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Enhanced DNA double-strand break repair of microbeam targeted A549 lung carcinoma cells by adjacent WI38 normal lung fibroblast cells via bi-directional signaling

Kobayashi A, Tengku Ahmad TAF, Autsavapromporn N, Oikawa M, Homma-Takeda S, Furusawa Y, et al.

Mutat Res, 2017 10;803-805:1-8.
PMID: 28689138 DOI: 10.1016/j.mrfmmm.2017.06.006

Understanding the mechanisms underlying the radiation-induced bystander effect (RIBE) and bi-directional signaling between irradiated carcinoma cells and their surrounding non-irradiated normal cells is relevant to cancer radiotherapy. The present study investigated propagation of RIBE signals between human lung carcinoma A549 cells and normal lung fibroblast WI38 cells in bystander cells, either directly or indirectly contacting irradiated A549 cells. We prepared A549-GFP/WI38 co-cultures and A549-GFP/A549 co-cultures, in which A549-GFP cells stably expressing H2BGFP were co-cultured with either A549 cells or WI38 cells, respectively. Using the SPICE-NIRS microbeam, only the A549-GFP cells were irradiated with 500 protons per cell. The level of γ-H2AX, a marker for DNA double-strand breaks (DSB), was subsequently measured for up to 24h post-irradiation in three categories of cells: (1) "targeted"/irradiated A549-GFP cells; (2) "neighboring"/non-irradiated cells directly contacting the "targeted" cells; and (3) "distant"/non-irradiated cells, which were not in direct contact with the "targeted" cells. We found that DSB repair in targeted A549-GFP cells was enhanced by co-cultured WI38 cells. The bystander response in A549-GFP/A549 cell co-cultures, as marked by γ-H2AX levels at 8h post-irradiation, showed a decrease to non-irradiated control level when approaching 24h, while the neighboring/distant bystander WI38 cells in A549-GFP/WI38 co-cultures was maintained at a similar level until 24h post-irradiation. Surprisingly, distant A549-GFP cells in A549-GFP/WI38 co-cultures showed time dependency similar to bystander WI38 cells, but not to distant cells in A549-GFP/A549 co-cultures. These observations indicate that γ-H2AX was induced in WI38 cells as a result of RIBE. WI38 cells were not only involved in rescue of targeted A549, but also in the modification of RIBE against distant A549-GFP cells. The present results demonstrate that radiation-induced bi-directional signaling had extended a profound influence on cellular sensitivity to radiation as well as the sensitivity to RIBE.

Matched MeSH terms: Lung Neoplasms/radiotherapy
Fulltext Characterization of MOSkin detector for in vivo skin dose measurement during megavoltage radiotherapy

Jong WL, Wong JH, Ung NM, Ng KH, Ho GF, Cutajar DL, et al.

J Appl Clin Med Phys, 2014 Sep 08;15(5):4869.
PMID: 25207573 DOI: 10.1120/jacmp.v15i5.4869

In vivo dosimetry is important during radiotherapy to ensure the accuracy of the dose delivered to the treatment volume. A dosimeter should be characterized based on its application before it is used for in vivo dosimetry. In this study, we characterize a new MOSFET-based detector, the MOSkin detector, on surface for in vivo skin dosimetry. The advantages of the MOSkin detector are its water equivalent depth of measurement of 0.07 mm, small physical size with submicron dosimetric volume, and the ability to provide real-time readout. A MOSkin detector was calibrated and the reproducibility, linearity, and response over a large dose range to different threshold voltages were determined. Surface dose on solid water phantom was measured using MOSkin detector and compared with Markus ionization chamber and GAFCHROMIC EBT2 film measurements. Dependence in the response of the MOSkin detector on the surface of solid water phantom was also tested for different (i) source to surface distances (SSDs); (ii) field sizes; (iii) surface dose; (iv) radiation incident angles; and (v) wedges. The MOSkin detector showed excellent reproducibility and linearity for dose range of 50 cGy to 300 cGy. The MOSkin detector showed reliable response to different SSDs, field sizes, surface, radiation incident angles, and wedges. The MOSkin detector is suitable for in vivo skin dosimetry.

