A proportion of patients receiving radiotherapy for head and neck squamous cell carcinoma (HNSCC) require
treatment re-planning. The aim of this retrospective study is to analyze the patients who ...required
re-planning and to identify factors, which may predict need for re-planning.
A single center evaluation of all patients receiving radical or adjuvant (chemo)radiotherapy (CRT) for HNSCC between January and December 2016 was undertaken. Patients who underwent
re-planning during the treatment were identified in electronic records. Reasons for re-planning were categorized as: weight loss, tumor shrinkage, changes in patient position and immobilization-related factors. Potential trigger factors for adaptive radiotherapy such as patient characteristics, primary tumor site, stage, concomitant chemotherapy, weight loss ratios, radical/adjuvant treatment, and nutritional interventions were investigated.
31/290 (10.6%) HNSCC patients who underwent radical/adjuvant radiotherapy required re-planning. The adaptive radiotherapy (ART) was performed at a mean fraction of 15. The most common documented reasons for re-planning were tumor shrinkage (35.5%) and weight loss (35.5%). Among the patient/tumor/treatment factors, nasopharyngeal primary site (p = 0.013) and use of concurrent chemotherapy with radiotherapy (p = 0.034) were found to be significantly correlated with the need for re-planning.
Effective on-treatment verification schedules and close follow up of patients especially with NPC primary and/or treated with concurrent chemoradiotherapy are crucial to identify patients requiring ART. We suggest an individualized triggered approach to ART rather than scheduled strategies as it is likely to be more feasible in terms of utilization of workload and resources.
Purpose and Objective:
To evaluate the disease-free survival, overall survival, dosimetric, and voice handicap index (VHI) results of T1a glottic invasive squamous cell carcinoma (SCC) patients who ...underwent hypofractionated single vocal cord irradiation (HSVCI).
Materials and Methods:
The data of 18 patients with stage T1a glottic SCC were collected prospectively and analyzed retrospectively between July 2016 and July 2019. Patients were immobilized using a custom-fitted thermoplastic face and shoulder mask in hyperextension position. The CT scan was performed with 1-mm-thick slices. A planned target volume (PTV) margin of 3 mm was given to clinical target volume (CTV) in all directions, and 13 organs at risk were identified. Patients were prescribed a total of 5760–5808 cGy in 15–16 fractions. Patients had daily cone-beam computed tomography (CBCT), and the treatment was carried out with the physician. VHI test was applied to patients before and at the end of radiotherapy (RT) and 1, 2, 3, 4, and 6 months after the completion of RT.
Results:
Local control and overall survival rate is 100% for a median of 18 months (6–44 months) of follow-up. A patient was diagnosed with 2nd primary lung cancer and active treatment still continues. All patients completed the treatment within the scheduled time. Grade 1–2 dysphagia and dermatitis occurred in all patients, and no grade 3 and above side effects were observed. The mean values of VHI were 37.00, 39.83, 38.28, 17.17, 12.22, 8.56, and 6.06 at the beginning of RT, at the end of RT, and 1, 2, 3, 4, and 6 months after RT, respectively.
Conclusion:
Compared to surgery and conventional laryngeal radiotherapy, HSVCI is an alternative treatment method for T1a glottic cancer by reducing the treatment time to 3 weeks, facilitating recurrence treatment, and providing effective sound quality without compromising local control. Considering that ~80% of recurrences in glottic cancer occur within the first 2 years, 100% local control in a median of 18 months is extremely successful, but long-term follow-up is essential to observe possible late side effects.
Solitary fibrous tumor/hemangiopericytoma (SFT/HPC) is a rare neoplasm arising from spindle cells and most commonly arising from pleura. Spinal SFT/HPC is a rare entity; hence, it is not on the top ...of the differential diagnosis list when a clinician faces a spinal lesion. In the review of the literature, there exist less than 50 case reports of intradural extramedullary SFT/HPC. Here, we present a 54-year-old female patient who underwent subtotal surgical excision of an intradural extramedullary spinal mass pathologically reported to be SFT/HPC and had symptomatic recurrence in the 3rd year of follow-up. Surgical intervention was unachievable and the patient was given 45 Gy to the surgical cavity followed by a 5.4 Gy boost to visible tumor with external radiotherapy. Patient reported significant relief of her symptoms. We aim to contribute to the formation of a treatment algorithm for this rare entity.
Malignant Fibrous Histiocytoma (MFH) is a fairly common tumor in the deep soft tissues: the most frequent primary sites are the lower (49%) and upper (19%) limbs, but it has been reported even in the ...retroperitoneum and abdomen (16%), while localization in the breast is extremely rare (1-2). Breast cancer is rarely seen in males, accounts for approximately 1% of all breast cancer, and the breast sarcomas constitute less than 1% of breast tumors in both sexes. In the review of the literature, this is the third male and first young male with MFH. Here, we present a 37-years-old male patient who is diagnosed to have malignant fibrous histiocytoma in a variant of pleomorphic fusiform cell localized in the left breast. Following the wide local excision, the patient was given an adjuvant 50 Gy of external radiotherapy. He remained alive and well after 42 months of followup. We believe that reporting such few cases would contribute to forming treatment algorithms of rare tumors.
