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Preoperative Radiation Therapy (preoperative + radiation_therapy)
Selected AbstractsPreoperative radiation therapy with selective dose escalation to the margin at risk for retroperitoneal sarcomaCANCER, Issue 2 2006Ching-Wei D. Tzeng MD Abstract BACKGROUND Retroperitoneal sarcomas (RPSs) are rare tumors with poor survival rates due to difficult resectability and high local and distant recurrence rates. Preoperative radiation therapy appears to have dosimetric advantages to utilize the tumor as a tissue expander to limit exposure of small bowel to higher radiation doses. METHODS Between June 1999 and December 2003, 16 consecutive patients with biopsy-proven RPS were treated with preoperative radiation with selective dose escalation. This included 45 grays (Gy) in 25 fractions to the entire tumor plus margin and a boost dose of 57.5 Gy to the volume predicted as high risk for positive surgical margins. Treatment toxicity and local control were evaluated prospectively as primary endpoints. The secondary goal was the theoretical calculation of future dose escalation and feasibility. Each patient underwent laparotomy. Tumor response was judged using computed tomography (CT) scan and by necrosis on final pathology. Theoretical treatment plans evaluated the potential for additional radiation dose escalation. RESULTS All patients completed the radiation protocol. The most common acute side effects were nausea/vomiting, which affected 4 patients (25%), with only 1 patient requiring inpatient intravenous hydration. There was no severe late postoperative morbidity or mortality. Twelve tumors (75%) decreased in maximum dimension, with a median decrease of 9.4%. Fourteen of 16 patients (88%) underwent complete macroscopic resection. With a median follow-up of 28 months (range, 7-52 months), there were only 2 local recurrences. The actuarial 2-year local control rate was 80%. Theoretical treatment plans suggest that significant dose escalation (up to 80 Gy) may be possible. CONCLUSIONS Preoperative radiation therapy with selective dose escalation to the margin at risk is tolerable and allows higher radiation dose to the volume judged to be at greatest risk for local tumor recurrence. Cancer 2006. © 2006 American Cancer Society. [source] Cyclin D1 overexpression associates with radiosensitivity in oral squamous cell carcinomaINTERNATIONAL JOURNAL OF CANCER, Issue 3 2001Ph.D., Satoru Shintani D.D.S. Abstract Overexpression of cyclin D1, a G1 cell cycle regulator, is often found in many different tumor types, including oral squamous cell carcinomas (SCC). Recent laboratory experiments have demonstrated that cyclin D1 levels can influence radiosensitivity in various cell lines. This study evaluated the relationship between cyclin D1 expression levels and radiosensitivity in nine oral SCC cell lines (HSC2, HSC3, HSC4, SCC15, SCC25, SCC66, SCC111, Ca9-22, and NAN2) and 41 clinical patients with oral SCC who underwent preoperative radiation therapy. Radiosensitivity of the nine oral SCC cell lines differed greatly in their response to radiation, assessed by a standard colony formation assay. Likewise, the expression of cyclin D1 varied, and the magnitude of the cyclin D1 expression correlated with increased tumor radiosensitivity. The similar significant association between the response to preoperative radiation therapy and cyclin D1 overexpression was observed in the oral SCC patients who were treated with preoperative radiation therapy. These results suggest that cyclin D1 expression levels correlate to radiosensitivity and could be used to predict the effectiveness of radiation therapy on oral SCC. © 2001 Wiley-Liss, Inc. [source] Reconstruction of the hypopharynx with the free jejunum transferJOURNAL OF SURGICAL ONCOLOGY, Issue 6 2006Joseph J. Disa MD Abstract Microsurgical techniques have revolutionized pharyngolaryngeal reconstruction. Free flap reconstruction with the free jejunal flap enables one stage reconstruction with minimal morbidity and mortality. This review will examine indications, operative technique, postoperative management, and expected outcomes for the hypopharyngeal reconstruction with the free jejunum flap. This procedure allows for maintenance of oral sections and rapid return of per-oral feeds and swallowing. The vast majority of patients resume swallowing and can maintain adequate nutrition without the need for supplemental enteral feeding via a tube. The free jejunal transfer can be rapidly harvested in most instances and transplanted to the hypopharyngeal region with a greater than 95% success rate. The jejunum fee flap is most useful for circumferential defects of the hypopharynx, but can also be used for partial defects. The most common local complications are stricture and fistula formation. A history of preoperative radiation therapy increases the risk of local complications. J. Surg. Oncol. 2006;94:466,470. © 2006 Wiley-Liss, Inc. [source] Metastatic Renal Cell Carcinoma to the Head and Neck,THE LARYNGOSCOPE, Issue 9 2002Keith M. Pritchyk MD Abstract Objectives The objectives of the study were to present four cases of renal cell carcinoma (RCC) metastatic to the head and neck, to recognize the appearance on radiographic studies, to understand the importance of preoperative embolization, and to review the results of treatment. Study Design Retrospective review of patients diagnosed with metastatic RCC to the head and neck. Methods The records of four patients diagnosed with metastatic RCC at a tertiary medical center over a 5-year period from 1996 to 2001 were reviewed and analyzed for demographic and outcomes data. Results Metastatic RCC to the head and neck was seen in the following locations: nasal cavity, lower lip, hard palate, tongue, and maxillary sinus. Presenting signs were loose upper molars, dysphagia, nasal obstruction, lower lip lesion, recurrent epistaxis, and foul nasal drainage. Histological studies confirmed metastasis of RCC in all four patients. Treatment consisted of preoperative radiation therapy, embolization, and local excision with adjunct chemotherapy. Conclusions Metastatic RCC to the head and neck is rare but can have serious consequences if not recognized before biopsy. We present several treatment options with local excision as the primary mode of treatment. [source] Temporal Approach for Resection of Juvenile Nasopharyngeal Angiofibromas,THE LARYNGOSCOPE, Issue 8 2000J. Dale Browne MD Abstract Objective To describe a lateral preauricular temporal approach for resection of juvenile nasopharyngeal angiofibroma (JNA). Study Design A retrospective review of five patients with JNA tumors that were resected by a lateral preauricular temporal approach. Methods The medical records of five patients who underwent resection of JNA tumors via a lateral preauricular temporal approach were reviewed, and the following data collected: tumor extent, blood loss, hospital stay, and surgical complications. Results Five patients with JNA tumors had resection by a lateral preauricular temporal approach. These tumors ranged from relatively limited disease to more e-tensive intracranial, e-tradural tumors. Using the staging system advocated by Andrews et al., 1 these tumors included stages II, IIIa, and IIIb. Four patients (stages II, IIIa, IIIa, and IIIb) who underwent primary surgical excision had minimal blood losses and were discharged on the first or third postoperative day with minimal transient complications (mild trismus, frontal branch paresis, serous effusion, and cheek hypesthesia). The remaining patient (stage IIIb) did well after surgery, despite having undergone preoperative radiation therapy and sustaining a significant intraoperative blood loss. There have been no permanent complications or tumor recurrences. Conclusions A lateral preauricular temporal approach to the nasopharynx and infratemporal fossa provides effective exposure for resection of extradural JNA tumors. The advantages of this approach include a straightforward route to the site of origin, the absence of facial and palatal incisions, and avoidance of a permanent ipsilateral conductive hearing loss. [source] Late gastrointestinal disorders after rectal cancer surgery with and without preoperative radiation therapy (Br J Surg 2008; 95: 206,213)BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 6 2008K. Talapatra No abstract is available for this article. [source] | ||||||||||