Radiation Therapy in Kimura's Disease

Kimura's disease is a rare disorder which predominantly involves the head and neck region and causes eosinophilia in peripheral blood. It often responds well to corticosteroid therapy but some patients can be resistant; in these patients symptomatic radiation therapy can be of value. We reviewed 10 patients with Kimura's disease who received radiation therapy from 1975 through 1981 in the Department of Radiology, Chiba University Hospital. Nineteen tumors were irradiated and 15 of them locally controlled. in 5 patients, steroid therapy could be withdrawn. for local control, 25 to 30 Gy seemed to be adequate.     

阳泉市一万例乳腺疾病临床流行病学研究分析

目的 探讨山西省阳泉市肿瘤防治研究所1987年至2006年间1万例乳腺疾病的临床流行病学情况.方法 查阅1987年至2006年间阳泉市城、矿、郊三区在研究所就诊患者资料,对有较完整病例资料,并经乳腺钼靶X线、乳线近红外线、乳腺超声及部分针吸活检、溢液涂片检查,诊断为乳腺疾病的1万例患者进行分析研究.结果 门诊治疗患者8919例,其中乳腺增生7493例;住院患者1081人,其中排序前5位疾病为:乳腺癌342例,1987年至1996年,125例:其中21～30岁,3例,31～40岁,23例;1997年至2006年,217例:其中21～30岁,24例,31～40岁,69例,乳腺增生252例,乳腺纤维瘤104例,导管内乳头状瘤86例,乳腺导管扩张76例.结论 10000例乳腺疾病中,乳腺增生7745例,占77.45%,居首位;乳腺癌342例,占3.42%,位居第二,其发病率上升,年龄提前.     

Extramammary Paget disease: review of patients seen in a non-melanoma skin cancer clinic

Extramammary Paget disease (EMPD) is a rare skin disease commonly found in the anogenital region. In this study, we aimed to identify EMPD patients seen in the non-melanoma skin cancer clinic at Odette Cancer Centre and to describe the treatments delivered and outcomes achieved. From 2000 to 2009, 14 patients were seen. Initial treatment recommendations included imiquimod and surgical excision, although half the patients required more than one treatment modality, highlighting the difficulty of achieving complete eradication of this disease.     

Hodgkin disease in monozygotic twins: A case report

Presented are the case histories of monozygotic male twins concordant for Hodgkin disease. This is believed to be the third such case report in the world literature. Its significance as it relates to the role of heredity in carcinogenesis is discussed.     

Delusional parasitosis in ENT

Otolaryngologists in India often encounter patients with various insects presenting as foreign bodies in the ear and nose. However they overlook the possibility of the clinical entity that has come to be known as delusional parasitosis. Three patients presented in our OPD with this condition and their case reports are discussed.     

Skin involvement in Hodgkin's disease

Hodgkin's disease involving the skin is an unusual occurrence and is found in 0.5-3.4 percent of these patients. The most common clinical presentation is of single or multiple dermal or subcutaneous nodules. The mechanisms usually implicated include direct extension from an underlying nodal focus, hematogenous dissemination, and, most often, retrograde lymphatic spread, distal to involved lymph nodes. We report the case of a patient with refractory Hodgkin's disease who presented with skin involvement.     

Efficacy of Intravenous Immunoglobulin for Preventing Infections in Patients with Multiple Myeloma

IntroductionDespite many recent advances in the treatment of multiple myeloma (MM), infection remains a major cause of morbidity and mortality. Prior studies have shown mixed results using intravenous immunoglobulin (IVIG) to prevent infections in MM and were conducted prior to most modern MM therapies.Patients and MethodsWe retrospectively reviewed all patients with MM treated with IVIG at our institution from 2010 to 2017. The primary endpoint was the incidence rate ratio (IRR) of infectious events (IEs) per patient-year during IVIG versus observation.ResultsA total of 68 patients were included; 151 IEs occurred during 918 months of IVIG treatment, whereas 446 IEs occurred during 2484 months of observation. Although the annual rate of IEs was substantially higher during periods of progressive disease (PD) compared with non-PD (4.9 vs. 1.8; P < .001), most IEs occurred during periods of non-PD (75% vs. 25% during PD). There was no overall difference in the annual rate of IEs per patient between IVIG and observation (1.97 vs. 2.16; IRR, 0.92; 95% confidence interval [CI], 0.76-1.10; P = .376). The subgroup of patients with hypogammaglobulinemia and whose myeloma was in a non-PD phase had a significant reduction in all-grade IEs (1.20 vs. 1.92; IRR, 0.63; 95% CI, 0.45-0.88; P = .009) and ≥ grade 3 IEs (0.25 vs. 0.56; IRR, 0.45; 95% CI, 0.22-0.94; P = .041) with IVIG compared with observation.ConclusionAlthough treatment with IVIG did not show benefit in the overall population, there may be subgroups of patients that derive significant benefit. Additional observational studies are needed to confirm these findings and further refine patient selection.     

