Role of Adjuvant Radiotherapy in Early Stage Tongue Cancer: Need for Establishing Stringent Guidelines

2021 ◽  
Author(s):  
Vishal Rao ◽  
Anand Subash ◽  
Piyush Sinha ◽  
Sameep Shetty ◽  
Shalini Thakur ◽  
...  
Keyword(s):  
Adjuvant Radiotherapy ◽  
Tongue Cancer ◽  
Early Stage

scholarly journals The Role of Radiotherapy for Pancreatic Malignancies- A Population-based Analysis of the SEER-Medicare Database.

2020 ◽  
Author(s):  
yunxiu luo ◽  
Shengjun Xiao
Keyword(s):  
Pancreatic Cancer ◽  
Pancreatic Carcinoma ◽  
Adjuvant Radiotherapy ◽  
Adenosquamous Carcinoma ◽  
Early Stage ◽  
Pancreatic Head ◽  
Population Based ◽  
Anatomical Location ◽  
Duct Carcinoma

Abstract Background and objective. To investigate the role of adjuvant radiotherapy in patients after surgical resection for pancreatic cancer. Methods and patients. The patients with pancreatic cancer from 18 registered institutions in the Surveillance Epidemiology and End Results (SEER) database were retrospectively analyzed. The characteristics of patients who would benefit from adjuvant radiotherapy were screened, as well as whether neoadjuvant or adjuvant radiotherapy conferred to a better clinical outcome. Results. 30249 patients included in this study (21295 vs 8954 in surgery and adjuvant radiotherapy group) .The median survivals in the surgery (S) group and adjuvant radiotherapy (S+R) group were 24 and 21 months respectively, The 1, 3, and 5-year overall survival (OS) rates in the S group and S+R group were 68%, 40%, 31% ,and 75%, 30%, 20%, respectively (p<0.001).Stratified analysis showed patients with histological classified as adenocarcinoma(15 VS 21, P<0.0001), infiltrating duct carcinoma (17 VS 21,P<0.0001), adenosquamous carcinoma(10 VS 18,P<0.0001) could be benefit from adjuvant radiotherapy. Adjuvant radiotherapy was helpful to improve the OS for patients with pancreatic head (19 VS 21, P=0.0003) and duct carcinoma (18VS 28, P=0.0121). Subgroup stratified assay indicated specific patients with early stage (AJCC 7th I, II, T2, N0) pancreatic carcinoma had better OS after additional radiotherapy than surgery alone. Conclusion. Additional radiotherapy may contribute to improved prognosis for patients with pancreatic carcinoma of specific histological types (adenocarcinoma/carcinoma, infiltrating duct carcinoma, adenosquamous carcinoma, and squamous), anatomical location, and advanced stage. A specific subgroup of patients with an early stage (I/II, T2) pancreatic cancer should be considered for additional radiotherapy.

scholarly journals The evolving role of adjuvant radiotherapy for elderly women with early-stage breast cancer

Cancer ◽  
2015 ◽  
Vol 121 (14) ◽  
pp. 2331-2340 ◽  
Author(s):  
Charles E. Rutter ◽  
Nataniel H. Lester-Coll ◽  
Brandon R. Mancini ◽  
Christopher D. Corso ◽  
Henry S. Park ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Radiotherapy ◽  
Elderly Women ◽  
Early Stage ◽  
Early Stage Breast Cancer

Role of radical hysterectomy in patients with early-stage high-grade neuroendocrine cervical carcinoma: a NeCTuR study

2021 ◽  
Vol 31 (4) ◽  
pp. 495-501 ◽  
Author(s):  
Gloria Salvo ◽  
Preetha Ramalingam ◽  
Alejandra Flores Legarreta ◽  
Anuja Jhingran ◽  
Naomi R Gonzales ◽  
...  
Keyword(s):  
Adjuvant Therapy ◽  
Cervical Carcinoma ◽  
Adjuvant Treatment ◽  
Adjuvant Radiotherapy ◽  
Radical Surgery ◽  
Early Stage ◽  
Pelvic Lymphadenectomy ◽  
High Grade ◽  
Parametrial Involvement

ObjectivePatients with early-stage, high-grade neuroendocrine cervical carcinoma typically undergo radical hysterectomy with pelvic lymphadenectomy followed by adjuvant radiotherapy and/or chemotherapy. To explore the role of radical surgery in patients with this disease, who have a high likelihood of undergoing postoperative adjuvant therapy, we aimed to determine the rate of parametrial involvement and the rate of parametrial involvement without other indications for adjuvant treatment in these patients.MethodsWe retrospectively studied patients in the Neuroendocrine Cervical Tumor Registry (NeCTuR) at our institution to identify those with International Federation of Gynecology and Obstetrics (FIGO) 2018 stage IA1-IB2, high-grade neuroendocrine cervical carcinoma who underwent up-front radical surgery with or without adjuvant therapy.ResultsOne hundred patients met the inclusion criteria. The median age was 35 years (range 22–65), and 51% (51/100) had pure high-grade neuroendocrine carcinoma. No patient had a tumor >4 cm or suspected parametrial or nodal disease before surgery. Ten patients (10%) had microscopic parametrial compromise in the final surgical specimens. Ninety-four (94%) patients underwent nodal assessment, and 19 (19%) had positive nodes. Ten patients underwent both sentinel lymph node biopsy and pelvic lymphadenectomy, and none had false-negative findings. Patients with parametrial compromise were more likely to have positive pelvic nodes (80% vs 12%, p<0.0001), and a positive vaginal margin (20% vs 1%, p=0.03). All patients with parametrial compromise had lymphovascular space invasion (100% vs 73%, p=0.10). Of the 100 patients, 95 (95%) were recommended adjuvant therapy and 89 (89%) were known to have received it. Adjuvant pelvic radiotherapy reduced the likelihood of local recurrence by 62%.ConclusionsIn carefully selected patients with high-grade neuroendocrine cervical carcinoma, the rate of microscopic parametrial involvement is 10%. As most patients receive adjuvant treatment, we hypothesize that simple hysterectomy may be adequate when followed by adjuvant radiotherapy with concurrent cisplatin and etoposide followed by additional chemotherapy.

