ABSTRACT
Extracranial metastasis of glioblastoma multiforme (GBM) is very rare, in spite of very aggressive tumor behavior and being documented in only a few patients. In this article we present a 25-year-old man with secondary glioblastoma associated with extracranial progression and distant metastasis. He was diagnosed by magnetic resononce (MR) with an intracranial lesion in the right parietofrontal region, which was subsequently resected. Histology revealed a diffuse astrocytoma (grade II). The tumor recurred 1 year later and the patient received a second craniotomy. A diagnosis of GBM was made. After radiotherapy, he presented with right cervical lymph node metastases. The cytomorphological features supported a diagnosis of metastatic glioblastoma multiforme. The neck dissection was made and histology confirmed the fine needle aspiration diagnosis of glioblastoma multiforme. MR with diffusion-weighted imaging revealed right cervical lymph node metastases and multi-bone metastases (mainly pelvic bone) 3 weeks later.
Subject(s)
Brain Neoplasms/pathology , Glioblastoma/pathology , Neoplasms, Second Primary/secondary , Adult , Craniotomy/methods , ErbB Receptors/metabolism , Humans , Magnetic Resonance Imaging , Male , Neoplasms, Second Primary/diagnosis , Neoplasms, Second Primary/metabolism , Neoplasms, Second Primary/surgery , S100 Proteins/metabolism , Tomography, X-Ray Computed/methods , Tumor Suppressor Protein p53/metabolismABSTRACT
Objective To evaluate the efficacy of three-dimensional conformal radiotherapy (3DCRT) combined with concurrent chemotherapy for loco-regionally recurrent or mastastatie rectal cancer. Methods Between June 2004 and January 2007,47 patients with loco-regionally recurrent or nmatastatic rectal cancer were treated by 3DCRT of 55-65 Gy in 1.8-2.0 Gy fractions. Chemotherapy was given concurrenfly using oxaliplatin(100 mg/m2 ,iv drop,d1 ) and capecitabine(1500 mg/m2,orally,dl-14,21 days per cycle). Results After the follow-up of 12-35 months, the total response rate, complete response rate and partial response rate were 79% (37/47) ,19% (9/47) and 60% (28/47) ,respectively. The pain-alleviation rate and the mean pain-alleviation time were 85% and 6 months. The 1- and 2-year survival rates were 83% and 51%. Quality of life was improved without any treatment related death. Conclusions 3DCRT combined with concurrent chemotherapy is effective and well-tolerated in patients with post-operatively locoregionally recurrent or mastastatic rectal cancer.
ABSTRACT
Objectives To determine maximal tolerated dose(MTD)and dose-limiting toxicity (DLT) of oxaliplatin(L-OHP)when combined with constant dosing of 5-Fu、Lv and concurrent radiotherapy in postoperative patients with rectal cancer.Methods A total of 21 patients with stage Ⅱ or Ⅲ rectal adenocarcinoma after curative surgery were treated with radiotherapy to a total dose of 50 Gy in 5 weeks.L-OHP was administered at a dosge of 45 mg/m2(n=3),55 mg/m2(n=3),65 mg/m2(n=3),75 mg/m2(n=6),and 85 mg/m2(n=6)once a week for 2 weeks(first cycle)followed by a second cycle after a 14-day break.5-Fu and LV at a fixed dose of 5-Fu 300 mg/m2 ivdrip for 2 h,then 500 mg/m2 ivdrip within 22 h,d1,d2.LV 200 mg/m2 ivdrip 2 h d1,d2.DLT was defined as grade Ⅲ or Ⅳ hematologic and nonhenmologic toxicity. Results Grade Ⅰ-Ⅲ leukopenia,diarrhea,and nausea/vomiting were the most common toxic side effects.and most were of grade 1-2.DLT was first observed in 2 of 3 patients at 75 mg/m2(1 of grade Ⅲ diarrhea and 1 of grade Ⅲ leukopenia).L-OHP at dosage of 85 mg/m2 caused DLT in 4 of 6 patients(2 of grade Ⅲ leukopenia and 1 of grade Ⅲ diarrhea and 1 of grade Ⅲ diarrhea).Conclusions Diarrhea was the most common dose-limiting toxicity(DLT).Tlle maximal tolerated dose(MTD)of L-OHP in this setting was 75 mg/m2 which was comparable to the maximal tolerated dose of L-OHP seen in the neoadjuvant setting.
