scholarly journals Carotid Blowout Syndrome of an Infected Pseudoaneurysm after Radiation Therapy of Parotid Cancer: Successful Multidisciplinary Treatment with Coiling, Pseudoaneurysm Excision, Debridement, and Plastic Reconstruction

2020 ◽  
Vol 36 (4) ◽  
pp. 268-269
Author(s):  
Hyunmin Ko ◽  
Ahram Han ◽  
Hak Chang ◽  
Seung-Kee Min
Keyword(s):  
Radiation Therapy ◽  
Multidisciplinary Treatment ◽  
Parotid Cancer ◽  
Carotid Blowout Syndrome ◽  
Plastic Reconstruction ◽  
Infected Pseudoaneurysm

scholarly journals BT-02 MULTIDISCIPLINARY TREATMENT FOR EPENDYMOMA

2019 ◽  
Vol 1 (Supplement_2) ◽  
pp. ii37-ii37
Author(s):  
Daisuke Hirokawa ◽  
Tomoko Hayashi ◽  
Hironobu Sato ◽  
Dai Keino ◽  
Tomoko Yokosuka ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Multidisciplinary Treatment ◽  
Total Excision ◽  
Local Irradiation ◽  
Tumor Removal ◽  
Vp Shunt ◽  
Life Prognosis ◽  
Intracranial Ependymoma ◽  
Grade Ii ◽  
Grade Iii

Abstract BACKGROUND In intracranial ependymoma, the effectiveness of chemotherapy and radiation therapy is unclear, and the degree of tumor removal contributes to the improvement of life prognosis. Methods: We examined ependymoma cases treated in our institution from July 1998 to March 2017. RESULTS There were 18 boys and 7 girls. The average age at the time of surgery is 5.3 ± 3.6 years. The pathological diagnosis was Grade II for 8 cases and Grade III for 17 cases. Genetic analysis was performed in 16/25 cases (64%). Of the infratentorial cases, 10/11 cases (90.1%) were PFA and PFB were one case. Of the supratentorial cases, 3/5 cases (60%) were positive for RELA fusion. As chemotherapy, 19 patients were VCR + VP-16 + CDDP + CPA. Irradiation was performed in all cases, local irradiation (50.4–55.8Gy) in 22 cases (88%), and craniospinal irradiation in 2 cases (8%). The 7-year OS was 74.6 ± 9% and the 7-year PFS was 59.7 ± 10.5%. Grade III showed a short OS (p = 0.053). GTR and NTR were obtained in the first excision in 14 cases (56%), and OS and PFS were not significantly different from those in the STR group (p = 0.219, p = 0.248). GTR and NTR including 2nd-look surgery were obtained in 18 cases (72%), and significant improvement of OS was observed compared with STR group (p = 0.02). In patients with hydrocephalus preoperatively, OS tended to be short (p = 0.057), especially in cases requiring VP shunt placement, OS was significantly shortened (p = 0.017). CONCLUSION Even if it is not GTR or NTR at the first operation, improvement of OS is expected by total excision after chemotherapy. The importance of chemotherapy was suggested to be suppression of tumor growth until reoperation and reduction of blood loss during surgery.

Chemoradiotherapy for highly advanced gastric cancer.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 121-121
Author(s):  
Mai Tsutsui ◽  
Tsunehiro Takahashi ◽  
Yoshiro Saikawa ◽  
Hirofumi Kawakubo ◽  
Norihito Wada ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Radiation Therapy ◽  
Lymph Nodes ◽  
Advanced Gastric Cancer ◽  
Multidisciplinary Treatment ◽  
Multimodality Treatment ◽  
Complete Response ◽  
Technological Advancement ◽  
Regional Lymph Nodes ◽  
Grade 3

