scholarly journals Long‐term urological complications after conservative local treatment (surgery and brachytherapy) in children with bladder–prostate rhabdomyosarcoma: A single‐team experience

2022 ◽  
Author(s):  
Rezkalla Akkary ◽  
Florent Guérin ◽  
Cyrus Chargari ◽  
Loic Jochault ◽  
Georges Audry ◽  
...  
Author(s):  
Rezkalla Akkary ◽  
Cyrus Chargari ◽  
Florent Guérin ◽  
Loic Jochault ◽  
Georges Audry ◽  
...  

Background: Outcome of children with bladder-prostate rhabdomyosarcoma has improved with multimodal therapies, including surgery and/or radiotherapy for local treatment. Our aim was to report the long-term urological complications after a conservative approach combining conservative surgery and brachytherapy. Patients and methods: Eighty-six patients, free of disease, were retrospectively reviewed. Symptoms related to urinary tract obstruction, incontinence, infection and lithiasis were reported and graded according to CTCAE classification. Only symptomatic patients underwent urodynamic studies. Risk factors for complications were analyzed. Results: There were 76 males and 10 females. The median follow-up was 6.3 years (18 months-24 years). Complications occurred after a median follow up 5 years (0-21). Twenty-two patients had long-term urological complications. Urinary tract obstruction was found in 15 patients, urinary incontinence in 14 patients. Recurrent urinary tract infection and urinary lithiasis were found in 5 patients respectively. Beyond symptom, 3 etiologies were identified: bladder dysfunction in 15 patients, urethral stenosis in 6 and uretero-vesical junction stenosis in 5. Posterior bladder wall dissection used in large prostatic tumors, operation at age less than 2 years and partial prostatectomy were identified as risk factors for these complications. Conclusion: The conservative surgical approach combined with brachytherapy for BPRMS leads to long-term urological complications in 22% of patients free of their disease. Optimizing brachytherapy doses for young children and establishing a clear and long term follow-up protocol, could help to reduce these complications.


Author(s):  
Shelemekh K.E. ◽  
Petrov Yu.A. ◽  
Arndt I.G. ◽  
Evdokimova E.P. ◽  
Chernavsky V.V.

The analysis of the data of modern scientific literature containing information on topical issues in the treat-ment of chronic endometritis as one of the most acute, frequently encountered problems of modern gynecol-ogy is carried out. This disease today requires special attention of doctors and scientists due to the erased course of the disease, complex diagnostics and multi-faceted treatment. Chronic inflammation affects men-strual function, fertility of women, is often a complica-tion of pregnancy, childbirth, the postpartum period, and can also cause infertility and early loss, which actualizes the topic of timely and individually selected treatment for patients diagnosed with chronic endo-metritis. Treatment should be aimed at relieving clini-cal symptoms, eradicating the pathogen and combat-ing adverse long-term consequences. Today, many approaches to treatment are known, but it is worth choosing the most effective and promising ones. In addition to etiotropic and symptomatic treatment, attention should be paid to restoring the morphofunc-tional potential of the endometrium with the help of physiotherapy. An important advantage of such com-plexes is the possibility of intracavitary effects that increase the effectiveness of treatment due to local treatment.


2001 ◽  
Vol 165 (6 Part 1) ◽  
pp. 1884-1887 ◽  
Author(s):  
J. HERMAN van ROIJEN ◽  
WIM J. KIRKELS ◽  
ROBERT ZIETSE ◽  
JOKE I. ROODNAT ◽  
WILLEM WEIMAR ◽  
...  

Author(s):  
Benedetta Zampetti ◽  
Giorgia Simonetti ◽  
Roberto Attanasio ◽  
Antonio Silvani ◽  
Renato Cozzi

Summary We describe the 20-year course of a 63-year-old male with a macroprolactinoma that acquired resistance to treatment and aggressive behavior after a 4-year successful treatment with cabergoline. He was submitted to multiple surgical resections by a skilled surgeon, fractionated radiotherapy and was eventually treated with temozolomide. After a first 6-month standard cycle, a relapse occurred and he was treated again successfully. Learning points: Prolactinomas are the most frequent type of pituitary adenoma. They usually have a benign course. In most cases dopamine-agonist drugs, mainly cabergoline, are first-line (and usually only) treatment. Occasionally prolactinomas can have or acquire resistance to treatment and/or aggressive behavior. Temozolomide (TMZ), an oral alkylating drug, can be effective in such aggressive tumors. Multimodal treatment (surgery, radiation, cabergoline and TMZ) is warranted in aggressive pituitary tumors. We describe here successful rechallenge with TMZ after relapse occurring 18 months after a first TMZ cycle.


