The US, MR, and dynamic MR findings in four patients with sclerosing stromal tumor of the ovary are reported. US showed a tumor with multilocular cystic components and irregularly thickened septa and tumor walls or a solid tumor including several small cystic components. On T2-weighted MR images, signal intensities of the cystic components were high and those of the solid components were inhomogeneous, ranging from intermediate-high to high. Dynamic MRI demonstrated marked early enhancement of the solid components.

Thin-section oblique axial T2-weighted images are useful for the assessment of parametrial invasion by cervical carcinoma.

Abstract

A patient with the Marfan syndrome and echocardiographic and angiocardiographic evidence of hypertrophic cardiomyopathy is presented. Endomyocardial biopsy was performed. Histologic abnormalities of the endomyocardium noted in this patient were considered to be related to the basic generalized connective tissue abnormality, and the patient subsequently developed myocardial disease compatible with hypertrophic non-obstructive cardiomyopathy. We believe that this case emphasizes the possible coexistance of subclinical myocardial disease in patients with the Marfan syndrome.

The tumor size on T2-weighted images is considered to be a useful index for evaluating parametrial involvement by cervical carcinoma with full-thickness stromal invasion.

Background Cisplatin (CDDP) and vinorelbine as an adjuvant chemotherapy improve the overall survival of patients with completely resected non‐small cell lung cancer (NSCLC). However, the treatment completion rate is low due to severe adverse events (AEs). Pemetrexed (PEM) has been used in advanced NSCLC due to its high safety and efficacy. Additionally, the safety of a short hydration method for CDDP administration has been previously reported. Here, we investigated the feasibility of CDDP plus PEM with a short hydration method as adjuvant chemotherapy. Methods A total of 21 completely resected nonsquamous NSCLC patients with pathological stage IIA to IIIA disease were enrolled into the study. Adjuvant chemotherapy consisted of four cycles of CDDP (75 mg/m2) plus PEM (500 mg/m2) every three weeks with a short hydration method. The primary endpoint was the treatment completion rate, and the secondary endpoints included toxicity, the two‐year relapse‐free survival (RFS) rate, and the outpatient treatment rate. Results A total of 21 patients (median age: 66 years; 12 males) were enrolled in two centers. All cases were adenocarcinoma with PS0 (71.4%) or PS1 (28.6%). A total of 81.0% of the patients received four cycles of therapy as scheduled and the primary endpoint was met. The rate of outpatient chemotherapy completion after the second cycle was 90.5%. The grade 3 or higher toxicities were anorexia (n = 2) and pulmonary thromboembolism (n = 1). No grade 3/4 hematological toxicities or creatinine level elevations were observed. The two‐year RFS rate was 57.3%. Conclusions CDDP and PEM with a short hydration is well tolerated in the outpatient setting with limited toxicity. Key points Significant findings of the study CDDP plus PEM adjuvant therapy with a short hydration method is well tolerated in the outpatient setting with limited toxicity. What this study adds CDDP plus PEM with a short hydration method has the potential to be one of the options of adjuvant therapy in the future.

BACKGROUND:A previous phase 3 trial demonstrated noninferiority in terms of overall survival for combined S-1 (an oral fluoropyrimidine) and carboplatin compared with combined paclitaxel and carboplatin as first-line treatment for advanced non-small cell lung cancer (NSCLC). In the current study, the authors evaluated the efficacy and safety of combined S-1, carboplatin, and bevacizumab followed by maintenance with S-1 and bevacizumab in chemotherapy-naive patients with advanced nonsquamous NSCLC. METHODS: Patients received carboplatin (area under the concentration-time curve, 5 mg mL 21 per minute) and bevacizumab (15 mg/kg) on day 1 plus oral S-1 (80 mg/m 2 per day) on days 1 through 14 every 21 days for up to 6 cycles. For patients without disease progression, S-1 and bevacizumab were continued until disease progression or unacceptable toxicity developed. RESULTS: Forty-eight patients were enrolled in the phase 2 study; of these, 35 patients (72.9%) completed at least 4 cycles. Most toxicities of grade 3 were hematologic, and no increase in relative incidence associated with maintenance with S-1 and bevacizumab was observed. The objective response rate was 54.2% (95% confidence interval, 39.2%-68.6%), and the median progression-free survival was 6.8 months (95% confidence interval, 4.3-8.2 months). CONCLUSIONS: The regimen of combined S-1, carboplatin, and bevacizumab followed by maintenance with S-1 and bevacizumab was active and feasible as first-line treatment for advanced nonsquamous NSCLC. Cancer 2013;119:2275-81. INTRODUCTIONLung cancer is the leading cause of death related to cancer worldwide, with non-small cell lung cancer (NSCLC) accounting for 85% of lung cancer cases. 1 For individuals with advanced or metastatic NSCLC, platinum-based chemotherapy is the mainstay of first-line treatment 2,3 on the basis of the moderate improvement in survival and quality of life it affords compared with best supportive care alone. 4 A phase 3 study, the Eastern Cooperative Oncology Group (ECOG) E4599 trial, demonstrated that bevacizumab, a humanized monoclonal antibody specific for vascular endothelial growth factor, 5 given with paclitaxel and carboplatin resulted in significant improvements in the overall response rate (ORR), progression-free survival (PFS), and overall survival (OS) compared with paclitaxel and carboplatin alone in individuals with advanced nonsquamous NSCLC. 6 A Japanese phase 2 study also indicated that bevacizumab in combination with paclitaxel and carboplatin improved the ORR and PFS compared with paclitaxel and carboplatin alone. 7 In a confirmatory phase 3 study (the Avastin in Lung [AVAiL] trial), the addition of bevacizumab to cisplatin and gemcitabine resulted in a significant improvements in the ORR and PFS. 8,9 These observations provide a rationale for combining bevacizumab with platinum-doublet chemotherapy in individuals with advanced nonsquamous NSCLC.

Background: Hypoxia in the center of large tumor directly leads to radiation resistance. Concurrently, heat loss results in incomplete ablation oflarge tumors abutting airways or blood vessels. The combining stereotactic body radiation therapy (SBRT) and radiofrequency ablation (RFA) for non-small cell lung cancer (NSCLC) treatment could overcome respective shortcoming. Methods: In this study, we report our experience with combined SBRT and RFA in 27 medically inoperable patients with biopsy-proven T2aN0M0 NSCLC. Patients were treated with SBRT to a dose of 50 Gy followed by CTguided RFA within 7 days. Results: There were no treatment-related deaths. At a mean follow-up period of 29.6 months (range, 3 to 56 months), 15 patients (55.6%) died, with 1-year, 2-year, and 3-year cumulative survival rates of 77.8%, 63.0% and 48.1%, respectively. Threeof the deaths were cancer related. Four (14.8%) and five (18.5%) patients had local and distant recurrence, respectively. Conclusions: We concluded that SBRT followed by RFA appears effective for centrally located NSCLC. Survival rates appear to be better than with SBRT or RFA alone. Interactions between the two modalities warrants deeper investigation. Legal entity responsible for the study: N/A Funding: Has not received any funding Disclosure: All authors have declared no conflicts of interest.