Pub Date : 1900-01-01DOI: 10.47733/gjccr.2020.1207
I. M. Sala, B. Maurer, Cristian Solano, R. Levitin, T. M. Guerrero
Purpose: The purpose of this first-in-man study is to directly measure thoracic tumor immobilization by high frequency percussive ventilation (HFPV). Methods: In an IRB approved protocol (IRB # 2017-046) we screened patients with conspicuous lung tumors that exhibited motion >10 mm to undergo kV fluoroscopy with HFPV. Two sets of consecutive AP (anterior posterior) fluoroscopy frames were acquired during multiple breathing cycles for freeand HFPVbreathing. All images were acquired using our kV source/panel of the therapeutic linear accelerator. Percussions were delivered via the intrapulmonary percussive ventilation device (IPV-2C) and phasitron (Percussionaire Corp., Sagle, Idaho). The baseline settings for the IPV-2C (pressure, frequency, CPAP and inspiration time) were set during an initial training session, but minor adjustments were made prior to imaging at the direction and comfort of the patient. Results: Patient recruited was a 69 y.o. female with stage IB (cT2a, cN0, cM0) adenocarcinoma of the LLL with lepidic and acinar growth pattern. She experienced slight discomfort lying flat on the treatment table, however successfully completed HFPV. Peak-to-peak tumor motion during 4DCT sim was 11.0 mm, however patient had already received 4x 10Gy fractions of SBRT when enrolled in the study, and therefore peak-to-peak motion during free-breathing measured with fluoroscopy, at the time of the study, was 6.2 mm. Subsequently, peak-to-peak motion measured with fluoroscopy during HFPV was at 2.7 mm. This resulted in a 57 % tumor motion reduction. Conclusion: In this first-in-man study, we have shown that HFPV is a novel respiratory motion technique that can significantly reduce tumor motion.
{"title":"Fluoroscopic Demonstration of Thoracic Tumor Immobilization with High Frequency Percussive Ventilation","authors":"I. M. Sala, B. Maurer, Cristian Solano, R. Levitin, T. M. Guerrero","doi":"10.47733/gjccr.2020.1207","DOIUrl":"https://doi.org/10.47733/gjccr.2020.1207","url":null,"abstract":"Purpose: The purpose of this first-in-man study is to directly measure thoracic tumor immobilization by high frequency percussive ventilation (HFPV). Methods: In an IRB approved protocol (IRB # 2017-046) we screened patients with conspicuous lung tumors that exhibited motion >10 mm to undergo kV fluoroscopy with HFPV. Two sets of consecutive AP (anterior posterior) fluoroscopy frames were acquired during multiple breathing cycles for freeand HFPVbreathing. All images were acquired using our kV source/panel of the therapeutic linear accelerator. Percussions were delivered via the intrapulmonary percussive ventilation device (IPV-2C) and phasitron (Percussionaire Corp., Sagle, Idaho). The baseline settings for the IPV-2C (pressure, frequency, CPAP and inspiration time) were set during an initial training session, but minor adjustments were made prior to imaging at the direction and comfort of the patient. Results: Patient recruited was a 69 y.o. female with stage IB (cT2a, cN0, cM0) adenocarcinoma of the LLL with lepidic and acinar growth pattern. She experienced slight discomfort lying flat on the treatment table, however successfully completed HFPV. Peak-to-peak tumor motion during 4DCT sim was 11.0 mm, however patient had already received 4x 10Gy fractions of SBRT when enrolled in the study, and therefore peak-to-peak motion during free-breathing measured with fluoroscopy, at the time of the study, was 6.2 mm. Subsequently, peak-to-peak motion measured with fluoroscopy during HFPV was at 2.7 mm. This resulted in a 57 % tumor motion reduction. Conclusion: In this first-in-man study, we have shown that HFPV is a novel respiratory motion technique that can significantly reduce tumor motion.","PeriodicalId":165998,"journal":{"name":"Global Journal of Cancer Case Reports","volume":"151 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"113986786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.47733/gjccr.2021.2202
Ismail Ghorbel
Background: Role of primary and metastasis directed radiotherapy established for several cancer sites. While it is not yet clarified in metastatic nasopharyngeal cancer (mNPC). Material and method: A research of relevant studies published in the literature through Pubmed between 2000 and 2020 in English language. The following key words used; metastatic nasopharyngeal cancer, role of radiotherapy in metastatic nasopharyngeal cancer, metastasis directed radiotherapy, primary treatment in metastatic nasopharyngeal cancer. Results: Fifteen retrospective studies, one meta-analysis and one randomized controlled trial (RCT) found. All retrospective studies showed a significant overall survival (OS) benefit of primary radiotherapy in addition to induction chemotherapy. This confirmed by RCT and the meta-analysis. Number of metastasis, response to chemotherapy and EBV DNA level could be part of a prognostic scoring system to indicate primary treatment. Conclusion: primary and metastasis directed radiotherapy has a role in metastatic nasopharyngeal cancer. Further RCT are necessary to establish this indication.
