Vaginal embryonal rhabdomyosarcoma

2021 ◽  
Vol 20 (3) ◽  
pp. 174-177
Author(s):  
N.I. Minashkina ◽  
◽  
V.A. Strykov ◽  
T.G. Dyadik ◽  
I.V. Karachentsova ◽  
...  
Keyword(s):  
Tumor Response ◽  
Management Strategies ◽  
Young Patients ◽  
Reproductive Function ◽  
High Dose Rate ◽  
Local Tumor Control ◽  
Embryonal Rhabdomyosarcoma ◽  
Tumor Control ◽  
High Dose ◽  
Local Tumor

Vaginal embryonal rhabdomyosarcoma is a relatively rare tumor, which is more commonly diagnosed in children under three years of age and is rarely associated with organ-sparing treatment. Neoadjuvant chemotherapy followed by radiotherapy or surgery can be currently used as local tumor control. A clinical case of vaginal embryonal rhabdomyosarcoma in a 5-year-old girl is presented. Considering the tumor response to polychemotherapy, high dose rate intracavitary radiation therapy (brachytherapy) was chosen as the method of local control. Brachytherapy reduces the need for surgery and radiation of large regions in children and enables young patients to realize their reproductive function in the future. Key words: brachytherapy, management strategies, embryonal rhabdomyosarcoma

High-Dose Rate Interstitial Spine Brachytherapy Using an Intraoperative Mobile Computed Tomography-Guided Surgical Navigation System

2021 ◽  
Author(s):  
Rogelio Medina ◽  
Luke Macyszyn ◽  
Andrew S Lim ◽  
Mark Attiah ◽  
Kayla Kafka-Peterson ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Cauda Equina ◽  
High Dose Rate ◽  
Local Tumor Control ◽  
Tumor Control ◽  
High Dose ◽  
Hdr Brachytherapy ◽  
Treatment Alternative ◽  
Local Tumor

Abstract BACKGROUND Up to 15% of previously irradiated metastatic spine tumors will progress. Re-irradiation of these tumors poses a significant risk of exceeding the radiation tolerance to the spinal cord. High-dose rate (HDR) brachytherapy is a treatment alternative. OBJECTIVE To develop a novel HDR spine brachytherapy technique using an intraoperative computed tomography-guided navigation (iCT navigation). METHODS Patients with progressive metastatic spine tumors were included in the study. HDR brachytherapy catheters were placed under iCT navigation. CT-based planning with magnetic resonance imaging fusion was performed to ensure conformal dose delivery to the target while sparing normal tissue, including the spinal cord. Patients received single fraction radiation treatment. RESULTS Five patients with thoracolumbar tumors were treated with HDR brachytherapy. Four patients previously received radiotherapy to the same spinal level. Preimplant plans demonstrated median clinical target volume (CTV) D90 of 116.5% (110.8%-147.7%), V100 of 95.7% (95.5%-99.6%), and Dmax of 8.08 Gy (7.65-9.8 Gy) to the spinal cord/cauda equina. Postimplant plans provided median CTV D90 of 113.8% (93.6%-120.1%), V100 of 95.9% (87%-99%), and Dmax of 9.48 Gy (6.5-10.3 Gy) to cord/cauda equina. Patients who presented with back pain (n = 3) noted symptomatic improvement at a median follow-up of 22 d after treatment. Four patients demonstrated local tumor control of spinal metastatic tumor at a median follow-up of 92 d after treatment. One patient demonstrated radiographic evidence of local tumor progression 2.7 mo after treatment. CONCLUSION HDR spine brachytherapy with iCT navigation is a promising treatment alternative to induce local tumor control and reduce pain symptoms associated with metastatic spine disease.

High-Dose-Rate Brachytherapy Boost Effect on Local Tumor Control in Young Women With Breast Cancer

2015 ◽  
Vol 91 (1) ◽  
pp. 165-171 ◽  
Author(s):  
Jose-Luis Guinot ◽  
Cristobal Baixauli-Perez ◽  
Pablo Soler ◽  
Maria Isabel Tortajada ◽  
Araceli Moreno ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Dose Rate ◽  
Young Women ◽  
High Dose Rate ◽  
Local Tumor Control ◽  
Tumor Control ◽  
High Dose ◽  
Local Tumor ◽  
High Dose Rate Brachytherapy ◽  
Brachytherapy Boost

Petroclival meningiomas: long-term outcomes of multimodal treatments and management strategies based on 30 years of experience at a single institution

