Radiotherapy of unicentric mediastinal Castleman's disease

Li, Yuemin; Liu, Penghui; Zhang, Yuhai; Xia, Huosheng; Li, Liangliang; Qu, Yi-Mei; Wu, Yichen; Han, S C; Liao, Guo-Qing; Pu, Yong

doi:10.5732/cjc.010.10402

Cited by 16 publications

(10 citation statements)

References 13 publications

(18 reference statements)

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“…Chan et al 92 identified 17 cases of unresectable UCD in the literature treated with similar doses of radiotherapy. 53,85,87,88,90,91,[93][94][95][96][97][98] Thirteen achieved disease control, with 7 patients attaining a partial response and 6 a complete response. At a median follow-up of 20 months, only 1 had died as a result of progressive disease.…”

Section: Management Of Ucdmentioning

confidence: 99%

International evidence-based consensus diagnostic and treatment guidelines for unicentric Castleman disease

et al. 2020

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Castleman disease (CD) includes a group of rare and heterogeneous disorders with characteristic lymph node histopathological abnormalities. CD can occur in a single lymph node station, which is referred to as unicentric CD (UCD). CD can also involve multicentric lymphadenopathy and inflammatory symptoms (multicentric CD [MCD]). MCD includes human herpesvirus-8 (HHV-8)–associated MCD, POEMS-associated MCD, and HHV-8−/idiopathic MCD (iMCD). The first-ever diagnostic and treatment guidelines were recently developed for iMCD by an international expert consortium convened by the Castleman Disease Collaborative Network (CDCN). The focus of this report is to establish similar guidelines for the management of UCD. To this purpose, an international working group of 42 experts from 10 countries was convened to establish consensus recommendations based on review of treatment in published cases of UCD, the CDCN ACCELERATE registry, and expert opinion. Complete surgical resection is often curative and is therefore the preferred first-line therapy, if possible. The management of unresectable UCD is more challenging. Existing evidence supports that asymptomatic unresectable UCD may be observed. The anti–interleukin-6 monoclonal antibody siltuximab should be considered for unresectable UCD patients with an inflammatory syndrome. Unresectable UCD that is symptomatic as a result of compression of vital neighboring structures may be rendered amenable to resection by medical therapy (eg, rituximab, steroids), radiotherapy, or embolization. Further research is needed in UCD patients with persisting constitutional symptoms despite complete excision and normal laboratory markers. We hope that these guidelines will improve outcomes in UCD and help treating physicians decide the best therapeutic approach for their patients.

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Section: Management Of Ucdmentioning

confidence: 99%

International evidence-based consensus diagnostic and treatment guidelines for unicentric Castleman disease

et al. 2020

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“…3,23 For disease that cannot be completely excised, radiation therapy is an option due to its high rates of objective response, including complete responses in nearly one-half of reported cases. [25][26][27][28][29][30][31] For select patients who are not candidates for surgical excision, but who are also not candidates for radiation therapy based on the location of the dis-ease, partial resection followed by clinical observation alone may result in lengthy remissions; however, such treatment warrants careful attention to local progression. Select patients who are asymptomatic with a low disease burden who cannot be treated with either surgery or radiation may be closely followed, given the often indolent nature of the disease.…”

Section: Managementmentioning

confidence: 99%

Diagnosis and Management of Castleman Disease

2014

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“…For patients with well-vascularized large tumors, preoperative angiography with selective embolization should be performed in order to reduce the bleeding risk. Radiotherapy is a viable alternative for the patients for whom the operative risks are too high or for whom a complete surgical excision is not possible, often this type of treatment providing good results [31][32][33][34][35][36][37]. Several studies have reported good results of neoadjuvant treatment in patients with large tumors -UCD, tumors that involved vessels like the vena cava, aorta, and iliac vessels.…”

Section: Clinical Aspectsmentioning

confidence: 99%

“…Several studies have reported good results of neoadjuvant treatment in patients with large tumors -UCD, tumors that involved vessels like the vena cava, aorta, and iliac vessels. The neoadjuvant radiotherapy or rituximab has resulted in tumor downsizing, which further permitted surgical excision [34,38].…”

Section: Clinical Aspectsmentioning

confidence: 99%

Castleman�s Disease - Clinical, Histological and Therapeutic Features

Marcu¹,

Spînu²,

Socea³

et al. 2018

Rev. Chim.

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Castleman�s disease (CD) is a rare and benign lymphoproliferative pathology, characterized by lymphoid tissue hyperplasia, process that can occur at any site of the lymphoid chain. The purpose of this paper is to review the existing data regarding Castleman�s disease etiopathogenesis and treatment. Considering the extent of the lymphoid tissue involvement Castleman�s disease can be classified as unicentric (UCD) and multicentric (MCD). Another classification of this pathology is based on the histopathological features: hyaline vascular CD (90% of cases), plasma cell CD (less than 10%) and mixed cell type. Patients with UCD have good prognosis, the gold standard treatment being complete surgical excision. The multicentric type in contrast to UCD has a worse prognosis and associates the risk of evolving to lymphoma. Over the years different therapeutic strategies have been applied in the management of multicentric Castleman�s disease: glucocorticoids, chemotherapy, antiviral agents and monoclonal antibodies that target CD (cluster of differentiation) 20, interleukin -6 (IL-6) and IL-6 receptors. Castleman�s disease is a rare and complex pathology, whose etiopathogenesis is still incompletely elucidated. In the past few years the overall survival and progression free survival has significantly increased, due to different therapeutic options that have emerged, options that have constantly offered better and better results. Further investigation regarding the chemical interactions between different receptors and therapeutic molecules, understanding the mechanism of action and the potential benefits of each therapeutic agent may prove useful in clinical practice for treating CD.

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Radiotherapy of unicentric mediastinal Castleman's disease

Cited by 16 publications

References 13 publications

International evidence-based consensus diagnostic and treatment guidelines for unicentric Castleman disease

International evidence-based consensus diagnostic and treatment guidelines for unicentric Castleman disease

Diagnosis and Management of Castleman Disease

Castleman�s Disease - Clinical, Histological and Therapeutic Features

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