• Title/Summary/Keyword: Conservative surgery and radiation

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Conservative Surgery of Hypopharyngeal Cancer and Intraoperative Radiation Therapy of Neck Recurrence (하인두암의 보존적 수술과 경부 재발의 술중방사선치료 치험 1예)

  • Cho, Woo-Sung;Kim, Yang-Soo;Kim, Moo-Pil;Baek, Seung-Kuk;Jung, Kwang-Yoon
    • Korean Journal of Head & Neck Oncology
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    • v.23 no.2
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    • pp.181-184
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    • 2007
  • Hypopharyngeal cancer usually has invasiveness to adjacent tissue and frequent metastasis to cervical lymph node. In addition, because it often accompanies submucosal extension and second primary malignancy, the sacrifice of larynx and postoperative radiation therapy had been performed in the past. However, it has been reported that conservative surgery of hypopharyngeal cancer show good functional and oncologic outcome according to the development of diagnostic tool and reconstructive technique. We report a case of hypopharyngeal cancer that received conservative surgery followed radiation therapy and intraoperative radiation therapy for neck recurrence.

Phase II Study on Breast Conservative Surgery Plus Chemo- and Radiotherapy in Treating Chinese Patients with Early Staged Breast Cancer

  • Liu, Yang-Chen;Zhou, Shao-Bing;Gao, Fei;Yin, Xiao-Xiang;Zhao, Ying;Huang, Xin-En
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.6
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    • pp.3747-3750
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    • 2013
  • Purpose: To evaluate the efficacy of conservative surgery plus chemo-, radio-therapy in treating patients with early stage breast cancer. Patients and Methods: Eligible patients were treated by postoperative chemotherapy as well as whole-breast irradiation with tumor bed boost. Postoperative radiotherapy consisted of 6 MV whole breast linear accelerator irradiation with two tangential half fields to a total dose of 45~50 Gy, followed by $10{\sim}15MeV{\beta}$ boost irradiation to tumor bed for 10~20Gy, total dose 56~66Gy. Results: Fifty-two patients were enrolled. Overall 1-, 2- and 3 year survival rates were 98.1%, 92.3%, and 90.4%, respectively, with a local recurrence rate of 5.77%. Cosmetic results were evaluated as good by doctors in 90.4% of patients. Conclusions: Breast conservative surgery combined with chemo- radio-therapy could be a treatment option for Chinese patients with early stage breast cancer.

The Role of Conservative Surgery and Radiation Therapy for the Extremity Soft Tissue Sarcomas (사지 악성 육종에서 보존적 수술후 방사선 치료의 역할)

  • Kim Woo Cheol;Suh Chang Ok;Kim Gwi Eon;Park Kwang Hwa;Shin Dong-Hwan;Lee Kyung Hee
    • Radiation Oncology Journal
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    • v.11 no.2
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    • pp.411-419
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    • 1993
  • A total of 44 patients with extremity soft tissue sarcomas had received conservative surgery and radiation therapy in the Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine between Jan. 1980 and Dec. 1990. Initial surgical treatment consisted of intracapsular excision in 33 patients $(75\%),$ marginal excision in 9 patients, and wide excision in two patients. Total radiation doses were between 40Gy and 65Gy (median 60 Gy). Median follow-up period was 47 months. Overall actuarial 5-year survival rate was $76.9\%$ and 5-year recurrence free survival rate was $39.3\%.$ There was no statistically significant prognostic factors but the 5-year survival rates tended to be decreased in the patients with high grade tumors and treated with narrow surgical extent. Sixteen patients recurred during fellow-up (16/31, $51.6\%).$ The incidence of initial local recurrence was $22.6\%$ (7/31) and distant metastasis was $29\%(9/31).$ Of the 7 who did not have metastasis at diagnosis of local recurrence, 5 were submitted to a salvage treatment. All of them achieved local control and distant metastasis appeared in three of them. In conclusion, conservative surgery and radiation therapy in the patients with extremity soft tissue sarcomas was the effective treatment modality.

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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.

