S. Das Majumdar, S. Dhar, Chinzah Lalsangzuala, R. Sahu, S. Purkait, D. Parida
Central nervous system high‐grade glioma (HGG) occurring in an infratentorial midline location is not commonly found in the pediatric population. Though pediatric HGGs appear similar to their adult counterparts histopathologically, they differ in molecular, genetic, and clinical characteristics. Evidence for the management of HGG is sparse in the literature. Surgery in the form of maximum safe resection is the backbone of management and has been variably supplemented with external beam radiotherapy and cytotoxic chemotherapy. The outcome, though largely dismal, has some positive surprises too. As shown in the presented case, the combined modality of management in a 5‐year‐old female child has resulted in a disease‐free survival of 3.5 years.
{"title":"Combined treatment modality in pediatric infratentorial midline high‐grade glioma can lead to long‐term survival: A case study and review of literature","authors":"S. Das Majumdar, S. Dhar, Chinzah Lalsangzuala, R. Sahu, S. Purkait, D. Parida","doi":"10.1002/pro6.1127","DOIUrl":"https://doi.org/10.1002/pro6.1127","url":null,"abstract":"Central nervous system high‐grade glioma (HGG) occurring in an infratentorial midline location is not commonly found in the pediatric population. Though pediatric HGGs appear similar to their adult counterparts histopathologically, they differ in molecular, genetic, and clinical characteristics. Evidence for the management of HGG is sparse in the literature. Surgery in the form of maximum safe resection is the backbone of management and has been variably supplemented with external beam radiotherapy and cytotoxic chemotherapy. The outcome, though largely dismal, has some positive surprises too. As shown in the presented case, the combined modality of management in a 5‐year‐old female child has resulted in a disease‐free survival of 3.5 years.","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/pro6.1127","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42287328","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}
Recent reports have documented in‐field rib fractures as a rare complication of accelerated partial breast irradiation. Here, we report a case of an out‐of‐field rib fracture, with a maximum point dose of <50% of the prescribed dose, and Mondor's disease in a 61‐year‐old woman after MammoSite brachytherapy. This is the first case in the literature in which rib fractures occurred out‐of‐field, without trauma or risk factors. It also highlights a rare clinical entity, Mondor's disease, of which its recognition is important for radiation oncologists given its potential for tumor recurrence.
{"title":"Unusual complications after MammoSite brachytherapy: out‐of‐field rib fracture and Mondor's disease","authors":"E. Rahimy, S. Evans","doi":"10.1002/pro6.1128","DOIUrl":"https://doi.org/10.1002/pro6.1128","url":null,"abstract":"Recent reports have documented in‐field rib fractures as a rare complication of accelerated partial breast irradiation. Here, we report a case of an out‐of‐field rib fracture, with a maximum point dose of <50% of the prescribed dose, and Mondor's disease in a 61‐year‐old woman after MammoSite brachytherapy. This is the first case in the literature in which rib fractures occurred out‐of‐field, without trauma or risk factors. It also highlights a rare clinical entity, Mondor's disease, of which its recognition is important for radiation oncologists given its potential for tumor recurrence.","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/pro6.1128","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44315670","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}
Charged particle radiotherapy can be traced back to 1954 when Lawrence Berkeley National Laboratory launched proton therapy. After experimentation with different kinds of particles, including neutrons, mesons, helium ions, and neon ions, the National Institute of Radiological Sciences in Japan started using carbon ions for cancer treatment. Proton therapy has the physical advantage of the Bragg peak, which can well realize the high-dose distribution in the tumor target volume and the low-dose distribution in surrounding normal tissue, so proton therapy has found wide applications in the field of ion radiotherapy. Nevertheless, the physical dose distribution and biological characteristics of carbon ions are significantly superior to those of other particles. Compared with the conventional photon radiotherapy, carbon ion radiotherapy stands outwith its favorable radiophysical and biological advantages.1 In the current clinical practice, heavy ion radiotherapymainly refers to the carbon ion radiotherapy. So far, although some textbooks and publications have provided references for standardized applications of ion radiotherapy, there has not yet been any consensus to guide clinical practices. With the rapid development of ion radiotherapy in China, and the increase of proton and heavy ion therapy centers, ion radiotherapy, which serves as a promising radiotherapy technology, has been applicable to more and more indications. Nevertheless, there has not yet been a guideline to guide ion therapy clinical practices based on national circumstances
