A case of mediastinal mesenchymal tumor with pericytic neoplasm feature that responded to radiation therapy.

Here, we report a case of mediastinal mesenchymal tumor with a pericytic neoplasm feature that responded to radiation therapy. A 43-year-old man visited our hospital with a complaint of esophageal obstruction and chest pain. Chest computed tomography revealed a middle mediastinal tumor and a mesenchymal tumor was diagnosed with a pericytic neoplasm feature by video-assisted thoracoscopic biopsy. The definitive treatment for soft tissue tumor is surgical resection; however, the mediastinal tumor was unresectable because of esophageal and tracheal invasion. Radiation therapy was administered and there was a partial tumor response and 2 years disease-free status. With a review of the literature, we discuss the clinical and pathological characteristics of this rare tumor and its treatment.

Successful Concurrent Chemoradiotherapy with Cisplatin plus Vinorelbine for Locally Advanced Thymic Carcinoma.

Little information is available about the usefulness of concurrent chemoradiotherapy for locally advanced thymic carcinoma due to a rare anterior mediastinal tumor. We experienced a case of locally advanced thymic carcinoma that responded well to concurrent thoracic radiotherapy combined with cisplatin plus vinorelbine chemotherapy. The patient showed remarkable tumor regression and has remained disease free for over 4 years following combined therapy. Concurrent chemoradiotherapy seems to be effective for locally advanced thymic carcinoma, and cisplatin plus vinorelbine could be an alternative chemotherapy regimen in combination with thoracic radiotherapy in patients with thymic carcinoma.

Treatment outcome of elderly patients with glioblastoma who received combination therapy.

OBJECTIVES: Large population-based registries in Western countries show that the treatment strategy for glioblastoma multiforme (GBM) in elderly patients is likely less intensive. The purpose of this study was to clarify the treatment outcome of elderly patients with GBM and to explore appropriate treatment strategies. METHODS: We analyzed records from 86 patients (median age, 59 y; range, 9 to 77 y) diagnosed and histologically confirmed to have GBM, between January 1991 and June 2006 at our institutions; 14 elderly patients (range, 71 to 77 y) and 72 younger patients (range, 9 to 70 y). Fifty-two patients underwent total or subtotal resection and 34 patients underwent partial resection or biopsy. The median radiation dose was 54 Gy and 79 patients (92%) received anticancer agents. RESULTS: Among the 51 patients in recursive partitioning analysis (RPA) classes 5 and 6, the median survival time of the 12 elderly and 39 younger patients were 10.5 months [95% confidence interval, 5.8-12.8] and 11.7 months (95% confidence interval, 9.3-13.0), respectively (P = 0.32). Multivariate analysis showed only RPA class as an independent prognostic factor for overall survival rate (P = 0.009), whereas age (P = 0.85), total radiation dose (P = 0.052), and treatment with anticancer agents (P = 0.32) were not. CONCLUSIONS: After adjustment for RPA class, the treatment outcome of patients aged >70 years was equal to that of younger patients. Definitive treatment should not be withheld based on age alone.

Risk factors for local-regional recurrence following preoperative radiation therapy and surgery for head and neck cancer (stage II-IVB).

PURPOSE: To discover possible risk factors for local-regional recurrence (LRR) following preoperative radiation therapy and curative surgery for head and neck squamous cell carcinoma (SCC) (stage II-IVB). MATERIALS AND METHODS: Clinical records from 1987 to 1999 of 161 patients with head and neck SCC (oral cavity, 80 patients; larynx, 50; hypopharynx, 19; oropharynx, 12) who underwent preoperative radiation therapy and surgery were retrospectively reviewed. One hundred thirty-two (82%) of the patients had stage III or IV cancer. The median radiation dose was 38 Gy. RESULTS: The 5-year overall survival rate and LRR rate were 58% and 35%, respectively. At multivariate analysis, oral cavity cancer (P =.020), clinical T stage (P =.016), clinical N stage (P =.017), and status of surgical margins (P =.008) emerged as variables that were significantly associated with LRR. The analysis of only those patients with lymph node involvement showed that oral cavity cancer (P =.008), advanced N-stage cancer (P =.045), and long interval between the start of preoperative radiation therapy and surgery (> or =7 weeks) (P =.019) emerged as variables that were significantly associated with LRR. CONCLUSION: Oral cavity cancer, advanced T or N stage of disease, and unsatisfactory margins were risk factors for LRR. A long interval (> or =7 weeks) was a risk factor for LRR in patients with lymph node involvement.

[Impact of treatment extending to 60 Gy on the outcome of radiotherapy for nasopharyngeal carcinoma].

PURPOSE: To clarify the impact of treatment duration on the outcome of nasopharyngeal carcinoma (NPC). MATERIALS AND METHODS: Forty-three patients with NPC were treated with definitive radiotherapy from January 1980 through May 1996. The male-to-female ratio was 32:11, and median age was 58 years (10-78 years). According to the fifth UICC classification, 4 patients were stage I, 12 were stage II, 6 were stage III, and 21 were stage IV. Twenty-nine patients received chemotherapy. Each patient was treated to various doses according to their disease extension. Thus, treatment duration was defined as the duration from the start of radiotherapy to the end of 60 Gy. The median follow-up period was 63 months (2-164 months). RESULTS: The 5-year overall and disease-free survival rates of all patients were 66% and 59%, respectively. The 5-year disease-free survival rates of the patients treated with the short treatment duration (< or = 8 weeks) and those treated with the long treatment duration (> 8 weeks) were 76% and 38%, respectively (p = 0.008). CONCLUSION: Long treatment duration may lead to poor treatment outcome in NPC.