• Title/Summary/Keyword: Thoracic radiotherapy

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Surgical Experience of Pulmonary Blastoma -A Report of a Case - (폐아세포종 수술치험 1례)

  • 박성혁
    • Journal of Chest Surgery
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    • v.22 no.2
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    • pp.357-363
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    • 1989
  • We experienced very rare case of pulmonary blastoma in a 5 year old girl. She complained of right chest pain and productive cough for 3 months. With computerized tomography and echocardiography it is disclosed that huge mediastinal solid tumor is occupied to whole right thoracic cavity and compressed mediastinal structures to left and extended to left atrium. We removed the thoracic tumor and its extended intracardiac portion completely using the technique of intrapericardial pneumonectomy with cardiopulmonary bypass. Postoperatively the patient recovered without any problem and received adjuvant chemotherapy and radiotherapy. But she was succumbed 2 months later because of opportunistic pulmonary infection with pneumocystis carinii.

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Successful Management of a Recurrent Primary Malignant Fibrous Histiocytoma of the Lung: Report of a Case

  • Jeon, Yun-Ho;Park, Ki-Sung
    • Journal of Chest Surgery
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    • v.45 no.5
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    • pp.345-347
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    • 2012
  • We describe herein an extremely rare case of a recurrent primary pulmonary malignant fibrous histiocytoma 3 months after operation that occurred in a 55-year-old man who was treated with chemotherapy and radiotherapy successfully. Until now, 36 months later, the patient has shown no evidence of tumor recurrence. The clinical, radiographic, and pathologic features are reported here together with a brief review of the literature.

STRATOS Titanium Rib Bridge for Chest Wall Reconstruction after Infantile Fibrosarcoma Resection: A Case Report

  • Llalle, Wildor Samir Cubas;Valenzuela, Maisa;Pachas-Canales, Carlos;Vasquez-Arias, Jaime
    • Journal of Chest Surgery
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    • v.54 no.6
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    • pp.539-542
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    • 2021
  • Resection and reconstruction of the chest wall for the radical surgical treatment of malignant soft tissue tumors are currently considered a substantial challenge for thoracic surgeons. We present an unusual case of infantile fibrosarcoma with tropomyosin 3-neurotrophic receptor tyrosine kinase 1 fusion in a 13-year-old patient. The surgical treatment consisted of radical resection of the right posterior chest wall and reconstruction with the use of the STRATOS (Strasbourg Thoracic Osteosynthesis System) titanium rib bridge system. The patient had a favorable postoperative course and received respiratory-ventilatory rehabilitation, adjuvant therapy with chemotherapeutic agents, immunotherapy, and radiotherapy.

Effects of Thermotherapy on Th1/Th2 Cells in Esophageal Cancer Patients Treated with Radiotherapy

  • Hong, Mei;Jiang, Zao;Zhou, Ying-Feng
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.2359-2362
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    • 2014
  • Background: To investigate the effects of double radiofrequency hyperthermia on Th1/Th2 cells in esophageal cancer patients treated with radiotherapy. Materials and Methods: 22 patients with esophageal cancer were divided into a radiotherapy group (10 cases) and a combined group (double radiofrequency hyperthermia combined with radiotherapy group, 12 cases). Both groups received conventional radiotherapy using a cobalt-60 therapy apparatus (TD60-66Gy/30-33F). Patients in the combined group also underwent double radiofrequency hyperthermia (2F/W, 8-10F). Before and after treatment, Th1, Th2, Tc1 and Tc2 cells in peripheral blood were determined with flow cytometry. Results: In the radiotherapy group, Th1 cell contents before and after radiotherapy were $17.5{\pm}5.26%$ and $9.69{\pm}4.86%$, respectively, with a significant difference (p<0.01). The Th1/Th2 ratio was significantly decreased from $28.2{\pm}14.3$ to $16.5{\pm}10.4 $(p<0.01). In the combined group, Th1 cell content before radiotherapy was $15.9{\pm}8.18%$, and it increased to $18.6{\pm}8.84$ after radiotherapy (p>0.05), the Th1/Th2 ratio decreasing from $38.4{\pm}36.3$ to $28.1{\pm}24.0$ (p>0.05). Changes in Th2, Tc1 and Tc2 cell levels were not significant in the two groups before and after therapy (p>0.05). Conclusions: Double radiofrequency hyperthermia can promote the conversion from Th2 to Th1 cells, and regulate the balance of Th1/Th2 cells.