{"title":"Ion therapy guideline (Version 2020)","authors":"Qiuning Zhang, L. Kong, Ruifeng Liu, Xiaohu Wang","doi":"10.1002/pro6.1120","DOIUrl":"https://doi.org/10.1002/pro6.1120","url":null,"abstract":"Charged particle radiotherapy can be traced back to 1954 when Lawrence Berkeley National Laboratory launched proton therapy. After experimentation with different kinds of particles, including neutrons, mesons, helium ions, and neon ions, the National Institute of Radiological Sciences in Japan started using carbon ions for cancer treatment. Proton therapy has the physical advantage of the Bragg peak, which can well realize the high-dose distribution in the tumor target volume and the low-dose distribution in surrounding normal tissue, so proton therapy has found wide applications in the field of ion radiotherapy. Nevertheless, the physical dose distribution and biological characteristics of carbon ions are significantly superior to those of other particles. Compared with the conventional photon radiotherapy, carbon ion radiotherapy stands outwith its favorable radiophysical and biological advantages.1 In the current clinical practice, heavy ion radiotherapymainly refers to the carbon ion radiotherapy. So far, although some textbooks and publications have provided references for standardized applications of ion radiotherapy, there has not yet been any consensus to guide clinical practices. With the rapid development of ion radiotherapy in China, and the increase of proton and heavy ion therapy centers, ion radiotherapy, which serves as a promising radiotherapy technology, has been applicable to more and more indications. Nevertheless, there has not yet been a guideline to guide ion therapy clinical practices based on national circumstances","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/pro6.1120","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45590848","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}
Esophageal carcinoma is a high-incidence malignant tumor in China, ranking sixth and fourth highest in morbidity and mortality, respectively. Radiotherapy plays an important role in the comprehensive treatment of esophageal carcinoma. Standardized diagnosis and treatment based on the suggestions of a multidisciplinary team (MDT) form its foundation. For operable esophageal carcinoma, surgery after neoadjuvant chemoradiotherapy is the standard treatment; contrarily, for inoperable esophageal carcinoma, radical chemoradiotherapy is the only treatment option, and postoperative adjuvant radiotherapy can improve local control and survival rates in selected cases. Owing to the rapid technological development in radiotherapy, three-dimensional conformal radiotherapy, intensity-modulated radiotherapy, and image guidance technology are widely used in the treatment of esophageal carcinoma. Though drugs for treating cancer have been developed rapidly, we need to explore their optimal combination with radiotherapy, including chemotherapy, targetedor immune, and radiosensitizers. Esophageal carcinoma in China differs greatly from that in European and American countries in terms of etiology, pathological type, highincidence site, etc. Therefore, the European and American guidelines on radiotherapy for esophageal carcinoma cannot be applied in clinical practice in China. This gap was addressed when the 2019 edition of
{"title":"Guidelines for Radiotherapy of Esophageal Carcinoma (2020 Edition)","authors":"H. Gong, Baosheng Li","doi":"10.1002/pro6.1119","DOIUrl":"https://doi.org/10.1002/pro6.1119","url":null,"abstract":"Esophageal carcinoma is a high-incidence malignant tumor in China, ranking sixth and fourth highest in morbidity and mortality, respectively. Radiotherapy plays an important role in the comprehensive treatment of esophageal carcinoma. Standardized diagnosis and treatment based on the suggestions of a multidisciplinary team (MDT) form its foundation. For operable esophageal carcinoma, surgery after neoadjuvant chemoradiotherapy is the standard treatment; contrarily, for inoperable esophageal carcinoma, radical chemoradiotherapy is the only treatment option, and postoperative adjuvant radiotherapy can improve local control and survival rates in selected cases. Owing to the rapid technological development in radiotherapy, three-dimensional conformal radiotherapy, intensity-modulated radiotherapy, and image guidance technology are widely used in the treatment of esophageal carcinoma. Though drugs for treating cancer have been developed rapidly, we need to explore their optimal combination with radiotherapy, including chemotherapy, targetedor immune, and radiosensitizers. Esophageal carcinoma in China differs greatly from that in European and American countries in terms of etiology, pathological type, highincidence site, etc. Therefore, the European and American guidelines on radiotherapy for esophageal carcinoma cannot be applied in clinical practice in China. This gap was addressed when the 2019 edition of","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42063943","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}
Intensity‐modulated radiotherapy (IMRT) has been used to treat locally advanced non‐small cell lung cancer (LA‐NSCLC) disseminated to primary gross tumor volume (pGTV) and mediastinal lymph nodes (LNs). However, it is challenging to deliver definitive doses to the pGTV and regional LNs without exceeding the tolerance of the organs at risk (OAR). Iodine‐125 (I‐125) brachytherapy has recently been applied in clinical practice for the treatment of malignant tumors. Its merits include a higher dose to the primary tumor lesion and lower dose surrounding the tumor mass. Using brachytherapy in these settings may maximize the dose delivered to the pGTV while minimizing the dose delivered to the OAR. I‐125 brachytherapy combined with IMRT for the treatment of LA‐NSCLC has rarely been reported. Here we report a patient with peripheral squamous cell carcinoma of the lung who received I‐125 brachytherapy for pulmonary lung lesions and IMRT for metastatic mediastinal LNs. The patient received 16 months of follow‐up care with no evidence of complications or disease recurrence. Moreover, we compared brachytherapy plus IMRT to theoretically planned IMRT dosimetry to evaluate the merits of each approach. This treatment modality resulted in a higher target dose escalation and lower doses delivered to the OAR.
