scholarly journals EVOLUTION OF TREATMENT OF CANCER OF THE MAJOR DUODENAL PAPILLA

2021 ◽  
Vol 20 (1) ◽  
pp. 141-148
Author(s):  
D. V. Nazarova ◽  
R. I. Rasulov ◽  
K. G. Zubrinsky ◽  
G. I. Sogolov
Keyword(s):  
Radiation Therapy ◽  
Prognostic Factors ◽  
Survival Rate ◽  
Life Expectancy ◽  
Adjuvant Treatment ◽  
Neoadjuvant Treatment ◽  
External Beam Radiation ◽  
Duodenal Papilla ◽  
Radical Treatment ◽  
Major Duodenal Papilla

Cancer of the major duodenal papilla is a rare disease with a reported population incidence of 6 per million. Endoscopic ultrasonography and intraductal ultrasonography are useful for diagnosing tumor  extension of the major duodenal papilla. However, there are no specific biochemical studies or tumor markers, and an algorithm for early diagnosis of cancer of the major duodenal papilla has not been developed. Pancreatoduodenal resection remains the main treatment method for patients with a resectable tumor. However, long-term outcomes of radical surgeries are not satisfactory, with the median survival rate of 52–113 months, and the 5-year survival rate of 30–78.8 %. The study of prognostic factors will allow the development of the effective schemes of radical treatment, a therapeutic algorithm that will inevitably increase life expectancy. Radical surgery should be integrated into multi-modal treatment. Of all the variety of prognostic factors, the morphological differentiation of the tumor is of interest. According to our data, the overall 5-year survival rate, the average life expectancy for pancreatobiliary and intestinal subtypes of cancer of the major duodenal papilla after expanded pancreatoduodenal resection, respectively, was 0 % versus 38.05 % and 9.3 ± 1.79 months versus 48.0 ± 7.69 months. An accurate morphological diagnosis is of paramount prognostic importance, since it can have therapeutic consequences; that is, morphologically oriented and specific (neo)adjuvant treatment corresponding to subtypes of cancer of the major duodenal papilla. Currently, a multi-modal approach in the treatment of cancer of the major duodenal papilla is under development. Data on the use of adjuvant therapy in the radical treatment regimen are contradictory. There are no randomized controlled trials for neoadjuvant treatment. Little attention is paid to complications of chemotherapy and radiation therapy in the neoadjuvant treatment option. According to our data, chemoembolization of the gastro-duodenal artery resulted in complications in 21.4 %, and external beam radiation therapy resulted in radiation-induced injuries in 25 %. NCC N and ESMO currently do not provide recommendations for (neo)adjuvant treatment of cancer of the major duodenal papilla.

Improved survival in patients with limited stage IIIA Hodgkin's disease treated with combined radiation therapy and chemotherapy.

1994 ◽  
Vol 12 (12) ◽  
pp. 2567-2572 ◽  
Author(s):  
K C Marcus ◽  
L A Kalish ◽  
C N Coleman ◽  
L N Shulman ◽  
D S Rosenthal ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Prognostic Factors ◽  
Survival Rate ◽  
Hodgkin's Disease ◽  
Hodgkin’S Disease ◽  
Survival Rates ◽  
Stage Iii ◽  
Combined Modality Treatment ◽  
Stage Iiia ◽  
Long Term Treatment

