scholarly journals GCT-08. PROTON BEAM RADIOTHERAPY FOR PEDIATRIC AND YOUNG-ADULT PATIENTS WITH INTRACRANIAL GERM CELL TUMOR

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii329-iii329
Author(s):  
Minako Sugiyama ◽  
Takayuki Hashimoto ◽  
Takashi Mori ◽  
Kazuya Hara ◽  
Yukayo Terashita ◽  
...  
Keyword(s):  
Young Adult ◽  
Adverse Events ◽  
Germ Cell ◽  
Cell Count ◽  
Proton Beam ◽  
Adult Patients ◽  
Short Term ◽  
Intracranial Germ Cell Tumor ◽  
X Ray ◽  
Proton Beam Radiotherapy

Abstract BACKGROUND To reduce treatment-related adverse events in pediatric and young-adult patients with brain tumors, proton beam radiotherapy (PBT) has recently been performed instead of conventional X-ray radiotherapy. However, whether PBT is as effective as X-ray radiotherapy has not been sufficiently investigated, especially in patients receiving whole-ventricular irradiation. METHODS We report a retrospective observation of 15 patients with intracranial germ cell tumors (GCT), who received PBT at our institution from April 2014 to September 2019. We evaluated their clinical course, short-term adverse events, and prognosis. RESULTS/ CONCLUSION Fifteen patients (9 males and 6 females; median age 13 years) who received PBT following induction chemotherapy were analyzed. Nine patients received 23.4–27.0 GyE of whole-ventricular irradiation due to GCT in the pituitary gland, pineal body, or hypothalamic area. Three patients received 23.4 GyE of whole-brain irradiation: one of them had boost irradiation for basal ganglia. Three patients received 30.6 GyE of craniospinal irradiation (CSI). Six of the 15 patients experienced nausea (grade 2, according to the CTCAE version 4.0). Four patients, including two who received CSI, showed myelosuppression: decrease in white blood cell count, lymphocyte cell count, and neutrophil count (grade 3). No other severe short-term adverse events of >grade 2 was observed in any of the patients. At a median follow-up of 21 months (2-62 months) after irradiation. all patients are alive without recurrence. Our results may be encouraging and further investigations with a larger scale is warranted.

scholarly journals 4-D flow MRI aortic 3-D hemodynamics and wall shear stress remain stable over short-term follow-up in pediatric and young adult patients with bicuspid aortic valve

2018 ◽  
Vol 49 (1) ◽  
pp. 57-67 ◽  
Author(s):  
Michael J. Rose ◽  
Cynthia K. Rigsby ◽  
Haben Berhane ◽  
Emilie Bollache ◽  
Kelly Jarvis ◽  
...  
Keyword(s):  
Shear Stress ◽  
Young Adult ◽  
Aortic Valve ◽  
Wall Shear Stress ◽  
Bicuspid Aortic Valve ◽  
Adult Patients ◽  
Short Term ◽  
Flow Mri ◽  
Wall Shear

scholarly journals Low dose long-acting factor VIII prophylaxis in pediatric and young adult patients with hemophilia A: Short-term single-center experience from a developing country

2021 ◽  
Vol 0 ◽  
pp. 1-6
Author(s):  
Shailendra Prasad Verma ◽  
Anil Kumar Tripathi ◽  
Geeta Suri Sharma ◽  
Nidhish Kumar ◽  
Rashmi Kushwaha
Keyword(s):  
Young Adult ◽  
Adverse Events ◽  
Factor Viii ◽  
Low Dose ◽  
Hemophilia A ◽  
Adult Patients ◽  
Severe Hemophilia ◽  
Emergency Visits ◽  
Episodic Treatment ◽  
Long Acting

