scholarly journals Radiation Treatment for Inoperable Local Relapse of Parathyroid Carcinoma With Symptomatic Hypercalcemia: A Case Report

2021 ◽  
Vol 11 ◽  
Author(s):  
Heleen Bollen ◽  
Brigitte Decallonne ◽  
Sandra Nuyts
Keyword(s):  
Parathyroid Carcinoma ◽  
Radiation Treatment ◽  
Symptomatic Treatment ◽  
Local Relapse ◽  
Adjuvant Radiation ◽  
Slow Progression ◽  
Local Radiation ◽  
Rare Malignancy

BackgroundParathyroid carcinoma (PC) is an extremely rare malignancy, characterized by slow progression, frequent recurrences and difficult-to-control hypercalcemia which is typically the main contributor to the morbidity and mortality of these patients. Patients often undergo repeated surgical resections, whether or not in combination with adjuvant radiation treatment. The role of radiation therapy within the symptomatic treatment of PC currently remains unclear.Case descriptionWe describe a 30-year-old male patient with an inoperable local relapse of PC and secondary symptomatic hypercalcemia, maximally pharmacologically treated. After a local radiation treatment to a total dose of 70 Gray in 35 fractions serum calcium and parathyroid hormone (PTH) levels decreased, accompanied by improvement of the severe gastro-intestinal disturbances.ConclusionFor patients with inoperable symptomatic PC despite maximal medical treatment who are in a good overall condition, radiation treatment can be considered in well-defined cases to decrease symptoms and improve quality of life.

Revisiting the Role of Radiation Treatment for Non-serous Subtypes of Epithelial Ovarian Cancer

2013 ◽  
pp. e205-e208
Author(s):  
G. Thomas
Keyword(s):  
Ovarian Cancer ◽  
Radiation Treatment ◽  
Residual Disease ◽  
Postoperative Treatment ◽  
Molecular Characteristics ◽  
Adjuvant Radiation ◽  
Subtype A ◽  
Chemotherapy Agents ◽  
Retrospective Examination

Except for its palliative use, radiation has been largely abandoned in the management of ovarian cancers because of the recognized efficacy of chemotherapy agents. Whole abdominal irradiation (WAR), however, has been shown to be of adjuvant and curative value in ovarian cancer with microscopic or minimal residual disease in the pelvis, the so-called “intermediate risk group.” Recent hypothesis generating data from the use of adjuvant radiation following adjuvant chemotherapy in ovarian cancer has shown an incremental survival benefit for the rarer non-serous ovarian subtypes including clear cell, endometrioid, and mucinous. No incremental benefit was observed for the more common serous subtype. A retrospective examination of early trials using WAR as the sole postoperative treatment in ovarian cancer has determined that the majority of patients in these studies and cured by radiation actually had the non-serous subtypes. The recognition that the non-serous subtypes differ from the serous cancers in their stage of presentation, their molecular characteristics, their response to classic chemotherapy, and their outcomes suggest the non-serous subtypes should be treated as rare and different cancers. In addition to specific targeting therapies that may be developed, radiation should be reconsidered as part of the treatment armamentarium for these diseases.

scholarly journals Management of Endocrine Manifestations and the Use of Mitotane As a Chemotherapeutic Agent for Adrenocortical Carcinoma

2009 ◽  
Vol 27 (27) ◽  
pp. 4619-4629 ◽  
Author(s):  
Irina Veytsman ◽  
Lynnette Nieman ◽  
Tito Fojo
Keyword(s):  
Malignant Disease ◽  
Local Relapse ◽  
Hormone Production ◽  
Randomized Controlled ◽  
Aggressive Management ◽  
Effective Doses ◽  
Rare Malignancy ◽  
Control Study

