TREATMENT OF CHORDOMAS WITH CYBERKNIFE

Neurosurgery ◽  
2009 ◽  
Vol 64 (suppl_2) ◽  
pp. A44-A53 ◽  
Author(s):  
Fraser C. Henderson ◽  
Kyle McCool ◽  
Juliet Seigle ◽  
Walter Jean ◽  
William Harter ◽  
...  
Keyword(s):  
Tumor Volume ◽  
Statistical Significance ◽  
Local Control Rate ◽  
Treatment Delivery ◽  
Female Ratio ◽  
Adequate Dose ◽  
Mobile Spine ◽  
Treatment Volume ◽  
Reduce Tumor Volume ◽  
Disseminated Disease

Abstract OBJECTIVE To determine the efficacy and safety of chordoma treatment with CyberKnife (Accuray, Inc., Sunnyvale, CA) stereotactic radiosurgery (CK/SRS). METHODS Eighteen patients with chordoma were treated with CK/SRS as a primary adjuvant (17 patients) or the only treatment (1 patient). The series included 24 lesions (28 treatments). The median age of the patients was 60 years (range, 24–85 years). Forty-four percent of the tumors were located in the mobile spine, 39% inside the cranium, and 17% in the sacral region. The male-to-female ratio was 1:1. The mean tumor volume was 128.0 mL (range, 12.0–457.3 mL), and the median dose of 35 Gy (range, 24.0–40.0 Gy) was delivered in 5 sessions. The median follow-up period was 46 months (range, 7–65 months). RESULTS There were 3 significant complications in patients with previous irradiation, including infection in the surgical/radiation site (2 patients) and decreased vision (1 patient). Improvement in pain and quality of life did not reach statistical significance (α = 0.05). Seven patients experienced recurrence at a median of 10 months (range, 5–38 months), and 4 patients with disseminated disease died 7 to 48 months after therapy. Two patients had a partial response, whereas 9 others had stable disease. The local control rate at 65 months was 59.1%, with an overall survival of 74.3% and disease-specific survival of 88.9%. We estimated an α/β ratio of 2.45 for chordomas, which supports hypofractionation. CONCLUSION The CK/SRS safety and efficacy profile compares favorably with those of other treatment delivery systems. CK/SRS appears to reduce tumor volume, given an adequate dose. The authors recommend treatment with 40 Gy in 5 sessions to the clinical treatment volume, which includes the gross tumor volume and at least a 1-cm margin.

scholarly journals Neoadjuvant Treatment in Rectal Cancer: Actual Status

2011 ◽  
Vol 2011 ◽  
pp. 1-12 ◽  
Author(s):  
Ingrid Garajová ◽  
Stefania Di Girolamo ◽  
Francesco de Rosa ◽  
Jody Corbelli ◽  
Valentina Agostini ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Tumor Volume ◽  
Standard Treatment ◽  
Locally Advanced ◽  
Neoadjuvant Treatment ◽  
Local Control Rate ◽  
Concomitant Chemoradiotherapy ◽  
International Union ◽  
Clinical Stages ◽  
Reduce Tumor Volume

Neoadjuvant (preoperative) concomitant chemoradiotherapy (CRT) has become a standard treatment of locally advanced rectal adenocarcinomas. The clinical stages II (cT3-4, N0, M0) and III (cT1-4, N+, M0) according to International Union Against Cancer (IUCC) are concerned. It can reduce tumor volume and subsequently lead to an increase in complete resections (R0 resections), shows less toxicity, and improves local control rate. The aim of this review is to summarize actual approaches, main problems, and discrepancies in the treatment of locally advanced rectal adenocarcinomas.

Preliminary results of linear accelerator radiosurgery for acoustic schwannomas

1996 ◽  
Vol 85 (6) ◽  
pp. 1013-1019 ◽  
Author(s):  
William M. Mendenhall ◽  
William A. Friedman ◽  
John M. Buatti ◽  
Francis J. Bova
Keyword(s):  
Stereotactic Radiosurgery ◽  
Local Control ◽  
Linear Accelerator ◽  
Local Control Rate ◽  
Magnetic Resonance Images ◽  
High Rate ◽  
Content Type ◽  
Treatment Volume ◽  
Fine Print

