IntroductionStandard treatment for locally advanced cervical cancer (LACC) includes concomitant chemoradiotherapy (CRT) that typically controls localized disease. However, most patients develop distant metastasis, ultimately leading to death.ObjectiveTo determine the role of adjuvant carboplatin and paclitaxel for clinical outcomes in patients with LACC.MethodsBetween 2010 and 2017, 109 patients with LACC were retrospectively evaluated. All patients received cisplatin (40 mg/m2) with concurrent external-beam radiotherapy (up to 50.4 Gy), followed by intra-cavitary brachytherapy. Forty-six of 109 patients received a median of six cycles (range 3–6 cycles) of adjuvant chemotherapy consisting of paclitaxel (175 mg/m2) and carboplatin (CRT + chemotherapy group; area under the curve 5). The remaining 63 patients did not receive adjuvant chemotherapy (CRT group).ResultsDisease-free survival and overall survival after a median follow-up of 24.5 months (range 2.6–94.75 months) were 93.5% and 95.7% and 69.8% and 82.5 % for the CRT + chemotherapy and CRT groups, respectively (p = 0.001, p = 0.012, respectively). No acute grade 3/4 gastrointestinal or genitourinary toxicities were seen during CRT. During adjuvant chemotherapy, the most troublesome side effects were hematologic and neurologic toxicities; however, most were manageable. No chronic grade 3/4 genitourinary toxicities were seen.DiscussionAdjuvant chemotherapy in patients with LACC significantly improved both disease-free survival and overall survival without increasing unmanageable toxicity. Future larger prospective trials are warranted to verify these findings.
receiving salvage SBRT, met inclusion criteria (median follow up of 21 months). No significant differences (p¼0.77) were observed between maximum point doses to BP, SCV, and SCA. Within one year post-SBRT, two patients (3%) developed BPX (grade 2); both patients had exceeded 32 Gy to the BP and were treated with salvage SBRT. No patient treated with definitive SBRT (91%) developed BP, despite 17 of these exceeding recommended maximum doses. Conclusion: No BPX was observed for patients that exceeded a maximum dose of 32 Gy to the BP, unless they were treated as salvage SBRT. This suggests higher doses to the BP may be considered when clinically required for definitive SBRT. However, salvage SBRT may require more conservative BP constraints than used in the definitive setting.
Kaposi sarcoma (KS), a vascular tumor caused by infection with human herpesvirus 8 (HHV8), is a systemic disease that can present with cutaneous lesions with or without visceral involvement. Very few cases of KS, most of which were associated with AIDS, have been reported in the adrenal gland. Anaplastic transformation of KS is a rare clinical presentation known as an aggressive disease with local recurrence and metastatic potential. We report here a 47-year-old HIV negative male presented with extra-adrenal symptoms and had an incidentally detected anaplastic adrenal KS exhibited aggressive clinical course. To the best of our knowledge, this is the first case of anaplastic primary adrenal KS without mucocutaneous involvement but subsequently developed other side adrenal metastases in an HIV negative patient.
Günümüzde, FOLFOX (5-fluorourasil, leucoverin ve oxaliplatin) ileri evre veya metastatik gastrointestinal sistem tümörlerinde ilk sırada kullanılan kemoterapötik rejimdir. Bu rejimin hematolojik, gastrointestinal ve sensörinöral sistem ile ilgili yan etkileri bilinmesine karşın pulmoner toksisitesi sınırlı sayıda olgu bildirimleri düzeyindedir. Hızla ilerleyerek mortal seyredebileceğinden akciğer toksisitesinin erken farkındalığı ve tedavisi önemlidir. Bu yazıda, metastatik özofagus kanseri nedeniyle kullanılan FOLFOX tedavisine sekonder gelişen interstisyel akciğer hastalığı olgusu nadir olması nedeniyle sunulmuştur.
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