中国2009年恶性肿瘤发病和死亡分析

[目的]评估中国肿瘤登记地区2009年恶性肿瘤的发病与死亡情况.[方法]按照全国肿瘤登记中心制定的审核方法和评价标准对全国104个肿瘤登记处上报的2009年肿瘤登记数据进行评估,共72个登记处的数据入选,计算恶性肿瘤发病率、死亡率,前10位恶性肿瘤顺位、构成、累积率;人口标准化率根据全国1982年人口普查的人口结构和Segi's世界人口结构为标准.[结果]2009年72个登记地区共覆盖人口85 470 522人(其中城市57 489 009人,农村27 981 513人),恶性肿瘤新发病例244 366例,肿瘤死亡病例154 310例.病理诊断比例为67.23％,只有死亡证明书比例为3.14％,死亡发病比为0.63.全部地区恶性肿瘤发病率为285.91/10万(男性317.97/10万,女性253.09/10万),中标发病率146.87/10万,世标发病率191.72/10万,累积率(0～74岁)为22.08％.城市地区发病率为303.39/10万,中标发病率150.31/10万;农村地区发病率为249.98/10万,中标发病率139.68/10万.全部地区恶性肿瘤死亡率为180.54/10万(男性224.20/10万,女性135.85/10万),中标死亡率85.06/10万,世标死亡率115.65/10万,累积死亡率(0～74岁)为12.94％.城市地区死亡率为181.86/10万,中标死亡率80.86/10万;农村地区死亡率为177.83/10万,中标死亡率94.40/10万.肺癌、胃癌、结直肠癌、肝癌、食管癌、胰腺癌、脑瘤、淋巴瘤、女性乳腺癌和宫颈癌是中国常见的恶性肿瘤,约占全部新发病例的76.39％.肺癌、胃癌、肝癌、食管癌、结直肠癌、胰腺癌、乳腺癌、脑瘤、白血病和淋巴瘤是主要的肿瘤死因,约占全部肿瘤死亡病例的84.27％.[结论]中国城乡地区肿瘤负担差异明显,应根据实际情况有重点地开展防治工作.     

中国2009年卵巢癌发病与死亡分析

[目的]评估中国肿瘤登记地区2009年卵巢癌的发病与死亡情况.[方法]按照全国肿瘤登记中心制定的审核方法和评价标准对全国104个肿瘤登记处上报的2009年肿瘤登记数据进行评估,共72个登记处的数据入选,计算卵巢癌发病率、死亡率、累积率、截缩率、构成比;人口标准化率根据全国1982年人口普查的人口结构和Segi’s世界人口结构为标准.[结果] 2009年72个登记地区共覆盖登记人口85 470 522人(其中城市57 489 009人,农村27 981 513人),卵巢癌新发病例3360例,死亡病例1454例.72个肿瘤登记地区卵巢癌发病率为7.95/10万,中标发病率为4.54/10万,世标发病率为5.53/10万,累积率(0～74岁)为0.59％.城市地区卵巢癌的发病率为9.37/10万,中标率为5.15/10万;农村地区发病率为5.02/10万,中标率为3.15/10万.全部地区卵巢癌死亡率为3.44/10万,中标率为1.71/10万,世标率为2.23/10万,累积率(0～74岁)为0.26％.城市地区卵巢癌死亡率为4.19/10万,中标率为1.97/10万;农村地区死亡率为1.89/10万,中标率为1.09/ 10万.[结论]我国女性卵巢癌的发病和死亡率虽然不高,但由于其发病隐匿,病死率高,严重威胁着妇女的健康,应成为女性重点预防的妇科恶性肿瘤.     