✓ In this paper the authors evaluate the results of linear accelerator (LINAC)—based stereotactic radiosurgery for acoustic schwannomas. Fifty-six patients underwent LINAC-based stereotactic radiosurgery for acoustic schwannomas at the University of Florida between July 1988 and November 1994. Each patient was followed for a minimum of 1 year or until death; no patient was lost to follow up. One or more follow-up magnetic resonance images or computerized tomography scans were obtained in 52 of the 56 patients. Doses ranged between 10 and 22.5 Gy with 69.6% of patients receiving 12.5 to 15 Gy. Thirty-eight patients (68%) were treated with one isocenter and the dose was specified to the 80% isodose line in 71% of patients. Fifty-five patients (98%) achieved local control after treatment. The 5-year actuarial local control rate was 95%. At the time of analysis, 48 patients were alive and free of disease, seven had died of intercurrent disease, and one was alive with disease. Complications developed in 13 patients (23%). The likelihood of complications was related to the dose and treatment volume: 10 to 12.5 Gy to all volumes, three (13%) of 23 patients; 15 to 17.5 Gy to 5.5 cm3 or less, two (9%) of 23 patients; 15 to 17.5 Gy to more than 5.5 cm3, five (71%) of seven patients; and 20 to 22.5 Gy to all volumes, three (100%) of three patients. Linear accelerator—based stereotactic radiosurgery results in a high rate of local control at 5 years. The risk of complications is related to the dose and treatment volume.

scholarly journals Comparison of efficacy of myringoplasty in dry and wet ears in chronic otitis media of tubotympanic type

2017 ◽  
Vol 3 (3) ◽  
pp. 705 ◽  
Author(s):  
Yogeshwar Chandrashekar ◽  
Ravishankar Chandrashekar
Keyword(s):  
Otitis Media ◽  
Statistical Significance ◽  
Chronic Otitis Media ◽  
Pure Tone Audiometry ◽  
Inflammatory Cells ◽  
P Value ◽  
Hearing Improvement ◽  
Female Ratio ◽  
Fascia Graft ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> The objective of the study was to compare the outcome of myringoplasty in dry and wet ears in tubotympanic type of chronic otitis media (COM) with respect to graft uptake and hearing improvement.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study done in department of ENT Bangalore Medical College and Research Institute during the study period of November 2014 to May 2016, wherein a total of 60 patients of tubotympanic type COM with 30 cases each of dry and wet ears, aged 15-60 years were included. The hearing impairment was assessed and recorded by pure tone audiometry (PTA). After obtaining informed written consent the patients underwent myringoplasty (temporalis fascia graft, underlay technique). Microbiological examination of discharge in wet ears was done and histopathology of the excised remnant TM analyzed in both groups. Both groups of patients were followed up for 3 months and assessed for graft uptake and hearing improvement. PTA was repeated at 3 months postoperatively.  </p><p class="abstract"><strong>Results:</strong> Our study included 60 patients of tubotympanic type of COM with 30 cases each with dry and wet ears who underwent myringoplasty. Majority of our patients were in second decade in both the groups. There was slight female preponderance in our study with male to female ratio of 0.93:1. Discharge from ears in wet ears was mucoid in consistency and were culture negative. Histopathology of excised remnant TM in wet ears revealed evidence of inflammatory cells and vascularization within stroma of fibroblasts while these were absent in dry ear cases. The overall successful graft uptake following myringoplasty was 88.3% with 86.7% for wet ears and 90% for dry ears with no statistical significance (p value of 0.688&gt;0.05) between the two groups. With respect to hearing improvement post-operatively there was significant hearing improvement in both the groups when compared to preoperative hearing with a mean hearing gain (dB) of 3.43±2.81 in wet ear cases to 3.85±3.05 in dry ear cases, but when compared between the two groups, there was no significant statistical difference (p value of 0.582&gt;0.05).</p><p><strong>Conclusions:</strong> The outcome is equally good for myringoplasty in dry and wet ears in tubotympanic type of chronic otitis media with respect to graft uptake and hearing improvement. </p>

scholarly journals Knowledge, attitude, and practice on COVID-19 among undergraduate students of B. P. Koirala Institute of Health Sciences, Dharan, Nepal: An online cross-sectional survey

2021 ◽  
Vol 8 (1) ◽  
pp. 15-22
Author(s):  
KR Pandey ◽  
DR Panday ◽  
P Pyakurel ◽  
S Marahatta ◽  
SP Rimal ◽  
...  
Keyword(s):  
Nursing Students ◽  
Undergraduate Students ◽  
Human Life ◽  
Statistical Significance ◽  
Medical Institute ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Health Crisis ◽  
Female Ratio ◽  
Validated Questionnaire

