Ultrasound-assisted endocavitary HDR-Ir192 brachytherapy for unresectable locally advanced uterine cervix carcinoma: retrospective analysis focusing the efficacy and tolerability

PURPOSE: To evaluate the impact of uterine cavity's ultrasound to final selected length of intracavitary tandem. The efficacy and tolerability of external beam radiation plus HDR-Ir(192) brachytherapy in our cohort of patients were also estimated. MATERIALS AND METHODS: 48 women with locally advanced unresectable uterine cervix carcinoma were treated by HDR-Ir(192) endocavitary brachytherapy between January 2007 and January 2009. The median age was 63 (range 38-74). The distribution according to Federation of Gynaecology and Obstetrics (FIGO) staging system was as follows: Stage IIB, 54.16 %; IIIA, 10.4 %; IIIB, 27.0 %; and IVA, 8.3 %. HDR intracavitary brachytherapy was given weekly, beginning at the last week of whole pelvis irradiation, with a dose of 7 Gy to point A for three to four fractions. The median overall treatment time was 50 days (range 42-73 days). The median follow-up time was 2.7 years (range 3 months to 4.9 years). Multivariate analysis was performed using the Cox regression proportional hazards model. RESULTS: The complete remission rate after radiotherapy was 93.75 % (45/48). The 5-year actuarial major complication rates (Grade 3 or above) were 6.3 % overall (2.1 % proctitis, 2.1 % cystitis and 2.1 % enteritis). Estimation of the length of uterine cavity by ultrasound helped decisively in the proper placement of the intrauterine tandem inserted. CONCLUSIONS: Prior knowledge of the length of uterine cavity can facilitate the decisions regarding the proper insertion length of the tandem. Results of cervical cancer treatment with external beam radiation and HDR intracavitary brachytherapy in our hospital are encouraging (AU)

Ameloblastoma, a rare benign odontogenic tumour: an interesting tumour review targeting the role of radiation therapy

Ameloblastoma is known as a benign, slow-growing, rare, odontogenic neoplasm. The solid/multicystic, the unicystic with a fibrous connective-tissue capsule and the peripheral ameloblastoma represent the three well distinguished clinical types of ameloblastoma. Surgical resection with an attempt to achieve adequate free margins constitutes a well documented and accepted treatment modality. Controversies exist, however, with regard to the extent of operative intervention. Patients with inadequate or positive surgical margins or unresectable lesions can be treated with radiation or combined radiation and chemotherapy. The authors present a review of this sparse disease focusing on the special role and efficacy of radiation therapy in its management (AU)

Targeted therapy with bevacizumab (Avastin) for metastatic colorectal cancer

During the last decade, the development of new drugs known as targeted therapies was the result of a better understanding of the processes involved in the transformation of normal cells into cancer. The term targeted therapy refers to drugs that selectively target specific molecular pathways involved in tumorigenesis or tumour progression. Angiogenesis is important for tumour growth and metastasis, and is an important target for new biological agents. Bevacizumab is a humanised recombinant antibody that prevents vascular endothelial growth factor (VEGF) receptor binding, and inhibits angiogenesis and tumour growth. On February 26, 2004, the Food and Drug Administration approved bevacizumab as first-line treatment for patients with metastatic colorectal cancer (CRC). The integration of targeted therapies in the treatment of colon cancer has resulted in significant improvements in efficacy outcomes. The efficacy of bevacizumab in the treatment of metastatic CRC is presented in this review article (AU)

Embryonal rhabdomyosarcoma of the uterine cervix

INTRODUCTION: Embryonal rhabdomyosarcoma (RMS) of the uterine cervix is a rare and extremely malignant entity. Generally, embryonal RMS originating in the uterine cervix is usually diagnosed in adolescence. Before the introduction of effective adjuvant chemotherapy, the prognosis of these lesions was poor. We have treated a young woman suffering from this disease using a combination of surgery, chemotherapy and radiation therapy (RT) with excellent results. The medical community should keep in mind that embryonal RMS of the uterine cervix, despite its malignancy and rarity, can be cured if adequate treatment is given. CASE: A case of a young woman aged 20, presenting with vaginal bleeding, is reported. The histological examination revealed embryonal RMS of uterine cervix. The patient was treated with a combination of surgery, chemotherapy and RT. A review in the literature, which is also presented, shows that the combined treatment of embryonal RMS using surgery and multidrug chemotherapy has significantly improved survival. CONCLUSION: Patients with favourable prognostic parameters, such as localised disease without deep myometrial invasion, single polyp and embryonal histologic subtype, can effectively be treated by surgery. Patients with unfavourable prognostic parameters seem to benefit from a multimodality approach including surgery, adjuvant chemotherapy and RT (AU)