Daniel Indelicato, MD, University of Florida, Jacksonville, FL
Presented at the 2010 Texas Adolescent and Young Adult Oncology Conference, Methodist Healthcare-San Antonio
Osteosarcoma is the most common primary bone cancer, often arising in the appendicular skeleton of teenagers and young adults. It is typically a high grade tumor associated with rapid bone proliferation and spread. Treatment involves complete surgical resection with limb-sparing surgery when possible, along with chemotherapy both before and after surgery. Radiation therapy may be used for unresectable or incompletely resected tumors. Prognostic factors include tumor size, location of metastases, and response to preoperative chemotherapy. While survival has improved with modern multimodal treatment, new strategies are still needed given the risk of recurrence and lung metastases.
Soft tissue sarcomas are rare mesenchymal tumors that can arise in various soft tissues of the body. They are classified based on their cell of origin and differentiation. Treatment involves surgical excision with negative margins, with adjuvant radiation therapy sometimes used to improve local control. Prognosis depends on tumor size, grade, depth and margins of resection, with retroperitoneal and high grade tumors having a worse prognosis due to difficulty obtaining clear margins. Metastatic disease typically spreads to the lungs and has a poor median survival of 8-12 months.
This document discusses radiotherapy for soft tissue sarcomas. It notes that sarcomas are a heterogeneous group of rare malignant tumors arising from mesenchymal tissue. Radiotherapy plays an important role in optimizing local control when used as an adjuvant treatment along with surgery. Post-operative radiotherapy has been shown to significantly increase local control rates compared to surgery alone, without affecting patient survival. Both pre-operative and post-operative radiotherapy have been shown to be equally effective, with considerations for each based on anatomical site and tumor characteristics. The document outlines recommendations for indications, planning, immobilization and implementation of post-operative radiotherapy for soft tissue sarcomas.
Preoperative Radiotherapy In Extremity Soft Tissue Sarcomafondas vakalis
1. The study analyzed 56 patients with extremity soft tissue sarcomas treated with preoperative radiotherapy using 3D planning with CT simulation to define optimal treatment volumes.
2. Margins of 1-1.5cm radially and 3.5cm longitudinally around the gross tumor resulted in adequate coverage for most patients. Positive margins were associated with higher risk of local failure.
3. Acceptable wound complication rates were observed, related to factors like volume of resected specimen and presence of diabetes. The defined volumes appear appropriate for preoperative radiotherapy in extremity soft tissue sarcomas.
This document discusses soft tissue sarcomas (STS). It notes that STS are rare malignant tumors that arise from connective tissues. Specific syndromes like neurofibromatosis can increase the risk of certain STS. Imaging like MRI and biopsy are used to evaluate STS. Surgery is the primary treatment and radiation or chemotherapy may be used as well, depending on the grade and stage of the tumor. Recurrence rates are high for certain types of STS like retroperitoneal sarcomas. Overall prognosis depends on factors like grade, size, and whether clear margins can be obtained with surgery.
A 60-year-old male laborer presented with a recurrent soft tissue sarcoma on his right proximal arm that had been growing over 7 years. He had previously undergone 3 surgeries and chemotherapy/radiation for the mass. Examination found a large, necrotic mass with normal neurovascular function. Biopsy confirmed a low-grade soft tissue sarcoma. The management plan was a wide excision with reconstruction to remove the recurrent tumor.
This document provides algorithms for the management of soft tissue sarcoma, bone tumors, and gastrointestinal stromal tumors (GISTs). For soft tissue sarcoma, it outlines the evaluation, biopsy, staging, treatment options based on resection status and grade, and follow-up protocols. For bone tumors, it discusses primary disease management and further management for local or systemic relapse. For GISTs, it outlines evaluation, risk stratification, primary treatment options including surgery and adjuvant imatinib, and management of recurrent or metastatic disease including imatinib dose escalation.
Osteosarcoma is the most common primary bone cancer, often arising in the appendicular skeleton of teenagers and young adults. It is typically a high grade tumor associated with rapid bone proliferation and spread. Treatment involves complete surgical resection with limb-sparing surgery when possible, along with chemotherapy both before and after surgery. Radiation therapy may be used for unresectable or incompletely resected tumors. Prognostic factors include tumor size, location of metastases, and response to preoperative chemotherapy. While survival has improved with modern multimodal treatment, new strategies are still needed given the risk of recurrence and lung metastases.
Soft tissue sarcomas are rare mesenchymal tumors that can arise in various soft tissues of the body. They are classified based on their cell of origin and differentiation. Treatment involves surgical excision with negative margins, with adjuvant radiation therapy sometimes used to improve local control. Prognosis depends on tumor size, grade, depth and margins of resection, with retroperitoneal and high grade tumors having a worse prognosis due to difficulty obtaining clear margins. Metastatic disease typically spreads to the lungs and has a poor median survival of 8-12 months.
This document discusses radiotherapy for soft tissue sarcomas. It notes that sarcomas are a heterogeneous group of rare malignant tumors arising from mesenchymal tissue. Radiotherapy plays an important role in optimizing local control when used as an adjuvant treatment along with surgery. Post-operative radiotherapy has been shown to significantly increase local control rates compared to surgery alone, without affecting patient survival. Both pre-operative and post-operative radiotherapy have been shown to be equally effective, with considerations for each based on anatomical site and tumor characteristics. The document outlines recommendations for indications, planning, immobilization and implementation of post-operative radiotherapy for soft tissue sarcomas.
Preoperative Radiotherapy In Extremity Soft Tissue Sarcomafondas vakalis
1. The study analyzed 56 patients with extremity soft tissue sarcomas treated with preoperative radiotherapy using 3D planning with CT simulation to define optimal treatment volumes.
2. Margins of 1-1.5cm radially and 3.5cm longitudinally around the gross tumor resulted in adequate coverage for most patients. Positive margins were associated with higher risk of local failure.
3. Acceptable wound complication rates were observed, related to factors like volume of resected specimen and presence of diabetes. The defined volumes appear appropriate for preoperative radiotherapy in extremity soft tissue sarcomas.
This document discusses soft tissue sarcomas (STS). It notes that STS are rare malignant tumors that arise from connective tissues. Specific syndromes like neurofibromatosis can increase the risk of certain STS. Imaging like MRI and biopsy are used to evaluate STS. Surgery is the primary treatment and radiation or chemotherapy may be used as well, depending on the grade and stage of the tumor. Recurrence rates are high for certain types of STS like retroperitoneal sarcomas. Overall prognosis depends on factors like grade, size, and whether clear margins can be obtained with surgery.
