Cancer immunotherapy has made rapid progress over the past decade leading to high enthusiasm and interest worldwide. Codelivery of immunomodulators with chemotherapeutic agents and radioisotopes has ...been shown to elicit a strong and sustained immune response in animal models. Despite showing promising results in metastatic and recurrent cancers, the utilisation of immunotherapy in clinical settings has been limited owing to uncertainties in elicited immune response and occurrence of immune-related adverse events. These uncertainties can be overcome with the help of nanoparticles possessing unique properties for the effective delivery of targeted agents to specific sites. Nanoparticles play a crucial role in the effective delivery of cancer antigens and adjuvants, modulation of tumour microenvironment, production of long-term immune response and development of cancer vaccines. Here, we provide a comprehensive summary of nanotechnology-based cancer immunotherapy and radiotherapy including basics of nanotechnology, properties of nanoparticles and various methods of employing nanoparticles in cancer treatment. Thus, nanotechnology is anticipated to overcome the limitations of existing cancer immunotherapy and to effectively combine various cancer treatment modalities.
COVID-19 has affected the lives of every medical professional including oncologists. The goal of this survey was to evaluate the impact of COVID-19 on the work routine, psychological state and ...radiotherapy practice of radiation oncologists.
An anonymous survey consisting of 23 questions regarding the lives of radiation oncologists during the COVID-19 pandemic was distributed online via social media from July 14 to July 21, 2020. Statistical analysis was performed with Statistical Package for the Social Sciences 18.0 software and basic descriptive statistics were applied.
A total of 82 radiation oncologists responded to the survey. The majority were professors (28/82; 34.1%) and residents (28/82; 34.1%) and <50 years old (70/82; 85.4%). Cancer screening programs (57/62; 91.9%) and number of new cases reduced (44/82; 53.7%) in many institutes. Follow-up was still done in-person by 73.2% respondents. 35/82 (42.7%) respondents were satisfied about their safety during COVID-19, at the same time 36/82 (43.9%) were worried about the patient's safety. The fear of contracting COVID-19 (57/82; 69.5%) and infecting their families (64/82; 78%) was high. Physical presence during case implementation (59/82; 72%) and daily setup verification (60/82; 73.2%) remained the same during COVID-19. Half of the respondents adopted new fractionation schedules, commonly in breast and palliative cases. Time spent on research had reduced by 62.2%. Only 41.4% respondents were satisfied with the patient care provided by them during the COVID-19 pandemic.
COVID-19 has significantly altered the work routine, radiotherapy practice and mental state of radiation oncologists.
Primary intracranial malignancies with extra-skeletal myxoid chondrosarcoma (EMC) features are extremely rare. EMC constitutes a distinct genomic entity characterised by reciprocal translocation of ...fusion genes, most commonly EWS RNA Binding Protein 1 (EWSR1) in 22q12 with Nuclear Receptor Subfamily 4 Group A Member 3 (NR4A3) in 9q2-q31.1. It is reported to have a high propensity for local recurrence and has potential for metastasis. So far in 28 years since its first description, only 17 cases of primary intracranial EMC were reported in literature. This would be the second case of intraventricular origin and first case from lateral ventricle.
A 27-year-old male presenting with complaints of headache, seizures and pain in neck was diagnosed to have a mass lesion in right lateral ventricle in Magnetic Resonance Imaging of brain. He underwent right parieto-occipital craniotomy with total excision of the lesion. Initial histopathological examination was reported as Ependymoma, WHO grade II. However, blocks and slides review with immunohistochemistry (IHC) markers revealed neoplastic aetiology with extensive myxoid changes. Hence, fluorescent in-situ hybridisation (FISH) testing was done with EWSR1 break apart probe, which demonstrated EWSR1 break apart signals. Therefore, correlating the clinical findings with morphology, IHC and FISH, the diagnosis of primary intracranial EMC was rendered. Patient received adjuvant external beam radiation of 54 Gy in 30 fractions to the post-op region. At 29-month follow-up, there was no evidence of disease recurrence.
Owing to the rarity of the condition, there are no standard treatment guidelines available for primary intracranial EMC. A combined treatment approach with surgery followed by adjuvant radiotherapy provides good local control with less morbidity.
Abstract The scientific basis of uterus transplantation has been developing in parallel to other organ transplants throughout the modern period of transplant medicine. Immunosuppression and surgical ...techniques have been adequate for at least a decade; ethics and society have been less clearly developed. To many observers, it is still unclear if the endeavor is an overall positive or negative. Although scientific and technical challenges have been overcome, the ethical determinations will be a dynamic process while more experience continues to be gained. The most significant experience still lacking is a term gestation. Undoubtedly during a nine-month gestation, unforeseen challenges will test scientific processes and ethical assumptions. Despite dozens of animal experiments and a few animal births, no human birth has occurred to allow any definitive conclusions.
