Effect of simultaneous integrated boost intensity-modulated radiation therapy in the treatment of multiple metastasis tumor of brain / 新乡医学院学报

Objective To investigate the clinical effect of simultaneous integrated boost intensity-modulated radiation therapy (SIB-IMRT)and whole brain radiation therapy (WBRT) plus sequential boost conformal radiation therapy (SBCRT) in the treatment of multiple metastasis tumor of brain.Methods A total of 98 patients with multiple metastasis tumor of brain in the Radiation Oncology Center of the First Affiliated Hospital of Xinxiang Medical University from August 2014 to July 2015 were divided into observation group (n =60) and control group (n =38) according to the treatment plan.The patients in the observation group were treated with SIB-IMRT,the whole brain planned target dose was 2 Gy every time,and the target dose of the metastatic target volume was 3 Gy every time for 20 times (5 times weekly).The patients in the control group received WBRT plus SBCRT,the WBRT dose was 3 Gy every time for 10 times(5 times weekly),then the metastatic tumor target area was treated with SBCRT,the prescribed dose was 3 Gy every time for 10 times.All patients were followed up from the end of treatment to December 2016.The effective rate,disease control rate and one-year survival rate were compared between the two groups.Results The patients in the two groups were successfully treated with radiotherapy.Ninety patients were followed up,eight patients were lost to follow-up,the follow-up rate was 91.8％ (90/98).The effective rate,disease control rate and oneyear survival rate in the observation group were significantly higher than those in the control group (x2 =5.371,4.352,6.002;P ＜ 0.05).The median progression free survival time in the observation group was significantly longer than that in the control group (x2 =6.537,P ＜ 0.05).There were no significant differences in the incidence of bone marrow suppression,digestive system reaction and nervous system damage between the two groups (x2 =1.821,2.032,3.782;P ＞ 0.05).Conclusion SIB-IMRT can improve the effective rate,disease control rate and one-year survival rate of patients with multiple metastasis tumor of brain.

Multi-disciplinary diagnosis and treatment of a malignant pheochromocytoma with multiple metastases / 中国肿瘤临床

Malignant pheochromocytomas are rare tumors that arise from chromaffin tissue, and the diagnostic criterion of malig-nancy is based on the development of metastases. In the case a patient suffers the tumor with liver, lung and bone metastases. However, the test results of tumor markers, gastroscopy, chest and abdominal CT, and PET-CT examination are hard to make a definite diagnosis. The patient was finally diagnosed with malignant pheochromocytoma with liver, lung and bone metastases following the needle biopsy of liver and underwent the excision of a right adrenal pheochromocytoma. Therapeutic standard for the malignant pheochromocytomas is not available so far. It is reported that chemotherapeutic CVD regimen (cyclophosphamide, vincristine, and daecarbazine) and suni-tinib may be effectual in the alike cases. The patient received two cycles of CVD and one cycle of sunitinib, nevertheless, slow progres-sion of the disease remained after the treatment. The results of multi-disciplinary treatment have suggested that 131I-MIBG may just be a choice for this patient.

Surgical Treatment for an Invasive Leiomyosarcoma of the Inferior Vena Cava

A 49-year-old woman presented with right lumbar pain and edema in both legs. Computed tomography showed a large low attenuated mass around and in the S7 segment of the liver involving the right kidney and multiple enlarged mesenteric lymph nodes. There were multiple variably sized discrete nodules in both lungs. Cavography showed subtotal occlusion of the inferior vena cava (IVC). She was successfully treated by wide resection and IVC reconstruction with partial cardiopulmonary bypass and metastasectomy.

Metástase tardia múltipla de carcinoma renal de células claras: relato de caso / Late multiple metastasis from clear renal cell carcinoma: case report

Metástases para o pâncreas são raras, podendo ocorrer a partir do carcinoma renal de células claras. Apresentamos um caso demetástase pancreática, envolvendo suprarrenal e hilo esplênico, em uma mulher de 49 anos, que teve carcinoma renal de células clarassete anos atrás. Em seguimento após nefrectomia, a paciente teve o diagnóstico de metástase em pâncreas, suprarrenal e hiloesplênico. Tratada com cirurgia e interferon. Imunohistoquímica para gp200 e CD-10, foi positiva. Tomografia computadorizada mostroumetástase para o estômago oito anos após a nefrectomia, estando a paciente em uso de interferon atualmente. Carcinoma de célulasrenais pode recidivar anos após a nefrectomia. Identificação e tratamento cirúrgico podem proporcionar suporte paliativo e sobrevidaem longo prazo.

Metastasis to the pancreas is uncommon; however, it may occur from clear renal cell carcinomas. We present a case of pancreaticmetastasis involving adrenal and splenic hilum in a 49 year-old woman that had clear renal cell carcinoma seven years ago. The patientin post nephrectomy follow-up presented a diagnosis of metastasis in the pancreas, adrenal and splenic hilus. The patients was treatedby surgery and interferon. Immunohistochemistry for gp200 and CD-10 was positive and computed tomography showed metastasis inthe stomach eight years after surgery. She is currently treated with interferon. Renal cell carcinoma can reappear years afternephrectomy, therefore, recognition and surgical treatment can provide palliation and long-term survival.

A case of low-grade endometrial stromal sarcoma with multiple metastasis / 대한산부인과학회지

Uterine sarcomas are rare tumors of mesodermal origin and constitute 2-6% of uterine malignancies. They are classified into leiomyosarcoma (LMS), malignant mixed mullerian tumors (MMMTs), and endometrial stromal sarcoma (ESS) by histologic types. Endometrial stromal sarcomas account for about 7-15% of uterine sarcomas, about 0.2% of female genital tract malignancies. Endometrial stromal sarcomas are divided into endometrial stromal nodule, low-grade endometrial stromal sarcoma, and high-grade endometrial stromal sarcoma on the basis of mitotic activity and vascular invasion. Clinical outcome of low-grade endometrial sarcoma is better than that of high-grade endometrial stromal sarcoma and has a propensity for slow metastasis. We have experienced a case of low-grade endometrial stromal sarcoma with multiple metastasis in a 41-year-old woman and was treated by surgical resection and combination chemotherapy, which is presented with a review of brief literature.