of surgical methods, safety, and clinical outcome.Methods: Between January 2011 and May 2012, 8 patients over the age of 65 years (7 men, 1 woman; aged 66 to 75 years (median, 69.6)) with oral cavity and oropharyngeal cancers underwent combined submandibular gland and sternocleidomastoid myocutaneous flaps for postoperative reconstruction at Ganzhou Tumor Hospital. All eight patients had comorbid cardiovascular, cerebrovascular, or chronic respiratory disease or diabetes. Clinical outcomes, complications, and tolerance to surgical treatment were observed.Results: Surgical treatment was successful in all eight patients. All submandibular gland flaps survived with well-mucosalized surfaces and with no complications. During the postoperative follow-up period of 12 to 28 months, no patient developed local recurrence or distant metastasis, and all had good recovery of function and local contour.Conclusions: This combined reconstruction technique enables appropriate restoration of oral function, facial aesthetics and improved quality of life. Further, this technique has several advantages: it is easier to perform, reduces operation time and surgical risk, causes less surgical injury, and has minor impact on contour. The technique provides a new and safe reconstruction option for older aged patients with oral cavity and oropharyngeal cancers. © 2014 Zhang et al.; licensee BioMed Central Ltd. Source


Zhang X.,Tumor Hospital of Ganzhou | Liu F.,Gannan Medical University | Lan X.,Tumor Hospital of Ganzhou | Yu L.,Peking Union Medical College | And 4 more authors.
Radiation Oncology | Year: 2014

Background: The aim of this study was to evaluate the clinical efficacy of submandibular gland transfer for the prevention of xerostomia after radiotherapy for nasopharyngeal carcinoma.Methods: Using the randomized controlled clinical research method, 65 patients with nasopharyngeal carcinoma were randomly divided into an experimental group consisting of 32 patients and a control group consisting of 33 patients. The submandibular glands were averted to the submental region in 32 patients with nasopharyngeal carcinoma before they received conventional radiotherapy; a lead block was used to shield the submental region during therapy. Prior to radiotherapy, the function of the submandibular glands was assessed using imaging. Submandibular gland function was measured using 99mTc radionuclide scanning at 60 months after radiotherapy. The data in the questionnaire regarding the degree of xerostomia were investigated and saliva secretion was measured at 3, 6, 12, and 60 months after radiotherapy. In addition, the 5-year survival rate was calculated.Results: After follow-up for 3, 6, and 12 months, the incidence of moderate to severe xerostomia was significantly lower in the experimental group than in the control group. The average amount of saliva produced by the experimental and control groups was 1.60 g and 0.68 g, respectively (P < 0.001). After follow-up for 60 months, the uptake and secretion functions of the submandibular glands in the experimental group were found to be significantly higher than in the control group (P < 0.001 and P < 0.001, respectively). The incidence of moderate or severe xerostomia was significantly lower than in the control group (15.4% and 76.9%, respectively; P < 0.001). The 5-year survival rates of the experimental group and the control group were 81.3% and 78.8%, respectively, and there was no significant difference between the two groups (P = 0.806).Conclusions: After a 5 year follow-up period involving 32 patients who had their submandibular glands transferred for the prevention of xerostomia after radiotherapy for nasopharyngeal carcinoma, we found that clinical efficacy was good. This approach could improve the quality of life of nasopharyngeal carcinoma patients after radiotherapy and would not affect long-term treatment efficacy. © 2014 Zhang et al.; licensee BioMed Central Ltd. Source


Zhang X.,Tumor Hospital of Ganzhou | Liu F.,Gannan Medical University | Lan X.,Tumor Hospital of Ganzhou | Huang J.,Ganzhou Institute of Cancer Research | And 2 more authors.
Oncology Letters | Year: 2015

If not promptly or properly treated, certain cervical metastatic cancers that develop from unknown primary tumors may rapidly grow into giant tumors that can invade the blood vessels, muscle and skin. The present study examined the feasibility and efficacy of radical neck dissection combined with reconstruction using the pectoralis major myocutaneous flap for the treatment of giant cervical metastatic cancers that have developed from unknown primary tumors and have invaded the skin. A total of 16 patients who met the inclusion criteria were subjected to radical neck dissection to adequately resect invaded skin, and the pectoralis major myocutaneous flap was used to repair the large skin defect created in the cervical region. Following the surgery, the patients received concurrent chemoradiotherapy. The pectoralis major myocutaneous flap survived in all 16 patients, with no cases of flap necrosis. In addition, no post-operative lymphedema, paresthesia or dysfunction of an upper extremity occurred due to the cutting of a pectoralis major muscle. In 9 cases, patients were satisfied with their post-operative shoulder movement at the donor site; in the remaining 7 cases, patients felt greater weakness in this region following surgery relative to prior to surgery. The 14 male patients were generally satisfied with the post-operative appearance of the donor region, whereas the 2 female patients were dissatisfied with the appearance of this region. Follow-up for 6-53 months after the patients were discharged following surgery and chemotherapy revealed that the recurrence of cervical tumors in 6 cases. Overall, radical neck dissection combined with the use of the pectoralis major myocutaneous flap for reconstruction is a feasible approach for the treatment of giant cervical metastatic cancers that have developed from unknown primary tumors and have invaded the skin. Post-operative concurrent chemoradiotherapy should be administered to improve the local control rate and patient quality of life, allowing a satisfactory therapeutic efficacy to be achieved. © 2015, Spandidos Publications. All rights reserved. Source