中国2009年白血病发病和死亡资料分析

[目的]评估中国肿瘤登记地区2009年白血病发病与死亡情况.[方法]按照全国肿瘤登记中心制定的审核方法和评价标准,对全国104个肿瘤登记处上报的2009年肿瘤登记数据进行评估,共72个登记处的数据入选,计算白血病发病率、死亡率、构成、累积率;人口标准化率根据全国1982年人口普查的人口结构和Segi’s世界人口结构为标准.[结果]2009年72个登记地区共覆盖人口85 470 522人(其中城市57 489 009人,农村27 981 513人),白血病新发病例4 853例,死亡病例3 661例.白血病总体MV％为93.72％、DCO％为1.50％、M/I比例为0.75,其中城市地区分别为94.38％、1.45％和0.71,农村地区分别为91.68％、1.68％和0.88.全国肿瘤登记地区白血病发病率为5.68/10万(男性6.35/10万,女性4.99/10万),中标率为4.34/10万,世标率为4.92/10万,累积率(0～74岁)为0.44％,占全部恶性肿瘤发病的1.99％;城市地区发病率为6.37/10万,中标率4.85/10万,世标率5.53/10万;农村地区发病率为4.25/10万,中标率为3.41/10万,世标率为3.76/10万.全国肿瘤登记地区白血病死亡率为4.28/10万(男性5.00/10万,女性3.55/10万),中标率为2.88/10万,世标率为3.35/10万,累积率(0～74岁)为0.31％,占全部恶性肿瘤死亡的2.37％;城市地区死亡率为4.56/10万,中标率2.91/10万,世标率3.43/10万;农村地区死亡率为3.72/10万,中标率2.82/10万,世标率3.14/10万.白血病发病率、死亡率均为城市高于农村,男性高于女性.髓样白血病发病率、死亡率远高于淋巴样白血病.[结论]积极开展白血病病因学研究,制定有效的干预措施,以期降低白血病发病率和死亡率.     

2013年中国胆囊癌发病与死亡分析

摘 要：［目的］分析2013年全国肿瘤登记地区胆囊癌的发病与死亡情况。［方法］ 对全国347个肿瘤登记处上报的2013年肿瘤登记数据进行评估,共255个登记处的数据入选,计算胆囊癌的发病率、死亡率、构成及0~74岁累积率等。人口标准化率以2000年全国人口普查的人口结构和国际Segi’s标准人口结构作为标准。［结果］ 2013年255个登记处覆盖人口226 494 490人,其中城市111 595 772人,农村114 898 718人。全国胆囊癌粗发病率为3.64/10万（男性3.31/10万,女性4.00/10万）,0~74岁累积率为0.28%,中标发病率为2.41/10万,世标发病率为2.39/10万。城市地区发病率为4.09/10万,中标发病率为2.62/10万;农村地区发病率为2.89/10万,中标发病率为2.12/10万。全国胆囊癌死亡率为2.76/10万,0~74岁累积率为0.19%,中标死亡率为1.78/10万,世标死亡率为1.76/10万。城市地区死亡率为3.22/10万,中标死亡率为2.00/10万;农村地区死亡率为2.22/10万,中标死亡率为1.51/10万。［结论］ 胆囊癌发病与死亡在不同性别和城乡之间存在差异,应针对女性尤其是城市地区的高龄女性开展防治工作。     

中国2009年喉恶性肿瘤发病和死亡分析

[目的]评估中国肿瘤登记地区2009年喉恶性肿瘤的发病与死亡情况.[方法]按照全国肿瘤登记中心制定的审核方法和评价标准对全国104个肿瘤登记处上报的2009年肿瘤登记数据进行评估,共72个登记处的数据入选,分别计算喉恶性肿瘤的发病率、死亡率、构成、中国人口标化率(中标率)、世界人口标化率(世标率)、累积率、截缩率.[结果] 2009年新发喉恶性肿瘤病例1 673例,喉恶性肿瘤死亡病例870例.MV％为76.69％,DCO％为2.93％,M/I为0.52,UB％为1.08％.全部地区喉恶性肿瘤发病率为1.96/10万(男性3.51/10万,女性0.37/10万),中标率0.98/10万,世标率1.31/10万,累积率(0～74岁)为0.16％,截缩率(35～64岁)为2.31/10万.城市地区发病率为2.33/10万,中标率1.12/10万,农村地区发病率为1.19/10万,中标率0.67/10万.全部地区喉恶性肿瘤死亡率为1.02/10万(男性1.75/10万,女性0.27/10万),中标率0.47/10万,世标率0.64/10万,累积率(0～74岁)为0.07％,截缩率(35～64岁)为0.81/10万.城市地区死亡率为1.10/10万,中标率0.47/10万.农村地区死亡率为0.85/10万,中标率0.46/10万.[结论]我国喉恶性肿瘤的发病率和死亡率均处于较低水平,男性明显高于女性,城市地区发病率明显高于农村地区,死亡率城乡之间无明显差异.无论是城市地区还是农村地区,男性发病率和死亡率明显高于女性.     

