Small cell carcinoma with neuroendocrine differentiation of subglottic larynx- a case report.

Small cell cancer (SCC) is a neuroendocrine neoplasm, which is most frequently found in the lungs. Extrapulmonary location of SCC is rare and may involve 2.5-5% of SCCs. We present a case of a 31-year-old male patient with an extremely uncommon subglottic SCC. The patient was qualified for a radical sequential chemoradiotherapy. After treatment, patient's condition suggested complete remission. Recurrence was detected one year later, and the disease rapidly progressed, despite a second line chemotherapy. The patient died 29 months after initial diagnosis. This case aims to raise awareness on the aggressive laryngeal SCC and its good response to first line chemotherapy composed of cisplatin and etoposide, followed by radiotherapy.

[Accelerated postoperative radiotherapy in patients with advanced larynx cancer]. / Przyspieszona pooperacyjna radioterapia u chorych na zaawansowanego raka krtani.

AIM: The aim of study was test efficacy of accelerated postoperative radiotherapy--concomitant boost in patients with advanced larynx cancer. METHODS AND MATERIALS: The prospective study included 112 patients with advanced larynx cancer after radical surgical treatment. Patients had postoperative radiation therapy, conventional (C) or accelerated (CB). RESULTS: The 3-year overall survival in CB was 59%, in C--58% (p = 0.2), 3-year locoregional control in CB--83%, in C--75% (p = 0.01), the 3-year disease free survival was in CB--72%, C--66% (p = 0.1). CONCLUSION: Concomitant boost postoperative radiation therapy did not improve overall survival, loco-regional control, disease free survival. Patients with close surgical margins, longer interval between surgery and radiation, high level of hemoglobin, T4 had benefit from accelerated radiotherapy.

Outcome of a multimodal therapy of a recurrent adenocarcinoma arising from Caesarean section scar endometriosis-A case report.

BACKGROUND: Endometriosis occurring in surgical scars is a well-described entity. Malignant transformation of endometriosis is a rare event, with most cases belonging to adenocarcinoma. The initial surgical treatment is a method of choice. Due to lack of therapeutic recommendations, adjuvant therapy and recurrence management are a great challenge for oncologists. AIM: The aim of this paper was to present a long-term survival as the outcome of multimodal therapy in the patient with recurrent adenocarcinoma arising from Caesarean section scar endometriosis. CASE: We present the case of a woman with recurrent adenocarcinoma arising from Caesarean section scar endometriosis. The disease was first diagnosed in September 1997 at age 43. The patient underwent abdominal hysterectomy with tumour excision. Due to a local recurrence after 4 years, tumour excision with abdominal wall repair using a plastic mesh, regional lymphadenectomy, bilateral salpingo-ovariectomy and adjuvant radiotherapy for the pelvic region with local boost were performed; in addition hormontherapy with medroxyprogesterone was started. Because of a recurrent pelvic tumour, chemotherapy, further local palliative radiotherapy and brachytherapy were administered. Subsequently distant metastases in bilateral axillary lymph nodes were diagnosed and palliative radiotherapy was performed. The patient died of morbus neoplasmaticus generalisatus in September 2008. The follow-up period had been 132 months. CONCLUSION: This paper is, to our knowledge, the only report in literature that presents a long-term survival as the outcome of multimodal therapy in the patient with this rare diagnosis. Further reports of new cases can help establish optimal treatment guidelines.

[An analysis of factor influencing the outcome of patients with locally advanced larynx cancer]. / Analiza czynników rokowniczych u chorych z miejscowo zaawansowanym rakiem krtani.

PURPOSE: Results of treatment of locally advanced larynx cancer T3-4No-4 are unsatisfied. The aim of study is analysis of risk factors. METHODS AND MATERIALS: 112 patiens with larynx cancer after radical surgical treatment had postoperative radiotherapy (conventional or accelarated). RESULTS: The 3-year overall survival (OS) was 58%. Margin status and numer of risk factors had impast on OS. The 3-year locoregional control (LRC) was 80%. Number of risk factors, level of hemoglobin, overall tratment time and dose were significantly associated with LRC. Incidence of distant metastases was asssociated with G3 suamous cell carcinoma and index of nalignancy H. Glanz.

[Intranasal sinus operation in palliative therapy in maxillary cancer patient--preliminary report]. / Zastosowanie wewnatrznosowej operacji zatok w leczeniu paliatywnym raka zatoki szczekowej--doniesienie wstepne.

The authors present a case of 64 years old woman treated with palliative radiotherapy due to maxillary sinus cancer--non-operative stage. The cancer-relative pain couldn't be released after radiotherapy and with pain killers. She used NSAIDs and opioid drugs. Before chemiotherapy she was undertaken intranasal sinus operation as a palliative operation. Maxillary sinus was opened. The pain after operation diminished significantly. She died 2 and a half months later, during chemiotherapy, but free of pain.

Radiotherapy of skeletal metastases.

Radiotherapy plays an important role in treatment of bone metastases.
The mayor problem associated with bone metastases is pain, pathological fractures and a spinal cord compression. Radiotherapy is employed as a palliative treatment, mainly to relieve pain.
1.Radiotherapy with a single dose of 5-8 Gy/T is an efficient method of pain management especially in patients with bone metastases outside the vertebral column. This treatment can be provided as a day procedure.
2.Multi-fractionated irradiation - patients receive 20 Gy/T in 5 fractions or 30 Gy/T in 10 fractions. This is advocated for patients with metastases in the vertebral column or bones of the pelvis.
3.Half- body irradiation is designed for patients with multiple bone metastases. It's a single dose treatment. The upper half of body is irradiated with a dose of 6 Gy/T, the lower part with a dose of 8 Gy/T. Patients need a special preparation beforehand (steroids, hydratation) and hospitalization afterwards.