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At least 307 records · Page 17Linked to original sources
PubMed1994

Giant intrasacral schwannoma: an unusual cause of lumbrosacral radiculopathy.

Sacral schwannoma is a rare lesion (23 reported cases) with a tendency to reach large proportions. Symptoms are back and leg pain, leg weakness, hypoesthesias, paresthesias, constipation, and incontinence. The peak incidence is between ages 30 and 50. Radiographs of the sacrum are abnormal in nearly all cases. Computed tomography and magnetic resonance imaging may reveal large lesions with bony erosion and involvement of the soft tissues. The treatment of this lesion is complete removal, which is curative.

Adult↗
PubMed1980

Urologic tumors presenting as neurosurgical masses.

Metastases from urologic neoplasms often occur to the central nervous system or surrounding bony structures. Usually these metastases are discovered after the primary tumor has been identified. However, these tumors may present primarily with only manifestations of their central nervous system metastases. Five cases of different urologic tumors presenting as neurosurgical masses are presented, along with a brief review of the pertinent literature.

Adult↗
PubMed1986

Spongious bone density determination for staging and follow-up of patients with prostatic cancer.

Quantitative computerized tomography (QCT) of vertebral bodies could reveal metastatic spread of prostatic cancer before such lesions are seen with standard examinations. Focal increase in the density of the spongious bone in face of normal bone scan and serum acid phosphatase is suggestive of metastasis, but certitude is gained only if further increase in density or structural bone changes are demonstrated on follow-up studies. QCT also may provide an objective measurement of tumor response to therapy.

Adenocarcinoma↗
PubMed1987

Metastatic renal oncocytic neoplasm with benign histologic appearance.

We present a case of malignant renal oncocytoma which displayed a benign histologic appearance in the primary renal tumor and in metastases to the spine and liver. The case demonstrates the difficulty that may be encountered in distinguishing benign renal oncocytomas from malignant renal oncocytomas. Whereas, the accepted criteria will enable a distinction in the majority of instances, occasional instances may be encountered in which a benign histology does not provide an accurate reflection on the clinical course.

Adenoma↗
PubMed1988

Ketoconazole in initial management and treatment of metastatic prostate cancer to spine.

Ketoconazole in high doses causes castrate levels of testosterone within twenty-four to forty-eight hours; therefore it is extremely useful in the initial medical treatment of patients with metastatic prostate cancer who need a prompt therapeutic response. Review of 17 patients who presented with severe radicular pain or acute paraparesis/paraplegia showed that there was frequent delay in urologic consultation, pathologic confirmation, and initiation of efficacious therapy. In fact, 5 of 12 patients (42%) who received radiation therapy prior to effective hormonal therapy suffered significant morbidity and mortality. The case is made for the use of ketoconazole for initial empirical therapy for these patients.

Humans↗
PubMed1993

A low frequency, high amplitude rhythmic fluctuation of laser-Doppler skin blood flow after subarachnoid phenol block.

A 51-year-old male with a huge chondrosarcoma received subarachnoid dorsal root blocks with 10% phenol in glycerine to treat severe pain along the left leg. The dermatomes below the Th9 lost all somatic sensation on the left side after the nerve blocks, but the patient was not completely relieved from the pain. Laser-Doppler flowmetry on the toe of the left foot disclosed an increased blood flow and an abnormal fluctuation of the cutaneous capillary blood flow, i.e. a high amplitude rhythmic (HAR) wave with 2.5 to 3 cycles.min-1. The low frequency HAR wave persisted for the subsequent 3 months until a tingling sensation returned to the left leg. It would seem that some travelling roots of the sympathetic nerve were preserved from the chemical neurolysis and the remaining efferent and afferent nerve fibers were responsible for the persisting low frequency HAR wave and pain in the left leg.

Administration, Oral↗
PubMed1993

Chordoma: results of radiation therapy in eighteen patients.

Between 1975 and 1990, eighteen patients with a histologically proven diagnosis of chordoma were treated at our institution. All patients initially underwent a surgical procedure and were referred for irradiation due to residual disease or postsurgical relapse. The mean dose administered was 50.1 Gy (range, 29.9-64.8 Gy). Eight patients were treated according to a hyperfractionated schedule. The overall actuarial 5-year survival and 5-year progression-free survival were 38% and 17%, respectively. The progression-free interval was longer for patients receiving doses greater than 48 Gy when compared with doses below 40 Gy (actuarial 5-year progression-free survival of 31 +/- 35% vs. 0%, respectively; p = 0.04). We conclude that in the treatment of chordoma, the administration of high radiation doses may increase the disease-free interval. The objective response and dose-response relationships were analyzed in twelve patients for whom sequential CT scans were available.

Adult↗
PubMed1990

Mesenchymal chondrosarcoma of the craniocervical junction.

Mesenchymal chondrosarcomas are found with equal low frequency in bone and soft tissue. The CNS is the most commonly reported site of extraosseous origin of mesenchymal chondrosarcomas. This report concerns the CT, MRI, and pathologic findings as well as the operative management of a mesenchymal chondrosarcoma of the craniocervical junction.

Adult↗
PubMed1982

Treatment of cancer with heavy charged particles.

A clinical radiotherapeutic trial using heavy charged particles in the treatment of human cancers has accrued over 400 patients since 1975, 378 of whom were treated with particles and 28 with low LET photons as control patients. Heavy charged particle radiotherapy offers the potential advantages of improved dose localization and/or enhanced biologic effect, depending on particle selected for treatment. Target sites have included selected head and neck tumors, ocular melanomata, malignant gliomata of the brain, carcinoma of the esophagus, carcinoma of the stomach, carcinoma of the pancreas, selected juxtaspinal tumors and other locally advanced, unresectable tumors. A Phase III prospective clinical trial has been started in carcinoma of the pancreas using helium ions. Phase I-II studies are underway with heavier particles such as carbon, neon and argon ions in order to prepare for prospective Phase III trials. Silicon ions are also under consideration for clinical trial. These studies are supported by the United States Department of Energy and National Institutes of Health.

