20 research outputs found
Spinal intradural extraosseous Ewing's sarcoma
Extraosseous Ewing's sarcoma (EES) involving the central nervous system is rare, but can be diagnosed and distinguished from other primitive neuroectodermal tumors (PNET) by identification of the chromosomal translocation (11;22)(q24;q12). We report EES arising from the spinal intradural extramedullary space, based on imaging, histopathological, and molecular data in two men, ages 50 and 60 years old and a review of the literature using PubMed (1970–2009). Reverse transcriptase polymerase chain reaction (RT-PCR) identified the fusion product FL1-EWS. Multimodal therapy, including radiation and alternating chemotherapy including vincristine, cyclophosphamide, doxorubicin and ifosfamide and etoposide led to local tumor control and an initial, favorable therapeutic response. No systemic involvement was seen from the time of diagnosis to the time of last follow-up (26 months) or death (4 years). This report confirms that EES is not confined to the earliest decades of life, and like its rare occurrence as an extra-axial meningeal based mass intracranially, can occasionally present as an intradural mass in the spinal canal without evidence of systemic tumor. Gross total resection followed by multimodal therapy may provide for extended progression free and overall survival
A prospective study evaluating surgery and chemo radiation in muscle invasive bladder cancer
Aim : The aim of our study was to compare the two standard treatment
approaches in muscle invasive carcinoma of urinary bladder - radical
cystectomy and chemo radiation. Materials and Methods : Transitional
cell carcinoma (TCC) of bladder of stages, T2 to T4, N0/N1/N2 and MO
were included in the study. Patients were allotted to two arms of the
study. Arm A consisted of radical cystectomy. Adjuvant CMV chemotherapy
was given for T3/T4 or Node positive disease only. Arm B received 2
cycles of neoadjuvant CMV chemo therapy followed by concurrent chemo
radiation Results : Forty-four patients were recruited into the study.
Thirty patients in the surgical arm and 13 patients in the chemo
radiation arm. The actuarial two-year survival rate in surgical arm is
56% while in chemo radiation arm it is 54%. There was no statistically
significant difference in disease-free survival also between the two
groups. Conclusion : Chemo radiation yielded equivalent survival
results with radical cystectomy. So it is worth giving preference to
chemo radiation that will give a better quality of life for the
patient
A prospective study evaluating surgery and chemo radiation in muscle invasive bladder cancer
Aim : The aim of our study was to compare the two standard treatment
approaches in muscle invasive carcinoma of urinary bladder - radical
cystectomy and chemo radiation. Materials and Methods : Transitional
cell carcinoma (TCC) of bladder of stages, T2 to T4, N0/N1/N2 and MO
were included in the study. Patients were allotted to two arms of the
study. Arm A consisted of radical cystectomy. Adjuvant CMV chemotherapy
was given for T3/T4 or Node positive disease only. Arm B received 2
cycles of neoadjuvant CMV chemo therapy followed by concurrent chemo
radiation Results : Forty-four patients were recruited into the study.
Thirty patients in the surgical arm and 13 patients in the chemo
radiation arm. The actuarial two-year survival rate in surgical arm is
56% while in chemo radiation arm it is 54%. There was no statistically
significant difference in disease-free survival also between the two
groups. Conclusion : Chemo radiation yielded equivalent survival
results with radical cystectomy. So it is worth giving preference to
chemo radiation that will give a better quality of life for the
patient
Brief Report - Comparison of computed tomography and magnetic resonance based target volume in brain tumors
Purpose : This study was mainly framed to study the difference in tumor
volumes as seen on computed tomography (CT) and magnetic resonance (MR)
and their significance in planning. Materials and Methods : Twenty-five
patients with brain tumor of different diagnoses who underwent
stereotactic radiotherapy were included in this study. CT and MR
imaging was done for all the patients with 2.5 mm slice thickness. The
CT tumor volume and MR tumor volume were measured and compared with
each other. The center of mass (CM) of the tumor volume delineated on
CT and MR were computed and the shift between the two CMs was
determined. Results : The mean and median volume of the tumor as
measured from MR scans was 19.67 cc \ub1 13.73 and 16.13 cc (range:
3.25 cc - 50.37 cc). Similarly, the mean and median volume of the tumor
as measured from CT scans was 15.05 cc \ub1 10.13 and 11.63 cc
(range: 3.0 cc - 36.25 cc) respectively. The mean and median CM shift
between CT and MR was 5.47 mm and 5.21 mm respectively. Conclusion :
The study demonstrates that MR is an indispensable imaging modality in
radiotherapy for planning brain tumors
Field-in-field technique for upper abdominal malignancies in clinical radiotherapy
Background: In upper abdominal malignancies (UAM), due to the presence
of multiple inhomogeneous tissues, a wedge-based conformal treatment
planning results in high-dose regions inside the target volume. Aim:
This study was designed to explore the feasibility of using a
field-in-field (FIF) technique in different UAM and its efficacy in
reducing the high-dose regions. Materials and Methods: Twelve patients
of UAM (which included malignancies of the gastroesophageal junction,
stomach, gall bladder, and pancreas) were selected for this study.
