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Author(s):
Nouhaila, MARWA.
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Brachytherapy in Pediatric Vaginal Rhabdomyosarcoma: A Case Report and Literature Review
Abstract
Pediatric vaginal rhabdomyosarcoma is a rare malignancy, constituting only 3.5% of genital tract sarcomas in children [1]. The standard treatment includes chemotherapy, surgery, and radiotherapy. We report a case of a 4-year-old girl diagnosed with botryoid vaginal rhabdomyosarcoma. The patient received neoadjuvant chemotherapy, followed by surgical resection via vaginoscopy and adjuvant chemotherapy. Additionally, endovaginal brachytherapy was administered, and the patient received consolidation chemotherapy. Post-treatment MRI evaluation showed a complete response. The patient remains in remission with no signs of recurrence, demonstrating the effectiveness and feasibility of combining chemotherapy, conservative surgery, and brachytherapy in managing pediatric vaginal rhabdomyosarcoma.
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Author(s):
Tinatin, Mikheil.
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Adjuvant Radiation Therapy for Positive Surgical Margins in Muscle-Invasive Bladder Cancer: A Case-Based Discussion
Abstract
The standard of care for locally advanced bladder cancer is neoadjuvant chemotherapy followed by radical cystectomy. The benefit of adjuvant radiation therapy (RT) in muscle-invasive bladder cancer (MIBC) remains controversial, largely due to concerns about toxicity. Recent data suggest that adjuvant RT may reduce local recurrence rates in high-risk patients. Moreover, advances in radiotherapy techniques now allow for more precise treatment delivery with reduced toxicity.
We describe here the case of a 67-year-old male with locally advanced MIBC who underwent neoadjuvant chemotherapy and radical cystectomy. Postoperative pathology reported positive surgical margins at the bladder neck with incidental prostate adenocarcinoma. Given these high-risk features, adjuvant pelvic RT was administered following multidisciplinary discussion.
This case report highlights the importance of balancing the potential toxicities of adjuvant RT against its benefit in high-risk MIBC patients. Further research is necessary to establish clearer guidelines.
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Author(s):
Mara, Monica.
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Timing Matters: Two Divergent Paths in the Multimodal Treatment of Merkel Cell Carcinoma
Abstract
Merkel cell carcinoma (MCC) is a rare but aggressive cutaneous neuroendocrine malignancy with high rates of recurrence and metastasis. Optimal management requires a multidisciplinary approach, including surgery, radiotherapy, and, increasingly, immunotherapy with checkpoint inhibitors. We present a comparative report of two male patients with axillary nodal involvement from MCC who underwent multimodal treatment. The first patient, a 73-year-old male with known primary cutaneous MCC of the forearm, underwent surgical lymphadenectomy followed by postoperative radiotherapy and immunotherapy with Avelumab between February and September 2021, achieving stable disease without progression. The second patient, a 66-year-old male with nodal MCC of unknown primary origin, initially progressed on cisplatin-etoposide chemotherapy but achieved significant tumor regression and complete pathological response after early initiation of Avelumab and neoadjuvant radiotherapy, followed by surgical lymphadenectomy. These cases highlight the critical importance of early systemic immunotherapy integration, careful radiotherapy planning, and personalized sequencing of multimodal therapies to maximize disease control. The contrasting outcomes reinforce the need for flexible, patient-tailored strategies in Merkel cell carcinoma management, especially in the immunotherapy era.
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Author(s):
Alice, Fátima , Pedro , Fernando , Patricia, Rosa, Daniela, Anabela , Vitor, Cláudia, Ana , Gabriel , Rui , Pedro , Luisa, Armanda, Lígia.
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Stereotactic Radiosurgery for Brainstem Metastases: A Case Series and Literature Review
Abstract
Brainstem metastases (BSM) represent a rare but clinically significant subset of brain metastases, often associated with severe neurological impairment and limited treatment options due to their location near critical neural structures. Stereotactic radiosurgery (SRS) has emerged as a safe and effective non-invasive alternative, yet dose guidelines remain non-standardized. This article presents a series of three patients with BSM treated at our institution using fractionated SRS (21 Gy in 3 fractions), followed by a literature review. All cases demonstrated initial clinical and radiological responses, with manageable toxicity profiles. One patient achieved a complete response with no adverse events, another experienced radionecrosis requiring corticosteroids, and the third showed intracranial progression post-treatment. These cases highlight the complexity of managing BSM and reinforce the role of SRS in achieving local control while preserving neurological function. Our findings align with existing literature supporting SRS as a viable option for BSM, emphasizing the importance of individualized treatment planning based on tumor characteristics and prior therapies. Further research is warranted to optimize dose protocols and integrate systemic treatments to improve long-term outcomes.
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Author(s):
Angel, Angel, Helena BZ, Raquel, Ivica.
