Difficulties using the Franco-Italian Glossary in assessing toxicity of cervical cancer treatment

Shakespeare TP, Ferrier AJ, Holecek MJ, Jagavkar RS, Stevens MJ. Difficulties using the Franco-Italian Glossary in assessing toxicity of cervical cancer treatment. Int J Gynecol Cancer 1998; 8: 51–55
We assessed the toxicities of patients treated for cervical cancer using the revised Franco-Italian Glossary (FIG). A total of 69 separate complications were appraised in 47 patients; however, only 43.5% of these side-effects could be accurately graded. In all, 56.5% of toxicities could not be scored for a variety of reasons: (1) the FIG does not account for all possible complications of cervical cancer treatment; (2) some important toxicities are regarded as too minor to be graded; (3) subjective assessment of some side-effects did not allow consensus to be reached when assigning a grade; (4) we could not accurately score toxicities using the FIG in a retrospective manner. Previous studies utilizing the FIG retrospectively have noted few problems with its use, with no indication of the number of toxicities unable to be graded. In view of the inability to grade the majority of complications in the present study in an accurate manner, we conclude that the revised FIG requires detailed data that are best collected prospectively and that several minor modifications of the glossary should be considered. Results of studies using the glossary retrospectively should be viewed with caution.     

Treatment of localized prostate cancer using a combination of high dose rate Iridium‐192 brachytherapy and external beam irradiation: Initial Australian experience

Combination high dose rate brachytherapy (HDRB) and external beam radiation therapy is technically and clinically feasible as definitive treatment for localized prostate cancer. We report the first large Australian experience using this technique of radiation dose escalation in 82 patients with intermediate‐ and high‐risk disease. With a median follow up of 3 years (156 weeks), complications were low and overall prostate‐specific antigen progression‐free survival was 91% using the American Society for Therapeutic Radiology and Oncology consensus definition. The delivery of hypofractionated radiation through the HDRB component shortens overall treatment time and is both biologically and logistically advantageous. As a radiation boost strategy, HDRB is easy to learn and could be introduced into most facilities with brachytherapy capability.     

Endometrial adenosarcoma with adjuvant tamoxifen therapy for primary breast carcinoma

The first documented case of endometrial adenosarcoma associated with chronic tamoxifen usage is reported.     

Epidemiologic Approach to Community Dermatology

A survey on communicable dermatoses in economically weak villages in India showed wide variations in prevalence rates in similar ecologic setup. A skin diseases, on-spot-treatment, 1-day-camp was organized to treat 1787 subjects in five villages. Two applications of 1% lindane 1 week apart was the only treatment used without attending to hygiene for scabies and pediculosis. Application of 1% gentian violet with four daily doses of sulfamethoxy-pysidazine was administered for pyoderma. The cure rate for scabies and pediculosis was 86%. Epidemiologic determinants of communicable dermatoses are the most important factors in the practice of community dermatology.     

Epidemiologic Approach to Community Dermatology

Abstract: A survey on communication dermatoses in economically werk village in India showed wide variations in prevalence rate in similar ecologic setup. A skin diseases, on-spot- treatment, 1-day camp was organized to treat 1787 subject in five villaged. Two applications of 1% lindane 1 week apart was the only treatment used without attending to hygiene for scabies and pediculosis. Application of 1% gention violet with four daily doses of sulfamethoxy-pysidazine was administered for pyoderma. The cure rate for scabies and pediculosis was 86%. Epidemiologic determinants of communicable dermatoses are the most important factors in the practice of community dermatology.     

Treatment of localized prostate cancer using a combination of high dose rate Iridium-192 brachytherapy and external beam irradiation: initial Australian experience

Combination high dose rate brachytherapy (HDRB) and external beam radiation therapy is technically and clinically feasible as definitive treatment for localized prostate cancer. We report the first large Australian experience using this technique of radiation dose escalation in 82 patients with intermediate- and high-risk disease. With a median follow up of 3 years (156 weeks), complications were low and overall prostate-specific antigen progression-free survival was 91% using the American Society for Therapeutic Radiology and Oncology consensus definition. The delivery of hypofractionated radiation through the HDRB component shortens overall treatment time and is both biologically and logistically advantageous. As a radiation boost strategy, HDRB is easy to learn and could be introduced into most facilities with brachytherapy capability.     

Supraclavicular radiotherapy must be limited laterally by the coracoid to avoid significant adjuvant breast nodal radiotherapy lymphoedema risk

This cross-sectional study aimed to investigate the effect of supraclavicular fossa (SCF) radiotherapy volumes as well as patient characteristics and nodal pathology on the development of lymphoedema. Ninety-one women who had received SCF nodal radiotherapy after axillary dissection were evaluated. Lymphoedema was defined by two measurements: limb volume difference 200 mL, or circumference difference 10 cm proximal or distal to the olecranon>2 cm. On univariate analysis, the addition of axillary to SCF radiotherapy, increasing width of the SCF field, increasing age, presence of extracapsular extension of nodal involvement and use of hormone treatment was associated with lymphoedema by either one or both definitions. For both definitions of lymphoedema, on multivariate analysis, increasing nodal radiotherapy volume remained significant (P=0.02 to 0.007), as did increased age (P=0.05 to 0.001). We conclude that conventionally fractionated SCF radiotherapy limited laterally by the coracoid process has a lymphoedema risk similar to that expected from axillary dissection alone and a lower risk than wider SCF fields with or without an axillary boost.     

Supraclavicular radiotherapy must be limited laterally by the coracoid to avoid significant adjuvant breast nodal radiotherapy lymphoedema risk

This cross‐sectional study aimed to investigate the effect of supraclavicular fossa (SCF) radiotherapy volumes as well as patient characteristics and nodal pathology on the development of lymphoedema. Ninety‐one women who had received SCF nodal radiotherapy after axillary dissection were evaluated. Lymphoedema was defined by two measurements: limb volume difference 200 mL, or circumference difference 10 cm proximal or distal to the olecranon >2 cm. On univariate analysis, the addition of axillary to SCF radiotherapy, increasing width of the SCF field, increasing age, presence of extracapsular extension of nodal involvement and use of hormone treatment was associated with lymphoedema by either one or both definitions. For both definitions of lymphoedema, on multivariate analysis, increasing nodal radiotherapy volume remained significant (P = 0.02 to 0.007), as did increased age (P = 0.05 to 0.001). We conclude that conventionally fractionated SCF radiotherapy limited laterally by the coracoid process has a lymphoedema risk similar to that expected from axillary dissection alone and a lower risk than wider SCF fields with or without an axillary boost.