A Case of Salvage Maxillectomy for Recurrent Oral Cancer After Boron Neutron Capture Therapy During the COVID-19 Pandemic

• Published in: Anticancer research Vol. 42; no. 3; pp. 1653 - 1657
• Main Authors: Suzuki, Hidenori, Yokoi, Mai, Hagiwara, Sumitaka, Sasaki, Eiichi, Kobayashi, Yoshiaki, Iwaki, Sho, Nishikawa, Daisuke, Beppu, Shintaro, Terada, Hoshino, Sawabe, Michi, Hanai, Nobuhiro
• Format: Journal Article
• Language: English
• Published: Greece International Institute of Anticancer Research 01.03.2022
• Subjects: Boron; Boron Neutron Capture Therapy; Cancer; Chemoradiotherapy; Complications; Coronaviruses; COVID-19; COVID-19 - epidemiology; Head & neck cancer; Health risks; Humans; Japan - epidemiology; Male; Margins of Excision; Metastases; Middle Aged; Mouth Neoplasms - pathology; Mouth Neoplasms - radiotherapy; Mouth Neoplasms - surgery; Neoplasm Recurrence, Local; Nuclear capture; Oral cancer; Orthognathic Surgical Procedures; Ostomy; Pandemics; Radiation therapy; Salvage Therapy; SARS-CoV-2; Squamous cell carcinoma; Squamous Cell Carcinoma of Head and Neck - pathology; Squamous Cell Carcinoma of Head and Neck - radiotherapy; Squamous Cell Carcinoma of Head and Neck - surgery; Surgery; Surgical Flaps; Tracheostomy; Treatment Outcome; Japan; COVID-19; nasoseptal flap; boron neutron capture therapy; recurrent oral cancer; salvage maxillectomy
• ISSN: 0250-7005; 1791-7530
• 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.