Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.
Anticancer Res. 2022 Mar;42(3):1653-1657. doi: 10.21873/anticanres.15642.
During the COVID-19 pandemic, pedicle flaps instead of free flap transfer were recommended for head and neck reconstruction to reduce infection risk. Boron neutron-capture therapy in Japan was clinically approved in 2020 as a salvage radiotherapy for recurrent head and neck cancer following chemoradiotherapy. The efficacy and safety of salvage surgery following boron neutron-capture therapy remain unclear.
We describe a 57-year-old male with crT4aN0M0 oral cancer after three different forms of radiotherapy including boron neutron-capture therapy, treated by salvage partial maxillectomy with both buccal fat pad and nasoseptal flaps. His postsurgical course was successful, without tracheostomy, and he had no Clavien- Dindo grade 3 or 4 complications. The pathological diagnosis was T4a squamous cell carcinoma with a negative surgical margin. No recurrence or metastasis had occurred at 113 days postoperatively. No opioid consumption was needed postoperatively.
Pathological negative margins were achieved in this case and there were no severe complications. Further accrual of cases salvage surgery following boron neutron-capture therapy is required to clarify treatment strategies for recurrent head and neck cancer.
在 COVID-19 大流行期间，建议对头颈重建采用皮瓣转移而不是游离皮瓣，以降低感染风险。日本的硼中子俘获疗法于 2020 年被临床批准作为放化疗后复发头颈癌的挽救性放疗。硼中子俘获治疗后挽救性手术的疗效和安全性尚不清楚。
我们描述了一位 57 岁男性，在接受了包括硼中子俘获疗法在内的三种不同形式的放疗后，患有 crT4aN0M0 口咽癌，接受了挽救性部分上颌骨切除术，同时使用颊脂垫和鼻中隔瓣。他的术后过程顺利，无需气管造口术，也没有发生 3 或 4 级 Clavien-Dindo 并发症。病理诊断为 T4a 鳞状细胞癌，切缘阴性。术后 113 天无复发或转移。术后无需使用阿片类药物。
在本例中达到了病理阴性切缘，且无严重并发症。需要进一步积累硼中子俘获治疗后挽救性手术的病例，以阐明复发头颈癌的治疗策略。
