• Title, Summary, Keyword: Postoperative radiotherapy

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The Role of Postoperative Radiotherapy in the Management of Intracranial Meningiomas (뇌수막종 환자에서 수술후 방사선 치료의 역할)

  • Chang Sei Kyung;Suh Chang Ok;Shin Hyun Soo;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.12 no.2
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    • pp.159-164
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    • 1994
  • Purpose : To evaluate the role of postoperative radiotherapy in the management of primary or recurrent intracranial meningiomas. Methods and Materials : A retrospective review of 34 intracranial meningioma patients referred to the Yonsei Cancer Center for postoperative radiotherapy between 1981 and 1990 was undertaken. Of the 34 patients, 24 patients received elective postoperative radiotherapy after total or subtotal resection(Group 1), and 10 patients received postoperative radiotherapy as a salvage treatment for recurrent tumors(Group 2). Ten patients received postoperative radiotherapy after total resection, and twenty-four after subtotal resection. Ten patients who had total tumor resection were referred for radiotherapy either because of angioblastic or malignant histologic type(4 patients in Group 1) or because of recurrent disease after initial surgery(6 patients in Group 2). Radiation dose of 50-56 Gy was delivered over a period of 5-5.5 weeks using 4MV LINAC or Co-60 teletherapy unit. Results : Overall actuarial progression free survival(PFS) at 5 years was $80\%$. Survival was most likely affected by histologic subtypes. Five year PFS rate was $52\%$ for benign angioblastic histology as compared with $100\%$ for classic benign histology. For malignant meningiomas, 5 year PFS rate was $44\%$. The recurrence rates of classic, angioblastic, and malignant type were $5\%(1/21),\;80\%(4/5)$, and $50\%(4/8)$, respectively. The duration between salvage post-operative radiotherapy and recurrence was longer than the duration between initial surgery and recurrence in the patients of group 2 with angioblastic or malignant histology. Conclusion . Postoperative radiotherapy of primary or recurrent intracranial meningiomas appears to be effective modality, especially in the patients with classic meningiomas. In angioblastic or malignant histologies, a more effective approach seems to be needed for decreasing recurrence rate.

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Treatment outcome in patients with vulvar cancer: comparison of concurrent radiotherapy to postoperative radiotherapy

  • Lee, Ja-Young;Kim, Sung-Hwan;Kim, Gi-Won;Yu, Mi-Na;Park, Dong-Choon;Yoon, Joo-Hee;Yoon, Sei-Chul
    • Radiation Oncology Journal
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    • v.30 no.1
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    • pp.20-26
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    • 2012
  • Purpose: To evaluate outcome and morbidity in patients with vulvar cancer treated with radiotherapy, concurrent chemoradiotherapy or postoperative radiotherapy. Materials and Methods: The records of 24 patients treated with radiotherapy for vulvar cancer between July 1993 and September 2009 were retrospectively reviewed. All patients received once daily 1.8-4 Gy fractions external beam radiotherapy to median 51.2 Gy (range, 19.8 to 81.6 Gy) on pelvis and inguinal nodes. Seven patients were treated with primary concurrent chemoradiotherapy, one patient was treated with primary radiotherapy alone, four patients received palliative radiotherapy, and twelve patients were treated with postoperative radiotherapy. Results: Twenty patients were eligible for response evaluation. Response rate was 55% (11/20). The 5-year disease free survival was 42.2% and 5-year overall survival was 46.2%, respectively. Fifty percent (12/24) experienced with acute skin complications of grade III or more during radiotherapy. Late complications were found in 8 patients. 50% (6/12) of patients treated with lymph node dissection experienced severe late complications. One patient died of sepsis from lymphedema. However, only 16.6% (2/12) of patients treated with primary radiotherapy developed late complications. Conclusion: Outcome of patients with vulvar cancer treated with radiotherapy showed relatively good local control and low recurrence. Severe late toxicities remained higher in patients treated with both node dissection and radiotherapy.

