Forty-seven patients with recurrent head and neck cancer in a previously irradiated field were treated with surgical resection and intraoperative radiation therapy (IORT). Recurrent disease occurred at a median of 18 months from primary treatment, and was at the primary tumor site in 31 and metastatic to regional lymph nodes in 16. Recurrences were squamous cell carcinomas in 42 and adenoid cystic in five. Surgical resection left microscopic residual disease in 41 and gross residual in six. All patients received IORT with a median of 20 Gy. Two-year actuarial survival is 54.9%, and 15 patients are alive and disease free with a median survival of 29 months. Two-year actuarial local control is 61.5%. A trend toward increased survival (P less than 0.09) and local recurrence control (P = 0.05) was noticed when treating microscopic residual disease as opposed to gross residual disease. Perioperative mortality was seen in 8.5% and there was no increase in morbidity secondary to IORT. The authors believe that surgical resection and IORT is an effective treatment modality for head and neck cancers recurrent in previously irradiated fields and is adaptable to tertiary care hospitals.
A 21-year-old, gravida 1, para O, woman presented at approximately 25 weeks gestation with a large Ewing's sarcoma involving her iliac wing. She was treated with multiagent chemotherapy before a successful Cesarean delivery of a normal infant at approximately 34 weeks gestation. Four years later both the mother and child are doing well. The literature regarding sarcoma occurring during pregnancy and that regarding multiagent chemotherapy in pregnant patients is reviewed. Chemotherapy should be instituted early in the course of many malignant sarcomas, despite pregnancy, to prevent the occurrence of metastases.
This article documents the first case of adenocarcinoma arising in a colonic interposition that was performed after resection of squamous cell esophageal cancer. In long-term survivors of esophageal cancer surgery, this unusual complication must be considered as a cause of recurrent dysphagia or other symptoms.
An imidazole type ionic liquid (IL), 1‐hexadecyl‐3‐methylimidazolium chloride (I16IL) was used as a template in the preparation of mesoporous silica with incorporated titanium dioxide. In this process, the IL is the structural template as well as the source of the Ti. The steps leading to the formation of the nanocrystalline metal oxide include: a) formation of metal‐containing IL (M‐IL); b) using the M‐IL as a template for the mesoporous silica; c) calcination of the sample to remove the organic moiety, while leaving the metal centers to form oxides on the porous framework. By varying the TiO2–SiO2 calcination temperature, the particle size and phase of TiO2 have been studied. These TiO2–SiO2 hybrid materials were characterized by using various physicochemical techniques, such as UV/Vis diffuse‐reflectance spectroscopy, Raman spectroscopy, X‐ray diffraction, N2 adsorption‐desorption isotherm measurement, Fourier transform infrared spectroscopy, and transmission electron microscopy. The resultant hybrid silica demonstrated effective photocatalytic activity for the oxidation of cyclohexene and styrene.
A 61‐year‐old man presented with nephrotic syndrome in March 1978. Renal biopsy revealed mesangial and endocapillary proliferation with no underlying cause found. One year later, evaluation of back pain resulted in the finding of undifferentiated adenocarcinoma with compression fracture of the T‐11 vertebra. Local irradiation relieved the pain and ameliorated the nephrotic syndrome. In 1981 the nephrotic syndrome recurred. Evaluation revealed metastases to the right pelvis and to the brain without an identifiable primary lesion. Irradiation of these lesions reduced protein excretion to 50 to 150 mg/day. A gastric carcinoma was later found. Exacerbation of nephrotic syndrome may herald exacerbation of tumor activity as occurs in Hodgkin's disease. Survival with tumor‐related nephrotic syndrome is not invariably poor, and treatment of metastases may be worthwhile in similar patients in whom only partial tumor reduction is possible.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.