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Author(s):
Bianca Elena.
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Laryngeal neoplasm treated with surgery and radiotherapy – squamous cell carcinoma with sarcomatoid dedifferentiation – clinical case
Abstract
Sarcomatoid carcinoma is a rare and aggressive form of SCC (squamous cell carcinoma), a biphasic tumor that has been shown to be a dedifferentiated monoclonal form of classic squamous cell carcinoma. The factors that contribute to proliferation from SCC to sarcomatoid carcinoma are not precisely known but some studies revealed the importance of anterior radiation therapy. This case report describes a 62 year old man, heavy smoker and alcohol drinker diagnosed with laryngeal neoplasm. The pathological diagnosis was well-differentiated SCC of the piriform sinus. Surgery was performed and the pathology report revealed medium differentiated SCC, pT4aN1Mx. The patient underwent external radiotherapy with 66Gy/target volume. At 4 months post RT the Ear, Nose and Throat exam revealed tumor recurrence near the tracheal stoma. A second surgery was performed and the pathology diagnosed recurrence of SCC with sarcomatoid-looking areas, with two surgical margins being invaded by the tumor. Postoperative computer tomography of the neck showed no evidence of macroscopic disease. The next treatment approach was chemotherapy with 4 cycles of carboplatin paclitaxel but soon after, an inoperable locoregional recurrence was diagnosed and he started treatment with Nivolumab followed by rapid locoregional progression. Squamous cell carcinoma with sarcomatoid dedifferentiation is a rare histology of laryngeal cancer, with a more aggressive behavior that requires more intense treatment and follow up.
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Author(s):
Petru Vladimir, Marius.
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PROGNOSTIC AND PREDICTIVE MARKERS FOR IMMUNOTHERAPY IN NON SMALL CELL LUNG CANCER (NSCLC)
Abstract
Lung cancer has benefited in the last decade from novel, efficient and targeted therapeutic advances such as immunotherapy, which allows for a more personalized approach of the oncologic treatment. However,up to this date, there is not a standardized method of determining the potential success of immunotherapy in spite of the existence of a variety of markers that are being studied for this purpose. We therefore aim to review the immune markers described in the literature in response to PD-1, PDL-1 and CTLA-4 immunotherapy and offer a more comprehensive picture of their utility, prognostic and predictive value.
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Author(s):
Jose Ma. H. , Valerie Anne, Juan Miguel L., Juan Martin J. , Angela , Angela.
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Cancer-related search queries in the Philippines: A trend analysis across a fifteen-year period
Abstract
Analyzing the trends of internet search queries can provide rapid, unrestricted, and valuable insight on health-seeking behaviors of entire populations. More than half of the Philippine population use the internet; however, trends of search queries have rarely been analyzed. This study analyzed the trends of cancer-related search queries in the Philippines over a fifteen-year period. For the period spanning December 31, 2007 to December 31, 2022 in the Philippines, Google TrendsTM was used to compute the search volume index (SVI) for pre-selected cancer-related search terms. Two-way repeated measures analysis of variance with post-hoc Dunnett’s multiple comparisons test was performed to detect a significant difference between the search terms across the period of study and to explore the trend of these differences. There were statistically significant increases in SVI for the pre-selected terms from 2016 to 2022, indicating a significant increase in cancer-related search activity in the Philippines in recent years.
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Author(s):
Camil Ciprian , Roxana Irina, Dragoș Petru Teodor .
