Scalp and Forehead Injury: Management of Acute and Secondary Defects

2021 ◽  
Author(s):  
Arya W. Namin ◽  
Patrick T. Tassone ◽  
Tabitha L.I. Galloway ◽  
Gregory J. Renner ◽  
C.W. David Chang
Keyword(s):  
Radiation Therapy ◽  
Adjuvant Therapy ◽  
Vascular Supply ◽  
Convex Shape ◽  
Concomitant Infection ◽  
Medical Comorbidities ◽  
Injury Management ◽  
Scalp Reconstruction ◽  
Reconstructive Ladder

AbstractThe primary challenges in scalp reconstruction are the relative inelasticity of native scalp tissue and the convex shape of the calvarium. All rungs of the reconstructive ladder can be applied to scalp reconstruction, albeit in a nuanced fashion due to the unique anatomy and vascular supply to the scalp. Important defect variables to incorporate into the reconstructive decision include site, potential hairline distortion, size, depth, concomitant infection, prior radiation therapy, planned adjuvant therapy, medical comorbidities, patient desires, and potential calvarium and dura defects.

Teratomas of the central nervous system: treatment considerations based on 34 cases

1998 ◽  
Vol 89 (5) ◽  
pp. 728-737 ◽  
Author(s):  
Yutaka Sawamura ◽  
Tsutomu Kato ◽  
Jun Ikeda ◽  
Jun-ichi Murata ◽  
Mitsuhiro Tada ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Radiation Therapy ◽  
Adjuvant Therapy ◽  
Karnofsky Performance Scale ◽  
Content Type ◽  
Treatment Considerations ◽  
Low Incidence ◽  
A Prospective Study ◽  
Fine Print

Object. The optimum clinical management of central nervous system (CNS) teratomas, particularly postsurgical adjuvant therapy, is still unclear, partly as a result of the tumors' low incidence. In this study the authors analyze 34 cases of CNS teratomas so that they may adequately indicate management of these lesions. Methods. The median age of the 34 patients was 13 years. Twenty-seven patients treated between 1970 and 1991 were retrospectively reviewed. Four of these 27 patients died as a result of radical surgery; each of them had a teratoma involving the hypothalamus. After initial treatment, which included radiation therapy, 20 patients (48%) had died. In all seven cases of mature teratomas there was no recurrence. In two cases of immature teratomas in which there was complete surgical resection there was recurrence; however, salvage therapies were effective. Seven of eight patients with highly malignant teratomas died; for these patients salvage therapies, including repeated radiation and chemotherapy, failed. Seven patients who presented with CNS teratomas between 1992 and 1996 received adjuvant chemotherapy and radiation therapy according to a prospective study protocol. All seven patients were free from recurrence with a 70 to 100% Karnofsky Performance Scale score at a median follow-up period of 41 months. Patients with CNS teratomas rarely responded completely to chemotherapy or radiation therapy; an effective adjuvant therapy produced a partial response at best. Conclusions. Because teratomas show various responses to adjuvant therapy, a misdiagnosis of their histological subtype will lead to inadequate therapy. A diverse therapeutic protocol based on histological diagnosis is necessary to plan appropriate management. Treatment recommendations are discussed in detail in the article.

scholarly journals Times Not to Forget Radiotherapy When Treating Patients With Lymphoma

2019 ◽  
Vol 15 (4) ◽  
pp. 167-172 ◽  
Author(s):  
Charles A. Enke
Keyword(s):  
Patient Outcome ◽  
Radiation Therapy ◽  
Adjuvant Therapy ◽  
Local Control ◽  
Combined Modality Therapy ◽  
Primary Treatment ◽  
Lymphoma Treatment ◽  
Clinical Presentations ◽  
Refractory Lymphoma ◽  
Affect Patient Outcome

Radiation therapy remains an important component of lymphoma treatment. It has evolved with improvements in technology and a better understanding of how to successfully integrate it into lymphoma treatment. There are specific clinical presentations where omission of radiation therapy could adversely affect patient outcome and should not be overlooked. Radiation therapy may serve an important role as primary treatment, as a component of combined modality therapy, as adjuvant therapy to maximize local control, and as an important component of salvage therapy for relapsed or primary refractory lymphoma and in the successful palliation of lymphoma. This review identifies those clinical presentations where the use of radiation therapy should not be overlooked or should at least be considered.

