Intracranial meningioma: Experience with stereotactic radiotherapy.

PURPOSE: Definitive radiotherapy is a treatment option for patients with inoperable meningiomas. The purpose of this study was to evaluate the results of stereotactic radiotherapy as first-line treatment for intracranial meningiomas that were diagnosed radiologically. METHODS: Between January 2010 and June 2016, 56 patients with intracranial meningioma treated with Cyberknife- based Stereotactic Radiosurgery (SRS) or hypofractionated stereotactic radiotherapy (hFSRT) were included. The median prescribed radiation dose was 16 Gy (range 13-18) for SRS and 25 Gy (range 18-33) for hFSRT. hFSRT doses were delivered in 3 to 5 fractions. RESULTS: Median follow-up was 58 months (range 6-97). Overall survival (OS) for the whole group was 89.2%; for SRS group it was 100% and for hFSRT group 87.5% (p=0.29). Progression free survival (PFS) for the whole group was 89.3%; for SRS group it was 87.5% and for hFSRT 89.5% at 5 years (p=0.93). CONCLUSION: SRS and hFSRT were effective with excellent local control rates and they can be an alternative treatment option for patients with inoperable meningiomas.

Bilateral metaplastic squamous cell breast cancer.

ABSTRACT: Metaplastic breast cancer is a rare and heterogeneous breast cancer group that encompasses both malign epithelial and mesenchymal tissue components. Squamous cell breast cancer (SCC) is one of the types of metaplastic breast cancer, and diagnosis is established when more than 90% of the malignant cells are of squamous cell origin. Squamous cell metaplastic breast carcinoma is considered an aggressive tumor because of the risk of distant metastases, and there are limited data on treatment patterns. In this study, we report patient characteristics and treatment results of one patient with bilateral metaplastic squamous cell breast cancer.

Clinical features of metaplastic breast carcinoma: A single-center experience.

AIM: Metaplastic breast cancer (MBC) is a rare subtype with unusual clinical features. We aimed to analyze treatment results and define patients' characteristic features in our large MBC patient series. MATERIALS AND METHODS: Fifty-six patients with early MBC who received adjuvant radiotherapy (RT) in our center were included in the study. The age, sex, subtypes of MBC, histopathology, hormone and nodal status, tumor size, and types of treatment were retrospectively provided from hospital records. RESULTS: The median tumor size was 4 (1.3-16.5) cm, and triple-negative MBC cases were 38 (67.8%) of all patients. Axillary nodal involvements were present in 25 (44.6%) patients. The median follow-up time was 45.8 (4.9-130) months; the overall survival (OS) and disease-free survival (DFS) for 5 years were 67% and 64%, respectively. While distant metastases were seen in 15 (26.7%) patients, local recurrences were seen in only 4 patients. The median OS and DFS were higher in patients with ≤5.2 cm tumor than >5.2 cm ([130 vs. 49 months, P = 0.01] and [130 vs. 30 months, P = 0.009], respectively). Nodal involvement, hormone receptor status, surgical treatment, and type of RT had no effect on survival. In multivariate analysis, tumor size was not an independent prognostic factor for OS (P = 0.068; hazard ratio [HR]: 3.4, 95% confidence interval [CI] = 0.91-12.8), whereas age >65 years was found an independent poor prognostic factor for OS ([HR: 4.25, 95% CI: 0.23-0.78, P = 0.021] and DFS [HR: 3.1, 95% CI: 0.02-0. 87; P = 0.04], respectively). CONCLUSIONS: Distant metastasis is at the forefront rather than local recurrence in MBC patients. More studies are needed to determine the factors that affect survival independently in MBC.

Medulloblastoma/primitive neuroectodermal tumor in adults: prognostic factors and treatment results: a single-center experience from Turkey.

We performed retrospective review of 29 adult patients with cerebellar medulloblastoma/primitive neuroectodermal tumor (PNET) who received craniospinal radiotherapy in Ankara Oncology Hospital between years 2000 and 2005. All patients were operated followed by craniospinal irradiation; 11 of 29 patients also received chemotherapy. All patients had no distant or spinal metastases at the time of diagnosis. Median follow up time was 26 months. Progression-free survival was 86% at 2 years, 55% at 5 years. Mean progression-free survival was 25 months in patients with PNET; 61.4 months in patients with medulloblastoma (P = 0.0016). Mean survival was 61.33% months in patients <25 age, 38 months in patients >25 age. (P = 0.04). Overall mean survival was 59.80 months in patients who received chemotherapy and 41.4 months in patients who did not have chemotherapy (P = 0.15). Cranial relapses were observed in 3 of 29 patients, and 3 of 29 patients had distant metastases. The mean time to cranial recurrence was 19 months; to distant metastases was 18 months. In conclusion, adult patients with PNET have worse survival rates than patients with medulloblastoma, like in childhood patients. Patients younger than 25 years of age also had statistically significant better survival.

Whole Brain Radiotherapy Combined with Stereotactic Radiosurgery versus Stereotactic Radiosurgery Alone for Brain Metastases.

BACKGROUND: The aim of this study was to evaluate the effect of whole brain radiotherapy (WBRT) combined with streotactic radiosurgery versus stereotactic radiosurgery (SRS) alone for patients with brain metastases. MATERIALS AND METHODS: This was a retrospective study that evaluated the results of 46 patients treated for brain metastases at Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Radiation Oncology Department, between January 2012 and January 2015. Twenty-four patients were treated with WBRT+SRS while 22 patients were treated with only SRS. RESULTS: Time to local recurrence was 9.7 months in the WBRT+SRS arm and 8.3 months in SRS arm, the difference not being statistically significant (p= 0.7). Local recurrence rate was higher in the SRS alone arm but again without significance (p=0,06). CONCLUSIONS: In selected patient group with limited number (one to four) of brain metastases SRS alone can be considered as a treatment option and WBRT may be omitted in the initial treatment.

Treatment of recurrent cerebellar hemangioblastoma with external radiotherapy in a patient with von Hippel-Lindau disease: a case report and review of the literature.

Von Hippel-Lindau Disease, a multisystem familial cancer syndrome, is inherited as an autosomal-dominant trait. Common manifestations of the disease are retinal, cerebellar and medullary hemangioblastomas; renal cysts and carcinomas; pancreatic cysts; pheochromocytoma; and papilllary cystadenoma of the epididym. We report the case of a 40-year-old man with type I von Hippel-Lindau disease treated with external radiotherapy for recurrent cerebellar hemangioblastoma.

Brain metastasis of cardiac myxoma: case report and review of the literature.

Cardiac myxoma is the most common benign heart tumor. Cardiac myxoma can be a sporadic lesion (93% of cases) and usually occurs in women over 30 years. Complete surgical removal of the myxoma and its cardiac attachment is usually curative. The frequency of recurrences in cardiac myxomas varies between 3% for sporadic cases and 22% for cases of Carney complex. Recurrence has been related to incomplete excision, multifocality, and embolism of tumor fragments. We report a case with multiple brain metastases presumably due to tumor embolization from previously operated cardiac myxoma.