The authors report an unusual case of volar wrist swelling with the appearance of a simple ganglion on magnetic resonance imaging (MRI); however, operative and histologic examination identified the swelling as an ancient schwannoma. Ancient schwannomas mostly present as a solitary tumor. A lobulated tumor in this location has not been described previously. The pathologic findings of these uncommon tumors and the difficulties encountered in accurate preoperative diagnosis are discussed.
Objective: The aim of study was to assess the effect of Biobran in reducing of chemotherapy induced side effects in termsof tiredness, anorexia, vomiting and hair loss and quality of life in terms of weight loss. Setting: Radiotherapy Department, NishtarHospital Multan. Material and Methods: Fifty patients of breast cancer were enrolled randomly in two groups. Group-A patients weregiven 3 gram dose of Biobran MGN-3 per day one week before and one week after chemotherapy. Group-B patient were givenchemotherapy alone. Total six cycles of chemotherapy were given. No multivitamin or food supplements were given during this study.Chemotherapy induced side effects (tiredness, anorexia, and vomiting, hair loss) were assessed by questionnaire to the patients beforestart of each cycle. Weight was checked before each cycle to assess weight gain or loss. White blood cells were checked by completeblood count just before and one week after chemotherapy. Results: Between six months, 50 patients were enrolled in RadiotherapyDepartment, Nishtar Hospital Multan. There was a significant reduction in tiredness and anorexia in group-A patients. 20 (80%) patients ofgroup-A felt increase in their diet and no tiredness without any appetizer or multivitamin. But group-B patients demanded for appetizer dueto severe anorexia after chemotherapy except 3 (12%) patients who didn’t use any appetizer or food supplement. In group-A, 15 (60%)patients didn’t need any anti-emetic as compared to group-B all patient (100%) experienced severe nausea during and afterchemotherapy. Group-A patients experienced less hair fall 7 (28%) patients as compared to other group which is 25 (100%) patients.Conclusions: The study showed that, by helping to optimize the immune system, Biobran MGN-3 can not only help maximize treatmentsuccess, but also minimize treatment side effects and improve quality of life during treatment and in recovery.
10684 Background: Sequential use of docetaxel after four cycles of AC chemotherapy delays the postoperative radiation and can compromise loco-regional control. This delay can be avoided by starting radiotherapy concurrent with the docetaxel. We evaluated the feasibility of concurrent docetaxel and radiation therapy to chest wall and peripheral lymphatics after four cycles of AC chemotherapy. The preliminary results were reported in ASCO 2005 (Abstract 858). Methods: Females between 18–50 years, T2-T3 lesions, four or more positive nodes and hormone receptor negative tumors were eligible. Patients were enrolled after MRM. Four cycles of AC at 60/600 mg/m2 were followed by four cycles of docetaxel at 75mg/m2 every 21-days. Concurrent radiation to chest wall and peripheral lymphatics was started with the third cycle of docetaxel. A dose of 50 Gy in 5 weeks or equivalent was delivered. Successful completion of treatment in 18 out of 20 or 25 out of 30 patients was chosen as an index of feasibility. CTC version 2.0 of NCI and RTOG/EORTC Late Radiation Morbidity Scoring Scheme was used. Results: All the 30 enrolled patients successfully completed the planned treatment. Radiation was completed within 6 months of surgery in 27(90%) of the patients. Febrile neutropenia was seen in 5(16.7%). Grade-3 neutropenia and diarrhea in 8(26.7%) and 6(20%) respectively. Grade-3 dermatitis in the radiated area was seen in 2(6.7%) and grade-2 in 5(16.7%). Late toxicity included grade-2 skin atrophy and telangiectasia in radiated area in 6(20%) each. At a median follow up of 20 months (range 9–25 months) two local recurrences and two systemic relapses have been seen. Conclusion: This treatment schedule is feasible and safe in patients with high-risk operable breast cancer. It allows delivery of post mastectomy radiation within 6 months of surgery in patients undergoing sequential AC-docetaxel chemotherapy. No significant financial relationships to disclose.
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