{"title":"Intensity‐modulated radiotherapy combined with intensity‐modulated radiotherapy CT–guided iodine 125 seed brachytherapy for non‐small cell lung cancer: A case report","authors":"Xinyi Gu, Zhe Wang, Yingming Sun, Lian-Gui Yang, Jinyu Wu, Zaishuang Ju, Ruoyu Wang","doi":"10.1002/pro6.1121","DOIUrl":"https://doi.org/10.1002/pro6.1121","url":null,"abstract":"Intensity‐modulated radiotherapy (IMRT) has been used to treat locally advanced non‐small cell lung cancer (LA‐NSCLC) disseminated to primary gross tumor volume (pGTV) and mediastinal lymph nodes (LNs). However, it is challenging to deliver definitive doses to the pGTV and regional LNs without exceeding the tolerance of the organs at risk (OAR). Iodine‐125 (I‐125) brachytherapy has recently been applied in clinical practice for the treatment of malignant tumors. Its merits include a higher dose to the primary tumor lesion and lower dose surrounding the tumor mass. Using brachytherapy in these settings may maximize the dose delivered to the pGTV while minimizing the dose delivered to the OAR. I‐125 brachytherapy combined with IMRT for the treatment of LA‐NSCLC has rarely been reported. Here we report a patient with peripheral squamous cell carcinoma of the lung who received I‐125 brachytherapy for pulmonary lung lesions and IMRT for metastatic mediastinal LNs. The patient received 16 months of follow‐up care with no evidence of complications or disease recurrence. Moreover, we compared brachytherapy plus IMRT to theoretically planned IMRT dosimetry to evaluate the merits of each approach. This treatment modality resulted in a higher target dose escalation and lower doses delivered to the OAR.","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/pro6.1121","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44204391","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}
Paulo César Rosenbaum, Aroldo Henrique da Silva Boigues, Fernando Zambelli Tassone, Isabela Martinhão, João Italo Fortaleza de Melo, Raphael Oliveira Ramos Franco Netto, V. Fernandes, Messias Villa Mendonça, Lindyane de Souza Freitas Melo, Cindy Liberato Rocha Castilhos, Leonardo Gattass Ferreira, Luiz Dias Dutra
Leiomyosarcoma is a malignant tumor that develops from the smooth muscle constituents of the middle layer in veins, usually affecting the inferior vena cava (IVC); however, this disease is observed in older patients. In this report, we describe a rare case of a 32‐year‐old female patient who presented with leiomyosarcoma. Initially, the patient complained of moderate‐intensity pain in the abdominal region of the right hypochondrium and nausea, worsening postprandial starting 6 days earlier. Abdominal ultrasonography showed a heterogeneous hypoechoic expansive formation, with lobulated contours and ill‐defined limits in the projection of the IVC. Inferior vena cavography, showed obliteration of the vessel in almost all of its extensions. Magnetic resonance examination showed a large expansive lesion occupying the IVC. The lesion was resected, and the specimen was sent for anatomopathological analysis, which showed a leiomyosarcoma of the IVC. Patients with leiomyosarcoma have a poor prognosis, and early diagnosis and complete resection with free surgical margins are the only chance of long‐term survival. The report stands out due to the appearance of this condition in a young patient with no family history of this disease or other predisposing carcinogenic pathologies.
