Wednesday, 17 January 2018

Cost-Effectiveness of Primary Radiation Therapy Versus Radical Prostatectomy for Intermediate- to High-Risk Prostate Cancer

Cost-Effectiveness of Primary Radiation Therapy Versus Radical Prostatectomy for Intermediate- to High-Risk Prostate Cancer: To compare, using a cost-effectiveness analysis, the quality-adjusted life expectancy
(QALE) and cost between the 2 treatment options for intermediate- to high-risk prostate
cancer: (1) radiation (RT) with androgen deprivation therapy (ADT) or (2) radical
prostatectomy (RP) followed by adjuvant RT for patients with risk factors.

Sunday, 31 December 2017

TGR (tumor regression grade) in rectal cancer

Pathological features, or TGR, of rectal cancer after preoperative radiochemotherapy:
Source: Dworak O, et al, 1997, cited by Park YJ, Oh BR, Lim SW, Huh JW, Joo JK, Kim YJ, Kim HR. Clinical significance of tumor regression grade in rectal cancer with preoperative chemoradiotherapy. J Korean Soc Coloproctol. 2010 Aug;26(4):279-86. Available at: https://doi.org/10.3393/jksc.2010.26.4.279.

TRG (tumor regression grade) in esophageal carcinoma

Pathological response grading or TRG following neoadjuvant chemoradiation in oesophageal cancer:
Source: Mandard AM, et al., 1994, cited by Gillham CM, Reynolds J, Hollywood D. Predicting the response of localised oesophageal cancer to neo-adjuvant chemoradiation. World J Surg Oncol. 2007 Aug 23;5:97. Available at: https://doi.org/10.1186/1477-7819-5-97.

Saturday, 2 December 2017

Non-small cell lung cancer treatment (r)evolution: ten years of advances and more to come. ecancermedicalscience - The open access journal from the European Institute of Oncology and the OCEI

Non-small cell lung cancer treatment (r)evolution: ten years of advances and more to come. ecancermedicalscience - The open access journal from the European Institute of Oncology and the OCEI

Source: Toschi L, Rossi S, Finocchiaro G, Santoro A. Non-small cell lung cancer treatment (r)evolution: ten years of advances and more to come. ecancermedicalscience. 2017;11. doi:10.3332/ecancer.2017.787.

Source: Toschi L, Rossi S, Finocchiaro G, Santoro A. Non-small cell lung cancer treatment (r)evolution: ten years of advances and more to come. ecancermedicalscience. 2017;11. doi:10.3332/ecancer.2017.787.

Monday, 27 November 2017

Direct inguinal hernia

«A direct inguinal hernia arises from protrusion of abdominal viscera through a weakness of the posterior wall of the inguinal canal medial to the inferior epigastric vessels, specifically through the Hesselbach's triangle. This type of hernia is termed direct as the hernial sac directly protrudes through the inguinal wall in contrast to indirect ones which arise through the deep ring and enter the inguinal canal. Since direct hernias do not have a guiding path, they seldom extend into the scrotum unless very large and chronic.»
Source: Jamanetworkcom. Available at: https://jamanetwork.com/data/Journals/JAMA/936324/jpg170007fa.png. Accessed November 27, 2017.


Source: Direct Versus Indirect Inguinal Hernia. Holistic Hernia Remediation. 2016. Available at: http://herniaremediation.org/2016/06/direct-versus-indirect-inguinal-hernia/. Accessed November 27, 2017.


Source: Imagesradiopaediaorg. Available at: https://images.radiopaedia.org/images/1779273/667e66e46b7fe1c61bfa6b9b42a571_gallery.jpg. Accessed November 27, 2017.

Bibliographic reference: Wijayagoonawardana P, et al. Direct inguinal hernia | Radiology Reference Article | Radiopaedia.org. Radiopaediaorg. Available at: https://radiopaedia.org/articles/direct-inguinal-hernia. Accessed November 27, 2017.

Saturday, 25 November 2017

Leptomeninges

«The inner two meninges, the arachnoid, and the pia mater, between which circulates the cerebrospinal fluid [1].» «(...). Because the arachnoid is connected to the pia by cobweb-like strands, it is structurally continuous with the pia, hence the name pia-arachnoid or leptomeninges. They are responsible for the production of beta-trace protein (prostaglandin D synthase), a major cerebrospinal fluid protein [2-4].»
Source: Powell S. Introduction to Course and Nervous System. Imagesslideplayercom. 2011. Available at: http://images.slideplayer.com/22/6333238/slides/slide_32.jpg. Accessed November 25, 2017.

