RESUMO
A 71-year-old male was diagnosed with a non-small cell lung cancer (NSCLC) within the radiotherapy field that was used for the treatment of a small cell lung cancer (SCLC) 11 years ago. At the initial diagnosis in 1996 the patient had limited-stage SCLC located in the right upper lobe of the lung with mediastinal involvement. He received 4 cycles of chemotherapy and then mediastinal radiotherapy. With a complete response after chemoradiotherapy he was given prophylactic cranial radiotherapy. After 11 years of disease-free period a new mass in left lower lobe of the lung was detected. Bronchoscopic biopsy showed second lung cancer with epidermoid histology. Although the incidence of a second lung cancer is higher in SCLC survivors, this is a unique case in the literature with second NSCLC developing in the previously irradiated side of limited-stage SCLC.
Assuntos
Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Carcinoma Pulmonar de Células não Pequenas/etiologia , Neoplasias Pulmonares/diagnóstico , Segunda Neoplasia Primária/etiologia , Carcinoma de Pequenas Células do Pulmão/diagnóstico , Idoso , Terapia Combinada , Irradiação Craniana , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/radioterapia , Masculino , Recidiva Local de Neoplasia/diagnóstico , Recidiva Local de Neoplasia/tratamento farmacológico , Segunda Neoplasia Primária/tratamento farmacológico , Carcinoma de Pequenas Células do Pulmão/tratamento farmacológico , Carcinoma de Pequenas Células do Pulmão/radioterapiaRESUMO
Epidural spinal metastasis of Ewing's sarcoma is rarely observed. We report on a rare case of purely epidural spinal metastasis of Ewing's sarcoma with pain and paraplegia, and describe the treatment and final outcome of the patient.
RESUMO
Metastasis of renal cell carcinoma (RCC) to the nose and paranasal sinuses is very rare. We present two cases of RCC metastatic to the nose who were treated with palliative radiotherapy. Although the prognosis was poor for both of the patients, the main symptoms (epistaxis and unilateral airway obstruction) were successfully palliated with irradiation.
RESUMO
The results of 75 patients with soft-tissue sarcomas treated by the combination of local surgical excision plus postoperative radiotherapy are reported. Thirty-five tumors were situated in the extremities, 32 in the trunk, and eight in the head and neck. Twenty-eight tumors were high grade, 33 intermediate and 14 low grade. Sixty-two patients had complete resections (wide or marginal) and 13 incomplete resections (intralesional). Radiation was administered with a shrinking-field technique (median total dose, 64 Gy; range, 50-78). Twenty-five patients developed local recurrence (33%). The 5-year local control rate was 67%. On univariate analysis, a tumor site other than extremity (p < 0.05), unfavorable histology (p < 0.01), and incomplete resection (p < 0.01) were poor risk factors for local recurrence. When multivariate analysis were performed, only incomplete resection (relative risk (RR) 7.2) remained a poor risk factor. The 5-year overall survival rate was 50.5% for the entire group. Following a univariate analysis of host tumor and treatment-related factors, a tumor site other than extremity (p < 0.05), high tumor grade (p < 0.01) unfavorable histology (p < 0.05), and incomplete tumor resection (p < 0.01) were found to significantly increase the risk of further tumor death. Multivariate analysis found high tumor grade (RR 5.6), and incomplete resection (RR 7) to be independent poor risk factors for survival.
