Changes in mucosa laryngopharyngeal vascularization after radiotherapy and concomitant chemotherapy observed with narrow band imaging. Description of two cases
Abstract Introduction and objective: Narrow Band Imaging (NBI) is an image enhancement system used to detect vascular anomalies in the mucosa and submucosa of neoplasms. In 2011 Ni established the five types of imaging patterns in the laryngeal mucosa relating them to the histopathological findings of the lesions. However, these patterns are modified by previous treatments of laser surgery, radiotherapy and chemotherapy. Our objective is to describe the NBI type images obtained in patients treated with the therapeutic regimen of radiotherapy and concomitant chemotherapy. Description: NBI images in a 68-year-old patient with stage III supraglottic non-keratinizing squamous cell carcinoma treated with radiotherapy and concomitant chemotherapy at three months and the year after treatment. NBI images in a 50-year-old patient with stage II nasopharynx non-keratinizing squamous cell carcinoma treated with radiotherapy and concomitant chemotherapy at three months and the year after treatment. Results: The obtained patterns are not identified with any of those previously established by Ni. The images differ depending on the time elapsed since the treatment. Conclusions: It is important to know the alterations observed in the mucosa and submucosa of patients treated with radiotherapy and concomitant chemotherapy since they differ from the characteristic patterns described by Ni associated with the presence of neoplasia.
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American Joint Committee on Cancer (AJCC) TNM Staging System. 7th edition. New York: Springer, 2010.
Forastiere AA, Goepfert H, Maor M, Pajak TF, Weber R, Morrison W et al. Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. N Engl J Med. 2003;349(22):2091-8 - https://doi.org/10.1056/NEJMoa031317. - PMid:14645636
Lin Yc, Wang WH, Tsai WC, Chen CC, Chen WC, Lee KF. Predicting the early invasiveness of nasopharyngeal mucosal neoplasia after radiotherapy by narrow-band imaging: a pilot study. Head Neck. 2013;35(1):46-51. - https://doi.org/10.1002/hed.22912. - PMid:22488876
Muto M, Katada C, Sano Y, Yoshida S. Narrow band imaging: a new diagnostic approach to visualize angiogenesis in superficial neoplasia. Clin Gastroenterol Hepatol. 2005;3(7):16-20. - https://doi.org/10.1016/S1542-3565(05)00262-4
Ni XG, He S, Xu ZG, Gao L, Lu N, Yuan Z et al. Endoscopic diagnosis of laryngeal cancer and precancerous lesions by narrow band imaging. J Laryngol Otol. 2011;125:288-96. - https://doi.org/10.1017/S0022215110002033. - PMid:21054921
Watanabe A, Taniguchi M, Tsujie H, Hosokawa M, Fujita M, Sasaki S. The value of narrow band imaging endoscope for early head and neck cancers. Otolaryngol Head Neck Surg. 2008;138(4):446-51. - https://doi.org/10.1016/j.otohns.2007.12.034. - PMid:18359352
Zabrodsky M, Lukes P, Lukesova E, Boucek J, Plzak J. The role of narrow band imaging in the detection of recurrent laryngeal and hypopharyngeal cancer after curative radiotherapy. Biomed Res In. 2014;77(2):430-7. - https://doi.org/10.1155/2014/175398
Forastiere AA, Goepfert H, Maor M, Pajak TF, Weber R, Morrison W et al. Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. N Engl J Med. 2003;349(22):2091-8 - https://doi.org/10.1056/NEJMoa031317. - PMid:14645636
Lin Yc, Wang WH, Tsai WC, Chen CC, Chen WC, Lee KF. Predicting the early invasiveness of nasopharyngeal mucosal neoplasia after radiotherapy by narrow-band imaging: a pilot study. Head Neck. 2013;35(1):46-51. - https://doi.org/10.1002/hed.22912. - PMid:22488876
Muto M, Katada C, Sano Y, Yoshida S. Narrow band imaging: a new diagnostic approach to visualize angiogenesis in superficial neoplasia. Clin Gastroenterol Hepatol. 2005;3(7):16-20. - https://doi.org/10.1016/S1542-3565(05)00262-4
Ni XG, He S, Xu ZG, Gao L, Lu N, Yuan Z et al. Endoscopic diagnosis of laryngeal cancer and precancerous lesions by narrow band imaging. J Laryngol Otol. 2011;125:288-96. - https://doi.org/10.1017/S0022215110002033. - PMid:21054921
Watanabe A, Taniguchi M, Tsujie H, Hosokawa M, Fujita M, Sasaki S. The value of narrow band imaging endoscope for early head and neck cancers. Otolaryngol Head Neck Surg. 2008;138(4):446-51. - https://doi.org/10.1016/j.otohns.2007.12.034. - PMid:18359352
Zabrodsky M, Lukes P, Lukesova E, Boucek J, Plzak J. The role of narrow band imaging in the detection of recurrent laryngeal and hypopharyngeal cancer after curative radiotherapy. Biomed Res In. 2014;77(2):430-7. - https://doi.org/10.1155/2014/175398
Porras-Alonso, E. C., Salom-Coveñas, C., Gutiérrez-Bayard, L., & García-Teno, M. (2019). Changes in mucosa laryngopharyngeal vascularization after radiotherapy and concomitant chemotherapy observed with narrow band imaging. Description of two cases. Revista ORL, 10(1), 83–87. https://doi.org/10.14201/orl.17033
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