Radiation-induced cancer after radiotherapy for non-Hodgkin's lymphoma of the head and neck: a retrospective study

<p>Abstract</p> <p>Background</p> <p>survivors of non-Hodgkin's lymphoma (NHL) are well known to be at an increased risk of second malignancies. In this study, we evaluated the incidence and clinical features of head and neck cancer (HNC) occurring after radiotherapy (RT) for NHL.</p> <p>Materials and methods</p> <p>We investigated the clinical records of 322 patients who had received RT for early-stage NHL of the head and neck at our institute between 1952 and 2000.</p> <p>Results</p> <p>There were 4 patients with a second HNC developing in the irradiated field, consisting of 2 patients with gum cancer, 1 case with tongue cancer and 1 case with maxillary sinus cancer. The pathological diagnosis in all the 4 patients was squamous cell carcinoma (SCC). Two of the patients (one with gum cancer and one with maxillary sinus cancer) died of the second HNC, while the remaining 2 patients are still living at the time of writing after therapy for the second HNC, with neither recurrence of the second tumor nor relapse of the primary tumor. The ratio of the observed to the expected number (O/E ratio) of a second HNC was calculated to be 12.7 (95%CI, 4.07–35.0), and the absolute excess risk (AER) per 10,000 person-years was 13.3. The median interval between the RT and the diagnosis of the second HNC was 17.0 years (range, 8.7 to 22.7 years).</p> <p>Conlusion</p> <p>The risk of HNC significantly increased after RT for early-stage NHL. These results suggest that second HNC can be regarded as one of the late complications of RT for NHL of the head and neck.</p

Guidelines for histopathological specimen examination and diagnostic reporting of primary bone tumours

This review is intended to provide histopathologists with guidelines for clinical assessment, specimen handling and diagnostic reporting of benign and malignant primary bone tumours. Information from radiology, surgical, oncology and other clinical colleagues involved in the diagnosis and treatment of primary bone tumours should be properly assessed before undertaking a structured approach to specimen handling and histological reporting. This ensures that the information needed for planning appropriate treatment of these complex tumours is provided. Consistency in diagnostic evaluation with respect to both terminology and report content facilitates liaison at multidisciplinary bone tumour meetings and collaboration between cancer units and networks, as well as providing a common database for audit of the clinical, radiological and pathological aspects of bone tumours

National nursing registration in Australia: A way forward for nurse practitioner endorsement

Purpose: The move to national registration of health professionals and the creation of the Nursing and Midwifery Board of Australia (NMBA) provides both challenges and opportunities for the regulation of nurse practitioners (NPs) in Australia. Data sources: National and state health policy documents, accessible on the Internet, concerning the regulation and endorsement processes for NPs in Australia were examined. Conclusions: The similarities between two of the previous jurisdictional NP endorsement processes in New South Wales and Victoria provide a common ground on which to build a robust national system. However, there are also key differences between these two states. These differences were mainly in the evidence required to assess competency of NP applicants and the authority to prescribe medications. All Victorian NP applicants were required to complete an approved medication subject at a master's level. Implications for practice: A consistent endorsement process that delivers NPs of the highest standard and allows for efficient use of their skills and expertise is vital. This needs to be performed with the aim of providing high-quality care in a regulatory environment that protects the public and clearly articulates the level of competence expected of all NPs. © 2012 The Author(s) Journal compilation © 2012 American Academy of Nurse Practitioners

Aneurysmal bone cysts of the pelvis

Twenty-three cases of pelvic aneurysmal bone cysts treated at the Istituto Ortopedico Rizzoli were reviewed after a mean follow-up of 7 years. Eighteen cysts involved the anterior arch, four extended into the iliac wing and the anterior arch, and one invaded the entire hemipelvis. The acetabulum was involved in 56.5% of the cases. Fourteen patients were treated with surgery (curettage 11; resection 3), and five with radiation therapy; two patients had both modalities; two additional patients refused any treatment after biopsy. The overall recurrence rate was 13% (one case after curettage, one after radiation therapy, and one after combined treatment). Significant complications affected the final functional result in four of seven patients who received radiation therapy, while only one minor complication was seen in the surgical group