Primary Extradural Extraosseous Ewing’s Sarcoma of The Thoracic Spinal Canal: A Case Report

Ewing’s sarcoma most commonly occurs in bone and only very rarely in the extradural spinal canal. Herein, we present the clinical course, diagnosis, and treatment of a 6-year-old girl admitted with a complaint of strength loss in her right lower extremity. Magnetic resonance imaging revealed an extradural spinal canal tumor extending from level T2 to T5; she underwent laminectomy. The histopathological, immunohistochemical, and molecular cytogenetic data were compatible with Ewing’s sarcoma. We detected no malignant focus on postoperative staging work-up and prescribed postoperative radiotherapy and chemotherapy. A brief review of the literature on primary extradural extraosseous Ewing’s sarcoma of the spinal canal is presented

Ninety-degree angled collimator: a dosimetric study related to dynamic intensity-modulated radiotherapy in patients with endometrial carcinoma

Abstract Background Our purpose was to ensure that the dose constraints of the organs at risk (OARs) were not exceeded while increasing the prescription dose to the planning target volume (PTV) from 45 to 50.4 Gray (Gy) with the dynamic intensity-modulated radiotherapy (IMRT) technique. While trying for this purpose, a new dynamic IMRT technique named 90° angled collimated dynamic IMRT (A-IMRT) planning was developed by us. Methods This study was based on the computed tomography data sets of 20 patients with postoperatively diagnosed International Federation of Gynecology and Obstetrics stage 2 endometrial carcinoma. For each patient, conventional dynamic IMRT (C-IMRT, collimator angle of 0° at all gantry angles), A-IMRT (collimator angle of 90° at gantry angles of 110°, 180°, 215°, and 285°), and volumetric modulated arc therapy (VMAT) were planned. Planning techniques were compared with parameters used to evaluate PTV and OARs via dose-volume-histogram analysis using the paired two-tailed Wilcoxon’s signed-rank test; p < 0.05 was considered indicative of statistical significance. Results All plans achieved adequate dose coverage for PTV. Although the technique with the lowest mean conformality index was A-IMRT (0.76 ± 0.05) compared to both C-IMRT (0.79 ± 0.04, p = 0.000) and VMAT (0.83 ± 0.03, p = 0.000), it protected the OARs especially the bladder (V45 = 32.84 ± 2.03 vs. 44.21 ± 6.67, p = 0.000), rectum (V30 = 56.18 ± 2.05 vs. 73.80 ± 4.75, p = 0.000) and both femoral heads (V30 for right = 12.19 ± 1.34 vs. 21.42 ± 4.03, p = 0.000 and V30 for left = 12.58 ± 1.48 vs. 21.35 ± 4.16, p = 0.000) better than C-IMRT. While the dose constraints of the bladder, rectum and bilateral femoral heads were not exceeded in any patient with A-IMRT or VMAT, they were exceeded in 19 (95%), 20 (100%) and 20 (100%) patients with C-IMRT, respectively. Conclusions OARs are better protected when external beam radiotherapy is applied to the pelvis at a dose of 50.4 Gy by turning the collimator angle to 90° at some gantry angles with the dynamic IMRT technique in the absence of VMAT

Postmastectomy Radiotherapy Decision for Patients without Lymph Node Metastases: Turkish Radiation Oncology Society Breast Cancer Working Group

WOS: 000483636700005OBJECTIVE Recent meta-analysis have not revealed any positive effects of postmastectomy radiotherapy (PMRT) on locoregional recurrence (LRR) or overall survival in axilla-negative patients. However, risk of LRR increases to 15% in the presence of two or more adverse factors for the same patient group. In this study, PMRT indications and volume selections of radiation oncologists in Turkey for axilla-negative breast cancer was investigated. METHODS Questionnaires were distributed to members of the breast cancer study group. Data of patients with axillary negative or isolated/micrometastasis and PMRT over 10 years (2006-2016) were collected from 10 participating centers. Clinical and tumor histopathological features and treatment details of 185 patients were analyzed. RESULTS The median age of patients was 48 years. Ratio of early-stage patients was 60% (T1-15%,T2-45%). There were 147 (79%) negative cases, 32 (17%) with micrometastasis, and 6 (3%) with isolated tumor cells. Half of the patients had only their chest walls (CW) irradiated. Peripheral lymphatics were also included in the rest. In Nmic cases, ratio of irradiation of supraclavicular and axillary lymph nodes with CW were statistically significant compared to CW irradiation (72% and 28%, respectively; p=0.015). CONCLUSION Considering the low number of patients treated over 10 years in 10 different centers in Turkey, it can be said that PMRT is often done in node-negative breast cancer. It is difficult to reach a definite conclusion for patients with Nmic, due to lack of data from patients with PMRT. However, the general tendency is to irradiate peripheral lymphatics in Nmic cases if PMRT is to be performed

Evaluation of Nutritional Status and Anxiety Levels in Patients Applying to the Radiation Oncology Outpatient Clinic during the COVID-19 Pandemic: Turkish Society for Radiation Oncology Group Study (TROD 12:02)

Cancer patients often face malnutrition, which negatively affects their response to cancer treatment. This study aims to analyze the effects of the COVID-19 pandemic on nutritional status and anxiety in cancer patients with different types and stages of cancer. This is a cross-sectional cohort study that includes 1,252 patients with varying cancer types from 17 radiation oncology centers. The nutritional risk scores (NRS-2002) and coronavirus anxiety scale (CAS) scores of all patients were measured. NRS-2002 >= 3 and CAS >= 5 were accepted as values at risk. Of all patients, 15.3% had NRS-2002 >= 3. Breast cancer was the most prevalent cancer type (24.5%) with the lowest risk of nutrition (4.9%, p = 5) were significantly related to voluntary avoidance and clinical postponement of hospital visits due to the pandemic (p < 0.001), while clinical postponement was particularly frequent among patients with NRS-2002 < 3 (p = 0.0021). Fear and anxiety in cancer patients with COVID-19 cause hesitations in visiting hospitals, leading to disrupted primary and nutritional treatments. Thus, nutritional monitoring and treatment monitoring of cancer patients are crucial during and after radiotherapy