scholarly journals GIANT SOLITARY CUTANEOUS ANGIOSARCOMA OF THE FOREARM OCCURRING OUTSIDE THE SETTING OF LYMPHEDEMA

2021 ◽  
Vol 9 (04) ◽  
pp. 401-405
Author(s):  
S. Belanouane ◽  
◽  
F. Hali ◽  
F. Marnissi ◽  
S. Chiheb ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Clinical Manifestation ◽  
Radiation Treatment ◽  
Common Clinical Manifestation ◽  
History Of ◽  
Chronic Lymphedema

Angiosarcoma (AS) is an aggressive vascular malignancy that can affect various anatomic sites. Although rare, cutaneous angiosarcoma (CAS) is the most common clinical manifestation of AS, accounting for approximately 50% to 60% of all AS. CAS is typically known to occur in three settings: (1) idiopathic, (2) following radiation treatment, or (3) is classically diagnosed following mastectomy with subsequent chronic lymphedema (known as Stewart Treves syndrome). We present a case of CAS on the forearm in a man with no history of lymphedema or radiation therapy, highlighting the necessity to discuss this diagnosis even outside the setting of conventional angiosarcomas.

462 Single agent immunotherapy response in patients with head and neck squamous cell carcinoma with prior history of radiation therapy

2020 ◽  
Vol 8 (Suppl 3) ◽  
pp. A490-A490
Author(s):  
Moises Harari-Turquie ◽  
Shashank Cingam ◽  
David Lee ◽  
Gregory Gan ◽  
Emrullah Yilmaz ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Head And Neck ◽  
Squamous Cell ◽  
Radiation Treatment ◽  
Single Agent ◽  
Early Recurrence ◽  
Definitive Treatment ◽  
Refractory Disease ◽  
History Of ◽  
Platinum Refractory

BackgroundLocally advanced head and neck squamous cell carcinomas (HNSCC) are treated with multidisciplinary approach which includes radiation therapy. Immunotherapy with nivolumab or pembrolizumab is used for platinum refractory disease. We analyzed the association of radiation treatment patterns and immunotherapy responses HNSCC.MethodsWe performed a retrospective analysis at University of New Mexico Comprehensive Cancer Center for patients with diagnosis of HNSCC treated at our institution between 2011 and 2020 with immunotherapy agent’s nivolumab and pembrolizumab. Our cohort included 21 patients with previous history of definitive radiation therapy for HNSCC who received immunotherapy for recurrent disease, as part of adjuvant treatment as either front-line or second line therapy. In terms of response, patients were divided into responders (R) and non-responders (NR). Responders were defined as the presence of partial remission in initial imaging or stable disease for a period of six months or longer.ResultsOf our 21 patients, 10 patients were R and 11 patients were NR. p16 positivity was 6 (60%) in R vs 3 (27%) in NR. 8 patients in R group (80%) and 10 patients in NR group (91%) had prior platinum based chemotherapy concurrent with radiation or for recurrence as salvage chemotherapy.All patients had radiation therapy prior to immunotherapy for adjuvant or for definitive treatment. Time from last day of radiation treatment to start of immunotherapy was 47 months in R group while it was 9 months in NR group (P<0.05). (Figure 1) There was no difference in time from radiation to immunotherapy depending on the P16 status. Immunotherapy was stopped after completing 2 years of immunotherapy for 3 patients. 2 of those patients resumed immunotherapy due to progression, and continue to have response after resuming treatment. One of these patients received SBRT to lung nodule after resuming immunotherapy.Abstract 462 Figure 1Time from last day of radiation treatment to start of immunotherapyConclusionsImmunotherapy with single agent PD-L1 inhibitor is used for platinum refractory disease in HNSCC, however response rates are low. Our study shows that the patients who had early recurrence and received immunotherapy closer to definitive radiation therapy had lower response rate. Therefore we need further studies to investigate changes in immune micorenvironment with radiation therapy for better immune targeting of patients with early recurrence after radiation treatment.

