• Title/Summary/Keyword: Cancer radiotherapy

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Effects of Home Nursing Intervention on the Quality of Life of Patients with Nasopharyngeal Carcinoma after Radiotherapy and Chemotherapy

  • Shi, Ru-Chun;Meng, Ai-Feng;Zhou, Weng-Lin;Yu, Xiao-Yan;Huang, Xin-En;Ji, Ai-Jun;Chen, Lei
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.7117-7121
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    • 2015
  • Background: The effects of home nursing intervention on the quality of life in patients with nasopharyngeal carcinoma (NPC) after radiotherapy and chemotherapy are unclear. According to the characteristics of nursing home patients with nasopharyngeal carcinoma, we should continuously improve the nursing plan and improve the quality of life of patients at home. Materials and Methods: We selected 180 patients at home with NPC after radiotherapy and chemotherapy. The patients were randomly divided into experimental and control groups (90 patients each). The experimental group featured intervention with an NPC home nursing plan, while the control group was given routine discharge and outpatient review. Nursing intervention for patients was mainly achieved by regular telephone follow-up and home visits. We use the quality of life scale (QOL-C30), anxiety scale (SAS) and depression scale (SDS) to evaluate these patients before intervention, and during follow-up at 1 month and 3 months after the intervention. Results: Overall health and quality of life were significantly different between the groups (p<0.05), Emotional function score was significantly higher after intervention (p<0.05), as were cognitive function and social function scores after 3 months of intervention (p<0.05). Scores of fatigue, nausea and vomiting, pain, appetite and constipation were also significantly different between the two groups (p<0.05). Rates of anxiety and depression after 3 months of intervention were 11.1%, 22.2% and 34.4%, 53.3%, the differences being significant (p<0.05). Conclusions: NPC home nursing plan could effectively improve overall quality of life, cognitive function, social function (after 3 months) of patients, but improvement regarding body function is not suggested. Fatigue, nausea and vomiting, pain, appetite, constipation were clearly improved. We should further pursue a personalized, comprehensive measurements for nursing interventions and try to improve the quality of life of NPC patients at home.

Metastatic Colorectal Cancer Treatment and Survival: the Experience of Major Public Hospitals in South Australia Over Three Decades

  • Roder, David;Karapetis, Christos S;Wattchow, David;Moore, James;Singhal, Nimit;Joshi, Rohit;Keefe, Dorothy;Fusco, Kellie;Buranyi-Trevarton, Dianne;Sharplin, Greg;Price, Timothy J
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.5923-5931
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    • 2015
  • Background: Registry data from four major public hospitals indicate trends over three decades from 1980 to 2010 in treatment and survival from colorectal cancer with distant metastases at diagnosis (TNM stage IV). Materials and Methods: Kaplan-Meier product-limit estimates and Cox proportional hazards models for investigating disease-specific survival and multiple logistic regression analyses for indicating first-round treatment trends. Results: Two-year survivals increased from 10% for 1980-84 to 35% for 2005-10 diagnoses. Corresponding increases in five-year survivals were from 3% to 16%. Time-to-event risk of colorectal cancer death approximately halved (hazards ratio: 0.48 (0.40, 0.59) after adjusting for demographic factors, tumour differentiation, and primary sub-site. Survivals were not found to differ by place of residence, suggesting reasonable equity in service provision. About 74% of cases were treated surgically and this proportion increased over time. Proportions having systemic therapy and/or radiotherapy increased from 12% in 1980-84 to 61% for 2005-10. Radiotherapy was more common for rectal than colonic cases (39% vs 7% in 2005-10). Of the cases diagnosed in 2005-10 when less than 70 years of age, the percentage having radiotherapy and/or systemic therapy was 79% for colorectal, 74% for colon and 86% for rectum (&RS)) cancers. Corresponding proportions having: systemic therapies were 75%, 71% and 81% respectively; radiotherapy were 24%, 10% and 46% respectively; and surgery were 75%, 78% and 71% respectively. Based on survey data on uptake of offered therapies, it is likely that of these younger cases, 85% would have been offered systemic treatment and among rectum (&RS) cases, about 63% would have been offered radiotherapy. Conclusions: Pronounced increases in survivals from metastatic colorectal cancer have occurred, in keeping with improved systemic therapies and surgical interventions. Use of radiotherapy and/or systemic therapy has increased markedly and patterns of change accord with clinical guideline recommendations.