PURPOSE Patients with laparotomy-staged (PS) III 1A Hodgkin's disease confined to the upper abdomen are believed to have a favorable prognosis and require less aggressive treatment than patients with more-extensive stage III disease. We evaluated prognostic factors and outcome in 93 patients with PS III 1A Hodgkin's disease treated either with radiation therapy (RT) alone or combined RT and chemotherapy (combined modality treatment [CMT]) to determine the extent of treatment needed in this subgroup of stage IIIA patients. MATERIALS AND METHODS We retrospectively reviewed the freedom from relapse (FFR) rate, sites of recurrence, and survival rate of PS III 1A patients selected to receive extended-field irradiation (MPA, n = 27), total-nodal irradiation (TNI, n = 34), and CMT (n = 32) between 1969 and 1987. CMT consisted of six cycles of mechlorethamine, vincristine, procarbazine, and prednisone (MOPP) chemotherapy and MPA. Patients treated with MPA were part of a prospective trial designed to reduce treatment to patients with minimal stage III disease with very favorable characteristics. RESULTS Histologic subclass and treatment were the only prognostic factors for FFR and survival rates. Patients with nodular sclerosis or lymphocyte predominance histology had significantly higher FFR and survival rates compared to patients with mixed-cellularity (MC) histology. The 10-year actuarial FFR of PSIII 1A patients treated with MPA was only 39%, versus 55% for TNI (P = .02) and 94% for CMT (v MPA, P < .0001; v TNI, P = .006). The patterns of recurrence in patients who received MPA and TNI were significantly different, with MPA patients relapsing more often in untreated pelvic or inguinal nodes, and TNI patients relapsing more often in extranodal sites with or without nodal sites. The 10-year actuarial overall survival rate for patients treated with CMT was 89% versus 78% for MPA (v CMT, P = .09) and 70% for TNI (v CMT, P = .05). CONCLUSION Patients with PSIII 1A Hodgkin's disease treated with RT have a significantly higher risk of relapse and potentially a poorer survival compared with patients treated with CMT. These findings suggest that CMT should play a greater role in the treatment of this favorable substage of patients. Management with modified chemotherapy and RT in an attempt to reduce long-term treatment-induced complications may be a preferred approach for future trials.

scholarly journals Prognostic factors for eye globe salvage by external beam radiation therapy for resistant intraocular retinoblastoma

2020 ◽  
Vol 13 (3) ◽  
pp. 123
Author(s):  
Ibrahim Al-Nawaiseh ◽  
YacoubA Yousef ◽  
Mona Mohammad ◽  
Imad Jaradat ◽  
Raed Shatnawi ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Prognostic Factors ◽  
External Beam Radiation Therapy ◽  
External Beam Radiation ◽  
External Beam ◽  
Beam Radiation ◽  
Intraocular Retinoblastoma

scholarly journals Mo1417 – Adjuvant Treatment for Advanced Gallbladder Cancer; Does External Beam Radiation Therapy Play a Role?

2019 ◽  
Vol 156 (6) ◽  
pp. S-1467
Author(s):  
Eliahu Y. Bekhor ◽  
Nathan M. Bolton ◽  
Brianne Sullivan ◽  
Daniel Solomon ◽  
Natasha DeNicola ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Gallbladder Cancer ◽  
Adjuvant Treatment ◽  
External Beam Radiation Therapy ◽  
External Beam Radiation ◽  
External Beam ◽  
Beam Radiation ◽  
Advanced Gallbladder Cancer

Factors associated with survival in patients with meningioma

1998 ◽  
Vol 88 (5) ◽  
pp. 831-839 ◽  
Author(s):  
Bridget J. McCarthy ◽  
Faith G. Davis ◽  
Sally Freels ◽  
Tanya S. Surawicz ◽  
Denise M. Damek ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Prognostic Factors ◽  
Survival Rate ◽  
Proportional Hazards Model ◽  
Malignant Tumors ◽  
Age At Diagnosis ◽  
Benign Tumors ◽  
Content Type ◽  
Cancer Data ◽  
Fine Print

Object. To explore factors affecting the survival rate in patients with meningiomas, the authors used the National Cancer Data Base (NCDB), which includes tumors from approximately 1000 hospitals participating in the American College of Surgeons tumor registry program. Methods. Analysis included over 9000 cases diagnosed from 1985 to 1988 and 1990 to 1992. Survival estimates were computed and prognostic factors were identified using a proportional hazards model. The overall 5-year survival rate was 69% and it declined with patient age. This rate was 81% in patients aged 21 to 64 years and 56% for patients 65 years of age or older. When patients were grouped by the histological type of their tumors, those with benign tumors had an overall 5-year survival rate of 70%, whereas the overall 5-year survival rates in patients with atypical and malignant meningiomas were 75% and 55%, respectively. Prognostic factors for benign tumors included age at diagnosis, tumor size, whether treated surgically, hospital type, and radiation therapy; for malignant tumors, the prognostic factors included: age at diagnosis, whether treated surgically, and radiation therapy. These factors were statistically significant. The 5-year rate for recurrence of symptoms (regardless of the method of treatment) was 19.2% for those with benign tumors and 32.4% for those with malignant tumors. In patients whose benign tumor had been completely removed, the 5-year rate of tumor recurrence was 20.5%. Conclusions. Although not population-based, the NCDB has the potential for providing pertinent information regarding patient characteristics and methods of treatment for benign, as well as malignant, brain tumors.