Systemic chemotherapy compared with radiation therapy as adjuvant therapy after radical surgery in high-risk stage IB-IIB cervical adenocarcinoma.

2014 ◽  
Vol 32 (15_suppl) ◽  
pp. 5598-5598
Author(s):  
Toshiyuki Seki ◽  
Hiroshi Tanabe ◽  
Chie Nagata ◽  
Satoshi Takakura ◽  
Seiji Isonishi ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
High Risk ◽  
Adjuvant Therapy ◽  
Systemic Chemotherapy ◽  
Radical Surgery ◽  
Cervical Adenocarcinoma ◽  
Stage Ib

Adjuvant therapy for early-stage endometrial cancer: a review

2007 ◽  
Vol 17 (5) ◽  
pp. 949-956 ◽  
Author(s):  
S. Tangjitgamol ◽  
S. Manusirivithaya ◽  
C. Lertbutsayanukul
Keyword(s):  
Radiation Therapy ◽  
Endometrial Cancer ◽  
High Risk ◽  
Adjuvant Therapy ◽  
Adjuvant Treatment ◽  
Hormonal Therapy ◽  
Early Stage ◽  
Favorable Outcome ◽  
Early Stage Endometrial Cancer

Most patients with endometrial cancer (EMC) present their symptoms early in their course, leading to an overall favorable outcome. However, some patients who are in early-stage diseases may carry some risk features that would hamper their prognoses. For these early-stage diseases with high risk of recurrences, radiation therapy certainly plays a major role as an adjuvant treatment. Despite an excellent local diseases control by radiation, systemic failures are still encountered. To improve the prognoses, other types of adjuvant therapy have been attempted. In this review, various options of adjuvant treatment for this early-stage EMC including radiation therapy, chemotherapy, and hormonal therapy are discussed.

SURG-08. SARCOPENIA IS A PROGNOSTIC FACTOR OF 90-DAY MORTALITY AND OVERALL SURVIVAL IN ELDERLY PATIENTS WITH GLIOBLASTOMA

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi196-vi196
Author(s):  
Ramin Morshed ◽  
Jacob Young ◽  
Megan Casey ◽  
Elaina Wang ◽  
Manish K Aghi ◽  
...  
Keyword(s):  
Overall Survival ◽  
Radiation Therapy ◽  
Life Expectancy ◽  
Adjuvant Therapy ◽  
Elderly Patients ◽  
Tumor Resection ◽  
Preoperative Imaging ◽  
Imaging Features ◽  
Who Grade ◽  
Treatment Data

Abstract Elderly patients with glioblastoma (GBM) have worse overall prognosis compared to younger patients and are less likely to undergo tumor resection and adjuvant therapy. The goal of this study was to identify patient and treatment factors as well as preoperative imaging features associated with worse overall survival and death within 3 months of surgery in elderly GBM patients. A single-center retrospective study was conducted with patients who met the following inclusion criteria: 1) age ≥ 79 at surgery (past the average age of life expectancy), 2) underwent biopsy or resection of an IDH-wildtype WHO Grade IV GBM at the time of initial diagnosis, and 3) had no prior radiation or chemotherapy. Patient, imaging, and treatment data were collected retrospectively from the electronic medical record. Univariate and multivariate Cox proportional hazard and logistic regression analyses were performed to identify factors associated with overall survival and 90-day mortality. The cohort consisted of 110 patients with a mean age of 82.8 (range 79 to 94.1) at surgery and a median preoperative KPS of 80. Thirty-seven (33.6%) and 73 (66.4%) patients underwent biopsy and resection, respectively. Adjuvant chemo- and/or radiation therapy were used in 72.5% of cases. On multivariate analysis, age (HR 1.13 by year, p=0.01), increased masseter thickness (HR 0.88 by mm, p=0.049), adjuvant therapy (HR 0.05, p< .0001), and surgical resection rather than biopsy (HR 0.38, p=0.0007) were associated with improved survival. Decreased masseter thickness was the only preoperative factor on analysis that predicted 90-day mortality in the cohort (p=0.038). GBM patients past the average age of life expectancy still fare better when undergoing resection followed by adjuvant chemotherapy and radiation therapy. In addition to treatment factors that predict survival, smaller masseter diameter on preoperative imaging, a marker of sarcopenia, is associated with shorter survival and death within 90 days of surgery.

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