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Salvage surgery and microsurgical reconstruction for recurrence of skull base osteosarcoma after carbon ion radiotherapy.

Kohyama K, Yamada K, Sugiura H, Hyodo I, Ozawa T, Hasegawa Y, Kato H, Kamei Y - Nagoya J Med Sci (2015)

Bottom Line: As the patient developed no postoperative wound complications, she was able to initiate adjuvant chemotherapy early.Although the affected field may be limited, its high potency may severely damage adjacent normal tissue and lead to serious postoperative complications.Despite these concerns, satisfactory results were achieved in this case.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic and Reconstructive Surgery, Gifu University Hospital, Gifu, Japan ; Department of Plastic and Reconstructive Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.

ABSTRACT
Carbon ion radiotherapy has recently emerged as an alternative choice of treatment for malignant tumors of the head and neck. However, it is still in the infant stages and its influence on subsequent salvage surgery remains unclear. Here we report the case of a 43-year-old woman who underwent salvage surgery for left frontal bone osteosarcoma recurrence following carbon ion radiotherapy. Tumor resection was performed with a wide margin including the tissue considered to have been damaged by carbon ion radiotherapy. The dural defect was reconstructed using a fascia lata graft and pedicled galeal pericranial flap. The soft tissue defect was reconstructed using an anterolateral thigh flap anastomosed to the ipsilateral neck interposed by the radial forearm flap. As the patient developed no postoperative wound complications, she was able to initiate adjuvant chemotherapy early. Carbon ion radiotherapy is useful for its focused distribution and strong biological effects. Although the affected field may be limited, its high potency may severely damage adjacent normal tissue and lead to serious postoperative complications. Despite these concerns, satisfactory results were achieved in this case.

No MeSH data available.


Related in: MedlinePlus

Carbon ion dose distribution. The yellow line indicates the target volume; red line, 100% dose; pink line, 95% dose; orange line, 90% dose; green line, 50% dose; blue line, 30% dose; and purple line, 10% dose.
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fig1: Carbon ion dose distribution. The yellow line indicates the target volume; red line, 100% dose; pink line, 95% dose; orange line, 90% dose; green line, 50% dose; blue line, 30% dose; and purple line, 10% dose.

Mentions: A 43-year-old woman developed recurrent osteosarcoma in the left supraorbital area. While originally recommended to undergo surgery, she declined and underwent carbon ion radiotherapy at another institution. A total dose of 70.4 gray equivalents (GyE) in 16 fractions was administered over 4 weeks. Irradiation was performed according to dose distributions based on planning computed tomography (CT) (Figure 1). Stable disease was maintained for 15 months after primary treatment.


Salvage surgery and microsurgical reconstruction for recurrence of skull base osteosarcoma after carbon ion radiotherapy.

Kohyama K, Yamada K, Sugiura H, Hyodo I, Ozawa T, Hasegawa Y, Kato H, Kamei Y - Nagoya J Med Sci (2015)

Carbon ion dose distribution. The yellow line indicates the target volume; red line, 100% dose; pink line, 95% dose; orange line, 90% dose; green line, 50% dose; blue line, 30% dose; and purple line, 10% dose.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4664599&req=5

fig1: Carbon ion dose distribution. The yellow line indicates the target volume; red line, 100% dose; pink line, 95% dose; orange line, 90% dose; green line, 50% dose; blue line, 30% dose; and purple line, 10% dose.
Mentions: A 43-year-old woman developed recurrent osteosarcoma in the left supraorbital area. While originally recommended to undergo surgery, she declined and underwent carbon ion radiotherapy at another institution. A total dose of 70.4 gray equivalents (GyE) in 16 fractions was administered over 4 weeks. Irradiation was performed according to dose distributions based on planning computed tomography (CT) (Figure 1). Stable disease was maintained for 15 months after primary treatment.

Bottom Line: As the patient developed no postoperative wound complications, she was able to initiate adjuvant chemotherapy early.Although the affected field may be limited, its high potency may severely damage adjacent normal tissue and lead to serious postoperative complications.Despite these concerns, satisfactory results were achieved in this case.

View Article: PubMed Central - PubMed

Affiliation: Department of Plastic and Reconstructive Surgery, Gifu University Hospital, Gifu, Japan ; Department of Plastic and Reconstructive Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.

ABSTRACT
Carbon ion radiotherapy has recently emerged as an alternative choice of treatment for malignant tumors of the head and neck. However, it is still in the infant stages and its influence on subsequent salvage surgery remains unclear. Here we report the case of a 43-year-old woman who underwent salvage surgery for left frontal bone osteosarcoma recurrence following carbon ion radiotherapy. Tumor resection was performed with a wide margin including the tissue considered to have been damaged by carbon ion radiotherapy. The dural defect was reconstructed using a fascia lata graft and pedicled galeal pericranial flap. The soft tissue defect was reconstructed using an anterolateral thigh flap anastomosed to the ipsilateral neck interposed by the radial forearm flap. As the patient developed no postoperative wound complications, she was able to initiate adjuvant chemotherapy early. Carbon ion radiotherapy is useful for its focused distribution and strong biological effects. Although the affected field may be limited, its high potency may severely damage adjacent normal tissue and lead to serious postoperative complications. Despite these concerns, satisfactory results were achieved in this case.

No MeSH data available.


Related in: MedlinePlus