scholarly journals PROSPECTS FOR NEOADJUVANT TREATMENT OF AMPULLARY CANCER

ASJ. ◽  
2020 ◽  
Vol 3 (41) ◽  
pp. 28-36
Author(s):  
R. Rasulov ◽  
V. Dvornichenko ◽  
D. Nazarova ◽  
G. Nurbekian
Keyword(s):  
Radiation Therapy ◽  
Adjuvant Chemotherapy ◽  
Life Expectancy ◽  
Ampullary Cancer ◽  
Control Group ◽  
Radiation Injuries ◽  
Average Life ◽  
Average Life Expectancy ◽  
Radical Treatment ◽  
Experimental Group

Objective: to study the possibilities of preoperative radiation therapy in a radical treatment regimen for glandular ampullary cancer. Materials and methods. In 2001-2019, 21 cases of pancreatic-biliary type of ampullary cancer underwent radical treatment, including preoperative RT, extended GPDR and adjuvant chemotherapy according to indications (experimental group), 48 cases of pancreatic-biliary type of ampullary cancer underwent expanded GPDR and adjuvant chemotherapy according to indications (control group), and 43 cases of intestinal type of ampullary cancer underwent extended GPDR and adjuvant chemotherapy according to indications. Results. Radiation therapy caused radiation injuries in 28.6% of patients: grade 1 erythema (19.1%), grade 1 leukopenia (4.75%), and grade 2 leukopenia (4.75%). Postoperative complications, mortality of the experimental group and the control group, respectively, amounted to 28.6% and 50.0% (p = 0.09) and 4.8% and 6.3% (p = 0.8). The overall 5-year survival rate, the average life expectancy of the experimental group and the control group, respectively, were 50.7% and 9.8% (p = 0.01) and 74.8 ± 12.58 months and 21.7 ± 6.11 months (p = 0.0008). The overall 5-year survival rate, the average life expectancy of the group with intestinal ampullary cancer, were 61.3% and 60.5 ± 9.15 months, respectively. Relapse-free survival of patients with glandular ampullary cancer (n = 112) who received treatment according to the radical regimen was: 1-year - 77.8%, 3-year - 51.0%, 5-year - 35.2%, average life expectancy - 44.7 ± 5.44 months Conclusion. Radiation injuries were stopped by conservative measures and did not increase the duration of the preoperative period. Preoperative RT in the radical treatment regimen for pancreatic-biliary type of ampullary cancer neither changed the nature nor increased the incidence of postoperative complications. Combined treatment significantly improved long-term survival in cases with pancreatic-biliary type of ampullary cancer.

scholarly journals Factors associated with survival in patients with meningioma

1997 ◽  
Vol 2 (4) ◽  
pp. E3 ◽  
Author(s):  
Bridget J. McCarthy ◽  
Faith Davis ◽  
Sally Freels ◽  
Tanya S. Surawicz ◽  
Denise Damek ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Prognostic Factors ◽  
Survival Rate ◽  
Program Analysis ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Malignant Tumors ◽  
Survival Rates ◽  
Age At Diagnosis ◽  
Benign Tumors

Factors affecting the survival rate in patients with meningiomas were explored using the National Cancer Database (NCDB), which includes tumors from approximately 1000 hospitals participating in the American College of Surgeons tumor registry program. Analysis included over 9000 cases diagnosed from 1985 to 1988 and 1990 to 1992. Survival estimates were computed and prognostic factors were identified using a proportional hazards model. The overall 5-year survival rate was 69% and it declined with age. This rate was 81% in patients aged 21 to 64 and 56% for patients 65 years of age or older. When patients were grouped by the histological type of their tumors, those with benign tumors had an overall 5-year survival rate of 70%, whereas the overall 5-year survival rates in patients with atypical and malignant meningiomas were 75% and 55%, respectively. Prognostic factors for benign tumors included age at diagnosis, tumor size, whether treated surgically, hospital type, and radiation therapy; for malignant tumors, age at diagnosis, whether treated surgically, and radiation therapy were statistically significant. The 5-year rate for recurrence of symptoms (regardless of the method of treatment) was 18.2% for those with benign tumors and 27.5% for those with malignant tumors. In patients whose benign tumor had been completely removed, the 5-year rate of tumor recurrence was 20.5%. Although not population-based, the NCDB has the potential for providing pertinent information regarding patient characteristics and methods of treatment for benign, as well as malignant, brain tumors.

Sign in / Sign up

Export Citation Format

Share Document