Adolescent Plaque Brachytherapy for Large Choroidal Metastasis from Lung Carcinoid Tumor

The purpose of this publication is to report a child with choroidal metastasis from a primary lung carcinoid tumor treated with 125-iodine plaque brachytherapy while achieving complete tumor regression. A 15-year-old girl with a history of stage IV lung carcinoid tumor developed painless progressive visual loss in her right eye. Ophthalmological exam documented a unilateral solitary large choroidal mass with complete exudative retinal detachment. Planned palliative treatment with plaque brachytherapy was performed utilizing a total dose of 45 Gy to the tumor apex. No tumor regression was noted after 6 months of follow-up. Ten months after primary therapy, re-treatment with a total dose of 90 Gy to the tumor apex was performed due to tumor progression. Complete regression was achieved after secondary treatment without evidence of recurrence after 18 months of follow-up. In conclusion, high-dose plaque brachytherapy may induce complete tumor regression in select adolescent patients with choroidal metastasis from lung carcinoid tumor.

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STEREOTACTIC RADIOSURGERY FOR THE TREATMENT OF PRIMARY SARCOMAS AND SARCOMA METASTASES OF THE SPINE

Neurosurgery ◽

10.1227/01.neu.0000339131.28485.4a ◽

2009 ◽

Vol 64 (suppl_2) ◽

pp. A54-A59 ◽

Cited By ~ 44

Author(s):

Alan M. Levine ◽

Cardella Coleman ◽

Sylvia Horasek

Keyword(s):

Pain Relief ◽

Stereotactic Radiosurgery ◽

Tumor Regression ◽

Spinal Metastasis ◽

Definitive Treatment ◽

Complete Tumor Regression ◽

Institutional Review ◽

Spinal Sarcoma ◽

Complete Tumor

Abstract OBJECTIVE Spinal sarcomas pose unique treatment dilemmas because of the difficulty of achieving adequate surgical margins and/or delivering curative radiation doses (65 Gy) in close proximity to the spinal cord. This study used hypofractionated stereotactic radiosurgery (SRS) to deliver higher biologically effective doses to treat primary spinal sarcomas and spinal sarcoma metastases. METHODS Twenty-four patients with spinal or paraspinal sarcomas entered an Institutional Review Board-approved registry trial to evaluate SRS efficacy. They were assessed at regular intervals for pain control, disease progression, and complications for a minimum of 12 months or until death. RESULTS The median treatment dose for the spinal sarcoma lesions was 30 Gy at the 80% isodose in 3 fractions, with some variation based on tumor size, shape, and dose to adjacent critical structures. Seven patients were treated definitively; all had excellent pain relief and are alive with a mean follow-up period of 33 months. Two patients had complete tumor regression, 3 had partial regression, and 2 experienced recurrences and have been re-treated. Seven patients underwent resection and adjuvant SRS. One of 3 patients treated preoperatively had complete tumor regression, and none of the 4 patients treated postoperatively had a local recurrence with a mean follow-up period of 43.5 months. All 10 patients with sarcoma metastases to the spine (16 lesions) died, with a mean survival of 11.1 months from first spinal metastasis treatment. Complete pain relief was achieved in 8 patients, partial relief in 7 patients, and none in 1 patient. No patient developed radiation myelitis. CONCLUSION These preliminary results suggest that SRS may have a role in the definitive treatment of patients with primary spinal sarcomas who are deemed unresectable and as adjuvant treatment in those undergoing surgery and for palliation of sarcoma metastases.

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Transpupillary laser thermotherapy of retinoblastoma

Russian Journal of Pediatric Hematology and Oncology ◽

10.21682/2311-1267-2021-8-3-43-49 ◽

2021 ◽

Vol 8 (3) ◽

pp. 43-49

Author(s):

A. A. Yarovoy ◽

D. P. Volodin ◽

V. A. Yarovaya ◽

T. L. Ushakova ◽

E. S. Kotova ◽

...