{"title":"Role of Primary and Metastasis Directed Radiotherapy in Metastatic Nasopharyngeal Cancer","authors":"Ismail Ghorbel","doi":"10.47733/gjccr.2021.2202","DOIUrl":"https://doi.org/10.47733/gjccr.2021.2202","url":null,"abstract":"Background: Role of primary and metastasis directed radiotherapy established for several cancer sites. While it is not yet clarified in metastatic nasopharyngeal cancer (mNPC). Material and method: A research of relevant studies published in the literature through Pubmed between 2000 and 2020 in English language. The following key words used; metastatic nasopharyngeal cancer, role of radiotherapy in metastatic nasopharyngeal cancer, metastasis directed radiotherapy, primary treatment in metastatic nasopharyngeal cancer. Results: Fifteen retrospective studies, one meta-analysis and one randomized controlled trial (RCT) found. All retrospective studies showed a significant overall survival (OS) benefit of primary radiotherapy in addition to induction chemotherapy. This confirmed by RCT and the meta-analysis. Number of metastasis, response to chemotherapy and EBV DNA level could be part of a prognostic scoring system to indicate primary treatment. Conclusion: primary and metastasis directed radiotherapy has a role in metastatic nasopharyngeal cancer. Further RCT are necessary to establish this indication.","PeriodicalId":165998,"journal":{"name":"Global Journal of Cancer Case Reports","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131923100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.47733/gjccr.2022.3102
Gwendolyn S. Reeve, J. Spector, D. Kutler, H. J. Hansen
Objective: To describe a prosthetically-driven reconstruction of an edentulous atrophic maxilla and mandible using 3D surgical planning and intra-operative navigation. Methods: A twenty-eight-year-old male presented for reconstruction with fixed dental prostheses after a gunshot wound caused severe atrophy of the jaws and nasal deformity. His dentition was non-salvageable with insufficient maxillary bone for dental implant placement. To restore his midfacial deformity, reestablish upper lip support, and provide adequate bone, his maxilla was reconstructed using a free fibula flap. Dental implant placement is dictated by the planned prosthetic tooth position, and therefore the design of the maxillary reconstruction considered the necessary prosthetic space and the location of the planned prosthetics via Virtual Surgical planning. Intra-operative navigation confirmed the correct placement of the flap using surgical probe guidance. Results: Using our precise and prosthetically driven method, we were able to place dental implants to support fixed dental prostheses and correct the skeletal deformity in a single surgery. Conclusion: Traditional dental prosthetic design principles were applied to optimize functional and esthetic outcomes in a complex case of simultaneous maxilla-mandibular reconstruction. The use of 3D surgical planning and intra-operative navigation allowed us to shorten the treatment time providing a predictable and accurate outcome.
{"title":"A Prosthetically Driven Approach for Immediate Dental Implant Reconstruction of a Maxillary Free Fibula Flap with the Aid of Virtual Three-Dimensional Planning and Intra-Operative Navigation","authors":"Gwendolyn S. Reeve, J. Spector, D. Kutler, H. J. Hansen","doi":"10.47733/gjccr.2022.3102","DOIUrl":"https://doi.org/10.47733/gjccr.2022.3102","url":null,"abstract":"Objective: To describe a prosthetically-driven reconstruction of an edentulous atrophic maxilla and mandible using 3D surgical planning and intra-operative navigation. Methods: A twenty-eight-year-old male presented for reconstruction with fixed dental prostheses after a gunshot wound caused severe atrophy of the jaws and nasal deformity. His dentition was non-salvageable with insufficient maxillary bone for dental implant placement. To restore his midfacial deformity, reestablish upper lip support, and provide adequate bone, his maxilla was reconstructed using a free fibula flap. Dental implant placement is dictated by the planned prosthetic tooth position, and therefore the design of the maxillary reconstruction considered the necessary prosthetic space and the location of the planned prosthetics via Virtual Surgical planning. Intra-operative navigation confirmed the correct placement of the flap using surgical probe guidance. Results: Using our precise and prosthetically driven method, we were able to place dental implants to support fixed dental prostheses and correct the skeletal deformity in a single surgery. Conclusion: Traditional dental prosthetic design principles were applied to optimize functional and esthetic outcomes in a complex case of simultaneous maxilla-mandibular reconstruction. The use of 3D surgical planning and intra-operative navigation allowed us to shorten the treatment time providing a predictable and accurate outcome.","PeriodicalId":165998,"journal":{"name":"Global Journal of Cancer Case Reports","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126205486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.47733/gjccr.2020.2103
Luis E. Fregoso Arteaga, B. Z. Retes, Fatima Rincon Cabada, Michael P. White
Breast cancer is the most common female cancer, nevertheless it represents a rare entity in male patients; the presentation of breast cancer as a primary occult cancer in male patients is such a rare pathology that only case reports have been described. We present a 48 year old man who developed and axillary mass which resulted to be metastatic breast cancer, he was treated in the same fashion as female patients are treated.