Background: COVID-19, a global health crisis of the 21st century, has threatened possibly every aspect of human life. Since the pandemic is not yet over, this study was carried out among undergraduate students of a medical institute in Nepal to assess and boost their KAP status on the disease. Material and methods: It was an online cross-sectional census survey performed among consenting undergraduate healthcare students of BPKIHS. A self-made and validated questionnaire assessing KAP on COVID-19 was prepared in Google form and distributed online among target students. The study population was 745. Both descriptive and inferential analysis of the data was performed. Student’s T-Test and one-way ANOVA were applied for which level of statistical significance was kept at p<0.05. Results: Ninety-six students participated in a pilot-study (Cronbach α= 0.792). The response rate was 76.27%. Most participants (76.76%) were from Nepal.  The male/female ratio was 0.76. Most (59.2%) had not participated in such studies before. For 93.54%, the source of information was the internet. Assessed by questionnaire, right Knowledge (n=16) was 85.06% ± 8.81%; right Attitude (n=6) was 65.00% ± 16.16 and right Practice (n=6) was 82.88%± 8.50%. Male were more knowledgeable about the disease (p=0.011). However, females secured higher in practical aspects (p=0.000). Indian students possessed better knowledge (p=0.005) and a better attitude (p=0.033). MBBS students had better knowledge (p=0.000), but Nursing students secured higher in Practice (p=0.012). Attitude is better in the earlier years (p=0.045). Conclusion: We assessed KAP related to COVID-19 via score among healthcare undergraduate students. Different co-factors do impact students’ overall KAP status.

Carbon quantum dot–NO photoreleaser nanohybrids for two-photon phototherapy of hypoxic tumors

2015 ◽  
Vol 51 (1) ◽  
pp. 81-84 ◽  
Author(s):  
Colin Fowley ◽  
Anthony P. McHale ◽  
Bridgeen McCaughan ◽  
Aurore Fraix ◽  
Salvatore Sortino ◽  
...  
Keyword(s):  
Quantum Dots ◽  
Quantum Dot ◽  
Tumor Volume ◽  
Carbon Quantum Dots ◽  
Pancreatic Tumors ◽  
Two Photon ◽  
Carbon Quantum Dot ◽  
Nir Light ◽  
Photon Excitation ◽  
Reduce Tumor Volume

Carbon quantum dots conjugated with a NO photodonor reduce tumor volume in mice bearing human xenograft BXPc-3 pancreatic tumors upon two-photon excitation with NIR light.

Incidence and pattern of leukemia in Bhutanese population: a retrospective analysis of eight years (January 2008 to December 2015)

2016 ◽  
Vol 2 (2) ◽  
pp. 6-9
Author(s):  
Kuenzang Dorji ◽  
Krishna Prasad Sharma ◽  
Rinzin Jamtsho ◽  
Puja Devi Samal ◽  
Dorji Wangchuk ◽  
...  
Keyword(s):  
Risk Factors ◽  
Incidence Rate ◽  
Blood Cells ◽  
Statistical Significance ◽  
Descriptive Statistics ◽  
Haematological Malignancies ◽  
Female Ratio ◽  
Male To Female ◽  
National Referral Hospital

Introduction: The burden of haematological malignancies in developing countries is on the rise. This burden may be further aggravated in Bhutan due to the aging population and rapid modernization of the nation. Despite this, there is a paucity of information about the incidence and pattern of leukemia in the Bhutanese population. In this retrospective study, we aim to investigate the incidence and pattern of leukemia in Bhutan using a database of leukemia diagnosed at Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan from January 2008 to December 2015. Methods: The diagnoses and classification of leukemias were based on the morphology of blood cells on peripheral blood and bone marrow smears. The data was analyzed with descriptive statistics. The age-standardized incidence rate per 100,000 populations and its 95% confidence interval was calculated to assess the statistical significance. Results: In total 118 patients were diagnosed with leukemia over the period of eight years. Leukemia was found to be more frequent in male (51.69%) compared to female (48.30%) with a male to female ratio of 1.1:1. Acute leukemia accounted for 66.95% of all leukemia case diagnosed, whereas chronic leukemia accounted for only 33.05% of the cases. The average, annual, age-standardized incidence rate of leukemia per 100,000 population was 2.30 (95% CI: 1.87-2.73). Conclusions: The incidence and pattern of leukemia in the Bhutanese population is similar to other published literature. Leukemia is not uncommon in the Bhutanese population, thus additional studies on risk factors for leukemia in the Bhutanese population is necessary.

