Early onset radiation induced sarcoma of scalp: a case report

Radiation induced sarcoma is a rare but recognized complication of radiotherapy and is associated with poor prognosis, frequently occurs 5 years after completion of treatment. We report radiation-induced sarcoma in a 42 years old male, involving the left parietooccipital scalp region following treatment of brain tumor with craniotomy and post-operative radiation with[60]Co machine. Diagnosis of radiation induced sarcoma was confirmed by history, latency period and biopsy. This Radiation induced malignancy was diagnosed only 2 years after completion of Radiotherapy for primary lesion

Evaluation of a simple belly-board device for reduction of small bowel inside rectal cancer radiotherapy fields

We evaluated the efficacy of a simple belly-board device [BED] designed and made in our department for reduction of small bowel inside the post-operative pelvic radiotherapy fields of rectal carcinomas. A very simple BBD was designed and manufactured in our department. It was made of acrylic glass, and was 128 cm long, 40 cm wide, and 9 cm high, with a 25x25 cm square opening, the lower border of which was set to be positioned about 3 cm above patients' iliac crest. Patients to be treated post-operatively for rectal cancers were simulated using oral contrast with and without the BBD for postero-anterior [PA] and lateral fields. The small bowel surface area [SBSA] inside the fields was measured and compared in the films with and without the BBD. Twenty-one patients, mean age 56 years, male-to-female ratio 2:1, 12 abdominoperineal [APR] and 9 low anterior resection [LAR], gave consent for this study. The mean SBSA were 7 and 13 cm[2] in the lateral fields and 29 and 60 cm[2] in the PA fields with and without the BBD, respectively [p = 0.001]. The mean reduction in SBSA was 61% in the lateral fields, 53% in the PA fields, and 57% in both lateral and PA fields [p<0.001]. The mean reduction in SBSA in lateral fields was 77% after LAR and 49% after APR [p=0.08]. This difference was not significant for PA fields. The only factor with a significant effect was operation type [LAR versus APR] for reduction of SBSA in lateral fields [p=0.05]. Gender, age, body mass index, and field sizes did not have a significant effect. The simple BBD could significantly reduce the SBSA inside the pelvic radiotherapy fields of rectal cancers. This reduction seems more pronounced after LAR in the lateral fields, compared to APR

Incidence of hypothyroidism after external radiation to thyroid region

In this study we evaluated the incidence of hypothyroidism in patients who received external beam radiation due to cancer, when radiation portals included thyroid gland. This prospective study was conducted from April 2004 to December 2005 among patients with head and neck or breast malignancies who referred to Radiation Oncology Department of Cancer Institute, Imam Khomeini hospital, treated with external beam radiotherapy. All patients received radiation to the thyroid gland. Thyroid function was tested at the beginning of treatment, 3 months and 6 months after the completion of radiotherapy. In all 34 patients were included in the study. The median age of patients was 53 years. Eighteen patients were female and 16 were male. All patients received external radiotherapy. They received radiation ranging from 5000 cGY [14 patients 41.2%] to 7400 cGY [1 patient 2.9%] with median of 6000 cGY. Physical examination of thyroid at the beginning of treatment was normal and all of the patients were euthyroid. The results from TSH test showed significant difference at baseline, after 3 and 6 months follow-up [P =0.001]. The findings indicated that none of the patients developed hypothyroidism in a period of six months after completion of radiotherapy. However, it seems that 6 months fallow-up is early for judgment about evaluation of patients for hypothyroidism state and it needs further follow up for minimum of 12 months

Treatment results and epidemiologic factors in oral tongue cancer: analysis of 110 patients in cancer institute of Tehran

Tongue cancer is one of the most common cancers of the oral cavity, excluding lip, and the median age of the patients is approximately 60 years. Treatment results of a total of 110 patients with oral tongue cancer admitted to cancer Institute of Tehran University between 1999-2003 were retrospectively analyzed. The patients were treated by surgery or radiotherapy or chemotherapy in a curative setting. The median age at the time of first visit was 67 years [range 27- 91years].51 patients [46.4%] were female and 59 [53.6%] were male. Primary treatment was surgery in 86 patients [78.2%], radiotherapy alone in 12 patients [10.9%], chemo radiation in 3 patients [2.7%] and chemotherapy [as neo adjuvant therapy] in 8 patients [7.3%]. Median dose of radiation in patients who received radiotherapy was 6000CGY in the range of [5000-7500 CGY]. Median of follow-up of patients was 10 months in range of [1-78] months. Local and loco-regional recurrence remains a major clinical problem in oral cavity tumors. Additional studies and detailed analysis of the selection criteria and treatment outcomes across trials are needed to define the best treatment modalities

aggressive triple negative breast cancer with early but favorable brain metastatic course

Breast cancer is the second most common cause pf brain metastasis. Although patient prognosis is poor, isolated brain metastasis occasionally can be an option for treatment with curative intent in breast cancer patients. We report a patient with invasive ductal carcinoma of the breast who developed an isolated right frontal lobe metastasis within 5 months of finishing her breast cancer treatment. Despite aggressive course of primary disease the metastasis was successfully controlled by surgical excision and adjuvant whole brain radiation therapy. The patient is now quiet well and disease free approximately six years after treatment of brain metastasis. A small subgroup of brain metastasis with breast primary can have a considerable survival with adequate local treatment

Unusual presentation of gestational trophoblastic neoplasm: report of two cases

Gestational Trophoblastic Neoplasm [GTN] is among rare human tumors which can be observed with widespread metastasis. Two young patients with emergent neurologic symptoms with no gynecological problems are presented in this report. GTN was later diagnosed in both cases with brain metastasis.The first case: A 22 years old patient, admitted to the infectious disease ward, with probable diagnosis of Encephalitis. After brain CT scan and measurement of beta human chorionic gonadotropin [betahCG], GTN with brain metastasis was confirmed. The second case: A 33 years old patient who underwent craniotomy due to hemorrhagic brain tumor in neurosurgery department. Brain metastatic GTN was confirmed by histological examinations. Both cases received multiagent chemotherapy concurrent with whole brain irradiation of 3000 cGy in 10 fractions [F] within a period of 2 weeks, and chemotherapy was continued for additional course. The patients were both well after about 22 months. Diagnosis of GTN should be considered in any woman of reproductive age

Brain astrocytomas: a study of epidemiological finding, treatment results and prognostic factors in Tehran cancer institute's radiotherapy patients

Astrocytomas, including glioblastoma muttiforme [GBM], are the most common brain tumors. Post-operative radiotherapy plays an important role in their treatment. Records of all patients with a pathologic diagnosis of astrocytoma referred for radiotherapy from 1987-1992 were reviewed and prognostic factors with regard to recurrences were analyzed. During the study period, 162 astrocytoma patients were treated by radiation in our department. Male to female ratio was 1.4:1. The disease was most prevalent in the 3rd and 4th decades of life. Most tumors were in cerebral hemispheres and grade IV. In nearly all patients only CT scan had been used for diagnosis, and total resection had been performed. Radiation dose was mostly 5,000-5,500 cGy by standard fractionation. Follow-up was available for 91 patients, and in these patients CCNU [lomustine] chemotherapy was prescribed for high-grade tumors. Three-year local control was 77%. Grade, extent of surgery, and use of CCNU were statistically significant as prognostic factors. Also 4 GBM long-term survivors were found. Treatment of brain astrocytomas by radiation in our department was concluded to be reasonably successful