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Introduction: To evaluate clinical outcomes, pattern of failure, and toxicity after high-dose intensity-modulated radiation therapy (IMRT) for advanced vulvar cancer.
Methods: In this IRB approved retrospective study, the charts of women with histologically confirmed, non-metastatic vulvar cancer consecutively treated at our institution from 2012 to 2018 were reviewed to identify patients that received high-dose IMRT with curative intent. The treatment compliance, toxicities, and patterns of failure were investigated. Actuarial local, regional and distant recurrence and survival were estimated using Kaplan-Meier method and compared using log rank test.
Results: Twenty-six patients were identified, 23 were unresectable, and 3 refused surgery. Fifteen patients (58%) had inguinal node metastases; 10(38%) had pelvic node metastases. Elective surgical staging of groins was performed in 9-patients. Median tumor dose was 65.4Gy. Concurrent platinum-based chemotherapy was administered in 22(84.6%) patients. Complete response (CR) was achieved in 21/26 (80.7%) patients. Five patients had persistent disease following treatment and one sustained recurrence 5-months following radiotherapy. All persistent or recurrent disease occurred inside the irradiated volume. Median follow-up was 19 months (3-52 months). Actuarial 1-year local, regional and distant controls were 72.4%, 85.4%, and 86%, respectively. One and 2-year overall survivals were 91% and 62%, respectively. Complete response at 3-months was a strong predictor for overall survival (1-yr OS 73% vs 27%, HR 7.1 (95% CI 1.2-44); p = 0.01). Lymph node metastases adversely affected overall survival (2-yr OS 49% vs. 83%, p = 0.09). Grade 3-4 late urinary and soft-tissue toxicity was seen in 5 patients. Tumor doses >66 Gy (p = 0.03) and prior pelvic radiotherapy (p = 0.002) predicted grade 3-4 toxicity.
Conclusion: High-dose IMRT for vulvar cancer achieves high rates of local control with acceptable dose dependent long-term toxicity.
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http://dx.doi.org/10.1016/j.ygyno.2019.11.027 | DOI Listing |
Int J Nanomedicine
December 2024
Department of Physics, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, 999077, People's Republic of China.
Background: The lymphatic system is the major route of cancer metastasis, and sentinel lymph nodes (SLNs) are the first station for the spread of cancer cells. Accurate identification of SLNs by tracers during surgery is crucial for SLN biopsy and lymphadenectomy. However, conventional monomodal tracers such as blue dyes and carbon nanoparticles often induce a misjudgment of SLNs and thus are still unsatisfying for clinical applications.
View Article and Find Full Text PDFClin Lung Cancer
December 2024
Department of Surgery, Thoracic Surgery, INOVA Fairfax Medical Center, Fairfax, VA. Electronic address:
Background: Current staging work-up does not capture all occult lymph node (OLN) disease. We sought to determine if Computer Assisted Nodule Analysis and Risk Yield (CANARY) analysis could help distinguish OLN status in early-stage lung adenocarcinoma.
Methods: Retrospective review of resected lung cancer patients from 2016 to 2021 was performed.
BMC Cancer
December 2024
Department of Radiation Oncology, Cancer Center, West China Hospital, No. 37, Guoxue Alley, Chengdu, 610041, China.
Background: This study aimed to assess combined supraclavicular lymph node dissection (SLND) and radiotherapy (RT) versus standalone radiotherapy for efficacy in newly diagnosed breast cancer patients with ipsilateral supraclavicular lymph node metastasis (ISLNM).
Methods: Totally 143 ISLNM patients treated between 2014 and 2021 in two medical institutions were examined retrospectively. Patients were divided into two groups to undergo combined SLND and radiotherapy (surgery + RT, n = 73) or radiotherapy alone (RT, n = 70).
Wiad Lek
December 2024
STATE INSTITUTION OF SCIENCE ≪CENTER OF INNOVATIVE HEALTHCARE TECHNOLOGIES≫ STATE ADMINISTRATIVE DEPARTMENT, KYIV, UKRAINE; STATE INSTITUTION ≪NATIONAL SCIENTIFIC CENTER OF SURGERY AND TRANSPLANTATION NAMED AFTER O. O. SHALIMOV TO NATIONAL ACADEMY OF MEDICAL SCIENCES OF UKRAINE≫, KYIV, UKRAINE.
Objective: Aim: To investigate the incidence of progression and median time for metastasizing, the development of recurrent localization, and to identify localizations with a high tendency to recurrence of melanoma during 10 years of patient follow-up observation.
Patients And Methods: Materials and Methods: The retrospective data of dynamic observation by dermatovenereologists of SIS ≪CIHT≫ SAD of 183 patients with skin melanoma for the period 2014 - first half of 2024.
Results: Results: Among 183 cases of melanoma, 23 cases (12,6%) were detected in stage III and 11 cases (6,0%) in stage IV, so the neglect rate was 18,6%.
Endocrine
December 2024
Nuclear Medicine and Molecular Imaging, Institut de Cancérologie Strasbourg Europe (ICANS), University Hospitals of Strasbourg, University of Strasbourg, Strasbourg, France.
Purpose: To evaluate organ-specific response to [Lu]DOTATATE Peptide Receptor Radionuclide Therapy (PRRT) in patients with small intestine neuroendocrine tumor (SiNET) through [Ga]DOTATOC PET/CT, and to analyze tumor uptake and functional volume variations at different metastatic sites in relation to disease progression during clinical follow-up after treatment.
Methods: A retrospective analysis was conducted on 33 metastatic patients. PET/CT were performed pre-treatment (PET0), mid-treatment after two PRRT cycles (PET2), and post-treatment (PET4).
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