http://hdl.handle.net/11427/196 Mon, 10 Jul 2017 08:10:14 GMT 2017-07-10T08:10:14Z http://hdl.handle.net/11427/24484 A retrospective review: The outcomes of patients with anal carcinoma receiving treatment at Groote Schuur Hospital Dalmeyer, Lisa Objectives: The objective of this study was to compare the outcome of two cohorts of patients with anal squamous carcinoma treated with split course chemoradiation as opposed to continuous chemoradiation at Groote Schuur Hospital. Demographics including age at diagnosis, gender and HIV status were reviewed. The stage at diagnosis, the acute treatment toxicities and all surgical procedures were noted. The outcomes included complete response rate, local control rate, loco-regional failure free survival, colostomy-free survival and overall survival. Design and Methods: The data was obtained from patient records of all patients with histologically confirmed anal squamous cell carcinoma seen and registered at the Department of Radiation Oncology at Groote Schuur Hospital. Patients included were those treated with radical intent that presented between the years of 2008 and 2012. This data was then compared with a similar study performed between 2000-2 004-. Results: A total of 72 patients diagnosed with anal squamous carcinoma were seen at Groote Schuur Hospital in the 5-year period, of which 4-0 patients fitted the criteria for this study. The median age was 53 years, with a slight male preponderance (55%) and 27.5% tested HIV positive. A total of 68% of patients had T3 and T4- disease, with 4-2.5% node positive disease. The complete response rate was 60%, the local control rate was 52.5% and the loco-regional failure free survival at 5 years was 56%. The colostomy-free survival was I-"4-% and the 5-year overall survival was 4-0.67%. Haematological, gastrointestinal and skin toxicities were reviewed and the most common acute side effect experienced was grade 2[32.5%] and grade 3[4-15%] skin toxicity. Conclusion: The patient characteristics and treatment toxicities are in keeping with previous study findings. However, complete response rate and overall survival were less than expected. Although there was no statistically significant difference in overall survival between the two cohorts of patients, there was a definite trend to inferior treatment outcomes of those patients treated with continuous chemoradiation. We propose radiation dose escalation for future treatment of patients presenting with anal carcinoma at Groote Schuur Hospital. Sun, 01 Jan 2017 00:00:00 GMT http://hdl.handle.net/11427/24484 2017-01-01T00:00:00Z http://hdl.handle.net/11427/24483 Advanced breast cancer: A retrospective review comparing two palliative radiotherapy protocols used at Groote Schuur Hospital between 2010 and 2013 Fakie, Nazia Purpose: To retrospectively evaluate and compare the loco-regional progression free survival (PFS), overall survival (OS) and acute effects of the two breast palliative regimes used in patients with locally advanced or metastatic breast cancer between 2010 and 2013 in a single institution. Methods: Compliance to treatment, acute skin reactions, progression free and overall survival were retrospectively evaluated in patients who received palliative breast radiotherapy for locally advanced breast cancer between 2010 and 2013. The radiotherapy regimes were either 4Gy per fraction for 5 fractions treated 4 times a week (20Gy) or 6Gy per fraction for 6 fractions treated once a week (36Gy). They may have received previous chemotherapy with minimal or no clinical response, as well as hormonal treatment. Results: Forty three patients were followed up over a median period of 24 months, 14 of which received 20Gy and 29 received 36Gy. The average age was 64 years old. Compliance was 88% in both groups. Both groups had either grade 1 (71% vs 62%), grade 2 (21% vs 24%) or grade 3 (8% vs 14%) acute skin reactions. No grade 4 skin reactions were documented. The PFS was shorter at 4.5 months in the 20Gy group compared to 7.7 months in the 36Gy group (p=0.27). The OS was also shorter at 25.8 months in the 20Gy group compared to 29.6 months in the 36Gy group (p=0.51) Conclusion: This study did not show a statistically significant difference in terms of PFS and OS between the two radiotherapy regimes. They both remain reasonable options in local palliation in patients with locally advanced breast cancer. Fri, 01 Jan 2016 00:00:00 GMT http://hdl.handle.net/11427/24483 2016-01-01T00:00:00Z http://hdl.handle.net/11427/24226 Carcinoid heart disease: Two clinical cases and a review Weinreich, C; Ross, I L; Kotze, T; Levitt, N; Steyn, R E We present two cases of metastatic carcinoid tumours, complicated by carcinoid syndrome and by cardiac valve involvement, a well-known, but infrequent, complication. Carcinoid tumours are generally more indolent than other cancers and may have a long asymptomatic phase. The symptoms of carcinoid syndrome generally manifest only once metastases to the liver have occurred. Cardiac involvement occurs in up to 50% of patients, and heralds a poor prognosis. However, a multidisciplinary team approach has improved the prognosis and quality of life for patients with carcinoid heart disease. Therapy includes somatostatin analogues and treatment for heart failure, removal of primary or metastatic tumour deposits, valve replacement in the presence of valvular involvement, and radioisotopes therapy. Sat, 01 Jan 2011 00:00:00 GMT http://hdl.handle.net/11427/24226 2011-01-01T00:00:00Z http://hdl.handle.net/11427/24148 Hypoxic-ischaemic injury - the 'white cerebellum sign' versus the true 'reversal sign' Moosa, S; Andronikou, S A small percentage of patients who suffer a global cerebral hypoxic/ ischaemic injury develop reversal of the normal density relationship of grey and white matter on CT scans.1,2 The neuroradiology texts are confusing in their description of the CT appearance of the ‘reversal sign’3,4 which is a feature related to severe hypoxia (birth asphyxia, cardiopulmonary arrest), trauma (child abuse) and infection.1 2,5 We present two paediatric cases with this type of injury, one of which demonstrates the ‘white cerebellum sign’and the other the true ‘reversal sign’, in order to demonstrate the imaging differences Sat, 01 Jan 2005 00:00:00 GMT http://hdl.handle.net/11427/24148 2005-01-01T00:00:00Z