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Quality of Life
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CQ1-1 N CT 91
CQ1-2 T MRI 92
CQ1-3 93
CQ1-4 94
CQ1-5 95
CQ1-6 FDG-PET 96
CQ1-7 98
CQ1-8 100
2 102
CQ2-1 102
CQ2-2 104
CQ2-3 106
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CQ2-4 III
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CQ2-5 N1
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CQ2-6 111
CQ2-7 112
CQ2-8 114
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CQ4-3 II 122
CQ4-4 123
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CQ5-1-1 HPV 125
CQ5-1-2 HPV 125
CQ5-1-3 HPV 125
6 127
CQ6-1 127
CQ6-2 128
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CQ7-1 130
CQ7-2 131
CQ7-3 132
8 135
CQ8-1 1 cm 135
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CQ10-2 p16 EBER-ISH 153
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TPF TXTCDDP5-FUTXT
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CQ11-8 PD-1 168
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CQ12-1 170
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CQ12-4 CRT 175
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CQ12-6 178
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1 62018 2 72015 3 Sobin LH, Wittekind ChUICCTNMTNM8
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XUSCTMRICTMRICTMRIMRI1-3
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1 ZupiA,CalifanoL,MaremontiP,etal.Accuracyinthediagnosisofmandibularinvolvementbyoralcancer.JCraniomaxillofacSurg.199624281-4.
2 LeslieA,FyfeE,GuestP,etal.StagingofSquamousCellCarcinomaoftheOralCavityandOrophar-ynxAComparisonofMRIandCTinT-andN-Staging.JComputAssistTomogr.19992343-9.
3 BolzoniA,CappielloJ,PiazzaC,etal.Diagnosticaccuracyofmagneticresonanceimagingintheas-
sessmentofmandibularinvolvementinoral-oropharyngealsquamouscellcarcinomaaprospectivestudy.ArchOtolaryngolHeadNeckSurg.2004130837-43.
4 ParkJS,SonKR,NaDG,etal.Performanceofpreoperativesonographicstagingofpapillarythyroidcarcinomabasedon thesixtheditionof theAJCCUICCTNMclassification system.AJRAmJRoentgenol.200919266-72.
5 SeiberlingKA,DutraJC,GunnJ.Ultrasound-guidedfineneedleaspirationbiopsyofthyroidnodulesperformedintheoffice.Laryngoscope.2008118228-31.
6 CastelijnsJA,GerritsenGJ,KaiserMC,etal.Invasionoflaryngealcartilagebycancercompari-sonofCTandMRimaging.Radiology.1988167199-206.
7 FerriT,DeThomasisG,QuarantaN,etal.ThevalueofCTscansinimprovinglaryngoscopyinpa-tientswithlaryngealcancer.EurArchOtorhinolaryngol.1999256395-9.
8 GironJ,JoffreP,Serres-CousineO,etal.CTandMRevaluationoflaryngealcarcinomas.JOtolaryn-gol.199322284-93.
9 LjumanoviR,LangendijkJA,SchenkB,etal.SupraglotticcarcinomatreatedwithcurativeradiationtherapyidentificationofprognosticgroupswithMRimaging.Radiology.2004232440-8.
10 PhelpsPD.Carcinomaofthelarynxtheroleofimaginginstagingandpre-treatmentassessments.
ClinRadiol.19924677-83. 11 ZbrenP,BeckerM,LangH.Pretherapeuticstagingof laryngealcarcinoma.Clinical findings,com-
putedtomography,andmagneticresonance imagingcomparedwithhistopathology.Cancer.1996771263-73.
12 MutoM,NakaneM,KatadaC,etal.Squamouscellcarcinomainsituatoropharyngealandhypopha-ryngealmucosalsites.Cancer.20041011375-81.
13 MutoM,KatadaC,SanoY,etal.Narrowbandimaginganewdiagnosticapproachtovisualizean-giogenesisinsuperficialneoplasia.ClinGastroenterolHepatol.20053S16-20.
14 XCT199194577-86.
15 StuckensenT,KovcsAF,AdamsS,etal.StagingoftheneckinpatientswithoralcavitysquamouscellcarcinomasaprospectivecomparisonofPET,ultrasound,CTandMRI.JCraniomaxillofacSurg.200028319-24.
16 DietlB,MarienhagenJ,KhnelT,etal.FDG-PETinradiotherapytreatmentplanningofadvancedheadandneckcanceraprospectiveclinicalanalysis.AurisNasusLarynx.200633303-9.
17 GordinA,DaitzchmanM,DoweckI,etal.Fluorodeoxyglucose-positronemissiontomographycom-
putedtomographyimaginginpatientswithcarcinomaofthelarynxdiagnosticaccuracyandimpactonclinicalmanagement.Laryngoscope.2006116273-8.
18 RumboldtZ,GordonL,GordonL,etal.Imaginginheadandneckcancer.CurrTreatOptionsOncol.2006723-34.
19 KyzasPA,EvangelouE,Denaxa-KyzaD,etal.18F-fluorodeoxyglucosepositronemissiontomogra-
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phytoevaluatecervicalnodemetastasesinpatientswithheadandnecksquamouscellcarcinomaaMeta-analysis.JNatlCancerInst.2008100712-20.
20 LiaoLJ,LoWC,HsuWL,etal.DetectionofcervicallymphnodemetastasisinheadandneckcancerpatientswithclinicallyN0neck-ameta-analysiscomparingdifferentimagingmodalities.BMCCan-cer.201212236.
21 FletcherJW,DjulbegovicB,SoaresHP,etal.Recommendationsontheuseof18F-FDGPETinon-cology.JNuclMed.200849480-508.
22 200329526-40.
23 JOHNS1997131281-5.
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1 CDC. Infection Control and Hospital Epidemiology Guideline for Prevention of Surgical Site Infection, 1999.
2 2013 3 42014 4 CDC. Draft Guideline for the Prevention of Surgical Site Infection, 2014. 5
2016
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1 1
CRT
ICTMACH-NC 154.56.52.4-1CRT 2
2
CQ11-2CQ11-1CQ12-1QOLCRT 3,4 258.6
CDDP100mgm 2
3EGFRCmab
CQ11-7-1 5CmabCRT 6
CRTRTRT
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chemoselection
ICTCQ11-8CRTCRPRPRPRCBDCA-RTCmab-RT
CDDP5-FUPFTXTCDDP5-FUTPF 7PFTPF 8TPFTPFCDDP-RT
CRTCRTICT-TPFCRTCRTICTCRT 9
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11PF 12CDDP 100mgm 25-FU 1000mgm 2day45days370805-FUPF 13CmabCDDPPFPFPFCmabQOL 15CDDPCBDCA6coursePt5-FUCmabTPF2
6DOCPTXS-1MTXPD-1DOCMTXCmab 16 17CQ11-8immune-related adverse eventirAE 18
1 Pignon JP, Bourhis J, Domenge C, et al. Chemotherapy added to locoregional treatment for head and neck squamous-cell carcionomathree meta-analysis of updated individual data. Lancet. 2000355949-55.
2 Pignon JP, Aurlie Al, Maillard E, et al. Meta-analysis of chemotherapy in head and neck cancerMACH-NCan update 93 randomized trials and 17,346 patients. Radiotherapy and Oncology. 2009924-14.
3 Lin S, Tham IW, Pan J, et al. Combined high-dose radiation therapy and systemic chemotherapy improves survival in patients with newly diagnosed metastatic nasopharyngeal cancer. Am J Clin Oncol. 201235474-9.
4 Chen MY, Jiang R, Guo L, et al. Locoregional radiotherapy in patients with distant metastasis of nasopharyngeal carcinoma at diagnosis. Chin J Cancer. 201332604-13.
5 Bonner JA, Harari PM, Giralt J, et al. Radiotherapy plus cetuximab for squamous-cell carcinoma of the head and neck N Engl J Med. 200635456778.
6 Ang KK, Zhang Q, Rosenthal DI, et al. Randomized phase trial of concurrent accelerated radiation plus cisplatin with or without cetuximab for stage to head and neck carcinomaRTOG 0522. J
009592-01_GL_03_A-01-06_DIC95_.indd 6 17/09/25 19:33
24/181
-
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Clin Oncol. 2014322940-50. 7 Janoray G, Pointreau Y, Garaud P, et al. Long-term results of a multicenter randomized phase trial
of induction chemotherapy with cisplatin, 5-fluorouracil, -docetaxel for larynx preservation. J Natl Cancer Inst. 20151084. piidjv368.
8 Blanchard P, Bourhis J, Lacas B, et al. Taxane-cisplatin-fluorouracil as induction chemotherapy in locally advanced head and neck cancersan individual patients data meta-analysis of the meta-analysis of chemotherapy in head and neck cancer group. J Clin Oncol. 2013312854-60.
9 Budach W, Blke E, Kammers K, et al. Induction chemotherapy followed by concurrent radio-chemotherapy versus radio-chemotherapy alone as treatment of locally advanced squamous cell carcinoma of the head and neckHNSCCa meta-analysis of randomized trials. Radiotherapy and Oncology. 2016118238-43.
10 Zhong L, Zhang C, Ren G, et al. Randomized phase trial of induction chemotherapy with docetaxel, cisplatin, and fluorouracil followed by surgery versus up-front surgery in locally advanced resectable oral squamous cell carcinoma. J Clin Oncol. 201231744-51.
11 Morton RP, Rugman F, Droman EB, et al. Cisplatinum and bleomycin for advanced or recurrent squamous cell carcinoma of the head and necka randomised factorial phase controlled trial. Cancer chemotherapy and pharmacology. 198515283-289.
12 Kish JA, Weaver A, Jacob J, et al. Cisplatin and 5-fuluorouracil infusion in patients with recurrent and disseminated epidermoid cancer of the head and neck. Cancer. 1984531819-24.
13 Gibson MK, Li Y, Murphy B, et al. Randomized Phase evaluation of cisplatin plus fluorouracil versus cisplatin plus paclitaxel in advanced head and neck cancerE1395an intergroup trial of the Eastern Cooperative Oncology Group. J Clin Oncol. 2005233562-67.
14 Vermorken J, Mesia R, Rivera F, et al. Platinum-based chemotherapy plus cetuximab in head and neck cancer. N Engl J Med. 20083591116-27.
15 Yoshino T, Hasegawa Y, Takahashi S, et al. Platinum-based chemotherapy plus cetuximab for the first-line treatment of Japanese patients with recurrent andor metastatic squamous cell carcinoma of the head and neckresults of a phase study trial. Jpn J Clin Oncol. 201343524-31.
16 Ferris RL, Blumenschen G, Fayette J, et al. Nivolumab for recurrent squamous-cell carcinoma of the
head and neck. N Engl J Med. 20163751856-67. 17 NCCN Clinical Practice Guideline in Oncology Head and Neck Cancers Version 2. 2017. httpswww.
nccn.orgprofessionalsphysician_glspdfhead-and-neck18 2017
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QOL
1 Withers HR, Taylor JM, Maciejewski B. The hazard of accelerated tumor clonogen repopulation during radiotherapy. Acta Oncol. 198827131-46.
2 Bourhis J, Overgaard J, Audry H, et al. Hyperfractionated or accelerated radiotherapy in head and neck cancera meta-analysis. Lancet. 2006368843-54.
3 Nguyen-Tan PF, Zhang Q, Ang KK, et al. Randomized phase trial to test accelerated versus standard fractionation in combination with concurrent cisplatin for head and neck carcinomas in the Radiation Therapy Oncology Group 0129 triallong-term report of efficacy and toxicity. Journal of clinical oncologyofficial journal of the American Society of Clinical Oncology. 2014323858-66.
4 Marta GN, Silva V, de Andrade Carvalho H, et al. Intensity-modulated radiation therapy for head and neck cancersystematic review and meta-analysis. Radiotherapy and oncologyjournal of the European Society for Therapeutic Radiology and Oncology. 20141109-15.
5 Tribius S, Bergelt C. Intensity-modulated radiotherapy versus conventional and 3D conformal radiotherapy in patients with head and neck canceris there a worthwhile quality of life gain? Cancer treatment reviews. 201137511-9.
6 Klein J, Livergant J, Ringash J. Health related quality of life in head and neck cancer treated with radiation therapy with or without chemotherapya systematic review. Oral Oncol. 201450254-62.
7 Lohia S, Rajapurkar M, Nguyen SA, et al. A comparison of outcomes using intensity-modulated radiation therapy and 3-dimensional conformal radiation therapy in treatment of oropharyngeal cancer. JAMA Otolaryngol Head Neck Surg. 2014140331-7.
