Surgical spacer placement prior carbon ion radiotherapy (CIRT): an effective feasible strategy to improve the treatment for sacral chordoma

Cobianchi, Lorenzo; Peloso, Andréa; Vischioni, Barbara; Panizza, D.; Fiore, Maria Rosaria; Fossati, Piero; Vitolo, Viviana; Iannalfi, Alberto; Ciocca, Mario; Brugnatelli, Silvia; Dominioni, Tommaso; Bugada, Dario; Maestri, Marcello; Alessiani, M.; Valvo, Francesca; Orecchia, Roberto; Dionigi, Paolo

doi:10.1186/s12957-016-0966-6

Cited by 23 publications

(20 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One patient, at the time of the first recurrence, underwent re-irradiation with stereotactic radiotherapy (30 Gy in six fractions). Before CIRT, four patients received spacer implantation via open surgery to create adequate distance between the bowel and the tumor (32). In three cases, an omental flap was used to create space between the tumor and the intestine, and in one case, a polytetrafluoroethylene (PTFE) prosthesis was placed.…”

Section: Resultsmentioning

confidence: 99%

Re-irradiation With Carbon Ion Radiotherapy for Pelvic Rectal Cancer Recurrences in Patients Previously Irradiated to the Pelvis

Barcellini

Vitolo

Cobianchi

et al. 2020

In Vivo

Self Cite

View full text Add to dashboard Cite

Background/Aim: Re-irradiation of locally recurrent rectal cancer poses challenges due to the proximity of critical organs, such as the bowel. This study aimed at evaluating the safety and efficacy of re-irradiation with Carbon Ion Radiotherapy (CIRT) in rectal cancer patients with local recurrence. Patients and Methods: Between 2014 and 2018, 14 patients were treated at the National Center of Oncological Hadrontherapy (CNAO Foundation) with CIRT for locally recurrent rectal cancer. Results: All patients concluded the treatment. No G≥3 acute/late reaction nor pelvic infections were observed. The 1-year and 2-year local control rates were, 78% and 52%, respectively, and relapse occurred close to the bowel in 6 patients. The 1-year and 2-year overall survival rates were 100% and 76.2% each; while the 1-year and 2-year metastasis free survival rates were 64.3% and 43%. Conclusion: CIRT as re-irradiation for locally recurrent rectal cancer emerges as a safe and valid treatment with an acceptable rate of morbidity of surrounding healthy tissue.

show abstract

Section: Resultsmentioning

confidence: 99%

Re-irradiation With Carbon Ion Radiotherapy for Pelvic Rectal Cancer Recurrences in Patients Previously Irradiated to the Pelvis

Barcellini

Vitolo

Cobianchi

et al. 2020

In Vivo

Self Cite

View full text Add to dashboard Cite

show abstract

“…The mechanism of CIRT is the release of low radiation dose along the travel path, except for the maximum energy at the end of the path (Bragg peak); thus, CIRT allows selective irradiation of the target tumor, sparing the surrounding normal tissues. 3 Although CIRT causes relatively little damage to surrounding normal tissues, once the damage occurs, the normal tissues become sublethally compromised as a result of extensive tissue destruction, and recovery cannot be expected. In our case, the damage affected not only the surrounding tissue but also the rectum.…”

Section: Discussionmentioning

confidence: 99%

Sacral and Rectal Necrosis after Carbon Ion Radiotherapy Reconstructed with Transpelvic Rectus Abdominis Flap

