Background: The long-term outcome for early stage tongue cancer is generally good, however patients who suffered from local recurrence experienced a worse outcome than those who had not. The purpose of this study was to analyze long-term outcome for early stage tongue cancer patients treated by surgery alone for potential factors in predicting any subsequent relapse. Methods:The inclusion criteria for this retrospective study involved previously untreated, biopsy-proven squamous cell carcinoma (SCC) of the tongue, clinical stage T1-2N0M0 and patients who had received surgery alone. From February 2007 to January 2015, the chart records and images of 199 eligible patients were reviewed.Results: After a medial follow-up period of 89 months, we discovered 53 recurrences and 34 deaths. The 5-year overall survival (OS) and locoregional failure-free survival (LRFFS) rates were 83.9% and 72.4%, respectively. Univariate and multivariate analyses revealed that a poorly differentiated histology, depth of invasion (DOI) >5 mm, and perineural invasion (PNI) affected both OS and LRFFS. Patients with an absence of any risk factors (poorly differentiated histology, invasion depth over 5 mm, and PNI) experienced significantly better OS (5-year rates, 92.0% vs. 72.7%, P=0.0001) and LRFFS (5-year rates, 76.8% vs. 66.6 %, P=0.0382) than those with at least one of the risk factors.Conclusions: An overall relapse rate of 26.6% was observed for patients with early tongue cancer treated by surgery alone. Patients with risk factors (poorly differentiated histology, DOI >5 mm, and PNI) should be considered for postoperative adjuvant therapy in future trials.
Background: To investigate the treatment outcomes of patients with locally advanced vulva cancer in our hospital, and to analyze the outcomes of postoperative radiotherapy (PORT) and definitive radiotherapy (RT)/ concurrent chemoradiotherapy (CCRT). Methods: From March 2001 to July 2019, patients with stage III-IVA vulvar squamous cell carcinoma (SCC) treated with RT were retrospectively evaluated. The inclusion criteria were (I) pathologically proven SCC of the vulva; (II) International Federation of Gynecology and Obstetrics (FIGO) stage III-IVA, and IVB with only pelvic lymph node (LN) metastasis; (III) patients receiving PORT or definitive RT/CCRT. Eighteen patients were finally eligible for inclusion in the study. Patients received either surgery with PORT or definitive RT/CCRT. The endpoints were overall survival (OS), local regional relapse-free survival (LRRFS), and distant metastasis relapse-free survival (DMRFS).Results: The patients' ages ranged from 41 to 87 years and the median age was 67 years. The median follow-up for all patients was 16 months, with a range from six to 194 months. The two-year OS and DFS were 59.7% and 43.9%, respectively. Most patients suffered from grade 1-2 skin (83.3%) and genitourinary (61.1%) acute reactions. Grade 3 skin reactions were found in three patients (16.7%), and grade 3 hematological toxicity was found in another three patients (16.7%). Late toxicities in the PORT group included cellulitis in 2 patients. Late toxicities in the RT/CCRT group included cellulitis in one patient, skin necrosis and poor healing in 4 patients, and proctitis in one patient.Conclusions: For stage III-IVA vulvar SCC, both PORT and definitive RT are reasonable options according to the clinical status. Skin and genitourinary toxicities should be monitor carefully during the treatment.
Background: To evaluate the clinical feasibility of interstitial brachytherapy by intraoperative free-hand catheter implantation in the treatment of early breast cancer after breast-conserving surgery (BCS). Methods: Between January 2018 and December 2019, 44 patients with early breast cancer after BCS who met the inclusion criteria ≥45 years old, invasive carcinoma ≤3 cm or ductal carcinoma in situ <2.5 cm, estrogen receptor positive, lymph node negative, surgical margin negative, no distant metastasis, and an ECOG performance score ≤1 were enrolled in this phase II single-arm study. The postoperative irradiation field includes the tumor bed plus 2-cm margin in all directions, except in the anterior-posterior direction. The total prescribed tumor dose was 3400 cGy delivered in 10 fractions twice daily at 6-hour intervals. The primary endpoints were acute side effects, late treatment-related toxicity, and cosmetic outcome. The secondary endpoints were local recurrence-free survival (LRFS), regional recurrence-free survival (RRFS), distant metastasis-free survival (DMFS), and overall survival (OS). Results: The median follow-up time was 33.5 months (mean, 32.9 months; range, 20-43 months). The cosmetic results were good to very good in 92.3% of the questionnaire respondents. The acute toxicities were mild, and no acute grade 3-4 toxicity was noted. Wound infection was noted in two patients (4.5%). There was only one event of regional lymph node recurrence in one patient. The 3-year LRFS, DMFS, and OS were 100%, and RRFS was 94.7%. For two patients who had a positive lymph node based on their final pathology reports, postoperative irradiation, including whole breast and regional lymph nodes, was added. Conclusion: Accelerated partial breast irradiation using interstitial brachytherapy with the intraoperative free-hand catheter implantation technique provides an alternative method of postoperative radiotherapy for selected patients with early breast cancer after BCS with acceptable toxicities.
BACKGROUND Electronic medical records streamline medical processes, improve quality control, and facilitate data sharing among hospital departments. They also reduce maintenance costs and storage space needed for paper records, while saving time and providing structured data for future research. OBJECTIVE To integrate whether the radiation oncology information system and Hospital Information System (HIS) improve the electronic medical records and enhance the efficiency of the department of radiation oncology. METHODS Multidisciplinary discussions between physicians, physicists, medical radiation technologists, nurses, and engineers were held. We integrated paper records from the radiation oncology department into the existing HIS within the hospital. The new electronic interface was designed for physicians to fill in information related to radiotherapy, and detailed information about radiotherapy was also retrieved from the HIS. Finally, a new and improved electronic medical record system was launched in the HIS. RESULTS Since the system was launched in August 2020, more than 1,000 medical records have been entered into the system, and this figure continues to increase. The electronic medical record simplifies the radiotherapy preparation procedure, and the total time needed for the radiation preparation process has been reduced from 286.8 mins to 154.3 mins, a reduction of 46.2%. CONCLUSIONS The integration of the radiation oncology information system and HIS has significantly increased the efficiency of radiotherapy preparation, reduced the demand for manpower and storage space, and improved electronic medical records.
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