• Title/Summary/Keyword: Radiation oncology practice

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Application of radiotherapy for hepatocellular carcinoma in current clinical practice guidelines

  • Rim, Chai Hong;Seong, Jinsil
    • Radiation Oncology Journal
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    • v.34 no.3
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    • pp.160-167
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    • 2016
  • In oncologic practice, treatment guidelines provide appropriate treatment strategies based on evidence. Currently, many guidelines are used, including those of the European Association for the Study of the Liver and European Organization for Research and Treatment of Cancer (EASL-EORTC), National Comprehensive Cancer Network (NCCN), Asia-Pacific Primary Liver Cancer Expert (APPLE), and Korean Liver Cancer Study Group and National Cancer Centre (KLCSG-NCC). Although radiotherapy is commonly used in clinical practice, some guidelines do not accept it as a standard treatment modality. In this review, we will investigate the clinical practice guidelines currently used, and discuss the application of radiotherapy.

Computerization of Radiation Oncology Practice Using Order-Communicating System (처방전달 시스템을 이용한 방사선종양학과 진료업무의 전산화)

  • Shin, Sei-One;Yei, Ji-Won
    • Journal of Yeungnam Medical Science
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    • v.13 no.1
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    • pp.97-109
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    • 1996
  • Recently there has been attempts to develop hospital information system including order communicating system, patient tracing system, tumor registry system, office automation system and picture archiving and communication system(PACS). The authors devloped a practical system that was operated via order communication system of Yeungnam University Hospital. The system provided us the speed, accuracy, reliability, retention, economy and wide applicability through practical test. So we believed that this system would be one of standard computerized programs in radiation oncology practice and providing widely usable data for clinical statistics, medical record, tumor registry system and clinical researches.

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Hypofractionated whole breast irradiation: new standard in early breast cancer after breast-conserving surgery

  • Kim, Kyung Su;Shin, Kyung Hwan;Choi, Noorie;Lee, Sea-Won
    • Radiation Oncology Journal
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    • v.34 no.2
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    • pp.81-87
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    • 2016
  • Hypofractionated whole breast irradiation (HF-WBI) has been proved effective and safe and even better for late or acute radiation toxicity for early breast cancer. Moreover, it improves patient convenience, quality of life and is expected to be advantageous in the medical care system by reducing overall cost. In this review, we examined key randomized trials of HF-WBI, focusing on adequate patient selection as suggested by the American Society of Therapeutic Radiology and Oncology (ASTRO) guideline and the radiobiologic aspects of HF-WBI in relation to its adoption into clinical settings. Further investigation to identify the current practice pattern or cost effectiveness is warranted under the national health insurance service system in Korea.

Stereotactic radiotherapy for early stage non-small cell lung cancer

  • Ricardi, Umberto;Badellino, Serena;Filippi, Andrea Riccardo
    • Radiation Oncology Journal
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    • v.33 no.2
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    • pp.57-65
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    • 2015
  • Stereotactic body radiotherapy (SBRT) represents a consolidated treatment option for patients with medically inoperable early stage non-small cell lung cancer (NSCLC). The clinical evidence accumulated in the past decade supports its use as an alternative to surgery with comparable survival outcomes. Due to its limited toxicity, SBRT is also applicable to elderly patients with very poor baseline pulmonary function or other severe comorbidities. Recent comparative studies in operable patients raised the issue of the possible use of SBRT also for this subgroup, with quite promising results that still should be fully confirmed by prospective trials with long-term follow-up. Aim of this review is to summarize and discuss the major studies conducted over the years on SBRT and to provide data on the efficacy and toxicity of this radiotherapy technique for stage I NSCLC. Technical aspects and quality of life related issues are also discussed, with the goal to provide information on the current role and limitations of SBRT in clinical practice.