Objectives: High dose factor prophylaxis in hemophilia has been proven to prevent joint bleeds in the western world effectively. We look for a cost-effective and feasible way for Indian patients to reduce the dose and frequency of factor infusion. Data on prophylaxis with a low dose, long-acting factor infusion twice a week dosing schedule is limited. The purpose was to study the efficacy and safety of long-acting factor VIII (Eloctate) for secondary/ tertiary prophylaxis in pediatric and young adult patients with moderate and severe hemophilia A. Materials and Methods: Thirty-eight patients with moderate and severe hemophilia A with an age range from 1 to 25 years were included in the study. During the initial 4 months, they received therapeutic doses of ELOCTATE (Factor VIII with Fc Fusion Protein) on an episodic basis after a clinical bleed. In the next 4 months, they received prophylactic intravenous ELOCTATE at the dose of 20 units/kg body weight twice a week. Annual bleeding rates (ABR), school absenteeism, emergency visits, joint scores, and adverse events were compared during both periods. Results: The total number of joint bleeds during the episodic treatment and prophylaxis period was 608 and 67, respectively. ABR was 47.9 during the episodic treatment period and 5.3 during prophylaxis showing an 88.9% reduction in joint bleeds. School/college absenteeism and emergency visits were significantly reduced during prophylaxis. No significant adverse events were noted during prophylaxis. Conclusion: Low dose, twice a week, and long-acting recombinant factor VIII-Fc (Eloctate) prophylaxis can be a reasonable options for patients with hemophilia A in developing countries.

Early Experience of the World’s First Single-Room Gantry Mounted Active Scanning Proton Therapy System at an Integrated Cancer Center

2020 ◽  
Author(s):  
Matthew Forsthoefel ◽  
Elizabeth Ballew ◽  
Keith R. Unger ◽  
Peter H. Ahn ◽  
Sonali Rudra ◽  
...  
Keyword(s):  
Proton Beam ◽  
Proton Therapy ◽  
Insurance Coverage ◽  
Early Experience ◽  
Cancer Center ◽  
X Ray ◽  
Proton Beam Radiotherapy ◽  
Single Room ◽  
Active Scanning ◽  
Insurance Approval

Abstract Introduction Review the early experience with a single-room gantry mounted active scanning proton therapy system implemented in the modern era. Materials and Methods All patients treated with proton beam radiotherapy (PBT) were enrolled in an institutional review board-approved patient registry. Proton beam radiotherapy was delivered with a 250 MeV gantry mounted synchrocyclotron in a single-room integrated facility within the pre-existing cancer center. Demographic data, cancer diagnoses, treatment technique, and geographic patterns were obtained for all patients. Treatment plans were evaluated for mixed modality therapy. Insurance approval data was collected for all patients treated with PBT. Results A total of 132 patients were treated with PBT between March 2018 and June 2019. The most common oncologic subsites treated included the central nervous system (22%), gastrointestinal tract (20%), and genitourinary tract (20%). The most common histologies treated included prostate adenocarcinoma (19%), non-small cell lung cancer (10%), primary CNS gliomas (8%), and esophageal cancer (8%). Rationale for PBT treatment included limitation of dose to adjacent critical organs at risk (67%), reirradiation (19%), and patient comorbidities (11%). Patients received at least one x-ray fraction delivered as prescribed (36%) or less commonly due to unplanned machine downtime (34%). Concurrent systemic therapy was administered to 57 patients (43%). Twenty-six patients (20%) were initially denied insurance coverage and required peer-to-peers (65%), written appeals (12%), secondary insurance approval (12%), and comparison x-ray to proton plans (8%) for subsequent approval. Proton beam radiotherapy approval required a median of 17 days from insurance submission. Conclusion Incorporation of PBT into our existing cancer center allowed for multidisciplinary oncologic treatment of a diverse population of patients. Insurance coverage for PBT presents as a significant hurdle and improvements are needed to provide more timely access to necessary oncologic care.

scholarly journals GCT-17. WHAT IS THE CLINICAL OUTCOME OF PROTON BEAM THERAPY FOR PATIENTS WITH INTRACRANIAL GERM CELL TUMOR IN KOREA?