2020 ◽  
Vol 132 (6) ◽  
pp. 1675-1682 ◽  
Author(s):  
Jin Wook Kim ◽  
Hee-Won Jung ◽  
Yong Hwy Kim ◽  
Chul-Kee Park ◽  
Hyun-Tai Chung ◽  
...  
Keyword(s):  
Adjuvant Treatment ◽  
Management Strategies ◽  
Local Tumor Control ◽  
Tumor Control ◽  
Years Of Experience ◽  
Local Tumor ◽  
Long Term Outcomes ◽  
Single Institution ◽  
Petroclival Meningiomas

OBJECTIVEA thorough investigation of the long-term outcomes and chronological changes of multimodal treatments for petroclival meningiomas is required to establish optimal management strategies. The authors retrospectively reviewed the long-term clinical outcomes of patients with petroclival meningioma according to various treatments, including various surgical approaches, and they suggest treatment strategies based on 30 years of experience at a single institution.METHODSNinety-two patients with petroclival meningiomas were treated surgically at the authors’ institution from 1986 to 2015. Patient demographics, overall survival, local tumor control rates, and functional outcomes according to multimodal treatments, as well as chronological change in management strategies, were evaluated. The mean clinical and radiological follow-up periods were 121 months (range 1–368 months) and 105 months (range 1–348 months), respectively.RESULTSA posterior transpetrosal approach was most frequently selected and was followed in 44 patients (48%); a simple retrosigmoid approach, undertaken in 30 patients, was the second most common. The initial extent of resection and following adjuvant treatment modality were classified into 3 subgroups: gross-total resection (GTR) only in 13 patients; non-GTR treatment followed by adjuvant radiosurgery or radiation therapy (non-GTR+RS/RT) in 56 patients; and non-GTR without adjuvant treatment (non-GTR only) in 23 patients. The overall progression-free survival rate was 85.8% at 5 years and 81.2% at 10 years. Progression or recurrence rates according to each subgroup were 7.7%, 12.5%, and 30.4%, respectively.CONCLUSIONSThe authors’ preferred multimodal treatment strategy, that of planned incomplete resection and subsequent adjuvant radiosurgery, is a feasible option for the management of patients with large petroclival meningiomas, considering both local tumor control and postoperative quality of life.

scholarly journals Local disease control for spinal metastases following “separation surgery” and adjuvant hypofractionated or high-dose single-fraction stereotactic radiosurgery: outcome analysis in 186 patients

2013 ◽  
Vol 18 (3) ◽  
pp. 207-214 ◽  
Author(s):  
Ilya Laufer ◽  
J. Bryan Iorgulescu ◽  
Talia Chapman ◽  
Eric Lis ◽  
Weiji Shi ◽  
...  
Keyword(s):  
Low Dose ◽  
Spinal Metastases ◽  
Local Tumor Control ◽  
Surgical Decompression ◽  
Tumor Control ◽  
High Dose ◽  
Local Tumor ◽  
Single Fraction ◽  
Tumor Histology ◽  
Local Progression

Object Decompression surgery followed by adjuvant radiotherapy is an effective therapy for preservation or recovery of neurological function and achieving durable local disease control in patients suffering from metastatic epidural spinal cord compression (ESCC). The authors examine the outcomes of postoperative image-guided intensity-modulated radiation therapy delivered as single-fraction or hypofractionated stereotactic radiosurgery (SRS) for achieving long-term local tumor control. Methods A retrospective chart review identified 186 patients with ESCC from spinal metastases who were treated with surgical decompression, instrumentation, and postoperative radiation delivered as either single-fraction SRS (24 Gy) in 40 patients (21.5%), high-dose hypofractionated SRS (24–30 Gy in 3 fractions) in 37 patients (19.9%), or low-dose hypofractionated SRS (18–36 Gy in 5 or 6 fractions) in 109 patients (58.6%). The relationships between postoperative adjuvant SRS dosing and fractionation, patient characteristics, tumor histology–specific radiosensitivity, grade of ESCC, extent of surgical decompression, response to preoperative radiotherapy, and local tumor control were evaluated by competing risks analysis. Results The total cumulative incidence of local progression was 16.4% 1 year after SRS. Multivariate Gray competing risks analysis revealed a significant improvement in local control with high-dose hypofractionated SRS (4.1% cumulative incidence of local progression at 1 year, HR 0.12, p = 0.04) as compared with low-dose hypofractionated SRS (22.6% local progression at 1 year, HR 1). Although univariate analysis demonstrated a trend toward greater risk of local progression for patients in whom preoperative conventional external beam radiation therapy failed (22.2% local progression at 1 year, HR 1.96, p = 0.07) compared with patients who did not receive any preoperative radiotherapy (11.2% local progression at 1 year, HR 1), this association was not confirmed with multivariate analysis. No other variable significantly correlated with progression-free survival, including radiation sensitivity of tumor histology, grade of ESCC, extent of surgical decompression, or patient sex. Conclusions Postoperative adjuvant SRS following epidural spinal cord decompression and instrumentation is a safe and effective strategy for establishing durable local tumor control regardless of tumor histology–specific radiosensitivity. Patients who received high-dose hypofractionated SRS demonstrated 1-year local progression rates of less than 5% (95% CI 0%–12.2%), which were superior to the results of low-dose hypofractionated SRS. The local progression rate after single-fraction SRS was less than 10% (95% CI 0%–19.0%).