Molecules ◽  
2020 ◽  
Vol 25 (10) ◽  
pp. 2270
Author(s):  
Marlon Osorio ◽  
Estefanía Martinez ◽  
Tonny Naranjo ◽  
Cristina Castro

Colorectal cancer (CRC) is the type with the second highest morbidity. Recently, a great number of bioactive compounds and encapsulation techniques have been developed. Thus, this paper aims to review the drug delivery strategies for chemotherapy adjuvant treatments for CRC, including an initial scientific-technological analysis of the papers and patents related to cancer, CRC, and adjuvant treatments. For 2018, a total of 167,366 cancer-related papers and 306,240 patents were found. Adjuvant treatments represented 39.3% of the total CRC patents, indicating the importance of adjuvants in the prognosis of patients. Chemotherapy adjuvants can be divided into two groups, natural and synthetic (5-fluorouracil and derivatives). Both groups can be encapsulated using polymers. Polymer-based drug delivery systems can be classified according to polymer nature. From those, anionic polymers have garnered the most attention, because they are pH responsive. The use of polymers tailors the desorption profile, improving drug bioavailability and enhancing the local treatment of CRC via oral administration. Finally, it can be concluded that antioxidants are emerging compounds that can complement today’s chemotherapy treatments. In the long term, encapsulated antioxidants will replace synthetic drugs and will play an important role in curing CRC.


2020 ◽  
Vol 48 (7) ◽  
pp. 030006052094050
Author(s):  
Kezhong Tang ◽  
Bo Zhang ◽  
Linping Dong ◽  
Lantian Wang ◽  
Zhe Tang

Objective To compare the short- and long-term outcomes of radiofrequency ablation (RFA) versus liver resection and chemotherapy for liver metastases from gastric cancer. Methods We retrospectively evaluated 50 patients who underwent curative gastrectomy and local treatments for liver metastases (RFA, n = 20; liver resection, n = 20; and chemotherapy, n = 10) from 2008 to 2018. Results The short- and long-term outcomes of each local treatment were evaluated. The median overall survival (OS) after RFA was similar to that after liver resection (20 vs. 20 months, respectively) and longer than that after chemotherapy (20 vs. 10 months, respectively). The 3-year OS and progression-free survival (PFS) rates after RFA were 20% and 10%, respectively, while those in the liver resection group were 23.5% and 23.5%, respectively. The 3-year OS rate after chemotherapy was 10%. The size and number of metastases were prognostic factors for patients with gastric cancer with liver metastasis without statistical significance. Conclusions Among patients with liver metastasis from gastric cancer, OS and PFS were satisfactory and comparable between RFA and liver resection but better than those of chemotherapy. RFA is an appropriate option for patients with gastric cancer who have a solitary liver metastasis measuring ≤3.0 cm.


2007 ◽  
Vol 96 (3) ◽  
pp. 209-213 ◽  
Author(s):  
M. Sørensen ◽  
F. V. Mortensen ◽  
M. Høyer ◽  
H. Vilstrup ◽  
S. Keiding ◽  
...  

Background and Aim: Colorectal cancer is a common cancer in the Nordic countries and 50% of the patients develop liver metastases. Liver resection may result in long term survival. Proper staging is therefore essential and CT is the standard imaging modality. We examined whether additional FDG-PET improves therapeutic management of patients with colorectal liver metastases. Patients and Methods: Fifty-four consecutive patients were enrolled. Each patient had a treatment plan made based on our standard evaluation. The patients then had a PET scan and the treatment plan was re-evaluated, taking these results into account. Results: In 76% of the cases, PET did not change the treatment plan due to complete concordance with CT. In another 19% of the cases, the plan was altered due to finding of more liver lesions by PET than by CT (four patients), fewer or no liver lesions (three patients), and extrahepatic lesions not visible on CT (three patients). In 5% of the cases, non-concordance between PET and CT did not change the therapeutic plan. Conclusion: Pre-treatment FDG-PET, used supplementary to CT, improved the treatment plan in one fifth of the patients with colorectal liver metastases.


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