For instance, hair loss, which is one of the major concerns for some patients, such as a young lady with BM of breast cancer, is a less frequently encountered problem with SRS than WBRT as a result of the smaller irradiated field size and focalized dose distribution Figure 2.
All the aforementioned advantages of SRS are provided by utilization of multiple convergent narrow beams to deliver high dose focal irradiation in a single fraction by using multiple cobalt sources, linear accelerators or cyclotrons 37, Similar with neurosurgery, SRS alone or in combination with WBRT has been exhibited to associate with prolonged overall survival, local papillary thyroid cancer pet ct and also better neurologic status in these patients compared to WBRT alone 33, However, SRS differs from neurosurgery by offering a chance of ablative treatment to those patients who are not appropriate candidates for neurosurgery due to various reasons.
Albeit such an approach may be beneficial in a select group of patients, prerequisites for close monitorization with monthly or bimonthly magnetic resonance imaging MRI and risk for unavoidable repeat SRS procedures for newly emerging BM, both increasing the total cost of papillary thyroid cancer pet ct treatment, should be carefully considered Moreover, contrasted with SRS and WBRT combination, the risk for a plausibility of inferior survival outcomes with SRS alone in patients with controlled primary and no extracranial disease should be kept in mind, as it has been accentuated previously by various authors 41, Although local- and distant brain control rates were reported to be better with the addition of WBRT, this distinction did not translate into a notable survival advantage in any study.
Furthermore, in the study by Chang et al. It papillary thyroid cancer pet ct unfortunate to point out that the results of these RCTs ought to be interpreted with caution because of their insufficient design to explicitly concentrate on survival endpoints, such as significant imbalances between the study groups with regards to the prognostic factors and utilization of salvage WBRT in SRS alone cohorts 43, First meta-analysis was performed by Duan et al.
In the second meta-analysis, Hasan et al. Thirdly, the meta-analysis by Soon et al.
In the fourth and most recent meta-analysis, by Sahgal et al. Additionally omission of WBRT in this subgroup was not identified to relate with increased papillary thyroid cancer pet ct of distant brain relapses.
In a recent systematic review of 14 studies incorporating BM patients, Gans et al. Therefore, although the concept of TC-SRS is relatively new, with its acceptable toxicity rates the results appear to be encouraging for irradiation of a limited area with ablative doses of radiotherapy. In a study by Pinkham et al.
Verbal memory and fine motor functions were the commonest parameters to be impaired in this study Theoretically, restriction of the irradiated brain volume with local therapies like surgery and SRS may prove beneficial in preservation of neurocognitive functions without any scarification in tumor control rates.
Although results of some studies appear to support this idea 35others reported poorer neurocognitive outcomes with omission of WBRT. In one such study, with the end goal of preserving neurocognitive functions with maximum BM control rates, Aoyoma et al.
Because many of the traditionally argued WBRT toxicity data is derived from small-cell lung carcinoma patients treated with chemotherapy prior to prophylactic cranial irradiation, caution is advised when diagnosing WBRT toxicity.
Therefore, as the side effects evoked by cranial irradiation are largely similar, it is not astounding that the impacts were preferably ascribed to the radiation than to chemotherapy. This information papillary thyroid cancer pet ct of foremost significance for radiation oncologists considering the way that almost all toxicities following therapeutic WBRT are almost constantly cancerul de colon se trateaza to cranial irradiation by the other oncologic disciplines.
Deteriorations in neurocognitive functions may also be already present before the initiation of WBRT. This issue has been addressed in two key toxine quete by Meyers et al.
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In the second study by Komaki et al. The authors pointed out that roughly half of all eligible patients had neurocognitive shortages before the onset of cranial prophylaxis, and observed a somewhat noteworthy decay in executive function and language after one year, which turned inconsequential in later evaluations.
These two excellent studies strongly emphasize the paramount importance of implementation of neurocognitive function tests prior to WBRT in order to reflect the actual impact of therapeutic WBRT on neurocognitive domains.
Moreover, the negative neurocognitive impact of progressive BM may further be ameliorated or even improved by WBRT in some patients groups with resultant enhancement in executive functions and fine motor co-ordination as neurologic deterioration is reported to directly relate with disease progression in the brain 51, Management of this regretful complication of cancer involves neurosurgery, WBRT, SRS, chemotherapy, and targeted agents individually or as any combination of them, regarding the prognostic factors.
Papillary thyroid cancer pet ct Probl Surg J Clin Oncol Cancer Oncologist Cancer Metastasis Rev J Cell Biochem Berk L: An overview of radiotherapy trials for the treatment of brain metastases.
Oncology Williston Park ; discussion, Radiother Oncol Sperduto PW, Kased N, Roberge D, et al: Summary report on the graded prognostic assessment: an accurate and facile diagnosis-specific tool to estimate survival for patients with brain metastases. Abrahams JM, Torchia M, Putt M, et al: Risk factors affecting survival after brain metastases from non-small cell lung carcinoma: a follow-up study of 70 patients.
J Neurosurg Chin Clin Oncol BMC Cancer Strahlenther Onkol Rades D, Dziggel L, Haatanen T, et al: Scoring systems to estimate intracerebral control and survival rates of patients irradiated for brain metastases. Topkan E, Parlak C, Kotek A, et al: Impact of prophylactic cranial irradiation timing on brain relapse rates in patients with stage IIIB non-small-cell papillary thyroid cancer pet ct carcinoma treated with two different chemoradiotherapy regimens.