山东省2012年恶性肿瘤发病与死亡

[目的]估计山东省恶性肿瘤的发病与死亡水平.[方法] 2015年共收到21个肿瘤登记处上报的2012年肿瘤登记数据,通过审核和评估,共15个肿瘤登记处的数据符合人选标准.将入选的登记处按地区(城乡)、性别以及年龄别、肿瘤别发病率和死亡率分层,结合2012年山东省人口数据,估计山东省恶性肿瘤合计和主要肿瘤的发病、死亡情况.标化率分别采用2000年全国人口普查人口和Segi's标准人口结构为标准.[结果]山东省15个肿瘤登记处共覆盖登记人口17 189 988人(其中城市7 486 039人,农村9 703 949人).恶性肿瘤病理诊断比例为66.12％,只有死亡证明书比例为2.93％,死亡发病比为0.60.估计全省2012年新发恶性肿瘤病例253 060例,死亡病例157 750例.山东省恶性肿瘤发病率为263.86/10万(男性303.29/10万、女性223.23/10万).中国人口标化率(中标率)为192.42/10万,世界人口标化率(世标率)为189.50/10万,累积率(0～74岁)为22.07％.城市地区发病率为267.64/10万,中标发病率为195.27/10万,农村地区发病率为262.32/10万,中标发病率为191.26/10万.山东省恶性肿瘤死亡率为164.47/10万(男性207.42/10万,女性120.23/10万),中标死亡率为117.54/10万,世标死亡率为116.90/10万,累积死亡率(0～74岁)为13.53％.城市地区死亡率为141.59/10万,中标死亡率为101.17/10万,农村地区恶性肿瘤死亡率为173.79/10万,中标死亡率为124.20/10万.肺癌、胃癌、肝癌、食管癌、结直肠癌、女性乳腺癌、脑瘤、白血病、膀胱癌和胰腺癌是山东省主要的恶性肿瘤,约占全部新发病例的82.12％.肺癌、胃癌、肝癌、食管癌、结直肠癌、乳腺癌、胰腺癌、脑瘤、白血病和淋巴瘤是主要的肿瘤死因,约占全部肿瘤死亡病例的89％.[结论]目前山东省肿瘤疾病负担严重,应继续加强肿瘤防治工作.     

中国2009年胃癌发病与死亡分析

[目的]评估中国肿瘤登记地区2009年胃癌的发病与死亡情况.[方法]按中国肿瘤登记中心制定的审核方法和评价标准对全国104个肿瘤登记处上报的2009年肿瘤登记数据进行评估,共72个登记处的数据入选,计算胃癌的发病率、死亡率、顺位、构成、累积率;根据全国1982年人口普查的人口结构和Segi's世界人口结构的标准计算人口标准化率.[结果]2009年胃癌新发病例30 949例,死亡病例22 120例.病理学诊断比例为76.14％,只有死亡医学证明书比例为2.95％,死亡/发病比为0.71.全部地区胃癌发病率为36.21/10万(男性49.61/10万.女性22.50/10万),中标率为17.85/10万,世标率为23.93/10万,累积率(0～74岁)为2.94％.城市地区发病率为30.20/10万,中标率为14.15/10万;农村地区发病率为48.57/10万,中标率为26.31/10万.全部地区胃癌死亡率为25.88/10万(男性34.64/10万,女性16.91/10万),中标率为11.86/10万,世标率为16.38/10万,累积率(0～74岁)为1.89％.城市地区死亡率为21.15/10万,中标率为9.07/10万.农村地区死亡率为35.60/10万,中标率为18.25/10万.[结论]胃癌是威胁我国居民健康的主要癌症之一,其在男性、女性和城乡地区之间存在明显差异,应根据实际情况有重点地开展防治工作.     

