The Role of Radiation Therapy in Vulvar Cancer: Review of the Current Literature

2016 ◽  
Vol 103 (5) ◽  
pp. 422-429 ◽  
Author(s):  
Piera Sciacero ◽  
Domenico Cante ◽  
Cristina Piva ◽  
Valeria Casanova Borca ◽  
Edoardo Petrucci ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Vulvar Cancer ◽  
Intensity Modulated Radiotherapy ◽  
Long Term Outcomes ◽  
Cancer Review ◽  
Prospective Trials ◽  
Low Incidence ◽  
Tissue Sparing

The purpose of this article is to discuss the current role of radiation therapy in vulvar cancer and especially to review the recent literature relative to the use of intensity-modulated radiotherapy (IMRT) in disease management. Owing to the low incidence of vulvar cancer, at present there are no available results of cooperative prospective trials. As evidenced in dosimetric and preliminary retrospective clinical studies, the use of IMRT has resulted in superior normal tissue sparing and lower rates of acute and chronic toxicities compared to previous studies that used conventional approaches. Data on long-term outcomes in these patients remain limited.

Long-term outcomes of post-mastectomy radiation therapy in the setting of neoadjuvant chemotherapy for locally advanced breast cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e12030-e12030
Author(s):  
Winnifred M. Wong ◽  
Larissa A. Korde ◽  
Toni K. Roberts ◽  
Andrea L. Arnett ◽  
Dylan A. Mart ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Triple Negative ◽  
Cox Regression ◽  
Locally Advanced ◽  
Rank Test ◽  
Long Term Outcomes ◽  
Cox Regression Analysis ◽  
Tumor Subtypes

e12030 Background: The role of post-mastectomy radiation therapy (PMRT) after neo-adjuvant chemotherapy (NCT) in those with T3N0 disease, younger age, and different tumor subtypes is unclear. Methods: We conducted a single institution, retrospective analysis of patients treated with NCT and mastectomy from 1985-2010. The primary objectives were to (1) assess the association between PMRT and long-term outcomes, and (2) describe outcomes and practice patterns based on tumor subtype, pathologic response, and age at diagnosis. Secondary objectives were to analyze the benefit of PMRT in those with favorable tumor subtypes, cT3N0 disease, and patients younger than 40. Log-rank test and Cox regression was used to test the association of predictors with outcomes. IRB approval was obtained. Results: Of 131 evaluable patients, 115 (88%) received PMRT. Mean±SD age was 48±10 years (range 29-79). Of patients <40 years of age (n=33) 88% received PMRT. At diagnosis, 69.5% were cT3; 53.5% were cN1; 12.3% were cT3N0. Seventy-eight percent of patients received anthracycline-based NCT and 52% received both anthracycline and taxane NCT. Twenty-eight percent of all patients achieved pCR. With a median f/u of 39 months (range 8-177), 30.5% of patients had a recurrence event (6.9% local, 5.3% nodal, 16.8% distant). Ten year OS and DFS for all patients were 56.7% (95% CI, 43.5-73.8) and 66.1% (95% CI, 52.3-83.5), respectively. Those with pCR had a non-significant trend toward better outcome, with 10 year OS=68.0% vs. 54.0% (p=0.7); DFS=70.2% vs. 65.2% (p=1.0). In the Cox regression analysis, pathologic T-stage, triple negative disease, and tumor grade were significantly associated with OS; triple negative disease was also predictive of DFS. Benefit of PMRT was not analyzable in cT3N0 due to small numbers. Conclusions: Most patients had PMRT, with outcomes on par with historical data. Most patients <40 years received PMRT, with no events for the non-PMRT cohort most likely due to selection bias. Unfavorable subgroups were not more likely to receive PMRT, but of those who did, only triple negative was predictive of outcome. A future non-PMRT matched cohort study is necessary to further elucidate the role of PMRT.

Long-Term Outcomes for Nonacoustic Schwannomas Treated with Stereotactic Radiation Therapy

2019 ◽  
Author(s):  
Anna Bistline ◽  
Andrew Song ◽  
James Evans ◽  
Christopher Farrell ◽  
David Andrews ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Stereotactic Radiation Therapy ◽  
Long Term Outcomes ◽  
Stereotactic Radiation

scholarly journals COVID-19 related mortality in post-operative cardiac surgical patients

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Azhar Hussain ◽  
Amina Khalil ◽  
Priyanka Kolvekar ◽  
Prity Gupta ◽  
Shyamsunder Kolvekar
Keyword(s):  
Cardiac Surgery ◽  
Long Term Outcomes ◽  
Case Presentation ◽  
Elective Cardiac Surgery ◽  
The United Kingdom ◽  
Global Pandemic ◽  
Cardiac Operations ◽  
Related Mortality

Abstract Background COVID-19 has caused a global pandemic of unprecedented proportions. Elective cardiac surgery has been universally postponed with only urgent and emergency cardiac operations being performed. The National Health Service in the United Kingdom introduced national measures to conserve intensive care beds and significantly limit elective activity shortly after lockdown. Case presentation We report two cases of early post-operative mortality secondary to COVID-19 infection immediately prior to the implementation of these widespread measures. Conclusion The role of cardiac surgery in the presence of COVID-19 is still very unpredictable and further studies on both short term and long term outcomes are warranted.

