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Showing 8 results for Recurrence
L. Ghahramani, M. Forooghi, M. Mohammadianpanah, S.v Hosseini, A. Izadpanah, S. Rahimikazerooni, F. Ghafarpasand, Dr. H. Khazraei,
Volume 14, Issue 3 (7-2016)
Abstract
Background: Colorectal carcinoma is the third most common cause of death in Iran. This study was performed in order to determine the appropriate distal clearance margin (DCM) for resection of rectal cancer in patients who undergo neoadjuvant chemoradiotherapy for sphincter preserving procedure. Materials and Methods: This was a cross-sectional study conducted in Shahid Faghihi Hospital of Shiraz University of Medical Sciences from 2006 to 2011. We included all patients with low rectal cancer who underwent neoadjuvant chemoradiotherapy. The medical charts of patientsand disease characteristics were recorded. The local recurrence, recurrence-free survival and mortality rates were compared between those with DCM ≥2cm and DCM <2cm. Results: Overall, 82 patients with a mean age of 56.7 ± 16.4 years were included. The DCM was found to be ≥2cm in 45 (54.9%) patients and <2cm in 37 (45.1%). The two study groups were comparable in terms of age (p=0.573), sex (p=0.505), histopathological tumor grade (p=0.165), and distance of tumor to anal verge (p=0.125). Patients with DCM ≥2cm had a lower local recurrence rate (35.6% vs. 97.3%; p<0.001), a higher recurrence-free survival rate (88.9% vs. 67.6%; p=0.032) and a lower mortality rate (11.1% vs. 32.4%; p=0.027). Conclusion: Although some studies have showed that DCM<2cm leads to similar results compared to DCM≥ 2cm, our findings revealed that obtaining a distal clearance margin of 2cm for resection of rectal cancer in patients who have undergone neo-adjuvant chemoradiotherapy is associated with a lower local recurrence rate, higher recurrence-free survival rate and lower mortality rate.
Md., F. Tugrul, N. Isık, G. Yaprak,
Volume 20, Issue 2 (4-2022)
Abstract
Background: To determine the patterns of recurrence, prognostic factors and treatment outcomes in stage I-II lip cancer. Materials and Methods: A retrospective review was made of the data of 74 patients diagnosed with squamous cell carcinoma (SCC) of the lip between 2000 and 2009. Results: In all, 44 of the patients had stage I disease and 30 had stage II disease. Surgery was performed on the primary tumor in all patients, 15 received adjuvant radiotherapy and 23 underwent elective neck therapy. Recurrence occurred in 23 (31%) of the patients, with a mean time from surgery to relapse of 23 months. The frequency of nodal recurrence increased as tumor stage and depth increased. Adjuvant radiotherapy and neck dissection or elective radiotherapy decreased the risk of recurrence in tumors with depths of over 0.5 cm, with positive or close margins, and with perineural invasion. The median overall survival (OS) was 120 months and the median disease-free survival (DFS) was 83 months. A univariate analysis revealed tumor stage and depth, adjuvant radiotherapy, and neck treatment (lymphatic dissection + nodal irradiation) to affect DFS, while a multivariate analysis showed that elective neck radiotherapy improved DFS. Conclusion: Greater tumor stage and depth increase the risk of nodal recurrence in early-stage lip cancer, although the frequency of recurrence is decreased in such patients if treated with elective neck dissection and/or postoperative radiotherapy.
D.h. Kim, Ph.d., Y.k. Ki, W.t. Kim, D. Park, J.h. Joo, H.s. Jeon, J.h. Nam,
Volume 20, Issue 2 (4-2022)
Abstract
Background: The appropriate extent of the radiation field (primary site ± neck) in pathologically node-negative (pN0) head and neck cancer (HNC) with adverse features at the primary site remains controversial. We investigated the effect of adjuvant neck radiotherapy (RT) on regional control and survival in patients with pN0 HNC. Materials and Methods: A systematic search of databases (MEDLINE, EMBASE, and Cochrane library) was performed for literature published until January 2021. Studies of HNC patients with pN0 neck that reported on the regional recurrence (RR) rate and regional recurrence-free survival (RRFS) with respect to adjuvant neck RT were included. Results: Five studies comprising 553 patients, with a median follow-up of 50 months, were included. The overall RR rates were 2.0% (3/153) for patients treated with adjuvant neck RT and 6.5% (26/400) for patients treated with neck dissection (ND) only. Patients who received adjuvant neck RT had a 0.37-fold (95% confidence interval [CI]=0.13–1.04, P=0.06, I2=0%) lower risk of RR than did patients with ND only. The addition of adjuvant neck RT did not significantly improve RRFS (hazard ratio=0.58, 95% CI=0.16–2.08, P=0.41, I2=0%). Conclusions: Given the RR rate of 6.5% in the RT-negative group, ND alone appears to be sufficient for treating neck disease in pN0 HNC. However, the neck RT group had a lower RR rate than that of the non-RT group, suggesting that pN0 HNC patients with a high risk of recurrence may benefit from elective neck RT.