{"title":"Primary Occult Breast Cancer in A Male Patient: A Case Report and Brief Overview of Literature","authors":"Luis E. Fregoso Arteaga, B. Z. Retes, Fatima Rincon Cabada, Michael P. White","doi":"10.47733/gjccr.2020.2103","DOIUrl":"https://doi.org/10.47733/gjccr.2020.2103","url":null,"abstract":"Breast cancer is the most common female cancer, nevertheless it represents a rare entity in male patients; the presentation of breast cancer as a primary occult cancer in male patients is such a rare pathology that only case reports have been described. We present a 48 year old man who developed and axillary mass which resulted to be metastatic breast cancer, he was treated in the same fashion as female patients are treated.","PeriodicalId":165998,"journal":{"name":"Global Journal of Cancer Case Reports","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114842249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.47733/gjccr.2021.2203
N. Chrysanthakopoulos, E. Vryzaki, K. Karkoulias
Synovial sarcomas (SS) are rare soft tissue malignant tumors that mainly arise from the lower extremities, especially the lower thigh-knee region. The literature has shown that this tumor may be observed in uncommon regions such as the abdominal wall and the head and neck region which are non-synovium-lined spaces. SS rarely occurs in the head and neck region, as only 3-10% of these neoplasms appear in this region. The parapharyngeal space is the most common location, whereas primary SS of the palatine tonsil is extremely rare as only a few cases of primary tonsillar SS have been described. It is considered as a high grade malignant tumor, however current investigation regarding its clinical and histopathological features revealed in all these cases a biphasic morphology. Molecular analyses detected a typical SYT gene t(X;18) (p11; q11) translocation and a representative SYT/SSX1fusion type. Immunohistochemical analysis recorded cytokeratin OSCAR, Bcl-2, EMA, vimentin, TLE1 and PGP 9.5, were diffusely positive. The aim of the current review was to present the molecular basis of SS and SS rare location in palatine tonsil.
{"title":"Molecular Basis of Synovial Sarcoma and the Rare Case of its Localization in Palatine Tonsil: A Review of the Literature","authors":"N. Chrysanthakopoulos, E. Vryzaki, K. Karkoulias","doi":"10.47733/gjccr.2021.2203","DOIUrl":"https://doi.org/10.47733/gjccr.2021.2203","url":null,"abstract":"Synovial sarcomas (SS) are rare soft tissue malignant tumors that mainly arise from the lower extremities, especially the lower thigh-knee region. The literature has shown that this tumor may be observed in uncommon regions such as the abdominal wall and the head and neck region which are non-synovium-lined spaces. SS rarely occurs in the head and neck region, as only 3-10% of these neoplasms appear in this region. The parapharyngeal space is the most common location, whereas primary SS of the palatine tonsil is extremely rare as only a few cases of primary tonsillar SS have been described. It is considered as a high grade malignant tumor, however current investigation regarding its clinical and histopathological features revealed in all these cases a biphasic morphology. Molecular analyses detected a typical SYT gene t(X;18) (p11; q11) translocation and a representative SYT/SSX1fusion type. Immunohistochemical analysis recorded cytokeratin OSCAR, Bcl-2, EMA, vimentin, TLE1 and PGP 9.5, were diffusely positive. The aim of the current review was to present the molecular basis of SS and SS rare location in palatine tonsil.","PeriodicalId":165998,"journal":{"name":"Global Journal of Cancer Case Reports","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127176150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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