Phase II Study of Induction Irinotecan + Cisplatin Chemotherapy Followed by Concurrent Irinotecan + Cisplatin Plus Twice-Daily Thoracic Radiotherapy (유제한성 병기의 소세포 폐암에서 3주 간격으로 시행된 irinotecan과 cisplatin을 이용한 과다분할 방사선 동시 요법)

  • Lee, Jeong Eun;Park, Hee Sun;Jung, Sung Soo;Kim, Ju Ock;Cho, Moon June;Kim, Jin Hwan;Lee, Choong Sik;Kim, Sun Young
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.2
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    • pp.154-164
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    • 2007
  • Background: Irinotecan hydrochloride, a topoisomerase I inhibitor, is effective against small-cell lung cancer. Irinotecan also can act as a potential radiation sensitizer along with cisplatin. To evaluate efficacy and toxicity of irinotecan plus cisplatin (IP) with concurrent thoracic radiotherapy, we conducted a phase II study of IP followed by concurrent IP plus hyperfractionated thoracic radiotherapy in patients with previously untreated limited-stage small-cell lung cancer. Methods: Twenty-four patients with previously untreated small-cell lung cancer were enrolled onto the study since November 2004. Irinotecan $60mg/m^2$ was administered intravenously on days 1 and 8 in combination with cisplatin $60mg/m^2$ on day1 every 21 days. From the first day of third cycle, twice-daily thoracic irradiation (total 45 Gy) was given. Prophylactic cranial irradiation was given to the patients who showed complete remission after concurrent chemoradiotherapy. Restaging was done after second and sixth cycle with chest CT and/or bronchosocpy. Results: Up to November 2004, 19 patients were assessable. The median follow-up time was 12.5 months. A total of 99 cycles (median 5.2 cycles per patient) were administered. The actual dose intensity values were cisplatin $19.6mg/m^2$/week and irinotecan $38.2mg/m^2$/week. Among the 19 patients, the objective response rate was 95% (19 patients), with 9 patients (47%) having a complete response (CR). The major grade 3/4 hematological toxicities were neutropenia (35% of cycles), anemia (7% of cycles), thrombocytopenia (7% of cycles). Febrile neutropenia was 4% of cycles. The predominant grade 3/4 non-hematological toxicities was diarrhea (5% of cycles). Toxicities was not significantly different with concurrent administration of irinotecan and cisplatin with radiotherapy, except grade 3/4 radiation esophagitis (10% of patients). No treatment-related deaths were observed. The 1-year and 2-year survival rate of eligible patients was 89% (16/18) and 47% (9/18), respectively. Conclusion: Three-week schedule of irinotecan plus cisplatin followed by concurrent IP plus hyperfractionated thoracic radiotherapy is an effective treatment for limited disease small-cell lung cancer, with acceptable toxicity.

Intramedullary Subependymoma of the Thoracic Spinal Cord

  • Jang, Woo-Youl;Lee, Jung-Kil;Kim, Jae-Hyoo;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • v.39 no.5
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    • pp.385-388
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    • 2006
  • An Intramedullary subependymoma of the spinal cord is a rare tumor with only 43 reported cases in the literature. Most of them are reported to be localized within the cervical spinal cord. We report a rare case of a thoracic spine intramedullary subependymoma in a 37-year-old female who presented with back pain and radiating leg pain. Subtotal resection and post-operative radiotherapy were performed. Subependymomas developing in the spinal cord are benign with a low proliferative potential. Complete resection of the tumor appears to be the optimal method for a complete cure. However aggressive surgery may cause severe neurological deficit. Therefore, if severe neurological deficits are expected after complete removal, a partial removal and postoperative radiation therapy is an alternative method for treatment in selected cases. A large-scale randomized study is mandatory to clarify the effectiveness of radiotherapy and to establish the recurrence rate and prognosis with respect to the surgical removal of these tumors.

Thoracomyoplasty for Chronic Empyema and Osteoradionecrosis of the Chest Wall

  • Hong, Jeong In;Shin, Hong Ju;Jo, Won-Min;Shin, Jae Seung;Hwang, Jinwook
    • Journal of Chest Surgery
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    • v.54 no.3
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    • pp.228-231
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    • 2021
  • Herein, we report a case in which thoracomyoplasty was performed to manage chronic postlobectomy empyema (PLE). A 54-year-old male patient with a surgical history of right upper lobectomy and thymectomy 35 years previously who had undergone adjuvant radiotherapy presented with purulent discharge on the anterior chest wall. The patient was diagnosed with chronic PLE with ascending infection and concurrent osteonecrosis of the parasternum. Proper drainage was performed for local infection control and the dead spaces were successfully closed with muscle flaps. There have been no complications to date.