2012年中国恶性肿瘤发病和死亡分析

[目的]对2015年全国肿瘤登记中心收集的全国各登记处上报的2012年恶性肿瘤登记资料进行分析,估计我国恶性肿瘤的发病与死亡.[方法]全国肿瘤登记中心共收到261个登记处上报的2012年肿瘤登记数据,通过审核和评估,共193个肿瘤登记处的数据符合入选标准.将入选的登记处按地区(城乡)、性别以及年龄别、肿瘤别发病率和死亡率分层,结合2012年全国人口数据,估计全国恶性肿瘤合计和主要肿瘤的发病、死亡情况.标化率采用2000年全国人口普查人口和Segi's标准人口结构为标准.[结果]全国193个登记处共覆盖登记人口198 060 406人(其中城市100 450 109人,农村97 610 297人),报告的恶性肿瘤新病例556 163例,死亡病例345 483例.病理诊断比例为69.13％,只有死亡证明书比例为2.38％,死亡发病比为0.62.据估计,全国2012年新发恶性肿瘤病例约358.6万例,死亡病例218.7万例.全国恶性肿瘤发病率为264.85/10万(男性289.30/10万,女性239.15/10万),中国人口标化率(中标率)为191.89/10万,世界人口标化率(世标率)为187.83/10万,累积率(0～74岁)为21.82％.城市地区发病率为277.17/10万,中标发病率为195.56/10万,农村地区发病率为251.20/10万,中标发病率为187.10/10万.全部地区恶性肿瘤死亡率为161.49/10万(男性198.99/10万,女性122.06/10万),中标死亡率为112.34/10万,世标死亡率为111.25/10万,累积死亡率(0～74岁)为12.61％.城市地区死亡率为159.00/10万,中标死亡率107.23/10万.农村地区恶性肿瘤死亡率为164.24/10万,中标死亡率118.22/10万.肺癌、胃癌、肝癌、结直肠癌、食管癌、女性乳腺癌、甲状腺癌、宫颈癌、脑瘤和胰腺癌是我国主要的恶性肿瘤,约占全部新发病例的75％.肺癌、肝癌、胃癌、食管癌、结直肠癌、胰腺癌、乳腺癌、脑瘤、白血病和淋巴瘤是主要的肿瘤死因,约占全部肿瘤死亡病例的80％.[结论]全国肿瘤登记中心定期发布我国恶性肿瘤负担情况,为制定肿瘤防治策略和科学研究提供可靠的基础依据.随着覆盖人群逐渐增加和数据质量不断提高,肿瘤登记在肿瘤防治中正在发挥越来越大的作用.     

中国2009年肾及泌尿系统其他癌发病和死亡分析

[目的]根据2009年全国各肿瘤登记处恶性肿瘤登记数据资料,分析我国肿瘤登记地区肾癌的发病与死亡情况.[方法]以入选的72个肿瘤登记处的数据为依据,采用一般性描述方法分析肾癌的发病和死亡流行情况.[结果] 2009年全国肾癌新发病例4 916例,死亡1 619例.M/I为0.33,MV％为76.61％,DCO％为1.22％,UB％为0.69％.登记地区肾癌发病率为5.75/10万(男性7.07/10万,女性4.40/10万),中标率为3.03/10万,世标率为3.95/10万,累积率(0～74岁)为0.45％;死亡率为1.89/10万(男性2.37/10万,女性1.41/10万),中标率为0.88/10万,世标率为1.21/10万,累积率(0～74岁)为0.12％.[结论]我国肾癌的发病率和死亡率城市明显高于农村,男性高于女性.在不同地区、不同性别中,随年龄的增长肾癌发病率和死亡率均呈上升趋势.     

