PurposeTo evaluate the feasibility of acute and chronic toxicity in patients suitable for accelerated partial breast irradiation (APBI) in a single 18 Gy fraction with multicatheter high-dose-rate (HDR) brachytherapy, as well as cosmetic and oncological outcomes.Material and methodsBetween September 2014 and March 2016, twenty consecutive patients with low-risk invasive and ductal carcinoma in situ were treated with interstitial multicatheter HDR brachytherapy in a single 18 Gy fraction.ResultsMedian age was 63.5 years (range, 51-79). Acute toxicity was observed in seven patients, while the pain during following days and hematoma were seen in four patients. With a median follow-up of 24 months, late toxicity was found in one patient with fat necrosis g2 and fibrosis g2 in another patient. The overall survival (OS) and locoregional control (LC) was 100%. Disease-free survival (DFS) and distant control was 95%. Good to excellent cosmetic outcomes were noted in 80% of patients and fair in 4 patients (20%).ConclusionsThis is the first report in the medical literature that focuses on feasibility and acute and chronic toxicity, with a median follow-up of 24 months (range, 20-40). The protocol is viable and convenient. However, a longer follow-up is needed to know chronic toxicity and oncologic outcomes.
lower limb lymphoedema. FIGO staging requires a histopathological dissection of the primary tumour and the inguinofemoral lymph nodes (IFLN). Metastasis to IFLN constitutes stage 3 cancer. Radiological methods of IFLN assessment often lack accuracy.In this study we report on the use of [ 18 F] FDG-PET/CT to determine its accuracy as a pre-operative assessment tool for the groin in vulval squamous carcinoma. This could be beneficial in preoperative assessment to facilitate sentinel lymph node assessment, thus sparing the patient the morbidity associated with full lymphadenectomy. Methodology This retrospective study analysed the data of 200 patients with vulval cancer, treated in St. James's Hospital Dublin between 2010 and 2022. The predictive value of PET/CT in preoperative assessment of the groin node metastasis was assessed. SUVmax of the nodal uptake of each inguinal area (if present) was calculated and correlated to histologically confirmed groin metastasis. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of PET/CT in predicating groin node metastasis were calculated. Results Out of the 200 patients 149 patients had unilateral or bilateral lymphadectomy and a preoperative PET scan resulting in 197 groins with full histopathological assessment of inguinal area and a PET/CT. 46 groins(23.3%) had histologically confirmed groin metastasis, of which 27 groins(58.7%) had positive PET/CT. The sensitivity of PET/CT for IFLN metastasis was 58.7% and specificity was 91.4%. The PPV was 67.5% and the NPV was 87.9%. The mean SUVmax was 6.5(range 1.6-30.0) for metastatic nodes (true positive) and 2.4(range 1.9-3.1) for negative nodes (false positive).
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