Vaginal evisceration is a rare complication after a hysterectomy, especially a radical hysterectomy. Up to now, there have only been three cases of transvaginal evisceration after radical hysterectomy reported in the English literature. We report one case of transvaginal evisceration occurring after radical hysterectomy and adjuvant radiotherapy for stage IIA cervical cancer, with a brief review of the literature.
Hysterectomy ; Radiotherapy, Adjuvant ; Uterine Cervical Neoplasms

Intracranial tumors secondary to radiotherapy are rare. In this group gliomas are the rarest. Only 6 cases of glioblastoma multiforme (GBM) have been reported in patients undergoing radiotherapy (RT) for craniopharyngiomas of which only 4 have been in children less than 18 years of age. In recent years RT has become a mainstay of adjuvant therapy for recurrent or partially excised craniopharyngiomas. We report a child of 12 years who had previously undergone RT for a suprasellar craniopharyngioma and presented 10 years later with a GBM. This is the 5th pediatric case in literature demonstrating a GBM after RT for a craniopharyngioma. The implications of subjecting the pediatric population to RT for a benign lesion versus the outcome of gross total removal and management of RT induced tumors is discussed and the need to avail of safer alternatives such as stereotactic radiosurgery is stressed.
Child ; Craniopharyngioma* ; Glioblastoma ; Glioma ; Humans ; Radiosurgery ; Radiotherapy ; Radiotherapy, Adjuvant*

The fibromatosis (desmoid tumor) is histologically benign fibrous neoplasm arising from the musculoaponeurotic structures through out the body, but that shows locally aggressive growth. Common anatomic sites includes the limbs, trunk and mesentery. Fibromatoses arising in the neck have been reported rarely. If the tumors are occurred in the neck, complete resection is often difficult, because of its locally infiltrative nature. Therefore radiotherapy, chemotherapy and hormonal therapy are occasionally needed to reduce local recurrence. We report herein a case of fibromatosis arising in the left supraclavicular region with infiltration to surrounding tissues, which was successfully treated by complete surgical excision and postoperative adjuvant radiotherapy.
Drug Therapy ; Extremities ; Fibroma* ; Mesentery ; Neck* ; Radiotherapy ; Radiotherapy, Adjuvant ; Recurrence

Radiotherapy has an important role in the management of prostate cancer patients. It can be used as definitive treatment in place of surgery, postoperative adjuvant radiotherapy, or salvage treatment when recurrences develop after surgery. During definitive radiotherapy treatment, dose escalation can improve biochemical control but has not led to improved survival to date. Hypofractionated radiotherapy is applied for prostate cancer treatment, since prostate cancer has a low alpha/beta ratio. Contrary to theoretical expectations, hypofractionated treatment does not show improved therapeutic results and decreased toxicity, but it can reduce overall treatment time. Ongoing non-inferiority trials may assist in determining optimal hypofractionated treatment regimens. Adjuvant radiotherapy in patients with pathological T3 or positive resection margins can improve biochemical control and might increase overall survival. However, there is debate regarding the superiority of adjuvant radiotherapy over early salvage radiotherapy in high-risk patients after surgery. To address this issue, it will be necessary to wait for the results of current randomized trials.
Humans ; Prostatic Neoplasms* ; Proton Therapy ; Radiotherapy* ; Radiotherapy, Adjuvant ; Recurrence

For locally advanced rectal cancer after neoadjuvant radiation, it is difficult to make a choice between close observation, local resection, and radical resection. The decision should be made after carefully weighing postoperative complications, anal function, local recurrence and long-term survival. There is a high consistency of the radiosensitivity between primary tumor and mesenteric lymph node, which may be used to guide the treatment decisions. If the primary tumor shrinks significantly after neoadjuvant radiation, local resection is recommended, and the next treatment plan should be made based on the pathological examination of resected specimen. Transabdominal radical resection is recommended for unfavorable tumors. Distal resection margin should be at least 1 cm, and marking the inferior margin of tumor is also recommended before neoadjuvant radiation since it would shrink significantly after radiation.
Humans ; Neoadjuvant Therapy ; Radiotherapy, Adjuvant ; Rectal Neoplasms ; radiotherapy ; surgery

Single modality treatment of advanced gastrointestinal cancer has been associated with unfavorable outcomes. Radiotherapy as an important component of the combined modality therapy of gastrointestinal tract tumors may achieve down-staging, increase resection rate while preserving sphincter function, decrease local recurrence rate, and improve survival rate. Precision radiotherapy has better conformity, accuracy, and lower toxicity. Precision radiotherapy will become more and more important in the combined modality therapy of gastrointestinal tract cancer.
Combined Modality Therapy ; Gastrointestinal Neoplasms ; radiotherapy ; Humans ; Radiotherapy, Adjuvant ; methods