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CTCAE v4.03MedDRA v12.0MedDRAJ v19.0httpwww.jcog.jpdoctortoolCTCAEv4J_20160310.pdf
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1 Navari RM, Qin R, Ruddy KJ, et al. Olanzapine for the Prevention of Chemotherapy-Induced Nausea and Vomiting. The New England journal of medicine. 2016375134-42.
2 Zenda S, Matsuura K, Tachibana H, et al. Multicenter phase study of an opioid-based pain control program for head and neck cancer patients receiving chemoradiotherapy. Radiotherapy and oncolo-gyjournal of the European Society for Therapeutic Radiology and Oncology. 2011101410-4.
3 Hofheinz RD, Deplanque G, Komatsu Y, et al. Recommendations for the Prophylactic Management of Skin Reactions Induced by Epidermal Growth Factor Receptor Inhibitors in Patients With Solid Tu-mors. The oncologist. 2016211483-91.
4 Zenda S, Ishi S, Kawashima M, et al. A Dermatitis Control ProgramDeCoPfor head and neck can-cer patients receiving radiotherapya prospective phase study. International journal of clinical oncology. 201318350-5.
5 Winter GD. Formation of the scab and the rate of epithelization of superficial wounds in the skin of the young domestic pig. Nature. 1962193293-4.
6 Zenda S, Ishi S, Akimoto T, et al. DeCoP, a Dermatitis Control Program using a moderately absorbent surgical pad for head and neck cancer patients receiving radiotherapya retrospective analysis. Jap-anese journal of clinical oncology. 201545433-8.
7 Bostrom A, Lindman H, Swartling C, et al. Potent corticosteroid creammometasone furoatesignifi-cantly reduces acute radiation dermatitisresults from a double-blind, randomized study. Radiother-apy and oncologyjournal of the European Society for Therapeutic Radiology and Oncology. 200159257-65.
8 Shukla PN, Gairola M, Mohanti BK, et al. Prophylactic beclomethasone spray to the skin during post-operative radiotherapy of carcinoma breasta prospective randomized study. Indian journal of can-cer 200643180-4.
9 Miller RC, Schwartz DJ, Sloan JA, et al. Mometasone furoate effect on acute skin toxicity in breast cancer patients receiving radiotherapya phase double-blind, randomized trial from the North Central Cancer Treatment Group N06C4. International journal of radiation oncology, biology, physics, 2011791460-6.
10 Elting LS, Cooksley C, Chambers M, et al. The burdens of cancer therapy. Clinical and economic out-comes of chemotherapy-induced mucositis. Cancer. 2003981531-9.
11 Nabil S, Samman N. Risk factors for osteoradionecrosis after head and neck radiationa systematic review. Oral surgery, oral medicine, oral pathology and oral radiology. 201211354-69.
12 Yokota T, Tachibana H, Konishi T, et al. Multicenter phase study of an oral care program for pa-tients with head and neck cancer receiving chemoradiotherapy. Supportive care in cancerofficial journal of the Multinational Association of Supportive Care in Cancer. 2016243029-36.
13 20162016
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1 12
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1 ADLQOL B
2 B
3 B
4 C1
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6 C1
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1 2011pp23-37
2 Dietz JH. Rehabilitation oncology, John Wiley Sons, New York, USA, 1981 3
2013. 4 CAREERhttpwww.lpc.or.jpreha2015430 5
2011pp68-87. 6 Dejonckere PH, Hordijk GJ. Prognostic factors for swallowing after treatment of head and neck
cancer. Clin Otolaryngol Allied Sci. 199823218-23. 7 Suarez-Cunqueiro MM, Schramm A, Schoen R, et al. Speech and swallowing impairment after
treatment for oral and oropharyngeal cancer. Arch Otolaryngol Head Neck Surg. 20081341299-304.
8 de Carvalho-Teles V, Sennes LU, Gielow I. Speech evaluation after palatal augmentation in patients undergoing glossectomy. Arch Otolaryngol Head Neck Surg. 20081341066-70.
9 Hillman RE, Walsh MJ, Wolf GT, et al. Functional outcomes following treatment for advanced laryngeal cancer. Part --Voice preservation in advanced laryngeal cancer. Part --Laryngectomy rehabilitationthe state of the art in the VA System. Research Speech-Language Pathologists. Department of Veterans Affairs Laryngeal Cancer Study Group. Ann Otol Rhinol Laryngol Suppl. 19981721-27.
10 Finizia C, Bergman B. Health-related quality of life in patients with laryngeal cancera post-treatment comparison of different modes of communication. Laryngoscope. 2001111918-23.
11 Hybasek I. Surgical substitution of glottis after total laryngectomy. Sb Ved Pr Lek Fak Karlovy Univerzity Hradci Kralove. 198124325-9.
12 Mehta AR, Sarkar S, Mehta SA, et al. The Indian experience with immediate tracheoesophageal puncture for voice restoration. Eur Arch Otorhinolaryngol. 1995252209-14.
13 Terada T, Saeki N, Toh K, et al. Voice rehabilitation with Provox2 voice prosthesis following total laryngectomy for laryngeal and hypopharyngeal carcinoma. Auris Nasus Larynx. 20073465-71.
14 Voice prosthesis20096016-22.
15 FRONTIER2015346-9
16 Lazarus CL, Logemann JA, Pauloski BR, et al. Swallowing disorders in head and neck cancer patients treated with radiotherapy and adjuvant chemotherapy. Laryngoscope. 19961061157-66.
17 Bleier BS, Levine MS, Mick R, et al. Dysphagia after chemoradiationanalysis by modified barium swallow. Ann Otol Rhinol Laryngol. 2007116837-41.
18 Nguyen NP, Moltz CC, Frank C, et alDysphagia following chemoradiation for locally advanced head and neck cancer. Ann Oncol. 200415383-8.
19 Salerno G, Cavaliere M, Foglia A, et alThe 11 th nerve syndrome in functional neck dissection. Laryngoscope. 20021121299-307.
20 McNeely ML, Parliament MB, Seikaly H, et al. Effect of exercise on upper extremity pain and dysfunction in head and neck cancer survivorsa randomized controlled trial. Cancer. 2008113214-22.
21 20083467-70.
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1 World Health Organization. Definition of palliative care. GenevaWHO, 2002. www.who.intcancerpalliativedefinitionen. last accessed Apr.29, 2017.
2 Temel JS, Greer JA, Muzikansky A, et al. Early palliative care for patients with metastatic non-small-cell lung cancer. N Engl J Med. 2010363733-42.
3 Yoong J, Park ER, Greer JA, et al. Early palliative care in advanced lung cancera qualitative study. JAMA Intern Med. 2013173283-90.
4 Hui D, Mori M, Watanabe SM, et al. Referral criteria for outpatient specialty palliative cancer carean international consensus. Lancet Oncol. 201617e552-9.
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-B-11
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TX T0 Tis T1 2cm5mm
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N2a3cm6cm
N2b6cmN2c6cm
009592-01_GL_03_B-01-09_DIC95_.indd 1 17/09/25 19:34
45/181
-
2
N3a6cmN3b
M
M0 M1
0 Tis N0 M0 T1 N0 M0 T2 N0 M0 T3 N0 M0 T1T2T3 N1 M0A T4a N0N1 M0 T1T2T3T4a N2 M0B T N3 M0 T4b N M0C T N M1
009592-01_GL_03_B-01-09_DIC95_.indd 2 17/09/25 19:34
46/181
-
-B-13
2
T1T2
N0
N
T3
N0
N
T4
N0
N
CQ11-4
T1T2T31-4CQ2-1
5-10CQ2-2CQ2-311,12CQ2-4
009592-01_GL_03_B-01-09_DIC95_.indd 3 17/09/25 19:34
47/181
-
4
CQ2-6
1 NakagawaT,ShibuyaH,YoshimuraR,etal.Necknodemetastasisaftersuccessfulbrachytherapyforearlystagetonguecarcinoma.RadiotherOncol.200368129-35.
2 OotaS,ShibuyaH,YoshimuraR,etal.Brachytherapyofstagemobiletonguecarcinoma.PredictionoflocalcontrolandQOL.RadiatOncol.2006121.
3 200247741-9
4 InoueTa,InoueTo,YoshidaK,etal.Phasetrialofhigh-vs.low-dose-rateinterstitialradiotherapyforearlymobiletonguecancer.IntJRadiatOncolBiolPhys.200151171-5.
5 274200430550-7
6 200531536-40
7 20041473-9
8 124200496317-22 9 T2-T4N0200248
Suppl.1S25-32 10 LimSC,ZhangS,IshiiG,etal.Predictivemarkersforlatecervicalmetastasisinstageandinva-
sivesquamouscellcarcinomaoftheoraltongue.ClinCancerRes.2004101Pt1166-72. 11 KimataY,UchiyamaK,EbiharaS,etal.Postoperativecomplicationsandfunctionalresultsaftertotal
glossectomywithmicrovascularreconstruction.PlastReconstrSurg.20001061028-35.12
19866964-72
009592-01_GL_03_B-01-09_DIC95_.indd 4 17/09/25 19:34
48/181
-
-B-25
-B-2
1 T
TX T0 Tis T1 T2
T3
T4a
T4b
V2
N
NX N0 N1 3cmN2
N2a3cm6cm
N2b6cmN2c 6cmN3a 6cmN3b
009592-01_GL_03_B-01-09_DIC95_.indd 5 17/09/25 19:34
49/181
-
6
M
M0 M1
0 Tis N0 M0 T1 N0 M0 T2 N0 M0 T3 N0 M0 T1T2T3 N1 M0A T1T2T3 N2 M0 T4a N0N1N2 M0B T4b N M0 T N3 M0C T N M1
009592-01_GL_03_B-01-09_DIC95_.indd 6 17/09/25 19:34
50/181
-
-B-27
2
T1
N0
N
T2
N0
N
T3
N0
N
T4a
N0
N
6070Gy303567
1-56intensitymodulatedradiotherapyIMRTCQ11-5
009592-01_GL_03_B-01-09_DIC95_.indd 7 17/09/25 19:34
51/181
-
8
CQ3-17-910
CQ3-2
1 199194214-24
2 200349145-7 3 DulguerovP,JacobsenMS,AllalAS,etal.Nasalandparanasalsinuscarcinomaarewemaking
progress Aseriesof220patientsandasystematicreview.Cancer.2001923012-29. 4 200147233-5 5 NibuK,SugasawaM,AsaiM,etal.Resultsofmultimodalitytherapyforsquamouscellcarcinomaof
maxillarysinus.Cancer.2002941476-82. 6 KawashimaM,OginoT,HayashiR,etal. Influenceofpostsurgicalresidual tumorvolumeon local
controlinradiotherapyformaxillarysinuscancer.JpnJClinOncol.200131195-202. 7 19711786-99 8 SatoY,MoritaM,TakahashiHO,etal.Combinedsurgery,radiotherapy,andregionalchemotherapy
incarcinomaoftheparanasalsinuses.Cancer.197025571-9. 9 ItamiJ,UnoT,ArugaM,etal.Squamouscellcarcinomaofthemaxillarysinustreatedwithradiation
therapyandconservativesurgery.Cancer.199882104-7. 10
200127142-7
009592-01_GL_03_B-01-09_DIC95_.indd 8 17/09/25 19:34
52/181
-
-B-39
-B-3
1 T
TX T0 Tis T1
T2
T3 T4
N
NX N0 N1
6cmN2 6cmN3 6cm
M
M0 M1
0 Tis N0 M0 T1 N0 M0 T1 N1 M0
009592-01_GL_03_B-01-09_DIC95_.indd 9 17/09/25 19:34
53/181
-
10
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2
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2
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4 CQ4-2
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-A
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009592-01_GL_03_B-01-09_DIC95_.indd 10 17/09/25 19:34
54/181
-
-B-311
IMRT1,2CTMRIPETPET-CT
3-7CQ4-14
8
1 PowEH,KwongDL,McMillanAS,etal.Xerostomiaandqualityoflifeafterintensity-modulatedra-diotherapyvs.conventionalradiotherapyforearly-stagenasopharyngealcarcinomainitialreportonarandomizedcontrolledclinicaltrial.IntJRadiatOncolBiolPhys.200666981-91.
2 KamMK,LeungSF,ZeeB,etal.Prospectiverandomizedstudyofintensity-modulatedradiotherapyonsalivaryglandfunctioninearly-stagenasopharyngealcarcinomapatients.JClinOncol.2007254873-9.
3 LangendijkJA,LeemansCR,ButerJ,etal.Theadditionalvalueofchemotherapytoradiotherapyinlocallyadvancednasopharyngealcarcinomaameta-analysisofthepublishedliterature.JClinOncol.2004224604-12.
