Research progress on radiotherapy and radiation-associated adverse effects of high-risk neuroblastoma / 中华放射肿瘤学杂志

High-risk neuroblastoma (NB) is highly aggressive and has poor prognosis. Treatment of NB mainly includes comprehensive therapies, of which radiotherapy serves as a part of consolidation therapy. For patients who receive complete resection of the primary lesion, usually an irradiation dose of 21-23.4 Gy is given; for patients with incomplete resection, further study focused on radiation dose is necessary. Recurrence is most commonly observed in the bone lesions involved at presentation. Currently, the principle of irradiation to the metastatic sites is to treat lesions where metaio-dobenzylguanidine (MIBG) uptake remains positive after induction chemotherapy, or those become negative uptake but still at high risk of recurrence. On the premise of lacking of MIBG imaging, positron emission tomography CT (PET-CT) may assist in screening for metastatic sites requiring irradiation. The late side effects of radiotherapy are mainly mild musculoskeletal abnormalities. No significant increase is observed in the incidence of second primary tumor during short-term follow-up.

Metastases of Hepatocellular Carcinoma to Unusual Sites: A 10 Year Case Study.

Introduction: Hepatocellular carcinoma is the most common primary tumor of the liver, usually arising in a background of chronic hepatitis and cirrhosis. It is the fifth most common cancer worldwide comprising almost 6% of all newly diagnosed cancers. Aim: The aim of our study is to report unusual metastasis of HCC seen in our practice. Methods and Results: Data of 10 years were collected. A total of 30 cases diagnosed as metastatic hepatocellular carcinoma during the period 2004-2013 were retrieved and reviewed from files of the Section of Histopathology, Aga Khan University Hospital. Cases presenting with metastases to the lungs were excluded from the data. Age range of the patients was 31-84 years with mean age of 59.1 years. There were 28 males and 2 females. The most frequent unusual site of extrahepatic metastases was bone (n= 23), followed by soft tissue of the gluteal region (n=2), posterior triangle of neck (n=1), inguinal region (n=1), iliopsoas muscle (n=1), parotid region (n=1) and the eyeball region presenting as retrobulbar mass (n=1). Conclusion: Lung and bone metastases are frequently seen in patients with HCC. However, HCC sometimes metastasizes to unusual sites/organs. An early diagnosis of these metastases by appropriate diagnostic modalities is essential and can improve the quality of the patient’s life.