Postoperative radiotherapy in salivary ductal carcinoma: a single institution experience

  • Kim, Tae Hyung;Kim, Mi Sun;Choi, Seo Hee;Suh, Yang Gun;Koh, Yoon Woo;Kim, Se Hun;Choi, Eun Chang;Keum, Ki Chang
    • Radiation Oncology Journal
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    • v.32 no.3
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    • pp.125-131
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    • 2014
  • Purpose: We reviewed treatment outcomes and prognostic factors for patients with salivary ductal carcinoma (SDC) treated with surgery and postoperative radiotherapy from 2005 to 2012. Materials and Methods: A total of 16 patients were identified and 15 eligible patients were included in analysis. Median age was 61 years (range, 40 to 71 years) and 12 patients (80%) were men. Twelve patients (80%) had a tumor in the parotid gland, 9 (60%) had T3 or T4 disease, and 9 (60%) had positive nodal disease. All patients underwent surgery and postoperative radiotherapy. Postoperative radiotherapy was delivered using 3-dimensional conformal radiotherapy or intensity-modulated radiotherapy. Locoregional failure-free survival (LRFFS), distant failure-free survival (DFFS), progression-free survival (PFS), and overall survival (OS) were calculated using the Kaplan-Meier method. Differences in survival based on risk factors were tested using a log-rank test. Results: Median total radiotherapy dose was 60 Gy (range, 52.5 to 63.6 Gy). Four patients received concurrent weekly chemotherapy with cisplatin. Among 10 patients who underwent surgery with neck dissection, 7 received modified radical neck dissection. With a median follow-up time of 38 months (range, 24 to 105 months), 4-year rates were 86% for LRFFS, 51% for DFFS, 46% for PFS, and 93% for OS. Local failure was observed in 2 patients (13%), and distant failure was observed in 7 (47%). The lung was the most common involved site of distant metastasis. Conclusion: Surgery and postoperative radiotherapy in SDC patients resulted in good local control, but high distant metastasis remained a major challenge.

Value of Postoperative Radiation Therapy for Regional Control after Dissection in Head and Neck Squamous Cell Carcinoma Cases

  • Li, Xiao-Ming;Di, Bin;Shang, Yao-Dong;Tao, Zhen-Feng;Cheng, Ji-Min;He, Zhan-Guo
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.7
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    • pp.4273-4278
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    • 2013
  • Objective: We aimed to define clinicopathologic risk factors associated with regional recurrence (RR) and thus the effectiveness of postoperative radiotherapy (PORT) for neck control for head and neck squamous cell carcinomas (HNSCCs) with differing cervical lymph node status. Methods: A retrospective study was performed in 196 HNSCC patients with pathologically positive neck node (N+) to evaluate the high-risk factors for RR and to define the role of PORT in control after neck dissection and postoperative radiotherapy (PORT). Results: Overall, the RR rate after neck dissection and PORT was 29%. Extracapsular spread (ECS) was confirmed to be the only independent risk factor for RR. There were no significant risk factors associated with RR in the ECS- group. The 5-year disease-specific survival rate was 45%, which descended to 10% with the emergence of RR. Conclusions: ECS remains a determined risk factor for RR after neck dissection and PORT in patients with N+. PORT alone is not adequate for preventing RR in the neck with ECS after neck dissection. More intensive postoperative adjuvant therapies, especially combined chemotherapy and radiotherapy, are needed to prevent regional failure in HNSCC patients with ECS.

Treatment outcome of conservative surgery plus postoperative radiotherapy for extremity soft tissue sarcoma

  • Lee, Ji-Eun;Park, Young-Je;Yang, Dae-Sik;Yoon, Won-Sup;Lee, Jung-Ae;Rim, Chai-Hong;Kim, Chul-Yong
    • Radiation Oncology Journal
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    • v.30 no.2
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    • pp.62-69
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    • 2012
  • Purpose: To evaluate the treatment outcome and prognostic factor of postoperative radiotherapy for extremity soft tissue sarcoma (STS). Materials and Methods: Forty three patients with extremity STS were treated with conservative surgery and postoperative radiotherapy from January 1981 to December 2010 at Korea University Medical Center. Median total 60 Gy (range, 50 to 74.4 Gy) of radiation was delivered and 7 patients were treated with chemotherapy. Results: The median follow-up period was 70 months (range, 5 to 302 months). Twelve patients (27.9%) sustained relapse of their disease. Local recurrence occurred in 3 patients (7.0%) and distant metastases developed in 10 patients (23.3%). The 5-year overall survival (OS) was 69.2% and disease free survival was 67.9%. The 5-year local relapse-free survival was 90.7% and distant relapse-free survival was 73.3%. On univariate analysis, no significant prognostic factors were associated with development of local recurrence. Histologic grade (p = 0.005) and stage (p = 0.02) influenced the development of distant metastases. Histologic grade was unique significant prognostic factor for the OS on univariate and multivariate analysis. Severe acute treatment-related complications, Common Terminology Criteria for Adverse Events (CTCAE) grade 3 or 4, developed in 6 patients (14.0%) and severe late complications in 2 patients (4.7%). Conclusion: Conservative surgery with postoperative radiotherapy achieved a satisfactory rate of local control with acceptable complication rate in extremity STS. Most failures were distant metastases that correlate with tumor grade and stage. The majority of local recurrences developed within the field. Selective dose escalation of radiotherapy or development of effective systemic treatment might be considered.