4 BaujatB,AudryH,BourhisJ,etal.Chemotherapyinlocallyadvancednasopharyngealcarcinomaanindividualpatientdatameta-analysisofeightrandomizedtrialsand1753patients.IntJRadiatOn-colBiolPhys.20066447-56.
5 ZhangL,ZhaoC,GhimireB,etal.Theroleofconcurrentchemoradiotherapyinthetreatmentoflo-coregionallyadvancednasopharyngealcarcinomaamongendemicpopulationameta-analysisofthephaserandomizedtrials.BMCCancer.201010558.
6 ChenL,HuCS,ChenXZ,etal.Concurrentchemoradiotherapyplusadjuvantchemotherapyversusconcurrentchemoradiotherapyaloneinpatientswithlocoregionallyadvancednasopharyngealcarci-nomaaphase3multicentrerandomisedcontrolledtrial.LancetOncol.201213163-71.
7 ChenQY,WenYF,GuoL,etal.Concurrentchemoradiotherapyvsradiotherapyaloneinstagena-
sopharyngealcarcinomaphaserandomizedtrial.JNatlCancerInst.20111031761-70. 8 WeiWI.Cancerofthenasopharynxfunctionalsurgicalsalvage.WorldJSurg.200327844-8.
009592-01_GL_03_B-01-09_DIC95_.indd 11 17/09/25 19:34
55/181
-
12
-B-4
1 T
p16TX T0 Tis T1 2cmT2 2cm4cmT3 4cmT4a /
T4b
p16TX T0 Tis T1 2cmT2 2cm4cmT3 4cmT4 /
009592-01_GL_03_B-01-09_DIC95_.indd 12 17/09/25 19:34
56/181
-
-B-413
N
p16NX N0 N1 3cmN2
N2a3cm6cm
N2b6cmN2c6cm
N3a 6cmN3b
p16NX N0 N1 6cmN2 6cmN3 6cm
M
M0 M1
p160 Tis N0 M0 T1 N0 M0 T2 N0 M0 T3 N0 M0 T1T2T3 N1 M0
009592-01_GL_03_B-01-09_DIC95_.indd 13 17/09/25 19:34
57/181
-
14
A T1T2T3 N2 M0 T4a N0N1N2 M0B T4b N M0 T N3 M0C T N M1p16
0 Tis N0 M0 T1T2 N0N1 M0 T1T2 N2 M0 T3 N0N1N2 M0 T1T2T3 N3 M0 T4 N M0 T N M1
2
T1
N0
N
TN
T
N
009592-01_GL_03_B-01-09_DIC95_.indd 14 17/09/25 19:34
58/181
-
-B-415
T2
N0
N
TN
T
N
T
N
T3T4
N0
N
TN
1HPVHPV1,2TNMUICC/AJCC82017HPVp16HPVp16HPVN
HPVp16HPV3,4
009592-01_GL_03_B-01-09_DIC95_.indd 15 17/09/25 19:34
59/181
-
16
CQ5-1
4050Gy
6070Gy3035675HPV6,7
T12
8HPV3,4pull throughlevel9,1011
HPV3,4
1 AngKK,HarrisJ,WheelerR,etal.Humanpapillomavirusandsurvivalofpatientswithoropharyn-gealcancer.NEnglJMed.201036324-35.
2 HorneZD,GlaserSM,VargoJA,etal.Confirmationofproposedhumanpapillomavirusrisk-adaptedstagingaccording toAJCCUICCTNMcriteria forpositiveoropharyngeal carcinomas.Cancer.2016122132021-30.
3 MastersonL,MoualedD,LiuZW,etal.De-escalationtreatmentprotocols forhumanpapillomavi-rus-associatedoropharyngealsquamouscellcarcinomaasystematicreviewandmeta-analysisofcurrentclinicaltrials.EurJCancer.2014502636-48.
4 MirghaniH,AmenF,BlanchardP,etal.Treatmentde-escalation inHPV-positiveoropharyngealcarcinomaongoingtrials,criticalissuesandperspectives.IntJCancer.13671494-503,2015
009592-01_GL_03_B-01-09_DIC95_.indd 16 17/09/25 19:34
60/181
-
-B-417
5 PignonJP,BourhisJ,DomengeC,etal.Chemotherapyaddedtolocoregionaltreatmentforheadand
necksquamous-cellcarcinomathreemeta-analysesofupdatedindividualdata.Lancet2000355949-55.
6 BernierJ,CooperJS,PajakTF,etal.Definingrisk levels in locallyadvancedheadandneckcan-cersacomparativeanalysisofconcurrentpostoperativeradiationpluschemotherapytrialsof theEORTC#22931andRTOG#9501.HeadNeck.200527843-50.
7 CooperJS,PajakTF,ForastiereAA,etalRadiationTherapyOncologyGroup9501Intergroup.Postoperativeconcurrentradiotherapyandchemotherapyforhigh-risksquamous-cellcarcinomaoftheheadandneck.NEnglJMed.20043501937-44.
8 AdelsteinDJ,RidgeJA,BrizelDM,etal.TransoralresectionofpharyngealcancerSummaryofaNationalCancerInstituteHeadandNeckCancerSteeringCommitteeClinicalTrialsPlanningMeet-ing,November6-7,2011,Arlington,Virginia.HeadNeck.2012341681-703
9 10-712pp220-62000 b
10 LimYC,KooBS,LeeJS,etal.Distributionsofcervicallymphnodemetastasesinoropharyngealcarci-nomatherapeuticimplicationsfortheN0neck.Laryngoscope.20061161148-52. b
11 KimataY,UchiyamaK,SakurabaM,etal.Velopharyngeal functionaftermicrosurgicalreconstruc-tionoflateralandsuperiororopharyngealdefects.Laryngoscope.20021121037-42.
009592-01_GL_03_B-01-09_DIC95_.indd 17 17/09/25 19:34
61/181
-
18
-B-5
1 T
TX T0 Tis T1 12cmT2 1
2cm4cmT3 4cmT4a
T4b
N
NX N0 N1 3cmN2
N2a3cm6cm
N2b6cmN2c6cm
N3a 6cmN3b
009592-01_GL_03_B-01-09_DIC95_.indd 18 17/09/25 19:34
62/181
-
-B-519
M
M0 M1
0 Tis N0 M0 T1 N0 M0 T2 N0 M0 T3 N0 M0 T1T2T3 N1 M0A T1T2T3 N2 M0 T4a N0N1N2 M0B T4b N M0 T N3 M0C T N M1
2
T1
N0
N
009592-01_GL_03_B-01-09_DIC95_.indd 19 17/09/25 19:34
63/181
-
20
T2
N0
N
T3
p.
T4a
p.
009592-01_GL_03_B-01-09_DIC95_.indd 20 17/09/25 19:34
64/181
-
-B-521
CQ11-4
CQ6-1CQ6-2QOL
6070Gy303567
T121,23,4
5-910-1213-1516
009592-01_GL_03_B-01-09_DIC95_.indd 21 17/09/25 19:34
65/181
-
22
17-20CQ11-13
1 VandenbrouckC,EschwegeF,DelaRochefordiereA,etal.Squamouscellcarcinomaofthepyriformsinusretrospectivestudyof351casesattheInstitutGustave-Roussy.HeadNeckSurg.1987104-13.
2 GardenAS,MorisonWH,ClaymanGL,etal.Earlysquamouscellcarcinomaofthehypopharynxoutcomesoftreatmentwithradiationalonetotheprimarydisease.HeadNeck.199618317-22.
3
1999104-10. 4 PignonJP,BourhisJ,DomengeC,etal.Chemotherapyaddedtolocoregionaltreatmentforheadand
neck squamous-cell carcinomathreemeta-analyses of updated individual data.MACH-NCCollaborativeGroup.Meta-AnalysisofChemotherapyonHeadandNeckCancer.Lancet.2000355949-55.
5 NakatsukaT,HariiK,UedaK,etal.Preservationofthelarynxafterresectionofacarcinomaoftheposteriorwallofthehypopharynxversatilityofafreeflappatchgraft.HeadNeck.199719137-42.
6 LaccourreyeO,Mrite-DrancyA,BrasnuD, et al. Supracricoidhemilaryngopharyngectomy inselectedpyriformsinuscarcinomastagedasT2.Laryngoscope.19931031373-9.
7 NakayamaM,TakahashiH,YaoK,etal.Limitedsurgeryforcancerofthelarynxandhypopharynxoptionsandconsequences.ActaOtolaryngolSuppl.200254741-5.
8 JOHNS1999151227-9. 9 -1996501975-83. 10 TimonCV,TonerM,ConlonBJ.Paratracheal lymphnode involvement inadvancedcancerof the
larynx,hypopharynx,andcervicalesophagus.Laryngoscope.20031131595-9. 11 SpauldingCA,HahnSS,ConstableWC.Theeffectivenessoftreatmentoflymphnodesincancersof
thepyriformsinusandsupraglottis.IntJRadiatOncolBiolPhys.198713963-8. 12 BillersHF,DavisWH,Ogura JH.Delayedcontralateral cervicalmetastaseswith laryngeal and
laryngopharyngealcancers.Laryngoscope.1971811499-502. 13 MutoM,NakaneM,KatadaC, et al. Squamous cell carcinoma in situ at oropharyngeal and
hypopharyngealmucosalsites.Cancer.20041011375-81. 14 MutoM,KatadaC,SanoY,etal.Narrowband imaginganewdiagnosticapproach tovisualize
angiogenesisinsuperficialneoplasia.ClinGastroenterolHepatol.20053S16-20. 15 -ELPS
2006109581-6. 16 ShiotaniA,TomifujiM,ArakiK,etal.Videolaryngoscopictransoralenblocresectionofsupraglottic
andhypopharyngealcancersusing laparoscopicsurgical instruments.AnnOtolRhinolLaryngol.2010119225-32.
17 Lefebvre JL,ChevalierD,LuboinskiB, et al. Larynxpreservation inpyriformsinus cancerpreliminaryresultsofaEuropeanOrganizationforResearchandTreatmentofCancerphasetrial.EORTCHeadandNeckCancerCooperativeGroup.JNatlCancerInst.199688890-9.
18 BeauvillianC,MahM,BourdinS,etal.Finalresultsofarandomizedtrialcomparingchemotherapyplusradiotherapywithchemotherapyplussurgeryplusradiotherapyinlocallyadvancedresectablehypopharyngealcarcinomas.Laryngoscope.1997107648-53.
009592-01_GL_03_B-01-09_DIC95_.indd 22 17/09/25 19:34
66/181
-
-B-523
19 TheDepartmentofVeteransAffairsLaryngealCancerStudyGroup. Inductionchemotherapyplusradiationcomparedwithsurgeryplusradiationinpatientswithadvancedlaryngealcancer.NEnglMed.19913241685-90.
20 BonnerJA,HarariPM,GiraltJ,etal.Radiotherapypluscetuximabforsquamous-cellcarcinomaoftheheadandneck.NEnglJMed.2006354567-78.
009592-01_GL_03_B-01-09_DIC95_.indd 23 17/09/25 19:34
67/181
-
24
-B-6
1 T
TX T0 Tis
T1 1T2 2
T3
T4a
T4b
T1
T1a T1b
T2
T3
T4a
T4b
009592-01_GL_03_B-01-09_DIC95_.indd 24 17/09/25 19:34
68/181
-
-B-625
T1 T2 T3 T4a
T4b
N
NX N0 N1 3cmN2
N2a3cm6cm
N2b6cmN2c6cm
N3a 6cmN3b
M
M0 M1
0 Tis N0 M0 T1 N0 M0 T2 N0 M0 T3 N0 M0 T1T2T3 N1 M0
009592-01_GL_03_B-01-09_DIC95_.indd 25 17/09/25 19:34
69/181
-
26
A T4a N0N1 M0 T1T2T3T4a N2 M0B T4b N M0 T N3 M0C T N M1
2
Tis
T
N
T1
N0
N
1
1
1
1
1
TN
009592-01_GL_03_B-01-09_DIC95_.indd 26 17/09/25 19:34
70/181
-
-B-627
T
N
T2
N0
N
1
1
1
1
TN
1
T3
N0
N
1
1
T4a, N03
009592-01_GL_03_B-01-09_DIC95_.indd 27 17/09/25 19:34
71/181
-
28
1
2CQ11-4
1CQ7-1
X46MV3
212Gy5T160
66Gy3033T270Gy352-42T21
56
78
009592-01_GL_03_B-01-09_DIC95_.indd 28 17/09/25 19:34
72/181
-
-B-629
9-11CQ7-112-18CQ7-2T4a19,2021-23
CQ11-3
1 PfisterDG,LaurieSA,WeinsteainGS,etal.AmericanSocietyofClinicalOncologyclinicalpracticeguideline fortheuseof larynx-preservationstrategies inthetreatmentof laryngealcancer.JClinOncol.2006243693-704.