骨骼Rosai-Dorfman病的诊疗进展

Rosai-Dorfman病，又称窦组织细胞增生伴巨大淋巴结病，是一种罕见的组织细胞病，通常表现为青少年的无痛性双侧颈部淋巴结肿大。Rosai-Dorfman病发病累及骨骼者不到10%，并且多达75%的骨骼Rosai-Dorfman病患者同时存在软组织病灶。颅骨、颌面骨和胫骨是骨骼Rosai-Dorfman病最常见的发病部位。该病临床表现缺乏特异性，诊断主要依靠常规病理学和免疫组织化学染色检查。临床表现主要是局部疼痛和肿胀。影像学上，通常表现为髓内的溶解性病变，有时伴有周围硬化。目前，Rosai-Dorfman病的病因尚不明确，可能涉及潜在的宿主免疫失调、IgG4相关疾病、多种自身免疫性疾病和基因突变等。目前伴有症状的骨骼Rosai-Dorfman病的治疗方案主要取决于具体病灶位置，主要包括手术刮除或切除，其他治疗方案包括激素治疗和化疗等。由于骨骼Rosai-Dorfman病的临床和影像学表现通常提示恶性病变可能，部分患者可能接受比较激进的治疗。全身PET/CT可以用于Rosai-Dorfman病的分期、随访和评估。     

放射治疗Kimura‘s病

目的分析Kimura’s病的放疗疗效。方法回顾性分析了1971～1998年放疗的7例病人,使用低能X线、电子线或高能X线治疗,剂量10～40Gy。结果剂量低于20Gy者均复发,照射10Gy者病变基本无变化,而剂量高于20Gy者肿块基本消失．剂量高于30Gy者,疗毕即消,全部病人存活。结论本文研究表明,放疗对Kimura’s病疗效很好．剂量应为20～30Gy,放疗可做为Kimura’s病的首选治疗。     

Serial assessment of measurable residual disease in medulloblastoma liquid biopsies

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Inflammatory bowel disease in Ashkenazi Jews: implications for familial colorectal cancer

Inflammatory bowel disease (IBD) has a multifactorial etiology and includes ulcerative colitis (UC) and Crohn's disease (CD). Powerful epidemiologic and genetic studies have provided ample evidence that a subset of both CD and UC are attributable to a likely primary genetic etiology. This is evidenced by the recent identification of the IBD1 gene (NOD2) mutations which show an association with susceptibility to CD. The IBD complex shows a significant increased frequency in Jews when compared to non-Jews. While there is an increased incidence of colorectal cancer (CRC) in patients with IBD, it nevertheless is important to realize that IBD likely accounts for no more than 1–3% of all cases of CRC in Ashkenazi Jews. Importantly, however, awareness of the increased CRC risk in IBD may aid immeasurably in preventive interventions. The molecular pathway leading to CRC in IBD appears to differ from the well-known adenoma-to-CRC sequence, given the fact that these cancers appear to arise from either flat, dysplastic tissue or dysplasia-associated lesions or masses (DALMs). An important model, but by no means an absolute one, for colon carcinogenesis in IBD follows progression from an absence of dysplasia, to indefinite dysplasia, to low-grade dysplasia, on to high-grade dysplasia, and ultimately to invasive CRC. This carcinogenic process relates to the disease duration with respect to the extent of colonic involvement and may also involve primary sclerosing cholangitis. Given this knowledge of an increased risk for CRC in UC and CD, surveillance colonoscopy should initially be performed 8–10 years after onset of symptoms as opposed to diagnosis, and it should be performed 1–2 years after 8 years of disease in patients with pancolitis or after 15 years in those with left-sided colitis. A search for dysplasia of colonic mucosa with biopsies performed in all four quadrants every 10 cm throughout the colon is exceedingly important. Additional biopsies should be taken of any flat lesions, masses, or strictures. Prophylactic colectomy may then be indicated when severe dysplasia is confirmed by knowledgeable pathologists.     

Immunotherapy in triple-negative breast cancer: A literature review and new advances

Triple-negative breast cancer (TNBC) is a highly complex, heterogeneous disease and historically has limited treatment options. It has a high probability of disease recurrence and rapid disease progression despite adequate systemic treatment. Immunotherapy has emerged as an important alternative in the management of this malignancy, showing an impact on progression-free survival and overall survival in selected populations. In this review we focused on immunotherapy and its current relevance in the management of TNBC, including various scenarios (metastatic and early -neoadjuvant, adjuvant-), new advances in this subtype and the research of potential predictive biomarkers of response to treatment.     

