核医学と放射線治療

Purpose: To evaluate the treatment outcomes of chemoradiotherapy for patients with advanced esophageal cancer and estimate the prognostic factors. Materials and methods: Patients with advanced esophageal cancer, who were treated with chemoradiotherapy (CRT) between April 2003 and December 2010, were evaluated. Patients received concurrent chemoradiotherapy (cisplatin plus 5-fluorouracil and 61.2 Gy radiotherapy). Therapeutic response, overall survival time, and toxicity were examined and statistical evaluation was performed. Results: One hundred and fourteen patients were treated with CRT. Among them, 84 patients (77.2%) received the complete course of CRT. Eighteen patients (15.8%) had a complete response, 90 patients (78.9%) had a partial response and 6 patients (5.3%) exhibited progressive disease. The mean follow-up period was 14.6 months (range, 2-90 months). The median overall survival time was 13.0 months. The 2-year and 3-year overall survival rates were 38.1% and 19.2%, respectively. Severe hematological toxicities included Grade 3 leukopenia in 40 patients (35.1%). Treatment-related death was estimated to have occurred in 7 patients. Performance status and body weight loss were identified as significant prognostic factors. Conclusion: In our study, PS and body weight loss showed prognostic factors in CRT for advanced esophageal cancer.

Considered a public health problem in the world, cervical cancer mainly affects women in developing countries, where the incidence is up to twice that observed in developed countries. In Brazil, for example, the estimated incidence for 2012 is 17,540 new cases (17/100,000 women).

We report on a case of focal haematopoietic hyperplasia occurring in the haematopoietic marrow in a lumbar vertebral body, of a young man. The PET scan performed showed high uptake of the radiotracer in the vertebral body of L3 and a MRI of the lumbar spine confirmed the vertebral lesion. A biopsy of the L3 vertebral body lesion was performed and the histological result was of chronic myeloproliferative disease but the analysis performed consequently excluded the diagnosis of chronic myeloproliferative disorder, according to the WHO criteria. Focal benign hyperplasia is regarded a late reactive process after trauma, as well as the case reported

Pineoblastoma is an extremely rare primary tumor occurring in the pineal gland and belongs to the supratentorial primitive neuroectodermal tumors [1,2]. Intensive multimodality treatment that combines surgery, craniospinal irradiation (CSI), and chemotherapy is needed for this uncommon disease. CSI still remains one of the most technically challenging processes in radiation therapy (RT) planning and delivery because of the need to irradiate a very large and complex shaped target volume uniformly. There is a growing concern regarding treatment-related side effects and is the clinical motivation for investigating sophisticated emerging RT techniques to reduce doses to non-target tissues to ameliorate toxicity [3]. Consequently, several strategies have been proposed to limit the radiation-induced toxicity, such as the use of helical tomotherapy (HT) [4,5].

X-ray or photon therapy is by large the most widely used modality in radiation oncology. Particle therapy using light ions [ex- proton (1H)] and heavier ions [ex- carbon (12C)] is now gaining increasing attention and acceptance. In the United States of America (USA), the push has been towards proton therapy with several new centers opening in the last few years and many more planned in the near future. There are currently no operational 12C centers in the USA. Clinical evidence with 12C has been very limited emanating mostly from existing centers in Japan and Germany. To date about 100,000 patients have been treated with protons and about 12,000 with 12C worldwide

Cancer range between disease that remains local throughout its course and disease that is already systemic at the time of diagnoses (spectrum hypothesis). Successful metastatization is a complex interation between the tumor cells, tumor microenvironment, and host. For a tumor cell to acquire the ability to colonize a distant organ, genetic and epigenetic changes in expression are required.

Introduction: Radiotherapy is treatment for nasopharyngeal carcinoma, and concurrent chemoradiotherapy has been shown to prolong survival. Radiation-induced is a dramatic late complication of radiation therapy for tumors involving structures in the vicinity of the visual pathway. The association between dose and radiation retinopathy is well established. Case presentation: The patient was a 48-year-old turkish man. A case history of bilateral radiation-induced optic neuropathy and retinopathy, 105 months after combined treatment by chemotherapy, conformal radiotherapy and 62 months after gamma knife for a nasopharyngeal carcinoma. Conclusion: We recommend that all patients undergoing radiotherapy, which is likely to result in retinal irradiation, be warned of risk of radiation retinopthy of the dose applied.