J Buon
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Throughout the past two decades the efforts to improve the efficacy of treatment for locally advanced head and neck squamous cell carcinoma (HNSCC) have led to increased use of multimodality approaches combining surgery, radiotherapy (RT), and chemotherapy (CT). Conventional RT, a standard approach for locoregionally advanced disease, was associated with unsatisfactory results, thereby, a greater understanding of radiobiology led to the development of two classes of altered radiation fractionation schedules incorporating hyperfractionation (HF) and acceleration in the management of advanced HNSCC. Randomized controlled trials and meta-analyses demonstrated that for patients with locally advanced HNSCC major improvements in locoregional control (LRC) at high level of evidence can be achieved by accelerated fractionation (AF) and HF. ⋯ CCRT is now a standard treatment approach for patients with locally advanced HNSCC. CCRT has been also shown to allow organ preservation in almost two thirds of patients without affecting survival. Recently, strong evidence for an improved outcome for high-risk resected patients has been shown by the use of adjuvant CCRT.
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The objective of this study was to evaluate the palliation of pain of bone metastases with biphosphonates and different radiotherapy protocols in 372 cancer patients. ⋯ When combined with palliative radiotherapy, biphosphonates did not have any additive effects on pain palliation in the management of painful bone metastases. In addition, a single radiotherapy fraction provides equal pain palliation as multiple fractions.
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Case Reports
Leptomeningeal carcinomatosis presenting as bilateral sensorineural deafness and unilateral facial palsy.
This paper describes the case of a 56-year-old man with a history of small cell lung cancer under chemotherapy, who presented with left-sided peripheral facial palsy and progressive bilateral sensorineural deafness due to leptomeningeal carcinomatosis (LMC). Brain magnetic resonance imaging (MRI) of the petrosal bones and posterior cranial fossa revealed 2 solid lesions in the internal acoustic meatuses bilaterally and LMC of the skull base. Whole brain radiation therapy and methotrexate intrathecally were applied to the patient.
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Surgery remains the primary curative treatment for patients who have early-stage non-small cell lung cancer (NSCLC). The proper use of surgical resection depends on a careful assessment of the extent of disease and the cardiopulmonary function. Because lung cancer is more common in patients who have chronic obstructive pulmonary disease (COPD), it is important to select carefully those patients who can safely undergo potentially curative therapy, thereby minimizing postoperative morbidity and mortality. This article discusses the preoperative pulmonary assessment for patient selection, the preparation of high-risk patients, special surgical considerations, and patient management in the immediate postoperative period.
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To retrospectively assess prognostic factors and patterns of relapse in patients with oral tongue cancer treated by adjuvant radiotherapy (RT). ⋯ Local failure was the most important problem concerning the final outcome. High local recurrence rates and poor survival rates are important issues in the management of oral tongue cancer. Further strategies should be directed to enhancing cure rates.