Matched MeSH terms: Radiotherapy, High-Energy/instrumentation*
Fulltext Photobiostimulatory Effect of a Single Dose of Low-Level Laser on Orthodontic Tooth Movement and Pain

Qamruddin I, Alam MK, Mahroof V, Fida M, Khamis MF, Husein A

Pain Res Manag, 2021;2021:6690542.
PMID: 34055122 DOI: 10.1155/2021/6690542

Objective: To assess the effect of low-level laser applied at 3 weeks intervals on orthodontic tooth movement (OTM) and pain using conventional brackets (CB).
Materials and Methods: Twenty patients with Angle's class II div 1 (10 males and 10 females; aged 20.25 ± 3.88 years) needing bilateral extractions of maxillary first bicuspids were recruited. Conventional brackets MBT of 0.022 in slot (McLaughlin Bennett Trevisi) prescription braces (Ortho Organizers, Carlsbad, Calif) were bonded. After alignment and levelling phase, cuspid retraction began with nitinol closed coil spring on 19 × 25 stainless steel archwire, wielding 150 gram force. 7.5 J/cm2 energy was applied on 10 points (5 buccal and 5 palatal) on the canine roots on the investigational side using gallium-aluminum-arsenic diode laser (940 nm wavelength, iLase™ Biolase, Irvine, USA) in a continuous mode. Target tissues were irradiated once in three weeks for 9 weeks at a stretch (T0, T1, and T2). Patients were given a feedback form based on the numeric rating scale (NRS) to record the pain intensity for a week. Silicon impressions preceded the coil activation at each visit (T0, T1, T2, and T3), and the casts obtained were scanned with the Planmeca CAD/CAM™ (Helsinki, Finland) scanner.
Results: The regimen effectively accelerated (1.55 ± 0.25 mm) tooth movement with a significant reduction in distress on the investigational side as compared to the placebo side (94 ± 0.25 mm) (p < 0.05).
Conclusions: This study reveals that the thrice-weekly LLLT application can accelerate OTM and reduce the associated pain.

Matched MeSH terms: Toothache/radiotherapy*
ENDOMETRIAL CARCINOMA

MEARSES SD

Med J Malaysia, 1963 Jun;17:253-62.
PMID: 14065443
Matched MeSH terms: Neoplasms/radiotherapy*
Neck stiffness in a post-irradiated nasopharyngeal carcinoma adult: An unusual diagnosis

Lorna Ting KN, Liew YT, Abu Bakar Z, Narayanan P

Auris Nasus Larynx, 2019 Jun;46(3):469-473.
PMID: 30049634 DOI: 10.1016/j.anl.2018.07.002

Nasopharyngeal carcinoma is a neoplasm commonly found in population of South East Asia. The mainstay of treatment is high dose irradiation. Complications from radiotherapy are not uncommon especially to those nearby structures such as vertebrae and spinal cord. A 57 year-old gentleman with nasopharyngeal carcinoma (NPC) who was treated with chemo-radiation (total of 35 fractions,70Gy) presented to us 6 months post therapy with bilateral nasal discharge and progressive neck stiffness. Nasoendoscopy showed inflamed nasophayngeal mucosa and Computed Tomography (CT) brain and cervical spine showed retropharyngeal and anterior epidural collection with extension into atlantoaxial bone and spinal cord compression. Histopathological specimen revealed features of chronic inflammations with multiple actinomycetes colonies. Our patient suffered severe neck stiffness and loss of sensations on both upper limbs. He was treated conservatively with Halo vest and intravenous antibiotics for 8 weeks and recovered fully. Irradiation in NPC is known to cause devastating complications to cervical spine such as osteoradionecrosis, osteomyelitis. It also renders tissues hypoxic and risk of getting rare infection like actinomycosis. This report can represent a great diagnostic and therapeutic challenge with differentials of tumor recurrence, osteoradionecrosis or osteomyelitis. Patients must be regularly followed up to look for possible cervical complications as a result from irradiation, to prevent devastating outcome or prognosis.