Concurrent Chemoradiation with Weekly Cisplatin for the Treatment of Head and Neck Cancers: an Institutional Study on Acute Toxicity and Response to Treatment

  • Ghosh, Saptarshi;Rao, Pamidimukkala Brahmananda;Kumar, P Ravindra;Manam, Surendra
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.16
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    • pp.7331-7335
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    • 2015
  • Background: Concurrent chemoradiation with three weekly high dose cisplatin is the non-surgical standard of care for the treatment of locally advanced head and neck cancers. Although this treatment regime is efficacious, it has high acute toxicity, which leads not only to increased treatment cost, but also to increased overall treatment time. Hence, the current study was undertaken to evaluate the acute toxicity and tumor response in head and neck cancer patients treated with concurrent chemoradiation using $40mg/m^2$ weekly cisplatin, which has been our institutional practice. Materials and Methods: This single institution retrospective study included data for 287 head and neck cancer patients treated with concurrent chemoradiation from 2012 to 2014. Results: The mean age of the patients was 48.8 years. The most common site of involvement was oral cavity. Most of the study patients presented with advanced stage disease. The mean overall treatment time was 56.9 days. Some 67.2% had overall complete response to treatment as documented till 90 days from the start of treatment. According to the Radiation Therapy Oncology Group (RTOG) acute radiation morbidity scoring criteria, mucositis was seen in 95.1% of the patients. Dermatitis and emesis were observed in 81.9% and 98.6%, respectively. Regarding haematological toxicity, 48.8% and 29.6% suffered from anaemia and leukopenia, respectively, during treatment. Acute kidney injury was assessed using the Common Terminology Criteria for Adverse Events (CTCAE), and was found in 18.8% of the patients. Conclusions: Concurrent chemoradiotherapy with weekly cisplatin is an effective treatment regime for head and neck cancers with reasonable toxicity which can be used in developing countries, where cost of treatment is so important.

Short-course Versus Long-course Preoperative Radiotherapy plus Delayed Surgery in the Treatment of Rectal Cancer: a Meta-analysis

  • Liu, Shi-Xin;Zhou, Zhi-Rui;Chen, Ling-Xiao;Yang, Yong-Jing;Hu, Zhi-De;Zhang, Tian-Song
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.5755-5762
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    • 2015
  • Background: Short-course preoperative radiation (SCRT) with delayed surgery was found to increase pathologic complete response (pCR) rates in several trials. However, there was no clear answer on whether SCRT or long-course chemo-radiotherapy (LCRT) is more effective. Therefore we conducted this meta-analysis to evaluate the safety and efficacy of SCRT versus LCRT, both with delayed surgery, for treatment of rectal cancer. Materials and Methods: The literature was searched from PubMed, EMBASE, Web of Science, Cochrane Library and clinicaltrials.gov up to November, 2014. Quality of the randomized controlled trials (RCTs) was evaluated according to the Cochrane's risk of bias tool of RCT. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was used to rate the level of evidence. Review Manager 5.3 was employed for statistical analysis. Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were calculated. Results: Three RCTs, with a total of 357 rectal cancer patients, were included in this systematic review. Metaanalysis results demonstrated there were no significantly differences in sphincter preservation rate, local recurrence rate, grade 3~4 acute toxicity, R0 resection rate and downstaging rate. Compared with SCRT, LCRT was associated with significant increase in the pCR rate [RR=0.49, 95%CI (0.31, 0.78), P=0.003]. Conclusions: In terms of sphincter preservation rate, local recurrence rate, grade 3~4 acute toxicity, R0 resection rate and downstaging rate, SCRT with delayed surgery is as effective as LCRT with delayed surgery for management of rectal cancer. LCRT significantly increased pCR rate compared with SCRT. Due to risk of bias and imprecision, further multi-center large sample RCTs were needed to confirm this conclusion.

Retrospective analysis of intensity-modulated radiotherapy and three-dimensional conformal radiotherapy of postoperative treatment for biliary tract cancer

  • Lee, Hyo Chun;Lee, Jong Hoon;Lee, Sea-Won;Lee, Joo Hwan;Yu, Mina;Jang, Hong Seok;Kim, Sung Hwan
    • Radiation Oncology Journal
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    • v.37 no.4
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    • pp.279-285
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    • 2019
  • Purpose: This study was conducted to compare the outcome of three-dimensional conformal radiotherapy (3D-CRT) and intensity-modulated radiotherapy (IMRT) for the postoperative treatment of biliary tract cancer. Materials and Methods: From February 2008 to June 2016, 57 patients of biliary tract cancer treated with curative surgery followed by postoperative 3D-CRT (n = 27) or IMRT (n = 30) were retrospectively enrolled. Results: Median follow-up time was 23.6 months (range, 5.2 to 97.6 months) for all patients and 38.4 months (range, 27.0 to 89.2 months) for survivors. Two-year recurrence-free survival is higher in IMRT arm than 3D-CRT arm with a marginal significance (25.9% vs. 47.4%; p = 0.088). Locoregional recurrence-free survival (64.3% vs. 81.7%; p = 0.122) and distant metastasis-free survival (40.3% vs. 55.8%; p = 0.234) at two years did not show any statistical difference between two radiation modalities. In the multivariate analysis, extrahepatic cholangiocarcinoma, poorly-differentiated histologic grade, and higher stage were significant poor prognostic factors for survival. Severe treatment-related toxicity was not significantly different between two arms. Conclusions: IMRT showed comparable results with 3D-CRT in terms of recurrence, and survival, and radiotherapy toxicity for the postoperative treatment of biliary tract cancer.

