ABSTRACT
We describe our experience, gained over the past 3 years, in the treatment of gastroesophageal junction adenocarcinoma, whose incidence has been increasing in recent years. In our series, we present the results to a follow-up of about 2 years for a total of 18 patients, treated with a particularly intensive combination treatment. It consists of neoadjuvant induction chemotherapy with the protocol docetaxel-cisplatin-5-fluorouracil for four cycles, before a concomitant chemoradiotherapy treatment. During combined phase, patients received an intensity-modulated radiotherapy and a weekly cisplatin. We will present the data to a long follow-up time and we will discuss the literature, the integration with thoracoabdominal surgery and other specific issues of this pathology.
Subject(s)
Adenocarcinoma/therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Esophageal Neoplasms/therapy , Esophagogastric Junction/pathology , Radiotherapy, Intensity-Modulated/methods , Stomach Neoplasms/therapy , Adenocarcinoma/diagnostic imaging , Adenocarcinoma/mortality , Adenocarcinoma/pathology , Aged , Aged, 80 and over , Chemoradiotherapy/methods , Disease-Free Survival , Esophageal Neoplasms/diagnostic imaging , Esophageal Neoplasms/mortality , Esophageal Neoplasms/pathology , Esophagogastric Junction/diagnostic imaging , Female , Follow-Up Studies , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Neoadjuvant Therapy/adverse effects , Neoadjuvant Therapy/methods , Neoplasm Staging , Radiation Dosage , Radiotherapy, Intensity-Modulated/adverse effects , Stomach Neoplasms/diagnostic imaging , Stomach Neoplasms/mortality , Stomach Neoplasms/pathology , Taxoids/therapeutic use , Tomography, X-Ray ComputedABSTRACT
The use of novel radiotherapy techniques is widely increasing, allowing clinicians to treat diseases that were previously difficult to treat with radiation therapy. Malignant pleural mesothelioma is a clear example of this clinical challenge. We describe our first experience with intensity-modulated radiotherapy technique which was used to treat a 73-year-old patient with multiple relapsing malignant pleural mesothelioma. Intensity-modulated radiation therapy has allowed to respect the QUANTEC (quantitative analyses of normal tissue effects in the clinic) dose constraints, patient has experienced a 14 months progression-free time, without relevant subacute or late lung toxicity.
Subject(s)
Lung Neoplasms/diagnosis , Lung Neoplasms/radiotherapy , Mesothelioma/diagnosis , Mesothelioma/radiotherapy , Pleural Neoplasms/diagnosis , Pleural Neoplasms/radiotherapy , Radiotherapy, Intensity-Modulated , Aged , Fluorodeoxyglucose F18 , Humans , Male , Mesothelioma, Malignant , Neoplasm Recurrence, Local , Positron Emission Tomography Computed Tomography , Radiotherapy Dosage , Radiotherapy Planning, Computer-Assisted , Radiotherapy, Intensity-Modulated/adverse effects , Radiotherapy, Intensity-Modulated/methods , Treatment Outcome , Tumor BurdenABSTRACT
The management of pediatric thoracic synovial sarcoma remains a matter of debate in clinical oncology, especially as regard to the local control of the disease. Surgery remains the gold standard, while the role and timing of radiotherapy is still controversial. We report a 14-year-old male, who has not received proper treatment at the time of diagnosis and initial management. Intensity-modulated irradiation was performed only at relapse, as a salvage treatment and, at 10-month follow-up, the young patient was free from relapse, without significant acute and subacute toxicity. We discuss the role and timing of radiotherapy in thoracic synovial sarcoma, a disease in which the need to increase local control should be placed in the foreground.
Subject(s)
Radiotherapy, Intensity-Modulated , Sarcoma, Synovial/radiotherapy , Thoracic Neoplasms/radiotherapy , Adolescent , Combined Modality Therapy , Humans , Male , Positron Emission Tomography Computed Tomography , Radiotherapy Dosage , Radiotherapy, Intensity-Modulated/adverse effects , Radiotherapy, Intensity-Modulated/methods , Sarcoma, Synovial/diagnosis , Thoracic Neoplasms/diagnosis , Time Factors , Treatment OutcomeABSTRACT
Follicular dendritic cell sarcoma is a rare and aggressive tumor and its management is a major clinical challenge. Surgery is considered the mainstay of treatment and no adjuvant approach has demonstrated the ability to reduce the rate of relapses. We report on a case of a man with a 26-year clinical history of mediastinal follicular dendritic cell sarcoma, with several relapses after multiple surgical interventions. The impact of chemotherapy was very small, unlike the radiation therapy that was performed twice, with an interval time of 8 years, through an intensity-modulated technique and an altered fractionation schedule.