Matched MeSH terms: Radiotherapy, Conformal/adverse effects
A computational model to investigate the influence of electrode lengths on the single probe bipolar radiofrequency ablation of the liver

Cheong JKK, Yap S, Ooi ET, Ooi EH

Comput Methods Programs Biomed, 2019 Jul;176:17-32.
PMID: 31200904 DOI: 10.1016/j.cmpb.2019.04.028

BACKGROUND AND OBJECTIVES: Recently, there have been calls for RFA to be implemented in the bipolar mode for cancer treatment due to the benefits it offers over the monopolar mode. These include the ability to prevent skin burns at the grounding pad and to avoid tumour track seeding. The usage of bipolar RFA in clinical practice remains uncommon however, as not many research studies have been carried out on bipolar RFA. As such, there is still uncertainty in understanding the effects of the different RF probe configurations on the treatment outcome of RFA. This paper demonstrates that the electrode lengths have a strong influence on the mechanics of bipolar RFA. The information obtained here may lead to further optimization of the system for subsequent uses in the hospitals.
METHODS: A 2D model in the axisymmetric coordinates was developed to simulate the electro-thermophysiological responses of the tissue during a single probe bipolar RFA. Two different probe configurations were considered, namely the configuration where the active electrode is longer than the ground and the configuration where the ground electrode is longer than the active. The mathematical model was first verified with an existing experimental study found in the literature.
RESULTS: Results from the simulations showed that heating is confined only to the region around the shorter electrode, regardless of whether the shorter electrode is the active or the ground. Consequently, thermal coagulation also occurs in the region surrounding the shorter electrode. This opened up the possibility for a better customized treatment through the development of RF probes with adjustable electrode lengths.
CONCLUSIONS: The electrode length was found to play a significant role on the outcome of single probe bipolar RFA. In particular, the length of the shorter electrode becomes the limiting factor that influences the mechanics of single probe bipolar RFA. Results from this study can be used to further develop and optimize bipolar RFA as an effective and reliable cancer treatment technique.

Matched MeSH terms: Liver Neoplasms/radiotherapy
Fulltext Racial/ancestral diversity in 174 toxicity-related radiogenomic studies: A systematic review

Zuber SH, Yahya N

J Cancer Res Ther, 2021 6 15;17(2):477-483.
PMID: 34121695 DOI: 10.4103/jcrt.JCRT_896_18

Purpose: This study systematically reviews the distribution of racial/ancestral features and their inclusion as covariates in genetic-toxicity association studies following radiation therapy.
Materials and Methods: Original research studies associating genetic features and normal tissue complications following radiation therapy were identified from PubMed. The distribution of radiogenomic studies was determined by mining the statement of country of origin and racial/ancestrial distribution and the inclusion in analyses. Descriptive analyses were performed to determine the distribution of studies across races/ancestries, countries, and continents and the inclusion in analyses.
Results: Among 174 studies, only 23 with a population of more one race/ancestry which were predominantly conducted in the United States. Across the continents, most studies were performed in Europe (77 studies averaging at 30.6 patients/million population [pt/mil]), North America (46 studies, 20.8 pt/mil), Asia (46 studies, 2.4 pt/mil), South America (3 studies, 0.4 pt/mil), Oceania (2 studies, 2.1 pt/mil), and none from Africa. All 23 studies with more than one race/ancestry considered race/ancestry as a covariate, and three studies showed race/ancestry to be significantly associated with endpoints.
Conclusion: Most toxicity-related radiogenomic studies involved a single race/ancestry. Individual Participant Data meta-analyses or multinational studies need to be encouraged.

Matched MeSH terms: Neoplasms/radiotherapy*
Fulltext The radiobiological effects of He, C and Ne ions as a function of LET on various glioblastoma cell lines

Chew MT, Bradley DA, Suzuki M, Matsufuji N, Murakami T, Jones B, et al.

J Radiat Res, 2019 Mar 01;60(2):178-188.
PMID: 30624699 DOI: 10.1093/jrr/rry099

The effects of the charged ion species 4He, 12C and 20Ne on glioblastoma multiforme (GBM) T98G, U87 and LN18 cell lines were compared with the effects of 200 kVp X-rays (1.7 keV/μm). These cell lines have different genetic profiles. Individual GBM relative biological effectiveness (RBE) was estimated in two ways: the RBE10 at 10% survival fraction and the RBE2Gy after 2 Gy doses. The linear quadratic model radiosensitivity parameters α and β and the α/β ratio of each ion type were determined as a function of LET. Mono-energetic 4He, 12C and 20Ne ions were generated by the Heavy Ion Medical Accelerator at the National Institute of Radiological Sciences in Chiba, Japan. Colony-formation assays were used to evaluate the survival fractions. The LET of the various ions used ranged from 2.3 to 100 keV/μm (covering the depth-dose plateau region to clinically relevant LET at the Bragg peak). For U87 and LN18, the RBE10 increased with LET and peaked at 85 keV/μm, whereas T98G peaked at 100 keV/μm. All three GBM α parameters peaked at 100 keV/μm. There is a statistically significant difference between the three GBM RBE10 values, except at 100 keV/μm (P < 0.01), and a statistically significant difference between the α values of the GBM cell lines, except at 85 and 100 keV/μm. The biological response varied depending on the GBM cell lines and on the ions used.