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LEARNING, TEACHING, PUBLISHING: WRITE TO CURE, SHARE TO GROW
Abstract
ABSTRACT
Scientific publishing in medicine is often viewed as a burdensome requirement rather than a meaningful extension of clinical practice. While the phrase "publish or perish" captures the urgency of disseminating knowledge, its rigid interpretation has led to distortions in the academic landscape, fueling metrics-driven publication pressures, the rise of pay-to-publish models, and decreased recognition of valuable yet non-mainstream research. This environment discourages many clinicians, especially early-career professionals, from sharing their experiences and findings. Despite these barriers, publishing remains a fundamental professional duty and ethical commitment. It serves not only to transmit knowledge but to inspire inquiry, support collective learning, and honor the legacy of those who came before. Ultimately, writing and publishing are acts of intellectual generosity and humility—tools for growth, reflection, and improved patient care. In an era of AI-generated answers and financial gatekeeping, reclaiming the value of authentic scientific communication is more urgent than ever.
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Author(s):
Muatasim.
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Photobiomodulation Therapy for Chemotherapy-Induced Peripheral Neuropathy: Targeted Mechanisms and Optimized Strategies for Sensory Symptom Relief
Abstract
Chemotherapy-induced peripheral neuropathy (CIPN) is a widespread and often disabling effect of neurotoxic cancer therapies. Patients frequently experience sensory abnormalities such as numbness, tingling, heightened sensitivity to mechanical or cold stimuli (allodynia), and disrupted proprioception. These symptoms can persist long after treatment, significantly impairing daily function and quality of life. Photobiomodulation (PBM), which uses specific wavelengths of low-level red or near-infrared light, has recently emerged as a viable non-pharmacologic option for reducing these sensory disruptions.
Evidence from both laboratory and clinical research shows that PBM can enhance mitochondrial activity, facilitate axonal repair, and suppress oxidative stress and inflammatory responses within nervous tissue. In particular, PBM administered in the 780–850 nm wavelength range with fluences between 3 and 48 J/cm² has demonstrated the ability to relieve allodynia mediated by transient receptor potential (TRP) channels and restore proprioceptive function via nerve regeneration. Clinical implementation is hampered by inconsistencies in reported treatment parameters such as wavelength, dosage, and session frequency, making it difficult to replicate findings or compare studies. Furthermore, many existing PBM protocols do not tailor treatments to specific sensory symptoms or differentiate by chemotherapy type.
This review consolidates current mechanistic and clinical data, evaluates PBM’s effects across various CIPN symptom categories, and highlights the need for standardization and patient-specific protocol development. Future progress should include the integration of biomarkers for response prediction, the use of quantitative sensory testing (QST), and rigorous long-term safety assessments. Adopting an approach that matches PBM parameters to sensory symptom patterns and underlying chemotherapeutic mechanisms may greatly enhance its therapeutic impact in treating CIPN.
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Author(s):
ALOUAN.
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Rare Case of Pinealoblastoma in Children – Diagnostic and Therapeutic Aspect in a Low-Resource Country
Abstract
Pinealoblastoma in children is a rare tumor of the central nervous system, with limited knowledge regarding its clinical features and outcomes. The optimal therapeutic strategy for pediatric pinealoblastoma remains uncertain. This case presents an 11-year-old girl diagnosed with pinealoblastoma. Due to potential impacts on quality of life and the available technical resources, tumor resection was not performed. Instead, the patient was treated exclusively with radiotherapy and remained free of recurrence for 36 months post-treatment.
This case underscores a minimally invasive approach to managing rare pineal tumors located near critical structures, demonstrating favorable responses and excellent neurological outcomes. Additionally, the radiographic and histopathological characteristics of pinealoblastomas are reviewed, alongside a discussion of the various treatment options documented in the literature.
| 8 |
Author(s):
Yassine, Zineb, Luigi.
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The ‘Watch and Wait’ Strategy in Rectal Cancer: Weighing the Pros and Cons
Abstract
Background: Treatment for locally advanced rectal cancer has evolved significantly, particularly with the advent of neoadjuvant chemoradiotherapy (nCRT). The "watch and wait" (W&W) approach, designed to avoid surgery for patients with a complete clinical response (cCR) following nCRT, has emerged as an alternative to traditional surgical interventions, particularly total mesorectal excision (TME). However, its long-term efficacy and safety remain debated.
Methods: This article reviews the W&W strategy, focusing on its definition, clinical outcomes, and both its advantages and disadvantages. We analyze the pros of W&W, including improved quality of life, organ preservation, and comparable disease-free survival rates. We also examine the cons, such as higher risks of recurrence, metastasis, and logistical challenges related to surveillance.
Results: The W&W approach has demonstrated promising results in preserving rectal function and improving patient quality of life. However, studies show an increased local recurrence rate compared to TME, with a higher likelihood of distant metastasis in cases of recurrence. Additionally, the strategy requires intense follow-up, posing a challenge for patient compliance and healthcare resource management. Psychological stress related to the uncertainty of treatment further complicates the approach.
Conclusions: While the W&W strategy offers substantial benefits in terms of organ preservation and quality of life, it presents significant risks, including higher recurrence rates, logistical complications, and psychological burdens on patients.