Long-term outcomes in children with glioblastoma

2010 ◽  
Vol 6 (2) ◽  
pp. 145-149 ◽  
Author(s):  
Kyung Sun Song ◽  
Ji Hoon Phi ◽  
Byung-Kyu Cho ◽  
Kyu-Chang Wang ◽  
Ji Yeoun Lee ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Progression Free Survival ◽  
Radical Resection ◽  
Tumor Location ◽  
Recurrent Glioblastoma ◽  
Subtotal Resection ◽  
Long Term Outcomes ◽  
Term Outcome ◽  
Long Term Outcome

Object Glioblastoma is the most common primary malignant brain tumor; however, glioblastoma in children is less common than in adults, and little is known about its clinical outcome in children. The authors evaluated the long-term outcome of glioblastoma in children. Methods Twenty-seven children were confirmed to have harbored a glioblastoma between 1985 and 2007. The clinical features and treatment outcomes were reviewed retrospectively. All patients underwent resection; complete resection was performed in 12 patients (44%), subtotal resection in 12 patients (44%), and biopsy in 3 patients (11%). Twenty-four patients (89%) had radiation therapy, and 14 (52%) patients received chemotherapy plus radiation therapy. Among the latter, 5 patients had radiation therapy concurrent with temozolomide chemotherapy. Four patients with small-size recurrent glioblastoma received stereotactic radiosurgery. Results The median overall survival (OS) was 43 months, and the median progression-free survival was 12 months. The OS rate was 67% at 1 year, 52% at 2 years, and 40% at 5 years. The median OS was significantly associated with tumor location (52 months for superficially located tumors vs 7 months for deeply located tumors; p = 0.017) and extent of removal (106 months for completely resected tumors vs 11 months for incompletely resected tumors; p < 0.0001). Conclusions The prognosis of glioblastoma is better in children than in adults. Radical resection followed by concurrent chemoradiation therapy may be the initial treatment of choice.

scholarly journals MinimallyInvasive Radiofrequency Surgery in Sleep-Disordered Breathing

Healthcare ◽  
2019 ◽  
Vol 7 (3) ◽  
pp. 97
Author(s):  
Ankit Patel ◽  
Bhik Kotecha
Keyword(s):  
Sleep Disordered Breathing ◽  
Sleep Apnoea ◽  
Long Term Outcomes ◽  
Sustained Improvement ◽  
Radiofrequency Surgery ◽  
Obstructive Sleep ◽  
Good Quality Research ◽  
Disordered Breathing

Sleep-disordered breathing encompasses a spectrum of conditions ranging from simple snoring to obstructive sleep apnoea (OSA). Radiofrequency surgery represents a relatively new technique available to surgeons involved in managing this condition. Its principal advantage relates to its minimally invasive nature resulting in a reduced morbidity when compared to traditional sleep surgery. The presence of good-quality research evaluating the long-term outcomes is currently scarce, although the short-term data is promising. Careful patient selection appears to be paramount in obtaining a sustained improvement. The role of radiofrequency surgery in sleep-disordered breathing has been reviewed.

scholarly journals The role of ventromedial prefrontal cortex in reward valuation and future thinking during intertemporal choice

2021 ◽  
Author(s):  
Elisa Ciaramelli ◽  
Flavia De Luca ◽  
Donna Kwan ◽  
Jenkin N. Y. Mok ◽  
Francesca Bianconi ◽  
...  
Keyword(s):  
Prefrontal Cortex ◽  
Reward Magnitude ◽  
Intertemporal Choice ◽  
Ventromedial Prefrontal Cortex ◽  
Future Thinking ◽  
Long Term Outcomes ◽  
Trade Offs ◽  
Reward Valuation

Intertemporal choices require trade-offs between short-term and long-term outcomes. Ventromedial prefrontal cortex (vmPFC) damage causes steep discounting of future rewards (delay discounting; DD) and impoverished episodic future thinking (EFT). The role of vmPFC in reward valuation, EFT, and their interaction during intertemporal choice is still unclear. Here, twelve patients with lesions to vmPFC and forty-one healthy controls chose between smallerimmediate and larger-delayed rewards while we manipulated reward magnitude and the availability of EFT cues. In the EFT condition, participants imagined personal events to occur at the delays associated with the larger-delayed rewards. We found that DD was steeper in vmPFC patients compared to controls, and not modulated by reward magnitude. However, EFT cues downregulated DD in vmPFC patients as well as controls. These findings indicate that vmPFC integrity is critical for the valuation of (future) rewards, but not to instill EFT in intertemporal choice.

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