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3 results

  • Trimodality approach, using modern radiation techniques, for management of locally advanced adrenocortical carcinoma – case report

  • André Laranja, Carolina Ferreira
  • Journal:
    Journal of Radiotherapy in Practice / Volume 22 / 2023
    Published online by Cambridge University Press:
    18 August 2021, e14
  • Background:

    Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy. Surgery is the mainstay of treatment, still even after a R0 surgical margins, there is a high risk of recurrence.

    Case Presentation:

    A 26-year-old female diagnosed with a large functioning ACC treated with a trimodality approach (surgery, radiotherapy and chemotherapy). Postoperative radiotherapy was proposed regarding the high risk of recurrence. A dose of 50.4 Gy in 28 fractions was delivered to the patient using a volumetric-modulated arc therapy plan. Radiotherapy was safe and well tolerated, and no local recurrence was observed so far (13 months after radiotherapy).

    Conclusions:

    Due to the rarity of ACC and the lack of evidence regarding this entity, therapeutic approach can be challenging. Recent evidence suggests that radiotherapy could have an important role in the therapeutic arsenal.

  • Is there a role of adjuvant treatment for salivary duct carcinoma?

  • T Nakashima, R Yasumatsu, S Toh, K Hashimoto, M Shinoto, K Nakamura, S Komune
  • Journal:
    The Journal of Laryngology & Otology / Volume 129 / Issue S2 / March 2015
    Published online by Cambridge University Press:
    23 February 2015, pp. S98-S101
    Print publication:
    March 2015
  • Objective:

    To determine the clinical effect of post-operative radiotheraphy and systemic chemotherapy for the treatment of salivary duct carcinoma.

    Study design:

    Retrospective review.

    Design:

    The medical records of 26 patients treated by surgery with or without radiotheraphy and/or systemic chemotherapy for salivary duct carcinoma were retrospectively reviewed to investigate the role of post-operative adjuvant treatment for the patients' prognosis.

    Results:

    The overall three-year and five-year survival rates were 54 and 48.1 per cent, respectively. There was no correlation with the clinical stage and the patients' prognosis. The overall three-year survival of the patients with or without post-operative radiotheraphy was 64 and 33 per cent, respectively (p = 0.29). The overall three-year survival of the patients with or without post-operative chemotherapy was 53 and 56 per cent, respectively (p = 0.78).

    Conclusion:

    Post-operative adjuvant therapy did not improve the patients' overall prognosis with salivary duct carcinoma. Developing novel treatment modalities may be necessary to improve the prognosis of this aggressive disease.

  • Chapter 28 - Impact upon related conditions and quality of life

  • from Section 7 - The Prognosis of Neuropathic Pain
  • Edited by Cory Toth, Dwight E. Moulin
  • Book:
    Neuropathic Pain
    Published online:
    05 December 2013
    Print publication:
    07 November 2013, pp 334-340

  • Summary

    Fibromyalgia is an illness seen mostly in women and characterized by widespread body pain with abnormality located in the nervous system. A diagnosis of fibromyalgia should be considered when a patient presents with widespread body pain lasting for longer than 3 months, with associated tenderness to palpation of soft tissues, as well as the possible presence of symptoms of sleep disturbance, fatigue, cognitive symptoms, and mood changes. Nervous system, genetic, and psychological mechanisms likely all play a part in the final expression of fibromyalgia, with evidence showing abnormalities at multiple levels. Ideal management includes both non-pharmacological and pharmacological treatments in a multimodal approach incorporating a strong patient-centered internal locus of control. Non-pharmacological treatments with emphasis on a regular exercise program, stress management, and coping skills should be an integral part of any treatment strategy for fibromyalgia. The traditional pharmacological treatment paradigm begins with simple analgesics and tricyclic antidepressant medications (TCAs).