• 제목, 요약, 키워드: Radiotherapy

검색결과 2,659건 처리시간 0.061초

Outcome of Palliative and Radical Radiotherapy in Patients with Oral Squamous Cell Carcinoma - a Retrospective Study

  • Rai, Narendra Prakash;Divakar, Darshan Devang;Al Kheraif, Abdulaziz Abdullah;Ramakrishnaiah, Ravikumar;Mustafa, Shabil Mohamed;Durgesh, BH;Basavarajappa, Santhosh;Khan, Aftab Ahmed
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.6919-6922
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    • 2015
  • Background: The treatment selection for the oral squamous cell carcinoma remains controversial. Radiation therapy or surgical excision of the lesion can be applied as the sole treatment or it can be used in combination with other treatment modalities. Radiotherapy is considered to be the safest of all the treatment modalities and can be used in several situations for oral and oropharyngeal cancers. The aim of this study was to evaluate the survival outcome differences in patients treated with radical and palliative radiotherapy as the primary treatment modality. Materials and Methods: The study included a total of 47 patients with oral cancer reporting to our hospital between years 2009 to 2010. The age group for the selected patients was more than 65 years, treated with radical and palliative radiotherapy with no prior surgical interventions. Patients were evaluated till Dec 2013 for overall survival time. Results: Twenty nine patients were treated with radical radiotherapy as main stay of treatment, out of which 21 died during the follow up time with median survival of $352{\pm}281.7$ days with 8 patients alive. All the 16 patients were dead who received palliative radiotherapy with a median survival time of $112{\pm}144.0$ days. Conclusions: This retrospective study showed improved overall survival time, loco regional control rates and reduced morbidity in patients treated with radical radiotherapy when compared to patients treated with palliative radiotherapy.

Impact of Adaptive Radiotherapy on Locally Advanced Head and Neck Cancer - A Dosimetric and Volumetric Study

  • Dewan, Abhinav;Sharma, SK;Dewan, AK.;Srivastava, Himanshu;Rawat, Sheh;Kakria, Anjali;Mishra, Maninder;Suresh, T;Mehrotra, Krati
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.985-992
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    • 2016
  • Objective of the study is to evaluate volumetric and dosimetric alterations taking place during radiotherapy for locally advanced head and neck cancer (LAHNC) and to assess benefit of replanning in them. Materials and Methods: Thirty patients with LAHNC fulfilling the inclusion and exclusion criteria were enrolled in a prospective study. Planning scans were acquired both pre-treatment and after 20 fractions (mid-course) of radiotherapy. Single plan (OPLAN) based on initial CT scan was generated and executed for entire treatment course. Beam configuration of OPLAN was applied to anatomy of interim scan and a hybrid plan (HPLAN30) was generated. Adaptive replanning (RPLAN30) for remaining fractions was done and dose distribution with and without replanning compared for remaining fractions. Results: Substantial shrinkage of target volume (TV) and parotids after 4 weeks of radiotherapy was reported (p<0.05). No significant difference between planned and delivered doses was seen for remaining fractions. Hybrid plans showed increase in delivered dose to spinal cord and parotids for remaining fractions. Interim replanning improved homogeneity of treatment plan and significantly reduced doses to cord (Dmax, D2% and D1%) and ipsilateral parotid (D33%, D50% and D66%) (p<0.05). Conclusions: Use of one or two mid-treatment CT scans and replanning provides greater normal tissue sparing along with improved TV coverage.

Long-term outcomes after salvage radiotherapy for postoperative locoregionally recurrent non-small-cell lung cancer

  • Kim, Eunji;Song, Changhoon;Kim, Mi Young;Kim, Jae-Sung
    • Radiation Oncology Journal
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    • v.35 no.1
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    • pp.55-64
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    • 2017
  • Purpose: The outcomes and toxicities of locoregionally recurrent non-small-cell lung cancer (NSCLC) patients treated with curative radiotherapy were evaluated in the modern era. Materials and Methods: Fifty-seven patients receiving radical radiotherapy for locoregionally recurrent NSCLC without distant metastasis after surgery from 2004 to 2014 were reviewed. Forty-two patients were treated with concurrent chemoradiotherapy (CCRT), and 15 patients with radiotherapy alone. The median radiation dose was 66 Gy (range, 45 to 70 Gy). Lung function change after radiotherapy was evaluated by comparing pulmonary function tests before and at 1, 6, and 12 months after radiotherapy. Results: Median follow-up was 53.6 months (range, 12.0 to 107.5 months) among the survivors. The median overall survival (OS) and progression-free survival (PFS) were 54.8 months (range, 3.0 to 116.9 months) and 12.2 months (range, 0.8 to 100.2 months), respectively. Multivariate analyses revealed that single locoregional recurrence focus and use of concurrent chemotherapy were significant prognostic factors for OS (p = 0.048 and p = 0.001, respectively) and PFS (p = 0.002 and p = 0.026, respectively). There was no significant change in predicted forced expiratory volume in one second after radiotherapy. Although diffusing lung capacity for carbon monoxide decreased significantly at 1 month after radiotherapy (p < 0.001), it recovered to pretreatment levels within 12 months. Acute grade 3 radiation pneumonitis and esophagitis were observed in 3 and 2 patients, respectively. There was no chronic complication observed in all patients. Conclusion: Salvage radiotherapy showed good survival outcomes without severe complications in postoperative locoregionally recurrent NSCLC patients. A single locoregional recurrent focus and the use of CCRT chemotherapy were associated with improved survival. CCRT should be considered as a salvage treatment in patients with good prognostic factors.

