Postmastectomy irradiation in breast in breast cancer patients with T1-2 and 1-3 positive axillary lymph nodes: Is there a role for radiation therapy?

<p>Abstract</p> <p>Background</p> <p>We aimed to evaluate retrospectively the correlation of loco-regional relapse (LRR) rate, distant metastasis (DM) rate, disease free survival (DFS) and overall survival (OS) in a group of breast cancer (BC) patients who are at intermediate risk for LRR (T1-2 tumor and 1-3 positive axillary nodes) treated with or without postmastectomy radiotherapy (PMRT) following modified radical mastectomy (MRM).</p> <p>Methods</p> <p>Ninety patients, with T1-T2 tumor, and 1-3 positive nodes who had undergone MRM received adjuvant systemic therapy with (n = 66) or without (n = 24) PMRT. Patient-related characteristics (age, menopausal status, pathological stage/tumor size, tumor location, histology, estrogen/progesterone receptor status, histological grade, nuclear grade, extracapsular extension, lymphatic, vascular and perineural invasion and ratio of involved nodes/dissected nodes) and treatment-related factors (PMRT, chemotherapy and hormonal therapy) were evaluated in terms of LRR and DM rate. The 5-year Kaplan-Meier DFS and OS rates were analysed.</p> <p>Results</p> <p>Differences between RT and no-RT groups were statistically significant for all comparisons in favor of RT group except OS: LRR rate (3%vs 17%, p = 0.038), DM rate (12% vs 42%, p = 0.004), 5 year DFS (82.4% vs 52.4%, p = 0.034), 5 year OS (90,2% vs 61,9%, p = 0.087). In multivariate analysis DM and lymphatic invasion were independent poor prognostic factors for OS.</p> <p>Conclusion</p> <p>PMRT for T1-2, N1-3 positive BC patients has to be reconsidered according to the prognostic factors and the decision has to be made individually with the consideration of long-term morbidity and with the patient approval.</p

Clinical Effects of First and Last Updates of 8th Edition of AJCC Manual on Breast Cancer

At the end of 2016, the American Joint Committee on Cancer (AJCC) Cancer Staging Manual (8th edition) was published. The anatomic and prognostic stage groups were defined in the section on breast cancer. In the prognostic stage group, the stages were identified by using T, N, and M, as well as ER, PR, HER2, and tumor-grade biomarkers. In addition, patients in T1-2, N0, M0, grades 1-3 and those with ER (+), HER2 (-), and Oncotype DX recurrence score <11 were classified as stage IA. A year later, in the light of new data, the breast cancer section of the AJCC manual (8th edition) was updated. This review aims to reveal the changes in the stages of our institutional breast cancer patients according to the first and updated versions of the AJCC manual (8th edition) and to compare the clinical reflections with the help of staging studies with regard to the manual. According to the pathological prognostic stage data, patients mostly display downstaging

Factors that affect the presence of the entire liver incidentally detected by the simulation computed tomography and the detection of inferior border through anthropometric measurement in breast cancer patients

Objective: The aim was to evaluate the parameters that influence the incidental presence of whole liver detected by simulation computed tomography (simCT) while irradiation in breast cancer patients and to evaluate the factors predicting the presence of the liver in simCT scanning and defining the inferior border in simCT

3D Brachytherapy Treatment in Locally Advanced Cervical Cancer: A Case Presentation

Cervical cancer is the most frequent gynecologic malignancy worldwide and is the fourth most common cancer among women. The treatment of locally advanced cervical cancer is concomitant radiochemotherapy. Intracavitary brachytherapy is used following concomitant external radiotherapy with cisplatin chemotherapy. Three-dimensional brachytherapy is currently the treatment of choice for cervical cancer. It was previously shown that high-dose rate (HDR) brachytherapy and low-dose rate brachytherapy have similar survival rates in cervical cancer. he advantages of HDR brachytherapy are possibility of treatment in outpatient basis, no radiation exposure for staff, advanced ability of controlling, the immobilization of applicators, and better dose optimization. In this case report, the treatment planning of a patient with locally advanced cervical cancer from Istanbul University Oncology Institute, with three-dimensional planning and HDR intracavitary brachytherapy following chemoradio therapy, is discussed

Pancreas is an Unusual Initial Metastatic Site of Intracranial Hemangiopericytoma

Intracranial hemangiopericytoma (HPC) is rare and aggressive tumor with local recurrences as well as distant metastases. The majority of metastases are encountered in bone, lung, and liver. Pancreatic metastasis is extremely rare. Described in the present report is the case of a 41-year-old woman who had undergone surgical resection of intracranial HPC 16 years earlier. The tumor recurred 3 years after the operation and was successfully managed with surgery followed by adjuvant radiotherapy. Thirteen years later, an isolated pancreatic metastasis developed. Patient underwent Whipple procedure for pancreatic head lesion and received adjuvant radiotherapy. Patient died of extensive disease in lungs, bones, mediastinum, cranium and peritoneal carcinomatosis in abdomen 17 months after pancreatic surgery

Changing Trends in Radiotherapy for Glioblastoma Multiforme and Effects on Normal Tissue Doses

Introduction: The aim of the study is to reveal the changing trends in radiotherapy (RT) for glioblastoma multiforme (GBM) from past to present and to show the changes in organs at risk (OARs) doses

An Unusual Presentation of Merkel Cell Carcinoma

WOS: 000303618400024We describe a 71-year-old male patient admitted to the hospital with posterior chest pain. Following the detection of a paravetebral mass at the level of the 2(nd) thoracic vertebra, the patient underwent a surgical en bloc resection of the mass. The histopathologic examination revealed a Merkel cell carcinoma. One month after the operation, magnetic resonance imaging showed an inoperable mass in the same location, which indicated a rapid progression of the tumor. The patient died of progressive respiratory failure due to pneumonia on the 6(th) day after the onset of radiochemotherapy. Although this appears to be an isolated case, Merkel cell carcinoma must be included in the differential diagnosis of intrathoracic masses

Comparison of Pathological Prognostic Stage and Anatomic Stage Groups According to the Updated Version of the American Joint Committee on Cancer (AJCC) Breast Cancer Staging 8th Edition

Background: We compared pathological prognostic stage (PPS) with anatomic stage (AS) groups according to the updated version of breast cancer staging of the American Joint Committee on Cancer (AJCC) 8th Edition