A 60-year-old male laborer presented with a recurrent soft tissue sarcoma on his right proximal arm that had been growing over 7 years. He had previously undergone 3 surgeries and chemotherapy/radiation for the mass. Examination found a large, necrotic mass with normal neurovascular function. Biopsy confirmed a low-grade soft tissue sarcoma. The management plan was a wide excision with reconstruction to remove the recurrent tumor.
This document provides algorithms for the management of soft tissue sarcoma, bone tumors, and gastrointestinal stromal tumors (GISTs). For soft tissue sarcoma, it outlines the evaluation, biopsy, staging, treatment options based on resection status and grade, and follow-up protocols. For bone tumors, it discusses primary disease management and further management for local or systemic relapse. For GISTs, it outlines evaluation, risk stratification, primary treatment options including surgery and adjuvant imatinib, and management of recurrent or metastatic disease including imatinib dose escalation.
Learn about the process of radiation therapy to treat soft tissue sarcoma, and how new radiation technology has improved treatment of the disease.
This presentation was given by Elizabeth H. Baldini, MD, MPH, radiation oncology director for the Center for Sarcoma and Bone Oncology at Dana-Farber Cancer Institute. It was originally presented as part of the "15 Years of GIST/Soft Tissue Sarcoma Symposium," held on Sept. 12, 2015 at Dana-Farber in Boston, Mass.
This document provides information on the management of soft tissue sarcoma. It discusses the clinical presentation, patterns of spread, imaging, histology, grading, staging, prognostic factors and management of soft tissue sarcomas. The key points are:
1) Soft tissue sarcomas most commonly present as painless swellings in the extremities and can invade locally along fascial planes. Imaging like MRI is important for assessing tumor extent.
2) Histologically, the most common subtypes are undifferentiated pleomorphic sarcoma and liposarcoma. Grading systems consider tumor differentiation, mitosis and necrosis.
3) Staging is based on tumor size, depth, nodal status and metastasis
This document discusses soft tissue sarcomas (STS), including:
- Incidence rates in the US and Egypt. Radiation therapy is a risk factor.
- Common primary and metastatic sites vary by tumor type.
- STS originate from mesenchymal cells and include many subtypes.
- Diagnosis involves biopsy, imaging, and genetic testing to identify specific mutations in certain sarcoma subtypes.
- Treatment depends on grade and stage but commonly involves surgery with or without chemotherapy and/or radiation therapy. Outcomes vary significantly by histology, grade, and other factors.
A 38-year-old male presented with a gradually increasing swelling on his left mid thigh for 7-8 months. An MRI showed a 5x4.8x8 cm mass in his left thigh muscles. A biopsy determined it was a grade I mixoid liposarcoma. He underwent a wide local excision of the lesion along with brachytherapy catheter insertion. The final pathology report found the tumor was a mixoid liposarcoma invading the adjacent skeletal muscle, with clear margins over 1 cm away and no necrosis or mitosis. Brachytherapy catheters were placed in the excised tumor bed to deliver radiation treatment.
This document discusses retroperitoneal soft tissue sarcoma (RPS), including its most common histologies, clinical presentation, evaluation, treatment with surgery, radiotherapy, chemotherapy, targeted therapy, and management of recurrent disease. It provides details on surgical approaches for RPS including the importance of obtaining clear margins. It also reviews evidence on multimodality treatments including preoperative chemoradiation. Recurrence after initial treatment is high, but salvage surgery may provide a survival benefit in select patients depending on factors like tumor size and disease-free interval.
Soft tissue sarcomas account for less than 1% of malignant tumors but around 40% of patients die from the disease. While most soft tissue sarcomas have no clear cause, some risk factors include genetic predispositions, prior radiation therapy, and chemical exposure. A recent study found that over 50% of soft tissue sarcoma patients have a germline genetic variant contributing to tumor development. Diagnosis involves biopsy or imaging like CT or MRI. Treatment depends on location and grade, with surgery to remove the tumor with margins. High-risk cases may also receive radiation therapy or chemotherapy.
This document provides an overview of soft tissue sarcomas (STS). Some key points:
- STS are rare tumors that can arise from any soft tissue site, most commonly the extremities. They are characterized by genetic alterations and histological grade.
- Surgery is the primary treatment, with the goal of complete resection with negative margins while preserving function. Radiotherapy and chemotherapy may be used as adjuvants.
- Prognosis depends on factors like size, grade, depth and presence of metastases. Visceral and retroperitoneal STS pose additional challenges due to critical surrounding organs.
Soft Tissue Sarcoma, Can we refine the approachMohamed Abdulla
Soft Tissue Sarcoma: Can We Refine The Approach?
1) Soft tissue sarcomas are a heterogeneous group of cancers accounting for 1% of malignancies with over 50 histological subtypes and poor outcomes for metastatic disease.
2) The PALETTE trial found that treatment with pazopanib resulted in a median progression-free survival of 20 weeks compared to 7 weeks for placebo, representing a 65% reduction in risk of disease progression or death.
3) Subgroup analyses showed benefit of pazopanib across patient characteristics including number of prior therapies. Pazopanib was generally well-tolerated with mainly grade 1-2 adverse events.
NEOADJUVANT RADIOTHERPAY IN SOFT TISSUE SARCOMA- A DEBATEKanhu Charan
This document discusses the use of preoperative radiotherapy for soft tissue sarcomas (STS). Generally, guidelines recommend preoperative radiotherapy in 25-28 fractions of 1.8-2 Gy up to a total of 50-50.4 Gy over 5-6 weeks to increase local control compared to surgery alone. However, surgeons may be reluctant due to potential for increased wound complications and delayed surgery. A review of 11 studies found preoperative radiotherapy was associated with less local recurrence in retroperitoneal STS but more wound complications in extremity sarcoma, though it did not negatively affect overall survival or functional outcomes. Guidelines from NCCN and ESMO recommend considering preoperative radiotherapy for high-grade, deep or large
This document provides information about gynecologic cancers including ovarian cancer, cervical cancer, and endometrial cancer. It discusses risk factors, signs and symptoms, screening and prevention methods, staging, treatment options, and survival rates for each cancer. The key points are that ovarian cancer has no effective early screening test and often presents at advanced stages, while cervical and endometrial cancers can be prevented or detected early through regular pelvic exams and Pap/HPV testing. Treatment may involve surgery, radiation, chemotherapy, or a combination depending on the cancer type and stage. Overall survival rates vary but early detection improves prognosis. The document emphasizes patient education and advocacy.