Li S.,Ganzhou Institute of Cancer Research | Zhang X.,Ganzhou Institute of Cancer Research | Li R.,Ganzhou Institute of Cancer Research | Liu L.,Ganzhou Institute of Cancer Research | And 3 more authors.
Chinese Journal of Clinical Oncology | Year: 2014

Objective: A study was conducted to determine the expression of acetyl-coa carboxylase product of phosphorylation (P-ACC) and an enzyme called cyclooxygenase 2 (COX-2) in non-small cell lung cancer (NSCLC) tissue, as well as the relationship and correlations between tumor size, lymph node metastasis, clinical stage, and pathological type. Methods: Sixty-two patients with NSCLC lung cancer tissues were included in the patient group, whereas 20 patients who underwent lobectomy for other reasons and had normal lung tissues were included in the control group. Immunohistochemical streptavidin peroxidase method was used to detect the expression of P-ACC and COX-2 in lung cancer and normal lung tissues. Results: The positive expressions of P-ACC and COX-2 in NSCLC lung cancer and normal lung tissues were significantly different (P<0.05). In NSCLC tissues, the positive expression of P-ACC was significantly associated with tumor size (P<0.05), but was not significantly associated with lymph node metastasis, clinical stage, and pathological type. We found no correlation between the positive expression of COX-2 and tumor size, lymph node metastasis, clinical stage and pathological type. Further analysis revealed that the positive expression of P-ACC and COX-2 in NSCLC was significantly and negatively correlated (r=-2.37, P=0.032). Conclusion: The positive expression of COX-2 in NSCLC greatly increased compared with that of P-ACC, and a significantly negative correlation was observed between them. We propose that the positive expression of P-ACC reduction may activate the positive expression of COX-2 and promote the occurrence, development, invasion, and metastasis of NSCLC. Source


Li S.-J.,Ganzhou Institute of Cancer Research | Zhang X.-M.,Ganzhou Institute of Cancer Research | Liu L.-B.,Ganzhou Institute of Cancer Research | Zhou M.-H.,Ganzhou Institute of Cancer Research | And 4 more authors.
Chinese Journal of Cancer Prevention and Treatment | Year: 2016

OBJECTIVE: Many results of geophysical chemistry, epidemiology, nutrition, biochemistry, clinical studies and animal experiments have confirmed that the rare earth elements (REEs) were closely related to tumor occurrence, development and treatment. With the development of rare earth utilization, more and more REEs enter the human body through different approaches, and the toxic effects of REEs affected on human health has become a hot topic. In this study, our aim was to detect the REEs contents and distribution characteristics of non-small cell lung cancer (NSCLC) patients and discuss the relevance with tumor size, lymph node metastasis and clinical stage. METHODS: From April 1, 2013 to January 31, 2014, the REEs contents were measured by inductively coupled plasma-mass spectrometry (ICP-MS/MS) in 14 cases with NSCLC in Ganzhou Cancer Hospital, and the REEs contents and distribution were analyzed. RESULTS: The average standard deviation value of REEs in lung cancer was the minimum mostly. Light REEs content was higher than the medium REEs, and medium REEs content was higher than the heavy REEs content. In addition to the Y, Gd elements, the REEs contents of La, Ce, Pr, Nd, Sm, Eu, Dy, Ho, Er in T1-T3 had ascendant trends, the elements of La, Ce, Pr, Nd, Sm, Eu, Dy, Er in which T2-T3 were more higher than the T1-T2. These nine REEs concentrations in T4 were sharply decreased and the contents were more dispersed in T3. The REEs contents of La, Nd, Sm, Dy, Er, Tm, Yb, Lu had ascendant trends in N0-N3 and the distribution characteristics were more dispersed in N3. With the increase of lung cancer staging, the multiple differences in REEs contents were increased and the distribution points were more dispersed, REEs contents in lung cancer was also more disordered. The La, Pr, Nd, Sm, Dy, Er, Tm of REEs contents increased with the clinical stage progress, and these elements were positively correlated with clinical stage. CONCLUSIONS: With the staging of lung cancer increase, REEs contents have ascendant trends, and the REEs contents are more disordered. The La, Pr, Nd, Sm, Dy, Er, Tm of REEs contents is positively correlated with clinical stage. © 2016, Editorial Board of Chinese Journal of Cancer Prevention and Treatment. All right reserved. Source

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