2009～2012年湖南省肿瘤登记地区肺癌发病与死亡分析

[目的]分析2009～2012年湖南省肿瘤登记地区肺癌发病与死亡情况.[方法]计算肺癌的发病率、死亡率、顺位、0～74岁累积率等指标,标化率采用2000年全国人口普查人口和Segi's标准人口结构为标准.[结果] 2009～2012年湖南省6个肿瘤登记点人口人年数为1011.3867万人年,报告肺癌新发病例4785例,死亡病例3740例.病理诊断比例59.62％,只有死亡证明书比例3.82％,死亡/发病比为0.78.肺癌发病率47.31/10万(男性67.77/10万,女性25.44/10万),中标率35.82/10万,世标率35.66/10万,0～74岁累积率4.54％.城市地区肺癌发病率52.28/10万,农村地区45.36/10万.肺癌死亡率为36.98/10万(男性53.32/10万,女性19.51/10万),中标率为27.80/10万,世标率27.50/10万,0～74岁累积率3.43％.城市地区肺癌死亡率为44.36/10万,农村地区为34.07/10万.[结论]湖南省肺癌发病率和死亡率较高,肺癌是威胁湖南省居民健康的头号恶性肿瘤,应加强其防治研究.     

Trends in in-patient Hospital Utilization and Surgical Procedures for Breast,Prostate, Lung and Colorectal Cancers in Canada

Objective: To analyse population-based trends of in-patient surgical procedures for breast (female), prostate, lung and colorectal cancers. Methods: The Hospital Morbidity Files supplied hospital data and the Canadian Cancer Registry, incidence data. Age-adjusted rates were standardized to the 1991 Canadian population. Results: All four cancers showed major changes in trends of surgical procedures. For breast cancer, the rate of in-patient breast conservation surgery (BCS) increased from 1981 to the early 1990s while the rate of mastectomy decreased. Because day surgery was not included, the subsequent in-patient BCS rate stayed level. For prostate cancer, the rate of transurethral prostatectomy was initially high but decreased after 1990, while the rate of radical prostatectomy increased rapidly, only minimally affected by the PSA-related peak in incidence. The lung cancer lobectomy rate in men remained at 10/100,000 after 1986, but in women rose from 3/100,000 to 7/100,000, reflecting increasing lung cancer incidence. For colorectal cancer, right hemicolectomies and anterior resections increased, especially in men. Conclusions: Surgery trends reflected changes in incidence and treatment preferences. Canadian trends were generally similar to US trends, although the timing of some of the changes differed. Canadians tended to use less invasive procedures such as BCS and anterior resection.     

Processed meat consumption and risk of cancer: a multisite case–control study in Uruguay

Background:

The role of processed meat in the aetiology of several cancers was explored in detail.

Methods:

In the time period 1996–2004, a multisite case–control study was conducted in Montevideo, Uruguay. The study included 6 060 participants (3 528 cases and 2 532 controls) corresponding to cancers of the oral cavity, pharynx, oesophagus, stomach, colon, rectum, larynx, lung, female breast, prostate, urinary bladder, and kidney (renal cell carcinoma only).

Results:

The highest odds ratios (ORs) were positively associated with cancers of the colon, rectum, stomach, oesophagus, and lung. With the exception of renal cell carcinoma, the remaining cancer sites were significantly associated with elevated risks for processed meat consumption. Furthermore, mortadella, salami, hot dog, ham, and salted meat were strongly associated with risk of several cancer sites.

Conclusion:

It could be concluded that processed meat intake could be a powerful multiorgan carcinogen.     

Cancer surveillance behaviors and psychosocial factors among long‐term survivors of breast cancer

BACKGROUND:

Little is known about cancer surveillance (mammography, clinical breast examination, and pelvic examination) behaviors in long‐term (9‐16 years) breast cancer survivors. This report describes the relation of these behaviors to demographic and clinical characteristics, psychological symptoms, body satisfaction, and social support.