The Result of Radiation Therapy in the Esophageal Cancer (식도암의 방사선 치료결과)

  • Choi, Seog-Young;Chun, Ha-Chung;Lee, Myung-Za
    • Radiation Oncology Journal
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    • v.12 no.2
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    • pp.185-190
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    • 1994
  • Purpose : Patients with esophageal cancer treated with surgery plus postoperative radiotherapy or radiation alone were retrospectively analyzed. Method : From August 1980 to June 1992, 93 patients who were treated with 30 Gy or more in the Department of Therapeutic Radiology were evaluated. Median age was 59 years. Ninety one were male and remaining 2 were female. Patients with stage II, III and IV disease were 25, 62 and 6 respectively. Thirteen of the tumor were located in upper one third, 56 in middle one third and 24 in lower one third. Forty three patients had tumors 5cm or less in size and remaining 50 had greater than 5cm. Of those 93 patients, 41 were treated with surgery plus postoperative radiotherapy and 52 with radiation alone. Dose of radiation ranged from 34 to 66.6 Gy. Follow up period was 12 to 61 months. Results : Stage of the tumor was the most important prognostic factor of the evaluated factors. Median survival for entire group of patients was 12 months. Median survival for patients treated with surgery plus postoperative radiotherapy and radiation alone were 15 and 10 months, respectively. There was no difference of 2 year survival. Median survival was 21 months for Stage II and 10 months for Stage m disease. In Stage II disease, that was 21 months for postoperative group and 17.5 months for radiation alone group. Five year survival were $27.5\%$ and $9\%$, respectively. Conclusion : This study showed that the result of surgery plus postoperative radiotherapy was not different from that of radiation alone despite of slightly longer median survival in postoperative group. Also stage of the disease was the most important prognostic factor.

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Therapeutic results and safety of postoperative radiotherapy for keloid after repeated Cesarean section in immediate postpartum period

  • Kim, Ju-Ree;Lee, Sang-Hoon
    • Radiation Oncology Journal
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    • v.30 no.2
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    • pp.49-52
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    • 2012
  • Purpose: To evaluate the effectiveness and safety of postoperative radiotherapy for the treatment of keloid scars administered immediately after Cesarean section. Materials and Methods: A total of 26 postpartum patients with confirmed keloids resulting from previous Cesarean sections received either 12 or 15 Gy radiotherapy. The radiotherapy was divided into three 6 MeV electron beam fractions administered during the postpartum period immediately following the final Cesarean section. To evaluate ovarian safety, designated doses of radiation were estimated at the calculated depth of the ovaries using a solid plate phantom and an ionization chamber with the same lead cutout as was used for the treatment of Cesarean section operative scars and a tissue equivalent bolus. Results: In total, the control rate was 77% (20 patients), while six (23%) developed focally elevated keloids (ranging from 0.5 to 2 cm in length) in the middle of the primary abdominal scar. Five patients experienced mild hyperpigmentation. Nonetheless, most patients (96%) were satisfied with the treatment results. The estimated percentage of the applied radiation doses that reached the calculated depth of the ovaries ranged from 0.0033% to 0.0062%. Conclusion: When administered during the immediate postpartum period, postoperative electron beam radiotherapy for repeated Cesarean section scars is generally safe and produces good cosmetic results with minimal toxicity.