Background
We aimed to evaluate patients with nasopharyngeal carcinoma (NPC) in a nonendemic population.
Methods
In a national, retrospective, multicenteric study, 563 patients treated with intensity ...modulated radiotherapy at 22 centers between 2015 and 2020 were analyzed.
Results
Median age was 48 (9–83), age distribution was bimodal, 74.1% were male, and 78.7% were stage III‐IVA. Keratinizing and undifferentiated carcinoma rates were 3.9% and 81.2%. Patients were treated with concomitant chemoradiotherapy (48.9%), or radiotherapy combined with induction chemotherapy (25%) or adjuvant chemotherapy (19.5%). After 34 (6–78) months follow‐up, 8.2% locoregional and 8% distant relapse were observed. Three‐year overall survival was 89.5% and was lower in patients with age ≥50, male sex, keratinizing histology, T4, N3 and advanced stage (III‐IVA).
Conclusions
Patients with NPC in Turkey have mixed clinical features of both east and west. Survival outcomes are comparable to other reported series; however, the rate of distant metastases seems to be lower.
Objective: Glioblastoma multiforme (GBM) is the most aggressive and commonly seen primary malignant brain tumor in adults. In addition to clinical, molecular and histopathological prognostic factors, ...sarcopenia, defined as low skeletal muscle mass, has become one of the important parameters. The relationship between skeletal muscle mass and temporal muscle thickness (TMT) has been demonstrated. We evaluated the prognostic value of TMT in patients with newly diagnosed GBM. Methods: A total of 66 GBM patients were included in this retrospective study. Left and right TMT's from pre-operative magnetic resonance images were measured separately by an experienced radiologist, and the mean TMT value for each patient was calculated. The survival times and rates were examined with the Kaplan-Meier method. Overall survival (OS) was calculated from the day of diagnosis. The correlation coefficients and their significance were calculated using the Spearman test. Results: The median right TMT was 4.4 (1.7-9.5) mm, the left TMT was 4.1 (1.5-9.6) mm. The median TMT was 4.38 (1.66- 9.45) mm. Spearman correlation test revealed a slight correlation between the mean TMT value and the age at the diagnosis (p=0.044). Spearman correlation test for gender also showed a slight correlation between the mean TMT value and gender (p=0.024). In the multivariate analysis using the Cox regression model showed that increased TMT was a positive prognostic marker for OS in GBM patients (p=0.030). Conclusion: TMT greater than 4.38 mm was found to be an independent prognostic factor in de novo glioblastoma. However, studies with larger series are needed to generalize this result to the Turkish population. Keywords: Glioblastoma, sarcopenia, prognosis, temporal muscle Amac: Glioblastoma multiforme (GBM), yetiskinlerde gorulen en agresif primer malign beyin tumorudur. Klinik, molekuler ve histopatolojik faktorlerin yani sira dusuk iskelet kasi kutlesi olarak tanimlanan sarkopeni onemli prognostik faktorlerden biri haline gelmistir. Iskelet kasi kutlesi ile temporal kas kalinligi (TMT) arasindaki iliski ortaya konmustur. Calismamizda yeni tani konmus GBM'li hastalarda TMT'nin prognostik degerini degerlendirmeyi amacladik. Gerec ve Yontem: Calismaya GBM tanisi olan 66 hasta dahil edildi. Ameliyat oncesi manyetik rezonans goruntulerinden sol ve sag TMT'ler deneyimli bir radyolog tarafindan ayri ayri olculdu ve her hasta icin ortalama TMT degeri hesaplandi. Yasam sureleri ve oranlari Kaplan-Meier yontemi ile incelendi. Genel sagkalim (OS) tani gununden itibaren hesaplandi. Korelasyon katsayilari ve anlamliliklari Spearman testi kullanilarak hesaplandi. Bulgular: Medyan sag TMT 4,4 (1,7-9,5) mm, sol TMT 4,1 (1,5-9,6) mm idi. Medyan TMT 4,38 (1,66-9,45) mm idi. Spearman korelasyon testi, ortalama TMT degeri ile tani yasi arasinda hafif bir korelasyon oldugunu ortaya koydu (r=-0,248, p=0,044). Cinsiyete gore Spearman korelasyon testi de ortalama TMT degeri ile cinsiyet arasinda hafif bir korelasyon gosterdi (r=-0,277, p=0,024). Cox regresyon analizi kullanilarak yapilan multivaryant analizde TMT'nin toplam OS icin pozitif prognostik bir marker oldugu gosterildi (p=0,030). Sonuc: TMT'nin 4,38 mm'den buyuk olmasinin de novo glioblastomda bagimsiz bir prognostik faktor oldugu bulundu. Ancak bu sonucun Turk toplumuna genellenmesi icin daha genis serili calismalara ihtiyac vardir. Anahtar Kelimeler: Glioblastoma, sarkopeni, prognoz, temporal kas
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