A Case Report of Adult Pineoblastoma Occurring in a Pregnant Woman.

2019

Background/aim Pineoblastoma of the adult age is an uncommon tumor with only 200 cases reported. A standardized approach for an optimal adjuvant strategy is currently lacking. The case presented herein also deals with the issue of central nervous system tumors in pregnancy. Case report A 21-year-old pregnant woman presented with massive hydrocephalus due to a mass in the pineal region detected with MRI. After positioning an urgent ventricular derivation, a cesarean section was performed. During a third ventriculocisternostomy, a biopsy revealed a pineoblastoma. After a maximal safe resection, postoperative craniospinal irradiation for a total dose of 36 Gy plus a sequential boost to the tum…

Hypofractionated postoperative helical tomotherapy in prostate cancer: a mono-institutional report of toxicity and clinical outcomes

2018

Francesco Cuccia,1,2 Gianluca Mortellaro,2 Vincenzo Serretta,3 Vito Valenti,1,2 Antonella Tripoli,1,2 Marina Gueci,1,2 Nicoletta Luca,1,2 Antonio Lo Casto,4 Giuseppe Ferrera2 1Radiation Oncology School, University of Palermo, Palermo, Italy; 2Radiation Oncology, ARNAS-Civico Hospital, Palermo, Italy; 3Section of Urology, Department of Surgical Oncological and Oral Science, University of Palermo, Palermo, Italy; 4Radiation Oncology School, Section of Radiological Sciences, DIBIMED, Università degli Studi di Palermo, Palermo, Italy Purpose: This is a mono-institutional study of acute and late toxicities and early biochemical control of a retrospective series of 75 prostate…

Salvage Re-irradiation Options in Adult Medulloblastoma: A Case Report and Review of the Literature

2020

Background/aim Medulloblastoma is a rare tumor of adult age, while it occurs more frequently in children. Given the rarity, there is a lack of evidence for the treatment of recurrent disease. Few data are available about salvage re-irradiation collecting very heterogeneous series. Case report A 51-year-old male presented with headache, nausea, double vision, and gait disorders. A contrast-enhanced brain-MRI showed the presence of multifocal medulloblastoma. After surgery, adjuvant craniospinal radiotherapy was performed, chemotherapy was stopped due to toxicity. After 27 months, a new MRI and a Methionine-PET revealed a late pontocerebellar relapse; multidisciplinary board decided for a SBR…

Acute and late toxicity and preliminary outcomes report of moderately hypofractionated helical tomotherapy for localized prostate cancer: a mono-inst…

2019

Aims: To assess toxicity and clinical outcomes of moderately hypofractionated helical tomotherapy (HT) for the curative treatment of localized prostate cancer (PC). Methods: From December 2012 to May 2018, 170 patients were treated with definitive intent for PC. Thirty-four percent were low risk, 30% intermediate risk (IR) and 36% high risk (HR). All patients received 70 Gy in 28 fractions to the prostate; 61.6 Gy were delivered to the seminal vesicles for IR; pelvic lymph nodes irradiation for a total dose of 50.4 Gy was added in the HR subgroup. Toxicity was assessed using CTCAE V4.0, and biochemical failure was defined following Phoenix criteria. Time-to-event data were analyzed using th…

Re-irradiation With Carbon Ion Radiotherapy for Pelvic Rectal Cancer Recurrences in Patients Previously Irradiated to the Pelvis

2020

Background/Aim: Re-irradiation of locally recurrent rectal cancer poses challenges due to the proximity of critical organs, such as the bowel. This study aimed at evaluating the safety and efficacy of re-irradiation with Carbon Ion Radiotherapy (CIRT) in rectal cancer patients with local recurrence. Patients and Methods: Between 2014 and 2018, 14 patients were treated at the National Center of Oncological Hadrontherapy (CNAO Foundation) with CIRT for locally recurrent rectal cancer. Results: All patients concluded the treatment. No G≥3 acute/late reaction nor pelvic infections were observed. The 1-year and 2-year local control rates were, 78% and 52%, respectively, and relapse occurred clos…

Migraine Headaches in a High School Student Population.