Retroperitoneal Soft-Tissue Sarcoma: Retrospective Study at Shaukat Khanum Ca...Jibran Mohsin
This study retrospectively analyzed 54 patients with retroperitoneal soft tissue sarcoma treated at Shaukat Khanum Cancer Hospital over 5 years. The most common histology was well-differentiated liposarcoma (74%). The median age was 43 years and most patients presented with abdominal pain and mass. The 5-year overall survival rate was 74% and disease-free survival was 14 months. Factors associated with improved outcomes included negative resection margins and neoadjuvant therapy. This study provides valuable local data on treatment and outcomes of retroperitoneal soft tissue sarcoma in Pakistan.
Ewing sarcoma is the second most common bone tumor in children. Radiotherapy plays an important role in the treatment of both localized and metastatic Ewing sarcoma. For localized disease, radiotherapy is recommended for patients who cannot undergo surgery or have unresectable tumors. It is also used post-operatively if there is residual disease. For metastatic disease, radiotherapy can help control the primary tumor and reduce pulmonary metastases when combined with chemotherapy. Advances in radiotherapy planning and techniques have improved outcomes while reducing long-term side effects.
This article describes the management of 6 male patients with soft tissue sarcoma (STS) treated outside of a sarcoma center. Five patients presented with slowly growing painless masses of long duration, while the youngest patient had bilateral lung metastases shortly after resection of a primitive neuroectoderm tumor in his thigh. Investigations included imaging and biopsies to determine diagnoses, which included rare tumors. Wide surgical excision was performed in 5 cases, while forequarter amputation was necessary in one case. Local recurrence occurred in 3 patients, who received additional treatment. The author concludes that patients with STS can be satisfactorily managed outside a sarcoma center if standard guidelines are followed and the surgical team has adequate experience.
Radiation therapy plays an important role in the management of many bone tumors as an adjunct to surgery or as primary treatment for inoperable tumors. Newer radiation techniques like IMRT and proton beam therapy allow for more conformal dose distributions that improve local tumor control while reducing damage to surrounding healthy tissues. Radiation is used as primary treatment, post-operatively, or palliatively depending on the tumor type, location, surgical margins, and other factors.
ROLE OF RADIATION IN BONE TUMORS FOR ORTHOPEDICSKanhu Charan
This document discusses soft tissue sarcomas. It begins by listing various histologic diagnoses of soft tissue sarcomas categorized by tissue of origin. It then discusses imaging with MRI and CT to evaluate tumors. Key points regarding surgery include performing limb-sparing over amputation when possible and obtaining negative margins of at least 2cm if no post-op radiation is planned. Adjuvant radiation improves local control but not necessarily survival. Pre-op radiation may increase wound complications compared to post-op.
This document discusses the role of radiotherapy in treating extremity sarcoma. It notes that radiotherapy combined with conservative surgery can achieve local tumor eradication while preserving limb function with low toxicity. Several studies have shown that radiotherapy improves local control compared to surgery alone, without compromising overall survival. Modern imaging and radiotherapy techniques like IMRT allow for smaller treatment volumes and better sparing of critical structures like bone and skin flaps. Radiotherapy requires multidisciplinary collaboration between radiation oncologists and surgeons to determine the optimal treatment approach for each patient.
1) Chemotherapy has improved survival rates for osteosarcoma dramatically over the past 30 years from less than 20% to between 40-60% through the use of effective combination chemotherapy and neoadjuvant treatment.
2) Key trials showed that neoadjuvant chemotherapy followed by surgery and adjuvant chemotherapy improved relapse-free and overall survival compared to surgery alone.
3) The combination of doxorubicin and cisplatin administered every 3 weeks is now considered the standard first-line chemotherapy regimen based on results from large cooperative trials.
This document discusses the treatment of Ewing's sarcoma. It begins with an introduction to Ewing's sarcoma, describing its identification in 1921 and its characteristics. It then discusses the pathology, genetics, clinical presentation, routes of spread, diagnostic workup, staging, and prognostic factors. The bulk of the document focuses on treatment options, including induction chemotherapy, local therapy options of surgery or radiation, maintenance chemotherapy, and surveillance. It also covers treatment of metastatic and recurrent disease. The document provides detailed information on chemotherapy regimens, radiation techniques, and ongoing research directions.
These are the slides I used in a three hour presentation/workshop about responsive web design. The audience consisted of students wanting to get up to speed with responsive web design techniques.
1. This study aims to evaluate survival outcomes, quality of life, and activities of daily living in patients with high-grade gliomas treated with conformal radiation therapy followed by a boost with Cyberknife radiosurgery.
2. Patients with confirmed high-grade gliomas and good performance status will receive maximal safe resection followed by intensity-modulated radiation therapy and a Cyberknife boost to the tumor area.
3. The primary objectives are to assess progression-free survival, overall survival, quality of life scores, and activities of daily living after higher radiation doses.
Learn about the process of radiation therapy to treat soft tissue sarcoma, and how new radiation technology has improved treatment of the disease.
This presentation was given by Elizabeth H. Baldini, MD, MPH, radiation oncology director for the Center for Sarcoma and Bone Oncology at Dana-Farber Cancer Institute. It was originally presented as part of the "15 Years of GIST/Soft Tissue Sarcoma Symposium," held on Sept. 12, 2015 at Dana-Farber in Boston, Mass.
This document provides information on the management of soft tissue sarcoma. It discusses the clinical presentation, patterns of spread, imaging, histology, grading, staging, prognostic factors and management of soft tissue sarcomas. The key points are:
1) Soft tissue sarcomas most commonly present as painless swellings in the extremities and can invade locally along fascial planes. Imaging like MRI is important for assessing tumor extent.
2) Histologically, the most common subtypes are undifferentiated pleomorphic sarcoma and liposarcoma. Grading systems consider tumor differentiation, mitosis and necrosis.
3) Staging is based on tumor size, depth, nodal status and metastasis
This document discusses soft tissue sarcomas (STS), including:
- Incidence rates in the US and Egypt. Radiation therapy is a risk factor.
- Common primary and metastatic sites vary by tumor type.
- STS originate from mesenchymal cells and include many subtypes.
- Diagnosis involves biopsy, imaging, and genetic testing to identify specific mutations in certain sarcoma subtypes.
- Treatment depends on grade and stage but commonly involves surgery with or without chemotherapy and/or radiation therapy. Outcomes vary significantly by histology, grade, and other factors.
A 38-year-old male presented with a gradually increasing swelling on his left mid thigh for 7-8 months. An MRI showed a 5x4.8x8 cm mass in his left thigh muscles. A biopsy determined it was a grade I mixoid liposarcoma. He underwent a wide local excision of the lesion along with brachytherapy catheter insertion. The final pathology report found the tumor was a mixoid liposarcoma invading the adjacent skeletal muscle, with clear margins over 1 cm away and no necrosis or mitosis. Brachytherapy catheters were placed in the excised tumor bed to deliver radiation treatment.
