Neoadjuvant sequential chemoradiotherapy versus radiotherapy alone for treatment of high-risk extremity soft tissue sarcoma: a single-institution experience

Aim of the study : Patients with large and high-grade extremity soft-tissue sarcoma are at significant risk for distant metastasis and sarcoma-related death. There is no randomized trial comparing chemoradiotherapy to radiotherapy in the neoadjuvant setting for high risk extremity soft-tissue sarcoma. The aim of this study is to evaluate the outcomes of patients treated with two different modalities (neoadjuvant sequential chemoradiotherapy vs. radiotherapy alone) in a single center. Material and methods : Data of 67 patients were analyzed retrospectively. Thirty-four patients received neoadjuvant sequential chemoradiotherapy (2–3 cycles of doxorubicin (75 mg/m 2 ) and ifosfamide (6 g/m 2 ) followed by radiotherapy of 28 Grays (Gy) administered as 8 fractions of 35 Gy) and 33 patients received radiotherapy alone. R0 resection rates and 3-year survival estimates were evaluated. Results : Median follow-up time was 37 months. The estimated 3-year overall and disease-free survival rates for the whole patient group were 79% (95% CI: 67.0–86.4) and 57.9% (95% CI: 46.3–69.0), respectively. The most common side effects were nausea and leucopenia. Three-year overall, disease-free, local recurrence-free and distant recurrence-free survival rates did not differ significantly. All patients except one underwent wide excision or compartmental resection. R0 resection rate for the whole patient group was 92.5% (n = 62). Sites of progression were similar across both treatment arms. Conclusions : Preoperative hypofractionated radiotherapy alone or sequentially with chemotherapy result in high rates of limb salvage and acceptable toxicity. Our study results did not show a statistically significant treatment effect regarding survival and patterns of failure

Endocrine late effects of childhood cancer therapy

Survival rates are improving following effective cancer therapy in childhood cancer. As the number of childhood cancer survivors increases, the late effects of cancer therapy are encountered more frequently. Endocrine disorders are prominent among the late effects. The recognition and prompt management of these endocrine late effects are essential to prevent further morbidity and impairment of quality of life. The aim of this article was to investigate these late effects of chemotherapy and/or radiotherapy for each endocrine system

PCA3 Silencing Sensitizes Prostate Cancer Cells to Enzalutamide-mediated Androgen Receptor Blockade

Background/Aim: Prostate cancer (PCa) is an androgen-dependent disease. Novel anti-androgens (i.e. enzalutamide) have recently been developed for the treatment of patients with metastatic castration-resistant prostate cancer (CRPC). Evidence is accumulating that prostate cancer antigen 3 (PCA3) is involved in androgen receptor (AR) signaling. Here, in combination with enzalutamide-mediated AR blockade, we investigated the effect of PCA3 targeting on the viability of PCa cells. Materials and Methods: In hormone-sensitive LNCaP cells, AR-overexpressing LNCaP-AR(+) cells and VCaP cells (representing CRPC), PCA3 was silenced using siRNA oligonucleotides. Gene expression and cell viability was assessed in PCA3-silenced and/or AR-blocked cells. Results: PCA3 targeting reduced the expression of AR-related genes (i.e. prostate-specific antigen (PSA) and prostate-specific transcript 1 (non-protein coding) (PCGEM1)) and potentiated the effect of enzalutamide. Proliferation of PCa cells was suppressed upon PCA3 silencing with a greater effect in LNCaP-AR(+) cells. Furthermore, PCA3 silencing sensitized PCa cells to enzalutamide-induced loss of cell growth. Conclusion: PCA3, as a therapeutic target in PCa, might be used to potentiate AR antagonists

Absolute dose verification of static intensity modulated radiation therapy (IMRT) with ion chambers of various volumes and TLD detectors

AimThis study aims at examining absolute dose verification of step-and-shoot intensity modulated radiation treatment (IMRT) of prostate and brain patients by use of ion chambers of two different volumes and thermoluminescent detectors (TLD).BackgroundThe volume of the ion chamber (IC) is very important for absolute dose verification of IMRT plans since the IC has a volume average effect. With TLD detectors absolute dose verification can be done measuring the dose of multiple points simultaneously.Materials and methodsIon chambers FC65-P of volume 0.65cc and semiflex of volume 0.125cc as well as TLDs were used to measure the central axis absolute dose of IMRT quality assurance (QA) plans. The results were compared with doses calculated by a treatment planning system (TPS). The absolute doses of off axis points located 2cm and 4cm away from the isocenter were measured with TLDs.ResultsThe measurements of the 0.125cc ion chamber were found to be closer to TPS calculations compared to the 0.65cc ion chamber, for both patient groups. For both groups the root mean square (RMS) differences between doses of the TPS and the TLD detectors are within 3.0% for the central axis and points 2cm away from the isocenter of each axis. Larger deviations were found at the field edges, which have steep dose gradient.ConclusionsThe 0.125cc ion chamber measures the absolute dose of the isocenter more accurately compared to the 0.65cc chamber. TLDs have good accuracy (within 3.0%) for absolute dose measurements of in-field points

Absolute dose verification of static intensity modulated radiation therapy (IMRT) with ion chambers of various volumes and TLD detectors

Aim: This study aims at examining absolute dose verification of step-and-shoot intensity modulated radiation treatment (IMRT) of prostate and brain patients by use of ion chambers of two different volumes and thermoluminescent detectors (TLD)

Iris Metastasis from Small-Cell Lung Cancer

Uveal metastasis is the most common intraocular malignancy. In order of frequency, it affects choroid, iris, and ciliary body. We report herein the clinicopathologic features and response to therapy in a patient with iris metastasis from a small-cell lung cancer. A 60-yearold male presented with redness and epiphora in his right eye for 4 months. His medical history revealed the presence of a small-cell lung cancer that was detected almost a year ago. He had underwent systemic chemotherapy, local radiotherapy, and prophylactic cranial radiotherapy. The ophthalmological examination revealed amelanotic, yellow-white nodular mass in the iris stroma in his right eye. 27G fine-needle aspiration biopsy was performed under local anesthesia with the primary diagnosis of a metastatic iris tumor. Cytological analysis was consistent with metastatic iris carcinoma from small-cell lung cancer. He subsequently received a total of 3000 cGy (in 15 fractions) radiotherapy from frontal field (4x3 cm) with a 7Mev linear accelerator. The tumor regressed completely one month after therapy and did not recur during the 7-month follow-up. Metastatic iris tumors from small-cell lung cancer are quite rare. Fine-needle aspiration biopsy is required for the final diagnosis. Local radiotherapy is usually effective in controlling these tumors. (Turk J Ophthalmol 2013; 43: 67-9

Neoadjuvant sequential chemoradiotherapy versus radiotherapy alone for treatment of high-risk extremity soft tissue sarcoma: a single-institution experience

Aim of the study: Patients with large and high-grade extremity soft-tissue sarcoma are at significant risk for distant metastasis and sarcoma-related death. There is no randomized trial comparing chemoradiotherapy to radio-therapy in the neoadjuvant setting for high risk extremity soft-tissue sarcoma. The aim of this study is to evaluate the outcomes of patients treated with two different modalities (neoadjuvant sequential chemoradio-therapy vs. radiotherapy alone) in a single center