1991

Moderate hypofractionated helical tomotherapy for prostate cancer in a cohort of older patients: a mono-institutional report of toxicity and clinical…

2019

Purpose or objective: To evaluate toxicity and outcomes of moderately hypofractionated helical tomotherapy for the curative treatment of a cohort of patients aged ≥ 75 years with localized prostate cancer (PC). Materials and methods: From January 2013 to February 2017, 95 patients with median age 77 years (range 75–88) were treated for PC. 39% were low risk, 33% intermediate risk (IR), 28% high risk (HR). Median iPSA was 9.42 ng/ml (1.6–107). Androgen deprivation was prescribed according to NCCN recommendations. All patients received 70 Gy in 28 fractions to the prostate; 61.6 Gy were delivered to the seminal vesicles for IR; whole pelvis irradiation with a total dose of 50.4 Gy was added i…

Transitional cell carcinoma of endometrium: a case report of rare pure form

2018

Transitional cell carcinoma is a very rare histological subtype of endometrial cancer, with only 18 cases described in literature. Ovary represents the most common site where it accounts for 2% of all ovarian cancers. Due to the rarity of this disease, current management is controversial and includes various approaches, mostly described in the adjuvant setting, both radiotherapy and chemotherapy alone or in combination. Here, we report a case of a 65-year-old patient who underwent adjuvant vaginal brachytherapy for an endometrial transitional cell carcinoma. The patient was treated with radical total abdominal hysterectomy and bilateral salpingo-oophorectomy (TAH-BSO), without lymph-node sa…

Moderate hypofractionated helical tomotherapy for localized prostate cancer: preliminary report of an observational prospective study.

2019

Objective: To report preliminary findings of a phase II study exploring the clinical outcomes of moderate hypofractionated radiotherapy performed with helical tomotherapy (HT) using computed tomography–magnetic resonance imaging–based planning for localized prostate cancer. Methods: The phase II prospective study received ethics approval from our institutional ethics committee. A dose of 60 Gy/20 fractions for low–intermediate risk prostate cancer by means of HT was explored. Primary endpoints of the study were acute and late gastrointestinal (GI) and genitourinary (GU) toxicities. Secondary endpoints were quality of life and biochemical-free survival. Results: A total of 35 patients were i…

Helical Tomotherapy® is a safe and feasible technique for total scalp irradiation

2017

Angiosarcoma of the scalp is a rare aggressive tumor that affects elderly patients. Chemoradiation is the treatment of choice for multicentric and extensive disease. The shape of the scalp represents a dosimetric challenge in terms of achieving a homogeneous concave dose distribution with coverage of the entire target volume and an acceptable organs-at-risk sparing. We report a case of an 81-year-old man with a multifocal angiosarcoma of the scalp treated with Helical TomoTherapy® (Accuray Inc., Sunnyvale, CA, USA) intensity modulated radiotherapy. This technique allows precise and daily verifiable coverage of the target keeping the dose to the organs at risk within the constraints.

Prognostic value of two geriatric screening tools in a cohort of older patients with early stage Non-Small Cell Lung Cancer treated with hypofraction…

2020

Objectives: To investigatewhether assessmentwith two geriatric screening tools shows a correlationwith clinical outcomes of patients aged 65 years or more, with early-stage Non-Small Cell Lung Cancer (es-NSCLC) treated with hypofractionated stereotactic radiotherapy. Methods: FromMarch 2014 to June 2018we retrospectively evaluated 42 patientswith stage I and II lung tumors. Patients were assessed with Charlson Comorbidity Index (CCI) and G8 screening tool. Median age was 74 years (range, 65–91). Stereotactic radiotherapy was performed with Helical Tomotherapy delivering 50–70 Gray (Gy) in 8–10 fractions. Toxicity was evaluated using Common Terminology Criteria for Adverse Events v4.0 criter…

Hypo-fractionated stereotactic radiation therapy for lung malignancies by means of helical tomotherapy: report of feasibility by a single-center expe…

2018

Background: Several experiences in the literature report SBRT as an effective treatment option for medically inoperable early stage non-small cell lung cancer (NSCLC) and oligometastatic disease. The optimal fractionation schedules and total dose remain controversial. In this study, we evaluated the safety in terms of toxicity and efficacy of using of 8–10 fractions schedules with Helical Tomotherapy (HT) for primary and metastatic lung lesions. Methods: Between March 2014 and May 2016, a total of 39 patients (median age 72 years, range 26–91) were treated with HT-SBRT for malignant lung lesions: 22 patients with early stage NSCLC, 17 with oligometastases. Patients received 8–10 fract…