VINERI, 12 octombrie 2018
Coia LR: The role of radiation therapy in the treatment of brain metastases. Cancer Res Biomater Artif Cells Immobilization Biotechnol Mehta MP, Rodrigus P, Terhaard CH, et al: Survival and neurologic outcomes in a randomized trial of motexafin gadolinium and whole-brain radiation therapy in brain metastases.
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Scott Depistage cancer colorectal 95, Suh J, Stea B, et al: Improved survival, quality of life, papillary thyroid cancer pet ct qualityadjusted survival in breast cancer patients treated with efaproxiral Efaproxyn plus whole-brain radiation therapy for brain metastases. Am J Clin Oncol Quantin X, Khial F, Reme-Saumon M, et al: Concomitant brain radiotherapy and vinorelbine-ifosfamide-cisplatin chemotherapy in brain metastases of non-small cell lung cancer.
Lung Cancer Mornex F, Thomas L, Mohr P, et al: A prospective randomized multicentre phase III trial of fotemustine plus whole brain irradiation versus fotemustine alone in cerebral metastases of malignant melanoma.
Melanoma Res Ushio Y, Arita N, Hayakawa T, et al: Chemotherapy of brain metastases from lung carcinoma: a controlled randomized study. Neurosurgery Ann Oncol Antonadou D, Paraskevaidis M, Sarris G, et al: Phase II randomized trial of temozolomide and concurrent radiotherapy in patients with brain metastases. Lancet Fabi A, Felici Papillary thyroid cancer pet ct, Metro G, et al: Brain metastases from solid tumors: disease outcome according to type of treatment and therapeutic resources of the treating center.
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JAMA Kocher M, Soffietti R, Abacioglu U, et al: Adjuvant whole-brain radiotherapy versus observation after radiosurgery or papillary thyroid cancer pet ct resection of one to three cerebral metastases: results of the EORTC study.
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Knisely JP: Papillary thyroid cancer pet ct attention on brain metastases. Sahgal Papillary thyroid cancer pet ct, Aoyama H, Kocher M, et al: Phase 3 trials of stereotactic radiosurgery with or without whole-brain radiation therapy for 1 to 4 brain metastases: individual patient data meta-analysis. Duan L, Zeng R, Yang KH, et al: Whole brain radiotherapy combined with toxin binders radiotherapy versus stereotactic radiotherapy alone for brain metastases: a meta-analysis.
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Crit Rev Oncol Hematol J Natl Cancer Inst Wefel JS, Lenzi R, Theriault RL, et al: The cognitive sequelae of standard-dose adjuvant chemotherapy in women with breast carcinoma: results of a prospective, randomized, longitudinal trial.
Meyers CA, Smith JA, Bezjak A, et al: Neurocognitive function and progression in patients with brain metastases treated with whole-brain radiation and motexafin gadolinium: results of a randomized papillary thyroid cancer pet ct III trial. Komaki R, Meyers CA, Shin DM, et al: Evaluation of cognitive function in patients with limited small cell lung cancer prior to and shortly following prophylactic cranial irradiation. Regine WF, Huhn JL, Patchell RA, et al: Risk of symptomatic brain tumor recurrence and neurologic deficit after radiosurgery alone in patients with newly diagnosed brain metastases: results and implications.
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Ann Neurol Grigorescu3 1. This review focuses on the main diagnostic and treatment aspects concerning anal canal cancer. Anal cancer incidence has been increasing in the last years, probably due to the rise in the spread of sexually transmitted diseases, such as HPV and HIV infections.
Although many risk factors have been associated to anal cancer HPV, HIV infection, immunocompromised status, tobacco smokinganal cancer biology is only partly understood. Anal canal cancer should be distinguished from anal margin cancer, which is of better prognosis. Anal cancer diagnosis is usually delayed, due to its resemblance to benign perianal pathology that justifies the need for a better screening.
Anal canal carcinoma therapeutic management has witnessed a major shift in time from a radical surgical abdominoperineal resection to multimodal approach.
Adenom folicular de tiroide histologie animal
Nowadays, the standard treatment of anal carcinoma is represented by radiochemotherapy that is an effective therapy although can associate an important toxicity. Surgical treatment is reserved only to very small anal lesions and especially to residual disease papillary thyroid cancer pet ct tumor recurrences after primary therapy, representing a salvage therapy abdominoperineal rectal amputation for these cases. Inguinal lymphadenectomy is only indicated for voluminous lymphadenopathy blocks and inguinal lymph node metastases appeared after papillary thyroid cancer pet ct.
Cuvinte-cheie: cancer canal anal, papillary thyroid cancer pet ct de risc, diagnostic, tratament Background 1. Incidence Anal canal cancer is a relatively rare tumor, representing approximately 1. It is approximately 20 to 30 times rarer than colon cancer, but its annual incidence is increasing, reaching up to cases, with a female predominance 2.
There is an impor- 20 papillary thyroid cancer pet ct geographic variation regarding its incidence, as well as histopathological type.
The mainstay of the treatment is represented by chemo-radiotherapy, radical surgery being reserved to residual tumor or recurrences. Histopathology Depending on the lining epithelium, anal papillary thyroid cancer pet ct is divided into three regions: n colorectal zone: located proximally and containg columnar epithelium; n transitional zone: spread over a distance that varies between 0 and 12 mm papillary thyroid cancer pet ct contains a pseudostratified type of epithelium resembling the urothelial one.
A papillary thyroid cancer pet ct zone is unanimously accepted in uterine cancer. This region of metaplasia is extremely susceptible to HPV action 4 ; n squamous zone: contains a non-keratinized epithelium, without hair follicles.