121 Background: Although the prognosis of early gastric cancer is favorable, the treatment for advanced cases still have difficulty in achieving satisfactory results. Thus, more effective multimodality treatment should be established. Chemoradiotherapy has become a standard treatment for gastric cancer especially as an adjuvant therapy while radiotherapy has been expected as one of the modalities against highly advanced gastric cancer. Methods: Patients with advanced gastric cancer who were treated with chemotherapy of S-1 and cisplatin plus radiation were analyzed retrospectively. Concurrent radiation therapy (5 days/week) at 2 Gy/day was started with chemotherapy and repeated daily on days 1–5, 8–12, 15–19 and 22–26. Irradiation was planned using a computed tomography (CT) simulator for two rectangular portals with a pair of 45-degree wedge filters and was targeted at the primary tumor and surrounding lesions, including lymph nodes. Results: A total 109 patients were treated with chemoradiotherapy between 2002 and 2013 at our institute. The median age was 64 years. Histological type included 45 differentiated and undifferentiated 64 subtypes. The TNM stage before the treatment was diagnosed as IIIA: 11; IIIB: 10; IIIC: 14; IV: 74. Of the 98 evaluable patients, 69 patients had partial responses while no patients had a complete response, resulting in an overall response rate of 70%. Progressive disease (PD) occurred in 2 patients (4%). The most frequent adverse events more than grade 3 were hematologic toxicities, including leukocytopenia (47%), neutropenia (25%), and thrombocytopenia (24%). Non-hematologic toxicities such as general fatigue, renal-related events, and gastrointestinal toxicities were manageable with no treatment-related death. The median survival time was 537 days. Conclusions: While there were disadvantages of radiotherapy including the difficulty of confirming the area of irradiation due to peristaltic movement, risk of perforation and ulceration, recent technological advancement of radiation therapy has enabled pinpoint accuracy in treatment of primary gastric lesions and regional lymph nodes. There has been much anticipation that chemoradiotherapy will be a part of multidisciplinary treatment for advanced cancer.

Surgical Management of Extremity and Truncal Sarcoma

2017 ◽  
Author(s):  
Christina L Roland ◽  
Janice N Cormier
Keyword(s):  
Radiation Therapy ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Treatment Approach ◽  
Multidisciplinary Treatment ◽  
Survival Rates ◽  
Soft Tissue Sarcomas ◽  
The Body ◽  
Wide Resection ◽  
Staging Surgery

Soft tissue sarcomas are a heterogeneous group of neoplasms that arise throughout the body, but most commonly in the extremity and trunk. A multidisciplinary treatment approach has resulted in local control rates exceeding 90% and 5-year survival rates exceeding 70%. For patients with localized soft tissue sarcoma, limb-sparing surgical resection is the mainstay of therapy, with radiation therapy and chemotherapy used as adjuncts to reduce local and distant recurrences. Amputation is reserved for patients with primary or recurrent tumors that cannot be grossly resected with a limb-sparing procedure and preservation of function, which should occur in less than 5% of patients. Most patients who die of soft tissue sarcoma die of metastatic disease, which becomes evident within 2 to 3 years of initial diagnosis in 80% of cases, highlighting the need for improved systemic therapy options and optimal treatment at the time of diagnosis. This review contains 13 figures, 4 tables and 53 references Key words: amputation, multimodality, radiation therapy, soft tissue sarcoma, staging, surgery, treatment, wide resection  

scholarly journals EPEN-01. MULTIDISCIPLINARY TREATMENT IN EPENDYMOMA

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii307-iii307
Author(s):  
Daisuke Hirokawa
Keyword(s):  
Radiation Therapy ◽  
Genetic Analysis ◽  
Multidisciplinary Treatment ◽  
Total Excision ◽  
Local Irradiation ◽  
Tumor Removal ◽  
Life Prognosis ◽  
Intracranial Ependymoma ◽  
Grade Ii ◽  
Grade Iii

