BACKGROUND: Surgery and radiotherapy are current therapeutic options for malignant tumors involving the nasal vestibule. Depending on the location, organ-preserving resection is not always possible, even for small tumors. Definitive radiotherapy is an alternative as an organ-preserving procedure. Carbon ion beam radiotherapy offers highly conformal dose distributions and more complex biological radiation effects eventually resulting in optimized normal tissue sparing and improved outcome. The aim of the current study was to analyze toxicity, local control (LC), and organ preserving survival (OPS) after irradiation of carcinoma of the nasal vestibule with raster-scanned carbon ion radiotherapy boost (CIRT-B) combined with volumetric intensity modulated arc therapy (VMAT) with photons.
METHODS: Between 12/2015 and 05/2021, 21 patients with malignant tumors involving the nasal vestibule were irradiated with CIRT-B combined with VMAT and retrospectively analyzed. Diagnosis was based on histologic findings. A total of 17 patients had squamous cell carcinoma (SCC) and 4 had other histologies. In this series, 10%, 67%, and 24% of patients had Wang stages 1, 2, and 3 tumors, respectively. Three patients had pathologic cervical nodes on MRI. The median CIRT-B dose was 24 Gy(RBE), while the median VMAT dose was 50 Gy. All patients with pathologic cervical nodes received simultaneously integrated boost with photons (SIB) up to a median dose of 62.5 Gy to the pathological lymph nodes. Eight patients received cisplatin chemotherapy. All patients received regular follow-up imaging after irradiation. Kaplan-Meier estimation was used for statistical assessment.
RESULTS: The median follow-up after irradiation was 18.9 months. There were no common toxicity criteria grade 5 or 4 adverse events. A total of 20 patients showed grade 3 adverse events mainly on skin and mucosa. All patients were alive at the end of follow-up. The median OPS after treatment was 56.5 months. The 6- and 24-month OPS were 100% and 83.3%, respectively. All local recurrences occurred within 12 months after radiotherapy. The median progression free survival (PFS) after treatment was 52.4 months. The 6-, 12-, and 24-month PFS rates were 95%, 83.6%, and 74.3%, respectively.
CONCLUSIONS: CIRT-B combined with VMAT in malignant tumors of the nasal vestibule is safe and feasible, results in high local control rates, and thus is a good option as organ-preserving therapy. No radiation-associated grade 4 or 5 acute or late AE was documented.

OBJECTIVE: To report long-term follow-up of the efficacy of subtotal prostate ablation using a \"hockey-stick\" template, including oncologic control and quality of life (QoL) impact.
METHODS: We performed a prospective controlled trial to evaluate the efficacy of subtotal prostate ablation in selected men with baseline and confirmatory biopsy showing grade group (GG) 1-2 prostate cancer. \"Hockey-stick\" cryoablation that included the ipsilateral hemi-gland and contralateral anterior prostate was performed. Prostate biopsies and QOL queries were performed at 6, 18 and 36 months following regional ablation, and follow-up was updated to include subsequent clinic visits.
RESULTS: Between August 2009 and January 2012, 72 men were screened for eligibility and 47 opted to undergo confirmatory biopsy. Of these, 23 were deemed eligible and treated with regional cryoablation. Median age was 64 years. Median follow-up was 74 months. A single patient had < 1 mm of in-field viable tumor with therapy effect on 36-month biopsy. At time of last follow-up, a total of 12/23 (52%) patients did not have evidence of disease, all patients had preserved urinary control with no patients requiring pads for urinary incontinence. Sexual decline was significant at 3 and 6 months (P < 0.01 for both), though improvement was seen at subsequent time points.
CONCLUSIONS: Subtotal (hockey-stick template) cryoablation of the prostate provides oncologic control to targeted tissue in a generally low-risk group with minimal impact on sexual and urinary function. Further studies are needed to evaluate this ablation template in the MRI-targeted era and higher risk populations.

BACKGROUND: The objective of this study was to evaluate differences in various clinical endpoints in patients with reconstructive surgery by renal partial nephrectomy for tumors up to 4 cm compared to tumors larger than 4 cm.
METHODS: A total of 170 partial renal resection patients that presented malignant tumors were included in the retrospective study. Data was analyzed retrospectively based on internal clinic files, as well as a questionnaire to enhance the follow-up clinical outcomes data obtained. The most important outcomes determined included post-operative renal function, intra- and post-operative complications, local recurrence rate and total survival time.
RESULTS: The local recurrence rate was 6.1% for tumors up to 4 cm in size, compared to 14.9% for tumors that were larger than 4 cm. Compared to results for partial resection of T1a tumors, results for partial resection of tumors larger than 4 cm are worse in terms of post-operative renal function (p=0.007), as well as in terms of a total complications rate (p=0.048). It is important to note that there was not only a higher risk of post-operative bleeding that required transfusions (p=0.012), but also a higher risk of a hypertensive episode during the post-operative period reviewed (p=0.022). In addition, the total survival time for patients presenting tumors of up to 4 cm in size was significantly better (p=0.003).
CONCLUSIONS: The results of our retrospective study of 170 patients that underwent partial renal resection after the diagnosis of malignant tumors, is that partial renal resection presents an oncologicaly safe surgical solution with low local recurrence rates. Additionally, partial resection in case of tumors that are larger than 4 cm showed worse post-operative renal function, a higher complications rate and a worse survival rate.
Hintergrund: Ziel dieser Studie war es, Unterschiede in verschiedenen klinischen Endpunkten bei Patienten mit rekonstruktiver Nierenchirurgie mittels Nierenteilresektion bei malignen Tumoren bis zu 4 cm beziehungsweise größer als 4 cm zu evaluieren.Material und Methoden: Insgesamt wurden 170 Patienten mit einer Nierenteilresektion bei malignen Tumoren in die Studie eingeschlossen. Es wurde retrospektiv anhand der klinikinternen Unterlagen sowie eines Fragebogens zur Erhebung der Follow-up-Daten die klinischen Endpunkte erfasst. Wichtige klinische Endpunkte waren die postoperative Nierenfunktion, intra- und postoperative Komplikationen, die Lokalrezidivrate sowie das Gesamtüberleben.Ergebnisse: Die Lokalrezidivrate betrug 6,1% bei Tumoren bis 4 cm bzw. 14,9% bei Tumoren größer als 4 cm. Im Vergleich zu T1a-Tumoren ist bei mehr als 4 cm großen Nierentumoren nach einer Nierenteilresektion mit einer schlechteren postoperativen Nierenfunktion (p=0,007) sowie mit einer höheren Gesamtkomplikationsrate zu rechnen (p=0,048). Insbesondere zeigte sich hier neben einem höheren Risiko einer transfusionspflichtigen Nachblutung (p=0,012) auch ein höheres Risiko einer hypertensiver Entgleisung im postoperativen Verlauf (p=0,022). Zudem war das Gesamtüberleben bei Tumoren bis 4 cm signifikant besser (p=0,003). Schlussfolgerung: Den Ergebnissen unserer retrospektiven Studie nach, die 170 Pateinen mit Nierenteilresektion bei malignen Tumoren einschloss, ist die Nierenteilresektion ein onkologisch sicheres Operationsverfahren mit geringen Lokalrezidivraten. Allerdings ist bei Tumoren >4 cm mit einer schlechteren postoperativen Nierenfunktion, mit einer höheren Komplikationsrate sowie mit einem schlechterem Gesamtüberleben zu rechnen.