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Introduction: Brain metastases (BM) have a very poor prognosis, creating a demand for effective local therapies, such as radiotherapy (RT) and neurosurgery, the combination of which is debatable. The aim of the present study was to investigate prognostic factors and to develop treatment recommendations for patients with BM. Material and Methods: A total of 84 patients treated between May 2011 and July 2016 were analyzed in a single-institution retrospective study. Results: Overall survival (OS) was 10.3 months. Poor OS was defined by a Karnofsky performance index of =70% (2.9 vs. 15.8 months; p = 0.009), male gender (6.5 vs. 18.3 months; p = 0.044), and incomplete neurosurgical resection (2.5 vs. 15.8 months; p = 0.017). These factors were also shown to be significant in univariate analysis, while only radical resection remained significant in multivariate testing (p = 0.023). A direct comparison between whole-brain RT (with or without boost) and local RT illustrated a superior OS for local therapy (22.7 vs. 9.5 months; p = 0.022), especially in case of up to 3 metastases (p = 0.041). Intracranial control was 81% with a median duration of 31.6 months. Conclusion: Combined modality treatment of RT and neurosurgery is effective and feasible. A complete removal of all metastases is the cardinal prognostic factor. [ABSTRACT FROM AUTHOR]

Background: Cisplatin-based chemotherapy (CTX) is commonly used concurrently with radiotherapy for head and neck cancer. The value of CTX regimens other than cisplatin for locally advanced squamous cell carcinoma of head and neck (LASCCHN) has not been well established. Here we compare the outcome of patients treated with different platinum-based chemotherapy regimens. Methods: Medical records from 104 patients with LASCCHN treated with radiochemotherapy (RCTX) between February 2013 and August 2016 were analyzed. Results: All patients were treated with intensity-modulated radiation therapy (51 definitive, 53 postoperative). The median total dose was 66.6 Gy and the median fraction dose was 1.8 Gy. 81 (78%) patients were administered cisplatin CTX, 23 (22%) patients received carboplatin and paclitaxel (CarboTaxol). The rate of recurrence was 38% in patients treated with cisplatin and 30% in CarboTaxol-treated patients (p = 0.6). Regarding the CTX regimens, event-free survival (EFS) was 37 versus 30 months (p = 0.6) and overall survival (OS) was 35 versus 28 months (p = 0.5) in cisplatin group versus CarboTaxol group, respectively. Significantly higher grade 3/4 acute toxicity in terms of dysphagia was observed following cisplatin-based RCTX (p = 0.002). In multivariable analysis, females and patients with early primary tumors (T1-2) have longer EFS and OS, regardless the CTX regimen. Conclusions: Primary or adjuvant RCXT with CarboTaxol is a safe and effective treatment alternative for LASCCHN patients with contraindication to cisplatin-based RCTX. [ABSTRACT FROM AUTHOR]

Background: With advances in modern diagnostic and therapeutic modalities, the main goal of intrathoracic radiation treatment is to reduce treatment-related toxicities. Here, we describe a series of cases that involved positron emission tomography/computed tomography (PET/CT) and magnetic resonance imaging (MRI)-based radiation therapy (RT) for the treatment of primary cardiac angiosarcoma (PCA). Patients and Methods: The medical records of 3 patients who underwent imageguided RT at our department between 2012 and 2015 were analyzed. Results: 3 patients with PCA underwent pre-therapeutic imaging with fluorodeoxyglucose (FDG)- PET/CT (n = 3), as well as PET/MRI (n = 2) or MRI alone (n = 1). 2 patients underwent primary tumor resection (cases 1 and 2). The tumor in case 3 was unresectable and the patient underwent definitive chemoradiation. Intensity- modulated RT was applied with a median RT dose of 50.4 Gy. At the end of the study, 2 of the patients had survived for 35 and 16 months post-treatment (cases 1 and 3, respectively), and no evidence of tumor progression has since been detected. Conclusion: For the cases examined, RT was a feasible and tolerable treatment for PCA, and FDG-PET-MRI successfully characterized each PCA for therapy planning. [ABSTRACT FROM AUTHOR]