• Title/Summary/Keyword: External radiotherapy

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The Results of Combined External Radiotherapy and Chemotherapy in the Management of Esophageal Cancer (식도암의 방사선-항암화학 병용치료결과)

  • Lee Hyun Joo;Suh Hyun Suk;Kim Jun Hee;Kim Chul Soo;Kim Sung Rok;Kim Re Hwe
    • Radiation Oncology Journal
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    • v.14 no.1
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    • pp.17-23
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    • 1996
  • Purpose : To evaluate the role of combination therapy of external radio-therapy and chemotherapy in the management of advanced esophageal cancer as a primary treatment compared with radiation therapy alone. Materials and Methods : A retrospective review of evaluable 55 esophageal cancer patients referred to the Department of Therapeutic Radiology, Paik Hospital for the external radiotherapy between Jul, 1983 and Dec. 1994 was undertaken. Combined therapy patients (A group) were 30 and radiation alone patients (B group) were 25. Median age was 60 years old in A group (ranges : 42-81) and 65 years old in B group (ranges : 50-81). The male patients were 53. The fifty patients had squamous cell carcinomas. Radiation doses of 2520-6480c0y were delivered over a period of 4-7weeks, using 4MV LINAC. Chemotherapy was administered in bolus injection before, after, or during the course of external radiotherapy. The local control rate and patterns of failure according to both treatment modalities and 1, 2 year survival rates according to prognostic factors (stage, tumor length, radiation dose etc.) were analysed. Resuts : Median follow up Period was 7 months (range : 2-73 months). Median survival was 7.5 months (20 days-29 months) in A group and 5 months (20 days-73 months) in B group. The 1, 2 YSRs were $26.7\%$, $8.9\%$ in A group, $12.7\%$, $4.3\%$ in B group (p>0.05), respectively. The 1, 2 YSRs according to stage(II/III), tumor length (5cm more or less). radiation dose (5000cGymore or less) of A and B group were analyzed and the differences of survival rates of both treatments were not statistically significant. But among group B, patients who received 5000cGy or more showed significant survival benefits (p<0.05). The treatment response rates of A and B group were $43.8\%$. $25.0\%$, respectively. Complete response rate of $25.0\%$ in A and $8.3\%$ in B were achieved. The local failure and distant metastsis were $52.4\%$. $23.8\%$ in A group, $64.3\%$, $14.3\%$ in 8 group, respectively. The combination therapy revealed more frequent leukopenia and nausea/vomiting than radiation alone group, but degree of side effects was only mild to moderate. Conclusion : The combined external radiotherapy and chemotherapy for advanced esophageal cancer appears to improve the response rate, local control rate and survival rate, but the improvement was not statistically significant. The side effects of combined modalities were mild to moderate without significant morbidity. Therefore it may be worthwhile to continue the present combined external radiotherapy and chemotherapy in the management of advanced esophageal cancer to confirm our result.

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Nonfunctional Parathyroid Carcinoma: A Case Report (비기능성 부갑상선암: 증례 보고)

  • Choi, Sang-Gyu
    • Radiation Oncology Journal
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    • v.28 no.2
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    • pp.111-116
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    • 2010
  • Parathyroid carcinoma is a rare endocrine malignancy accounting for 0.5% to 4.0% of all cases of hyperparathyroidism and commonly present as hypercalcemia and parathyroid hormone (PTH) elevation. Nonfunctional parathyroid carcinoma does not show symptoms of hyperparathyroidism and only showed a vague indication of being pathologic, even when detected late. The optimal treatment is en bloc resection of the cancer, but frequent local recurrence after surgery has been reported. Adjuvant local treatment such as radiotherapy may improve the likelihood local control in cases with incompletely resected or microscopic residual tumor. The results of this study point to a case of nonfunctional parathyroid carcinoma treated by external beam radiotherapy after en-bloc resection of cancer.

A Randomized Controlled Trial Comparing Clinical Outcomes and Toxicity of Lobaplatin- Versus Cisplatin-Based Concurrent Chemotherapy Plus Radiotherapy and High-Dose-Rate Brachytherapy for FIGO Stage II and III Cervical Cancer