Situation of HPV16 E2 Gene Status During Radiotherapy Treatment of Cervical Carcinoma

  • Kahla, Saloua;Kochbati, Lotfi;Maalej, Mongi;Oueslati, Ridha
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.6
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    • pp.2869-2873
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    • 2014
  • Background: Human papillomavirus (HPV) integration within the E2 gene has been proposed as a critical event in cervical carcinogenesis. This study concerned whether HPV16 status and E2 gene intactness are predictive of radiation response in patients with cervical cancer. Materials and Methods: Biopsies of 44 patients with cervical cancer were collected before or after radiotherapy. The presence of HPV16 was assessed by polymerase chain reaction (PCR) using specific primers for the L1 region. E2 disruption was detected by amplifying the entire E2 gene. Results: HPV16 DNA was found in 54.5% of the clinical samples. Overall, 62.5% of the HPV16 positive tumors had integrated viral genome and 37.5% had episomal genome. There was a tendency of increase of HPV16 E2 negative tumors compared with HPV16 L1 ones in advanced stages (75% versus 20% in stage III respectively). Detection of E2 gene appeared influenced by the radiotherapy treatment, as the percentage of samples containing an intact HPV16 E2 was more frequent in pretreated patients compared to radiotherapy treated patients (66.6% versus 20%). The radiation therapy caused an eight-fold [OR= 8; CI=1.22-52.25; p=0.03] increase in the risk of HPV16 genome disruption. The integration status is influenced by the irradiation modalities, interestingly E2 disruption being found widely after radiotherapy treatment (75%) with a total fractioned dose of 50Gy. Conclusions: This study reveals that the status of the viral DNA may be used as a marker to optimize the radiation treatment.

Radiotherapy for Benign Diseases (양성질환의 방사선치료)

  • Choi, Sang Gyu
    • Journal of the Korean Society of Radiology
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    • v.10 no.8
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    • pp.611-618
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    • 2016
  • Radiotherapy, as a major 3 standard treatment for cancer, traditionally it has been useful treatment that aim of curative or palliative setting. In addition to some proliferative or inflammatory benign disease are also included in field of radiotherapy. Unlike cancer, in the case of benign disease, it shows good treatment result from usage of some medication, conservative management or surgery. But if fail of these treatment or impossible, low dose radiotherapy is use adjuvant or replacement treatment so that there are no harmful side effect result in safety and easy management for reduce pain or recurrence. Recently, the technical advances in radiotherapy that have been achieved make preservation of normal tissue and the clinical application of high precision radiotherapy focus to selective lesions is possible, and it makes useful treatment in senile patients especially.

Clinical outcome of high-dose-rate interstitial brachytherapy in patients with oral cavity cancer

  • Lee, Sung Uk;Cho, Kwan Ho;Moon, Sung Ho;Choi, Sung Weon;Park, Joo Yong;Yun, Tak;Lee, Sang Hyun;Lim, Young Kyung;Jeong, Chi Young
    • Radiation Oncology Journal
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    • v.32 no.4
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    • pp.238-246
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    • 2014
  • Purpose: To evaluate the clinical outcome of high-dose-rate (HDR) interstitial brachytherapy (IBT) in patients with oral cavity cancer. Materials and Methods: Sixteen patients with oral cavity cancer treated with HDR remote-control afterloading brachytherapy using $^{192}Ir$ between 2001 and 2013 were analyzed retrospectively. Brachytherapy was administered in 11 patients as the primary treatment and in five patients as salvage treatment for recurrence after the initial surgery. In 12 patients, external beam radiotherapy (50-55 Gy/25 fractions) was combined with IBT of 21 Gy/7 fractions. In addition, IBT was administered as the sole treatment in three patients with a total dose of 50 Gy/10 fractions and as postoperative adjuvant treatment in one patient with a total of 35 Gy/7 fractions. Results: The 5-year overall survival of the entire group was 70%. The actuarial local control rate after 3 years was 84%. All five recurrent cases after initial surgery were successfully salvaged using IBT ${\pm}$ external beam radiotherapy. Two patients developed local recurrence at 3 and 5 months, respectively, after IBT. The acute complications were acceptable (${\leq}grade$ 2). Three patients developed major late complications, such as radio-osteonecrosis, in which one patient was treated by conservative therapy and two required surgical intervention. Conclusion: HDR IBT for oral cavity cancer was effective and acceptable in diverse clinical settings, such as in the cases of primary or salvage treatment.