8 Gy single dose radiotherapy for bone metastasis in COVID-19 pandemia period: Review

Bone metastases in cancer patients are highly painful and decrease the quality of life for these group of population. Covid-19 pandemia is a global challenging issue that mostly affect the patients with immune suppression or having comorbid diseases older than 65 years old. The palliation and management of bone metastases varies from single dose to several fractionation. The main goal of this article is to decide that short or long term fit for the cancer patients with bone metastasis in the Covid-19 era. We reviewed the topic about the short course and long term radiotherapy in the patients with painful bone metastases via novel literature

A concise review of immunotherapy for glioblastoma

Glioblastoma (GB) is the most common and aggressive form of primary brain tumors in adults with a universally poor prognosis despite multimodal management including surgery, chemotherapy and radiation therapy. Among the novel therapeutic strategies, immunotherapy deserves particular attention with its potential to evoke biologic response and harness the host immune system. Considerable success achieved for other tumors has elicited great enthusiasm and prompted research on immunotherapy for GB. While the central nervous system has traditionally been thought of as an immune-privileged site, our understanding is being refined with emerging evidence. Several studies have been conducted and more are under way to establish the role of immunotherapy in management of GB. Immunotherapy of GB has yet resulted in mixed success with conflicting research findings, emphasizing the need for extensive study before its integration into routine clinical practice. Although there is a lot of room for improvement, immunotherapy for GB may be feasible and serve as a viable management strategy broadening and strengthening the therapeutic armamentarium to combat this deadly disease. Herein, we present a concise review of immunotherapy for GB

A Concise Review of Pelvic Radiation Therapy (RT) for Rectal Cancer with Synchronous Liver Metastases

Background and Objective. Colorectal cancer is a major health concern as a very common cancer and a leading cause of cancer-related mortality worldwide. The liver is a very common site of metastatic spread for colorectal cancers, and, while nearly half of the patients develop metastases during the course of their disease, synchronous liver metastases are detected in 15% to 25% of cases. There is no standardized treatment in this setting and no consensus exists on optimal sequencing of multimodality management for rectal cancer with synchronous liver metastases. Methods. Herein, we review the use of pelvic radiation therapy (RT) as part of potentially curative or palliative management of rectal cancer with synchronous liver metastases. Results. There is accumulating evidence on the utility of pelvic RT for facilitating subsequent surgery, improving local tumor control, and achieving palliation of symptoms in patients with stage IV rectal cancer. Introduction of superior imaging capabilities and contemporary RT approaches such as Intensity Modulated Radiation Therapy (IMRT) and Image Guided Radiation Therapy (IGRT) offer improved precision and toxicity profile of radiation delivery in the modern era. Conclusion. Even in the setting of stage IV rectal cancer with synchronous liver metastases, there may be potential for extended survival and cure by aggressive management of primary tumor and metastases in selected patients. Despite lack of consensus on sequencing of treatment modalities, pelvic RT may serve as a critical component of multidisciplinary management. Resectability of primary rectal tumor and liver metastases, patient preferences, comorbidities, symptomatology, and logistical issues should be thoroughly considered in decision making for optimal management of patients

Obsessive compulsive disorder (ocd) as a severe mental health disorder: A concise review of management with radiosurgery for intractable disease

Obsessive Compulsive Disorder (OCD) is a mental health disorder with characteristic features including uncontrollable, reoccurring thoughts referred to as obsessions, and excessive urges to perform repeated certain routines referred to as compulsions. Affected patients may suffer from tics, anxiety, negative social behaviours and self mutilation. Symptoms of patients may be intrusive, anxiety-provoking, and rather distressing which may significantly compromise both social and occupational functioning. Deterioration in quality of life may occur as a consequence of unemployment, marriage failure, and maladjustment in familial relationships. Initial management of OCD may include exposure and response prevention, cognitive-bahavioural-therapy, and pharmacological agents such as selective serotonin reuptake inhibitors and tricyclic antidepressants. These management strategies may be effective for the majority of patients suffering from OCD. However, approximately 20% of patients have refractory OCD unresponsive to first-line therapies and a subgroup of patients unresponsive to first-line therapies suffer from severe debilitating symptoms referred to as intractable OCD. Radiosurgery has a long history as an excellent radiotherapeutic modality for management of several intracranial disorders. Radiosurgical or gamma capsulotomy technique involving discrete, circumscribed lesions in white matter of the anterior limb of the internal capsule has been introduced by the Swedish neurosurgeon Lars Leksell. Gammaknife Radiosurgery (GKRS) system has been used as a viable alternative to open surgical anterior capsulotomy procedures and gained popularity and widespread acceptance with accumulating evidence from several centers worldwide. Herein, we provide a concise review including the definition, epidemiology and symptomotology of OCD, patient selection criteria, and management options with focus on radiosurgery.</p

Evaluation of critical organ dosimetry with focus on heart exposure in supine versus prone patient positioning for breast irradiation

Breast cancer (Ca) remains to be the most frequent cancer among females and a leading cause of cancer associated mortality worldwide. Main modalities for management of breast Ca include surgery, Radiation Therapy (RT), and systemic treatments. Diagnosis at earlier stages of breast Ca is increasing with rigorous utilization of screening and raised public awareness. Improvements in therapy contribute to longer life expectancies for patients with breast Ca. In this context, adverse radiation effects are being a more pronounced aspect of breast Ca management recently.While the adverse effects of irradiation in earlier studies may have led to unfavorable outcomes for some patients with breast Ca, toxicity profile of radiation delivery has been improved with introduction of modernized equipment and contemporary techniques such as Breathing Adapted Radiation Therapy (BART), Image Guided Radiation Therapy (IGRT), Intensity Modulated Radiation Therapy (IMRT) and Adaptive Radiation Therapy (ART). Individualized patient positioning has also been utilized for improved normal tissue sparing while maintaining target coverage. While the conflicting results of cardiac dosimetry among different studies may partly be explained by variations in delineation and treatment techniques between treatment centers, prone positioning may be considered for at least a selected group of breast Ca patients as a viable alternative to supine positioning. Herein, we evaluate critical organ dosimetry with focus on heart exposure in supine versus prone patient positioning for breast irradiation.&nbsp;&nbsp;</p