RESUMEN
The aim of this analysis is to assess radiotherapy's role and technical aspects in an array of rare gastrointestinal (GI) cancers for adult patients. Collection data pertaining to radiotherapy and digestive rare cancers were sourced from Medline, EMBASE, and Cochrane Library. Preoperative chemoradiotherapy improved outcomes for patients with esophageal undifferentiated carcinoma compared with esophageal salivary gland types of carcinomas. For rare gastric epithelial carcinoma, perioperative chemotherapy is the common treatment. Adjuvant chemoradiotherapy showed no benefice compared with adjuvant chemotherapy for duodenal adenocarcinoma. Small bowel sarcomas respond well to radiotherapy. By analogy to anal squamous cell carcinoma, exclusive chemoradiotherapy provided better outcomes for patients with rectal squamous cell carcinoma. For anal adenocarcinoma, neoadjuvant chemoradiotherapy, followed by radical surgery, was the most effective regimen. For pancreatic neuroendocrine tumors, chemoradiotherapy can be a suitable option as postoperative or exclusive for unresectable/borderline disease. The stereotactic body radiotherapy (SBRT) is a promising approach for hepatobiliary malignancy. Radiotherapy is a valuable option in gastrointestinal stromal tumors (GIST) for palliative intent, tyrosine kinase inhibitors (TKIs) resistant disease, and unresectable or residual disease. Involved field (IF) radiotherapy for digestive lymphoma provides good results, especially for gastric extranodal marginal zone lymphoma (MALT). In conclusion, radiotherapy is not an uncommon indication in this context. A multidisciplinary approach is needed for better management of digestive rare cancers.
Asunto(s)
Adenocarcinoma , Carcinoma de Células Escamosas , Neoplasias Esofágicas , Neoplasias Gastrointestinales , Adulto , Humanos , Neoplasias Gastrointestinales/radioterapia , Carcinoma de Células Escamosas/radioterapia , Quimioradioterapia Adyuvante , Neoplasias Esofágicas/terapia , Quimioradioterapia , Terapia Neoadyuvante , Adenocarcinoma/tratamiento farmacológicoRESUMEN
BACKGROUND: The therapeutic modalities for nonmetastatic rectal cancer are presently undergoing major changes. The standard treatment is multidisciplinary, combining radiotherapy, chemotherapy, and surgery. The aim of this minireview is to provide an update on the place of organ preservation in the treatment of nonmetastatic rectal cancer in 2022. MAIN TEXT: The multimodal strategy based on initial radiochemotherapy followed by radical surgery with excision of the mesorectum has improved oncological results but at the expense of morbidity and sequelae altering life quality. The strategy of rectal preservation has been proposed since the 2000s after the publication of the results of the Brazilian study that proposed a simple surveillance after radiochemotherapy without surgery in good responders. In fact, preoperative radiochemotherapy was able to obtain a complete histological response in 10 to 30% of case. In view of this non-negligible percentage of tumor sterilization, which may well increase with the standardization of total neoadjuvant treatment, a strategy of organ preservation can be proposed in these patients to avoid morbidity and postoperative sequelae. SHORT CONCLUSION: This nonoperative approach is currently widely studied in certain patients who have a complete response (clinical, endoscopic, and radiological). However, the selection of these patients is not simple and still complex.
Asunto(s)
Preservación de Órganos , Neoplasias del Recto , Humanos , Neoplasias del Recto/patología , Quimioradioterapia , Terapia Neoadyuvante/métodos , Resultado del Tratamiento , Recurrencia Local de Neoplasia/tratamiento farmacológicoRESUMEN
This study proposes organization of the activity of a radiotherapy service during the pandemic COVID-19 period. Reliable circuits for staff as well as for patients are installed and treatment protocols are adapted to the current COVID-19 situation. Several scenarios are proposed to deal with any subsequent pandemic situation.
Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/prevención & control , Oncología Médica/métodos , Oncología Médica/organización & administración , Neoplasias/radioterapia , Pandemias/prevención & control , Neumonía Viral/prevención & control , COVID-19 , Humanos , Marruecos , SARS-CoV-2RESUMEN
Angiocentric lymphoma of the face is a rare malignancy. During 11 years, only two patients were treated for a lymphoma of the face. The first patient, 31-year-old, had an angiocentric lymphoma of the nasal cavity, the second patient, 40-year-old, had an angiocentric lymphoma of the nasopharynx and the maxillary sinuses, with an extension the hard palate. According to the Ann Arbor classification, the disease was stage IEab and stage IIEbb, respectively. The first patient was treated by chemotherapy alone (COP regimen) and the second patient underwent combined chemotherapy (CHOP) and radiotherapy. The follow-up was marked by progression of the disease 7 and 9 months after the end of the treatment in the two cases. For the angiocentric lymphoma, treatment based on radiotherapy or chemotherapy alone or combined does not often provide local control and the overall survival rate does not exceed 40% at 5 years.
Asunto(s)
Neoplasias Faciales/patología , Granuloma/patología , Linfoma/patología , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Progresión de la Enfermedad , Neoplasias Faciales/tratamiento farmacológico , Femenino , Granuloma/tratamiento farmacológico , Humanos , Linfoma/tratamiento farmacológico , Estadificación de Neoplasias , PronósticoRESUMEN
Nasopharyngeal adenoid cystic carcinoma is a rare tumor, few cases have been reported in the literature. The aim of this report is to present a new case of an adenoid cystic carcinoma of the nasopharynx. We report the case of a 50 years-old woman presenting with an adenoid cystic carcinoma of the nasopharynx with diffuse pulmonary metastasis. The treatment combined chemotherapy, based on cisplatin and adriamycin drugs, and palliative radiation therapy at the dose of 30 Gy. The patient died 6 months after diagnosis establishment. The best treatment of adenoid cystic carcinoma is complete surgical resection but extended resection can be difficult in some locations as nasopharynx. The adjuvant radiation therapy seems to improve local control.
Asunto(s)
Carcinoma Adenoide Quístico/diagnóstico , Carcinoma Adenoide Quístico/secundario , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/secundario , Neoplasias Nasofaríngeas/patología , Antibióticos Antineoplásicos/administración & dosificación , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Biopsia , Carcinoma Adenoide Quístico/tratamiento farmacológico , Cisplatino/administración & dosificación , Terapia Combinada , Doxorrubicina/administración & dosificación , Epistaxis/etiología , Resultado Fatal , Femenino , Cefalea/etiología , Humanos , Neoplasias Pulmonares/tratamiento farmacológico , Persona de Mediana Edad , Neoplasias Nasofaríngeas/complicaciones , Cuidados Paliativos , Pronóstico , Radioterapia Adyuvante , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
Muscular metatasis are rare, their number is probably underestimate. The authors report a case of a patient treated, in 1993, for a squamous cell carcinoma of the uterine cervix. Five years later, the patient developed a metatasis to muscular psoas. She underwent combined surgical excision and adjuvant radiation therapy. The patient is alive and well 30 months after diagnosis of the metastasis.
Asunto(s)
Carcinoma de Células Escamosas/secundario , Neoplasias de los Músculos/secundario , Músculos Psoas , Neoplasias del Cuello Uterino/patología , Biopsia , Braquiterapia , Carcinoma de Células Escamosas/cirugía , Femenino , Humanos , Persona de Mediana Edad , Neoplasias de los Músculos/cirugía , Estadificación de Neoplasias , Pronóstico , Radioterapia Adyuvante , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Neoplasias del Cuello Uterino/cirugíaRESUMEN
Botryoïde sarcoma of the uterine cervix is a very rare tumor of the young woman or during genial activity. Less than 100 cases have been reported in the literature. The treatment ranged from radical surgery to conservative surgery followed by chemotherapy. We report a case of cervical botryoide rhabdomyosarcoma occurred in a 33 year-old woman treated primary by chemotherapy followed by surgery and adjuvant chemotherapy. The patient died by extensive metastatic retroperitoneal nodes and lung.