Adrenal cortical carcinoma (ACC) is a rare malignancy in which patients have poor overall 5-year survival. Patients with ACC can present with symptoms of hormone excess, including Cushing's syndrome, virilization, feminization, or—less frequently—hypertension with hypokalemia. In many patients with ACC, advanced disease at presentation precludes surgery or is followed by local relapse or distant metastatic disease that cannot be managed surgically. In these instances, chemotherapy is often tried, but its limited efficacy all too often leaves the problem of persistent hormonal excess. Physicians who treat patients with ACC and severe hypercortisolism should recognize that uncontrolled hormone production is a malignant disease, which has severe consequences that require aggressive management. Because chemotherapy benefits only a small percentage of patients, steroidogenesis inhibitors, including mitotane, ketoconazole, metyrapone, and etomidate, should be used singly or in combination even as chemotherapy is administered. Diligent management with frequent adjustments is required, especially in patients with chemotherapy-refractory tumors that continue to grow. In the absence of randomized, controlled trials, adjuvant use of mitotane remains controversial, although the authors of a recent case-control study argue for its use. Despite difficulty administering effective doses, most clinicians agree that mitotane should be used if the tumor cannot be removed surgically or should be used as adjuvant therapy if there is a high likelihood of recurrence. The option of long-term monotherapy is restricted to patients who tolerate mitotane and either experience a clinical response or are at high risk for recurrence. Recommendations are provided to help manage patients with this difficult disease and to improve the quality of their lives.

scholarly journals Possibilities of symptomatic treatment of allergic rhinitis in children

2019 ◽  
pp. 179-185
Author(s):  
D. A. Tulupov ◽  
Е. Р. Karpova
Keyword(s):  
Allergic Rhinitis ◽  
Symptomatic Treatment ◽  
Comorbid Conditions ◽  
Pharmacokinetics And Pharmacodynamics ◽  
Medication Therapy ◽  
Leukotriene Receptor ◽  
High Level ◽  
First And Second Generation

This article presents an overview of current views on the problem of allergic rhinitis in children. Modern data on the epidemiology of allergic rhinitis and basic comorbid conditions are covered. The issue of patient routing with suspicion of allergic rhinitis and the main directions in the treatment of this disease is briefly discussed. On the basis of the data of the latest consensus papers, the role of various medication therapy for allergic rhinitis has been evaluated: first and second generation antihistamines, intranasal glucocorticosteroids, leukotriene receptor antagonists, and mast cell membrane stabilizers. Possibilities of symptomatic nasal obstruction therapy in case of allergic rhinitis with the help of nasal vasoconstrictor drugs (decongestants) have been assessed in more detail. The basics of pharmacokinetics and pharmacodynamics of decongestants are presented, as well as the data of a clinical study demonstrating the efficacy and safety of the combined preparation of phenylephrine and dimethindene maleate in the symptomatic treatment of allergic rhinitis in children. On the basis of the presented material it is concluded that timely diagnosis and further management of patients with allergic rhinitis in accordance with the principles reflected in modern clinical guidelines, in most cases, allow to effectively control the course of the disease, maintaining the quality of life of patients at a high level.

The role of adjuvant radiation treatment in older women with early breast cancer

2013 ◽  
Vol 4 (4) ◽  
pp. 402-412 ◽  
Author(s):  
Noam VanderWalde ◽  
Britni Hebert ◽  
Ellen Jones ◽  
Hyman Muss
Keyword(s):  
Breast Cancer ◽  
Older Women ◽  
Early Breast Cancer ◽  
Radiation Treatment ◽  
Adjuvant Radiation

Cognitive Health Counseling 40+

2013 ◽  
Vol 21 (1) ◽  
pp. 24-33 ◽  
Author(s):  
Anne Eschen ◽  
Franzisca Zehnder ◽  
Mike Martin
Keyword(s):  
Outcome Variable ◽  
Pilot Phase ◽  
Subjective Memory ◽  
Cognitive Health ◽  
Health Counseling ◽  
Agents Of Change ◽  
Main Outcome Variable ◽  
Further Development

This article introduces Cognitive Health Counseling 40+ (CH.CO40+), an individualized intervention that is conceptually based on the orchestration model of quality-of-life management ( Martin & Kliegel, 2010 ) and aims at improving satisfaction with cognitive health in adults aged 40 years and older. We describe the theoretically deduced characteristics of CH.CO40+, its target group, its multifactorial nature, its individualization, the application of subjective and objective measures, the role of participants as agents of change, and the rationale for choosing participants’ satisfaction with their cognitive health as main outcome variable. A pilot phase with 15 middle-aged and six older adults suggests that CH.CO40+ attracts, and may be particularly suitable for, subjective memory complainers. Implications of the pilot data for the further development of the intervention are discussed.

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