M.d., H. Demir, S. Özdemir, N. Işık, G. Yaprak ,
Volume 21, Issue 4 (10-2023)
Abstract
Background: To evaluate treatment outcomes and toxicity of pulmonary SBRT for intrathoracic recurrence in patients with locally advanced NSCLC treated as a combination of surgery, radiotherapy or chemotherapy. Materials and Methods: A total of 46 patients with NSCLC who received thoracic SBRT for local or non local intrapulmonary recurrent lesions in our department from 2009 to 2019 were retrospectively enrolled in this study. The patients received median 43.4 Gy (25 Gy -60 Gy) radiotherapy using the CyberKnife radiosurgery system in median 3.6 fractions (range, 1-8).Univariate and multivariate Cox regression analyses were performed on the factors predicting outcomes. Results: The median follow up time after SBRT was 23.5 months. Treatment of the primary tumor consisted of surgical resection, radiochemotherapy, and systemic therapy in 25, 8 and 13 patients, respectively. İsolated local recurrence, intrathoracic recurrence and distant metastasis were detected in 5 (10.9%), 12 (26.1%) and 8 (17.4%) patients, respectively. Kaplan-Meier analysis of 2 year OS, PFS and LC for all tumors treated after SBRT were; 51%, 56% and 91%, respectively. In parameters related to patient and treatment; no statistical significance was found affecting local control and survival.(p>0.05). Grade 2 radiation pneumonitis and chest wall pain were observed in 2 (4.3%) and 1 (2.1 %) patients. Grade 3 toxicity was detected in 3 ( 6.5%) cases. Conclusion: Pulmonary SBRT for recurrent NSCLC is a good treatment option with favourable LC and promising survival. SBRT can be an effective treatment modality in the treatment of patients with local/limited pulmonary relapses with acceptable toxicity rates.
Y. Fang, L. Wang, X. Chen, Ph.d., C. Cao,
Volume 22, Issue 1 (1-2024)
Abstract
Nasopharyngeal carcinoma (NPC) is a radiotherapy-sensitive tumor, but local recurrence still exists in part of the patients after receiving radiotherapy. The location of local recurrence of NPC is usually “in-field” and cases of parotid and mastoid recurrences have been reported. We report a fifty-nine-year-old female patient who presented with maxillary sinus anterior wall recurrence seven months after intensity-modulated radiotherapy (IMRT). Magnetic resonance imaging (MRI) showed a soft tissue mass in the anterior wall of the right maxillary sinus and the recurrence of NPC was confirmed by histopathology after biopsy. To date, the patient is alive with disease without distant metastasis. To our knowledge, this is the first report of maxillary Sinus anterior wall recurrence after IMRT for NPC.
J. Ma, T. Gan, Ph.d., A. Song,
Volume 22, Issue 2 (4-2024)
Abstract
Background: Breast cancer is a common cancer that affects women. The Luminal A subtype of breast cancer is defined by low Ki67 expression (<14%), Her-2 negative, and positive ER and PR. Luminal A exhibits a favorable prognosis compared to other breast cancer types. Materials and Methods: Gene expression profiling was employed in this investigation to discover genes linked to clinical efficacy and recurrence in Luminal A breast cancer tissue samples. The study's overarching goal was to discover new therapeutic targets by deciphering the molecular mechanisms behind Luminal A breast cancer. Results: Our analysis revealed specific genes linked to Luminal A breast cancer, and their expression levels were correlated with clinical outcomes. High expression of certain genes was associated with improved clinical efficacy and a reduced recurrence rate. Conclusion: The study provides valuable insights into the molecular mechanisms of Luminal A breast cancer, offering potential targets for personalized therapeutic approaches.
Y. Fang, L. Wang, X. Chen, C. Cao,
Volume 22, Issue 3 (7-2024)
Abstract
Nasopharyngeal carcinoma (NPC) is a radiotherapy-sensitive tumor, but local recurrence still exists in part of the patients after receiving radiotherapy. The location of local recurrence of NPC is usually “in-field” and cases of parotid and mastoid recurrences have been reported. We report a fifty-nine-year-old female patient who presented with maxillary sinus anterior wall recurrence seven months after intensity-modulated radiotherapy (IMRT). Magnetic resonance imaging (MRI) showed a soft tissue mass in the anterior wall of the right maxillary sinus and the recurrence of NPC was confirmed by histopathology after biopsy. To date, the patient is alive with disease without distant metastasis. To our knowledge, this is the first report of maxillary Sinus anterior wall recurrence after IMRT for NPC.
Y. Ma, Ph.d., Y. Pan, B. Zhang, Y. Zhang, W. Fan,
Volume 22, Issue 4 (10-2024)
Abstract
Background: This study aims to analyze the clinicopathological characteristics of breast cancer (BC) patients with different genotypes who underwent radiotherapy. The goal is to explore the relationship between these characteristics and the risk of recurrence, providing valuable insights for clinical adjuvant therapy. Materials and Methods: A retrospective analysis was conducted on pathological data of 256 BC patients who underwent surgical resection and radiotherapy. Data included age structure, tumor diameter and grading, estrogen receptor (ER) and progesterone receptor (PR) indicators, human epidermal growth factor receptor 2 (HER2), and the cell proliferation antigen marker (Ki-67). Multifactorial analysis was employed to assess correlations. Results: The distribution of BC patients in the low, medium-high, and high-risk groups was 70.9%, 23.2%, and 5.6%, respectively. Multifactorial analysis revealed that PR, Ki-67 expression, and histological grading were independent factors influencing the RS score, with corresponding P values less than 0.05. They were positively correlated (P < 0.001) with Ki-67 expression levels and tumor tissue grading, and negatively correlated with hormonal indicators. The short-term probability of survival for patients with the four staged BC in the low-risk group was 82.34%, 76.12%, 62.13%, and 60.23%, and 23.69%, respectively. Triple negative breast cancer (TNBC) patients and those with Luminal B BC exhibited a higher risk of metastasis (P < 0.05). Conclusion: The pathological characteristics of BC patients with different genotypes showed significant differences. TNBC patients and those with Luminal B BC should be particularly vigilant about their risk of recurrence and metastasis, and strengthen prognostic considerations.
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