A solitary fibrous tumor of the urinary bladder is an extremely rare type of mesenchymal tumor. We present a case of an 85-year-old woman with a large (14.5x10.7x10.1 cm) protruding intravesical mass detected by computed tomography (CT) and magnetic resonance imaging (MRI), which was proven to be a solitary fibrous tumor through histopathological examination. The clinicopathologic and radiological features are here discussed, along with a review of the published literature on this topic. Solitary fibrous tumors of the urinary bladder are more common in men (76%), with a peak incidence in people 40-60 years old. Most such tumors show heterogeneous intensity with a complete capsule. A decrease in the T2WI signal with an increase in collagen tissue content and gradual enhancement on CT/MRI images are their main features. Most such tumors are positive for CD34 under immunohistochemistry (100% in 24 available cases). The majority of tumors (88%) studied have been non-malignant and most patients (95.5%) showed favorable prognosis after a long-term follow-up.
Background: To investigate the clinical efficacy of apatinib in combination with oxaliplatin + 5-fluorouracil + leucovorin in clinical chemotherapy for the advanced gastric cancer. Materials and Methods: Between June 2016 and December 2018, we enrolled a total of 92 patients with advanced gastric cancer who were receiving 4500 cGy of radiation through the 5 weeks after resection of adenocarcinoma, and divided them into two groups as per the treatment strategies, with 46 patients in each group. Patients in the control group underwent the regular chemotherapy (oxaliplatin + 5-fluorouracil + leucovorin), while those in the observation group would additionally receive the medication of apatinib. We compared the efficacy, changes in the levels of high-sensitivity C-reactive protein (hs-CRP) and Tumor necrosis factor (TNFα) in serum, prognosis and adverse reactions between two groups, or before and after treatment. Results: In the observation group, the total effectiveness rate was higher than that in the control group. Also, after treatment, significant decreases were found in levels of high-sensitivity C-reactive protein and TNF-α in serum of patients in the observation group, more evident than those in the control group. Moreover, progression-free survival and total survival durations of patients were significantly longer than those in the control group, while the incidence rate of adverse reaction was reduced sharply (all P < 0.05). Conclusion: our study showed that apatinib combination with oxaliplatin + 5-fluorouracil + leucovorin seems to have promising efficacy, and is worthy of being studied as a new regimen of gastric
Background: Non-small-cell lung carcinoma (NSCLC) as the most common type of lung cancer has the most leading mortality rate among other cancers. Diabetes mellitus is one of the most common comorbidities of this disease. Metformin is a conventional anti-diabetic drug that is evaluated in various studies as an anti-cancer agent. This study was an updated systematic review and meta-analysis evaluating the effect of metformin on NSCLC. Materials and Methods: A systematic search was conducted through PubMed/Medline, EMBASE, and Cochrane library databases and all retrospective studies with the title the effect of metformin on the non-small cell lung cancer were collected. Statistical analyses were carried out using either random-effects or fixed-effects models according to the heterogeneity examined by I statistics and assessing Hazard Ratio of overall survival (OS) using Revman version 5 software. Result: Fourteen studies involving 3164 patients were included in the current meta-analysis. The pooled hazard ratio (HR) of comparison of overall survival (OS) between metformin user diabetic patients and diabetic patients without a history of using metformin was 0.87 (95 % CI 0.74–1.02; P = 0.08). Sub-group analysis showed that when studies were divided by region the HR of OS for Asia was 0.77 (95 % CI 0.65–0.90; P = 0.001), 1.11 (95 % CI 0.72–1.71; P = 0.64) for USA, and 0.86 (95 % CI 0.57–1.30; P = 0.47) for Europe. Conclusion: The use of metformin beside radiotherapy in patients with type 2 diabetes may be associated with a good prognosis. While this impact was just significantly seen in Asian studies.
Background: Conventional radiation dosimetry methods in computed tomography (CT) are not able to measure the dose distribution along the patient’s longitudinal axis. To calculate the dose index on a CT scan, the dose distribution from the center of the radiation field must be calculated. In this study, the most appropriate integral interval for calculating the CT dose index in the axial mode was determined using the Monte Carlo (MC) method based on X-ray photon energy and slice thickness. Materials and Methods: The computed tomography dose index (CTDI) phantom was simulated in the EGSnrc/BEAMnrcMC system and was irradiated with several X-ray energies and several slice thicknesses and dose profiles in phantom were investigated. The area under the dose profile and the scatter to primary radiation dose ratio (SPR) were calculated. Results: The range of scattered beams from the center of the radiation field reaches 450 mm in 140 kV and a 40 mm slice thickness. The SPR value for all levels of X-ray photon energy (between 80 and 140 kV) significantly decreases as slice thickness increases. CT scan imaging technical factors greater than 310 mm from the center of the slice thickness have no effect on the behavior of the scattered radiation. Conclusion: The primary beams are more affected by the energy of the photons, and the scatter beams are more strongly affected by the slice thickness. For 64-slice scanners, the polymethyl methacrylate (PMMA) phantom length should be between 700 mm and 900 mm to yield accurate CTDI estimations.
Background: The importance of dose in prostate radiotherapy is well known, and the dosimetric effects of radiotherapy in node-positive or node-negative patients with prostate cancer have become an important issue. Materials and Methods: Helical tomotherapy (TH) plans of 19 pelvic node-positive [THpn(+) plan] or node-negative [THpn(-) plan] patients with prostate cancer were retrospectively created in our clinic. In these plans, the beam angle was set to cover the planning target volume (PTV) of prostate cancer and minimize the dose to the organs at risk, including the bladder, rectum, femoral head, and bowel. Results: There were no differences in the conformity index, Dmax, Dmean, and homogeneity index of PTV between the THpn (+) and THpn (-) plans (p>0.05). However, V95 in the THpn (+) plan was lower than that in the THpn (-) plan (p=0.017). Moreover, Dmax, V75, V70, V65, V60, V50, V40, V30, and V20 for the rectum were not significantly different between the two plans (p>0.05), whereas Dmean was significantly different (p=0.025). Dmax, V70, V65, and V60 for the bladder were not significantly different between the two plans (p>0.05), whereas V55, V50, V40, and V30 were significantly different (p<0.05). Finally, Dmax and V50 for the femoral head and bowel were significantly different between the two plans (p<0.05). Conclusion: The THpn (+)] and [THpn(-) plans achieved acceptable target dose coverage in prostate
