Rapid and Significant Reduction in Size of Pituitary Adenoma in Children Treated with Fractionated Stereotactic Radiation Therapy: A Case Report

Radiation treatment in the management of pituitary adenoma in children is still a controversy due to the great concern of late radiation effect. Stereotactic radiation therapy is the modern radiation technique that is more widely applicable in pituitary adenoma because of the ability to give highly conformal radiation to the target organ and to reduce the radiation dose to normal tissue. A 15-year-old boy presented with postradiation therapy recurrence pituitary macroadenoma. His vision was useful only on the left eye. MRI revealed the recurrent macroadenoma with severe invasion of optic apparatus. Since no any other treatment option was to be given to this patient, we decided to reirradiate the patient with conventional fractionated stereotactic radiation. At 3 months of followup, MRI showed that the tumor had an early and significant reduction in size without any sign of toxicity

A Survey of Complementary and Alternative Medicine Use in Cancer Patients Treated with Radiotherapy in Thailand

Introduction. Use of complementary and alternative medicine (CAM) in cancer patients is increasingly acceptable worldwide, but most of the studies were surveyed from developed countries. In this study, we evaluated the first and large cohort of cancer patients with CAM use in Thailand. Materials and Methods. A self-administered questionnaire was completed by 248 cancer patients attending outpatient radiotherapy unit at Ramathibodi Hospital. Results. The prevalence of CAM use was 60.9%. The most frequently used CAM were dietary/vitamin supplements (56.9%). Independent predictors of CAM use were high income (P < 0.001) and cancer type (P = 0.019). About half of the patients (51%) reported positive effects from CAM use. Nevertheless, 9.4% of the patient also reported side effects. The majority of patients (58.3%) did not disclose their use of CAM to their doctors because they felt that it was not necessary for doctors to know (65.9%). The average spending for CAM use was 200 USD/month (range, 10–1,000). Conclusion. Although the cost for CAM is relatively expensive, the prevalence of CAM use in cancer patients in Thailand is high particularly, in patients with higher income. Therefore, all clinical oncologists should be concerned about the use of CAM during evaluation of the cancer patients

Interventions for preventing oral mucositis for patients with cancer receiving treatment

Interventions for preventing oral mucositis for patients with cancer receiving treatmentTreatment for cancer (including bone marrow transplant) can cause oral mucositis (severe ulcers in the mouth). This painful condition can cause difficulties in eating, drinking and swallowing, and may also be associated with infections which may require the patient to stay longer in hospital. Different strategies are used to try and prevent this condition, and the review of trials found that some of these are effective. Two interventions, cryotherapy (ice chips) and keratinocyte growth factor (palifermin®) showed some benefit in preventing mucositis. Sucralfate is effective in reducing the severity of mucositis, and a further seven interventions, aloe vera, amifostine, intravenous glutamine, granulocyte‐colony stimulating factor (G‐CSF), honey, laser and antibiotic lozenges containing polymixin/tobramycin/amphotericin (PTA) showed weaker evidence of benefit. These were evaluated in patients with different types of cancer, undergoing different types of cancer treatment. Benefits may be restricted to the disease and treatment combinations evaluated

Case Report Rapid and Significant Reduction in Size of Pituitary Adenoma in Children Treated with Fractionated Stereotactic Radiation Therapy: A Case Report

Radiation treatment in the management of pituitary adenoma in children is still a controversy due to the great concern of late radiation effect. Stereotactic radiation therapy is the modern radiation technique that is more widely applicable in pituitary adenoma because of the ability to give highly conformal radiation to the target organ and to reduce the radiation dose to normal tissue. A 15-year-old boy presented with postradiation therapy recurrence pituitary macroadenoma. His vision was useful only on the left eye. MRI revealed the recurrent macroadenoma with severe invasion of optic apparatus. Since no any other treatment option was to be given to this patient, we decided to reirradiate the patient with conventional fractionated stereotactic radiation. At 3 months of followup, MRI showed that the tumor had an early and significant reduction in size without any sign of toxicity

Radiation-Induced Peripheral Malignant Nerve Sheath Tumor Arising from Vestibular Schwannoma after Linac-Based Stereotactic Radiation Therapy: A Case Report and Review of Literatures

In recent years the use of stereotactic radiation for vestibular schwannomas has increased worldwide. However, malignant transformation associated with radiation, although uncommon, has been reported in recent publications. We present a case of the 34 year-old female who had left vestibular schwannoma and who underwent surgery and postoperative stereotactic radiotherapy (SRT), hypofraction in 2005. At 6 years after SRT, the patient came with left facial palsy and severe headache. CT brain revealed progression in size with cystic and hemorrhagic changes of the preexisting tumor at left CPA with new obstructive hydrocephalus. Partial tumor removal was done, and the pathological report was malignant peripheral nerve sheath tumor (MPNST). Regarding the uncertainty of carcinogenesis risk, we should still practice radiation therapy with caution, especially in the young patient with tumor predisposition syndrome. Because of low incidence of MPNST after radiation, it should not be a major decision about giving radiotherapy. However, with the poor prognosis of MPNST, this possibility should be explained to the patient before radiation treatment option