scholarly journals Dosimetric comparison of radiotherapy treatment plans done by IMRT and VMAT technique in head and neck cancer patients

2021 ◽  
Vol 9 (3) ◽  
pp. 167-171
Author(s):  
Dr. Aparajeeta Aparajeeta ◽  
◽  
Dr. Ankita Mehta ◽  
Mr. N.S. Silambarasan ◽  
Dr. Piyush Kumar ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Treatment Time ◽  
Statistical Significance ◽  
Target Volume ◽  
Treatment Delivery ◽  
Patient Load ◽  
Treatment Plans

Background: The increasing patient load in radiotherapy centres demands selection of thetechnique that provides plans with optimal dosimetry in terms of target volume coverage, organs atrisk (OAR) sparing and a lesser treatment time. This study was designed to compare the two widelypractised conformal techniques, IMRT and VMAT in head and neck cancer patients in terms ofplanning target volume (PTV) coverage, OAR sparing and treatment delivery parameters. Materialsand methods: For ten postoperative head and neck cancer patients who had been treated by IMRTtechnique virtual VMAT plans were generated for study purposes. The dose prescribed to PTV was 60Gy in 30 fractions. The dose-volume parameters of PTV and OARs and the treatment deliveryparameters were compared amongst both the techniques. Statistical significance was calculatedusing paired ‘t’ test. Results: Both the plans were comparable in terms of dosimetry. The onlysignificant difference being better conformity in the IMRT plans. The dose to OARs was alsocomparable in both the techniques except for a significant reduction in the point dose to brainstemwith the IMRT technique. Given the treatment delivery parameters, there was a significant reductionin the treatment delivery time and monitor units with the VMAT technique compared to the IMRTtechnique. Conclusion: VMAT technique gave comparable plans to that of the IMRT technique interms of dosimetry but reduced the treatment time. It seems feasible in radiotherapy centres withincreased patient load.

scholarly journals PAPRICA: The Pair Production Imaging Chamber—Proof of Principle

2021 ◽  
Vol 9 ◽  
Author(s):  
M. Toppi ◽  
I. Avanzolini ◽  
L. Balconi ◽  
G. Battistoni ◽  
G. Calvi ◽  
...  
Keyword(s):  
Pair Production ◽  
Pediatric Patients ◽  
Tumor Volume ◽  
Organs At Risk ◽  
Particle Therapy ◽  
Adequate Dose ◽  
Monitoring Technique ◽  
Safety Margins ◽  
Beam Range ◽  
Proof Of Principle

In Particle Therapy, safety margins are applied around the tumor to account for the beam range uncertainties and ensure an adequate dose coverage of the tumor volume during the therapy. The reduction of safety margins is in great demand in order to diminish the Particle Therapy side effects especially in the case of treatment of tumors close to Organs at Risk (OAR) and of pediatric patients. To this aim, beam range monitoring techniques are being developed by the scientific community, most of all based on the detection of secondary particles produced by the nuclear interactions of the beam with the patient’s tissue nuclei. In this contribution, a novel beam range monitoring technique is proposed, based on the detection of prompt photons exploiting the pair production mechanism. The proof of principle of the PAir PRoduction Imaging ChAmber (PAPRICA) is studied through the development of a Monte Carlo simulation and the detector performances toward a more realistic scenario are determined.

scholarly journals Clinicopathological study of ameloblastoma and detection of human papilloma virus by immunohistochemistry

2019 ◽  
Vol 35 (6) ◽  
Author(s):  
Misbah Ali ◽  
Mulazim Hussain Bukhari ◽  
Faiza Hassan ◽  
Maria Illyas
Keyword(s):  
Human Papilloma Virus ◽  
Statistical Significance ◽  
Cross Sectional Study ◽  
P Value ◽  
Cross Sectional ◽  
Female Ratio ◽  
Papilloma Virus ◽  
Creative Commons ◽  
Significant Difference ◽  
Clinicopathological Study