This document discusses retroperitoneal soft tissue sarcoma (RPS), including its most common histologies, clinical presentation, evaluation, treatment with surgery, radiotherapy, chemotherapy, targeted therapy, and management of recurrent disease. It provides details on surgical approaches for RPS including the importance of obtaining clear margins. It also reviews evidence on multimodality treatments including preoperative chemoradiation. Recurrence after initial treatment is high, but salvage surgery may provide a survival benefit in select patients depending on factors like tumor size and disease-free interval.
Soft tissue sarcomas account for less than 1% of malignant tumors but around 40% of patients die from the disease. While most soft tissue sarcomas have no clear cause, some risk factors include genetic predispositions, prior radiation therapy, and chemical exposure. A recent study found that over 50% of soft tissue sarcoma patients have a germline genetic variant contributing to tumor development. Diagnosis involves biopsy or imaging like CT or MRI. Treatment depends on location and grade, with surgery to remove the tumor with margins. High-risk cases may also receive radiation therapy or chemotherapy.
This document provides an overview of soft tissue sarcomas (STS). Some key points:
- STS are rare tumors that can arise from any soft tissue site, most commonly the extremities. They are characterized by genetic alterations and histological grade.
- Surgery is the primary treatment, with the goal of complete resection with negative margins while preserving function. Radiotherapy and chemotherapy may be used as adjuvants.
- Prognosis depends on factors like size, grade, depth and presence of metastases. Visceral and retroperitoneal STS pose additional challenges due to critical surrounding organs.
Soft Tissue Sarcoma, Can we refine the approachMohamed Abdulla
Soft Tissue Sarcoma: Can We Refine The Approach?
1) Soft tissue sarcomas are a heterogeneous group of cancers accounting for 1% of malignancies with over 50 histological subtypes and poor outcomes for metastatic disease.
2) The PALETTE trial found that treatment with pazopanib resulted in a median progression-free survival of 20 weeks compared to 7 weeks for placebo, representing a 65% reduction in risk of disease progression or death.
3) Subgroup analyses showed benefit of pazopanib across patient characteristics including number of prior therapies. Pazopanib was generally well-tolerated with mainly grade 1-2 adverse events.
NEOADJUVANT RADIOTHERPAY IN SOFT TISSUE SARCOMA- A DEBATEKanhu Charan
This document discusses the use of preoperative radiotherapy for soft tissue sarcomas (STS). Generally, guidelines recommend preoperative radiotherapy in 25-28 fractions of 1.8-2 Gy up to a total of 50-50.4 Gy over 5-6 weeks to increase local control compared to surgery alone. However, surgeons may be reluctant due to potential for increased wound complications and delayed surgery. A review of 11 studies found preoperative radiotherapy was associated with less local recurrence in retroperitoneal STS but more wound complications in extremity sarcoma, though it did not negatively affect overall survival or functional outcomes. Guidelines from NCCN and ESMO recommend considering preoperative radiotherapy for high-grade, deep or large
This document provides information about gynecologic cancers including ovarian cancer, cervical cancer, and endometrial cancer. It discusses risk factors, signs and symptoms, screening and prevention methods, staging, treatment options, and survival rates for each cancer. The key points are that ovarian cancer has no effective early screening test and often presents at advanced stages, while cervical and endometrial cancers can be prevented or detected early through regular pelvic exams and Pap/HPV testing. Treatment may involve surgery, radiation, chemotherapy, or a combination depending on the cancer type and stage. Overall survival rates vary but early detection improves prognosis. The document emphasizes patient education and advocacy.
Retroperitoneal Soft-Tissue Sarcoma: Retrospective Study at Shaukat Khanum Ca...Jibran Mohsin
This study retrospectively analyzed 54 patients with retroperitoneal soft tissue sarcoma treated at Shaukat Khanum Cancer Hospital over 5 years. The most common histology was well-differentiated liposarcoma (74%). The median age was 43 years and most patients presented with abdominal pain and mass. The 5-year overall survival rate was 74% and disease-free survival was 14 months. Factors associated with improved outcomes included negative resection margins and neoadjuvant therapy. This study provides valuable local data on treatment and outcomes of retroperitoneal soft tissue sarcoma in Pakistan.
Ewing sarcoma is the second most common bone tumor in children. Radiotherapy plays an important role in the treatment of both localized and metastatic Ewing sarcoma. For localized disease, radiotherapy is recommended for patients who cannot undergo surgery or have unresectable tumors. It is also used post-operatively if there is residual disease. For metastatic disease, radiotherapy can help control the primary tumor and reduce pulmonary metastases when combined with chemotherapy. Advances in radiotherapy planning and techniques have improved outcomes while reducing long-term side effects.
This article describes the management of 6 male patients with soft tissue sarcoma (STS) treated outside of a sarcoma center. Five patients presented with slowly growing painless masses of long duration, while the youngest patient had bilateral lung metastases shortly after resection of a primitive neuroectoderm tumor in his thigh. Investigations included imaging and biopsies to determine diagnoses, which included rare tumors. Wide surgical excision was performed in 5 cases, while forequarter amputation was necessary in one case. Local recurrence occurred in 3 patients, who received additional treatment. The author concludes that patients with STS can be satisfactorily managed outside a sarcoma center if standard guidelines are followed and the surgical team has adequate experience.
Radiation therapy plays an important role in the management of many bone tumors as an adjunct to surgery or as primary treatment for inoperable tumors. Newer radiation techniques like IMRT and proton beam therapy allow for more conformal dose distributions that improve local tumor control while reducing damage to surrounding healthy tissues. Radiation is used as primary treatment, post-operatively, or palliatively depending on the tumor type, location, surgical margins, and other factors.
ROLE OF RADIATION IN BONE TUMORS FOR ORTHOPEDICSKanhu Charan
This document discusses soft tissue sarcomas. It begins by listing various histologic diagnoses of soft tissue sarcomas categorized by tissue of origin. It then discusses imaging with MRI and CT to evaluate tumors. Key points regarding surgery include performing limb-sparing over amputation when possible and obtaining negative margins of at least 2cm if no post-op radiation is planned. Adjuvant radiation improves local control but not necessarily survival. Pre-op radiation may increase wound complications compared to post-op.
This document discusses the role of radiotherapy in treating extremity sarcoma. It notes that radiotherapy combined with conservative surgery can achieve local tumor eradication while preserving limb function with low toxicity. Several studies have shown that radiotherapy improves local control compared to surgery alone, without compromising overall survival. Modern imaging and radiotherapy techniques like IMRT allow for smaller treatment volumes and better sparing of critical structures like bone and skin flaps. Radiotherapy requires multidisciplinary collaboration between radiation oncologists and surgeons to determine the optimal treatment approach for each patient.