Purpose
Total body irradiation (TBI) can be safely delivered on TomoTherapy (Accuray, Sunnyvale, CA, USA) in both pediatric and adult patients with proper imaging and planning despite the length ...constraint of 135 cm. To overcome this limitation, two CT (Computed Tomography) scans (CT1& CT2) are taken in patients above 135 cm in height. Adequate junction dose coverage is important in TBI. Presently, there is no clinical report with a focus on the quality of dose distribution at the CT junction in view of the guidelines on quality of coverage from the RTOG. Hence, our main objectives were to evaluate the dose distribution and quality of coverage at the junction in 16 patients who received TBI using TomoTherapy.
Methods
PTV(upper) and PTV(lower) along with a junction were created on CT1 and CT2, respectively. Subsequently, the 10 cm junction in the thigh region was divided into five target volumes of 2 cm thickness with dose prescription ranging from 10 to 90% to deliver a total dose equal to 100% when fused.
Results
The D
50
was equal to the prescribed dose in most of the cases ranging from 99.5 to 104% for PTV(upper), 100–103% for PTV(lower), and 99.5–108% for junctional PTVs (1PTV, 2PTV, 3PTV, 4PTV, and 5PTV). The average D
95
doses from PTV(upper) and PTV(lower) were 97 ± 1.4% and 96.7 ± 1.08%, respectively. The average D
95
doses for 1PTV, 2PTV, 3PTV, 4PTV, and 5PTV were 96.1 ± 1.88%, 91.6 ± 1.82%, 87.3 ± 1.5%, 91.6 ± 1.4%, and 96.2 ± 1.5% respectively. Q
RTOG
values ranged between 0.85 and 1.05 and were in concordance with RTOG guidelines.
Conclusion
Since junction-based planning was required for most TBI patients, it is essential to evaluate the quality of dose coverage in the junction for better TBI plans.
Abstract Objective We hypothesized that exposure to high levels of hCG in women diagnosed with choriocarcinoma would decrease future breast cancer risk. Methods We used the Surveillance, ...Epidemiology, and End Results (SEER) registry limited-use database (1973–2004) to search for placenta tumors (ICD-10 C58), i.e. choriocarcinoma (CC). Demographics were obtained including patient ID, primary site, year of diagnosis, sex, race, DOB, age group and survival months. Patients with initial choriocarcinoma were searched for subsequent breast cancers. The cohort diagnosis with CC and subsequent breast cancers were compared to general population-based rates of breast cancer. Results A query for CC yielded 646 women between the ages 15 and 54 years. Of the 646 women, 422 were white, 129 African-American, and 95 “other”. Total women-years of observation were 7165.3 with two CC patients developing breast cancer yielding a breast cancer incidence rate of 27.9/100,000 women-years. The incidence rate ratio(IRR) of the CC cohort to the general population was 0.21 (95% CI(0.145–0.327); P < 0.01). In women with CC under the age of 35 years the breast cancer rate was 34.1/100,000, IRR 0.27 (95% CI(0.182–0.386); P < 0.01). Controlling for race, breast cancer rates in whites were 49.3/100,000 (IRR 0.37, P < 0.01); in African-American 1.3/100,000 (IRR 0.01, P < 0.001); and 2.6/100,000 (IRR 0.03, P < 0.001) in “others” compared to the general population. Conclusion Women with prior CC had a 79% reduction in breast cancer risk compared to the general population regardless of age and race. Given the high level of hCG and decreased rate of breast cancer among women with CC, the hypothesis that hCG is protective against breast cancer seems plausible.
The objective of this study was to evaluate the incidence of hypothyroidism with adjuvant treatment in oral tongue carcinoma patients treated primarily with surgery.
A retrospective review was ...carried out to analyze hypothyroidism incidence and its relation to adjuvant treatment (radiation/radio-chemotherapy) in oral tongue carcinoma after the primary surgical ablation and neck dissection. Hypothyroidism was analyzed in relation with dose of radiation, gender, and adjuvant treatment modality.
The study analyzed the patients who were treated between January 2012 and June 2015. Among 705 patients with carcinoma of the tongue treated primarily with wide local excision and neck dissection, 383 received adjuvant treatment. A total of 215 patients received radiation, and 168 received concurrent radio-chemotherapy. Of 378 patients, 78 developed hypothyroidism during follow-up: 27 patients received concurrent radio-chemotherapy, and the remaining 51 received only radiation. Lower neck received 40-48 Gy in 2 patients, 50 Gy in 74 patients, and 60-70 Gy and concurrent radio-chemotherapy in 27 patients. Median follow-up was 32 months. Hypothyroidism occurred in 21.5% of patients with squamous cell carcinoma of the oral tongue. The minimum period to develop hypothyroidism was 3 months in this study. Gender and adjuvant treatment were not found to be significant for the incidence of hypothyroidism.
A significant number of patients with carcinoma of the tongue who receive adjuvant treatment will develop hypothyroidism, hence frequent monitoring of thyroid function is advised during follow-up.
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