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Radiation induced secondary malignancy

Nathan Nordmann, Molly Hubbard, Tyler Nordmann, Paul W Sperduto, H Brent Clark, Matthew A Hunt
Learning objectives To evaluate radiation-induced changes in patients with brain metastasis secondary to malignant melanoma who received treatment with Gamma Knife radiosurgery (GKRS) and programmed cell death 1 (PD-1) receptor antagonists. Introduction  Stereotactic radiosurgery and chemotherapeutics are used together for treatment of metastatic melanoma and have been linked to delayed radiation-induced vasculitic leukoencephalopathy (DRIVL). There have been reports of more intense interactions with new immunotherapeutics targeting PD-1 receptors, but their interactions have not been well described and may result in an accelerated response to GKRS...
December 13, 2017: Curēus
Diego A S Toesca, Bulat Ibragimov, Amanda J Koong, Lei Xing, Albert C Koong, Daniel T Chang
Although well described in the 1960s, liver toxicity secondary to radiation therapy, commonly known as radiation-induced liver disease (RILD), remains a major challenge. RILD encompasses two distinct clinical entities, a 'classic' form, composed of anicteric hepatomegaly, ascites and elevated alkaline phosphatase; and a 'non-classic' form, with liver transaminases elevated to more than five times the reference value, or worsening of liver metabolic function represented as an increase of 2 or more points in the Child-Pugh score classification...
February 8, 2018: Journal of Radiation Research
Hsiao-Fei Lee, Jen-Hong Lan, Pei-Ju Chao, Hui-Min Ting, Hui-Chun Chen, Hsuan-Chih Hsu, Tsair-Fwu Lee
Background: Patients treated with radiotherapy are at risk of developing a second cancer during their lifetime, which can directly impact treatment decision-making and patient management. The aim of this study was to qualify and compare the secondary cancer risk (SCR) after intensity-modulated radiation therapy (IMRT) and volumetric-modulated arc therapy (VMAT) in nasopharyngeal carcinoma (NPC) patients. Patients and methods: We analyzed the treatment plans of a cohort of 10 NPC patients originally treated with IMRT or VMAT...
2018: Cancer Management and Research
Barrett Allen, Munjal M Acharya, Celine Lu, Erich Giedzinski, Nicole Chmielewski, David Quach, Mike Hefferan, Karl K Johe, Charles L Limoli
Clinical management of primary and secondary central nervous system (CNS) malignancies frequently includes radiotherapy to forestall tumor growth and recurrence after surgical resection. While cranial radiotherapy remains beneficial, adult and pediatric brain tumor survivors suffer from a wide range of debilitating and progressive cognitive deficits. Although this has been recognized as a significant problem for decades, there remains no clinical recourse for the unintended neurocognitive sequelae associated with these types of cancer treatments...
January 19, 2018: Radiation Research
Linda J Szymanski, Maria E Sibug Saber, Jonathan W Kim, John L Go, Gabriel Zada, Narsing Rao, Kyle M Hurth
Purpose: The aim of this study was to describe a 34-year-old male with hereditary bilateral retinoblastoma treated with radiotherapy as a child who developed 4 distinct tumors within the radiation field. Methods: A 34-year-old male with bilateral retinoblastoma status postradiation therapy and recurrence requiring enucleation presented with left-eye visual acuity changes. Magnetic resonance imaging demonstrated a left orbital mass and a right parasellar complex lobulated mass (right sphenoid and right cavernous sinus)...
December 2017: Ocular Oncology and Pathology
Zujaja Tauqeer, Frederick A Jakobiec, Suzanne K Freitag, Michael K Yoon, Natalie Wolkow
PURPOSE: To present 2 patients in whom orbital radiation preceded the development of periorbital extranodal marginal zone lymphoma by more than a decade and to investigate the likelihood of this representing irradiation-induced malignancy. METHODS: Retrospective chart review and histopathologic study with immunohistochemistry of 2 cases. RESULTS: The first patient was a 58-year-old woman who developed an orbital mass within the vicinity of the lateral rectus muscle 17 years after external beam proton radiation therapy for an inferotemporal choroidal melanoma...
January 9, 2018: Ophthalmic Plastic and Reconstructive Surgery
V S K Manem, A Dhawan
In the past few years, proton therapy has taken the centre stage in treating various tumour types. The primary contribution of this study is to investigate the tumour control probability (TCP), relapse time and the corresponding secondary cancer risks induced by proton beam radiation therapy. We incorporate tumour relapse kinetics into the TCP framework and calculate the associated second cancer risks. To calculate proton therapy-induced secondary cancer induction, we used the well-known biologically motivated mathematical model, initiation-inactivation-proliferation formalism...