Abstract BACKGROUND In intracranial ependymoma, the effectiveness of chemotherapy and radiation therapy is unclear, and the degree of tumor removal contributes to the improvement of life prognosis. METHODS We examined ependymoma cases treated in our institution from July 1998 to March 2017. RESULTS There were 18 boys and 7 girls. The average age at the time of surgery is 5.3±3.6 years. The pathological diagnosis was Grade II for 8 cases and Grade III for 17 cases. Genetic analysis was performed in 16/25 cases (64%). Of the infratentorial cases, 10/11 cases (90.1%) were PFA and PFB were one case. Of the supratentorial cases, 3/5 cases (60%) were positive for RELA fusion. As chemotherapy, 19 patients were VCR + VP-16 + CDDP + CPA. Irradiation was performed in all cases, local irradiation (50.4–55.8Gy) in 22 cases (88%), and craniospinal irradiation in 2 cases (8%). The 7-year OS was 74.6±9% and the 7-year PFS was 59.7±10.5%. Grade III showed a short OS (p = 0.053). GTR and NTR were obtained in the first excision in 14 cases (56%), and OS and PFS were not significantly different from those in the STR group (p = 0.219, p = 0.248). GTR and NTR including 2nd-look surgery were obtained in 18 cases (72%), and significant improvement of OS was observed compared with STR group (p = 0.02). CONCLUSION Even if it is not GTR or NTR at the first operation, improvement of OS is expected by total excision after chemotherapy.

scholarly journals A Critical Review of Radiation Therapy: From Particle Beam Therapy (Proton, Carbon, and BNCT) to Beyond

2021 ◽  
Vol 11 (8) ◽  
pp. 825
Author(s):  
Yoshitaka Matsumoto ◽  
Nobuyoshi Fukumitsu ◽  
Hitoshi Ishikawa ◽  
Kei Nakai ◽  
Hideyuki Sakurai
Keyword(s):  
Radiation Therapy ◽  
Nuclear Reactions ◽  
Ion Beam ◽  
Multidisciplinary Treatment ◽  
Treatment Strategies ◽  
Particle Beam ◽  
Particle Therapy ◽  
High Dose ◽  
Therapeutic Effects ◽  
Particle Beam Therapy

In this paper, we discuss the role of particle therapy—a novel radiation therapy (RT) that has shown rapid progress and widespread use in recent years—in multidisciplinary treatment. Three types of particle therapies are currently used for cancer treatment: proton beam therapy (PBT), carbon-ion beam therapy (CIBT), and boron neutron capture therapy (BNCT). PBT and CIBT have been reported to have excellent therapeutic results owing to the physical characteristics of their Bragg peaks. Variable drug therapies, such as chemotherapy, hormone therapy, and immunotherapy, are combined in various treatment strategies, and treatment effects have been improved. BNCT has a high dose concentration for cancer in terms of nuclear reactions with boron. BNCT is a next-generation RT that can achieve cancer cell-selective therapeutic effects, and its effectiveness strongly depends on the selective 10B accumulation in cancer cells by concomitant boron preparation. Therefore, drug delivery research, including nanoparticles, is highly desirable. In this review, we introduce both clinical and basic aspects of particle beam therapy from the perspective of multidisciplinary treatment, which is expected to expand further in the future.

Surgical Management of Extremity and Truncal Sarcoma

2017 ◽  
Author(s):  
Christina L Roland ◽  
Janice N Cormier
Keyword(s):  
Radiation Therapy ◽  
Soft Tissue ◽  
Soft Tissue Sarcoma ◽  
Treatment Approach ◽  
Multidisciplinary Treatment ◽  
Survival Rates ◽  
Soft Tissue Sarcomas ◽  
The Body ◽  
Wide Resection ◽  
Staging Surgery