Clinical Observation of Whole Brain Radiotherapy Concomitant with Targeted Therapy for Brain Metastasis in Non-small Cell Lung Cancer Patients with Chemotherapy Failure

  • Cai, Yong;Wang, Ji-Ying;Liu, Hui
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.10
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    • pp.5699-5703
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    • 2013
  • Objective: To investigate the clinical effects of whole brain radiotherapy concomitant with targeted therapy for brain metastasis in non-small cell lung cancer (NSCLC) patients with chemotherapy failure. Materials and Methods: Of the 157 NSCLC patients with chemotherapy failure followed by brain metastasis admitted in our hospital from January 2009 to August 2012, the combination group (65 cases) were treated with EGFR-TKI combined with whole brain radiotherapy while the radiotherapy group (92 cases) were given whole brain radiotherapy only. Short-term effects were evaluated based on the increased MRI in brain 1 month after whole brain radiotherapy. Intracranial hypertension responses, hematological toxicity reactions and clinical effects of both groups were observed. Results: There were more adverse reactions in the combination group than in radiotherapy group, but no significant differences were observed between the two groups in response rate (RR) and disease control rate (DCR) (P>0.05). Medium progression free survival (PFS), medium overall survival (OS) and 1-year survival rate in combination group were 6.0 months, 10.6 months and 42.3%, while in the radiotherapy group they were 3.4 months, 7.7 months and 28.0%, respectively, which indicated that there were significant differences in PFS and OS between the two groups (P<0.05). Additionally, RPA grading of each factor in the combination group was a risk factor closely related with survival, with medium PFS in EGFR and KRAS mutation patients being 8.2 months and 11.2 months, and OS being 3.6 months and 6.3 months, respectively. Conclusions: Whole brain radiotherapy concomitant with target therapy is favorable for adverse reaction tolerance and clinical effects, being superior in treating brain metastasis in NSCLC patients with chemotherapy failure and thus deserves to be widely applied in the clinic.

Minimally Invasive Stereotactical Radio-ablation of Adrenal Metastases as an Alternative to Surgery

  • Franzese, Ciro;Franceschini, Davide;Cozzi, Luca;D'Agostino, Giuseppe;Comito, Tiziana;De Rose, Fiorenza;Navarria, Pierina;Mancosu, Pietro;Tomatis, Stefano;Fogliata, Antonella;Scorsetti, Marta
    • Cancer Research and Treatment
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    • v.49 no.1
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    • pp.20-28
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    • 2017
  • Purpose The purpose of this study was to study the clinical outcome for patients with metastases of the adrenal gland treated with stereotactic body radiation therapy. Materials and Methods Forty-six patients were studied retrospectively. The dose prescription was 40 Gy in four fractions. Dosimetric analysis was performed using the dose volume histograms while clinical outcome was assessed using actuarial analysis with determination of the overall survival (OS) and local control (LC) rates. Results The planning objectives were met for all patients. With a median follow-up period of 7.6 months, at the last follow-up 42 patients (91.3%) were alive and four had died because of distant progression. The actuarial mean OS was $28.5{\pm}1.6months$, the median was not reached. One-year and 2-year OS were $87.6{\pm}6.1%$. None of the risk factors was significant in univariate analysis. Actuarial mean LC was $14.6{\pm}1.8months$ (95% confidence interval [CI], 11.0 to 18.2) and median LC was $14.5{\pm}2.0months$ (95% CI, 10.5 to 18.5). One-year and 2-year LC were $65.5{\pm}11.9%$ and $40.7{\pm}15.8%$, respectively. A mild profile of toxicity was observed in the cohort of patients. Forty patients (86.9%) showed no complication (grade 0); two patients reported asthenia, six patients (13.1%) reported either pain, nausea, or vomiting. Of these six patients, five patients (10.9%) were scored as grade 1 toxicity while one patient (2.2%) was scored as grade 2. Conclusion Stereotactic body radiation therapy treatment provided an adequate clinical response in the management of adrenal gland metastases.