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Radiomics breakthrough could spark the head and neck cancer radiotherapy revolution
Abstract
Artificial intelligence (AI), defined as machine capability of imitating human intelligence, has already been implemented on a large scale in oncology and radiotherapy. One of the two main branches (the virtual one) of machine learning depending on the application, artificial intelligence is involved both in the diagnostics processes as well as treatment planning, - dose delivery and radiotherapy quality assurance (QA). Head and neck cancer (HNC), although it is the 6th malignancy in incidence worldwide, is redoubtable due to the high rate of therapeutic failures, especially of loco-regional recurrence. Although intensity-modulated treatment techniques have brought benefits especially in limiting the toxicities associated with irradiation, AI and especially radiomics, due the possibility to extract data from high-resolution medical imaging in order to build predictive diagnostic and prognostic models, could upgrade the technological revolution in HNC radiotherapy at a higher level. Beyond the already intensively studied diagnostic applications, radiomics could be useful for predicting the response to radio-chemotherapy, anticipating treatment related toxicities and for pre-therapeutic evaluation of the need for adaptive radiotherapy (ART). Clinical-radiomic models have superior predictive power and the delta variation of radiomic features could be a biomarker still less evaluated. Due to characteristics of modern radiotherapy which includes as standard the image guided radiotherapy (IGRT) concept using the computer tomography (CT) simulator and Cone Beam CT (CBCT) to ensure the accuracy of the patient's positioning during the treatment, radiomics in radiotherapy could be the spearhead of the translation radiomics in daily clinical routine and of the HNC RGRT concept development.
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Author(s):
Andrada, Bogdan, Adrian, Viorica.
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Muir-Torre Syndrome: a long way to diagnosis
Abstract
Muir Torre syndrome is a rare genetic syndrome, a subtype of Lynch syndrome. We present the case of a female patient with a rich family history and who, starting at the age of 41, successively presented with numerous benign and malignant tumours of various histologies, including some with sebaceous features. Most of the tumours were at the skin level, treated with complete resection, but frequently recurring. She underwent several surgical procedures and received both systemic oncological therapies and external beam radiotherapy for endocervical adenocarcinoma, vulvar carcinoma and urothelial carcinoma. Following an evolution of over 20 years, extensive genetic testing was performed and germline mutations in the MMR (mismatch repair) genes were identified. She was finally diagnosed with Muir Torre syndrome in the light of this unusual clinical presentation and molecular profile. Unfortunately, the outcome was unfavourable, with an inoperable recurrence of the bladder urothelial carcinoma and extensive lymph node dissemination of a vulvar squamous carcinoma, which were outside the therapeutic resources and ultimately led to death.
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Author(s):
Irina.
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Highlights from ASCO Gastrointestinal Cancers Symposium 2023
Abstract
On January 19-21, 2023, international gastrointestinal (GI) cancer specialists gathered in San Francisco for the ASCO Gastrointestinal Cancers Symposium to celebrate a 20-year milestone and to discuss the latest research and treatment advances in the field. The multidisciplinary experts put the science into context and the attendees were provided with a truly comprehensive view of the latest innovations in GI oncology.
The current article highlights some of the most clinically relevant presentations from ASCO GI 2023 Symposium.
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Author(s):
Artiom, Monica-Emilia , Claudiu, Corneliu, Dumitru , Valentin.
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Optimization of Lung and Mediastinal Tumor Diagnosis Using Fluoroscopic-Guided Transthoracic Puncture-Biopsy
Abstract
Introduction: Pathological confirmation of a newly identified tumour is needed for choosing the adequate treatment. Patients may have a low performance status which makes them unsuitable for invasive diagnostic procedures. Percutaneous transthoracic biopsy is a minimally invasive method which can provide tissue samples for identification of lung or mediastinal tumours.
Material and method: Data from consecutive patients which underwent fluoroscopic-guided transthoracic puncture-biopsy (FGTPB) in a tertiary cancer center from Republic of Moldova from 2019 to 2021 were retrospectively collected.
Results: We identified 54 patients with lung tumors and 12 patients with mediastinal tumours. In the lung tumors group, median age was 57 years and in the mediastinal tumours group the median age was 27.5 years. Most of the lung tumors were situated in the superior lobes (79.6%) and had less than 5 cm (70.4%). The majority of mediastinal tumors were situated anteriorly (66.7%) and had more than 10 cm (58.3%). The sensitivity of transthoracic percutaneous biopsy was 79.6% in lung tumours and 83.3% in mediastinal tumours, identifying malignant or infectious pathology, or fibrosis. Lung biopsy had a low rate of pneumothorax (5.6%) and of bleeding (3.7%). Mediastinal tumor biopsy had a rate of pneumothorax of 16.7%.
Conclusion: Transthoracic puncture-biopsy made under fluoroscopic guidance is a safe and efficient alternative diagnostic procedure for unfit patients with lung or mediastinal tumours