{"title":"A rare case of leiomyosarcoma of the inferior vena cava in a 32‐year‐old patient","authors":"Paulo César Rosenbaum, Aroldo Henrique da Silva Boigues, Fernando Zambelli Tassone, Isabela Martinhão, João Italo Fortaleza de Melo, Raphael Oliveira Ramos Franco Netto, V. Fernandes, Messias Villa Mendonça, Lindyane de Souza Freitas Melo, Cindy Liberato Rocha Castilhos, Leonardo Gattass Ferreira, Luiz Dias Dutra","doi":"10.1002/pro6.1118","DOIUrl":"https://doi.org/10.1002/pro6.1118","url":null,"abstract":"Leiomyosarcoma is a malignant tumor that develops from the smooth muscle constituents of the middle layer in veins, usually affecting the inferior vena cava (IVC); however, this disease is observed in older patients. In this report, we describe a rare case of a 32‐year‐old female patient who presented with leiomyosarcoma. Initially, the patient complained of moderate‐intensity pain in the abdominal region of the right hypochondrium and nausea, worsening postprandial starting 6 days earlier. Abdominal ultrasonography showed a heterogeneous hypoechoic expansive formation, with lobulated contours and ill‐defined limits in the projection of the IVC. Inferior vena cavography, showed obliteration of the vessel in almost all of its extensions. Magnetic resonance examination showed a large expansive lesion occupying the IVC. The lesion was resected, and the specimen was sent for anatomopathological analysis, which showed a leiomyosarcoma of the IVC. Patients with leiomyosarcoma have a poor prognosis, and early diagnosis and complete resection with free surgical margins are the only chance of long‐term survival. The report stands out due to the appearance of this condition in a young patient with no family history of this disease or other predisposing carcinogenic pathologies.","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/pro6.1118","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47010566","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}
Y. Yao, Z. Qi, Qingqing Zhu, Qi Zhao, Zheng Zhang, S. Fu, Liyao Zhou, Jiaxing Zhu, Zhenhua Liu, Haiyan Xu, Yuhui Huang, J. Xue, S. Qin
Although radiotherapy (RT) has been widely used in cancer treatment, it provides limited benefits in patients with metastatic cancers due to rare abscopal antitumor effects. Recent progress in cancer immunotherapy provides a potential new strategy to boost the abscopal antitumor effects of RT.
{"title":"Erb‐(IL10)2 induces abscopal antitumor effects of radiotherapy through the activation and recruitment of lymph node CD8+ T cells","authors":"Y. Yao, Z. Qi, Qingqing Zhu, Qi Zhao, Zheng Zhang, S. Fu, Liyao Zhou, Jiaxing Zhu, Zhenhua Liu, Haiyan Xu, Yuhui Huang, J. Xue, S. Qin","doi":"10.1002/pro6.1138","DOIUrl":"https://doi.org/10.1002/pro6.1138","url":null,"abstract":"Although radiotherapy (RT) has been widely used in cancer treatment, it provides limited benefits in patients with metastatic cancers due to rare abscopal antitumor effects. Recent progress in cancer immunotherapy provides a potential new strategy to boost the abscopal antitumor effects of RT.","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48923926","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}
Z. Ding, X. Xiang, K. Kang, Q. Zeng, Q. Yuan, Mei Xu
We aimed to compare the dosimetric characteristics of 6‐MV flattening filter mode (FF) and flattening filter‐free mode (FFF) volumetric‐modulated arc therapy (VMAT) plans in preoperative radiotherapy for rectal cancer using an Edge linear accelerator.
{"title":"Comparison of dosimetric characteristics between flattening filter‐free and flattening filter mode volumetric‐modulated arc therapy plans in rectal cancer","authors":"Z. Ding, X. Xiang, K. Kang, Q. Zeng, Q. Yuan, Mei Xu","doi":"10.1002/pro6.1117","DOIUrl":"https://doi.org/10.1002/pro6.1117","url":null,"abstract":"We aimed to compare the dosimetric characteristics of 6‐MV flattening filter mode (FF) and flattening filter‐free mode (FFF) volumetric‐modulated arc therapy (VMAT) plans in preoperative radiotherapy for rectal cancer using an Edge linear accelerator.","PeriodicalId":32406,"journal":{"name":"Precision Radiation Oncology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/pro6.1117","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44124942","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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