Vinorelbine: A New Promising Drug in Hodgkin's Disease

Vinorelbine is a new semisyntetic vinca alkaloid that differs chemically from vinblastine by a substitution of the catharanthine moiety. The powerful cytostatic activity of vinorelbine against murine tumors, human malignant cell lines and human tumor xenografts in nude mice has been demonstrated. Phase I—II studies of intravenous vinorelbine, administered weekly as single agent or in combination chemotherapy have been conducted since 1986. Results suggest that vinorelbine has high activity in non-small cell lung cancer, breast cancer and cisplatin-resistant ovarian cancer with mild toxicity, beeing neutropenia the major treatment related complication. In this paper we critically review the activity of vinorelbine in pretreated Hodgkin's patients. Available results strongly suggest the inclusion of this drug in first or second line chemotherapy regimens in Hodgkin's disease.     

2015年第2版美国国立综合癌症网络(NCCN)非霍奇金淋巴瘤诊疗指南Castleman病解读

美国国立综合癌症网络(NCGN)在2015年3月3日发布了第2版非霍奇金淋巴瘤治疗指南,首次包括了Castleman病,为该病的规范化诊断和治疗提供了参考依据.基于最新文献及临床试验结果,该指南明确指出了Castleman病的一线、二线治疗方案,使临床医生在治疗该病时有依据可循.     

Hodgkin'S Disease in Association with Acquired Immunodeficiency Syndrome (Aids): A Report on 36 Patients

in an Italian cooperative study on AIDS and cancer a diagnosis of Hodgkin's disease was established in 36 HIV-positive patients. the series was characterized by a high proportion of drug abusers, a high proportion of mixed cellularity and lymphocytic depletion subtypes and short survival. It is still unclear if HIV infection promotes the development of Hodghn's disease or only modifies the course of the disease. According to the authors, however, patients who are HIV seropositive and have biopsyproven Hodgkin's disease should be considered as fulfilling the criteria for AIDS.     

Retrospective analysis of efficacy and safety of amrubicin in refractory and relapsed small-cell lung cancer

Background  Amrubicin, a totally synthetic 9-aminoanthracycline, was evaluated retrospectively for the treatment of refractory and relapsed small-cell lung cancer (SCLC). Methods  Retrospective analysis was performed in 32 patients. Amrubicin was infused over 5 min on days 1–3, with courses repeated at 3- or 4-week intervals. Amrubicin was given at a dose of 45 mg/m² per day, 40 mg/m² per day, 35 mg/m² per day, 30 mg/m² per day, or 25 mg/m² per day depending on medical conditions (patients’ age and performance status [PS]), and the dose was modulated according to myelosuppression. Results  The median number of treatment cycles was 3 (range, 1–6). Seventeen patients (53.1%) had a partial response. Median progression-free survival time for all patients was 96 days, and median survival time was 166 days. Grade 3 or 4 hematologic toxicities comprised neutropenia (78.1%), anemia (65.6%), and thrombocytopenia (50.0%). Febrile neutropenia was observed in 8 patients (25.0%). Nonhematologic toxicities were mild. Treatment-related death was observed in 1 patient. Conclusion  Treatment with amrubicin appeared effective in SCLC patients previously treated with chemotherapy, although it was not necessarily safe, because of myelosuppression. Further research is warranted to investigate amrubicin treatment for patients with SCLC.     

Hodgkin's Disease: Unsuspected Minimal Activity in Patients that Die from Causes Other than Tumoral Progression

Hodgkin's disease (HD) is a curable disease. However, there are still many questions that remain unanswered in this illness, such as the appearance of unsuspected microscopic active illness a long time after the conclusion of treatment, We do not know of any recent publications that have microscopically studied the presence of unsuspected HD activity in patients who died from causes other than tumoral progression. This aspect was analysed in our series of patients with HD. We studied 486 patients with a median follow-up of 8 years. Autopsy was performed in 40 of 144 non-surviving patients. Active HD was found in 60% (24/40) of the patients at autopsy. Of these, 10 patients (25%, 10/40) with active HD died from causes other than tumoral progression. Six patients had minimal clinically unsuspected isolated tumor foci. In spite of technical advances and the introduction of modern and more aggressive chemotherapy, the discovery of minimal unsuspected residual HD continues in an considerable percentage of patients who die from causes other than tumoral progression.