Matched MeSH terms: Glioblastoma/radiotherapy*
Borosilicate glass 60Co high dose rate brachytherapy thermoluminescence dosimetry

Nazeri AAZA, Sani SFA, Ung NM, Almugren KS, Alkallas FH, Bradley DA

Appl Radiat Isot, 2021 Oct;176:109814.
PMID: 34175543 DOI: 10.1016/j.apradiso.2021.109814

Brachytherapy is commonly used in treatment of cervical, prostate, breast and skin cancers, also for oral cancers, typically via the application of sealed radioactive sources that are inserted within or alongside the area to be treated. A particular aim of the various brachytherapy techniques is to accurately transfer to the targeted tumour the largest possible dose, at the same time minimizing dose to the surrounding normal tissue, including organs at risk. The dose fall-off with distance from the sources is steep, the dose gradient representing a prime factor in determining the dose distribution, also representing a challenge to the conduct of measurements around sources. Amorphous borosilicate glass (B2O3) in the form of microscope cover slips is recognized to offer a practicable system for such thermoluminescence dosimetry (TLD), providing for high-spatial resolution (down to

Matched MeSH terms: Radiotherapy Dosage*
An Îto stochastic differential equations model for the dynamics of the MCF-7 breast cancer cell line treated by radiotherapy

Oroji A, Omar M, Yarahmadian S

J Theor Biol, 2016 10 21;407:128-137.
PMID: 27457094 DOI: 10.1016/j.jtbi.2016.07.035

In this paper, a new mathematical model is proposed for studying the population dynamics of breast cancer cells treated by radiotherapy by using a system of stochastic differential equations. The novelty of the model is essentially in capturing the concept of the cell cycle in the modeling to be able to evaluate the tumor lifespan. According to the cell cycle, each cell belongs to one of three subpopulations G, S, or M, representing gap, synthesis and mitosis subpopulations. Cells in the M subpopulation are highly radio-sensitive, whereas cells in the S subpopulation are highly radio-resistant. Therefore, in the process of radiotherapy, cell death rates of different subpopulations are not equal. In addition, since flow cytometry is unable to detect apoptotic cells accurately, the small changes in cell death rate in each subpopulation during treatment are considered. Subsequently, the proposed model is calibrated using experimental data from previous experiments involving the MCF-7 breast cancer cell line. Consequently, the proposed model is able to predict tumor lifespan based on the number of initial carcinoma cells. The results show the effectiveness of the radiation under the condition of stability, which describes the decreasing trend of the tumor cells population.

Matched MeSH terms: Breast Neoplasms/radiotherapy*
Concurrent chemoradiotherapy for locoregionally advanced nasopharyngeal carcinoma: prospective feasibility and efficacy study in Malaysian patients

Elsherbieny E, Choo P, Alzoubi A

Hematol Oncol Stem Cell Ther, 2008 4 1;1(2):124-9.
PMID: 20063540
Matched MeSH terms: Radiotherapy*
Fulltext Potential lethal damage repair in glioblastoma cells irradiated with ion beams of various types and levels of linear energy transfer

Chew MT, Nisbet A, Suzuki M, Matsufuji N, Murakami T, Jones B, et al.