Computed tomography (CT) scans were performed and three-dimensional
conformal wedge plans were generated for all the cases. The same plan
was copied with the wedges removed and a FIF plan was generated. The
two plans were compared for mean, maximum, and median doses; dose
received by 2% (D2) and 98% (D98) of the target volume; volume
receiving> 107% (V > 107%) and < 95% (V < 95%) of the
prescribed dose; conformality index (CI); and total monitor units. The
doses to critical structures such as liver, kidneys, and spinal cord
were also compared. Statistical Analysis: Statistical analysis was
performed with SPSS, version 10.0. Results: For all the cases, the FIF
technique was better than wedge-based planning in terms of maximum
dose, D2, V > 107%, and CI; there was a statistically significant
reduction in monitor units. With regard to doses to critical
structures, there was marginal dose reduction for the kidneys and
spinal cord with FIF as compared to wedge-based planning. Conclusion:
The FIF technique can be employed for UAM in place of wedge-based
conformal treatment plans
Brief Report - Comparison of computed tomography and magnetic resonance based target volume in brain tumors
Purpose : This study was mainly framed to study the difference in tumor
volumes as seen on computed tomography (CT) and magnetic resonance (MR)
and their significance in planning. Materials and Methods : Twenty-five
patients with brain tumor of different diagnoses who underwent
stereotactic radiotherapy were included in this study. CT and MR
imaging was done for all the patients with 2.5 mm slice thickness. The
CT tumor volume and MR tumor volume were measured and compared with
each other. The center of mass (CM) of the tumor volume delineated on
CT and MR were computed and the shift between the two CMs was
determined. Results : The mean and median volume of the tumor as
measured from MR scans was 19.67 cc ± 13.73 and 16.13 cc (range:
3.25 cc - 50.37 cc). Similarly, the mean and median volume of the tumor
as measured from CT scans was 15.05 cc ± 10.13 and 11.63 cc
(range: 3.0 cc - 36.25 cc) respectively. The mean and median CM shift
between CT and MR was 5.47 mm and 5.21 mm respectively. Conclusion :
The study demonstrates that MR is an indispensable imaging modality in
radiotherapy for planning brain tumors
Comparison of computed tomography and magnetic resonance based target volume in brain tumors
A prospective study evaluating surgery and chemo radiation in muscle invasive bladder cancer
Aim : The aim of our study was to compare the two standard treatment
approaches in muscle invasive carcinoma of urinary bladder - radical
cystectomy and chemo radiation. Materials and Methods : Transitional
cell carcinoma (TCC) of bladder of stages, T2 to T4, N0/N1/N2 and MO
were included in the study. Patients were allotted to two arms of the
study. Arm A consisted of radical cystectomy. Adjuvant CMV chemotherapy
was given for T3/T4 or Node positive disease only. Arm B received 2
cycles of neoadjuvant CMV chemo therapy followed by concurrent chemo
radiation Results : Forty-four patients were recruited into the study.
Thirty patients in the surgical arm and 13 patients in the chemo
radiation arm. The actuarial two-year survival rate in surgical arm is
56% while in chemo radiation arm it is 54%. There was no statistically
significant difference in disease-free survival also between the two
groups. Conclusion : Chemo radiation yielded equivalent survival
results with radical cystectomy. So it is worth giving preference to
chemo radiation that will give a better quality of life for the
patient
A simple technique for cranio-spinal irradiation in pediatric patients
Purpose: Field matching poses challenges in craniospinal irradiation
(CSI) as it leads either to underdosage or overdosage in the junctional
area. A simple technique for CSI in pediatric patients is proposed.
Materials and Methods: Computed tomography scans were performed in the
prone position. Two lateral cranial fields and a direct posterior
spinal field were planned with a common central axis. Half-beam-blocked
cranial fields with zero collimator rotation were used for treating the
cranium. A half-beam-blocked field defined with jaws was used to treat
the spinal column at an extended source-to-surface distance. Before
treating the patient, matching of the cranial and spinal field junction
along the central axis was verified with an extended dose range film.
Results and Conclusion: The technique described is simple and easy to
implement and can be applied to pediatric patients undergoing CSI. This
method has the potential to reduce daily setup time and setup errors.
This technique is ideally suitable for patients with spinal fields less
than 30 cm