July 4, 2017: Mathematical Medicine and Biology: a Journal of the IMA
Pei-Ju Chao, Hsiao-Fei Lee, Jen-Hong Lan, Shih-Sian Guo, Hui-Min Ting, Yu-Jie Huang, Hui-Chun Chen, Tsair-Fwu Lee
Propensity score matching evaluates the treatment incidence of radiation-induced pneumonitis (RP) and secondary cancer risk (SCR) after intensity-modulated radiotherapy (IMRT) and volumetric-modulated arc therapy (VMAT) for breast cancer patients. Of 32 patients treated with IMRT and 58 who received VMAT were propensity matched in a 1:1 ratio. RP and SCR were evaluated as the endpoints of acute and chronic toxicity, respectively. Self-fitted normal tissue complication probability (NTCP) parameter values were used to analyze the risk of RP...
October 23, 2017: Scientific Reports
Dajana Juerß, Monique Zwar, Ulrich Giesen, Ralf Nolte, Stephan Kriesen, Giorgio Baiocco, Monika Puchalska, Marc-Jan van Goethem, Katrin Manda, Guido Hildebrandt
BACKGROUND: As there is a growing number of long-term cancer survivors, the incidence of carcinogenesis as a late effect of radiotherapy is getting more and more into the focus. The risk for the development of secondary malignant neoplasms might be significantly increased due to exposure of healthy tissue outside of the target field to secondary neutrons, in particular in proton therapy. Thus far, the radiobiological effects of these neutrons and a comparison with photons on normal breast cells have not been sufficiently characterised...
September 25, 2017: Radiation Oncology
Jean-Marie Michot, Julien Lazarovici, David Ghez, Alina Danu, Christophe Fermé, Amélie Bigorgne, Vincent Ribrag, Aurélien Marabelle, Sandrine Aspeslagh
Hodgkin lymphoma (HL) was one of the first few cancers to be cured first with radiotherapy alone and then with a combination of chemotherapy and radiotherapy. Around 80% of the patients with HL will be cured by first-line therapy. However, the ionising radiation not only produces cytotoxicity but also induces alterations in the microenvironment, and patients often struggle with the long-term consequences of these treatments, such as cardiovascular disorders, lung diseases and secondary malignancies. Hence, it is essential to improve treatments while avoiding delayed side-effects...
November 2017: European Journal of Cancer
J Vogel, L Lin, L A Litzky, A T Berman, C B Simone
PURPOSE: Thymic malignancies are the most common tumors of the anterior mediastinum. The benefit of adjuvant radiation therapy for stage II disease remains controversial, and patients treated with adjuvant radiation therapy are at risk of late complications, including radiation-induced secondary malignant neoplasms (SMNs), that may reduce the overall benefit of treatment. We assess the risk of predicted SMNs following adjuvant proton radiation therapy compared with photon radiation therapy after resection of stage II thymic malignancies to determine whether proton therapy improves the risk-benefit ratio...
October 1, 2017: International Journal of Radiation Oncology, Biology, Physics
Isabella C Glitza, Nandita Guha-Thakurta, Neil M D'Souza, Rodabe N Amaria, Susan L McGovern, Ganesh Rao, Jing Li
Radiation necrosis (RN) is a potential late complication of radiotherapy for intracranial malignancy, which is often associated with significant neurological morbidity. Prolonged treatment with high-dose corticosteroids or surgical resection has been the standard care for RN, but protracted steroid use can lead to significant side effects and surgical resection is not always feasible. The antivascular endothelial growth factor monoclonal antibody bevacizumab induces clinical and radiographic improvements in RN, with overall good tolerance...
December 2017: Melanoma Research
Alexander V Tschulakow, Klaus Dittmann, Stephan M Huber, Dominik Klumpp, Benjamin Stegen, Ulrich Schraermeyer, H Peter Rodemann, Sylvie Julien-Schraermeyer
BACKGROUND: Radiotherapy (RT) is used to treat retinoblastoma (Rb), the most frequent ocular tumour in children. Besides eradicating the tumour, RT can cause severe side effects including secondary malignancies. This study aimed to define whether the radioprotector ortho-phospho-L-tyrosine (pTyr) prevents RT-induced side effects and affects local tumour control in a xenograft and a genetic orthotopic Rb mouse model. METHODS: B6;129-Rb1tm3Tyj/J (Rb(+/-)) and Y79-Rb cell-xenografted nude mice were fractionated external beam irradiated (15 fractions of 5Gy 6MV photons during 3weeks) with or without pTyr pre-treatment (100mg/kg BW, 16h prior to each irradiation)...
