Assessing information and service needs of young adults with cancer at a single institution: the importance of information on cancer diagnosis, fertility preservation, diet, and exercise.

BACKGROUND: Young adults (YA) with cancer have unique psychosocial and medical needs. The objective of this study was to identify information and service needs important to YA cancer patients. METHODS: A supportive care needs survey was administered to ambulatory patients (

Predictive Factor Analysis of Response-Adapted Radiation Therapy for Chemotherapy-Sensitive Pediatric Hodgkin Lymphoma: Analysis of the Children's Oncology Group AHOD 0031 Trial.

PURPOSE: To evaluate whether clinical risk factors could further distinguish children with intermediate-risk Hodgkin lymphoma (HL) with rapid early and complete anatomic response (RER/CR) who benefit significantly from involved-field RT (IFRT) from those who do not, and thereby aid refinement of treatment selection. METHODS AND MATERIALS: Children with intermediate-risk HL treated on the Children's Oncology Group AHOD 0031 trial who achieved RER/CR with 4 cycles of chemotherapy, and who were randomized to 21-Gy IFRT or no additional therapy (n=716) were the subject of this study. Recursive partitioning analysis was used to identify factors associated with clinically and statistically significant improvement in event-free survival (EFS) after randomization to IFRT. Bootstrap sampling was used to evaluate the robustness of the findings. RESULT: Although most RER/CR patients did not benefit significantly from IFRT, those with a combination of anemia and bulky limited-stage disease (n=190) had significantly better 4-year EFS with the addition of IFRT (89.3% vs 77.9% without IFRT; P=.019); this benefit was consistently reproduced in bootstrap analyses and after adjusting for other prognostic factors. CONCLUSION: Although most patients achieving RER/CR had favorable outcomes with 4 cycles of chemotherapy alone, those children with initial bulky stage I/II disease and anemia had significantly better EFS with the addition of IFRT as part of combined-modality therapy. Further work evaluating the interaction of clinical and biologic factors and imaging response is needed to further optimize and refine treatment selection.

Orthovoltage radiotherapy in the management of medial canthal basal cell carcinoma.

AIMS: To report the local control and complication rates of orthovoltage radiotherapy in the management of medial canthal basal cell carcinoma (BCC). METHODS: The medical records of all patients treated with medial canthal BCC between 1998 and 2010, with orthovoltage radiotherapy as primary treatment, adjuvant treatment after incomplete surgical excision, or for tumour recurrence following surgical excision, were retrospectively studied. The actuarial rates of tumour control and complications were calculated using Kaplan-Meier estimates. Main outcome measures were rates of tumour control and radiation complications. RESULTS: 90 patients were included with a median follow-up of 80 months. Tumour control rate at 10 years for the entire cohort was 94% (95% CI 84% to 98%). Tumour control rates showed no statistically significant differences among different treatment intents or treatment radiation energies. Radiation-related complication rates included loss of eyelashes in 59% (95% CI 48% to 66%), epiphora 51% (95% CI 39% to 62%), dry eye 14% (95% CI 3% to 35%) and conjunctival scarring 11% (95% CI 1% to 33%). No patient developed long-term corneal complications. CONCLUSIONS: Orthovoltage radiotherapy can be a reliable therapeutic alternative for selected medial canthal BCCs, which can be contained within the prescribed radiation field, with anticipated radiation-related toxicities.