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Rhabdomyoma is a well characterised entity in a neonate. Herein, we report a massive biventricular rhabdomyoma in a neonate presenting with cyanosis and congestive heart failure which was confirmed on autopsy. The report is for documentation of an unusually large tumour. [ABSTRACT FROM AUTHOR]

Introduction: Radiation therapy to left breast cancer patients results in significant exposure to heart resulting in long-term cardiac morbidity. This exposure can be reduced by performing deep inspiratory breath-hold (DIBH) technique, however, patient selection criteria or predictive parameters are not routinely used which can identify patients who will have significant benefit with this technique. This study intends to find and use these predictive parameters measured on free-breathing (FB) simulation scan which can help to select such patients so as to develop our institutional protocol. Methods: A total of 35 patients of left breast cancer postsurgery were recruited in the study. All patients underwent 2--3 sessions of DIBH coaching followed by planning computed tomography scan in both FB phase and DIBH phase. Various anatomical parameters such as cardiac contact distance parasagittal (CCDps), CCD axial, heart--chest distance (HCD), and D were measured on FB scan and were correlated with a mean heart dose achieved in DIBH scan. Results: Dose to normal structures, namely heart and lung, was drastically reduced for DIBH scan over FB scan. V5, V10, and V20 of heart also followed a similar reduction. The mean dose to heart in FB scan was 5.34 Gy, while in DIBH scan, it was 2.79 Gy which was statistically significant. Among all the parameters measured, CCDps and D had a statistically significant positive correlation with the mean heart dose in DIBH phase while HCD had a negative correlation which was statistically significant. Conclusion: Cardiac parameters on FB scan such as CCDps, HCD, and D predict the patients with usual cardiac risk who will benefit most with DIBH techniques setting an arbitrarily cutoff value. [ABSTRACT FROM AUTHOR]

Cancer is considered to be an age related disease because the incidence of most types of cancers increases with age rising more rapidly beginning in midlife. Adolescents and young adults are a distinct population, which is not a usual age for diagnosis of tumors that are usually found in older adults. Tumors in this group of patients tend to be different from tumors found in children or older adults. The treatment of such patients is challenging as they are at a higher risk of developing long-term side effects. In this case series, we report 3 cases of adult cancers that presented at an unusually younger age highlighting the fact that there is a recent shift in paradigm in terms of age of presentation of cancer. We present 3 cases namely, supraglottic larynx squamous cell carcinoma in a 21-year-old female, adenocarcinoma of the rectum in a 22-year-old male, and adenocarcinoma of the stomach and gastro-esophageal junction in a 25-year-old male. With this case series we want to highlight this recent change in the age presentation of adult cancers and this could foreshadow the future trend of the disease. [ABSTRACT FROM AUTHOR]

The objective of this study was to analyze the influence of the increment of gantry angle and the number of arcs on esophageal volumetric modulated arc therapy plan. All plans were done in Monaco planning system for Elekta Synergy linear accelerator with 80 multileaf collimator (MLC). Volumetric modulated arc therapy (VMAT) plans were done with different increment of gantry angle like 15°, 20°, 30° and 40°. The remaining parameters were similar for all the plans. The results were compared. To compare the plan quality with number of arcs, VMAT plans were done with single and dual arc with increment of gantry angle of 20°. The dose to gross tumor volume (GTV) for 60 Gy and planning target volume (PTV) for 48 Gy was compared. The dosimetric parameters D98%, D95%, D50% and Dmax of GTV were analyzed. The homogeneity index (HI) and conformity index (CI) of GTV were studied and the dose to 98% and 95% of PTV was analyzed. Maximum dose to spinal cord and planning risk volume of cord (PRV cord) was compared. The Volume of lung receiving 10 Gy, 20 Gy and mean dose was analyzed. The volume of heart receiving 30 Gy and 45 Gy was compared. The volume of normal tissue receiving greater than 2 Gy and 5 Gy was compared. The number of monitor units (MU) required to deliver the plans were compared. The plan with larger increment of gantry angle proved to be superior to smaller increment of gantry angle plans in terms of dose coverage, HI, CI and normal tissue sparing. The number of arcs did not make any difference in the quality of the plan. [ABSTRACT FROM AUTHOR]

The aim of this study was to compare the various dosimetric parameters of dynamic multileaf collimator (MLC) intensity modulated radiation therapy (IMRT) plans with volumetric modulated arc therapy (VMAT) plans for base of tongue cases. All plans were done in Monaco planning system for Elekta synergy linear accelerator with 80 MLC. IMRT plans were planned with nine stationary beams, and VMAT plans were done for 360° arc with single arc or dual arc. The dose to the planning target volumes (PTV) for 70, 63, and 56 Gy was compared. The dose to 95, 98, and 50% volume of PTV were analyzed. The homogeneity index (HI) and the conformity index (CI) of the PTV70 were also analyzed. IMRT and VMAT plan showed similar dose coverage, HI, and CI. Maximum dose and dose to 1-cc volume of spinal cord, planning risk volume (PRV) cord, and brain stem were compared. IMRT plan and VMAT plan showed similar results except for the 1 cc of PRV cord that received slightly higher dose in VMAT plan. Mean dose and dose to 50% volume of right and left parotid glands were analyzed. VMAT plan gave better sparing of parotid glands than IMRT . In normal tissue dose analyses VMAT was better than IMRT . The number of monitor units (MU) required for delivering the good quality of the plan and the time required to deliver the plan for IMRT and VMAT were compared. The number of MUs for VMAT was higher than that of IMRT plans. However, the delivery time was reduced by a factor of two for VMAT compared with IMRT . VMAT plans yielded good quality of the plan compared with IMRT, resulting in reduced treatment time and improved efficiency for base of tongue cases. [ABSTRACT FROM AUTHOR]