Radical Radiotherapy with Lumpectomy (wide excisional biopsy) for Early Breast Cancer -A Case Report and Review of Literature- (초기 유방함의 근치적 방사선치료)

  • Oh, Won-Young;Whang, In-Soon
    • Radiation Oncology Journal
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    • v.6 no.2
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    • pp.283-288
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    • 1988
  • However, long-term results of retrospective studies suggest that, for the great majority of individuals, mastectomy or conservative surgery with radiation therapy were be equally effective. The results at 5 and 10 years from prospective randomized trials indicate that survival following primary radiation therapy for early breast cancer is equivalent to that fellowing mastectomy. When competently Performed, Primary radiation therapy gives highly satisfactory cosmetic results and acceptably low rates of local tumor recurrence. A number of controversial issues remain concerning patient evaluation and selection and the optimal techniques of treatment, both surgical and radiotherapeutic. In addition, further work is needed to clearity the best way to integrate primary radiotherapy with adjuvant systemic treatment. And further follow-up of these patients with primary radiation therapy for early beast cancer will be required for ultimate proof of the relative merits. A case which was conservative surgery and radical irradiation of early breast cancer with review of literatures will be done.

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Survey for the Side effects of Radiation Therapy Following Breast Cancer Surgery : Comparision of Modified Raidcal Mastectomy and Breast Conservative Surgery (유방암 환자의 수술후 방사선치료의 부작용의 변화 : 유방절제술과 유방보존술의 비교)

  • Chon, Myong-Hui
    • Journal of Haehwa Medicine
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    • v.5 no.2
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    • pp.473-484
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    • 1997
  • This study was performed to survey the specific information about the time of onset, frequency, duration, and severity of the side effect of radiation therapy following breast cancer surgery, and identify the difference of these data according to the type of breast cancer surgery : modified radical mastectomy(MRM) vs. breast consevative operation(BCO). 38 breast cancer patients were interviewed with side effect profile about radiation therapy. Interview was done weekley from the start of radiation therapy through 6 weeks and 3 month follow-up interview was done at 3 month after completion of the treatment. The results are as follow : 1. Total score of side effect experienced by the breast cancer patients was rapidly increased at 2-3 week after intiating treatement and continousely raised maintaing high score until completion of the treatement. Some problems like cough, dyspnea and pain were more experienced after treatment. 2. Patients with modified radical mastectomy showed more total score of side effects than patients with breast conservative operation. And both patients with MRM and BCO experienced similar pattern of side effect to radiation therapy. Through these data we concluded that side effect to radiation therapy was not ended at completion of treatement. Patents will continously experiend various problems and suffer from not only acute side effects like skin problem, sore throat and swollowing difficulty but also late effect of the radiation therapy. Clinically these data can be used for oncologic nurse to provide informational interventions to prepare breast cancer patients for the radiation therapy.

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V-Y Latissimus Dorsi Musculocutaneous Flap for Reconstruction of Radiation-induced Skin Injuries on the Back (V-Y 광배근피판을 이용한 등의 방사선 유발 피부 손상의 치험)

  • Shim, Seung-Hyun;Chung, Chul-Hoon;Kim, Kuyl-Hee
    • Archives of Plastic Surgery
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    • v.38 no.5
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    • pp.707-710
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    • 2011
  • Purpose: Cardiac radiofrequency catheter ablation procedures using fluoroscopy were performed for the treatment of supraventricular and selected ventricular tachyarrhythmia. Fluoroscopy is used to localize the position of the intracardiac catheter. Fluoroscopically-guided procedures often involve high radiation doses to patient's skin, but the incidence of serious radiation injuries in these patients is rare. We reported two cases of severe postradiation skin injury on the back treated with the V-Y latissimus dorsi musculocutaneous flap. Methods: These two patients underwent radiofrequency catheter ablation under the diagnosis of Woff Parkinson White syndrome (WPW syndrome). They had radiation-induced skin injuries on the subscapular area and these lesions represented chronic ulceration, surrounding induration, hardness, and dyspigmentation. We treated these lesions with complete excision and coverage with V-Y latissimus dorsi musculocutaneous flap. Results: These two patients had no recurrence and no special complications during 20 months and 12 months follow-up periods and were satisfied aesthetically and functionally. Conclusion: V-Y latissimus dorsi musculocutaneous flap obtained better results functionally and aesthetically compared with conservative management and skin graft in severe radiation-induced skin injuries after cardiac radiofrequency catheter ablation procedure.