September 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Sonia Gandhi, Sudhir Chandna
The disease-free survival following radiotherapy is often limited by the development of second/secondary cancers. This significant impediment to effective cancer treatment implicated even in the modern-day radiotherapy needs to be countered effectively. Critical analysis reveals that besides achieving effective tumor control, radiotherapy elicits certain cellular and systemic inflammatory events in tumor infiltrate, which remain relatively stable and tend to facilitate "in-field" or "out of field" oncogenesis in due course of time...
June 2017: Cancer Metastasis Reviews
Ivy Ng, Char Loo Tan, Tseng Tsai Yeo, Balamurugan Vellayappan
Glioblastoma (GBM) typically occurs as a primary tumour (i.e., primary GBM) and predominantly affects elderly patients. The remaining ~10% occur as a result of malignant progression from lower grade astrocytic tumours (i.e., secondary GBM). Although there are no certain causative environmental agents, prior radiation exposure may play a role. We report on a patient who had been treated six years prior for a vestibular schwannoma with high-dose conventional radiotherapy and subsequently developed a rapidly fatal glioblastoma at the same location...
June 11, 2017: Curēus
Nilamani Sahoo, Arunn Narasimhan, Purbarun Dhar, Sarit Kumar Das
Comprehending the mechanism of thermal transport through biological tissues is an important factor for optimal ablation of cancerous tissues and minimising collateral tissue damage. The present study reports detailed mapping of the rise in internal temperature within the tissue mimics due to NIR (1064 nm) laser irradiation, both for bare mimics and with gold nanostructures infused. Gold nanostructures such as mesoflowers and nano spheres have been synthesized and used as photothermal converters to enhance the temperature rise, resulting in achieving the desired degradation of malignant tissue in targeted region...
June 13, 2017: International Journal of Hyperthermia
Ryuya Yamanaka, Azusa Hayano
OBJECTIVE: Radiation-induced malignant peripheral nerve sheath tumors (MPNSTs) are an uncommon late risk of irradiation. We conducted the largest systematic review to date of individual patient data for patients with these tumors. METHODS: We conducted a systematic search using the PubMed database, and compiled a systematic literature review. We used Kaplan-Meier analysis and a log-rank test to estimate survival. RESULTS: We analyzed 65 radiation-induced and 26 radiation-associated MPNSTs in patients with neurofibromatosis...
September 2017: World Neurosurgery
Marcus Lehnhardt, Jens Bohm, Tobias Hirsch, Björn Behr, Adrien Daigeler, Kamran Harati
Background Radiation-induced angiosarcomas of the breast are rare secondary malignancies that occur after adjuvant radiation of breast cancer. They grow in a multifocal manner and frequently develop local recurrences. Therefore, they often pose a surgical challenge. Due to their rarity it is still unclear whether a radical surgical approach leads to a beneficial outcome. The aim of this study was to determine the prognostic significance of surgical margins. Patients and methods We retrospectively assessed the outcome of 18 patients who underwent surgical treatment at our institution...
April 2017: Handchirurgie, Mikrochirurgie, Plastische Chirurgie
Boram Lee, Sung Hwan Ahn, Hyeyoung Kim, Jaeman Son, Jiwon Sung, Youngyih Han, Seung Jae Huh, Jin Sung Kim, Dong Wook Kim, Myonggeun Yoon
This study was designed to estimate radiation-induced secondary cancer risks from high-dose-rate (HDR) brachytherapy and external radiotherapy for patients with cervical cancer based on measurements of doses absorbed by various organs. Organ doses from HDR brachytherapy and external radiotherapy were measured using glass rod dosimeters. Doses to out-of-field organs were measured at various locations inside an anthropomorphic phantom. Brachytherapy-associated organ doses were measured using a specialized phantom that enabled applicator insertion, with the pelvis portion of the existing anthropomorphic phantom replaced by this new phantom...
September 2016: Journal of Applied Clinical Medical Physics
Alexandra E Quimby, Lisa Caulley, Danielle Rodin, Bibianna Purgina, Libni Eapen, Luke Shier, Stephanie Johnson-Obaseki
BACKGROUND: Burkitt lymphoma is a high-grade B cell lymphoma which accounts for less than 1% of all adult cases of non-Hodgkin lymphoma. Rare instances of Burkitt lymphoma developing secondary to prior irradiation have been described in the literature. CASE PRESENTATION: We report a case of a 90-year-old white woman with a recent history of irradiation for Hodgkin lymphoma, who presented with primary Burkitt lymphoma of the supraglottic larynx. She underwent emergency awake tracheostomy with biopsy...
March 10, 2017: Journal of Medical Case Reports
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