Oesophageal cancer

2016 ◽  
pp. 365-387
Author(s):  
Melissa Thomas ◽  
Karin Haustermans ◽  
Eric Van Cutsem ◽  
Piet Dirix ◽  
Xavier Sagaert ◽  
...  
Keyword(s):  
Oesophageal Cancer ◽  
Adjuvant Radiotherapy ◽  
Palliative Treatment ◽  
Early Stage ◽  
Locally Advanced ◽  
Adjuvant Chemoradiotherapy ◽  
Valuable Alternative ◽  
Early Stage Carcinoma

Worldwide, oesophageal cancer, including cancer of the gastro-oesophageal junction (GEJ), is the sixth leading cause of death from cancer. Despite recent advances, treatment of oesophageal cancer remains challenging and is best approached by an experienced multidisciplinary team. Surgery alone is the treatment of choice in early stage carcinoma although in superficial cancers (T1a) endoscopic resection is to be preferred. In locally advanced tumours induction therapy followed by surgery is the preferred treatment. In selected cases definitive chemoradiotherapy could be considered as a valuable alternative. The role of adjuvant chemotherapy is unclear, but could be considered for selected GEJ adenocarcinoma patients. Adjuvant chemoradiotherapy should be considered in all patients with advanced disease or positive margins who did not receive neo-adjuvant radiotherapy. For metastatic disease, the goal is to prolong and maximize quality of life. Regarding the palliative treatment of dysphagia, brachytherapy was shown to be more effective than stenting.

scholarly journals The role of radiotherapy for early-stage pancreatic malignancies: a population-based analysis of the SEER-Medicare database

2021 ◽  
Author(s):  
Y. Luo
Keyword(s):  
Pancreatic Cancer ◽  
Adjuvant Radiotherapy ◽  
Early Stage ◽  
Pancreatic Head ◽  
Population Based ◽  
Duct Carcinoma ◽  
Radiotherapy Group ◽  
Pancreatic Body ◽  
Specific Subgroup

Abstract Background To investigate the role of adjuvant radiotherapy in patients with pancreatic cancer. Methods and patients The patients with pancreatic cancer from 18 registered institutions in the Surveillance Epidemiology and End Results (SEER) database were retrospectively analyzed. The characteristics of patients who would benefit from adjuvant radiotherapy were screened, as well as whether neoadjuvant or adjuvant radiotherapy conferred to a better clinical outcome. Propensity score matching was used to control for confounding features. Results Thirty thousand two hundred and forty-nine patients were included in this study (21,295 vs 8954 in surgery and adjuvant radiotherapy group); 1150 patients were matched in two groups. The median survivals in the surgery (S) group and adjuvant radiotherapy (S + R) group were 24 and 21 months, respectively. The 1-, 3-, and 5-year overall survival (OS) rates in the S group and S + R group were 68%, 40%, 31%, and 75%, 30%, 20%, respectively (p < 0.001), and the median OS was 22 and 25 months in S and S + R group after PSM, the former 1-, 2-, 3-, and 5-year OS were 73%, 45%, 30%, and 19%, and the later were 81%, 52%, 37%, and 24% (p = 0.0015), respectively; stratified analysis showed patients whose carcinoma located at pancreatic head with II stage infiltrating duct carcinoma (22 vs 25, p = 0.0276), T4 adenocarcinoma (28 vs 33, p = 0.0022), N1 stage adenocarcinoma (20 vs 23, p = 0.0203), and patients with infiltrating duct carcinoma received regional resection (23 vs 25, p = 0.028) and number of resected lymph node were ≥ 4 (22 vs 25, p = 0.009) had better OS after additional radiotherapy than surgery alone. Patients with pancreatic body/tail carcinoma III stage adenocarcinoma (13 vs, p = 0.0503) and T4 adenocarcinoma (14 vs, p = 0.0869) had survival advantage within 24 months for additional radiotherapy. However, patients with T2 stage adenocarcinoma located in pancreatic body/tail had better OS in surgery group than that in R + S group. Conclusions Additional radiotherapy may contribute to improved prognosis for patients with pancreatic head II stage infiltrating duct carcinoma, III stage adenocarcinoma, T4 stage carcinoma, N1 stage adenocarcinoma, regional resection, or number of lymphadenectomy ≥ 4 in infiltrating duct carcinoma. A specific subgroup of patients with specific stage and histological type pancreatic cancer should be considered for additional radiotherapy.

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