Intensity Modulated Proton Therapy (IMPT) to the Parotid Gland: A Seven-Year Experience
We report our dosimetric and clinical outcomes in terms of disease control and toxicity in patients with parotid gland malignancies treated with IMPT.
Chordomas of the cervical spine present unique challenges for treatment due to nearby critical neurovasculature. Surgical planning requires coordination with surgical, radiation, and medical specialists to achieve oncologically sound surgery and functional preservation. The post-operative airway, voice, and swallowing functions of a patient with fibula free flap reconstruction after a cervical chordoma resection have not yet been characterized.
Anaplastic thyroid cancer is decimal disease with a poor prognosis due to its aggressive and rapid metastasis with median survival of less than 6 months. Multimodal treatment involving surgery and chemoradiotherapy has been used to improve the survival of patients. Here, we retrospectively review of treatment outcome of 28 consecutive patients who were treated at a single center.
Locally advanced NMSC is an uncommon disease characterized by a lack of robust data. Classical outcomes cited for T4 NMSC treated with definitive RT are 50% 5y LC. Most publications describing this therapy are from the pre-IMRT era. Simultaneous with major advancements in RT technology (and resultant improved outcomes across disease sites with the ability to dose escalate), T staging has evolved dramatically. In AJCC 6, a T2 NMSC was defined as tumor>2 cm but5 cm; and T4 as invading deep extradermal structures (cartilage, skeletal muscle, or bone).
Patients with metastatic thyroid cancer (mTC) have limited options for effective therapies. Tyrosine kinase inhibitors (TKIs) remain the mainstay of treatment, often at the expense of significant systemic side effects without a proven survival benefit. The use of immunotherapy has revolutionized the treatment of cancer, however, its specific utility in mTC is not yet known.
The incidence of thyroid cancer has been on the rise in recent decades with approximately 90% of these being differentiated thyroid carcinomas (DTCs) (including papillary and follicular). The majority of DTCs have a good prognosis and are potentially curable with standard treatment, the cornerstone of which is thyroidectomy. Commonly, patients may also receive adjuvant thyroid stimulating hormone suppression or radioactive iodine-131 (RAI). Due to a lack of randomized clinical trials, the role of adjuvant external beam radiation therapy (EBRT) in DTC is not well-established.
Locally advanced sinonasal cancer (LA-SC) remains a challenge to manage given the lack of prospective studies and the rarity of these lesions. Surgical resection and adjuvant radiation has traditionally been associated with improved outcomes over primary radiation/chemoradiation (RT/CRT). Advances in systemic therapy, radiation, endoscopic surgery and skull base resection as well as increasing use of induction chemotherapy in some centers necessitates re-evaluation of outcomes between surgery and primary RT/CRT approaches.
To report control and toxicity outcomes for patients with adenoid cystic carcinoma (ACC) of the non-skull base head and neck treated at a single institution with proton therapy.
Adenoid cystic carcinoma (ACC) is a rare tumor, with variable growth pattern and propensity for distant metastasis. Factors affecting prognosis are under-studied. In this retrospective study, we describe a population of ACC patients (pts) treated at our institution and identify factors associated with survival.
We report outcomes of LA-SC patients undergoing primary resection. Materials/Methods: From a single institution IRB approved registry of head and neck cancer we identified all patients (Pts) with a first sinonasal cancer diagnosis of LA-SC (T3/T4 or equivalent primary tumor) treated with primary surgical resection.
Proton beam radiation therapy has dosimetric advantages compared to photon radiation therapy for the treatment of major salivary gland tumors (MSGTs), due to the typically unilateral pattern of disease spread requiring only ipsilateral irradiation. However, clinical data on treatment outcomes and the potentially reduced toxicity with proton beam therapy is lacking.