• Title, Summary, Keyword: Radiotherapy

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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.

Comparison of Conventional and Hypofractionated Radiotherapy in Breast Cancer Patients in Terms of 5-Year Survival, Locoregional Recurrence, Late Skin Complications and Cosmetic Results

  • Hashemi, Farnaz Amouzegar;Barzegartahamtan, Mohammadreza;Mohammadpour, Reza Ali;Sebzari, Ahmadreza;Kalaghchi, Bita;Haddad, Peiman
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.11
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    • pp.4819-4823
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    • 2016
  • Bckground: Adjuvant radiation therapy is commonly administered following breast-conserving surgery for breast cancer patients. Hypofractionated radiotherapy can significantly reduce the waiting time for radiotherapy, working load on machines, patient visits to radiotherapy departments and medical costs. Material/Methods: Fifty-two patients with operable breast cancer (pT1-3pN0M0) who underwent breast conservation surgery in Tehran Cancer Institute during January 2011 to January 2012, were randomly assigned to undergo radiotherapy in two arms (hypofractionated radiotherapy arm with 30 patients, dose 42.5 Gy in 16 fractions; and conventional radiotherapy arm with 22 patients, dose 50 Gy in 25 fractions). W compared these two groups in terms of overall survival, locoregional control, late skin complications and cosmetic results. Results: At a median follow-up of 52.4 months (range: 0-64 months), the follow-up rate was 82.6%. Overall, after 60 months, there was no detectable significant differences between groups regarding cosmetic results (p = 0.857), locoregional control or survival. Conclusions: The results confirm that hypofractionated radiotherapy with a subsequent boost is as effective as conventional radiotherapy, is well-tolerated and can be used as an alternative treatment method following breast conservation surgery.

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.

Outcomes of Preoperative Chemoradiotherapy and Combined Chemotherapy with Radiotherapy Without Surgery for Locally Advanced Rectal Cancer

  • Supaadirek, Chunsri;Pesee, Montien;Thamronganantasakul, Komsan;Thalangsri, Pimsiree;Krusun, Srichai;Supakalin, Narudom
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.7
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    • pp.3511-3514
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    • 2016
  • Purpose: To evaluate the treatment outcomes of patients with locally advanced rectal cancer treated with preoperative concurrent chemoradiotherapy (CCRT) or combined chemotherapy together with radiotherapy (CMT-RT) without surgery. Materials and Methods: A total of 84 patients with locally advanced rectal adenocarcinoma (stage II or III) between January $1^{st}$, 2003 and December $31^{st}$, 2013 were enrolled, 48 treated with preoperative CCRT (Gr.I) and 36 with combined chemotherapy and radiotherapy (CMT-RT) without surgery (Gr.II). The chemotherapeutic agents used concurrent with radiotherapy were either 5-fluorouracil short infusion plus leucovorin and/or capecitabine or 5-fluorouracil infusion alone. All patients received pelvic irradiation. Results: There were 5 patients (10.4%) with a complete pathological response. The 3 year-overall survival rates were 83.2% in Gr.I and 24.8 % in Gr.II (p<0.01). The respective 5 year-overall survival rates were 70.3% and 0% (p<0.01). The 5 year-overall survival rates in Gr.I for patients who received surgery within 56 days after complete CCRT as compared to more than 56 days were 69.5% and 65.1% (p=0.91). Preoperative CCRT used for 12 of 30 patients in Gr.I (40%) with lower rectal cancer demonstrated that in preoperative CCRT a sphincter sparing procedure can be performed. Conclusions: The results of treatment with preoperative CCRT for locally advanced rectal cancer showed comparable rates of overall survival and sphincter sparing procedures as compared to previous studies.

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
    • Proceedings of the Korean Society of Medical Physics Conference
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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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Long-Term Complications of Radiotherapy in a Patient with Maxillary Squamous Cell Carcinoma: A Matter of Trismus and Osteoradionecrosis

  • Kim, Keon-Hyung;Park, Jo-Eun;Kim, Mee-Eun;Kim, Hye-Kyoung
    • Journal of Oral Medicine and Pain
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    • v.43 no.4
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    • pp.136-141
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    • 2018
  • Oral cancer is a malignant neoplasm of the lips or oral cavity. Surgery, radiotherapy and chemotherapy depending on the location and stage of the tumor can be considered as important treatment modalities of oral cancer. Unfortunately, all three treatments can have both acute and chronic complications. Among them, trismus and osteoradionecrosis (ORN), unique complications of radiotherapy in the orofacial region, are particularly difficult to treat once manifested. Therefore, these two complications of radiotherapy have devastating effects on the patient's oral health and furthermore, overall quality of life. In this study, we present a case of a patient showing trismus and ORN following radiotherapy for the treatment of maxillary squamous cell carcinoma and briefly discuss this matter of trismus and ORN in the perspective of a dentist.

Current status of stereotactic body radiotherapy for the treatment of hepatocellular carcinoma

  • Park, Jongmoo;Park, Jae Won;Kang, Min Kyu
    • Yeungnam University Journal of Medicine
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    • v.36 no.3
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    • pp.192-200
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    • 2019
  • Stereotactic body radiotherapy (SBRT) is an advanced form of radiotherapy (RT) with a growing interest on its application in the treatment of hepatocellular carcinoma (HCC). It can deliver ablative radiation doses to tumors in a few fractions without excessive doses to normal tissues, with the help of advanced modern RT and imaging technologies. Currently, SBRT is recommended as an alternative to curative treatments, such as surgery and radiofrequency ablation. This review discusses the current status of SBRT to aid in the decision making on how it is incorporated into the HCC management.

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

  • Huh, Seung-Jae
    • 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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