J Radiat Res, 2019 Jan 01;60(1):59-68.
PMID: 30452663 DOI: 10.1093/jrr/rry081

Glioblastoma (GBM), a Grade IV brain tumour, is a well-known radioresistant cancer. To investigate one of the causes of radioresistance, we studied the capacity for potential lethal damage repair (PLDR) of three altered strains of GBM: T98G, U87 and LN18, irradiated with various ions and various levels of linear energy transfer (LET). The GBM cells were exposed to 12C and 28Si ion beams with LETs of 55, 100 and 200 keV/μm, and with X-ray beams of 1.7 keV/μm. Mono-energetic 12C ions and 28Si ions were generated by the Heavy Ion Medical Accelerator at the National Institute of Radiological Science, Chiba, Japan. Clonogenic assays were used to determine cell inactivation. The ability of the cells to repair potential lethal damage was demonstrated by allowing one identical set of irradiated cells to repair for 24 h before subplating. The results show there is definite PLDR with X-rays, some evidence of PLDR at 55 keV/μm, and minimal PLDR at 100 keV/μm. There is no observable PLDR at 200 keV/μm. This is the first study, to the authors' knowledge, demonstrating the capability of GBM cells to repair potential lethal damage following charged ion irradiations. It is concluded that a GBM's PLDR is dependent on LET, dose and GBM strain; and the more radioresistant the cell strain, the greater the PLDR.

Matched MeSH terms: Glioblastoma/radiotherapy*
Fulltext Thermoluminescence Response of Ge-Doped Cylindrical-, Flat- and Photonic Crystal Silica-Fibres to Electron and Photon Radiation

Entezam A, Khandaker MU, Amin YM, Ung NM, Bradley DA, Maah J, et al.

PLoS One, 2016;11(5):e0153913.
PMID: 27149115 DOI: 10.1371/journal.pone.0153913

Study has been made of the thermoluminescence (TL) response of silica-based Ge-doped cylindrical, flat and photonic crystal fibres (referred to herein as PCF-collapsed) to electron (6, 12 and 20 MeV) and photon (6, 10 MV) irradiation and 1.25 MeV γ-rays, for doses from 0.1 Gy to 100 Gy. The electron and photon irradiations were delivered through use of a Varian Model 2100C linear accelerator located at the University of Malaya Medical Centre and γ-rays delivered from a 60Co irradiator located at the Secondary Standard Dosimetry Laboratory (SSDL), Malaysian Nuclear Agency. Tailor-made to be of various dimensions and dopant concentrations (6-10% Ge), the fibres were observed to provide TL yield linear with radiation dose, reproducibility being within 1-5%, with insensitivity to energy and angular variation. The sensitivity dependency of both detectors with respect to field size follows the dependency of the output factors. For flat fibres exposed to 6 MV X-rays, the 6% Ge-doped fibre provided the greatest TL yield while PCF-collapsed showed a response 2.4 times greater than that of the 6% Ge-doped flat fibres. The response of cylindrical fibres increased with core size. The fibres offer uniform response, high spatial resolution and sensitivity, providing the basis of promising TL systems for radiotherapy applications.

Matched MeSH terms: Radiotherapy/methods
Fulltext Salivary Amylase as a Marker of Salivary Gland Function in Patients Undergoing Radiotherapy for Oral Cancer

Vedam VKV, Boaz K, Natarajan S, Ganapathy S

J Clin Lab Anal, 2017 May;31(3).
PMID: 27637993 DOI: 10.1002/jcla.22048

BACKGROUND: The aim of this study was to evaluate salivary amylase in patients with primary oral cancer undergoing radiotherapy as the main modality of treatment.
MATERIALS/METHODS: The study was conducted on ten histologically proven cases of oral cancer undergoing radiotherapy. Stimulated whole saliva was collected at three stages of radiotherapy-0, 3, and 6 weeks. Salivary amylase was estimated using Henry-Chiamori method and comparison was made with appropriate age- and gender-matched controls.
RESULTS: Salivary amylase levels showed significant decrease in healthy subjects when compared to oral cancer patients (P < 0.001). The latter group also showed changing trend with initial decrease from 0 to 3 weeks followed by increase from 3 to 6 weeks following radiotherapy (P < 0.0528).
CONCLUSIONS: The trend in changes in the levels of salivary amylase could be used as a surrogate marker of salivary gland function in patients with oral cancer undergoing radiotherapy as primary treatment.

