We read with interest the article by Robertson et al., 1 Robertson B.F. Robertson G.A. Shoaib T. Soutar D.S. Morley S. Robertson A.G. Pleomorphic adenomas:post-operative radiotherapy is unnecessary following primary incomplete excision: a retrospective review. J Plast Reconstr Aesthet Surg. 2014; 67: e297-302 Abstract Full Text Full Text PDF PubMed Scopus (17) Google Scholar which suggests radiotherapy should not be used to manage incompletely excised pleomorphic adenoma. Pleomorphic adenomas: Post-operative radiotherapy is unnecessary following primary incomplete excision: A retrospective reviewJournal of Plastic, Reconstructive & Aesthetic SurgeryVol. 67Issue 12PreviewCurrent standard treatment of Pleomorphic Salivary Adenoma (PSA) of the Parotid Gland is by surgical excision. The management of incomplete excision remains undecided with post-operative radiotherapy advocated by some and observation by others. Full-Text PDF

not available at time of publication. 89 Oral Abstracts Journal of Medical Imaging and Radiation Oncology and Journal of Medical Radiation Sciences © 2014 Combined Scientific Meeting Obstetric ultrasound – Early detection of fetal malformation: Are we ready?

Aims: To determine prognostic factors for locoregional relapse (LRR), distant relapse and all-cause death in a contemporary cohort of locoregionally advanced oropharyngeal squamous cell carcinoma (OSCC) treated with definitive chemoradiotherapy or radiotherapy alone.Materials and methods: OSCC patients treated with definitive radiotherapy between 2005 and 2010 were identified from a prospective head and neck database. Patient age, gender, smoking history, human papillomavirus (HPV) status, T- and N-category, lowest involved nodal level and gross tumour volume of the primary (GTV-p) and nodal (GTV-n) disease were analysed in relation to LRR, distant relapse and death by way of univariate and multivariate analysis.Results: In total, 130 patients were identified, 88 HPV positive, with a median follow-up of 42 months. On multivariate analysis HPV status was a significant predictor of LRR (hazard ratio 0.15; 95% confidence interval 0.05-0.51) and death (hazard ratio 0.29; 95% confidence interval 0.14-0.59) but not distant relapse (hazard ratio 0.53, 95% confidence interval 0.22-1.27). Increasing T-category was associated with a higher risk of LRR (hazard ratio 1.80 for T3/4 versus T1/2; 95% confidence interval 1.08-2.99), death (hazard ratio 1.37, 95% confidence interval 1.06-1.77) and distant relapse (hazard ratio 1.35; 95% confidence interval 1.00-1.83). Increasing GTV-p was associated with increased risk of distant relapse and death. N3 disease and low neck nodes were significant for LRR, distant relapse and death on univariate analysis only.Conclusion: Tumour HPV status was the strongest predictor of LRR and death. T-category is more predictive of distant relapse and may provide additional prognostic value for LRR and death when accounting for HPV status. (C) 2014 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

The authors document the long term follow up of adult patients with histologically proven primary intracranial germinoma treated with radiotherapy alone using a craniospinal with local boost technique. A retrospective review was conducted on adults diagnosed with intracranial germinoma who received radiotherapy at the Princess Margaret Hospital, Toronto from 1990 to 2007. The study group consisted of 10 males with a median age of 24.1 years. All patients received radiotherapy alone using craniospinal radiotherapy and local boost. There were 10 patients (all male) with a median follow up of 10.9 years (range 2.2-18.9 years). At date of last follow up all patients were still alive, none with relapsed disease. Seven of ten patients (70%) had panhypopituitarianism prior to commencing radiotherapy and hormonal function was not affected in those with an intact pituitary axis. There was no reported cognitive decline in the treated cohort. For adult intracranial germinomas, with long term follow up, low-dose craniospinal radiotherapy with in field boost is highly effective with minimal morbidity.

Summary The aim of this study was to determine the regional control rate with concurrent chemoradiotherapy (CRT) based on pretreatment nodal size in mucosal head and neck squamous cell carcinoma (HNSCC) in patients who achieved a complete response (CR) at the primary site by 12 weeks post‐treatment. Between December 1997 and November 2003, 117 patients with node‐positive HNSCC were treated with concurrent CRT, with 108 (92%) achieving a CR at the primary site by 12 weeks. There were 93 males (86%), median age 55 (37–79) years and the most common primary site was the oropharynx (65%). Patients were divided into three subgroups: ≤3.0 cm 70 (65%), 3.1–6.0 cm 30 (28%) and ≥6.1 cm 8 (7%). All patients received concurrent platinum‐based chemotherapy and the median radiation dose was 70 Gy (60–72 Gy). The 3‐year regional control rate based on pretreatment nodal size was ≤3.0 cm 88% (95% confidence interval (CI) 78–94%), 3.1–6.0 cm 72% (95%CI 49–86%) and ≥6.1 cm 50% (95%CI 15–77%) ( P = 0.001). The 3‐year regional control rate based on pre‐treatment nodal size was ≤3.0cm 88% (95%CI 78–94%), 3.1–6.0 cm 72% (95%CI 49–86%) and ≥6.1 cm 50% (95%CI 15–77%) ( P = 0.001). These results provide a quantitative guide for the clinician as to the likelihood of regional control based on pretreatment nodal size following CRT in patients who achieve a CR at the primary site by 12 weeks post‐treatment.

A collection of temporal bonesrepresenting over 650 temporal bone dissections demonstrating the anatomic relationships of the temporal bone and common routes of extension of cholesteatoma, infection, and tumors of the temporal bone are used as a foundation for surgical approaches. Surgical approaches to themanagement ofcholesteatoma and infection are demonstrated by both transcanal and transmastoid routes. Surgical approaches to the skullbaseusedin the management of glomus tumors, acoustic neuromas, carcinoma, andpetrous apex lesions are presented demonstrating the varied approaches to skull base pathologic examination, Familiarization with the anatomy, pathology, and alternativesurgical approaches permits selection of thebestoperation for each individual patient. Jay 8. Farrior, MD Farrior Clinic Tampa,Flo, of acoustic neuroma, Potential pitfalls of the technique will be discussed.