Introduction: Regression of non-irradiated metastatic lesions after radiation therapy is known as the abscopal effect. We report a case of urothelial carcinoma in which the abscopal effect was possibly observed after immune checkpoint inhibitor administration.
Case Presentation: A 68-year-old woman diagnosed with left renal pelvic cancer underwent total nephroureterectomy and regional lymph node dissection. Eight months later, imaging studies detected local recurrence and paraaortic lymph node metastasis. The tumor progressed despite cisplatin + gemcitabine, pembrolizumab, and gemcitabine + docetaxel therapy. Radiation therapy was administered to a painful back lesion, which resulted in dramatic symptom relief. Computed tomography 2 months after radiation therapy indicated reduced size of the irradiated lesion and some non-irradiated lymph nodes.
Conclusion: Combined radiation therapy and immune checkpoint inhibitors can provide additional benefits for certain cancers, possibly due to negative immunomodulatory response blockade. Thus, this combined therapy may be a new metastatic urothelial carcinoma treatment strategy.
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http://dx.doi.org/10.1002/iju5.12133 | DOI Listing |
Biomed Phys Eng Express
January 2025
Department of Medical Physics, Osaka Heavy Ion Therapy Center, Otemae, Chuo-ku, Osaka, Osaka, 5400008, JAPAN.
Objective Applying carbon ion beams, which have high linear energy transfer and low scatter within the human body, to Spatially Fractionated Radiation Therapy (SFRT) could benefit the treatment of deep-seated or radioresistant tumors. This study aims to simulate the dose distributions of spatially fractionated beams (SFB) to accurately determine the delivered dose and model the cell survival rate following SFB irradiation. Approach Dose distributions of carbon ion beams are calculated using the Triple Gaussian Model.
View Article and Find Full Text PDFJ Neurosurg Case Lessons
January 2025
Department of Neurology, Mayo Clinic, Rochester, Minnesota.
Background: Adamantinomatous craniopharyngiomas (ACPs) are slow-growing, cystic, highly morbid central nervous system tumors located adjacent to vital structures including the pituitary, hypothalamus, and optic chiasm. Tumor recurrence is common. Treatment relies on resection with or without adjuvant radiation and is highly individualized.
View Article and Find Full Text PDFJ Clin Oncol
January 2025
Department of Epidemiology and Health Economics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
Purpose: To evaluate the cost utility of a 9-month supervised exercise program for patients with metastatic breast cancer (mBC), compared with control (usual care, supplemented with general activity advice and an activity tracker). Evidence on the cost-effectiveness of exercise for patients with mBC is essential for implementation in clinical practice and is currently lacking.
Methods: A cost-utility analysis was performed alongside the multinational PREFERABLE-EFFECT randomized controlled trial, conducted in 8 centers across Europe and Australia.
PLoS One
January 2025
Department of Hospital Administration, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Background: Establishing and maintaining gamma knife facility incurs significant costs, mandating healthcare institutions to meticulously assess financial implications for sustainability.
Methods: This study explores the financial implications of setting up and operating a Gamma Knife facility, with an aim to ascertain user charges for achieving breakeven. The study was conducted from January to June 2019 at the largest neurosurgery centre of an Institute of National Importance (INI), in Delhi, India.
Phys Eng Sci Med
January 2025
School of Physics, Mathematics and Computing, The University of Western Australia, Crawley, WA, Australia.
Artificial Intelligence (AI) based auto-segmentation has demonstrated numerous benefits to clinical radiotherapy workflows. However, the rapidly changing regulatory, research, and market environment presents challenges around selecting and evaluating the most suitable solution. To support the clinical adoption of AI auto-segmentation systems, Selection Criteria recommendations were developed to enable a holistic evaluation of vendors, considering not only raw performance but associated risks uniquely related to the clinical deployment of AI.
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