Bibliographic references:
[1] leptomeninges | Definition of leptomeninges in English by Oxford Dictionaries. Oxford Dictionaries | English. Available at: https://en.oxforddictionaries.com/definition/leptomeninges. Accessed November 25, 2017.
[2] Meninges. Enwikipediaorg. Available at: https://en.wikipedia.org/wiki/Meninges. Accessed November 25, 2017.
[3] Yamashima T, Sakuda K, Tohma Y, Yamashita J, Oda H, Irikura D, et al. Prostaglandin D synthase (beta-trace) in human arachnoid and meningioma cells: roles as a cell marker or in cerebrospinal fluid absorption, tumorigenesis, and calcification process. J Neurosci. 1997 Apr 1;17(7):2376-82.
[4] Prostaglandin D2 synthase. TheFreeDictionarycom. 2014. Available at: https://encyclopedia.thefreedictionary.com/Prostaglandin+D2+synthase. Accessed November 25, 2017.

Carcinomatous meningitis

«Carcinomatous meningitis, also called meningeal carcinomatosis, neoplastic meningitis, or leptomeningeal carcinoma, is a form of metastatic cancer that has spread to the lining of the brain and spinal cord, the parts of the body that make up the central nervous system [1].» It «is a clinical syndrome caused by leptomeningeal metastases with widespread involvement of the cerebral cortex. The disease is associated with a poor prognosis [2].»
Source: Aboutcancercom. Available at: http://www.aboutcancer.com/meniingitis_1208_bmc.jpg. Accessed November 25, 2017.

Bibliographic reference:
[1] Carcinomatous Meningitis - Dictionary definition of Carcinomatous Meningitis | Encyclopedia.com: FREE online dictionary. Encyclopediacom. Available at: http://www.encyclopedia.com/medicine/encyclopedias-almanacs-transcripts-and-maps/carcinomatous-meningitis. Accessed November 25, 2017.
[2] Kehrer JD, Stall B. 87 - Brain Metastases. In: Hristov B, Lin S, Christodouleas J. Radiation Oncology. 2nd ed. Philadelphia, USA: Wolters Klumer Health; 2015:568.

Single brain metastases


It «is only one brain lesion in addition to other sites of disease.»
Bibliographic reference: Kehrer JD, Stall B. 87 - Brain Metastases. In: Hristov B, Lin S, Christodouleas J. Radiation Oncology. 2nd ed. Philadelphia, USA: Wolters Klumer Health; 2015:567.

Solitary brain metastases

It «is only one brain lesion and the only site of disease.»
Bibliographic reference: Kehrer JD, Stall B. 87 - Brain Metastases. In: Hristov B, Lin S, Christodouleas J. Radiation Oncology. 2nd ed. Philadelphia, USA: Wolters Klumer Health; 2015:567.

Friday, 17 November 2017

Mesorectal fascia (MRF)

In total mesorectal excision (TME), «the entire mesorectal compartment including the rectum, surrounding mesorectal fat, perirectal lymph nodes, and its envelope, the MRF, is completely removed by precise dissection along anatomical planes [1].»«The mesorectal fat is surrounded by the MRF, (...) [1].» It surrounds the mesorectal fat outside the rectum or the sphincters in the lowest part [2]:
Source: The Radiology Assistant: Rectal Cancer - MR staging 2.0. Radiologyassistantnl. Available at: http://www.radiologyassistant.nl/en/p56195b237699d/rectal-cancer-mr-staging-20.html. Accessed November 17, 2017.

Source: The Radiology Assistant: Rectal Cancer - MR staging 2.0. Radiologyassistantnl. Available at: http://www.radiologyassistant.nl/en/p56195b237699d/rectal-cancer-mr-staging-20.html. Accessed November 17, 2017.

«The MRF is only circumferential in the low-rectum below the anterior peritoneal reflection.The MRF does not apply to the anterior peritonealized surface of the anterior mid- and high rectum [1]»:
Source: The Radiology Assistant: Rectal Cancer - MR staging 2.0. Radiologyassistantnl. Available at: http://www.radiologyassistant.nl/en/p56195b237699d/rectal-cancer-mr-staging-20.html. Accessed November 17, 2017.