Soft tissue sarcomas are a heterogeneous group of neoplasms that arise throughout the body, but most commonly in the extremity and trunk. A multidisciplinary treatment approach has resulted in local control rates exceeding 90% and 5-year survival rates exceeding 70%. For patients with localized soft tissue sarcoma, limb-sparing surgical resection is the mainstay of therapy, with radiation therapy and chemotherapy used as adjuncts to reduce local and distant recurrences. Amputation is reserved for patients with primary or recurrent tumors that cannot be grossly resected with a limb-sparing procedure and preservation of function, which should occur in less than 5% of patients. Most patients who die of soft tissue sarcoma die of metastatic disease, which becomes evident within 2 to 3 years of initial diagnosis in 80% of cases, highlighting the need for improved systemic therapy options and optimal treatment at the time of diagnosis. This review contains 13 figures, 4 tables and 53 references Key words: amputation, multimodality, radiation therapy, soft tissue sarcoma, staging, surgery, treatment, wide resection  

scholarly journals Endovascular Covered Stent Reconstruction Improved the Outcomes of Acute Carotid Blowout Syndrome

2008 ◽  
Vol 14 (2_suppl) ◽  
pp. 23-27 ◽  
Author(s):  
Yao-Liang Chen ◽  
Ho-Fai Wong ◽  
Yi-Kang Ku ◽  
Alex Mun-Ching Wong ◽  
Yau-Yau Wai ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Alternative Treatment ◽  
Transarterial Embolization ◽  
Massive Bleeding ◽  
Covered Stent ◽  
Covered Stents ◽  
Carotid Blowout Syndrome ◽  
Delayed Complication

Carotid blowout is a devastating complication in patients with head and neck cancer, commonly encountered as a delayed complication of radiation therapy. The clinical outcomes in patients with carotid blowout are discouraging; even transarterial embolization has been performed to control the acute massive bleeding. In recent years, covered stents have been reported as an alternative treatment producing favorable results. In this study, 13 consecutive patients with acute carotid blowout syndrome were treated at our institute by covered-stent reconstruction between December 2005 and December 2007. The median posthemorrhagic survival period after reconstruction (187 days) was more than that reported in patients treated only with transarterial embolization (26 days). Though the estimated mortality was about 54%, those who survived showed favorable outcomes, and only one transit complication of acute in-stent thrombosis occurred. Thus, endovascular covered-stent reconstruction is a safe and effective approach to manage acute carotid blowout syndrome.

Parotid Cancer: Treatment and Results

1993 ◽  
Vol 72 (12) ◽  
pp. 787-793 ◽  
Author(s):  
David W. Roberson ◽  
Felix W. K. Chu ◽  
C. Thomas Yarington
Keyword(s):  
Radiation Therapy ◽  
Clinical Outcome ◽  
Neck Dissection ◽  
Residual Disease ◽  
Late Recurrence ◽  
Low Grade ◽  
High Grade ◽  
Parotid Cancer ◽  
High Incidence ◽  
Age And Sex

The records of 74 consecutive patients with primary parotid malignancy were reviewed. The age and sex incidence was comparable to that described in previous studies; we observed a high incidence of adenocarcinoma not reported by other investigators. Stage at the time of examination and histologic grade of tumor were independent statistically significant predictors of clinical outcome. Long survival with low grade disease and late recurrence were common. Radiation therapy has been shown to increase survival in a number of studies; however, it had no demonstrable benefit in our series. Parotid cancer should be managed aggressively and early surgery is indicated for all parotid neoplasms. Neck dissection is indicated for clinically positive nodes and high grade cancers; radiation therapy is indicated for high grade cancers and residual disease.

scholarly journals Carotid Dosimetry and the Risk of Carotid Blowout Syndrome After Reirradiation With Head and Neck Stereotactic Body Radiation Therapy

2018 ◽  
Vol 101 (1) ◽  
pp. 195-200 ◽  
Author(s):  
Brian J. Gebhardt ◽  
John A. Vargo ◽  
Diane Ling ◽  
Brianna Jones ◽  
Mary Mohney ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Head And Neck ◽  
Stereotactic Body Radiation Therapy ◽  
Stereotactic Body Radiation ◽  
Carotid Blowout Syndrome
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