Objective: To study the clinocopathological factors and presence of Human Pappiloma Virus in ameloblastoma by immnohistochemistry. Methods: It was a cross sectional study on 50 surgical specimens of ameloblastoma, completed in six months. These were selected and processed for initial screening by H&E and then by immunohistochemistry (IHC) for detection of Human Papilloma Virus (HPV). The questionnaire was designed to study the clinicopathological factors associated in these patients. Sections of 4µm were cut, placed on special positive charged glass slides in the Department of Pathology, King Edward Medical University. It was then examined by the histopathologists for grading and scoring of these lesions. Chi Square test was used to assess the differences found in types of ameloblastomas. The p-value was smaller than 0.05 (p < 0.05). Results: The mean age of the patients (12-80 years old) was 38.6±15.1 years, with male-female ratio 2.84: 1. HPV was positive in 9 (18%), whereas negative in of 41 (82%) patients. Among the positive, reactive HPV with score-1 was 8 and score-2 was 1. According to histological variant, follicular was present in 78%, Plexiform pattern in 8%, Conventional and Desmoplastic variants in one patient each; and Cystic and Acanthomatous were seen in two and three patients respectively. The mandible was involved in 39 patients, maxilla and right maxilla involved in 4 patients each, right retromolar, cheek and angle of mandible was seen in one patient each. About 16% patients had anterior, 66% had posterior and 18% had both anterior and posterior regions involved. Among the HPV positive reactive statistically, no significant difference was found with smoking, Paan and exposure to pesticides, factory or mine (p-value > 0.05). Among HPV positive reactive patients, eight had ameloblastoma whereas, 1 had ameloblastomic fibroma. There was no statistical significance of type, location and region of tumor in HPV positivity. Conclusion: Mandible and posterior region was more commonly involved. Follicular pattern was most common. There was no effect of exposure to pesticides, factory or mine, smoke and human papilloma virus in the etiology of ameloblastoma because only 18% of patients showed the association of HPV16 doi: https://doi.org/10.12669/pjms.35.6.909 How to cite this:Ali M, Bukhari MH, Hassan F, Illyas M. Clinicopathological study of ameloblastoma and detection of human papilloma virus by immunohistochemistry. Pak J Med Sci. 2019;35(6):1691-1696. doi: https://doi.org/10.12669/pjms.35.6.909 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Weak Intra-facility Referral Linkages: Missed Opportunity for Tuberculosis Case Detection and Treatment in a Tertiary Health Facility in Benue State, Nigeria

2020 ◽  
Vol 3 (4) ◽  
pp. 444-449
Author(s):  
O Audu ◽  
OS Ogiri ◽  
S-A Igbabul ◽  
OO Ijachi ◽  
PO Enokela ◽  
...  
Keyword(s):  
Health Care Providers ◽  
Low Income ◽  
Detection Rate ◽  
Statistical Significance ◽  
Scale Up ◽  
Case Detection ◽  
Care Providers ◽  
Tuberculosis Case ◽  
Female Ratio ◽  
Case Detection Rate

Despite the scale up of quality-assured Tuberculosis diagnostic and treatment strategies over the years, case detection rate remains a serious challenge globally and particularly in Nigeria. Integrated service delivery is essential to addressing some of the challenges, but it's often neglected especially in low income settings. Recognizing these limitations, a 27-months retrospective review of all presumptive Pulmonary Tuberculosis cases sent to the directly observed short course treatment centre of Benue State University Teaching Hospital, a tertiary health institution in north central Nigeria was conducted to assess the source of referrals and diagnostic processes including outcome of the tests. Chi- square (χ2) test was used for test of association between the intra-facility linkages/referrals system and the tuberculosis case detection rate, with statistical significance set at p-value of ≤5%. There were 918 presumptive Tuberculosis cases with male to female ratio (M: F) of 1:1.3. The mean age of patients was 41.0.0 ±18.4 years. Majority (33.7%, n=) of the referrals were from general outpatient department of the hospital, followed by sexually transmitted infection clinic (26.0%) and Paediatrics department (1.6%, n=). The diagnostic positive rate was 145(15.8%). Overall, 295(32.2%) did not collect their results, of these 76(25.8%) were positive and 219(74.2%) were negative. The relationship between the missed cases and the weak intra-facility referral linkages was statistically significant (p=0.000). The hospital management should consider the engagement of all relevant health care providers on efficient two-way referral system towards ensuring adequate Tuberculosis case notification and prompt treatment.

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