scholarly journals Exceeding Radiation Dose to Volume Parameters for the Proximal Airways with Stereotactic Body Radiation Therapy Is More Likely for Ultracentral Lung Tumors and Associated with Worse Outcome

Cancers ◽  
2021 ◽  
Vol 13 (14) ◽  
pp. 3463
Author(s):  
Mark Farrugia ◽  
Sung Jun Ma ◽  
Mark Hennon ◽  
Chukwumere Nwogu ◽  
Elisabeth Dexter ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Propensity Score ◽  
Stereotactic Body Radiation Therapy ◽  
Performance Status ◽  
Bronchial Tree ◽  
Lung Tumors ◽  
Gender Performance ◽  
Dose Fractionation ◽  
Stereotactic Body Radiation ◽  
History Of

The preferred radiotherapeutic approach for central (CLT) and ultracentral (UCLT) lung tumors is unclear. We assessed the toxicity and outcomes of patients with CLT and UCLT who underwent definitive five-fraction stereotactic body radiation therapy (SBRT). We reviewed the charts of patients with either CLT or UCLT managed with SBRT from June 2010–April 2019. CLT were defined as gross tumor volume (GTV) within 2 cm of either the proximal bronchial tree, trachea, mediastinum, aorta, or spinal cord. UCLT were defined as GTV abutting any of these structures. Propensity score matching was performed for gender, performance status, and history of prior lung cancer. Within this cohort of 83 patients, 43 (51.8%) patients had UCLT. The median patient age was 73.1 years with a median follow up of 29.9 months. The two most common dose fractionation schemes were 5000 cGy (44.6%) and 5500 cGy (42.2%) in five fractions. Multivariate analysis revealed UCLT to be associated with worse overall survival (OS) (HR = 1.9, p = 0.02) but not time to progression (TTP). Using propensity score match pairing, UCLT correlated with reduced non-cancer associated survival (p = 0.049) and OS (p = 0.03), but not TTP. Within the matched cohort, dosimetric study found exceeding a D4cc of 18 Gy to either the proximal bronchus (HR = 3.9, p = 0.007) or trachea (HR = 4.0, p = 0.02) was correlated with worse non-cancer associated survival. In patients undergoing five fraction SBRT, UCLT location was associated with worse non-cancer associated survival and OS, which could be secondary to excessive D4cc dose to the proximal airways.

scholarly journals RADT-29. EFFECT OF RADIATION THERAPY ON OVERALL SURVIVAL FOLLOWING SUBTOTAL RESECTION OF ADULT PILOCYTIC ASTROCYTOMA

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii187-ii188
Author(s):  
Adham Khalafallah ◽  
Adrian Jimenez ◽  
Henry Brem ◽  
Debraj Mukherjee
Keyword(s):  
Overall Survival ◽  
Radiation Therapy ◽  
Pilocytic Astrocytoma ◽  
Radiation Treatment ◽  
Cox Proportional Hazards Model ◽  
Adult Patients ◽  
Subtotal Resection ◽  
Adjuvant Radiation ◽  
Low Grade ◽  
Risk Of Death

Abstract BACKGROUND Pilocytic astrocytoma (PCA) is a low-grade glioma common in children but also rarely diagnosed in adults. The role of adjuvant radiation therapy (RT) in treating these tumors remains unclear. OBJECTIVE We investigated the effect of RT on overall survival, specifically among adult patients who had undergone subtotal PCA resection. METHODS Information on adult patients (age 18 years old) who had undergone subtotal PCA resection between 2004 and 2016 was collected from the National Cancer Database (NCDB). A multivariate Cox proportional hazards model was utilized to determine factors independently associated with overall survival. RESULTS A total of 451 patients were identified. The mean age of our patient cohort was 36.8 years old, and the majority of patients (83.4%) did not receive radiation treatment following subtotal PCA resection. Overall median survival was 93.8 months. Survival was longer (p &lt; 0.001) in the patients who did not receive post-surgical RT (median: 98.3 months) compared to patients who did (median: 54.8 months). Patients who had older age at diagnosis (hazard ratio [HR]=1.05, 95% confidence interval [CI]=1.03-1.07, p &lt; 0.01), were Black or African American (HR=2.76, CI=1.12-6.46, p=0.019), received radiation during their initial treatment (HR=4.53, CI=2.08-9.89, p &lt; 0.01), or had a Charlson/Deyo score of &gt; 1 (HR=3.68, CI=1.55, p=0.003) had a significantly higher risk of death following subtotal PCA resection. CONCLUSION Postoperative RT is independently associated with a significantly higher risk of death among adults who underwent subtotal PCA resection. Our findings provide a rationale for further investigation into the efficacy and safety of RT within this patient population.

