Radiation-induced breast cancer in women with Hodgkin's disease.

AIM AND BACKGROUND: The aim of this study is to analyze the main clinical and pathologic characteristics of radiation-induced breast carcinomas (BC) following treatment for Hodgkin's disease (HD) and to identify the risk factors for their induction. To create a mathematical model for the prediction of expected age at which a BC might develop based on the age at treatment for HD. MATERIALS AND METHODS: Thirty-nine cases of women with BC that developed after treatment for HD in puberty or adolescence were analyzed retrospectively. The median age at initiation of treatment for HD was 12.9 years (9-21). The median age at diagnosis of the second malignancy - breast carcinoma was 32.4 years (22.9-39). RESULTS: THE DISTRIBUTION OF PATIENTS ACCORDING TO THE CLINICAL T STAGE OF BREAST CANCER WAS AS FOLLOWS: 11 patients with T1 stage BC (28%), 22 with T2 stage (56%) and 6 with stage T3 (16%). Prevalent were tumors localized in the lateral breast quadrants. The observed 5 year survival was 95%. CONCLUSION: The risk of solid tumors, especially breast cancer, is high among women with HD disease who were treated with radiotherapy in their childhood. In this article, we propose a specific mathematical age formula which could be used as predictive equation when the age of the treatment for HD is in the range between 9 and 21 years. Systematic screening for breast cancer in these patients would be significantly important for their health and could improve their survival.

Degree of tumor regression after preoperative chemo-radiotherapy in locally advanced rectal cancer-Preliminary results.

AIM: The aim of this investigation is to determine the degree of tumor regression by histopathological evaluation of surgical specimen after neoadjuvant chemo-radiotherapy for patients with stage IIIB rectal cancer. BACKGROUND: The standard therapy for rectal carcinoma is surgical, however, preoperative radiochemotherapy will play an increasing role especially in locally advanced disease. To estimate the prognosis and the effect of radiochemotherapy the postradiochemotherapeutical pathological features are important to assess. MATERIALS AND METHODS: Ten patients with cT3-4, cN1 stage rectal cancer received preoperative chemo-radiotherapy. A total tumor dose of 50 Gy was applied to all patients, with a daily fraction of 2 Gy, 5 times a week, with concomitant Capecitabine 1650 mg/m(2). A pathomorphologic assessment of the therapeutic response of the residual tumor volumes and estimation of tumor control were performed using Dworak's system of tumor regression grading (TRD) from no regression (0) to a complete tumor control (4). RESULTS: Dworak's TRD for the examined patients is as follows: in 20% of the patients no tumor regression was observed - Grade 0, in 30% - Grade 1, in 20% - Grade 2 and in 30% a complete tumor regression was achieved - Grade 4. Four of the patients (40%) presented with borderline resectable tumors before the neoadjuvant chemo-radiotherapy. Nine of the patients (90%) underwent radical surgery. In one case (10%) a radical surgery was not possible. One patient (10%) developed severe radiation enteritis in both the early and late postoperative period, with her tumor regression evaluated as Grade 4. CONCLUSION: Accurate evaluation of local tumor control using Dworak's tumor regression grading scale after preoperative chemo-radiotherapy gives the basis for a larger investigation and search for a correlation with the prognosis of the disease and individual choice of adjuvant treatment.

Analysis of a cohort of prostate patients treated with HDR mono-brachytherapy.

The aim of this study is to perform volumetric and basic radiobiological analyses using the database on prostate patients treated by HDR brachytherapy in our institution during the period 2011-2016. Real-time ultrasound based technique was used, with Oncentra Prostate planning software. The whole period was divided into two sub-periods, according to the 100% dose per fraction, which was 10.5 Gy during the first period (2011-2012), and 11 Gy during the second period (2013-2016), for each of the three fractions. The follow up time varied from 19 to 81 months, with a median of 45 months and a mean of 47 months. The uniformity of the treatment technique for both periods is investigated. Tumour Control Probability (TCP) values for the expected local control are calculated according to a population phenomenological TCP model for different values of the α/ß ratio. The calculations are based on the obtained averaged Dose Volume Histograms for the two investigated sub-periods. 74 patients were treated in total. Local control failure is observed in 5 cases, which corresponds to an observed TCP = 93.2%. The comparison of the calculated population average DVH with the DVHs of the cases with local control failure shows that in 4 of them, doses higher than average were delivered to the prostate. It is shown that the uniformity of the treatment was improved during the second sub-period. A possible explanation of the observed failures may be that these cases exhibit inherent tumour cell radio-resistance higher than average. Our radiobiological analysis indicates a α/ß ratio value somewhat higher than the one currently accepted. The value of the prostate α/ß ratio is estimated to be in the range of [3.5-6] Gy.