Radiotherapy (RT) is a mainstay in the treatment of head and neck squamous cell carcinoma (HNSCC). For locally advanced HCSCC, concurrent chemoradiotherapy (CCRT) benefits HCSCC patients in terms of better survival and loco-regional control. In this study, we evaluated changes in oral microbiota in patients, who received CCRT for head and neck cancer. Oral rinsed samples were weekly collected before and during CCRT and at 4 weeks following treatment from HNSCC patients, who had received 70 Gy of radiation delivered to the primary sites for over 7 weeks and concurrent chemotherapy. Oral microbiota changes in three patients were analyzed by next-generation sequencing using 16S rRNA 454 pyrosequencing. On an average, 15,000 partial 16S rRNA gene sequences were obtained from each sample. All sequences fell into 11 different bacterial phyla. During early CCRT, the microbial diversity gradually decreased. In a patient, who did not receive any antibiotics during the CCRT, Firmicutes and Proteobacteria were the most abundant phylum. During the early CCRT, proteobacteria gradually decreased while Firmicutes increased. During the late CCRT, firmicutes gradually decreased while Bacteroides and Fusobacteria increased. In all the patients, yellow complex showed a gradual decrease, while orange and red complex showed a gradual increase during the CCRT. At 4 weeks after CCRT, the recovery of oral microbiota diversity was limited. During CCRT, there was a gradual increase in major periodontopathogens in association with the deterioration of the oral hygiene. Henceforth, it is proposed that understanding oral microbiota shift should provide better information for the development of effective oral care programs for patients receiving CCRT for HNSCC.

Urachal cancer is extremely rare and accounts for fewer than 1% of malignant neoplasms of the bladder. Urachal remnants persist from the bladder dome to umbilicus after birth, and urachal carcinoma may arise from any of these segments. The standard treatment for urachal cancer is primarily wide excision with extended partial cystectomy of the urachal mass, urachal tract and umbilicus, and pelvic lymph node dissection. Nevertheless, prognosis is generally poor because early diagnosis is difficult and local invasions, distant metastasis, and recurrence frequently develop. The authors present a patient with recurred urachal adenocarcinoma, who was treated by partial cystectomy with lymph node dissection. One year after subsequent concurrent chemoradiotherapy, she achieved complete remission. A brief review of the literature on urachal adenocarcinoma is provided.