Trimodality approach, using modern radiation techniques, for management of locally advanced adrenocortical carcinoma – case report

2021 ◽  
pp. 1-4
Author(s):  
André Laranja ◽  
Carolina Ferreira
Keyword(s):  
Case Report ◽  
High Risk ◽  
Local Recurrence ◽  
Adrenocortical Carcinoma ◽  
Postoperative Radiotherapy ◽  
Locally Advanced ◽  
Volumetric Modulated Arc Therapy ◽  
Case Presentation ◽  
Risk Of Recurrence ◽  
Arc Therapy

Abstract Background: Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy. Surgery is the mainstay of treatment, still even after a R0 surgical margins, there is a high risk of recurrence. Case Presentation: A 26-year-old female diagnosed with a large functioning ACC treated with a trimodality approach (surgery, radiotherapy and chemotherapy). Postoperative radiotherapy was proposed regarding the high risk of recurrence. A dose of 50.4 Gy in 28 fractions was delivered to the patient using a volumetric-modulated arc therapy plan. Radiotherapy was safe and well tolerated, and no local recurrence was observed so far (13 months after radiotherapy). Conclusions: Due to the rarity of ACC and the lack of evidence regarding this entity, therapeutic approach can be challenging. Recent evidence suggests that radiotherapy could have an important role in the therapeutic arsenal.

scholarly journals Benefit of Postoperative Radiotherapy for Patients With Nonmetastatic Adrenocortical Carcinoma: A Population-Based Analysis

2021 ◽  
Vol 19 (12) ◽  
pp. 1425-1432
Author(s):  
Kan Wu ◽  
Xu Liu ◽  
Zhihong Liu ◽  
Yiping Lu ◽  
Xianding Wang ◽  
...  
Keyword(s):  
High Risk ◽  
Adrenocortical Carcinoma ◽  
Survival Benefit ◽  
Cox Regression ◽  
Radical Surgery ◽  
Postoperative Radiotherapy ◽  
Disease Stage ◽  
Cox Regression Analysis ◽  
Risk Of Recurrence ◽  
Risk Of Death

Background: Adrenocortical carcinoma (ACC) is an aggressive cancer with high recurrence rates and poor prognosis, even after radical surgery. The survival benefit of adjuvant radiotherapy (RT) in patients with ACC has not been well explored. The aim of this study was to evaluate the effect of adjuvant RT on the survival outcome of patients with ACC. Patients and Methods: All patients with nonmetastatic ACC who underwent complete resection were identified from the SEER database (2004–2016). Overall survival (OS) was estimated using the Kaplan-Meier method. Multivariable Cox regression analysis was performed to identify prognostic factors associated with survival. Results: Of 365 patients with nonmetastatic ACC, 55 (15.1%) received adjuvant RT and the remainder underwent surgery alone. Patient characteristics were similar between the 2 groups, but those with a higher disease stage were more likely to receive adjuvant RT. Overall, patients receiving RT seemed to have better survival compared with the non-RT group (3-year OS rate, 63.1% vs 52.8%; P<.062). After adjustment for confounding factors, adjuvant RT was indeed associated with a 48% decreased risk of death (hazard ratio, 0.52; 95% CI, 0.29–0.91; P=.023) for all patients. In addition, adjuvant RT may confer a survival benefit only in patients with a high risk of recurrence (3-year OS rate, 55.1% vs 40.0%; P=.048) rather than in those with low/moderate-risk ACC (P=.559). Conclusions: Our findings suggest that adjuvant RT may be associated with improved survival in patients with nonmetastatic ACC who underwent radical surgery, especially those with high risk of recurrence.

scholarly journals Formulating an anesthetic plan using a list of high-risk pregnant women on cloud-based business communication tools: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Junnosuke Kimura ◽  
Kento Kawamura ◽  
Manami Minoura ◽  
Ayako Hiramoto ◽  
Yoshifumi Suga ◽  
...  
Keyword(s):  
Case Report ◽  
High Risk ◽  
Cesarean Section ◽  
General Anesthesia ◽  
Pregnant Women ◽  
Cesarean Delivery ◽  
Business Communication ◽  
Communication Tools ◽  
Case Presentation ◽  
Emergency Cesarean

Abstract Background We report a case in which a list of high-risk pregnant women on cloud-based business communication tools was useful in formulating an anesthetic plan for unscheduled cesarean section. Case presentation A 37-year-old woman, who had been prescribed icosapentate for hypertriglyceridemia, received an antenatal anesthetic evaluation for possible cesarean delivery, and it was agreed that the anesthetic method for emergency cesarean section was general anesthesia if the surgery would take place within 7 days after the discontinuation of the drug, and regional anesthesia if it would take place any time later. Then this agreement was uploaded on the cloud-based business communication tools, and updated until she delivered her baby via unscheduled cesarean section. Conclusions A cloud-based business communication tools was useful in formulating an anesthesia plan for a patient undergoing a cesarean delivery. However, more discussion would be needed to utilize it in security.

Tangential Volumetric Modulated Arc Therapy for Locally Advanced Breast Cancer

2021 ◽  
Author(s):  
Pedro L. Zamora ◽  
Geoffrey Baran ◽  
Christopher Nagle ◽  
Ahmad Hammoud ◽  
Michael Dominello
Keyword(s):  
Breast Cancer ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Volumetric Modulated Arc Therapy ◽  
Advanced Breast ◽  
Arc Therapy

scholarly journals Bilateral Breast Irradiation Using Hybrid Volumetric Modulated Arc Therapy (h-VMAT) Technique: A Planning Case Report

Cureus ◽  
2016 ◽  
Author(s):  
Sitaraman Balaji Subramanian ◽  
Karunakaran Balaji ◽  
Moorthi Thirunavukarasu ◽  
Sumana Premkumar
Keyword(s):  
Case Report ◽  
Volumetric Modulated Arc Therapy ◽  
Breast Irradiation ◽  
Arc Therapy
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