The clinical features of thoracic stomach cancer after surgical treatment for esophageal carcinoma

Objective:Postoperative recurrence of esophageal carcinoma was the main factor that affect the patients' survival and quality of life.This study mainly investigated the clinical features of thoracic stomach cancer (TSC) after surgical treatment for esophageal carcinoma.Methods:We retrospectively reviewed 51 cases of postoperative TSC in our hospital (Henan Province Tumor Hospital,Zhengzhou,China).Results:The 51 (10.97%) of all 465 cases that underwent endoscope after surgical treatment for esophageal carcinoma in our hospital were TSCs.There were 13 cases with complicating anastomotic recurrence.The locations of 46 cases (90.2%) were the same as the primary cancer.The 48 cases were squamous cell carcinomas and 3 cases were adenocarcinomas after esophagectomy for esophageal carcinoma.Endoscopic manifestations were puffiness-infiltrating type at 39.2% (20/51),massive type at 15.7% (8/51),ulcerative type at 7.8% (4/51) and ulcerative infiltrating type at 3.9% (2/51) and stenotic type etc.Conclusion:The incidence of TSC after surgical treatment for esophageal carcinoma is high.The main cause was that the local residual cancer invaded gastric wall.The gastroscopic features of TSC are different from those of gastric cancer.Regular review with endoscopy in postoperative esophageal carcinoma patients was a major way to diagnose TSC.

Clinical significance and characteristics of recurrent laryngeal nerve lymph node metastasis of thoracic esophageal cancer

Objective To investigate the clinical significance and characteristics of recurrent laryngeal nerve lymph node metastasis of thoracic esophageal cancer. Methods One hundred and twenty-four patients who had undergone thoracic esophageal resection with recurrent laryngealnerve lymph node dissection in our hospital from March 2007 to February 2010. All clinical data were retrospectively analysed. Results Recurrent laryngeal

Lung cancer management during the COVID-19 pandemic:experience of a medical oncology unit at a tertiary hospital in Singapore

Coronavirus disease 2019(COVID-19),caused by the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),was declared a pandemic by the World Health Organisation(WHO)on 11 March 2020.The pandemic has had profound effects on healthcare systems across the world,and also poses unique challenges for oncology services.Singapore saw its first imported case of COVID-19 on 23 January 2020,and there has since been 52,000 confirmed cases and 27 deaths as of early August 2020 locally.Oncologists have a special duty to our patients to ensure patient safety and provide optimum care without undue disruption which may compromise long-term cancer-specific outcomes.We herein examine the impact that the COVID-19 pandemic has had on our clinical services,and share our experience with regards to manpower reconfiguration,infection control measures,diagnostic evaluation of patients with suspected COVID-19,oncological management of lung cancer patients,as well as changes in the education and training of juniors,from our unique position as a Medical Oncology department in Tan Tock Seng Hospital,a tertiary hospital affiliated with the National Centre of Infectious Diseases in Singapore.

Dose Calculation Accuracy of Individualized Bulk Electron Density Assignment Approaches for Simulated MRI-only Planning of Thoracic Tumors

Objective This study aimed to investigate the dose calculation accuracy of individualized bulk electron density(IBED)assignment approaches for simulated magnetic resonance imaging(MRI)-only planning of thoracic tumors via the use of a 3 DVH system.Methods 8 patients with thoracic cancer were included in this study.Based on standard planning CT,single-arc dynamic conformal therapy(DCT)and double-arc volumetric modulated arc therapy(VMAT)plans with a6 MV photon beam were generated as a baseline plan(Plan-CT)for each patient.The simulated MRI-only planning(Plan-IBED)was implemented by copying the Plan-CT and forcing the electron density of each region of interest to its average value and recalculating the dose distribution.A 3 DVH system was used to visualize and compare the dosimetric differences between Plan-CT and Plan-IBED,and the criteria of the 3 D-Gamma pass rate were set to 1.0%/1.0 mm.Results The maximum percentage relative deviation(MPRD)of the dosimetric parameters D2,D95,D98,and Dmean of planning tumor volumes(PTVs)between Plan-CT and Plan-IBED was less than 1.3%.The MPRD of the average dose for organs at risk(OARs)was less than 1.5%.The MPRDs of the lung V5,V20,and V30 were 1.29%,3.26%,and 2.78%,respectively.Gamma analysis revealed an averaged pass rate of>95.0%for the body,as well as between 91.9%and 98.2%for OARs.Conclusion The proposed IBED assignment in simulated MRI-only treatment planning allows for dose calculation with comparable accuracy to the baseline plan and is appropriate for thoracic tumors.

Radiotherapy-induced heart disease:a review of the literature

Radiotherapy as one of the four pillars of cancer therapy plays a critical role in the multimodal treatment of thoracic cancers.Due to significant improvements in overall cancer survival,radiotherapy-induced heart disease(RIHD)has become an increasingly recognized adverse reaction which contributes to major radiationassociated toxicities including non-malignant death.This is especially relevant for patients suffering from diseases with excellent prognosis such as breast cancer or Hodgkin’s lymphoma,since RIHD may occur decades after radiotherapy.Preclinical studies have enriched our knowledge of many potential mechanisms by which thoracic radiotherapy induces heart injury.Epidemiological findings in humans reveal that irradiation might increase the risk of cardiac disease at even lower doses than previously assumed.Recent preclinical studies have identified non-invasive methods for evaluation of RIHD.Furthermore,potential options preventing or at least attenuating RIHD have been developed.Ongoing research may enrich our limited knowledge about biological mechanisms of RIHD,identify non-invasive early detection biomarkers and investigate potential treatment options that might attenuate or prevent these unwanted side effects.Here,we present a comprehensive review about the published literature regarding clinical manifestation and pathological alterations in RIHD.Biological mechanisms and treatment options are outlined,and challenges in RIHD treatment are summarized.