A new research program that aims to establish an external audit system to radiotherapy QA in Japan

  • Shimbo, Munefumi;Tabushi, Katsuyoshi;Endo, Masahiro;Ikeda, Hiroshi
    • 한국의학물리학회:학술대회논문집
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    • pp.17-18
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    • 2002
  • Last year, a three-year research program was started in order to establish an external audit system to radiotherapy QA in Japan. It consists of questionnaire surveys, mailed (off-site) dosimetry and visited (on-site) dosimetry at radiotherapy facilities in Japan. The first questionnaire was sent to all Japanese radiotherapy facilities in October 2001, surveying basic QA procedures at each facility. 628 answers were returned with the return rate of 87%. In February 2002, the second questionnaire was sent. Off-site and on-site dosimetry have been tested in several facilities, and will be started soon. We anticipates that this program will gradually grow to a radiotherapy quality control center similar to Radiological Physics Center at MD Anderson Hospital.

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자궁경부암 IIIB 기의 방사선치료 성적 (Result of Radiation Therapy of the Cervix Cancer Stage IIIB)

  • 허승재
    • Radiation Oncology Journal
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    • v.11 no.1
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    • pp.143-148
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    • 1993
  • From September 1985 through September 1989,56 patients with stage IIIB carcinoma of the cervix were treated with radiation therapy with curative aim. The overall survival at 5 year was $38{\%}$. The survival rate was better for patients treated with combined external radiotherapy and high dose rate intracavitary radiotherapy than with external radiotherapy alone. No significant survival difference was observed between the unilateral and bilateral parametrial extension of the tumor Seventeen patients experienced recurrence within the irradiated field with a loco-regional recurrence rate of $30{\%}$. Ten patients had complications ($18{\%}$). The complications were mild in three, moderate in four, and severe in three patients. A study was made on the relationship between the fraction numbers of intracavitary radiotherapy, vaginal packing and the complication rate, respectively. In this analysis author observed that the significant treatment factor influencing the survival of cervical cancer was the use of intracavitary radiation, and meticulous vaginal packing could decrease the late complication rate of radiotherapy of cervical cancer.

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An 87-year-old patient with repeated oligorecurrences over six years whose disease were treated with radiotherapy alone

  • Yun, Hyong Geun
    • Radiation Oncology Journal
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    • v.32 no.4
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    • pp.266-271
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    • 2014
  • In the clinical state of oligometastases or oligorecurrence, a transitional state between localized and widespread systemic disease, local control of the disease may yield improved systemic control. Radiotherapy may be a good means for controlling oligometastatic tumors, particularly in very old patients for whom surgery may be infeasible. A combination of systemic therapy and local therapy is necessary to prevent systemic progression. Some kinds of cancers found in the elderly are known to be somewhat indolent for systemic progression. So, for very old patients who refuse or cannot tolerate chemotherapy, the use of radical radiotherapy alone to treat oligorecurrences may be very helpful. We successfully treated an 87-year-old patient who had been diagnosed with oligorecurrences three times over six years with radiotherapy alone. The patient is now, about four years after his first radiotherapy for liver metastasis, alive without any evidence of cancer and with fully active performance status.

30 Years of Radiotherapy Service in Southern Thailand: Workload vs Resources

  • Phungrassami, Temsak;Funsian, Amporn;Sriplung, Hutcha
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7743-7748
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    • 2013
  • Background: To study the pattern of patient load, personnel and equipment resources from 30-years experience in Southern Thailand. Materials and Methods: This retrospective study collected secondary data from the Division of Therapeutic Radiology and Oncology and the Songklanagarind Hospital Tumor Registry database, Faculty of Medicine, Prince of Songkla University, during the period of 1982-2012. Results: The number of new patients who had radiation treatment gradually increased from 121 in 1982 to 2,178 in 2011. Shortages of all kinds of personnel were demonstrated as compared to the recommendations, especially in radiotherapy technicians. In 2011, Southern Thailand, with two radiotherapy centers, had 0.44 megavoltage radiotherapy machines (cobalt or linear accelerator) per million of population. This number is suboptimal, but could be managed cost-effectively by prolonging machine operating times during personnel shortages. Conclusions: This study identified a discrepancy between workload and resources in one medical school radiotherapy center in Southern Thailand. This information is crucial for future strategic planning both regionally and nationally.