1) Chemotherapy has improved survival rates for osteosarcoma dramatically over the past 30 years from less than 20% to between 40-60% through the use of effective combination chemotherapy and neoadjuvant treatment.
2) Key trials showed that neoadjuvant chemotherapy followed by surgery and adjuvant chemotherapy improved relapse-free and overall survival compared to surgery alone.
3) The combination of doxorubicin and cisplatin administered every 3 weeks is now considered the standard first-line chemotherapy regimen based on results from large cooperative trials.
This document discusses the treatment of Ewing's sarcoma. It begins with an introduction to Ewing's sarcoma, describing its identification in 1921 and its characteristics. It then discusses the pathology, genetics, clinical presentation, routes of spread, diagnostic workup, staging, and prognostic factors. The bulk of the document focuses on treatment options, including induction chemotherapy, local therapy options of surgery or radiation, maintenance chemotherapy, and surveillance. It also covers treatment of metastatic and recurrent disease. The document provides detailed information on chemotherapy regimens, radiation techniques, and ongoing research directions.
These are the slides I used in a three hour presentation/workshop about responsive web design. The audience consisted of students wanting to get up to speed with responsive web design techniques.
1. This study aims to evaluate survival outcomes, quality of life, and activities of daily living in patients with high-grade gliomas treated with conformal radiation therapy followed by a boost with Cyberknife radiosurgery.
2. Patients with confirmed high-grade gliomas and good performance status will receive maximal safe resection followed by intensity-modulated radiation therapy and a Cyberknife boost to the tumor area.
3. The primary objectives are to assess progression-free survival, overall survival, quality of life scores, and activities of daily living after higher radiation doses.
Current and emerging partnerships in imaging and radiotherapy by musila mutalaKesho Conference
This document discusses the role of imaging in radiotherapy and outlines several key points:
1. Imaging has evolved from basic x-rays to cross-sectional imaging like CT and MRI to better define tumor volumes and organs at risk.
2. Modern radiotherapy relies on accurate tumor delineation using imaging for treatment planning, simulation, delivery, verification and monitoring.
3. Emerging technologies like PET and functional MRI provide complementary anatomical and biological information that can further improve radiotherapy outcomes.
4. Greater collaboration between radiology and radiation oncology departments, including dedicated imaging units and personnel, can help maximize the benefits of modern imaging for radiotherapy.
Bone tumors can be benign or malignant. Common benign bone tumors include osteochondroma and osteoid osteoma, while common malignant bone tumors are osteosarcoma, chondrosarcoma, and Ewing's sarcoma. Bone tumors are classified based on their location, histologic type, and other characteristics. Diagnostic evaluation involves imaging like x-rays, CT, MRI and biopsy. Staging systems evaluate tumor grade, size, and metastasis status. Treatment depends on tumor type, stage, and other factors.
This slide includes physical, biological properties of proton and its advantage over the photon. It also provides information from beam production to treatment planning system of proton therapy, its potential applications, cost effectiveness and demerits.
This document discusses radiotherapy planning and techniques for breast cancer treatment. It describes the iterative process of developing a treatment plan, which involves initial beam arrangement based on clinical experience, reviewing dose distributions, and modifying the plan based on parameters like isodose lines and dose-volume histograms. It also covers challenges like respiratory motion and setup uncertainties, and techniques to address these like deep inspiratory breath hold and respiratory gating. The goal is to deliver the prescribed radiation dose to the target while sparing surrounding healthy tissues as much as possible.
This document discusses guidelines for evaluating radiotherapy treatment plans for primary brain tumors. It provides indications for radiotherapy based on tumor type and extent of resection. Key factors in treatment planning include: contouring target volumes and organs at risk, optimizing dose distribution to cover the target while sparing organs at risk, and quantitatively evaluating plans using tools like isodose distributions, dose volume histograms and indices like coverage, conformity and homogeneity. Plan evaluation ensures the target receives adequate and uniform dose while respecting organ at risk tolerances.
This document discusses technical issues in breast radiotherapy. It covers immobilization methods like breast boards and vac-locks to position patients. It describes how to determine field borders and angles for tangential fields. It also discusses treatment of regional lymph nodes like supraclavicular and internal mammary nodes. Techniques for breast conservation therapy like electron boosts and interstitial brachytherapy are covered. Guidelines for contouring regions like the breast and lymph nodes on CT scans are provided. The role of newer techniques like IMRT in breast radiotherapy is also summarized.
Soft tissue sarcomas are rare cancers that arise from connective tissues. They most commonly occur in the extremities and abdominal cavity. Diagnosis involves biopsy and imaging such as MRI or CT. Treatment is primarily surgical resection with clear margins, sometimes combined with radiation therapy or chemotherapy. Prognostic factors include tumor size, grade, and margin status. Complete surgical removal with negative margins improves local control and survival outcomes for soft tissue sarcomas.
This study aimed to evaluate the role of delayed primary excision (DPE) surgery after induction chemotherapy in localized nonmetastatic adult head and neck rhabdomyosarcoma. The study retrospectively analyzed 24 patients treated with either DPE followed by surgery, radiotherapy and chemotherapy or chemoradiotherapy without surgery. It found that 59% of DPE patients had a complete resection but 82% had residual viable tumors. Response to chemotherapy significantly impacted local control, with 100% local control for good responders versus 33% for poor responders. In good responders, DPE resulted in significantly better local control than chemoradiotherapy alone. However, treatment modality did not impact overall survival. Distant metastases
This document provides information on the evaluation and treatment of metastatic bone disease and spinal cord compression. It discusses:
1. Common sites of bone metastases from various primary cancers. Imaging tools to evaluate bone metastases like x-rays, bone scans, CT, PET, and MRI scans are described.
2. A multi-disciplinary treatment approach is recommended, including medical treatment, surgery, radiotherapy, radionuclides, chemotherapy, and hormonal therapy.
3. Details are provided on conventional and advanced radiation therapy techniques for treating bone metastases and spinal cord compression, including stereotactic radiosurgery. Overall pain relief rates, time to pain relief, and the benefits of combining surgery and radiation therapy are
Presentation by Scott Oliver, MD. Presented at the 2018 Eyes on a Cure: Patient & Caregiver Symposium, hosted by the Melanoma Research Foundation's CURE OM initiative.
This document provides an overview of pediatric bone tumors, focusing on osteosarcoma and Ewing sarcoma. It discusses the epidemiology, clinical presentation, diagnostic workup, treatment, and outcomes of these two malignant bone tumors. Osteosarcoma most commonly affects the long bones of adolescents and is typically treated with neoadjuvant chemotherapy followed by surgery. Ewing sarcoma occurs in younger children and commonly involves the pelvis or long bones. It is treated with chemotherapy and local control with surgery or radiation therapy when possible. Both tumors require a multidisciplinary treatment approach to achieve long-term survival in approximately 60-75% of patients.
