Purpose The aim of the study was to evaluate the usefulness and accuracy of 18-fluorine-labeled fluorodeoxyglucose (PET) and magnetic resonance imaging (MRI) hybrid in gross tumor volume (GTV) delineation during radiotherapy planning in patients with carcinoma of the tongue. Methods Ten patients with squamous cell carcinoma (SCC) of the tongue underwent computed tomography (CT) and PET/MRI examination. The GTV for primary tumor and lymph nodes (nGTV) were defined on CT (GTV-CT) and compared to GTVs obtained from PET (GTV-PET) and MRI (GTV-MRI) images. Two methods of GTV determination were used: visual interpretation of CT, PET (GTV-PET vis ) and MRI images and quantitative automatic method (Syngovia, Siemens) based on a chosen threshold value (20%, 30%, 40%, 50%) of standardized uptake values (SUV max ) from PET examination (GTV-PET 20% , GTV-PET 30% , etc.). Statistical analysis of differences in GTV values obtained from CT, PET and MRI studies was performed. GTV-CT was used as a reference. Results In all, 80% of GTV-MRI and 40% of GTV-PET vis were larger than GTV-CT. Respectively, 20% of GTV-MRI and 60% of GTV-PET vis were smaller than GTV-CT. Taking into account all threshold measurements, 70% of volumes were smaller than GTV-CT. GTV-PET 30% were the most closely related volumes to GTV-CT from all threshold methods in 50% of patients. GTV-PET vis generated the most similar volumes in relation to GTV-CT from all PET measurements. Statistical analysis confirmed those results. Compared to nGTV-CT, 70% of nGTV-MRI and 20% of nGTV-PET vis were larger. The remaining nGTV-MRI and nGTV-PET vis measurements were smaller than nGTV-CT. Measurements of all thresholds nGTVs were smaller than nGTV-CTV in 52.5% of cases. nGTV-PET 20% were the most closely related volumes to nGTV-CT in 40% of the cases. Statistical analysis showed that nGTV-PET 20% ( p = 0.0468), nGTV-PET vis ( p = 0.0166), and nGTV-PET 50% ( p = 0.0166) diverge significantly from nGTV-CT results. nGTV-MRI ( p = 0.1141), nGTV-PET 30% ( p = 0.2845), and nGTV-PET 40% ( p = 0.5076) were significantly related with nGTV-CT. Conclusion Combination of PET/MRI provides more information during target tumor mass delineation in radiotherapy planning of patients with SCC of the tongue than other standard imaging methods. The most frequently matching threshold value was 30% of SUV ...

Angiosarcoma is a rare malignant neoplasm, accounting for 1-2% of all sarcomas. The main cause of developing secondary angiosarcoma is radiotherapy. We analysed the case of a 52-year-old woman with breast cancer, who had undergone breast-conserving therapy. Four years after finishing treatment, she was diagnosed with secondary angiosarcoma in the irradiated area. The patient underwent a mastectomy. The disease relapsed six months after the operation in form of local recurrence, as well as liver and lung metastases. The patient's condition gradually deteriorated despite treatment (chemotherapy and symptomatic management). The patient died due to cardiorespiratory failure nine months after the diagnosis of secondary malignancy.

Patients with oral cavity cancer frequently experience recurrence in the regional lymph nodes. Postoperative chemoradiotherapy is recommended for the patients with pathological high-risk features such as extra-capsular extension in salvage neck dissection. Irradiation of the initial primary tumor bed may increase adverse events such as stomatitis or taste disorder, and may deteriorate patients' quality of life. The purpose of this study was to clarify the incidence of local recurrence and factors associated with it as a reference to determine the appropriate clinical target volume. Materials/Methods: We retrospectively reviewed 42 patients who received postoperative radiotherapy or chemoradiotherapy after salvage neck dissection for recurrent cervical lymph node metastases from oral cavity cancer at a single institution between 2007 and 2016. All patients received postoperative radiotherapy with simultaneous integrated boost intensitymodulated radiation therapy. The prescribed dose was 66 Gy in the highrisk planning target volume (PTV), 60 Gy in the intermediate-risk PTV, and 54 Gy in the low-risk PTV. Results: The median interval between initial surgery and salvage neck dissection was 6.5 months (range: 1.6-95.5). Pathological extra-capsular extension of recurrent lymph node metastases was noted in 39 patients (93%). Thirty patients (71%) received concurrent chemotherapy. The primary tumor bed was included in the high-risk clinical target volume (CTV) in one patient (2%), in the intermediate-risk CTV in 21 patients (50%), and in the low-risk CTV in 10 patients (24%), whereas the primary tumor bed was not included in the CTV in ten patients (24%). The median follow-up periods for censored patients were 78.2 months (range: 1.9-102.0). The 5-year overall and recurrent-free survival rates calculated from the initiation of radiotherapy were 60.0 and 51.0%, respectively. Up until the final follow-up, local recurrence had been noted in five patients (12%). Among 19 patients whose interval between initial surgery and salvage neck dissection was 6 months or shorter, five patients (26%) experienced local recurrence, whereas none of the 23 patients whose interval was longer than 6 months experienced local recurrence (p Z 0.014). No patients whose primary tumor bed has not been included in the CTV experienced local recurrence. Conclusion: Local recurrence was less frequent in patients who received postoperative radiotherapy after salvage neck dissection. In case the interval between initial surgery and salvage neck dissection is longer than 6 months, omission of the primary tumor bed may be considered.

No abstract

No abstract