scholarly journals Radiotherapy in the Treatment of Subcutaneous Melanoma

Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5859
Author(s):  
Valentina Borzillo ◽  
Paolo Muto
Keyword(s):  
Neutron Capture ◽  
Symptom Relief ◽  
Stage Iv ◽  
Distant Metastases ◽  
Surgical Excision ◽  
Treatment Modalities ◽  
Treatment Side Effects ◽  
Boron Neutron Capture ◽  
Regional Disease ◽  
In Transit

Malignant melanoma frequently develops cutaneous and/or subcutaneous metastases during the course of the disease. These may present as non-nodal locoregional metastases (microsatellite, satellite, or in-transit) included in stage III or as distant metastases in stage IV. Their presentation is heterogeneous and associated with significant morbidity resulting from both disease-related functional damage and treatment side effects. The standard treatment is surgical excision, whereas local therapies or systemic therapies have a role when surgery is not indicated. Radiotherapy can be used in the local management of ITM, subcutaneous relapses, or distant metastases to provide symptom relief and prolong regional disease control. To increase the local response without increasing toxicity, the addition of hyperthermia and intralesional therapies to radiotherapy appear to be very promising. Boron neutron capture therapy, based on nuclear neutron capture and boron isotope fission reaction, could be an alternative to standard treatments, but its use in clinical practice is still limited. The potential benefit of combining radiotherapy with targeted therapies and immunotherapy has yet to be explored in this lesion setting. This review explores the role of radiotherapy in the treatment of cutaneous and subcutaneous lesions, its impact on outcomes, and its association with other treatment modalities.

Isolated same-basin lymph node recurrence after precision lymph node excision for clinically evident melanoma metastasis.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 9576-9576
Author(s):  
Kevin Lynch ◽  
Yinin Hu ◽  
Norma Farrow ◽  
Yun Song ◽  
Max Meneveau ◽  
...  
Keyword(s):  
Lymph Node ◽  
Disease Control ◽  
Lymph Node Dissection ◽  
Patient Preference ◽  
Distant Metastases ◽  
Node Dissection ◽  
Melanoma Patients ◽  
Regional Disease ◽  
In Transit

9576 Background: While management of the nodal basin for melanoma has largely moved to observation for microscopic sentinel lymph node (SLN) metastasis, complete lymph node dissection (CLND) remains the current standard of care for melanoma patients with macroscopic, clinically detectable lymph node metastases (cLN). As CLND is associated with high surgical morbidity, we sought to study whether cLN may be safely managed by excision of only clinically abnormal nodes (precision lymph node dissection, PLND). Currently, a small subset of patients with cLN do not undergo CLND because of frailty or patient preference. We hypothesized that in these selected patients, PLND would provide acceptable regional control rates. Methods: Retrospective chart review was conducted at four academic tertiary care hospitals to identify melanoma patients who underwent PLND for cLN. cLN were defined as palpable or radiographically abnormal nodes. Recurrences were categorized as local/in-transit, same-basin lymph node, or distal lymph node/visceral. The primary outcome was isolated same-basin recurrence after PLND. Results: Twenty-one patients underwent PLND for cLN without synchronous distant metastases (characteristics of primary lesions summarized in Table). Reasons for forgoing CLND included patient preference (n=8), imaging indeterminate for distant metastases (n=2), comorbidities (n=4), loss to follow up (n=1), partial response to checkpoint blockade (n=1), or not reported (n=5). The inguinal node basin was the most common site (n=10), followed by the axillary (n=8) and cervical basins (n=3). A median of 2 nodes were resected at PLND, and 68% of resected nodes were positive for melanoma (median: 1, range: 1-3 nodes). Median follow-up was 23 months from PLND, and recurrence was observed in 28.6% of patients overall. Only 1 patient (4.8%) developed an isolated same-basin recurrence. The 3-year cumulative incidence of isolated same-basin recurrence was 5.3%, while risk of isolated local/in-transit recurrence or distant basin/visceral metastasis were 19.8% and 33.3%, respectively. Complications from PLND were reported in 1 patient (4.8%) and were limited to post-operative seroma and lymphedema. Conclusions: These pilot data suggest that PLND may offer acceptable regional disease control for cLN. Post-operative morbidity from PLND was also low, raising the possibility that PLND may provide adequate regional disease control without the morbidity associated with CLND. These data justify additional, prospective evaluation of PLND in selected patients.[Table: see text]

scholarly journals Boron Neutron Capture Therapy and Photodynamic Therapy for High-Grade Meningiomas

Cancers ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1334 ◽  
Author(s):  
Yukiko Nakahara ◽  
Hiroshi Ito ◽  
Jun Masuoka ◽  
Tatsuya Abe
Keyword(s):  
Photodynamic Therapy ◽  
Brain Tumors ◽  
Boron Neutron Capture Therapy ◽  
Neutron Capture ◽  
World Health ◽  
Treatment Modalities ◽  
Neutron Capture Therapy ◽  
High Grade ◽  
Boron Neutron Capture ◽  
Novel Treatment