A 67-year-old female presented with a large unresectable sacral chordoma. Chordomas are rare tumors that arise from notochord remnants in the spine or skull. She received radiotherapy but the tumor recurred. Adjuvant radiation therapy improves local control rates for chordoma compared to surgery alone, but conventional radiation doses were often too low. Modern intensity-modulated radiation therapy allows safer dose escalation and achieves better local control and survival compared to older techniques. Particle therapy may further improve outcomes by concentrating the high radiation dose in the tumor.
Management of ewings sarcoma & osteosarcomaPRARABDH95
EBRT can play an important role in the management of Ewing sarcoma and osteosarcoma.
For Ewing sarcoma, radiotherapy is commonly used pre-operatively to sterilize the tumor bed, post-operatively for positive or close margins, or definitively when surgery is not possible. Treatment planning aims to cover the pre-treatment tumor volume plus a 2-2.5cm margin using IMRT or 3D-CRT.
For osteosarcoma, radiotherapy can be used definitively for unresectable tumors or adjuvantly after surgery if margins were positive. A dose of 70.2Gy is typically prescribed for definitive cases and 64.8Gy for
Externalbeam rt in ews3.12.20 - frida yseminar-finallllPRARABDH95
1) Ewing sarcoma and osteosarcoma are rare bone cancers that typically affect children and young adults. Ewing sarcoma is the second most common primary bone cancer while osteosarcoma most commonly presents as a primary bone malignancy.
2) Both cancers are diagnosed through imaging, biopsy and staging workup. Management involves chemotherapy along with local therapy through surgery and/or radiation therapy.
3) Radiation therapy planning aims to adequately cover the tumor volume while sparing nearby organs at risk. Techniques such as 3D conformal radiation therapy and intensity modulated radiation therapy (IMRT) allow for improved dose distribution over conventional radiation.
Ewing's sarcoma is a rare type of cancer that affects bone or soft tissue. It was first described by Dr. James Ewing in the early 20th century. Ewing's sarcoma is considered to be radiosensitive, with radiation therapy historically being a primary treatment option. More recently, surgery has emerged as an important local treatment approach, especially with improvements in surgical techniques allowing for limb-sparing procedures. Current guidelines recommend a multi-disciplinary approach using a combination of radiation therapy, surgery, and chemotherapy depending on the specific factors of each case.
Ewing's sarcoma is a rare type of cancer that develops in bone or soft tissue. It is the second most common primary bone cancer in children and adolescents between 10-20 years old. The cancer presents with local swelling and tenderness at the affected site, most commonly the diaphysis of long bones. Metastasis is often present at diagnosis, with the lungs being the most common site. Diagnosis is confirmed through histopathological or cytogenetic testing. Treatment involves neoadjuvant chemotherapy followed by local tumor control through surgery or radiation therapy, along with adjuvant chemotherapy. Five-year survival rates have improved to around 70% with current multi-agent chemotherapy regimens.
Radiation induced sarcomas in head and neckSheh Rawat
The document discusses radiation-induced sarcomas that develop in the head and neck region after radiation therapy. Some key points:
1) These sarcomas are rare, occurring in less than 1% of patients who receive radiation therapy, and there is usually a long latency period of over 10 years between radiation exposure and tumor development.
2) Cahan's criteria from 1948 established diagnostic guidelines for radiation-induced sarcomas, requiring evidence of prior radiation, a latency period of over 5 years, and histological confirmation of sarcoma.
3) Prognosis for head and neck radiation-induced sarcomas is poor, with 5-year survival rates between 10-30%, due to delayed
Chondrosarcoma is the second most common primary bone tumor that occurs mostly in middle-aged and older adults. It is associated with cartilage matrix production and lacks osteoid. Risk factors include malignant transformation of osteochondromas or enchondromas. Diagnosis involves imaging like CT or MRI followed by biopsy. Treatment depends on histologic grade and location. Surgical excision is the primary treatment, while radiotherapy may be used for intermediate to high grade or unresectable tumors. Several studies have shown good local control rates with combined surgery and radiotherapy for chondrosarcoma.
This document provides an overview of palliative radiation therapy for cancer patients. It discusses the fundamentals of how radiation works and advances that have allowed it to more effectively treat cancer. It then focuses on how palliative radiation can effectively relieve symptoms from bone metastases, lung cancer, bleeding, and other cancers in 1-3 fractions rather than longer courses of treatment. Studies show short fractionation schedules provide pain relief comparable to longer schedules with fewer side effects and greater convenience. The document provides guidance on discussing palliative radiation options with radiation oncologists to help simplify the process for hospice patients.
Ewing's sarcoma is a rare cancer that affects bones or soft tissue. It is characterized by small, round cancer cells and commonly affects children and young adults. Treatment involves induction chemotherapy, followed by local therapy with surgery or radiation if possible, along with additional maintenance chemotherapy. The multimodal approach has improved survival rates in recent decades, though long-term outcomes remain challenging due to the risk of recurrence or secondary cancers.
This document summarizes information about acoustic neuromas, also known as vestibular schwannomas. It discusses the incidence, growth patterns, clinical presentation, evaluation, and management options for these tumors, including conservative management, microsurgery, and stereotactic radiosurgery. Key points include that acoustic neuromas are usually benign and slow-growing tumors originating in the internal auditory canal. Surgical removal aims to completely excise the tumor while preserving hearing and facial nerve function when possible. The appropriate treatment depends on factors like tumor size, growth rate, hearing status, and patient age and preferences.
High Risk disease is defined as “apparent localized cancer that has a high propensity of micro-metastatic disease” (cancer that is not visible on convention radiography, such as bone and CT scans). These cancers, once removed via radiation or surgery, are likely to "return," but in fact, they were never removed in the first place because the cancer cells were outside the treated region.
Therefore, successful eradication of high risk disease requires both aggressive local control and systemic treatment with androgen deprivation therapy and extended field radiation. This lecture will review the most up-to-date data on dose-intensity radiation therapy, pelvic radiation, surgery with adjuvant radiation, and adjuvant hormone therapy. Finally, data on experimental chemotherapy and abiraterone (Zytiga) will be presented.
