ABSTRACT
BACKGROUND: Oncoplastic surgery techniques lead to a rearrangement of the breast tissue and impede target definition during adjuvant radiotherapy (RT). The aim of this study was to assess local control rates after immediate oncoplastic surgery and adjuvant RT. METHODS: This study comprises 965 patients who underwent breast-conserving therapy and adjuvant RT between 01/2000 and 12/2005. 288 patients received immediate oncoplastic surgery (ONC) and 677 patients breast-conserving surgery only (NONC). All patients were treated with adjuvant external tangential-beam RT (total dose: 50/50.4 Gy; fraction dose 1.8/2.0 Gy). An additional boost dose of 10-16 Gy to the primary tumor bed was given in 900 cases (93.3%). Local control rates (LCR), Progression free survival (PFS) and overall survival (OS) were assessed retrospectively after a median follow-up period of 67 (Q25-Q75: 51-84) months. RESULTS: No significant difference was found between ONC and NONC in regard to LCR (5-yr: ONC 96.8% vs. NONC 95.3%; p = 0.25). This held also true for PFS (5-yr: ONC 92.1% vs. NONC 89.3%; p = 0.09) and OS (5-yr: ONC 96.0% vs. NONC 94.8%; p = 0.53). On univariate analyses G2-3 (p = 0.04), a younger age (p = 0.01), T-stage (p < 0.01) lymph node involvement (p < 0.01) as well as triple negative tumors (p < 0.01) were identified as risk factors for local recurrence. In a propensity score stratified Cox-regression model no significant impact of oncoplastic surgery on local control rate was found (HR: 2.05, 95% CI [0.93; 4.51], p = 0.08). CONCLUSION: Immediate oncoplastic surgery seems not to affect the effectiveness of adjuvant whole breast RT on local control rates in breast cancer patients.
Subject(s)
Breast Neoplasms/epidemiology , Breast Neoplasms/diagnosis , Breast Neoplasms/mortality , Breast Neoplasms/therapy , Combined Modality Therapy , Female , Humans , Mastectomy, Segmental , Neoplasm Grading , Neoplasm Staging , Prognosis , Radiotherapy Dosage , Radiotherapy, Adjuvant , Surgery, Plastic , Treatment OutcomeABSTRACT
BACKGROUND: Leiomyosarcoma of the mesosigma is a very rare entity, with low 5-year survival rates. Treatment consists of resection of the primary tumor and, if applicable, of synchronous or metachronous metastases. Local treatment options for metastatic disease should be exploited as long as possible, as response to chemotherapy is reportedly disappointing. Stereotactic radiotherapy is a fairly new locally effective treatment option which has been well established in stereotactic radiotherapy of lung tumors. Whether repeated stereotactic radiotherapy sessions for treatment of lung metastases can be safely and successfully performed over a long time period is not yet well documented. CASE REPORT: We present the case of a 71-year-old female patient who had a primary diagnosis of lung metastases 12 years ago. Atypical resections of 4 lung metastases were performed in 2001 and 2002. Between 2004 and 2011, 7 sessions of stereotactic body irradiation of lung metastases were performed. All stereotactic treatment were tolerated well (no radiation pneumonitis, FEV1 was 1.3 L [67.8%] in 2004 and 0.99 L [56.3%] in 2011). CONCLUSIONS: The present case could demonstrate that a repetitive treatment of lung metastases with multiple stereotactic radiotherapy sessions can lead to long-term survival with a good quality of life.
Subject(s)
Leiomyosarcoma/secondary , Leiomyosarcoma/therapy , Lung Neoplasms/secondary , Lung Neoplasms/therapy , Radiosurgery , Sigmoid Neoplasms/pathology , Sigmoid Neoplasms/therapy , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Chemotherapy, Adjuvant , Colectomy , Disease-Free Survival , Doxorubicin/administration & dosage , Female , Humans , Ifosfamide/administration & dosage , Oxonic Acid/administration & dosage , Pyridines/administration & dosage , Tegafur/administration & dosage , Treatment OutcomeABSTRACT
BACKGROUND: Marginal zone lymphomas (MZL) are indolent B-cell lymphomas with variable symptoms related to lymphoma location. Patients with such lymphoma often have an excellent prognosis. Concerning treatment, no large prospective trials have been published, making therapeutic decisions difficult. CASE REPORT: The Authors present the case of a female patient with an MZL which was slowly progressive throughout 9 years after diagnosis. Only clearly progressive lymphoma manifestations were treated with moderate-dose radiotherapy (total doses between 30 and 40 Gy). All irradiated lesions showed a complete regression and relapses only occurred at non-irradiated sites. The performance status remains very good. CONCLUSION: Moderate-dose radiotherapy is a safe and effective treatment to achieve local tumor control in patients with MZL.