2 201642016113-8.
3 MendenhallWM,ParisonJT,StringerSP,etal.T1-T2vocalcordcarcinomaabasisforcomparingtheresultsofradiotherapyandsurgery.HeadNeckSurg198810373-7.
4 InoueT,InoueT,IkedaH,etal.Prognosticfactoroftelecobalttherapyforearlyglottiscarcinoma.Cancer.1992702797-801.
5 ForastiereAA,GopfertH,MaorMH,etal.Concurrentchemotherapyandradiotherapy fororganpreservationinadvancedlaryngealcancer.NEnglJMed.20033492091-8.
6 PignonJP,MaitreA,maillardE,etal.Meta-analysisofchemotherapyinheadandneckMACH-NCAnupdateon93randomizedtrialsand17,346patients.RadiotherOncol.2009924-14.
7 WardMC,AdelsteinDJ,BhatejaP,etal.SeverelatedysphagiaandcauseofdeathafterconcurrentchemoradiationforlarynxcancerinpatientseligibleforRTOG91-11.OralOncol.20165721-26.
8 ForastiereAA,ZhangQ,WeberRS,etal.Long-TermResultsofRTOG91-11AComparisonof
ThreeNonsurgicalTreatmentStrategiestoPreservetheLarynxinPatientswithLocallyAdvancedLarynxCancer.JClinOncol.201331845-52.
9 MendenhallWM,Werning JW,HinermanRW,et al.ManagementofT1-T2glottic carcinomas.Cancer.20041001786-92. b
10 CohenSM,GarrettCG,DupontWDetal.Voice-relatedqualityoflifeinT1glotticcancerirradia-tionversusendoscopicexcision.AnnOtolRhinollaryngol.2006115581-6.
11 OsbornHA,HuA,VenkatatesanV,etal.Comparisonofendoscopiclaserresectionversusradiationtherapyforthetreatmentofearlyglottiscarcinoma.JOtolaryngolHeadNeckSurg.201140200-4.
b12 HolsingerFC,NussenbaumB,NakayamaM,etal.Currentconceptsandnewhorizonsinconserva-
tionlaryngealsurgeryanimportantpartofmultidisciplinarycare.HeadNeck.201032656-65. 13 SteinerW,VogtP,AmbroschP,etal.Transoralcarbondioxide lasermicrosurgery forrecurrent
glotticcarcinomaafterradiotherapy.HeadNeck.200426477-84. 14 AnserinM,PlanickaM,RotundoS,etal.Endoscopiccarbondioxidelasersurgeryforglottiscancer
recurrenceafterradiotherapy.ArchOtolaryngolHeadNeckSurg.20071331193-7.
009592-01_GL_03_B-01-09_DIC95_.indd 29 17/09/25 19:34
73/181
-
30
15 200632355-9. 16 74
2007110571-80. 17 NakayamaM,OkamotoM,HayakawaK,etal.Clinicaloutcomeofsupracricoid laryngectomywith
cricohyoidepiglottopexyradiationfailureversuspreviouslyuntreatedpatients.AurisNasusLarynx.201340207-10. b
18 MakeieffM,VenegoniD,MercanteG,etal.Supracricoidpartiallaryngectomiesafterfailureofradia-tiontherapy.Laryngoscope.2005115353-7.
19 GregoireVLefebvreJL,LicitraL.etal.Squamouscellcarcinomaof theheadandneckEHNSESMOESTROClinicalPracticeGuidelinesfordiagnosis,treatmentandfollow-up.AnnOncol.201021184-6.
20 NCCNClinicalPracticeGuidelinesinOncologyNCCNGuidelinesHeadandNeckCancerVersion2.2016
httpwww.nccn.orgprofessionalsphysician_glspdfhead-and-neck.pdf21 SpauldingCA,HahnSS,ConstableWC.Theeffectivenessoftreatmentoflymphnodesincancersof
thepyriformsinusandsupraglottis.IntJRadiatOncolBiolPhys.198713963-8. 22 BillersHF,DavisWH,Ogura JH.Delayedcontralateral cervicalmetastaseswith laryngeal and
laryngopharyngealcancers.Laryngoscope.1971811499-502. 23 1995585-94.
009592-01_GL_03_B-01-09_DIC95_.indd 30 17/09/25 19:34
74/181
-
-B-731
-B-7
1 papillarythyroidcarcinomaPTCfollicularthy-
roidcarcinomaFTCmedullarythyroidcarcinomaMTCundif-ferentiatedanaplasticthyroidcarcinomaATCdifferentiatedthyroidcarcinomaDTC
71UICCTNM72016UICC8220181
T
TX T0 T1 2cm
T1a1cmT1b1cm2cm
T2 2cm4cmT3 4cm
T3a 4cmT3b strapmuscles
T4a
T4b
Hurthle
N
NX N0 N1
009592-01_GL_03_B-01-09_DIC95_.indd 31 17/09/25 19:34
75/181
-
32
N1aDel-phian
N1b
55
T N M0 T N M155
T1aT1bT2 N0 M0 T3 N0 M0 T1T2T3 N1 M0 T4a N M0A T4b N M0B T N M1
T1aT1b N0 M0 T2T3 N0 M0 T1T2T3 N1a M0A T1T2T3 N1b M0 T4a N M0B T4b N M0C T N M1
A T1T2T3a N0 M0B T1T2T3a N1 M0B T3bT4aT4b N0N1 M0C T N M1Hurthle
2
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EORTC LaheyClinicAMESAge,Metastasis,Extrathyroidal invasion,
009592-01_GL_03_B-01-09_DIC95_.indd 32 17/09/25 19:34
76/181
-
-B-733
Size MayoClinic AGESAge,Grade,Extent,Size MACISMetastasis,Age,Completenessofresection,Invasion,Size3-6
2009ATA78ATA20159
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53cm
3cm4
009592-01_GL_03_B-01-09_DIC95_.indd 33 17/09/25 19:34
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-
34
3
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9
radioactive iodineRAI2010131 I30mCi2012
recombinantTSHrhTSH131 IRAI600mCiRAI
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009592-01_GL_03_B-01-09_DIC95_.indd 34 17/09/25 19:34
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-
-B-735
20164cm0.2cm59,10
RAICQ8-3
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shaving15
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16,176
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009592-01_GL_03_B-01-09_DIC95_.indd 35 17/09/25 19:34
79/181
-
36
TSH19
NCCNTSH0.1mULTSH0.10.5mUL10TSH0.5Uml20
RAItyrosinekinase inhibitor
TKI21-23PFSOSQOLCQ8-5
CEA
MEN2AMEN2BRET24
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StageAB6,10,25ATCTKI26CQ8-5
1 72015 2 AJCCCancerStagingManualEighthEditionSpringer2016 3 SandersLE,CadyB.Differentiatedthyroidcancerreexaminationofriskgroupsandoutcomeof
treatment.ArchSurg.1998133419-25. 4 HayID,GrantCS,TaylorWF,McConaheyWM.Ipsilaterallobectomyversusbilaterallobarresection
009592-01_GL_03_B-01-09_DIC95_.indd 36 17/09/25 19:34
80/181
-
-B-737
inpapillarythyroidcarcinomaaretrospectiveanalysisofsurgicaloutcomeusinganovelprognosticscoringsystem.Surgery.19871021088-95.
5 DeanDS,HayID.Prognosticindicatorsindifferentiatedthyroidcarcinoma.CancerControl.20007229-39.
6 20102010
7 AmericanThyroidAssociationATAGuidelinesTaskforceonThyroidNodulesandDifferentiatedThyroidCancer.CooperDS,DohertyGM,HaugenBR,etal.RevisedAmericanThyroidAssociationmanagementguidelinesforpatientswiththyroidnodulesanddifferentiatedthyroidcancer.Thyroid.2009191167-214.
8 TuttleRM,TalaH,ShahJ,etal.EstimatingriskofrecurrenceindifferentiatedthyroidcanceraftertotalthyroidectomyandradioactiveiodineremnantablationusingresponsetotherapyvariablestomodifytheinitialriskestimatespredictedbythenewAmericanThyroidAssociationstagingsystem.Thyroid.2010201341-9.
9 HaugenBR,AlexanderEK,BibleKC,etal.2015AmericanSocietyofThyroidAssociationManage-mentGuidelines forAdultPatientswithThyroidNodulesandDifferentiatedThyroidCancer.Thy-roid.2016261-92.
10 NCCNClinicalPracticeGuidelinesInOncologyHeadandNeckCancers. httpwww.nccn.orgprofessionalsphysician_glspdfhead-and-neck.pdf 11 -1996581375. 12 SugitaniI,FujimotoY,YamadaK,etal.Prospectiveoutcomesofselectivelymphnodedissectionfor
papillarythyroidcarcinomabasedonpreoperativeultrasonography.WorldJSurg.2008322494-502.
13 ItoY,MiyauchiA.Laterallymphnodedissectionguidedbypreoperativeandintraoperativefindingsindifferentiatedthyroidcarcinoma.WorldJSurg.200832729-39.
14 ErbilY,BarbarosU,IseverH,etal.Predictivefactorsforrecurrentlaryngealnervepalsyandhypo-parathyroidismafterthyroidsurgery.ClinOtolaryngol.20073232-7.
15 CzajaJM,McCaffreyTV.Thesurgicalmanagementoflaryngotrachealinvasionbywell-differentiat-edpapillarythyroidcarcinoma.ArchOtolaryngolHeadNeckSurg.19971235484-90.
16 DuranteC,HaddyN,BaudinE,etal.Long-termoutcomeof444patientswithdistantmetastasesfrompapillaryandfollicularthyroidcarcinomabenefitsandlimitsofradioiodinetherapy.JClinEn-docrinolMetab.2006912892-9.
17 SchlumbergerM,ChalletonC,DeVathaireF,etal.Radioactiveiodinetreatmentandexternalradio-therapyforlungandbonemetastasesfromthyroidcarcinoma.JNuclMed.199637598-605.
18 McGriffNJ,CsakoG,GourgiotisL,etal.Effectsofthyroidhormonesuppressiontherapyonadverse
clinicaloutcomesinthyroidcancer.AnnMed.200234554-64. 19 Sugitani I,FujimotoY.Doespostoperativethyrotropinsuppressiontherapytrulydecreaserecur-
rence inpapillary thyroidcarcinoma Arandomizedcontrolled trial. JClinEndocrinolMetab.2010954576-83.
20 SurksMI,OrtizE,DanielsGH,etal.Subclinicalthyroiddiseasescientificreviewandguidelinesfordiagnosisandmanagement.JAMA.2004291228-38.
21 BroseMS,NuttingCM,JarzabB,etal.Sorafenibinradioactiveiodine-refractory,locallyadvancedormetastaticdifferentiatedthyroidcancerarandomised,double-blind,phase3 trial.Lancet.2014384319-28.
22 SchlumbergerM,TaharaM,WirthLJ,etal.Lenvatinibversusplacebo inradio-iodine-refractorythyroidcancer.NEngJMed.2015372621-30.
23 KiyotaN,SchlumbergerM,MuroK,etal.SubgroupanalysisofJapanesepatientsinaphase3studyoflenvatinibinradioiodine-refractorydifferentiatedthyroidcancer.CancerSci.20151061714-21.
24 WellsSAJr,AsaSL,DralleH,etal.RevicedAmericanThyroidAssociationGuidelinesfortheMan-
009592-01_GL_03_B-01-09_DIC95_.indd 37 17/09/25 19:34
81/181
-
38
agementofMedullaryThyroidCarcinoma.Thyroid.201525567-610. 25 SmallridgeRC,AinKB,AsaSL,etal.AmericanThyroidAssociationGuidelinesforManagementof
PatientswithAnaplasticThyroidCancer.Thyroid.2012221104-39. 26 TaharaM,KiyotaN,YamazakiT,etal.LenvatinibforAnaplasticThyroidCancer.Frontiers in
Oncology.201725343-4.
