Cerebellar medulloblastoma in adults is an uncommon disease. Therefore, most information comes from the pediatric population, and the treatment for relapses is based on series and case reports. The expression of somatostatin receptors has been identified in most medulloblastoma patients, and preclinical experience has shown a promissory response to somatostatin analogs. This report presents a female patient with a high-risk left cerebellar medulloblastoma diagnosed at age 16 years old who was treated with complete resection, cranial-spinal radiotherapy, and chemotherapy. She presented again at 18 years of age with a sustained progression of her tumor, despite radiosurgery and another line of chemotherapy. Octreotide scintigraphy at that time showed a moderate to high expression of somatostatin receptors; thus, the patient was started on monthly octreotide. She is now 20 and has achieved stable disease over more than two years of active treatment without any drug-related toxicity. Somatostatin analogs could be considered as a treatment option in selected cases of medulloblastoma. Review of the literature is presented for this unusual response.
The annual Eastern Canadian Gastrointestinal Cancer Consensus Conference 2019 was held in Morell, Prince Edward Island, 19–21 September 2019. Experts in medical oncology, radiation oncology, and surgical oncology who are involved in the management of patients with gastrointestinal malignancies participated in presentations and discussion sessions for the purpose of developing the recommendations presented here. This consensus statement addresses multiple topics in the management of anal, colorectal, biliary tract, and gastric cancers, including: radiotherapy and systemic therapy for localized and advanced anal cancer; watch and wait strategy for the management of rectal cancer; role of testing for dihydropyrimidine dehydrogenase (DPD) deficiency prior to commencement of fluoropyrimidine therapy; radiotherapy and systemic therapy in the adjuvant and unresectable settings for biliary tract cancer; and radiotherapy and systemic therapy in the perioperative setting for early-stage gastric cancer.
Introducción y objetivos. El adenocarcinoma ductal de próstata (ADP) fue inicialmente descrito en 1967 por Mellicow, fue nombrado erróneamente carcinoma endometrioide hasta estudios posteriores que confirmaron su origen prostático.
e21037 Background: Currently low-dose computed tomography is used for lung cancer (LC) screening, but is limited by radiation exposure, cost, and a high false detection rate (1,2). An accurate, accessible and affordable screening technology is needed to improve detection of LC in high risk individuals. Methods: We conducted an unblinded, prospective cohort study on the effectiveness of a novel technology utilizing infrared absorption measurements via cavity ringdown spectroscopy (IR-CRDS) to differentiate the expired breath of treatment-naïve LC patients from controls without known cancer. Breath samples were taken from 100 LC patients and 98 control subjects but, only 62 non-small cell lung cancer (NSCLC) and 96 control samples were analyzed. Patients on treatment were eligible but, the protocol was amended to exclude these due to signal ambiguities. Samples were also excluded due to missing data, unclear histologic subtypes, or if they were classified as small cell LC samples to prevent obscuring the NSCLC signal. A piecewise cubic spline interpolation was used for the spectra with missing values (3). After first- and second-derivative spectra were computed to increase the information density, a one-dimensional local binary pattern extracted features from the spectra (4). Meaningful spectra-based features were selected using a minimum redundancy maximum relevance algorithm (5). Finally, a classification model was built using a support vector machine classifier (3). Results: The table below characterizes each cohort. The discriminant analysis differentiated between NSCLC and control cases with a cross validation accuracy of 86.1% (89.6% sensitivity and 80.7% specificity) using 20 selected spectra-based features. Conclusions: IR absorption measurements can be used to accurately discriminate between NSCLC and control participants. We continue to build our database to support more robust machine learning models. To our knowledge, this is the first time IR-CRDS has been used to differentiate between NSCLC and control cases. [Table: see text]
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