  • Wang, Ji-Quan;Wang, Tao;Shi, Fan;Yang, Yun-Yi;Su, Jin;Chai, Yan-Lan;Liu, Zi
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.14
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    • pp.5957-5961
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    • 2015
  • Background: We designed this randomized controlled trial (RCT) to assess whether lobaplatin-based concurrent chemotherapy might be superior to cisplatin-based concurrent chemotherapy for FIGO stage II and III cervical cancer in terms of efficacy and safety. Materials and Methods: This prospective, open-label RCT aims to enroll 180 patients with FIGO stage II and III cervical cancer, randomly allocated to one of the three treatment groups (cisplatin $15mg/m^2$, cisplatin $20mg/m^2$ and lobaplatin $35mg/m^2$), with 60 patients in each group. All patients will receive external beam irradiation (EBRT) and high-dose-rate intracavitary brachytherapy (HDR-ICBT). Patients in cisplatin $15mg/m^2$ and $20mg/m^2$ groups will be administered four cycles of $15mg/m^2$ or $20mg/m^2$ cisplatin intravenously once weekly from the second week to the fifth week during EBRT, while patients inthe lobaplatin $35mg/m^2$ group will be administered two cycles of $35mg/m^2$ lobaplatin intravenously in the second and fifth week respectively during pelvic EBRT. All participants will be followed up for at least 12 months. Complete remission rate and progression-free survival (PFS) will be the primary endpoints. Overall survival (OS), incidence of adverse events (AEs), and quality of life will be the secondary endpoints. Results: Between March 2013 and March 2014, a total of 61 patients with FIGO stage II and III cervical cancer were randomly assigned to cisplatin $15mg/m^2$ group (n=21), cisplatin $20mg/m^2$ group (n=21) and lobaplatin $35mg/m^2$ group (n=19). We conducted a preliminary analysis of the results. Similar rates of complete remission and grades 3-4 gastrointestinal reactions were observed for the three treatment groups (P=0.801 and 0.793, respectively). Grade 3-4 hematologic toxicity was more frequent in the lobaplatin group than the cisplatin group. Conclusions: This proposed study will be the first RCT to evaluate whether lobaplatin-based chemoraiotherapy will have beneficial effects, compared with cisplatin-based chemoradiotherapy, on complete remission rate, PFS, OS, AEs and quality of life for FIGO stage II and III cervical cancer.

Meningeal Hemangiopericytoma : Study of 6 Cases and Review of the Literatures

  • Kim, Jong-Hyun;Kwon, Taek-Hyun;Kim, Joo-Han;Park, Youn-Kwan;Chung, Yong-Gu;Chung, Heung-Seob
    • Journal of Korean Neurosurgical Society
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    • v.39 no.1
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    • pp.32-35
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    • 2006
  • Objective : Hemangiopericytoma is known as a malignant tumor originating from pericytes and rarely occurs in the central nervous system. We present 6 cases of pathologically confirmed meningeal hemangiopericytoma. Methods : Retrospective study was done based on patient's recordings including radiological studies. Each case of tumors was treated surgically and postoperative radiotherapy was done. Results : There were 5 cases of intracranial and 1 case of spinal hemangiopericytomas. Three of 5 intracranial hemangiopericytomas were located at tentorial region. Total tumor removal was done in 4 cases and postoperative local recurrence (or regrowth) was noted in 3 cases despite of postoperative external radiation therapy, 2 of which had died. Conclusion : Our cases show more frequent tentorial locations and poor clinical outcomes of hemangiopericytomas compared with meningiomas.

Dexmedetomidine for Repeated Sedation in Pediatric Sedation During Consecutive Radiation Therapy

  • Kim, Eun-Jung;Baek, Seung-Hoon;Byeon, Gyeong-Jo;Woo, Mi-Na
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.14 no.4
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    • pp.221-225
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    • 2014
  • External beam radiotherapy (EBRT) causes anxiety and claustrophobia in pediatric patients. To provide exact figures and radiation amounts, an appropriate sedation or anesthesia can be supplied. Alpha 2 agonist dexmedetomidine has been used for sedation and anesthesia in pediatric imaging. Dexmedetomidine has an advantage because it has minimal respiratory depression and no direct effects on myocardial function. We report repeated sedation with dexmedetomidine for 33 consecutive radiation therapies in 5 years old children.

Design of Multipurpose Phantom for External Audit on Radiotherapy

  • Lim, Sangwook
    • Progress in Medical Physics
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    • v.32 no.4
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    • pp.122-129
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    • 2021
  • Purpose: This study aimed to design a multipurpose dose verification phantom for external audits to secure safe and optimal radiation therapy. Methods: In this study, we used International Atomic Energy Agency (IAEA) LiF powder thermoluminescence dosimeter (TLD), which is generally used in the therapeutic radiation dose assurance project. The newly designed multipurpose phantom (MPP) consists of a container filled with water, a TLD holder, and two water-pressing covers. The size of the phantom was designed to be sufficient (30×30×30 cm3). The water container was filled with water and pressed with the cover for normal incidence to be fixed. The surface of the MPP was devised to maintain the same distance from the source at all times, even in the case of oblique incidence regardless of the water level. The MPP was irradiated with 6, 10, and 15 MV photon beams from Varian Linear Accelerator and measured by a 1.25 cm3 ionization chamber to get the correction factors. Monte Carlo (MC) simulation was also used to compare the measurements. Results: The result obtained by MC had a relatively high uncertainty of 1% at the dosimetry point, but it showed a correction factor value of 1.3% at the 5 cm point. The energy dependence was large at 6 MV and small at 15 MV. Various dosimetric parameters for external audits can be performed within an hour. Conclusions: The results allow an objective comparison of the quality assurance (QA) of individual hospitals. Therefore, this can be employed for external audits or QA systems in radiation therapy institutions.