009592-01_GL_03_B-01-09_DIC95_.indd 38 17/09/25 19:34
82/181
-
-B-839
-B-8
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009592-01_GL_03_B-01-09_DIC95_.indd 39 17/09/25 19:34
83/181
-
40
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2 585MucoepidermoidcarcinomalowgradeAciniccellcar-cinomaPolymorphousadenocarcinomaClearcellcarcinomaBasalcelladenocarcinomaIntraductalcarcinomaNOSAdenocarcinomaNOSlowgradeEpithelial-myoepithelialcarcino-maCarcinomaexpleomorphicadenomaintracap-sularandminimallyinvasivetypesSecretorycarcinomaOnco-cyticcarcinomaSialoblastoma55085MucoepidermoidcarcinomaintermediategradeAdenoidcysticcarcinomacribriformandtubulartypesSebaceousadenocarcinomaLymphoepithelialcarcinoma550MucoepidermoidcarcinomahighgradeAde-noidcysticcarcinomasolidtype NOS Adenocarcinoma,NOShighgradeSalivaryductcarcinomaMyoepithelialcarcinomaCarcinomaexpleomorphicadenomawidely invasivetypeCarcinosarcomaPoorlydifferentiatedcarcinomaSquamouscellcarcinoma
009592-01_GL_03_B-01-09_DIC95_.indd 40 17/09/25 19:34
84/181
-
-B-841
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N0
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T3T4
N0
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QOL
CQ9-21,23CQ9-1
4-6
1 GuntinasLichiusO,KlussmannJP,SchroederU,etal.Primaryparotidmalignomasurgeryinpa-tientswithnormalpreoperativefacialnervefunctionoutcomeandlongtermpostoperativefacialnervefunction.Laryngoscope.2004114949-56.
2 GodballeC,SchultzJH,KrogdahlA,etal.Parotidcarcinomaimpactofclinicalfactorsonprognosisinahistologicallyrevisedseries.Laryngoscope.20031131411-7.
3 SpiroRH.Managementofmalignanttumorsofthesalivaryglands.OncologyWillistonPark.1998
009592-01_GL_03_B-01-09_DIC95_.indd 41 17/09/25 19:34
85/181
-
42
12671-80discussion683. 4 GardenAS,WeberRS,MorrisonWH,etal.Theinfluenceofpositivemarginsandnerveinvasionin
adenoidcysticcarcinomaoftheheadandnecktreatedwithsurgeryandradiation.IntJRadiatOncolBiolPhys.199532619-26.
5 KoulR,DubeyA,ButlerJ,etal.Prognosticfactorsdepictingdiseasespecificsurvivalinparotidglandtumors.IntJRadiatOncolBiolPhys.200768714-8.
6 SpiroJD,SpiroRH.Canceroftheparotidglandroleof7 thnervepreservation.WorldJSurg.200327863-7.
009592-01_GL_03_B-01-09_DIC95_.indd 42 17/09/25 19:34
86/181
-
-B-943
-B-92017UICCTNM8
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FNACFNAC1
1 T
T0
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009592-01_GL_03_B-01-09_DIC95_.indd 43 17/09/25 19:34
87/181
-
44
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009592-01_GL_03_B-01-09_DIC95_.indd 44 17/09/25 19:34
88/181
-
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N
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1 SchmalbachCE,MillerFR.Occultprimaryheadandneckcarcinoma.CurrentOncologyreport.20079139-46.
2 PavlidisN,PentheroudakisG,PlataniotisG.Cervicallymphnodemetastasesofsquamouscellcarcino-mafromanunknownprimarysiteafavourableprognosissubsetofpatientswithCUP.ClinTranslOncol.200911340-8.
3 Jereczek-FossaBA,JassemJ,OrecchiaR.Cervicallymphnodemetastasesofsquamouscellcarcino-mafromanunknownprimary.CancerTreatRev.200430153-64.
4 ShinozakiT,HayashiR,EbiharaM,etal.Narrowbandimagingendoscopyforunknownprimarytu-morsitesoftheneck.HeadNeck2012.34826-9.
5 SakaiA,OkamiK,EbisumotoK,etal.Newtechniques todetectunknownprimaries incervicallymphnodemetastasis.Laryngoscope.20101201779-83.
6 LewJI,RodgersSEA,SolorzanoCC.Developmentsintheuseofultrasoundforthyroidcancer.CurrOpinOncol.20102211-6.
7 MillerFR,HusseyD,BeeramM,etal.Positronemissiontomographyinthemanagementofunknownprimaryheadandneckcarcinoma.ArchOtolaryngolHeadNeckSurg.2005131626-9.
009592-01_GL_03_B-01-09_DIC95_.indd 45 17/09/25 19:34
89/181
-
46
8 KochWM,BhattiN,WilliamsMF,etal.Oncologicrationale forbilateral tonsillectomy inheadandnecksquamouscell carcinomaofunknownprimarysource.OtolaryngolHeadNeckSurg.2001124331-3.
9 StrojanP,FerlitoA,LanqendijkJA,etal.Contemporarymanagementof lymphnodemetastasesfromanunknownprimarytotheneck.Areviewoftherapeuticoptions.HeadNeck.201335286-93.
10 ShehadehNJ,EnsleyJF,KucukO,etal.Benefitofpostoperativechemoradiotherapyforpatientswithunknownprimarysquamouscellcarcinomaoftheheadandneck.HeadNeck.2006281090-8.
009592-01_GL_03_B-01-09_DIC95_.indd 46 17/09/25 19:34
90/181
-
-11
-1CQ
11 NCT
B N CT
N
1,2CTMRI1CT
CTMRI2-4MRICT5PETPET-CT2
1 CurtinHD,IshwaranH,MancusoAA,etal.ComparisonofCTandMRimaginginstagingofneckmetastases.Radiology.1998207123-30.
2 Kyzas PA,EvangelouE,Denaxa-KyzaD, et al. 18F-Fluorodeoxyglucose positron emissiontomography toevaluatecervicalnodemetastases inpatientswithheadandnecksquamouscellcarcinomaameta-analysis.JNatlCancerInst.2008100712-20.
3 KingAD,TseGM,AhujaAT,etal.NecrosisinmetastaticnecknodesdiagnosticaccuracyofCT,MRimagingandUS.Radiology.2004230720-26.
4 KingAD,TseGM,YuenEH,etal.ComparisonofCTandMRimagingforthedetectionofextranodalneoplasticspreadinmetastaticnecknodes.EurJRadiol.200452264-70.
5 SomPM.Detectionofmetastasis incervical lymphnodesCTandMRcriteriaanddifferentialdiagnosis.AJRAmJRoentogenol.1992158961-9.
PubMedCTnecknodalstage52CTnecknodalstaging106
CTnecknodemetastasis338CTN
MRnecknodemetastasis44PETnecknodemetastasis171
32
009592-01_GL_04_01-05_DIC95_.indd 1 17/09/25 19:35
91/181
-
2
CQ12 TMRI
B T MRI
TMRICT
MRI
MRICT12TMRI1,2MRICT3,4MRICTMRIT5CTTMRI5CTMRI6MRI
1 NgSH,ChanSC,YenTC,etal.StagingofuntreatednasopharyngealcarcinomawithPETCTcomparisonwithconventionalwork-up.EurJNuclMedMolImaging.20093612-22.
2 KingAD,VlantisAC,BhatiaKS,etal.PrimarynasopharyngealcarcinomadiagnosticaccuracyofMRimagingversusthatofendoscopyandendoscopicbiopsy.Radiology.2011258531-7.
3 LeslieA,FyfeE,Guest P, et al. Staging of squamous cell carcinoma of the oral cavity and
oropharynxacomparisonofMRIandCTinT-andN-Staging.JComputAssistTomogr.19992343-9.
4 BolzoniA,CappielloJ,PiazzaC,etal.Diagnosticaccuracyofmagneticresonance imaging in theassessment ofmandibular involvement in oral-oropharyngeal squamous cell carcinomaaprospectivestudy.ArchOtolaryngolHeadNeckSurg.2004130837-43.
5 ZbrenP,BeckerM,LngH.Pretherapeuticstagingofhypopharyngealcarcinoma.Clinicalfindings,computedtomorgraphy,andmagneticresonanceimagingcomparedwithhistopathologicevaluation.ArchOtolaryngolHeadNeckSurg.1997123908-13.
6 ZbrenP,BeckerM,LngH.Stagingof laryngealcancerendoscopy,computedtomographyandmagneticresonanceversushistopathology.EurArchOtorhinolaryngol.1997254S117-22.
PubMed headandneckcancerstageMR 80nasopharyngealcarcinoma
MR104nasopharyngealcarcinomaCT403oralcavitycarcinoma
stagingMR32oralcavitycarcinomaimaging859oropharyngeal
009592-01_GL_04_01-05_DIC95_.indd 2 17/09/25 19:35
92/181
-
-13
carcinomastagingMR 19laryngealcancerstagingMR 28
hypopharygealcarcinomastagingimaging78
CQ13
B US
1US2CT3MRIFDG-PETPET-CT4US
US5,6US1,5,7US831US5,6USUS18US
US1,2,4, 55055vs70802CT3US
1 ParkJS,SonKR,NaDG,etal.Performanceofpreoperativesonographicstagingofpapillarythyroidcarcinomabasedonthesixtheditionof theAJCCUICCTNMclassificationsystem.AJR.200919266-72.
2 KouvarakiMA,ShapiroSE,FornageBD,etal.Roleofpreoperativeultrasonographyinthesurgicalmanagementofpatientswiththyroidcancer.Surgery.2003134946-54.
3 AhnJE,LeeJH,YiJS,etal.DiagnosticaccuracyofCTandultrasonographyforevaluatingmetastatic
cervicallymphnodesinpatientswiththyroidcancer.WorldJSurg.2008321552-8. 4 ChoiWH,ChungYA,HanEJ,etal.Clinicalvalueof integrated18Ffluoro-2-deoxyD-glucose
positronemissiontomographycomputedtomography in thepreoperativeassessmentofpapillarythyroidcarcinomacomparisonwithsonography.JUltrasoundMed.2011301267-73.
5 LewJI,RodgersSE,SolorzanoCC.Developmentsintheuseofultrasoundforthyroidcancer.Curr
OpinOncol.20102211-6. 6 2010p.35-39.
009592-01_GL_04_01-05_DIC95_.indd 3 17/09/25 19:35
93/181
-
4
7 SowerbyL,Franklin JH,ChinCJ, et al.Discrepancybetweenultrasoundand final pathologicmeasurementsinthyroidcancer.JOtolaryngolHeadNeckSurg.201140453-7.
8 TomodaC,UrunoT,TakamuraY,etal.Ultrasonographyasamethodof screening for trachealinvasionbypapillarythyroidcancer.SurgToday.200535819-22.
PubMedthyroidcancerstagingultrasonography67
2010
CQ14
B
fineneedleaspirationcytologyFNAC
FNACFNACFNAC194.296.985.598.498.479.760752,32
FNAC904,5US6FNAC57,89FNAC3,6-9FNAC
1 TandonS,ShahabR,BentonJI,etal.Fine-needleaspirationcytology inaregionalheadandneckcancercentercomparisonwithasystematicreviewandmeta-analysis.HeadNeck.2008301246-52.
2 CohenEG,PatelSG,LinO,etal.Fine-needleaspirationbiopsyofsalivaryglandlesionsinaselectedpatientpopulation.ArchOtolaryngolHeadNeckSurg.2004130773-8.
009592-01_GL_04_01-05_DIC95_.indd 4 17/09/25 19:35
94/181
-
-15
3 LinAC,BhattacharyyaN.Theutilityof fineneedleaspiration inparotidmalignancy.OtolaryngolHeadNeckSurg.2007136793-8.
4 SeiberlingKA,DutraJC,GunnJ,etal.Ultrasound-guided fineneedleaspirationbiopsyof thyroidnodulesperformedintheoffice.Laryngoscope.2008118228-31.
5 2010pp43-4492-932010.
6 MoonHJ,KwakJY,KimEK,etal.Thecombinedroleofultrasoundandfrozensection insurgicalmanagementof thyroidnodulesreadassuspicious forpapillarythyroidcarcinomaon fineneedleaspirationbiopsyaretrospectivestudy.WorldJSurg.200933950-57.
7 NishimuraG,MatsudaH,TaguchiT,etal.Treatmentevaluationofmetastatic lymphnodesafterconcurrentchemoradiotherapyinpatientswithheadandnecksquamouscellcarcinoma.AnticancerRes.201232595-600.
8 YomSS,GardenAS,StaerkelGA, et al. Sonographic examination of theneck afterdefinitiveradiotherapyfornode-positiveoropharyngealcancer.AJNRAmJNeuroradiol.2011321532-8.
9 AtulaTS,VarpulaMJ,KurkiTJ,etal.Assessmentofcervicallymphnodestatusinheadandneck
cancerpatientspalpation, computed tomography and low fieldmagnetic resonance imagingcomparedwithultrasound-guidedfine-needleaspirationcytology.EurJRadiol.199725152-61.
