33 research outputs found
Feasibility and safety of GliaSite brachytherapy in treatment of CNS tumors following neurosurgical resection
Purpose: To investigate feasibility and safety of GliaSite
brachytherapy for treatment of central nervous system (CNS) tumors
following neurosurgical resection. We report mature results of
long-term follow-up, outcomes and toxicity. Materials and Methods: In
the period from 2004 to 2007, 10 consecutive adult patients with
recurrent, newly diagnosed, and metastatic brain malignancies underwent
GliaSite brachytherapy following maximally safe neurosurgical
resection. While 6/10 (60%) patients were treated for recurrence,
having previously been treated with external beam radiotherapy (EBRT),
4/10 (40%) received radiotherapy (RT) for the first time. A median dose
of 52.0 Gy (range, 45.0 - 60.0 Gy) was prescribed to 0.5 cm - 1.0 cm
from the balloon surface. Radiation Therapy Oncology Group (RTOG)
criteria were used to assess toxicities associated with this technique.
Follow-up was assessed with MRI scans and was available on all enrolled
patients. Results: Median follow-up was 38 months (range, 18 - 57
months). Mean size of GliaSite balloon was 3.4 cm (range, 2.0 - 4.0
cm). Median survival was 14.0 months for the entire cohort after the
treatment. The 17.6 and 16.0 months average survival for newly
diagnosed and recurrent high grade gliomas (HGG), respectively,
translated into a three-month improvement in survival in patients with
newly diagnosed HGG compared to historical controls (P = 0.033). There
were no RTOG grades 3 or 4 acute or late toxicities. Follow-up magnetic
resonance imaging (MRI) imaging did not identify radiation necrosis.
Conclusions: Our data indicate that treatment with GliaSite
brachytherapy is feasible, safe and renders acceptable local control,
acute and long-term toxicities. We are embarking on testing larger
numbers of patients with this treatment modality
The role of post-cystectomy radiation in treatment of squamous cell carcinoma of the bladder: A combined retrospective analysis.
Practical Considerations in Setting Up an Intracoronary Brachytherapy Program: Results of a Multicenter Survey
Pure seminoma in the setting of androgen insensitivity syndrome treated with surgical resection and para-aortic radiation: A case report and review of literature
Complete androgen insensitivity is a rare X-linked disorder
characterized by a female phenotype in a chromosomally male individual.
Malignant transformation of the un-descended testis is a rare phenomena
compared to other inter-sex syndromes. This is a case of a 32-year-old
female who was diagnosed with androgen insensitivity and presented to
the emergency room with pelvic pain. Later the pelvic pain was found to
be due to testicular masses, one of which was pure seminoma. We
reviewed the literature emphasizing the biochemical and endocrinologic
abnormalities leading to the syndrome, as well as the potential for
malignant changes of the un-descended testes, diagnosis, and
therapeutic management. We discuss the importance of early diagnosis
and the consequence associated with misdiagnosis
MammoSite multilumen catheter: Dosimetry considerations
Purpose: To explore the dosimetric advantages of the new MammoSite
multilumen (ML) balloon for breast brachytherapy treatment compared to
conventional single lumen (SL) device plan. Materials and Methods:
Patients deemed appropriate for accelerated partial breast irradiation
(APBI) were implanted with the MammoSite ML balloon. Two plans were
generated in each patient for the same target coverage (PTV_EVAL) and
dose to normal structures were plotted. The first plan used only the
central single lumen with single-dwell position (SL), and the second
plan (ML) was generated using the other lumens of the device. Dose
distributions of the SL and ML plans were compared. Results: For the
same PTV_EVAL, the ML balloon improved dose coverage at the tip and
base of the applicator compared to SL plan. The skin and rib doses were
reduced using the ML plan versus SL plan for the same PTV_EVAL
in-patient 2, where the skin-balloon distance was 7 mm and the
rib-balloon distance was <1 cm. For patient 1, the skin and rib
distances were greater than 1 cm and the ML plan did not further
minimize the dose to normal structures. Conclusion: In our initial
experience, dosimetric goals can be better achieved using the ML
MammoSite balloon when normal structures (skin and ribs) are close to
PTV_EVAL with a distance of <7 mm and rib distance of <1 cm. The
multiple lumen of ML balloon can optimize dose and reduce excessive
dose to rib and skin and therefore minimize the long-term toxicities of
rib discomfort, skin fibrosis and fat necrosis
MammoSite catheter HDR brachytherapy for patients who refuse mastectomy for localized breast cancer after prior radiation
Pure seminoma in the setting of androgen insensitivity syndrome treated with surgical resection and para-aortic radiation: A case report and review of literature
Complete androgen insensitivity is a rare X-linked disorder
characterized by a female phenotype in a chromosomally male individual.
Malignant transformation of the un-descended testis is a rare phenomena
compared to other inter-sex syndromes. This is a case of a 32-year-old
female who was diagnosed with androgen insensitivity and presented to
the emergency room with pelvic pain. Later the pelvic pain was found to
be due to testicular masses, one of which was pure seminoma. We
reviewed the literature emphasizing the biochemical and endocrinologic
abnormalities leading to the syndrome, as well as the potential for
malignant changes of the un-descended testes, diagnosis, and
therapeutic management. We discuss the importance of early diagnosis
and the consequence associated with misdiagnosis