Purpose: The aim of this study is to compare the outcomes of intracavitary high-dose-rate brachytherapy (BT-IC) boost and external beam radiotherapy (EBRT) boost in patients treated with concomitant chemoradiotherapy for squamous cell carcinoma of the cervix. Material and methods: It is a retrospective review of 92 patients with stage IB1-IVA cervical cancer treated with concomitant chemoradiotherapy between 2008 and 2013. All patients received pelvic 3D conformal EBRT (range, 45-50.4 Gy) concomitant with weekly cisplatin (40 mg/m 2), and a BT-IC boost (37 patients: 4 fractions of 6 Gy prescribed to a point A) to the tumor or a 3D conformal EBRT boost (55 patients: 16.2 Gy), if the former was not technically feasible. Results: The 5-year overall survival and recurrence-free survival rates for both groups were 68% and 55%, respectively. The 5-year overall survival and recurrence-free survival were better and statistically significant in the BT-IC group with 82% and 79%, respectively, as compared to the EBRT group with 58% and 38%, respectively. In multivariate analysis controlling for maximum tumor dimension, lymph node status, and FIGO stage, EBRT boost was associated with a statistical significant increase in the risk of recurrence (HR: 3.56; 95%

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<p class="abstract">Merkel cell carcinoma is a rare neuroendocrine tumour of the skin, that shows a quickly and aggressive behaviour and carries a poor prognosis. Surgery is the standard primary treatment modality, while radiotherapy plays a role in postoperative treatment. Radiotherapy is also an alternative to unresectable lesions or patients who are unfit to surgery. Here we report a 90-year-old male with polycythemia vera that was chronically treated with hydroxyurea for about 30 years. The patient presented a purple and exophytic frontal scalp lesion, which had recurred after primary wide excision. This recurrence had been considered inoperable and the patient was treated with external beam radiotherapy to the lesion and locoregional lymph nodes, showing a complete clinical response after 12 weeks. However, disease progressed rapidly, and the patient died from distant metastasis 4 months later. This report is the second described case in literature of Merkel cell carcinoma as complication of chronic hydroxyurea and highlights the need for these patients to undergo regular and close dermatological evaluation.</p>

Background: A multimodality approach is the standard of care in the treatment of locally advanced non-metastatic gastric cancer. However, it lacks studies that compares the adjuvant chemoradiotherapy strategy of the landmark MacDonald clinical trial with the perioperative chemotherapy strategy of the landmark MAGIC clinical trial.Methods: Retrospective study of patients with gastric cancer stage IB-III treated at a single cancer center between 2010 and 2013 with MacDonald or MAGIC treatment protocols.Results: Sixty-two patients were identified (38 patients in the MacDonald protocol and 24 in the MAGIC protocol), with a mean age of 68 years (range: 39-84). At a median follow-up of 37 months, the DFS survival at 12 and 36 months of the patients in the MacDonald protocol was 83.5% and 61.1% versus 79.2% and 49.7% in the MAGIC protocol, respectively (p=0.319). The overall survival at 12 and 36 months of the patients in the MacDonald protocol was 89.5% and 65.8% versus 83.3% and 54.2% in the MAGIC protocol, respectively (p=0.168). At multivariate analysis, the risk of death was significantly superior in older patients undergoing the MAGIC protocol (p=0.02), but not the MacDonald protocol (p=0.627). The differences in toxicity between the two protocols were not statistically different.Conclusions: This result suggest that patient age is a factor to consider when choosing between the MacDonald or MAGIC protocols. However, the limitations inherent to a retrospective study of small sample size must be accounted for.

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