Small cell carcinoma of the ovary hypercalcemic type (SCCOHT): Comprehensive management of a newly diagnosed young adult.

SCCOHT is an aggressive malignancy linked to alterations of SMARCA4. We describe the diagnosis and therapy of a 32 year old who received multi-agent chemotherapy and underwent a second look operation with HIPEC followed by high-dose chemotherapy with stem cell transplant. Supportive care, oncofertility, and genetic counseling are described.

Radiation Therapy in the Treatment of Head and Neck Rhabdomyosarcoma.

The use of radiation therapy is an important part of multimodality treatment for rhabdomyosarcoma. The specific doses, treatment volumes, and techniques used in radiation therapy can vary dramatically based upon a number of factors including location, tumor size, and molecular characteristics, resulting in complex decisions in treatment planning. This article reviews the principles of evaluation and management for head and neck rhabdomyosarcoma including a summary of the historical studies upon which current management is based.

Improving the Pediatric Patient Experience During Radiation Therapy-A Children's Oncology Group Study.

PURPOSE: Treatment with radiation therapy (RT) can cause anxiety and distress for pediatric patients and their families. Radiation oncology teams have developed strategies to reduce the negative psychological impact. This survey study aimed to characterize these methods. METHODS AND MATERIALS: A 37-item questionnaire was sent to all radiation oncology members of the Children's Oncology Group to explore strategies to improve the pediatric patient experience. The Wilcoxon rank-sum test was used to assess factors associated with use of anesthesia for older children. RESULTS: Surveys were completed by 106 individuals from 84/210 institutions (40%). Respondents included 89 radiation oncologists and 17 supportive staff. Sixty-one percent of centers treated ≤50 children per year. Respondents described heterogenous interventions. The median age at which most children no longer required anesthesia was 6 years (range: ≤3 years to ≥8 years). Routine anesthesia use at an older age was associated with physicians' lack of awareness of these strategies (P = .04) and <10 years of pediatric radiation oncology experience (P = .04). Fifty-two percent of respondents reported anesthesia use added >45 minutes in the radiation oncology department daily. Twenty-six percent of respondents planned to implement new strategies, with 65% focusing on video-based distraction therapy and/or augmented reality/virtual reality. CONCLUSIONS: Many strategies are used to improve children's experience during RT. Lack of awareness of these interventions is a barrier to their implementation and is associated with increased anesthesia use. This study aims to disseminate these methods with the goal of raising awareness, facilitating implementation, and, ultimately, improving the experience of pediatric cancer patients and their caregivers.

Linac-based fractionated stereotactic radiosurgery for high-risk meningioma.

PURPOSE: Single-fraction stereotactic radiosurgery(SRS) for meningioma has high rates of symptomatic perilesional edema in some settings. Fractionated stereotactic radiosurgery(fSRS) could decrease edema rates while maintaining tumor control. METHODS AND MATERIALS: Patients at an institution were retrospectively reviewed(2013-2017). Adults receiving definitive, linear accelerator(linac)-based fSRS (25-30Gy/5 fractions) were included. fSRS was recommended for tumors at high risk for perilesional edema with SRS due to large size, prior irradiation, or proximity to organs at risk. Endpoints included rates of symptomatic, radiographically-defined perilesional edema and local control(LC). RESULTS: 12 Patients with 13 meningiomas met criteria. 24-month actuarial LC and overall survival were 87% and 100%. Symptomatic, post-treatment edema was identified on follow-up MRI in 31% of cases. No variables predicted edema, but affected lesions were larger(6.82 v. 2.46cc). CONCLUSION: Linac-based fSRS for meningioma has high local control and modest toxicity rates similar to SRS in the literature. Prospective studies comparing fSRS/SRS are warranted.

Relationship between prostate-specific antigen, age, and body mass index in a prostate cancer screening population.

BACKGROUND: Recent studies questioning the benefit of prostate-specific antigen (PSA) screening have increased the need for evaluating factors contributing to variance in levels and their clinical relevance. An inverse relationship between body mass index (BMI) and PSA has been illustrated, however the clinical implications have not been specified. We performed a retrospective review of patients screened through our free screening clinic to delineate any relationship between PSA and BMI in an attempt to understand its possible clinical significance. METHODS: The authors retrospectively reviewed data collected in relation to PSA values and patient characteristics from a community outreach program supplying information and screening for prostate cancer between June of 2003 and August of 2009. RESULTS: Mean BMI of our patient population was 28.7 m/kg(2) (SD 5.4) and our mean PSA value was 1.28 (SD 1.77). Our data indicate a small, but statistically significant decrease in PSA for an increasing BMI with a 0.026 decrease in PSA for every unit increase in BMI. CONCLUSIONS: Our study confirms the previously reported inverse relationship between PSA value and BMI. The significance of this finding and its impact on the value do not seem to indicate a rationale to change the accepted abnormal value in obese patients and should be used in the context of the clinical scenario and other PSA altering factors.