Mucoepidermoid carcinoma of the lung (Mucoepidermoid Carcinoma 치험 1예)

  • 백광제
    • Journal of Chest Surgery
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    • v.19 no.3
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    • pp.484-488
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    • 1986
  • Mucoepidermoid carcinoma is one of bronchial adenoma which arising from submucosal gland or mucosal gland of lower respiratory tract. The symptoms of the tumor were produced by bronchial irritation and bronchial obstruction such as coughing, pneumonitis, and atelectasis. The malignancy potency of this tumor was determined by histologic pattern but high grade malignancy was uncommon and so distant metastasis was rare. Three treatment modality such as surgery, radiotherapy, chemotherapy were used for treatment but radiotherapy and chemotherapy were lesser effective than surgery. So Early and radical resection of tumor was recommended. Here we report one case of mucoepidermoid carcinoma which treated with radical resection.

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The effects according to the timing of thoracic radiotherapy in limited stage small cell lung cancer (제한병기 소세포폐암에서 흉부 방사선 치료의 도입 시기에 따른 치료 효과의 비교 분석)

  • Park, Sang Ki;Kim, Geun Hwa;Jeong, Seong Su;Shin, Kyoung Sang;Kim, Ae Kyoung;Cho, Hai Jeong;Suhr, Jee Won;Kim, Jae Sung;Cho, Moon June;Kim, Ju Ock;Kim, Sun Young
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.903-915
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    • 1996
  • Background: Combination chemotherapy is now considered to be the cornerstone of small cell lung cancer (SCLC). management but the optimal management of limited SCLC is not well defined. The role of thoracic radiotherapy (TRT) is less well established. Recent meta-analyses reports revealed that TRT combined with chemotherapy produce "good" local control and prolonged survival. But other reports that survival was not changed. The liming, dose, volume and fractionation for TRT with the combined chemotherapy of SCLC remains unsettled. In this study, we analyzed the effects according to the timing of thoracic radiotherapy in limited SCLC. Method: All fifty one patients received cytoxan, adriamycin and vincristine(CAV) alternating with etoposide and cisplatin(VPP) every 3 weeks for 6 cycles were randomized prospectively into two groups: concurrent and sequential. 27 patients received 4500cGy in 30 fractions(twice daily 150cGy fractional dose) over 3 weeks 10 the primary site concurrent with the first cycle of VPP(concurrent gorup). 24 patients received 4000 to 5000cGy over 5 or 6 weeks after completion of sixth cycles of chemotherapy(sequential group). Results: 1. Response rates and response duration : Response rates were not significantly different between two groups(p=0.13). But response duration was superior in the concurrent group(p=0.03). 2. Survival duration was nor different between two groups(p=0.33). 3. Local control rate was superior in the concurrent group(p=0.00). 4. Side effects and toxicities: Hematologic toxicities, especially leukopenia, infection and frequency of radiation esophagitis were higher in the concurrent group (p=0.00, 0.03, 0.03). Conclusion: The concurrent use of TRT with chemotherapy failed to improve the survival of limited stage SCLC patients compared with the sequential use of TRT but response duration and local control rate were superior in the concurrent group. Frequency of radiation esophagitis, life threatening hematologic toxicities and infection were more frequent in the concurrent group than sequential group. So, the selection of an optimal schedule of chemotherapy combined with TRT that would lead to a major increase in survival with minimal toxicity is remained to be validated in large scale study in the future.

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Mediastinal Paraganglioma: Complete Resection Using Video-Assisted Thoracoscopic Surgery

  • Kim, Dohun;Kim, Si-Wook;Hong, Jong-Myeon
    • Journal of Chest Surgery
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    • v.47 no.2
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    • pp.197-199
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    • 2014
  • Mediastinal paragangliomas are very rare neuroendocrine tumors. Complete resection is the standard treatment of a paraganglioma because of the tumor's potential malignancy and poor response to chemo- or radiotherapy. However, the highly vascular nature of the tumor and its characteristic anatomic location make complete resection difficult. We report a case of an anterior mediastinal paraganglioma, which was incidentally found on a chest computed tomography scan for chronic cough work-up of a 55-year-old woman. Complete resection was accomplished using video-assisted thoracoscopic surgery, and the patient recovered without any complications.