METHODS:

Survivors who had participated in Cancer and Leukemia Group B treatment Trial 8541 completed a survey that included questions on breast cancer surveillance and pelvic examination, psychological well being, body satisfaction, and social support.

RESULTS:

The participation rate was 78% and included 245 breast cancer survivors. Survivors (n = 107; 44%) reported completing breast cancer surveillance (mammography and clinical breast examination) and completing pelvic examination (n = 162; 68%) within recommended guidelines. There were no significant associations between breast cancer surveillance and breast cancer anxiety, depression, stressful life events, body satisfaction, social support, or demographic characteristics. Survivors within recommended guidelines for pelvic examinations were younger (P = .05), married (P = .003), had health insurance (P = .004), and had lower depression scores (P = .005) than survivors who underused or overused pelvic examination. In addition, survivors within recommended pelvic examination guidelines had significantly lower levels of breast cancer anxiety (P = .03) compared with survivors who underused pelvic examination.

CONCLUSIONS:

Many long‐term breast cancer survivors were not within recommended cancer surveillance guidelines. Private health insurance was associated with following recommendations for pelvic examinations, although such a relation did not exist for breast cancer surveillance. The results of this study have implications for the development of educational programs to improve cancer surveillance among the growing population of long‐term breast cancer survivors. Cancer 2009. © 2009 American Cancer Society.     

Decreasing the cancer burden in developing countries: concerns and recommendations

Although the close of the 20th century witnessed advances in cancer detection and treatment, cancer morbidity and mortality rates steadily increase across the globe within the 21st century. The majority of this cancer burden can be found in underdeveloped and developing countries. A growing concern can be seen regarding this issue, with the research community as well as governmental and non-governmental organizations considering efforts that need to be developed and implemented. In this article, we propose several strategies to reduce cancer burden in developing countries that involve not only governmental and non-governmental organizations in such developing countries but also the research community. Such measures may prove helpful in gaining a better understanding of cancer burden and assist in clinical decision making and the design of prevention strategies for developing countries.     

Rationale and design of the National Program of Cancer Registries' breast, colon, and prostate cancer patterns of care study

Background: Investigators from the Centers for Disease Control and Prevention (CDC), National Program of Cancer Registries (NPCR), are collaborating with public health professionals from seven states and the District of Columbia to conduct the Patterns of Care study to assess the quality of cancer data and to determine whether stage-specific treatments are being carried out. Methods: To assess the quality and completeness of cancer care data in the United States, trained staff from the Patterns of Care study are abstracting medical records to obtain detailed clinical data on treatment, tumor characteristics, stage at diagnosis, and demographics of representative samples of patients diagnosed with breast, colon, and prostate cancer. Altogether staff from each of the eight participating cancer registries will abstract 500 cases of breast, prostate, and colon/rectum/anus cancer for the CONCORD study and an additional 150 cases of localized breast cancer, 100 cases of stage III colon cancer, and 100 cases of localized prostate cancer for the Patterns of Care study. Chi-square tests will be used to compare routine registry data with re-abstracted data. The investigators will use logistic regression techniques to describe the characteristics of patients with localized breast and prostate cancer and stage III colon cancer. Age, race, sex, type of insurance, and comorbidity will be examined as predictors of the use of those treatments that are consistent with consensus guidelines. The investigators plan to use data from the CONCORD study to determine whether treatment factors are the reason for the reported differences between relative survival rates in the United States and Europe. Conclusions Results from the methodology used in the Patterns of Care study will provide, for the first time, detailed information about the quality and completeness of stage and treatment data that are routinely collected by states participating in the NPCR. It will add significantly to our understanding of factors that determine receipt of treatment in compliance with established guidelines. As part of the CONCORD study, it will also examine differences in survival among cancer patients with breast, prostate, and colon/rectum/anus cancers in the United States and Europe.     