Pharyngocutaneous Fistula which Occurred During Postoperative Radiotherapy in Larynx Cancer Patient with Dementia (치매가 있는 후두암 환자에서 술 후 방사선치료 중 발생한 인두피부누공)

  • Kim, Jung Jun;Kang, Ju Yong;Choi, Ik Joon;Lee, Myung-Chul
    • Korean Journal of Head & Neck Oncology
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    • v.35 no.2
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    • pp.51-55
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    • 2019
  • Pharyngocutaneous fistula is a relatively common, but serious complication after pharyngeal or laryngeal cancer surgery. It can cause wound infection, longer hospitalization period and sometimes carotid artery rupture which can be fatal. Recently, we experienced a 63-year-old larynx cancer patient who had dementia and alcoholic liver cirrhosis for underlying diseases. He underwent total laryngectomy and both neck dissection, and pharyngocutaneous fistula occurred during postoperative radiotherapy. Pharyngocutaneous fistula during postoperative radiotherapy has not yet reported in the literature, and there are few reports about pre and postoperative management of dementia patient after head and neck cancer surgery. Therefore, we report this case with a brief review of literature.

Postoperative radiotherapy for endometrial cancer

  • Choi, Eun Cheol;Kim, Jin Hee;Kim, Ok Bae;Byun, Sang Jun;Park, Seung Gyu;Kwon, Sang Hoon
    • Radiation Oncology Journal
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    • v.30 no.3
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    • pp.108-116
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    • 2012
  • Purpose: To investigate the prognostic factors and effectiveness of postoperative radiotherapy alone for endometrial carcinoma. Materials and Methods: Sixty four patients with stage I-III endometrial cancer (EC) treated with postoperative radiotherapy alone between January 1989 and December 2008 at the Keimyung University Dongsan Medical Center were chosen for the present study. Typically, total hysterectomy, salpingo-oophorectomy and lymphadenectomy were performed on the patient's pelvis. Total dose from 50.4 Gy to 63 Gy was irradiated at pelvis or extended field. Thirteen patients were treated with Co-60 or Ir-192 intracavitary radiotherapy. Follow-up periods were from 7 to 270 months, with a median of 56 months. Results: Five year overall survival (OS) rate was 58.7%, respectively. Five year disease-free survival (DFS) rate was 59.2%, respectively. In univariate analysis for OS and DFS, stage, menopausal age, type of operation, serosal invasion, and lymph node involvement were found to be statistically significant. Histologic type was marginally significant. In multivariate analysis for OS and DFS, stage, types of operation, histologic type were also found to be statistically significant. Treatment failure occurred in 14 patients. The main pattern of failure was found to be distant metastasis. Time to distant metastasis was from 3 to 86 months (median, 12 months). There were no grade 3 or 4 complications. Conclusion: Stage, types of operation, and histologic type could be the predictive prognostic factors in patients. We contemplated postoperative radiation as effective and safe treatment method for EC. Additional treatment would be needed to reduce distant metastasis.

Postoperative radiotherapy for mucoepidermoid carcinoma of the major salivary glands: long-term results of a single-institution experience

  • Park, Geumju;Lee, Sang-wook
    • Radiation Oncology Journal
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    • v.36 no.4
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    • pp.317-324
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    • 2018
  • Purpose: This study aimed to evaluate the long-term survival outcomes and prognostic factors that affect the clinical outcomes of patients who underwent surgery and postoperative radiotherapy for major salivary gland mucoepidermoid carcinoma (MEC). Materials and Methods: We retrospectively reviewed the clinical data of 44 patients who underwent surgery followed by radiotherapy for primary MEC of the major salivary glands between 1991 and 2014. The median follow-up period was 9.8 years (range, 0.8 to 23.8 years). Results: The overall outcomes at 5 and 10 years were 81.5% and 78.0% for overall survival (OS), 86.2% and 83.4% for disease-free survival, 90.6% and 87.6% for locoregional recurrence-free survival, and both 90.5% for distant metastasis-free survival (DMFS). Histologic grade was the only independent predictor of OS (low vs. intermediate vs. high; hazard ratio = 3.699; p = 0.041) in multivariate analysis. A poorer survival was observed among patients with high-grade tumors compared with those with non-high-grade tumors (5-year OS, 37.5% vs. 91.7%, p < 0.001; 5-year DMFS, 46.9% vs. 100%, p < 0.001). Conclusion: Surgery and postoperative radiotherapy resulted in excellent survival outcomes for patients with major salivary gland MEC. However, high-grade tumors contributed to poor DMFS and OS. Additional aggressive strategies for improving survival outcomes should be developed for high-grade MEC.