A Call to Define Stereotactic Radiosurgery

Neurosurgery ◽  
2004 ◽  
Vol 55 (6) ◽  
pp. 1371-1373 ◽  
Author(s):  
Bruce E. Pollock ◽  
L Dade Lunsford
Keyword(s):  
Radiation Therapy ◽  
Stereotactic Radiosurgery ◽  
Single Session ◽  
Short History ◽  
Effective Radiation Dose ◽  
The Past ◽  
Radiation Delivery ◽  
History Of ◽  
Effective Radiation ◽  
And Training

Abstract STEREOTACTIC RADIOSURGERY IS the single-session, precise delivery of a therapeutically effective radiation dose to an imaging-defined target. Conceived and developed during the past 5 decades, stereotactic radiosurgery has involved significant advances, which have improved patient outcomes and made it a critical component of modern neurosurgical practice and training. In this article, a short history of stereotactic surgery and radiosurgery are presented, and radiosurgery is contrasted to radiation therapy. Adherence to accepted, descriptive terms in defining stereotactic radiosurgery and radiation therapy permits a clear distinction among the results of the different radiation delivery techniques for patients, physicians, and other interested parties.

scholarly journals An Overview on Radiotherapy: From Its History to Its Current Applications in Dermatology

2017 ◽  
Vol 5 (4) ◽  
pp. 521-525 ◽  
Author(s):  
Serena Gianfaldoni ◽  
Roberto Gianfaldoni ◽  
Uwe Wollina ◽  
Jacopo Lotti ◽  
Georgi Tchernev ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Effective Treatment ◽  
Malignant Diseases ◽  
Oncologic Patients ◽  
History Of

For more than a century, radiotherapy has been an effective treatment for oncologic patients. The Authors report a brief history of the radiation therapy and its actual indication for the treatments of cutaneous malignant diseases.

Flap Reconstruction of Sarcoma Defects in the Setting of Neoadjuvant and Adjuvant Radiation

2018 ◽  
Vol 35 (04) ◽  
pp. 287-293 ◽  
Author(s):  
Rohini Kadle ◽  
Catherine Motosko ◽  
George Zakhem ◽  
John Stranix ◽  
Timothy Rapp ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Soft Tissue ◽  
Radiation Treatment ◽  
Soft Tissue Sarcomas ◽  
Adjuvant Radiation ◽  
Complication Rates ◽  
Flap Reconstruction ◽  
Fasciocutaneous Flaps ◽  
Musculoskeletal Tumor Society

Background Limb-sparing treatment of extremity soft tissue sarcomas requires wide resections and radiation therapy. The resulting complex composite defects necessitate reconstructions using either muscle or fasciocutaneous flaps, often in irradiated wound beds. Methods A retrospective chart review was performed of all limb-sparing soft tissue sarcoma resections requiring immediate flap reconstruction from 2012 through 2016. Results Forty-four patients with 51 flaps were identified: 25 fasciocutaneous and 26 muscle-based flaps. Mean defect size, radiation treatment, and follow-up length were similar between groups. More often, muscle-based flaps were performed in younger patients and in the lower extremity. Seventeen flaps were exposed to neoadjuvant radiation, 12 to adjuvant radiation, 5 to both, and 17 to no radiation therapy. Regardless of radiation treatment, complication rates were comparable, with 28% in fasciocutaneous and 31% in muscle-based groups (p < 0.775). Muscle-based flaps performed within 6 weeks of undergoing radiotherapy were less likely to result in complications than those performed after greater than 6 weeks (p < 0.048). At time of follow-up, Musculoskeletal Tumor Society scores for fasciocutaneous and muscle-based reconstructions, with or without radiation, showed no significant differences between groups (mean [SD]: 91% [8%] vs. 89% [13%]). Conclusion The similar complication rates and functional outcomes in this study support the safety and efficacy of both fasciocutaneous flaps and muscle-based flaps in reconstructing limb-sparing sarcoma resection defects, with or without radiotherapy.