Contemporary treatment with radiosurgery for spine metastasis and spinal cord compression in 2015

  • Ryu, Samuel;Yoon, Hannah;Stessin, Alexander;Gutman, Fred;Rosiello, Arthur;Davis, Raphael
    • Radiation Oncology Journal
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    • v.33 no.1
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    • pp.1-11
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    • 2015
  • With the progress of image-guided localization, body immobilization system, and computerized delivery of intensity-modulated radiation delivery, it became possible to perform spine radiosurgery. The next question is how to translate the high technology treatment to the clinical application. Clinical trials have been performed to demonstrate the feasibility of spine radiosurgery and efficacy of the treatment in the setting of spine metastasis, leading to the randomized trials by a cooperative group. Radiosurgery has also demonstrated its efficacy to decompress the spinal cord compression in selected group of patients. The experience indicates that spine radiosurgery has a potential to change the clinical practice in the management of spine metastasis and spinal cord compression.

Gonadotrophin Releasing Hormone Analogues for Ovarian Function Preservation in Young Females Undergoing Chemotherapy

  • Bansal, Anshuma;Patel, Firuza Darius;Rai, Bhavana;Dhanireddy, Bhaswanth;Sharma, Suresh Chand
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.2185-2190
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    • 2014
  • Chemotherapy has significantly improved the prognosis of cancer patients with various malignancies. However, female patients, especially those whoich are premenopausal, suffer from significant chemotherapy induced ovarian function impairment, which decreases their quality of life. Many new techniques for ovarian preservation have been established in recent years. Although the use of gonadotrophin releasing hormone analogues (GnRHa) for this purpose is not a new concept, its effectiveness in protection of ovarian function is still debatable. This article deals with studies and metaanalyses which have been undertaken in the past, demonstrating the impact of GnRHa in ovarian function preservation, and whether their use can be implemented in routine practice.

Effects of Millimetric Shifts in Breast Cancer Radiotherapy on the Radiation Dose Distribution

  • Sanli, Yusuf Tolga;Cukurcayir, Funda;Abacigil, Fatma
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.1197-1199
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    • 2016
  • Background: This study aimed to facilitate decision-making in cases of breast cancer radiotherapy shifts by simulating millimetric shifts and analyzing their effects on dose distribution. Methods: The study included 30 patients with left side breast cancer who were treated with three dimensional conformal radiotherapy (3D-CRT) in the Radiation Oncology Department in Hatay Public Hospital, between January 2013 and April 2015. A treatment plan shifting at three axes with six different measures was simulated. Results: The biggest difference in values was (+3mm shift) 476cGy, with a 7.7 % change for heart and 25.6% for spinal cord. The shifts in values respectively for CTV min, mean, max were -4.8%, 2.5%, 4%. The differences for lymphatic min, mean, max were 21.3%, 20.3%, -12.2%. Conclusion: The most important thing is not the treatment plan quality, but its practicality. The treatment plan must be practical and its practice must be controlled rigidly.

Minimization of Treatment Time Using Partial-Arc Volumetric Modulated Arc Therapy with Bladder Filling Protocol for Prostate Cancer

  • Hojeong Lee;Dong Woon Kim;Ji Hyeon Joo;Yongkan Ki;Wontaek Kim;Dahl Park;Jiho Nam;Dong Hyeon Kim;Hosang Jeon
    • Progress in Medical Physics
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    • v.33 no.4
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    • pp.101-107
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    • 2022
  • Purpose: Radiotherapy after bladder filling protocol (BFP) is known to enhance treatment quality and reduce side effects in prostate cancer, a common male solid cancer globally. However, due to the need to hold back urine during treatment, patients frequently complain of discomfort, and treatment is frequently suspended when patients urinate during treatment and urine penetrates the treatment device, causing malfunction. Therefore, the effect of minimizing treatment time when partial-arc volumetric modulated arc therapy (VMAT) was used instead of full-arc was assessed in this study. Methods: A total of 70 plans were created in 10 patients using 7 different arc sizes, and the treatment time for each plan was calculated. Results: Reduced arc size by half resulted in a 54.4% decrease in mean treatment duration, with a proportional tendency observed. Furthermore, the effect of VMAT arc size reduction on target dose homogeneity was significantly limited, and the effect on surrounding organs at risk (OAR) was negligible. It should be noted, however, that when the arc size decreases by >40%, the dose increases in the area without OAR around the target. Conclusions: The results of this study demonstrated that partial-arc VMAT for enhancing treatment convenience and efficacy of prostate cancer patients undergoing BFP can achieve a considerable reduction in treatment time while preserving treatment quality, and it is expected to be useful for partial-arc VMAT plan design and implementation in practice.