Keyword(s):

Tumor Regression ◽

Vitreous Hemorrhage ◽

Transpupillary Thermotherapy ◽

Complete Tumor Regression ◽

Application Mode ◽

Local Methods ◽

Small Primary ◽

The Mean ◽

Complete Tumor

Introduction. Despite the fact that transpupillary thermotherapy (TTT) is one of the main local methods of small retinoblastoma (RB) destruction, only a few studies have been published on the use of this method, and they are devoted only to certain aspects of the application of TTT.Purpose of the study – to evaluate the effectiveness of TTT in the treatment of children with RB.Material and methods. In the period from 2011 to 2020, 177 children (224 eyes, 1156 tumors) with RB were treated by TTT. Of these, 99 (56 %) patients were boys, 78 (44 %) – girls. The mean age at the time of treatment was 16.8 months (from 0 to 86 months). Bilateral RB was observed in 128 (72.3 %) patients, monolateral – in 49 (27.7 %). In 51 (28.8 %) cases, TTT was performed on an only eye. TTT was performed on eyes that had RB of groups A (n = 43; 19 %), B (n = 81; 36 %), C (n = 31; 14 %), D (n = 63; 28 %), E (n = 6; 3 %). In total, 1156 tumors were treated by TTT. 488 (42 %) tumors were localized post-equatorially (of which 27 were located juxtapapillary, 23 – in the macular zone, 22 – paramacular). 668 (58 %) foci had pre-equatorial localization (on the middle and far periphery of the fundus). The number of foci in one eye varied from 1 to 48 (mean – 5). The mean tumor thickness was 1.1 mm (from 0.2 to 4.5), the mean base diameter was 2.2 mm (from 0.3 to 13.4). TTT was performed using a diode laser with the following parameters: wavelength – 810 nm, spot diameter – 1200 microns, power from 200 to 800 mW (mean – 350 mW), exposure-from 3 to 15 s in the application mode, and continuous in the scanning mode.Results. Complete tumor regression after TTT was achieved in 92 % of cases (1064 tumors). Incomplete regression of the tumor with stabilization was achieved in 0.7 % (8 tumors). The average number of TTT sessions to achieve full regression was 1.7 (from 1 to 10). Complete tumor regression after 1 TTT session was achieved in 54 % of cases (622 tumors), after 2 sessions – in 11 % (132 tumors), after 3 sessions – in 7 % (85 tumors), after 4 or more sessions– in 19 % (225 tumors). In 7 % of cases (82 tumors), due to the progression of the tumor, other treatment methods (brachytherapy, cryotherapy, stereotactic radiosurgery) were applied. 209 (93 %) eyes were preserved. 15 (7 %) eyes were enucleated due to continued tumor growth, total retinal detachment, vitreous hemorrhage, or subatrophy of the eyeball. The mean follow-up after TTT was 35.5 months (from 3 to 112 months).Conclusion. TTT is a highly effective method of RB treatment and can be used for destruction of small primary foci of both post-equatorial and pre-equatorial localization, residual tumors after inefficiency of other local methods. TTT is also effective in the treatment of large cavitary tumors located in functionally significant areas of the retina.

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ORGAN SAVING TREATMENT OF LOW RECTAL CANCER

Problems in oncology ◽

10.37469/0507-3758-2019-65-6-850-854 ◽

2019 ◽

Vol 65 (6) ◽

pp. 850-854

Author(s):

Sergey Afanasev ◽

Aleksey Dobrodeev ◽

A. Avgustinovich ◽

Anna Tarasova ◽

Maksim Volkov ◽

...

Keyword(s):

