[Placement of metal clips as a means for identifying the tumor bed in women post lumpectomy].

INTRODUCTION: Surgical clips inserted during breast-conserving surgery [BCS] serve as a surrogate of the lumpectomy cavity. Visualization of the surgical clips by imaging prior to radiotherapy (RT), during treatment planning, aids in designing the treatment volume for breast irradiation. OBJECTIVES: The aim of this study was to evaluate whether there is a distinct difference in the tendency to insert a metal clip during BCS, that is related to the hospital where the procedure was performed and to evaluate whether there are differences in the boost planning treatment volume (PTV). METHODS: This is a retrospective study. The records of all patients treated by adjuvant RT after BCS were reviewed. Boost PTV was calculated in cubic centimeters (ccj and compared between the groups. RESULTS: Of the 143 patients included in the study, 31% were operated on in private hospitals and 69% were operated on in public hospitals. A statistically significant difference was found in clip insertion in patients treated in private hospitals compared to public hospitals. No statistical differences were found in the boost PTV size between the groups (p = 0.448). A similar difference was found when comparing tertiary public centers to smaller secondary public centers. CONCLUSION: Our study demonstrates a higher tendency to insert metal clips during BCS in private hospitals as compared to public hospitals. There were no differences in the tumor bed PTV in patients with or without surgical clips.

Vulvar cancer in the north of Israel.

PURPOSE: This is a population study of patients who were treated for vulvar cancer in a tertiary center in northern Israel, aimed to report clinical findings, treatment, and outcome. METHODS: A retrospective chart review of all medical records of consecutive patients who were treated for vulvar cancer in the years 1993-2012 was conducted. Data extracted from the medical records included demographics, histology, size of lesion, stage of disease at diagnosis, type of treatment, radiation dose, follow-up, recurrence, and survival. RESULTS: The study included 44 patients with a median age of 69.8 years (range, 42-93 years). Thirty-five (79.5%) of the patients were of Jewish descent, five were Arabic, and four were of other descent. The most common histology type was squamous cell carcinoma in 35 (79.5%) patients. Most patients were staged FIGO II-III at time of diagnosis. Surgery was the most common primary treatment modality (54.2%). Twenty-three (52.2%) patients had recurrent disease. Older age and more advanced stage at diagnosis were associated with increased mortality. CONCLUSION: Vulvar cancer is common among elderly women with co-morbidities who present in advanced disease stage; all these factors are significant for survival.

The role of imaging in the management of non-metastatic cervical cancer.

The role of the physician is to choose the best treatment in terms of survival benefits with the lowest toxicity. Surgery is indicated for early disease, but insufficient pretreatment evaluation may result in an unnecessary procedure or the need for adjuvant therapy. Appropriate imaging may aid in these decisions. Involvement of imaging in radiotherapy allows more accurate and localized irradiation. Confirmation of correct patient positioning is an integral part of radiotherapy, and in the era of modern imaging, newer image-guided techniques are used to ensure adequate positioning of the target. It seems that the evolution of radiotherapy in the era of advanced imaging and the field of adaptive radiotherapy in uterine cervical cancer is a result of the availability of these novel modalities. This review discusses the role of imaging in the treatment planning of cervical cancer.

Current principles for radiotherapy in cervical cancer.

Cancer of the uterine cervix is most common in countries that do not have access to cervical cancer screening and prevention programs. Treatment of cervical cancer varies significantly between countries (adjusted to stage) and is dependent on medical resources. Radiotherapy for the treatment of gynecological malignancy has been used with different techniques for treating the local tumor and regional lymph nodes. This review discusses recommendations of radiotherapy for cervical cancer according to stage.

Anaplastic ganglioglioma in the spinal cord: case report and literature review.

Anaplastic ganglioglioma (AGG) is a rare tumor. A PubMed database search yielded only a few case reports and fewer case series. An even rarer entity is AGG arising in the spinal cord. We present a case of a pediatric patient with a pathological diagnosis of spinal AGG.