Meningiomas are the most common type of intracranial brain tumors in adults. The majority of meningiomas are benign with a low risk of recurrence after resection. However, meningiomas defined as grades II or III, according to the 2016 World Health Organization (WHO) classification, termed high-grade meningiomas, frequently recur, even after gross total resection with or without adjuvant radiotherapy. Boron neutron capture therapy (BNCT) and photodynamic therapy (PDT) are novel treatment modalities for malignant brain tumors, represented by glioblastomas. Although BNCT is based on a nuclear reaction and PDT uses a photochemical reaction, both of these therapies result in cellular damage to only the tumor cells. The aim of this literature review is to investigate the possibility and efficacy of BNCT and PDT as novel treatment modalities for high-grade meningiomas. The present review was conducted by searching PubMed and Scopus databases. The search was conducted in December 2019. Early clinical studies of BNCT have demonstrated activity for high-grade meningiomas, and a phase II clinical trial is in progress in Japan. As for PDT, studies have investigated the effect of PDT in malignant meningioma cell lines to establish PDT as a treatment for malignant meningiomas. Further laboratory research combined with proper controlled trials investigating the effects of these therapies is warranted.

scholarly journals Outcomes of Advanced Malignant Melanoma in a South African Public Health Sector Cohort: The Urgent Need for Effective Therapy

2020 ◽  
Author(s):  
Thulo Molefi
Keyword(s):  
Public Health ◽  
Malignant Melanoma ◽  
South African ◽  
Health Sector ◽  
Stage Iv ◽  
Treatment Modalities ◽  
Public Health Sector ◽  
Advanced Malignant Melanoma ◽  
Stage Iv Disease ◽  
Regional Disease

Abstract Background: Immunotherapy and molecularly targeted therapy have revolutionised the treatment of malignant melanoma however for South Africas public health sector patient population these treatment modalities are far out of reach and chemotherapy remains the only treatment option. Aim: To evaluate the outcomes of advanced melanoma and determine the need for therapies other than conventional chemotherapy in South Africas public health sector. Setting: The Department of Medical Oncology Steve Biko Academic hospital (SBAH) Pretoria South Africa. Methods: Files of patients with advanced malignant melanoma managed at SBAH from 01 January 2009 to 31 December 2019 were retrospectively reviewed. Results: One hundred files meeting the inclusion criteria were analysed 24 with regional (stage III) and 76 with metastatic (stage IV) disease. 23 (96%) patients with regional disease didnt receive adjuvant therapy and had a median time to progression (mTTP) of 12 months (95%CI; 8.9-15.0). Within the metastatic melanoma cohort 34 (79.1%) patients received chemotherapy and had a median overall survival (mOS) of 5 months (95% CI; 4.3-5.6) while patients that didnt receive chemotherapy had a mOS of 2 months (95% CI; 0.8-3.1) (p=0.213). Conclusion: These results reaffirm the impotent effects of chemotherapy in treating malignant melanoma and it is imperative that South Africas public health sector expands its armamentarium against this lethal disease.

Iodine 125 suture implants in the management of advanced tumors in the neck attached to the carotid artery.

1985 ◽  
Vol 3 (6) ◽  
pp. 809-812 ◽  
Author(s):  
S B Paryani ◽  
D R Goffinet ◽  
W E Fee ◽  
R L Goode ◽  
P Levine ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Head And Neck ◽  
Local Control ◽  
Residual Disease ◽  
Locally Advanced ◽  
Stage Iv ◽  
Distant Metastases ◽  
Surgical Excision ◽  
Local Control Rate ◽  
Iodine 125

Between 1975 and 1982, 38 patients with locally advanced head and neck cancer attached to the carotid artery underwent surgical excision followed by iodine 125 vicryl suture implant in the neck. Most patients had neck masses that were greater than 6 cm and stage IV disease without clinically evident distant metastases. Twelve patients had received no previous therapy while 26 underwent an implant for recurrent disease. The local control rate in the implant volume was 79%. The local and regional control rate in all head and neck sites was 53%. The mean survival was 11 months. The overall complication rate was 26%. There was no significant correlation of local control or complications with the minimum total dose, volume implanted, individual 125I seed strength, or total seed strength. In patients with large masses attached to the carotid artery, surgical resection followed by a 125I implant for residual disease is a viable alternative to resection of the carotid artery.

scholarly journals HGG-05. REGRESSION OF RECURRENT GLIOBLASTOMA AFTER BORON NEUTRON CAPTURE THERAPY AND CHIMERIC ANTIGEN RECEPTOR T-CELL THERAPY IN A CHILD

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii345-iii345
Author(s):  
Hsin-Hung Chen ◽  
Yi-Wei Chen
Keyword(s):  
T Cells ◽  
T Cell ◽  
Chimeric Antigen Receptor ◽  
Boron Neutron Capture Therapy ◽  
Neutron Capture ◽  
Antigen Receptor ◽  
Neutron Capture Therapy ◽  
T Cell Therapy ◽  
Boron Neutron Capture ◽  
Car T

Abstract A 6 y/o girl with recurrent multifocal glioblastoma received 3 times of boron neutron capture therapy (BNCT) and chimeric antigen receptor (CAR)–engineered T cells targeting the tumor-associated antigen HER2. Multiple infusions of CAR T cells were administered over 30 days through intraventricular delivery routes. It was not associated with any toxic effects of grade 3 or higher. After BNCT and CAR T-cell treatment, regression of all existing intracranial lesions were observed, along with corresponding increases in levels of cytokines and immune cells in the cerebrospinal fluid, but new lesions recurred soon after the treatment. This clinical response continued for 14 months after the initiation of first recurrence.

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