PubMedheadandneckcancerFNAC363
CQ15
A
1889Billroth1932WarrenGates
IARCIACR
6,2212
756514.5,481.914.1,2.62,000232
009592-01_GL_04_01-05_DIC95_.indd 5 17/09/25 19:35
95/181
-
6
38.9218.717.0639.19253.0231.2216.087.106.5822.36
4,56
1 200632292-9.
2 200329526-540
3 --1993961501-9
4 PetitT,GeorgesC,JungGM,etal.Systematicesophagealendoscopyscreeninginpatientspreviouslytreatedforheadandnecksquamous-cellcarcinoma.AnnOncol.200112643-6.
5 ChungCS,LoWC,WenMH,etal.LongTermOutcomeofRoutineImage-enhancedEndoscopyinNewlyDiagnosedHeadandNeckCanceraProspectiveStudyof145Patients.SciRep.2016629573.
6 YamamotoE,ShibuyaH,YoshimuraR,etal.Sitespecificdependencyofsecondprimarycancerinearlystageheadandnecksquamouscellcarcinoma.Cancer2002942007-14.
3216
PubMedheadandneccancer,endoscopyscreening,survivalrate632
retoroprosupectivestudy
CQ16 FDG-PET
BPET NM
PETFDG-PET
F-18
009592-01_GL_04_01-05_DIC95_.indd 6 17/09/25 19:35
96/181
-
-17
GaPET-CT
PETNPETKyzas17995 CI72858695 CI8389cN08795 CI76935095 CI3763Liao2cN0PETCTMRIMPET103
PETPET252
PETFDGPETPET7310057100CTMRI388783
1 Kyzas PA, EvangelouE,Denaxa-KyzaD, et al. 18 F-fluorodeoxyglucose positron emissiontomography toevaluatecervicalnodemetastases inpatientswithheadandnecksquamouscellcarcinomaameta-analysis.JNatlCancerInst.2008100712-20.
2 LiaoLJ,LoWC,HsuWL,etal.Detectionofcervicallymphnodemetastasisinheadandneckcancerpatientswith clinicallyN0neck-ameta-analysis comparingdifferent imagingmodalities.BMCCancer.201212236.
3 FletcherJW,DjulbegovicB,SoaresHP,etal.Recommendationson theuseof18F-FDGPET inoncology.JNuclMed.200849480-508.
PubMedheadandneckneoplasmsheadneckcancerPET
8023
3
009592-01_GL_04_01-05_DIC95_.indd 7 17/09/25 19:35
97/181
-
8
CQ17
BCTMRI
B PET-CT
12
34Schwartzintensive5Kissum5449220918MRI11CT614526
1990X2000CT2000PET-CTXVisscherX7OMearaX8WarnerXCTCTX9NCCNCT10CTMRI3611NCCN10
PET-CTCTMRI12,133
009592-01_GL_04_01-05_DIC95_.indd 8 17/09/25 19:35
98/181
-
-19
RTCRTNCCNCRT48CTPET812CT
20126OngCRTPETPET-CT1214IslesPET-CTCRT101520153PET-NECKstudy12PET-CT16
CTMRI
CTXCT
22CTMRI17
PET-CT
1 SimoR,HomerJ,ClarkeP, etal.Follow-upafter treatment forheadandneckcancerUnitedKingdomNationalMultidisciplinaryGuidelines.JLaryngolOtol.2016130S208-S211.
2 ManikantanK,KhodeS,DwivediRC,etal.Makingsenseofpost-treatmentsurveillanceinheadandneckcancerwhenandwhatoffollow-up.CancerTreatRev.200935744-53.
3 ManikantanK,DwivediRC,SayedSI,etal.Currentconceptsofsurveillanceanditssignificanceinheadandneckcancer.AnnRCollSurgEngl.201193576-82.
4 FlynnCJ,KhaouamN,GardnerS, et al.Thevalue of periodic follow-up in thedetection ofrecurrencesafterradical treatment in locallyadvancedheadandneckcancer.ClinOncolRCollRadiol.201022868-73.
5 SchwartzDL,BarkerJJr,ChanskyK,etal.Postradiotherapysurveillancepracticeforheadandnecksquamouscellcarcinoma--toomuchfortoolittle?HeadNeck.200325990-9.
6 KissunD,MagennisP,LoweD,etal.Timingandpresentationofrecurrentoralandoropharyngealsquamouscellcarcinomaandawareness intheoutpatientclinic.BrJOralMaxillofacSurg.200644371-6.
7 deVisscherAV,ManniJJ.Routinelong-termfollow-upinpatientstreatedwithcurativeintentforsquamous cell carcinomaof the larynx, pharynx, and oral cavity.Does itmake sense?ArchOtolaryngolHeadNeckSurg.1994120934-9.
8 OMearaWP,Thiringer JK, JohnstonePA.Follow-upofheadandneck cancerpatientspost-radiotherapy.RadiotherOncol.200366323-6.
9 WarnerGC,CoxGJ.Evaluationofchestradiographyversuschestcomputedtomographyinscreening
009592-01_GL_04_01-05_DIC95_.indd 9 17/09/25 19:35
99/181
-
10
forpulmonarymalignancyinadvancedheadandneckcancer.JOtolaryngol.200332107-9. 10 RomanBR,GoldenbergD,GiviB.EducationCommitteeofAmericanHeadandNeckSocietyAHNS..
AHNSSeries--Doyouknowyourguidelines?Guidelinerecommendedfollow-upandsurveillanceofheadandneckcancersurvivors.HeadNeck.201638168-74.
11 HermansR, PameijerFA,MancusoAA, et al. Laryngeal or hypopharyngeal squamous cellcarcinomacanfollow-upCTafterdefinitiveradiationtherapybeusedtodetectlocalfailureearlierthanclinicalexaminationalone?Radiology.2000214683-7.
12 YooJ,HendersonS,Walker-DilksC.Evidence-basedguideline recommendationson theuseofpositronemissiontomographyimaging inheadandneckcancer.ClinOncolRCollRadiol.201325e33-66.
13 FletcherJW,DjulbegovicB,SoaresHP,etal.Recommendationson theuseof18F-FDGPET inoncology.JNuclMed.200849480-508.
14 OngSC,SchderH,LeeNY,etal.Clinicalutilityof18F-FDGPETCTinassessingtheneckafterconcurrentchemoradiotherapyforLocoregionaladvancedheadandneckcancer.JNuclMed.200849532-40.
15 IslesMG,McConkeyC,MehannaHM.Asystematicreviewandmeta-analysisoftheroleofpositronemission tomography in the followup of head and neck squamous cell carcinoma followingradiotherapyorchemoradiotherapy.ClinOtolaryngol.200833210-22.
16 MehannaH,WongWL,McConkeyCC, et al.PET-CTSurveillanceversusNeckDissection inAdvancedHeadandNeckCancer.NEnglJMed.2016374151444-54.
17 LoeffelbeinDJ,EiberM,MayrP,etal.Loco-regionalrecurrenceaftersurgical treatmentoforalsquamouscellcarcinomaProposals for follow-up imagingbasedon literature,nationalguidelinesandinstitutionalexperience.JCraniomaxillofacSurg.2015431546-52.
PubMedrecurrence,imaging,recommendations,headandneckcancer
5266
1
CQ18
C1
A
B
1SCCCYFRA21-13060
009592-01_GL_04_01-05_DIC95_.indd 10 17/09/25 19:35
100/181
-
-111
C1
2,3A
16414654B
1 GuerraEN,RgoDF,EliasST,etal.Diagnosticaccuracyofserumbiomarkers forheadandneckcancerAsystematicreviewandmeta-analysis.CritRevOncolHematol.201610193-118.
2 GiovanellaL,TregliaG,SadeghiR,etal.Unstimulatedhighlysensitivethyroglobulininfollow-upof
differentiatedthyroidcancerpatientsameta-analysis.JClinEndocrinolMetab.201499440-7 3 Eustatia-Rutten CF, Smit JW, Romijn JA, et al. Diagnostic value of serum thyroglobulin
measurementsinthefollow-upofdifferentiatedthyroidcarcinoma,astructuredmeta-analysis.ClinEndocrinolOxf.20046161-74.
4 BoomsmaMJ,BijlHP,LangendijkJA.Radiation-inducedhypothyroidism inheadandneckcancerpatientsasystematicreview.RadiotherOncol.20119915.
serumbiomarkerheadandneckcancermeta-analysis16thyroidneoplasmthyro-
globulinfollowupmeta-analysis13hypothyroidismheadandneckcancerirradia-
tion490CQ4
009592-01_GL_04_01-05_DIC95_.indd 11 17/09/25 19:35
101/181
-
12
-2CQ
21
B MRIUS CT
2018TNM8
depthofinvasionDOIT5mmDOI10mmT2DOI10mmT3113,149DOITheInternationalConsortiumforOutcomeResearchICORinHeadandNeckCancer1
2
DOICTMRIDOIthicknessDOI4mm6mmDOI
depth
thickness2depththickness
depththicknessMRI3-11depth5,97,112DOIDOI
USShintani1213-16YesuratnamUSMRIUSthickness16USthicknessDOI
CTMRICT
009592-01_GL_04_01-05_DIC95_.indd 12 17/09/25 19:35
102/181
-
-213
CTthickness17
AlsaffarMRIdepth45mmMRIdepth5mmdepth
depththicknessLwin0.70.8610Goel0.85cT3pT2depththicknessDOI
1 InternationalConsortiumforOutcomeResearchICORinHeadandNeckCancer,EbrahimiA,GilZ,etal.Primary tumorstaging fororalcancerandaproposedmodification incorporatingdepthofinvasionan internationalmulticenter retrospective study. JAMAOtolaryngolHeadNeckSurg.20141401138-48.
2 AminMB,EdgeSB,GreeneFL,etal.AJCCCancerStagingManual8thed.,Springer,NewYork2017
3 ImaiT,SatohI,MatsumotoK,etal.Retrospectiveobservationalstudyofoccultcervicallymph-nodemetastasis inT1N0tonguecancer.JpnJClinOncol.2016Nov25.EpubaheadofprintPubMedPMID27889695.
4 AlsaffarHA,GoldsteinDP,KingEV,etal.CorrelationbetweenclinicalandMRIassessmentofdepthofinvasioninoraltonguesquamouscellcarcinoma.JOtolaryngolHeadNeckSurg.20164561.
5 GoelV,PariharPS,PariharA,etal.AccuracyofMRIinPredictionofTumourThicknessandNodal
StageinOralTongueandGingivobuccalCancerWithClinicalCorrelationandStaging.JClinDiagnRes.201610TC01-5.
6 LamP,Au-YeungKM,ChengPW,etal.CorrelatingMRIandhistologic tumor thickness in theassessmentoforaltonguecancer.AJRAmJRoentgenol.2004182803-8.
7 PredaL,ChiesaF,CalabreseL,etal.RelationshipbetweenhistologicthicknessoftonguecarcinomaandthicknessestimatedfrompreoperativeMRI.EurRadiol.2006162242-8.
8 ParkJO,JungSL,JooYH,etal.Diagnosticaccuracyofmagneticresonance imagingMRIintheassessmentoftumorinvasiondepthinoraloropharyngealcancer.OralOncol.201147381-6.
9 JungJ,ChoNH,KimJ,etal.Significantinvasiondepthofearlyoraltonguecanceroriginatedfrom
the lateralbordertopredictregionalmetastasesandprognosis. IntJOralMaxillofacSurg.200938653-60.
10 LwinCT,HanlonR,LoweD,etal.AccuracyofMRI inpredictionof tumourthicknessandnodalstageinoralsquamouscellcarcinoma.OralOncol.201248149-54.
11 IwaiH,KyomotoR,Ha-KawaSK,etal.Magneticresonancedeterminationof tumorthicknessas
009592-01_GL_04_01-05_DIC95_.indd 13 17/09/25 19:35
103/181
-
14
predictivefactorofcervicalmetastasisinoraltonguecarcinoma.Laryngoscope.2002112457-61. 12 ShintaniS,NakayamaB,MatsuuraH,etal. Intraoralultrasonography isuseful toevaluatetumor
thicknessintonguecarcinoma.AmJSurg.1997173345-7. 13 MarkTaylor S,DroverC,MaceachernR, et al. Is preoperativeultrasonography accurate in
measuringtumorthicknessandpredictingtheincidenceofcervicalmetastasis inoralcancer?OralOncol.20104638-41.
14 YuenAP,NgRW,LamPK,etal.Preoperativemeasurementof tumor thicknessoforal tonguecarcinomawithintraoralultrasonography.HeadNeck.200830230-4.
15 LodderWL,TeertstraHJ,Tan IB, et al.Tumour thickness in oral cancerusingan intra-oralultrasoundprobe.EurRadiol.20112198-106.