Adult↗
PubMed1982

Evaluation of the clinical applicability of proton beams in definitive fractionated radiation therapy.

We report on the treatment of 317 patients treated either wholly or in part with proton beams at the Harvard Cyclotron Laboratory. These include: 130 patients treated for definitive radiation therapy of choroidal melanoma; 17 patients treated for tumors of the base of skull, cervical spine and cranium, which abut structures of the central nervous system (CNS); 23 patients treated for sarcomas of soft tissue and bone; 65 patients treated for carcinoma of the prostate; 14 patients treated for carcinoma of the rectum and anus; and 23 patients treated for squamous carcinoma of the oral cavity and oro-pharynx. Data on causes of failure and morbidity of treatment are presented. Overall the results are judged to be extremely encouraging. In particular, the treatment of the choroidal melanomas and sarcomas abutting CNS structures have clear clinical value, and the treatment of prostatic tumors and tumors of the head and neck are thought to be promising.

Bone Neoplasms↗
PubMed1983

Chordoma: the results of megavoltage radiation therapy.

Twenty-four patients with chordoma who received one or more courses of megavoltage radiation therapy following biopsy or incomplete resection were reviewed. The uncorrected survival rate at five years was 62%, and at 10 years was 28%, but most patients had clinically detectable residual chordoma present at the time of death or last follow-up. The duration of symptomatic improvement following irradiation ranged from a few months to 18 years, median 3.5 years. Detailed dose-time and symptomatic response data for 56 patients from this series and from the literature who were treated by conventional daily fractionated megavoltage irradiation show no convincing evidence that symptomatic relief is more likely after high doses than after total doses of only 4000 to 5500 cGy. Patients are rarely cured of chordoma by partial tumor resection and conventional radiation. Four patients received multiple fractions of 100 cGy each day either as retreatment for recurrence, or as initial treatment. Symptomatic responses, and decreases in the size of tumor masses, were seen following total doses ranging from 2000 cGy/20 fractions/5 days/4 X 3 hourly fractions each day to 4000 cGy/40 fractions/12 days/4 X 3 hourly fractions each day. The short duration of follow-up in these patients prevents comparison with conventional fractionation. However, this technique presents one possible new approach for the treatment of chordoma.

Adult↗
PubMed1984

A versatile permanent planar implant technique utilizing iodine-125 seeds imbedded in gelfoam.

Tumors attached or adjacent to critical structures can often not be completely resected or resected with adequate surgical margins. Sites involving major blood vessels, the vertebral column or the brain with small residual tumors or suspicious margins often present technical difficulties for standard I-125 or Ir-192 implants. A relatively simple, accurate and inexpensive implant method is described using I-125 seeds imbedded in gelfoam to implant permanently into small residual tumors or suspicious margins where standard implant techniques may be unsatisfactory. A method for planning the treatment dose for such an implant is described. Cases involving paraspinal and brain tumors are reported to illustrate the technique.

Adolescent↗
PubMed1988

Charged particle radiotherapy of selected tumors in the head and neck.

For selected tumors in some sites in the head and neck region, charged particles such as protons or helium, carbon, neon and silicon ions provide improved dose distributions, higher tumor doses, and an increased chance of local control and prolonged survival. In tumors with "radioresistant" histologies, slow growth kinetics and/or hypoxic cells, the high-LET component of neon or silicon ions may also offer and added potential for increased effect on tumors. Sixty-seven (67) evaluable patients with tumors in the head and neck region having a histology other than squamous carcinoma received partial or full treatment with charged particles at the University of California Lawrence Berkeley Laboratory. The tumor sites included base of skull or cervical spine, salivary glands, paranasal sinuses, nasopharynx, and miscellaneous sites such as lacrimal gland, soft tissues of the neck, or thyroid. Follow-up ranges from 1-9 years with a mean of 36 months and a median survival (Kaplan-Meier technique) of 50 months. The actuarial local control rate is 60% at 24 months post-treatment. Thirty-one (31) patients with squamous carcinoma of various sites in the head and neck have also been treated using charged particle irradiation; local control was lower (11 of 31 pts) and survival shorter (mean: 9 months) in this group of patients with advanced squamous carcinoma.

Adult↗
PubMed1988

Charged particle irradiation of chordoma and chondrosarcoma of the base of skull and cervical spine: the Lawrence Berkeley Laboratory experience.

Forty-five consecutive patients with chordoma or chondrosarcoma at the base of skull or cervical spine were treated at the University of California Lawrence Berkeley Laboratory (UCLBL) and University of California School of Medicine, San Francisco (UCSF) between November 1977 and October 1986. All patients had undergone a subtotal surgical resection. Twenty-three patients were treated definitively with charged particles, 13 patients were treated with photons and particles, and 9 patients were treated for recurrent disease. Total doses ranged from 36 to 80 Gray equivalent (GyE). Thirty-three patients are alive with a minimum followup of 1 year. The actuarial survival and local control for all patients at 5 years is 62% and 59%, respectively. Patients treated for primary disease had a 78% actuarial local control rate at 2 years, whereas the rate for patients with recurrent disease was 33%. Patients with smaller visible tumor volumes (less than 20 cc) had a significantly better local control rate than patients with larger tumor volumes (80% vs 33% actuarial rate at 5 years). Patients with chondrosarcoma had the highest local control rate, as did patients treated with particles alone. Complications included 3 patients with unilateral visual loss, two patients who became blind, and 4 patients with radiation injury to the brainstem.

Actuarial Analysis↗