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii331-iii331
Author(s):  
Sang Hee Youn ◽  
Joo-Young Kim
Keyword(s):  
Basal Ganglia ◽  
Clinical Outcome ◽  
Germ Cell ◽  
Proton Beam ◽  
Germ Cell Tumor ◽  
Germ Cell Tumors ◽  
Proton Beam Therapy ◽  
Cell Tumor ◽  
Intracranial Germ Cell Tumor ◽  
Failure Patterns

Abstract PURPOSE To evaluate the clinical outcome of patients with intracranial germ cell tumor treated with proton beam therapy (PBT). MATERIALS AND METHODS Fifty-seven patients with intracranial germ cell tumor treated with PBT between 2009 and 2016 were retrospectively analyzed. RESULTS Median follow-up duration was 63.7 months (range, 5.6–204.5). Thirty-seven patients (64.9%) were pure germinoma and 20 patients (35.1%) were non-germinomatous germ cell tumor (NGGCT). All patients except 2 patients received chemotherapy before PBT. Twenty-one patients (36.8%) of localized germinoma were treated with whole ventricle irradiation (WVI), while 36 (63.2%) patients who were diagnosed as disseminated germinoma or NGGCT received cranio-spinal irradiation (CSI). Two patients with pure germinoma in basal ganglia showed disease relapse at 3.0 and 6.9 years after PBT at the primary site and pituitary gland, respectively. There was one patient with NGGCT who died of chemotherapy-related mortality at 4.7 years after PBT while her disease was complete remission. The 7-year progression-free survival and overall survival were 70.8% and 100% for focal germinoma, 100% and 100% for disseminated germinoma, 100% and 100% for focal NGGCTs, and 100% and 80.0% for disseminated NGGCTs, respectively. CONCLUSIONS PBT of pure germinoma resulted in comparable clinical outcomes to that with photon radiotherapy. Our result for NGGCT is also excellent compared to other reports. Failure patterns of germ cell tumors originating in basal ganglia needs to be assessed in large pooled data.

scholarly journals Short-term outcome of ceramic-on-ceramic total hip replacement in young adult patients

2015 ◽  
Vol 24 (3) ◽  
pp. 163-7
Author(s):  
Ismail H. Dilogo ◽  
William Chandra
Keyword(s):  
Young Adult ◽  
Femoral Component ◽  
Total Hip Replacement ◽  
Hip Replacement ◽  
Adult Patients ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome ◽  
Sf 36 ◽  
Ceramic On Ceramic

Background: Ceramic-on-ceramic (CoC) total hip replacement (THR) was developed to minimize debris and osteolytic reaction. The major concern is its brittleness. The aim of this study was to evaluate the short-term outcome of CoC THR in young adult patients. Methods: 11 patients, 13 THR procedures, were followed up until six months after surgery in Cipto Mangunkusumo Hospital. Evaluation included Harris hip score (HHS), visual analog scale (VAS), patients’ complaint, short form-36 (SF-36), and acetabular and femoral component angles. Data were analyzed using Wilcoxon signed rank test, paired t-test, and Spearman test. Results: The average age of the patients was 33.6 years old and 55% of them were female. Systemic lupus erythematosus was the main causative disease for THR. The VAS average decreased before surgery and after six months of surgery (5 to 1). Pre- and post-operative HHS and SF-36 increased significantly by (25 to 92) and (21 to 54) respectively. Squeaking sound was reported by two patients. No correlation was found between acetabular and femoral component and squeaking incidence.Conclusion: CoC THR showed excellent short term outcome for young adult patients. With proper indications, CoC THR ensures excellent clinical outcomes and promising survivorship.

A Technique of Partial Breast Irradiation Utilizing Proton Beam Radiotherapy: Comparison with Conformal X-Ray Therapy

2007 ◽  
Vol 13 (2) ◽  
pp. 114-118 ◽  
Author(s):  
David A. Bush ◽  
Jerry D. Slater ◽  
Carlos Garberoglio ◽  
Grace Yuh ◽  
Janet M. Hocko ◽  
...  
Keyword(s):  
Proton Beam ◽  
Partial Breast Irradiation ◽  
Breast Irradiation ◽  
X Ray ◽  
Proton Beam Radiotherapy
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