scholarly journals Esophageal neuroendocrine carcinoma presenting as a rare cause of dysphagia

2018 ◽  
Vol 5 (2) ◽  
pp. 1
Author(s):  
Sylvester Luu ◽  
Brian C. Benson ◽  
Kelly A. Haeusler ◽  
Robert O. Brady ◽  
Katherine M. Cebe ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Neuroendocrine Carcinoma ◽  
Poor Prognosis ◽  
Gastroesophageal Junction ◽  
Prior History ◽  
High Grade ◽  
Active Smoking ◽  
Platinum Based Chemotherapy ◽  
History Of ◽  
Neuroendocrine Carcinomas

A 60-year-old male with prior history of laryngeal carcinoma and active smoking presented with six months of solid food dysphagia. Endoscopy showed a large, friable gastroesophageal junction mass. Biopsies revealed a high-grade, poorlydifferentiated neuroendocrine carcinoma. He was subsequently started on platinum based chemotherapy and radiation therapy and his tumor decreased dramatically in size. This case is unique as neuroendocrine carcinomas (NECs) are rarely found in the esophagus and usually have a poor prognosis at time of diagnosis.

scholarly journals Factors increasing the risk of flap complications following pectoralis major myocutaneous flap reconstruction for head and neck cancers

2020 ◽  
Vol 6 (6) ◽  
pp. 1138
Author(s):  
Subbiah Shanmugam ◽  
Syed Afroze Hussain ◽  
Rajiv Michael
Keyword(s):  
Radiation Therapy ◽  
Head And Neck ◽  
Radiation Treatment ◽  
Demographic Data ◽  
Major Complication ◽  
Pectoralis Major ◽  
Head And Neck Reconstruction ◽  
Complication Rates ◽  
Flap Reconstruction ◽  
Operative Care

<p class="abstract"><strong>Background:</strong> Oral cavity cancer is one of the most common cancers and a leading cause of cancer death in India. Pectoralis major myocutaneous flaps (PMMC) are still widely used for reconstruction of defects in the head and neck, though microvascular free flaps are the ‘gold standard’. This study was aimed to identify the risk factors involved in increasing the post-operative PMMC flap complications.</p><p class="abstract"><strong>Methods:</strong> Patients who underwent surgical resection of primary head and neck cancer with PMMC flap reconstruction were included and their demographic data, pre-operative laboratory values, surgery details and post-operative flap morbidity were collected retrospectively from the master case sheets from January 2013 to December 2019. Factors such as age, gender, stage of disease, pre-operative anemia, hypoprotenemia and radiation therapy, presence of diabetes and size of the flaps were analysed to find their relation in causing flap complications.  </p><p class="abstract"><strong>Results:</strong> Totally 285 patients were included for analysis and 9.82% (n=28) had major flap complications. On analysis we found that pre-operative hypoproteinemia (serum albumin &lt;3.5) (p=0.001) and prior radiation therapy (p=0.02) significantly increased the risk of flap complications. Similarly, patients with larger bipaddled flaps had higher flap complication rates (p=0.0002) and previous radiation treatment further increased the major complication rates in bipaddle flaps.</p><p class="abstract"><strong>Conclusions:</strong> PMMC flaps are still a viable option for head and neck reconstruction especially in patients with multiple comorbidities and where free microvascular flaps are not done routinely. Careful patient selection, pre-operative optimisation and good post-operative care will help to reduce flap complications.</p><p> </p>

Sign in / Sign up

Export Citation Format

Share Document