Introduction: Radiation therapy after breast surgery is an integral part of the treatment of early breast cancer. The goal of radiation therapy is to achieve the best possible coverage of the planning target volume (P...Introduction: Radiation therapy after breast surgery is an integral part of the treatment of early breast cancer. The goal of radiation therapy is to achieve the best possible coverage of the planning target volume (PTV), while reducing the dose to organs at risk (OARs) which are normal tissues whose sensitivity to irradiation could cause damage that can lead to modification of the treatment plan. In the last decade, radiation oncologist started to use the Intensity Modulated Radiotherapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT) for irradiating the breast, in order to achieve better dose distribution and target dose to the PTV and OAR. The aim of this study is to compare 2 external radiotherapy techniques (VMAT vs 3D) for patients with node-positive left breast cancer. Patients and Methods: We randomly selected 10 cases of postoperative radiotherapy for breast cancer in our hospital. The patients are all female, the average age was 45.4 years old, and the primary lesions are left breast. The ANOVA test was used to compare the mean difference between subgroups, and the p value Results: Dose volume histogram (DVH) was used to analyze each evaluation dose of clinical target volume (CTV) and organs at risk (OARs). Compared to 3DCRT plans, VMAT provided more uniform coverage to the breast and regional lymph nodes. The max point dose for tVMAT was lower on average (106.4% for VMAT versus 109% for 3DCRT). OAR sparing was improved with tVMAT, with a lower average V17Gy for the left lung (27.91% for VMAT versus 30.04% for 3DCRT, p and lower for V28Gy (13.75% for VMAT versus 22.34% for 3DCRT, p = 0.01). We also found a lower V35Gy for the heart on VMAT plan (p = 0.02). On the contrary, dose of contralateral breast was lower in 3DCRT than VMAT (0.59 Gy vs 3.65 Gy, p = 0.00). Conclusion: The both types of plans can meet the clinical dosimetry demands of postoperative radiotherapy for left breast cancer. The VMAT plan has a better conformity, but 3CDRT can provide a lower dose to the contralateral organs (breast and lung) to avoid the risk of secondary cancers.展开更多
<strong>Background and Purpose:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Paragangliomas are rare tumors of the he...<strong>Background and Purpose:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Paragangliomas are rare tumors of the head and </span><span style="font-family:Verdana;">neck. Their management remains problematic and</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">varies considerably de</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">pending on the center. This study reported 14 years of experience in the</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> management of head and neck paraganglioma (HNPGls)</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">.</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> We aimed to assess the therapeutic results of these tumors in terms of local control and overall survival. </span><b><span style="font-family:Verdana;">Materials and Methods</span></b><span style="font-family:Verdana;">: We included 16 patients followed for HNPGls and treated by radiotherapy from January 2006 to June 2018 in the National Institute of Oncology in Rabat. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> The median age was 44.5 years (15 - 67). 13 patients were female and three male with a sex ratio of 4.3. Cervical mass was the common sign (56</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">.</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">3%). All patients received radiation therapy. This radiation was exclusive in 43.7% of cases or adjuvant to partial surgical resection in 56.3%. The median dose of radiotherapy was 54 Gy (46 - 60) and it was delivered by a three-dimensional conformal radiotherapy technique in 15 patients and volumetric modulated arc therapy in one. There were few acute complications such as grade I and II mucositis and dermatitis. After a median follow-up of 5.6 years (2 - 13.4), local control, defined by radiological stability or regression, was obtained in 14 patients, two patients progressed and one died. Progression-free survival rates at 5 and 7 years were 93.8% and 78.1% respectively, and overall survival at 5 and 7 years was 92.3%. </span><b><span style="font-family:Verdana;">Conclu</span><span style="font-family:Verdana;">sions:</span></b><span style="font-family:Verdana;"> Surgery is the first-line treatment for HNPGls. When surgery is not</span><span style="font-family:Verdana;"> possible or incomplete, radiotherapy has its place in the therapeutic strategy of this rare disease for long-term local control.</span></span></span></span>展开更多
PURPOSE: Leiomyosarcoma of the breast is extremely rare. To date, the factors that are predictive of patient prognosis have not been identified. To clarify the nature of leiomyosarcoma of the breast, and also to estab...PURPOSE: Leiomyosarcoma of the breast is extremely rare. To date, the factors that are predictive of patient prognosis have not been identified. To clarify the nature of leiomyosarcoma of the breast, and also to establish the proper treatment strategy, we report this case We report this case while discussing The Clinical presentation, diagnosis, therapy and pathologic feature. INTRODUCION: Sarcomas comprise less than 1% of all primary breast neoplasms and only a minority of these are leiomyosarcomas. There were only 35 cases being reported in English literature. The mainstay of treatment is surgical excision with clear margins and longterm followup is essential. Its prognosis is better compared to other breast sarcoma. CASE PRESENTATION: We report a case of primary leiomyosarcoma of the breast occurring in young female patient which was successfully treated by surgery and radiotherapy. CONCLUSION: According to literature data, primary leiomyosarcoma is characterized by a better prognosis compared with other breast sarcomas, To date, the factors that are predictive of patient prognosis have not been identified. .The rarity and diagnostic difficulty imposed a multidisciplinary approach.展开更多