16 YesuratnamA,WiesenfeldD,TsuiA,etal.Preoperativeevaluationoforal tonguesquamouscellcarcinomawith intraoral ultrasound andmagnetic resonance imaging-comparison withhistopathological tumour thickness and accuracy in guiding patientmanagement. Int JOralMaxillofacSurg.201443787-94.
17 Madana J, LalibertF,MorandGB, et al. Computerized tomographybased tumor-thicknessmeasurementisusefultopredictpostoperativepathologicaltumorthicknessinoraltonguesquamouscellcarcinoma.JOtolaryngolHeadNeckSurg.20154449.
PubMedoraltongue,thickness,depth,measurement,magneticresonanceimaging
151
CQ22
C1
lowdoserateLDRhighdoserateHDRLDR192Ir137Cs198AuHDR192Irremoteafter-loadingsystemRALS
T1N0T2N01-5T36,74,6
799372801-5,81,2,45819675891-5,8
009592-01_GL_04_01-05_DIC95_.indd 14 17/09/25 19:35
104/181
-
-215
LDRHDR7-935
1,4,1010QOL11
1 ShibuyaH,HoshinaM,TakedaM,etal.Brachytherapyforstageoraltonguecancerananalysisofpastcasesfocusingoncontrolandcomplications.IntJRadiationOncolBiolPhys.19932651-8.
2 IchimiyaY,FuwaN,KamataM,etal.TreatmentresultsofstageIoraltonguecancerwithdefinitive
radiotherapy.OralOncol.200541520-5. 3 -
113456-622010. 4 FujitaM,HirokawaY,KashiwadoK,etal.InterstitialbrachytherapyforStageandsquamous
cellcarcinomaoftheoraltonguefactorsinfluencinglocalcontrolandsofttissuecomplications.IntJRadiationOncolBiolPhys.199944767-75.
5 UmedaM,KomatsubaraH,OjimaY,etal.Acomparisonofbrachytherapyandsurgery for thetreatmentofstage-squamouscellcarcinomaofthetongue.IntJOralMaxillofacSurg.200534739-44.
6 IharaN,ShibuyaH,YoshimuraR,etal.InterstitialbrachytherapyandneckdissectionforStagesquamouscellcarcinomaofthemobiletongue.ActaOncol.200544709-16.
7 KakimotoN,InoueT,InoueT,etal.Resultsoflow-andhigh-dose-rateinterstitialbrachytherapyforT3mobiletonguecancer.RadiotherOncol.200368123-8.
8 InoueT,InoueT,ToshidaK,etal.Phasetrialofhigh-vs.low-dose-rateinterstitialradiotherapyforearlymobiletonguecancer.IntJRadiationOncolBiolPhys.200151171-5.
9 AkiyamaH,YoshidaK,ShimizutaniK,etal.Dosereductiontrialfrom60Gyin10fractionsto54Gyin9 fractionsschedule inhigh-dose-rate interstitialbrachytherapy forearlyoral tonguecancer.JRadiatRes.201253722-6.
10 MiuraM,TakedaM,SasakiT,etal.Factorsaffectingmandibularcomplications in lowdoseratebrachytherapyfororaltonguecarcinomawithspecialreferencetospacer.IntJRadiationOncolBiolPhys.199841763-70.
11 YoshimuraR,ShibuyaH,MiuraM,etal.Qualityof lifeoforalcancerpatientsafter low-dose-rateinterstitialbrachytherapy.IntJRadiationOncolBiolPhys.200973772-8.
72PubMed
interstitialradiotherapybrachytherapytonguecancer128
009592-01_GL_04_01-05_DIC95_.indd 15 17/09/25 19:35
105/181
-
16
CQ23
C1
20151
N0
702-45-7level9108-10
11,12N0
UMIN000006510199613
14-18Paleri200530119Thompson201326766949620
FDA2014NCCN2017T1-2N021
1 DCruzAK,VaishR,KapreN,etal.ElectiveversusTherapeuticNeckDissectioninNode-Negative
009592-01_GL_04_01-05_DIC95_.indd 16 17/09/25 19:35
106/181
-
-217
OralCancer.NEnglJMed.2015373521-529. 2 SchiefkeF,AkdemirM,WeberA,etal.,Function,postoperativemorbidity,andqualityof lifeafter
cervicalsentinelnodebiopsyandafterselectiveneckdissection.HeadNeck.200931503-12. 3 MurerK,HuberGF,HaileSR,etal.Comparisonofmorbiditybetweensentinelnodebiopsyand
electiveneckdissectionfortreatmentofthen0neckinpatientswithoralsquamouscellcarcinoma.HeadNeck.2011331260-4.
4 HernandoJ,VillarrealP,Alvarez-MarcosF,etal.Comparisonofrelatedcomplicationssentinelnodebiopsyversuselectiveneckdissection.IntJOralMaxillofacSurg.2014431307-12.
5 Govers,TM,TakesRP,BarisKarakullukcuM,etal.ManagementoftheN0neckinearlystageoralsquamouscellcanceramodelingstudyofthecost-effectiveness.OralOncol.201349771-7.
6 Kosuda,S,KusanoS,KohnoN, et al.Feasibilityandcost-effectivenessof sentinel lymphnode
radiolocalizationinstageN0headandneckcancer.ArchOtolaryngolHeadNeckSurg.20031291105-9.
7 OConnorR,PezierT,SchillingC,etal.Therelativecostofsentinellymphnodebiopsyinearlyoralcancer.JCraniomaxillofacSurg.201341721-7.
8 Shah, JP.Patterns of cervical lymphnodemetastasis fromsquamous carcinomasof theupperaerodigestivetract.AmJSurg.1990160405-9.
9 Byers,RM,WeberRS,AndrewsT,etal.Frequencyandtherapeuticimplicationsofskipmetastasesintheneckfromsquamouscarcinomaoftheoraltongue.HeadNeck.19971914-9.
10 Crean,SJ,HoffmanA,Potts J, et al.Reductionof occultmetastaticdiseasebyextensionof thesupraomohyoidneckdissectiontoincludelevel.HeadNeck.200325758-62.
11 Fan,SF,ZengZY,PengHW,etal.Sentinel lymphnodebiopsyversuselectiveneckdissection inpatientswithcT1-2N0oraltonguesquamouscellcarcinoma.OralSurgOralMedOralPatholOralRadiol.2014117186-90.
12 AlvarezJ,BidagurenA,McGurkM,etal.Sentinelnodebiopsyinrelationtosurvivalinfloorofthemouthcarcinoma.IntJOralMaxillofacSurg.201443269-73.
13 AlexJC,KragDN.Thegamma-probe-guidedresectionofradiolabeledprimarylymphnodes.SurgOncolClinNAm.1996533-41.
14 AlkureishiLW,RossGL,ShoaibT, et al. Sentinelnodebiopsy inheadandnecksquamouscellcancer5-yearfollow-upofaEuropeanmulticentertrial.AnnSurgOncol.2010172459-64.
15 CivantosFJ,ZitschRP,SchullerDE,etal.Sentinellymphnodebiopsyaccuratelystagestheregional
lymphnodes forT1-T2oralsquamouscellcarcinomasresultsofaprospectivemulti-institutionaltrial.JClinOncol.2010281395-400.
16 SchillingC,StoeckliSJ,HaerleSK,etal.SentinelEuropeanNodeTrialSENT3-yearresultsofsentinelnodebiopsyinoralcancer.EurJCancer.2015512777-84.
17 MiuraK,HirakawaH,UemuraH, et al. Sentinel nodebiopsy for oral cancerAprospectivemulticenterPhasetrial.AurisNasusLarynx.201744319-26.
18 FlachGB,BloemenaE,KlopWM,etal.SentinellymphnodebiopsyinclinicallyN0T1-T2stagedoralcancertheDutchmulticentertrial.OralOncol.2014501020-4.
19 PaleriV,ReesG,ArullendranP,etal.Sentinelnodebiopsyinsquamouscellcanceroftheoralcavityandoralpharynxadiagnosticmeta-analysis.HeadNeck.200527739-47.
20 ThompsonCF,StJohnMA,LawsonG,etal.Diagnosticvalueofsentinellymphnodebiopsyinheadandneckcancerameta-analysis.EurArchOtorhinolaryngol.20132702115-22.
21 AdelsteinD,GillisonML,PfisterDG,etal.NCCNGuidelines InsightsHeadandNeckCancers,Version2.2017.JNatlComprCancNetw.201715761-70.
009592-01_GL_04_01-05_DIC95_.indd 17 17/09/25 19:35
107/181
-
18
PubMedsentinel,lymphnodebiopsy,earlyoralcancer77
7multicenter,sentinel,headandneck382
12
CQ24
C1
8638decisionanalysis1168682201543-6N0CQ40.5795 CI0.36-0.8974
20155TATA8596380.067.53mmN320CQ
1 SongT,BiN,GuiL, at al.ElectiveneckdissectionorwatchfulwaitingoptimalmanagementstrategyforearlystageN0tonguecarcinomausingdecisionanalysistechniques.ChinMedJ.2008
009592-01_GL_04_01-05_DIC95_.indd 18 17/09/25 19:35
108/181
-
-219
1211871-4. V 2 KanekoS,YoshimuraT,IkemuraK,etal.Primaryneckmanagementamongpatientswithcancerof
theoralcavitywithoutclinicalnodalmetastasesadecisionandsensitivityanalysis.HeadNeck.200224582-90. V
3 VandenbrouckC,Sancho-GarnierH,ChassagneD,etal.Electiveversus therapeuticradicalneckdissectioninepidermoidcarcinomaoftheoralcavityresultsofarandomizedclinicaltrial.Cancer.198046386-90.
4 FakihAR,RaoRS,BorgesAM,etal.Electiveversustherapeuticneckdissectioninearlycarcinomaoftheoraltongue.AmJSurgery.1989158309-13.
5 KligermanJ,LimaRA,SoaresJR,etal.Supraomohyoidneckdissection inthetreatmentofT1T2squamouscellcarcinomaoforalcavity.AmJSurg.1994168391-4.
6 YuenAP,HoCM,ChowTL,etal.ProspectiverandomizedstudyofselectiveneckdissectionversusobservationforN0neckofearlytonguecarcinoma.HeadNeck.200931765-72.
7 FasunlaAJ,GreeneB,TimmesfeldN,etal.Ameta-analysisoftherandomizedcontrolledtrialsonelectiveneckdissectionversustherapeuticneckdissectioninoralcavitycancerswithclinicallynode-negativeneck.OralOncology.201147320-4.
8 DCruzAK,VanishR,KapreN,etal.Electiveversustherapeuticneckdissection innode-negativeoralcancer.NEnglJMed.2015373521-9.
PubMedtonguecancerdissectionclinical trial
36hit52
18
CQ25 N1
C2Supraomohyoid Neck DissectionSOHND N0 N SOHNDN1ExtendedSOHND
SupraomohyoidNeckDissectionSOHND
1modifiedRadicalNeckDissectionSOHND2N0SOHNDNSOHNDNSOHNDretrospectivestudyrandom-izedcontrolledtrial
Beyers27715.83Shah501
009592-01_GL_04_01-05_DIC95_.indd 19 17/09/25 19:35
109/181
-
20
516retrospective1.5Beyers4DiasT1T23391.56.5N01.5N23.725
AndersenN106N158-63.2588.156.74.3N6Kowalski00.6N1SOHND7,8
ShahN15164Dias9N0SOHNDNKoerdtEx-tendedSOHND10
NSOHND5Liang5retro-spectivestudyN--1112N1ExtendedSOHND
KowalskiN157.4pN07USPET-CTN1
1 FerlitoA,SomPM,RinaldoA, et al.Classificationand terminologyofneckdissections.ORLJOtorhinolaryngolRelatSpec.200062212-6.
2 BrazilianHeadandNeckCancerStudyGroup.ResultsofaProspectiveTrialonElectiveModifiedRadicalClassicalVersusSupraomohyoidNeckDissection in theManagementofOralSquamousCarcinoma.AmJSurg.1998176422-7.
3 ByersRM,WeberRS,AndrewsT, et al. Frequency andTherapeutic Implications ofSkipMetastasesintheNeckfromSquamousCarcinomaoftheOralTongue.HeadNeck.19971914-9.
