Giant cell tumor of the larynx (GCTL) is a rare entity; only 34 cases have been reported in the literature. We report a case of GCTL in a 46 year-old male presenting clinical, radiographic, histological and therapeutic features. Previously reported cases are also reviewed.
Objective-To assess the role of serial FLT-PET scans during early neoadjuvant treatment as a prognostic marker of response to treatment and survival.Methods-This study is a prospective cohort study which draws from a larger original study which examined the utility of FLT-PET imaging across multiple cancers. Our cohort consisted of patients who had biopsy-confirmed breast cancer amenable to surgical resection. These patients underwent serial FLT-PET scans: the first scan prior to starting neoadjuvant chemotherapy (NAC), and a second scan shortly after starting NAC. SUV mean was derived using an isocontour ROI drawn approximately half way between the SUV max and background on three planes for each scan. The change in mean standardized uptake value (SUV mean ) for the primary tumor between these two scans was then calculated, and patients were stratified into "responder" and "nonresponder" groups based on a cut-off of 20% arithmetic decrease in SUV mean between the two scans. The rates of pathologic complete response (pCR) on subsequent surgical excision, overall survival (OS), and progression-free survival (PFS) were then compared between the two groups to assess for significant difference between responders and non-responders.Results-16 patients (n = 16) met criteria for inclusion and successfully underwent FLT-PET scans in the prescribed sequence of events. Seven of these patients had a decrease of 20% or larger between the two serial PET scans, making them "responders". The remaining nine patients were "non-responders" to NAC based on PET imaging. Between responders and non-responders, there was no significant difference in median PFS (7.9 years versus 3.7 years; p = 0.425) and median OS (7.5 years versus 5.0 years; p = 0.944). In the 14 patients who underwent surgical resection (n = 14), there was no significant difference in the rate of achieving pCR (33% vs. 14%; p = 0.5846) between responders and non-responders.Conclusion-Further study of a larger sample size is needed to examine the potential role for FLT-PET in predicting response to neoadjuvant treatment, particularly in correlating with long-Benjamin E. Ueberroth,
Objective: To compare the outcome of patients undergoing autologous peripheral blood stem cell transplantation (PBSCT) conditioned with FluBuTBI or BEAM (BCNU, Etoposide, Cytarabine, and Melphalan) at our institution. Patients and Methods: We conducted a retrospective analysis of patients (n¼101) who underwent autologous PBSCT at our institution and were conditioned with BEAM (n¼63) or FluBuTBI (n¼38) between January 2006 and December 2012. Recipients were classified according to CIBMTR criteria and those conditioned with BEAM were low risk (n¼17) and intermediate risk (n¼46). Recipients conditioned with FluBuTBI were low risk (n¼9), intermediate risk (n¼25), and high risk (n¼4). Median age of patients in the BEAM group was 52.3 years compared to 59.6 years for FluBuTBI. At the time of transplantation, 38 of 63 patients who received BEAM were in complete remission (60%) compared to 19 of 38 patients (50%) for FluBuTBI. Median time of follow up was 57 months for BEAM and 24 months for FluBuTBI. FluBuTBI consisted of intravenous (IV) Fludarabine 50 mg/ m 2 /day infused over 1 hour on days-6 through-2, IV Busulfan 3.2 mg/kg/day on days-5 through-2 (infusion rate 80 mg/kg/hour) and TBI 200 cGy on days-2 and-1. BEAM regimen consisted of IV BCNU 300 mg/m 2 infused over 1 hr on day-5, Etoposide 200 mg/m 2 /day over 3 hours on days-5 through-2, Cytarabine 200 mg/m 2 /day over 1 hour every 12 hours on days-5 through-2, and Melphalan 140 mg/m 2 over 1 hr on day-1. Diagnoses were Hodgkin's lymphoma (n¼26), B-cell lymphoma NOS (n¼3), anaplastic large cell lymphoma (n¼2), Burkitt's lymphoma (n¼3), diffuse large B-cell lymphoma (n¼ 23), follicular lymphoma (n¼16), mantle cell lymphoma (n¼22), peripheral T-cell lymphoma (n¼5), transformed follicular lymphoma (n¼1). Results: Overall survival at 3 years for patients undergoing BEAM was 71% and for FluBuTBI 72%. Cumulative incidence of disease progression or relapse at 3 years for BEAM was 39% compared to 32% for the FluBuTBI group. Treatment related mortality was 3% (n¼2) in the BEAM group and 0% in the FluBuTBI group. Treatment related MDS/AML occurred in 6% (n¼4) in the BEAM group compared to 2% (n¼1) in the Flu-BuTBI group. Grade 3-4 mucositis was seen in 16% (n¼6) in the FluBuTBI group compared to 4% (n¼3) in the BEAM group. Conclusion: Comparison of the two groups showed identical overall survival at 3 years, but a trend to reduced relapse, treatment related mortality and secondary MDS/AML, in patients conditioned with FluBuTBI. This difference was present despite older and higher risk patients in the FluBuTBI group. Mucositis was more frequent in the FluBuTBI group. Conditioning with FluBuTBI is a safe and effective alternative to BEAM for autologous PBSCT that offers the potential for further optimization by study of Busulfan pharmacokinetics and the introduction of targeted radiation.
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