Small cell lung cancer (SCLC) accounts for 13% of lung cancers and is strongly linked to smoking. SCLC typically presents as a large mass in the mediastinal lymph nodes. It is classified as limited stage, confined to one lung, or extensive stage with distant metastases. Treatment involves chemotherapy with cisplatin and etoposide, and sometimes radiation therapy. For limited stage SCLC, surgery may be an option for early tumors. While initial response rates are high, most patients experience relapse. Prophylactic cranial irradiation can reduce the risk of brain metastases. Even with optimal treatment, the 5-year survival rate remains low at 5-10% for extensive stage and 30-40% for limited stage disease
Primary bone tumors of the spine are rare, accounting for only 4.2% of spinal tumors. This study summarizes the experience of treating 18 cases of primary bone tumors of the spine over 10 years at two hospitals in Bangladesh. The most common tumors were malignant (61%), with the dorsal and lumbar spine being most commonly involved. Pain was the primary presenting symptom in most cases. Surgical treatment with the aim of complete resection when possible combined with preservation of neurological function and spinal stabilization was performed. Adjuvant chemotherapy and radiation were also used. Outcomes were improved pain and function, though malignant tumors often had poorer outcomes and higher mortality. Early diagnosis and multidisciplinary treatment were concluded to be important for managing these rare tumors
Soft tissue sarcomas, treatment (surgical, radiation, chemotherapy)Joseph A. Di Como MD
This document discusses soft tissue sarcomas (STS), a rare type of cancer that arises in connective tissues like muscles or fat. It notes that STS account for about 1% of adult cancers in the US, with most occurring in extremities or trunk. Risk factors include radiation exposure, certain chemicals, and genetic conditions. STS are classified and graded based on cell type and differentiation. Treatment typically involves surgical resection with clear margins, sometimes combined with radiation or chemotherapy depending on stage, grade, and location. Prognosis depends on stage and grade, with 5-year survival rates ranging from 54-65% after complete resection of primary retroperitoneal sarcomas.
This document summarizes several studies on the risks of cancer from radiation exposure during medical imaging exams like CT scans and X-rays. Some key findings discussed are: 1) Studies have found small increased risks of leukemia and brain tumors from radiation exposure during childhood medical imaging; 2) Exposure to low doses of radiation from cardiac imaging after a heart attack was associated with a small increased risk of cancer; 3) One study estimated that CT scans in children could triple the risk of leukemia from doses over 50 mGy and triple the risk of brain tumors from doses over 60 mGy. However, the absolute risks were considered small.
This document provides information about soft tissue tumors. It discusses the epidemiology, classification, etiology, diagnosis and treatment of both benign and malignant soft tissue tumors. Some key points include:
- Benign soft tissue tumors are more common than sarcomas. Common benign tumors include lipomas, schwannomas and giant cell tumors of the tendon sheath.
- Risk factors for soft tissue sarcoma include exposure to herbicides/pesticides, radiation exposure, genetic conditions and viral infections.
- MRI is usually the best imaging modality for evaluating soft tissue tumors. Biopsy is needed for diagnosis.
- Treatment depends on whether the tumor is benign or malignant. Benign tumors may
Similar to Radiotherapy in the Treatment of Sarcomas in Adolescents and Young Adults (20)
Cancer is a leading cause of death among adolescents and young adults aged 15-39 years in industrialized societies. Incidence rates of cancer rise sharply from 150 per million per year among those aged 15-19 to 550 per million per year among those aged 25-29. While survival rates are high for certain cancers common in this age group like Hodgkin's lymphoma and testicular cancer, overall survival rates remain lower than for younger children and older adults. Ensuring adolescents and young adults receive treatment in age-appropriate settings through specialized centers and have access to clinical trials is important to improving outcomes.
Adolescents and Young Adults With Cancer Treatment and Transition to An Adult...Methodist HealthcareSA
The document discusses adolescents and young adults with cancer, focusing on their treatment and transition to adult oncology care. It notes that this age group has among the highest cancer incidence rates, poorest health outcomes, and faces unique psychosocial challenges. Specifically, it finds that they have lower rates of health insurance, experience more delayed diagnoses, receive suboptimal treatment dosing, and have worse survival rates than pediatric or older adult cancer patients. The document also examines barriers to appropriate care during the transition period and possible solutions such as establishing healthcare transition teams and increasing education for adult providers.
Alberto Pappo, MD, St. Jude Children’s Hospital, Memphis TN
Presented at the 2010 Texas Adolescent and Young Adult Oncology Conference hosted by Methodist Healthcare-San Antonio. October 2010.
This document summarizes research on fostering resilience in adolescents and young adults with cancer. It describes:
1) The development of a preliminary Resilience in Illness Model (RIM) to guide interventions based on both qualitative and quantitative studies.
2) Evaluation studies providing support for the RIM and its ability to explain variance in resilience and other outcomes.
3) A current randomized clinical trial testing a therapeutic music video intervention incorporating the RIM for adolescents undergoing stem cell transplantation.
4) Preliminary positive findings and plans for future studies expanding the intervention to include family communication support.
This document discusses barriers to cancer care for adolescents and young adults (AYAs), including a lack of specialized centers for their age group, transitioning between pediatric and adult care, and being a medically underserved population. It notes AYAs face health disparities like unequal access to care, inferior outcomes, and unequal burden of morbidity and quality of life. Diagnostic delays can occur from ignoring symptoms, lack of access to care, and physicians not considering cancer. Treatment barriers include difficulties with intensive dosing schedules, side effects impacting daily life, and pressure to remain "normal." Survivorship brings additional long term risks. The adult oncology setting does not provide a peer group and patients may feel out of place developmentally
This document discusses fertility preservation options for adolescents and young adults undergoing cancer treatment. It provides an overview of the risks cancer treatments pose to fertility for both males and females. For males, sperm banking and testicular tissue freezing are discussed as options. For females, embryo banking, oocyte cryopreservation, and ovarian tissue freezing are covered, though many methods are still considered experimental. The challenges of discussing fertility with young patients and barriers to accessing fertility preservation are also summarized.
The document discusses the impact of cancer and its treatments on the sexual health and intimacy of adolescent and young adult cancer survivors. It describes how cancer can affect patients physically, psychologically, and socially. This includes effects on sexual function, esteem, and distress as well as quality of life. The document recommends using models like PLISSIT to assess patients' sexual health needs and addresses challenges and barriers to discussing sexuality with young patients.
Osteosarcomas and Ewing Sarcomas most commonly affect teenagers and young adults, with osteosarcomas occurring more often in males and Ewing sarcomas occurring more often in females. Younger patients tend to have worse survival rates for both cancers. The objectives of the study were to analyze how age and gender impact outcomes for patients with osteosarcoma and Ewing sarcoma.
This document summarizes a presentation on fostering resilience in adolescents and young adults with cancer. The presentation reviews the current state of knowledge on resilience and quality of life. It then describes the Resilience in Illness Model, which examines risk and protective factors for individuals and families coping with illness. Finally, it identifies potential strategies and future research areas to help promote resilience in adolescent and young adult cancer patients.