Single-fraction radiosurgery for the treatment of renal tumors in singular renal units.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 368-368
Author(s):  
M. D. Staehler ◽  
P. Nuhn ◽  
A. Karl ◽  
M. Bader ◽  
C. Stief ◽  
...  
Keyword(s):  
Radiation Treatment ◽  
Eastern Cooperative Oncology Group ◽  
Skin Toxicity ◽  
Local Tumor Control ◽  
Renal Tumors ◽  
Tumor Control ◽  
High Dose ◽  
Local Tumor ◽  
Single Fraction ◽  
Oncological Treatment

368 Background: High-dose local radiation treatment (stereotactic radiosurgery [SRS]) was added for selected patients to improve local control and overall survival in metastases. We report on toxicity and local tumor control in patients with renal tumors who were treated with aggressive local irradiation using a single fraction SRS with the Cyberknife in singular renal units to avoid hemodialysis. Methods: n=18 patients with renal tumors and an eastern cooperative oncology group (ECOG) status of 0 or 1 were treated with SRS. Patients with surgically removable renal lesions were not included. Prior to SRS gold markers were planted into the renal parenchyma under ultrasonographic guidance. Results: Nine patients had transitional carcinoma of the renal pelvis, six patients had renal cell carcinoma and three had other tumor entities. No skin toxicity occurred after SRS, and SRS did not induce other side effects. Local tumor control 9 months after SRS was 98% (95% CI: 89-99%). There were no treatment related deaths, and late complications after SRS were not noted so far. Renal function so far remained stable without a change in serum creatinine. Conclusions: SRS for selected patients with renal tumors is safe and effective. Single-fraction delivery as an outpatient procedure allows for convenient integration of SRS into various oncological treatment concepts. Further studies are needed to determine the limits of SRS in this setting. No significant financial relationships to disclose.

High-Dose-Rate Interstitial Brachytherapy (Interventional Radiotherapy) for Conjunctival Melanoma with Orbital Extension

2021 ◽  
pp. 1-7
Author(s):  
Monica Maria Pagliara ◽  
Luca Tagliaferri ◽  
Gustavo Savino ◽  
Bruno Fionda ◽  
Andrea D’Aviero ◽  
...  
Keyword(s):  
Dose Rate ◽  
Late Toxicity ◽  
Surgical Excision ◽  
High Dose Rate ◽  
Local Tumor Control ◽  
Tumor Control ◽  
High Dose ◽  
Conjunctival Melanoma ◽  
Aesthetic Results ◽  
Excellent Functional Outcome

Purpose: To evaluate local control and functional and cosmetic outcomes of postoperative high-dose-rate interventional radiotherapy (HDR-IRT) in patients affected by conjunctival melanoma with orbit invasion. Methods: A retrospective study was conducted in 2 patients affected by conjunctival melanoma infiltrating the orbit, treated with surgical excision and HDR-IRT. The treatment procedures consisted of surgical excision of the orbital infiltrating nodule followed, 1 month after surgery, by adjuvant HDR-IRT. A target dose of 34 Gy was delivered in 10 twice-a-day fractions over 5 consecutive days. Data analysis included local tumor control and metastatic rate, acute and late toxicity, functional and aesthetic results. Results: In both patients, treatment was well tolerated, and there was no orbital recurrence at a median follow-up of 37–40 months. There was an excellent functional outcome, without no significant acute or late side effects. Conclusions: HDR-IRT could be considered a promising, feasible, successful, and well-tolerated option for selected patients affected by ocular tumors with orbital invasion.

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