«The MRF plays a crucial role in the treatment planning. In TME the mesorectal fascia is the resection plane and it has to be tumor-free. A distance of the tumor to the mesorectal fascia of ⩽1 mm is regarded as not suitable for TME and is called an involved MRF [1].»
Source: The Radiology Assistant: Rectal Cancer - MR staging 2.0. Radiologyassistantnl. Available at: http://www.radiologyassistant.nl/en/p56195b237699d/rectal-cancer-mr-staging-20.html. Accessed November 17, 2017.

T-stage and mesorectal fascia involvement in the axial plane
Source: The Radiology Assistant: Rectal Cancer - MR staging 2.0. Radiologyassistantnl. Available at: http://www.radiologyassistant.nl/en/p56195b237699d/rectal-cancer-mr-staging-20.html. Accessed November 17, 2017.

«Low rectal cancer has a higher local recurrence rate. The distal tapering of the mesorectal fat implies that low rectal cancer more easily invades the MRF, pelvic wall, and surrounding organs [1]»:
Source: The Radiology Assistant: Rectal Cancer - MR staging 2.0. Radiologyassistantnl. Available at: http://www.radiologyassistant.nl/en/p56195b237699d/rectal-cancer-mr-staging-20.html. Accessed November 17, 2017.

«The low rectum is totally covered by the mesorectal fascia. In the mid-rectum, it is covered by the mesorectal fascia on the posterior and lateral side, but on the anterior side, it is covered by the visceral peritoneum [1].»
Bibliographic references:
[1] The Radiology Assistant: Rectal Cancer - MR staging 2.0. Radiologyassistantnl. Available at: http://www.radiologyassistant.nl/en/p56195b237699d/rectal-cancer-mr-staging-20.html. Accessed November 17, 2017.
[2] Glimelius B, Beets-Tan R, Blomqvist L, et al. Mesorectal fascia instead of circumferential resection margin in preoperative staging of rectal cancer. J Clin Oncol. 2011 Jun 1;29(16):2142-3. Available at: https://doi.org/10.1200/JCO.2010.34.4473.

UICC

Union for International Cancer Control

Circumferential resection margin

«The circumferential resection margin (CRM) is a term used in rectal carcinoma excision surgery. Pathologic evaluation of the resection margin on the excised rectum has been considered important for determining the risk of local recurrence. A margin of ≤1 mm is considered by some to be a negative prognostic factor for local recurrence (Park JS, et al., 2014, apud 1). (...). The CRM is not valid for excised colon covered by a peritoneal lining [1].» It is defined as the shortest distance from an affected region to the mesorectal fascia (MRF) and should be at least 1 mm [2]. It also called the radial margin. 
Bibliographic references:
[1] Weerakkody Y, Morgan M, et al. Circumferential resection margin | Radiology Reference Article | Radiopaedia.org. Radiopaediaorg. Available at: https://radiopaedia.org/articles/circumferential-resection-margin. Accessed November 17, 2017.
[2] Bond S, Joshi N, Petroudi S, Brady M. Estimating the mesorectal fascia in MRI. Inf Process Med Imaging. 2007;20:650-61. Available at: https://doi.org/10.1007/978-3-540-73273-0_54.

Sunday, 12 November 2017

Bystander effects

«Bystander effects describe the ability of an irradiated cell to send a signal capable of eliciting a response in a nonirradiated cell. This signal may be communicated via cell-to-cell gap junction communication and/or from secreted or shed factors from irradiated cells [1].»
Bibliographic references:
[1] Varnum SM, Sowa MB, and Morgan WF. (2013). B. In: L. Brady and T. Yaeger, ed., Encyclopedia of Radiation Oncology, 1st ed. Springer-Verlag Berlin Heidelberg, pp.75.

Tuesday, 7 November 2017

Blogs Portugal

Há pouco tempo, aderi à plataforma Blogs Portugal (https://blogsportugal.come fiquei surpreendida com o ranking nacional deste blog, o Radiotherapy Dictionary. Além disso, a plataforma Blogs Portugal permite classificar os blogs portugueses no geral e por categorias e aceder a muitos benefícios, por intermédio de campanhas e através da divulgação dos blogs aderentes. Blogueiros, experimentem! (Portuguese)

Not long ago, I joined the platform Blogs Portugal and I was surprised by the national ranking of this blog, the Radiotherapy Dictionary. In addition, the Blogs Portugal platform allows ranking Portuguese blogs in general and by categories and access to many benefits, through campaigns and through the dissemination of blogs. Bloggers, try!