Matched MeSH terms: Mouth Neoplasms/radiotherapy*
Prognostic factors in patients with nasopharyngeal carcinoma treated in Hospital Kuala Lumpur

El-Sherbieny E, Rashwan H, Lubis SH, Choi VJ

Asian Pac J Cancer Prev, 2011;12(7):1739-43.
PMID: 22126556

BACKGROUND: Nasopharyngeal carcinoma is the third most common cancer among men in Peninsular Malaysia. However, no information is available about the prognostic factors. The objective of this study was to identify factors with an influence on outcome in patients treated in Hospital Kuala Lumpur.
METHODS: A total of 159 patients with non-metastatic nasopharyngeal carcinoma treated during 2002-2003 in Hospital Kuala Lumpur were included in this study. All received radiotherapy. Fifty three patients were treated with radiotherapy alone, while 106 patients received combination chemotherapy. Overall survival and local recurrence-free survival were analyzed using the Kaplan-Meier method and univariate analysis was performed using the log-rank test.
RESULTS: This study found out that 5-year overall survival and 5-year local recurrence-free survival rates were 58.6% and 54.2% respectively. The stage specific 5-year overall survival rates were: Stage I, 100%; Stage II; 93.3%, Stage III, 62.7%; Stage IVA, 42.2%; and Stage IVB, 40.6%. On univariate analysis, gender (p<0.05), T-classification (p<0.001), N-classification (p<0.05), stage (p<0.05) and cranial nerve involvement (p<0.001) were found to be significant prognostic factors for 5-year overall survival, while gender (p<0.05) and N-classification (p<0.05) were significant prognostic factors for 5-year local recurrence-free survival.
CONCLUSION: The overall survival rate of patients for this study was low. The patient factor that significantly affected 5-year overall survival was gender, while disease factors were stage, T-classification, N-classification and cranial nerve involvement.

Matched MeSH terms: Carcinoma, Squamous Cell/radiotherapy; Nasopharyngeal Neoplasms/radiotherapy
Fulltext Visual epilepsy in glioblastoma multiforme

Chong PK, Loo AV

Med J Malaysia, 2008 Dec;63(5):406-7.
PMID: 19803301 MyJurnal

We report a 33-year-old Chinese gentleman who presented with visual epilepsy and symptoms of raised intracranial pressure in which clinical examination revealed normal visual fields and acuity despite Magnetic Resonance Imaging (MRI) brain showing large contrast enhancing mass at the right occipital lobe. Craniotomy and excision of tumour was done and the histology confirmed glioblastoma multiforme (GBM). He completed radiotherapy and recovered well except developing left inferior homonymous quadrantropia post operatively which improved with time.

Matched MeSH terms: Brain Neoplasms/radiotherapy; Glioblastoma/radiotherapy
Endoscopic transpterygoidal repair of a large cranial defect with cerebrospinal fluid leak in a patient with extensive osteoradionecrosis of the skull base: case report and technical note

Brand Y, Lim E, Waran V, Prepageran N

J Laryngol Otol, 2015 Dec;129(12):1243-7.
PMID: 26412297 DOI: 10.1017/S0022215115002601

Endoscopic endonasal techniques have recently become the method of choice in dealing with cerebrospinal fluid leak involving the anterior cranial fossa. However, most surgeons prefer an intracranial approach when leaks involve the middle cranial fossa. This case report illustrates the possibilities of using endoscopic techniques for cerebrospinal fluid leaks involving the middle fossa.

Matched MeSH terms: Nasopharyngeal Neoplasms/radiotherapy*; Neoplasm Recurrence, Local/radiotherapy*
Phyllodes tumours of the breast: retrospective analysis of a University Hospital's experience