Hematologic Toxicity in Patients Undergoing Radical Anti-cancer Therapy: A Cross-Sectional Analysis of Patients in an Oncology Ward in India

  • Roy, Soumyajit;Mallick, Supriya;Raza, Md. Waseem;Haresh, Kunhi Parambath;Gupta, Subhash;Sharma, Daya Nand;Julka, Pramod Kumar;Rath, Goura Kisore
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.8
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    • pp.3587-3592
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    • 2014
  • Burden of cancer is progressively increasing in developing countries like India which has also led to a steep rise in toxicity due to anti-cancer therapy. A cross-sectional analysis was here conducted for patients with different malignancies (except leukaemia) who while undergoing radical anti-cancer therapy were admitted to our oncology ward from January-July 2013. In a total of 280 patients, the total number of toxicity events was 473. Nine patients expired over this time period. Among the events, grade 2 anaemia the most common (n=189) while the most common grades of neutropenia and thrombocytopenia were grade 4 (n=114) and grade 2 (n=48), respectively. Among the tracable microbial etiologies, gram negative bacteria were the most commonly found pathogens. Treatment interruptions took place in 240 patients (median duration=8.8 days). Prolonged hospital admission, intensive care and artificial ventilation support was needed to be given in 48, 7 and 13 patients respectively. Advanced NSCLC, KPS <70, pancytopenia and artificial ventilation requirement were found to have a significant impact on death. Such studies show the prevailing practice from institutes of our country and may guide us formulating a guideline for managing such toxicities for this part of the world.

Analysis of radiation exposure in radiation worker in medical facility and student in clinical practice (의료기관 방사선작업종사자와 임상실습 학생의 피폭선량 분석)

  • Lee, Joo-Ah;Choi, Kwan-Woo;Min, Jung-Whan;Lim, Jong-Cheon;Son, Soon-Yong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.8
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    • pp.442-448
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    • 2016
  • This study was conducted to determine the appropriateness of systemic radiation exposure control for students in clinical practice by comparing radiation exposure in radiography employees at different stations of a hospital with that of students conducting clinical practice using identical stations. Overall, 121 students who conducted clinical practice in the department of radiology area of C university hospital from July 2014 to August 2014 and 62 workers working in the same medical facility (47 in the department of radiology, 8 in the department of radiation oncology, 7 in the department of nuclear medicine) were investigated. The radiation exposure experienced by students was measured for 8 weeks, which is the duration of the clinical practice. Additionally, radiation exposure of workers were classified into 4 groups, department of radiology, department of radiation oncology, and department of nuclear medicine was compared. Dose was measured with OSLD and differences among groups were identified by ANOVA followed by Duncan's multiple range test. Among employees, those in the department of radiology, oncology and nuclear medicine were exposed depth doses of $0.127{\pm}0.331mSv$, $0.01{\pm}0.003mSv$, and $0.431{\pm}0.205mSv$, respectively, while students were exposed to $0.143{\pm}0.136mSv$. Additionally, workers in the department of radiology, oncology and nuclear medicine were exposed to surface doses of $0.131{\pm}0.331mSv$, $0.009{\pm}0.003mSv$, and $0.445{\pm}0.198mSv$, respectively, while students were exposed to $0.151{\pm}0.14mSv$, which was significantly different in both doses (p < 0.01). The average dose that students received is higher than that of the other groups (except for nuclear medicine workers), indicating that further improvements must be made in systemic controls for individual radiation exposure by including the students as subjects of management for protection from radiation.