Survival outcome of women with synchronous cancers of endometrium and ovary: a 10 year retrospective cohort study

Objective

Synchronous occurrence of endometrial and ovarian tumors is uncommon, and they affect less than 10% of women with endometrial or ovarian cancers. The aim of this study is to describe the epidemiological and clinical factors; and survival outcomes of women with these cancers.

Methods

This is a retrospective cohort study in a large tertiary institution in Singapore. The sample consists of women with endometrial and epithelial ovarian cancers followed up over a period of 10 years from 2000 to 2009. The epidemiological and clinical factors include age at diagnosis, histology types, grade and stage of disease.

Results

A total of 75 patients with synchronous ovarian and endometrial cancers were identified. However, only 46 patients met the inclusion criteria. The median follow-up was 74 months. The incidence rate for synchronous cancer is 8.7% of all epithelial ovarian cancers and 4.9% of all endometrial cancers diagnosed over this time frame. Mean age at diagnosis was 47.3 years old. The most common presenting symptom was abnormal uterine bleeding (36.9%) and 73.9% had endometrioid histology for both endometrial and ovarian cancers. The majority of the women (78%) presented were at early stages of 1 and 2. There were 6 (13.6%) cases of recurrence and the 5 year cumulative survival rate was at 84%.

Conclusion

In our cohort, we found that majority of women afflicted with synchronous cancer of the endometrium and ovary were younger at age of diagnosis, had early stage of cancer and good survival.     

Clinical delivery of intensity modulated conformal radiotherapy for relapsed or second-primary head and neck cancer using a multileaf collimator with dynamic control

Background and purpose: Concave dose distributions generated by intensity modulated radiotherapy (IMRT) were applied to re-irradiate three patients with pharyngeal cancer.

Patients, materials and methods: Conventional radiotherapy for oropharyngeal (patients 1 and 3) or nasopharyngeal (patient 2) cancers was followed by relapsing or new tumors in the nasopharynx (patients 1 and 2) and hypopharynx (patient 3). Six non-opposed coplanar intensity modulated beams were generated by combining non-modulated beamparts with intensities (weights) obtained by minimizing a biophysical objective function. Beamparts were delivered by a dynamic MLC (Elekta Oncology Systems, Crawley, UK) forced in step and shoot mode.

Results and conclusions: Median PTV-doses (and ranges) for the three patients were 73 (65–78), 67 (59–72) and 63 (48–68) Gy. Maximum point doses to brain stem and spinal cord were, respectively, 67 Gy (60% of volume below 30 Gy) and 32 Gy (97% below 10 Gy) for patient 1; 60 Gy (69% below 30 Gy) and 34 Gy (92% below 10 Gy) for patient 2 and 21 Gy (96% below 10 Gy) at spinal cord for patient 3. Maximum point doses to the mandible were 69 Gy for patient 1 and 64 Gy for patient 2 with, respectively, 66 and 92% of the volume below 20 Gy. A treatment session, using the dynamic MLC, was finished within a 15-min time slot.     

Metastatic breast cancer from gastric and ovarian cancer,mimicking inflammatory breast cancer: report of two cases

Breast metastases from extra-mammary malignancies, especially those mimicking primary inflammatory breast carcinoma, are extremely rare. We report here two cases of inflammatory breast metastases from gastric or ovarian cancer. Both patients, who had prior advanced malignant disease, presented with unilateral breast redness and swelling with peau d’orange sign, resembling primary inflammatory breast cancer or acute mastitis. Breast biopsy revealed poorly differentiated adenocarcinoma with signet-ring cells or clear cell carcinoma in the lymphatic vessels and the parenchyma without an in situ lesion, similar to primary lesions of the stomach or ovary, respectively. Immunohistochemical staining for estrogen receptor, progesterone receptor, and gross cystic disease fluid protein 15 was of value for correct diagnosis. Since breast metastasis is a sign of poor prognosis of the primary malignant disease, the possibility of breast metastasis should be considered in appropriate patients to preclude unnecessary major surgery.