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      • Record: found
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      Helical Tomotherapy ® is a Safe and Feasible Technique for Total Scalp Irradiation

      case-report

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Angiosarcoma of the scalp is a rare aggressive tumor that affects elderly patients. Chemoradiation is the treatment of choice for multicentric and extensive disease. The shape of the scalp represents a dosimetric challenge in terms of achieving a homogeneous concave dose distribution with coverage of the entire target volume and an acceptable organs-at-risk sparing. We report a case of an 81-year-old man with a multifocal angiosarcoma of the scalp treated with Helical TomoTherapy ® (Accuray Inc., Sunnyvale, CA, USA) intensity modulated radiotherapy. This technique allows precise and daily verifiable coverage of the target keeping the dose to the organs at risk within the constraints.

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          Treatment and prognosis of angiosarcoma of the scalp and face: a retrospective analysis of 48 patients.

          S Iraha, S Murayama, K. Ogawa … (2012)
          The objective of this study was to retrospectively analyse the treatment results of clinically localised angiosarcoma of the scalp and face. The records of 48 patients who were treated between 1987 and 2009 were reviewed. single modality or a combination of surgery, radiotherapy, chemotherapy and immunotherapy were administered. The median follow-up of all 48 patients was 13.7 months (range 2.5-105.9 months). At the time of analysis, 45 of 48 patients (93.8%) had disease recurrences, and the lung was the most frequent site for recurrence (37 patients). In multivariate analysis, performance status (PS) and number of tumours were significant predictors of lung-metastasis-free (LMF) rate. For patients with multifocal tumours, chemotherapy use significantly decreased the LMF rate (p=0.0072). The 2-year actuarial overall survival (OS), progression-free survival and local control rates in all 48 patients were 22.1%, 10.7% and 46.3%, respectively. In multivariate analysis, PS, number of tumours, surgery and radiotherapy were significant prognostic factors for OS. Patients treated with both surgery and radiotherapy (2-year OS: 45.8%) had a significantly more favourable OS (p<0.0001) than patients treated with either surgery or radiotherapy (2-year OS: 11.1%) and patients treated with neither surgery nor radiotherapy (2-year OS: 0%). Our results indicated that PS and number of tumours were significant predictors for developing lung metastases. Our results also indicated that PS, number of tumours, surgery use and radiotherapy use were independent prognostic factors for OS. Multimodal treatments including surgery and radiotherapy were effective in improving OS for patients with these tumours. Advances in knowledge Multimodal treatments including surgery and radiotherapy are effective in improving overall survival for patients with angiosarcoma of the scalp and face.
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            Angiosarcoma of the scalp treated with curative radiotherapy plus recombinant interleukin-2 immunotherapy.

            Takayuki Ohguri, Masutaka Furue, Masanori Hisaoka … (2005)
            To evaluate the effectiveness of curative radiotherapy (RT) plus recombinant interleukin-2 (rIL-2) immunotherapy regarding the treatment results for angiosarcoma of the scalp. Curative resection of angiosarcoma of the scalp is usually difficult because of the diffuse, clinically undetectable local spread. RT is a rational therapeutic approach, because a wide region of the dermis can be treated, while sparing the underlying normal tissues. Recently, the effectiveness of immunotherapy with rIL-2 has also been reported in the treatment of angiosarcoma of the scalp. The data of 20 patients with angiosarcoma of the scalp treated with curative RT plus rIL-2 immunotherapy between January 1988 and June 2002 were retrospectively analyzed. The total radiation dose was 70.3 +/- 6.9 Gy. The fractions were 2-3 Gy daily, given 5 d/wk. rIL-2 immunotherapy was performed by transcatheter arterial administration in 10 patients, systemic administration in 11 during the course of RT, and intratumoral injection in 10 during and/or after RT; 12 patients received a combination of two. Five patients underwent limited surgery, and concomitant pacilitaxel chemotherapy was also used in 2 patients. The median survival time for overall, local recurrence-free, and distant metastasis-free survival was 36.2, 11.1, and 17.8 months, respectively. Local recurrence developed in 7 patients (35%), 4 of whom also had evidence of distant metastases. An additional 7 patients (35%) developed distant metastases alone. Recurrence within the radiation field was recognized in 2 patients with systemic rIL-2 administration alone (p < 0.05). Arterial or intratumoral administration combined with systemic administration of rIL-2 resulted in better distant metaststasis-free survival rates (p < 0.05). Curative RT plus rIL-2 immunotherapy provided an efficient, effective means of treating angiosarcoma of the scalp. Arterial or intratumoral administration combined with systemic administration of rIL-2 may prolong survival. Additional studies with detailed treatment protocols are recommended.
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              Treatment of the scalp using photon and electron beams.

              C Akazawa (1988)
              Many problems arise when treating superficial malignancies along the entire scalp. Some techniques will irradiate too much of the underlying brain while others are highly complex and may involve field junction problems. One approach to circumvent such difficulties is to use lateral opposed photon fields and adjoining electron fields as described in this paper. Sufficient dose coverage throughout the entire scalp is achieved, the normal brain tissues receives minimal dosages, the complexities of simulation and treatment are greatly eased, and the ambiguities of doses at field junction regions are diminished.
              Article 0 comments Cited 15 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Rare Tumors
                Journal ID (iso-abbrev): Rare Tumors
                Journal ID (publisher-id): RT
                Title: Rare Tumors
                Publisher: PAGEPress Publications, Pavia, Italy
                ISSN (Print): 2036-3605
                ISSN (Electronic): 2036-3613
                Publication date (Electronic): 28 March 2017
                Publication date Collection: 24 March 2017
                Volume: 9
                Issue: 1
                Electronic Location Identifier: 6942
                Affiliations
                [1 ]Department of Radiation Oncology, ARNAS-Civico Hospital , Palermo
                [2 ]Radiation Oncology School, University of Palermo , Palermo, Italy
                [3 ]Department of Medical Oncology, AO Ospedali Riuniti , Palermo, Italy
                Author notes
                Department of Radiation Oncology, ARNASCivico Hospital, Piazza Nicola Leotta 4, 90127 Palermo, Italy. +39.091.6664216. mariellamannino@ 123456yahoo.co.uk

                Contributions: the authors contributed equally.

                Article
                DOI: 10.4081/rt.2017.6942
                PMC ID: 5379234
                PubMed ID: 28435647
                SO-VID: 6f408c0b-e8a1-4ce0-b274-05826aacb144
                Copyright © ©Copyright F. Cuccia et al., 2017
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 21 October 2016
                Date accepted : 10 January 2017
                Page count
                Figures: 1, Tables: 0, Equations: 0, References: 11, Pages: 2
                Categories
                Subject: Case Report

                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: tomotherapy,igrt,imrt,scalp irradiation,angiosarcoma
                Data availability:
                ScienceOpen disciplines: Oncology & Radiotherapy
                Keywords: tomotherapy, igrt, imrt, scalp irradiation, angiosarcoma

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