Radiotherapy Results of Early Uterine Cervix Cancer (초기 자궁경부암의 방사선치료 성적)

  • Choi, Doo-Ho;Huh, Seung-Jae
    • Radiation Oncology Journal
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    • v.14 no.1
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    • pp.33-39
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    • 1996
  • Purpose : This study was done to analyze survivals, patterns of failure, and complications of early uterine cervix cancer after curative radiotherapy. Materials and Methods : Eighty patients with uterine cervix cancer FIGO Stage IB (48 cases) and Stage IIA (32 cases) treated with radiotherapy were analyzed retrospectively. Patients were treated from November 1985 to May 1993, and minimum follow up period was 24 months and 6 cases were lost to follow up. All of them were treated with external radiotherapy and different fractions of high dose rate intracavitary radiotherapy, Survival rates, failure patterns, complication rates and degrees of severity were analyzed according to several factors. Results : Overall 5 year survival rate and relapse free survival rate were $72.3\%$, and $72.8\%$ respectively. Prognostic factors were stage, size, pathology, RT response and there was no significant survival difference among the reasons of radiotherapy choice. There were 19 cases of treatment failure, another 3 cases were not tumor related death, and most of treatment related failure occurred within 24 months Late complication rate of bladder and rectum were $8.8\%,\;15\%$ respectively, frequency and severity of complication were correlated with ICR fractionation dose and total dose. Conclusion : These results showed that survival rates of early stage radiation treated cervix cancer patients were comparable to surgical series, but more aggressive treatment methods needed for stage IIA poor prognostic patients. To decrease late complication, choice of proper ICR dose and meticulous vaginal packing is needed.

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Development of Dose Verification Method for In vivo Dosimetry in External Radiotherapy (방사선치료에서 투과선량을 이용한 체내선량 검증프로그램 개발)

  • Hwang, Ui-Jung;Baek, Tae Seong;Yoon, Myonggeun
    • Progress in Medical Physics
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    • v.25 no.1
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    • pp.23-30
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    • 2014
  • The purpose of this study is to evaluate the developed dose verification program for in vivo dosimetry based on transit dose in radiotherapy. Five intensity modulated radiotherapy (IMRT) plans of lung cancer patients were used in the irradiation of a homogeneous solid water phantom and anthropomorphic phantom. Transit dose distribution was measured using electronic portal imaging device (EPID) and used for the calculation of in vivo dose in patient. The average passing rate compared with treatment planning system based on a gamma index with a 3% dose and a 3 mm distance-to-dose agreement tolerance limit was 95% for the in vivo dose with the homogeneous phantom, but was reduced to 81.8% for the in vivo dose with the anthropomorphic phantom. This feasibility study suggested that transit dose-based in vivo dosimetry can provide information about the actual dose delivery to patients in the treatment room.

Chromosomal Aberration in Fractionated Radiotherapy (전골반 방사선 분할 조사시 방사선량에 따른 염색체이상 빈도의 변화 양상)

  • Yun, Hyong-Geun;Ha, Sung-Sung
    • Radiation Oncology Journal
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    • v.16 no.2
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    • pp.115-123
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    • 1998
  • Purpose : This study was tried to evaluate the effect of the partial body fractionated irradiation on the frequency of chromosomal aberration. Materials and Methods : In three patients with uterine cervix carcinoma, chromosomal aberrations were analyzed during fractionated external beam radiotherapy Radiation field included whole pelvis and total dose was 5040 cGy in 28 fractions. Results : The values of the frequency of dicentrics and rings (Ydr) in pre-irradiated peripheral lymphocytes in three patients were 0.0060, 0.0000, and 0.0029, respectively. The frequency of dicentrics and rings, estimated during the course of radiotherapy, increased with radiation dose and best fitted to the linear equation, $Ydr=7.31{\times}10^{-5}D(cGy)+1.45{\times}10^{-2}$. The frequency of dicentrics and rings among the cells with dicentric and/or ring(Qdr) also showed increasing tendency and best fitted to the linear equation, $Qdr=1.01{\times}10^{-4}D(cGy)+1.04$. Conclusion : Ydr increased linearly with radiation dose in the dose range of our study, and Qdr showed increasing tendency with dose.

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