Impact of dental imaging on pregnant women and recommendations for fetal radiation safety: A systematic review

  • Thiago Oliveira Gamba;Fernanda Visioli;Deise Renata Bringmann;Pantelis Varvaki Rados;Heraldo Luis Dias da Silveira;Isadora Luana Flores
    • Imaging Science in Dentistry
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    • v.54 no.1
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    • pp.1-11
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    • 2024
  • Purpose: This study was conducted to investigate the safety of dental imaging in pregnant women with respect to fetal health. Materials and Methods: Searches were conducted of the PubMed, Scopus, and Web of Science databases in May 2023. The inclusion criteria encompassed cross-sectional and longitudinal studies that focused on the analysis of diagnostic dental imaging in pregnant women, as well as studies utilizing phantoms to simulate imaging examinations. The exclusion criteria consisted of reviews, letters to the editor, book chapters, and abstracts from scientific conferences and seminars. Results: A total of 3,913 articles were identified. Based on a review of the titles and abstracts, 3,892 articles were excluded, leaving 21 articles remaining for full-text review. Of these, 18 were excluded, and 4 additional articles were included as cross-references. Ultimately, 7 articles underwent quantitative-qualitative analysis. Three retrospective studies were focused on pregnant women who underwent dental imaging procedures. The remaining 4 studies utilized female phantoms to simulate imaging examinations and represent the radiation doses absorbed by the uterus or thyroid. Conclusion: Few dental radiology studies have been conducted to determine the safe radiation threshold for pregnant women. Additionally, the reviewed articles did not provide numbers of dental examinations, by type, corresponding to this dose. Dental imaging examinations of pregnant women should not be restricted if clinically indicated. Ultimately, practitioners must be able to justify the examination and should adhere to the "as low as diagnostically acceptable, being indication-oriented and patient-specific" (ALADAIP) principle of radioprotection.

THE INFECTION CONTROL METHOD FOR EARLY RADIATION THERAPY IN THE HEAD & NECK CANCER PATIENTS WITH ADVANCED ODONTOGENIC INFECTIOUS LESIONS : REPORT OF CASES (진행성 치성감염 병소들을 가진 두경부 악성종양 환자에서 조기 방사선치료를 위한 치성감염 조절법 : 증례보고)

  • Yoo, Jae-Ha;Lee, Jong-Young;Chung, Won-Gyun;Kim, Young-Nam;Jang, Sun-Ok;Jeon, Hyun-Sun;Kim, Jong-Bae;Nam, Ki-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.2
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    • pp.168-173
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    • 2006
  • The side effects of head and neck radiation therapy include mucositis, xerostomia, loss of taste, radiation caries, oral infection, osteoradionecrosis and trismus. When a patient is arranged to begin head & neck radiotherapy, oral pathologic lesions are examined and managed for the prevention of oral complications. The advanced odontogenic infection should be especially controlled before the radiotherapy and the patient must be instructed for proper oral prophylaxis. Generally the more conservative treatments, such as, scaling, restoration, endodontic treatment, are the care of choice and dental extraction is performed in advanced periapical and periodontal pathologic conditions. If the dental extraction should be done, the radiotherapy consequently will be delayed until there is epithelium covering the extraction socket, leaving no exposed bone. The cancer patient with severe emotional stress pray for the early radiation therapy, in spite of possibility of the recurrent odontogenic infectious lesions. So, the authors attempted to do the early radiation therapy by the conservative endodontic drainage and surgical incision & drainage without extraction of the infected teeth, and resulted in relatively good prognosis without the severe side effects of head and neck radiotherapy.

Conservative Treatment of Lymphedema (임파부종 환자의 보존적 치료법)

  • Kim, Sung-Jung;Hwang, Ji-Hye
    • Physical Therapy Korea
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    • v.6 no.1
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    • pp.62-73
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    • 1999
  • The purpose of this article was to provide basic knowledge and treatment principles of patient with lymphedema, which was usually not treated at all, or the treatment given didn't work efficiently. Lmphedema is defined as an abnormal accumulation of protein-rich fluid, edema, and chronic inflammation within an extremity. Lmphedema may be classified as either primary results from defects with aplasia, hypoplasia, and hyperplasia in the lymphatic system at birth or secondary is caused by known precipitating factors such as cancer, infection, inflammation, radiation, surgery, or trauma etc. There are essentially several conservative treatment methods which has been utilized successfully to treat lymphedema in Samsung Medical Center. We used following procedures: CPT (Complex Physical therapy) or CDP (Complex Decongesitive Physical therapy) such as skin care, MLD (Manual Lymph Drainage), compression with short-stretch bandage, exercise, elevation, elastic stocking, and pneumatic compression. Our experiences shows that conservative treatments can significantly reduce lymphedema and prevent different complications.

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