Adolescents and young adults (AYA) with cancer face barriers to care in medical oncologist offices. Common barriers include a lack of AYA-specific clinical trials, guidelines, and treatment protocols. There is also a lack of psychosocial support services tailored to the unique needs of AYAs. Developing dedicated AYA clinics, expanding clinical trial eligibility, and improving psychosocial support could help overcome these barriers and improve cancer care for AYAs.
This document provides suggestions for sexual health and lubricants for positive sexual interaction, including recommended lubricants like Astroglide, K-Y, and Replens as well as alternatives like vitamin E oil, plain yogurt, and albolene. It also lists resources for dilators, periometers, websites with information and support, and books on topics like sexuality and illness, enhancing intimacy, and coping with issues like erectile dysfunction.
This document discusses fertility assessment and interventions for adolescents and young adults with cancer. It aims to raise awareness of the fertility risks cancer poses to this group and reviews options available to preserve their reproductive potential, such as sperm, egg, and embryo banking. Fertility preservation should be discussed with all patients facing cancer treatments that could impact fertility.
Soft tissue sarcomas are a group of rare cancers that develop in tissues like muscle, fat, blood vessels or deep skin tissues. The most common soft tissue sarcomas in adolescents and young adults are undifferentiated pleomorphic sarcoma, myxofibrosarcoma and synovial sarcoma. A diagnostic plan involves imaging tests, biopsy and pathology review to determine the type and stage of cancer. Treatment typically involves surgery along with radiation and/or chemotherapy depending on the cancer's stage and grade.
Sexual and Intimate Needs of Adolescents and Young Adults with Cancer: A Qual...Methodist HealthcareSA
Sexual and Intimate Needs of Adolescents and Young Adults with Cancer: A Quality of Life Issue
Author: Sage Bolte, PhD, LCSW., Life With Cancer, Fairfax, VA
Presented to the 2010 Texas Adolescent and Young Adult Oncology Conference hosted by Methodist Healthcare-San Antonio in October 2010
Informed Consent for the Treatment of Adolescents and Young Adults with CancerMethodist HealthcareSA
Author: Conrad Fernandez, MD., IWK Health Centre, Halifax, NS
Presented at the 2010 Texas Adolescent and Young Adult Oncology Conference hosted by Methodist Healthcare-San Antonio in October 2010
This document discusses treating young adults with acute lymphoblastic leukemia and whether current progress is being made. It notes that ALL represents about 1% of adult malignancies but outcomes differ based on age, with younger patients faring better. The document advocates starting a clinical trial for patients aged 21-39 to test whether a pediatric-based therapy could achieve better results than standard adult protocols given improvements seen in adolescents. Key questions to address include what regimen should be the standard arm and how to overcome obstacles to recruiting this underinsured patient group.
Developing an AYA Oncology Center requires assessing the value, reviewing necessary elements, and discussing potential barriers and strategies. Elements include dedicated clinicians, social workers, psychologists, child life specialists, and programs tailored for AYA patients' unique psychosocial needs. Barriers include lack of funding and clinical trials, but these can be overcome through community partnerships, research collaborations, and advocacy.
This document discusses acute leukemia in adolescent and young adult (AYA) patients from a nursing perspective. It aims to identify supportive care issues unique to AYA patients, discuss nursing interventions that can improve their care, and list resources nurses can provide AYA patients for additional guidance and support.
The document discusses updates on clinical trials at Dana Farber Cancer Institute for adolescents and young adults (AYA) with acute leukemia. It aims to identify differences in presenting characteristics and chemotherapy side effects between children and adults with acute leukemia, and determine which components of childhood acute lymphoblastic leukemia treatment regimens differ from those historically used for adults.
Adult patients with acute lymphoblastic leukemia have seen little progress in treatment outcomes compared to children, despite decades of research. The reasons include lower enrollment of adults in clinical trials, biological differences between adult and childhood ALL, and less intensive treatment protocols used for adults. New clinical trials aim to improve outcomes for young adult patients with ALL through more targeted therapies and protocols adapted from pediatric oncology.
Our backs are like superheroes, holding us up and helping us move around. But sometimes, even superheroes can get hurt. That’s where slip discs come in.
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
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Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
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These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
Radiotherapy in the Treatment of Sarcomas in Adolescents and Young Adults
1. Radiotherapy in the Treatment of Sarcomas in Adolescents and Young Adults 2008 ACC Defensive Player of the Year, and his 2009 season was expected to make him an NFL first-round draft pick
3. Scope of Problem in AYAs Sarcomas 15% Leukemia 14% Germ Cell Tumors 13% Brain Tumors 10% Thyroid Carcinoma 8% Melanoma 8% Other 9% Lymphoma 23% Bone sarcoma 8% Soft tissue sarcoma 7%
4. How Radiation is Perceived Seminars in Oncology, 2009 Number of times “radiation” is mentioned relative to side effects: 11 Number of times “radiation” is mentioned as a treatment modality: 7
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8. Value of RT for Adolescent and Young Adult Bone Sarcomas Remember: Sarcoma type determines radiosensitivity, disease control outcomes
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13. Value of RT for Adolescent and Young Adult Soft Tissue Sarcomas
14. “ The management of this condition should be radical surgery and that no help should be expected from radiotherapy either as a pre- or postoperative procedure” - Dr. Ralston Paterson (1963) Holt Radium Institute at the Christie Cancer Hospital, founded by Ralston Patterson Soft Tissue Sarcoma: Then
15. Annals of Surgery, 1982 27 pts WLE+RT 16 pts Amputation 43 pts High grade STS Extremity
32. Bone Complications of Radiation Treatment Traditional risk factors for fracture: ● radiation dose (mean dose >37 Gy) ● periosteal stripping ● female gender Pathogenesis: microvascular supply; osteoclast alteration? Rate of fracture in patients with Ewing sarcoma of weight bearing bone: 30% Slipped femoral capital epiphysis radiation injury to the proximal femoral growth apparatus + weight-bearing stress After only 12 Gy
In 1970’s, 30-40% extremity sarcoma’s were treated with amputation Now, its <15%
AP view of a knee in a teenager treated with 54.8 Gy for a synovial sarcoma Transverse pathologic fracture of the paroximal tibial metaphysis 4 years later, healed fracture but extensive radiation osteitis of the distal femur and proximal tibia 9 years later, osteosarcoma developed in the proximal tibia
AP view of the knee of a Ewing sarcoma patient shows growth impairment with metasphseal widening and sclerosis 14 months laters, the distal femoral metaphysis is markedly sclerotic and irregegular. The epiphyseal cartilage plate appears hypertrophied.
Teenager treated for Ewing sarcoma of the right humerus, photo 11 years post RT. Note difference in the muscule development when he started lifting weights.