Toh YF, Cheah PL, Looi LM, Teoh KH, Tan PH

Malays J Pathol, 2016 Apr;38(1):19-24.
PMID: 27126660

Taking cognizance of the purported variation of phyllodes tumours in Asians compared with Western populations, this study looked at phyllodes tumours of the breast diagnosed at the Department of Pathology, University of Malaya Medical Centre over an 8-year period with regards to patient profiles, tumour parameters, treatment offered and outcome. Sixty-four new cases of phyllodes tumour were diagnosed during the period, however only 30 (21 benign, 4 borderline and 5 malignant) finally qualified for entry into the study. These were followed-up for 4-102 months (average = 41.7 months). Thirteen cases (8 benign, 3 borderline, 2 malignant) were Chinese, 9 (all benign) Malay, 7 (4 benign, 1 borderline, 2 malignant) Indian and 1 (malignant) Indonesian. Prevalence of benign versus combined borderline and malignant phyllodes showed a marginally significant difference (p=0.049) between the Malays and Chinese. Patients' ages ranged from 21-70 years with a mean of 44.9 years with no significant difference in age between benign, borderline or malignant phyllodes tumours. Except for benign phyllodes tumours (mean size = 5.8 cm) being significantly smaller at presentation compared with borderline (mean size = 12.5 cm) and malignant (mean size = 15.8 cm) (p<0.05) tumours, history of previous pregnancy, breast feeding, hormonal contraception and tumour laterality did not differ between the three categories. Family history of breast cancer was noted in 2 cases of benign phyllodes. Local excision was performed in 17 benign, 2 borderline and 3 malignant tumours and mastectomy in 4 benign, 2 borderline and 2 malignant tumours. Surgical clearance was not properly recorded in 10 benign phyllodes tumours. Six benign and all 4 borderline and 5 malignant tumours had clearances of <10 mm. Two benign tumours recurred locally at 15 and 49 months after local excision, however information regarding surgical clearance was not available in both cases. One patient with a malignant tumour developed a radiologically-diagnosed lung nodule 26 months after mastectomy, was given a course of radiotherapy and remained well 8-months following identification of the lung nodule.

Matched MeSH terms: Phyllodes Tumor/radiotherapy; Lung Neoplasms/radiotherapy
Prognostic role of adjuvant radiotherapy in triple-negative breast cancer: A historical cohort study

Bhoo-Pathy N, Verkooijen HM, Wong FY, Pignol JP, Kwong A, Tan EY, et al.

Int J Cancer, 2015 Nov 15;137(10):2504-12.
PMID: 26018878 DOI: 10.1002/ijc.29617

The value of adjuvant radiotherapy in triple-negative breast cancer (TNBC) is currently debated. We assessed the association between adjuvant radiotherapy and survival in a large cohort of Asian women with TNBC. Women diagnosed with TNBC from 2006 to 2011 in five Asian centers (N = 1,138) were included. Survival between patients receiving mastectomy only, breast-conserving therapy (BCT, lumpectomy and adjuvant radiotherapy) and mastectomy with radiotherapy were compared, and adjusted for demography, tumor characteristics and chemotherapy types. Median age at diagnosis was 53 years (range: 23-96 years). Median tumor size at diagnosis was 2.5 cm and most patients had lymph node-negative disease. The majority of patients received adjuvant chemotherapy (n = 861, 76%) comprising predominantly anthracycline-based regimes. In 775 women with T1-2, N0-1, M0 TNBCs, 5-year relative survival ratio (RSR) was highest in patients undergoing mastectomy only (94.7%, 95% CI: 88.8-98.8%), followed by BCT (90.8%, 95% CI: 85.0-94.7%), and mastectomy with radiotherapy (82.3%, 95% CI: 73.4-88.1%). The adjusted risks of mortality between the three groups were not significantly different. In 363 patients with T3-4, N2-3, M0 TNBCs, BCT was associated with highest 5-year RSR (94.1%, 95% CI: 81.3-99.4%), followed by mastectomy with radiotherapy (62.7%, 95% CI: 54.3-70.1%), and mastectomy only (58.6%, 95% CI: 43.5-71.6%). Following multivariable adjustment, BCT and mastectomy with radiotherapy remained significantly associated with lower mortality risk compared to mastectomy only. Overall, adjuvant radiotherapy was associated with higher survival in women aged <40 years, but not in older women. Adjuvant radiotherapy appears to be independently associated with a survival gain in locally advanced as well as in very young TNBC.

Matched MeSH terms: Radiotherapy, Adjuvant; Triple Negative Breast Neoplasms/radiotherapy*
Fulltext Neurological recovery in a patient with recurrent aggressive giant cell tumour of the axis--a case report

Razak MA, Fazir M

Med J Malaysia, 2000 Sep;55 Suppl C:97-100.
PMID: 11200052

A rare case of an aggressive recurrent giant cell tumour of axis is presented. The problems encountered in diagnosis and management are discussed. High dose dexamethasone was found to be useful managing this inoperable aggressive tumour which was compressing the cord. Early diagnosis would facilitate wide excision of the tumour with good prognosis.

Matched MeSH terms: Giant Cell Tumors/radiotherapy; Spinal Neoplasms/radiotherapy

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