RESUMEN
A 60 year old woman presented in gynecology department with bleeding per vagina and subsequently histotpathologically, it was diagnosed as malignant melanoma of the vagina. She underwent excision biopsy. On metastatic work-up, Positron emission tomography (PET) scan proved that she had distant metastasis and received palliative radiotherapy and chemotherapy, with temozolamide. She is alive after one year.
RESUMEN
Therapy of gastro-intestinal stromal tumour (GIST) has changed significantly with the use of imatinib mesylate. Disease progression remains a complicated clinical issue, suggesting the need for multimodality management. This is a prospective clinical study evaluating the neoadjuvant use of Imatinib mesylate in primary GIST. There is pre-operative use of imatinib in 10 patients with operable advanced and metastatic GIST. The follow-up continued postoperatively for maximum period of two years and postoperative imatinib was given for two years. Ten patients were accrued in the study. Following imatinib mesylate therapy, the median reduction of tumour volume was 45% (range 20-60%). Six of the ten patients underwent complete resection of the tumour following neoadjuvant imatinib for a median period of three months, and are disease-free for a median follow-up of eleven months (range 6-24 months). Three patients in whom the tumours were deemed to be operable after downsizing and who refused surgery are also continuing imatinib. Imatinib did not produce serious toxicity in any patient.
Asunto(s)
Benzamidas , Procedimientos Quirúrgicos del Sistema Digestivo/métodos , Tumores del Estroma Gastrointestinal , Terapia Neoadyuvante/métodos , Piperazinas , Pirimidinas , Adulto , Anciano , Anciano de 80 o más Años , Antineoplásicos/administración & dosificación , Antineoplásicos/efectos adversos , Benzamidas/administración & dosificación , Benzamidas/efectos adversos , Supervivencia sin Enfermedad , Femenino , Tumores del Estroma Gastrointestinal/patología , Tumores del Estroma Gastrointestinal/cirugía , Humanos , Mesilato de Imatinib , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia , Recurrencia Local de Neoplasia , Piperazinas/administración & dosificación , Piperazinas/efectos adversos , Cuidados Preoperatorios/métodos , Pirimidinas/administración & dosificación , Pirimidinas/efectos adversos , Resultado del TratamientoRESUMEN
AIMS: This study focused on pelvic recurrence rate and late complications following treatment with high dose rate brachytherapy with a three fractionation scheme. SETTING AND DESIGN: This retrospective observational study was conducted from 1st November 2003 to 31st March 2005 at a tertiary care centre. METHODS AND MATERIALS: Women were treated with external beam radiotherapy and three fractions of high dose rate brachytherapy, divided into two broad groups IIB+ IIIA and IIIB+IVA. Duration of follow-up was 2 years and main outcome measures were recurrence and rectal and urinary bladder complications. Results were assessed with the Chi square test and P-values using an alpha level of 0.05 for Type I error. RESULTS: Of the total of 286 women, 72 (25.4%) developed central-regional recurrence. Overall two year pelvic control rate was 74.6%, with values of 78.1% and 72.8% for stages IIB+ IIIA, IIIB+IVA, respectively. Five women developed distant metastasis and 21.5% suffered low grade rectal complications. After two years the prevalence of bladder complications was only 5.4%. CONCLUSION: Using a three fraction scheme, high dose rate brachytherapy is safe and effective in the management of cervix cancer.