Atomura

Makiguchi

Nakamura

et al. 2020

Plastic and Reconstructive Surgery - Global Open

View full text Add to dashboard Cite

Summary: Carbon ion radiotherapy (CIRT) has been used for malignant tumors that are difficult to excise surgically, such as sacral chordoma, and the success of its outcomes is attributable to the high dose concentration and biological effects. CIRT has produced successful clinical outcomes, and it is considered to have fewer adverse effects on surrounding normal tissues; moreover, complications have been rarely reported. We describe a 75-year-old woman with a full-thickness sacral defect, who had received CIRT for sacral chordoma 3 years earlier. Computed tomography showed sacral bone destruction, and a colonoscopy revealed rectal necrosis. Rectectomy in addition to sacral bone resection was necessary, which resulted in a huge sacral defect of slightly anxious viability. We performed reconstruction of the sacral defect by using pedicled vertical rectus abdominis myocutaneous (VRAM) flap, obliterating sacral defects and intrapelvic dead space that occurred after rectectomy. Six months after surgery, the wound had healed well, and no complication was observed. Sacral complications after CIRT may affect surrounding normal tissues such as the rectum, and it would be difficult to reconstruct the resulting complications. The vertical rectus abdominis myocutaneous flap is considered useful for the simultaneous obliteration of sacral defects and intrapelvic dead space after CIRT.

show abstract

“… 13 In our case, the use of the expander was a better treatment from the radiotherapeutic point of view, as reported in other conditions wherein the insertion of a spacer has led to advancements in the field of radiotherapy. 14 15 …”

Section: Discussionmentioning

confidence: 99%

The First Reported Pediatric Case of Primary Myoepithelial Carcinoma Involving the Whole Lung: Surgical Radical Treatment and Prosthesis Implant

Filisetti

Russo

Pansini

et al. 2020

European J Pediatr Surg Rep

View full text Add to dashboard Cite

Primary myoepithelial carcinoma of the lung (PMC-L) arising from the bronchial glands in lower respiratory tract is exceedingly rare. Thus far, few cases in adults and only one in a pediatric patient have been recorded. To our knowledge, this is the first report of PMC-L successfully removed in a child, focusing on the importance of multidisciplinary primary surgery for the treatment of this tumor. A 7-year-old girl was admitted for persistent cough and fever; she was unresponsive to oral antibiotics. Chest radiography showed loss of volume of left lung sustained by almost total atelectasis. After routine clinical investigations, she was referred for computed tomography scan and magnetic resonance imaging that documented the presence of a mass occupying the entire left upper lobe, infiltrating the pulmonary hilum (main bronchus, pulmonary artery, superior pulmonary vein, and pericardium). After multidisciplinary evaluation, the histopathologic diagnosis of PMC-L was established using ultrasonography-guided transthoracic core needle biopsy and bronchoscopic biopsies. She was then subjected to left pneumonectomy under extracorporeal circulation and positioning of a thoracic expander filled with 200 mL of saline solution. The postoperative course was uneventful. With TREP (very Rare Tumor in Pediatric Age) consent radiotherapy was performed (61.2 Gy). At the 10-month follow-up, the patient was alive, breathing normally without any oxygen support, without recurrence of PMC-L or metastasis, and without any chest deformity. To our knowledge, this is the first case where a pediatric patient was successfully operated for PMC-L involving the whole lung. Extracorporeal circulation enabled us to perform radical primary surgery. Prosthesis implant not only maintained normal chest expansion but also allowed focused radiotherapy, thus enabling us to prevent damage to vital organs.

show abstract

Surgical spacer placement prior carbon ion radiotherapy (CIRT): an effective feasible strategy to improve the treatment for sacral chordoma

Cited by 23 publications

References 30 publications

Re-irradiation With Carbon Ion Radiotherapy for Pelvic Rectal Cancer Recurrences in Patients Previously Irradiated to the Pelvis

Re-irradiation With Carbon Ion Radiotherapy for Pelvic Rectal Cancer Recurrences in Patients Previously Irradiated to the Pelvis

Sacral and Rectal Necrosis after Carbon Ion Radiotherapy Reconstructed with Transpelvic Rectus Abdominis Flap

The First Reported Pediatric Case of Primary Myoepithelial Carcinoma Involving the Whole Lung: Surgical Radical Treatment and Prosthesis Implant

Contact Info

Product

Resources

About