Radiotherapy has been an important component in the multidisciplinary treatment strategy of gastric cancer. INT0116 has showed the improvement of survival with adjuvant chemoradiation in resected gastric cancer. The benefit of adjuvant chemoradiation has been confirmed further in gastric cancer population. Recent reported ARTIST trial which all patients got D2 dissection has showed the benefit of adjuvant chemoradiation only seen in patients with lymph node positive. As the same observed in other two trail, ACT-GC and CLASSIC, extremely low local recurrence were reported in these trial. We should be very cautious when we interpret these results and treatment into our clinical practice due to the difference of local recurrence between trials and daily practice. Neoadjuvant radiation has been reported its effectiveness of cardiac gastric cancer in earlier randomized trial. Phase II( trials have shown the high pCR rate with neoadjuvant chemoradiation. However, concurrent chemoradiation was with more toxicity and limited it development. Even though, further investigation in neoadjuvant setting is worthy but with reduce of toxicity. New progress in high technique of radiation will help the application of radiotherapy in gastric cancer. The future of radiation in gastric cancer treatment will focus on the selection of patients which are of most benefit, detection of radiosensitivity and how to optimize combination of radiation with surgery and novel chemotherapy and target therapy.
Humans ; Perioperative Care ; Radiotherapy, Adjuvant ; Stomach Neoplasms ; radiotherapy ; surgery

In gastric adenocarcinoma, high rates of loco-regional recurrences have been reported even after complete resection, and various studies have been tried to find the role of postoperative adjuvant therapy. Among them, Intergroup 0116 trial was a landmark trial, and demonstrated the definite survival benefit in adjuvant chemoradiotherapy, compared with surgery alone. However, the INT 0116 trial had major limitation for global acceptance of the INT 0116 regimen as an adjuvant treatment modality because of the limited lymph node dissection. Lately, several randomized studies that were performed to patients with D2-dissected gastric cancer were published. This review summarizes the data about patterns of failure after surgical resection and the earlier prospective studies, including INT 0116 study. Author will introduce the latest studies, including ARTIST trial and discuss whether external beam radiotherapy should be applied to patients receiving extended lymph node dissection and adjuvant chemotherapy.
Adenocarcinoma ; Chemoradiotherapy, Adjuvant ; Chemotherapy, Adjuvant ; Humans ; Lymph Node Excision ; Radiotherapy, Adjuvant ; Recurrence ; Stomach Neoplasms ; Tetrazolium Salts

In gastric adenocarcinoma, high rates of loco-regional recurrences have been reported even after complete resection, and various studies have been tried to find the role of postoperative adjuvant therapy. Among them, Intergroup 0116 trial was a landmark trial, and demonstrated the definite survival benefit in adjuvant chemoradiotherapy, compared with surgery alone. However, the INT 0116 trial had major limitation for global acceptance of the INT 0116 regimen as an adjuvant treatment modality because of the limited lymph node dissection. Lately, several randomized studies that were performed to patients with D2-dissected gastric cancer were published. This review summarizes the data about patterns of failure after surgical resection and the earlier prospective studies, including INT 0116 study. Author will introduce the latest studies, including ARTIST trial and discuss whether external beam radiotherapy should be applied to patients receiving extended lymph node dissection and adjuvant chemotherapy.
Adenocarcinoma ; Chemoradiotherapy, Adjuvant ; Chemotherapy, Adjuvant ; Humans ; Lymph Node Excision ; Radiotherapy, Adjuvant ; Recurrence ; Stomach Neoplasms ; Tetrazolium Salts

PURPOSE: The purpose of this study was to identify changes of symptom distress and quality of life (QOL) in breast cancer patients receiving adjuvant therapy. METHODS: 113 patients with breast cancer were administered the Memorial Symptom Assessment Scale-Short Form and the Functional Assessment of Cancer Therapy-Breast before adjuvant therapy, both a week and 6 months after completing adjuvant therapy. 71 patients (CTx group) were treated with adjuvant chemotherapy and radiotherapy. 42 patients (RTx group) received only adjuvant radiotherapy. Data were analysed using the SPSS/Win 21.0 program. RESULTS: Compared with the RTx group, patients in the CTx group reported higher overall symptom distress and physical symptom distress. The CTx group reported lower scores in overall QOL, physical well-being and the breast cancer specific domain than the RTx group. CONCLUSION: Findings from this study support that chemotherapy results in higher risk for more severe symptoms and leads to impaired QOL for breast cancer patients. Comprehensive symptom management should be implemented for breast cancer patients receiving chemotherapy.
Breast Neoplasms* ; Chemotherapy, Adjuvant ; Drug Therapy ; Humans ; Quality of Life* ; Radiotherapy ; Radiotherapy, Adjuvant ; Symptom Assessment ; Surveys and Questionnaires