009592-01_GL_04_01-05_DIC95_.indd 20 17/09/25 19:35
110/181
-
-221
4 ShahJP,CandelaFC,PoddarAK.ThePatternsofCervicalLymphNodeMetastasesfromSquamous
CarcinomaoftheOralCavity.Cancer.199066109-13, 5 DiasFL,LimaRA,KligermanJ,etal.Relevanceofskipmetastasesforsquamouscellcarcinomaof
theoraltongueandthefloorofthemouth.OtolaryngolHeadNeckSurg.2006134460-5. 6 AndersenPE,WarrenF,SpriroJ,etal.Resultsofselectiveneckdissection inmanagementof the
node-positiveneck.ArchOtolaryngolHeadNeckSurg.20021281180-4. 7 KowalskiLP,CarvalhoAL.FeasibilityofsupraomohyoidneckdissectioninN1andN2aoralcancer
patients.HeadNeck.200224921-4. 8
200531536-540. 9 N1
200935370-373. 10 KoerdtS,Rckl J,RommelN,etal.Lymphnodemanagement in the treatmentoforalcancer
Analysisofastandardizedapproach.JCraniomaxillofacSurg.2016441737-42. 11 CappielloJ,PiazzaC,GiudiceM,etal.Shoulderdisabilityafterdifferentselectiveneckdissections
levels-versuslevels-Vacomparativestudy.Laryngoscope.2005115259-63. 12 LiangL,ZhangT,KongQ,etal.Ameta-analysisonselectiveversuscomprehensiveneckdissection
inoralsquamouscellcarcinomapatientswithclinicallynode-positiveneck.OralOncol.2015511076-81.
N1 70 Pubmed Oral
carcinomaCarcinomaselectiveneckdissectionSOHNDN1NpositiveSupraomohyoidNeck
dissection313
CQ26
C3
2ICT1CDDP5-FU
ICT5PFSICT5746ICT32
ICTTPFICTRTICTRT3ICT80.6
009592-01_GL_04_01-05_DIC95_.indd 21 17/09/25 19:35
111/181
-
22
OS425N2ICT
ICT6-8ICT
1 LicitraL,GrandiC,GuzzoM,etal.Primarychemotherapy inresectableoralcavitysquamouscellcancerarandomizedcontrolledtrial.JClinOncol.200321327-33.
2 BossiP,LoVulloS,GuzzoM,etal.Preoperativechemotherapy inadvancedresectableOCSCClong-termresultsofarandomizedphasetrial.AnnOncol.201425462-6.
3 ZhongLP,ZhangCP,RenGX,etal.Randomizedphasetrial of inductionchemotherapywithdocetaxel,cisplatin,andfluorouracilfollowedbysurgeryversusup-frontsurgeryinlocallyadvancedresectableoralsquamouscellcarcinoma.JClinOncol.201331744-51.
4 ZhongLP,ZhangCP,RenGX,et al.Long-termresultsof a randomizedphasetrial ofTPFinductionchemotherapy followedbysurgeryandradiation in locallyadvancedoralsquamouscellcarcinoma.Oncotarget.201530618707-14.
5 MartaGN,RieraR,BossiP, et al. Induction chemotherapyprior to surgerywith orwithoutpostoperativeradiotherapy fororalcavitycancerpatientsSystematicreviewandmeta-analysis.EurJCancer.2015512596-603.
6 El-SayedS,NelsonN.Adjuvantandadjunctivechemotherapyinthemanagementofsquamouscellcarcinomaoftheheadandneckregion.Ameta-analysisofprospectiveandrandomizedtrials.JClinOncol.199614838-47.
7 PignonJP,BourhisJ,DomengeC,etal.Chemotherapyaddedtolocoregionaltreatmentforheadandneck squamous-cell carcinomathreemeta-analyses of updated individual data.MACH-NCCollaborativeGroup.Meta-AnalysisofChemotherapyonHeadandNeckCancer.Lancet.2000355949-55.
8 MaJ,LiuY,HuangXL,etal. Inductionchemotherapydecreases therateofdistantmetastasis inpatientswithheadandnecksquamouscellcarcinomabutdoesnotimprovesurvivalorlocoregionalcontrolameta-analysis.OralOncol.2012481076-84.
PubMed,Oralsquamouscellcarcinoma,neoadjuvantchemotherapy,preoperativechemotherapy
CQ27
C1
1,2
009592-01_GL_04_01-05_DIC95_.indd 22 17/09/25 19:35
112/181
-
-223
1,2,4-632
78QOL705,9
781,104,5,9, 11212
1 MatsuiY,ShirotaT,YamashitaK,etal.Analysesofspeechintelligibilityinpatientsafterglossectomyandreconstructionwithfasciocutaneousmyocutaneousflaps.IntJOralMaxillofacSurg.200938339-45.
2 BressmannT,SaderR,WhitegillTL,etal.Consonant intelligibilityandtonguemotility inpatientswithpartialglossectomy.JOralMaxillofacSurg.200462298-303.
3 200551391-402.
4 20107727-34. 5 NicolettiG,SoutarDS,JaksonMS,etal.Chewingandswallowingaftersurgical treatment fororal
cancerfunctionalevaluationin196selectedcases.PlastReconstrSurg.2004114329-38. 6 HellerKS,LevyJ,SciubbaJJ.Speechpatternsfollowingpartialglossectomyforsmalltumorsofthe
tongue.HeadNeck.199113340-3. 7 HsiaoHT, LeuYS, LinCC. Primary closure versus radial forearm flap reconstruction after
hemiglossectomyfunctionalassessmentofswallowingandspeech.AnnPlasticSurg.200249612-6.
8 SuWF,ChenSG,ShengH.Speechandswallowingfunctionafterreconstructionwitharadialforearmfreeflaporapectoralismajorflapfortonguecancer.JFormosMedAssoc.2002101472-7.
009592-01_GL_04_01-05_DIC95_.indd 23 17/09/25 19:35
113/181
-
24
9 Thankappan K, KuriakoseMA, Chatni SS, et al. Lateral Arm free flap for oral tongue
reconstructionananalysisofsurgicaldetails,morbidity,andfunctionalandaestheticoutcome.AnnPlastSurg.201166261-6.
10 ShpizerT,GuttmanD,GurE,etal.Transoral reconstructionof themobile tongue,usingradialforearmfreeflap.Microsurgery.20032318-20.
11 Hsiao HT, Leu YS, Lin CC. Tongue reconstruction with free radial forearm flap afterhemiglossectomyafunctionalassessment.JReconstrMicrosurg.200419137-42.
12 deVicente JC, deVillalan L,TorreA, et al.Microvascular free tissue transfer for tonguereconstructionafterhemiglossectomyafunctionalassessmentofradialforearmversusanterolateralthighflap.JOralMaxillofacSurg.2008662270-5.
PubMedheadandneckneoplasmstongueswallowingspeech464
103672
CQ
CQ28
B
QOLQOL
1-4volume1-4
volume70804-8Kimata3
009592-01_GL_04_01-05_DIC95_.indd 24 17/09/25 19:35
114/181
-
-225
Yun9
1 HaugheyBH.Tonguereconstructionconceptsandpractice.Laryngoscope.19931031132-41. 2 KiyokawaK,TaiY,InoueY,etal.Functionalreconstructionofswallowingandarticulationaftertotal
glossectomywithoutlaryngectomymoneypouch-likereconstructionmethodusingrectusabdominismyocutaneousflap.PlastReconstrSurg.19991042015-20.
3 KimataY,SakurabaM,HishinumaS, et al.Analysis of the relationsbetween the shapeof thereconstructedtongueandpostoperativefunctionsaftersubtotalandtotalglossectomy.Laryngoscope.2003113905-9.
4 YuP,RobbGL.Reconstructionfortotalandnear-totalglossectomydefects.ClinPlasticSurg.200532411-9.
5 LyosAT,EvansGR,PerezD,etal.Tonguereconstructionoutcomeswiththerectusabdominisflap.PlastReconstrSurg.1999103442-7discussion448-9.
6 KimataY,UchiyamaK,EbiharaS,etal.Postoperativecomplicationsandfunctionalresultsaftertotalglossectomywithmicrosurgicalreconstruction.PlastReconstrSurg.20001061028-35.
7 YanaiC,KikutaniT,AdachiM,etal.Functionaloutcomeaftertotalandsubtotalglossectomywithfreeflapreconstruction.HeadNeck.200830909-18.
8 VegaC,LeonX,CervelliD,etal.Totalorsubtotalglossectomywithmicrosurgicalreconstructionfunctionalandoncologicalresults.Microsurgery.201131517-23.
9 YunIS,LeeDW,LeeWJ,etal.Correlationofneotonguevolumechangeswithfunctionaloutcomesafterlong-termfollow-upoftotalglossectomy.JCraniofacSurg.201021111-6.
PubMedheadandneckneoplasmstongueswallowingspeech4647
367
2
009592-01_GL_04_01-05_DIC95_.indd 25 17/09/25 19:35
115/181
-
26
-3CQ
31
C1
C1
60801
2-4
51651,574,5
6,8,95
1 CarrauRL,SegasJ,NussDW,etal.Squamouscellcarcinomaof thesinonasal tract invadingtheorbit.Laryngoscope.1999109230-5.
2 NazarG,RodrigoJP,LlorenteJL,etal.Prognostic factorsofmaxillarysinusmalignancies.AmJRhinol.200418233-8.
3 CarrilloJF,GemesA,Ramrez-OrtegaMC,etal.Prognostic factors inmaxillarysinusandnasalcavitycarcinoma.EurJSurgOncol.2005311206-12.
4 SurezC,FerlitoA,LundVJ,etal.Managementof theorbit inmalignantsinonasal tumors.HeadNeck.200830242-50.
5 ImolaMJ,SchrammVLJr.Orbitalpreservation insurgicalmanagementofsinonasalmalignancy.
009592-01_GL_04_01-05_DIC95_.indd 26 17/09/25 19:35
116/181
-
-327
Laryngoscope.20021121357-65. 6 -
201137349-54 7 DulguerovP,JacobsenMS,AllalAS,etal.Nasalandparanasalsinuscarcinomaarewemaking
progress?Aseriesof220patientsandasystemicreview.Cancer.2001923012-29. 8 KanotoM,OdaA,HosoyaT,etal. Impactofsuperselectivetransarterial infusiontherapyofhigh-
dosecisplatinonmaxillarycancerwithorbitalinvasion.AJNRAmJNeuroradiol.2010311390-4. 9 NishinoH, IchimuraK,TanakaH, et al.Results of orbitalpreservation foradvancedmalignant
maxillarysinustumors.Laryngoscope.20031131064-9.
373PubMedsinonasalorbit127
maxillarysinuscancer1,456
CQ32
C1
12-4
IA-CRT-CRTlocoregion-alcontroldiseasefreesurvivaloverallsurvival-CRTIA-CRT45-CRTIA-CRT30ccIA-CRT
6-910,11N2b312,13
009592-01_GL_04_01-05_DIC95_.indd 27 17/09/25 19:35
117/181
-
28
IA-CRT
1 RobbinsKT,StornioloAM,KerberC,etal.Phase I studyofhighlyselectivesupradosecisplatininfusionsforadvancedheadandneckcancer.JClinOncol.1994122113-20.
2 RobbinsKT,VicarioD,SeagrenS,etal.Atargetedsupradosecisplatinchemoradiationprotocolforadvancedheadandneckcancer.AmJSurg.1994168419-22.
3 RobbinsKT,KumarP,HarrisJ,etal.Supradose intra-arterialcisplatinandconcurrentradiationtherapy for the treatment of stageheadandneck squamous cell carcinoma is feasible andefficaciousinamulti-institutionalsettingresultsofRadiationTherapyOncologyGroupTrial9615.JClinOncol.2005231447-54.
4 RaschCR,HauptmannM,SchornagelJ,etal. Intra-arterialversus intravenouschemoradiation foradvancedheadandneckcancerResultsofarandomizedphase3trial.Cancer.20101162159-65.
5 RobbinsKT,HowellSB,WilliamsJS.Intra-arterialchemotherapyforheadandneckcanceristhere
averdict?Cancer.20101162068-70. 6 ShigaK,YokoyamaJ,HashimotoS,etal.Combinedtherapyaftersuperselectivearterialcisplatin
infusiontotreatmaxillarysquamouscellcarcinoma.OtolaryngolHeadNeckSurg.20071361003-9.
7 HommaA,OridateN,SuzukiF,etal.Superselectivehigh-dosecisplatin infusionwithconcomitantradiotherapy inpatientswithadvancedcancerof thenasalcavityandparanasalsinusesasingleinstitutionexperience.Cancer.20091154705-14.
8 --201137498-502.
9 KanoS,HommaA,OridateN, et al. Superselectivearterial cisplatin infusionwithconcomitantradiationtherapyforbaseoftonguecancer.OralOncol.201147665-70.
10 YoshizakiT,KondoS,WakisakaN,etal.Concurrentintra-arterialchemotherapyandradiotherapyforadvancedlaryngealcancer.AnnOtolRhinolLaryngol.200911817