Painful Horner Syndrome as a Harbinger of Silent Carotid Dissection

A painful Horner's syndrome should alert clinicians to the possibilty of a silent carotid dissectio

Definitive chemoradiation in non metastatic squamous cell carcinoma anal canal: a single institution experience

Background: To analyze the oncological outcomes in anal canal squamous cell carcinoma treated with concurrent chemoradiotherapy. Materials and Methods: A single centre retrospective hospital based study with sample size of 51 patients of anal canal Squamous cell carcinoma treated with concurrent chemoradiotherapy with mitomycin @10mg/m2 and 5FU based. Disease free survival (DFS), Colostomy free survival (CFS) and Overall survival (OS) rates were calculated by Kaplan-Meier method. Results: Among 51 eligible patients, after a median follow up of 46 months (range 10-68 months). The 3year Disease free survival (DFS) was 73.9%. 3patients developed locoregional recurrence while 1patient developed distant metastasis. At 3 years Overall survival (OS) rate was 77%. Out of 44 patients 6 patients lost to follow up while 2 patients died due to progressive disease and 2 due to non cancer causes. 3year Colostomy free survival (CFS) rate was 59%. Total 18 out of 44 patients underwent colostomy. No grade 3 or 4 late toxicities occurred after completion of treatment. Conclusion: This study concluded that definitive chemoradiotherapy achieves good local control, overall survival and colostomy free survival with acceptable toxicity and can be recommended as standard treatment in patients with carcinoma anal canal

Dosimetry in Lu-177-DOTATATE peptide receptor radionuclide therapy: a systematic review

Purpose: 177Lu- labelled somatostatin analog DOTATATE is an excellent vector for systemic radiation therapy in NETs. However, this treatment can affect organ functions or impact the quality of life of the patient, due to collateral irradiation of normal body organs. Here we conducted a comprehensive systematic review on organ and tumour dosimetry in 177Lu-DOTATATE therapy.Design: in this review, published peer-reviewed articles on organ dosimetry in patients following PRRT using 177Lu-DOTATATE have been included. All the articles were screened for inclusion based on the title and abstract of the study. PubMed, Publons and DOAJ were used as search engines to conduct a systematic search in the database. Articles were categorized into three groups: (1) Clinical studies describing the technical parameter and method of dosimetry in 177Lu-DOTATATE therapy or (2) Organ dosimetry in 177Lu-DOTATATE treatment or (3) Tumour dosimetry in 177Lu- DOTATATE treatment.Result: in total, 694 studies were retrieved from database searching on NET and PRRT and 43 original articles on 177Lu-DOTATATE dosimetry were included in this review. The median absorbed dose per unit of administered activity for kidneys, spleen, liver, bone marrow and tumour were 0.64 (0.47–0.90 Gy/GBq), 1.23 (0.53–1.59 Gy/GBq), 0.54 (0.23–0.62 Gy/GBq), 0.04 (0.02–0.06 Gy/GBq) and 4.6 (3.09–9.47 Gy/GBq), respectively.Conclusion: according to the present dosimetric review, 177Lu-DOTATATE PRRT appears to be a safe and reliable treatment option for advanced GEP-NETs. From the dosimetric point of view, kidneys are theoretically the major organs at risk in 177Lu-DOTATATE treatment. The optimization of the number of treatment cycles beyond the prescribed limit of four and the maximum administered activity in each cycle must be determined by individual patient dosimetry in order to reduce the risk of organ toxicities whilst maximizing therapeutic efficacy

Dosimetry in Lu-177-PSMA-617 prostate-specific membrane antigen targeted radioligand therapy:a systematic review

BACKGROUND: 177Lu-prostate-specific membrane antigen (PSMA) gained popularity as a choice of agent in the treatment of patients with advanced prostate cancer or metastatic castration-resistant stage of prostate carcinoma (mCRPC) diseases. However, this treatment may cause fatal effects, probably due to unintended irradiation of normal organs. We performed an extensive systematic review to assess the organs at risk and the absorbed dose received by tumor lesions in 177Lu-PSMA therapy. DESIGN: In this review, published peer-reviewed articles that cover clinical dosimetry in patients following peptide radionuclide ligand therapy using 177Lu-PSMA have been included. Two senior researchers independently checked the articles for inclusion. A systematic search in the database was made using PubMed, Publons and DOAJ. All selected articles were categorized into three groups: (1) clinical studies with the technical description of dosimetry in 177Lu-PSMA therapy (2) organ dosimetry in 177Lu-PSMA therapy or (3) tumor dosimetry in 177Lu-PSMA therapy. RESULT: In total, 182 citations were identified on PSMA therapy and 17 original articles on 177Lu-PSMA dosimetry were recognized as eligible for review. The median absorbed dose per unit of administered activity for kidneys, salivary, liver, spleen, lacrimal and bone marrow was 0.55, 0.81, 0.1, 0.1, 2.26 and 0.03 Gy/GBq, respectively. The median absorbed dose per unit of activity for tumor lesions was found in a range of 2.71-10.94 Gy/GBq. CONCLUSION: 177Lu-PSMA systemic radiation therapy (SRT) is a well-tolerated and reliable treatment option against the management of the mCRPC stage of prostate carcinoma. Lacrimal glands and salivary glands are the major critical organs in 177Lu-PSMA SRT. Besides, tumors receive 3-6 times higher absorbed doses compared to organs at risk