文摘Introduction: Radiation therapy after breast surgery is an integral part of the treatment of early breast cancer. The goal of radiation therapy is to achieve the best possible coverage of the planning target volume (PTV), while reducing the dose to organs at risk (OARs) which are normal tissues whose sensitivity to irradiation could cause damage that can lead to modification of the treatment plan. In the last decade, radiation oncologist started to use the Intensity Modulated Radiotherapy (IMRT) and Volumetric Modulated Arc Therapy (VMAT) for irradiating the breast, in order to achieve better dose distribution and target dose to the PTV and OAR. The aim of this study is to compare 2 external radiotherapy techniques (VMAT vs 3D) for patients with node-positive left breast cancer. Patients and Methods: We randomly selected 10 cases of postoperative radiotherapy for breast cancer in our hospital. The patients are all female, the average age was 45.4 years old, and the primary lesions are left breast. The ANOVA test was used to compare the mean difference between subgroups, and the p value Results: Dose volume histogram (DVH) was used to analyze each evaluation dose of clinical target volume (CTV) and organs at risk (OARs). Compared to 3DCRT plans, VMAT provided more uniform coverage to the breast and regional lymph nodes. The max point dose for tVMAT was lower on average (106.4% for VMAT versus 109% for 3DCRT). OAR sparing was improved with tVMAT, with a lower average V17Gy for the left lung (27.91% for VMAT versus 30.04% for 3DCRT, p and lower for V28Gy (13.75% for VMAT versus 22.34% for 3DCRT, p = 0.01). We also found a lower V35Gy for the heart on VMAT plan (p = 0.02). On the contrary, dose of contralateral breast was lower in 3DCRT than VMAT (0.59 Gy vs 3.65 Gy, p = 0.00). Conclusion: The both types of plans can meet the clinical dosimetry demands of postoperative radiotherapy for left breast cancer. The VMAT plan has a better conformity, but 3CDRT can provide a lower dose to the contralateral organs (breast and lung) to avoid the risk of secondary cancers.
文摘<strong>Background and Purpose:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Paragangliomas are rare tumors of the head and </span><span style="font-family:Verdana;">neck. Their management remains problematic and</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">varies considerably de</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">pending on the center. This study reported 14 years of experience in the</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> management of head and neck paraganglioma (HNPGls)</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">.</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> We aimed to assess the therapeutic results of these tumors in terms of local control and overall survival. </span><b><span style="font-family:Verdana;">Materials and Methods</span></b><span style="font-family:Verdana;">: We included 16 patients followed for HNPGls and treated by radiotherapy from January 2006 to June 2018 in the National Institute of Oncology in Rabat. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> The median age was 44.5 years (15 - 67). 13 patients were female and three male with a sex ratio of 4.3. Cervical mass was the common sign (56</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">.</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">3%). All patients received radiation therapy. This radiation was exclusive in 43.7% of cases or adjuvant to partial surgical resection in 56.3%. The median dose of radiotherapy was 54 Gy (46 - 60) and it was delivered by a three-dimensional conformal radiotherapy technique in 15 patients and volumetric modulated arc therapy in one. There were few acute complications such as grade I and II mucositis and dermatitis. After a median follow-up of 5.6 years (2 - 13.4), local control, defined by radiological stability or regression, was obtained in 14 patients, two patients progressed and one died. Progression-free survival rates at 5 and 7 years were 93.8% and 78.1% respectively, and overall survival at 5 and 7 years was 92.3%. </span><b><span style="font-family:Verdana;">Conclu</span><span style="font-family:Verdana;">sions:</span></b><span style="font-family:Verdana;"> Surgery is the first-line treatment for HNPGls. When surgery is not</span><span style="font-family:Verdana;"> possible or incomplete, radiotherapy has its place in the therapeutic strategy of this rare disease for long-term local control.</span></span></span></span>
文摘PURPOSE: Leiomyosarcoma of the breast is extremely rare. To date, the factors that are predictive of patient prognosis have not been identified. To clarify the nature of leiomyosarcoma of the breast, and also to establish the proper treatment strategy, we report this case We report this case while discussing The Clinical presentation, diagnosis, therapy and pathologic feature. INTRODUCION: Sarcomas comprise less than 1% of all primary breast neoplasms and only a minority of these are leiomyosarcomas. There were only 35 cases being reported in English literature. The mainstay of treatment is surgical excision with clear margins and longterm followup is essential. Its prognosis is better compared to other breast sarcoma. CASE PRESENTATION: We report a case of primary leiomyosarcoma of the breast occurring in young female patient which was successfully treated by surgery and radiotherapy. CONCLUSION: According to literature data, primary leiomyosarcoma is characterized by a better prognosis compared with other breast sarcomas, To date, the factors that are predictive of patient prognosis have not been identified. .The rarity and diagnostic difficulty imposed a multidisciplinary approach.