Rectal Cancer ◽

Tumor Regression ◽

Neoadjuvant Chemoradiation ◽

Low Rectal Cancer ◽

Hematogenous Metastasis ◽

Active Monitoring ◽

Complete Tumor Regression ◽

Daily Dose ◽

Complete Tumor

The objective is to study the treatment results of patients with low rectal cancer with complete tumor regression after neoadjuvant chemoradiation (CRT) and consolidating chemotherapy. Materials and methods. The investigation involved 70 patients with adenocarcinoma of the low rectal cancer with the stage mrT2-3N0-1M0 who were treated from 2013 till 2018. All of these patients were given chemoradiation in the standard long-course fractionated radiation 2.0 Gy per day, total dose of 45 Gy and with Capecitabine in the daily dose of 825 mg / m2 in the days of radiation. If complete clinical and morphological regression of tumor was registered in 6 weeks after completion of CRT the patients were held 2 courses of consolidating chemotherapy with capecitabine in the daily dose of 3,500 mg / m2 for 14 days (the interval between chemotherapy courses was 7 days). Results. Complete tumor regression was recorded in 22 (31.4 ± 5.5%) of 70 patients. The median follow-up was 26 months: any signs of progression weren’t detected in 20 (90.9 ± 6.1%) patients with detailed survey which was held every 3 months, and local recurrence was detected (R0) in 2 (9.1 ± 6.1%) patients in the first year of follow-up. Conclusions. Neoadjuvant CLT and consolidating chemotherapy provide reliable local monitoring and prevention of hematogenous metastasis in patients with low rectal cancer. The preliminary results which were obtained in our research confirm the adequacy of the surviving approach after Complete tumor regression using the condition of active monitoring using a complex of clinical and instrumental methods. Final conclusions require further research.

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Faculty Opinions recommendation of Structure-based discovery of BM-957 as a potent small-molecule inhibitor of Bcl-2 and Bcl-xL capable of achieving complete tumor regression.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717959626.793462957 ◽

2012 ◽

Author(s):

Mark Searcey

Keyword(s):

Small Molecule ◽

Tumor Regression ◽

Small Molecule Inhibitor ◽

Complete Tumor Regression ◽

Molecule Inhibitor ◽

Complete Tumor

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IMAT-IGRT Treatment with Simultaneous Integrated Boost as Dose Escalation for Patients with Cervical Cancer: A Single Institution, Prospective Pilot Study

Pathology & Oncology Research ◽

10.3389/pore.2021.608446 ◽

2021 ◽

Vol 27 ◽

Author(s):

Zoltán Lőcsei ◽

Klára Sebestyén ◽

Zsolt Sebestyén ◽

Eszter Fehér ◽

Dorottya Soltész ◽

...

Keyword(s):

Cervical Cancer ◽

Total Dose ◽

Dose Escalation ◽

Tumor Regression ◽

Simultaneous Integrated Boost ◽

Disease Stage ◽

Mri Scan ◽

Regression Rate ◽

Integrated Boost

Purpose: The aim of this study was to introduce the simultaneous integrated boost (SIB) technique to assess the safety of replacement of the brachytherapy (BT) boost for ineligible patients with cervical cancer receiving radiochemotherapy (RCT).Methods: Fourteen patients were enrolled between 2015 and 2018. SIB was delivered using RapidArc technique at doses of 2.4 Gy per fraction during pelvic irradiation with 50.4/1.8 Gy in seven patients (to a total dose of 67.2 Gy) with limited volume disease. In 7 patients with a more advanced disease stage (>5 cm tumor, parametric invasion both sides), parametric boost therapy was added to the pelvic radiotherapy to a total dose of the macroscopic tumor of 79.2 Gy. All patients received simultaneous cisplatin-based chemotherapy for 5 cycles with a dosage of 40 mg/m2. We examined acute toxicity (CTCAE v4.1) and quality of life (EORTC QLQ30 and CX24). The tumor regression rate was evaluated with RECIST 1.1 after the first 3- to 4-months follow-up Magnetic Resonance Imaging (MRI) scan. We calculated the percentage of tumor regression rate and the local control during the follow-up period and evaluated the survival data.Results: Our patient data are presented at a median follow-up time of 24.5 months. During the treatment period, no grade 3 to 4 toxicity was observed. During the follow-up period, no late-onset toxicity was observed. The tumor regression rate at the first MRI scan was 95.31% on average. Disease free survival (DFS) during the median follow-up of 24 months was 98.6%.Conclusion: In patients with cervical cancer, the SIB technique is amenable as part of definitive RCT. Dose escalation with the SIB technique can be safely administered to cervical cancer patients during definitive RCT if BT is not feasible. However, further randomized clinical studies are needed to validate the method, so routine use of it cannot be recommended yet.

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