High‐dose‐rate brachytherapy as part of a multidisciplinary treatment of nasopharyngeal lymphoepithelioma in childhood

Abstract

Neuropeptide‐containing hippocampal interneurons and dentate granule cell inhibition were investigated at different periods following electrical stimulation‐induced, self‐sustaining status epilepticus (SE) in rats. Immunohistochemistry for somatostatin (SOM), neuropeptide Y (NPY), parvalbumin (PV), cholecystokinin (CCK), and Fluoro‐Jade B was performed on sections from hippocampus contralateral to the stimulated side and studied by confocal laser scanning microscopy. Compared to paired age‐matched control animals, there were fewer SOM and NPY‐immunoreactive (IR) interneurons in the hilus of the dentate gyrus in animals with epilepsy (40–60 days after SE), and 1, 3, and 7 days following SE. In the hilus of animals that had recently undergone SE, some SOM‐IR and NPY‐IR interneurons also stained for Fluoro‐Jade B. Furthermore, there was electron microscopic evidence of the degeneration of SOM‐IR interneurons following SE. In contrast, the number of CCK and PV‐IR basket cells in epileptic animals was similar to that in controls, although it was transiently diminished following SE; there was no evidence of degeneration of CCK or PV‐IR interneurons. Patch‐clamp recordings revealed a diminished frequency of inhibitory postsynaptic currents in dentate granule cells (DGCs) recorded from epileptic animals and animals that had recently undergone SE compared with controls. These results confirm the selective vulnerability of a particular subset of dentate hilar interneurons after prolonged SE. This loss may contribute to the reduced GABAergic synaptic inhibition of granule cells in epileptic animals. J. Comp. Neurol. 500:876–893, 2007. © 2006 Wiley‐Liss, Inc.

Prognostic aspects in the treatment of juvenile nasopharyngeal carcinoma: a systematic review

“…Between the subjects grouped in this review, the large majority (83.1 %) presented with a Type III tumor. Patients affected by juvenile NPC typically present advanced locoregional disease at diagnosis, with distant metastasis [12], and the American Joint Committee for Cancer Staging system [13] is normally used in the staging of NPC. Our data strongly confirmed this concept.…”

Use of brachytherapy in children with cancer: the search for an uncomplicated cure

“…[28][29][30] Other studies [31][32][33][34][35][36] have also shown no noticeable complications and similar rates of long-term local control after intraoperative high-dose-rate radiotherapy (table 2).…”

“…In the study by Nakamura and colleagues, 34 15 children with stage IV nasopharyngeal lymphoepithelioma and one with stage III nasopharyngeal lymphoepithelioma were given high-dose-rate brachytherapy between May, 1992, and May, 2000. Children received two sessions of high-dose-rate brachytherapy (5 Gy) 1 week apart prescribed at 10 mm from the applicators.…”

Long-term Outcomes Following Radiotherapy for Adolescent Patients With Nonmetastatic WHO Type III Nasopharyngeal Carcinoma

“…In a similar manner, other authors report using brachytherapy to escalate the high-risk target volume. 18 This approach stands in contrast to the Children's Cancer and Leukaemia Group (CCLG) rare tumor guidelines for managing NPC in pediatric and adolescent patients. These guidelines, based largely on the Manchester, UK experience from 2007, suggest that the necessary dose to the high-risk region is only 45 Gy.…”