ABSTRACT
Metastatic breast cancer (MBC) management is based on systemic treatment (ST), while the local therapy role remains controversial. We present the case of a 36-year-old woman with a diagnosis of hormone receptor-positive and human epidermal growth factor receptor type 2-positive breast cancer and isolated sternal metastasis, who received neoadjuvant ST with complete remission and later primary tumour surgery. Oligometastatic patients are a subgroup of MBC that can benefit from aggressive local therapies, even with curative intent.
ABSTRACT
No randomized controlled trials have been conducted in gallbladder cancer to establish standard treatments. We therefore conducted the first Latin American Consensus meeting for the management of gallbladder cancer. In this paper we report the conclusions of the experts' panel for (neo) adjuvant treatment of resectable gallbladder cancer. These are based on the review of the literature, the discussion of the participating experts and the vote of the assistants (surgical oncologists, medical oncologists, radiation oncologists and others). The reviewed topics were the role or adjuvant radiochemotherapy in T1 bN0M0, T2-3 N0-1M0 and T4 N0-1 M0 disease and doses, schedules and drugs for radiochemotherapy.
Subject(s)
Gallbladder Neoplasms/drug therapy , Gallbladder Neoplasms/radiotherapy , Adjuvants, Immunologic , Chemotherapy, Adjuvant , Consensus , Humans , Latin America , Radiotherapy, AdjuvantABSTRACT
BACKGROUND: Overall 5 years survival for surgically excised gastric cancer is 30%. Adjuvant treatment may improve the surgical results. AIM: To assess treatment results and toxicity in patients with surgically excised gastric cancer, treated with adjuvant radiotherapy and concomitant continuous 5-Fluorouracil (5-FU). MATERIAL AND METHODS: Forty one patients aged 32 to 73 years (29 males) with stage II-IVA gastric cancer, subjected to a total or subtotal gastrectomy and D2 nodal dissection between 1997 to 2006, were studied. They received adjuvant radiotherapy to the gastric bed and draining nodes in a total dose of 50.4 Gy in 28 fractions and chemotherapy with continuous infusion 5-FU, 200 mg/m(2)/day. Results were compared to historical controls matched according to demographic parameters and tumor characteristics. RESULTS: Eighteen patients were in stage II, 10 in stage IIIA, nine in stage IIIB and four in stage IVA. Twelve patients had an NO nodal status, 15 were NI, nine were N2 and five were N3. After a mean follow up of 32 months, 26 patients (63%) were alive. Five year overall survival was 49.6% for surgery plus radiochemotherapy compared to 30.7% for the historical group subjected only to surgery (p =0.002). Radiotherapy was associated with grade 1-2 toxicity and treatment was completed without interruptions in all patients. Chemotherapy was delayed temporarily in 3 patients. CONCLUSIONS: Adjuvant radio-chemotherapy improved overall survival in gastric cancer, compared to historical controls subjected only to surgical treatment.
Subject(s)
Adenocarcinoma/drug therapy , Adenocarcinoma/radiotherapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Stomach Neoplasms/drug therapy , Stomach Neoplasms/radiotherapy , Adenocarcinoma/surgery , Adult , Aged , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Chemotherapy, Adjuvant , Female , Fluorouracil/administration & dosage , Humans , Male , Middle Aged , Postoperative Care , Radiation Dosage , Radiotherapy, Adjuvant , Stomach Neoplasms/surgery , Survival RateABSTRACT
Background: Overall 5 years survival for surgically excised gastric cancer is 30 percent. Adjuvant treatment may improve the surgical results. Aim: To assess treatment results and toxicity in patients with surgically excised gastric cancer, treated with adjuvant radiotherapy and concomitant continuous 5-Fluorouracil (5-FU). Material and Methods: Forty one patients aged 32 to 73 years (29 males) with stage II-IVA gastric cancer, subjected to a total or subtotal gastrectomy and D2 nodal dissection between 1997 to 2006, were studied. They received adjuvant radiotherapy to the gastric bed and draining lymphatic nodes in a total dose of 50.4 Gy in 28 fractions and chemotherapy with continuous infusión 5-FU, 200 mg/m²/day. Results were compared to historical controls matched according to demographic parameters and tumor characteristics. Results: Eighteen patients were in stage II, 10 in stage IIIA, nine in stage IIIB and four in stage IVA. Twelve patients had an NO nodal status, 15 were NI, nine were N2 and five were N3. After a mean follow up of 32 months, 26 patients (63 percent) were alive. Five year overall survival was 49.6 percent for surgery plus radiochemotherapy compared to 30.7 percent for the historical group subjected only to surgery (p =0.002). Radiotherapy was associated with grade 1-2 toxicity and treatment was completed without interruptions in all patients. Chemotherapy was delayed temporarily in 3 patients. Conclusions: Adjuvant radio-chemotherapy improved overall survival in gastric cancer, compared to historical controls subjected only to surgical treatment.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Adenocarcinoma/drug therapy , Adenocarcinoma/radiotherapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Stomach Neoplasms/drug therapy , Stomach Neoplasms/radiotherapy , Adenocarcinoma/surgery , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Chemotherapy, Adjuvant , Fluorouracil/administration & dosage , Postoperative Care , Radiation Dosage , Radiotherapy, Adjuvant , Stomach Neoplasms/surgery , Survival RateABSTRACT
BACKGROUND: Breast cancer will develop in one out of ten women during their lifetime. Early diagnosis has increased in recent years. AIM: To describe a population of women with breast cancer stage T1N0M0. To analyze radiation therapy toxicity and to evaluate treatment results. MATERIAL AND METHODS: Retrospective review of the medical records of 125 women (aged 35 to 80 years) with breast cancer T1N0M0, that were treated between January 1997 and May 2004, with breast conserving surgery and postoperative radiation therapy at an oncology center. Patients lost from follow up were contacted by telephone. RESULTS: An abnormal screening mammography was the reason for consult in 62% of cases. The average tumor size was 11.6 mm. Tumors detected with screening mammogram were smaller than those detected on physical exam. The most common radiotherapy toxicity was erithema, which was severe in 2.5% of cases. No patient had to stop the radiation treatment due to toxicity. One patient developed arm edema. Tamoxifen was prescribed for 5 years to 80% of patients and 17 patients received chemotherapy. After an average follow up of 40 months, no patient has developed local breast relapse, three patients developed contralateral breast cancer and three developed distant metastasis. Two patients died from breast cancer. Disease free survival was 95%. CONCLUSIONS: Radiotherapy was well tolerated and had excellent local control. Screening mammography detects small tumors. Survival is excellent for early stage breast cancer.